Research roundup: mindfulness for young offenders and breast cancer survivors, and brain-training for the elderly

Can mindfulness help prevent the downward spiral into emotional disturbance and impulsive behaviour in stressful environments such as prisons and young offenders institutions?

This month’s roundup of brain plasticity and mindfulness research features adolescents in young offenders institutions, women who have survived breast cancer, and a brain-training game for older people. For a complete list of mindfulness research published last month, check out the wonderful Mindfulness Research Guide.

Teenagers doing time

Adolescence is a tough rite of passage for most of us, but for troubled teenagers who have committed a crime and been sentenced to time in a young offenders institution, it’s about to get even tougher. It’s little wonder that vulnerable young people can become mentally distressed while in custody and even take their own lives.

Stressful environments exact a heavy toll on our ability to focus and maintain attention, which is a key mental skill needed to think clearly, make good decisions and regulate emotions. The result is poor decision-making, emotional disturbance and impulsive behaviour. Researchers at New York University, the University of Miami and the Lionheart Foundation wanted to find out whether cognitive behavioural therapy and mindfulness training (CBT/MT) could help prevent this downward spiral among incarcerated adolescents.

They randomly assigned dormitories of 16 to 18-year-olds in an American young offenders institution to receive either 750 minutes of CBT/MT or the same amount of time on an “active control intervention” over a 3-5 week period. There were 147 individuals in the CBT/MT group and 117 in the control group. Those in the active intervention also logged how much time they spent outside the sessions practising the mindfulness exercises.

Before the intervention and four months later, participants took an Attention Network Test to assess how good they were at focusing their attention.

Overall, performance on the attention test got worse in both groups, but the erosion of attention skills was significantly less in the CBT/MT group. And when the researchers looked at how much of their own time those in the intervention group were spending on mindfulness practice, the ability to focus attention declined among those who did nothing but remained stable among those who did the exercises.

This is a very encouraging study, since it suggests that there is a simple but effective way to mitigate some of the damage that being incarcerated does to young people’s mental health and wellbeing. Of course this isn’t just beneficial for these individuals, but also for society as a whole if it means adolescents are less likely to re-offend. It’s worth noting that the US, where this research was conducted, incarcerates more of its young people than anywhere else in the world.

In as far as it’s possible to judge from such a short summary, this research looks solid. The numbers of participants were relatively large. The study was randomised and there was a control group. Ideally, the randomisation process would have been carried out at an individual level, rather than by dormitory, but there were obviously significant constraints on the study design when operating in this particular setting. The article doesn’t specify what the “active control intervention” was, but it’s good to know that the effectiveness of CBT/MT wasn’t compared with doing nothing (because the chances are that providing any kind of social support will lead to a better outcome than providing none at all) .

Distressed breast cancer survivors

Women who have survived breast cancer face a host of challenges in getting their life back to normal and coping with worries about their future health. A study published in the Journal of Clinical Oncology looked at the effectiveness of two interventions for dealing with stress among breast cancer survivors: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET).

MBCR involved 18 hours of training in mindfulness meditation and yoga. SET involved the same amount of time devoted to emotional expression and group support. A control group took a one-day course in stress management. Patients were randomly assigned to the three groups.

The researchers recorded the women’s mood, stress symptoms and quality of life before and after the interventions. Importantly, they also looked at an objective physiological indicator of stress: the levels of cortisol in their saliva. Cortisol is a hormone released by the body in response to stress. Levels normally peak at around 8am and then decline steadily during the day, reaching their lowest point in the middle of the night and small hours of the morning. In people under a lot of stress, however, this “cortisol slope” becomes flatter. In other words, levels don’t decline as steeply from the early-morning peak.

Breast cancer survivors who took MBCR or SET courses maintained healthy cortisol slopes, whereas those in the control group developed flatter slopes – their cortisol levels failed to decline as much from the early morning peak. The stress symptoms of women in the MBCR group improved more over time compared with the SET group, and they saw greater improvements in their quality of life compared with the control group.

This looks promising. It’s the largest ever trial of mindfulness in breast cancer survivors and the authors recommend further investigation into its effectiveness for reducing stress.

Brain training for older people

While brain training games have not been shown to have any concrete benefits for young or middle-aged people – apart from making them better at performing the tasks in the game itself – now it seems older people really could benefit from playing specially designed video games.

We’re not talking Grand Theft Auto here, but simpler, more targeted games like the multitasking driving game called NeuroRacer devised by researchers at the University of California, San Francisco. They found that 60-year-olds who played the game for 12 hours over the course of a month improved substantially, getting even better at the game than 20-year-olds who had never played it before.

Better still, their attention and short-term memory improved – cognitive skills that the game wasn’t designed to affect directly. This is important, because other research has failed to find any transfer of improvements on the trained cognitive tasks to closely related but untrained tasks.

These findings suggest older people’s brains are more “plastic” than previously thought. In other words, with the right kind of training they can regain some of their lost capacity, in the same way that older people who do weight training can maintain and even regain some of their former muscle strength.

This boost in “brain power” was confirmed by measuring the electrical activity of the subjects’ brains with electroencephalography (EEG), before and after the training.

You can find more details in this report by Alok Jha for the Guardian, in the original paper published in Nature and in the informative video (above) produced by Nature to explain the research.

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