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Marusak HA, Iadipaolo AS, Cohen C, Goldberg E, Taub JW, Harper FWK, Bluth MH, Rabinak CA. Martial Arts-Based Therapy Reduces Pain and Distress Among Children with Chronic Health Conditions and Their Siblings. J Pain Res 2020; 13:3467-3478. [PMID: 33402843 PMCID: PMC7778380 DOI: 10.2147/jpr.s283364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/18/2020] [Indexed: 01/14/2023] Open
Abstract
Objective Test whether a martial arts-based therapy, Kids Kicking Cancer (KKC), can reduce pain and emotional distress in children with cancer, other chronic health conditions (e.g., sickle cell), and healthy siblings. Methods This study surveyed children’s pain and distress levels immediately before and after a 1-hr in-person KKC class. Eligible participants were enrolled in standard KKC classes, were diagnosed with a chronic health condition (e.g., cancer, sickle cell) or were the sibling of a child diagnosed and were between the ages of 5–17 years (inclusive). Children reported on their pain and distress using Likert-style scales (Coloured Analog Scale and modified FACES scale, respectively). Friedman test was used to test for overall changes in pain and distress, and within subgroups. Age and sex effects were evaluated using Spearman’s rank-order correlation. Additional Yes/No questions were administered regarding KKC satisfaction and use of techniques. Results Fifty-nine youth (19 cancer patients, 17 non-cancer patients, 23 siblings; 5–17 yrs, 26 females) completed this study. Overall, there was a significant reduction in pain (p = 0.033) and emotional distress (p < 0.001) after a 1-hr class, with 50% and 89% of youth reporting a reduction in pain and distress, respectively. On average, pain levels remained within the mild/moderate range on average (i.e., pre vs. post levels; pre: M = 1.67, post: M = 1.33) and emotional distress went from mild/moderate to none/mild distress, on average (pre: M = 1.92, post: M = 1.08). Youth with higher pre-class pain and distress reported greater reductions (p = 0.001 and p < 0.001, respectively). The reduction in pain appeared to be most pronounced with cancer and non-cancer patients. In contrast, the reduction in distress appeared to be most pronounced among healthy siblings. However, overall, reductions in pain and distress did not significantly differ among subgroups (i.e., cancer patients, non-cancer patients, siblings), and change in pain and distress was not associated with age or sex. Ninety-six percent of youth would recommend KKC to others and 81% reported using KKC techniques (e.g., the Breath BrakeTM or other martial arts techniques) outside of class, such as at home. Conclusion Results support the more widespread application of KKC as a psychosocial intervention for reducing pain and distress in various pediatric populations.
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Affiliation(s)
- Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA.,Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA
| | - Allesandra S Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | | | - Elimelech Goldberg
- Kids Kicking Cancer, Southfield, MI, USA.,Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Felicity W K Harper
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA.,Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Martin H Bluth
- Kids Kicking Cancer, Southfield, MI, USA.,Department of Pathology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Christine A Rabinak
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA.,Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, USA.,Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.,Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
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Crane, PhD C, Ganguli, PhD P, Ball, MSc S, Taylor, PhD L, Blakemore, PhD SJ, Byford, PhD S, Dalgleish, PhD T, Ford, PhD T, Greenberg, PhD M, Kuyken, PhD W, Lord, MA L, Montero-Marin, PhD J, Sonley, MEd A, Ukoumunne, PhD OC, Williams, PhD JMG. Training School Teachers to Deliver a Mindfulness Program: Exploring Scalability, Acceptability, Effectiveness, and Cost-effectiveness. Glob Adv Health Med 2020; 9:2164956120964738. [PMID: 33403157 PMCID: PMC7745556 DOI: 10.1177/2164956120964738] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND There is growing research support for the use of mindfulness training (MT) in schools, but almost no high-quality evidence about different training models for people wishing to teach mindfulness in this setting. Effective dissemination of MT relies on the development of scalable training routes. OBJECTIVE To compare 4 training routes for school teachers wishing to deliver MT differing in intensity and potential scalability, considering teaching competency, training acceptability, and cost-effectiveness. METHODS Schools were randomized to an existing route comprising an 8-session instructor-led personal mindfulness course, combined with 4-day MT program training, or 1 of 3 more scalable, lower intensity, alternatives: an instructor-led personal mindfulness course combined with 1-day MT program training, a self-taught personal mindfulness course (delivered through a course book) combined with 4-day MT program training, and a self-taught personal mindfulness course combined with 1-day MT program training. RESULTS Attrition from training was substantial across all routes. The instructor-led course was more effective than the self-taught course in increasing teachers' personal mindfulness skills. Even the most intensive (existing) training route brought only 29% of the teachers commencing training, and 56% of those completing the study protocol, to the required minimum competency threshold (an advanced beginner rating on an adapted version of the Mindfulness-based Interventions Teaching Assessment Criteria). The differences in levels of competency achieved by existing training compared with the more scalable alternatives were modest, with economic evaluation suggesting that the existing route was both more expensive and more effective than lower intensity alternatives, but with no statistically significant differences between routes. CONCLUSIONS This research questions the move toward abbreviating teacher training to increase scalability and suggests instead that many teachers require additional support to ensure competency from first delivery of MT in the classroom.
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Affiliation(s)
| | - Poushali Ganguli, PhD
- King’s Health Economics, Institute of Psychiatry, Psychology and Neuroscience at King’s College London, London, UK
| | - Susan Ball, MSc
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Laura Taylor, PhD
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | | | - Sarah Byford, PhD
- King’s Health Economics, Institute of Psychiatry, Psychology and Neuroscience at King’s College London, London, UK
| | - Tim Dalgleish, PhD
- Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Tamsin Ford, PhD
- St Luke's Campus, University of Exeter Medical School, Exeter, UK
| | - Mark Greenberg, PhD
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania Current address: Tamsin Ford is now with the Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Willem Kuyken, PhD
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Liz Lord, MA
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | | | - Anna Sonley, MEd
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Obioha C Ukoumunne, PhD
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
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103
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Perrier MF, Gurgel-Juarez N, Flowers HL, McCormick A, Short SJ. Mindfulness-based interventions for children and adolescents across all settings: a scoping review protocol. Syst Rev 2020; 9:286. [PMID: 33287887 PMCID: PMC7722299 DOI: 10.1186/s13643-020-01548-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 11/26/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Although mindfulness-based interventions (MBIs) are becoming increasingly popular, the application of MBIs with children and adolescents is still in its infancy. Mapping the existing literature is necessary to help guide pediatric mindfulness interventions. Our purpose is to synthesize the evidence of reported MBIs for children and adolescents with and without physical, mental, and cognitive disorders. Accordingly, we aim to identify trends and gaps in the literature, so that we can provide direction to researchers who seek to advance the evidence base for using MBIs in pediatric populations. METHODS Our search strategy will be conducted following Arksey and O'Malley's methodological framework. It will include a comprehensive search of published studies in 7 databases, gray literature, conference proceedings, and citations of selected articles. Two independent reviewers will evaluate all abstracts and full articles that have a pediatric sample (children 2-17 years), use MBIs to promote development or to remediate underlying disorders, and are written in English or French. We will identify the definitions and concepts from MBIs, categorize accepted studies according to etiology and rehabilitation type, describe intervention methodology, and report outcomes of selected studies. DISCUSSION Our review will provide a comprehensive overview of the pediatric mindfulness intervention literature to date, involving a range of mental, cognitive, and physical outcomes for healthy children and adolescents and for those with a variety of disorders in clinical and institutional settings. We will disseminate results to mindfulness practitioners and provide guidance to future pediatric researchers in their development and application of mindfulness interventions, thereby contributing to the scientific understanding of mindfulness for the ultimate betterment of child and adolescent well-being and life-long functioning. SYSTEMATIC REVIEW REGISTRATION PROSPERO does not accept scoping review protocols.
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Affiliation(s)
- Marie-France Perrier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. .,Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
| | - Nalia Gurgel-Juarez
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Heather Leslie Flowers
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Institut du savoir - A Knowledge Institute, Montfort Hospital, Ottawa, ON, Canada
| | - Anna McCormick
- Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sarah J Short
- Department of Educational Psychology, School of Education, University of Wisconsin-Madison, Madison, WI, USA.,Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
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104
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Baer R, Crane C, Montero-Marin J, Phillips A, Taylor L, Tickell A, Kuyken W. Frequency of Self-reported Unpleasant Events and Harm in a Mindfulness-Based Program in Two General Population Samples. Mindfulness (N Y) 2020; 12:763-774. [PMID: 33747251 PMCID: PMC7920887 DOI: 10.1007/s12671-020-01547-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2020] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Evidence-based mindfulness programs have well-established benefits, but the potential for harmful effects is understudied. We explored the frequency and severity of unpleasant experiences and harm in two nonclinical samples participating in an adaptation of mindfulness-based cognitive therapy (MBCT) for the general population. METHODS Study 1 included 84 schoolteachers; study 2 included 74 university students. Both studies were uncontrolled. Participants completed self-report questionnaires about psychological symptoms before and after the 8-week mindfulness course. After the course, they responded to a survey designed for this study that included Likert ratings and free-text questions about unpleasant experiences and harm. All data were collected online. RESULTS In both samples, about two-thirds of participants reported unpleasant experiences associated with mindfulness practice during the course. Most participants (85-92%) rated these experiences as not at all or somewhat upsetting; some indicated that difficult experiences led to important learning or were beneficial in some way. The proportion of participants reporting harm from the mindfulness course ranged from 3 to 7%. The proportion showing reliable deterioration on symptom questionnaires ranged from 2 to 7%. Those reporting harm and those showing reliable deterioration on questionnaires were largely separate subgroups; only one participant fell in both. CONCLUSIONS Findings highlight the need for mindfulness teachers to manage expectations about benefits and difficulties that may occur in mindfulness-based programs and to work skilfully with participants experiencing difficulties. Experiences of harm may not be captured by symptom questionnaires and should be explicitly assessed in other ways. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12671-020-01547-8.
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Affiliation(s)
- Ruth Baer
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - Catherine Crane
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - Alice Phillips
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - Laura Taylor
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - Alice Tickell
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - Willem Kuyken
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
| | - The MYRIAD team
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX UK
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105
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Goldberg SB, Imhoff-Smith T, Bolt DM, Wilson-Mendenhall CD, Dahl CJ, Davidson RJ, Rosenkranz MA. Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR Ment Health 2020; 7:e23825. [PMID: 33245288 PMCID: PMC7732708 DOI: 10.2196/23825] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques. OBJECTIVE This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app-the Healthy Minds Program (HMP)-which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight). METHODS A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood. RESULTS A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=-0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified. CONCLUSIONS This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement. TRIAL REGISTRATION ClinicalTrials.gov NCT04139005; https://clinicaltrials.gov/ct2/show/NCT04139005.
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Affiliation(s)
- Simon B Goldberg
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Daniel M Bolt
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Cortland J Dahl
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Healthy Minds Innovations Inc, Madison, WI, United States
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - Melissa A Rosenkranz
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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106
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Waedel L, Daubmann A, Zapf A, Reis O. Effectiveness of a mindfulness-oriented substance use prevention program for boys with mild to borderline intellectual disabilities: study protocol for a randomised controlled trial. BMC Public Health 2020; 20:1780. [PMID: 33238932 PMCID: PMC7686945 DOI: 10.1186/s12889-020-09878-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Boys with mild to borderline intellectual disabilities (MBID) are at particular risk to drink in harmful ways once they start to consume alcohol. Interventions based on mindfulness have been proven to be effective in preventing substance use, but mostly for adults with MBID. A mindfulness oriented intervention targeting 11-17 years old boys will be tested in a randomised controlled trial. Study aim is to investigate the benefits of this new intervention compared to an active control condition within a 12 months follow-up. METHODS In this randomised controlled proof of concept study, 82 boys with MBID who consumed any alcohol during the last year will be randomised either to the 6 week mindfulness oriented intervention or the control group receiving a control intervention equal in dose and length. The intervention group undergoes mindfulness training combined with interactive drug education, while the control group completes a health training combined with the same education. In the intention-to-treat analysis the primary outcome is the self-reported delay of first post-intervention drunkeness within a 12 months follow-up time span, measured weekly with a short app-based questionnaire. Secondary outcome is the use of alcohol, tobacco and other drugs within 30 days post-intervention. Changes in neurobiological behavioural parameters, such as impulse control, reward anticipation, and decision making, are also investigated. Other secondary outcomes regard trait mindfulness, emotion regulation, psychopathological symptoms, peer networks, perceived stress, and quality of life. In addition, a prospective registry will be established to record specific data on the population of 11-17 year old boys with MBID without any alcohol experience. DISCUSSION This study offers the opportunity to gain first evidence of the effectiveness of a mindfulness-oriented program for the prevention of substance use for boys with MBID. TRIAL REGISTRATION German Clinical Trials Register, DRKS00014042 . Registered on March 19th 2018.
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Affiliation(s)
- Lucie Waedel
- Department of Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Antonia Zapf
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Olaf Reis
- Department of Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
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Goldberg SB, Riordan KM, Sun S, Kearney DJ, Simpson TL. Efficacy and acceptability of mindfulness-based interventions for military veterans: A systematic review and meta-analysis. J Psychosom Res 2020; 138:110232. [PMID: 32906008 PMCID: PMC7554248 DOI: 10.1016/j.jpsychores.2020.110232] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/12/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Military veterans report high rates of psychiatric and physical health symptoms that may be amenable to mindfulness-based interventions (MBIs). Inconsistent prior findings and questions of fit between MBIs and military culture highlight the need for a systematic evaluation of this literature. OBJECTIVE To quantify the efficacy and acceptability of MBIs for military veterans. DATA SOURCES We searched five databases (MEDLINE/PubMed, CINAHL, Scopus, Web of Science, PsycINFO) from inception to October 16th, 2019. STUDY SELECTION Randomized controlled trials (RCTs) testing MBIs in military veterans. RESULTS Twenty studies (k = 16 unique comparisons, N = 898) were included. At post-treatment, MBIs were superior to non-specific controls (e.g., waitlist, attentional placebos) on measures of posttraumatic stress disorder (PTSD), depression, general psychological symptoms (i.e., aggregated across symptom domains), quality of life / functioning, and mindfulness (Hedges' gs = 0.32 to 0.80), but not physical health. At follow-up (mean length = 3.19 months), MBIs continued to outperform non-specific controls on general psychological symptoms, but not PTSD. MBIs were superior to specific active controls (i.e., other therapies) at post-treatment on measures of PTSD and general psychological symptoms (gs = 0.19 to 0.25). Participants randomized to MBIs showed higher rates of attrition than those randomized to control interventions (odds ratio = 1.98). Several models were not robust to tests of publication bias. Study quality and risk of bias assessment indicated several areas of concern. CONCLUSIONS MBIs may improve psychological symptoms and quality of life / functioning in veterans. Questionable acceptability and few high-quality studies support the need for rigorous RCTs, potentially adapted to veterans.
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108
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Hafeman DM, Ostroff N, Feldman J, Hickey MB, Phillips ML, Creswell D, Birmaher B, Goldstein TR. Mindfulness-based intervention to decrease mood lability in at-risk youth: Preliminary evidence for changes in resting state functional connectivity. J Affect Disord 2020; 276:23-29. [PMID: 32697703 PMCID: PMC7484458 DOI: 10.1016/j.jad.2020.06.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/01/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND In youth at familial risk for bipolar disorder (BD), mood lability is an important precursor to BD onset. Previous work in adults indicates that mindfulness-based interventions (MBI) may improve emotion regulation, in part by increasing resting-state functional connectivity (rsFC) between posterior cingulate cortex (PCC) and executive control network (ECN). In this pilot study, we assessed effects of an MBI on PCC-ECN rsFC and mood lability in at-risk youth. METHODS We recruited 35 youth (10-14 years old) with a first-degree family history of BD and mood lability, and 21 age-matched healthy controls. Eligible at-risk youth were scanned pre/post an 8-week MBI and assessed three months later. Healthy controls were scanned at matched timepoints but did not participate in the MBI. The MBI used age-appropriate strategies to promote non-judgmental, present-moment awareness. We assessed pre/post changes in PCC-ECN rsFC and how rsFC changes were related to mood outcomes. RESULTS Twenty at-risk youth were scanned pre/post MBI; 16 had high-quality rsFC data. Following MBI, at-risk youth showed increased rsFC between PCC and left dorsolateral prefrontal cortex (DLPFC) (BA 9; k = 28; corrected p=.006); healthy controls did not show this increase. Following MBI, at-risk youth reported more mindfulness (F = 7.15, p=.003), less mood lability (F = 7.2, p=.002), and less suppression of negative emotions (F = 5.05, p=.01). PCC-DLPFC rsFC increases predicted less mood lability (t=-2.25, p=.04) and less emotion suppression (t=-2.75, p=.02) at follow-up. LIMITATIONS Small sample and lack of a control intervention. CONCLUSIONS PCC-DLPFC rsFC may be a clinically meaningful neural target of an MBI in at-risk youth, related to improvements in mood lability.
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Affiliation(s)
- Danella M. Hafeman
- University of Pittsburgh, School of Medicine, Department of Psychiatry;,University of Pittsburgh Medical Center
| | | | | | | | - Mary L. Phillips
- University of Pittsburgh, School of Medicine, Department of Psychiatry
| | | | - Boris Birmaher
- University of Pittsburgh, School of Medicine, Department of Psychiatry;,University of Pittsburgh Medical Center
| | - Tina R. Goldstein
- University of Pittsburgh, School of Medicine, Department of Psychiatry
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Chavez LJ, Kelleher K, Slesnick N, Holowacz E, Luthy E, Moore L, Ford J. Virtual Reality Meditation Among Youth Experiencing Homelessness: Pilot Randomized Controlled Trial of Feasibility. JMIR Ment Health 2020; 7:e18244. [PMID: 32969834 PMCID: PMC7545327 DOI: 10.2196/18244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Homelessness among youth is devastating, with high rates of substance use disorders and mental health comorbidity. Mindfulness-based interventions that include meditation and mindfulness skills training reduce stress and symptoms of anxiety or depression. However, engaging high-risk youth in interventions is challenging. Virtual reality is a more flexible platform for delivering meditation and may be appealing to youth. OBJECTIVE The study objectives were to evaluate the feasibility of delivering virtual reality meditation and of collecting outcome measures, including anxiety and physiologic stress. METHODS A sample of 30 youth experiencing homelessness was enrolled in the study. Youth were randomized to receive 10 minutes of one of three interventions: (1) virtual reality meditation, (2) audio meditation (through a web-based platform), or (3) virtual reality imagery of historical pictures and text. Subjects who consented to the study attended two research visits. The first visit collected survey measures of demographics, mental health, and substance use, and oriented subjects to the intervention platforms. The second visit (1-3 days later) delivered the intervention and collected pre and post outcome measures of anxiety and physiologic stress (salivary cortisol). Changes in anxiety and cortisol at the second visit were compared across groups using a linear regression model in which the primary analysis compared virtual reality meditation to audio meditation and secondary analyses compared virtual reality meditation to virtual reality imagery. RESULTS Anxiety scores decreased in all groups, with a larger reduction among the virtual reality meditation group (difference=10.8) compared to the web-based meditation or virtual reality images groups (difference=5.8 and 5.0, respectively). After controlling for baseline values, there were no significant group differences in changes in anxiety scores or cortisol levels. In comparing virtual reality meditation and audio meditation, the effect size for anxiety was moderate (Cohen d=0.58) while the effect size for cortisol was small (Cohen d=0.08). CONCLUSIONS Preliminary results suggest that virtual reality meditation has a moderate benefit for anxiety but not physiologic stress. Future research is needed to confirm these results in a larger sample and to investigate whether the effects are sustained or increase with repeated use of virtual reality mediation. Virtual reality meditation appears feasible to deliver among homeless youth and merits further study. TRIAL REGISTRATION ClinicalTrials.gov NCT04004520; https://clinicaltrials.gov/ct2/show/NCT04004520.
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Affiliation(s)
| | - Kelly Kelleher
- Nationwide Children's Hospital, Columbus, OH, United States
| | - Natasha Slesnick
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Eugene Holowacz
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Ellison Luthy
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Laura Moore
- College of Nursing, Columbus, OH, United States
| | - Jodi Ford
- College of Nursing, Columbus, OH, United States
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110
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Clinical Application of Mindfulness-Oriented Meditation: A Preliminary Study in Children with ADHD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186916. [PMID: 32971803 PMCID: PMC7557753 DOI: 10.3390/ijerph17186916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/12/2020] [Accepted: 09/18/2020] [Indexed: 12/30/2022]
Abstract
Mindfulness-oriented meditation (MOM) is a self-regulatory training used for attentional and behavioral problems. With its focus on attention, MOM is a promising form of training that is gaining empirical support as a complementary or alternative intervention for attention deficit/hyperactivity disorder (ADHD). In this study, we tested the preliminary efficacy of MOM training in children with ADHD, by comparing its efficacy with an active control condition (Emotion Education Program, EEP). Twenty-five children with ADHD aged 7–11 years participated in MOM training (n = 15) or EEP (n = 10) 3 times per week for 8 weeks. Neuropsychological and academic measures and behavioral, emotional, and mindfulness ratings were collected before and after the two programs. On average, MOM training had positive effects on neuropsychological measures, as evidenced by a significant mean improvement in all outcome measures after training. Moreover, positive effects on ADHD symptoms were found only in the MOM group. Although they are preliminary, our results documented that MOM training promotes changes in neuropsychological measures and in certain behavioral symptoms, suggesting it as a promising tool for ameliorating cognitive and clinical manifestations of ADHD.
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111
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Affiliation(s)
- David Saunders
- Clinical and Research Fellow, Child and Adult Psychiatry, Yale Child Study Center
| | - Hedy Kober
- Associate Professor, Department of Psychiatry, Department of Psychology, Cognitive Science Program, Interdepartmental Neuroscience Program, Yale University School of Medicine
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112
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López-Navarro E, Del Canto C, Mayol A, Fernández-Alonso O, Reig J, Munar E. Does mindfulness improve inhibitory control in psychotic disorders? A randomized controlled clinical trial. Int J Clin Health Psychol 2020; 20:192-199. [PMID: 32994792 PMCID: PMC7501450 DOI: 10.1016/j.ijchp.2020.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/01/2020] [Indexed: 01/10/2023] Open
Abstract
Background/Objective: Impaired Inhibitory Control (IC) is a core feature of psychotic disorders and is related with impaired social functioning in people experiencing psychosis. Despite research showing the benefits of mindfulness over IC in the general population, no study has assessed its effects on IC in psychoses. The aim of our study was to assess the effectiveness of a mindfulness-based intervention combined with integrated rehabilitation treatment in a sample of people diagnosed of psychotic disorders. Method: Fifty-six patients diagnosed with psychotic disorder were recruited and randomly allocated either to integrated rehabilitation treatment or integrated rehabilitation treatment enhanced with 26 mindfulness group sessions. Measures comprised PANSS interview, MAAS scale, and Stroop Color Word Test (SCWT). The primary outcome variable was the performance in the non-congruent trials of the SCWT. Results: There were no differences between groups at baseline. At post-treatment patients allocated to mindfulness group increased their scores in non-congruent trials of SCWT and in MAAS. At post-treatment mindfulness group scored higher than integrated rehabilitation treatment in MAAS. Conclusions: Data suggest that mindfulness added to integrated rehabilitation treatment may improve IC in psychosis. Results are convergent with prior works about the effect of mindfulness over cognitive performance in general population.
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Affiliation(s)
- Emilio López-Navarro
- EvoCog Group, University of Balearic Islands, IFISC, Associated Unit to CSIC, Spain
- Corresponding author: EvoCog Group, Department of Psychology, AMAS Building, University of Balearic Islands, Carretera de Valldemossa km 7.5, Palma de Mallorca 07122, Balearic Islands, Spain.
| | - Cristina Del Canto
- Department of Psychiatry, Son Llàtzer Hospital, Balearic Health Service, Spain
| | - Antoni Mayol
- UCR Serralta Community Rehabilitation Centre, Balearic Health Service, Spain
| | | | - Josep Reig
- EvoCog Group, University of Balearic Islands, IFISC, Associated Unit to CSIC, Spain
| | - Enric Munar
- EvoCog Group, University of Balearic Islands, IFISC, Associated Unit to CSIC, Spain
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113
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Carlton CN, Sullivan-Toole H, Strege MV, Ollendick TH, Richey JA. Mindfulness-Based Interventions for Adolescent Social Anxiety: A Unique Convergence of Factors. Front Psychol 2020; 11:1783. [PMID: 32774320 PMCID: PMC7387717 DOI: 10.3389/fpsyg.2020.01783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Social anxiety disorder (SAD) is a debilitating and often chronic psychiatric disorder that typically onsets during early adolescence. Cognitive behavior therapy (CBT), the current "gold-standard" treatment for SAD, tends to focus on threat- and fear-based systems hypothesized to maintain the disorder. Despite this targeted approach, SAD ranks among the least responsive anxiety disorders to CBT in adolescent samples, with a considerable proportion of individuals still reporting clinically significant symptoms following treatment, suggesting that the CBT-family of interventions may not fully target precipitating or maintaining factors of the disorder. This gap in efficacy highlights the need to consider new therapeutic modalities. Accordingly, this brief review critically evaluates the emergent literature supporting the use of mindfulness-based interventions (MBIs) for treating adolescent SAD. MBIs may be particularly relevant for addressing maintaining factors within this diagnosis, as they may target and interrupt cycles of avoidance and de-motivation. Despite limitations in the relative lack of randomized controlled trials (RCTs) on this topic, a unique convergence of factors emerge from the extant literature that support the notion that MBIs may hold particular promise for attenuating symptoms of SAD in adolescents. These factors include: (1) MBIs demonstrate the ability to directly engage symptoms of SAD; (2) MBIs also show consistent reduction of anxiety, including symptoms of social anxiety in adolescent populations; and (3) MBIs demonstrate high rates of feasibility and acceptability in anxious adolescent samples. We briefly review each topic and conclude that MBIs are an encouraging treatment approach for reducing symptoms of social anxiety in adolescents. However, given the lack of research within MBIs for adolescent SAD in particular, more research is needed to determine if MBIs are more advantageous than other current treatment approaches.
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Affiliation(s)
- Corinne N. Carlton
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Holly Sullivan-Toole
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, United States
| | - Marlene V. Strege
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Thomas H. Ollendick
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - John A. Richey
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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Tejada-Gallardo C, Blasco-Belled A, Torrelles-Nadal C, Alsinet C. Effects of School-based Multicomponent Positive Psychology Interventions on Well-being and Distress in Adolescents: A Systematic Review and Meta-analysis. J Youth Adolesc 2020; 49:1943-1960. [DOI: 10.1007/s10964-020-01289-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/09/2020] [Indexed: 11/29/2022]
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115
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Quach JL, Deery B, Kern M, Clinton J, Gold L, Orsini F, Sciberras E. Can a teacher-led mindfulness intervention for new school entrants improve child outcomes? Protocol for a school cluster randomised controlled trial. BMJ Open 2020; 10:e036523. [PMID: 32393614 PMCID: PMC7223282 DOI: 10.1136/bmjopen-2019-036523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The first years of school are critical in establishing a foundation for positive long-term academic, social and well-being outcomes. Mindfulness-based interventions may help students transition well into school, but few robust studies have been conducted in this age group. We aim to determine whether compared with controls, children who receive a mindfulness intervention within the first years of primary school have better: (1) immediate attention/short-term memory at 18 months post-randomisation (primary outcome); (2) inhibition, working memory and cognitive flexibility at 18 months post-randomisation; (3) socio-emotional well-being, emotion-regulation and mental health-related behaviours at 6 and 18 months post-randomisation; (4) sustained changes in teacher practice and classroom interactions at 18 months post-randomisation. Furthermore, we aim to determine whether the implementation predicts the efficacy of the intervention, and the cost effectiveness relative to outcomes. METHODS AND ANALYSIS This cluster randomised controlled trial will be conducted in 22 primary schools in disadvantaged areas of Melbourne, Australia. 826 students in the first year of primary school will be recruited to detect between groups differences of Cohen's d=0.25 at the 18-month follow-up. Parent, teacher and child-assessment measures of child attention, emotion-regulation, executive functioning, socio-emotional well-being, mental health-related behaviour and learning, parent mental well-being, teacher well-being will be collected 6 and 18 months post-randomisation. Implementation factors will be measured throughout the study. Intention-to-treat analyses, accounting for clustering within schools and classes, will adopt a two-level random effects linear regression model to examine outcomes for the intervention versus control students. Unadjusted and analyses adjusted for baseline scores, baseline age, gender and family socioeconomic status will be conducted. ETHICS AND DISSEMINATION Ethics approval has been received by the Human Research Ethics Committee at the University of Melbourne. Findings will be reported in peer-review publications, national and international conference presentations and research snapshots directly provided to participating schools and families. PRE-RESULTS TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000326190).
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Affiliation(s)
- Jon L Quach
- Melbourne Graduate School of Education, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ben Deery
- Melbourne Graduate School of Education, The University of Melbourne, Carlton, Victoria, Australia
| | - Margaret Kern
- Melbourne Graduate School of Education, The University of Melbourne, Carlton, Victoria, Australia
| | - Janet Clinton
- Melbourne Graduate School of Education, The University of Melbourne, Carlton, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
| | - Francesca Orsini
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Emma Sciberras
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
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Abstract
Initially inspired by Buddhist philosophy and practice, mindfulness has become ubiquitous in psychotherapy, counseling, and popular psychology. Several mindfulness interventions have been developed and investigated, many of them attaining strong empirical support for a variety of conditions. However, the authors argue that mindfulness interventions should not be used uncritically and indiscriminately, because, for instance, there is not enough efficacy evidence for all the uses and applications of mindfulness (e.g., mobile apps). Second, following the definition of the concept, the authors argue that detachment may decrease motivational relevance in the face of personal goals and may encourage low intensity affect in cases where this would not be either needed or desirable. On the other hand, they argue that mindfulness-based interventions can be particularly useful treating chronic and severe cases, particularly in depression, pain conditions, and addictions.
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Affiliation(s)
- Simona Stefan
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Daniel David
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
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117
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Calvete E, Fernández-González L, Echezarraga A, Orue I. Dispositional Mindfulness Profiles in Adolescents and their Associations with Psychological Functioning and Hypothalamic-Pituitary-Adrenal Axis Hormones. J Youth Adolesc 2019; 49:1406-1419. [PMID: 31631232 DOI: 10.1007/s10964-019-01128-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
Adolescence is often accompanied by an increase in stress and depression. Although there is considerable consensus about the benefits of mindfulness-based interventions to reduce these problems, the results for the role of dispositional mindfulness facets have been mixed. Recent studies have contributed to clarifying this role by identifying subtypes of individuals according to their profiles in mindfulness facets and examining the functioning of these profiles in relation to several self-reported indicators of wellbeing and health. The current study extends previous research by exploring mindfulness profiles in adolescents and by providing several sources of indicators (self-reports, parent-reports, and hypothalamic-pituitary-adrenal axis hormones) to examine the adaptive role of these profiles. A sample of 571 adolescents (50.61% girls; 12-17 years old) completed measures of mindfulness, depression, maladaptive schemas, and temperament (neuroticism, extraversion, and effortful control), and provided salivary samples for cortisol and dehydroepiandrosterone sulfate. In addition, 331 adolescents' parents completed measures of their children' temperaments. The results of latent profile analyses supported a three-profile solution: (1) moderate mindfulness (65.5%), (2) judgmental observing (24.2%), and (3) nonjudgmentally aware (10.3%). The judgmental observing profile was associated with a worse adjustment, indicated by higher depressive symptoms, maladaptive schemas, perceived stress, stress-associated hormones, and neuroticism, as well as lower scores on extroversion and effortful control. This profile was more frequent among the oldest adolescents. In contrast, the nonjudgmentally aware group presented a better adjustment and was more frequent among the youngest adolescents. These findings have implications for preventive interventions. Analyzing the specific profile of each adolescent can help improve individual intervention, taking into account the strengths and weaknesses of each adolescent.
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Affiliation(s)
- Esther Calvete
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Spain.
| | - Liria Fernández-González
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Spain
| | - Ainara Echezarraga
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Spain
| | - Izaskun Orue
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Avenida de las Universidades, 24, 48007, Bilbao, Spain
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Vago DR, Gupta RS, Lazar SW. Measuring cognitive outcomes in mindfulness-based intervention research: a reflection on confounding factors and methodological limitations. Curr Opin Psychol 2019; 28:143-150. [PMID: 30682701 PMCID: PMC6597333 DOI: 10.1016/j.copsyc.2018.12.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/11/2018] [Accepted: 12/17/2018] [Indexed: 11/22/2022]
Abstract
One potential pathway by which mindfulness-based meditation improves health outcomes is through changes in cognitive functioning. Here, we summarize and comment upon three systematic reviews conducted over the last seven years that have had the goal of identifying the impact of mindfulness on cognitive outcomes. In our analysis, we identified a number of methodological limitations and potential confounding factors that interfere with and limit our ability to interpret the results. In order to gain a granular view of the relationship between mindfulness training and cognition, we report on the following: 1) What do we know? How does mindfulness affect cognition? 2) variable criteria that define an MBI; 2) limitations of assays used to measure cognition; and 3) methodological quality of an MBI trial and reporting of findings. Finally, we offer constructive means for interpretation and recommendations for moving the field of mindfulness research forward regarding effects on cognition.
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Affiliation(s)
- David R. Vago
- Contemplative Neuroscience and Integrative Medicine (CNIM) Laboratory, Osher Center for Integrative Medicine, Vanderbilt University, Nashville, TN, 37212, USA, ;,
| | - Resh S. Gupta
- Contemplative Neuroscience and Integrative Medicine (CNIM) Laboratory, Osher Center for Integrative Medicine, Vanderbilt University, Nashville, TN, 37212, USA, ;,
| | - Sara W. Lazar
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Boston, MA 02129, USA,
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Yaghubi M, Zargar F. Effectiveness of Mindfulness-based Relapse Prevention on Quality of Life and Craving in Methadone-treated Patients: A Randomized Clinical Trial. ADDICTION & HEALTH 2019; 10:250-259. [PMID: 31263524 PMCID: PMC6593172 DOI: 10.22122/ahj.v10i4.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Quality of life (QOL) is always considered as a final consequence of clinical trials, interventions, and health care. The results of studies indicate that addiction leads to lower QOL. However, studies have been conducted on the effectiveness of mindfulness-based interventions on improving QOL. The aim of this study was to investigate the efficacy of mindfulness-based relapse prevention (MBRP) on QOL and craving in methadone-treated patients. Methods This study was conducted in Qom, Iran, in 2017. A sample of 70 methadone-treated patients were randomly selected and assigned to two groups (intervention and control). Participants in both groups completed the 36-item Short Form (SF-36) QOL Questionnaire and Craving Beliefs Questionnaire (CBQ) at the beginning of the study (pre-test), 8 weeks after the study (post-test), and two months after the study (follow up). In this study, the experimental group received 8 training sessions on mindfulness prevention, while the control group did not receive general information about addiction and did not receive any psychological intervention. Finally, data of 63 patients were analyzed with the SPSS software, chi-square test, t-test, and repeated-measures ANOVA. Findings The results of repeated-measures ANOVA showed that there was no significant difference between intervention and control groups in the pre-test, but MBRP in the intervention group significantly increased the scores of QOL and decreased the scores of craving, significantly (P < 0.001). Conclusion The findings of present study indicate that MBRP training can increase the psychological and physical health in dependent methadone-treated patients and decrease craving. These findings suggest that mindfulness training can be used as an effective intervention for improving QOL and reducing craving.
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Affiliation(s)
- Mehdi Yaghubi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Zargar
- Associate Professor, Department of Psychiatry, School of Medicine AND Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Baer R, Crane C, Miller E, Kuyken W. Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clin Psychol Rev 2019; 71:101-114. [PMID: 30638824 PMCID: PMC6575147 DOI: 10.1016/j.cpr.2019.01.001] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 12/08/2018] [Accepted: 01/04/2019] [Indexed: 12/20/2022]
Abstract
The benefits of empirically supported mindfulness-based programs (MBPs) are well documented, but the potential for harm has not been comprehensively studied. The available literature, although too small for a systematic review, suggests that the question of harm in MBPs needs careful attention. We argue that greater conceptual clarity will facilitate more systematic research and enable interpretation of existing findings. After summarizing how mindfulness, mindfulness practices, and MBPs are defined in the evidence-based context, we examine how harm is understood and studied in related approaches to physical or psychological health and wellbeing, including psychotherapy, pharmacotherapy, and physical exercise. We also review research on harmful effects of meditation in contemplative traditions. These bodies of literature provide helpful parallels for understanding potential harm in MBPs and suggest three interrelated types of factors that may contribute to harm and require further study: program-related factors, participant-related factors, and clinician- or teacher-related factors. We discuss conceptual issues and empirical findings related to these factors and end with recommendations for future research and for protecting participants in MBPs from harm.
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Vink M, Vink-Niese A. Cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective. Re-analysis of a Cochrane review. Health Psychol Open 2019; 6:2055102919840614. [PMID: 31080632 PMCID: PMC6498783 DOI: 10.1177/2055102919840614] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Analysis of the 2008 Cochrane review of cognitive behavioural therapy for chronic fatigue syndrome shows that seven patients with mild chronic fatigue syndrome need to be treated for one to report a small, short-lived subjective improvement of fatigue. This is not matched by an objective improvement of physical fitness or employment and illness benefit status. Most studies in the Cochrane review failed to report on safety or adverse reactions. Patient evidence suggests adverse outcomes in 20 per cent of cases. If a trial of a drug or surgical procedure uncovered a similar high rate, it would be unlikely to be accepted as safe. It is time to downgrade cognitive behavioural therapy to an adjunct support-level therapy, rather than a treatment for chronic fatigue syndrome.
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Affiliation(s)
- Mark Vink
- Family and Insurance Physician, Amsterdam, The Netherlands
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