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Sparacio A, IJzerman H, Ropovik I, Giorgini F, Spiessens C, Uchino BN, Landvatter J, Tacana T, Diller SJ, Derrick JL, Segundo J, Pierce JD, Ross RM, Francis Z, LaBoucane A, Ma-Kellams C, Ford MB, Schmidt K, Wong CC, Higgins WC, Stone BM, Stanley SK, Ribeiro G, Fuglestad PT, Jaklin V, Kübler A, Ziebell P, Jewell CL, Kovas Y, Allahghadri M, Fransham C, Baranski MF, Burgess H, Benz ABE, DeSousa M, Nylin CE, Brooks JC, Goldsmith CM, Benson JM, Griffin SM, Dunne S, Davis WE, Watermeyer TJ, Meese WB, Howell JL, Standiford Reyes L, Strickland MG, Dickerson SS, Pescatore S, Skakoon-Sparling S, Wunder ZI, Day MV, Brenton S, Linden AH, Hawk CE, O'Brien LV, Urgyen T, McDonald JS, van der Schans KL, Blocker H, Ng Tseung-Wong C, Jiga-Boy GM. Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study. Nat Hum Behav 2024:10.1038/s41562-024-01907-7. [PMID: 38862815 DOI: 10.1038/s41562-024-01907-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/02/2024] [Indexed: 06/13/2024]
Abstract
Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ ; retrospective registration at ClinicalTrials.gov NCT06308744 ) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = -0.56; 95% confidence interval, -0.43 to -0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries.
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Affiliation(s)
- Alessandro Sparacio
- LIP/PC2s, Université Grenoble Alpes, Grenoble, France.
- School of Psychology, Swansea University, Swansea, UK.
- Singapore Institute for Clinical Sciences (SICS), A*STAR, Singapore, Singapore.
| | - Hans IJzerman
- LIP/PC2s, Université Grenoble Alpes, Grenoble, France.
- Annecy Behavioral Science Lab, Saint-Jorioz, France.
- Institut Universitaire de France, Paris, France.
| | - Ivan Ropovik
- Institute of Psychology, Czech Academy of Sciences, Prague, Czech Republic.
- Faculty of Education, Institute for Research and Development of Education, Charles University, Prague, Czech Republic.
- Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Štefánikova, Bratislava, Slovakia.
| | - Filippo Giorgini
- Department of Economics, Management and Statistics (DEMS), University of Milano-Bicocca, Milan, Italy
| | | | - Bert N Uchino
- Department of Psychology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Joshua Landvatter
- Department of Psychology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Tracey Tacana
- Department of Psychology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Sandra J Diller
- Private University Seeburg Castle, Seekirchen am Wallersee, Austria
- LMU Munich, Munich, Germany
| | | | | | | | - Robert M Ross
- School of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Zoë Francis
- University of the Fraser Valley, Abbotsford, British Colombia, Canada
| | - Amanda LaBoucane
- University of the Fraser Valley, Abbotsford, British Colombia, Canada
| | | | - Maire B Ford
- Psychology department, Loyola Marymount University, Los Angeles, CA, USA
| | | | | | - Wendy C Higgins
- School of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Bryant M Stone
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Samantha K Stanley
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Gianni Ribeiro
- School of Law and Justice, The University of Southern Queensland, Ipswich, Queensland, Australia
| | | | - Valerie Jaklin
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Andrea Kübler
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Philipp Ziebell
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | | | | | | | | | | | - Hannah Burgess
- Pennsylvania Western University California, California, PA, USA
| | | | | | - Catherine E Nylin
- Department of Social and Behavioral Sciences, Glendale Community College, Glendale, AZ, USA
| | - Janae C Brooks
- Department of Social and Behavioral Sciences, Glendale Community College, Glendale, AZ, USA
| | - Caitlyn M Goldsmith
- Department of Social and Behavioral Sciences, Glendale Community College, Glendale, AZ, USA
| | | | | | | | | | - Tam J Watermeyer
- Northumbria University, Newcastle upon Tyne, UK
- University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | | | | | | | - Martin V Day
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Shawna Brenton
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Audrey H Linden
- Centre for Research in Autism and Education, Institute of Education, University College London, London, UK
- Department of Psychology and Counselling, The Open University, Milton Keynes, UK
| | | | - Léan V O'Brien
- University of Canberra, Canberra, Australian Capital Territory, Australia
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Pickett SM, Kozak AT, Lanni DJ, Warnke AS, Gaillard P, Jarrett NL. The comparison of brief, online mindfulness and relaxation interventions to reduce stress and improve sleep-related outcomes in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1085-1093. [PMID: 35709245 DOI: 10.1080/07448481.2022.2066979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 02/24/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The current study aimed to examine whether brief online stress reduction exercises supplemented with sleep improvement strategies would reduce stress, arousal, and sleep difficulties in college students who were not required to use the sleep improvement strategies for participation. PARTICIPANTS A sample of 114 college student participants were enrolled because they were experiencing stress and/or wanted to improve their sleep. METHODS Participants were randomized into an abbreviated progressive muscle relaxation, a mindful breathing, or a self-monitoring control condition for the 4-week intervention. Measures of physical relaxation, mindfulness, perceived stress, pre-sleep arousal, and insomnia symptom severity were collected. RESULTS The APMR group improved on five of the six dependent measures and was significantly different than the SM group at posttest, but not different than the MB group. CONCLUSION The results suggests promise for brief, online, scaled back stress reduction interventions to reduce stress, arousal, and sleep difficulties in college students.
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Affiliation(s)
- Scott M Pickett
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Andrea T Kozak
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Daniel J Lanni
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Andrew S Warnke
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Philippe Gaillard
- Office of Clinical Research Advancement, Florida State University, Tallahassee, Florida, USA
| | - Nicole L Jarrett
- Department of Psychology, Oakland University, Rochester, Michigan, USA
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Luo M, Gan Q, Huang Z, Jiang Y, Li K, Wu M, Yang D, Shao H, Chen Y, Fu Y, Chen Z. Changes in Mental Health and EEG Biomarkers of Undergraduates Under Different Patterns of Mindfulness. Brain Topogr 2024; 37:75-87. [PMID: 38145437 PMCID: PMC10771601 DOI: 10.1007/s10548-023-01026-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] [Received: 11/17/2022] [Accepted: 11/20/2023] [Indexed: 12/26/2023]
Abstract
The effects of short-term mindfulness are associated with the different patterns (autonomic, audio guided, or experienced and certified mindfulness instructor guided mindfulness). However, robust evidence for reported the impacts of different patterns of mindfulness on mental health and EEG biomarkers of undergraduates is currently lacking. Therefore, we aimed to test the hypotheses that mindfulness training for undergraduates would improve mental health, and increase alpha power over frontal region and theta power over midline region at the single electrode level. We also describe the distinction among frequency bands patterns in different sites of frontal and midline regions. 70 participants were enrolled and assigned to either 5-day mindfulness or a waiting list group. Subjective questionnaires measured mental health and other psychological indicators, and brain activity was recorded during various EEG tasks before and after the intervention. The 5-day mindfulness training improved trait mindfulness, especially observing (p = 0.001, d = 0.96) and nonreactivity (p = 0.03, d = 0.56), sleep quality (p = 0.001, d = 0.91), and social support (p = 0.001, d = 0.95) while not in affect. Meanwhile, the expected increase in the alpha power of frontal sites (p < 0.017, d > 0.84) at the single electrode level was confirmed by the current data rather than the theta. Interestingly, the alteration of low-beta power over the single electrode of the midline (p < 0.05, d > 0.71) was difference between groups. Short-term mindfulness improves practitioners' mental health, and the potentially electrophysiological biomarkers of mindfulness on neuron oscillations were alpha activity over frontal sites and low-beta activity over midline sites.
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Affiliation(s)
- Miaoling Luo
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Quan Gan
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Ziyang Huang
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Yunxiong Jiang
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Kebin Li
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Minxiang Wu
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Dongxiao Yang
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Heng Shao
- Department of Geriatrics, The First People's Hospital of Yunnan Province, Kunming, China
| | - Yanmei Chen
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Yu Fu
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Zhuangfei Chen
- Medical Faculty, Kunming University of Science and Technology, Kunming, China.
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China.
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Mora Álvarez MG, Hölzel BK, Bremer B, Wilhelm M, Hell E, Tavacioglu EE, Koch K, Torske A. Effects of web-based mindfulness training on psychological outcomes, attention, and neuroplasticity. Sci Rep 2023; 13:22635. [PMID: 38114554 PMCID: PMC10730881 DOI: 10.1038/s41598-023-48706-0] [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] [Received: 06/16/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
Mindfulness meditation training (MMT) reliably reduces stress and anxiety while also improving attention. The primary aim of this study was to investigate the relationship between MMT, stress and anxiety reduction, and its impact upon improvements in attention on the behavioral and neuronal levels. As a second aim, we sought to explore any relationship between MMT, attention, and modified states of mind such as flow. 118 healthy, meditation-naïve, participants were either assigned to a 31-day, web-based, MMT or an active control, health training (HT). Participants underwent functional magnetic resonance imaging while performing the attention network test (ANT) to assess functional and behavioural attentional changes, diffusion tensor imaging (DTI) to assess microstructural neuronal changes and completed relevant questionnaires to explore changes in psychological outcomes. Results confirmed a reduction in perceived stress and anxiety levels in the MMT group and significant improvements in the overall reaction time during the ANT, albeit no specific effects on the attentional components were observed. No statistically significant changes were found in the HT group. Interestingly, a significant group-by-time interaction was seen in flow experience. Functional data exhibited an increased activity in the superior frontal gyrus, posterior cingulate cortex, and right hippocampus during the alerting condition of the ANT after the MMT; decreased stress and trait anxiety were significantly correlated with the activation in the right hippocampus, and increased flow was also significantly correlated with all the aforementioned areas. DTI data showed increased fractional anisotropy values in the right uncinate fasciculus indicating white matter microarchitecture improvement between the right hippocampus and frontal areas of the brain. This study, therefore, demonstrates the effectiveness of web-based MMT on overall well-being and attentional performance, while also providing insight into the relationship between psychological outcomes, attention, and neuroplastic changes.
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Affiliation(s)
- María Guadalupe Mora Álvarez
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
| | - Britta Karen Hölzel
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Benno Bremer
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maximilian Wilhelm
- Center for Psychotherapy Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Elena Hell
- Department of Psychology, Ludwig Maximilians Universität München, Munich, Germany
| | - Ebru Ecem Tavacioglu
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Psychology, Ludwig Maximilians Universität München, Munich, Germany
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Kathrin Koch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
| | - Alyssa Torske
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
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De Coninck S, Emmers E. "Online, the counselor can't see me cry": a systematic literature review on emotion and computer-mediated care. Front Digit Health 2023; 5:1216268. [PMID: 37720162 PMCID: PMC10504663 DOI: 10.3389/fdgth.2023.1216268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Computer-mediated care is becoming increasingly popular, but little research has been done on it and its effects on emotion-related outcomes. This systematic literature review aims to create an overview that addresses the research question: "Is there a relationship between computer-mediated care and emotional expression, perception, and emotional and (long-term) emotion outcomes?" Method This systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and used five eligibility criteria, namely, (1) participants: adults seeking support; (2) intervention: eHealth; (3) diagnostic criteria: transdiagnostic concept of difficulty identifying, expressing, and/or regulating emotions (e.g., alexithymia); (4) comparator: either face-to-face care or no comparator; and (5) study design: quantitative studies or qualitative studies. Quality was assessed using the QualSyst tool. Results The analysis includes 25 research papers. Self-paced interventions appear to have a positive effect on emotion regulation. Videoconferencing interventions improved emotion regulation from before to after treatment but worsened emotion regulation compared with face-to-face treatment. Discussion The lack of variation in the modalities studied and the emotion measurements used make it difficult to draw responsible conclusions. Future research should examine how different modalities affect the real-time communication of emotions and how non-verbal cues influence this.
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Affiliation(s)
- Sarah De Coninck
- Research Unit Inclusive Society, University College Leuven Limburg, Leuven, Belgium
- Research Units Sustainable Resources and Smart Organizations, University College Leuven Limburg, Diepenbeek, Belgium
- Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Elke Emmers
- School of Educational Studies, UHasselt, Hasselt, Belgium
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Stratton E, Lampit A, Choi I, Malmberg Gavelin H, Aji M, Taylor J, Calvo RA, Harvey SB, Glozier N. Are Organizational EHealth Interventions Becoming More Effective at Addressing Employee Mental Health; A Systematic Review and Meta-Analysis (Preprint). J Med Internet Res 2022; 24:e37776. [PMID: 36166285 PMCID: PMC9555335 DOI: 10.2196/37776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/26/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mental health conditions are considered the leading cause of disability, sickness absence, and long-term work incapacity. eHealth interventions provide employees with access to psychological assistance. There has been widespread implementation and provision of eHealth interventions in the workplace as an inexpensive and anonymous way of addressing common mental disorders. Objective This updated review aimed to synthesize the literature on the efficacy of eHealth interventions for anxiety, depression, and stress outcomes in employee samples in organizational settings and evaluate whether their effectiveness has improved over time. Methods Systematic searches of relevant articles published from 2004 to July 2020 of eHealth intervention trials (app- or web-based) focusing on the mental health of employees were conducted. The quality and bias of all studies were assessed. We extracted means and SDs from publications by comparing the differences in effect sizes (Hedge g) in standardized mental health outcomes. We meta-analyzed these data using a random-effects model. Results We identified a tripling of the body of evidence, with 75 trials available for meta-analysis from a combined sample of 14,747 articles. eHealth interventions showed small positive effects for anxiety (Hedges g=0.26, 95% CI 0.13-0.39; P<.001), depression (Hedges g=0.26, 95% CI 0.19-0.34; P<.001), and stress (Hedges g=0.25, 95% CI 0.17-0.34; P<.001) in employees’ after intervention, with similar effects seen at the medium-term follow-up. However, there was evidence of no increase in the effectiveness of these interventions over the past decade. Conclusions This review and meta-analysis confirmed that eHealth interventions have a small positive impact on reducing mental health symptoms in employees. Disappointingly, we found no evidence that, despite the advances in technology and the enormous resources in time, research, and finance devoted to this area for over a decade, better interventions are being produced. Hopefully, these small effect sizes do not represent optimum outcomes in organizational settings. Trial Registration PROSPERO CRD42020185859; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=185859
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Affiliation(s)
- Elizabeth Stratton
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia
| | - Isabella Choi
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
| | - Hanna Malmberg Gavelin
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Melissa Aji
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
| | - Jennifer Taylor
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
| | - Rafael A Calvo
- Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St George Hospital, Sydney, Australia
| | - Nick Glozier
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
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Krane NA, Simmons JK, Sykes KJ, Kriet JD, Humphrey CD. Guided Mindfulness Meditation for Pain Control After Septorhinoplasty: A Randomized-Controlled Pilot Study. Facial Plast Surg Aesthet Med 2021; 24:111-116. [PMID: 34861125 DOI: 10.1089/fpsam.2021.0184] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Mindfulness meditation has been shown to alleviate pain and may be an appealing adjunctive pain management option. Objective: To compare measures of pain, mindfulness, and opioid usage, and collect evaluative feedback among patients undergoing septorhinoplasty with and without guided meditation. Methods: Patients undergoing septorhinoplasty were randomized to online-guided meditation postoperative days 0-3 versus standard care; all received the same pain medications. Primary outcome measures included pain intensity, opioid consumption, mindfulness scores, and evaluative feedback. Results: Twenty-one patients received guided meditation and 24 received standard care. No significant difference in opioid consumption or pain scores was seen with the exception of higher opioid use in patients with intranasal splints in the standard care group. Twenty out of 21 patients provided evaluative feedback; all recommended mindfulness meditation to friends undergoing nasal surgery, 90% reported it was beneficial, 85% believed it eased pain/discomfort, and 80% believed it aided with sleep. Conclusion: Although no objective difference was found in opioid consumption or pain scores, most patients reported that guided mindfulness meditation was beneficial to their recovery following septorhinoplasty.
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Affiliation(s)
- Natalie A Krane
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - J Kai Simmons
- Department of Otolaryngology - Head and Neck Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Kevin J Sykes
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - J David Kriet
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Clinton D Humphrey
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head & Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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Hilt LM, Swords CM. Acceptability and Preliminary Effects of a Mindfulness Mobile Application for Ruminative Adolescents. Behav Ther 2021; 52:1339-1350. [PMID: 34656190 DOI: 10.1016/j.beth.2021.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/26/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
Rumination is a transdiagnostic risk factor that appears to be reduced through mindfulness interventions. However, mindfulness mobile apps have not been tested for their effects on rumination, especially among adolescents. Thus, we aimed to test the acceptability and effects of a mindfulness mobile intervention among ruminative adolescents using a within-subjects pretest/posttest design. Participants were 80 adolescents ages 12-15, selected for moderate-to-high rumination (M age = 14.01, SD = .99; 46.2% girls; 86.25% White; 3.75% Hispanic). We asked adolescents to use our mindfulness app 3 times per day for 3 weeks. Participants and parents completed questionnaires at baseline, post-intervention, and 6 and 12 weeks later. Acceptability was assessed by tracking app use and asking adolescents and parents to report on their experiences post-intervention. We assessed repetitive negative thinking (i.e., rumination and worry) and internalizing symptoms via self- and parent-report. The intervention demonstrated acceptability, and there were significant reductions in rumination, worry, anxiety and parent-reported internalizing symptoms post-intervention. Effects on rumination, anxiety and internalizing symptoms persisted throughout the 12-week follow-up with large effect sizes using an intention-to-treat approach. Thus, a brief mindfulness mobile app intervention appeared to be both engaging and helpful in reducing negative repetitive thinking and internalizing symptoms among ruminative adolescents. It will be important to test this intervention in a randomized controlled trial to control for effects of time and attention.
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Taylor H, Strauss C, Cavanagh K. Can a little bit of mindfulness do you good? A systematic review and meta-analyses of unguided mindfulness-based self-help interventions. Clin Psychol Rev 2021; 89:102078. [PMID: 34537665 DOI: 10.1016/j.cpr.2021.102078] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/30/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022]
Abstract
Over the last decade there has been an explosion of interest in mindfulness-based self-help (MBSH) interventions. While widely available and extensively promoted, there is little consensus on their impact in public health or healthcare contexts. We present a systematic review and meta-analyses of 83 randomized controlled trials, comparing unguided MBSH to control conditions on outcomes of depression, mindfulness, anxiety, stress and/or wellbeing/ quality of life. A random effects model was used to compute post-intervention, between-groups effect sizes for each outcome. MBSH demonstrated small, statistically significant effects at post-interventions for outcomes of depression (g = -0.23), mindfulness (g = 0.37) anxiety (g = -0.25), stress (g = -0.41) and wellbeing/ quality of life (g = 0.34). Significant effects were retained at follow-up for mindfulness, stress and wellbeing/ quality of life but not for depression or anxiety. Planned moderator analyses demonstrated significantly larger effects of MBSH when compared to inactive, versus active-control conditions on all outcomes except wellbeing/ quality of life, and non-digital MBSH interventions demonstrated significantly greater effects on depression, mindfulness and wellbeing/ quality of life outcomes than digitally-delivered MBSH. When studies that utilised samples selected for mental and physical health-related difficulties were respectively compared to studies that utilised unselected samples, no significant moderation effects were observed. In sum, these findings provide evidence for the effectiveness of unguided MBSH in public health settings and the practical, access-related implications of this are discussed.
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Affiliation(s)
- Heather Taylor
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QJ, UK.
| | - Clara Strauss
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QJ, UK; R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, BN3 7HZ, UK.
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9QJ, UK; R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, BN3 7HZ, UK.
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Cavalcante VN, Cavalcanti ACD, Tinoco JDMVP, Figueiredo LDS, Mesquita ET. Effectiveness of Mindfulness Meditation Programs in the Promotion of Quality of Life in Patients with Heart Failure: A Systematic Review. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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11
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Sommers-Spijkerman M, Austin J, Bohlmeijer E, Pots W. New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials. JMIR Ment Health 2021; 8:e28168. [PMID: 34279240 PMCID: PMC8329762 DOI: 10.2196/28168] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/05/2021] [Accepted: 05/16/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND There is a need to regularly update the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing. OBJECTIVE This study presents an updated meta-analysis of randomized controlled trials assessing the effects of online MBIs on mental health and the potential moderators of these effects. METHODS We conducted a systematic literature search in PsycINFO, PubMed, and Web of Science up to December 4, 2020, and included 97 trials, totaling 125 comparisons. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges g) were calculated for depression, anxiety, stress, well-being, and mindfulness using a random effects model. RESULTS The findings revealed statistically significant moderate pre-to-post effects on depression (g=0.34, 95% CI 0.18-0.50; P<.001), stress (g=0.44, 95% CI 0.32-0.55; P<.001), and mindfulness (g=0.40, 95% CI 0.30-0.50; P<.001) and small effects on anxiety (g=0.26, 95% CI 0.18-0.33; P<.001). For well-being, a significant small effect was found only when omitting outliers (g=0.22, 95% CI 0.15-0.29; P<.001) or low-quality studies (g=0.26, 95% CI 0.12-0.41; P<.001). Significant but small follow-up effects were found for depression (g=0.25, 95% CI 0.12-0.38) and anxiety (g=0.23, 95% CI 0.13-0.32). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. In terms of stress and mindfulness, studies that used inactive control conditions yielded larger effects. For anxiety, populations with psychological symptoms had higher effect sizes. Adherence rates for the interventions ranged from 35% to 92%, but most studies lacked clear definitions or cut-offs. CONCLUSIONS Our findings not only demonstrate that online MBIs are booming but also corroborate previous findings that online MBIs are beneficial for improving mental health outcomes in a broad range of populations. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence, and long-term follow-up measurements.
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Affiliation(s)
- Marion Sommers-Spijkerman
- Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht, Netherlands
| | - Judith Austin
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Ernst Bohlmeijer
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Wendy Pots
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
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12
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Streaming mindfulness: Well-being and mindfulness among subscribers to a video streaming service. Internet Interv 2021; 25:100419. [PMID: 34401378 PMCID: PMC8350607 DOI: 10.1016/j.invent.2021.100419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Internet and smartphone technology have advanced the dissemination of mindfulness practices and philosophy. This study explored how individuals interact with Spectiv, a subscription-based video streaming service (VSS) that advertises content for meditation, and measured levels of mindfulness and well-being. We hypothesized that users engaging with Spectiv for longer sessions and on a regular basis would report higher levels of mindfulness and well-being. METHOD A 46-question online survey was developed and distributed to all active subscribers of Spectiv (N = 119). The survey included two validated scales: (1) The Cognitive and Affective Mindfulness Scale, and (2) The Warwick-Edinburgh Mental Well-being Scale. A series of one-way ANOVAs were performed, along with a simple linear regression and descriptive statistics. RESULTS Users reported relaxation as the most common activity. Levels of mindfulness and well-being were significantly higher for users whose session-duration lasted 2 hours (p = .01) and 3 hours (p = .03). Users engaging with the VSS daily had significant levels of both mindfulness (p < .001) and well-being (p < .001). There was no difference between subscription length and mindfulness and well-being. Mindfulness was found to be a significant positive predictor of well-being (p < .0001). CONCLUSION VSS could be valuable to facilitating mindfulness. Users engaging with a VSS for longer durations and more frequently may be more likely to experience benefits. Future research using controlled designs such as randomized control trials and feasibility studies should be conducted to determine if VSS can maintain or increase levels of mindfulness and well-being.
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13
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Hanley AW, Dehili V, Krzanowski D, Barou D, Lecy N, Garland EL. Effects of Video-Guided Group vs. Solitary Meditation on Mindfulness and Social Connectivity: A Pilot Study. CLINICAL SOCIAL WORK JOURNAL 2021; 50:316-324. [PMID: 34188317 PMCID: PMC8224259 DOI: 10.1007/s10615-021-00812-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
Interest in mindfulness meditation continues to grow as accumulating evidence suggests mindfulness training encourages more positive functioning. However, basic questions about the conditions best suited for realizing mindful states remain unanswered. Prominent among these is whether a group mindfulness practice setting is more effective for novice meditators than a solitary practice setting. Answering this question has assumed new urgency due to the imposition of physical distancing measures designed to stop the spread of COVID-19. In a time of limited social contact, is a simulated group practice setting better than practicing alone? This preliminary study investigated whether environmental setting impacted mindfulness practice experience by examining the effects of three simulated meditation practice environments (1. group practice, 2. nature practice, and 3. solitary practice) on state mindfulness and perceived social connectivity in a sample of novice meditators. Significant differences emerged across the three simulated practice settings. Findings suggest watching others meditate while meditating appears to most effectively induce a state of mindfulness and strengthen feelings of social connectivity. This study supports traditional beliefs about the benefits of group mindfulness practice. These findings also have implications for social workers struggling to stretch limited resources to address growing mental health demands, especially during times of heightened social isolation due to COVID-19. If a simulated group practice confers the same cognitive benefits as solitary practice while also conferring social benefits, simulated group instruction may be preferable for therapeutic and economic reasons.
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Affiliation(s)
- Adam W. Hanley
- College of Social Work, University of Utah, Salt Lake City, USA
| | | | | | | | - Natalie Lecy
- College of Social Work, University of Utah, Salt Lake City, USA
| | - Eric L. Garland
- College of Social Work, University of Utah, Salt Lake City, USA
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14
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Berry MP, Lutz J, Schuman-Olivier Z, Germer C, Pollak S, Edwards RR, Gardiner P, Desbordes G, Napadow V. Brief Self-Compassion Training Alters Neural Responses to Evoked Pain for Chronic Low Back Pain: A Pilot Study. PAIN MEDICINE 2021; 21:2172-2185. [PMID: 32783054 DOI: 10.1093/pm/pnaa178] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Self-compassion meditation, which involves compassion toward the self in moments of suffering, shows promise for improving pain-related functioning, but its underlying mechanisms are unknown. This longitudinal, exploratory pilot study investigated the effects of a brief (eight contact hours, two weeks of home practice) self-compassion training on pain-related brain processing in chronic low back pain (cLBP). METHODS We evaluated functional magnetic resonance imaging (fMRI) response to evoked pressure pain and its anticipation during a self-compassionate state and compared altered brain responses following training with changes on self-reported measures of self-compassion (Self-Compassion Scale [SCS]), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness [MAIA]), and clinical pain intensity. RESULTS In a sample of participants with cLBP (N = 20 total, N = 14 with complete longitudinal data) who underwent self-compassion training, we observed reduced clinical pain intensity and disability (P < 0.01) and increased trait self-compassion and interoceptive awareness (all P < 0.05) following training. Evoked pressure pain response in the right temporo-parietal junction (TPJ) was reduced following training, and decreases were associated with reduced clinical pain intensity. Further, increased fMRI responses to pain anticipation were observed in the right dorsolateral prefrontal cortex (dlPFC) and ventral posterior cingulate cortex (vPCC), and these increases were associated with mean post-training changes in SCS scores and scores from the body listening subscale of the MAIA. DISCUSSION These findings, though exploratory and lacking comparison with a control condition, suggest that self-compassion training supports regulation of pain through the involvement of self-referential (vPCC), salience-processing (TPJ), and emotion regulatory (dlPFC) brain areas. The results also suggest that self-compassion could be an important target in the psychotherapeutic treatment of cLBP, although further studies using controlled experimental designs are needed to determine the specificity of these effects.
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Affiliation(s)
- Michael P Berry
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Jacqueline Lutz
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.,Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Zev Schuman-Olivier
- Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Christopher Germer
- Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Susan Pollak
- Center for Mindfulness and Compassion, Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Paula Gardiner
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gaelle Desbordes
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Vitaly Napadow
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
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15
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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16
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Nymberg P, Calling S, Stenman E, Palmér K, Hansson EE, Sundquist K, Sundquist J, Zöller B. Effect of mindfulness on physical activity in primary healthcare patients: a randomised controlled trial pilot study. Pilot Feasibility Stud 2021; 7:70. [PMID: 33731219 PMCID: PMC7968363 DOI: 10.1186/s40814-021-00810-6] [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: 04/13/2020] [Accepted: 03/02/2021] [Indexed: 11/24/2022] Open
Abstract
Abstract Increased physical activity can have health benefits among inactive individuals. In Sweden, the healthcare system uses physical activity on prescription (PAP) to motivate patients to increase their physical activity level. Mindfulness may further heighten the internal motivation to engage in physical activity. However, previous research has not demonstrated clear evidence of such an association. Aim Examine the feasibility of the study design as a preparation for a full-scale study, and examine the differences, between three interventions, in change over time in physical activity levels and in related variables. Method Comparison between three different interventions in an ordinary primary health care setting: PAP, mindfulness, and a combination of PAP and mindfulness. Physical activity was measured with self-report and ACTi Graph GT1X activity monitor. Statistical analysis was performed with a mixed-effect model to account for repeated observations and estimate differences both within groups and between groups at 3- and 6-months follow-up. Results Between September 2016 and December 2018, a total of 88 participants were randomised into three groups. The total dropout rate was 20.4%, the attendance rate to the mindfulness courses (52% > 6 times) and the web-based mindfulness training (8% > 800 min) was low according to the stated feasibility criteria. Eleven participants were excluded from analysis due to low activity monitor wear time. Neither the activity monitor data nor self-reported physical activity showed any significant differences between the groups. Conclusion The study design needs adjustment for the mindfulness intervention design before a fully scaled study can be conducted. A combination of PAP and mindfulness may increase physical activity and self-rated health more than PAP or mindfulness alone. Trial registration ClinicalTrials.gov, registration number NCT02869854. Regional Ethical Review Board in Lund registration number 2016/404. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00810-6.
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Affiliation(s)
- Peter Nymberg
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden. .,Department of Clinical Sciences, Malmö Lund University, Lund, Sweden.
| | - Susanna Calling
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden.,Department of Clinical Sciences, Malmö Lund University, Lund, Sweden
| | - Emelie Stenman
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden.,Department of Clinical Sciences, Malmö Lund University, Lund, Sweden
| | - Karolina Palmér
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden
| | - Eva Ekvall Hansson
- Department of Health Sciences/Physiotherapy, Lund University, Lund, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden.,Department of Clinical Sciences, Malmö Lund University, Lund, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden.,Department of Clinical Sciences, Malmö Lund University, Lund, Sweden
| | - Bengt Zöller
- Center for Primary Health Care Research, Region Skåne, Lund, Sweden.,Department of Clinical Sciences, Malmö Lund University, Lund, Sweden
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17
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Beurskens-Meijerink J, Waal GHD, Wanten G. Identifying patients with benign chronic intestinal failure on home parenteral nutrition in whom a psychological support intervention may improve quality of life. Clin Nutr ESPEN 2021; 42:400-402. [PMID: 33745612 DOI: 10.1016/j.clnesp.2020.12.026] [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: 11/11/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
RATIONALE Home parenteral nutrition (HPN) is the ultimate treatment for patients who suffering from chronic intestinal failure (CIF). We tested the feasibility and effects of Mindfulness Based Cognitive Therapy (MBCT) in patients on HPN. Because of the high dropout rate, however, we were next urged to develop and test a web-based coaching program (web-based MBCT). The aim of the present study was to compare the effects of MBCT with this web-based MBCT. METHODS A quasi-experimental pilot study was conducted in a tertiary referral center for CIF in the Netherlands to evaluate the feasibility of both a MBCT and the internet-based MBCT intervention. In 2016 we included 17 patients in the MBCT group. These patients followed MBCT training. End of 2016 an internet-based online MBCT program was constructed for which we invited 14 patients and their caregivers. RESULTS In the MBCT 5 out of 17 patients (29%) completed their therapy. Patients attributed positive effects to their acquired mindfulness skills and reported a better QoL. In the internet-based mindfulness therapy group 2 out of 14 patients (14%) fulfilled the training sessions. Also, six caregivers started the training in this latter group and one caregiver fulfilled the training. CONCLUSION The study suggests that both MBCT and the internet-based MBCT are no feasible strategies to decrease disease burden and improve QoL for CIF patients and their caregivers due to the intensity of these programs on one side and the experienced physical limitations on the other. The patients who fulfilled the program were positive and use MBCT in daily practice.
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Affiliation(s)
- Judith Beurskens-Meijerink
- Dept of Gastroenterology and Hepatology, Intestinal Failure Unit, Radboud University Medical Centre, Nijmegen, the Netherlands.
| | | | - Geert Wanten
- Dept of Gastroenterology and Hepatology, Intestinal Failure Unit, Radboud University Medical Centre, Nijmegen, the Netherlands
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18
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Gubler DA, Makowski LM, Troche SJ, Schlegel K. Loneliness and Well-Being During the Covid-19 Pandemic: Associations with Personality and Emotion Regulation. JOURNAL OF HAPPINESS STUDIES 2021; 22:2323-2342. [PMID: 33100896 PMCID: PMC7574670 DOI: 10.1007/s10902-020-00326-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 05/09/2023]
Abstract
The present study examined how neuroticism, extraversion, and emotion regulation were related to loneliness and well-being during 6 weeks of major public life restrictions in the Covid-19 pandemic in Switzerland. Cross-sectional results from 466 participants showed that neuroticism and emotion regulation strategies were associated with higher loneliness and lower well-being. However, in contrast to prior research, associations of extraversion with loneliness and well-being were weak and were qualified by interactions with emotion regulation. For introverts, maladaptive cognitive strategies such as rumination or catastrophizing were related to higher levels of loneliness. For extraverts, emotion suppression was related to lower levels of affective well-being. Individuals with low maladaptive regulation reported higher well-being the longer the public life restrictions were in place at the time of study participation. These findings suggest that first, extraversion may lose some of its protective value for loneliness and well-being when opportunities to engage in social activities are limited; second, that loneliness and well-being do not decrease over 6 weeks of public life restrictions; and third, that future studies should further investigate the moderating role of emotion regulation on the link between personality, loneliness, and well-being.
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Affiliation(s)
- Danièle A. Gubler
- Institute for Psychology, University of Bern, Fabrikstr. 8, 3012 Bern, Switzerland
| | - Lisa M. Makowski
- Institute for Psychology, University of Bern, Fabrikstr. 8, 3012 Bern, Switzerland
| | - Stefan J. Troche
- Institute for Psychology, University of Bern, Fabrikstr. 8, 3012 Bern, Switzerland
| | - Katja Schlegel
- Institute for Psychology, University of Bern, Fabrikstr. 8, 3012 Bern, Switzerland
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19
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Lucas-Thompson RG, Rayburn S, Seiter NS, Broderick PC, Smyth JM, Coatsworth JD, Henry KL. Learning to BREATHE "Plus": A Multi-Modal Adaptive Supplement to an Evidence-Based Mindfulness Intervention for Adolescents. Front Public Health 2020; 8:579556. [PMID: 33282814 PMCID: PMC7705247 DOI: 10.3389/fpubh.2020.579556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/19/2020] [Indexed: 01/03/2023] Open
Abstract
Incorporating technological supplements into existing group mindfulness-based interventions (MBIs), particularly for use with adolescents, is an important next step in the implementation of MBIs. Yet there is little available content. Herein we present the development and content of a technological supplement for MBIs, which incorporates multiple technological elements to support (a) skill transfer from the group MBI to daily life, (b) the establishment of a formal mindfulness practice, and (c) the use of mindfulness during periods of high stress. A mixed-methods approach was used to develop this multi-method adaptive supplement. Findings about the use of this supplement will be disseminated scientifically and/or publicly as appropriate.
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Affiliation(s)
- Rachel G Lucas-Thompson
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Stephanie Rayburn
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Natasha S Seiter
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Patricia C Broderick
- Bennett-Pierce Prevention Research Center, Pennsylvania State University, University Park, PA, United States
| | - Joshua M Smyth
- Biobehavioral Health and Medicine, Pennsylvania State University, University Park, PA, United States
| | - J Douglas Coatsworth
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
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20
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El Morr C, Layal M. Effectiveness of ICT-based intimate partner violence interventions: a systematic review. BMC Public Health 2020; 20:1372. [PMID: 32894115 PMCID: PMC7476255 DOI: 10.1186/s12889-020-09408-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/18/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Intimate Partner Violence is a "global pandemic". Meanwhile, information and communication technologies (ICT), such as the internet, mobile phones, and smartphones, are spreading worldwide, including in low- and middle-income countries. We reviewed the available evidence on the use of ICT-based interventions to address intimate partner violence (IPV), evaluating the effectiveness, acceptability, and suitability of ICT for addressing different aspects of the problem (e.g., awareness, screening, prevention, treatment, mental health). METHODS We conducted a systematic review, following PRISMA guidelines, using the following databases: PubMed, PsycINFO, and Web of Science. Key search terms included women, violence, domestic violence, intimate partner violence, information, communication technology, ICT, technology, email, mobile, phone, digital, ehealth, web, computer, online, and computerized. Only articles written in English were included. RESULTS Twenty-five studies addressing screening and disclosure, IPV prevention, ICT suitability, support and women's mental health were identified. The evidence reviewed suggests that ICT-based interventions were effective mainly in screening, disclosure, and prevention. However, there is a lack of homogeneity among the studies' outcome measurements and the sample sizes, the control groups used (if any), the type of interventions, and the study recruitment space. Questions addressing safety, equity, and the unintended consequences of the use of ICT in IPV programming are virtually non-existent. CONCLUSIONS There is a clear need to develop women-centered ICT design when programming for IPV. Our study showed only one study that formally addressed software usability. The need for more research to address safety, equity, and the unintended consequences of the use of ICT in IPV programming is paramount. Studies addressing long term effects are also needed.
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Affiliation(s)
- Christo El Morr
- School of Health Policy and Management, York University, 4700 Keele St, Toronto, Ontario, Canada.
| | - Manpreet Layal
- Global Health Program, York University, 4700 Keele St, Toronto, Ontario, Canada
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21
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El Morr C, Ritvo P, Ahmad F, Moineddin R. Effectiveness of an 8-Week Web-Based Mindfulness Virtual Community Intervention for University Students on Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial. JMIR Ment Health 2020; 7:e18595. [PMID: 32554380 PMCID: PMC7395254 DOI: 10.2196/18595] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/27/2020] [Accepted: 06/17/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A student mental health crisis is increasingly acknowledged and will only intensify with the COVID-19 crisis. Given accessibility of methods with demonstrated efficacy in reducing depression and anxiety (eg, mindfulness meditation and cognitive behavioral therapy [CBT]) and limitations imposed by geographic obstructions and localized expertise, web-based alternatives have become vehicles for scaled-up delivery of benefits at modest cost. Mindfulness Virtual Community (MVC), a web-based program informed by CBT constructs and featuring online videos, discussion forums, and videoconferencing, was developed to target depression, anxiety, and experiences of excess stress among university students. OBJECTIVE The aim of this study was to assess the effectiveness of an 8-week web-based mindfulness and CBT program in reducing symptoms of depression, anxiety, and stress (primary outcomes) and increasing mindfulness (secondary outcome) within a randomized controlled trial (RCT) with undergraduate students at a large Canadian university. METHODS An RCT was designed to assess undergraduate students (n=160) who were randomly allocated to a web-based guided mindfulness-CBT condition (n=80) or to a waitlist control (WLC) condition (n=80). The 8-week intervention consisted of a web-based platform comprising (1) 12 video-based modules with psychoeducation on students' preidentified life challenges and applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided 20-minute live videoconferences. The outcomes (depression, anxiety, stress, and mindfulness) were measured via an online survey at baseline and at 8 weeks postintervention using the Patient Health Questionnaire-9 (PHQ9), the Beck Anxiety Inventory (BAI), the Perceived Stress Scale (PSS), and the Five Facets Mindfulness Questionnaire Short Form (FFMQ-SF). Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible covariates (gender, age, country of birth, ethnicity, English as first language, paid work, unpaid work, relationship status, physical exercise, self-rated health, and access to private mental health counseling). RESULTS Of the 159 students who provided T1 data, 32 were males and 125 were females with a mean age of 22.55 years. Participants in the MVC (n=79) and WLC (n=80) groups were similar in sociodemographic characteristics at T1 with the exception of gender and weekly hours of unpaid volunteer work. At postintervention follow-up, according to the adjusted comparisons, there were statistically significant between-group reductions in depression scores (β=-2.21, P=.01) and anxiety scores (β=-4.82, P=.006), and a significant increase in mindfulness scores (β=4.84, P=.02) compared with the WLC group. There were no statistically significant differences in perceived stress for MVC (β=.64, P=.48) compared with WLC. CONCLUSIONS With the MVC intervention, there were significantly reduced depression and anxiety symptoms but no significant effect on perceived stress. Online mindfulness interventions can be effective in addressing common mental health conditions among postsecondary populations on a large scale, simultaneously reducing the current burden on traditional counseling services. TRIAL REGISTRATION ISRCTN Registry ISRCTN12249616; http://www.isrctn.com/ISRCTN12249616.
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Affiliation(s)
- Christo El Morr
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Farah Ahmad
- School of Health Policy and Management, York University, Toronto, ON, Canada
| | - Rahim Moineddin
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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- School of Health Policy and Management, York University, Toronto, ON, Canada
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22
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Zhang Y, Xue J, Huang Y. A meta-analysis: Internet mindfulness-based interventions for stress management in the general population. Medicine (Baltimore) 2020; 99:e20493. [PMID: 32664060 PMCID: PMC7360300 DOI: 10.1097/md.0000000000020493] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psychological stress was an important mental health problem among the general population and warrant research to inform strategies for effective prevention. iMBIs provide a possibility to offer easily accessible, efficacious, convenient, and low-cost interventions on a wide scale. However, the efficacy of iMBIs in the general population remains unclear. The aim of this meta-analysis is to evaluate the effects of iMBIs for stress reduction in the general population. METHODS A systematic search in PubMed, Embase, Web of Science, Medline, Cochrane Library, CNKI, and Wanfang Data databases was performed up to April 10, 2019. The overall effect sizes of the iMBIs on stress, depression, anxiety, and mindfulness were recorded by the metric of Hedges' g with 95% confidence interval (CI), Z-value, and P value. RESULTS Sixteen eligible studies were included in the meta-analysis. The overall results indicated that iMBIs had small to moderate effects on stress (Hedges' g = -0.393) and mindfulness (Hedges' g = -0.316) compared with the control group. Results from subgroup analyses revealed that the type of sample and delivery mode had a greater impact on heterogeneity across the studies. Meta-regression found that the overall effect might be moderated by guidance for iMBIs. CONCLUSION The present meta-analysis suggested that iMBIs had small to moderate effects in reducing stress and improving mindfulness of the general population in comparison with the control group. Future research is needed to explore how iMBIs are remolded to improve adherence and suit specific individuals.
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Affiliation(s)
- Yun Zhang
- West China School of Basic Medical Sciences and Forensic Medicine
| | - Jiaming Xue
- West China School of Basic Medical Sciences and Forensic Medicine
| | - Ying Huang
- Department of Pathophysiology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan Province, China
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23
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Throuvala MA, Griffiths MD, Rennoldson M, Kuss DJ. Mind over Matter: Testing the Efficacy of an Online Randomized Controlled Trial to Reduce Distraction from Smartphone Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4842. [PMID: 32635650 PMCID: PMC7369880 DOI: 10.3390/ijerph17134842] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 02/07/2023]
Abstract
Evidence suggests a growing call for the prevention of excessive smartphone and social media use and the ensuing distraction that arises affecting academic achievement and productivity. A ten-day online randomized controlled trial with the use of smartphone apps, engaging participants in mindfulness exercises, self-monitoring and mood tracking, was implemented amongst UK university students (n = 143). Participants were asked to complete online pre- and post-intervention assessments. Results indicated high effect sizes in reduction of smartphone distraction and improvement scores on a number of self-reported secondary psychological outcomes. The intervention was not effective in reducing habitual behaviours, nomophobia, or time spent on social media. Mediation analyses demonstrated that: (i) emotional self-awareness but not mindful attention mediated the relationship between intervention effects and smartphone distraction, and (ii) online vigilance mediated the relationship between smartphone distraction and problematic social media use. The present study provides preliminary evidence of the efficacy of an intervention for decreased smartphone distraction and highlights psychological processes involved in this emergent phenomenon in the smartphone literature. Online interventions may serve as complementary strategies to reduce distraction levels and promote insight into online engagement. More research is required to elucidate the mechanisms of digital distraction and assess its implications in problematic use.
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Affiliation(s)
- Melina A. Throuvala
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
| | - Mike Rennoldson
- Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK; (M.D.G.); (D.J.K.)
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24
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Saghayi M, Greenberg J, O’Grady C, Varno F, Hashmi MA, Bracken B, Matwin S, Lazar SW, Hashmi JA. Brain network topology predicts participant adherence to mental training programs. Netw Neurosci 2020; 4:528-555. [PMID: 32885114 PMCID: PMC7462432 DOI: 10.1162/netn_a_00136] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/02/2020] [Indexed: 11/04/2022] Open
Abstract
Adherence determines the success and benefits of mental training (e.g., meditation) programs. It is unclear why some participants engage more actively in programs for mental training than others. Understanding neurobiological factors that predict adherence is necessary for understanding elements of learning and to inform better designs for new learning regimens. Clustering patterns in brain networks have been suggested to predict learning performance, but it is unclear whether these patterns contribute to motivational aspects of learning such as adherence. This study tests whether configurations of brain connections in resting-state fMRI scans can be used to predict adherence to two programs: meditation and creative writing. Results indicate that greater system segregation and clustering predict the number of practice sessions and class participation in both programs at a wide range of network thresholds (corrected p value < 0.05). At a local level, regions in subcortical circuitry such as striatum and accumbens predicted adherence in all subjects. Furthermore, there were also some important distinctions between groups: Adherence to meditation was predicted by connectivity within local network of the anterior insula and default mode network; and in the writing program, adherence was predicted by network neighborhood of frontal and temporal regions. Four machine learning methods were applied to test the robustness of the brain metric for classifying individual capacity for adherence and yielded reasonable accuracy. Overall, these findings underscore the fact that adherence and the ability to perform prescribed exercises is associated with organizational patterns of brain connectivity.
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Affiliation(s)
- Marzie Saghayi
- Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, NSHA, Halifax, Canada
| | | | - Christopher O’Grady
- Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, NSHA, Halifax, Canada
| | - Farshid Varno
- Faculty of Computer Science, Dalhousie University, Halifax, Canada
| | | | | | - Stan Matwin
- Faculty of Computer Science, Dalhousie University, Halifax, Canada
- Institute of Computer Science, Polish Academy of Sciences, Warsaw, Poland
| | - Sara W. Lazar
- Harvard Medical School, Mass General Hospital, Boston, MA, USA
| | - Javeria Ali Hashmi
- Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, NSHA, Halifax, Canada
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25
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Chavez JL, Porucznik CA, Gren LH, Guan J, Joyce E, Brodke DS, Dailey AT, Mahan MA, Hood RS, Lawrence BD, Spiker WR, Spina NT, Bisson EF. The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Outcomes in Lumbar Spine Degenerative Disease: 3-Month and 12-Month Results of a Pilot Study. World Neurosurg 2020; 139:e230-e236. [PMID: 32278820 DOI: 10.1016/j.wneu.2020.03.186] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, noncrossover pilot study using preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3-month and 12-month postoperative PROs of preoperative MBSR in lumbar spine surgery for degenerative disease. METHODS Intervention group participants were prospectively enrolled in a preoperative online MBSR course. A comparison standard care only group was one-to-one matched retrospectively by age, sex, surgery type, and prescription opioid use. Three-month and 12-month postoperative PROs for pain, disability, quality of life, and opioid use were compared within and between groups. Regression models were used to assess whether MBSR use predicted outcomes. RESULTS Twenty-four participants were included in each group. At 3 months, follow-up was 87.5% and 95.8% in the comparison and intervention groups, respectively. In the intervention group, mean Patient-Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF) was significantly higher, whereas mean Patient-Reported Outcomes Measurement Information System-Pain Interference (PROMIS-PI) and Oswestry Disability Index were significantly lower. The change from baseline in mean PROMIS-PF and PROMIS-PI was significantly greater than in the comparison group. At 12 months, follow-up was 58.3% and 83.3% in the comparison and intervention groups, respectively. In the intervention group, mean PROMIS-PI was significantly lower and change in mean PROMIS-PI from baseline was significantly greater. MBSR use was a significant predictor of change in PROMIS-PF at 3 months and in PROMIS-PI at 12 months. No adverse events were reported. CONCLUSIONS Three-month and 12-month results suggest that preoperative MBSR may have pain control benefits in lumbar spine surgery.
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Affiliation(s)
- Juneyoung L Chavez
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Lisa H Gren
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jian Guan
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Evan Joyce
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Darrel S Brodke
- Department of Orthopaedic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Andrew T Dailey
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Mark A Mahan
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Robert S Hood
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Brandon D Lawrence
- Department of Orthopaedic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - William R Spiker
- Department of Orthopaedic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Nicholas T Spina
- Department of Orthopaedic Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Erica F Bisson
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
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26
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Stjernswärd S, Hansson L. A Qualitative Study of Caregivers' Experiences, Motivation and Challenges Using a Web-Based Mindfulness Intervention. Community Ment Health J 2020; 56:416-425. [PMID: 31571086 PMCID: PMC7056690 DOI: 10.1007/s10597-019-00477-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 09/24/2019] [Indexed: 02/06/2023]
Abstract
Caregivers report experiences of stress and burden that can affect their health negatively. Web-based mindfulness interventions have shown beneficial health effects in clinical and non-clinical populations, including caregivers. The study's aim was to explore the experiences of a web-based mindfulness program, including motivation and challenges to use, in caregivers of a person with somatic illness. Ten participants were interviewed. Data was analyzed with content analysis, resulting in four categories illustrating the participants' experiences of the program, including motivations and barriers to training: A timely or untimely intervention; Mainly positive effects even at low levels of training; Relationship to the patient; and Creating a routine and maintaining motivation. Qualitative studies can contribute to enrich our understanding of the value of such interventions, which may be a flexible supportive tool for caregivers. The findings illuminate the importance of supporting motivation and adherence to such interventions, with the potential for enhanced beneficial outcomes.
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Affiliation(s)
- Sigrid Stjernswärd
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden.
| | - Lars Hansson
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden
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27
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Schultchen D, Küchler AM, Schillings C, Weineck F, Karabatsiakis A, Ebert DD, Baumeister H, Pollatos O. Effectiveness of a guided online mindfulness-focused intervention in a student population: Study protocol for a randomised control trial. BMJ Open 2020; 10:e032775. [PMID: 32209621 PMCID: PMC7202707 DOI: 10.1136/bmjopen-2019-032775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies show that university students experience higher psychological stress than the general population, resulting in increased vulnerability for mental disorders for the student population. Online mindfulness interventions will be delivered to students as a potentially promising and more flexible approach compared to face-to-face interventions with the aim of improving their mental health. This study purposes to investigate the effectiveness of a guided online mindfulness-focused intervention for university students by using both self-reported and psychobiological measures. METHODS AND ANALYSES In this multicentre, two-armed randomised controlled trial with a parallel design, a guided version of the online mindfulness-focused intervention 'StudiCare Mindfulness' will be compared with a waitlist control group. In total, 120 participants will be recruited at different universities (of Applied Sciences) in (Neu-) Ulm. Data will be assessed prior to randomisation, after eight weeks (post-intervention) and six months after randomisation (follow-up). The primary outcome measure is mindfulness. The secondary outcome measures include depression, anxiety and stress levels, well-being, interoceptive sensibility, emotion regulation and alexithymia. Psychobiological parameters comprise interoceptive accuracy, hair cortisol and FKBP5 genotype. Sociodemographic variables, treatment expectations, side and adverse side effects, as well as intervention satisfaction and adherence will be assessed. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION All study procedures have been approved by the Ethics Committee of Ulm University (application No. 48/18). The findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER DRKS00014701.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Christine Schillings
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Felicitas Weineck
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
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28
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Hudson MP, Thompson AR, Emerson LM. Compassion-focused self-help for psychological distress associated with skin conditions: a randomized feasibility trial. Psychol Health 2019; 35:1095-1114. [DOI: 10.1080/08870446.2019.1707829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Mark P. Hudson
- Department of Psychology, Clinical Psychology Unit, Western Bank, The University of Sheffield, Sheffield, UK
| | - Andrew R. Thompson
- Department of Psychology, Clinical Psychology Unit, Western Bank, The University of Sheffield, Sheffield, UK
| | - Lisa-Marie Emerson
- Department of Psychology, Clinical Psychology Unit, Western Bank, The University of Sheffield, Sheffield, UK
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29
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Lippmann M, Laudel H, Heinzle M, Narciss S. Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. J Med Internet Res 2019; 21:e12497. [PMID: 31774413 PMCID: PMC6906627 DOI: 10.2196/12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 08/17/2019] [Accepted: 09/26/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness. OBJECTIVE The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness. METHODS The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1. RESULTS A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions. CONCLUSIONS Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.
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Affiliation(s)
- Marie Lippmann
- Department of Psychology, California State University, Chico, CA, United States
| | - Helena Laudel
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
| | - Marlene Heinzle
- Department of Media, Cognition and Communication, Faculty of Humanities, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Narciss
- Psychology of Learning and Instruction, Faculty of Psychology - School of Science, Technische Universität Dresden, Dresden, Germany
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30
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Clarke J, Draper S. Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the "Calm" app's (mostly positive) effects. Internet Interv 2019; 19:100293. [PMID: 31890639 PMCID: PMC6928287 DOI: 10.1016/j.invent.2019.100293] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Despite a weak evidence base, daily use of mindfulness-based self-help smartphone applications (apps) is said to promote wellbeing. However, many do not use these apps in the way that app developers and mindfulness proponents recommend. We sought to determine whether the "Calm" app works, and whether it does so even when it is used intermittently. METHODS Employing a mixed-methods design, we recruited a self-selected sample of 269 students from a Scottish university (81% female, 84% white, mean age 23.89) to engage with a seven-day introductory mindfulness course, delivered using Calm, currently one of the most popular, yet under-researched, apps. RESULTS Daily course engagement was associated with significant gains in wellbeing (p ≤.001, d = 0.42), trait mindfulness (p ≤.001, d = 0.50) and self-efficacy (p ≤.014, d = 0.21). Intermittent course engagement was also associated with significant gains in wellbeing (p ≤.028, d = 0.34), trait mindfulness (p ≤.010, d = 0.47) and self-efficacy (p ≤.028, d = 0.32). This study is therefore the first to demonstrate that the Calm app is associated with positive mental health outcomes. It also shows that regular use is not essential. A thematic analysis of qualitative data supported these quantitative findings. However it also revealed that some participants had negative experiences with the app. CONCLUSIONS FOR PRACTICE Mindfulness-based self-help apps such as Calm have the potential to both enhance and diminish users' wellbeing. Intermittent mindfulness practice can lead to tangible benefits. Therefore, mindfulness proponents should not recommend daily practice, should increase awareness of the potential for negative outcomes, and resist the idea that mindfulness practice works for everyone. Developers of mindfulness apps ought to make specific features customisable in order to enhance their effectiveness.
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Affiliation(s)
- Joseph Clarke
- Corresponding author at: 2 Hillhead St, Glasgow G12 8QB.
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31
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Potharst ES, Boekhorst MGBM, Cuijlits I, van Broekhoven KEM, Jacobs A, Spek V, Nyklíček I, Bögels SM, Pop VJM. A Randomized Control Trial Evaluating an Online Mindful Parenting Training for Mothers With Elevated Parental Stress. Front Psychol 2019; 10:1550. [PMID: 31379646 PMCID: PMC6650592 DOI: 10.3389/fpsyg.2019.01550] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/19/2019] [Indexed: 01/02/2023] Open
Abstract
Objectives The prevalence of maternal stress in early years of parenting can negatively impact child development. Therefore, there is a need for an early intervention that is easily accessible and low in costs. The current study examined the effectiveness of an 8-session online mindful parenting training for mothers with elevated levels of parental stress. Methods A total of 76 mothers were randomized into an intervention (n = 43) or a waitlist control group (n = 33). The intervention group completed pretest assessment prior to the online intervention. Participants completed a post intervention assessment after the 10 weeks intervention and a follow-up assessment 10 weeks later. The waitlist group completed waitlist assessment, followed by a 10-week waitlist period. After these 10 weeks, a pretest assessment took place, after which the waitlist group participants also started the intervention, followed by the posttest assessment. Participating mothers completed questionnaires on parental stress (parent-child interaction problems, parenting problems, parental role restriction) and other maternal (over-reactive parenting discipline, self-compassion, symptoms of depression and anxiety) and child outcomes (aggressive behavior and emotional reactivity) while the non-participating parents (father or another mother) were asked to also report on child outcomes. Results The online mindful parenting intervention was shown to be significantly more effective at a 95% level than a waitlist period with regard to over-reactive parenting discipline and symptoms of depression and anxiety (small and medium effect sizes), and significantly more effective at a 90% level with regard to self-compassion, and mother-rated child aggressive behavior and child emotional reactivity (small effect sizes). The primary outcome, parental stress, was found to have a 95% significant within-group effect only for the subscale parental role restriction (delayed small effect size improvement at follow-up). No significant improvements on child outcomes were found for the non-participating parent. Conclusion To conclude, the results provide first evidence that an online mindful parenting training may be an easily accessible and valuable intervention for mothers with elevated levels of parental stress.
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Affiliation(s)
- Eva S Potharst
- UvA Minds, Academic Outpatient (Child and Adolescent) Treatment Center, University of Amsterdam, Amsterdam, Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands.,Department of Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Ivon Cuijlits
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Kiki E M van Broekhoven
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Anne Jacobs
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | - Viola Spek
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.,Department of Psychology, Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Ivan Nyklíček
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
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32
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Villalba DK, Lindsay EK, Marsland AL, Greco CM, Young S, Brown KW, Smyth JM, Walsh CP, Gray K, Chin B, Creswell JD. Mindfulness training and systemic low-grade inflammation in stressed community adults: Evidence from two randomized controlled trials. PLoS One 2019; 14:e0219120. [PMID: 31295270 PMCID: PMC6622480 DOI: 10.1371/journal.pone.0219120] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/12/2019] [Indexed: 12/14/2022] Open
Abstract
Mindfulness interventions have garnered significant attention as a complementary health treatment for many physical and psychological conditions. While some research has shown that mindfulness training can decrease psychological and physiological stress responses, it remains unclear whether mindfulness training impacts inflammation—a predictor of poor health outcomes. In addition, little research has examined the active components of mindfulness that may drive health-related improvements. Here, we provide data from two 3-arm randomized controlled trials that examined the effect of mindfulness training on inflammation in stressed community adults. Specifically, we examined whether training individuals to have an accepting attitude towards present moment experiences is a key emotion regulation skill that can lead to decreases in inflammation. Both studies randomly assigned participants to one of three conditions: mindfulness training that taught both attention monitoring and acceptance skills (Monitor+Accept); mindfulness training teaching monitoring without the acceptance component (Monitor Only); or a control condition. Study 1 employed a novel 2-week smartphone-based intervention and Study 2 employed a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention. We hypothesized that Monitor+Accept training would lead to reductions in the inflammatory biomarker C-Reactive Protein (CRP) compared to Monitor Only training and control groups. Contrary to this hypothesis, we found that Monitor+Accept mindfulness training did not lead to reductions in CRP. Exploratory analyses combining study subsamples, however, suggest that both mindfulness interventions may reduce CRP in populations at risk for systemic inflammation—midlife-to-older adults and individuals with high BMI. Overall, the present studies contribute significantly to the question of whether mindfulness interventions can reduce systemic markers of low-grade inflammation.
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Affiliation(s)
- Daniella K. Villalba
- Psychology Department, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Emily K. Lindsay
- Psychology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Anna L. Marsland
- Psychology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Carol M. Greco
- Psychology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Shinzen Young
- College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Kirk Warren Brown
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Joshua M. Smyth
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Catherine P. Walsh
- Psychology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Katarina Gray
- Psychology Department, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Brian Chin
- Psychology Department, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America
| | - J. David Creswell
- Psychology Department, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America
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Lyzwinski LN, Caffery L, Bambling M, Edirippulige S. The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e12210. [PMID: 30969174 PMCID: PMC6479283 DOI: 10.2196/12210] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/07/2018] [Accepted: 12/29/2018] [Indexed: 12/19/2022] Open
Abstract
Background University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight-related behaviors because of stress. Mindfulness holds promise for weight management. However, there has not been any previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight-related behaviors, and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based, mindfulness-based stress reduction and mindful eating (ME) techniques that were tailored to university students, with student-relevant themes for targeting weight behaviors, weight, and stress. Objectives The aim of this study was to test the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress. Testing this app in a rigorous randomized controlled trial (RCT) for these outcomes is a novelty and contribution to this emerging field. Methods A 2-arm RCT of an 11-week duration was undertaken at the University of Queensland. Students were either randomized to the mindfulness app (n=45) or to a behavioral self-monitoring electronic diary (e-diary; n=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, ME, physical activity, and eating behaviors between both groups. Results Neither the mindfulness app group nor the e-diary group lost weight and there were no differences between the groups at follow-up. The mindfulness app group had significantly lower stress levels (P=.02) (adherers only), lower emotional eating (P=.02), and uncontrolled eating (P=.02) as well as higher mindfulness (P≤.001) and ME levels overall (P≤.001). The e-diary group had higher metabolic equivalents of moderate activity levels (P≤.01). However, the effect sizes were small. Regular adherence to mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. Compared with other exercises, the most helpful reported meditation was the short breathing exercise observing the breath (39.4% [13/33] preferred it). This was the first RCT that tested a mindfulness app for weight and weight-related behaviors in students. The modest level of user adherence likely contributes to the lack of effect on weight loss. However, there was a small, albeit promising, effect on weight-related eating behavior and stress. Conclusions A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness, and ME, but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance. Trial Registration Australian New Zealand Trial Registry ACTRN12616001349437; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371370 (Archived by WebCite at http://www.webcitation.org/761cc2K6ft)
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Affiliation(s)
| | - Liam Caffery
- University of Queensland, School of Medicine, Centre for Online Health, Woloongabba, Australia
| | - Matthew Bambling
- University of Queensland, School of Medicine, Centre for Online Health, Woloongabba, Australia
| | - Sisira Edirippulige
- University of Queensland, School of Medicine, Centre for Online Health, Woloongabba, Australia
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Svetlov AS, Nelson MM, Antonenko PD, McNamara JPH, Bussing R. Commercial mindfulness aid does not aid short-term stress reduction compared to unassisted relaxation. Heliyon 2019; 5:e01351. [PMID: 30923771 PMCID: PMC6423491 DOI: 10.1016/j.heliyon.2019.e01351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/31/2018] [Accepted: 03/12/2019] [Indexed: 10/27/2022] Open
Abstract
Increased public interest in mindfulness has generated a burgeoning market in new consumer technologies. Two exploratory studies examined effects of InteraXon's "Muse" electroencephalography (EEG)-based neurofeedback device and mobile application on mindfulness-based relaxation activities. Psychophysiological outcomes (heart rate variability (HRV), electro-dermal activity (EDA), saliva amylase activity (sAA) and Muse application EEG "calm percent") were collected for two 7-minute conditions: Muse-assisted relaxation exercise (MARE), and unassisted relaxation exercise (URE). In the first study, participants (n = 99) performed both conditions in a randomized sequential design. A follow-up study used a randomized parallel condition (n = 44) to test for differences in HRV effects between the two conditions and extended follow-up observation. Generalized estimating equation models demonstrated a moderate increase in HRV following relaxation exercises, with no observable difference between MARE and URE conditions. Both MARE and URE conditions produced equally effective short-term increases in heart rate variability, without additional benefit from neurofeedback.
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Affiliation(s)
- Artem S Svetlov
- Department of Psychiatry, College of Medicine, University of Florida, PO Box 100256, 1149 Newell, Dr., L4-100, Gainesville, FL 32611, USA
| | - Melanie M Nelson
- Department of Psychiatry, College of Medicine, University of Florida, PO Box 100256, 1149 Newell, Dr., L4-100, Gainesville, FL 32611, USA
| | - Pavlo D Antonenko
- College of Education, University of Florida, G416 Norman Hall, PO Box 117042, Gainesville, FL 32611, USA
| | - Joseph P H McNamara
- Department of Psychiatry, College of Medicine, University of Florida, PO Box 100256, 1149 Newell, Dr., L4-100, Gainesville, FL 32611, USA
| | - Regina Bussing
- Department of Psychiatry, College of Medicine, University of Florida, PO Box 100256, 1149 Newell, Dr., L4-100, Gainesville, FL 32611, USA
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Lindsay EK, Chin B, Greco CM, Young S, Brown KW, Wright AGC, Smyth JM, Burkett D, Creswell JD. How mindfulness training promotes positive emotions: Dismantling acceptance skills training in two randomized controlled trials. J Pers Soc Psychol 2019; 115:944-973. [PMID: 30550321 DOI: 10.1037/pspa0000134] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Mindfulness meditation interventions-which train skills in monitoring present-moment experiences with a lens of acceptance-have shown promise for increasing positive emotions. Using a theory-based approach, we hypothesized that learning acceptance skills in mindfulness interventions helps people notice more positive experiences in daily life, and tested whether removing acceptance training from mindfulness interventions would eliminate intervention-related boosts in positive affect. In 2 randomized controlled trials (RCTs) of stressed community adults, mindfulness skills were dismantled into 2 structurally equivalent interventions: (a) training in both monitoring and acceptance (Monitor + Accept) and (b) training in monitoring only (Monitor Only) without acceptance training. Study 1 tested 8-week group-based Monitor + Accept and Monitor Only interventions compared with a no treatment control group. Study 2 tested 2-week smartphone-based Monitor + Accept and Monitor Only interventions compared with an active control training. In both studies, end-of-day and momentary positive affect and negative affect were measured in daily life for 3 days pre- and post-intervention using ambulatory assessments. As predicted, across 2 RCTs, Monitor + Accept training increased positive affect compared with both Monitor Only and control groups. In Study 1, this effect was observed in end-of-day positive affect. In Study 2, this effect was found in both end-of-day and momentary positive affect outcomes. In contrast, all active interventions in Studies 1 and 2 decreased negative affect. These studies provide the first experimental evidence that developing an orientation of acceptance toward present-moment experiences is a central mechanism of mindfulness interventions for boosting positive emotions in daily life. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | - Brian Chin
- Department of Psychology, Carnegie Mellon University
| | | | | | - Kirk W Brown
- Department of Psychology, Virginia Commonwealth University
| | | | - Joshua M Smyth
- Department of Biobehavioral Health, Pennsylvania State University
| | - Deanna Burkett
- Center for Integrative Medicine, University of Pittsburgh Medical Center
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Yi JL, Porucznik CA, Gren LH, Guan J, Joyce E, Brodke DS, Dailey AT, Mahan MA, Hood RS, Lawrence BD, Spiker WR, Spina NT, Bisson EF. The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Patient-Reported Pain, Disability, Quality of Life, and Prescription Opioid Use in Lumbar Spine Degenerative Disease: A Pilot Study. World Neurosurg 2019; 121:e786-e791. [DOI: 10.1016/j.wneu.2018.09.223] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/01/2022]
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Lucas-Thompson RG, Broderick PC, Coatsworth JD, Smyth JM. New Avenues for Promoting Mindfulness in Adolescence using mHealth. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:131-139. [PMID: 31160875 PMCID: PMC6544044 DOI: 10.1007/s10826-018-1256-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
There is a large evidence base supporting the efficacy of mindfulness interventions in adulthood, and growing support for the efficacy of these interventions in adolescence. Historically mindfulness interventions have been delivered in person and in groups, with recommendations for home practice being a critical part of the intervention. However, compliance with these practice recommendations in adolescence is very poor. Past studies indicate that using mobile technology to promote skill transfer to real life can be an effective strategy, particularly when used as a supplement to an in-person intervention strategy. To date, however, mobile technology has largely been used to create stand-alone mindfulness interventions. The goals of the current paper are to discuss the potential opportunities and challenges with a mobile-technology-enhanced mindfulness intervention, and to present the rationale that such an approach is not only theoretical and empirically sound but also a critical next step to increase the efficacy and developmental appropriateness of mindfulness interventions for adolescents. This discussion is grounded in a specific example of a mindfulness intervention supplemented by momentary interventions we are developing.
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Affiliation(s)
| | | | - J Doug Coatsworth
- Department of Human Development & Family Studies, Colorado State University
| | - Joshua M Smyth
- Biobehavioral Health and Medicine, Pennsylvania State University
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Nymberg P, Ekvall Hansson E, Stenman E, Calling S, Sundquist K, Sundquist J, Zöller B. Pilot study on increased adherence to physical activity on prescription (PAP) through mindfulness: study protocol. Trials 2018; 19:563. [PMID: 30333052 PMCID: PMC6192071 DOI: 10.1186/s13063-018-2932-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the Swedish population aged between 50 and 64 years only 7.1% reach the recommended level of physical activity. Physical activity on prescription (PAP) has been used in Sweden since the beginning of the twenty-first century with moderate adherence of approximately 50%. Mindfulness seems to affect motivation to and satisfaction with physical activity. The aim is to test the feasibility of a study in routine care; i.e. to test if mindfulness can improve adherence to PAP, measured by changes in physical activity. METHODS/DESIGN We will include 90 sedentary individuals, aged 40-65 years, from primary health care centres in Sweden. Individuals will be randomised to only PAP, mindfulness and PAP or mindfulness only. The PAP group will be based on patients' preferences. The mindfulness groups will meet once a week for 8 weeks and practise 20 min of individual training per day. There will not be any motivational interview or physical activity on prescription in the group assigned to only mindfulness. The participants will complete the Five Facet Mindfulness Questionnaire, the Insomnia Severity Index and also answer questions concerning their lifestyle. Physical activity will be measured by ACTi Graph GT1X activity monitor at baseline and after 3 and 6 months. Patients with a severe psychological disease, unstable angina or a recent myocardial infarction will be excluded. The main outcome will be adherence to PAP in an ordinary primary health care setting. In this pilot study, we will also evaluate measures such as the recruitment rate, number of dropouts and adherence to mindfulness practice. DISCUSSION This study is the first to explore the effect of mindfulness on adherence to PAP and test the feasibility of the study design. TRIAL REGISTRATION ClinicalTrials.gov, NCT02869854 . Registered on 26 August 2016.
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Affiliation(s)
- Peter Nymberg
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden.
| | - Eva Ekvall Hansson
- Department of Health Sciences, Division of Physiotherapy, Lund University, Baravägen 3, SE-221 00, Lund, Sweden
| | - Emelie Stenman
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Susanna Calling
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Kristina Sundquist
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Jan Sundquist
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Bengt Zöller
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
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Kladnitski N, Smith J, Allen A, Andrews G, Newby JM. Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial. Internet Interv 2018; 13:41-50. [PMID: 30206518 PMCID: PMC6112099 DOI: 10.1016/j.invent.2018.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/30/2018] [Accepted: 06/07/2018] [Indexed: 01/13/2023] Open
Abstract
Transdiagnostic internet-delivered cognitive behavioural therapies (iCBT) are effective for treating anxiety and depression, but there is room for improvement. In this study we developed a new Mindfulness-Enhanced iCBT intervention by incorporating formal and informal mindfulness exercises within an existing transdiagnostic iCBT program for mixed depression and anxiety. We examined the acceptability, feasibility, and outcomes of this new program in a sample of 22 adults with anxiety disorders and/or major depression. Participants took part in the 7-lesson clinician-guided online intervention over 14 weeks, and completed measures of distress (K-10), anxiety (GAD-7), depression (PHQ-9), mindfulness (FFMQ) and well-being (WEMBWS) at pre-, mid-, post-treatment, and three months post-treatment. Treatment engagement, satisfaction, and side-effects were assessed. We found large, significant reductions in distress (Hedges g = 1.55), anxiety (g = 1.39), and depression (g = 1.96), and improvements in trait mindfulness (g = 0.98) and well-being (g = 1.26) between baseline and post-treatment, all of which were maintained at follow-up. Treatment satisfaction was high for treatment-completers, with minimal side-effects reported, although adherence was lower than expected (59.1% completed). These findings show that it is feasible to integrate online mindfulness training with iCBT for the treatment of anxiety and depression, but further research is needed to improve adherence. A randomised controlled trial is needed to explore the efficacy of this program.
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Affiliation(s)
- Natalie Kladnitski
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia
| | - Jessica Smith
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia
| | - Adrian Allen
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia
| | - Gavin Andrews
- Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia
| | - Jill M. Newby
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW 2052, Australia
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Stjernswärd S, Hansson L. Effectiveness and usability of a web-based mindfulness intervention for caregivers of people with mental or somatic illness. A randomized controlled trial. Internet Interv 2018; 12:46-56. [PMID: 30135768 PMCID: PMC6096325 DOI: 10.1016/j.invent.2018.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sigrid Stjernswärd
- Lund University, Department of Health Sciences, Box 157, 221 50 Lund, Sweden
| | - Lars Hansson
- Lund University, Department of Health Sciences, Sweden
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Bostock S, Crosswell AD, Prather AA, Steptoe A. Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being. J Occup Health Psychol 2018; 24:127-138. [PMID: 29723001 DOI: 10.1037/ocp0000118] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We investigated whether a mindfulness meditation program delivered via a smartphone application could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large United Kingdom companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 prerecorded 10- to 20-min guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures and blood pressure throughout one working day were measured at baseline and eight weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0-45 sessions). The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from pre- to post-intervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment. This trial suggests that short guided mindfulness meditations delivered via smartphone and practiced multiple times per week can improve outcomes related to work stress and well-being, with potentially lasting effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Sophie Bostock
- Department of Epidemiology and Public Health, University College London
| | | | - Aric A Prather
- Department of Psychiatry, University of California, San Francisco
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London
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Querstret D, Cropley M, Fife-Schaw C. The Effects of an Online Mindfulness Intervention on Perceived Stress, Depression and Anxiety in a Non-clinical Sample: A Randomised Waitlist Control Trial. Mindfulness (N Y) 2018; 9:1825-1836. [PMID: 30524514 PMCID: PMC6244637 DOI: 10.1007/s12671-018-0925-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mindfulness interventions have been shown to be effective for health and wellbeing, and delivering mindfulness programmes online may increase accessibility and reduce waiting times and associated costs; however, research assessing the effectiveness of online interventions is lacking. We sought to: (1) assess the effects of an online mindfulness intervention on perceived stress, depression and anxiety; (2) assess different facets of mindfulness (i.e. acting with awareness, describing, non-judging and non-reacting) as mechanisms of change and (3) assess whether the effect of the intervention was maintained over time. The sample was comprised of 118 adults (female, n = 95) drawn from the general population. Using a randomised waitlist control design, participants were randomised to either an intervention (INT) or waitlist control (WLC) group. Participants completed the online intervention, with the WLC group starting after a 6-week waitlist period. Participants completed measures of depression (PHQ-9), anxiety (GAD-7) and perceived stress (PSS-10) at baseline, post-treatment, 3- and 6-month follow-up. Participants who completed the mindfulness intervention (n = 60) reported significantly lower levels of perceived stress (d = − 1.25 [− 1.64, − 0.85]), anxiety (d = − 1.09 [− 1.47, − 0.98]) and depression (d = − 1.06 [− 1.44, − 0.67]), when compared with waitlist control participants (n = 58), and these effects were maintained at follow-up. The effect of the intervention was primarily explained by increased levels of non-judging. This study provides support for online mindfulness interventions and furthers our understanding with regards to how mindfulness interventions exert their positive effects.
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Affiliation(s)
- Dawn Querstret
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH UK
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH UK
| | - Chris Fife-Schaw
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH UK
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Myers ND, Dietz S, Prilleltensky I, Prilleltensky O, McMahon A, Rubenstein CL, Lee S. Efficacy of the Fun For Wellness Online Intervention to Promote Well-Being Actions: A Secondary Data Analysis. Games Health J 2018; 7:225-239. [PMID: 29708773 DOI: 10.1089/g4h.2017.0132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Fun For Wellness (FFW) is a new online intervention designed to promote growth in well-being by providing capability-enhancing learning opportunities (e.g., play an interactive game) to participants. The purpose of this study was to provide an initial evaluation of the efficacy of the FFW intervention to increase well-being actions. MATERIALS AND METHODS The study design was a secondary data analysis of a large-scale prospective, double-blind, parallel-group randomized controlled trial. Data were collected at baseline and 30 and 60 days postbaseline. A total of 479 adult employees at a major university in the southeast of the United States of America were enrolled. Participants who were randomly assigned to the FFW group were provided with 30 days of 24-hour access to the intervention. A two-class linear regression model with complier average causal effect estimation was fitted to well-being actions scores at 30 and 60 days. RESULTS Intent-to-treat analysis provided evidence that the effect of being assigned to the FFW intervention, without considering actual participation in the FFW intervention, had a null effect on each dimension of well-being actions at 30 and 60 days. Participants who complied with the FFW intervention, however, had significantly higher well-being actions scores, compared to potential compliers in the Usual Care group, in the interpersonal dimension at 60 days, and the physical dimension at 30 days. CONCLUSIONS Results from this secondary data analysis provide some supportive evidence for both the efficacy of and possible revisions to the FFW intervention in regard to promoting well-being actions.
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Affiliation(s)
- Nicholas D Myers
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
| | - Samantha Dietz
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Isaac Prilleltensky
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Ora Prilleltensky
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Adam McMahon
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Carolyn L Rubenstein
- 3 Department of Educational and Psychological Studies, University of Miami , Coral Gables, Florida
| | - Seungmin Lee
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
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Noone C, Hogan MJ. A randomised active-controlled trial to examine the effects of an online mindfulness intervention on executive control, critical thinking and key thinking dispositions in a university student sample. BMC Psychol 2018; 6:13. [PMID: 29622047 PMCID: PMC5887193 DOI: 10.1186/s40359-018-0226-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/26/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Arguments for including mindfulness instruction in higher education have included claims about the benefits of mindfulness practice for critical thinking. While there is theoretical support for this claim, empirical support is limited. The aim of this study was to test this claim by investigating the effects of an online mindfulness intervention on executive function, critical thinking skills and associated thinking dispositions. METHOD Participants recruited from a university were randomly allocated, following screening, to either a mindfulness meditation group or a sham meditation group. Both the researchers and the participants were blind to group allocation. The intervention content for both groups was delivered through the Headspace online application, an application which provides guided meditations to users. Both groups were requested to complete 30 guided mindfulness meditation sessions across a 6 week period. Primary outcome measures assessed mindfulness, executive functioning, critical thinking, actively open-minded thinking and need for cognition. Secondary outcome measures assessed wellbeing, positive and negative affect, and real-world outcomes. RESULTS In a series of full-information maximum likelihood analyses, significant increases in mindfulness dispositions and critical thinking scores were observed in both the mindfulness meditation and sham meditation groups. However, no significant effects of group allocation were observed for either primary or secondary measures. Furthermore, mediation analyses testing the indirect effect of group allocation through executive functioning performance did not reveal a significant result and moderation analyses showed that the effect of the intervention did not depend on baseline levels of the key thinking dispositions, actively open-minded thinking and need for cognition. CONCLUSION No evidence was found to suggest that engaging in guided mindfulness practice for 6 weeks using the online intervention method applied in this study improves critical thinking performance. While further research is warranted, claims regarding the benefits of mindfulness practice for critical thinking should be tempered in the meantime. TRIAL REGISTRATION The study was initially registered in the AEA Social Science Registry before the recruitment was initiated (RCT ID: AEARCTR-0000756; 14/11/2015) and retrospectively registered in the ISRCTN registry ( RCT ID: ISRCTN16588423 ) in line with requirements for publishing the study protocol.
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Affiliation(s)
- Chris Noone
- School of Psychology, National University of Ireland Galway, Newcastle Road, Galway, Ireland
| | - Michael J. Hogan
- School of Psychology, National University of Ireland Galway, Newcastle Road, Galway, Ireland
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Minami H, Brinkman HR, Nahvi S, Arnsten JH, Rivera-Mindt M, Wetter DW, Bloom EL, Price LH, Vieira C, Donnelly R, McClain LM, Kennedy KA, D'Aquila E, Fine M, McCarthy DE, Graham Thomas J, Hecht J, Brown RA. Rationale, design and pilot feasibility results of a smartphone-assisted, mindfulness-based intervention for smokers with mood disorders: Project mSMART MIND. Contemp Clin Trials 2018; 66:36-44. [PMID: 29288740 PMCID: PMC5841579 DOI: 10.1016/j.cct.2017.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/22/2017] [Accepted: 12/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although individuals with psychiatric disorders are disproportionately affected by cigarette smoking, few outpatient mental health treatment facilities offer smoking cessation services. In this paper, we describe the development of a smartphone-assisted mindfulness smoking cessation intervention with contingency management (SMI-CM), as well as the design and methods of an ongoing pilot randomized controlled trial (RCT) targeting smokers receiving outpatient psychiatric treatment. We also report the results of an open-label pilot feasibility study. METHODS In phase 1, we developed and pilot-tested SMI-CM, which includes a smartphone intervention app that prompts participants to practice mindfulness, complete ecological momentary assessment (EMA) reports 5 times per day, and submit carbon monoxide (CO) videos twice per day. Participants earned incentives if submitted videos showed CO≤6ppm. In phase 2, smokers receiving outpatient treatment for mood disorders are randomized to receive SMI-CM or enhanced standard treatment plus non-contingent CM (EST). RESULTS The results from the pilot feasibility study (N=8) showed that participants practiced mindfulness an average of 3.4times/day (≥3min), completed 72.3% of prompted EMA reports, and submitted 68.0% of requested CO videos. Participants reported that the program was helpful overall (M=4.85/5) and that daily mindfulness practice was helpful for both managing mood and quitting smoking (Ms=4.50/5). CONCLUSIONS The results from the feasibility study indicated high levels of acceptability and satisfaction with SMI-CM. The ongoing RCT will allow evaluation of the efficacy and mechanisms of action underlying SMI-CM for improving cessation rates among smokers with mood disorders.
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Affiliation(s)
| | | | - Shadi Nahvi
- Albert Einstein College of Medicine, Montefiore Medical Center, United States
| | - Julia H Arnsten
- Albert Einstein College of Medicine, Montefiore Medical Center, United States
| | | | | | - Erika Litvin Bloom
- Rhode Island Hospital, Alpert Medical School of Brown University, United States
| | - Lawrence H Price
- Butler Hospital, Alpert Medical School of Brown University, United States
| | | | | | | | | | | | | | - Danielle E McCarthy
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, United States
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, Alpert Medical School of Brown University, United States
| | - Jacki Hecht
- University of Texas at Austin, United States
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Martin KJ, Golijani-Moghaddam N, dasNair R. Mindfulness self-help interventions for symptoms of depression, anxiety and stress: Review and meta-analysis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.2.82] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Roshan dasNair
- Professor of clinical psychology and neuropsychology, School of Medicine and Institute of Mental Health, University of Nottingham, Nottingham, UK
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Cavanagh K, Churchard A, O'Hanlon P, Mundy T, Votolato P, Jones F, Gu J, Strauss C. A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention in a Non-clinical Population: Replication and Extension. Mindfulness (N Y) 2018; 9:1191-1205. [PMID: 30100934 PMCID: PMC6061247 DOI: 10.1007/s12671-017-0856-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Building on previous research, this study compared the effects of two brief, online mindfulness-based interventions (MBIs; with and without formal meditation practice) and a no intervention control group in a non-clinical sample. One hundred and fifty-five university staff and students were randomly allocated to a 2-week, self-guided, online MBI with or without mindfulness meditation practice, or a wait list control. Measures of mindfulness, perceived stress, perseverative thinking and anxiety/depression symptoms within were administered before and after the intervention period. Intention to treat analysis identified significant differences between groups on change over time for all measured outcomes. Participation in the MBIs was associated with significant improvements in all measured domains (all ps < 0.05), with effect sizes in the small to medium range (0.25 to 0.37, 95% CIs 0.11 to 0.56). No significant changes on these measures were found for the control group. Change in perseverative thinking was found to mediate the relationship between condition and improvement on perceived stress and anxiety/depression symptom outcomes. Contrary to our hypotheses, no differences between the intervention conditions were found. Limitations of the study included reliance on self-report data, a relatively high attrition rate and absence of a longer-term follow-up. This study provides evidence in support of the feasibility and effectiveness of brief, self-guided MBIs in a non-clinical population and suggests that reduced perseverative thinking may be a mechanism of change. Our findings provide preliminary evidence for the effectiveness of a mindfulness psychoeducation condition, without an invitation to formal mindfulness meditation practice. Further research is needed to confirm and better understand these results and to test the potential of such interventions.
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Affiliation(s)
- Kate Cavanagh
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Alasdair Churchard
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Puffin O'Hanlon
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Thomas Mundy
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Phoebe Votolato
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Fergal Jones
- 2Sussex Partnership NHS Foundation Trust, Hove, BN3 7HZ UK.,3School of Psychology, Politics and Sociology, Canterbury Christ Church University, Kent, UK
| | - Jenny Gu
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK
| | - Clara Strauss
- 1School of Psychology, University of Sussex, Falmer, East Sussex BN1 9QH UK.,2Sussex Partnership NHS Foundation Trust, Hove, BN3 7HZ UK
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Lindsay EK, Young S, Smyth JM, Brown KW, Creswell JD. Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology 2018; 87:63-73. [PMID: 29040891 DOI: 10.1016/j.psyneuen.2017.09.015] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Mindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects. METHOD In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor+Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age=32years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test. RESULTS As predicted, Monitor+Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress. CONCLUSIONS This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.
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49
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Upper secondary school students' compliance with two Internet-based self-help programmes: a randomised controlled trial. Eur Child Adolesc Psychiatry 2018; 27:191-200. [PMID: 28776094 PMCID: PMC5842245 DOI: 10.1007/s00787-017-1035-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 11/05/2022]
Abstract
Psychiatric symptoms and stress are on the increase among Swedish adolescents. We aimed to study the potential effect and feasibility of two Internet-based self-help programmes, one mindfulness based (iMBI) and the other music based in a randomised controlled trial that targeted adolescents. A total of 283 upper secondary school students in two Swedish schools were randomised to either a waiting list or one of the two programmes, on their own incentive, on schooltime. General psychiatric health (Symptoms Checklist 90), sleep quality (Pittsburgh Sleep Quality Index), and perceived stress (Perceived Stress Scale) were assessed before and after the interventions. In total, 202 participants answered the questionnaires. Less than 20 logged into each intervention and only 1 performed a full intervention (iMBI). No significant differences in any of the scales were found between those who logged in and those who did not. The potential effect of Internet-based self-help programmes was not possible to examine due to low compliance rates. Adolescents seem to have a very low compliance with Internet-based self-help programmes if left to their own incentive. There were no associations between the psychiatric and stress-related symptoms at baseline and compliance in any of the intervention groups, and no evidence for differences in compliance in relation to the type of programme. Additional studies are needed to examine how compliance rates can be increased in Internet-based self-help mindfulness programmes in adolescents, as the potentially positive effects of mindfulness are partly related to compliance rates.
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50
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Stratton E, Lampit A, Choi I, Calvo RA, Harvey SB, Glozier N. Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. PLoS One 2017; 12:e0189904. [PMID: 29267334 PMCID: PMC5739441 DOI: 10.1371/journal.pone.0189904] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2017] [Indexed: 02/03/2023] Open
Abstract
Background Many organisations promote eHealth applications as a feasible, low-cost method of addressing mental ill-health and stress amongst their employees. However, there are good reasons why the efficacy identified in clinical or other samples may not generalize to employees, and many Apps are being developed specifically for this group. The aim of this paper is to conduct the first comprehensive systematic review and meta-analysis evaluating the evidence for the effectiveness and examine the relative efficacy of different types of eHealth interventions for employees. Methods Systematic searches were conducted for relevant articles published from 1975 until November 17, 2016, of trials of eHealth mental health interventions (App or web-based) focused on the mental health of employees. The quality and bias of all identified studies was assessed. We extracted means and standard deviations from published reports, comparing the difference in effect sizes (Hedge’s g) in standardized mental health outcomes. We meta-analysed these using a random effects model, stratified by length of follow up, intervention type, and whether the intervention was universal (unselected) or targeted to selected groups e.g. “stressed”. Results 23 controlled trials of eHealth interventions were identified which overall suggested a small positive effect at both post intervention (g = 0.24, 95% CI 0.13 to 0.35) and follow up (g = 0.23, 95% CI 0.03 to 0.42). There were differential short term effects seen between the intervention types whereby Mindfulness based interventions (g = 0.60, 95% CI 0.34 to 0.85, n = 6) showed larger effects than the Cognitive Behaviour Therapy (CBT) based (g = 0.15, 95% CI 0.02 to 0.29, n = 11) and Stress Management based (g = 0.17, 95%CI -0.01 to 0.34, n = 6) interventions. The Stress Management interventions however differed by whether delivered to universal or targeted groups with a moderately large effect size at both post-intervention (g = 0.64, 95% CI 0.54 to 0.85) and follow-up (g = 0.69, 95% CI 0.06 to 1.33) in targeted groups, but no effect in unselected groups. Interpretation There is reasonable evidence that eHealth interventions delivered to employees may reduce mental health and stress symptoms post intervention and still have a benefit, although reduced at follow-up. Despite the enthusiasm in the corporate world for such approaches, employers and other organisations should be aware not all such interventions are equal, many lack evidence, and achieving the best outcomes depends upon providing the right type of intervention to the correct population.
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Affiliation(s)
- Elizabeth Stratton
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | - Amit Lampit
- School of Psychiatry, University of Sydney, Sydney, Australia
| | - Isabella Choi
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Rafael A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Samuel B. Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St George Hospital, Sydney, Australia
| | - Nicholas Glozier
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
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