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Wang T, Tang C, Jiang X, Guo Y, Zhu S, Xu Q. Effectiveness of Web-Based Mindfulness-Based Interventions for Patients With Cancer: Systematic Review and Meta-Analyses. J Med Internet Res 2024; 26:e47704. [PMID: 38917445 PMCID: PMC11234071 DOI: 10.2196/47704] [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: 03/30/2023] [Revised: 03/26/2024] [Accepted: 04/23/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Cancer has emerged as a considerable global health concern, contributing substantially to both morbidity and mortality. Recognizing the urgent need to enhance the overall well-being and quality of life (QOL) of cancer patients, a growing number of researchers have started using online mindfulness-based interventions (MBIs) in oncology. However, the effectiveness and optimal implementation methods of these interventions remain unknown. OBJECTIVE This study evaluates the effectiveness of online MBIs, encompassing both app- and website-based MBIs, for patients with cancer and provides insights into the potential implementation and sustainability of these interventions in real-world settings. METHODS Searches were conducted across 8 electronic databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CINAHL Complete, Scopus, and PsycINFO, until December 30, 2022. Randomized controlled trials involving cancer patients aged ≥18 years and using app- and website-based MBIs compared to standard care were included. Nonrandomized studies, interventions targeting health professionals or caregivers, and studies lacking sufficient data were excluded. Two independent authors screened articles, extracted data using standardized forms, and assessed the risk of bias in the studies using the Cochrane Bias Risk Assessment Tool. Meta-analyses were performed using Review Manager (version 5.4; The Cochrane Collaboration) and the meta package in R (R Foundation for Statistical Computing). Standardized mean differences (SMDs) were used to determine the effects of interventions. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to assess the potential implementation and sustainability of these interventions in real-world settings. RESULTS Among 4349 articles screened, 15 (0.34%) were included. The total population comprised 1613 participants, of which 870 (53.9%) were in the experimental conditions and 743 (46.1%) were in the control conditions. The results of the meta-analysis showed that compared with the control group, the QOL (SMD 0.37, 95% CI 0.18-0.57; P<.001), sleep (SMD -0.36, 95% CI -0.71 to -0.01; P=.04), anxiety (SMD -0.48, 95% CI -0.75 to -0.20; P<.001), depression (SMD -0.36, 95% CI -0.61 to -0.11; P=.005), distress (SMD -0.50, 95% CI -0.75 to -0.26; P<.001), and perceived stress (SMD -0.89, 95% CI -1.33 to -0.45; P=.003) of the app- and website-based MBIs group in patients with cancer was significantly alleviated after the intervention. However, no significant differences were found in the fear of cancer recurrence (SMD -0.30, 95% CI -1.04 to 0.44; P=.39) and posttraumatic growth (SMD 0.08, 95% CI -0.26 to 0.42; P=.66). Most interventions were multicomponent, website-based health self-management programs, widely used by international and multilingual patients with cancer. CONCLUSIONS App- and website-based MBIs show promise for improving mental health and QOL outcomes in patients with cancer, and further research is needed to optimize and customize these interventions for individual physical and mental symptoms. TRIAL REGISTRATION PROSPERO CRD42022382219; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382219.
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Affiliation(s)
- Ting Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Chulei Tang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiaoman Jiang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yinning Guo
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, China
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2
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Ellett L. Mindfulness for psychosis: Current evidence, unanswered questions and future directions. Psychol Psychother 2024; 97:34-40. [PMID: 37387330 DOI: 10.1111/papt.12480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/09/2023] [Accepted: 06/04/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE & METHOD Mindfulness for psychosis research has grown exponentially over the last 15 years. In this paper, a brief overview of mindfulness for psychosis is provided followed by a summary of the findings from a systematic search of meta-analyses dated up to February 2023. Current issues in the field are discussed and a future research agenda is presented. RESULTS Ten meta-analyses published between 2013 and 2023 were identified. Reported effect sizes on reductions in psychotic symptoms ranged from small-large across reviews. Four key issues in the field are identified and discussed - (1) is mindfulness for psychosis safe? (2) is home practice essential and related to clinical outcomes? (3) what is the impact of mindfulness practice versus metacognitive insights derived from practice, on clinical outcomes? (4) do the benefits translate into routine clinical practice? CONCLUSIONS Mindfulness is a promising intervention that is emerging as being both safe and effective for people with psychosis. Future research focused on evaluating mechanisms of change and implementation in routine clinical practice should be prioritised.
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Affiliation(s)
- Lyn Ellett
- University of Southampton, Southampton, UK
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3
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Cernasov PM, Kinard JL, Walsh E, Kelley L, Phillips R, Pisoni A, Arnold M, Lowery SC, Ammirato M, Nagy GA, Oliver JA, Haworth K, Daughters SB, Dichter GS, Smoski M. Parsing within & between-person dynamics of therapy homework completion and clinical symptoms in two cognitive behavioral treatments for adults with anhedonia. Behav Res Ther 2023; 166:104322. [PMID: 37148652 PMCID: PMC10330658 DOI: 10.1016/j.brat.2023.104322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE Homework is a key theoretical component of cognitive-behavioral therapies, however, the effects of homework on clinical outcomes have largely been evaluated between-persons rather than within-persons. METHODS The effects of homework completion on treatment response were examined in a randomized trial comparing Behavioral Activation Treatment for Anhedonia (BATA, n = 38), a novel psychotherapy, to Mindfulness-Based Cognitive Therapy (MBCT, n=35). The primary endpoint was consummatory reward sensitivity, measured weekly by the Snaith Hamilton Pleasure Scale (SHAPS), up to 15 weeks. Multilevel models evaluated change in SHAPS scores over time and the effects of clinician-reported and participant-reported homework. RESULTS BATA and MBCT resulted in significant, equivalent reductions in SHAPS scores. Unexpectedly, participants who completed greater mean total amounts of homework did not improve at a faster rate (i.e., no between-person effect). However, sessions with greater than average participant-reported homework completion were associated with greater than average reductions in SHAPS scores (i.e., a within-person effect). For clinician-reported homework, this effect was only evident within the BATA condition. CONCLUSION This study shows psychotherapy homework completion relates to symptomatic improvement in cognitive-behavioral treatments for anhedonia when session-to-session changes are examined within-person. On the contrary, we found no evidence that total homework completion predicted greater improvements between-person. When possible, psychotherapy researchers should evaluate their constructs of interest across multiple sessions (not just pre/post) to allow more direct tests of hypotheses predicted by theoretical models of individual change processes.
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Affiliation(s)
- Paul M Cernasov
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA.
| | - Jessica L Kinard
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, Chapel Hill, NC, 27510, USA; Division of Speech and Hearing Sciences, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA
| | - Erin Walsh
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27514, USA
| | - Lisalynn Kelley
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA
| | - Rachel Phillips
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA
| | - Angela Pisoni
- Department of Psychology and Neuroscience, Duke University, Durham, NC, 27505, USA
| | - Macey Arnold
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA
| | - Sarah C Lowery
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA
| | - Marcy Ammirato
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA
| | - Gabriela A Nagy
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA; Duke University School of Nursing, 307 Trent Drive, Durham, NC, 27710, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA; Division of Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, 27705, USA
| | - Kevin Haworth
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA
| | - Gabriel S Dichter
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27514, USA; Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, Chapel Hill, NC, 27510, USA; Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27514, USA
| | - Moria Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA; Department of Psychology and Neuroscience, Duke University, Durham, NC, 27505, USA
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Tilden EL, Holmes LR, Vasquez Guzman CE, Orzech CP, Seghete KM, Eyo V, Supahan N, Rogers GR, Caughey AB, Starr D, DiPietro JL, Fisher PA, Graham AM. Adapting Mindfulness-Based Cognitive Therapy for Perinatal Depression to Improve Access and Appeal of Preventive Care. J Midwifery Womens Health 2022; 67:707-713. [PMID: 36527394 PMCID: PMC10015792 DOI: 10.1111/jmwh.13444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 12/23/2022]
Abstract
Existing and emerging evidence indicates that perinatal depression is a key contributor to preventable morbidity and mortality during and after childbearing. Despite this, there are few effective options for prevention and treatment that are readily accessible for and appealing to pregnant people. Aspects of routine health care systems contribute to this situation. Furthermore, societal and health care systems factors create additional barriers for people of color, people living in rural regions, and people living in poverty. Our interprofessional team of perinatal care providers, mental health providers, community partners, health services scientists, health equity scientists, and business leaders developed and are piloting a perinatal mental health preventive intervention designed to increase access and appeal of a program incorporating mindfulness cognitive behavioral therapy with proven efficacy in preventing perinatal depression. In this article, we briefly summarize key systems barriers to delivering preventive care for perinatal depression in standard prenatal care clinics. We then describe Mindfulness-Based Cognitive Therapy for Perinatal Depression and outline our adaptation of this intervention, Center M. Finally, we identify next steps, challenges, and opportunities for this recent innovation.
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Affiliation(s)
- Ellen L Tilden
- Nurse-Midwifery Department, School of Nursing, Oregon Health & Science University, Portland, Oregon.,Department of Obstetrics and Gynecology, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Leah R Holmes
- Nurse-Midwifery Department, School of Nursing, Oregon Health & Science University, Portland, Oregon
| | - Cirila Estela Vasquez Guzman
- Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon.,Zapotec/Mayan, Mexico
| | - Catherine Polan Orzech
- Mental Health Division, Center for Women's Health, Oregon Health & Science University, Portland, Oregon
| | | | | | - Nisha Supahan
- Karuk Tribal Leader, Karuk Tribal Land, California.,Small Business Owner, Tattoo 34, Portland, Oregon
| | - Ginger R Rogers
- Hupa Culture and Language Specialist, Hoopa Tribal Reservation, California
| | - Aaron B Caughey
- Nurse-Midwifery Department, School of Nursing, Oregon Health & Science University, Portland, Oregon.,Department of Obstetrics and Gynecology, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - David Starr
- Biomedical Innovation Program Consultant, Oregon Health & Science University, Portland, Oregon
| | - Jennifer L DiPietro
- School of Medicine, Oregon Health & Science University, Portland, Oregon.,School of Public Health, Portland State University and Oregon Health & Science University, Portland, Oregon
| | - Philip A Fisher
- Graduate School of Education, Stanford University, Stanford, USA, California
| | - Alice M Graham
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, Oregon
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5
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Shallcross AJ, Duberstein ZT, Sperber SH, Visvanathan PD, Lutfeali S, Lu N, Carmody J, Spruill TM. An Open Trial of Telephone-Delivered Mindfulness-Based Cognitive Therapy: Feasibility, Acceptability, and Preliminary Efficacy for Reducing Depressive Symptoms. COGNITIVE AND BEHAVIORAL PRACTICE 2022; 29:280-291. [DOI: 10.1016/j.cbpra.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mazaheri Asadi D, Zahedi Tajrishi K, Gharaei B. Mindfulness Training Intervention With the Persian Version of the Mindfulness Training Mobile App for Premenstrual Syndrome: A Randomized Controlled Trial. Front Psychiatry 2022; 13:922360. [PMID: 35782413 PMCID: PMC9249312 DOI: 10.3389/fpsyt.2022.922360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Premenstrual syndrome (PMS) is a common problem for women of reproductive age, affecting various aspects of their lives. While various in-person psychotherapeutic interventions, including Mindfulness therapy, have yielded promising results in reducing PMS symptoms, due to the COVID-19 Pandemic, psychotherapists are providing their services via online methods. Therefore, the present study is the first one worldwide to examine whether smartphone-based Mindfulness training can reduce symptoms of PMS and improve the quality of life in women with PMS. We recruited 80 Iranian women (aged 25-45) with PMS through online advertising who were randomly allocated into two groups of 40. The intervention group underwent two online introductory group sessions followed by 8 weeks of Mindfulness practice, while the control group received no intervention. Before and after the intervention, participants completed the 12-Item Short-Form Health Survey and the Premenstrual Symptoms Screening (PSST) questionnaires. Data were analyzed using the Analysis of Covariance (ANCOVA). Following the intervention, the mean scores of PMS symptoms were significantly lower in the intervention group than in the control group (p < 0.001; η2 = 0.18). Likewise, the quality of life score was significantly higher in the intervention group (p < 0.001; η2 = 0.14). Our results indicated that the smartphone-based Mindfulness training intervention could be an effective treatment modality for women with PMS symptoms, especially during the COVID-19 Pandemic, which has posed limitations for in-person therapies. CLINICAL TRIAL REGISTRATION https://fa.irct.ir/trial/59924, identifier: IRCT20180607040000N2.
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Affiliation(s)
- Dorsa Mazaheri Asadi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Komeil Zahedi Tajrishi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Banafsheh Gharaei
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
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3-Doors Compassion Project: Examining the longitudinal effects of a nine-month Tibetan mind-body meditation program. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractAbundant research supports the benefits of participating in mindfulness meditation training programs including Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. However, these well researched programs include a narrow range of meditation practices and research to date has minimally examined how home practice associates with favorable outcomes. The present study evaluated the 3 Doors Compassion Project (3DCP), a structured 9-months meditation program that teaches Tibetan Mind-Body practices and examined how frequency and duration of home practice associated with favorable outcomes. Twenty-seven medical and mental healthcare professionals completed assessments prior to, during, and following participation in the 3DCP program and recorded daily meditation practices. Study aims were to test general effectiveness of the 3DCP program and to test the hypotheses that frequency and duration of meditation home-practice would associate with improvements on mindfulness, stress, and depression. General linear mixed modeling demonstrated significant improvements throughout the duration of the 3DCP program for mindfulness, depression (p < .001) and stress (p < .05), with each variable evidencing incremental monthly improvements. Frequency of meditation (i.e., days practiced per month), but not time (i.e., minutes per month) was significantly associated with improvements throughout the 3DCP program. Results provide support for the benefits of the 3DCP while offering clinically useful information that can inform current guidelines for meditation home practice. As predicted, the 3DCP was associated with significant improvements on all outcomes. Favorable outcomes were linked to frequency, but not total time of meditation practice, which suggests that consistent meditation may be more helpful than extended meditation.
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8
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Abstract
OBJECTIVE Because of fast-growing interest in the applications of mindfulness to promote well-being and mental health, there are field-wide efforts to better understand how mindfulness training works and thereby to optimize its delivery. Key to these efforts is the role of home practice in mindfulness-based intervention (MBI) outcomes. Despite its centrality in MBIs, recent reviews have documented limited and mixed effects of home practice on MBI outcomes. However, methodological issues regarding monitoring and quantifying home practice and focus on cumulative or additive effects may limit our understanding of it. Temporally proximate, more transient, and contextually circumscribed effects of mindfulness mediation practice have not been examined. METHODS We applied intensive experience sampling to measure daily practice and levels of targeted proximal outcomes (state mindfulness, decentering, emotional valance, and arousal) of training over the course of a 21-day MBI among a community-based sample of 82 meditation-naive adults. RESULTS Despite intensive experience sampling, we found no evidence of cumulative or additive effects of total mindfulness meditation practice on outcomes at postintervention for mindfulness, decentering, emotional valence, or emotional arousal. However, we found that that daily dose of mindfulness meditation home practice significantly predicted same-day levels of state mindfulness (B = 0.004, SE = 0.001, t = 3.17, p = .000, f2 = 0.24), decentering (B = 0.004, SE = 0.001, t = 2.757, p = .006, f2 = 0.05), and emotional valence (B = 0.006, SE = 0.003, t = 2.015, p = .044, f2 = 0.01) but not daily levels of emotional arousal. Daily dose-response practice effects did not carry over to next-day levels of monitored outcomes. CONCLUSIONS Findings show that effects of daily home mindfulness meditation practice dose on state mindfulness, decentering, and positive emotion are reliable but transient and time-limited. Findings are discussed with respect to the proposed daily dose-response hypothesis of mindfulness meditation practice.
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9
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Goldberg SB, Imhoff-Smith T, Bolt DM, Wilson-Mendenhall CD, Dahl CJ, Davidson RJ, Rosenkranz MA. Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR Ment Health 2020; 7:e23825. [PMID: 33245288 PMCID: PMC7732708 DOI: 10.2196/23825] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques. OBJECTIVE This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app-the Healthy Minds Program (HMP)-which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight). METHODS A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood. RESULTS A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=-0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified. CONCLUSIONS This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement. TRIAL REGISTRATION ClinicalTrials.gov NCT04139005; https://clinicaltrials.gov/ct2/show/NCT04139005.
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Affiliation(s)
- Simon B Goldberg
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Daniel M Bolt
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Cortland J Dahl
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Healthy Minds Innovations Inc, Madison, WI, United States
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - Melissa A Rosenkranz
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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10
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Galante J, Stochl J, Dufour G, Vainre M, Wagner AP, Jones PB. Effectiveness of providing university students with a mindfulness-based intervention to increase resilience to stress: 1-year follow-up of a pragmatic randomised controlled trial. J Epidemiol Community Health 2020; 75:151-160. [PMID: 32913130 PMCID: PMC7116569 DOI: 10.1136/jech-2020-214390] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/15/2020] [Accepted: 08/30/2020] [Indexed: 11/24/2022]
Abstract
Background There is concern that increasing demand for student mental health services reflects deteriorating student well-being. We designed a pragmatic, parallel, single-blinded randomised controlled trial hypothesising that providing mindfulness courses to university students would promote their resilience to stress up to a year later. Here we present 1-year follow-up outcomes. Methods University of Cambridge students without severe mental illness or crisis were randomised (1:1, remote software-generated random numbers), to join an 8-week mindfulness course adapted for university students (Mindfulness Skills for Students (MSS)), or to mental health support as usual (SAU). Results We randomised 616 students; 53% completed the 1-year follow-up questionnaire. Self-reported psychological distress and mental well-being improved in the MSS arm for up to 1 year compared to SAU (p<0.001). Effects were smaller than during the examination period. No significant differences between arms were detected in the use of University Counselling Service and other support resources, but there was a trend for MSS participants having milder needs. There were no differences in students’ workload management; MSS participants made more donations. Home practice had positive dose–response effects; few participants meditated. No adverse effects related to self-harm, suicidality or harm to others were detected. Conclusion Loss to follow-up is a limitation, but evidence suggests beneficial effects on students’ average psychological distress that last for at least a year. Effects are on average larger at stressful times, consistent with the hypothesis that this type of mindfulness training increases resilience to stress. Trial registration number ACTRN12615001160527.
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Affiliation(s)
- Julieta Galante
- Department of Psychiatry, University of Cambridge, Cambridge, UK .,National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK.,Department of Kinanthropology, Charles University, Prague, Czech Republic
| | - Géraldine Dufour
- University Counselling Service, University of Cambridge, Cambridge, UK.,Universities and Colleges Division, British Association for Counselling and Psychotherapy, Lutterworth, UK
| | - Maris Vainre
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England, Cambridge, UK
| | - Adam Peter Wagner
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Peter Brian Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,National Institute for Health Research Applied Research Collaboration East of England, Cambridge, UK
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11
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Goldberg SB, Hanley AW, Baldwin SA, Bernstein A, Garland EL. Does mindfulness practice promote psychological functioning or is it the other way around? A daily diary study. Psychotherapy (Chic) 2020; 57:310-322. [PMID: 32352811 DOI: 10.1037/pst0000286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mindfulness-based interventions are commonly used to reduce psychological symptoms and enhance positive qualities of human functioning. However, the influence of mindfulness practice dosage remains poorly understood, limiting dissemination and implementation efforts. The current study examined the association between practice dosage and several constructs related to psychological functioning (positive and negative affect, state mindfulness) over the course of a standardized mindfulness-based intervention (Mindfulness-Oriented Recovery Enhancement). Twenty-five participants completed daily diary assessments for 12 weeks. Two-part gamma regression models examined the dichotomous (did practice occur?) and continuous (how much practice?) components of practice minutes. Practice time and outcomes showed same-day relationships in the expected directions. Lagged models, however, showed no evidence that current day practice time predicts subsequent day outcomes. In contrast, higher current day negative affect predicted less subsequent day practice time, and higher current day mindfulness predicted more subsequent day practice time. In a post hoc analysis, practice time moderated the link between day-to-day affect, strengthening the link for positive affect and weakening the link for negative affect. Collectively, these findings suggest that the causal direction linking practice time and outcome may flow from outcome to practice time, rather than the reverse-with potential recursive relationships between these factors. Further examination of lagged relationships between practice time and outcome as well as random assignment of participants to varying practice dosages (e.g., in within-person microrandomized trials) may help clarify the influence of this central treatment ingredient within mindfulness-based interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin-Madison
| | - Adam W Hanley
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah
| | | | | | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah
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