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Fox J, Erlandsson LK, Shiel A. A systematic review and narrative synthesis of occupational therapy-led interventions for individuals with anxiety and stress-related disorders. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/0164212x.2018.1516172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jackie Fox
- Discipline of Occupational Therapy, School of Health Sciences, National University of Ireland, Galway, Ireland
| | | | - Agnes Shiel
- Discipline of Occupational Therapy, School of Health Sciences, National University of Ireland, Galway, Ireland
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102
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Exploring the cultural flexibility of the ACT model as an effective therapeutic group intervention for Turkish speaking communities in East London. COGNITIVE BEHAVIOUR THERAPIST 2019. [DOI: 10.1017/s1754470x18000041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AbstractThis study describes a successful community-based partnership project between statutory and third-sector services in East London; The City and Hackney Black and Minority Ethnic (BME) Access Service [East London NHS Foundation Trust (ELFT)] collaborated with Derman, a local community organization supporting the well-being of Turkish-speaking communities, to explore the cultural adaptability of an empirically supported, third-wave cognitive behavioural intervention, Acceptance and Commitment Therapy (ACT). The aim was to develop a culturally acceptable group that was responsive to the therapeutic needs of participants from Turkish-speaking communities. The study implemented a mixed-method analysis with a one group pre/post-test design to examine the effectiveness of a 7-session culturally adapted ACT group intervention and a descriptive approach was implemented to assess usefulness, relevance and acceptability. Results demonstrated an overall positive effect of the culturally adapted ACT intervention in terms of both symptoms and patient-reported outcomes. Participants showed significant improvements on measures of depression (p = 0.014), anxiety (p = 0.041) and psychological distress (p = 0.003). The magnitude of these changes was categorized as large, with effect sizes from 0.90 to 2.03. Qualitative responses indicated that the group was experienced as enjoyable and useful and was considered to be an accessible and acceptable therapeutic format. Although a pilot within clinical practice, the findings provide preliminary support for the clinical utility of ACT as an effective, culturally acceptable therapeutic approach for Turkish-speaking communities living in an urban UK setting. The study highlights the importance of culturally appropriate service development and a need for further research within this area.
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Hilton LG, Marshall NJ, Motala A, Taylor SL, Miake-Lye IM, Baxi S, Shanman RM, Solloway MR, Beroesand JM, Hempel S. Mindfulness meditation for workplace wellness: An evidence map. Work 2019; 63:205-218. [PMID: 31156202 PMCID: PMC6598008 DOI: 10.3233/wor-192922] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/14/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. OBJECTIVE In support of evidence-based decision making in workplace contexts, we created an evidence map summarizing physical and mental health, cognitive, affective, and interpersonal outcomes from systematic reviews of randomized controlled trials (RCTs) of mindfulness interventions. METHODS We searched nine electronic databases to July 2017, dually-screened all reviews, and consulted topic experts to identify systematic reviews on mindfulness interventions. The distribution of evidence is presented as an evidence map in a bubble plot. RESULTS In total, 175 systematic reviews met inclusion criteria. Reviews included a variety of mindfulness-based interventions. The largest review included 109 randomized controlled trials. The majority of these addressed general health, psychological conditions, chronic illness, pain, and substance use. Twenty-six systematic reviews assessed studies conducted in workplace settings and with healthcare professionals, educators, and caregivers. The evidence map shows the prevalence of research by the primary area of focus. An outline of promising applications of mindfulness interventions is included. CONCLUSIONS The evidence map provides an overview of existing mindfulness research. It shows the body of available evidence to inform policy and organizational decision-making supporting employee wellbeing in work contexts.
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Affiliation(s)
- Lara G. Hilton
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
- Deloitte Consulting LLP, Los Angeles, CA, USA
| | - Nell J. Marshall
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Aneesa Motala
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Stephanie L. Taylor
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Health Policy, UCLA, Los Angeles, CA, USA
| | - Isomi M. Miake-Lye
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Sangita Baxi
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Roberta M. Shanman
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
| | - Michele R. Solloway
- Child and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Jessica M. Beroesand
- Evidence-Based Synthesis Program (ESP) Center, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Susanne Hempel
- Evidence-Based Practice Center (EPC), RAND Corporation, Santa Monica, CA, USA
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104
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The effect of brief mindfulness training on momentary impulsivity. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2018.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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105
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Lucas-Thompson RG, Broderick PC, Coatsworth JD, Smyth JM. New Avenues for Promoting Mindfulness in Adolescence using mHealth. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:131-139. [PMID: 31160875 PMCID: PMC6544044 DOI: 10.1007/s10826-018-1256-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
There is a large evidence base supporting the efficacy of mindfulness interventions in adulthood, and growing support for the efficacy of these interventions in adolescence. Historically mindfulness interventions have been delivered in person and in groups, with recommendations for home practice being a critical part of the intervention. However, compliance with these practice recommendations in adolescence is very poor. Past studies indicate that using mobile technology to promote skill transfer to real life can be an effective strategy, particularly when used as a supplement to an in-person intervention strategy. To date, however, mobile technology has largely been used to create stand-alone mindfulness interventions. The goals of the current paper are to discuss the potential opportunities and challenges with a mobile-technology-enhanced mindfulness intervention, and to present the rationale that such an approach is not only theoretical and empirically sound but also a critical next step to increase the efficacy and developmental appropriateness of mindfulness interventions for adolescents. This discussion is grounded in a specific example of a mindfulness intervention supplemented by momentary interventions we are developing.
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Affiliation(s)
| | | | - J Doug Coatsworth
- Department of Human Development & Family Studies, Colorado State University
| | - Joshua M Smyth
- Biobehavioral Health and Medicine, Pennsylvania State University
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106
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Duprey EB, McKee LG, O'Neal CW, Algoe SB. Stressful life events and internalizing symptoms in emerging adults: The roles of mindfulness and gratitude. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.mhp.2018.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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107
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Vollbehr NK, Bartels-Velthuis AA, Nauta MH, Castelein S, Steenhuis LA, Hoenders HJR, Ostafin BD. Hatha yoga for acute, chronic and/or treatment-resistant mood and anxiety disorders: A systematic review and meta-analysis. PLoS One 2018; 13:e0204925. [PMID: 30273409 PMCID: PMC6166972 DOI: 10.1371/journal.pone.0204925] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 09/17/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The aim of this study was to systematically investigate the effectiveness of hatha yoga in treating acute, chronic and/or treatment-resistant mood and anxiety disorders. METHODS Medline, Cochrane Library, Current Controlled Trials, Clinical Trials.gov, NHR Centre for Reviews and Dissemination, PsycINFO and CINAHL were searched through June 2018. Randomized controlled trials with patients with mood and anxiety disorders were included. Main outcomes were continuous measures of severity of mood and anxiety symptoms. Cohen's d was calculated as a measure of effect size. Meta-analyses using a random effects model was applied to estimate direct comparisons between yoga and control conditions for depression and anxiety outcomes. Publication bias was visually inspected using funnel plots. RESULTS Eighteen studies were found, fourteen in acute patients and four in chronic patients. Most studies were of low quality. For depression outcomes, hatha yoga did not show a significant effect when compared to treatment as usual, an overall effect size of Cohen's d -0.64 (95% CI = -1.41, 0.13) or to all active control groups, Cohen's d -0.13 (95% CI = -0.49, 0.22). A sub-analysis showed that yoga had a significant effect on the reduction of depression compared to psychoeducation control groups, Cohen's d -0.52 (95% CI = -0.96, -0.08) but not to other active control groups, Cohen's d 0.28 (95% CI = -0.07, 0.63) For studies using a follow-up of six months or more, hatha yoga had no effect on the reduction of depression compared to active control groups, Cohen's d -0.14 (95% CI = -0.60, 0.33). Regarding anxiety, hatha yoga had no significant effect when compared to active control groups, Cohen's d -0.09 (95% CI = -0.47, 0.30). The I2 and Q-statistic revealed heterogeneity amongst comparisons. Qualitative analyses suggest some promise of hatha yoga for chronic populations. CONCLUSIONS The ability to draw firm conclusions is limited by the notable heterogeneity and low quality of most of the included studies. With this caveat in mind, the results of the current meta-analysis suggest that hatha yoga does not have effects on acute, chronic and/or treatment-resistant mood and anxiety disorders compared to treatment as usual or active control groups. However, when compared to psychoeducation, hatha yoga showed more reductions in depression. It is clear that more high-quality studies are needed to advance the field.
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Affiliation(s)
- Nina K. Vollbehr
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Agna A. Bartels-Velthuis
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Maaike H. Nauta
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Stynke Castelein
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands
| | - Laura A. Steenhuis
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - H. J. Rogier Hoenders
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands
| | - Brian D. Ostafin
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
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108
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Hedman-Lagerlöf M, Hedman-Lagerlöf E, Öst LG. The empirical support for mindfulness-based interventions for common psychiatric disorders: a systematic review and meta-analysis. Psychol Med 2018; 48:2116-2129. [PMID: 29455695 DOI: 10.1017/s0033291718000259] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Mindfulness-based interventions (MBIs) have become widely used for common mental disorders (CMDs) but the state of the evidence has not been sufficiently investigated. The aims for this study were: (1) to quantify the effect size of MBIs for CMDs in the acute phase; (2) to explore moderator variables; and (3) to evaluate the evidence status of MBIs for the CMDs it has been tried for. A comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted. RCTs that evaluated MBI and included patients with a primary manifest CMD was included. Methodological quality, the risk of bias, publication bias and evidence status were assessed. Literature searches gave 2448 hits and 19 studies were included. MBIs were more effective than no treatment (g = 1.07) and treatment-as-usual (g = 0.40) but not in comparison to placebo (g = 0.17) or other active treatments (g = -0.01). Methodological quality was negatively correlated with outcome. For all psychiatric disorders it has been tested, MBIs were judged to have weak or no empirical support. The conclusion of the study is that the evidence-base for MBIs for CMDs in the acute phase is weak.
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Affiliation(s)
- Maria Hedman-Lagerlöf
- Department of Clinical Neuroscience, Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - Erik Hedman-Lagerlöf
- Department of Clinical Neuroscience, Division of Psychology,Karolinska Institutet,Stockholm,Sweden
| | - Lars-Göran Öst
- Department of Psychology,Stockholm University,Stockholm,Sweden
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109
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Sevilla-Llewellyn-Jones J, Santesteban-Echarri O, Pryor I, McGorry P, Alvarez-Jimenez M. Web-Based Mindfulness Interventions for Mental Health Treatment: Systematic Review and Meta-Analysis. JMIR Ment Health 2018; 5:e10278. [PMID: 30274963 PMCID: PMC6231788 DOI: 10.2196/10278] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Web-based mindfulness interventions are increasingly delivered through the internet to treat mental health conditions. OBJECTIVE The objective of this study was to determine the effectiveness of web-based mindfulness interventions in clinical mental health populations. Secondary aims were to explore the impact of study variables on the effectiveness of web-based mindfulness interventions. METHODS We performed a systematic review and meta-analysis of studies investigating the effects of web-based mindfulness interventions on clinical populations. RESULTS The search strategy yielded 12 eligible studies. Web-based mindfulness interventions were effective in reducing depression in the total clinical sample (n=656 g=-0.609, P=.004) and in the anxiety disorder subgroup (n=313, g=-0.651, P<.001), but not in the depression disorder subgroup (n=251, P=.18). Similarly, web-based mindfulness interventions significantly reduced anxiety in the total clinical sample (n=756, g=-0.433, P=.004) and the anxiety disorder subgroup (n=413, g=-0.719, P<.001), but not in the depression disorder group (n=251, g=-0.213, P=.28). Finally, web-based mindfulness interventions improved quality of life and functioning in the total sample (n=591, g=0.362, P=.02) in the anxiety disorder subgroup (n=370, g=0.550, P=.02) and mindfulness skills in the total clinical sample (n=251, g=0.724, P<.001). CONCLUSIONS Results support the effectiveness of web-based mindfulness interventions in reducing depression and anxiety and in enhancing quality of life and mindfulness skills, particularly in those with clinical anxiety. Results should be interpreted with caution given the high heterogeneity of web-based mindfulness interventions and the low number of studies included.
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Affiliation(s)
- Julia Sevilla-Llewellyn-Jones
- Institute of Psychiatry and Mental Health, Health Research Institute (IdISSC). Hospital Clínico San Carlos, Madrid, Spain.,Mental Health Department, Clinico Virgen de la Victoria Hospital, Málaga, Spain.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Faculty of Psychology, Malaga University, Malaga, Spain
| | - Olga Santesteban-Echarri
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Faculty of Health Sciences, Universidad Internacional de la Rioja (UNIR), Madrid, Spain
| | - Ingrid Pryor
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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110
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Cramer H, Lauche R, Anheyer D, Pilkington K, de Manincor M, Dobos G, Ward L. Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials. Depress Anxiety 2018; 35:830-843. [PMID: 29697885 DOI: 10.1002/da.22762] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/11/2018] [Accepted: 02/17/2018] [Indexed: 12/11/2022] Open
Abstract
Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta-analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0-38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta-analyses revealed evidence for small short-term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = -0.43; 95% confidence interval [CI] = -0.74, -0.11; P = .008), and large effects compared to active comparators (SMD = -0.86; 95% CI = -1.56, -0.15; P = .02). Small effects on depression were found compared to no treatment (SMD = -0.35; 95% CI = -0.66, -0.04; P = .03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety-related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high-quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Karen Pilkington
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, United Kingdom
| | - Michael de Manincor
- National Institute of Complementary Medicine (NICM), Western Sydney University (WSU), Sydney, Australia
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.,Centre for Rehabilitation Research in Oxford (RRIO), Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
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111
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Norris CJ, Creem D, Hendler R, Kober H. Brief Mindfulness Meditation Improves Attention in Novices: Evidence From ERPs and Moderation by Neuroticism. Front Hum Neurosci 2018; 12:315. [PMID: 30127731 PMCID: PMC6088366 DOI: 10.3389/fnhum.2018.00315] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/17/2018] [Indexed: 11/13/2022] Open
Abstract
Past research has found that mindfulness meditation training improves executive attention. Event-related potentials (ERPs) have indicated that this effect could be driven by more efficient allocation of resources on demanding attentional tasks, such as the Flanker Task and the Attention Network Test (ANT). However, it is not clear whether these changes depend on long-term practice. In two studies, we sought to investigate the effects of a brief, 10-min meditation session on attention in novice meditators, compared to a control activity. We also tested moderation by individual differences in neuroticism and the possible underlying neural mechanisms driving these effects, using ERPs. In Study 1, participants randomly assigned to listen to a 10-min meditation tape had better accuracy on incongruent trials on a Flanker task, with no detriment in reaction times (RTs), indicating better allocation of resources. In Study 2, those assigned to listen to a meditation tape performed an ANT more quickly than control participants, with no detriment in performance. Neuroticism moderated both of these effects, and ERPs showed that those individuals lower in neuroticism who meditated for 10 min exhibited a larger N2 to incongruent trials compared to those who listened to a control tape; whereas those individuals higher in neuroticism did not. Together, our results support the hypothesis that even brief meditation improves allocation of attentional resources in some novices.
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Affiliation(s)
- Catherine J Norris
- Department of Psychology, Swarthmore College, Swarthmore, PA, United States
| | - Daniel Creem
- Department of Psychology, Swarthmore College, Swarthmore, PA, United States
| | - Reuben Hendler
- Psychiatry Department, Massachusetts General Hospital, Boston, MA, United States
| | - Hedy Kober
- Department of Psychology, Yale University, New Haven, CT, United States
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112
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Duff W, Haskey N, Potter G, Alcorn J, Hunter P, Fowler S. Non-pharmacological therapies for inflammatory bowel disease: Recommendations for self-care and physician guidance. World J Gastroenterol 2018; 24:3055-3070. [PMID: 30065553 PMCID: PMC6064965 DOI: 10.3748/wjg.v24.i28.3055] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/23/2018] [Accepted: 06/01/2018] [Indexed: 02/06/2023] Open
Abstract
We performed a scoping review on sought-after complementary therapies for patients with inflammatory bowel disease (IBD), specifically diet, physical activity and exercise (PA/E), and psychotherapy. We aim to update patients with IBD on therapies for self-care and provide physicians with guidance on how to direct their patients for the management of IBD. A search of MEDLINE, EMBASE, and PUBMED was completed in Sept 2016. Studies on diet, PA/E, or psychotherapy in patients with IBD were included. Medical Subject Heading terms and Boolean operators were used. The search was limited to full-text English articles describing an adult population. This review included 67 studies: Diet (n = 19); PA/E (n = 19); and psychotherapy (n = 29). We have made the following recommendations: (1) Diet: Consumption of diets rich in vegetables, fruit and soluble fiber may be beneficial in IBD. A trial of a low FODMAP diet can be considered in those patients with functional gastrointestinal symptoms. Restrictive diets are lacking in evidence and should be avoided; (2) PA/E: Regular low-moderate intensity activity, including cardiovascular and resistance exercise, has been shown to improve quality of life (QOL) and may improve inflammation; and (3) psychotherapy: Therapies such as cognitive-behavioural interventions, mindfulness, hypnosis, and stress management have been shown to improve QOL, but evidence is limited on their impact on anxiety, depression, and disease activity. Overall, these complementary therapies are promising and should be used to treat patients with IBD from a more holistic perspective.
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Affiliation(s)
- Whitney Duff
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5B2, Canada
| | - Natasha Haskey
- Irving K Barber School of Arts and Science, University of British Columbia-Okanagan, Kelowna, British Columbia V1V 1V7, Canada
| | - Gillian Potter
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5A5, Canada
| | - Jane Alcorn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E5, Canada
| | - Paulette Hunter
- St Thomas More College, University of Saskatchewan, Saskatoon, SK S7N 0W6, Canada
| | - Sharyle Fowler
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0W8, Canada
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113
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Family Wellness in Intellectual and Developmental Disabilities: a Balanced Approach. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2018. [DOI: 10.1007/s40474-018-0145-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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114
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Proctor BJ, Moghaddam NG, Evangelou N, das Nair R. Telephone-supported acceptance and commitment bibliotherapy for people with multiple sclerosis and psychological distress: A pilot randomised controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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115
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116
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Abstract
Previous research suggests that for people living with chronic pain, pain expectancy can undermine access to adaptive resources and functioning. We tested and replicated the unique effect of pain expectancy on subsequent pain through 2 daily diary studies. We also extended previous findings by examining cognitive and affective antecedents of pain expectancy and the consequences of pain expectancy for daily social enjoyment and stress. In study 1, 231 individuals with rheumatoid arthritis completed 30 end-of-day diaries. Results of multilevel structural equation model showed that controlling for today's pain, pain expectancy predicted next day pain. In study 2, diary assessments of affective, cognitive, and social factors were collected during the morning, afternoon, and evening for 21 days from a sample of 220 individuals with fibromyalgia. Results showed that both positive affect and the extent to which pain interfered with daily activities in the afternoon predicted evening pain expectancy in the expected direction. However, negative affect and pain coping efficacy were not associated with pain expectancy. Consistent with study 1, more than usual evening pain expectancy was related to greater next morning pain. We also found that next morning pain predicted next afternoon social enjoyment but not social stress. The findings of these 2 studies point to the importance of promoting positive affect and reducing pain expectancy as a way of decreasing the detrimental effect of chronic pain on enjoyable social experiences.
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117
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Musey PI, Lee JA, Hall CA, Kline JA. Anxiety about anxiety: a survey of emergency department provider beliefs and practices regarding anxiety-associated low risk chest pain. BMC Emerg Med 2018. [PMID: 29540151 PMCID: PMC5853064 DOI: 10.1186/s12873-018-0161-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Approximately 80% of patients presenting to emergency departments (ED) with chest pain do not have any true cardiopulmonary emergency such as acute coronary syndrome (ACS). However, psychological contributors such as anxiety are thought to be present in up to 58%, but often remain undiagnosed leading to chronic chest pain and ED recidivism. Methods To evaluate ED provider beliefs and their usual practices regarding the approach and disposition of patients with low risk chest pain associated with anxiety, we constructed a 22-item survey using a modified Delphi technique. The survey was administered to a convenience sample of ED providers attending the 2016 American College of Emergency Physicians Scientific Assembly in Las Vegas. Results Surveys were completed by 409 emergency medicine providers from 46 states and 7 countries with a wide range of years of experience and primary practice environment (academic versus community centers). Respondents estimated that 30% of patients presenting to the ED with chest pain thought to be low risk for ACS have anxiety or panic as the primary cause but they directly communicate this belief to only 42% of these patients and provide discharge instructions to 48%. Only 39% of respondents reported adequate hospital resources to ensure follow-up. Community-based providers reported more adequate follow-up for these patients than their academic center colleagues (46% vs. 34%; p = 0.015). Most providers (82%) indicated that they wanted to have referral resources available to a specific clinic for further outpatient evaluation. Conclusion Emergency Department providers believe approximately 30% of patients seeking emergency care for chest pain at low risk for ACS have anxiety as a primary problem, yet fewer than half discuss this concern or provide information to help the patient manage anxiety. This highlights an opportunity for patient centered communication. Electronic supplementary material The online version of this article (10.1186/s12873-018-0161-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - John A Lee
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.,University of Virginia School of Medicine, Charlottesville, Virginia, 22908, USA
| | - Cassandra A Hall
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Jeffrey A Kline
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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Economides M, Martman J, Bell MJ, Sanderson B. Improvements in Stress, Affect, and Irritability Following Brief Use of a Mindfulness-based Smartphone App: A Randomized Controlled Trial. Mindfulness (N Y) 2018; 9:1584-1593. [PMID: 30294390 PMCID: PMC6153897 DOI: 10.1007/s12671-018-0905-4] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Mindfulness training, which involves observing thoughts and feelings without judgment or reaction, has been shown to improve aspects of psychosocial well-being when delivered via in-person training programs such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). Less is known about the efficacy of digital training mediums, such as smartphone apps, which are rapidly rising in popularity. In this study, novice meditators were randomly allocated to an introductory mindfulness meditation program or to a psychoeducational audiobook control featuring an introduction to the concepts of mindfulness and meditation. The interventions were delivered via the same mindfulness app, were matched across a range of criteria, and were presented to participants as well-being programs. Affect, irritability, and two distinct components of stress were measured immediately before and after each intervention in a cohort of healthy adults. While both interventions were effective at reducing stress associated with personal vulnerability, only the mindfulness intervention had a significant positive impact on irritability, affect, and stress resulting from external pressure (between group Cohen's d = 0.44, 0.47, 0.45, respectively). These results suggest that brief mindfulness training has a beneficial impact on several aspects of psychosocial well-being, and that smartphone apps are an effective delivery medium for mindfulness training.
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Affiliation(s)
- Marcos Economides
- Headspace Inc, 2415 Michigan Avenue, Santa Monica, Los Angeles, CA 90404 USA
| | - Janis Martman
- Headspace Inc, 2415 Michigan Avenue, Santa Monica, Los Angeles, CA 90404 USA
| | - Megan J. Bell
- Headspace Inc, 2415 Michigan Avenue, Santa Monica, Los Angeles, CA 90404 USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA 94305 USA
| | - Brad Sanderson
- Headspace Inc, 2415 Michigan Avenue, Santa Monica, Los Angeles, CA 90404 USA
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119
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Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S, Abdulmalik J, Aguilar-Gaxiola S, Al-Hamzawi A, Andrade LH, Bruffaerts R, Cardoso G, Cia A, Florescu S, de Girolamo G, Gureje O, Haro JM, He Y, de Jonge P, Karam EG, Kawakami N, Kovess-Masfety V, Lee S, Levinson D, Medina-Mora ME, Navarro-Mateu F, Pennell BE, Piazza M, Posada-Villa J, Have MT, Zarkov Z, Kessler RC, Thornicroft G. Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries. Depress Anxiety 2018; 35:195-208. [PMID: 29356216 PMCID: PMC6008788 DOI: 10.1002/da.22711] [Citation(s) in RCA: 247] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 11/20/2017] [Accepted: 11/25/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anxiety disorders are a major cause of burden of disease. Treatment gaps have been described, but a worldwide evaluation is lacking. We estimated, among individuals with a 12-month DSM-IV (where DSM is Diagnostic Statistical Manual) anxiety disorder in 21 countries, the proportion who (i) perceived a need for treatment; (ii) received any treatment; and (iii) received possibly adequate treatment. METHODS Data from 23 community surveys in 21 countries of the World Mental Health (WMH) surveys. DSM-IV mental disorders were assessed (WHO Composite International Diagnostic Interview, CIDI 3.0). DSM-IV included posttraumatic stress disorder among anxiety disorders, while it is not considered so in the DSM-5. We asked if, in the previous 12 months, respondents felt they needed professional treatment and if they obtained professional treatment (specialized/general medical, complementary alternative medical, or nonmedical professional) for "problems with emotions, nerves, mental health, or use of alcohol or drugs." Possibly adequate treatment was defined as receiving pharmacotherapy (1+ months of medication and 4+ visits to a medical doctor) or psychotherapy, complementary alternative medicine or nonmedical care (8+ visits). RESULTS Of 51,547 respondents (response = 71.3%), 9.8% had a 12-month DSM-IV anxiety disorder, 27.6% of whom received any treatment, and only 9.8% received possibly adequate treatment. Of those with 12-month anxiety only 41.3% perceived a need for care. Lower treatment levels were found for lower income countries. CONCLUSIONS Low levels of service use and a high proportion of those receiving services not meeting adequacy standards for anxiety disorders exist worldwide. Results suggest the need for improving recognition of anxiety disorders and the quality of treatment.
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Affiliation(s)
- Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Zhaorui Liu
- Institute of Mental Health, Peking University, Beijing, China
| | - Sara Evans-Lacko
- Kings College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom,PSSRU, London School of Economics and Political Science, London, United Kingdom
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Somnath Chatterji
- Department of Information, Evidence and Research,World Health Organization, Geneva, Switzerland
| | - Jibril Abdulmalik
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
| | - Laura Helena Andrade
- Section of Psychiatric Epidemiology - LIM 23, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Graça Cardoso
- Department of Mental Health, Faculdades de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Alfredo Cia
- Anxiety Disorders Center, Buenos Aires, Argentina
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS-St. John of God Clinical Research Centre, Brescia, Italy
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Yanling He
- Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, Netherlands,Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon,Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Norito Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Daphna Levinson
- Mental Health Services, Ministry of Health, Jerusalem, Israel
| | | | - Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - Beth-Ellen Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Marina Piazza
- Universidad Cayetano Heredia, Lima, Peru; National Institute of Health, Lima, Peru
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Margreet ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Zahari Zarkov
- Directorate of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Graham Thornicroft
- Kings College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
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Cavanagh K, Churchard A, O'Hanlon P, Mundy T, Votolato P, Jones F, Gu J, Strauss C. A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention in a Non-clinical Population: Replication and Extension. Mindfulness (N Y) 2018; 9:1191-1205. [PMID: 30100934 PMCID: PMC6061247 DOI: 10.1007/s12671-017-0856-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Building on previous research, this study compared the effects of two brief, online mindfulness-based interventions (MBIs; with and without formal meditation practice) and a no intervention control group in a non-clinical sample. One hundred and fifty-five university staff and students were randomly allocated to a 2-week, self-guided, online MBI with or without mindfulness meditation practice, or a wait list control. Measures of mindfulness, perceived stress, perseverative thinking and anxiety/depression symptoms within were administered before and after the intervention period. Intention to treat analysis identified significant differences between groups on change over time for all measured outcomes. Participation in the MBIs was associated with significant improvements in all measured domains (all ps < 0.05), with effect sizes in the small to medium range (0.25 to 0.37, 95% CIs 0.11 to 0.56). No significant changes on these measures were found for the control group. Change in perseverative thinking was found to mediate the relationship between condition and improvement on perceived stress and anxiety/depression symptom outcomes. Contrary to our hypotheses, no differences between the intervention conditions were found. Limitations of the study included reliance on self-report data, a relatively high attrition rate and absence of a longer-term follow-up. This study provides evidence in support of the feasibility and effectiveness of brief, self-guided MBIs in a non-clinical population and suggests that reduced perseverative thinking may be a mechanism of change. Our findings provide preliminary evidence for the effectiveness of a mindfulness psychoeducation condition, without an invitation to formal mindfulness meditation practice. Further research is needed to confirm and better understand these results and to test the potential of such interventions.
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Affiliation(s)
- Kate Cavanagh
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Alasdair Churchard
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Puffin O'Hanlon
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Thomas Mundy
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Phoebe Votolato
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Fergal Jones
- 2Sussex Partnership NHS Foundation Trust, Hove, BN3 7HZ UK.,3School of Psychology, Politics and Sociology, Canterbury Christ Church University, Kent, UK
| | - Jenny Gu
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Clara Strauss
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK.,2Sussex Partnership NHS Foundation Trust, Hove, BN3 7HZ UK
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121
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Upper secondary school students' compliance with two Internet-based self-help programmes: a randomised controlled trial. Eur Child Adolesc Psychiatry 2018; 27:191-200. [PMID: 28776094 PMCID: PMC5842245 DOI: 10.1007/s00787-017-1035-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 11/05/2022]
Abstract
Psychiatric symptoms and stress are on the increase among Swedish adolescents. We aimed to study the potential effect and feasibility of two Internet-based self-help programmes, one mindfulness based (iMBI) and the other music based in a randomised controlled trial that targeted adolescents. A total of 283 upper secondary school students in two Swedish schools were randomised to either a waiting list or one of the two programmes, on their own incentive, on schooltime. General psychiatric health (Symptoms Checklist 90), sleep quality (Pittsburgh Sleep Quality Index), and perceived stress (Perceived Stress Scale) were assessed before and after the interventions. In total, 202 participants answered the questionnaires. Less than 20 logged into each intervention and only 1 performed a full intervention (iMBI). No significant differences in any of the scales were found between those who logged in and those who did not. The potential effect of Internet-based self-help programmes was not possible to examine due to low compliance rates. Adolescents seem to have a very low compliance with Internet-based self-help programmes if left to their own incentive. There were no associations between the psychiatric and stress-related symptoms at baseline and compliance in any of the intervention groups, and no evidence for differences in compliance in relation to the type of programme. Additional studies are needed to examine how compliance rates can be increased in Internet-based self-help mindfulness programmes in adolescents, as the potentially positive effects of mindfulness are partly related to compliance rates.
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122
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Christoforou M, Sáez Fonseca JA, Tsakanikos E. Two Novel Cognitive Behavioral Therapy-Based Mobile Apps for Agoraphobia: Randomized Controlled Trial. J Med Internet Res 2017; 19:e398. [PMID: 29175809 PMCID: PMC5722980 DOI: 10.2196/jmir.7747] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/09/2017] [Accepted: 09/27/2017] [Indexed: 01/04/2023] Open
Abstract
Background Despite the large body of literature demonstrating the effectiveness of cognitive behavioral treatments for agoraphobia, many patients remain untreated because of various barriers to treatment. Web-based and mobile-based interventions targeting agoraphobia may provide a solution to this problem, but there is a lack of research investigating the efficacy of such interventions. Objective The objective of our study was to evaluate for the first time the effectiveness of a self-guided mobile-based intervention primarily targeting agoraphobic symptoms, with respect to a generic mobile app targeting anxiety. Methods A Web-based randomized controlled trial (RCT) compared a novel mobile app designed to target agoraphobia (called Agoraphobia Free) with a mobile app designed to help with symptoms of anxiety in general (called Stress Free). Both interventions were based on established cognitive behavioral principles. We recruited participants (N=170) who self-identified as having agoraphobia and assessed them online at baseline, midpoint, and end point (posttreatment) over a period of 12 weeks. The primary outcome was symptom severity measured by the Panic and Agoraphobia Scale. Results Both groups had statistically significant improvements in symptom severity over time (difference –5.97, 95% CI –8.49 to –3.44, P<.001 for Agoraphobia Free and –6.35, 95% CI –8.82 to –3.87, P<.001 for Stress Free), but there were no significant between-group differences on the primary outcome (difference 0.38, 95% CI –1.96 to 3.20, P=.64). Conclusions This is, to our knowledge, the first RCT to provide evidence that people who identify as having agoraphobia may equally benefit from a diagnosis-specific and a transdiagnostic mobile-based intervention. We also discuss clinical and research implications for the development and dissemination of mobile mental health apps. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 98453199; http://www.isrctn.com /ISRCTN98453199 (Archived by WebCite at http://www.webcitation.org/6uR5vsdZw)
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Affiliation(s)
| | - José Andrés Sáez Fonseca
- Division of Psychiatry, University College London, London, United Kingdom.,Department of Psychology, University of Roehampton, London, United Kingdom
| | - Elias Tsakanikos
- Department of Psychology, University of Roehampton, London, United Kingdom
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123
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Schoenberg PLA, Ruf A, Churchill J, Brown DP, Brewer JA. Mapping complex mind states: EEG neural substrates of meditative unified compassionate awareness. Conscious Cogn 2017; 57:41-53. [PMID: 29169033 DOI: 10.1016/j.concog.2017.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 12/30/2022]
Abstract
Specific mental training cultivates diminished self-reference, encompassing non-duality, emptiness, awakened-awareness, and compassionate experiences. We aimed to elucidate the neural substrates of four distinct, interdependent Essence-of-Mind states: (1) timelessness, (2) non-preference, non-duality, non-conceptualization, (3) the view of luminosity and limitlessness, (4) unified compassionate experience of oneness (stable awakened-awareness). EEG data were collected from 30 advanced meditators concomitant to eyes-open/eyes-closed resting baseline, followed by 60-min of instructed practice. Alpha, beta, and gamma, frequency-spatial EEG-dimensions were analyzed. The results revealed that compared to baseline, current density across frequencies significantly decreased upon meditation onset in self-referential, and executive-control regions. During meditation, gamma-band current density significantly increased from state-1 compared to state-4, within the ACC, precuneus, and superior parietal lobule, whereas beta-band activity increased within the insula. These findings suggest a dissociation between brain regions regulating self-referential vs. executive-control processing, during non-dual, compassionate states, characterized by brilliantly awake awareness, free from conceptual thought and "doing".
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Affiliation(s)
- Poppy L A Schoenberg
- University of Massachusetts Medical School, Center for Mindfulness, Department of Medicine, Division of Preventive and Behavioral Medicine, Shrewsbury, MA, USA; Vanderbilt University Medical Center, Osher Center for Integrative Medicine, Nashville, TN, USA.
| | - Andrea Ruf
- University of Massachusetts Medical School, Center for Mindfulness, Department of Medicine, Division of Preventive and Behavioral Medicine, Shrewsbury, MA, USA
| | - John Churchill
- William James College, Department of Clinical Psychology, Newton, MA, USA
| | - Daniel P Brown
- Harvard Medical School, Beth Israel-Deaconess Medical Center, Department of Psychiatry, Boston, MA, USA
| | - Judson A Brewer
- University of Massachusetts Medical School, Center for Mindfulness, Department of Medicine, Division of Preventive and Behavioral Medicine, Shrewsbury, MA, USA
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124
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Chen YF, Huang XY, Chien CH, Cheng JF. The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety. Perspect Psychiatr Care 2017; 53:329-336. [PMID: 27553981 DOI: 10.1111/ppc.12184] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 07/17/2016] [Accepted: 07/25/2016] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To evaluate the effectiveness on reducing anxiety of a diaphragmatic breathing relaxation (DBR) training program. DESIGN AND METHODS This experimental, pre-test-post-test randomized controlled trial with repeated measures collected data using the Beck Anxiety Inventory and biofeedback tests for skin conductivity, peripheral blood flow, heart rate, and breathing rate. FINDINGS The experimental group achieved significant reductions in Beck Anxiety Inventory scores (p < .05), peripheral temperature (p = .026), heart rate (p = .005), and breathing rate (p = .004) over the 8-week training period. The experimental group further achieved a significant reduction in breathing rate (p < .001). PRACTICE IMPLICATIONS The findings provide guidance for providing quality care that effectively reduces the anxiety level of care recipients in clinical and community settings.
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Affiliation(s)
- Yu-Fen Chen
- Nurse, Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Xuan-Yi Huang
- Professor, Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Ching-Hui Chien
- Assistant Professor, Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Jui-Fen Cheng
- Assistant Professor, Department of Nursing, China Medical University and Hospital, Taichung, Taiwan, ROC
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125
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Stephenson KR, Kerth J. Effects of Mindfulness-Based Therapies for Female Sexual Dysfunction: A Meta-Analytic Review. JOURNAL OF SEX RESEARCH 2017; 54:832-849. [PMID: 28617103 DOI: 10.1080/00224499.2017.1331199] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Mindfulness-based therapy (MBT) represents a potentially efficacious treatment for female sexual dysfunction (FSD). A number of recent trials assessing MBT for FSD have been published, but we are aware of no existing meta-analysis synthesizing these results. We conducted a literature review to identify all published trials of MBT for FSD. References of retrieved studies were searched and key authors were contacted with requests for complete but unpublished trials. Eleven trials, including a total of 449 participants, were identified. Two of these studies were under review at the time of the current analyses. Four trials utilized wait-list controls. All aspects of sexual function and subjective sexual well-being exhibited significant improvement during MBT, with effect sizes generally moderate. Controlled effect sizes versus wait list were of similar magnitude in most cases; however, they did not reach statistical significance for multiple outcome measures. Results for some outcomes were consistent with possible publication bias. For some outcomes, larger effect sizes tended to be reported in studies requiring participants to be in a romantic relationship or studies providing individual (versus group) therapy. MBT may be an efficacious intervention for FSD. However, important limitations of the current literature and future directions for research are discussed.
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126
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Abstract
Approximately 18% of the US adult population has a mental illness, yet only 13% with mental illness receive any treatment. Although pharmacotherapy and psychotherapy are the mainstays of treatment, treatment discontinuation and failure are common. Skepticism toward such treatments has fueled interest in and use of complementary therapies, such as acupuncture, meditation, and natural products. Many medical providers are unaware of the use of these therapies by their patients, and knowledge of the evidence base for these therapies is often lacking. This article presents current evidence-based recommendations for complementary therapies in the treatment of depression, anxiety, and posttraumatic stress disorder.
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Affiliation(s)
- Gary N Asher
- Department of Family Medicine, University of North Carolina, 590 Manning Drive, CB# 7595, Chapel Hill, NC 27599-7595, USA.
| | - Jonathan Gerkin
- Department of Psychiatry, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27759, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27759, USA
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127
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Waters CS, Frude N, Flaxman PE, Boyd J. Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist-controlled evaluation of an ACT workshop in a routine practice setting. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2017; 57:82-98. [PMID: 28857254 DOI: 10.1111/bjc.12155] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/30/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To examine the effects of a 1-day acceptance and commitment therapy (ACT) workshop on the mental health of clinically distressed health care employees, and to explore ACT's processes of change in a routine practice setting. DESIGN A quasi-controlled design, with participants block allocated to an ACT intervention or waiting list control group based on self-referral date. METHODS Participants were 35 health care workers who had self-referred for the ACT workshop via a clinical support service for staff. Measures were completed by ACT and control group participants at pre-intervention and 3 months post-intervention. Participants allocated to the waitlist condition went on to receive the ACT intervention and were also assessed 3 months later. RESULTS At 3 months post-intervention, participants in the ACT group reported a significantly lower level of psychological distress compared to the control group (d = 1.41). Across the 3-month evaluation period, clinically significant change was exhibited by 50% of ACT participants, compared to 0% in the control group. When the control group received the same ACT intervention, 69% went on to exhibit clinically significant change. The ACT intervention also resulted in significant improvements in psychological flexibility, defusion, and mindfulness skills, but did not significantly reduce the frequency of negative cognitions. Bootstrapped mediation analyses indicated that the reduction in distress in the ACT condition was primarily associated with an increase in mindfulness skills, especially observing and non-reactivity. CONCLUSIONS These findings provide preliminary support for providing brief ACT interventions as part of routine clinical support services for distressed workers. PRACTITIONER POINTS A 1-day ACT workshop delivered in the context of a routine staff support service was effective for reducing psychological distress among health care workers. The brief nature of this group intervention means it may be particularly suitable for staff support and primary care mental health service settings. The findings indicate that the beneficial effects of an ACT workshop on distressed employees' mental health were linked to improvements in specific mindfulness skills. Study limitations include non-random allocation of participants to the ACT and control groups, and measurement of mediators and outcome at the same time point (3 months post-intervention).
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Affiliation(s)
- Cerith S Waters
- School of Psychology, Cardiff University, Wales, UK.,Psychology and Counselling, Whitchurch Hospital, Cardiff University, Wales, UK
| | - Neil Frude
- School of Psychology, Cardiff University, Wales, UK.,Psychology and Counselling, Whitchurch Hospital, Cardiff University, Wales, UK
| | | | - Jane Boyd
- Psychology and Counselling, Whitchurch Hospital, Cardiff University, Wales, UK
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128
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Gawrysiak MJ, Grassetti SN, Greeson JM, Shorey RC, Pohlig R, Baime MJ. The many facets of mindfulness and the prediction of change following mindfulness-based stress reduction (MBSR). J Clin Psychol 2017; 74:523-535. [PMID: 28815600 DOI: 10.1002/jclp.22521] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 06/06/2017] [Accepted: 06/28/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Mindfulness-based stress reduction (MBSR) promotes numerous psychological benefits, but few studies have identified for whom MBSR is most effective. The current study tested the hypothesis that lower baseline mindfulness invites more "room to grow" and, thus, predicts greater improvement during MBSR. METHOD We examined three facets of mindfulness (awareness, acceptance, decentering) among 131 MBSR participants prior to enrollment, to test the hypothesis that lower baseline mindfulness predicts greater improvements in perceived stress, positive affect (PA), and negative affect (NA) following MBSR. RESULTS Lower acceptance and decentering predicted greater decreases in perceived stress. Higher awareness, acceptance, and decentering predicted greater increases in PA. Higher awareness predicted greater reductions in NA. Lower decentering predicted greater reductions in NA. CONCLUSION Findings partly supported the hypothesis that lower baseline mindfulness predicts greater improvement following MBSR and emphasize the importance of assessing multiple mindfulness facets given their unique, contrasting relations to outcomes.
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129
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Firth J, Torous J, Nicholas J, Carney R, Rosenbaum S, Sarris J. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J Affect Disord 2017; 218:15-22. [PMID: 28456072 DOI: 10.1016/j.jad.2017.04.046] [Citation(s) in RCA: 350] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/06/2017] [Accepted: 04/23/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Various psychological interventions are effective for reducing symptoms of anxiety when used alone, or as an adjunct to anti-anxiety medications. Recent studies have further indicated that smartphone-supported psychological interventions may also reduce anxiety, although the role of mobile devices in the treatment and management of anxiety disorders has yet to be established. METHODS We conducted a systematic review and meta-analysis of all randomized clinical trials (RCTs) reporting the effects of psychological interventions delivered via smartphone on symptoms of anxiety (sub-clinical or diagnosed anxiety disorders). A systematic search of major electronic databases conducted in November 2016 identified 9 eligible RCTs, with 1837 participants. Random-effects meta-analyses were used to calculate the standardized mean difference (as Hedges' g) between smartphone interventions and control conditions. RESULTS Significantly greater reductions in total anxiety scores were observed from smartphone interventions than control conditions (g=0.325, 95% C.I.=0.17-0.48, p<0.01), with no evidence of publication bias. Effect sizes from smartphone interventions were significantly greater when compared to waitlist/inactive controls (g=0.45, 95% C.I.=0.30-0.61, p<0.01) than active control conditions (g=0.19, 95% C.I.=0.07-0.31, p=0.003). LIMITATIONS The extent to which smartphone interventions can match (or exceed) the efficacy of recognised treatments for anxiety has yet to established. CONCLUSIONS This meta-analysis shows that psychological interventions delivered via smartphone devices can reduce anxiety. Future research should aim to develop pragmatic methods for implementing smartphone-based support for people with anxiety, while also comparing the efficacy of these interventions to standard face-to-face psychological care.
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Affiliation(s)
- Joseph Firth
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK.
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Canter, Harvard Medical School, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Jennifer Nicholas
- Black Dog Institute, UNSW Australia, Australia; School of Psychiatry, Faculty of Medicine, UNSW Australia, Australia
| | - Rebekah Carney
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Simon Rosenbaum
- Black Dog Institute, UNSW Australia, Australia; School of Psychiatry, Faculty of Medicine, UNSW Australia, Australia
| | - Jerome Sarris
- Department of Psychiatry, University of Melbourne, The Melbourne Clinic, Melbourne, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia; NICM, School of Science and Health, University of Western Sydney, Australia
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130
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Kerrigan D, Chau V, King M, Holman E, Joffe A, Sibinga E. There Is No Performance, There Is Just This Moment: The Role of Mindfulness Instruction in Promoting Health and Well-Being Among Students at a Highly-Ranked University in the United States. J Evid Based Complementary Altern Med 2017; 22:909-918. [PMID: 28762289 PMCID: PMC5871302 DOI: 10.1177/2156587217719787] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Mindfulness-based stress reduction (MBSR) has been shown to improve health outcomes across populations. We explored the feasibility, acceptability, and initial effects of a pilot MBSR program at a highly-ranked university in the United States. We conducted 23 in-depth interviews with 13 students. Interviews explored stressors and coping mechanisms, experiences with MBSR, and its reported impact and potential future use. Interviews were analyzed using thematic content and narrative analyses. Results indicated that students are exposed to a very high level of constant stress related to the sheer amount of work and activities that they have and the pervasive surrounding university culture of perfectionism. MBSR offered an opportunity to step back and gain perspective on issues of balance and priorities and provided concrete techniques to counter the effects of stressors. We conclude that MBSR and mindfulness programs may contribute to more supportive university learning environments and greater health and well-being among students.
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Affiliation(s)
- Deanna Kerrigan
- 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Victoria Chau
- 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa King
- 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily Holman
- 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alain Joffe
- 2 The Johns Hopkins University, Baltimore, MD, USA
| | - Erica Sibinga
- 3 The Johns Hopkins School of Medicine, Baltimore, MD, USA
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131
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Burckhardt R, Manicavasagar V, Batterham PJ, Hadzi-Pavlovic D, Shand F. Acceptance and commitment therapy universal prevention program for adolescents: a feasibility study. Child Adolesc Psychiatry Ment Health 2017; 11:27. [PMID: 28559924 PMCID: PMC5445489 DOI: 10.1186/s13034-017-0164-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 05/16/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is a need to prevent anxiety and depression in young people and mindfulness contains important emotion regulation strategies. Acceptance and commitment therapy (ACT), a mindfulness-based therapy, has yet to be evaluated as a prevention program, but has demonstrated an ability to reduce symptoms of anxiety and depression in adult and adolescent populations. This study examines the feasibility of using an ACT-based prevention program in a sample of year 10 (aged 14-16 years) high school students from Sydney, Australia. METHODS Participants were allocated to either their usual classes or to the ACT-based intervention. Participants were followed for a period of 5 months post-intervention and completed the Flourishing Scale, Depression Anxiety Stress Scale, and a program evaluation questionnaire. Analyses were completed using intention-to-treat mixed models for repeated measures. RESULTS The results indicated that the intervention was acceptable to students and feasible to administer in a school setting. There were no statistically significant differences between the conditions, likely due to the small sample size (N = 48). However, between-group effect sizes demonstrated small to large differences for baseline to post-intervention mean scores and medium to large differences for baseline to follow-up mean scores, all favouring the ACT-based condition. CONCLUSION The results suggest that an ACT-based school program has potential as a universal prevention program and merits further investigation in a larger trial. Trial registration Australian New Zealand Clinical Trials Registry. Trial ID: ACTRN12616001383459. Registered 06/10/2016. Retrospectively registered.
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Affiliation(s)
- Rowan Burckhardt
- School of Psychiatry at the University of NSW, Randwick, Australia
- The Black Dog Institute, Hospital Rd, Randwick, NSW 2031 Australia
| | - Vijaya Manicavasagar
- School of Psychiatry at the University of NSW, Randwick, Australia
- The Black Dog Institute, Hospital Rd, Randwick, NSW 2031 Australia
| | - Philip J. Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | | | - Fiona Shand
- School of Psychiatry at the University of NSW, Randwick, Australia
- The Black Dog Institute, Hospital Rd, Randwick, NSW 2031 Australia
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132
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Smith KE, Norman GJ. Brief relaxation training is not sufficient to alter tolerance to experimental pain in novices. PLoS One 2017; 12:e0177228. [PMID: 28493923 PMCID: PMC5426711 DOI: 10.1371/journal.pone.0177228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/24/2017] [Indexed: 11/23/2022] Open
Abstract
Relaxation techniques, such as deep breathing and muscle relaxation, are aspects common to most forms of mindfulness training. There is now an abundance of research demonstrating that mindfulness training has beneficial effects across a wide range of clinical conditions, making it an important tool for clinical intervention. One area of extensive research is on the beneficial effects of mindfulness on experiences of pain. However, the mechanisms of these effects are still not well understood. One hypothesis is that the relaxation components of mindfulness training, through alterations in breathing and muscle tension, leads to changes in parasympathetic and sympathetic nervous system functioning which influences pain circuits. The current study seeks to examine how two of the relaxation subcomponents of mindfulness training, deep breathing and muscle relaxation, influence experiences of pain in healthy individuals. Participants were randomized to either a 10 minute deep breathing, progressive muscle relaxation, or control condition after which they were exposed to a cold pain task. Throughout the experiment, measures of parasympathetic and sympathetic nervous system activity were collected to assess how deep breathing and progressive muscle relaxation alter physiological responses, and if these changes moderate any effects of these interventions on responses to pain. There were no differences in participants’ pain tolerances or self-reported pain ratings during the cold pain task or in participants’ physiological responses to the task. Additionally, individual differences in physiological functioning were not related to differences in pain tolerance or pain ratings. Overall this study suggests that the mechanisms through which mindfulness exerts its effects on pain are more complex than merely through physiological changes brought about by altering breathing or muscle tension. This indicates a need for more research examining the specific subcomponents of mindfulness, and how these subcomponents might be acting, to better understand their utility as a clinical treatment.
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Affiliation(s)
- Karen E. Smith
- Department of Psychology, Integrative Neuroscience Area, University of Chicago, Chicago, Illinois, United States of America
- * E-mail:
| | - Greg J. Norman
- Department of Psychology, Integrative Neuroscience Area, University of Chicago, Chicago, Illinois, United States of America
- Grossman Institute for Neuroscience, University of Chicago, Chicago, Illinois, United States of America
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133
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Abstract
Anxiety disorders constitute the largest group of mental disorders in most western societies and are a leading cause of disability. The essential features of anxiety disorders are excessive and enduring fear, anxiety or avoidance of perceived threats, and can also include panic attacks. Although the neurobiology of individual anxiety disorders is largely unknown, some generalizations have been identified for most disorders, such as alterations in the limbic system, dysfunction of the hypothalamic-pituitary-adrenal axis and genetic factors. In addition, general risk factors for anxiety disorders include female sex and a family history of anxiety, although disorder-specific risk factors have also been identified. The diagnostic criteria for anxiety disorders varies for the individual disorders, but are generally similar across the two most common classification systems: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, Tenth Edition (ICD-10). Despite their public health significance, the vast majority of anxiety disorders remain undetected and untreated by health care systems, even in economically advanced countries. If untreated, these disorders are usually chronic with waxing and waning symptoms. Impairments associated with anxiety disorders range from limitations in role functioning to severe disabilities, such as the patient being unable to leave their home.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California Los Angeles, 405 Hilgard Avenue, Los Angeles, California 90095, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Thalia C Eley
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mohammed R Milad
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Charleston, Massachusetts, USA
| | - Andrew Holmes
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland, USA
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Faculty of Science, Technische Universitaet Dresden, Dresden, Germany
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134
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Chiesa A, Fazia T, Bernardinelli L, Morandi G. Citation patterns and trends of systematic reviews about mindfulness. Complement Ther Clin Pract 2017; 28:26-37. [PMID: 28779934 DOI: 10.1016/j.ctcp.2017.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/22/2017] [Accepted: 04/27/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES We performed a citation analysis of the literature about mindfulness aimed at describing the most significant topics and the impact of more relevant papers. METHODS We classified 128 systematic reviews about mindfulness-based intervention retrieved in Scopus according to their object, the population included and the type of mindfulness proposed. The citation counting was reported. The cumulative citation numbers per chronological years and article life were analyzed thorough a linear regression model. RESULTS 1) We observed a general increase in the number of reviews published from 2003 to 2016; 2) two reviews collected the 33% of the overall citations; 3) citation counting for clinical and mixed population collected the 90% of total citations; 4) clinical reviews had higher cumulative citation per publication/year growth. CONCLUSIONS As mindfulness research advances, higher attention should be given to the mechanisms by which mindfulness interventions work so as to provide fruitful insights for future research.
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Affiliation(s)
- Alberto Chiesa
- Istituto Mente e Corpo, Bologna, Italy; Associazione di Psicologia Cognitiva - Scuola di Psicoterapia Cognitiva, Roma, Italy
| | - Teresa Fazia
- Department of Brain and Behavioral Science, Medical and Genomic Statistics Unit, University of Pavia, Italy
| | - Luisa Bernardinelli
- Department of Brain and Behavioral Science, Medical and Genomic Statistics Unit, University of Pavia, Italy
| | - Gabriella Morandi
- Department of Brain and Behavioral Science, Medical and Genomic Statistics Unit, University of Pavia, Italy.
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135
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Smith ORF, Melkevik O, Samdal O, Larsen TM, Haug E. Psychometric properties of the five-item version of the Mindful Awareness Attention Scale (MAAS) in Norwegian adolescents. Scand J Public Health 2017; 45:373-380. [PMID: 28382831 DOI: 10.1177/1403494817699321] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the present study was to examine the factor structure, model-based reliability, measurement invariance and concurrent validity of the five-item version of the Mindfulness Attention Awareness Scale (MAAS) in Norwegian adolescents. METHODS An initial pilot study was carried out using a sample of 77 fifteen year olds. For the main analyses, a sample of 2140 Norwegian adolescents was used who participated in the cross-sectional Health Behaviour in School-Aged Children (HBSC) study. All participants were asked to complete a questionnaire. RESULTS Confirmatory factor analyses found support for the one-factor structure of the five-item version of the MAAS. Acceptable model fit was found in both the pilot sample (χ2=6.48, df=5, p=0.26; root mean square error of approximation [RMSEA]=0.06; comparative fit index [CFI]=0.99; standardised root mean square residual [SRMR]=0.03) and the HBSC sample (χ2=27.1, df=4, p<0.001; RMSEA=0.05; CFI=0.99; SRMR=0.01). The model-based reliability of the scale was good (ω=0.84 and ω=0.81, respectively). Scalar measurement invariance was established for sex, age and material affluence. Finally, the five-item MAAS displayed concurrent validity through moderate negative associations with health complaints ( r=-0.44; p<0.001) and school stress ( b=-0.44, p<0.001), and a positive moderate correlation with life satisfaction ( r=0.26; p<0.001). CONCLUSIONS The five-item version of the MAAS is an adequate measure of mindfulness in Norwegian adolescents. Due to the brief nature of the scale, it can easily be included in epidemiological and clinical studies with an interest for trait mindfulness. The five-item MAAS may therefore have great potential to facilitate more knowledge about the role of mindfulness in adolescent health.
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Affiliation(s)
- Otto R F Smith
- 1 Department of Health Promotion, Norwegian Institute of Public Health, Norway.,2 Department of Psychosocial Science, University of Bergen, Norway
| | - Ole Melkevik
- 3 National Research Centre for the Working Environment, Denmark
| | - Oddrun Samdal
- 4 Department of Health Promotion and Development, Faculty of Psychology; University of Bergen, Norway
| | - Torill M Larsen
- 4 Department of Health Promotion and Development, Faculty of Psychology; University of Bergen, Norway
| | - Ellen Haug
- 4 Department of Health Promotion and Development, Faculty of Psychology; University of Bergen, Norway.,5 NLA University College, Norway
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136
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Heber E, Ebert DD, Lehr D, Cuijpers P, Berking M, Nobis S, Riper H. The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis. J Med Internet Res 2017; 19:e32. [PMID: 28213341 PMCID: PMC5336602 DOI: 10.2196/jmir.5774] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 11/15/2016] [Accepted: 11/23/2016] [Indexed: 01/17/2023] Open
Abstract
Background Stress has been identified as one of the major public health issues in this century. New technologies offer opportunities to provide effective psychological interventions on a large scale. Objective The aim of this study is to investigate the efficacy of Web- and computer-based stress-management interventions in adults relative to a control group. Methods A meta-analysis was performed, including 26 comparisons (n=4226). Cohen d was calculated for the primary outcome level of stress to determine the difference between the intervention and control groups at posttest. Analyses of the effect on depression, anxiety, and stress in the following subgroups were also conducted: risk of bias, theoretical basis, guidance, and length of the intervention. Available follow-up data (1-3 months, 4-6 months) were assessed for the primary outcome stress. Results The overall mean effect size for stress at posttest was Cohen d=0.43 (95% CI 0.31-0.54). Significant, small effects were found for depression (Cohen d=0.34, 95% CI 0.21-0.48) and anxiety (Cohen d=0.32, 95% CI 0.17-0.47). Subgroup analyses revealed that guided interventions (Cohen d=0.64, 95% CI 0.50-0.79) were more effective than unguided interventions (Cohen d=0.33, 95% CI 0.20-0.46; P=.002). With regard to the length of the intervention, short interventions (≤4 weeks) showed a small effect size (Cohen d=0.33, 95% CI 0.22-0.44) and medium-long interventions (5-8 weeks) were moderately effective (Cohen d=0.59; 95% CI 0.45-0.74), whereas long interventions (≥9 weeks) produced a nonsignificant effect (Cohen d=0.21, 95% CI –0.05 to 0.47; P=.006). In terms of treatment type, interventions based on cognitive behavioral therapy (CBT) and third-wave CBT (TWC) showed small-to-moderate effect sizes (CBT: Cohen d=0.40, 95% CI 0.19-0.61; TWC: Cohen d=0.53, 95% CI 0.35-0.71), and alternative interventions produced a small effect size (Cohen d=0.24, 95% CI 0.12-0.36; P=.03). Early evidence on follow-up data indicates that Web- and computer-based stress-management interventions can sustain their effects in terms of stress reduction in a small-to-moderate range up to 6 months. Conclusions These results provide evidence that Web- and computer-based stress-management interventions can be effective and have the potential to reduce stress-related mental health problems on a large scale.
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Affiliation(s)
- Elena Heber
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany.,Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany.,Faculty of Social and Human Sciences, University of Southampton, Southampton, United Kingdom
| | - David Daniel Ebert
- Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany.,Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen Nuremberg, Erlangen, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany.,Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany
| | - Pim Cuijpers
- Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Matthias Berking
- Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany.,Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen Nuremberg, Erlangen, Germany
| | - Stephanie Nobis
- Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany
| | - Heleen Riper
- Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Lueneburg, Germany.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Telepsychiatric Centre, University of Southern Denmark, Odense, Denmark
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137
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Sundquist J, Palmér K, Johansson LM, Sundquist K. The effect of mindfulness group therapy on a broad range of psychiatric symptoms: A randomised controlled trial in primary health care. Eur Psychiatry 2017; 43:19-27. [PMID: 28365464 DOI: 10.1016/j.eurpsy.2017.01.328] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The need for psychotherapy in primary health care is on the increase but individual-based treatment is costly. The main aim of this randomised controlled trial (RCT) was to compare the effect of mindfulness-based group therapy (MGT) with treatment as usual (TAU), mainly individual-based cognitive behavioural therapy (CBT), on a broad range of psychiatric symptoms in primary care patients diagnosed with depressive, anxiety and/or stress and adjustment disorders. An additional aim was to compare the effect of MGT with TAU on mindful attention awareness. METHODS This 8-week RCT took place in 2012 at 16 primary care centres in southern Sweden. The study population included both men and women, aged 20-64years (n=215). A broad range of psychiatric symptoms were evaluated at baseline and at the 8-week follow-up using the Symptom Checklist-90 (SCL-90). Mindful attention awareness was also evaluated using the Mindful Attention Awareness Scale (MAAS). RESULTS In both groups, the scores decreased significantly for all subscales and indexes in SCL-90, while the MAAS scores increased significantly. There were no significant differences in the change in psychiatric symptoms between the two groups. The mindfulness group had a somewhat larger change in scores than the control group on the MAAS (P=0.06, non-significant). CONCLUSIONS No significant differences between MGT and TAU, mainly individual-based CBT, were found in treatment effect. Both types of therapies could be used in primary care patients with depressive, anxiety and/or stress and adjustment disorders, where MGT has a potential to save limited resources. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01476371.
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Affiliation(s)
- J Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02 Malmö, Sweden.
| | - K Palmér
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - L M Johansson
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
| | - K Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02 Malmö, Sweden
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138
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Van der Gucht K, Takano K, Labarque V, Vandenabeele K, Nolf N, Kuylen S, Cosyns V, Van Broeck N, Kuppens P, Raes F. A Mindfulness-Based Intervention for Adolescents and Young Adults After Cancer Treatment: Effects on Quality of Life, Emotional Distress, and Cognitive Vulnerability. J Adolesc Young Adult Oncol 2016; 6:307-317. [PMID: 28002681 DOI: 10.1089/jayao.2016.0070] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Adolescent and young adult cancer (AYAC) survivors show an elevated risk of distress. Targeted psychosocial interventions for this distinct population are needed. This study examined the potential efficacy of a mindfulness-based intervention (MBI) to alleviate emotional distress and improve quality of life (QoL) in AYAC survivors. METHODS Participants were 16 AYAC survivors, aged 14-24, who had completed acute medical treatment. A two-baseline (8 and 1 week before the intervention), post- (1 week after the intervention) and 3 months follow-up within-subjects design was used. Each participant completed two baseline assessments, followed by an 8-week MBI. The primary outcome variables were emotional distress and QoL. Secondary outcomes were cognitive vulnerability factors and mindfulness skills. RESULTS Multilevel modeling showed (1) a significant reduction in emotional distress and improvement in QoL at 3 months of follow-up, (2) a significant reduction in negative attitudes toward self (i.e., a cognitive vulnerability factor), and (3) a significant improvement in mindfulness skills. CONCLUSION MBI is a promising approach that is used to treat emotional distress and to improve QoL in AYAC survivors. Further research using randomized controlled trials is needed to generalize these findings. Trial registration information: www.trialregister.nl ; NTR4358.
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Affiliation(s)
- Katleen Van der Gucht
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Keisuke Takano
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Veerle Labarque
- 2 Department of Pediatric Hemato-Oncology, University Hospitals Leuven , Leuven, Belgium
| | - Karen Vandenabeele
- 2 Department of Pediatric Hemato-Oncology, University Hospitals Leuven , Leuven, Belgium
| | - Nathalie Nolf
- 3 Department of Paediatric Haematology-Oncology and Stem Cell Transplantation, Ghent University Hospital , Ghent, Belgium
| | - Sanne Kuylen
- 4 Paediatric Haematology, Oncology and HIV, Antwerp University Hospital , Edegem, Belgium
| | - Veerle Cosyns
- 5 Medical Oncology & Haematology KZ, Brussel University Hospital , Jette, Belgium
| | - Nady Van Broeck
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Peter Kuppens
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
| | - Filip Raes
- 1 Faculty of Psychology and Educational Sciences, University of Leuven , Leuven, Belgium
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139
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Abstract
Anxiety disorders (separation anxiety disorder, selective mutism, specific phobias, social anxiety disorder, panic disorder, agoraphobia, and generalised anxiety disorder) are common and disabling conditions that mostly begin during childhood, adolescence, and early adulthood. They differ from developmentally normative or stress-induced transient anxiety by being marked (ie, out of proportion to the actual threat present) and persistent, and by impairing daily functioning. Most anxiety disorders affect almost twice as many women as men. They often co-occur with major depression, alcohol and other substance-use disorders, and personality disorders. Differential diagnosis from physical conditions-including thyroid, cardiac, and respiratory disorders, and substance intoxication and withdrawal-is imperative. If untreated, anxiety disorders tend to recur chronically. Psychological treatments, particularly cognitive behavioural therapy, and pharmacological treatments, particularly selective serotonin-reuptake inhibitors and serotonin-noradrenaline-reuptake inhibitors, are effective, and their combination could be more effective than is treatment with either individually. More research is needed to increase access to and to develop personalised treatments.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Murray B Stein
- Department of Psychiatry and Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA
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Guillaumie L, Boiral O, Champagne J. A mixed-methods systematic review of the effects of mindfulness on nurses. J Adv Nurs 2016; 73:1017-1034. [DOI: 10.1111/jan.13176] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Laurence Guillaumie
- Faculty of Nursing; Université Laval; Centre de Recherche du CHU de Québec; Québec Québec Canada
| | - Olivier Boiral
- Faculty of Administration; Université Laval; Québec Québec Canada
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Abstract
Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.
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Affiliation(s)
- J David Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213;
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Wong SYS, Yip BHK, Mak WWS, Mercer S, Cheung EYL, Ling CYM, Lui WWS, Tang WK, Lo HHM, Wu JCY, Lee TMC, Gao T, Griffiths SM, Chan PHS, Ma HSW. Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: randomised controlled trial. Br J Psychiatry 2016; 209:68-75. [PMID: 26846612 DOI: 10.1192/bjp.bp.115.166124] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 05/14/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD). AIMS To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive-behavioural therapy-based psychoeducation and usual care. METHOD In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. RESULTS Linear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only. CONCLUSIONS These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms.
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Affiliation(s)
- Samuel Yeung Shan Wong
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Benjamin Hon Kei Yip
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Winnie Wing Sze Mak
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Stewart Mercer
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Eliza Yee Lai Cheung
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Candy Yuet Man Ling
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Wacy Wai Sze Lui
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Wai Kwong Tang
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Herman Hay Ming Lo
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Justin Che Yuen Wu
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Tatia Mei Chun Lee
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Ting Gao
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Sian M Griffiths
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Peter Hoi Sing Chan
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
| | - Helen Shuk Wah Ma
- Samuel Yeung Shan Wong, MD, Benjamin Hon Kei Yip, PhD, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Winnie Wing Sze Mak, PhD, Department of Psychology, The Chinese University of Hong Kong, New Territories, Hong Kong; Stewart Mercer, MD, Institute of Health and Wellbeing, The University of Glasgow, Glasgow, UK; Eliza Yee Lai Cheung, PhD, Hong Kong Red Cross Headquarters, Hong Kong; Candy Yuet Man Ling, MSSc, New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong; Wacy Wai Sze Lui, MSSc, Hospital Authority, Kowloon, Hong Kong; Wai Kwong Tang, MD, Department of Psychiatry, The Chinese University of Hong Kong, New Territories, Hong Kong; Herman Hay Ming Lo, PhD, Department of Applied Social Studies, The City University of Hong Kong, Hong Kong; Justin Che Yuen Wu, MD, Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong; Tatia Mei Chun Lee, PhD, Department of Psychiatry and Department of Medicine, The University of Hong Kong, Hong Kong Island, Hong Kong; Ting Gao, MSc, Sian M. Griffiths, MSc, Division of Family Medicine and Primary Care, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong; Peter Hoi Sing Chan, MSSc, Holy Trinity Bradbury Centre, Kowloon City, Kowloon, Hong Kong; Helen Shuk Wah Ma, PhD, Centre of Buddhist Studies, The University of Hong Kong, Hong Kong Island, Hong Kong, China
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ZOU T, WU C, FAN X. The Clinical Value, Principle, and Basic Practical Technique of Mindfulness Intervention. SHANGHAI ARCHIVES OF PSYCHIATRY 2016; 28:121-130. [PMID: 28638181 PMCID: PMC5434297 DOI: 10.11919/j.issn.1002-0829.216060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mindfulness intervention is a psychotherapy based on the Buddhist practice of meditation, combining the theories and methodology of contemporary psychology. The empirical research in recent years has indicated that mindfulness intervention yields favorable results including reduction of depression relapse, alleviation of the symptoms of depression and anxiety, reduction of substance abuse, relief of pain, blood pressure management, enhancement of immunity, and improvement of sleep. Currently, mindfulness therapy has become the mainstream of psychotherapy in the realm of European and American psychotherapy. The fields of psychology and psychotherapy in China have also begun to introduce mindfulness intervention in recent years. However, there is a lack of relevant practice and research in the field of clinical mental health. This article will briefly introduce the concept of mindfulness, the basic mechanism of the intervention, and the basic skills and guidelines in clinical practice.
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Affiliation(s)
- Tao ZOU
- Department of Psychology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Chenghan WU
- Department of Psychology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xiaoduo FAN
- UMass Memorial Medical Center/ UMass Medical School, Worcester, MA, USA
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Mellor NJ, Ingram L, Van Huizen M, Arnold J, Harding AH. Mindfulness training and employee well-being. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2016. [DOI: 10.1108/ijwhm-11-2014-0049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to assess the effects of mindfulness training (MT) on employee well-being. Mindfulness is the awareness of one’s thoughts, emotions, sensations, actions and surroundings in the present moment.
Design/methodology/approach
– The authors used pre-post training measures and a four-week follow-up on a sample of 23 employees from a UK-based organization. The MT group (n=12) received a weekly two-hour training over eight weeks whilst the control group (n=11) received no training. Qualitative interviews (n=36) were conducted with the MT group at three time points to further assess the subjective experiences of training participants.
Findings
– Compared to the control group, the MT group significantly increased their mindfulness skills including observing and acting with awareness. Scores on well-being, i.e. satisfaction with life, hope and anxiety also improved and were generally maintained at follow-up. Some improvements were seen in the control group too but there was a larger difference in change scores in the MT group on most variables. Qualitative data show additional benefits of MT such as improved concentration at work and better interpersonal relationships. More practice at home led to greater benefits suggesting a dose-response relationship between the amount of practice and substantial benefits.
Research limitations/implications
– Inviting participants to have a greater amount of practice between sessions may further increase the benefits of mindfulness. Future research should consider a longer follow-up period to further explore the sustainability of the training benefits.
Originality/value
– Employing a mixed-method approach, this study showed that MT is a viable psychological intervention for enhancing employee well-being.
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Lever Taylor B, Cavanagh K, Strauss C. The Effectiveness of Mindfulness-Based Interventions in the Perinatal Period: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0155720. [PMID: 27182732 PMCID: PMC4868288 DOI: 10.1371/journal.pone.0155720] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 05/03/2016] [Indexed: 12/20/2022] Open
Abstract
Perinatal mental health difficulties are associated with adverse consequences for parents and infants. However, the potential risks associated with the use of psychotropic medication for pregnant and breastfeeding women and the preferences expressed by women for non-pharmacological interventions mean it is important to ensure that effective psychological interventions are available. It has been argued that mindfulness-based interventions may offer a novel approach to treating perinatal mental health difficulties, but relatively little is known about their effectiveness with perinatal populations. This paper therefore presents a systematic review and meta-analysis of the effectiveness of mindfulness-based interventions for reducing depression, anxiety and stress and improving mindfulness skills in the perinatal period. A systematic review identified seventeen studies of mindfulness-based interventions in the perinatal period, including both controlled trials (n = 9) and pre-post uncontrolled studies (n = 8). Eight of these studies also included qualitative data. Hedge's g was used to assess uncontrolled and controlled effect sizes in separate meta-analyses, and a narrative synthesis of qualitative data was produced. Pre- to post-analyses showed significant reductions in depression, anxiety and stress and significant increases in mindfulness skills post intervention, each with small to medium effect sizes. Completion of the mindfulness-based interventions was reasonable with around three quarters of participants meeting study-defined criteria for engagement or completion where this was recorded. Qualitative data suggested that participants viewed mindfulness interventions positively. However, between-group analyses failed to find any significant post-intervention benefits for depression, anxiety or stress of mindfulness-based interventions in comparison to control conditions: effect sizes were negligible and it was conspicuous that intervention group participants did not appear to improve significantly more than controls in their mindfulness skills. The interventions offered often deviated from traditional mindfulness-based cognitive therapy or mindfulness-based stress reduction programmes, and there was also a tendency for studies to focus on healthy rather than clinical populations, and on antenatal rather than postnatal populations. It is argued that these and other limitations with the included studies and their interventions may have been partly responsible for the lack of significant between-group effects. The implications of the findings and recommendations for future research are discussed.
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Affiliation(s)
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Clara Strauss
- Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom
- School of Psychology, University of Sussex, Brighton, United Kingdom
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Bartels-Velthuis AA, Schroevers MJ, van der Ploeg K, Koster F, Fleer J, van den Brink E. A Mindfulness-Based Compassionate Living Training in a Heterogeneous Sample of Psychiatric Outpatients: a Feasibility Study. Mindfulness (N Y) 2016; 7:809-818. [PMID: 27429664 PMCID: PMC4923083 DOI: 10.1007/s12671-016-0518-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We developed a novel compassion-focused training (mindfulness-based compassionate living; MBCL) and examined its effects in a heterogeneous psychiatric outpatient population with regard to feasibility and changes in levels of depression, anxiety, mindfulness and compassion. The training consisted of nine weekly 2.5-h sessions. Thirty-three patients, who had followed a mindfulness-based stress reduction (MBSR) program or a mindfulness-based cognitive therapy (MBCT) program beforehand, participated in the study (mean age 48.1 years; 82 % female). Participants completed self-report questionnaires before and directly after the MBCL training. Levels of depression, but not of anxiety, reduced, and levels of mindfulness and self-compassion increased. Serious limitations of this study are the small sample size, the lack of a control group and the fact that about half of the participants did not complete the posttraining questionnaires. However, we determined that it is feasible to conduct further research on this novel MBCL training program as a basis for more robust empirical investigation in the future, more specifically examining the effects of MBCL and preferably also the underlying working mechanisms.
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Affiliation(s)
- Agna A Bartels-Velthuis
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands ; University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karen van der Ploeg
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
| | - Frits Koster
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
| | - Joke Fleer
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik van den Brink
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
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147
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Saper RB, Lemaster CM, Elwy AR, Paris R, Herman PM, Plumb DN, Sherman KJ, Groessl EJ, Lynch S, Wang S, Weinberg J. Yoga versus education for Veterans with chronic low back pain: study protocol for a randomized controlled trial. Trials 2016; 17:224. [PMID: 27129472 PMCID: PMC4850721 DOI: 10.1186/s13063-016-1321-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 04/01/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic low back pain is the most frequent pain condition in Veterans and causes substantial suffering, decreased functional capacity, and lower quality of life. Symptoms of post-traumatic stress, depression, and mild traumatic brain injury are highly prevalent in Veterans with back pain. Yoga for low back pain has been demonstrated to be effective for civilians in randomized controlled trials. However, it is unknown if results from previously published trials generalize to military populations. METHODS/DESIGN This study is a parallel randomized controlled trial comparing yoga to education for 120 Veterans with chronic low back pain. Participants are Veterans ≥18 years old with low back pain present on at least half the days in the past six months and a self-reported average pain intensity in the previous week of ≥4 on a 0-10 scale. The 24-week study has an initial 12-week intervention period, where participants are randomized equally into (1) a standardized weekly group yoga class with home practice or (2) education delivered with a self-care book. Primary outcome measures are change at 12 weeks in low back pain intensity measured by the Defense and Veterans Pain Rating Scale (0-10) and back-related function using the 23-point Roland Morris Disability Questionnaire. In the subsequent 12-week follow-up period, yoga participants are encouraged to continue home yoga practice and education participants continue following recommendations from the book. Qualitative interviews with Veterans in the yoga group and their partners explore the impact of chronic low back pain and yoga on family relationships. We also assess cost-effectiveness from three perspectives: the Veteran, the Veterans Health Administration, and society using electronic medical records, self-reported cost data, and study records. DISCUSSION This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities. TRIAL REGISTRATION ClinicalTrials.gov: NCT02224183.
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Affiliation(s)
- Robert B. Saper
- />Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA USA
| | - Chelsey M. Lemaster
- />Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA USA
| | - A. Rani Elwy
- />Center for Information Dissemination and Education Resources, VA Boston Healthcare System, Boston, MA USA
- />Department of Health Policy and Management, Boston University School of Public Health, Boston, MA USA
| | - Ruth Paris
- />Boston University School of Social Work, Boston, MA USA
| | | | - Dorothy N. Plumb
- />Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA USA
| | - Karen J. Sherman
- />Group Health Research Institute, Seattle, WA USA
- />Department of Epidemiology, University of Washington, Seattle, WA USA
| | - Erik J. Groessl
- />VA San Diego Healthcare System, San Diego, CA USA
- />Department of Family and Preventive Medicine, University of California San Diego School of Medicine, San Diego, CA USA
| | - Susan Lynch
- />There & Back Again, Inc., Wakefield, MA USA
| | - Shihwe Wang
- />Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA USA
| | - Janice Weinberg
- />Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
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148
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Pompoli A, Furukawa TA, Imai H, Tajika A, Efthimiou O, Salanti G. Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database Syst Rev 2016; 4:CD011004. [PMID: 27071857 PMCID: PMC7104662 DOI: 10.1002/14651858.cd011004.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Panic disorder is characterised by the presence of recurrent unexpected panic attacks, discrete periods of fear or anxiety that have a rapid onset and include symptoms such as racing heart, chest pain, sweating and shaking. Panic disorder is common in the general population, with a lifetime prevalence of 1% to 4%. A previous Cochrane meta-analysis suggested that psychological therapy (either alone or combined with pharmacotherapy) can be chosen as a first-line treatment for panic disorder with or without agoraphobia. However, it is not yet clear whether certain psychological therapies can be considered superior to others. In order to answer this question, in this review we performed a network meta-analysis (NMA), in which we compared eight different forms of psychological therapy and three forms of a control condition. OBJECTIVES To assess the comparative efficacy and acceptability of different psychological therapies and different control conditions for panic disorder, with or without agoraphobia, in adults. SEARCH METHODS We conducted the main searches in the CCDANCTR electronic databases (studies and references registers), all years to 16 March 2015. We conducted complementary searches in PubMed and trials registries. Supplementary searches included reference lists of included studies, citation indexes, personal communication to the authors of all included studies and grey literature searches in OpenSIGLE. We applied no restrictions on date, language or publication status. SELECTION CRITERIA We included all relevant randomised controlled trials (RCTs) focusing on adults with a formal diagnosis of panic disorder with or without agoraphobia. We considered the following psychological therapies: psychoeducation (PE), supportive psychotherapy (SP), physiological therapies (PT), behaviour therapy (BT), cognitive therapy (CT), cognitive behaviour therapy (CBT), third-wave CBT (3W) and psychodynamic therapies (PD). We included both individual and group formats. Therapies had to be administered face-to-face. The comparator interventions considered for this review were: no treatment (NT), wait list (WL) and attention/psychological placebo (APP). For this review we considered four short-term (ST) outcomes (ST-remission, ST-response, ST-dropouts, ST-improvement on a continuous scale) and one long-term (LT) outcome (LT-remission/response). DATA COLLECTION AND ANALYSIS As a first step, we conducted a systematic search of all relevant papers according to the inclusion criteria. For each outcome, we then constructed a treatment network in order to clarify the extent to which each type of therapy and each comparison had been investigated in the available literature. Then, for each available comparison, we conducted a random-effects meta-analysis. Subsequently, we performed a network meta-analysis in order to synthesise the available direct evidence with indirect evidence, and to obtain an overall effect size estimate for each possible pair of therapies in the network. Finally, we calculated a probabilistic ranking of the different psychological therapies and control conditions for each outcome. MAIN RESULTS We identified 1432 references; after screening, we included 60 studies in the final qualitative analyses. Among these, 54 (including 3021 patients) were also included in the quantitative analyses. With respect to the analyses for the first of our primary outcomes, (short-term remission), the most studied of the included psychological therapies was CBT (32 studies), followed by BT (12 studies), PT (10 studies), CT (three studies), SP (three studies) and PD (two studies).The quality of the evidence for the entire network was found to be low for all outcomes. The quality of the evidence for CBT vs NT, CBT vs SP and CBT vs PD was low to very low, depending on the outcome. The majority of the included studies were at unclear risk of bias with regard to the randomisation process. We found almost half of the included studies to be at high risk of attrition bias and detection bias. We also found selective outcome reporting bias to be present and we strongly suspected publication bias. Finally, we found almost half of the included studies to be at high risk of researcher allegiance bias.Overall the networks appeared to be well connected, but were generally underpowered to detect any important disagreement between direct and indirect evidence. The results showed the superiority of psychological therapies over the WL condition, although this finding was amplified by evident small study effects (SSE). The NMAs for ST-remission, ST-response and ST-improvement on a continuous scale showed well-replicated evidence in favour of CBT, as well as some sparse but relevant evidence in favour of PD and SP, over other therapies. In terms of ST-dropouts, PD and 3W showed better tolerability over other psychological therapies in the short term. In the long term, CBT and PD showed the highest level of remission/response, suggesting that the effects of these two treatments may be more stable with respect to other psychological therapies. However, all the mentioned differences among active treatments must be interpreted while taking into account that in most cases the effect sizes were small and/or results were imprecise. AUTHORS' CONCLUSIONS There is no high-quality, unequivocal evidence to support one psychological therapy over the others for the treatment of panic disorder with or without agoraphobia in adults. However, the results show that CBT - the most extensively studied among the included psychological therapies - was often superior to other therapies, although the effect size was small and the level of precision was often insufficient or clinically irrelevant. In the only two studies available that explored PD, this treatment showed promising results, although further research is needed in order to better explore the relative efficacy of PD with respect to CBT. Furthermore, PD appeared to be the best tolerated (in terms of ST-dropouts) among psychological treatments. Unexpectedly, we found some evidence in support of the possible viability of non-specific supportive psychotherapy for the treatment of panic disorder; however, the results concerning SP should be interpreted cautiously because of the sparsity of evidence regarding this treatment and, as in the case of PD, further research is needed to explore this issue. Behaviour therapy did not appear to be a valid alternative to CBT as a first-line treatment for patients with panic disorder with or without agoraphobia.
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Affiliation(s)
- Alessandro Pompoli
- Private practice, no academic affiliationsLe grotte 12MalcesineVeronaItaly37018
| | - Toshi A Furukawa
- Kyoto University Graduate School of Medicine/School of Public HealthDepartment of Health Promotion and Human BehaviorYoshida Konoe‐cho, Sakyo‐ku,KyotoJapan606‐8501
| | - Hissei Imai
- Kyoto University Graduate School of Medicine/School of Public HealthDepartment of Health Promotion and Human BehaviorYoshida Konoe‐cho, Sakyo‐ku,KyotoJapan606‐8501
| | - Aran Tajika
- Kyoto University Graduate School of Medicine/School of Public HealthDepartment of Health Promotion and Human BehaviorYoshida Konoe‐cho, Sakyo‐ku,KyotoJapan606‐8501
| | - Orestis Efthimiou
- University of Ioannina School of MedicineDepartment of Hygiene and EpidemiologyIoanninaEpirusGreece45500
| | - Georgia Salanti
- University of BernInstitute of Social and Preventive Medicine (ISPM) & Bern Institute of Primary Care (BIHAM)Finkenhubelweg 11BernSwitzerland3005
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Dundas I, Thorsheim T, Hjeltnes A, Binder PE. Mindfulness Based Stress Reduction for Academic Evaluation Anxiety: A Naturalistic Longitudinal Study. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2016; 30:114-131. [PMID: 27227169 PMCID: PMC4867855 DOI: 10.1080/87568225.2016.1140988] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Mindfulness based stress reduction (MBSR) for academic evaluation anxiety and self-confidence in 70 help-seeking bachelor's and master's students was examined. A repeated measures analysis of covariance on the 46 students who completed pretreatment and posttreatment measures (median age = 24 years, 83% women) showed that evaluation anxiety and self-confidence improved. A growth curve analysis with all 70 original participants showed reductions in both cognitive and emotional components of evaluation anxiety, and that reduction continued postintervention. Although more research is needed, this study indicates that MBSR may reduce evaluation anxiety.
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Affiliation(s)
- Ingrid Dundas
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen , Bergen , Norway
| | - Torbjørn Thorsheim
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen , Bergen , Norway
| | - Aslak Hjeltnes
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen , Bergen , Norway
| | - Per Einar Binder
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen , Bergen , Norway
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Geiger PJ, Boggero IA, Brake CA, Caldera CA, Combs HL, Peters JR, Baer RA. Mindfulness-Based Interventions for Older Adults: A Review of the Effects on Physical and Emotional Well-being. Mindfulness (N Y) 2016; 7:296-307. [PMID: 27200109 PMCID: PMC4868399 DOI: 10.1007/s12671-015-0444-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This comprehensive review examined the effects of mindfulness-based interventions on the physical and emotional wellbeing of older adults, a rapidly growing segment of the general population. Search procedures yielded 15 treatment outcome studies meeting inclusion criteria. Support was found for the feasibility and acceptability of mindfulness-based interventions with older adults. Physical and emotional wellbeing outcome variables offered mixed support for the use of mindfulness-based interventions with older adults. Potential explanations of mixed findings may include methodological flaws, study limitations, and inconsistent modifications of protocols. These are discussed in detail and future avenues of research are discussed, emphasizing the need to incorporate geriatric populations into future mindfulness-based empirical research.
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