Mindfulness is key to tinnitus relief

July 2, 2018

Science Daily/University of Bath

New studies suggest mindfulness-based CBT could significantly help tinnitus sufferers.

Published in the journals Ear and Hearing and Psychotherapy and Psychosomatics, the research led by Dr Laurence McKenna from University College London Hospitals NHS Foundation Trust (UCLH) and Dr Liz Marks, from Department of Psychology at the University of Bath, found that Mindfulness based Cognitive Therapy (MBCT) helps to significantly reduce the severity of tinnitus compared to relaxation-based treatments, an approach recommended by many tinnitus clinics.

Tinnitus, described as a sensation or awareness of sound that is not caused by an external sound source, affects approximately six million people in the UK -- 10 percent of the UK's population. Approximately 1 in 100 people are very distressed or disabled by it and as many as 1 in 20 people are at least moderately distressed by it. Tinnitus is associated with complaints of emotional stress, insomnia, auditory perceptual problems and concentration problems.

As yet there is no treatment to stop the tinnitus noise but this research, funded by the British Tinnitus Association (BTA), shows clearly that treatment can make it less severe, intrusive and bothersome.

Dr Liz Marks, from the Department of Psychology at the University of Bath, will explore the report's findings in more detail at the BTA's annual conference in Birmingham in September. She said: "We compared MBCT to relaxation therapy, a traditional treatment for people with chronic tinnitus, to determine if MBCT was a better option than the current recommended practice.

"In total 75 patients took part in the trial at UCLH's Royal National Throat, Nose and Ear Hospital receiving either MBCT or relaxation therapy. The study found that both treatments led to a reduction in tinnitus severity, psychological distress, anxiety and depression for patients.

"However, the MBCT treatment led to significantly greater reductions in tinnitus severity than the relaxation treatment, and this improvement lasted for longer. In addition, 182 patients who completed MBCT routinely in our clinic showed a similar level of improvement."

Relaxation therapy provides patients with specific skills to reduce stress arousal levels. In contrast, MBCT, taught by highly-trained clinical psychologists, teaches patients to pay purposeful, present-moment attention to experiences, rather than trying to supress those experiences. Practicing mindfulness meditation in this way can cultivate a more helpful way of responding to tinnitus. People learn how to 'allow' and 'accept' tinnitus, rather than having to 'fight it' or 'push it away'. Mindfulness does not aim to change the nature or sound of the tinnitus, but the therapy can lead to tinnitus becoming less intrusive, to a point where it is no longer a problem for people.

Dr Marks added: "MBCT turns traditional tinnitus treatment on its head -- so rather than trying to avoid or mask the noise, it teaches people to stop the battle with tinnitus.

"The mindfulness approach is radically different from what most tinnitus sufferers have tried before, and it may not be right for everyone. We are confident, however, that the growing research base has demonstrated how it can offer an exciting new treatment to people who may have found that traditional treatment has not been able to help them yet. We hope the results of our research will be one of the first steps to MBCT becoming more widely adopted."

David Stockdale, chief executive of the British Tinnitus Association, said: "The results of this research are extremely encouraging particularly for people with chronic tinnitus who find that current treatments are not working for them. We really hope that more people will be able to benefit from this approach moving forward."

"Funding this kind of innovative research is a major part of what we do here at the BTA but as a charity, we rely heavily on the donations made to us. We hope more people will support us as we work tirelessly to grow the understanding and knowledge around tinnitus in order to help people with the condition to manage."

Dr McKenna and Dr Marks are now continuing their research in tinnitus looking at how Cognitive Behavioural Therapy can be used to treat tinnitus related insomnia.

https://www.sciencedaily.com/releases/2018/07/180702094054.htm

Mindfulness helps injured athletes improve pain tolerance and awareness

June 26, 2018

Science Daily/University of Kent

A new study of injured athletes found they can benefit from using mindfulness as part of the sport rehabilitation process to improve their pain tolerance and awareness.

The research, carried out by Dr Warhel Asim Mohammed and Dr Athanasios Pappous (School of Sport and Exercise Sciences) and Dr Dinkar Sharma (School of Psychology) could have major implications in the treatment of sporting injuries at all levels.

Every year there are 29.7 million injuries among athletes in the UK. These have both psychological and physiological effects on athletes and for some it may mean the end of a career in sport.

To understand if mindfulness could play a part in the rehabilitation process of injuries, the researchers conducted tests on 20 athletes (14 male, six female), aged from 21-36 years who had severe injuries, preventing their participation in sport for more than three months.

Both groups followed their normal physiotherapy treatment but, in addition, the intervention group practised mindfulness meditation in one 90-min session per week for eight weeks.

A Cold Pressor Test (CPT) was used to assess pain tolerance. In contrast, the perception of pain was measured using a Visual Analogue Scale. Other measurements used were the Mindful Attention Awareness Scale (MAAS), Depression Anxiety and Stress Scale (DASS), and Profile of Mood States (POMS).

Results demonstrated an increase in pain tolerance for the intervention group and an increase in mindful awareness for injured athletes. Moreover, there was a promising change in positive mood for both groups. Regarding the Stress/Anxiety scores, findings showed a notable decrease across sessions.

The study used a common meditation technique, based on Mindfulness-Based Stress Reduction (MBSR), as an intervention for utilisation during the recovery period of injured athletes -- this is the first study using MBSR as an intervention for this purpose.

The aim of this research was to investigate the role of MBSR practise in reducing the perception of pain and anxiety/stress and increasing pain tolerance and mindfulness. Additionally, the aim was to increase positive mood and decrease negative mood in injured athletes.

Sport injuries are a considerable public health concern. The impact of the injured athlete extends beyond the individual. Although it may impact on their seasonal and potential career performance, it additionally impacts upon the clubs and organisations for whom they perform. Furthermore, it leads to a greater general burden on the health service.

https://www.sciencedaily.com/releases/2018/06/180626113350.htm

Mindful movement may help lower stress, anxiety

June 21, 2018

Science Daily/Penn State

Taking a walk may be a good opportunity to mentally review your to-do list, but using the time to instead be more mindful of your breathing and surroundings may help boost your wellbeing, according to researchers who found that while students reported being less stressed while they were on their feet and moving, they received an even greater benefit when they reported also being more mindful.

The researchers found that while students reported being less stressed while they were on their feet and moving, they received an even greater benefit when they reported also being more mindful.

Chih-Hsiang "Jason" Yang, a postdoctoral scholar at the University of Southern California who led the study while earning his doctorate at Penn State, said the results suggest a simple way for people to boost their wellbeing throughout the day.

"It can be difficult to ask people to spend a lot of time doing moderate or vigorous activity by going to the gym or out for a run, especially if they feel stressed," Yang said. "But if they don't need to change their everyday behavior, and can instead try to change their state of mind by becoming more mindful, they can probably see this beneficial effect. You don't need to exert a lot of extra effort in order to improve your wellbeing by being more mindful while you're moving around."

David Conroy, professor of kinesiology at Penn State, also said the findings -- recently published in the journal Psychology of Sports and Exercise -- could help people who are not able to engage in strenuous exercise.

"If someone is looking for a way to manage these kinds of feelings, it may be worth trying some sort of mindful movement," Conroy said. "This option may be especially beneficial for people who don't enjoy exercise and would prefer a less intense form of physical activity."

According to the American College Health Association, more than half of college students experience anxiety, sadness or mental exhaustion at least once a year, suggesting a need for a simple way to reduce these negative states. Because students are often moving throughout their days, as they walk to class and go about other activities, the researchers wanted to see if there was a connection between mindfulness, movement and a reduction in negative states.

The researchers recruited 158 Penn State students for the study. For two weeks, a special mobile phone app, called Paco, randomly prompted the participants eight times a day to answer questions about their current activity and states of mind. The prompts included questions about where the participant was, if they were moving, and if they were stressed or anxious, as well as questions designed to assess mindfulness.

After analyzing the data, the researchers found that in the moments when participants were more mindful or active than usual, they showed reduced negative affect. They also found a possible synergistic effect when people were both mindful and active.

"When people were both more mindful and more active than usual, they seem to have this extra decrease in negative affect," Yang said. "Being more active in a given moment is already going to reduce negative affect, but by also being more mindful than usual at the same time, you can see this amplified affect."

Conroy said it was interesting to see patterns emerge within the individual participants, instead of just comparing people who are generally more mindful to people who are generally less mindful.

"Most studies in this area have focused on the differences between people who are more versus people who are less mindful, but we saw that college students often slipped in and out of mindful states during the day," Conroy said. "Developing the ability to shift into these states of mindfulness as needed may be valuable for improving self-regulation and well-being."

To better explore the causal role of mindfulness on lower negative states of being, Yang completed a second study, in which older adults who participated in an outdoor mindfulness activity then reported on their feelings of stress, anxiety and depression. Yang found that the mindful walking was associated with lower levels of these feelings.

The researchers said that in the future, studies that collect more objective data -- like gathering information about physical activity by using accelerometers -- and include more varied populations could be useful.

https://www.sciencedaily.com/releases/2018/06/180621112007.htm

Changes in stress after meditation

June 21, 2018

Science Daily/U.S. Army Research Laboratory

For a thousand years, people have reported feeling better by meditating but there are few systematic studies that quantified stress and how much stress changes as a direct result of meditation, until now.

U.S. Army Research Laboratory researchers spent a year collaborating with a team of scientists from the University of North Texas to develop a new data processing technique that uses heart rate variability as a sensor to monitor the state of the brain. Their findings are reported in a paper published in the June edition of Frontiers in Physiology.

Healthy heartbeats have irregularities built into them with a slight random variation occurring in the time interval between successive beats. The sinus node, or the heart's natural pacemaker, receives signals from the autonomic or involuntary portion of the nervous system, which has two major branches: the parasympathetic, whose stimulation decreases the firing rate of the sinus node, and the sympathetic, whose stimulation increases the firing rate. These two branches produce a continual tug-of-war that generates fluctuations in the heart rate of healthy individuals.

Heart rate variability provides a window through which we can observe the heart's ability to respond to external disturbances, such as stress, said Dr. Bruce West, the Army's senior research scientist for mathematics.

He said it turns out that the HRV time series is very sensitive to changes in the physiological state of the brain and the new data processing system, called dynamic subordination technique, can quantify the changes in HRV and relate these directly to brain activity, such as produced by meditation. Thus, the DST has quantified the level of stress reduction produced by meditation and offers the potential to quantify such things as the inability to concentrate and sustain focus, impatience, impulsiveness and other dysfunctional properties that severely limit a soldier's ability to do his job.

Stress modulates the autonomic nervous system signals, which in turn disrupts normal HRV and therefore the stress level can be detected by processing HRV time series.

Through a new method of processing HRV time series data, the researchers developed a way to measure the change in the level of stress provided by meditation. This measure assigns a number to the level of variability of heartbeat interval time series before and during meditation. This number indicates precisely how much stress is alleviated by control of the heart-brain coupling through meditation.

In the article, Rohisha Tuladhar, Gyanendra Bohara, and Paolo Grigolini, all from the University of North Texas and Bruce J. West, Army Research Office, propose and successfully test a new model for the coupling between the heart and brain, along with a measure of the influence of meditation on this network. Traditional models of biofeedback focus on the coherent behavior, assuming a kind of resonance, however the new approach includes both periodicity and complexity.

The research team compared two schools of meditation and determined that Yoga, over Chi meditation, is more effective in reducing stress and can show by how much. They also found that the long-term practice of meditation has the effect of making permanent the meditation-induced physiologic changes. Moreover that meditators show a stronger executive control, that is, the ability to carry out goal-oriented behavior, using complex mental processes and cognitive abilities.

Many military historians believe battles, even wars, have been won or lost in the warrior's mind, long before any physical conflict is initiated. Learning how to circumvent the debilitating psychological influence of stress requires that we have in hand a way to quantify its influence, in order to gauge the effectiveness of any given procedure to counteract its effects, explained West, who's a Fellow with the American Physical Society, American Association for the Advancement of Science and ARL.

Historically, one purpose of meditation has been to reduce stress, however, the Army's long-term goal is to use it to mitigate the effects of post-traumatic stress disorder, or PTSD. West said the potential for this to succeed has been dramatically increased with the new ability to quantify the degree of effectiveness in stress reduction using different meditation techniques.

From a physiological perspective, meditation constitutes a coupling of the functionalities of the heart and brain. We are only now beginning to understand how to take advantage of the coupling of the two to measure stress reduction by applying the methods of science and data analysis to HRV time series.

Our research focus is on changes in physiologic processes, such as stress level. It is the most direct measure of the effectiveness of meditation in reducing stress to date and compliments an existing ARL program on determining the efficacy of mindfulness meditation stress reduction, which quantifies the influence on different task performance measures, such as changes in PTSD symptoms, West said.

This early research could guide the design and testing of new interventions for improving warrior readiness and resilience, as well as reducing symptoms of PTSD.

https://www.sciencedaily.com/releases/2018/06/180621111955.htm

Biofeedback relaxation app may help kids during medical procedures

April 19, 2018

Science Daily/Wiley

A new study indicates that biofeedback-assisted relaxation may help manage pain and anxiety in children undergoing medical procedures.

BrightHearts is a biofeedback mediation relaxation app designed for mobile phones and tablet computers that responds to changes in heart rate and can be used to teach children biofeedback assisted relaxation.

In the study of 30 children aged 7 to 18 years undergoing a medical procedure (peripheral blood collection, botulinum toxin injections, or intravenous cannula insertion), BrightHearts was acceptable to patients, their parents, and their healthcare providers. The pilot study also demonstrated that the use of BrightHearts did not impede the administration of medical procedures and in some cases was perceived to facilitate the procedure. The majority of patients, parents and healthcare providers indicated that they would use BrightHearts again during a procedure.

"BrightHearts taps into children's interest in devices like smart phones and tablets," said co-author Dr. Angela Morrow, of The Children's Hospital at Westmead and the University of Sydney, in Australia. "Biofeedback is a modality that we hope will empower children and help them to manage their pain and anxiety without the need for medications."

https://www.sciencedaily.com/releases/2018/04/180419100207.htm