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Jovanovic B, Garfin DR. Can mindfulness-based interventions reduce PTSD symptoms? An umbrella review. J Anxiety Disord 2024; 104:102859. [PMID: 38761551 DOI: 10.1016/j.janxdis.2024.102859] [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: 09/20/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 05/20/2024]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating, often chronic condition with substantial cross-national lifetime prevalence. Although mindfulness-based interventions (MBIs) may help reduce PTSD symptoms, efficacy results are inconsistent. Despite many systematic reviews (SRs) examining MBIs for PTSD, SR quality has been neither evaluated nor synthesized. We conducted an umbrella review to summarize and evaluate existing evidence regarding MBIs for PTSD, identifying 69 SRs (27 meta-analyses), consisting of 83 primary studies. Using AMSTAR2 (a valid SR quality assessment tool), we evaluated each SR on key domains relevant to methodological rigor and rated the confidence of inferences. Results found SRs were 65.2% non-rigorous, 27.5% likely rigorous, and 7.2% rigorous; common limitations included inadequate risk of bias assessment, extractions not completed in duplicate, and lack of pre-registration, highlighting the need for higher quality SRs. We then performed a meta-meta-analysis to estimate the efficacy of MBIs to reduce PTSD symptoms, yielding a medium effect size (SMD=0.41, p < .001), derived from 22 meta-analyses (with replicable data) and 35 unique articles. Analyses were consistent across control conditions and MBI type (first-generation/narrow [i.e., MBIs with well-established protocols]) versus broad (i.e., other MBI types), comparable with second-line treatments (e.g., pharmacotherapy). Findings were narratively synthesized; areas for methodological improvements in MBI research were identified.
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Affiliation(s)
- Branislav Jovanovic
- Department of Psychological Science, University of California, Irvine, 4201 Social & Behavioral Sciences Gateway, Irvine, CA 92697, United States
| | - Dana Rose Garfin
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Drive South, Box 951772, Los Angeles, CA 90095, United States.
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Li Y, Rhee H, Bullock LFC, McCaw B, Bloom T. Self-Compassion, Health, and Empowerment: A Pilot Randomized Controlled Trial for Chinese Immigrant Women Experiencing Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1571-1595. [PMID: 37902465 PMCID: PMC10913346 DOI: 10.1177/08862605231207624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Chinese immigrant survivors of men's violence experience both significant mental health impacts from abuse and barriers to formal services. Therefore, we examined the preliminary efficacy of an innovative mobile-based empowerment-based intervention (self-compassion, health, and empowerment; SHE) that specifically focuses on abused Chinese immigrant women in the US. This pilot study used a two-arm randomized controlled design with repeated measures. A convenience sample (N = 50) of Chinese immigrant women who experienced past year intimate partner violence (IPV) were recruited online and randomly assigned to the intervention or control group (25 per group). We assessed IPV exposure, safety behaviors, depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and self-compassion at baseline, post-intervention, and 8-week follow-up. Of 95 eligible participants, 50 (52.6%) agreed to participate and completed baseline data collection; intervention completion rate was 64%. We found a significant group and time interaction for self-judgment (a self-compassion component), with a significant reduction seen in the intervention group compared to the control group. Despite no other significant group differences observed over time, the intervention group showed consistent trends toward improvements in most outcome measures, including specific types of IPV (i.e., negotiation, psychological aggression, and sexual coercion), depressive and PTSD symptoms, self-compassion, and certain components of self-compassion (i.e., isolation and over-identification) when compared to the control group. Our findings suggest that the SHE intervention shows promise in improving the mental health well-being of Chinese immigrant survivors. However, a fully powered randomized controlled trial is warranted to determine its efficacy. Our intervention has the potential to be translated in the Chinese immigrant populations with the necessary organizational support.
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Affiliation(s)
- Yang Li
- School of Nursing, The University of Texas at Austin, USA
| | - Hyekyun Rhee
- School of Nursing, The University of Texas at Austin, USA
| | | | - Brigid McCaw
- Center to Advance Trauma-Informed Health Care, University of California, San Francisco, USA
| | - Tina Bloom
- School of Nursing, Notre Dame of Maryland University, Baltimore, USA
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Guyon R, Fernet M, Girard M, Cousineau MM, Tardif M, Godbout N. Who am I as a Sexual Being? The Role of Sexual Self-Concept Between Dispositional Mindfulness and Sexual Satisfaction among Child Sexual Abuse Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5591-5612. [PMID: 36113079 PMCID: PMC9969487 DOI: 10.1177/08862605221123290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Childhood sexual abuse (CSA) is associated with long-lasting and pervasive impacts on survivors' sexual health, particularly on their sexual satisfaction. Dispositional mindfulness has been found to be associated with greater sexual satisfaction among adult CSA survivors. However, the mechanisms involved in this association remain understudied. The present study examined the role of sexual self-concept (i.e., sexual esteem, sexual preoccupation, and sexual depression) in the relationship between dispositional mindfulness and sexual satisfaction among CSA survivors. A total of 176 adult CSA survivors (60.6% women, 39.4% men) completed an online survey assessing dispositional mindfulness, sexual self-concept, and sexual satisfaction. Path analyses revealed that dispositional mindfulness was positively related to sexual satisfaction through a significant indirect effect of higher sexual esteem and lower sexual depression. The integrative model explained 66.5% of the variance in sexual satisfaction. These findings highlight the key roles that dispositional mindfulness and sexual self-concept play in CSA survivors' sexual satisfaction. Implications for interventions based on trauma-sensitive mindfulness targeting the sexual self-concept are discussed, as they may promote sexual satisfaction in adult CSA survivors.
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Affiliation(s)
- Roxanne Guyon
- Université du Québec à Montréal,
Canada
- Roxanne Guyon, Department of Sexology,
Université du Québec à Montréal, C.P. 8888, Succursale Centre-Ville, Montréal,
Québec, Canada.
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Gimenez LBH, Fernandes MNDF, Esper LH, Moraes VSD, Zanetti ACG, Gherardi-Donato ECDS. Perceived Stress Associated Factors in Workers at a Public University. Rev Esc Enferm USP 2022; 56:e20220219. [PMID: 36346181 PMCID: PMC10101149 DOI: 10.1590/1980-220x-reeusp-2022-0219en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/15/2022] [Indexed: 11/06/2022] Open
Abstract
ABSTRACT Objective: To describe the predictors of perceived stress in a broad sample of workers at a Brazilian public university. Method: Cross-sectional study carried out with a convenience sample of workers at a public university in Brazil. To be included in the present study, the worker had to be an administrative technician. From March to August, 2017, workers were surveyed, and 929 participants answered the questionnaires of sociodemographic characterization, work and health conditions, perceived stress (Perceived Stress Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory). Results: The multiple linear regression showed that higher perceived stress was associated with being younger and male, occupying a higher or technical position, and presenting higher levels of depression and anxiety. Conclusion: These findings have implications for occupational health nurses and other health professionals to identify workers at risk for chronic and mental illness through predictors of perceived stress and to guide institutions in planning practical actions for stress management interventions.
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Kerrigan D, Karver TS, Barrington C, Donastorg Y, Perez M, Gomez H, Mbwambo J, Likindikoki S, Davis W, Wilson Beckham S, Mantsios A, Galai N, Sibinga E. Mindfulness, Mental Health and HIV Outcomes Among Female Sex Workers in the Dominican Republic and Tanzania. AIDS Behav 2021; 25:2941-2950. [PMID: 33511496 DOI: 10.1007/s10461-021-03168-1] [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] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
We examined the relationship between mindfulness, mental health and HIV outcomes among female sex workers (FSW) from the Dominican Republic (DR) (n = 201) and Tanzania (n = 208) using cross-sectional survey and biologic data. We employed stratified multivariate linear and logistic regression. Depression was associated with lower odds of ART adherence in the DR (AOR 0.25, 95% CI: 0.08-0.78) and of viral suppression in Tanzania (AOR 0.49, 95% CI: 0.24-0.97). In both countries, mindfulness was associated with lower odds of moderate to severe depression (AOR 0.82, 95% CI: 0.76-0.88 for the DR; AOR 0.85, 95% CI: 0.77-0.95 for Tanzania). In the DR, mindfulness was associated with lower odds of anxiety (AOR 0.83, 95% CI: 0.77-0.89), lower HIV stigma (β = - 0.28 per unit change, 95% CI: - 0.37 to - 0.19) and greater odds of viral suppression (AOR 1.09, 95% CI: 1.02-1.15). Findings demonstrate the potential of tailored mindfulness interventions to improve mental health and HIV outcomes among FSW.
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Leyro TM, Versella MV, Yang MJ, Brinkman HR, Hoyt DL, Lehrer P. Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression. Clin Psychol Rev 2021; 84:101980. [PMID: 33540222 PMCID: PMC8302658 DOI: 10.1016/j.cpr.2021.101980] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. METHODS The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. RESULTS Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. CONCLUSIONS Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.
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Affiliation(s)
- Teresa M Leyro
- Department of Psychology, Rutgers, The State University of New Jersey, United States.
| | - Mark V Versella
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Min-Jeong Yang
- Department of Psychology, Rutgers, The State University of New Jersey, United States; Department of Health Outcomes and Behavior, Moffitt Cancer Center, United States
| | - Hannah R Brinkman
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Paul Lehrer
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, United States
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Esper LH, Gherardi-Donato ECDS. Early stress, mindfulness, and mental health in mothers of children exposed to sexual violence. Arch Psychiatr Nurs 2020; 34:110-114. [PMID: 32513459 DOI: 10.1016/j.apnu.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Larissa Horta Esper
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, Sao Paulo, Brazil.
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Reyes AT, Bhatta TR, Muthukumar V, Gangozo WJ. Testing the acceptability and initial efficacy of a smartphone-app mindfulness intervention for college student veterans with PTSD. Arch Psychiatr Nurs 2020; 34:58-66. [PMID: 32248935 DOI: 10.1016/j.apnu.2020.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/08/2020] [Indexed: 01/25/2023]
Abstract
This single-arm, pre-post feasibility study evaluated the acceptability and initial efficacy of a mindfulness smartphone-app intervention intended to promote resilience and improve posttraumatic stress disorder (PTSD) symptoms among college student military veterans. The app contained mindfulness exercises and meditations based on the acceptance and commitment therapy. Twenty-three student veterans used the app for four weeks. The results showed high levels of perceived satisfaction and usability of the app. Significant changes in resilience, mindfulness, PTSD, experiential avoidance, and rumination were observed. Future research is needed to test the intervention in a randomized controlled trial.
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Affiliation(s)
| | - Tirth R Bhatta
- Department of Sociology, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Venkatesan Muthukumar
- Department of Electrical and Computer Engineering, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - William J Gangozo
- School of Nursing, University of Nevada Las Vegas, Las Vegas, NV, USA
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