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Hsiao YY, Tofighi D, Kruger ES, Lee Van Horn M, MacKinnon DP, Witkiewitz K. The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders. Mindfulness (N Y) 2019; 10:724-736. [PMID: 30931014 PMCID: PMC6435335 DOI: 10.1007/s12671-018-1023-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The development and evaluation of mindfulness-based interventions for a variety of psychological and medical disorders has grown exponentially over the past 20 years. Yet, calls for increasing the rigor of mindfulness research and recognition of the difficulties of conducting research on the topic of mindfulness have also increased. One of the major difficulties is the measurement of mindfulness, with varying definitions across studies and ambiguity with respect to the meaning of mindfulness. There is also concern about the reproducibility of findings given few attempts at replication. The current secondary analysis addressed the issue of reproducibility and robustness of the construct of self-reported mindfulness across two separate randomized clinical trials of mindfulness-based relapse prevention (MBRP), as an aftercare treatment for substance use disorder. Specifically, we tested the robustness of our previously published findings, which identified a latent construct of mindfulness as a significant mediator of the effect of MBRP on reducing craving following treatment. First, we attempted to replicate the findings in a separate randomized clinical trial of MBRP. Second, we conducted sensitivity analyses to test the assumption of the no-omitted confounder bias in a mediation model. The effect of MBRP on self-reported mindfulness and overall mediation effect failed to replicate in a new sample. The effect of self-reported mindfulness in predicting craving following treatment did replicate and was robust to the no-omitted confounder bias. The results of this work shine a light on the difficulties in the measurement of mindfulness and the importance of examining the robustness of findings.
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302
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Predictors of Mindfulness Meditation and Exercise Practice, from MEPARI-2, a randomized controlled trial. Mindfulness (N Y) 2019; 10:1842-1854. [PMID: 31938076 DOI: 10.1007/s12671-019-01137-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives Health-supporting behaviors can be challenging to initiate and maintain. Data from the MEPARI-2 randomized trial were used to assess predictors of sustained exercise and meditation practice. Methods Adults aged 30 to 69 years not exercising regularly and without prior meditation training were randomized to 8-week trainings in mindfulness meditation, moderate intensity exercise, or observational control, and monitored for 8 months. Exercise participants reported day-to-day minutes of moderate and vigorous activity; mindfulness meditation participants reported minutes of informal and formal practice. Demographic characteristics and psychosocial factors were assessed as predictors of practice. Growth mixture modeling was used to identify higher and lower practice subgroups. Results 413 participants (75.8% female; mean (SD) age 49.7 (11.6) years) were randomized to exercise (137), mindfulness meditation (138), or control (138), with 390 (95%) completing the study. Seventy-nine percent of exercisers and 62% of meditators reported ≥150 minutes/week practice for at least half of the 37 weeks monitored. Self-reported minutes of mindfulness meditation and/or exercise practice were significantly (p<0.01) predicted by baseline levels of: general mental health, self-efficacy, perceived stress, depressive symptoms, openness, neuroticism, physical activity, smoking status, and number of social contacts. Growth mixture modeling identified subsets of people with moderate (100-200 min/week) and high (300-450 min/week) levels of self-reported practice for both mindfulness meditation (62% moderate; 38% high) and exercise (71% moderate; 29% high). Conclusions In this sample, participants randomized to behavioral trainings reported high levels of practice sustained over 37 weeks. Baseline psychosocial measures predicted practice levels in expected directions.
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303
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Characteristics of yoga and meditation users among older Australian women - results from the 45 and up study. Complement Ther Clin Pract 2019; 35:219-223. [PMID: 31003661 DOI: 10.1016/j.ctcp.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Yoga and meditation are predominantly utilised by healthy well-educated young women, but little is known about utilisation by older chronically ill women. Therefore, the purpose of this study was to investigate the characteristics of yoga and meditation use among middle-to-higher aged Australian women with chronic conditions. MATERIALS AND METHODS This is a sub-study of the 45 and Up Study including 1925 Australian women aged 53-95 years diagnosed with chronic conditions (asthma, depression, diabetes, osteoarthritis, and osteoporosis). Information on yoga and meditation use frequencies (categories: 'no yoga', 'at least once daily', 'at least once weekly', and 'at least once monthly'), self-perceived effectiveness and communication with health care providers were assessed via self-report. Logistic regression analyses were conducted to identify independent predictors of yoga and meditation use, using SPSS 24.0. RESULTS Overall 6.8% and 10.7% of women reported the use of yoga and meditation respectively. Meditation was rarely practiced supervised (11.7%), compared to significant higher rates in yoga (53.2%). Predictors for yoga and meditation use were marital status (married/in relationship > not married/in relationship), higher health related hardiness, and higher education, whereas obesity, and diabetes decreased likelihood of use. While the majority found yoga and meditation helpful for their condition, the use was rarely monitored by or discussed with health care practitioners. CONCLUSION This study finds that yoga and meditation are used by middle-to-higher aged Australian women with chronic illnesses. The lack of communication with health care providers is concerning and might hinder coordinated and effective health care around chronic illness. Further research is necessary to help understand possible concurrent health care use and thereby help inform safe, effective and coordinate health seeking amongst those with chronic illness.
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304
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Dunning DL, Griffiths K, Kuyken W, Crane C, Foulkes L, Parker J, Dalgleish T. Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents - a meta-analysis of randomized controlled trials. J Child Psychol Psychiatry 2019; 60:244-258. [PMID: 30345511 PMCID: PMC6546608 DOI: 10.1111/jcpp.12980] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design. METHODS A systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition. RESULTS Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen's d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only. CONCLUSIONS This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.
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Affiliation(s)
- Darren L. Dunning
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Kirsty Griffiths
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Willem Kuyken
- Department of PsychiatryUniversity of OxfordOxfordUK
| | | | - Lucy Foulkes
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
| | - Jenna Parker
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
- Cambridgeshire and Peterborough NHS Foundation TrustCambridgeUK
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305
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Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) is the first-choice intervention for obsessive-compulsive disorder (OCD); however, a notable proportion of patients either do not respond to treatment or relapse after CBT. Mindfulness-based treatment has been suggested as an alternative or complementary therapeutic strategy for OCD. However, only a few studies have focused on its application in clinical samples. OBJECTIVE To evaluate the impact of a new treatment, called "Mindfulness-based Cognitive Therapy for OCD." It is an 11-session manualized group intervention that integrates elements of CBT, mindfulness, compassion-focused therapy, and acceptance and commitment therapy. METHODS The program was delivered to 35 patients with a primary diagnosis of OCD. RESULTS Participants demonstrated good adherence to the intervention. There was a significant reduction in mean total score on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS-TS) (P<0.001; Cohen d=-0.72). One third of the participants (n=13) showed at least a 25% reduction on the Y-BOCS-TS, and 40% of the sample (n=14) were assigned to a lower Y-BOCS severity category after treatment. Significant changes were also found in depression (P<0.001; d=-0.80), worry (P<0.001; d=-0.79), alexithymia (P<0.01; d=-0.41), dissociation (P<0.05; d=-0.46), and general psychopathology (P<0.001; d=-0.58). Repeated measures linear mixed models showed that OCD symptom reduction was associated with an increase in mindfulness skills, in particular on the acting with awareness (P=0.006), nonjudging (P=0.001), and nonreactivity (P=0.001) facets. CONCLUSIONS Overall, these findings are promising and they suggest that randomized controlled studies be conducted to test the effectiveness of this new treatment program for this challenging and disabling mental disorder.
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306
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Greven CU, Lionetti F, Booth C, Aron EN, Fox E, Schendan HE, Pluess M, Bruining H, Acevedo B, Bijttebier P, Homberg J. Sensory Processing Sensitivity in the context of Environmental Sensitivity: A critical review and development of research agenda. Neurosci Biobehav Rev 2019; 98:287-305. [DOI: 10.1016/j.neubiorev.2019.01.009] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
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307
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Külz AK, Landmann S, Cludius B, Rose N, Heidenreich T, Jelinek L, Alsleben H, Wahl K, Philipsen A, Voderholzer U, Maier JG, Moritz S. Mindfulness-based cognitive therapy (MBCT) in patients with obsessive-compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2019; 269:223-233. [PMID: 30446822 DOI: 10.1007/s00406-018-0957-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022]
Abstract
Up to one-third of individuals with obsessive-compulsive disorder (OCD) do not benefit from evidence-based psychotherapy. We examined the efficacy of mindfulness-based cognitive therapy (MBCT) as a complementary treatment option. In a prospective, bicentric, assessor-blinded, randomized, and actively controlled clinical trial, 125 patients with OCD and residual symptoms after cognitive behavioral therapy (CBT) were randomized to either an MBCT group (n = 61) or to a psychoeducational group (OCD-EP; n = 64) as an active control condition. At post-treatment, there was no significant benefit of MBCT over OCD-EP with the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) as the primary outcome measure, but with the Obsessive-Compulsive Inventory [OCI-R; F(1, 101) = 5.679, p = .036, effect size η2partial = 0.053]. Moreover, the response rate and the improvement on secondary outcomes such as obsessive beliefs and quality of life was significantly larger in the MBCT group. Non-completion rates were below 10%. At the 6-month follow-up, OC symptoms were further improved in both groups; group differences were no longer significant. Our findings suggest that MBCT, compared to a psychoeducational program, leads to accelerated improvement of self-reported OC symptoms and secondary outcomes, but not of clinician-rated OC symptoms. In the midterm, both interventions yield similar and stable, but small improvements, suggesting that additional treatment options may be necessary.
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Affiliation(s)
- Anne Katrin Külz
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany.
| | - Sarah Landmann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Barbara Cludius
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nina Rose
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | | | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Alsleben
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karina Wahl
- Department of Psychology, Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Jonathan G Maier
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104, Freiburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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308
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Nguyen MC, Gabbe SG, Kemper KJ, Mahan JD, Cheavens JS, Moffatt-Bruce SD. Training on mind-body skills: Feasibility and effects on physician mindfulness, compassion, and associated effects on stress, burnout, and clinical outcomes. JOURNAL OF POSITIVE PSYCHOLOGY 2019. [DOI: 10.1080/17439760.2019.1578892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Michelle C. Nguyen
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Steven G. Gabbe
- Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center
| | - Kathi J. Kemper
- Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - John D. Mahan
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | | | - Susan D. Moffatt-Bruce
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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309
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Effects of Mindfulness-Based Cognitive Therapy on a Behavioural Measure of Rumination in Patients with Chronic, Treatment-Resistant Depression. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-09997-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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310
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Goldberg SB, Tucker RP, Greene PA, Davidson RJ, Kearney DJ, Simpson TL. Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis. Cogn Behav Ther 2019; 48:445-462. [PMID: 30732534 DOI: 10.1080/16506073.2018.1556330] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to non-specific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [-0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [-0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [-0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.
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Affiliation(s)
- Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin - Madison , WI , USA.,Center for Healthy Minds, University of Wisconsin - Madison , WI , USA.,VA Puget Sound Health Care System , Seattle , WA , USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University , Baton Rouge , LA , USA
| | | | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin - Madison , WI , USA.,Department of Psychology, University of Wisconsin - Madison , WI , USA
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311
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Barcaccia B, Baiocco R, Pozza A, Pallini S, Mancini F, Salvati M. The more you judge the worse you feel. A judgemental attitude towards one's inner experience predicts depression and anxiety. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.09.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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312
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Huijbers MJ, Wentink C, Speckens AEM. Preventive cognitive therapy could be a viable and effective addition to antidepressant medication in preventing relapse or recurrence in major depressive disorder. EVIDENCE-BASED MENTAL HEALTH 2019; 22:e7. [PMID: 30530763 PMCID: PMC10270387 DOI: 10.1136/ebmental-2018-300054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/30/2018] [Accepted: 11/12/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Marloes J Huijbers
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carolien Wentink
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
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313
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Bisseling EM, Schellekens MPJ, Spinhoven P, Compen FR, Speckens AEM, van der Lee ML. Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients. Clin Psychol Psychother 2019; 26:309-318. [PMID: 30650245 PMCID: PMC6680267 DOI: 10.1002/cpp.2352] [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] [Received: 06/26/2018] [Revised: 11/13/2018] [Accepted: 01/07/2019] [Indexed: 11/06/2022]
Abstract
Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet‐based versus group‐based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group‐based MBCT out of 120 patients who were randomized to group‐based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.
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Affiliation(s)
- Else M Bisseling
- Department of Psychiatry, Radboud University Nijmegen Medical Centre for Mindfulness, Nijmegen, The Netherlands.,Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Melanie P J Schellekens
- Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Félix R Compen
- Department of Psychiatry, Radboud University Nijmegen Medical Centre for Mindfulness, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Nijmegen Medical Centre for Mindfulness, Nijmegen, The Netherlands
| | - Marije L van der Lee
- Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
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314
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Abdoun O, Zorn J, Poletti S, Fucci E, Lutz A. Training novice practitioners to reliably report their meditation experience using shared phenomenological dimensions. Conscious Cogn 2019; 68:57-72. [PMID: 30658238 PMCID: PMC6374282 DOI: 10.1016/j.concog.2019.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 10/29/2022]
Abstract
Empirical descriptions of the phenomenology of meditation states rely on practitioners' ability to provide accurate information on their experience. We present a meditation training protocol that was designed to equip naive participants with a theoretical background and experiential knowledge that would enable them to share their experience. Subsequently, novices carried on with daily practice during several weeks before participating in experiments. Using a neurophenomenological experiment designed to explore two different meditation states (focused attention and open monitoring), we found that self-reported phenomenological ratings (i) were sensitive to meditation states, (ii) reflected meditation dose and fatigue effects, and (iii) correlated with behavioral measures (variability of response time). Each of these effects was better predicted by features of participants' daily practice than by desirable responding. Our results provide evidence that novice practitioners can reliably report their experience along phenomenological dimensions and warrant the future investigation of this training protocol with a longitudinal design.
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Affiliation(s)
- Oussama Abdoun
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR5292, Lyon 1 University, Lyon, France
| | - Jelle Zorn
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR5292, Lyon 1 University, Lyon, France
| | - Stefano Poletti
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR5292, Lyon 1 University, Lyon, France
| | - Enrico Fucci
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR5292, Lyon 1 University, Lyon, France
| | - Antoine Lutz
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR5292, Lyon 1 University, Lyon, France.
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315
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Tickell A, Ball S, Bernard P, Kuyken W, Marx R, Pack S, Strauss C, Sweeney T, Crane C. The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services. Mindfulness (N Y) 2019; 11:279-290. [PMID: 32064009 PMCID: PMC6995449 DOI: 10.1007/s12671-018-1087-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Depression is common with a high risk of relapse/recurrence. There is evidence from multiple randomised controlled trials (RCTs) demonstrating the efficacy of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence, and it is included in several national clinical guidelines for this purpose. However, little is known about whether MBCT is being delivered safely and effectively in real-world healthcare settings. In the present study, five mental health services from a range of regions in the UK contributed data (n = 1554) to examine the impact of MBCT on depression outcomes. Less than half the sample (n = 726, 47%) entered with Patient Health Questionnaire (PHQ-9) scores in the non-depressed range, the group for whom MBCT was originally intended. Of this group, 96% sustained their recovery (remained in the non-depressed range) across the treatment period. There was also a significant reduction in residual symptoms, consistent with a reduced risk of depressive relapse. The rest of the sample (n = 828, 53%) entered treatment with PHQ-9 scores in the depressed range. For this group, 45% recovered (PHQ-9 score entered the non-depressed range), and overall, there was a significant reduction in depression severity from pre-treatment to post-treatment. For both subgroups, the rate of reliable deterioration (3%) was comparable to other psychotherapeutic interventions delivered in similar settings. We conclude that MBCT is being delivered effectively and safely in routine clinical settings, although its use has broadened from its original target population to include people experiencing current depression. Implications for implementation are discussed.
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Affiliation(s)
- Alice Tickell
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Susan Ball
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Paul Bernard
- Tees Esk and Wear Valleys NHS Foundation Trust, Durham, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Robert Marx
- Sussex Partnership NHS Foundation Trust, Sussex, UK
| | | | - Clara Strauss
- Sussex Partnership NHS Foundation Trust & School of Psychology, University of Sussex, Sussex, UK
| | - Tim Sweeney
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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316
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Abstract
Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.
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Affiliation(s)
- David McDaid
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
| | - A-La Park
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
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317
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318
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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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319
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Richard N. Psychotherapy for Depressive Disorders. Pain 2019. [DOI: 10.1007/978-3-319-99124-5_88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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320
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Breedvelt JJF, Amanvermez Y, Harrer M, Karyotaki E, Gilbody S, Bockting CLH, Cuijpers P, Ebert DD. The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis. Front Psychiatry 2019; 10:193. [PMID: 31068842 PMCID: PMC6491852 DOI: 10.3389/fpsyt.2019.00193] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/18/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Meditation, yoga, and mindfulness are popular interventions at universities and tertiary education institutes to improve mental health. However, the effects on depression, anxiety, and stress are unclear. This study assessed the effectiveness of meditation, yoga, and mindfulness on symptoms of depression, anxiety, and stress in tertiary education students. Methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, PsycINFO and identified 11,936 articles. After retrieving 181 papers for full-text screening, 24 randomized controlled trials were included in the qualitative analysis. We conducted a random-effects meta-analysis amongst 23 studies with 1,373 participants. Results: At post-test, after exclusion of outliers, effect sizes for depression, g = 0.42 (95% CI: 0.16-0.69), anxiety g = 0.46 (95% CI: 0.34-0.59), stress g = 0.42 (95% CI: 0.27-0.57) were moderate. Heterogeneity was low (I 2 = 6%). When compared to active control, the effect decreased to g = 0.13 (95% CI: -0.18-0.43). No RCT reported on safety, only two studies reported on academic achievement, most studies had a high risk of bias. Conclusions: Most studies were of poor quality and results should be interpreted with caution. Overall moderate effects were found which decreased substantially when interventions were compared to active control. It is unclear whether meditation, yoga or mindfulness affect academic achievement or affect have any negative side effects.
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Affiliation(s)
- Josefien J F Breedvelt
- Department of Psychiatry, Academic Medical Center, Amsterdam University Medical Center, Amsterdam, Netherlands.,Research Department, Mental Health Foundation, London, United Kingdom
| | - Yagmur Amanvermez
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Mathias Harrer
- Department of Psychology, Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Eirini Karyotaki
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Simon Gilbody
- Mental Health and Addictions Research Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Claudi L H Bockting
- Department of Psychiatry, Academic Medical Center, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - David D Ebert
- Department of Psychology, Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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321
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Mander J, Blanck P, Neubauer AB, Kröger P, Flückiger C, Lutz W, Barnow S, Bents H, Heidenreich T. Mindfulness and progressive muscle relaxation as standardized session-introduction in individual therapy: A randomized controlled trial. J Clin Psychol 2019; 75:21-45. [PMID: 30295914 PMCID: PMC6826255 DOI: 10.1002/jclp.22695] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE There is scarce research on the effects of mindfulness in individual therapy. As many practitioners integrate mindfulness exercises into individual therapy, empirical evidence is of high clinical relevance. METHOD We investigated the effects of a session-introducing intervention with mindfulness elements (SIIME) in a randomized, controlled design. The effects of SIIME on therapeutic alliance and symptomatic outcome were compared with progressive muscle relaxation (PMR) and treatment-as-usual (TAU) control conditions. The sample comprised 162 patients with anxiety and depression. RESULTS Multilevel modeling revealed a significant symptom reduction and significant increase of alliance over the course of therapy. There were no significant time-condition interactions on outcome and alliance, indicating the comparable efficiency of all three treatment conditions. CONCLUSIONS We found no advantage of SIIME versus PMR and TAU. Add-on mindfulness might not improve individual therapy related to alliance and outcome.
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Affiliation(s)
- Johannes Mander
- Center for Psychological PsychotherapyUniversity of HeidelbergHeidelbergGermany
| | - Paul Blanck
- Center for Psychological PsychotherapyUniversity of HeidelbergHeidelbergGermany
| | - Andreas B. Neubauer
- German Institute for International Educational Research (DIPF)Frankfurt am MainGermany
| | - Paula Kröger
- Center for Psychological PsychotherapyUniversity of HeidelbergHeidelbergGermany
| | - Christoph Flückiger
- Department of Clinical Psychology and PsychotherapyUniversity of ZürichZürichSwitzerland
| | - Wolfgang Lutz
- Department of Clinical Psychology and PsychotherapyUniversity of TrierTrierGermany
| | - Sven Barnow
- Department of Clinical Psychology and PsychotherapyUniversity of HeidelbergHeidelbergGermany
| | - Hinrich Bents
- Center for Psychological PsychotherapyUniversity of HeidelbergHeidelbergGermany
| | - Thomas Heidenreich
- Department of Social Work, Health and NursingUniversity of Applied Sciences EsslingenEsslingen am NeckarGermany
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322
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Lutz A, Klimecki OM, Collette F, Poisnel G, Arenaza-Urquijo E, Marchant NL, De La Sayette V, Rauchs G, Salmon E, Vuilleumier P, Frison E, Vivien D, Chételat G. The Age-Well observational study on expert meditators in the Medit-Ageing European project. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2018; 4:756-764. [PMID: 30662933 PMCID: PMC6300614 DOI: 10.1016/j.trci.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The Age-Well observational, cross-sectional study investigates the affective and cognitive mechanisms of meditation expertise with behavioral, neuroimaging, sleep, and biological measures sensitive to aging and Alzheimer's disease (AD). METHODS Thirty cognitively unimpaired individuals aged 65 years or older with at least 10,000 hours of practice in mindfulness meditation (MM) and loving-kindness and compassion meditation (LKCM) are selected. The outcomes are the neuroimaging brain correlates of MM and LKCM and the assessments of long-term meditation practices on behavioral, neural, and biological measures as compared to nonmeditator older controls from the Age-Well randomized controlled trial. RESULTS Recruitment and data collection began in late 2016 and will be completed by late 2019. DISCUSSION Results are expected to foster the understanding of the effects of meditation expertise on aging and of the mechanisms of action underlying the meditation intervention in the Age-Well randomized controlled trial. These finding will contribute to the design of meditation-based prevention randomized controlled trials for the aged population and to the exploration of the possible long-time developmental trajectory of meditation training.
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Affiliation(s)
- Antoine Lutz
- Lyon Neuroscience Research Center INSERM U1028, CNRS UMR5292, Lyon University, Lyon, France
| | - Olga M. Klimecki
- Swiss Center for Affective Sciences, Department of Medicine and Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Fabienne Collette
- GIGA-CRC, In Vivo Imaging, Université de Liège, Liège, Belgium
- Belgian National Fund for Scientific Research (F.R.S.-FNRS), Bruxelles, Belgium
| | - Géraldine Poisnel
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
| | - Eider Arenaza-Urquijo
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
| | | | - Vincent De La Sayette
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1077, GIP Cyceron, Caen, France
- CHU Caen-Normandie, Department of Clinical Research, Caen, France
| | - Géraldine Rauchs
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1077, GIP Cyceron, Caen, France
| | - Eric Salmon
- GIGA-CRC, In Vivo Imaging, Université de Liège, Liège, Belgium
- Belgian National Fund for Scientific Research (F.R.S.-FNRS), Bruxelles, Belgium
| | | | - Eric Frison
- EUCLID/F-CRIN Clinical Trials Platform, University of Bordeaux, INSERM, Bordeaux Population Health Center, Bordeaux, France
- CHU Bordeaux, F-33000 Bordeaux, France
| | - Denis Vivien
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
- CHU Caen-Normandie, Department of Clinical Research, Caen, France
| | - Gaël Chételat
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
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323
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The Age-Well randomized controlled trial of the Medit-Ageing European project: Effect of meditation or foreign language training on brain and mental health in older adults. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2018; 4:714-723. [PMID: 30581977 PMCID: PMC6296161 DOI: 10.1016/j.trci.2018.10.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction The Age-Well clinical trial is an ongoing monocentric, randomized, controlled trial aiming to assess an 18-month preventive meditation-based intervention directly targeting the attentional and emotional dimensions of aging to promote mental health and well-being in elderly people. Methods One hundred thirty-seven cognitively unimpaired older adults are randomized to either an 18-month meditation-based intervention, a structurally matched foreign language training, or a passive control arm. The impact of the intervention and underlying mechanisms are assessed with detailed cognitive, behavioral, biological, neuroimaging and sleep examinations. Results Recruitment began in late 2016 and ended in May 2018. The interventions are ongoing and will be completed by early 2020. Discussion This is the first trial addressing the emotional and cognitive dimension of aging with a long-term nonpharmacological approach and using comprehensive assessments to investigate the mechanisms. Results are expected to foster the development of preventive strategies reducing the negative impact of mental conditions and disorders. Meditation or language training could improve mental health and well-being in aging. Age-Well is a randomized controlled trial targeting mental health in aging. Age-Well includes 18-month meditation and foreign language training in 137 elderly. Age-Well interventions are expected to positively impact brain structure and function.
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324
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Wielgosz J, Goldberg SB, Kral TRA, Dunne JD, Davidson RJ. Mindfulness Meditation and Psychopathology. Annu Rev Clin Psychol 2018; 15:285-316. [PMID: 30525995 DOI: 10.1146/annurev-clinpsy-021815-093423] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.
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Affiliation(s)
- Joseph Wielgosz
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA; , , , , .,Sierra Pacific MIRECC, VA Palo Alto Health Care System, Palo Alto, California 94304, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California 94304, USA
| | - Simon B Goldberg
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA; , , , , .,Department of Counseling Psychology, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA
| | - Tammi R A Kral
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA; , , , , .,Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA.,Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA
| | - John D Dunne
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA; , , , , .,Department of Asian Languages and Cultures, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA; , , , , .,Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA.,Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA.,Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin 53703, USA
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325
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Teoh D, Smith TJ, Song M, Spirtos NM. Care After Chemotherapy: Peripheral Neuropathy, Cannabis for Symptom Control, and Mindfulness. Am Soc Clin Oncol Educ Book 2018; 38:469-479. [PMID: 30231411 DOI: 10.1200/edbk_209437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
As cancer therapies improve, patients are living longer. With these improvements in therapy comes a responsibility to optimize patients' quality of life during cancer therapy and beyond. This report reviews three timely and important topics. The first section reviews the mechanism underlying chemotherapy-induced peripheral neuropathy and evaluates the evidence for interventions to prevent and treat peripheral neuropathy. It also provides a framework for approaching the diagnosis and management of this common and bothersome side effect. The second section addresses the controversial but effective use of cannabinoids for cancer and chemotherapy symptoms. Although clinical trials are difficult to conduct because of the political and social stigma of this class of drugs, this review provides evidence of the efficacy of cannabinoids for treatment of pain and nausea. The last section addresses the mind-body connection, with a focus on the negative emotions patients with cancer often experience. This section assesses the literature regarding mindfulness-based programs to improve cancer-related stress. These three topics may appear unrelated, but all address one common goal: treating the body and the mind to optimize quality of life during and after cancer therapy.
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Affiliation(s)
- Deanna Teoh
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
| | - Thomas J Smith
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
| | - Mihae Song
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
| | - Nick M Spirtos
- From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV
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326
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Vieten C, Wahbeh H, Cahn BR, MacLean K, Estrada M, Mills P, Murphy M, Shapiro S, Radin D, Josipovic Z, Presti DE, Sapiro M, Chozen Bays J, Russell P, Vago D, Travis F, Walsh R, Delorme A. Future directions in meditation research: Recommendations for expanding the field of contemplative science. PLoS One 2018; 13:e0205740. [PMID: 30403693 PMCID: PMC6221271 DOI: 10.1371/journal.pone.0205740] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 10/01/2018] [Indexed: 02/07/2023] Open
Abstract
The science of meditation has grown tremendously in the last two decades. Most studies have focused on evaluating the clinical effectiveness of mindfulness-based interventions, neural and other physiological correlates of meditation, and individual cognitive and emotional aspects of meditation. Far less research has been conducted on more challenging domains to measure, such as group and relational, transpersonal and mystical, and difficult aspects of meditation; anomalous or extraordinary phenomena related to meditation; and post-conventional stages of development associated with meditation. However, these components of meditation may be crucial to people's psychological and spiritual development, could represent important mediators and/or mechanisms by which meditation confers benefits, and could themselves be important outcomes of meditation practices. In addition, since large numbers of novices are being introduced to meditation, it is helpful to investigate experiences they may encounter that are not well understood. Over the last four years, a task force of meditation researchers and teachers met regularly to develop recommendations for expanding the current meditation research field to include these important yet often neglected topics. These meetings led to a cross-sectional online survey to investigate the prevalence of a wide range of experiences in 1120 meditators. Results show that the majority of respondents report having had many of these anomalous and extraordinary experiences. While some of the topics are potentially controversial, they can be subjected to rigorous scientific investigation. These arenas represent largely uncharted scientific terrain and provide excellent opportunities for both new and experienced researchers. We provide suggestions for future directions, with accompanying online materials to encourage such research.
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Affiliation(s)
- Cassandra Vieten
- Research Department, Institute of Noetic Sciences, Petaluma, California, United States of America
| | - Helané Wahbeh
- Research Department, Institute of Noetic Sciences, Petaluma, California, United States of America
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - B. Rael Cahn
- Department of Psychiatry, University of Southern California, Los Angeles, California, United States of America
| | - Katherine MacLean
- Center for Optimal Living, New York, New York, United States of America
| | - Mica Estrada
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, San Francisco, California, United States of America
| | - Paul Mills
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
| | - Michael Murphy
- Center for Theory and Research, Esalen Institute, Big Sur, California, United States of America
| | - Shauna Shapiro
- Department of Counseling Psychology, Santa Clara University, Santa Clara, California, United States of America
| | - Dean Radin
- Research Department, Institute of Noetic Sciences, Petaluma, California, United States of America
| | - Zoran Josipovic
- Department of Psychology, New York University and Nonduality Institute, New York, New York, United States of America
| | - David E. Presti
- Department of Molecular and Cell Biology, University of California, Berkeley, California, United States of America
| | - Michael Sapiro
- Research Department, Institute of Noetic Sciences, Petaluma, California, United States of America
| | - Jan Chozen Bays
- Randall Children’s Hospital, Portland, Oregon, United States of America
| | - Peter Russell
- Research Department, Institute of Noetic Sciences, Petaluma, California, United States of America
| | - David Vago
- Osher Center for Integrative Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Fred Travis
- Center for Brain, Consciousness and Cognition, Maharishi University of Management, Fairfield, Iowa, United States of America
| | - Roger Walsh
- School of Medicine, University of California, Irvine, California, United States of America
| | - Arnaud Delorme
- Research Department, Institute of Noetic Sciences, Petaluma, California, United States of America
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
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327
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Lovas DA, Schuman-Olivier Z. Mindfulness-based cognitive therapy for bipolar disorder: A systematic review. J Affect Disord 2018; 240:247-261. [PMID: 30086469 PMCID: PMC7448295 DOI: 10.1016/j.jad.2018.06.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Persisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of first-line, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that it may have effects on some of the theorized pathophysiological processes in BD. METHODS We conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD. RESULTS This search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control. LIMITATIONS As meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated. CONCLUSIONS MBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.
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Affiliation(s)
- David A Lovas
- IWK Health Centre, Department of Psychiatry, Dalhousie University; 5980 University Ave, Halifax, Nova Scotia, B3K 6R8.
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Department of Psychiatry, Harvard Medical School, USA
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328
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Hitchcock C, Gormley S, Rees C, Rodrigues E, Gillard J, Panesar I, Wright IM, Hammond E, Watson P, Werner-Seidler A, Dalgleish T. A randomised controlled trial of memory flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with major depressive disorder. Behav Res Ther 2018; 110:22-30. [PMID: 30199738 PMCID: PMC6173798 DOI: 10.1016/j.brat.2018.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
Abstract
Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval can thereby have a detrimental impact on mental health. This randomised controlled phase II exploratory trial (N = 60) evaluated the potential of a novel intervention drawn from basic science - an autobiographical Memory Flexibility (MemFlex) training programme - which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and diagnostic status at three-month follow-up. These effect sizes could subsequently be used to estimate sample size for a fully-powered trial. Results demonstrated small-moderate, though as expected statistically non-significant, effect sizes in favour of MemFlex for memory flexibility (d = 0.34, p = .20), and loss of diagnosis (OR = 0.65, p = .48), along with the secondary outcome of depression-free days (d = 0.36, p = .18). A smaller effect size was observed for between-group difference in self-reported depressive symptoms (d = 0.24, p = .35). Effect sizes in favour of MemFlex in this early-stage trial suggest that fully-powered evaluation of MemFlex may be warranted as an avenue to improving low-intensity treatment of depression. TRIAL REGISTRATION ClinicalTrials.gov, Identifier NCT02371291.
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Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom.
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Julia Gillard
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Inderpal Panesar
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Isobel M Wright
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
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Timm C, Rachota-Ubl B, Beddig T, Zamoscik VE, Ebner-Priemer U, Reinhard I, Kirsch P, Kuehner C. Mindfulness-Based Attention Training Improves Cognitive and Affective Processes in Daily Life in Remitted Patients with Recurrent Depression: A Randomized Controlled Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2018; 87:184-186. [PMID: 29768276 DOI: 10.1159/000488862] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/27/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Timm
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bettina Rachota-Ubl
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Park Clinic Wiesbaden Schlangenbad, Schlangenbad, Germany
| | - Theresa Beddig
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vera E Zamoscik
- Department of Clinical Psychology, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrich Ebner-Priemer
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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330
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Running too far ahead? Towards a broader understanding of mindfulness in organisations. Curr Opin Psychol 2018; 28:32-36. [PMID: 30390478 DOI: 10.1016/j.copsyc.2018.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 12/18/2022]
Abstract
Current workplace mindfulness research and interventions assume that teaching mindfulness will have beneficial effects for people and organizations. While research shows that mindfulness trainings may increase resilience of working adults, assuming that mindfulness will have independent effects on outcomes at different levels of an organization is not well grounded. We assert that mindfulness training would, however, be beneficial for organizations when tailored to that context and shaped by an understanding of organizational theory and practice. We also envisage mindfulness as a beneficial property of teams, organizations and the individuals who constitute them. To close the evidence gap we propose building multi-level models of mindfulness in organizations, broadening training programs, and developing a novel competency framework for teachers in this context.
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331
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Cognitive control neuroimaging measures differentiate between those with and without future recurrence of depression. NEUROIMAGE-CLINICAL 2018; 20:1001-1009. [PMID: 30321791 PMCID: PMC6197328 DOI: 10.1016/j.nicl.2018.10.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 12/18/2022]
Abstract
Background Major Depressive Disorder (MDD) is a prevalent, disruptive illness. A majority of those with MDD are at high risk for recurrence and increased risk for morbidity and mortality. This study examined whether multimodal baseline (and retest) Cognitive Control performance and neuroimaging markers (task activation and neural connectivity between key brain nodes) could differentiate between those with and without future recurrence of a major depressive (MD) episode within one year. We hypothesized that performance and neuroimaging measures of Cognitive Control would identify markers that differ between these two groups. Methods A prospective cohort study of young adults (ages 18–23) with history (h) of early-onset MDD (N = 60), now remitted, and healthy young adults (N = 49). Baseline Cognitive Control measures of performance, task fMRI and resting state connectivity (and reliability retest 4–12 weeks later) were used to compare those with future recurrence of MDD (N = 21) relative to those without future recurrence of MDD (N = 34 with resilience). The measures tested were (1) Parametric Go/No-Go (PGNG) performance, and task activation for (2) PGNG Correct Rejections, (3) PGNG Commission errors, and (4 & 5), resting state connectivity analyses of Cognitive Control Network to and from subgenual anterior cingulate. Results Relative to other groups at baseline, the group with MDD Recurrence had less bilateral middle frontal gyrus activation during commission errors. MDD Recurrence exhibited greater connectivity of right middle frontal gyrus to subgenual anterior cingulate (SGAC). SGAC connectivity was also elevated in this group to numerous regions in the Cognitive Control Network. Moderate to strong ICCs were present from test to retest, and highest for rs-fMRI markers. There were modest, significant correlations between task, connectivity and behavioral markers that distinguished between groups. Conclusion Markers of Cognitive Control function could identify those with early course MD who are at risk for depression recurrence. Those at high risk for recurrence would benefit from maintenance or preventative treatments. Future studies could test and validate these markers as potential predictors, accounting for sample selection and bias in feature detection. Tools are needed to increase identification of MDD recurrence Cognitive control behavior and depression symptoms have been predictive of recurrence in prior studies, but with low accuracy In remitted Major Depressive Disorder, those who will go on to have future depressive episodes differed in cognitive control activation and connectivity Symptoms, performance, task activation, and seed-based connectivity can contribute to identification of risk for recurrence
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332
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Cladder‐Micus MB, Speckens AE, Vrijsen JN, T. Donders AR, Becker ES, Spijker J. Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial. Depress Anxiety 2018; 35:914-924. [PMID: 30088834 PMCID: PMC6175087 DOI: 10.1002/da.22788] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Chronic and treatment-resistant depressions pose serious problems in mental health care. Mindfulness-based cognitive therapy (MBCT) is an effective treatment for remitted and currently depressed patients. It is, however, unknown whether MBCT is effective for chronic, treatment-resistant depressed patients. METHOD A pragmatic, multicenter, randomized-controlled trial was conducted comparing treatment-as-usual (TAU) with MBCT + TAU in 106 chronically depressed outpatients who previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions). RESULTS Based on the intention-to-treat (ITT) analysis, participants in the MBCT + TAU condition did not have significantly fewer depressive symptoms than those in the TAU condition (-3.23 [-6.99 to 0.54], d = 0.35, P = 0.09) at posttreatment. However, compared to TAU, the MBCT + TAU group reported significantly higher remission rates (χ2 (2) = 4.25, φ = 0.22, P = 0.04), lower levels of rumination (-3.85 [-7.55 to -0.15], d = 0.39, P = 0.04), a higher quality of life (4.42 [0.03-8.81], d = 0.42, P = 0.048), more mindfulness skills (11.25 [6.09-16.40], d = 0.73, P < 0.001), and more self-compassion (2.91 [1.17-4.65], d = 0.64, P = 0.001). The percentage of non-completers in the MBCT + TAU condition was relatively high (n = 12, 24.5%). Per-protocol analyses revealed that those who completed MBCT + TAU had significantly fewer depressive symptoms at posttreatment compared to participants receiving TAU (-4.24 [-8.38 to -0.11], d = 0.45, P = 0.04). CONCLUSION Although the ITT analysis did not reveal a significant reduction in depressive symptoms of MBCT + TAU over TAU, MBCT + TAU seems to have beneficial effects for chronic, treatment-resistant depressed patients in terms of remission rates, rumination, quality of life, mindfulness skills, and self-compassion. Additionally, patients who completed MBCT showed significant reductions in depressive symptoms. Reasons for non-completion should be further investigated.
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Affiliation(s)
- Mira B. Cladder‐Micus
- Behavioural Science InstituteRadboud University NijmegenNijmegenThe Netherlands,Depression Expertise CentrePro Persona Mental Health CareNijmegenThe Netherlands,Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
| | - Anne E.M. Speckens
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
| | - Janna N. Vrijsen
- Depression Expertise CentrePro Persona Mental Health CareNijmegenThe Netherlands,Department of PsychiatryDonders Institute for BrainCognition and BehaviourRadboud University Medical CenterNijmegenThe Netherlands
| | - A. Rogier T. Donders
- Department for Health EvidenceRadboud University Medical CenterNijmegenThe Netherlands
| | - Eni S. Becker
- Behavioural Science InstituteRadboud University NijmegenNijmegenThe Netherlands
| | - Jan Spijker
- Behavioural Science InstituteRadboud University NijmegenNijmegenThe Netherlands,Depression Expertise CentrePro Persona Mental Health CareNijmegenThe Netherlands
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333
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Garzón de la Iglesia J, Caparrós de la Jara M, Fernández Horcajuelo J. Experiencia con intervención basada en mindfulness (atención plena) en pacientes de un centro de salud urbano. Semergen 2018; 44:463-471. [DOI: 10.1016/j.semerg.2018.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 04/16/2018] [Accepted: 04/20/2018] [Indexed: 10/28/2022]
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334
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Stötter A, Harrer ME, Mosgoeller W, Endler PC, Haring C. [Achtsame Massage und Achtsamkeitsschulung (Insightouch®) bei Depressionen, psychosomatischen und Bindungsstörungen]. Complement Med Res 2018; 26:4-12. [PMID: 30261502 DOI: 10.1159/000492060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hintergrund: Bindungsstörungen können das Auftreten von Angst und Depression begünstigen, lassen sich aber durch korrigierende emotionale Erfahrungen verändern. Eine Massage - insbesondere wenn beide, Masseur (m/w) und Klient, sich in einem Zustand der Achtsamkeit befinden - kann eine solche korrigierende Erfahrung vermitteln. In der vorliegenden Interventionsstudie wurden die Auswirkungen von Insightouch® - einer Kombination von achtsamkeitsbasierter Massage mit Achtsamkeitsschulung - untersucht. Teilnehmer und Methoden: Wir rekrutierten 36 Personen mit psychischen Beschwerden, geringer Bindungsfähigkeit und geringer Achtsamkeit. In Intervallen von 8 Wochen wurden mittels validierter Fragebögen Parameter wie psychosomatische Symptome (Brief Symptom Inventory), Bindungsqualitäten (Adult Attachment Scale) und Achtsamkeit (Freiburger Achtsamkeitsfragebogen) erhoben. Die Hälfte der Teilnehmer (Gruppe A) startete mit der 8-wöchigen Behandlungsphase; nach weiteren 8 Wochen ohne Behandlung wurde die Nachhaltigkeit der Behandlungswirkung dokumentiert. Die Teilnehmer der Gruppe B starteten mit einer 8-wöchigen Wartephase (Kontrollphase ohne Behandlung), gefolgt von der Behandlungsphase. Ergebnisse: Während sich nach der Kontrollphase keine signifikanten Änderungen zeigten, bewirkte die aktive Behandlung statistisch signifikante Besserungen der 1) Symptomatik, 2) Bindungsdefizite und 3) Achtsamkeit. Nach der 8-wöchigen Nachbeobachtungsphase waren die psychischen und die bindungsbezogenen Symptome weiter verbessert; die behandlungsbedingt erhöhte Fähigkeit zur Achtsamkeit blieb hoch. Schlussfolgerung: Insightouch als primär nonverbale Intervention erhöht die Bindungsfähigkeit, verbessert psychosomatische Symptome und erhöht nachhaltig die Fähigkeit zur Achtsamkeit.
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335
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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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336
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Michalak J, Heidenreich T. Dissemination before evidence? What are the driving forces behind the dissemination of mindfulness‐based interventions? CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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337
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Shallcross AJ, Willroth EC, Fisher A, Dimidjian S, Gross JJ, Visvanathan PD, Mauss IB. Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month Follow-Up of Mindfulness-Based Cognitive Therapy Versus an Active Control. Behav Ther 2018; 49:836-849. [PMID: 30146148 PMCID: PMC6112178 DOI: 10.1016/j.beth.2018.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/23/2018] [Accepted: 02/02/2018] [Indexed: 12/18/2022]
Abstract
We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n = 46) or the ACC (n = 46). Outcomes were assessed at baseline; postintervention; and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26-month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from postintervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b = -4.12, p <= .008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.
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338
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An evaluation of mindfulness-based childbirth and parenting courses for pregnant women and prospective fathers/partners within the UK NHS (MBCP-4-NHS). Midwifery 2018; 64:1-10. [DOI: 10.1016/j.midw.2018.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/05/2018] [Accepted: 05/08/2018] [Indexed: 01/26/2023]
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339
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Askey-Jones R. Mindfulness-based cognitive therapy: An efficacy study for mental health care staff. J Psychiatr Ment Health Nurs 2018; 25:380-389. [PMID: 29782077 DOI: 10.1111/jpm.12472] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/10/2018] [Accepted: 05/15/2018] [Indexed: 12/30/2022]
Abstract
WHAT IS KNOWN OF THE SUBJECT Burnout is a major concern within the NHS impacting negatively on mental healthcare professionals. Evidence suggests that burnout can lead to reduced productivity and reduced quality of care for patients. Mindfulness-based interventions (MBIs) have demonstrated effectiveness in mitigating burnout for healthcare professionals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE This paper reinforces the positive outcomes within the current literature that MBIs can help reduce burnout amongst mental healthcare professionals. The strength of the paper is that it reports significant correlations between decreased burnout following an increase in mindfulness. No previous research has examined this area and this is the first study to do so. The participants within this study demonstrated increased personal accomplishment and decreased emotional exhaustion following an 8-week MBCT course which was maintained at 6-month follow-up. WHAT ARE THE IMPLICATIONS FOR PRACTICE Occupational departments should consider MBI's as part of a package of care for mental healthcare staff as a preventative intervention or as a means of reducing burnout amongst healthcare staff that are currently experiencing emotional and physical exhaustion. ABSTRACT Introduction Burnout is a major concern within the NHS impacting negatively on mental healthcare professionals. Evidence suggests that burnout can lead to reduced productivity and reduced quality of care for patients. Mindfulness-based interventions (MBIs) have demonstrated effectiveness in mitigating burnout for healthcare professionals; however, no previous research has directly reported correlations between burnout and mindfulness. Aim Does mindfulness-based cognitive therapy (MBCT) reduce burnout amongst mental healthcare professionals and are there any direct correlations between mindfulness and burnout itself? Method This effectiveness study evaluated a series of 8-week (MBCT) groups adapted for healthcare professionals. Participants completed the Maslach Burnout Inventory (MBI) and Friedberg Mindfulness Inventory (FMI) at pre, post and 6-month follow-up. Results Analysis revealed overall significance and large effect sizes on all three subscales of the MBI and the FMI. There were significant correlations in mindfulness when burnout was reduced. Discussion These results suggest that MBCT groups for healthcare professionals offer a promising intervention for reducing burnout. Implications for Practice Occupational departments could consider MBI's as part of a package of care for mental healthcare staff as a preventative intervention or as a means of reducing burnout amongst healthcare staff.
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Affiliation(s)
- Ryan Askey-Jones
- First Step, Cumbria Partnership Foundation NHS Trust, Carlisle, Cumbria, UK
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340
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Greenberg J, Datta T, Shapero BG, Sevinc G, Mischoulon D, Lazar SW. Compassionate Hearts Protect Against Wandering Minds: Self-compassion Moderates the Effect of Mind-Wandering on Depression. ACTA ACUST UNITED AC 2018; 5:155-169. [PMID: 30906796 DOI: 10.1037/scp0000168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Depression is associated with high levels of mind-wandering and low levels of self-compassion. However, little is known about whether and how these two factors interact with one another to influence depressive symptoms. The current study examined the interaction between mind-wandering, self-compassion and depressive symptoms in a depressed sample and tested the effects of an eight-week Mindfulness Based Cognitive Therapy (MBCT) program on these constructs. At baseline, mind-wandering was associated with higher depressive symptoms only among individuals with low self-compassion. Self-compassion additionally predicted depressive improvement. As expected, MBCT increased self-compassion and reduced mind-wandering compared to a treatment-as-usual control group. Overall, longitudinal changes in self-compassion produced a moderation effect similar to the one at baseline so that increases in mind-wandering were associated with increases in depressive symptoms only among those who decreased in self-compassion. Results provide the first evidence that self-compassion can protect against the deleterious effects of mind-wandering among depressed participants, both at baseline and longitudinally. Findings also suggest that self-compassion is an effective predictor of depressive improvement. Finally, MBCT is effective not only at reducing depressive symptoms, but also at targeting protective and risk factors associated with depression.
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Affiliation(s)
- Jonathan Greenberg
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School
| | - Tanya Datta
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School
| | - Benjamin G Shapero
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School
| | - Günes Sevinc
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School
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341
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Yang D, Hur JW, Kwak YB, Choi SW. A Systematic Review and Meta-Analysis of Applicability of Web-Based Interventions for Individuals with Depression and Quality of Life Impairment. Psychiatry Investig 2018; 15:759-766. [PMID: 30048585 PMCID: PMC6111215 DOI: 10.30773/pi.2018.03.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/15/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purpose of this meta-analysis was to determine the applicability of web-based treatment programs for individuals with depression and quality of life impairments. METHODS We conducted database and manual searches using imprecise search-term strategy and inclusion criteria. Research published from 2005 to December 2015 was included in this study. Upon review, a total of 12 published papers on web-based intervention for individuals with depression were assessed eligible for this meta-analysis. Effect sizes were estimated for depression and quality of life. RESULTS The mean effect size of web-based treatment on depressive symptoms was 0.72. However, unlike the result showing medium to large effect size, the analysis on the quality of life did not yield adequate effects of web-based interventions. CONCLUSION Our results suggest robust benefits of employing web-based treatments for depressive symptoms. However, the adequacy of these relatively new intervention tools for individuals who suffer severe impairments of quality of life was found insufficient. The current study demonstrates the need to further develop web-based intervention techniques to improve overall functioning, as well as the clinical symptoms of patients with mental disorders.
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Affiliation(s)
- Danbi Yang
- Department of Psychology, Duksung Women's University, Seoul, Republic of Korea
| | - Ji-Won Hur
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sung-Won Choi
- Department of Psychology, Duksung Women's University, Seoul, Republic of Korea
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342
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Meditation or exercise for preventing acute respiratory infection (MEPARI-2): A randomized controlled trial. PLoS One 2018; 13:e0197778. [PMID: 29933369 PMCID: PMC6014660 DOI: 10.1371/journal.pone.0197778] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/07/2018] [Indexed: 12/31/2022] Open
Abstract
Background Practice of meditation or exercise may enhance health to protect against acute infectious illness. Objective To assess preventive effects of meditation and exercise on acute respiratory infection (ARI) illness. Design Randomized controlled prevention trial with three parallel groups. Setting Madison, Wisconsin, USA. Participants Community-recruited adults who did not regularly exercise or meditate. Methods 1) 8-week behavioral training in mindfulness-based stress reduction (MBSR); 2) matched 8-week training in moderate intensity sustained exercise (EX); or 3) observational waitlist control. Training classes occurred in September and October, with weekly ARI surveillance through May. Incidence, duration, and area-under-curve ARI global severity were measured using daily reports on the WURSS-24 during ARI illness. Viruses were identified multiplex PCR. Absenteeism, health care utilization, and psychosocial health self-report assessments were also employed. Results Of 413 participants randomized, 390 completed the trial. In the MBSR group, 74 experienced 112 ARI episodes with 1045 days of ARI illness. Among exercisers, 84 had 120 episodes totaling 1010 illness days. Eighty-two of the controls had 134 episodes with 1210 days of ARI illness. Mean global severity was 315 for MBSR (95% confidence interval 244, 386), 256 (193, 318) for EX, and 336 (268, 403) for controls. A prespecified multivariate zero-inflated regression model suggested reduced incidence for MBSR (p = 0.036) and lower global severity for EX (p = 0.042), compared to control, not quite attaining the p<0.025 prespecified cut-off for null hypothesis rejection. There were 73 ARI-related missed-work days and 22 ARI-related health care visits in the MBSR group, 82 days and 21 visits for exercisers, and 105 days and 24 visits among controls. Viruses were identified in 63 ARI episodes in the MBSR group, compared to 64 for EX and 72 for control. Statistically significant (p<0.05) improvements in general mental health, self-efficacy, mindful attention, sleep quality, perceived stress, and depressive symptoms were observed in the MBSR and/or EX groups, compared to control. Conclusions Training in mindfulness meditation or exercise may help protect against ARI illness. Limitations This trial was likely underpowered. Trial registration Clinicaltrials.gov NCT01654289
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343
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MacKenzie MB, Abbott KA, Kocovski NL. Mindfulness-based cognitive therapy in patients with depression: current perspectives. Neuropsychiatr Dis Treat 2018; 14:1599-1605. [PMID: 29950842 PMCID: PMC6018485 DOI: 10.2147/ndt.s160761] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Mindfulness-based cognitive therapy (MBCT) was developed to prevent relapse in individuals with depressive disorders. This widely used intervention has garnered considerable attention and a comprehensive review of current trends is warranted. As such, this review provides an overview of efficacy, mechanisms of action, and concludes with a discussion of dissemination. Results provided strong support for the efficacy of MBCT despite some methodological shortcomings in the reviewed literature. With respect to mechanisms of action, specific elements, such as mindfulness, repetitive negative thinking, self-compassion and affect, and cognitive reactivity have emerged as important mechanisms of change. Finally, despite a lack of widespread MBCT availability outside urban areas, research has shown that self-help variations are promising. Combined with findings that teacher competence may not be a significant predictor of treatment outcome, there are important implications for dissemination. Taken together, this review shows that while MBCT is an effective treatment for depression, continued research in the areas of efficacy, mechanisms of action, and dissemination are recommended.
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Affiliation(s)
| | - Kayleigh A Abbott
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Nancy L Kocovski
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
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344
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Moosavi Nejad M, Shahgholian N, Samouei R. The effect of mindfulness program on general health of patients undergoing hemodialysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:74. [PMID: 29963567 PMCID: PMC6009148 DOI: 10.4103/jehp.jehp_132_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/19/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Patients undergoing hemodialysis have a low level of health and mindfulness technique in mind-body medicine is used to help patients with chronic illness. Therefore, this clinical trial was conducted to determine the effect of the mindfulness program on the general health of patients undergoing treatment with hemodialysis. METHODS Sixty hemodialysis patients were selected through the convenient method and randomly divided into experimental and control groups. Both groups completed demographic information questionnaire and general health questionnaire. Then, the experimental group received 8 sessions of mindfulness training and the control group received 8 sessions of education in relation to end-stage renal disease and hemodialysis. Educational sessions were performed for both groups in the second 30 min after hemodialysis for 1 h in six individual sessions and two 1.5 h group sessions. Immediately after and 1 month after the intervention, the General Health Questionnaire was completed by both groups. RESULTS Analysis of the findings showed no significant differences between the mean score of general health disorder and its subscales before the intervention in to two groups (P > 0.05). Nevertheless, after intervention in the experimental group, the mean of general health disorder score decreased from 44.17 ± 12.32 to 21.9 ± 6.4 and 1 month after the intervention, the mean score of this score was 23.6 ± 6.2. The mean score of physical symptoms, anxiety and sleep disorder, social functioning deficiency, and depression were also significantly lower in the experimental group immediately after intervention and 1 month after the intervention; however, there were no significant differences between the mean of this score immediately and 1 month after the intervention. In addition, the mean score of general health disorder changes immediately and 1 month after the intervention in the experimental group was significantly more than the control group. In the control group, there was no significant difference between the mean score of general health disorder and its subscales before, immediately, and 1 month after the intervention (P > 0.05). CONCLUSIONS The results of this research showed that mindfulness has been effective in reducing physical and anxiety symptoms, sleep disorder, social dysfunction, and depression symptoms. Therefore, the use of mindfulness as a complementary treatment can improve the general health level in these patients.
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Affiliation(s)
- Maryam Moosavi Nejad
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Social Security Organization, Isfahan, Iran
| | - Nahid Shahgholian
- Department of Critical Care Nursing, Kidney Disease Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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345
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Jasbi M, Sadeghi Bahmani D, Karami G, Omidbeygi M, Peyravi M, Panahi A, Mirzaee J, Holsboer-Trachsler E, Brand S. Influence of adjuvant mindfulness-based cognitive therapy (MBCT) on symptoms of post-traumatic stress disorder (PTSD) in veterans - results from a randomized control study. Cogn Behav Ther 2018; 47:431-446. [PMID: 29893182 DOI: 10.1080/16506073.2018.1445773] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Even 30 or more years after the end of a war, veterans can suffer from post-traumatic stress disorder (PTSD). In the present study, we explored the influence on symptoms of PTSD among Iranian veterans of the Iran-Iraq war of mindfulness-based cognitive therapy (MBCT) as add-on to a standard treatment with citalopram. Forty-eight male veterans with PTSD (mean age: 52.97 years) took part in this eight-week intervention study. Standard treatment for all patients consisted of citalopram (30-50 mg/day at therapeutic dosages). Patients were randomly assigned either to the treatment or to the control condition. Treatment involved MBCT delivered in group sessions once a week. Patients in the control condition met at the hospital with the same frequency and duration for socio-therapeutic events. At baseline and at study completion, patients completed questionnaires covering symptoms of PTSD, depression, anxiety, and stress. At study completion after eight weeks, scores for PTSD (re-experiencing events, avoidance, negative mood and cognition, hyperarousal), depression, anxiety, and stress were lower, but more so in the intervention than the control group. Data suggest that, as adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.
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Affiliation(s)
| | - Dena Sadeghi Bahmani
- b Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS) , University of Basel , Basel , Switzerland.,c Department of Psychiatry, Sleep Disorders Research Center , Kermanshah University of Medical Sciences (KUMS) , Kermanshah , Iran
| | | | | | - Maryam Peyravi
- f Researching Science Unit of Tehran , Tehran University of Medical Sciences , Tehran , Iran
| | | | - Jafar Mirzaee
- h Janbazan Medical and Engineering Research Center (JMERC) , Tehran University of Medical Sciences , Tehran , Iran
| | - Edith Holsboer-Trachsler
- b Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS) , University of Basel , Basel , Switzerland
| | - Serge Brand
- b Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS) , University of Basel , Basel , Switzerland.,c Department of Psychiatry, Sleep Disorders Research Center , Kermanshah University of Medical Sciences (KUMS) , Kermanshah , Iran.,i Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health , University of Basel , Basel , Switzerland
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346
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Schuling R, van Herpen N, de Nooij R, de Groot WT, Speckens A. Silent into Nature: Factors Enabling Improvement in a Mindful Walking Retreat in Nature of People with Psychological Symptoms. ECOPSYCHOLOGY 2018. [DOI: 10.1089/eco.2017.0045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Rhoda Schuling
- Centre for Mindfulness, Radboudumc, Nijmegen, the Netherlands
| | - Nina van Herpen
- Centre for Mindfulness, Radboudumc, Nijmegen, the Netherlands
| | - Reinier de Nooij
- Institute for Science, Innovation and Society, Radboud University, Nijmegen, the Netherlands
| | - Wouter T. de Groot
- Institute for Science, Innovation and Society, Radboud University, Nijmegen, the Netherlands
| | - Anne Speckens
- Centre for Mindfulness, Radboudumc, Nijmegen, the Netherlands
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347
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Strege MV, Swain D, Bochicchio L, Valdespino A, Richey JA. A Pilot Study of the Effects of Mindfulness-Based Cognitive Therapy on Positive Affect and Social Anxiety Symptoms. Front Psychol 2018; 9:866. [PMID: 29910759 PMCID: PMC5992451 DOI: 10.3389/fpsyg.2018.00866] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 05/14/2018] [Indexed: 01/09/2023] Open
Abstract
Randomized controlled trials have demonstrated that mindfulness-based cognitive therapy (MBCT) is efficacious in reducing residual depressive symptoms and preventing future depressive episodes (Kuyken et al., 2016). One potential treatment effect of MBCT may be improvement of positive affect (PA), due to improved awareness of daily positive events (Geschwind et al., 2011). Considering social anxiety disorder (SAD) is characterized by diminished PA (Brown et al., 1998; Kashdan, 2007), we sought to determine whether MBCT would reduce social anxiety symptoms, and whether this reduction would be associated with improvement of PA deficits. Adults (N = 22) who met criteria for varied anxiety disorders participated in a small, open-label trial of an 8-week manualized MBCT intervention. Most participants presented with either a diagnosis (primary, secondary, or tertiary) of generalized anxiety disorder (GAD) (N = 15) and/or SAD (N = 14) prior to treatment, with eight individuals meeting diagnostic criteria for both GAD and SAD. We hypothesized participants would demonstrate improvements in social anxiety symptoms, which would be predicted by improvements in PA, not reductions in negative affect (NA). Results of several hierarchical linear regression analyses (completed in both full and disorder-specific samples) indicated that improvements in PA but not reductions in NA predicted social anxiety improvement. This effect was not observed for symptoms of worry, which were instead predicted by decreased NA for individuals diagnosed with GAD and both decreased NA and increased PA in the entire sample. Results suggest that MBCT may be efficacious in mitigating social anxiety symptoms, and this therapeutic effect may be linked to improvements in PA. However, further work is necessary considering the small, heterogeneous sample, uncontrolled study design, and exploratory nature of the study.
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Affiliation(s)
| | | | | | | | - John A. Richey
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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348
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Strauss C, Lea L, Hayward M, Forrester E, Leeuwerik T, Jones AM, Rosten C. Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial. J Anxiety Disord 2018; 57:39-47. [PMID: 29739634 DOI: 10.1016/j.janxdis.2018.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Only about half of people with obsessive compulsive disorder (OCD) show clinically significant improvement following the recommended therapy, exposure and response prevention (ERP), partly due to poor therapy acceptability. A mindfulness-based approach to ERP (MB-ERP) has the potential to improve acceptability and outcomes. METHODS This was an internal pilot randomised controlled trial (RCT) of group MB-ERP compared to group ERP. 37 participants meeting DSM-IV OCD criteria were randomly allocated to MB-ERP or ERP. RESULTS Both groups improved in OCD symptom severity. However, MB-ERP did not lead to clinically important improvements in OCD symptom severity at post-intervention compared to ERP - the minimum clinically important difference was not contained in the 95% confidence intervals. There were negligible between-group differences in engagement and MB-ERP did not appear to have broader benefits compared to ERP on depression, wellbeing or OCD-related beliefs. Conversely, MB-ERP led to medium/medium-large improvements in mindfulness compared to ERP. CONCLUSIONS MB-ERP is unlikely to lead to clinically meaningful improvements in OCD symptom severity compared to ERP alone. We underline the importance of adhering to treatment guidelines recommending ERP for OCD. Insufficient attention may have been given to mindfulness practice/discussion in MB-ERP and further research is recommended to explore this possibility.
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Affiliation(s)
- Clara Strauss
- School of Psychology, University of Sussex, Brighton, UK; Sussex Partnership NHS Foundation Trust, Brighton, UK.
| | - Laura Lea
- Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, UK; Sussex Partnership NHS Foundation Trust, Brighton, UK
| | | | | | - Anna-Marie Jones
- Sussex Partnership NHS Foundation Trust, Brighton, UK; Centre for Health Research, University of Brighton, UK
| | - Claire Rosten
- Centre for Health Research, University of Brighton, UK
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349
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Mindfulness training induces structural connectome changes in insula networks. Sci Rep 2018; 8:7929. [PMID: 29785055 PMCID: PMC5962606 DOI: 10.1038/s41598-018-26268-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/09/2018] [Indexed: 02/07/2023] Open
Abstract
Although mindfulness meditation is known to provide a wealth of psychological benefits, the neural mechanisms involved in these effects remain to be well characterized. A central question is whether the observed benefits of mindfulness training derive from specific changes in the structural brain connectome that do not result from alternative forms of experimental intervention. Measures of whole-brain and node-level structural connectome changes induced by mindfulness training were compared with those induced by cognitive and physical fitness training within a large, multi-group intervention protocol (n = 86). Whole-brain analyses examined global graph-theoretical changes in structural network topology. A hypothesis-driven approach was taken to investigate connectivity changes within the insula, which was predicted here to mediate interoceptive awareness skills that have been shown to improve through mindfulness training. No global changes were observed in whole-brain network topology. However, node-level results confirmed a priori hypotheses, demonstrating significant increases in mean connection strength in right insula across all of its connections. Present findings suggest that mindfulness strengthens interoception, operationalized here as the mean insula connection strength within the overall connectome. This finding further elucidates the neural mechanisms of mindfulness meditation and motivates new perspectives about the unique benefits of mindfulness training compared to contemporary cognitive and physical fitness interventions.
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350
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Bottaccioli AG, Bottaccioli F, Minelli A. Stress and the psyche-brain-immune network in psychiatric diseases based on psychoneuroendocrineimmunology: a concise review. Ann N Y Acad Sci 2018; 1437:31-42. [PMID: 29762862 DOI: 10.1111/nyas.13728] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/14/2018] [Accepted: 03/20/2018] [Indexed: 12/12/2022]
Abstract
In the last decades, psychoneuroendocrineimmunology research has made relevant contributions to the fields of neuroscience, psychobiology, epigenetics, molecular biology, and clinical research by studying the effect of stress on human health and highlighting the close interrelations between psyche, brain, and bodily systems. It is now well recognized that chronic stress can alter the physiological cross-talk between brain and biological systems, leading to long-lasting maladaptive effects (allostatic overload) on the nervous, immune, endocrine, and metabolic systems, which compromises stress resiliency and health. Stressful conditions in early life have been associated with profound alterations in cortical and subcortical brain regions involved in emotion regulation and the salience network, showing relevant overlap with different psychiatric conditions. This paper provides a summary of the available literature concerning the notable effects of stress on the brain and immune system. We highlight the role of epigenetics as a mechanistic pathway mediating the influences of the social and physical environment on brain structure and connectivity, the immune system, and psycho-physical health in psychiatric diseases. We also summarize the evidence regarding the effects of stress management techniques (mainly psychotherapy and meditation practice) on clinical outcomes, brain neurocircuitry, and immune-inflammatory network in major psychiatric diseases.
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Affiliation(s)
- Anna Giulia Bottaccioli
- Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, Università degli Studi di Roma La Sapienza, Internal Medicine Unit, ICOT Hospital, Latina, Italy
| | - Francesco Bottaccioli
- Dipartimento di Medicina Clinica, Università degli Studi dell'Aquila, Sanita Pubblica Scienze della Vita e dell'Ambiente, L'Aquila, Italy
| | - Andrea Minelli
- Dipartimento di Scienze Biomolecolari, Università degli Studi di Urbino Carlo Bo, Urbino, Italy
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