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Jiang S, Chen Y, Wang L. Effectiveness of Community-Based Programs on Aggressive Behavior Among Children and Adolescents: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2845-2861. [PMID: 38293961 DOI: 10.1177/15248380241227986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Adolescent aggressive behavior has increasingly become a central issue affecting the safety of both school campuses and the broader society. Despite the existence of numerous community interventions targeting this issue, there has been a paucity of efforts to consolidate the findings on the effectiveness of community-based programs in preventing aggressive behavior. This meta-analysis sought to address this gap by reviewing and assessing the impact of community-based initiatives on reducing adolescent aggression. A thorough search was carried out on 12 electronic databases: EBSCO, ERIC, PubMed, PsycINFO, MEDLINE, EMBASE, Scopus, Web of Science, ProQuest Dissertations and Theses, the China National Knowledge, Wanfang Databases, and China Science and Technology Journal Database. Sixteen studies were finalized, and meta-analyses were performed using a random effect model on RevMan v5.4 software developed by Cochrane. The analysis encompassed 16 published studies, involving a total of 2,585 participants. The key components of existing programs for aggression reduction included providing behavioral skills and training for adolescents, employing a problem-solving approach to address behavioral issues, offering psychological treatment, and emphasizing community supervision. The results indicate a significant positive effect of community-based interventions on aggression reduction (standardized mean difference = -0.26, 95% confidence intervals [-0.39, -0.13], Z = 3.84, p < .001). The subgroup analyses revealed that the intervention's effectiveness was moderated by the duration of the intervention, its theoretical foundation, and the sample size. This study furnishes empirical evidence supporting the enhancement of policies and practices to foster community engagement in mitigating aggressive behavior.
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Affiliation(s)
| | | | - Lin Wang
- Fudan University, Shanghai, China
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2
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Corthorn C, Pedrero V, Torres N, Reynaldos-Grandón K, Paredes P. Mindfulness, teacher mental health, and well-being in early education: a correlational study. BMC Psychol 2024; 12:428. [PMID: 39107861 PMCID: PMC11304776 DOI: 10.1186/s40359-024-01930-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
This study analyzed the relationship between mindfulness and variables considered relevant for teacher-student interactions: teacher burnout, general stress, anxiety, depression, and quality of life. We hypothesized that mindfulness would relate negatively with mental health variables and positively with quality of life. We also explored which specific aspects of mindfulness would predict burnout, depression, anxiety, stress, and quality of life. Given the results of regression analyses, mediation models were performed to explore the mechanisms through which different facets of mindfulness affect quality of life. As predicted, the correlation analysis showed that mindfulness and its dimensions were positively associated with the quality of life of the teachers and burnout dimension of personal fulfillment and negatively associated with anxiety, depression, and stress (considering FFMQ total score and most of its dimensions). Consistently, regression analysis showed that the overall level of mindfulness, after controlling for the grade level at which the teacher works, showed significant associations with the level of personal fulfillment, depression, anxiety, stress, and quality of life. The results of the mediation analyses showed that the ability not to judge ourselves was associated with fewer symptoms of depression and stress and, through these pathways, positively affected quality of life. On the other hand, the ability not to react favored quality of life by reducing anxiety and stress. Finally, acting with awareness was the only facet of mindfulness that favored quality of life, affecting one of the dimensions of burnout.
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Affiliation(s)
- Carolina Corthorn
- Department of Education and Social Sciences, Facultad de Educación, Universidad Andrés Bello, Fernández Concha 700, Edificio C2, Tercer Piso, Las Condes, Santiago, Chile.
| | - Víctor Pedrero
- Faculty of Nursing, Universidad Andrés Bello, Santiago, Chile
| | - Natalia Torres
- Department of Education and Social Sciences, Facultad de Educación, Universidad Andrés Bello, Fernández Concha 700, Edificio C2, Tercer Piso, Las Condes, Santiago, Chile
| | | | - Paola Paredes
- Department of Social Sciences, Universidad Central de Chile, Santiago, Chile
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Kéri S, Kancsev A, Kelemen O. Algorithm-Based Modular Psychotherapy Alleviates Brain Inflammation in Generalized Anxiety Disorder. Life (Basel) 2024; 14:887. [PMID: 39063640 PMCID: PMC11278507 DOI: 10.3390/life14070887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Generalized anxiety disorder (GAD) is marked by prolonged and excessive worry, physical signs of anxiety, and associated neuroinflammation. Traditional treatments, like pharmacotherapy and cognitive-behavioral therapy (CBT), often leave residual symptoms and have high relapse rates. This study aimed to explore the efficacy of algorithm-based modular psychotherapy (MoBa), a combination of CBT and mindfulness meditation as validated by the research domain criteria (RDoC), in reducing anxiety and neuroinflammation in GAD. A longitudinal design was used, with 50 patients with GAD undergoing a 12-week MoBa treatment. The patients were investigated pre- and post-treatment using MRI to measure neuroinflammatory markers (DBSI-RF, diffusion-basis spectral imaging-based restricted fraction) in the hippocampus, amygdala, and neocortex. Clinical symptoms were assessed using the Hamilton Anxiety Rating Scale (HAM-A) and the Generalized Anxiety Disorder 7-item scale (GAD-7). Results indicated significant reductions in both anxiety symptoms and MRI RF values in the amygdala, suggesting decreased neuroinflammation. A reduction in anxiety was associated with the amelioration of neuroinflammation in the amygdala. These results suggest that MoBa is effective in alleviating both the psychological and neuroinflammatory aspects of GAD, offering a promising personalized treatment approach. Future research should focus on long-term effects and the mechanisms through which MoBa impacts neuroinflammation and anxiety.
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Affiliation(s)
- Szabolcs Kéri
- Sztárai Institute, University of Tokaj, 3944 Sárospatak, Hungary
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary
| | - Alexander Kancsev
- Department of Psychiatry and Psychotherapy, András Jósa Hospital, 4400 Nyíregyháza, Hungary;
| | - Oguz Kelemen
- Department of Behavioral Sciences, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary;
- Department of Psychiatry and Psychotherapy, Bács-Kiskun County Hospital, 6000 Kecskemét, Hungary
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Gandarela L, de A. Sampaio TP, Marçal L, Burdmann EA, Neto FL, Bernik MA. Inflammatory markers changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial. Brain Behav Immun Health 2024; 38:100779. [PMID: 38725444 PMCID: PMC11081778 DOI: 10.1016/j.bbih.2024.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Generalized anxiety disorder (GAD) has been associated with elevated levels of C-reactive protein (CRP) and proinflammatory cytokines. Despite robust evidence as an effective treatment for GAD, research on the effects of cognitive-behavioral therapies (CBT) in the inflammatory profile of patients with clinical anxiety has presented mixed results. Objective The present study aimed to investigate the effect of an acceptance-based behavior therapy (ABBT) on inflammatory biomarkers and their association with anxiety levels in GAD patients in comparison to supportive therapy as an active control. Methods Peripheral inflammatory biomarkers (CRP, IL-1β, IL-4, IL-6, IL-10, TNF-α) were measured in 77 GAD patients who participated in a 14-week 10-session randomized clinical trial of group ABBT (experimental, n = 37) or supportive group therapy (ST: active control group, n = 40). Results The concentrations of IL-1β decreased in the control group and the concentrations of IL-6 increased in the experimental group from baseline to post-treatment, whereas no difference was identified in IL-4, IL-10, TNF, or CRP. Although anxiety and depression levels decreased in both treatment conditions, no correlation with inflammation markers was found for most clinical and biological variables. A negative correlation between changes in IL-6 and IL-10 and anxiety symptom score changes was identified. Conclusions The present study results found that a short trial of acceptance-based behavior therapy did not change the proinflammatory profile which may be associated with GAD. Additional research is needed to evaluate the influence of other inflammation-related variables, longer periods of follow-up as well as the effect of supportive therapy on peripheral inflammatory biomarkers in GAD patients.
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Affiliation(s)
- Lucas Gandarela
- Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
| | - Thiago P. de A. Sampaio
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Lia Marçal
- LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Emmanuel A. Burdmann
- LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Francisco Lotufo Neto
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Marcio A. Bernik
- Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
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Conway AE, Verdi M, Shaker MS, Bernstein JA, Beamish CC, Morse R, Madan J, Lee MW, Sussman G, Al-Nimr A, Hand M, Albert DA. Beyond Confirmed Mast Cell Activation Syndrome: Approaching Patients With Dysautonomia and Related Conditions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1738-1750. [PMID: 38499084 DOI: 10.1016/j.jaip.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/23/2024] [Accepted: 03/09/2024] [Indexed: 03/20/2024]
Abstract
Allergist-immunologists face significant challenges as experts in an ever-evolving field of neuroimmunology. Among these challenges is the increasingly frequent need to counsel patients with suspected mast cell activation disorders about perceived comorbidities, which may include hypermobile Ehlers-Danlos syndrome, amplified pain syndrome, fibromyalgia, burning sensation syndromes, migraines, irritable bowel syndrome, and postural orthostatic tachycardia syndrome. Patients may experience comorbid anxiety, panic disorder, and depression associated with disturbed sleep, fatigue, and cognitive impairment that often worsen when their physical symptoms increase in severity. These conditions may mimic mast cell activation disorders and are emotionally taxing for patients and clinicians because they are often accompanied by vague diagnostic courses, perceived unmanageability, social stigma, and significant impairment in quality of life. Combined with relatively poorly researched therapies, it is no surprise that clinicians may feel overwhelmed or find it difficult to provide consistently compassionate care for this population. In this article, we review available therapies for these conditions, which run the gamut from physical therapy to antidepressants to multimodal pain control. We highlight the benefit of multidisciplinary care within the primary care home, which includes an important role by the allergist-immunologist. By outlining simple approaches to initial treatment, we hope to empower clinicians with the tools needed to curb emotional burnout and embrace this patient population with compassion.
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Affiliation(s)
| | | | - Marcus S Shaker
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
| | - Jonathan A Bernstein
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Immunology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Claire C Beamish
- Department of Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Richard Morse
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Neurology, Children's Hospital at Dartmouth, Lebanon, NH
| | - Juliette Madan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Division of Child Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Department of Psychiatry, Division of Child Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Michael W Lee
- Department of Medical Education, Dartmouth Geisel School of Medicine, Hanover, NH
| | - Gordon Sussman
- Division of Immunology, University of Toronto, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amer Al-Nimr
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Matthew Hand
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Nephrology and Integrative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Daniel A Albert
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Rheumatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
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de Oliveira Santana K, Figueira Pereira C, Silva Ramos M, da Silva RR, de Vargas D, de Fátima Fernandes MN, da Silva Gherard-Donato EC. The effectiveness of mindfulness for the management of anxiety in the nursing staff: Systematic review and meta-analysis. Arch Psychiatr Nurs 2024; 50:129-146. [PMID: 38789225 DOI: 10.1016/j.apnu.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/10/2024] [Accepted: 03/17/2024] [Indexed: 05/26/2024]
Abstract
A systematic review with meta-analysis following Joanna Briggs Institute recommendations. It aimed to determine the effectiveness of mindfulness for the management of anxiety symptoms in the nursing staff and stress as a secondary outcome. The databases searched were MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Psycinfo. Search was conducted in October 2022. Independent reviewers used standardized methods to research, track, and code the included studies. Data meta-analysis was performed using random effects models. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used as an approach to assess the quality and certainty of evidence in research studies. The review examined the effectiveness of mindfulness on nursing staff in 13 studies. The meta-analysis revealed a statistically significant decrease in anxiety and stress after treatment, with an average reduction of 0.36 in anxiety and 0.48 in stress. The results emphasizes the possibility of mindfulness being an effective intervention to the management of anxiety and stress in nursing staff. However, the studies analyzed presented limitations in the design and sampling in the development of the intervention, which impact the conclusive statements about the effectiveness of mindfulness and the generalization of the results. The implications to the nursing field involve adopting evidence-based research and practices to improve the well-being and quality of life of nursing professionals, as well as strengthening the evidence base surrounding mindfulness interventions in nursing practice. This may lead to changes in healthcare policies, care practices, and recognition of the importance of nurses' well-being for effective healthcare delivery.
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El Morr C, Tavangar F, Ahmad F, Ritvo P. Predicting the Effectiveness of a Mindfulness Virtual Community Intervention for University Students: Machine Learning Model. Interact J Med Res 2024; 13:e50982. [PMID: 38578872 PMCID: PMC11130772 DOI: 10.2196/50982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/05/2023] [Accepted: 04/05/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Students' mental health crisis was recognized before the COVID-19 pandemic. Mindfulness virtual community (MVC), an 8-week web-based mindfulness and cognitive behavioral therapy program, has proven to be an effective web-based program to reduce symptoms of depression, anxiety, and stress. Predicting the success of MVC before a student enrolls in the program is essential to advise students accordingly. OBJECTIVE The objectives of this study were to investigate (1) whether we can predict MVC's effectiveness using sociodemographic and self-reported features and (2) whether exposure to mindfulness videos is highly predictive of the intervention's success. METHODS Machine learning models were developed to predict MVC's effectiveness, defined as success in reducing symptoms of depression, anxiety, and stress as measured using the Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS), to at least the minimal clinically important difference. A data set representing a sample of undergraduate students (N=209) who took the MVC intervention between fall 2017 and fall 2018 was used for this secondary analysis. Random forest was used to measure the features' importance. RESULTS Gradient boosting achieved the best performance both in terms of area under the curve (AUC) and accuracy for predicting PHQ-9 (AUC=0.85 and accuracy=0.83) and PSS (AUC=1 and accuracy=1), and random forest had the best performance for predicting BAI (AUC=0.93 and accuracy=0.93). Exposure to online mindfulness videos was the most important predictor for the intervention's effectiveness for PHQ-9, BAI, and PSS, followed by the number of working hours per week. CONCLUSIONS The performance of the models to predict MVC intervention effectiveness for depression, anxiety, and stress is high. These models might be helpful for professionals to advise students early enough on taking the intervention or choosing other alternatives. The students' exposure to online mindfulness videos is the most important predictor for the effectiveness of the MVC intervention. TRIAL REGISTRATION ISRCTN Registry ISRCTN12249616; https://www.isrctn.com/ISRCTN12249616.
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Affiliation(s)
- Christo El Morr
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Farideh Tavangar
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Paul Ritvo
- Kinesiology & Health Science, York University, Toronto, ON, Canada
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Saragih ID, Batubara SO, Sharma S, Saragih IS, Chou FH. A meta-analysis of mindfulness-based interventions for improving mental health and burden among caregivers of persons living with dementia. Worldviews Evid Based Nurs 2024; 21:183-193. [PMID: 37950556 DOI: 10.1111/wvn.12690] [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: 08/01/2023] [Revised: 09/18/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Mindfulness-based interventions are becoming increasingly popular and are effective in lowering depressive symptoms and caregiver burden. However, the overall efficacy of therapies in stress and anxiety management is unreported, and no study to date has performed a subgroup analysis to investigate the intervention dose response of outcomes. AIMS To quantitatively identify the effectiveness of mindfulness-based interventions for caregivers of persons living with dementia. METHODS A comprehensive literature search of six databases was undertaken from the date of inception to June 18, 2023. The DerSimonian-Laird model with random effects was used to examine the overall effect and its heterogeneity in the studies. Version 2 of the risk of bias (RoB 2) tool was employed to analyze the publication bias of each randomized study. Funnel and forest plots were created to represent the findings. RESULTS Thirteen randomized trials were included in the meta-analysis. Mindfulness-based interventions significantly reduced stress and anxiety of caregivers of persons living with dementia. In addition, interventions provided for ≥8 weeks were beneficial in reducing depression in caregivers. However, mindfulness-based interventions did not offer significant benefits in reducing depression or caregiver burden immediately after the intervention. CONCLUSION Mindfulness-based interventions have the potential to help caregivers of people living with dementia. This study could be used as a model for future research into and implementation of mindfulness-based therapies for caregivers. LINKING EVIDENCE TO ACTION Mindfulness-based therapies appear to alleviate stress and anxiety but are ineffective in reducing depression and burden in caregivers of persons living with dementia. Well-designed RCTs with more rigorous methodology and a larger sample size should be conducted to firm the conclusion of the effectiveness of mindfulness-based interventions for caregivers of persons living with dementia.
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Affiliation(s)
| | | | - Sapna Sharma
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ice Septriani Saragih
- Department of Medical Surgical Nursing, STIkes Santa Elisabeth Medan, Medan, Indonesia
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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Golubickis M, Tan LBG, Jalalian P, Falbén JK, Macrae NC. Brief mindfulness-based meditation enhances the speed of learning following positive prediction errors. Q J Exp Psychol (Hove) 2024:17470218241228859. [PMID: 38229479 DOI: 10.1177/17470218241228859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Recent research has demonstrated that mindfulness-based meditation facilitates basic aspects of cognition, including memory and attention. Further developing this line of inquiry, here we considered the possibility that similar effects may extend to another core psychological process-instrumental learning. To explore this matter, in combination with a probabilistic selection task, computational modelling (i.e., reinforcement drift diffusion model analysis) was adopted to establish whether and how brief mindfulness-based meditation influences learning under conditions of uncertainty (i.e., choices based on the perceived likelihood of positive and negative outcomes). Three effects were observed. Compared with performance in the control condition (i.e., no meditation), mindfulness-based meditation (1) accelerated the rate of learning following positive prediction errors; (2) elicited a preference for the exploration (vs. exploitation) of choice selections; and (3) increased response caution. Collectively, these findings elucidate the pathways through which brief meditative experiences impact learning and decision-making, with implications for interventions designed to debias aspects of social-cognitive functioning using mindfulness-based meditation.
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Affiliation(s)
| | - Lucy B G Tan
- Clinical Psychology, School of Social and Health Sciences, James Cook University, Singapore
| | | | - Johanna K Falbén
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Neil C Macrae
- The School of Psychology, University of Aberdeen, Aberdeen, UK
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Lo K, Ahern G, Rossetto A, Farlie MK. Mental Health First Aid Training for Allied Health Clinical Educators: A Pre- and Post-Evaluation. Physiother Can 2024; 76:55-63. [PMID: 38465309 PMCID: PMC10919358 DOI: 10.3138/ptc-2021-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 02/20/2022] [Accepted: 03/06/2022] [Indexed: 03/12/2024]
Abstract
Purpose Health profession students may experience mental health issues during training, and clinical educators report that they don't feel confident in supporting students with these issues. This study explored whether a customized Mental Health First Aid (MHFA) training programme changed the knowledge, perceptions, intentions, and confidence of clinical educators in supporting students with mental health issues in the workplace. Method Twenty-four allied health clinical educators from a tertiary health service attended a two-day customized MHFA course. The educators completed assessments before (n = 21) and after (n = 23) the course. Quantitative data was analyzed using independent t-tests. Qualitative data was thematically analyzed using content analysis. Results Knowledge improved significantly (p = <0.001). The confidence to manage students with mental health issues increased significantly (p < 0.001). A significant change in perception was only found with respect to a character in a scenario being dangerous or unpredictable. Intentions to assist co-workers and students with mental health issues improved for all items but not necessarily significantly. Conclusions This programme improved educators' knowledge of mental health, perceptions of people with mental health issues, intentions of providing help, and confidence to support people with mental health issues.
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Affiliation(s)
- Kristin Lo
- From the:
Physiotherapy Department, Monash University, Frankston, Australia
| | - Geoffrey Ahern
- From the:
Physiotherapy Department, Monash University, Frankston, Australia
- Eastern Health/Victorian Police Mental Health and Police Response, Burwood, Australia
| | - Alyssia Rossetto
- School of Population and Global Health, University of Melbourne, Parkville, Australia
- Mental Health First Aid Australia, Melbourne, Australia
| | - Melanie K. Farlie
- From the:
Physiotherapy Department, Monash University, Frankston, Australia
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11
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Williams M, Honan C, Skromanis S, Sanderson B, Matthews AJ. Psychological and attentional outcomes following acute mindfulness induction among high anxiety individuals: A systematic review and meta-analysis. J Psychiatr Res 2024; 170:361-374. [PMID: 38215647 DOI: 10.1016/j.jpsychires.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 08/19/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Training outcomes of mindfulness interventions for anxiety have been extensively researched. Less is known about the acute effects of mindfulness induction and associated mechanisms. This systematic review aimed to identify 1) the effect of mindfulness induction on pre-post measures of state anxiety and attention among adults experiencing high levels of anxiety; and 2) the impact of predictors, mediators and moderators on post-induction changes in anxiety and attention. State distress and mindfulness were included as secondary outcomes. METHODS A systematic search was conducted in November 2021 in electronic databases using relevant search terms. Five studies (four randomised controlled trials and one non-randomised controlled trial) were included, comprising a total of 277 participants with elevated trait/generalised anxiety. Each study used a brief audio-based mindfulness induction exercise. RESULTS The meta-analysis indicated mindfulness induction had medium and large effects on state anxiety (k = 3, n = 100, g = -0.60, 95%CI [-1.04, -0.16]; p = .008) and state mindfulness (k = 2, n = 110, g = 0.91, 95%CI [0.52, 1.30], p < .001), respectively, when compared with non-therapeutic control conditions. Furthermore, two studies showed small and moderate effects of mindfulness on state anxiety when compared to therapeutic active controls, but were not pooled in a meta-analysis. While results could not be pooled for attention, there was limited evidence of behavioural improvements on tasks measuring aspects of attention following mindfulness induction. However, one study found an increase in Low Beta to High Beta ratio and a reduction in Beta activity in the Anterior Cingulate Cortex following mindfulness induction. Moreover, another study found aspects of state mindfulness mediated reductions in state anxiety. LIMITATIONS A small number of studies were included in the review, with high risk of bias and low certainty of evidence present. CONCLUSION The findings support the use of mindfulness induction to reduce state anxiety in anxious individuals but suggest gains in state mindfulness may be a more realistic expected outcome. Further controlled trials are needed to delineate the relative effects of objectively assessed anxiety outcomes from mindfulness induction in clinically defined samples.
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Affiliation(s)
- Monique Williams
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, Tasmania, Australia, 7001.
| | - Cynthia Honan
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia, 7250
| | - Sarah Skromanis
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia, 7250
| | - Ben Sanderson
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, Tasmania, Australia, 7001
| | - Allison J Matthews
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, Tasmania, Australia, 7001
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12
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Martín-Rodríguez A, Gostian-Ropotin LA, Beltrán-Velasco AI, Belando-Pedreño N, Simón JA, López-Mora C, Navarro-Jiménez E, Tornero-Aguilera JF, Clemente-Suárez VJ. Sporting Mind: The Interplay of Physical Activity and Psychological Health. Sports (Basel) 2024; 12:37. [PMID: 38275986 PMCID: PMC10819297 DOI: 10.3390/sports12010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
The symbiotic relationship between sports practice and psychological well-being has, in recent times, surged to the forefront of academic and public attention. The aim of this narrative review is to comprehensively explore the intricate pathways linking physical engagement in sports to its subsequent impacts on mental health and synthesize the multifarious effects of sports on psychological health, offering insights for integrating physical and psychological strategies to enhance well-being. From neurobiological underpinnings to therapeutic applications, this comprehensive manuscript provides an in-depth dive into the multifaceted world of sports and psychology. Highlighting evidence-based interventions, this review aspires to offer actionable insights for practitioners, athletes, and individuals alike, advocating for a holistic approach to mental well-being. This manuscript highlights the profound impact of sports on mental health, emphasizing its role in emotional regulation, resilience, cognitive function, and treating psychological conditions. It details how sports induce neurochemical changes, enhance brain functions like memory and learning, and aid against cognitive decline. This review also notes the benefits of regular exercise in mood improvement, stress management, and social skill enhancement, particularly when combined with mindfulness practices. It underscores the importance of considering cultural and gender perspectives in sports psychology, advocating for an integrated physical-psychological approach to promote overall well-being.
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Affiliation(s)
- Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | - Laura Augusta Gostian-Ropotin
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | | | - Noelia Belando-Pedreño
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | - Juan Antonio Simón
- Department Ciencias Sociales Act Fis Deporte & Ocio, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Clara López-Mora
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Valencia, Pg. de l’Albereda, 7, 46010 València, Spain;
| | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (A.M.-R.); (L.A.G.-R.); (N.B.-P.); (J.F.T.-A.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Eberhart L, Seegan P, McGuire J, Hu H, Tripuraneni BR, Miller MJ. Attributes of Provider Referrals for Digital Mental Health Applications in an Integrated Health System, 2019-2021. Psychiatr Serv 2024; 75:6-16. [PMID: 37494117 DOI: 10.1176/appi.ps.20220401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This article describes trends and attributes associated with digital mental health application (DMHA) referrals from December 2019 through December 2021. METHODS In total, 43,842 DMHA referrals for 25,213 unique patients were extracted from the electronic health record of a large, diverse, integrated health system. DMHAs were aggregated by type (cognitive-behavioral therapy [CBT] or mindfulness and meditation [MM]). Monthly referral patterns were described and categorized into mutually exclusive clusters (MM, CBT, or MM and CBT). Multinomial logistic regression and post hoc predicted probabilities were used to profile patient, clinical, and encounter attributes among referral clusters. RESULTS DMHA referrals increased, reached equilibrium, and then began to decline over the 25-month observation period. Compared with the referral cluster average, MM-alone referrals were more likely to occur for patients who were ages ≥65, who were Hispanic or Asian, whose reason for visit concerned mental health, and who had a primary diagnosis of other anxiety disorders. CBT-alone referrals were more likely to occur for patients with a primary diagnosis of depression and less likely to occur for Hispanic patients. Combined MM and CBT referrals were more likely to occur for patients who were ages 18-30, whose reason for visit was "other," and who had a primary diagnosis of depression and were less likely to occur for Hispanic patients and those ages ≥65. CONCLUSIONS Although this study demonstrates readiness to integrate DMHA referral into clinical workflows, observed variations in attributes of referral clusters support the need to further investigate provider decision making and whether referral patterns are optimal and sustainable.
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Affiliation(s)
- Lindsay Eberhart
- Mid-Atlantic Permanente Research Institute (Eberhart, Hu, Miller) and Medical Group (Eberhart, Hu, Tripuraneni, Miller), Rockville, Maryland; Johns Hopkins University School of Medicine, Baltimore (Seegan, McGuire)
| | - Paige Seegan
- Mid-Atlantic Permanente Research Institute (Eberhart, Hu, Miller) and Medical Group (Eberhart, Hu, Tripuraneni, Miller), Rockville, Maryland; Johns Hopkins University School of Medicine, Baltimore (Seegan, McGuire)
| | - Joseph McGuire
- Mid-Atlantic Permanente Research Institute (Eberhart, Hu, Miller) and Medical Group (Eberhart, Hu, Tripuraneni, Miller), Rockville, Maryland; Johns Hopkins University School of Medicine, Baltimore (Seegan, McGuire)
| | - Haihong Hu
- Mid-Atlantic Permanente Research Institute (Eberhart, Hu, Miller) and Medical Group (Eberhart, Hu, Tripuraneni, Miller), Rockville, Maryland; Johns Hopkins University School of Medicine, Baltimore (Seegan, McGuire)
| | - Bhaskara R Tripuraneni
- Mid-Atlantic Permanente Research Institute (Eberhart, Hu, Miller) and Medical Group (Eberhart, Hu, Tripuraneni, Miller), Rockville, Maryland; Johns Hopkins University School of Medicine, Baltimore (Seegan, McGuire)
| | - Michael J Miller
- Mid-Atlantic Permanente Research Institute (Eberhart, Hu, Miller) and Medical Group (Eberhart, Hu, Tripuraneni, Miller), Rockville, Maryland; Johns Hopkins University School of Medicine, Baltimore (Seegan, McGuire)
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Kumari B, Goyal N, El Morr C. Predictive Models for Canadian Healthcare Workers Mental Health During COVID-19. J Prim Care Community Health 2024; 15:21501319241241468. [PMID: 38511839 PMCID: PMC10958798 DOI: 10.1177/21501319241241468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE COVID-19 impact on the population's mental health has been reported worldwide. Predicting healthcare workers' mental health and life stress is needed to proactively plan for future emergencies. DESIGN Statistics Canada has surveyed Canadian healthcare workers and those working in healthcare settings to gauge their perceived mental health and perceived life stress. SETTING A cross-sectional survey of healthcare workers in Canada. SUBJECTS A sample of 18,139 healthcare workers respondents. ANALYSIS Eight algorithms, including Logistic Regression, Random Forest (RF), Naive Bayes (NB), K Nearest Neighbours (KNN), Adaptive boost (AdaBoost), Multi-layer perceptron (MLP), XGBoost, and LightBoost. AUC scores, accuracy and precision were measured for all models. RESULTS XGBoost provided the highest performing model AUC score (AUC = 82.07%) for predicting perceived mental health, and Random Forest performed the best for predicting perceived life stress (AUC = 77.74%). Perceived health, age group of participants, and perceived mental health compared to before the pandemic were found to be the most important 3 features to predict perceived mental health and perceived stress. Perceived mental health compared to before the pandemic was the most important predictor for perceived life stress. CONCLUSION Our models are highly predictive of healthcare workers' perceived mental health and life stress. Implementing scalable, non-expensive virtual mental health solutions to address mental health challenges in the workplace could mitigate the impact of workplace conditions on healthcare workers' mental health.
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Affiliation(s)
- Bhawna Kumari
- Indian Institute of Technology, Kharagpur, WB, India
| | - Nidhi Goyal
- Indian Institute of Technology, Kharagpur, WB, India
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Yook YS, Lee JH, Park I, Cho HY. Effects of Online Mindful Somatic Psychoeducation Program on Mental Health During the COVID-19. Psychiatry Investig 2024; 21:63-73. [PMID: 38198829 PMCID: PMC10822736 DOI: 10.30773/pi.2023.0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/24/2023] [Accepted: 10/05/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE This study aims to determine the effects of online mindful somatic psychoeducation program (o-MSP) on mental health in female university students during the coronavirus disease-2019 (COVID-19). METHODS Thirty-eight female university students were randomly assigned to an intervention group (IG, n=19) or a control group (CG, n=19). IG received o-MSP for 2-hours per session, twice weekly for 4-weeks; CG maintained their usual daily routine for 4-weeks. Measurements were performed pre- and post-intervention to assess stress, anxiety, and social connectedness using Perceived Stress Scale, State-Trait Anxiety Inventory, and Social Connectedness Scale. A qualitative analysis of changes in soma and social connectedness, subjectification of the soma, and mind-body integration was conducted through online interviews. RESULTS Regarding stress and social connectedness, there were no significant difference between the groups (p>0.05). However, significant differences were observed in the main effect of time of measurement and time×group interaction, with IG showing significant improvement post-intervention, unlike CG (p<0.05). Regarding anxiety, there were significant differences in the main effect of time of measurement, time×group interaction, and group factor (p<0.05). Post-intervention, CG did not show a significant change, while IG showed a significant decrease (p<0.05). Qualitative analysis revealed that participants experienced "changes in soma and social connectedness," "subjectification of soma-body," and "embodiment of mind-body integration," and reported improved mental health. CONCLUSION The o-MSP effectively reduced stress and anxiety in female university students and improved social connectedness. This suggests that o-MSP can be used to manage the mental health of university students in various settings.
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Affiliation(s)
- Young Sook Yook
- Department of Exercise Rehabilitation Welfare, Sungshin Women’s University, Seoul, Republic of Korea
| | - Jae-Hon Lee
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Inkyoung Park
- Department of Sport Science, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - Hwi-young Cho
- Department of Physical Therapy, Gachon University, Incheon, Republic of Korea
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Zuo X, Tang Y, Chen Y, Zhou Z. The efficacy of mindfulness-based interventions on mental health among university students: a systematic review and meta-analysis. Front Public Health 2023; 11:1259250. [PMID: 38146476 PMCID: PMC10749636 DOI: 10.3389/fpubh.2023.1259250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/27/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction We aimed to estimate the effect of mindfulness therapy on mental health. Methods Two researchers searched 12 databases to identify relevant trials that were published from 1 January 2018 to 1 May 2023. We performed a meta-analysis to determine the effect of mindfulness therapy on depression, which was measured by the Beck Depression Inventory (BDI), Patient Health Questionnaire-9 (PHQ-9), Quick Inventory of Depressive Symptomatology (QIDS), Hamilton Depression Rating Scale (HDRS), Patient-Reported Outcomes Measurement Information System (PROMIS), Hospital Anxiety and Depression Scale (HADS), and Depression Anxiety Stress Scales (DASS); anxiety, which was measured by the Beck Anxiety Inventory (BAI), PROMIS, and DASS, Generalized Anxiety Disorder-7 (GAD-7); stress, which was measured by the Perceived Stress Scale (PSS), DASS, and GAD-7; mindfulness, which was measured by the GAD-7, Five Facet Mindfulness Questionnaire (FFMQ), Mindful Attention Awareness Scale (MAAS), Short Form-12 Mental Component Score (SF-12 MCS) and Short Form-12 Physical Component Score (SF-12 PCS); and sleep quality, which was measured by the Pittsburgh Sleep Quality Index (PSQI). After screening studies based on the inclusion and exclusion criteria, 11 randomized controlled trials (RCTs) involving 1,824 participants were ultimately included. Results All these studies demonstrated positive effects of mindfulness therapy on depression (SMD = -0.33, 95% CI: [-0.44, -0.22], p < 0.00001, I2 = 29%), anxiety (SMD = -0.35, 95% CI: [-0.46, -0.25], p < 0.00001, I2 = 40%), stress (SMD = -0.39, 95% CI: [-0.48, -0.29], p < 0.00001, I2 = 69%) and sleep quality scores (SMD = -0.81, 95% CI: [-1.54, -0.09], p = 0.03, I2 = 0%). However, there was no significant difference in mindfulness (SMD = -0.12, 95% CI: [-0.36, -0.12], p = 0.34, I2 = 34%) between the mindfulness therapy group and the control group. Discussion In future studies, it is necessary to consider the investigation on whether the strategies of improving the mindfulness therapy in adherence and fidelity can work on the improvement of the outcomes in mental health. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42023469301].
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Affiliation(s)
- Xinyi Zuo
- Sociology Department, School of Government, Shenzhen University, Shenzhen, China
| | - Yong Tang
- Sociology Department, School of Government, Shenzhen University, Shenzhen, China
| | - Yifang Chen
- Institution of Policy Studies, Lingnan University, Tuen Mun, Hong Kong SAR, China
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Kou H, Luo W, Liu X, Ke M, Xie Q, Li X, Bi T. Mindfulness training modifies attentional bias to facial emotion and emotional symptoms. J Psychiatr Res 2023; 167:139-148. [PMID: 37871515 DOI: 10.1016/j.jpsychires.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/21/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Mindfulness training has been shown to improve emotional symptoms such as anxiety and depressive symptoms. However, its cognitive-behavioral mechanism is still unclear. The present study aimed to investigate the effect of mindfulness training on attention to emotional faces and its role in the improvement in emotional symptoms. METHODS Eighty participants were recruited and randomly divided into a training group (n = 40) that received eight weeks of mindfulness training and a control group (n = 40) that attended a mindfulness lecture. Before training (T1), immediately after training (T2), and three months after training (T3), all participants were asked to complete the Self-Rating Depression Scale (SDS) and the Self-Rating Anxiety Scale (SAS) to assess their emotional symptoms and a modified dot-probe task to measure their attention to emotional faces. RESULTS Mindfulness training significantly reduced anxiety and depressive symptoms at both T2 and T3. After training, the attentional bias toward happy faces increased, while the attentional bias toward sad faces decreased in the training group compared with the control group. Mediation analysis showed that the improvement in attentional bias toward sad faces partially mediated the effect of mindfulness training on depression at T2. LIMITATIONS Our participants were not a clinical sample (i.e., were not diagnosed with emotional disorders), and the time course of attention components was difficult to examine in the present study. CONCLUSIONS Mindfulness training can stably reduce anxious and depressive symptoms. However, it may have a temporary effect on attentional bias toward facial emotions, which plays a limited role in improving emotional symptoms.
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Affiliation(s)
- Hui Kou
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Wei Luo
- The Institute of Ethnology and Anthropology, Chinese Academy of Social Sciences, Beijing, China
| | - Xinnan Liu
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Mingyang Ke
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Qinhong Xie
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Xue Li
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Taiyong Bi
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China.
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Shepardson RL, Funderburk JS, Weisberg RB, Maisto SA. Brief, modular, transdiagnostic, cognitive-behavioral intervention for anxiety in veteran primary care: Development, provider feedback, and open trial. Psychol Serv 2023; 20:622-635. [PMID: 35099230 PMCID: PMC10166236 DOI: 10.1037/ser0000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anxiety is undertreated in primary care, and most treatment provided is pharmacological rather than behavioral. Integrating behavioral health providers (BHPs) using the Primary Care Behavioral Health (PCBH) model can help address this treatment gap, but brief interventions suitable for use in PCBH practice are needed. We developed a modular, cognitive-behavioral anxiety intervention, Modular Anxiety Skills Training (MAST), that is evidence-based, transdiagnostic, feasible for PCBH, and patient-centered. MAST comprises up to six 30-min sessions emphasizing skills training. This article describes the rationale for and development of MAST as well as pilot work in the Veterans Health Administration (VA) to tailor and refine MAST for delivery to Veterans in VA primary care (MAST-V) to improve feasibility for VA BHPs and acceptability to Veterans. We used a convergent mixed-methods design with concurrent data collection. In phase one, we interviewed five BHPs to obtain feedback on the treatment manual. BHPs assessed MAST-V to be highly compatible with PCBH and provided suggestions to enhance feasibility. In phase two, we conducted an open trial in which six Veterans experiencing clinically significant anxiety received and provided feedback on all nine possible modules; we also assessed changes in mental health symptoms and functioning as well as treatment satisfaction and credibility. Veterans found MAST-V to be highly acceptable, and pre-post clinical outcomes were very promising with large effect sizes. Findings from this initial pilot provide preliminary support for the feasibility, acceptability, and efficacy of MAST-V and suggest further research with a randomized clinical trial is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Robyn L. Shepardson
- Center for Integrated Healthcare, Syracuse VA Medical Center
- Department of Psychology, Syracuse University
| | - Jennifer S. Funderburk
- Center for Integrated Healthcare, Syracuse VA Medical Center
- Department of Psychology, Syracuse University
- Department of Psychiatry, University of Rochester
| | - Risa B. Weisberg
- VA Boston Healthcare System
- Department of Psychiatry, Boston University School of Medicine
- Department of Family Medicine, Alpert Medical School, Brown University
| | - Stephen A. Maisto
- Center for Integrated Healthcare, Syracuse VA Medical Center
- Department of Psychology, Syracuse University
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Zemla K, Sedek G, Wróbel K, Postepski F, Wojcik GM. Investigating the Impact of Guided Imagery on Stress, Brain Functions, and Attention: A Randomized Trial. SENSORS (BASEL, SWITZERLAND) 2023; 23:6210. [PMID: 37448060 PMCID: PMC10346678 DOI: 10.3390/s23136210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
The aim of this study was to investigate the potential impact of guided imagery (GI) on attentional control and cognitive performance and to explore the relationship between guided imagery, stress reduction, alpha brainwave activity, and attentional control using common cognitive performance tests. Executive function was assessed through the use of attentional control tests, including the anti-saccade, Stroop, and Go/No-go tasks. Participants underwent a guided imagery session while their brainwave activity was measured, followed by attentional control tests. The study's outcomes provide fresh insights into the influence of guided imagery on brain wave activity, particularly in terms of attentional control. The findings suggest that guided imagery has the potential to enhance attentional control by augmenting the alpha power and reducing stress levels. Given the limited existing research on the specific impact of guided imagery on attention control, the study's findings carry notable significance.
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Affiliation(s)
- Katarzyna Zemla
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (K.Z.)
| | - Grzegorz Sedek
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland; (K.Z.)
| | - Krzysztof Wróbel
- Department of Neuroinformatics and Biomedical Engineering, Institute of Computer Science, Maria Curie-Sklodowska University, 20-033 Lublin, Poland (F.P.)
| | - Filip Postepski
- Department of Neuroinformatics and Biomedical Engineering, Institute of Computer Science, Maria Curie-Sklodowska University, 20-033 Lublin, Poland (F.P.)
| | - Grzegorz M. Wojcik
- Department of Neuroinformatics and Biomedical Engineering, Institute of Computer Science, Maria Curie-Sklodowska University, 20-033 Lublin, Poland (F.P.)
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Bang M, Kim B, Lee KS, Choi TK, Lee SH. Long-term benefits of mindfulness on white matter tracts underlying the cortical midline structures in panic disorder: A 2-year longitudinal study. Psychiatry Clin Neurosci 2023; 77:355-364. [PMID: 36917206 DOI: 10.1111/pcn.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023]
Abstract
AIMS We aimed to examine the long-term benefits of mindfulness-based cognitive therapy (MBCT) on white matter plasticity in the cortical midline structures (CMS) for a period of 2 years in patients with panic disorder and the relationships between white matter changes in the CMS and severity of state and trait symptoms. METHODS Seventy-one participants were enrolled and underwent diffusion tensor imaging at baseline and after 2 years (26 who received MBCT as an adjunct to pharmacotherapy [MBCT+PT], 20 treated with pharmacotherapy alone [PT-alone], and 25 healthy controls [HCs]). The severity of symptoms and fractional anisotropy (FA) in white matter regions underlying the CMS were assessed at baseline and 2-year follow-up. RESULTS The MBCT+PT group showed better outcomes after 2 years than the PT-alone group. The groups showed different FA changes: the MBCT+PT group showed decreased FA in the left anterior cingulate cortex (ACC); the PT-alone group showed increased FA in the bilateral dorsomedial prefrontal cortex, posterior cingulate cortex (PCC), and precuneus. Decreased white matter FA in the ACC, PCC, and precuneus was associated with improvements in the severity of state and trait symptoms in patients with panic disorder. CONCLUSION Alleviation of excessive white matter connectivity in the CMS after MBCT leads to improvements in clinical symptoms and trait vulnerability in patients with panic disorder. Our study provides new evidence for the long-term benefits of MBCT on white matter plasticity and its clinical applicability as a robust treatment for panic disorder.
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Affiliation(s)
- Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tai Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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Arena AF, Mobbs S, Sanatkar S, Williams D, Collins D, Harris M, Harvey SB, Deady M. Mental health and unemployment: A systematic review and meta-analysis of interventions to improve depression and anxiety outcomes. J Affect Disord 2023; 335:450-472. [PMID: 37201898 DOI: 10.1016/j.jad.2023.05.027] [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: 12/02/2022] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Unemployment is associated with substantially greater depression and anxiety, constituting a considerable public health concern. The current review provides the most comprehensive synthesis to date, and first meta-analysis, of controlled intervention trials aimed at improving depression and anxiety outcomes during unemployment. METHODS Searches were conducted within PsycInfo, Cochrane Central, PubMed and Embase from their inception to September 2022. Included studies conducted controlled trials of interventions focused on improving mental health within unemployed samples, and reported on validated measures of depression, anxiety, or distress (mixed depression and anxiety). Narrative syntheses and random effects meta-analyses were conducted among prevention- and treatment-level interventions for each outcome. RESULTS A total of 39 articles reporting on 33 studies were included for review (sample sizes ranging from 21 to 1801). Both prevention and treatment interventions tended to be effective overall, with treatment interventions producing larger effect sizes than prevention interventions. The clearest evidence for particular intervention approaches emerged for prevention-level Cognitive Therapy/CBT, followed by prevention-level work-related interventions, although neither produced entirely consistent effects. LIMITATIONS Risk of bias was generally high across studies. Low numbers of studies within subgroups precluded any comparisons between long-term and short-term unemployment, limited comparisons among treatment studies, and reduced the power of meta-analyses. CONCLUSIONS Both prevention- and treatment-level mental health-focused interventions have merit for reducing symptoms of anxiety and depression among those experiencing unemployment. Cognitive Therapy/CBT and work-related interventions hold the most robust evidence base, which can inform both prevention and treatment strategies implemented by clinicians, employment services providers, and governments.
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Affiliation(s)
- Andrew F Arena
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - Sophia Mobbs
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Samineh Sanatkar
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Douglas Williams
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Daniel Collins
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Marnie Harris
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Samuel B Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Williams M, Honan C, Skromanis S, Sanderson B, Matthews AJ. Psychological Outcomes and Mechanisms of Mindfulness-Based Training for Generalised Anxiety Disorder: A Systematic Review and Meta-Analysis. CURRENT PSYCHOLOGY 2023:1-23. [PMID: 37359641 PMCID: PMC10173921 DOI: 10.1007/s12144-023-04695-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 06/28/2023]
Abstract
This systematic review aimed to identify 1) the effect of mindfulness training on pre-post measures of anxiety and attention among adults experiencing high levels of generalised anxiety; and 2) the impact of predictors, mediators and moderators on post-intervention changes in anxiety or attention. Trait mindfulness and distress measures were included as secondary outcomes. A systematic search was conducted in November 2021 in electronic databases using relevant search terms. Eight articles comprising four independent studies were included (N = 334). All studies included participants diagnosed with generalised anxiety disorder (GAD) who participated in an 8-week manualised program. The meta-analysis indicated that mindfulness training had a large effect on anxiety symptoms (g = -1.92, 95%CI[-3.44, -0.40]) when compared to inactive (i.e., care as usual, waitlist) or non-specified (i.e., condition not defined) controls. However, a significant effect was not found when compared to active controls. Effects for depression, worry and trait mindfulness did not reach statistical significance, despite small-large effect sizes favouring mindfulness compared to inactive/non-specified controls. Our narrative review found evidence that changes in aspects of trait mindfulness mediate anxiety reduction following mindfulness training. However, a small number of studies were available for inclusion in the review, with high risk of bias and low certainty of evidence present. Overall, the findings support the use of mindfulness training programs for GAD and indicate mechanisms that may differ from those involved in other cognitive therapy approaches. Further RCTs with evidence-based controls are needed to clarify techniques most beneficial for generalised anxiety to support individually tailored treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-023-04695-x.
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Affiliation(s)
- Monique Williams
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, TAS 7001 Australia
| | - Cynthia Honan
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250 Australia
| | - Sarah Skromanis
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250 Australia
| | - Ben Sanderson
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, TAS 7001 Australia
| | - Allison J. Matthews
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Private Bag 30, Hobart, TAS 7001 Australia
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A Qualitative Microanalysis of the Immediate Behavioural Effects of Mindfulness Practices on Students’ Self-Regulation and Attention. TRENDS IN PSYCHOLOGY 2023. [DOI: 10.1007/s43076-023-00263-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractThe study examined the immediate effects of mindfulness practices on students’ attention and self-regulation during mathematical problem-solving tasks. Participants were 15 4th-grade Finnish students and their teacher. Data were collected during six study sessions of mathematical problem-solving, with and without mindfulness practices. The sessions were video-recorded, and children responded to the Freiburg mindfulness inventory and the cognitive and affective mindfulness scale-revised. A qualitative video micro-analysis focused on coding the observable behaviours related to attention and self-regulation. Self-report instruments were scored and tabulated for comparison. The findings indicate microbehavioural changes indicating positive effects of mindfulness practices on students’ self-regulation, with higher signs of engagement and lower signs of disengagement after mindfulness practices. This study enlightens the use of mindfulness practices in school routines and discusses the impacts of these practices while evidencing that future research on the topic is needed.
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Gong XG, Wang LP, Rong G, Zhang DN, Zhang AY, Liu C. Effects of online mindfulness-based interventions on the mental health of university students: A systematic review and meta-analysis. Front Psychol 2023; 14:1073647. [PMID: 36844353 PMCID: PMC9944037 DOI: 10.3389/fpsyg.2023.1073647] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Objectives Mental health problems among university students are a cause of widespread concern. Mindfulness-based interventions (MBIs) delivered online have considerable potential to help university students manage mental health challenges. However, there is no consensus regarding the efficacy of online MBIs. This meta-analysis aims to determine whether MBIs are feasible and effective for improving university students' mental health. Methods Randomised controlled trials (RCTs) in Web of Science, PubMed, Cochrane Library, Embase and the US National Library of Medicine (Clinical Trial Registry) published through August 31, 2022, were searched. Two reviewers selected the trials, conducted a critical appraisal, and extracted the data. Nine RCTs met our inclusion criteria. Results This analysis showed that online MBIs were effective in improving depression (standardised mean difference [SMD] = -0.27; 95% confidence interval [CI], -0.48 to -0.07; P = 0.008), anxiety (SMD = -0.47; 95% CI, -080 to -0.14; P = 0.006), stress (SMD = -0.58; 95% CI, -0.79 to -0.37; P < 0.00001), and mindfulness (SMD = 0.71; 95% CI, 0.17 to 1.25; p = 0.009) in university students. No significant effect was found on wellbeing (SMD = 0.30; 95% CI, -0.00 to 0.60; P = 0.05). Conclusion The findings indicated that online MBIs could effectively improve the mental health of university students. Nevertheless, additional rigorously designed RCTs are required. Systematic review registration https://inplasy.com/inplasy-2022-9-0099/, identifier INPLASY202290099.
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Affiliation(s)
- Xiao-Gang Gong
- Department of Medicine, College of Special Education, Beijing Union University, Beijing, China
| | - Le-Peng Wang
- School of Humanities, Beijing University of Chinese Medicine, Beijing, China
| | - Guang Rong
- Department of Education, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Dao-Ning Zhang
- Department of Diagnostics of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - A-Yuan Zhang
- Department of Primary Education, Teachers College, Beijing Union University, Beijing, China,College of Education, Capital Normal University, Beijing, China,*Correspondence: A-Yuan Zhang,
| | - Chao Liu
- School of Journalism and Communication, Huaqiao University, Xiamen, China,Business Analytics Research Center, Chang Gung University, Taoyuan City, Taiwan,Chao Liu,
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Abbott D, Lack CW, Anderson P. Does Using a Mindfulness App Reduce Anxiety and Worry? A Randomized-Controlled Trial. J Cogn Psychother 2023; 37:26-42. [PMID: 36787997 DOI: 10.1891/jcpsy-d-20-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objectives: the availability of smartphone-based mindfulness training applications (apps) may circumvent many barriers to receiving in-person help, but little controlled research has been conducted on them. This study sought to evaluate the effectiveness of a widely used -mindfulness training app, Headspace, at reducing anxiety and worry. Methods: this study used a randomized-controlled design to examine the app using a 3 (Time; baseline, 4 weeks, 8 weeks) × 2 (Access; immediate, delayed for 4 weeks) design. Participants who reported moderate to high anxiety or worry were randomly assigned to receive -either -immediate access or delayed access to the app. For null hypothesis significance testing (NHST), analyses of variance were used to test the hypotheses that app access for 4 and 8 weeks would reduce anxiety and worry as compared to waitlist or baseline and that app access for 8 weeks would reduce anxiety and worry as compared to 4 weeks. Bayes estimates were used to -determine the level of evidence for the hypothesis that app access reduces anxiety and worry. Results: four weeks of app access significantly reduced anxiety symptoms, as did 8 weeks, but NHST indicated there were no significant difference between 4 and 8 weeks of access. We failed to reject the null for the analysis of variance on worry, but Bayesian estimates indicated substantial evidence for the hypothesis that the mindfulness training app reduces worry. Conclusions: this research shows that using Headspace can reduce anxiety and worry, but that there does not appear to be a consistent dose relation.
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Affiliation(s)
- Deah Abbott
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Caleb W Lack
- University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Page Anderson
- Georgia State University, Department of Psychology, Atlanta, Georgia, USA
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Li J, Xu C, Wan K, Liu Y, Liu L. Mindfulness-based interventions to reduce anxiety among Chinese college students: A systematic review and meta-analysis. Front Psychol 2023; 13:1031398. [PMID: 36687872 PMCID: PMC9853980 DOI: 10.3389/fpsyg.2022.1031398] [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: 08/30/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Mindfulness-based interventions are found to have a positive effect on an individual's mental health. Using a meta-analysis method, this study examined the effects of mindfulness-based interventions on alleviating anxiety among Chinese college students. Using six international and two Chinese electronic databases, we comprehensively researched literature published between 1 January 2012 and 31 December 2021. The literature was then carefully selected and classified. The literature selection, data extraction, and quality assessment were all independently conducted by two members of the research team; any disagreements were resolved through consultation with a third researcher. A total of 11 original articles met all the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that mindfulness-based interventions have a positive effect on the remission of anxiety among Chinese college students. This confirms the need to generalize mindfulness-based interventions as a form of treatment and prevention for anxiety among Chinese college students.
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Affiliation(s)
- Jun Li
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Can Xu
- Monetware Inc., Shanghai, China
| | - Keyan Wan
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Yihong Liu
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Liu Liu
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China,*Correspondence: Liu Liu,
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Stellern J, Xiao KB, Grennell E, Sanches M, Gowin JL, Sloan ME. Emotion regulation in substance use disorders: a systematic review and meta-analysis. Addiction 2023; 118:30-47. [PMID: 35851975 PMCID: PMC10087816 DOI: 10.1111/add.16001] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/19/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The ability to regulate emotions effectively has been associated with resilience to psychopathology. Individuals with substance use disorders (SUDs) have been shown to have higher levels of negative emotionality, with some evidence suggesting impairment in emotion regulation compared with individuals without SUDs. However, no previous attempt has been made to systematically review the literature to assess the magnitude of this difference. We aimed to assess the association between SUD diagnosis and emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ) through a systematic review and meta-analysis of existing findings. METHODS The systematic review was conducted using PubMed, PsycINFO and Embase. We examined cross-sectional studies that compared a SUD group with a control group and measured emotion regulation using the DERS or the ERQ. The primary analysis focused on papers using the DERS, as this was the predominant instrument in the literature. RESULTS Twenty-two studies met our primary analysis criteria, representing 1936 individuals with a SUD and 1567 controls. Individuals with SUDs relative to controls had significantly greater DERS scores, with a mean difference of 21.44 [95% confidence interval (CI) = 16.49-26.40, P < 0.001] and Hedges' g = 1.05 (95% CI = 0.86-1.24, P < 0.001). The difference was robust, remaining significant after removing outliers and studies with high risk of bias. Individuals with SUDs demonstrated poorer emotion regulation on each subscale of the DERS, with the largest deficits in the Strategies and Impulse subscales. The ERQ analysis revealed greater use of expressive suppression in those with SUDs relative to controls (Hedges' g = 0.76, 95% CI = 0.25-1.28, P = 0.004). CONCLUSIONS People with substance use disorders appear to have greater difficulties in emotion regulation than people without substance use disorders.
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Affiliation(s)
- Jordan Stellern
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ke Bin Xiao
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Erin Grennell
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marcos Sanches
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Joshua L Gowin
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew E Sloan
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
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Lewin RK, Acuff SF, Berlin KS, Berman JS, Murrell AR. Group-based acceptance and commitment therapy to enhance graduate student psychological flexibility: Treatment development and preliminary implementation evaluation. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:162-171. [PMID: 33577437 DOI: 10.1080/07448481.2021.1881522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/19/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Objective: Graduate student mental health is a growing concern and the need for interventions is well-documented. This manuscript outlines an Acceptance and Commitment Therapy group treatment for graduate students intended to promote psychological flexibility through the cultivation of six processes: contact with the present moment (mindfulness), freely chosen life direction (values), distance from thoughts (defusion), nonjudgmental acknowledgement of one's internal experiences (acceptance), meta-awareness of one's own experiences (self-as-context), and ongoing patterns of behavior in the service of values (committed action). Participants: The treatment was delivered to graduate students across academic disciplines with variable psychological concerns over several semesters. Method: Graduate students completed measures of preliminary acceptability. Results: Clients perceived the intervention positively and believed they benefited from participating. Conclusion: Treatment evaluation information support the social validity and acceptability of the treatment and justify future studies assessing treatment efficacy and effectiveness.
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Affiliation(s)
- Rivian K Lewin
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Samuel F Acuff
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Jeffrey S Berman
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Amy R Murrell
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
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29
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Cardle P, Kumar S, Leach M, McEvoy M, Veziari Y. Mindfulness and Chronic Musculoskeletal Pain: An Umbrella Review. J Multidiscip Healthc 2023; 16:515-533. [PMID: 36879651 PMCID: PMC9985422 DOI: 10.2147/jmdh.s392375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 03/04/2023] Open
Abstract
Background Chronic musculoskeletal pain (CMSP) disorders are a leading cause of disability globally, affecting up to one in three people. Mindfulness-based interventions (MBI) have become a popular treatment for CMSP. The aim of this umbrella review was to synthesise the best available research evidence for the effectiveness of MBI for adults with CMSP. Methods Eight databases were searched from inception to 30th June 2021 for systematic reviews that examined the use of MBI in CMSP (pain experienced >3 months) in adult populations. Two reviewers independently conducted screening and selection, data extraction, and assessment of methodological quality using The Assessing the Methodological Quality of Systematic Reviews tool (AMSTAR 2). Outcomes examined were pain, sleep quality, depression, quality of life, physical functioning, and mindfulness. Furthermore, definitions of mindfulness, and intervention parameters (mindfulness practices used, length, frequency of sessions, duration) were also reported. Results Nineteen systematic reviews (n = 1 rated high quality, n = 1 moderate quality, n = 2 low quality and n = 15 critically low quality) examining 194 primary studies met the review criteria. Although some promising evidence was identified for the use of MBI in CMSP, the general low quality and widespread heterogeneity of included SRs and made it difficult to reach a definitive conclusion. Differences in results and outcomes amongst systematic reviews that, in many cases, had a high overlap of included RCTs, suggests fundamental differences in critical design elements that make data difficult to compare. Conclusion This umbrella review found mixed results on the effectiveness of MBI for the management of CMSP across a range of outcomes (pain, sleep quality, depression, quality of life, physical functioning, mindfulness). Definitions of MBI varied as did parameters, which may have contributed to these mixed results. More rigorous research with stringent MBI protocols is required.
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Affiliation(s)
- Paul Cardle
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
| | - Saravana Kumar
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, New South Wales, Australia
| | - Maureen McEvoy
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
| | - Yasamin Veziari
- Allied Health and Human Performance Unit, The University of South Australia, Adelaide, SA, Australia
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30
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Juarez-Reyes M, Purington N, Kling SMR. Mindfulness-Based Group Medical Visits in Primary Care for Stress and Anxiety: An Observational Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:721-728. [PMID: 35671517 DOI: 10.1089/jicm.2021.0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: The prevalence of anxiety disorders in primary care is 20%, with 41% of these patients reporting no current treatment. Patients with anxiety are also more likely to have comorbidities with other medical and/or psychiatric conditions, increasing medical costs. Integrating mindfulness-based interventions (MBIs) into a group medical visit (GMV) format has been successfully used to manage pain, but limited literature is available on the effectiveness of these visit formats for patients with stress and anxiety. Methods: Ninety-two adult patients with self-reported stress and/or anxiety were recruited from three university outpatient primary care clinics between 2016 and 2019. Participants attended at least 4 of 6 weekly GMVs focused on MBIs. Change in heart rate, blood pressure, Generalized Anxiety Disorder-7 (GAD-7) score, and 9 item Patient Health Questionnaire (PHQ-9) score from the first to last visit were evaluated using mixed effect linear regression models. Results: Both GAD-7 (estimated change: -5.1; 95% confidence interval [CI]: -6.4 to -3.7) and PHQ-9 (estimated change: -3.3; 95% CI: -4.3 to -2.2) scores significantly decreased from the first to last visit. These reductions were independent of age, sex, and number of visits attended. No significant changes in heart rate or blood pressure were found. Conclusions: Significant reductions in anxiety and depression in primary care patients were observed after a 6-week standardized mindfulness based GMV. Intergroup variability was not significant indicating that the intervention is reproducible over time and across providers. Future randomized controlled trials with appropriate controls will better evaluate which components of the intervention account for findings.
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Affiliation(s)
- Maria Juarez-Reyes
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Portola Valley, CA, USA
| | - Natasha Purington
- Department of Medicine, Qualitative Sciences Unit, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Samantha M R Kling
- Department of Medicine, Evaluation Sciences Unit, Division of Primary Care and Population Health, Stanford University, Palo Alto, CA, USA
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Zhang YW, Wang J, Fang TH. The effect of horticultural therapy on depressive symptoms among the elderly: A systematic review and meta-analysis. Front Public Health 2022; 10:953363. [PMID: 36091570 PMCID: PMC9449424 DOI: 10.3389/fpubh.2022.953363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 01/24/2023] Open
Abstract
Objective This systematic review and meta-analysis aimed to assess the effectiveness of horticultural therapy on depressive symptoms in the elderly and determine the potential moderators of the intervention effect. Methods In early June 2022, randomized controlled trials and Quasi-experimental studies were searched on Web of Science, PsycINFO, CINAHL, EMBASE, Medline, PubMed, CNKI, WANFANG DATA, and CQVIP. Three independent authors proposed the following inclusion criterion for this study: the elderly with applied horticultural therapy intervention compared to non-HT intervention. From a total of 3,068 records, only 34 studies met the inclusion criteria. After the full-text screening, 13 studies were included in the analysis. An assessment of the risk of bias was conducted using RoBINS-I and RoB 2 tools. The comprehensive Meta-Analysis 3.3 tool was used for the meta-analysis. Results Meta-analysis suggested that mean depression scores of elderly people who underwent horticultural therapy intervention were significantly lower than those who did not receive HT therapy. More significant effects were found for the elderly with mean age equal to or over 75 years instead of younger than 75 years, in randomized controlled trials instead of quasi-experimental studies, for studies with more than 20 participants receiving horticultural therapy at the same time and place instead of equal to or fewer than 20 horticultural therapy participants. Conclusions This evidence supported that horticultural therapy had a significant positive effect on the depressive symptoms outcomes for the elderly. Therefore, our data revealed that horticultural therapy could be considered as a part of therapy in depressive symptoms reduction programs. Due to the high degree of heterogeneity and the limited number of studies, a future review is warranted to determine the effects of horticultural therapy on depressive symptoms reduction in the elderly. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272464, identifier: CRD42021272464.
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Amiri S, Esmaeili AA. Exercise and Anxiety in Cancer: A Meta-Analysis of Randomized Control Trials. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2110628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Esmaeili
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Bunjak A, Černe M, Schölly EL. Exploring the past, present, and future of the mindfulness field: A multitechnique bibliometric review. Front Psychol 2022; 13:792599. [PMID: 35959046 PMCID: PMC9361873 DOI: 10.3389/fpsyg.2022.792599] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 07/06/2022] [Indexed: 12/28/2022] Open
Abstract
This paper provides an overview of the mindfulness literature up until the end of 2020 by (a) uncovering its underlying intellectual structure, (b) identifying the most influential and popular themes, and (c) presenting new directions for future research on mindfulness. To this end, a systematic quantitative review based on bibliometric methods was conducted, which is perhaps less prone to researcher bias and can complement existing meta-analyses and qualitative (narrative) structured reviews as an objective approach. Three bibliometric techniques—document co-citation analysis, co-word (co-occurrence and content) analysis, and bibliographic coupling—were applied to explore the past, present, and future of mindfulness research. The co-citation analysis showed that measurement, mechanisms, mindfulness-based interventions, and examinations of the efficacy of mindfulness interventions are among the key theoretical knowledge bases from which the field of mindfulness is derived. The content analysis demonstrated the beneficial effects of mindfulness meditation for physical and mental health conditions. The bibliographic coupling revealed novel directions in cognitive behavioral therapy, emotion regulation, the application of mindfulness practice to children and adolescents, mindfulness at work, and the role of mindfulness in positive psychology. The large sample of articles that was analyzed allowed us to provide a broader and more objective overview than possible with other forms of literature reviews. The combination of the three bibliometric techniques granted deeper insights into the complex multidisciplinary field of mindfulness, along with specific suggestions for future research.
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Affiliation(s)
- Aldijana Bunjak
- Institute for Leadership and Human Resource Management, University of St. Gallen, St. Gallen, Switzerland
- *Correspondence: Aldijana Bunjak
| | - Matej Černe
- School of Economics and Business, University of Ljubljana, Ljubljana, Slovenia
| | - Emilie Lara Schölly
- Institute for Leadership and Human Resource Management, University of St. Gallen, St. Gallen, Switzerland
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Rahrig H, Vago DR, Passarelli MA, Auten A, Lynn NA, Brown KW. Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity. Sci Rep 2022; 12:12260. [PMID: 35851275 PMCID: PMC9293892 DOI: 10.1038/s41598-022-15195-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
This meta-analysis sought to expand upon neurobiological models of mindfulness through investigation of inherent brain network connectivity outcomes, indexed via resting state functional connectivity (rsFC). We conducted a systematic review and meta-analysis of rsFC as an outcome of mindfulness training (MT) relative to control, with the hypothesis that MT would increase cross-network connectivity between nodes of the Default Mode Network (DMN), Salience Network (SN), and Frontoparietal Control Network (FPCN) as a mechanism of internally-oriented attentional control. Texts were identified from the databases: MEDLINE/PubMed, ERIC, PSYCINFO, ProQuest, Scopus, and Web of Sciences; and were screened for inclusion based on experimental/quasi-experimental trial design and use of mindfulness-based training interventions. RsFC effects were extracted from twelve studies (mindfulness n = 226; control n = 204). Voxel-based meta-analysis revealed significantly greater rsFC (MT > control) between the left middle cingulate (Hedge's g = .234, p = 0.0288, I2 = 15.87), located within the SN, and the posterior cingulate cortex, a focal hub of the DMN. Egger's test for publication bias was nonsignificant, bias = 2.17, p = 0.162. In support of our hypothesis, results suggest that MT targets internetwork (SN-DMN) connectivity implicated in the flexible control of internally-oriented attention.
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Affiliation(s)
- Hadley Rahrig
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA.
| | - David R Vago
- Department of Psychology, Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA, TN
| | - Matthew A Passarelli
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA
| | - Allison Auten
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA
| | - Nicholas A Lynn
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA
| | - Kirk Warren Brown
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA.
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Shallcross AJ, Duberstein ZT, Sperber SH, Visvanathan PD, Lutfeali S, Lu N, Carmody J, Spruill TM. An Open Trial of Telephone-Delivered Mindfulness-Based Cognitive Therapy: Feasibility, Acceptability, and Preliminary Efficacy for Reducing Depressive Symptoms. COGNITIVE AND BEHAVIORAL PRACTICE 2022; 29:280-291. [DOI: 10.1016/j.cbpra.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chapman L, Hutson R, Dunn A, Brown M, Savill E, Cartwright-Hatton S. The impact of treating parental anxiety on children's mental health: An empty systematic review. J Anxiety Disord 2022; 88:102557. [PMID: 35397376 DOI: 10.1016/j.janxdis.2022.102557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/11/2022] [Accepted: 03/19/2022] [Indexed: 11/23/2022]
Abstract
Children of anxious parents are at heightened risk of developing an anxiety disorder of their own, but promising research indicates that targeting parenting behaviours can reduce the risk of intergenerational transmission of anxiety. Given there is extensive evidence for the efficacy of treatments for adult anxiety, the current review sought to identify whether interventions solely addressing parental symptoms had any effect on the mental health and wellbeing of their children. Randomised Controlled Trials of psychological interventions targeting adults with a probable anxiety disorder and which included a child mental health or wellbeing outcome were eligible for inclusion. Scopus, Web of Science, PubMed, PsychINFO, and PsychArticles were searched, and 2137 articles were systematically reviewed. However, no articles were identified that met the review criteria. Research into interventions targeting adult anxiety is failing to consider the potential benefit treatment may have on dependent children. This is a missed opportunity to evaluate a potential means of support for children who are known to be at risk of anxiety. Evaluation of psychological interventions for adult anxiety should consider including both adult and child mental health outcomes to determine potential preventative effects.
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Affiliation(s)
- Laura Chapman
- School of Psychology, University of Sussex, United Kingdom.
| | - Rosie Hutson
- School of Psychology, University of Sussex, United Kingdom
| | - Abby Dunn
- School of Psychology, University of Sussex, United Kingdom
| | - Maddy Brown
- School of Psychology, University of Sussex, United Kingdom
| | - Ella Savill
- School of Psychology, University of Sussex, United Kingdom
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Assessing mindfulness and self-compassion facets as mediators of change in patients with depressive, anxious and adjustment disorders: Secondary data analysis of a randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Wu JL, Hamilton JL, Fresco DM, Alloy LB, Stange JP. Decentering predicts attenuated perseverative thought and internalizing symptoms following stress exposure: A multi-level, multi-wave study. Behav Res Ther 2022; 152:104017. [PMID: 35316616 PMCID: PMC9007852 DOI: 10.1016/j.brat.2021.104017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 02/07/2023]
Abstract
While research identifies a growing list of risk factors for anxiety and depression, it is equally important to identify potential protective factors that may prevent or reduce vulnerability to developing internalizing psychopathology. We hypothesized that forms of perseverative thinking, such as rumination and worry, act as mechanisms linking negative life experiences and prospective symptoms of anxiety and depression. More specifically, we investigated whether decentering, the meta-cognitive capacity to adopt a distanced perspective toward one's thoughts and feelings, serves as a protective factor at various points along this mediational pathway. A sample of 181 undergraduate students were recruited and assessed at five time points over a 12-week period. Multilevel modeling indicated that decentering was associated with an attenuated impact of (1) negative events on prospective depressive symptoms; (2) negative events on prospective brooding, and (3) brooding, pondering and worry on prospective internalizing symptoms. Multilevel moderated mediation analyses provided partial support for the hypothesis that perseverative thinking would mediate the longitudinal associations between negative life events and internalizing symptoms, with decentering attenuating risk at several connections of the indirect pathways. The strongest support was provided for moderated mediation models in which decentering was associated with attenuated relationships between negative events, brooding, and symptoms of depression. This study is the first to elucidate the role of decentering as a protective factor against anxiety and depressive symptoms at different points in the path from stress to perseverative thought to internalizing symptoms. Decentering therefore may be a critical target for clinical intervention to promote resilience against anxiety and depression.
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Mellner C, Osika W, Niemi M. Mindfulness practice improves managers’ job demands-resources, psychological detachment, work-nonwork boundary control, and work-life balance – a randomized controlled trial. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-07-2021-0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeContemporary workplaces undergo frequent reorganizations in order to stay competitive in a working life characterized by globalization, digitalization, economic uncertainty, and ever-increased complexity. Managers are in the frontline of these challenges, leading themselves, organizations and their employees in high stress environments. This raises questions on how to support managers’ work-life sustainability, which is crucial for organizational sustainability. Mindfulness has been related to enhanced capacities to cope with challenges that are associated with organizational change. The authors evaluated short- and long-term effects of an eight-week mindfulness-based intervention in a company setting, which was going through reorganization.Design/methodology/approachForty managers (42.5% males), mean age 54.53 (SD 5.13), were randomized to the mindfulness intervention or a non-active wait-list control. Self-report data were provided on individual sustainability factors in a work context: job demands and resources, psychological detachment, i.e. possibilities for letting go of work-related thoughts during leisure, control over work-nonwork boundaries, work-life balance, and mindfulness at baseline, postintervention, and at 6-month follow-up.FindingsLinear mixed models (LMMs) analysis (all ps < 0.005 to 0.05) showed that the intervention group had a larger decrease in job demands and a smaller decrease in job resources, a larger increase in psychological detachment, work-nonwork boundary control, work-life balance, and mindfulness from baseline to postintervention when compared with the reference group. These initial effects were sustained at 6-month follow-up.Originality/valueThe study provides evidence that mindfulness practice can enhance managers’ long-term capacity to cope with challenging working conditions, and increase their work-life sustainability in times of organizational change and disruption.
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Liu Z, Jia Y, Li M, Meng X, Shang B, Wang C, Chen L. Effectiveness of online mindfulness-based interventions for improving mental health in patients with physical health conditions: Systematic review and meta-analysis. Arch Psychiatr Nurs 2022; 37:52-60. [PMID: 35337439 DOI: 10.1016/j.apnu.2021.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/19/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022]
Abstract
We aimed to determine the effectiveness of online mindfulness-based interventions (MBIs) for improving mental health in patients with physical health conditions. Randomized controlled trials (RCTs) in PubMed, Cochrane Library, Web of Science, Elsevier, and CINAHL published through September 2019 were searched. Two reviewers selected trials, conducted a critical appraisal, and extracted the data. Meta-analyses were performed. A total of nine RCTs were included. Analyses revealed that online MBIs was effective in improving depression [standardized mean difference (SMD) = -0.22, 95% confidence interval (CI) (-0.37, -0.07), p = 0.004], anxiety [SMD = -0.19, 95% CI (-0.33, -0.04), p = 0.01], and stress [SMD = -0.32, 95% CI (-0.52, -0.13), p = 0.001], and mindfulness [SMD = 1.67, 95% CI (0.14, 3.20), p = 0.03] in patients with physical conditions. We did not find any obvious effects on well-being [SMD = 1.12, 95% CI (-0.11, 2.36), p = 0.08]. Nevertheless, additional well-designed randomized clinical trials are further needed.
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Affiliation(s)
- Zengxia Liu
- School of Nursing, Jilin University, Changchun, China; School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Yong Jia
- School of Nursing, Jilin University, Changchun, China
| | - Min Li
- Invasive Technology Department, First Hospital of Jilin University, Changchun, China
| | - Xiangfei Meng
- School of Nursing, Jilin University, Changchun, China
| | - Binghan Shang
- School of Nursing, Jilin University, Changchun, China
| | - Chunyan Wang
- Senior Officials Inpatient Ward, First Hospital of Jilin University, Changchun, China.
| | - Li Chen
- School of Nursing, Jilin University, Changchun, China.
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Kraemer KM, Jain FA, Mehta DH, Fricchione GL. Meditative and Mindfulness-Focused Interventions in Neurology: Principles, Science, and Patient Selection. Semin Neurol 2022; 42:123-135. [PMID: 35139550 PMCID: PMC9177528 DOI: 10.1055/s-0042-1742287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A growing body of research suggests that meditative- and mindfulness-focused interventions may improve neuropsychiatric symptoms that commonly occur in a range of neurological disorders. In this article, the principles of meditation and mindfulness are first defined, as well as briefly describing the neurobiological mechanisms implicated in these interventions. Thereafter, a range of meditative- and mindfulness-focused interventions are detailed, along with their supporting evidence to treat neuropsychiatric symptoms in neurological conditions (e.g., headache, movement disorders, chronic pain, etc.). Overall, these interventions warrant further investigation among individuals with neurological conditions. When recommending these interventions, health care professionals must consider a combination of structural (e.g., insurance reimbursement) and patient factors (e.g., ability to tolerate a group setting).
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Affiliation(s)
- Kristen M. Kraemer
- Division of General Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, CO-1309, 2nd Floor, Boston, MA 02215
| | - Felipe A. Jain
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, One Bowdoin Square, 6th Floor, Boston MA 02114
| | - Darshan H. Mehta
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, 151 Merrimac Street, 4th Floor, Boston, MA 02114
- Osher Center for Integrative Medicine, Brigham & Women’s Hospital, 900 Commonwealth Avenue East, 3rd Floor, Boston, MA 02215
| | - Gregory L. Fricchione
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, 151 Merrimac Street, 4th Floor, Boston, MA 02114
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Rossman SM, Lerner RE, Córdova JV. Disentangling acceptance: Direct and indirect effects of partner acceptance on felt acceptance and relationship satisfaction. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:378-384. [PMID: 34197160 PMCID: PMC8720111 DOI: 10.1037/fam0000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acceptance in intimate relationships predicts relationship satisfaction, as well as positive treatment outcomes in some couple interventions. However, little research has attempted to disentangle the dyadic effects of husbands' and wives' partner acceptance (i.e., acceptance of one's partner) and felt acceptance (i.e., felt sense of being accepted by one's partner) on relationship satisfaction. This study utilized a modified actor-partner interdependence mediation model (APIMeM) to examine whether the associations between acceptance of one's partner and each partner's relationship satisfaction are mediated by each partner's felt acceptance. We analyzed baseline self-report data from 209 heterosexual married couples who participated in a brief marital intervention in the United States. The final model supported the prediction that a person's acceptance of their partner would relate to their partner's relationship satisfaction through their partner's felt acceptance (i.e., an "accuracy effect") and to their own relationship satisfaction through their own felt acceptance (i.e., a "projection effect"). In all, the study demonstrates the utility of examining partner acceptance and felt acceptance as distinct, but related, constructs. Researchers and clinicians working with couples may consider conceptualizing, assessing, and even targeting partners and felt acceptance separately. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Marshall JM, Dunstan DA, Bartik W. Smartphone Psychological Therapy During COVID-19: A Study on the Effectiveness of Five Popular Mental Health Apps for Anxiety and Depression. Front Psychol 2022; 12:775775. [PMID: 35069357 PMCID: PMC8771308 DOI: 10.3389/fpsyg.2021.775775] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 01/26/2023] Open
Abstract
The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate the proposed methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced (27 females and 12 males,MAge = 34.04 years,SD = 12.20), with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter (n = 8),Smiling Mind (n = 7),MoodMission (n = 8),MindShift (n = 8), andDestressify (n = 8). Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps. Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR), which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p (http://www.ANZCTR.org.au/ACTRN12619001302145p.aspx).
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Affiliation(s)
- Jamie M Marshall
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Debra A Dunstan
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Warren Bartik
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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Phillips S, Mychailyszyn M. The Effect of School-Based Mindfulness Interventions on Anxious and Depressive Symptoms: A Meta-analysis. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-021-09492-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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45
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Choate AM, Gorey C, Rappaport LM, Wiernik BM, Bornovalova MA. Alternative model of personality disorders traits predict residential addictions treatment completion. Drug Alcohol Depend 2021; 228:109011. [PMID: 34521057 PMCID: PMC8595711 DOI: 10.1016/j.drugalcdep.2021.109011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 08/06/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Among people receiving residential treatment for a substance use disorder (SUD), premature treatment termination predicts poor post-treatment outcomes. We examined the utility of the alternative model for personality disorders (AMPD) for predicting premature residential SUD treatment termination, including interactions with age and gender. METHODS Participants (N = 374) were receiving residential treatment for SUD and enrolled in a clinical trial with two conditions: Skills for Improving Distress Intolerance (SIDI) and Supportive Counseling (NCT01741415). Participants were assessed at intake on AMPD traits using the Personality Inventory for DSM-5 (PID-5) and tracked longitudinally. After establishing gender and age measurement invariance, we used competing risk models to predict treatment completion versus premature termination using interactions of PID-5 scores with age and gender. FINDINGS Disinhibition and Negative Emotionality domains and facets predicted premature treatment termination, particularly among younger, male participants. There were positive effects of SIDI on treatment completion for participants with high levels of domain and facet Negative Emotionality. A small proportion (≈ 12 %) of the PID-5 items showed differential item functioning by age or gender; however, the aggregate impact on test-level total scores was negligible. CONCLUSIONS Participants (particularly young men) displaying poor self-control and emotional regulation are at risk for premature termination. These findings, together with minimal aggregate differential item functioning at the scale level, suggest that the PID-5 is a practically useful, construct-valid, non-proprietary measure, aspects of which can be used for screening in residential SUD treatment. Furthermore, among those with high negative emotionality, SIDI may be effective in preventing premature treatment termination.
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Affiliation(s)
- Alexandria M Choate
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Claire Gorey
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | | | - Brenton M Wiernik
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Marina A Bornovalova
- Department of Psychology, University of South Florida, Tampa, FL, United States.
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Costa MDA, Gonçalves FG, Tatton-Ramos T, Fonseca NKDOD, Schwinn JK, Alves SG, Salum GA, Manfro GG. A Three-Arm Randomized Clinical Trial Comparing the Efficacy of a Mindfulness-Based Intervention with an Active Comparison Group and Fluoxetine Treatment for Adults with Generalized Anxiety Disorder. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:269-279. [PMID: 33321509 DOI: 10.1159/000511880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/25/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Mindfulness-based interventions have been studied as an alternative treatment for anxiety disorders, but there are only a few studies comparing these with established treatments. OBJECTIVE To evaluate the efficacy of a Body in Mind Training (BMT) program for adults with generalized anxiety disorder (GAD), an active comparison protocol called Quality of Life and Psychoeducation (QoL), and treatment with fluoxetine (FLX). METHODS This study comprises a 3-arm parallel-group, randomized clinical trial (ClinicalTrials.gov ID: NCT03072264). Adults with a primary diagnosis of GAD and no current treatment were recruited from the community and randomized in a ratio 1:1:1. The primary outcomes were assessed by means of the Hamilton Anxiety Rating Scale (HAM-A) and the Penn State Worry Questionnaire (PSWQ) at week 8. Data were analyzed using a superiority analysis (BMT vs. QoL) and a noninferiority analysis (BMT vs. FLX). RESULTS A total of 249 participants were included and 223 were analyzed (76 BMT, 79 FLX, and 68 QoL). All groups improved after intervention. However, BMT was not superior to QoL at week 8 (mean difference = -1.36; p = 0.47), nor was it noninferior to FLX as assessed with theHAM-A (mean difference = 3.5; 95% CI -0.06 to 7.06; noninferiority margin = -2.43; p = 0.054). QoL (mean difference = 3.54; p = 0.04) and FLX (mean difference = -7.72; 95% CI -10.89 to -4.56; noninferiority margin = -2.09; p < 0.001) were superior to BMT in reducing PSWQ score. CONCLUSION Our data suggest that BMT, in its current format, cannot be considered an effective mindfulness protocol to improve GAD.
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Affiliation(s)
- Marianna de Abreu Costa
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil, .,Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,
| | - Francine Guimarães Gonçalves
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Natasha Kim de Oliveira da Fonseca
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Julia Karl Schwinn
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Sofia Giusti Alves
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gisele Gus Manfro
- Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Graduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Rodriguez M, Eisenlohr-Moul TA, Weisman J, Rosenthal MZ. The Use of Task Shifting to Improve Treatment Engagement in an Internet-Based Mindfulness Intervention Among Chinese University Students: Randomized Controlled Trial. JMIR Form Res 2021; 5:e25772. [PMID: 34643532 PMCID: PMC8552103 DOI: 10.2196/25772] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/08/2021] [Accepted: 08/01/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Traditional in-person psychotherapies are incapable of addressing global mental health needs. Use of computer-based interventions is one promising solution for closing the gap between the amount of global mental health treatment needed and received. OBJECTIVE Although many meta-analyses have provided evidence supporting the efficacy of self-guided, computer-based interventions, most report low rates of treatment engagement (eg, high attrition and low adherence). The aim of this study is to investigate the efficacy of an adjunctive treatment component that uses task shifting, wherein mental health care is provided by nonspecialist peer counselors to enhance engagement in an internet-based, self-directed, evidence-based mindfulness intervention among Chinese university students. METHODS From 3 universities across China, 54 students who reported at least mild stress, anxiety, or depression were randomly assigned to a 4-week internet-based mindfulness intervention (MIND) or to the intervention plus peer counselor support (MIND+), respectively. Be Mindful delivers all the elements of mindfulness-based cognitive therapy in an internet-based, 4-week course. Participants completed daily monitoring of mindfulness practice and mood, as well as baseline and posttreatment self-reported levels of depression, anxiety, stress, and trait mindfulness. We screened 56 volunteer peer counselor candidates who had no former training in the delivery of mental health services. Of these, 10 were invited to participate in a day-long training, and 4 were selected. Peer counselors were instructed to provide 6 brief (15-20 minute) sessions each week, to help encouraging participants to complete the internet-based intervention. Peer counselors received weekly web-based group supervision. RESULTS For both conditions, participation in the internet-based intervention was associated with significant improvements in mindfulness and mental health outcomes. The pre-post effect sizes (Cohen d) for mindfulness, depression, anxiety, and stress were 0.55, 0.95, 0.89, and 1.13, respectively. Participants assigned to the MIND+ (vs MIND) condition demonstrated significantly less attrition and more adherence, as indicated by a greater likelihood of completing posttreatment assessments (16/27, 59% vs 7/27, 26%; χ21=6.1; P=.01) and a higher percentage of course completion (72.6/100, 72.6% vs 50.7/100, 50.7%; t52=2.10; P=.04), respectively. No significant between-group differences in daily frequency and duration of mindfulness practice were observed. Multilevel logistic growth models showed that MIND+ participants reported significantly greater pre-post improvements in daily stress ratings (interaction estimate 0.39, SE 0.18; t317=2.29; P=.02) and depression (interaction estimate 0.38, SE 0.16; t330=2.37; P=.02) than those in the MIND condition. CONCLUSIONS This study provides new insights into effective ways of leveraging technology and task shifting to implement large-scale mental health initiatives that are financially feasible, easily transportable, and quickly scalable in low-resource settings. The findings suggest that volunteer peer counselors receiving low-cost, low-intensity training and supervision may significantly improve participants' indices of treatment engagement and mental health outcomes in an internet-based mindfulness intervention among Chinese university students.
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Affiliation(s)
- Marcus Rodriguez
- Department of Psychology, Pitzer College, Claremont, CA, United States.,Boston Child Study Center, Los Angeles, CA, United States
| | - Tory A Eisenlohr-Moul
- Neuropsychiatric Institute, Department of Psychiatry, University of Illinois at Chicago College of Medicine, Chicago, IL, United States
| | - Jared Weisman
- Pitzer College, Claremont, CA, United States.,MCR Labs, LLC, Framingham, MA, United States
| | - M Zachary Rosenthal
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
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Slonena EE, Elkins GR. Effects of a Brief Mindful Hypnosis Intervention on Stress Reactivity: A Randomized Active Control Study. Int J Clin Exp Hypn 2021; 69:453-467. [PMID: 34330204 DOI: 10.1080/00207144.2021.1952845] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A novel, audio-based brief mindful hypnosis (BMH) intervention for reducing stress-reactivity during the Trier Social Stress Test (TSST) was investigated. Fifty-five college-aged participants with elevated stress were randomized to BMH or a cognitive training (CT) active-control condition. Participants received a BMH or CT session and downloaded the audio-recorded intervention for daily home practice. Approximately 1 week later, participants received their second BMH or CT session and then completed the TSST. Results indicated BMH produced significant and medium effects in reducing stress reactivity and weekly stress and increasing mindfulness, with large increases in immediate relaxation compared to the CT active control. BMH demonstrated excellent adherence and was rated highly regarding satisfaction, ease of practice, perceived benefit, and likelihood of future use. This study provides the first empirical support that BMH is superior to an active-control intervention for reducing stress reactivity while significantly increasing mindfulness and relaxation.
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Affiliation(s)
- Elizabeth E Slonena
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Gary R Elkins
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
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49
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Neurocircuitry of Mindfulness-Based Interventions for Substance Use Prevention and Recovery. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00396-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Baker HJ, Lawrence PJ, Karalus J, Creswell C, Waite P. The Effectiveness of Psychological Therapies for Anxiety Disorders in Adolescents: A Meta-Analysis. Clin Child Fam Psychol Rev 2021; 24:765-782. [PMID: 34471966 PMCID: PMC8541960 DOI: 10.1007/s10567-021-00364-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 12/23/2022]
Abstract
Anxiety disorders are common in adolescence but outcomes for adolescents are unclear and we do not know what factors moderate treatment outcome for this age group. We conducted meta-analyses to establish the effectiveness of psychological therapies for adolescent anxiety disorders in (i) reducing anxiety disorder symptoms, and (ii) remission from the primary anxiety disorder, compared with controls, and examine potential moderators of treatment effects. The protocol was registered with PROSPERO (CRD42018091744). Electronic databases (Web of Science, MEDLINE, Psycinfo, EMBASE) were searched from January 1990 to December 2019. 2511 articles were reviewed, those meeting strict criteria were included. Random effects meta-analyses were conducted. Analyses of symptom severity outcomes comprised sixteen studies (CBT k = 15, non-CBT k = 1; n = 766 adolescents), and analyses of diagnostic remission outcomes comprised nine (CBT k = 9; n = 563 adolescents). Post-treatment, those receiving treatment were significantly more likely to experience reduced symptom severity (SMD = 0.454, 95% CI 0.22–0.69) and remission from the primary anxiety disorder than controls (RR = 7.94, 95% CI 3.19–12.7) (36% treatment vs. 9% controls in remission). None of the moderators analysed were statistically significant. Psychological therapies targeting anxiety disorders in adolescents are more effective than controls. However, with only just over a third in remission post-treatment, there is a clear need to develop more effective treatments for adolescents, evaluated through high-quality randomised controlled trials incorporating active controls and follow-up data.
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Affiliation(s)
- Holly J. Baker
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL UK
| | - Peter J. Lawrence
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, SO17 1BJ UK
| | - Jessica Karalus
- Central North West London NHS Foundation Trust, Grenfell Health and Wellbeing Service, St Charles Hospital, Exmoor Street, London, W10 6DZ UK
| | - Cathy Creswell
- Radcliffe Observatory, University of Oxford, Anna Watts Building, Woodstock Rd, Oxford, OX2 6GG UK
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL UK
- Radcliffe Observatory, University of Oxford, Anna Watts Building, Woodstock Rd, Oxford, OX2 6GG UK
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