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Horvath M, Pittman B, O’Malley SS, Grutman A, Khan N, Gueorguieva R, Brewer JA, Garrison KA. Smartband-based smoking detection and real-time brief mindfulness intervention: findings from a feasibility clinical trial. Ann Med 2024; 56:2352803. [PMID: 38823419 PMCID: PMC11146247 DOI: 10.1080/07853890.2024.2352803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/29/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Smartbands can be used to detect cigarette smoking and deliver real time smoking interventions. Brief mindfulness interventions have been found to reduce smoking. OBJECTIVE This single arm feasibility trial used a smartband to detect smoking and deliver brief mindfulness exercises. METHODS Daily smokers who were motivated to reduce their smoking wore a smartband for 60 days. For 21 days, the smartband monitored, detected and notified the user of smoking in real time. After 21 days, a 'mindful smoking' exercise was triggered by detected smoking. After 28 days, a 'RAIN' (recognize, allow, investigate, nonidentify) exercise was delivered to predicted smoking. Participants received mindfulness exercises by text message and online mindfulness training. Feasibility measures included treatment fidelity, adherence and acceptability. RESULTS Participants (N=155) were 54% female, 76% white non-Hispanic, and treatment starters (n=115) were analyzed. Treatment fidelity cutoffs were met, including for detecting smoking and delivering mindfulness exercises. Adherence was mixed, including moderate smartband use and low completion of mindfulness exercises. Acceptability was mixed, including high helpfulness ratings and mixed user experiences data. Retention of treatment starters was high (81.9%). CONCLUSIONS Findings demonstrate the feasibility of using a smartband to track smoking and deliver quit smoking interventions contingent on smoking.
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Affiliation(s)
- Mark Horvath
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Aurora Grutman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Nashmia Khan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Judson A. Brewer
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Jones DR, Potter LN, Lam CY, Schlechter CR, Nahum-Shani I, Fagundes C, Wetter DW. Examining Links Between Distinct Affective States and Tobacco Lapse During a Cessation Attempt Among African Americans: A Cohort Study. Ann Behav Med 2024; 58:506-516. [PMID: 38740389 PMCID: PMC11185091 DOI: 10.1093/abm/kaae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Affect states are posited to play a pivotal role in addiction-related processes, including tobacco lapse (i.e., smoking during a quit attempt), and distinct affective states (e.g., joy vs. happiness) may differentially influence lapse likelihood. However, few studies have examined the influence of distinct affective states on tobacco lapse. PURPOSE This study examines the influence of 23 distinct affect states on tobacco lapse among a sample of tobacco users attempting to quit. METHODS Participants were 220 adults who identified as African American (50% female, ages 18-74). Ecological momentary assessment was used to assess affect and lapse in real-time. Between and within-person associations testing links between distinct affect states and lapse were examined with multilevel modeling for binary outcomes. RESULTS After adjusting for previous time's lapse and for all other positive or negative affect items, results suggested that at the between-person level, joy was associated with lower odds of lapse, and at the within-person level, attentiveness was associated with lower odds of lapse. Results also suggested that at the between-person level, guilt and nervous were associated with higher odds of lapse, and at the within-person level, shame was associated with higher odds of lapse. CONCLUSIONS The present study uses real-time, real-world data to demonstrate the role of distinct positive and negative affects on momentary tobacco lapse. This work helps elucidate specific affective experiences that facilitate or hinder the ability to abstain from tobacco use during a quit attempt.
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Affiliation(s)
- Dusti R Jones
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
| | - Lindsey N Potter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Cho Y Lam
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Chelsey R Schlechter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, USA
- Center for Methodologies for Adapting and Personalizing Prevention, Treatment, and Recovery Services for SUD and HIV (MAPS Center), University of Michigan, Ann Arbor, USA
| | | | - David W Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and the University of Utah, Salt Lake City, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, USA
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Zhang XF, Li RN, Deng JL, Chen XL, Zhou QL, Qi Y, Zhang YP, Fan JM. Effects of mindfulness-based interventions on cardiovascular risk factors: An umbrella review of systematic reviews and meta-analyses. J Psychosom Res 2024; 177:111586. [PMID: 38185037 DOI: 10.1016/j.jpsychores.2023.111586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Reviews have shown that mindfulness-based interventions (MBIs) were effective in improving cardiovascular risk factors (CVRFs), but the results were contradictory. This umbrella review aimed to summarize and grade the existing reviews on CVRFs associated with MBIs. METHODS The protocol of this umbrella review had been registered in PROSPERO (CRD42022356812). PubMed, Web of science, Embase, The Cochrane Library, Scopus, Medline, PsycINFO and CINAHL were searched from database inception to 20 July 2022. The quality of evidence was assessed through GRADE. RESULTS Twenty-seven reviews with 14,923 participants were included. Overall, 45% of reviews had low heterogeneity (I2 < 25%). For the quality of evidence, 31% were rated very low, 42% were rated low, 17% were rated moderate and 10% were rated high. MBIs significantly improved systolic blood pressure [SMD -5.53 mmHg (95% CI -7.81, -3.25)], diastolic blood pressure [SMD -2.13 mmHg (95% CI -2.97, -1.30)], smoking [Cohen's d 0.42 (95% CI 0.20, 0.64)], glycosylated hemoglobin [MD 0.01 (95% CI -0.43, -0.07)], binge eating behavior [SMD -6.49 (95% CI -10.80, -2.18)], depression [SMD -0.72 (95% CI -1.23, -0.21)] and stress [SMD -0.67 (95% CI -1.00, -0.34)]. CONCLUSIONS In conclusion, this umbrella review provided evidence for the role of MBIs in the improvement of CVRFs.
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Affiliation(s)
- Xiao-Feng Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Ruo-Nan Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Jin-Lan Deng
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Xiao-Li Chen
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Qi-Lun Zhou
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Yue Qi
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Yong-Ping Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China
| | - Jian-Ming Fan
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, China.
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Kapoor S, Dhankhar A, Bhatt G, Goel S, Singh RJ. Complementary and Alternative Medicine/Therapy for Tobacco Cessation in India: A Secondary Analysis of GATS-1 and 2. Indian J Community Med 2024; 49:144-151. [PMID: 38425957 PMCID: PMC10900453 DOI: 10.4103/ijcm.ijcm_188_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 10/03/2023] [Indexed: 03/02/2024] Open
Abstract
Background India has nearly 267 million adult tobacco users, with a slowly improving quitting rate. Among the many approaches to quitting the habit, such as counseling, nicotine replacement therapy, nicotine patch or gum, and prescribed allopathic medicines. Complementary and alternative medicine/therapy (CAM), a thousand-year-old practice in India, may also prove to be a potential method in tobacco cessation; however, there is scarce literature on the extent of use of CAM among tobacco users who attempt to quit the habit. Therefore, this study attempts to examine the potential of CAM as a strategy for tobacco control in India. Material and Methods We undertook a secondary analysis of the data from both rounds of the Global Adult Tobacco Survey (GATS 2009 and 2016). The dependent variable included in the analysis was the use of traditional medicine as a method for quitting tobacco in three types of users-smokers, smokeless tobacco users, and dual users. The prevalence of CAM use was reported, and Chi-square test was applied to find the factors significantly associated with the use of CAM among tobacco users considering a P value of 0.05 to be statistically significant. Results The overall prevalence of traditional medicine use for GATS-1 was observed to be more among dual users (4%), while for GATS-2, it was highest among smokers (3%). For both rounds of the GATS survey, the use of traditional medicine was found to be higher among males, rural residents, users with no education or less than primary education, and the eastern region. Conclusions CAM has a promising potential for supporting tobacco cessation provided a concerted effort is undertaken to standardize pharmacopeia and establish robust clinical evidence. In addition, there is a need to create awareness, build the capacity of healthcare providers, and foster academic-industrial research in indigenous Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) systems.
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Affiliation(s)
- Shivam Kapoor
- Tobacco Control Department, International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia, New Delhi, India
| | - Anushikha Dhankhar
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Garima Bhatt
- Tobacco Control Unit, International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia, New Delhi, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Ireland
- Faculty of Human and Health Sciences, Swansea University, United Kingdom
| | - Rana J. Singh
- Tobacco Control Department, International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia, New Delhi, India
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Demina A, Petit B, Meille V, Trojak B. Mindfulness interventions for craving reduction in substance use disorders and behavioral addictions: systematic review and meta-analysis of randomized controlled trials. BMC Neurosci 2023; 24:55. [PMID: 37853315 PMCID: PMC10583418 DOI: 10.1186/s12868-023-00821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND High-quality evidence is still required to affirm the efficacy of mindfulness-based interventions (MBIs) in craving reduction. MBIs may be particularly appropriate for this purpose given the neurobiological mechanisms of addiction with automatic behavior in response to the negative affect. In this systematic review and meta-analysis, we aimed to study the efficacy of MBIs in craving reduction and to synthetize the newly published data. METHODS We searched four databases and three clinical trial registries for randomized controlled trials (RCTs) up to August 2023, including studies with MBIs in all types of substance use disorders or behavioral addictions. We chose as our outcome of interest the change from the baseline of craving measures at posttreatment. Standardized mean difference was used as an effect size estimator. RESULTS We included 17 RCTs with 1228 participants. The overall effect size was estimated at -0.70 (95% CI -1.15, -0.26) in favor of MBIs. CONCLUSION Due to the high inconsistency (I2 = 92%), we were unable to conclude that there is a medium to large effect size. Overall risk of bias was high for most studies, and the GRADE approach detected a low quality of evidence. Previous clinical and fundamental research suggest that MBIs have a promising potential in addiction medicine. However, further investigation of whether MBIs effectively reduce craving is needed, and innovative solutions for resolving methodological limitations in MBI research are warranted. TRIAL REGISTRATION PROSPERO registration ID CRD42020221141.
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Affiliation(s)
- Anastasia Demina
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France.
- INSERM U1093, CAPS, Université de Bourgogne, UFR STAPS, BP 27877, F-21078, Dijon, France.
| | - Benjamin Petit
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France
| | - Vincent Meille
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France
| | - Benoit Trojak
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France
- INSERM U1093, CAPS, Université de Bourgogne, UFR STAPS, BP 27877, F-21078, Dijon, France
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Nian T, Guo K, Liu W, Deng X, Hu X, Xu M, E F, Wang Z, Song G, Yang K, Li X, Shang W. Non-pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses. BMC Med 2023; 21:378. [PMID: 37775745 PMCID: PMC10542700 DOI: 10.1186/s12916-023-03087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Although non-pharmacological smoking cessation measures have been widely used among smokers, current research evidence on the effects of smoking cessation is inconsistent and of mixed quality. Moreover, there is a lack of comprehensive evidence synthesis. This study seeks to systematically identify, describe, and evaluate the available evidence for non-pharmacological interventions in smoking populations through evidence mapping (EM), and to search for best-practice smoking cessation programs. METHODS A comprehensive search for relevant studies published from the establishment of the library to January 8, 2023, was conducted in PubMed, Web of Science, Embase, the Cochrane Library, CNKI, CBM, Wan Fang, and VIP. Two authors independently assessed eligibility and extracted data. The PRISMA statement and AMSTAR 2 tool were used to evaluate the report quality and methodology quality of systematic reviews/meta-analyses (SRs/MAs), respectively. Bubble plots were utilized to display information, such as the study population, intervention type, evidence quality, and original study sample size. RESULTS A total of 145 SRs/MAs regarding non-pharmacological interventions for smoking cessation were investigated, with 20 types of interventions identified. The most commonly used interventions were cognitive behaviour education (n = 32, 22.07%), professional counselling (n = 20, 13.79%), and non-nicotine electronic cigarettes (e-cigarettes) (n = 13, 8.97%). Among them, counselling and behavioural support can improve smoking cessation rates, but the effect varies depending on the characteristics of the support provided. These findings are consistent with previous SRs/MAs. The general population (n = 108, 74.48%) was the main cohort included in the SRs/MAs. The total score of PRISMA for the quality of the reports ranged from 8 to 27, and 13 studies (8.97%) were rated as high confidence, and nine studies (6.21%) as moderate confidence, in the AMSTAR 2 confidence rating. CONCLUSIONS The abstinence effect of cognitive behaviour education and money incentive intervention has advantages, and non-nicotine e-cigarettes appear to help some smokers transition to less harmful replacement tools. However, the methodological shortcomings of SRs/MAs should be considered. Therefore, to better guide future practice in the field of non-pharmacological smoking cessation, it is essential to improve the methodological quality of SRs and carry out high-quality randomized controlled trials (RCTs).
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Affiliation(s)
- Tao Nian
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Kangle Guo
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wendi Liu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xinxin Deng
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xiaoye Hu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
| | - Meng Xu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Fenfen E
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Ziyi Wang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Guihang Song
- Gansu Provincial Medical Security Bureau, Lanzhou, 730000, People's Republic of China
| | - Kehu Yang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Xiuxia Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wenru Shang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China.
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Collaborative Innovation Center of First Hospital, Lanzhou University, Lanzhou, 730000, People's Republic of China.
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Bourassa KJ, Moffitt TE, Harrington H, Houts R, Poulton R, Ramrakha S, Rasmussen LJH, Wertz J, Caspi A. Childhood Adversity and Midlife Health: Shining a Light on the Black Box of Psychosocial Mechanisms. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:817-828. [PMID: 36083434 PMCID: PMC9995600 DOI: 10.1007/s11121-022-01431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
Adverse childhood experiences (ACEs) are associated with poorer health, which has spurred public health efforts to reduce the number of adverse events children experience. Unfortunately, it is unlikely that all ACEs can be prevented. For adults who already experienced ACEs in childhood, what psychological, social, and behavioral intervention targets might reduce risk for negative health outcomes? To provide insight into the "black box" of psychosocial mechanisms linking ACEs to poor health, our study used data from the Dunedin Study, a longitudinal cohort assessed from birth to age 45. Mediation models (N = 859) were used to examine whether candidate psychosocial variables in adulthood explained the association between childhood ACEs and health in midlife. Potential psychosocial mediators included stressful life events, perceived stress, negative emotionality, and health behaviors. Children who experienced more ACEs had poorer health in midlife. They also had significantly more stressful life events, more perceived stress, more negative emotionality, and unhealthier behaviors as adults. These mediators were each independently associated with poorer health in midlife and statistically mediated the association between ACEs and midlife health. Health behaviors evidenced the strongest indirect effect from ACEs to midlife health. Together, these psychosocial mediators accounted for the association between ACEs in childhood and health three decades later. Public health efforts to mitigate the health consequences of ACEs could aim to reduce the stressful life events people experience, reduce negative emotionality, reduce perceived stress, or improve health behaviors among adults who experienced childhood adversity.
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Affiliation(s)
- Kyle J Bourassa
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
| | - Terrie E Moffitt
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - HonaLee Harrington
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Renate Houts
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Sandhya Ramrakha
- Department of Psychology, University of Otago, Otago, New Zealand
| | - Line J H Rasmussen
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Jasmin Wertz
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- School of Philosophy, Psychology, and Language Science, University of Edinburgh, Edinburgh, Scotland
| | - Avshalom Caspi
- Geriatric Research, Education, and Clinical Center, Durham VA Healthcare System, NC, Durham, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
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Koenig HG. Person-Centered Mindfulness: A Culturally and Spiritually Sensitive Approach to Clinical Practice. JOURNAL OF RELIGION AND HEALTH 2023; 62:1884-1896. [PMID: 36823258 DOI: 10.1007/s10943-023-01768-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Mindfulness meditation is rapidly being integrated into many different forms of counseling and psychotherapy, and there is a growing evidence base for its effectiveness. It is important to understand the spiritual roots of mindfulness, and to apply it in a patient-centered manner, sensitive to the patient's own faith tradition rather than taking a one-size-fits-all approach, assuming that mindfulness-based practice is a purely secular approach. The philosophical underpinning of mindfulness lies squarely in the Buddhist faith tradition. Indeed, mindfulness is the 7th step on the Eightfold Path, which is the heart of Buddhist teachings. Many practitioners, however, may not realize that there are Western meditative techniques that are very similar to mindfulness and that have deep roots within Christian, Jewish, and Muslim faith traditions. Patient-centered mindfulness involves the use of mindfulness and other meditation methods that are based on the patient's own faith tradition, rather than applying Eastern forms of mindfulness claiming these are a secular approach appropriate for everyone regardless of religious beliefs, even if those beliefs are not consistent with the Buddhist religious or philosophical approach. In this article, I briefly examine the evidence for the clinical effectiveness of mindfulness meditation, and then go into greater depth on Hindu, Buddhist, Christian, Jewish, and Muslim forms of mindfulness or similar meditative practices, providing resources that will better equip clinicians and researchers to provide patient-centered culturally-sensitive care.
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Affiliation(s)
- Harold G Koenig
- Departments of Psychiatry and Medicine, Duke University Health System, Durham, NC, 27705, USA.
- Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
- School of Public Health, Ningxia Medical University, Yinchuan, People's Republic of China.
- Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Franco Corso SJ, O'Malley K, Subaiya S, Mayall D, Dakwar E. The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness. J Affect Disord 2023; 335:166-176. [PMID: 37150220 DOI: 10.1016/j.jad.2023.04.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/13/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, about the therapeutic potential of NOSCs induced by mind-body practices such as meditation, yoga and breathwork. METHODS We conducted a literature review in online databases (PubMed, Scopus, Google Scholar) and preprint databases (SSRN, bioRxiv) to identify studies of NOSCs induced by mind-body practices and their effects in affective disorders and SUDs. RESULTS A wide variety of mind-body practices involving physical movement (i.e., shamanic drumming, yoga) and hyper-focused immersive mental experiences (i.e., meditation, breathwork) have been reported in the literature. Preliminary evidence, mostly from qualitative studies and open label studies, suggest that mind-body practices produce NOSCs. Such experiences have been associated with short-term reduced levels of anxiety and depression, increased motivation to quit addictive behaviors, and enhanced self-awareness and spiritual well-being. LIMITATIONS Findings are limited by the scarcity of literature in this field. Further rigorous and methodologically sound empirical research is needed, including comparative studies of NOSCs occasioned by different methods. CONCLUSIONS Mind-body practices may represent a promising approach for treating mental health disorders. The NOSCs induced by such practices may lead to beneficial shifts in perceptions, values, beliefs, and behaviors. Given the challenges with hallucinogen-based therapies, mind-body practices may represent a more accessible and acceptable way of eliciting potentially helpful NOSCs in clinical practice.
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Affiliation(s)
- Silvia J Franco Corso
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America.
| | - Kate O'Malley
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Saleena Subaiya
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Danielle Mayall
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Elias Dakwar
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
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Cioe PA, Sokolovsky AW, Brewer JA, Kahler CW. App-Delivered Mindfulness Training to Reduce Anxiety in People with HIV Who Smoke: A One-Armed Feasibility Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4826. [PMID: 36981734 PMCID: PMC10048883 DOI: 10.3390/ijerph20064826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/24/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION People with HIV (PWH) who smoke have reported that managing anxiety is a barrier to making a quit attempt and maintaining abstinence post-quit. This study examined the feasibility and acceptability of an app-based mindfulness intervention, Unwinding Anxiety, to reduce anxiety prior to a quit attempt in PWH who were not planning to quit in the next 30 days. METHODS Sixteen PWH (mean age 51.5 [SD = 13.2]; mean cigarettes per day 11.4 [SD = 5.4]) were enrolled and followed for eight weeks. A smartphone-based app with 30 modules designed to reduce anxiety was introduced at baseline; participants were encouraged to complete one module daily for four weeks. Symptoms of anxiety and readiness to quit smoking were measured at baseline and weeks 4 and 8. The mean number of modules completed, session attendance, and number of study completers were examined. Generalized estimating equations (GEE) were used to examine changes in self-reported anxiety and readiness to quit at baseline, week 4, and week 8. A brief qualitative interview was conducted at week 4 to explore the acceptability of the app. RESULTS Feasibility was high, with 93% of participants completing the study. The mean number of study sessions completed was 2.7 (SD = 0.59), and the mean number of modules completed was 16.0 (SD 16.8). Anxiety was high at baseline (M = 14.4, SD = 3.9), but lower at week 4 (b = -5.5; CI: [-9.4, -1.7]; p = 0.004) and week 8 (b = -5.1; CI: [-8.8, -1.3]; p = 0.008), and stable between weeks 4 and 8 (b = 0.48; CI: [-2.0, 3.0]; p = 0.706). Readiness to quit significantly increased from baseline M = 5.5 (SD = 1.6) to week 4 (b = 0.56; CI: [0.20, 0.91]; p = 0.002) but was not significantly different from baseline at week 8 (b = 0.34; CI: [-0.30, 1.0]; p = 0.30). Ad-hoc moderation analyses found that anxiety had a small significantly positive association with readiness to quit at baseline (main effect: b = 0.10; SE = 0.03; p < 0.001) and significantly attenuated the increase in readiness to quit observed at week 4 (anxiety by week 4 interaction: b = -0.08; SE = 0.03; p = 0.009). CONCLUSIONS App-based mindfulness training appears to be feasible and acceptable for PWH who smoke and report baseline anxiety. At week 4, anxiety was reduced and readiness to quit was increased, perhaps a key time point for a smoking cessation attempt.
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Affiliation(s)
- Patricia A. Cioe
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02903, USA; (A.W.S.); (J.A.B.); (C.W.K.)
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11
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Non-Pharmacologic Approaches to Tobacco Cessation. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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12
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Asfar T, Alcaide ML, Jones DL, McClure LA, Brewer J, Lee DJ, Carrico A. HIV patients’ perceptions of a potential multi-component mindfulness-based smoking cessation smartphone application intervention. PLoS One 2022; 17:e0271946. [PMID: 36006893 PMCID: PMC9409537 DOI: 10.1371/journal.pone.0271946] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives Cigarette smoking rates among people living with HIV (PLWH) in the US is triple that of the general population. PLWH smokers are a high-risk group for smoking-related health disparities and should be a prime focus for smoking cessation efforts. Our team has developed a novel evidence-based Mindfulness Training (MT) smoking cessation smartphone application (app), “Craving-to-Quit.” Using qualitative focus groups among PLWH smokers, this study aims to tailor and optimize the app’s content and design to PLWH’s unique psychosocial profile and needs. Methods We conducted 8 focus groups among PLWH smokers (n = 59; 47.5% females; ≥18 years) to gain insight into participants’ perceptions about the app, MT, and the feasibility and acceptability of adding two additional strategies (CM: Contingency Management; self-monitoring of anti-retroviral therapies intake [ART]) to further optimize the app. Participants were asked to practice MTs and watch videos from the app presented on a screen in the conference room to discuss their experience. Sessions were audio-taped, transcribed verbatim, and analyzed thematically using NVivo. Results Most participants were non-Hispanic black (67.8%), on a federal health insurance program (61.0%). Participants considered it easy to learn the app and thought that MT is helpful in reducing stress and motivating quit attempts and were supportive of adding CM and recommended providing $20-$50 weekly cash incentives to help in quitting. Participants felt that adding self-monitoring of ART is helpful but were concerned about confidentiality in case they lost their phone. Participants recommended making the app cost-free and adding information about smoking cessation medications and the negative effects of smoking among PLWH. Conclusions Findings will guide the development of a novel multi-component smoking cessation intervention app integrating MT, CM, and ART self-monitoring strategies. This intervention has the potential to address several barriers to quitting in PLWH. Further clinical research is needed to test this intervention.
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Affiliation(s)
- Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States of America
- * E-mail:
| | - Maria Luisa Alcaide
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States of America
- Internal Medicine, Jackson Memorial Hospital, Miami, FL, United States of America
| | - Deborah L. Jones
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Laura A. McClure
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Judson Brewer
- Department of Behavioral and Social Sciences, Brown Mindfulness Center, Brown University School of Public Health, Providence, RI, United States of America
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Adam Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
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Taylor VA, Smith R, Brewer JA. App-Based Mindfulness Training Predicts Reductions in Smoking Behavior by Engaging Reinforcement Learning Mechanisms: A Preliminary Naturalistic Single-Arm Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:5131. [PMID: 35890811 PMCID: PMC9317542 DOI: 10.3390/s22145131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Mindfulness training (MT) has been shown to influence smoking behavior, yet the involvement of reinforcement learning processes as underlying mechanisms remains unclear. This naturalistic, single-arm study aimed to examine slope trajectories of smoking behavior across uses of our app-based MT craving tool for smoking cessation, and whether this relationship would be mediated by the attenuating impact of MT on expected reward values of smoking. Our craving tool embedded in our MT app-based smoking cessation program was used by 108 participants upon the experience of cigarette cravings in real-world contexts. Each use of the tool involved mindful awareness to the experience of cigarette craving, a decision as to whether the participant wanted to smoke or ride out their craving with a mindfulness exercise, and paying mindful attention to the choice behavior and its outcome (contentment levels felt from engaging in the behavior). Expected reward values were computed using contentment levels experienced from the choice behavior as the reward signal in a Rescorla−Wagner reinforcement learning model. Multi-level mediation analysis revealed a significant decreasing trajectory of smoking frequency across MT craving tool uses and that this relationship was mediated by the negative relationship between MT and expected reward values (all ps < 0.001). After controlling for the mediator, the predictive relationship between MT and smoking was no longer significant (p < 0.001 before and p = 0.357 after controlling for the mediator). Results indicate that the use of our app-based MT craving tool is associated with negative slope trajectories of smoking behavior across uses, mediated by reward learning mechanisms. This single-arm naturalistic study provides preliminary support for further RCT studies examining the involvement of reward learning mechanisms underlying app-based mindfulness training for smoking cessation.
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Affiliation(s)
- Veronique A. Taylor
- Mindfulness Center, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, USA;
| | - Ryan Smith
- Laureate Institute for Brain Research, 6655 South Yale Ave., Tulsa, OK 74136, USA;
| | - Judson A. Brewer
- Mindfulness Center, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, USA;
- Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI 02903, USA
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Abstract
BACKGROUND Mindfulness-based smoking cessation interventions may aid smoking cessation by teaching individuals to pay attention to, and work mindfully with, negative affective states, cravings, and other symptoms of nicotine withdrawal. Types of mindfulness-based interventions include mindfulness training, which involves training in meditation; acceptance and commitment therapy (ACT); distress tolerance training; and yoga. OBJECTIVES To assess the efficacy of mindfulness-based interventions for smoking cessation among people who smoke, and whether these interventions have an effect on mental health outcomes. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, and trial registries to 15 April 2021. We also employed an automated search strategy, developed as part of the Human Behaviour Change Project, using Microsoft Academic. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs that compared a mindfulness-based intervention for smoking cessation with another smoking cessation programme or no treatment, and assessed smoking cessation at six months or longer. We excluded studies that solely recruited pregnant women. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. We measured smoking cessation at the longest time point, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of intervention and type of comparator. We carried out meta-analyses where appropriate, using Mantel-Haenszel random-effects models. We summarised mental health outcomes narratively. MAIN RESULTS We included 21 studies, with 8186 participants. Most recruited adults from the community, and the majority (15 studies) were conducted in the USA. We judged four of the studies to be at low risk of bias, nine at unclear risk, and eight at high risk. Mindfulness-based interventions varied considerably in design and content, as did comparators, therefore, we pooled small groups of relatively comparable studies. We did not detect a clear benefit or harm of mindfulness training interventions on quit rates compared with intensity-matched smoking cessation treatment (RR 0.99, 95% CI 0.67 to 1.46; I2 = 0%; 3 studies, 542 participants; low-certainty evidence), less intensive smoking cessation treatment (RR 1.19, 95% CI 0.65 to 2.19; I2 = 60%; 5 studies, 813 participants; very low-certainty evidence), or no treatment (RR 0.81, 95% CI 0.43 to 1.53; 1 study, 325 participants; low-certainty evidence). In each comparison, the 95% CI encompassed benefit (i.e. higher quit rates), harm (i.e. lower quit rates) and no difference. In one study of mindfulness-based relapse prevention, we did not detect a clear benefit or harm of the intervention over no treatment (RR 1.43, 95% CI 0.56 to 3.67; 86 participants; very low-certainty evidence). We did not detect a clear benefit or harm of ACT on quit rates compared with less intensive behavioural treatments, including nicotine replacement therapy alone (RR 1.27, 95% CI 0.53 to 3.02; 1 study, 102 participants; low-certainty evidence), brief advice (RR 1.27, 95% CI 0.59 to 2.75; 1 study, 144 participants; very low-certainty evidence), or less intensive ACT (RR 1.00, 95% CI 0.50 to 2.01; 1 study, 100 participants; low-certainty evidence). There was a high level of heterogeneity (I2 = 82%) across studies comparing ACT with intensity-matched smoking cessation treatments, meaning it was not appropriate to report a pooled result. We did not detect a clear benefit or harm of distress tolerance training on quit rates compared with intensity-matched smoking cessation treatment (RR 0.87, 95% CI 0.26 to 2.98; 1 study, 69 participants; low-certainty evidence) or less intensive smoking cessation treatment (RR 1.63, 95% CI 0.33 to 8.08; 1 study, 49 participants; low-certainty evidence). We did not detect a clear benefit or harm of yoga on quit rates compared with intensity-matched smoking cessation treatment (RR 1.44, 95% CI 0.40 to 5.16; 1 study, 55 participants; very low-certainty evidence). Excluding studies at high risk of bias did not substantially alter the results, nor did using complete case data as opposed to using data from all participants randomised. Nine studies reported on changes in mental health and well-being, including depression, anxiety, perceived stress, and negative and positive affect. Variation in measures and methodological differences between studies meant we could not meta-analyse these data. One study found a greater reduction in perceived stress in participants who received a face-to-face mindfulness training programme versus an intensity-matched programme. However, the remaining eight studies found no clinically meaningful differences in mental health and well-being between participants who received mindfulness-based treatments and participants who received another treatment or no treatment (very low-certainty evidence). AUTHORS' CONCLUSIONS We did not detect a clear benefit of mindfulness-based smoking cessation interventions for increasing smoking quit rates or changing mental health and well-being. This was the case when compared with intensity-matched smoking cessation treatment, less intensive smoking cessation treatment, or no treatment. However, the evidence was of low and very low certainty due to risk of bias, inconsistency, and imprecision, meaning future evidence may very likely change our interpretation of the results. Further RCTs of mindfulness-based interventions for smoking cessation compared with active comparators are needed. There is also a need for more consistent reporting of mental health and well-being outcomes in studies of mindfulness-based interventions for smoking cessation.
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Affiliation(s)
- Sarah Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| | - Emma Norris
- Health Behaviour Change Research Group, Brunel University London, London, UK
| | | | - Emily Hayes
- Centre for Behaviour Change, University College London, London, UK
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Klinsophona T, Thaveeratithama P, Janwantanakula P. The effect of three-part breathing exercise on smoking cessation: A 6-month cluster-randomized clinical trial. J Bodyw Mov Ther 2022; 32:156-162. [DOI: 10.1016/j.jbmt.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 01/11/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022]
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Barré T, Ramier C, Mounir I, David R, Menvielle L, Marcellin F, Carrieri P, Protopopescu C, Cherikh F. Mindfulness as a Protective Factor Against Increased Tobacco and Alcohol Use in Hospital Workers Following the First COVID-19-Related Lockdown: a Study in Southern France. Int J Ment Health Addict 2022; 21:1-21. [PMID: 35095351 PMCID: PMC8783775 DOI: 10.1007/s11469-021-00739-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 10/27/2022] Open
Abstract
COVID-19-related national lockdowns worldwide have had repercussions on people's well-being and have led to increased substance use. Mindfulness has previously been associated with reduced psychological distress and benefits in terms of addictive behaviors. We aimed to assess whether dispositional mindfulness protected against increased tobacco and alcohol use in hospital workers after France's first lockdown started. All workers in two French hospitals were contacted by email to participate in an online survey. Three hundred eighty-five workers answered. We ran two separate logistic regression models to test for associations between the level of dispositional mindfulness and both increased tobacco and alcohol use, after adjusting for affect deterioration. Dispositional mindfulness was associated with a lower likelihood of increased tobacco (adjusted odds ratio (AOR) [95% CI] 0.71 [0.51; 0.99], p = 0.046) and alcohol (0.66 [0.50; 0.87], p = 0.004) use. The effect of mindfulness on tobacco use was partially mediated by affect deterioration. Dispositional mindfulness appeared to be a protective factor against lockdown-related tobacco and alcohol use increases in French hospital workers.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Clémence Ramier
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Izza Mounir
- Addictology Unit, University Hospital of Nice, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France
| | - Renaud David
- Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressources Et de Recherche, Institut Claude Pompidou, 10 rue Molière, 06100 Nice, France
| | | | - Fabienne Marcellin
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
- SESSTIM, Faculté de Médecine de La Timone, aile bleue, 27 Bd Jean Moulin , 13385 Cedex 5 Marseille, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Camelia Protopopescu
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
| | - Faredj Cherikh
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, 27 Bd Jean Moulin, 13385 Cedex 5 Marseille, France
- Addictology Unit, University Hospital of Nice, Archet 2 Hospital, 151 Route de Saint-Antoine, 06200 Nice, France
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Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and Behavior Change. Harv Rev Psychiatry 2021; 28:371-394. [PMID: 33156156 PMCID: PMC7647439 DOI: 10.1097/hrp.0000000000000277] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
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Hollanda De Sa Neto H, Habfast-Robertson I, Hempel-Bruder C, Durand MA, Jacot-Sadowski I, Khazaal Y, Berlin I, Selby K. Formative provider testing of a New Encounter Decision Aid for Smoking Cessation (Preprint). JMIR Form Res 2021; 6:e32960. [PMID: 35442200 PMCID: PMC9069282 DOI: 10.2196/32960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/22/2021] [Accepted: 02/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Smoking cessation is an essential part of preventing and reducing the risk of smoking-associated morbidity and mortality. However, there is often little time to discuss smoking cessation in primary care. Decision aids (DAs) designed for clinic visits (encounter DAs) need to be clear, short, and concise to optimize therapeutic education, increase interaction, and improve the therapeutic alliance. Such a DA for smoking cessation could potentially improve counseling and increase the use of pharmacological treatments. Objective We aimed to collect feedback on an electronic encounter DA that facilitates physician-patient interaction and shared decision-making for smoking cessation in primary care. Methods We developed an electronic, encounter DA (howtoquit.ch) from a paper version created by our team in 2017 following user-centered design principles. The DA is a 1-page interactive website presenting and comparing medications for tobacco cessation and electronic cigarettes. Each smoking cessation medication has a drop down menu that presents additional information, a video demonstration, and prescribing information for physicians. To test the DA, we submitted a questionnaire to approximately 20 general practitioner residents of an academic general medicine department, 5 general practitioners, and 6 experts in the field of smoking cessation. The questionnaire consisted of 4 multiple-choice and 2 free-text questions assessing the usability or acceptability of the DA, the acquisition of new knowledge for practitioners, the perceived utility in supporting shared decision-making, perceived strengths and weaknesses, and whether the participants would recommend the tool to other clinicians. Results In all, 6 residents, 3 general practitioners in private practice, and 2 tobacco cessation experts completed the questionnaire (N=11), with 4 additional experts providing open-text feedback. On the 11 questionnaires, the DA was rated as practical and intuitive (mean 4.6/5), and providers felt it supported shared decision-making (mean 4.4/5), as comparisons were readily possible. Inclusion of explanatory videos was seen as a bonus. Several changes were suggested, like grouping together similar medications and adding a landing page to briefly explain the site. Changes were implemented according to end-user comments. Conclusions The overall assessment of the encounter DA by a group of physicians and experts was positive. The ultimate objective is to have the tool deployed and easily accessible for all to use.
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Affiliation(s)
| | | | | | - Marie-Anne Durand
- Lausanne University Hospital, Lausanne, Switzerland
- Centre d'Epidémiologie et de Recherche en Santé des Populations, University of Toulouse, Institut National de la Santé et de la Recherche Médicale, Toulouse, France
- Dartmouth Institute for Health Policy and Clinical Practice, University of Dartmouth, Lebanon, NH, United States
| | | | - Yasser Khazaal
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Ivan Berlin
- Hôpital Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Kevin Selby
- Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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Psychometric Validation of the Farsi Version of the Mindful Attention Awareness Scale (MAAS) in a Sample of Iranian Students in the USA. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00617-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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20
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Masetti V, Hadj-Henni L, Rouger G, Ben Bacha M, Kechid L. Establishment of a multimodal protocol combining a motivational interview, subcutaneous injection of NicoSan® and hyper-hydration for the "stopsmoking therapy": A multicentre real-life study'. Encephale 2021; 47:518-532. [PMID: 34148643 DOI: 10.1016/j.encep.2021.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/03/2021] [Accepted: 02/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The StopSmoking Therapy, combins a motivational interview, a subcutaneous injection of NicoSan® and a hyperhydration protocol. The objectives were to evaluate the number of patients declaring cessation and factors related to relapse. METHODS In the 18 months following protocol, 554 subjects who consented, responded to the study's questionnaire. Categorical variables are presented as the frequency and percentage, continuous variables are presented as the mean and standard deviation, responses of abstinent subjects and of those who had started smoking again are compared via the chi-square test for categorical variables, and the Student's t-test for continuous variables. RESULTS In our sample 92.8% of the subjects reported smoking for 10 years or more. A total of 475 subjects (85.7%) reported a complete cessation (31.2% for more than 6 months and 33.1% for more than a year). Among relapsing subjects, were significantly over-represented: youngest ages, lower motivation, more frequent close friends or family using tobacco, lower dependency scores. No subject reported any significant adverse effects. CONCLUSION The multimodal protocol explored seems to have a favorable impact on smoking cessation, which could be enhanced by additional interventions dedicated to the youngest age groups, to people having smoking close friends and family, and should possibly add interventions based on cognitive behavioral therapy. A dedicated support by specialist tobacco addiction in the first weeks after treatment and/or the use of mobile support applications could also be useful. In order to asses efficacy, a prospective randomized double blind controlled versus placebo protocol could be considered.
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Affiliation(s)
- V Masetti
- Clinea Psychiatrie, 2, Rue Jean Jaurès, 92800 Puteaux, France.
| | - L Hadj-Henni
- Clinique Pole de Santé du Plateau, 5-7, 9, Rue des Carnets, 92140 Clamart, France
| | - G Rouger
- Clinique Castelviel-Pays d'Oc, Chemin des Affieux, Lieudit Castelviel, 31180 Castelmaurou, France
| | - M Ben Bacha
- Clinique de l'Alliance, 3, Voie de l'Orchidée Sauvage, 93420 Villepinte, France
| | - L Kechid
- Clinique de l'Alliance, 3, Voie de l'Orchidée Sauvage, 93420 Villepinte, France
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21
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Mindfulness in Treatment Approaches for Addiction — Underlying Mechanisms and Future Directions. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00372-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Purpose of Review
While the treatment of addictive disorders proves to be challenging, new treatment approaches that evolved around the concepts of mindfulness and acceptance have been utilized and investigated in recent years. Our goal is to summarize the efficacy and possible underlying mechanisms of mindfulness-based interventions (MBI) in addictive disorders.
Recent Findings
Various meta-analyses have suggested that MBIs show clinical efficacy in the treatment of addictive disorders. Considering the factors that impact addictive disorders, MBIs have been indicated to augment responsiveness to natural rewards in contrast to addiction-related cues as well as to increase top-down cognitive control, decrease subjective and physiological stress perception, and enhance positive affect.
Summary
In summary, MBIs hold promise in treating addictive disorders while larger randomized controlled trials with longitudinal study designs are needed to confirm their utility. Newest clinical endeavors strive to enhance the clinical utility of MBIs by augmentation or personalization.
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Abstract
The impact of tobacco smoking treatment is determined by its reach into the smoking population and the effectiveness of its interventions. This review evaluates the reach and effectiveness of pharmacotherapy and psychosocial interventions for smoking. Historically, the reach of smoking treatment has been low, and therefore its impact has been limited, but new reach strategies such as digital interventions and health care system changes offer great promise. Pharmacotherapy tends to be more effective than psychosocial intervention when used clinically, and newer pharmacotherapy strategies hold great promise of further enhancing effectiveness. However, new approaches are needed to advance psychosocial interventions; progress has stagnated because research and dissemination efforts have focused too narrowly on skill training despite evidence that its core content may be inconsequential and the fact that its mechanisms are either unknown or inconsistent with supporting theory. Identifying effective psychosocial content and its mechanisms of action could greatly enhance the effectiveness of counseling, digital, and web interventions.
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Affiliation(s)
- Timothy B Baker
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53711, USA;
| | - Danielle E McCarthy
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53711, USA;
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Hoge EA, Acabchuk RL, Kimmel H, Moitra E, Britton WB, Dumais T, Ferrer RA, Lazar SW, Vago D, Lipsky J, Schuman-Olivier Z, Cheaito A, Sager L, Peters S, Rahrig H, Acero P, Scharf J, Loucks EB, Fulwiler C. Emotion-related constructs engaged by mindfulness-based interventions: A systematic review and meta-analysis. Mindfulness (N Y) 2021; 12:1041-1062. [PMID: 34149957 PMCID: PMC8210838 DOI: 10.1007/s12671-020-01561-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined. METHODS Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. RESULTS Seventy-two studies (N=7,378) were included (MBSR k=47, MBCT k = 21, Modified k=4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d=0.58; k =36), and in all constructs assessed: depression (d=0.66; k=26), anxiety (d =0.63; k=19), combined mental health (d =0.75; k=7 ) and stress (d =0.44; k=11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population-type did not moderate results, but MBI-type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. CONCLUSIONS This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.
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Affiliation(s)
- Elizabeth A. Hoge
- Department of Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Ave NW Suite 200, Washington, DC 20007, USA
| | - Rebecca L. Acabchuk
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, 06269, USA
| | - Hannah Kimmel
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Willoughby B. Britton
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Travis Dumais
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Rebecca A. Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - Sara W. Lazar
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - David Vago
- Osher Center for Integrative Medicine, Vanderbilt University, 3401 West End Avenue, Suite 380, Nashville, TN 37203, USA
| | - Jonah Lipsky
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Zev Schuman-Olivier
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
| | - Aya Cheaito
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 700 Butler Dr., Providence, RI 02906, USA
| | - Lauren Sager
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Sarah Peters
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Hadley Rahrig
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Pamela Acero
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Jodi Scharf
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Eric B. Loucks
- School of Public Health, Brown University, 121 South Main Street, Providence, Rhode Island 02903, USA
| | - Carl Fulwiler
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St., Cambridge MA 02139, USA
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
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Brief mindfulness training for smoking cessation in Chinese women in workplaces: A pilot randomized controlled trial. Addict Behav 2021; 113:106677. [PMID: 33069106 DOI: 10.1016/j.addbeh.2020.106677] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Mindfulness training (MT) has shown preliminary efficacy as a behavioral treatment for smoking cessation. We examined the effect of a brief-MT intervention on smoking cessation for Chinese women in workplaces in Hong Kong, China. METHODS In this pilot randomized controlled trial, 213 daily smokers were recruited from workplaces and computer-randomized into the intervention (n = 114) or control (n = 99) groups. Participants in both groups received a self-help booklet. Participants in the intervention group additionally attended 2 sessions of a brief-MT workshop. The primary outcome was self-reported 7-day point-prevalence abstinence (PPA) at 6 months. Secondary outcomes were biochemically validated abstinence (exhaled CO < 4 ppm and salivary cotinine < 10 ng/mL) and smoking reduction at 6 months. Analyses were done by intention to treat. We conducted a post-trial qualitative evaluation on participants in the intervention group (n = 14). Data were analyzed thematically. RESULTS At 6-month follow-up, self-reported 7-day PPA were similar between the intervention and control groups (18.4% vs. 21.2%; P = 0.61). Very few participated in biochemical validation (n = 17), and validated abstinence and smoking reduction rates showed no significant difference (5.3% vs. 11.1%, P = 0.12 and 20.2% vs. 20.2%, P = 1.00, respectively). A posteriori analysis showed that brief-MT participants who were psychologically engaged with the intervention had greater 6-month PPA. Qualitative evaluation showed brief-MT reduced stress but its effectiveness was restrained by the insufficient home practice. CONCLUSIONS This pilot trial on a brief-MT intervention for smoking cessation on Chinese women in workplaces showed feasibility, but improving compliance is needed to maximize the efficacy in future fully powered trials.
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Fattahi C, Hamada K, Chiang M, Kosuru S, Polavarapu M, Sitthichai R, Fan X. A narrative review of mindfulness-based therapy for schizophrenia, co-occurring substance use and comorbid cardiometabolic problems. Psychiatry Res 2021; 296:113707. [PMID: 33421838 DOI: 10.1016/j.psychres.2021.113707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
Mindfulness-based therapy (MBT) has gained attention in recent years as a promising treatment for patients with schizophrenia for whom traditional interventions are not effective. Research demonstrates improvements in psychotic symptoms, emotion regulation, and other areas including re-hospitalization rates and insight into illness following MBT interventions. Yet MBT studies have not carefully reported results in patients with schizophrenia and co-occurring substance use or comorbid medical problems, bringing into question the generalizability of these findings. This narrative review explores the literature regarding the use of mindfulness-based interventions for patients with schizophrenia as well as for patients with substance use disorder, cardiovascular disease, obesity, and diabetes. Findings suggest that MBTs can improve craving in substance use disorder, eating related behaviors in obesity, diabetes-related distress, and metabolic regulation in patients with diabetes. Increased insula and anterior cingulate cortex volumes and activities following MBTs might be associated with the potential benefit of MBTs in patients with schizophrenia. Our review provides a foundational basis in support of the need for future studies evaluating the safety and efficacy of MBTs for schizophrenia with co-occurring substance use disorder and/or comorbid cardiometabolic problems.
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Affiliation(s)
- Cameron Fattahi
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States
| | - Kareem Hamada
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States
| | - Mathew Chiang
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States
| | - Sindu Kosuru
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States
| | - Mona Polavarapu
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States
| | - Rangsun Sitthichai
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States
| | - Xiaoduo Fan
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA, 01605, United States.
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Alghzawi H, Trinkoff A, Zhu S, Storr C. Remission from nicotine dependence among people with severe mental illness who received help/services for tobacco/nicotine use. Int J Methods Psychiatr Res 2020; 29:1-11. [PMID: 32945054 PMCID: PMC7723218 DOI: 10.1002/mpr.1845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES A growing body of evidence supports pharmacological interventions to assist smoking cessation in people with severe mental illness (SMI); that is, lifetime major depressive disorder, bipolar disorders, or schizophrenia. Little is known about whether behavioral services are also associated with high probability of remission from nicotine dependence as compared to other types of help/services received (pharmacological, behavioral, or both). METHODS A sample of 726 American lifetime adult smokers with SMI and a history of nicotine dependence, who received help/services for tobacco/nicotine use, were identified. These data came from a limited public use dataset, the 2012-2013 NESARC-III. Survival analysis was used to compare the probability of remission from nicotine dependence and the time needed for full remission from nicotine dependence by type of help/services received for tobacco/nicotine use. RESULTS Remission was more frequent among those who received behavioral services. In addition, the average time from onset of nicotine dependence until full remission from nicotine dependence was shorter among those who received behavioral services. CONCLUSIONS The current study suggests a clinical need for behavioral interventions to promote the probability of remission from nicotine dependence among smokers with SMI. Health care providers could play a role in educating and encouraging smokers with SMI to seek and utilize behavioral services.
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Affiliation(s)
- Hamzah Alghzawi
- Department of Family and Community Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
| | - Alison Trinkoff
- Department of Family and Community Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
| | - Shijun Zhu
- Department of Organizational Systems and Adult Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
| | - Carla Storr
- Department of Family and Community Health, School of NursingUniversity of MarylandBaltimoreMarylandUSA
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Tobacco and Nicotine Cessation During Pregnancy: ACOG Committee Opinion, Number 807. Obstet Gynecol 2020; 135:e221-e229. [PMID: 32332417 DOI: 10.1097/aog.0000000000003822] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function. Children born to women who smoke during pregnancy are at an increased risk of respiratory infections, asthma, infantile colic, bone fractures, and childhood obesity. Pregnancy influences many women to stop smoking, and approximately 54% of women who smoke before pregnancy quit smoking directly before or during pregnancy. Smoking cessation at any point in gestation benefits the pregnant woman and her fetus. The greatest benefit is observed with cessation before 15 weeks of gestation. Although cigarettes are the most commonly used tobacco product in pregnancy, alternative forms of tobacco use, such as e-cigarettes or vaping products, hookahs, and cigars, are increasingly common. Clinicians should advise cessation of tobacco products used in any form and provide motivational feedback. Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. Available cessation-aid services and resources, including digital resources, should be discussed and documented regularly at prenatal and postpartum follow-up visits.
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Garrison KA, Pal P, O'Malley SS, Pittman BP, Gueorguieva R, Rojiani R, Scheinost D, Dallery J, Brewer JA. Craving to Quit: A Randomized Controlled Trial of Smartphone App-Based Mindfulness Training for Smoking Cessation. Nicotine Tob Res 2020; 22:324-331. [PMID: 29917096 DOI: 10.1093/ntr/nty126] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/15/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Mindfulness training may reduce smoking rates and lessen the association between craving and smoking. This trial tested the efficacy of mindfulness training via smartphone app to reduce smoking. Experience sampling (ES) was used to measure real-time craving, smoking, and mindfulness. METHODS A researcher-blind, parallel randomized controlled trial compared the efficacy of mobile mindfulness training with experience sampling (MMT-ES; Craving to Quit) versus experience sampling only (ES) to (1) increase 1-week point-prevalence abstinence rates at 6 months, and (2) lessen the association between craving and smoking. A modified intent-to-treat approach was used for treatment starters (MMT-ES n = 143; ES n = 182; 72% female, 81% white, age 41 ± 12 year). RESULTS No group difference was found in smoking abstinence at 6 months (overall, 11.1%; MMT-ES, 9.8%; ES, 12.1%; χ2(1) = 0.43, p = .51). From baseline to 6 months, both groups showed a reduction in cigarettes per day (p < .0001), craving strength (p < .0001) and frequency (p < .0001), and an increase in mindfulness (p < .05). Using ES data, a craving by group interaction was observed (F(1,3785) = 3.71, p = .05) driven by a stronger positive association between craving and cigarettes per day for ES (t = 4.96, p < .0001) versus MMT-ES (t = 2.03, p = .04). Within MMT-ES, the relationship between craving and cigarettes per day decreased as treatment completion increased (F(1,104) = 4.44, p = .04). CONCLUSIONS Although mindfulness training via smartphone app did not lead to reduced smoking rates compared with control, our findings provide preliminary evidence that mindfulness training via smartphone app may help lessen the association between craving and smoking, an effect that may be meaningful to support quitting in the longer term. IMPLICATIONS This is the first reported full-scale randomized controlled trial of any smartphone app for smoking cessation. Findings provide preliminary evidence that smartphone app-based MMT-ES may lessen the association between craving and smoking. TRIAL REGISTRATION Clinicaltrials.gov NCT02134509.
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Affiliation(s)
| | - Prasanta Pal
- Department of Medicine and Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | | | - Brian P Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, New Haven, CT.,Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | - Rahil Rojiani
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Jesse Dallery
- Department of Psychology, University of Florida, Gainesville, FL
| | - Judson A Brewer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT.,Department of Medicine and Psychiatry, University of Massachusetts Medical School, Worcester, MA.,Center for Mindfulness, University of Massachusetts Medical School, Worcester, MA
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Carpenter SM, Menictas M, Nahum-Shani I, Wetter DW, Murphy SA. Developments in Mobile Health Just-in-Time Adaptive Interventions for Addiction Science. CURRENT ADDICTION REPORTS 2020; 7:280-290. [PMID: 33747711 PMCID: PMC7968352 DOI: 10.1007/s40429-020-00322-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Addiction is a serious and prevalent problem across the globe. An important challenge facing intervention science is how to support addiction treatment and recovery while mitigating the associated cost and stigma. A promising solution is the use of mobile health (mHealth) just-in-time adaptive interventions (JITAIs), in which intervention options are delivered in situ via a mobile device when individuals are most in need. RECENT FINDINGS The present review describes the use of mHealth JITAIs to support addiction treatment and recovery, and provides guidance on when and how the micro-randomized trial (MRT) can be used to optimize a JITAI. We describe the design of five mHealth JITAIs in addiction and three MRT studies, and discuss challenges and future directions. SUMMARY This review aims to provide guidance for constructing effective JITAIs to support addiction treatment and recovery.
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Affiliation(s)
| | | | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - David W. Wetter
- Huntsman Cancer Institute and the University of Utah, Salt Lake City, UT
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Jackson S, Brown J, West R, Norris E, Livingstone-Banks J, Lindson N. Mindfulness for smoking cessation. Hippokratia 2020. [DOI: 10.1002/14651858.cd013696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah Jackson
- Department of Behavioural Science and Health; University College London; London UK
| | - Jamie Brown
- Department of Behavioural Science and Health; University College London; London UK
| | - Robert West
- Department of Behavioural Science and Health; University College London; London UK
| | - Emma Norris
- Centre for Behaviour Change; University College London; London UK
| | | | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
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Schwebel FJ, Korecki JR, Witkiewitz K. Addictive Behavior Change and Mindfulness-Based Interventions: Current Research and Future Directions. CURRENT ADDICTION REPORTS 2020; 7:117-124. [PMID: 33585158 PMCID: PMC7879483 DOI: 10.1007/s40429-020-00302-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Addictive behaviors are difficult to change and result in high rates of relapse following change attempts. A number of effective treatment approaches have been developed to treat addictive behaviors (e.g., cognitive behavioral therapies). More recently, there has been an increase in the development and evaluation of mindfulness-based interventions for addictive behaviors. This article discusses the history of mindfulness-based interventions for addictive behaviors and recent advances in treatment. RECENT FINDINGS Mindfulness-based interventions are as effective as existing evidence-based treatments for addictive behaviors. Further understanding of the neurobiological changes that occur could help identify the components of mindfulness-based interventions that are most helpful and which individuals may benefit most from mindfulness-based intervention. SUMMARY Additional large scale randomized controlled trials are needed for a better understanding of the effectiveness of mindfulness-based interventions. Future research should look at optimizing mindfulness-based interventions for specific settings and patient populations, as well as dissemination and implementation.
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Affiliation(s)
- Frank J. Schwebel
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, USA
| | | | - Katie Witkiewitz
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, USA
- Department of Psychology, University of New Mexico, Albuquerque, USA
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Vinci C. Cognitive Behavioral and Mindfulness-Based Interventions for Smoking Cessation: a Review of the Recent Literature. Curr Oncol Rep 2020; 22:58. [PMID: 32415381 PMCID: PMC7874528 DOI: 10.1007/s11912-020-00915-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Cigarette smoking is the primary cause of cancer and is the leading preventable cause of morbidity and mortality. Cognitive behavioral therapy (CBT) is one of the most well-established and efficacious interventions for smoking cessation. The study of mindfulness-based interventions (MBIs) has increased exponentially in recent years, showing efficacy for smoking cessation as well. This review highlights research from the past 5 years examining CBT and MBIs for smoking cessation. RECENT FINDINGS Both CBT and MBIs are efficacious for special populations (e.g., low SES; pregnant smokers) and have shown initial efficacy when delivered via mhealth/ehealth. CBT has shown efficacy when combined with another behavioral treatment (e.g., ACT). Continued research is needed on CBT and MBIs that have high potential for scalability. Understanding whether they are beneficial for certain populations (e.g., cancer survivors), along with determining for whom CBT vs MBIs are most effective, is also needed.
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Affiliation(s)
- Christine Vinci
- Moffitt Cancer Center, Health Outcomes and Behavior, 4115 E Fowler Ave, Tampa, FL, 33617, USA.
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Abstract
Initially inspired by Buddhist philosophy and practice, mindfulness has become ubiquitous in psychotherapy, counseling, and popular psychology. Several mindfulness interventions have been developed and investigated, many of them attaining strong empirical support for a variety of conditions. However, the authors argue that mindfulness interventions should not be used uncritically and indiscriminately, because, for instance, there is not enough efficacy evidence for all the uses and applications of mindfulness (e.g., mobile apps). Second, following the definition of the concept, the authors argue that detachment may decrease motivational relevance in the face of personal goals and may encourage low intensity affect in cases where this would not be either needed or desirable. On the other hand, they argue that mindfulness-based interventions can be particularly useful treating chronic and severe cases, particularly in depression, pain conditions, and addictions.
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Affiliation(s)
- Simona Stefan
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Daniel David
- Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
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Patterson F, Grandner MA, Malone SK, Rizzo A, Davey A, Edwards DG. Sleep as a Target for Optimized Response to Smoking Cessation Treatment. Nicotine Tob Res 2020; 21:139-148. [PMID: 29069464 DOI: 10.1093/ntr/ntx236] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 10/19/2017] [Indexed: 12/23/2022]
Abstract
Declining national rates of current tobacco use to an all-time low of 15.1% represents a public health victory. Undermining this progress, however, are smoking rates of up to 50% among high-risk, low-income populations. Current FDA-approved treatments for nicotine dependence are ineffective with between 70-95% of treatment-seekers relapsing within the first year of attempted abstinence. Thus, identification of novel intervention targets to optimize response to currently available treatments for nicotine dependence is a critical next step. One such target may be sleep insomnia. Insomnia is a clinically verified nicotine withdrawal symptom but, to date, addressing insomnia or other sleep disturbance symptoms as an adjunctive smoking cessation therapy has yet to be fully considered. To this end, this manuscript presents a narrative review of: (1) sleep continuity and architecture in smokers versus nonsmokers; (2) effects of nicotine abstinence on sleep; (3) possible mechanisms linking sleep with smoking cessation outcomes; (4) plausible adjunctive sleep therapies to promote smoking cessation; (5) possible treatments for unhealthy sleep in smokers; and (6) directions for future research. Taken together, this will provide conceptual support for sleep therapy as an adjunctive treatment for smoking cessation. Implications This narrative literature review presents a comprehensive discussion of the relationship between habitual sleep and cigarette smoking. The extent to which unhealthy sleep in smokers may be a viable intervention target for promoting response to smoking cessation treatment is considered. Ultimately, this review provides conceptual support for sleep therapy as an adjunctive treatment for smoking cessation.
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Affiliation(s)
- Freda Patterson
- College of Health Sciences, University of Delaware, Newark, DE
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ
| | - Susan K Malone
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Albert Rizzo
- Christiana Care Health System, Pulmonary and Critical Care Medicine, Newark, DE
| | - Adam Davey
- College of Health Sciences, University of Delaware, Newark, DE
| | - David G Edwards
- College of Health Sciences, University of Delaware, Newark, DE
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Melo GAA, Aguiar LL, Silva RA, Pereira FGF, Silva FLBD, Caetano JÁ. Effects of acupuncture in patients with chronic kidney disease: a systematic review. Rev Bras Enferm 2020; 73:e20180784. [DOI: 10.1590/0034-7167-2018-0784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 07/03/2019] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to analyze the effects of acupuncture techniques in patients with chronic kidney disease. Methods: a systematic review conducted in six databases, from September to December 2017, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ criteria. The following descriptors were used: Acupuncture AND Chronic Renal Insufficiency AND Clinical Trial. Results: nine studies were selected; the acupuncture techniques used were auriculotherapy, electroacupuncture and acupressure aimed at improving quality of life, fatigue, sleep and clinical variables of the disease. The studies that assessed quality of life, sleep and fatigue presented significant benefits. Studies that assessed quality of life, sleep and fatigue presented significant benefits. There was no statistical significance in the improvement of serum creatinine levels and glomerular filtration rate. Methodological and assessment tools’ divergence made impossible meta-analysis Conclusions: studies reinforce the positive effect of acupuncture in improving quality of life, fatigue and sleep in patients.
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36
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Lotfalian S, Spears CA, Juliano LM. The effects of mindfulness-based yogic breathing on craving, affect, and smoking behavior. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 34:351-359. [PMID: 31750699 DOI: 10.1037/adb0000536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Breathing practices are often incorporated into treatments for tobacco dependence, but there is little direct research testing the efficacy of breathing practices. This study examined the effects of a mindfulness-based yogic breathing (MB) intervention versus active treatment (cognitive strategy [CS]) and no-treatment (NT) control groups on craving, affect, withdrawal, and smoking behavior. Smokers (N = 60; 50% female; 83% African American) were randomized to receive 20 min of MB, CS, or NT. Participants completed self-report measures before and after the manipulation and then took part in a 50-min smoking choice procedure. Afterward, participants were advised to use the techniques they learned and self-monitor smoking for 24 hr. They received 3 reminder text messages and returned to the lab the following day. MB and CS were more effective than NT in decreasing craving to smoke and perceived nicotine withdrawal. MB, but not CS, was more effective than NT in reducing negative affect. MB reduced the risk of smoking by more than twofold relative to both CS and NT during the smoking choice procedure. Participants in the MB condition smoked fewer cigarettes than those in the CS and NT conditions in the 24 hr following the manipulation. There were no differential effects of the manipulations on state mindfulness or positive affect. Mindful yogic breathing appears to be particularly effective in alleviating the acute negative effects of smoking abstinence and decreasing smoking behavior. Mindful breathing techniques are safe, simple, and cost-effective strategies that deserve additional research attention, especially among underserved populations of smokers. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Claire A Spears
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University
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de Souza IW, Kozasa EH, Rabello LA, Mattozo B, Bowen S, Richter KP, Sartes LMA, Noto AR. Dispositional mindfulness, affect and tobacco dependence among treatment naive cigarette smokers in Brazil. Tob Induc Dis 2019; 17:28. [PMID: 31582939 PMCID: PMC6751993 DOI: 10.18332/tid/105846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/02/2019] [Accepted: 03/20/2019] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The current study examined associations between affective and smoking-related factors, and dispositional mindfulness among smokers seeking enrollment in a cessation program in Brazil. METHODS Participants were first-time treatment seeking adult smokers (N=90) on a waiting list for a government-sponsored cessation program. Pearson's bivariate correlations assessed relationships between the primary outcome variable (dispositional mindfulness) and each explanatory variable (nicotine dependence, depression, anxiety, and state positive/negative affect). Linear regression analyses evaluated the unique contribution of each explanatory variable when controlling for the others. RESULTS The sample (N=90) was predominantly female (n=71) and most (79%) had 11 or fewer years of education. In the final regression model, a total of 36.2% of the variance in dispositional mindfulness was accounted for by positive affect (B=0.81, p<0.001), negative affect (B= -0.44, p=0.02), and level of nicotine dependence (B=1.48, p=0.007). CONCLUSIONS Positive and negative affect, as well as nicotine dependence, account for a significant and sizable amount of the variance in dispositional mindfulness. Future mindfulness interventions for smoking cessation should be designed to address individual differences in affect, as well as nicotine dependence, in order to better tailor treatment to address baseline differences in mindfulness.
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Affiliation(s)
| | | | - Luane A Rabello
- Departamento de Psicologia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Beatriz Mattozo
- Departamento de Psicologia, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, Hillsboro, United States
| | - Kimber P Richter
- Department of Preventive Medicine and Public Health, School of Medicine, University of Kansas, Kansas City, United States
| | | | - Ana Regina Noto
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Belsher BE, Beech EH, Kelber MS, Hempel S, Evatt DP, Smolenski DJ, Campbell MS, Otto JL, Morgan MA, Workman DE, Stewart L, Morgan RL, Khusid M, Edwards-Stewart A, O’Gallagher K, Bush N. Establishing an Evidence Synthesis Capability For Psychological Health Topics in the Military Health System. Med Care 2019; 57 Suppl 10 Suppl 3:S265-S271. [PMID: 31517798 PMCID: PMC6750155 DOI: 10.1097/mlr.0000000000001172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To promote evidence-based health care, clinical providers and decision makers rely on scientific evidence to inform best practices. Evidence synthesis (ES) is a key component of this process that serves to inform health care decisions by integrating and contextualizing research findings across studies. OBJECTIVE This paper describes the process of establishing an ES capability in the Military Health System dedicated to psychological health topics. RESEARCH DESIGNS The goal of establishing the current ES capability was to facilitate evidence-based decision-making among clinicians, clinic managers, research funders, and policymakers, through the production and dissemination of trustworthy ES reports. We describe how we developed this capability, provide an overview of the types of evidence syntheses products we use to respond to different stakeholders, and detail the procedures established for selecting and prioritizing synthesis topics. RESULTS We report on the productivity, acceptability, and impact of our efforts. Our reports were used by a variety of stakeholders and working groups, briefed to major committees, included in official reports and policies, and cited in clinical practice guidelines and the peer-reviewed literature. CONCLUSIONS Our experiences thus far suggest that the current ES capability offers a needed service within our health system. Our framework may help inform other agencies interested in developing or sponsoring a similar capability.
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Affiliation(s)
- Bradley E. Belsher
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Erin H. Beech
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Marija S. Kelber
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Susanne Hempel
- RAND Corporation, Evidence-based Practice Center (EPC), Santa Monica, CA
| | - Daniel P. Evatt
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Derek J. Smolenski
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Marjorie S. Campbell
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Jean L. Otto
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Maria A. Morgan
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Don E. Workman
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Lindsay Stewart
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Rebecca L. Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Marina Khusid
- Department of Family Medicine, University of Illinois, Chicago, IL
| | - Amanda Edwards-Stewart
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Kevin O’Gallagher
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
| | - Nigel Bush
- Defense Health Agency, Psychological Health Center of Excellence (PHCoE), Falls Church, VA
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Sala M, Rochefort C, Lui PP, Baldwin AS. Trait mindfulness and health behaviours: a meta-analysis. Health Psychol Rev 2019; 14:345-393. [DOI: 10.1080/17437199.2019.1650290] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Margarita Sala
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | | | - P. Priscilla Lui
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Austin S. Baldwin
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
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Yaghubi M, Zargar F. Effectiveness of Mindfulness-based Relapse Prevention on Quality of Life and Craving in Methadone-treated Patients: A Randomized Clinical Trial. ADDICTION & HEALTH 2019; 10:250-259. [PMID: 31263524 PMCID: PMC6593172 DOI: 10.22122/ahj.v10i4.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Quality of life (QOL) is always considered as a final consequence of clinical trials, interventions, and health care. The results of studies indicate that addiction leads to lower QOL. However, studies have been conducted on the effectiveness of mindfulness-based interventions on improving QOL. The aim of this study was to investigate the efficacy of mindfulness-based relapse prevention (MBRP) on QOL and craving in methadone-treated patients. Methods This study was conducted in Qom, Iran, in 2017. A sample of 70 methadone-treated patients were randomly selected and assigned to two groups (intervention and control). Participants in both groups completed the 36-item Short Form (SF-36) QOL Questionnaire and Craving Beliefs Questionnaire (CBQ) at the beginning of the study (pre-test), 8 weeks after the study (post-test), and two months after the study (follow up). In this study, the experimental group received 8 training sessions on mindfulness prevention, while the control group did not receive general information about addiction and did not receive any psychological intervention. Finally, data of 63 patients were analyzed with the SPSS software, chi-square test, t-test, and repeated-measures ANOVA. Findings The results of repeated-measures ANOVA showed that there was no significant difference between intervention and control groups in the pre-test, but MBRP in the intervention group significantly increased the scores of QOL and decreased the scores of craving, significantly (P < 0.001). Conclusion The findings of present study indicate that MBRP training can increase the psychological and physical health in dependent methadone-treated patients and decrease craving. These findings suggest that mindfulness training can be used as an effective intervention for improving QOL and reducing craving.
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Affiliation(s)
- Mehdi Yaghubi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Zargar
- Associate Professor, Department of Psychiatry, School of Medicine AND Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Acceptance- and Mindfulness-Based Interventions for Health Behavior Change: Systematic Reviews and Meta-Analyses. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019; 13:74-93. [PMID: 32832377 DOI: 10.1016/j.jcbs.2019.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Behavioral health issues such as smoking and overweight are risk factors for a variety of adverse health outcomes, including mortality. Over the past decade, a growing number of randomized controlled trials have examined the efficacy of acceptance- and mindfulness-based interventions for smoking cessation and weight loss. The purpose of the current meta-analytic reviews was to quantitatively synthesize the existing literature comparing these interventions to controls for a) smoking cessation and b) weight loss outcomes. Searches identified 17 smoking cessation studies and 31 weight loss studies eligible for inclusion. Meta-analytic results indicated a non-significant effect favoring acceptance- and mindfulness-based interventions over controls for smoking cessation (OR = 1.13) and a small, significant effect favoring these interventions over controls for weight loss outcomes (Hedge's g = 0.30). Statistical heterogeneity and risk of bias were assessed. Subgroup and meta-regression analyses were conducted to examine moderating variables (e.g., sample and intervention characteristics). The findings indicated that acceptance- and mindfulness-based interventions were at least as efficacious as active control conditions. Given the significant health risks associated with smoking and overweight, these findings have important clinical and public health implications. Limitations (e.g., relative infancy of the literature; lack of diversity in sample demographics) and future directions (e.g., further exploration of mediators and moderators of change) are discussed.
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Paulus DJ, Langdon KJ, Wetter DW, Zvolensky MJ. Dispositional Mindful Attention in Relation to Negative Affect, Tobacco Withdrawal, and Expired Carbon Monoxide On and After Quit Day. J Addict Med 2019; 12:40-44. [PMID: 28922195 PMCID: PMC5786492 DOI: 10.1097/adm.0000000000000361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Mindfulness (or "Mindful Attention") has been described as the presence or absence of attention to, and awareness of, what is occurring in the present moment. Among smokers, greater mindfulness is associated with greater effect stability and reduced cue-induced craving. While studies have shown that mindfulness is associated with other smoking-related factors such as reduced withdrawal symptoms using cross-sectional data, relatively little is known about the associations between baseline mindful attention and future abstinence-related effect/withdrawal. The current study sought to examine whether levels of mindful attention before cessation predicts negative affect, withdrawal, and level of expired carbon monoxide (CO) on quit day, and also 3 and 7 days after quitting, during a self-quit attempt. METHODS Data from 58 adults (mean age = 34.9; 65.5% male) participating in a self-quit study were available for analysis. Self-report measures of mindful attention, negative affect, and withdrawal symptoms were collected. Biochemical measurement of expired CO was also collected. Dependent variables were assessed on quit day, and also 3 and 7 days after quitting. Covariates included age, race, sex, self-reported level of cigarette dependence, and smoking status through 7 days. Multivariate regression was used to evaluate the association of baseline mindful attention in relation to the studied outcomes. RESULTS Greater mindful attention predicted lower negative affect and reduced withdrawal at all 3 time-points. Mindful attention did not predict levels of expired CO. CONCLUSIONS The findings suggest that mindful attention before or during smoking-cessation treatment may help to reduce negative affect and withdrawal, which serve as barriers to cessation for many smokers.
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Affiliation(s)
| | | | - David W. Wetter
- University of Utah, Department of Population Health Sciences and the Huntsman Cancer Institute, Salt Lake City,
UT
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology, Houston, TX
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, Texas
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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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The Juul Curriculum Is Not the Jewel of Tobacco Prevention Education. J Adolesc Health 2018; 63:527-528. [PMID: 30348276 DOI: 10.1016/j.jadohealth.2018.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 12/16/2022]
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Derefinko KJ, Salgado García FI, Sumrok DD. Smoking Cessation for Those Pursuing Recovery from Substance Use Disorders. Med Clin North Am 2018; 102:781-796. [PMID: 29933829 DOI: 10.1016/j.mcna.2018.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This article summarizes the literature regarding the similar biopsychosocial mechanisms of tobacco use and alcohol and substance use disorders, and the evidence for and against the provision of tobacco cessation for those in treatment for alcohol and substance use disorders. The practicality of treatment, focusing on methods, timing, and breadth of intervention strategies, are also presented. Common methodologies that may be used across tobacco use and alcohol and substance use disorder to prevent lapse and relapse are discussed. Physicians can and should adhere to the policy that tobacco use is a common and dangerous comorbid condition that demands concomitant treatment.
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Affiliation(s)
- Karen J Derefinko
- University of Tennessee Health Science Center, 66 North Pauline Street, Suite 305, Memphis, TN 38163-2181, USA.
| | - Francisco I Salgado García
- University of Tennessee Health Science Center, 66 North Pauline Street, Suite 305, Memphis, TN 38163-2181, USA
| | - Daniel D Sumrok
- University of Tennessee Health Science Center, Department of Addiction Medicine, 6401 Popular Avenue, Suite 500, Memphis, TN 38119, USA
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Mantzios M, Giannou K. A Real-World Application of Short Mindfulness-Based Practices: A Review and Reflection of the Literature and a Practical Proposition for an Effortless Mindful Lifestyle. Am J Lifestyle Med 2018; 13:520-525. [PMID: 31662713 DOI: 10.1177/1559827618772036] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/18/2018] [Accepted: 03/30/2018] [Indexed: 12/19/2022] Open
Abstract
Mindfulness has become known to the Western world through mindfulness programs that entail different formal and informal mindfulness practices. To enable initiation and commitment to a practice of mindfulness and to enhance the intrinsic motivation to follow and commit to a more demanding mindfulness program and facilitate a lifestyle adaptation, we argue that associating 1 short, accessible, and easy to use mindfulness practice with implementation intentions and habit formation may be the best way forward for novices in meditation and mindfulness. We trust that other theories and findings from psychological science can enhance and enable a mindful lifestyle, which will strengthen the capacity to upkeep optimal living and being.
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Affiliation(s)
- Michail Mantzios
- Department of Psychology, Birmingham City University, West Midlands, UK (MM).,Division of Neuroscience and Experimental Psychology, University of Manchester, UK (KG)
| | - Kyriaki Giannou
- Department of Psychology, Birmingham City University, West Midlands, UK (MM).,Division of Neuroscience and Experimental Psychology, University of Manchester, UK (KG)
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Gryczynski J, Schwartz RP, Fishman MJ, Nordeck CD, Grant J, Nidich S, Rothenberg S, O'Grady KE. Integration of Transcendental Meditation® (TM) into alcohol use disorder (AUD) treatment. J Subst Abuse Treat 2018; 87:23-30. [DOI: 10.1016/j.jsat.2018.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 01/22/2023]
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Mindfulness and craving: effects and mechanisms. Clin Psychol Rev 2018; 59:101-117. [DOI: 10.1016/j.cpr.2017.11.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/24/2017] [Accepted: 11/12/2017] [Indexed: 01/02/2023]
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Britton WB, Davis JH, Loucks EB, Peterson B, Cullen BH, Reuter L, Rando A, Rahrig H, Lipsky J, Lindahl JR. Dismantling Mindfulness-Based Cognitive Therapy: Creation and validation of 8-week focused attention and open monitoring interventions within a 3-armed randomized controlled trial. Behav Res Ther 2018; 101:92-107. [PMID: 29106898 PMCID: PMC5801080 DOI: 10.1016/j.brat.2017.09.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/19/2017] [Accepted: 09/25/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND While mindfulness-based interventions (MBIs) employ two distinct practices, focused attention (FA) and open monitoring (OM), the integrated delivery of these practices in MBIs precludes understanding of their practice-specific effects or mechanisms of action. The purpose of this study is to isolate hypothesized active ingredients and practice-specific mechanistic target engagement by creating structurally equivalent interventions that differ only by the active ingredient (meditation practice) offered and to test whether the hypothesized components differentially engage the mechanistic targets that they are purported to engage. METHODS Participants were intended to be representative of American meditators and had mild to severe affective disturbances. Measures of structural equivalence included participant-level (sample characteristics), treatment-level (program structure and duration, program materials, class size, attendance, homework compliance, etc.), and instructor-level variables (training, ratings and adherence/fidelity). Measures of differential validity included analysis of program materials and verification of differential mechanistic target engagement (cognitive and affective skills and beliefs about meditation acquired by participants after the 8-week training). RESULTS The results indicate successful creation of structurally equivalent FA and OM programs that were matched on participant-level, treatment-level, and instructor-level variables. The interventions also differed as expected with respect to program materials as well as mechanistic targets engaged (skills and beliefs acquired). CONCLUSIONS These validated 8-week FA and OM training programs can be applied in future research to assess practice-specific effects of meditation.
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Affiliation(s)
- Willoughby B Britton
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States.
| | - Jake H Davis
- Virtues of Attention Project, New York University, New York, United States
| | - Eric B Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Barnes Peterson
- Director of Mental Health and Substance Abuse Recovery Services, Cheshire County Department of Corrections, Keene, NH, United States
| | - Brendan H Cullen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States
| | - Laura Reuter
- Stanley Street Treatment and Resource, Fall River, MA, United States
| | - Alora Rando
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Hadley Rahrig
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States
| | - Jonah Lipsky
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, RI, United States
| | - Jared R Lindahl
- Cogut Center for the Humanities, Brown University, Providence, RI, United States
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Wilson AD, Roos CR, Robinson CS, Stein ER, Manuel JA, Enkema MC, Bowen S, Witkiewitz K. Mindfulness-based interventions for addictive behaviors: Implementation issues on the road ahead. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:888-896. [PMID: 29072477 DOI: 10.1037/adb0000319] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Over the past 35 years, mindfulness meditation practices have increasingly been integrated into Western medical settings. Research into the benefits of mindfulness-based interventions (MBIs) continues to expand, such that there are currently more than a dozen different protocolled MBIs for patients suffering from a variety of physical and psychological disorders. In the last decade, a number of MBIs specifically designed to treat addictive behaviors have been developed and tested. This review first provides a brief overview of the current state of the science with respect to the efficacy of MBIs for addictive behaviors, and some of the proposed mechanisms underlying the efficacy of MBIs. Second, the review highlights unresolved implementation issues and provides suggestions for how future research can address the implementation challenges to advance the delivery of MBIs. Specifically, this review focuses on the lack of clear empirical guidelines in the following areas: (a) effective training for MBI treatment providers; (b) adaptations of the traditional 2-hr closed-cohort group format; (c) delivery of MBIs in 1-on-1 treatment contexts; (d) delivery of MBIs at different points in the change process; (e) delivery of MBIs via technology-based platforms; and (f) facilitation of precision medicine in the delivery of MBIs. Specific research directions are suggested with an eye toward a meaningful increase in access to MBIs for front-line clinicians and clients. (PsycINFO Database Record
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Affiliation(s)
| | - Corey R Roos
- Department of Psychology, University of New Mexico
| | | | | | | | | | - Sarah Bowen
- Department of Psychology, Pacific University
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