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Zhang M, Fan C, Ma L, Wang H, Zu Z, Yang L, Chen F, Wei W, Li X. Assessing the effectiveness of internet-based interventions for mental health outcomes: an umbrella review. Gen Psychiatr 2024; 37:e101355. [PMID: 39040128 PMCID: PMC11261690 DOI: 10.1136/gpsych-2023-101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 06/13/2024] [Indexed: 07/24/2024] Open
Abstract
Internet-based interventions (IBIs) for behavioural health have been prevalent for over two decades, and a growing proportion of individuals with mental health concerns prefer these emerging digital alternatives. However, the effectiveness and acceptability of IBIs for various mental health disorders continue to be subject to scholarly debate. We performed an umbrella review of meta-analyses (MAs), conducting literature searches in PubMed, Web of Science, Embase, Cochrane and Ovid Medline from their inception to 17 January 2023. A total of 87 MAs, reporting on 1683 randomised controlled trials and 295 589 patients, were included. The results indicated that IBIs had a moderate effect on anxiety disorder (standardised mean difference (SMD)=0.53, 95% CI 0.44 to 0.62) and post-traumatic stress disorder (PTSD) (SMD=0.63, 95% CI 0.38 to 0.89). In contrast, the efficacy on depression (SMD=0.45, 95% CI 0.39 to 0.52), addiction (SMD=0.23, 95% CI 0.16 to 0.31), suicidal ideation (SMD=0.23, 95% CI 0.16 to 0.30), stress (SMD=0.41, 95% CI 0.33 to 0.48) and obsessive-compulsive disorder (SMD=0.47, 95% CI 0.22 to 0.73) was relatively small. However, no significant effects were observed for personality disorders (SMD=0.07, 95% CI -0.13 to 0.26). Our findings suggest a significant association between IBIs and improved mental health outcomes, with particular effectiveness noted in treating anxiety disorders and PTSD. However, it is noteworthy that the effectiveness of IBIs was impacted by high dropout rates during treatment. Furthermore, our results indicated that guided IBIs proved to be more effective than unguided ones, playing a positive role in reducing dropout rates and enhancing patient adherence rates. PROSPERO registration number: CRD42023417366.
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Affiliation(s)
- Mi Zhang
- Research Centre for Translational Medicine, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Chuan Fan
- Department of Psychiatry, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lijun Ma
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Huixue Wang
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Zhenyue Zu
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Linxi Yang
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Fenglan Chen
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Wenzhuo Wei
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Xiaoming Li
- Research Centre for Translational Medicine, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
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Alexander S, Vue Z, Sevel L, Vang C, Neikirk K, Hinton A, Oliver KH. How to design a broad mindfulness program: One approach to introducing mindfulness to a STEM community within a university setting. J Cell Physiol 2024; 239:e31252. [PMID: 38606793 PMCID: PMC11323128 DOI: 10.1002/jcp.31252] [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: 01/12/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/13/2024]
Abstract
Mindfulness has become popular in recent decades as a tool for psychological well-being. However, mindfulness has yet to find a solid footing as a routine practice within the Science, Technology, Engineering, and Mathematics (STEM) field. Here, we discuss the design of an introductory mindfulness program that provides the STEM community with a broad overview of various mindfulness methods. We also discuss delivery implementation methods and other considerations when designing mindfulness programming. This article provides resources for those interested in incorporating mindfulness into the STEM field, especially within the university setting.
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Affiliation(s)
| | - Zer Vue
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Landrew Sevel
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chia Vang
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Kit Neikirk
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | - Kendra H Oliver
- Department of Pharmacology, Basic Sciences School of Medicine, Vanderbilt University, Nashville, Tennessee, USA
- ArtLab Studio LLC, Pittsburgh, Pennsylvania, USA
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Godara M, Singer T. 10-Week Trajectories of Candidate Psychological Processes Differentially Predict Mental Health Gains from Online Dyadic versus Mindfulness Interventions: A Randomized Clinical Trial. J Clin Med 2024; 13:3295. [PMID: 38893006 PMCID: PMC11172466 DOI: 10.3390/jcm13113295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Background: App-based contemplative interventions, such as mindfulness-based interventions, have gained popularity for the promotion of mental health; however, the understanding of underlying intervention-specific mechanisms remains limited, especially related to novel inter-relational dyadic practices. Methods: We tested (n = 253) seven putative mechanisms underlying two brief (daily 12-min) online mental interventions: attention-focused mindfulness and socio-emotional partner-based, both supported by weekly online coaching. Weekly self-reports of rumination, worry, psychological flexibility, affective control, social support, acceptance, and mindfulness were obtained over 10 weeks of intervention, and depression, anxiety, and resilience were assessed as pre- and post-intervention outcomes. Results: Significant week-to-week reductions in rumination and increases in psychological flexibility were observed in both interventions. Only attention-based practice led to temporal reductions in worry, and only socio-emotional dyadic practice led to temporal increases in affective control. Mediation analyses with slopes of weekly variables as mediators detected no significant indirect effects. However, exploratory moderation analyses revealed that intervention-related reductions in depressive symptomatology and anxiety vulnerability and increases in resilience were predicted by weekly increases in acceptance and affective control in the socio-emotional dyadic group, and by weekly reductions in rumination and worry in the mindfulness group. Limitations of the study include reliance on brief self-report measures, relatively small sample size, and absence of long-term follow-up assessments indicating the need for future well-powered longitudinal studies comparing intervention modalities. Conclusions: We present preliminary evidence for practice-specific active ingredients of contemplative interventions, which can be leveraged to enhance their efficiency for mental health.
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Affiliation(s)
- Malvika Godara
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany;
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Edwards C, Gibbs V, Love AMA, Brown L, Cai RY. A qualitative exploration of an autism-specific self-compassion program: The ASPAA. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1419-1430. [PMID: 38383994 PMCID: PMC11134985 DOI: 10.1177/13623613241234097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
LAY ABSTRACT Autistic people often struggle to find the right support for their mental health. We wanted to change that by trying a new approach to help autistic adults with their emotions and well-being. We focused on something called "self-compassion," which is a way of being kind and understanding toward ourselves. This approach has worked well for many people, but we didn't know if it would work for autistic individuals. We invited 39 autistic adults to join an online program that taught them about self-compassion. The program lasted 5 weeks and included educational materials, meditation exercises, and self-reflection activities. We asked the participants for feedback each week and at the end of the program. From their responses, we discovered four important things. First, self-compassion had a big positive impact on the well-being of autistic adults. Second, they faced some challenges during the program. Third, they saw self-compassion as a journey that takes time and practice. Finally, they described how they valued changes to help autistic people engage with the program. Our findings show that self-compassion can really help autistic adults. We learned about the benefits they experienced and the difficulties they faced. Most importantly, we found that personalized support is crucial for autistic individuals. By creating programs that consider their specific needs, we can improve their mental health and make their lives better.
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Affiliation(s)
- Chris Edwards
- Autism Spectrum Australia, Australia
- Griffith University, Australia
| | - Vicki Gibbs
- Autism Spectrum Australia, Australia
- University of Sydney, Australia
| | | | - Lydia Brown
- University of Melbourne, Australia
- North Eastern Rehabilitation Centre, Australia
- La Trobe University, Bundoora, Australia
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Figura HM, Saha FJ, Seibt S, Haller H, Bringmann HC, Kessler CS, Kugler J, Cramer H, Michalsen A, Kandil FI, Jeitler M. Effects of an Online Meditation Course on Quality of Life and Positive Emotions: A Prospective Observational Study (EXPANSION Study). JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:518-531. [PMID: 38011030 DOI: 10.1089/jicm.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: Several meditation interventions showed positive effects on physical and mental health. The aim of this study is a first evaluation of the (within-group) effects of a 21-day online meditation course of the "expansion method." Methods: For this exploratory observational study, parameters were assessed at baseline, at 1 month, and at a 3-month follow-up. Exploratory endpoints were health-related quality of life (PROMIS Preference Score), global health (PROMIS) with the subscales physical and mental health, stress perception (Perceived Stress Scale), positive and negative affect regulation (Positive and Negative Affect Schedule), flourishing (Flourishing Scale), self-efficacy (Short Scale for Measuring General Self-Efficacy Beliefs), gratitude and awe (Gratitude and Awe Questionnaire), resilience (Connor-Davidson Resilience Scale), spirituality (Aspects of Spirituality), and mysticism (Mysticism Scale) on validated inventories. In addition, self-constructed questions (NRS) assessed health status, lifestyle, and concept evaluation. Results: Data from 359 participants were included in this study (response rate: 68% at 1 month, 46% at 3 months). The main analysis was based on the complete cases at 1 month (n = 244 participants; 84% female; 51 ± 11 years; 89% German). Medium effect sizes were found for mental health (p < 0.0001; d = 0.6), flourishing (p < 0.0001; d = 0.63), and negative affect (p < 0.0001; d = 0.68) at 1 month. Small effect sizes were obtained for physical health, stress, positive affect, self-efficacy, spirituality, and mysticism at 3 months. In a sensitivity analysis, the strongest effects at 1 month were found in the subgroup that completed per-protocol (n = 140), followed by those with complete data at all time points (n = 159). Effects were lowest in the intention-to-treat analysis (n = 359). The content of the course was positively evaluated by the participants. Conclusions: The online meditation course based on the expansion method had potentially beneficial effects, especially on mental health parameters. Based on the feasibility results, further research using randomized controlled designs is warranted. Clinical Trial Registration: NCT04950543.
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Affiliation(s)
- Hannah Maja Figura
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Felix Joyonto Saha
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Sonja Seibt
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - Heidemarie Haller
- Center for Integrative Medicine and Planetary Health, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Holger C Bringmann
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian S Kessler
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Joachim Kugler
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
| | - Holger Cramer
- Institute for General Practice and Interprofessional Care, Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
- Bosch Health Campus, Stuttgart, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Farid I Kandil
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, and Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
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Baminiwatta A, Fernando R, Solangaarachchi I, Abayabandara-Herath T, Wickremasinghe AR, Hapangama A. Improving psychological well-being among healthcare workers during the COVID-19 pandemic with an online mindfulness intervention: A randomised waitlist-controlled trial. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024; 59:410-418. [PMID: 38355927 DOI: 10.1002/ijop.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 01/06/2024] [Indexed: 02/16/2024]
Abstract
The high prevalence of psychological problems observed among healthcare workers (HCWs) during the COVID-19 pandemic called for interventions to safeguard their mental health. We assessed the effectiveness of a 6-week online mindfulness-based intervention in improving well-being and reducing stress among HCWs in Sri Lanka. Eighty HCWs were recruited and randomised into two groups: waitlist-control (WLC) and intervention groups. In the intervention, 1-hour online sessions were conducted at weekly intervals and participants were encouraged to do daily home practice. Stress and well-being were measured pre- and post-intervention using the Perceived Stress Scale and WHO-5 Well-being Index, respectively. One-way analysis of covariance was used to evaluate the effectiveness, in both intention-to-treat (ITT) and complete-case (CC) analyses. A significantly greater improvement in well-being occurred in the intervention arm compared to WLC on both ITT (p = .002) and CC analyses (p < .001), with medium-to-large effect sizes (partial η2 = .117-.278). However, the reduction in stress following the intervention was not significant compared to the WLC group on both ITT (p = .636) and CC analyses (p = .262). In the intervention arm, the median number of sessions attended by participants was 3. Low adherence to the intervention may have contributed to the apparent non-significant effect on stress.
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Affiliation(s)
- Anuradha Baminiwatta
- Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Roshan Fernando
- Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | | | | | | | - Aruni Hapangama
- Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Schillings C, Meißner E, Erb B, Bendig E, Schultchen D, Pollatos O. Effects of a Chatbot-Based Intervention on Stress and Health-Related Parameters in a Stressed Sample: Randomized Controlled Trial. JMIR Ment Health 2024; 11:e50454. [PMID: 38805259 PMCID: PMC11167325 DOI: 10.2196/50454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 02/09/2024] [Accepted: 03/26/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Stress levels and the prevalence of mental disorders in the general population have been rising in recent years. Chatbot-based interventions represent novel and promising digital approaches to improve health-related parameters. However, there is a lack of research on chatbot-based interventions in the area of mental health. OBJECTIVE The aim of this study was to investigate the effects of a 3-week chatbot-based intervention guided by the chatbot ELME, specifically with respect to the ability to reduce stress and improve various health-related parameters in a stressed sample. METHODS In this multicenter two-armed randomized controlled trial, 118 individuals with medium to high stress levels were randomized to the intervention group (n=59) or the treatment-as-usual control group (n=59). The ELME chatbot guided participants of the intervention group through 3 weeks of training based on the topics stress, mindfulness, and interoception, with practical and psychoeducative elements delivered in two daily interactive intervention sessions via a smartphone (approximately 10-20 minutes each). The primary outcome (perceived stress) and secondary outcomes (mindfulness; interoception or interoceptive sensibility; subjective well-being; and emotion regulation, including the subfacets reappraisal and suppression) were assessed preintervention (T1), post intervention (T2; after 3 weeks), and at follow-up (T3; after 6 weeks). During both conditions, participants also underwent ecological momentary assessments of stress and interoceptive sensibility. RESULTS There were no significant changes in perceived stress (β03=-.018, SE=.329; P=.96) and momentary stress. Mindfulness and the subfacet reappraisal significantly increased in the intervention group over time, whereas there was no change in the subfacet suppression. Well-being and momentary interoceptive sensibility increased in both groups over time. CONCLUSIONS To gain insight into how the intervention can be improved to achieve its full potential for stress reduction, besides a longer intervention duration, specific sample subgroups should be considered. The chatbot-based intervention seems to have the potential to improve mindfulness and emotion regulation in a stressed sample. Future chatbot-based studies and interventions in health care should be designed based on the latest findings on the efficacy of rule-based and artificial intelligence-based chatbots. TRIAL REGISTRATION German Clinical Trials Register DRKS00027560; https://drks.de/search/en/trial/DRKS00027560. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-doi.org/10.3389/fdgth.2023.1046202.
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Affiliation(s)
- Christine Schillings
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Echo Meißner
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Benjamin Erb
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Eileen Bendig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Godara M, Singer T. Resilient Stress Reactivity Profiles Predict Mental Health Gains from Online Contemplative Training: A Randomized Clinical Trial. J Pers Med 2024; 14:493. [PMID: 38793075 PMCID: PMC11121773 DOI: 10.3390/jpm14050493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024] Open
Abstract
Low-dose app-based contemplative interventions for mental health are increasingly popular, but heterogeneity in intervention responses indicates that a personalized approach is needed. We examined whether different longitudinal resilience-vulnerability trajectories, derived over the course of the COVID-19 pandemic, predicted differences in diverse mental health outcomes after mindfulness and socio-emotional dyadic online interventions. The CovSocial project comprised a longitudinal assessment (phase 1) and an open-label efficacy trial (phase 2). A community sample of 253 participants received 12 min daily app-based socio-emotional dyadic or mindfulness-based interventions, with weekly online coaching for 10 weeks. Before and after the intervention, participants completed validated self-report questionnaires assessing mental health. Stress reactivity profiles were derived from seven repeated assessments during the COVID-19 pandemic (January 2020 to March/April 2021) and were categorized into resilient (more plasticity) or vulnerable (less plasticity) stress recovery profiles. After both interventions, only individuals with resilient stress reactivity profiles showed significant improvements in depression symptomatology, trait anxiety, emotion regulation, and stress recovery. Those with vulnerable profiles did not show significant improvements in any outcome. Limitations of this study include the relatively small sample size and potential biases associated with participant dropout. Brief app-based mental interventions may be more beneficial for those with greater levels of stress resiliency and plasticity in response to stressors. More vulnerable individuals might require more intense and personalized intervention formats.
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Affiliation(s)
- Malvika Godara
- Social Neuroscience Lab, Max Planck Society, 10557 Berlin, Germany;
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Mak WWS, Tong ACY, Fu ACM, Leung IWY, Jung OHC, Watkins ER, Lui WWS. Efficacy of Internet-based rumination-focused cognitive behavioral therapy and mindfulness-based intervention with guided support in reducing risks of depression and anxiety: A randomized controlled trial. Appl Psychol Health Well Being 2024; 16:696-722. [PMID: 38073271 DOI: 10.1111/aphw.12512] [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: 08/09/2023] [Accepted: 11/06/2023] [Indexed: 05/02/2024]
Abstract
Rumination and worry are common risk factors of depression and anxiety. Internet-based transdiagnostic interventions targeting individuals with these specific risks may be an effective way to prevent depression and anxiety. This three-arm randomized controlled trial compared the efficacy of Internet-based rumination-focused cognitive behavioral therapy (RFCBT), mindfulness-based intervention (MBI), and psychoeducation (EDU) control among 256 at-risk individuals. Participants' levels of rumination, worry, depressive, and anxiety symptoms were assessed at post-intervention (6 weeks), 3-month, and 9-month follow-ups. Linear mixed model analysis results showed similar levels of improvement in all outcomes across the three conditions. Changes in rumination differed comparing RFCBT and MBI, where a significant reduction in rumination was noted at a 3-month follow-up among participants in RFCBT, and no significant long-term effect among participants in MBI was noted at a 9-month follow-up. All three conditions showed similar reductions in risks and symptoms, implying that the two active interventions were not superior to EDU control. The high attrition at follow-ups suggested a need to exercise caution when interpreting the findings. Future studies should tease apart placebo effect and identify ways to improve adherence.
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Affiliation(s)
- Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Alan C Y Tong
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Amanda C M Fu
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ivy W Y Leung
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Olivia H C Jung
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Wacy W S Lui
- Center for Personal Growth and Crisis Intervention of the Corporate Clinical Psychology Services, Hospital Authority, Ma Tau Wai, Hong Kong
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Stecher C, Cloonan S, Domino ME. The Economics of Treatment for Depression. Annu Rev Public Health 2024; 45:527-551. [PMID: 38100648 DOI: 10.1146/annurev-publhealth-061022-040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12-17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments' relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.
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Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
| | - Sara Cloonan
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Marisa Elena Domino
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
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Christopher M, Bowen S, Witkiewitz K, Grupe D, Goerling R, Hunsinger M, Oken B, Korecki T, Rosenbaum N. A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers. BMC Complement Med Ther 2024; 24:142. [PMID: 38575888 PMCID: PMC10993469 DOI: 10.1186/s12906-024-04452-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: 08/26/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs. METHODS This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes. RESULTS We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures. CONCLUSIONS Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve. TRIAL REGISTRATION ClinicalTrials.gov, NCT03784846 . Registered on December 24th, 2018.
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Affiliation(s)
- Michael Christopher
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA.
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr, Albuquerque, NM, 87106, USA
| | - Daniel Grupe
- Center for Healthy Minds, University of Wisconsin Madison, 625 West Washington Ave, Madison, WI, 53703, USA
| | - Richard Goerling
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Matthew Hunsinger
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Barry Oken
- Department of Neurology, Oregon Center for Complementary and Alternative Medicine in Neurological Disorders, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Tyrus Korecki
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA
| | - Nils Rosenbaum
- Behavioral Sciences Department, Albuquerque Police Department, 400 Rome, NW, Albuquerque, NM, 87102, USA
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12
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Young DKW, Carlbring P, Cheng DYT, Ng SM, Ng PYN, Chen JQR. Guided Online Mindfulness-Based Intervention for Community Residents with Emotional Distress during the COVID-19 Pandemic. SOCIAL WORK 2024; 69:158-166. [PMID: 38364292 DOI: 10.1093/sw/swae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/15/2023] [Accepted: 08/01/2023] [Indexed: 02/18/2024]
Abstract
This study aimed to assess the efficacy of a guided online mindfulness-based intervention (iMBI) for community residents experiencing emotional distress during the COVID-19 pandemic in Hong Kong. In a randomized controlled trial, 64 participants were recruited from collaborating community-based mental health service units in Hong Kong and assigned to either the treatment (n = 32) or control (n = 32) groups. The treatment group received a guided iMBI consisting of 16 online modules, weekly telephone counseling, and two half-day online workshops on mindfulness practice. In contrast, the waitlist control group did not receive any intervention during the initial stage. Using a 2 (two groups) × time (pre versus post) repeated measures linear mixed model and one-way analysis of variance, authors demonstrated that the treatment group experienced a significantly larger reduction in anxiety and depressive symptoms with a large effect size compared with the control group. Additionally, the treatment group showed a significantly greater improvement in mindfulness with a moderate effect size. The findings support the effectiveness of guided iMBI for community residents experiencing emotional distress during the COVID-19 pandemic in Hong Kong.
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Affiliation(s)
- Daniel Kim-Wan Young
- PhD, is associate professor, Department of Social and Behavioural Sciences, City University of Hong Kong, Room 5618, Li Dak Sum Yip Yio Chin Academic Building, Kowloon Tong, Hong Kong
| | - Per Carlbring
- PhD, is professor, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Daphne Yi-Ting Cheng
- PhD, is postdoctoral research fellow, Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Siu-Man Ng
- PhD, is professor, Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong
| | - Petrus Yat-Nam Ng
- PhD, is associate department head and professor, Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Joseph Qi-Rong Chen
- MSocSc, is a PhD student, Department of Social Work, Hong Kong Baptist University, Hong Kong
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13
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dos Santos TM, Balsanelli AP, de Souza KMJ. Randomized crossover clinical trial of a Mindfulness-based intervention for nurse leaders: A pilot study. Rev Lat Am Enfermagem 2024; 32:e4101. [PMID: 38511731 PMCID: PMC10949850 DOI: 10.1590/1518-8345.6548.4101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/07/2023] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE to analyze the effects of a Mindfulness-based intervention on nurse leaders' emotional intelligence and resilience. METHOD a pilot study of a randomized crossover clinical trial. The sample (n=32) was randomized into Group A (n=18) and Group B (n=14) and evaluated at the pre-test, post-test and follow-up moments. The outcomes were assessed using the Emotional Intelligence Measure, the Connor-Davidson Resilience Questionnaire and the Five Facet Mindfulness Questionnaire, and analyzed using Generalized Linear Mixed Models. RESULTS a total of 32 nurses with a mean age of 42.6 years old were evaluated. The analyses showed significant interactions between the effects of the group x moment factors on the Self-motivation (p=0.005), Sociability (p<0.001), Self-control (p=0.013), and Total (p=0.002) emotional intelligence skill scores; as well as on the Observe (p=0.042), Describe (p=0.008), Non-judgment (p<0.001), Act with awareness (p=0.004) and Total (p<0.001) mindfulness facets. Post-test: there was a statistically significant increase in the Sociability (p=0.009) and Self-control (p=0.015) emotional intelligence skills; as well as in the Non-judgment (p=0.022) and Total (p=0.002) mindfulness facets. Follow-up: a significant increase was observed in the Non-judgment (p=0.024) and Total (p=0.026) mindfulness facets. The "resilience" variable did not present statistical significance in the "group x moment" factor, both in the post-test and during follow-up. CONCLUSION the Mindfulness-based intervention used proved to be effective in increasing nurse leaders' emotional intelligence and dispositional mindfulness skills. Brazilian Registry of Clinical Trials (RBR-3c62gy), registered on March 4 th , 2020, updated on September 16 th , 2022. BACKGROUND (1) Unpublished study of a Mindfulness-based intervention with nurse leaders. BACKGROUND (2) Positive effect on the participants' emotional intelligence and mindfulness. BACKGROUND (3) Advances in knowledge about emotional intelligence and leadership resilience. BACKGROUND (4) It encourages the implementation of sensitive and innovative health strategies.
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Affiliation(s)
- Teresa Maria dos Santos
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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14
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Galluzzi S, Lanfredi M, Moretti DV, Rossi R, Meloni S, Tomasoni E, Frisoni GB, Chiesa A, Pievani M. Cognitive, psychological, and physiological effects of a web-based mindfulness intervention in older adults during the COVID-19 pandemic: an open study. BMC Geriatr 2024; 24:151. [PMID: 38350854 PMCID: PMC10865647 DOI: 10.1186/s12877-024-04766-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/31/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The development of effective strategies to maintain good mental health of older adults is a public health priority. Mindfulness-based interventions have the potential to improve psychological well-being and cognitive functions of older adults, but little is known about the effect of such interventions when delivered through internet. During the COVID-19 pandemic we evaluated short- and long-term cognitive, psychological, and physiological effects of a mindfulness-based intervention (MBI) delivered via web-based videoconference in healthy older adults. METHODS Fifty older adults participated in an 8-week MBI, which comprised structured 2-h weekly group sessions. A comprehensive evaluation encompassing cognitive (verbal memory, attention and processing speed, executive functions) and psychological assessments (depression and anxiety symptoms, mindfulness, worries, emotion regulation strategies, well-being, interoceptive awareness and sleep) was conducted. Additionally, electroencephalography (EEG) data were recorded before and after the MBI and at the 6-month follow-up (T6). Data were analyzed using an intention-to-treat approach, using linear mixed models adjusted for age. The effect size for time was computed as omega squared. RESULTS We observed significant improvements from pre-MBI to post-MBI and at the T6 across several measures. These improvements were notable in the areas of verbal memory (California Verbal Learning Test, p ≤ .007), attention and executive functions (Trail Making Test A and BA, p < .050), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness, p = .0002 for self-regulation and p < .05 for noticing, body listening, and trusting dimensions), and rumination (Heidelberg Form for Emotion Regulation Strategies, p = .018). These changes were associated with low to medium effect size. Moreover, we observed significant changes in EEG patterns, with a decrease in alpha1 (p = .004) and an increase in alpha2 (p < .0001) from pre-MBI to T6. Notably, improvements in TMTBA and rumination were correlated with the decrease in alpha1 (p < .050), while improvements in TMTA were linked to the increase in alpha2 (p = .025). CONCLUSIONS The results of our study show that a web-based MBI in older adults leads to improvements in cognitive and psychological measures, with associated modulations in specific brain rhythms. While these findings are promising, further controlled studies are required to validate these preliminary results. TRIAL REGISTRATION The trial has been registered with the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT05941143 on July 12, 2023.
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Affiliation(s)
- Samantha Galluzzi
- Laboratory Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy.
| | - Davide Vito Moretti
- Alzheimer's Rehabilitation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Evita Tomasoni
- Laboratory Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | | | - Alberto Chiesa
- Istituto Mente E Corpo, Bologna, Italy
- Associazione Di Psicologia Cognitiva - Scuola Di Psicoterapia Cognitiva, Rome, Italy
| | - Michela Pievani
- Laboratory Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
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15
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Sangameswaran S, Laine M, Reid N, Xie SJ, Zampino L, Garrison MM, Rosenberg DE, Yip JC, Hartzler AL. Co-designing mind-body technologies for sleep with adolescents. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:1257-1266. [PMID: 38222402 PMCID: PMC10785901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Sleep is critical for well-being, yet adolescents do not get enough sleep. Mind-body approaches can help. Despite the potential of technology to support mind-body approaches for sleep, there is a lack of research on adolescent preferences for digital mind-body technology. We use co-design to examine adolescent perspectives on mind-body technologies for sleep. From our analysis of design sessions with 16 adolescents, four major themes emerged: system behavior, modality, content, and context. In light of these key findings, we recommend that technology-based mind-body approaches to sleep for adolescents be designed to 1) serve multiple functions while avoiding distractions, 2) provide intelligent content while maintaining privacy and trust, 3) provide a variety of content with the ability to customize and personalize, 4) offer multiple modalities for interaction with technology, and 5) consider the context of adolescent and their families. Findings provide a foundation for designing mind-body technologies for adolescent sleep.
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Affiliation(s)
| | | | - Nick Reid
- University of Washington, Seattle, WA
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16
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Juarez-Reyes M, Martinez E, Xiao L, Goldman Rosas L. A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241274240. [PMID: 39157776 PMCID: PMC11329901 DOI: 10.1177/27536130241274240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/05/2024] [Accepted: 07/29/2024] [Indexed: 08/20/2024]
Abstract
Background/Objective Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes. Method Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention). Results All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (-3.6 (CI -6.9, -0.2), P = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep. Conclusion This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer. Trial Registration ClinicalTrials.gov ID# NCT04834154.
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Affiliation(s)
- Maria Juarez-Reyes
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Portola Valley, CA, USA
| | - Erica Martinez
- Program in Medical Education for the Latino Community (PRIME-LC), School of Medicine, University of California, Irvine, CA, USA
| | - Lan Xiao
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Lisa Goldman Rosas
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
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Johnson E, Corrick S, Isley S, Vandermeer B, Dolgoy N, Bates J, Godfrey E, Soltys C, Muir C, Vohra S, Tandon P. Mind-body internet and mobile-based interventions for depression and anxiety in adults with chronic physical conditions: A systematic review of RCTs. PLOS DIGITAL HEALTH 2024; 3:e0000435. [PMID: 38261600 PMCID: PMC10805319 DOI: 10.1371/journal.pdig.0000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
This review summarizes the effectiveness of scalable mind-body internet and mobile-based interventions (IMIs) on depression and anxiety symptoms in adults living with chronic physical conditions. Six databases (MEDLINE, PsycINFO, SCOPUS, EMBASE, CINAHL, and CENTRAL) were searched for randomized controlled trials published from database inception to March 2023. Mind-body IMIs included cognitive behavioral therapy, breathwork, meditation, mindfulness, yoga or Tai-chi. To focus on interventions with a greater potential for scale, the intervention delivery needed to be online with no or limited facilitation by study personnel. The primary outcome was mean change scores for anxiety and depression (Hedges' g). In subgroup analyses, random-effects models were used to calculate pooled effect size estimates based on personnel support level, intervention techniques, chronic physical condition, and survey type. Meta-regression was conducted on age and intervention length. Fifty-six studies met inclusion criteria (sample size 7691, mean age of participants 43 years, 58% female): 30% (n = 17) neurological conditions, 12% (n = 7) cardiovascular conditions, 11% cancer (n = 6), 43% other chronic physical conditions (n = 24), and 4% (n = 2) multiple chronic conditions. Mind-body IMIs demonstrated statistically significant pooled reductions in depression (SMD = -0.33 [-0.40, -0.26], p<0.001) and anxiety (SMD = -0.26 [-0.36, -0.17], p<0.001). Heterogeneity was moderate. Scalable mind-body IMIs hold promise as interventions for managing anxiety and depression symptoms in adults with chronic physical conditions without differences seen with age or intervention length. While modest, the effect sizes are comparable to those seen with pharmacological therapy. The field would benefit from detailed reporting of participant demographics including those related to technological proficiency, as well as further evaluation of non-CBT interventions. Registration: The study is registered with PROSPERO ID #CRD42022375606.
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Affiliation(s)
- Emily Johnson
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
| | - Shaina Corrick
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
| | - Serena Isley
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
| | - Ben Vandermeer
- Department of Medicine, University of Alberta, Edmonton, Alberta
| | - Naomi Dolgoy
- Faculty of Rehabilitation Science, Edmonton, Alberta
| | - Jack Bates
- Faculty of Science, University of Alberta, Edmonton, Alberta
| | - Elana Godfrey
- Faculty of Science, University of Toronto, Toronto, Ontario
| | - Cassidy Soltys
- Faculty of Science, University of Alberta, Edmonton, Alberta
| | - Conall Muir
- Faculty of Science, University of Alberta, Edmonton, Alberta
| | - Sunita Vohra
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Puneeta Tandon
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta
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18
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Young DKW, Carlbring P, Ng PYN, Cheng DYT, Chen JQR, Ng SM. Low-intensity online mindfulness-based intervention for university students with anxiety during the COVID-19 pandemic-A randomized controlled trial with 3-month follow-up. Internet Interv 2023; 34:100665. [PMID: 37840645 PMCID: PMC10569980 DOI: 10.1016/j.invent.2023.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/21/2023] [Accepted: 09/07/2023] [Indexed: 10/17/2023] Open
Abstract
Objective This study investigated the effectiveness of a low-intensity online mindfulness-based Intervention (iMBI) for alleviating anxiety in university students during the COVID-19 pandemic. Methods In a randomized controlled trial involving 134 participants from a local university in Hong Kong, subjects were randomly assigned to either the intervention group (n = 67) or the inactive control group (n = 67). The intervention group participated in a low-intensity iMBI comprising 16 online modules and two half-day online mindfulness workshops over an eight-week period. Outcomes were measured via an online platform using standardized assessment scales, including the Beck Anxiety Inventory and the Chinese Five Facets Mindfulness Questionnaire, at three different time points: pre-intervention, post-intervention and at a three-month follow-up. Results Intent-to-treat analysis using 2 (group) × 3 (time) repeated measures of covariance (ANCOVA) showed that the intervention group, compared to the control group, showed a significant reduction in anxiety symptoms with a medium effect size (Cohen's d = 0.5) and a significant improvement in mindfulness skills with a medium effect size (Cohen's d = 0.5) at post-intervention. The effects of the intervention in reducing anxiety and improving mindfulness persisted at the three-month follow-up. Conclusion The results of this study demonstrate the effectiveness of the low-intensity iMBI in alleviating anxiety among university students.
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Affiliation(s)
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | | | | | - Siu-man Ng
- Department of Social Work & Social Administration, University of Hong Kong, Hong Kong
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19
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Holas P, Kamińska J. Mindfulness meditation and psychedelics: potential synergies and commonalities. Pharmacol Rep 2023; 75:1398-1409. [PMID: 37926796 PMCID: PMC10661803 DOI: 10.1007/s43440-023-00551-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
There has been increasing scientific and clinical interest in studying psychedelic and meditation-based interventions in recent years, both in the context of improving mental health and as tools for understanding the mind. Several authors suggest neurophysiological and phenomenological parallels and overlaps between psychedelic and meditative states and suggest synergistic effects of both methods. Both psychedelic-assisted therapy and meditation training in the form of mindfulness-based interventions have been experimentally validated with moderate to large effects as alternative treatments for a variety of mental health problems, including depression, addictions, and anxiety disorders. Both demonstrated significant post-acute and long-term decreases in clinical symptoms and enhancements in well-being in healthy participants, in addition. Postulated shared salutogenic mechanisms, include, among others the ability to alter self-consciousness, present-moment awareness and antidepressant action via corresponding neuromodulatory effects. These shared mechanisms between mindfulness training and psychedelic intervention have led to scientists theorizing, and recently demonstrating, positive synergistic effects when both are used in combination. Research findings suggest that these two approaches can complement each other, enhancing the positive effects of both interventions. However, more theoretical accounts and methodologically sound research are needed before they can be extended into clinical practice. The current review aims to discuss the theoretical rationale of combining psychedelics with mindfulness training, including the predictive coding framework as well as research findings regarding synergies and commonalities between mindfulness training and psychedelic intervention. In addition, suggestions how to combine the two modalities are provided.
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Affiliation(s)
- Paweł Holas
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
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20
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Hurwitz C, Shiner CT, Sharrock MJ, Millard M, Mahoney A. Mindfulness-enhanced internet-based cognitive behavioural therapy for anxiety and depression: Outcomes in routine care. J Affect Disord 2023; 341:1-7. [PMID: 37625704 DOI: 10.1016/j.jad.2023.08.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/02/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Clinical trials support the efficacy of mindfulness-enhanced, internet-based cognitive behavioural therapies (CBT) in reducing anxiety and depression symptom severity. However, it is unclear how effective these interventions are when delivered in routine clinical care settings. This study investigated the utilisation and treatment outcomes of an online mindfulness-enhanced CBT program in the general Australian community. METHODS Over a one-year study period, 2187 adults commenced the online mindfulness-enhanced CBT program. The program consisted of six sequential lessons to be completed within 90 days. Participants (mean age= 39 ± 14 years, 68 % female) completed measures of symptom severity for anxiety, depression, and psychological distress at pre-, mid- and post-treatment. Treatment effects were assessed via intention-to-treat linear mixed models with Hedges' g effect size calculations. RESULTS From pre- to post-treatment, the mindfulness-enhanced CBT program was associated with medium and large effect sized reductions in generalised anxiety symptom severity (g = 0.80, 95%CI: 0.74-0.86), depression symptom severity (g = 0.74, 95%CI: 0.68-0.80), and psychological distress (g = 0.97, 95%CI: 0.90-1.03). Program adherence was modest with approximately 30 % of participants completing all six lessons of the program. LIMITATIONS This study is limited by its lack of a comparator condition, longer-term follow-up, and assessment of the reasons for participant non-adherence. The relative acceptability and effectiveness of mindfulness versus CBT components was not examined. CONCLUSION This study supports the effectiveness of mindfulness-enhanced iCBT for symptoms of anxiety and depression when delivered in a routine care setting under the supervision of community health care practitioners.
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Affiliation(s)
- Claudia Hurwitz
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia.
| | - Christine T Shiner
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Clinical Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia.
| | - Maria J Sharrock
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia.
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales 2052, Australia.
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales 2052, Australia.
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21
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Wilson A, McKeaveney C, Carswell C, Atkinson K, Burton S, McVeigh C, Graham-Wisener L, Jääskeläinen E, Johnston W, O’Rourke D, Reid J, Rej S, Walsh I, Noble H. Experiences of People with Kidney Disease Following the Implementation of the Compassionate Mindful Resilience Programme: Qualitative Findings from the COSMIC Study. Healthcare (Basel) 2023; 11:2926. [PMID: 37998417 PMCID: PMC10671038 DOI: 10.3390/healthcare11222926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Kidney disease is a progressive, debilitating condition. Patients experience challenging physical and psychological symptoms and are at increased risk of anxiety, depression, and poor mental wellbeing. Access to specialist psychological or social support is limited, with inadequate provision of psychosocial support available across UK renal units. The COSMIC study (examining the acceptability and feasibility of the Compassionate Mindful Resilience programme for adult patients with chronic kidney disease) aimed to support a new service development project, in partnership with Kidney Care UK, by implementing the Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, and explore its feasibility for patients with stage 4 or 5 kidney disease and kidney transplant recipients. This paper reports on the qualitative exploratory work which examined the experiences of study participants, their adherence to practice, and the acceptability of the intervention. METHOD Participants (n = 19) took part in semi-structured interviews, which were transcribed, coded, and thematically analysed. RESULTS Three themes (and nine subthemes) were reported: experiences of the CMR programme that facilitated subjective benefit, participants' lived and shared experiences, and the practicalities of CMR programme participation. All participants reported that they found taking part in the CMR programme to be a beneficial experience. CONCLUSION The CMR programme was found to be an acceptable intervention for people living with kidney disease and provided tools and techniques that support the mental health and wellbeing of this patient group. Further qualitative exploration into participant experience should be integrated within future trials of this intervention.
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Affiliation(s)
- Anna Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
| | - Clare McKeaveney
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
| | - Claire Carswell
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | | | - Stephanie Burton
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
| | - Clare McVeigh
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
| | | | - Erika Jääskeläinen
- Research Unit of Population Health, University of Oulu, 90570 Oulu, Finland;
| | - William Johnston
- Patient and Carer Education Partnership, School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK
| | - Daniel O’Rourke
- Patient and Carer Education Partnership, School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
| | - Soham Rej
- Department of Psychiatry, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Ian Walsh
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast BT7 1NN, UK
- Knightsbridge Healthcare Group, Belfast BT9 5UB, UK
- Institute of Psychosexual Medicine, London W4 5YA, UK
| | - Helen Noble
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT7 1NN, UK; (C.M.); (C.C.); (C.M.); (H.N.)
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Fan M, Wang Y, Zheng L, Cui M, Zhou X, Liu Z. Effectiveness of online mindfulness-based interventions for cancer patients: a systematic review and meta-analysis. Jpn J Clin Oncol 2023; 53:1068-1076. [PMID: 37567587 DOI: 10.1093/jjco/hyad101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE Cancer is the second leading cause of mortality worldwide. Cancer negatively affects individuals' quality of life and overall health. Mindfulness-based interventions appear to be promising in the reduction of cancer- and treatment-related symptoms. This review aimed to determine the effectiveness of online mindfulness-based interventions on distress, anxiety, depression, stress, mindfulness, sleep disturbance, quality of life, rumination, fear of cancer recurrence, fatigue and post-traumatic growth among adult cancer patients. METHODS A literature search was conducted across five electronic databases. Only randomized controlled trials were eligible. Two reviewers independently screened the studies, extracted data, and performed quality assessment using the Cochrane risk of bias assessment tool. Meta-analyses were conducted using review manager software, and standardized mean difference was used to determine intervention effects. Heterogeneity was examined using the I2 statistics. RESULTS Ten studies were included with a total of 962 participants. Analyses revealed that online mindfulness-based interventions was effective in reducing distress (I2 = 98%;standardized mean difference = -2.21,95% confidence interval: -3.84 to 0.57;P = 0.008), depression (I2 = 45%;standardized mean difference = -0.33,95% confidence interval: -0.64 to -0.03;P = 0.03), stress (I2 = 97%;standardized mean difference = -2.14,95% confidence interval: -4.24 to -0.03;P = 0.05) and sleep disturbance (I2 = 54%;standardized mean difference = -0.30,95% confidence interval: -0.59 to -0.01;P = 0.04), and improving quality of life (I2 = 94%;standardized mean difference = 0.92,95% confidence interval: 0.09-1.76;P = 0.03). The online mindfulness-based interventions had no significant effects on anxiety, mindfulness, rumination, fear of cancer recurrence, fatigue and post-traumatic growth. Subgroup analyses revealed that online mindfulness-based interventions resulted in higher effect sizes for distress when delivered by website than application, significantly higher effect sizes were also found for online mindfulness-based interventions with guidance, but not on treatment or cancer type. For sleep disturbance, and quality of life, no significant differences between subgroups were found. CONCLUSION These results provide preliminary support that online mindfulness-based interventions may be feasible and acceptable, which can be used as an adjuvant therapy for the management of cancer-related symptoms among cancer patients.
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Affiliation(s)
- Meiling Fan
- Gynecology Department, Changchun University of Chinese Medicine, Changchun, China
| | - Yang Wang
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Lufang Zheng
- School of Nursing, Jilin University, Changchun, China
| | - Miao Cui
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Xiuling Zhou
- School of Nursing, Changchun University of Chinese Medicine, Changchun, China
| | - Zengxia Liu
- School of Nursing, Anhui Medical University, Hefei, China
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Davis JA, Ohan JL, Gregory S, Kottampally K, Silva D, Prescott SL, Finlay-Jones AL. Perinatal Women's Perspectives of, and Engagement in, Digital Emotional Well-Being Training: Mixed Methods Study. J Med Internet Res 2023; 25:e46852. [PMID: 37847537 PMCID: PMC10618893 DOI: 10.2196/46852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/30/2023] [Accepted: 08/22/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Psychological distress in the early postpartum period can have long-lasting deleterious effects on a mother's well-being and negatively affect her infant's development. Intervention approaches based in contemplative practices such as mindfulness and loving-kindness and compassion are intended to alleviate distress and cultivate well-being and can be delivered effectively as digital mental health interventions (DMHIs). OBJECTIVE To understand the feasibility of engaging perinatal women in digital interventions, this study aimed to document participants' experiences in the Mums Minds Matter (MMM) study, a pilot randomized controlled trial comparing mindfulness, loving-kindness and compassion, and progressive muscle relaxation training delivered in a digital format and undertaken during pregnancy. To assess the different stages of engagement during and after the intervention, we adapted the connect, attend, participate, enact (CAPE) framework that is based on the idea that individuals go through different stages of engagement before they are able to enact change. METHODS The MMM study was nested within a longitudinal birth cohort, The ORIGINS Project. We aimed to recruit 25 participants per randomization arm. Data were collected sequentially during the intervention through regular web-based surveys over 8 weeks, with opportunities to provide regular feedback. In the postintervention phase, qualitative data were collected through purposive sampling. RESULTS Of 310 eligible women, 84 (27.1% [connect rate]) enrolled to participate in MMM. Of the remaining 226 women who did not proceed to randomization, 223 (98.7%) failed to complete the baseline surveys and timed out of eligibility (after 30 weeks' gestation), and 3 (1.3%) displayed high psychological distress scores. Across all program groups, 17 (20% [attend rate]) of the 84 participants actively opted out, although more may have disengaged from the intervention but did not withdraw. The main reasons for withdrawal were busy life and other priorities. In this study, we assessed active engagement and ongoing skills use (participate and enact) through postintervention interviews. We undertook 15 participant interviews, conducted 1 month to 3 months after the intervention. Our results provide insights into participant barriers and enablers as well as app changes, such as the ability to choose topics, daily reminders, case studies, and diversity in sounds. Implementing a DMHI that is brief, includes frequent prompts or nudges, and is easily accessible is a key strategy to target perinatal women. CONCLUSIONS Our research will enable future app designs that are sufficiently nuanced to maximize the uptake, engagement, and application of mental health skills and contemplative practices in the perinatal period. Providing convenient access to engaging and effective prevention programs is critical and should be part of prenatal self-care. Our research underscores the appeal and feasibility of digital intervention approaches based in contemplative practices for perinatal women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) 12620000672954p; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000672954p. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19803.
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Affiliation(s)
- Jacqueline A Davis
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jeneva L Ohan
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | | | - Keerthi Kottampally
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
| | - Desiree Silva
- Telethon Kids Institute, Nedlands, Australia
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Susan L Prescott
- Medical School (Paediatrics), University of Western Australia, Crawley, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Nova Institute for Health, Baltimore, MD, United States
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Bogaert L, Van der Gucht K, Kuppens P, Kock M, Schreuder MJ, Kuyken W, Raes F. The effect of universal school-based mindfulness on anhedonia and emotional distress and its underlying mechanisms: A cluster randomised controlled trial via experience sampling in secondary schools. Behav Res Ther 2023; 169:104405. [PMID: 37797436 PMCID: PMC10938062 DOI: 10.1016/j.brat.2023.104405] [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: 02/03/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and emotional distress among mid-adolescents (15-18 years). It further examined three potential mechanisms: dampening of positive emotions, non-acceptance/suppression of negative emotions, and perceived social pressure not to experience/express negative emotions. Adolescents (ncontrol = 136, nintervention = 95) participated in three assessment points (before, after and two/three months after the in-class MT), consisting of Experience Sampling (ES) assessments and self-report questionnaires (SRQs) to corroborate the ES assessments. Analyses were based on general linear modelling and multilevel modelling. Overall, no evidence was found for a significant beneficial and long-lasting impact of the MT on adolescents' mental health. Importantly, some barriers inherently linked to universal MT approaches (low engagement in and mixed attitudes towards the MT) may have tempered the effectiveness of the MT in the current trial. Further research should prioritise overcoming these barriers to optimise programme implementation. Additionally, given the potential complex interplay of moderators at micro- (home practice), meso- (school climate), and macro-level (broader context), research should simultaneously focus on alternative ways of delivering MT at schools to strengthen adolescents' mental health.
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Affiliation(s)
- Liesbeth Bogaert
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| | - Katleen Van der Gucht
- Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium; Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium; Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Peter Kuppens
- Leuven Mindfulness Centre, KU Leuven, Belgium; Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium
| | - Merle Kock
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
| | - Marieke J Schreuder
- Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium
| | - Willem Kuyken
- Department of Psychiatry, Medical Sciences Division, University of Oxford, United Kingdom; University of Oxford Mindfulness Research Centre, University of Oxford, United Kingdom
| | - Filip Raes
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
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Cearns M, Clark SR. The Effects of Dose, Practice Habits, and Objects of Focus on Digital Meditation Effectiveness and Adherence: Longitudinal Study of 280,000 Digital Meditation Sessions Across 103 Countries. J Med Internet Res 2023; 25:e43358. [PMID: 37725801 PMCID: PMC10548318 DOI: 10.2196/43358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The efficacy of digital meditation is well established. However, the extent to which the benefits remain after 12 weeks in real-world settings remains unknown. Additionally, findings related to dosage and practice habits have been mixed, and the studies were conducted on small and homogeneous samples and used a limited range of analytical procedures and meditation techniques. Findings related to the predictors of adherence are also lacking and may help inform future meditators and meditation programs on how to best structure healthy sustainable practices. OBJECTIVE This study aimed to measure outcome change across a large and globally diverse population of meditators and meditations in their naturalistic practice environments, assess the dose-response relationships between practice habits and outcome change, and identify predictors of adherence. METHODS We used ecological momentary assessment to assess participants' well-being over a 14-month period. We engineered outcomes related to the variability of change over time (equanimity) and recovery following a drop in mood (resilience) and established the convergent and divergent validity of these outcomes using a validated scale. Using linear mixed-effects and generalized additive mixed-effects models, we modeled outcome changes and patterns of dose-response across outcomes. We then used logistic regression to study the practice habits of participants in their first 30 sessions to derive odds ratios of long-term adherence. RESULTS Significant improvements were observed in all outcomes (P<.001). Generalized additive mixed models revealed rapid improvements over the first 50-100 sessions, with further improvements observed until the end of the study period. Outcome change corresponded to 1 extra day of improved mood for every 5 days meditated and half-a-day-faster mood recovery compared with baseline. Overall, consistency of practice was associated with the largest outcome change (4-7 d/wk). No significant differences were observed across session lengths in linear models (mood: P=.19; equanimity: P=.10; resilience: P=.29); however, generalized additive models revealed significant differences over time (P<.001). Longer sessions (21-30 min) were associated with the largest magnitude of change in mood from the 20th session onward and fewer sessions to recovery (increased resilience); midlength sessions (11-20 min) were associated with the largest decreases in recovery; and mood stability was similar across session lengths (equanimity). Completing a greater variety of practice types was associated with significantly greater improvements across all outcomes. Adhering to a long-term practice was best predicted by practice consistency (4-7 d/wk), a morning routine, and maintaining an equal balance between interoceptive and exteroceptive meditations. CONCLUSIONS Long-term real-world digital meditation practice is effective and associated with improvements in mood, equanimity, and resilience. Practice consistency and variety rather than length best predict improvement. Long-term sustainable practices are best predicted by consistency, a morning routine, and a practice balanced across objects of focus that are internal and external to the body.
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Affiliation(s)
- Micah Cearns
- Insight Timer Research, Insight Timer, Sydney, Australia
- Discipline of Psychiatry, The University of Adelaide, Adelaide, Australia
| | - Scott R Clark
- Discipline of Psychiatry, The University of Adelaide, Adelaide, Australia
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26
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Listiyandini RA, Andriani A, Kusristanti C, Moulds M, Mahoney A, Newby JM. Culturally Adapting an Internet-Delivered Mindfulness Intervention for Indonesian University Students Experiencing Psychological Distress: Mixed Methods Study. JMIR Form Res 2023; 7:e47126. [PMID: 37651168 PMCID: PMC10502595 DOI: 10.2196/47126] [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: 03/20/2023] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Psychological distress is prevalent among university students. However, the availability of evidence-based mental health treatment remains limited in many low- and middle-income countries, including Indonesia. Internet-delivered, mindfulness-based interventions that reduce distress have potential for treating university student distress at scale. Unfortunately, evidence-based, internet-delivered mindfulness treatments are not yet available in Indonesia. Cultural adaptation of established evidence-based, internet-delivered mindfulness interventions is needed. OBJECTIVE In this paper, we describe the process of culturally adapting an Australian internet-delivered mindfulness program (Introduction to Mindfulness) to be relevant and appropriate for treating Indonesian university students' psychological distress. METHODS To assist the cultural adaptation process, we used a systematic cultural adaptation framework and a mixed methods approach combining quantitative and qualitative methods. In study 1 (information gathering), we administered an internet-delivered questionnaire to Indonesian university students (n=248) to examine their preferences regarding an internet-delivered mindfulness intervention. In study 2 (preliminary design), a draft program was developed and independently reviewed by Indonesian stakeholders. Stakeholders (n=25) included local Indonesian mindfulness and mental health professionals (n=6) and university students (n=19), who were selected to maximize sample representativeness regarding personal and professional characteristics. To evaluate the initial design and cultural congruence of the internet-delivered mindfulness program in the Indonesian context, we conducted interviews and focus groups with stakeholders. Stakeholders also completed the Cultural Relevance Questionnaire. RESULTS In study 1, most Indonesian university students (240/248, 96.8%) reported openness to an internet-delivered mindfulness program. Most of interested students (127/240, 52.9%) preferred the length of the program to be 3 to 4 sessions, with 45.8% (110/240) preferring brief lessons taking only 15 to 30 minutes to complete. They (194/240, 80.8%) recommended that the program be accessible both through websites and mobile phones. In study 2, Indonesian stakeholders generally found the internet-delivered program to be highly culturally appropriate in terms of language, concepts, context, treatment goals, and depictions of students' emotional and behavioral experiences. However, stakeholders also recommended some specific adaptations regarding the program's delivery model (eg, combining visual and audio modalities when delivering psychoeducation), cultural components (eg, including more social and spiritual activities), program practicality (eg, including rewards to promote engagement), and design elements (eg, including additional culturally relevant illustrations). Following stakeholder feedback, a new culturally adapted Indonesian internet-delivered mindfulness program called Program Intervensi Mindfulness Daring Mahasiswa Indonesia was created. CONCLUSIONS This study highlights the process and importance of cultural adaptation of an evidence-based mindfulness treatment and demonstrates how this may be achieved for internet-delivered psychotherapy programs. We found that a culturally adapted internet-delivered mindfulness program was relevant for Indonesian students with some adjustments to the programs' content and delivery. Future research is now needed to evaluate the clinical benefit of this program.
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Affiliation(s)
- Ratih Arruum Listiyandini
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
- Faculty of Psychology, Universitas YARSI, Jakarta Pusat, DKI Jakarta, Indonesia
| | | | | | - Michelle Moulds
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Jill M Newby
- School of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
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27
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Hong M, Liang D, Lu T, Liu S. The effect of brief digital mindfulness-based interventions on increasing online charitable behavior in Chinese adolescents. Front Psychol 2023; 14:1213089. [PMID: 37599709 PMCID: PMC10433157 DOI: 10.3389/fpsyg.2023.1213089] [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: 04/27/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Digital mindfulness-based interventions (d-MBIs) have garnered significant research interest in recent years due to their psychological benefits. However, little is known about their impact on prosocial behaviors. This study investigates how d-MBIs impact prosocial behaviors where time spent is money, with Chinese adolescents as the subjects, through an online charity task (www.freerice.com). 119 students from a high school in China, who were inexperienced with mindfulness meditation, participated in this randomized controlled trial. The d-MBI group (N = 39) received online MBI guidance, while the face-to-face mindfulness-based intervention (f-MBI, N = 43) group underwent mindfulness intervention under personal tutors. The active control group (N = 37) completed a crossword task. Data analysis first involved repeated measures variance analysis, including pre-and post-intervention assessments. Subsequently, a two-way variance analysis was performed, with gender (female and male) and group (d-MBI, f-MBI, active control) as independent variables and the number of grains as dependent variables for the three groups of participants. Results showed that d-MBIs effectively improved empathy and compassion in Chinese adolescents, leading to increased rice donations to the United Nations World Food Program. These results underscore the positive effect of d-MBIs on prosociality and suggest their applicability in beneficial real-world situations involving prosocial behaviors, extending beyond previous research primarily conducted in artificial and hypothetical scenarios.
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Affiliation(s)
- Mei Hong
- School of Management, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Dapeng Liang
- School of Management, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Teng Lu
- School of Management, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Shengchen Liu
- Harbin Institute of Technology, Harbin, Heilongjiang, China
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Küchler AM, Kählke F, Bantleon L, Terhorst Y, Ebert DD, Baumeister H. Moderators and mediators of change of an internet-based mindfulness intervention for college students: secondary analysis from a randomized controlled trial. Front Digit Health 2023; 5:1179216. [PMID: 37441226 PMCID: PMC10333756 DOI: 10.3389/fdgth.2023.1179216] [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: 03/03/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023] Open
Abstract
Background Existing evidence suggests internet- and mobile-based interventions (IMIs) improve depressive symptoms in college students effectively. However, there is far less knowledge about the potential mechanisms of change of mindfulness-based IMIs, which could contribute to optimizing target groups and interventions. Hence, within this secondary analysis of data from a randomized controlled trial (RCT), potential moderators and mediators of the effectiveness of the IMI StudiCare Mindfulness were investigated. Methods Moderation and mediation analyses were based on secondary data from a RCT that examined the effectiveness of the 7-module IMI StudiCare Mindfulness in a sample of college students (intervention group: n = 217; waitlist control group: n = 127). Assessments were collected before (t0; baseline), 4 weeks after (t1; during intervention), and 8 weeks after (t2; post-intervention) randomization. Longitudinal mediation analyses using structural equation modeling were employed, with depressive symptom severity as the dependent variable. For moderation analyses, bilinear interaction models were calculated with depressive symptom severity and mindfulness at t2 as dependent variables. All data-analyses were performed on an intention-to-treat basis. Results Mediation analyses showed a significant, full mediation of the intervention effect on depressive symptom severity through mindfulness (indirect effect, a*b = 0.153, p < 0.01). Only the number of semesters (interaction: β = 0.24, p = 0.035) was found to moderate the intervention's effectiveness on depressive symptom severity at t2, and only baseline mindfulness (interaction: β = -0.20, p = 0.047) and baseline self-efficacy (interaction: β = -0.27, p = 0.012) were found to be significant moderators of the intervention effect on mindfulness at t2. Conclusion Our results suggest a mediating role of mindfulness. Moderation analyses demonstrated that the intervention improved depressive symptom severity and mindfulness independent of most examined baseline characteristics. Future confirmatory trials will need to support these findings. Clinical Trial Registration The trial was registered a priori at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (TRN: DRKS00014774; registration date: 18 May 2018).
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Affiliation(s)
- Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Fanny Kählke
- Department for Sport and Health Sciences, Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Munich, Germany
| | - Leandra Bantleon
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - David Daniel Ebert
- Department for Sport and Health Sciences, Professorship for Psychology & Digital Mental Health Care, Technical University of Munich, Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Balci S, Küchler AM, Ebert DD, Baumeister H. An Online Mindfulness Intervention for International Students: A Randomized Controlled Feasibility Trial. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e9341. [PMID: 37732147 PMCID: PMC10508251 DOI: 10.32872/cpe.9341] [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: 04/19/2022] [Accepted: 05/03/2023] [Indexed: 09/22/2023] Open
Abstract
Background Student mobility across borders poses challenges to health systems at the university and country levels. International students suffer from stress more than their local peers, however, do not seek help or underutilize existing help offers. Some barriers to help-seeking among international students are insufficient information regarding the health offers, stigma, and language, which might be overcome via culturally adapted internet and mobile-based interventions (IMI). Method A randomized controlled feasibility trial with a parallel design assessed the feasibility and potential efficacy of an online mindfulness intervention adapted for international university students. Participants were randomized into either an adapted online mindfulness intervention (StudiCareM-E) (IG, n = 20) or a waitlist control group (WL, n = 20). Participants were assessed at baseline (t0) and eight-week post-randomization (t1). The feasibility of StudiCareM-E was evaluated regarding intervention adherence, client satisfaction, and potential negative effects. The potential efficacy of StudiCareM-E was measured by means of the level of mindfulness, perceived stress, depression, anxiety, presenteeism, and wellbeing. Efficacy outcomes were evaluated with regression models on the intention-to-treat (ITT) sample (n = 40), adjusting for the baseline values. Results Participants' formative feedback suggested improvements in the content of the IMI. There were no crucial negative effects compared to WL. Assessment dropout was 35% (IG: 50%: WL: 20%), and intervention dropout was 60%. StudiCareM-E yielded significant improvements in mindfulness (β = .34), well-being (β = .37), and anxiety (β = -.42) compared to WL. Conclusion StudiCareM-E might be used among culturally diverse international student populations to improve their well-being. Future studies might carefully inspect the extent of the adaptation needs of their target group and design their interventions accordingly.
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Affiliation(s)
- Sumeyye Balci
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - David Daniel Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Hulsbosch LP, Potharst ES, Schwabe I, Boekhorst MGBM, Pop VJM, Nyklíček I. Online mindfulness-based intervention for women with pregnancy distress: A randomized controlled trial. J Affect Disord 2023; 332:262-272. [PMID: 37054897 DOI: 10.1016/j.jad.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Pregnancy distress among childbearing women is common and can negatively affect both mother and infant. Mindfulness-based interventions (MBIs) may have a positive effect on pregnancy distress but randomized controlled trials with sufficient power are lacking. The current study examined the effectiveness of an online self-guided MBI in pregnant women with pregnancy distress. METHODS Pregnant women with elevated pregnancy distress levels at 12 weeks of pregnancy, measured with the Edinburgh Depression Scale (EDS) and Tilburg Pregnancy Distress Scale negative affect (TPDS-NA), were randomized into an intervention group (online MBI, N = 109) or control group (care as usual, N = 110). The primary outcome was the change in pregnancy distress post-intervention and at eight-weeks-follow-up. Secondary outcomes were mindfulness skills (Three Facet Mindfulness Questionnaire-Short Form), rumination (Rumination-Reflection Questionnaire), and self-compassion (Self-Compassion Scale-Short Form) at post-intervention and follow-up in the intervention group. RESULTS Significant improvements were found in pregnancy distress scores, but no significant differences between intervention and control group appeared. The MBI group showed improvements in mindfulness skills, rumination, and self-compassion. LIMITATIONS Low adherence to the intervention and assessment of secondary outcome measures in the intervention group only. CONCLUSIONS An intervention trial with one of the largest samples (N = 219) provided no evidence of a significant effect of an online self-guided MBI in distressed pregnant women. An online MBI may be associated with an improvement in mindfulness skills, rumination, and self-compassion. Future research should address the effectiveness of MBI's with different formats (online and group-based combined) and examine a possible delayed effect. TRIAL REGISTRATION ClinicalTrials.gov: NCT03917745, registered on 4 March 2019.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands.
| | - Eva S Potharst
- UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, Amsterdam, the Netherlands
| | - Inga Schwabe
- Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Myrthe G B M Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, Tilburg, the Netherlands
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Meynadier J, Malouff JM, Loi NM, Schutte NS. Lower Mindfulness is Associated with Problematic Social Media Use: A Meta-Analysis. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04587-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
AbstractProblematic social media use consists of use that interferes with individuals’ functioning, such as for example in failing to complete important tasks. A number of studies have investigated the association of trait mindfulness with problematic social media use. This meta-analysis synthesised research from 14 studies and a total of 5355 participants to examine the association between mindfulness and problematic social media use across studies. A lower level of mindfulness was associated with more problematic social media use, with a weighted effect size of r = -.37, 95% CI [-.42, -.33], k = 14, p < .001.
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Hellrigel-Holderbaum M, Romanczuk-Seiferth N, Glos M, Fietze I. Effects of mindfulness meditation and Acceptance and commitment therapy in patients with obstructive sleep apnea with residual excessive sleepiness: A randomized controlled pilot study. Sleep Med 2023; 106:33-41. [PMID: 37043999 DOI: 10.1016/j.sleep.2023.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/12/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Assessing the effects of Mindfulness-Based Stress Reduction (MBSR) on symptoms of OSA, especially on the primary outcome, excessive daytime sleepiness (EDS). METHODS Parallel randomized controlled trial. 16 OSA patients with residual EDS (rEDS) were randomized and assigned to either a standardized 8-week MBSR program or a time-matched program on Acceptance and Commitment Therapy (ACT). Both programs were conducted online. Participants answered questionnaires online at baseline (pre), post-intervention (post), three months after the intervention (follow-up) and were blinded to whether their group was the treatment or active control group but not to group allocation (partial blinding). Three participants dropped out early. Most analyses are based on the remaining 13 patients. RESULTS There was a significant difference between the MBSR (n = 7) and ACT group (n = 6) in changes of EDS between pre and post (Cohen's d = 1.24, CI [0.01, 2.42]) and a significant reduction of EDS for patients in the ACT group at post (Cohen's d = 1.18 and [0.08, 2.22]). This EDS reduction averaging 2.17 points on the Epworth Sleepiness Scale reached the prespecified bar for clinical significance of two points on that scale. Insomnia symptoms, a secondary outcome, reduced significantly following ACT (Cohen's d = 1.43 [0.23, 2.58]). In MBSR, both participants and the MBSR-trainer judged movement-based exercises to be most efficacious. CONCLUSION ACT shows potential as adjunctive therapy for OSA with rEDS, although further studies are needed. It seems promising to develop therapeutic approaches for OSA with rEDS using ACT, especially if they are tailored to the needs specific to this patient group. TRIAL REGISTRATION https://www.drks.de; Identifier: DRKS00026812.
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Affiliation(s)
- Max Hellrigel-Holderbaum
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Glos
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ingo Fietze
- Interdisciplinary Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; The Fourth People's Hospital of Guangyuan, Guangyuan City, China
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Küchler AM, Schultchen D, Dretzler T, Moshagen M, Ebert DD, Baumeister H. A Three-Armed Randomized Controlled Trial to Evaluate the Effectiveness, Acceptance, and Negative Effects of StudiCare Mindfulness, an Internet- and Mobile-Based Intervention for College Students with No and "On Demand" Guidance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3208. [PMID: 36833903 PMCID: PMC9965996 DOI: 10.3390/ijerph20043208] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The college years can be accompanied by mental distress. Internet- and mobile-based interventions (IMIs) have the potential to improve mental health but adherence is problematic. Psychological guidance might promote adherence but is resource intensive. In this three-armed randomized controlled trial, "guidance on demand" (GoD) and unguided (UG) adherence-promoting versions of the seven-module IMI StudiCare Mindfulness were compared with a waitlist control group and each other. The GoD participants could ask for guidance as needed. A total of 387 students with moderate/low mindfulness were recruited. Follow-up assessments took place after 1 (t1), 2 (t2), and 6 (t3) months. Post-intervention (t2), both versions significantly improved the primary outcome of mindfulness (d = 0.91-1.06, 95% CI 0.66-1.32) and most other mental health outcomes (d = 0.25-0.69, 95% CI 0.00-0.94) compared with WL, with effects generally persisting after 6 months. Exploratory comparisons between UG and GoD were mostly non-significant. Adherence was low but significantly higher in GoD (39%) vs. UG (28%) at the 6-month follow-up. Across versions, 15% of participants experienced negative effects, which were mostly mild. Both versions effectively promoted mental health in college students. Overall, GoD was not associated with substantial gains in effectiveness or adherence compared with UG. Future studies should investigate persuasive design to improve adherence.
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Affiliation(s)
- Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, 89081 Ulm, Germany
| | - Tim Dretzler
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Morten Moshagen
- Department of Quantitative Methods in Psychology, Ulm University, 89081 Ulm, Germany
| | - David D. Ebert
- Department for Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
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Austin J, Schroevers MJ, Van Dijk J, Sanderman R, Børøsund E, Wymenga AMN, Bohlmeijer ET, Drossaert CH. Compas-Y: A mixed methods pilot evaluation of a mobile self-compassion training for people with newly diagnosed cancer. Digit Health 2023; 9:20552076231205272. [PMID: 37868157 PMCID: PMC10588427 DOI: 10.1177/20552076231205272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Compas-Y is a compassionate mind training app that was co-designed to be fully adapted to mobile technology and to people with newly diagnosed cancer. This study aimed to evaluate the use, appreciation and impact of the app. Methods Seventy-one people with cancer who created an app account were included (38% breast cancer, 72% diagnosed <4 months ago, 76% received chemotherapy). Participants had very high baseline scores of self-compassion. In a convergent mixed methods design, back-end log-data (n = 71), pre-post surveys (n = 34) and semi-structured interviews (n = 23) collected for >8 weeks and were concurrently analysed using joint displays. Results About half of the participants (45%) used 4 of the 6 modules. Compas-Y was highly appreciated, with all content considered relevant and a source of support. Experienced benefits related to improved mental health. Particularly, we found significant changes in anxiety, but not in depression or well-being. In the interviews, people reported experiencing more rest and more positive emotions due to using the app. Process benefits included significant reductions in self-criticism (inadequate self and self-blame), but not self-compassion. In the interviews, people reported improved self-compassion and less self-criticism, more self-awareness, recognition and support, and improved emotion regulation and coping. The surveys did not capture the full range of outcomes that participants reported in the interviews. Conclusions Compas-Y is a highly appreciated mobile intervention that supported users in aspects of their mental health. Findings are discussed in terms of reach and adherence, app functionalities, co-design and tailoring of cancer-related and compassion-based eHealth.
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Affiliation(s)
- Judith Austin
- Section of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jelle Van Dijk
- Faculty of Engineering Technology, University of Twente, Enschede, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - A Machteld N Wymenga
- Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ernst T Bohlmeijer
- Section of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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Wang Y, Farb NAS. Web-based training for post-secondary student well-being during the pandemic: a randomized trial. ANXIETY, STRESS, AND COPING 2023; 36:1-17. [PMID: 35615957 DOI: 10.1080/10615806.2022.2079637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: The COVID-19 pandemic has been a highly stressful period where post-secondary education moved to online formats. Coping skills like decentering and reappraisal appear to promote stress resilience, but limited research exists on cultivating these skills in online learning contexts.Methods: In a three-arm randomized trial design, we evaluated three-week, web-based interventions to gauge how to best cultivate mindfulness and stress-reappraisal skills and whether the proposed interventions led to improved mental health. Undergraduate participants (N = 183) were randomly assigned to stress mindset, mindfulness meditation, or mindfulness with choice conditions.Results: At the study level (baseline vs. post-intervention), decentering improved across all conditions. Mindfulness with choice significantly decreased negative affect and rumination compared to stress mindset, while stress mindset significantly enhanced stress mindset skills compared to both mindfulness groups. At the daily level (three sessions per week), stress mindset significantly increased positive affect compared to mindfulness meditation.Conclusions: Results suggest that student mental health can be remotely supported through brief web-based interventions. Mindfulness practices seem to be effective in improving students' negative mood and coping strategies, while stress mindset training can help students to adopt a stress-is-enhancing mindset. Additional work on refining and better matching students to appropriate interventions is needed.
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Affiliation(s)
- Yiyi Wang
- Department of Psychology, University of Toronto Mississauga, Toronto, Canada
| | - Norman A S Farb
- Department of Psychology, University of Toronto Mississauga, Toronto, Canada.,Department of Psychological Clinical Science, University of Toronto Scarborough, Scarborough, Canada
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Rana M, Bock L, Riedel E, Moellmann HL, Schorn L, Rana M. The Effectiveness of a Four-Week Online Mindfulness Training Course on Individual Mindfulness Skills and Personal Perception of Stress in Company Employees Working from Home. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16422. [PMID: 36554302 PMCID: PMC9778306 DOI: 10.3390/ijerph192416422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Working from home comes with many benefits. However, employees are often exposed to various stressors when working outside of the traditional workplace environment. The subjective experience of these stressors is related to one's perception of the situation and the perceived resources available. As working from home has become the new normal for many during the COVID-19 pandemic, it is in the interest of companies to provide employees with tools to cope with these stressors. One such tool is online mindfulness training. This study investigates how a four-week online mindfulness training influences an individual's mindfulness skills, subjective perception, and processing of stressors. Forty participants working from home at the time of the study were examined in a pre-test using a pre-post design in which the experimental group participated in a four-week online training course in mindfulness. Since the results showed a significantly reduced subjective perception of stress in the experimental group after mindfulness training, a long-term study was conducted including 40 additional participants. The study revealed a training success of at least three months. It thus introduces new possibilities for effective stress management in all workplace settings.
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Affiliation(s)
- Madiha Rana
- Department of Psychology, European University of Applied Sciences for Distance Learning Hamburg, Doberaner Weg 20, 22143 Hamburg, Germany
| | - Lotte Bock
- Department of Psychology, European University of Applied Sciences for Distance Learning Hamburg, Doberaner Weg 20, 22143 Hamburg, Germany
| | - Erik Riedel
- Department of Psychology, European University of Applied Sciences for Distance Learning Hamburg, Doberaner Weg 20, 22143 Hamburg, Germany
| | - Henriette L. Moellmann
- Department of Oral, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Lara Schorn
- Department of Oral, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Majeed Rana
- Department of Oral, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University, Moorenstr. 5, 40225 Duesseldorf, Germany
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Karing C. The efficacy of online mindfulness-based interventions in a university student sample: Videoconference- or podcast-delivered intervention. Appl Psychol Health Well Being 2022; 15:740-756. [PMID: 36214182 DOI: 10.1111/aphw.12408] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/27/2022] [Indexed: 11/29/2022]
Abstract
The increasing mental health issues among university students during the COVID-19 pandemic and the challenges of delivering face-to-face interventions during lockdowns have increased the demand for online interventions. The report presents results from a randomized controlled trial investigating the benefits of online mindfulness interventions delivered by videoconference or podcast during the early phase of the pandemic in Germany. Fifty university students were randomized to a mindfulness intervention conducted by videoconference (n = 25) or to an unguided training provided by podcasts (n = 25). All students participated in a 7-week mindfulness intervention. Outcome measures included mindfulness, depression, anxiety, and life satisfaction preintervention and postintervention. The study showed a larger reduction in depression in the videoconferencing group than in the podcast group across per protocol (PP) and intention-to-treat (ITT) analyses. There was a significant increase in mindfulness (PP and ITT samples) and life satisfaction (ITT sample) in both groups. The frequency of home practice was related to positive changes in outcomes but only for the videoconferencing group. The results suggest that mindfulness training delivered via videoconferencing can be a viable option to address depressive symptoms among students. However, both interventions were effective in increasing mindfulness and life satisfaction.
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Affiliation(s)
- Constance Karing
- Institute of Psychology, Department of Research Synthesis, Intervention and Evaluation, Friedrich-Schiller-University Jena, Jena, Germany
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Cheung RYM, Chan SKC, Chui H, Chan WM, Ngai SYS. Enhancing Parental Well-being: Initial Efficacy of a 21-Day Online Self-help Mindfulness-Based Intervention for Parents. Mindfulness (N Y) 2022; 13:2812-2826. [PMID: 36248240 PMCID: PMC9540077 DOI: 10.1007/s12671-022-01998-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
Objectives Parental self-care is extremely important in the face of stress throughout parenthood. A 21-day online mindfulness-based intervention was developed that was aimed at enhancing parental well-being. The present study evaluated this intervention by examining its initial efficacy on parents’ mindfulness, parenting stress, subjective well-being, and symptoms of depression and anxiety. Methods Participants were 273 parents (90.11% mothers) who were randomly assigned to the 21-day mindfulness-based intervention group (n = 136) or waitlist control group (n = 137). Pre-intervention assessment, immediate post-intervention assessment, and 30-day follow-up assessment were conducted to assess parents’ mindfulness, parenting stress, subjective well-being, and symptoms of depression and anxiety. Results Linear mixed models indicated that the group × time effects on subjective well-being, anxiety symptoms, and mindfulness were significant, after controlling for sex, age, education, income, habit of mindfulness practice, hours of weekly mindfulness practice, and diagnostic history of psychiatric disorder. Follow-up analyses indicated that compared to baseline, participants from the intervention group reported significantly greater subjective well-being and mindfulness, and fewer symptoms of anxiety than did those from the waitlist control group. The group × time effects on parenting stress and depressive symptoms were non-significant. Exploratory findings further suggested practicality and perceived acceptability of the intervention. Conclusions This study showed initial efficacy of a 21-day online mindfulness-based intervention on parents’ subjective well-being, anxiety symptoms, and mindfulness. The findings inform researchers and practitioners about the utility of a brief mindfulness-based intervention in promotion parental well-being. Other areas of feasibility warrant future investigation.
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Spears CA, Mhende J, Hawkins C, Do VV, Hayat MJ, Eriksen MP, Hedeker D, Abroms LC, Wetter DW. Mindfulness-Based Smoking Cessation Delivered Through Telehealth and Text Messaging for Low-Income Smokers: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e35688. [PMID: 35916707 PMCID: PMC9379793 DOI: 10.2196/35688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tobacco use is the leading cause of preventable morbidity and mortality. Adults with low income and members of certain racial and ethnic minority groups are less likely to quit, and therefore, they experience profound tobacco-related health disparities. Mindfulness training can increase the rates of smoking cessation and lapse recovery, and telehealth and SMS text messaging have the potential to provide more accessible treatment. OBJECTIVE This study aims to test the efficacy of delivering mindfulness-based smoking cessation treatment through text messaging (iQuit Mindfully) and telehealth (group videoconferencing), both as stand-alone interventions and in combination. In addition, it aims to examine the underlying mechanisms of mindfulness treatment. METHODS In this 2×2 randomized controlled trial, participants are randomized into 1 of 4 groups based on assignment to iQuit Mindfully text messages (yes or no) and mindfulness videoconference groups (yes or no). The primary outcomes are biochemically verified smoking abstinence at 8, 12, and 24 weeks after the start of treatment. Secondary outcomes include the frequency of home mindfulness practice and self-reported levels of mindfulness, emotions, craving, withdrawal, dependence, self-efficacy, and social support. RESULTS Recruitment, treatment, and assessment began in spring and summer 2021, and data collection is expected to continue through spring 2024. CONCLUSIONS This project aims to improve smoking cessation outcomes for low-income, racially and ethnically diverse smokers through mindfulness-based telehealth group counseling and text messaging support. We also aim to advance the scientific study of the mechanisms of action of mindfulness treatment, which could inform the development of more efficacious and efficient treatments to reduce tobacco disparities. TRIAL REGISTRATION Clinicaltrials.gov NCT04965181; https://clinicaltrials.gov/ct2/show/NCT04965181. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/35688.
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Affiliation(s)
- Claire A Spears
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Josephine Mhende
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - China Hawkins
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Vuong Van Do
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Matthew J Hayat
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Michael P Eriksen
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - David W Wetter
- Department of Population Health Sciences, University of Utah and Huntsman Cancer Institute, Salt Lake City, UT, United States
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de Krijger E, Willems R, ten Klooster P, Bakker E, Miedema H, Drossaert C, Bohlmeijer E. Further Validation of a Dutch Translation of the Sussex Oxford Compassion for the Self Scale in Samples of Crisis Line Volunteers, Military Personnel and Nursing Students. Front Psychol 2022; 13:895850. [PMID: 35859833 PMCID: PMC9289624 DOI: 10.3389/fpsyg.2022.895850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Self-compassion is considered an important, transdiagnostic factor for mental health. The Sussex Oxford Compassion for the Self Scale (SOCS-S) is a recently developed comprehensive measure of self-compassion, that was found to have promising psychometric properties among health care staff and university students in the initial validation study. The aim of this study is the further psychometric evaluation of a Dutch translation of the SOCS-S in different populations and settings. The SOCS-S was administered in three different Dutch samples [crisis line volunteers (n = 560), military personnel (n = 244) and nursing students (n = 255)]. The results confirm the five-factor structure of the SOCS-S and its reliability and criterion and convergent validity across the samples. Measurement invariance was demonstrated for gender in two samples and for age in all three samples, but not across professions. Finally, the SOCS-S was found to explain additional variance in mental health in comparison to a widely used self-compassion measure (SCS-SF).
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Affiliation(s)
- Eva de Krijger
- Brain Research and Innovation Centre, Utrecht, Netherlands
| | - Renate Willems
- Rotterdam University of Applied Science, Research Centre Innovations in Care, Rotterdam, Netherlands
| | - Peter ten Klooster
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Ellen Bakker
- Rotterdam University of Applied Science, Research Centre Innovations in Care, Rotterdam, Netherlands
| | - Harald Miedema
- Rotterdam University of Applied Science, Research Centre Innovations in Care, Rotterdam, Netherlands
| | - Constance Drossaert
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Ernst Bohlmeijer
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
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Xia A. Potential benefits of Qi Gong meditation in quantifiable physiology: A five-year longitudinal observation. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2022. [DOI: 10.1016/j.jtcms.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Mishra KK, Victorson D, Mehta DH, Vago DR. Personalized Mind–Body Medicine in Integrative Oncology: Meeting the Moment with Each Patient. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:457-462. [PMID: 35549542 PMCID: PMC9232234 DOI: 10.1089/jicm.2022.0562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kavita K. Mishra
- Ocular Tumor Radiation Therapy Program, Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - David Victorson
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Osher Center for Integrative Health, Northwestern University, Chicago, IL, USA
| | - Darshan H. Mehta
- Harvard Medical School, Boston, MA, USA
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA
- Osher Center for Integrative Health, Brigham and Women's Hospital, Boston, MA, USA
| | - David R. Vago
- Department of Psychology, Vanderbilt Brain Institute, and Former Research Director, Osher Center for Integrative Health, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
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Mittal TK, Evans E, Pottle A, Lambropoulos C, Morris C, Surawy C, Chuter A, Cox F, de Silva R, Mason M, Banya W, Thakrar D, Tyrer P. Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study. Open Heart 2022; 9:openhrt-2022-001970. [PMID: 35545356 PMCID: PMC9096570 DOI: 10.1136/openhrt-2022-001970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/21/2022] [Indexed: 12/02/2022] Open
Abstract
Objective The study evaluated the feasibility of mindfulness-based cognitive therapy (MBCT) in patients with non-cardiac chest pain by assessing their willingness to participate and adhere to the programme, and for these data to help further refine the content of MBCT for chest pain. Patients and methods This prospective 2:1 randomised controlled trial compared the intervention of adapted MBCT as an addition to usual care with just usual care in controls. Among 573 patients who attended the rapid access chest pain clinic over the previous 12 months and were not diagnosed with a cardiac cause but had persistent chest pain were invited. The intervention was a 2-hour, weekly, online guided 8-week MBCT course. Compliance with attendance and the home practice was recorded. Enrolled patients completed the Seattle angina questionnaire (SAQ), Hospital Anxiety and Depression Scale, Cardiac Anxiety Questionnaire, Five-Facet Mindfulness Questionnaire, and Euro Quality of Life–5 Dimensions–5 Level at baseline assessment and after 8-week period. Results Persistent chest pain was reported by 114 patients. Of these, 33 (29%) patients with a mean age of 54.2 (±12.2) years and 68% women, consented to the study. Baseline questionnaires revealed mild physical limitation (mean SAQ, 76.8±25), high levels of anxiety (76%) and depression (53%), modest cardiac anxiety (CAQ,1.78±0.61) and mindfulness score (FFMQ, 45.5±7.3). Six patients subsequently withdrew due to bereavement, caring responsibilities and ill health. Of the remaining 27 participants, 18 in the intervention arm attended an average of 5 sessions with 61% attending ≥6 sessions. Although not statistically powered, the study revealed a significant reduction in general anxiety, improved mindfulness and a trend towards improvement in SAQ scores in the intervention arm. Conclusion One-third of patients with persistent non-cardiac chest pain were willing to participate in mindfulness-based therapy. An improvement in anxiety and mindfulness was detected in this feasibility study. A larger trial is required to demonstrate improvement in chest pain symptoms.
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Affiliation(s)
- Tarun Kumar Mittal
- Heart Division, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK .,Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Emma Evans
- Oxford Psychological Medicine Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alison Pottle
- Heart Division, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | - Christina Surawy
- Oxford Mindfulness Centre, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Antony Chuter
- Heart Division, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Felicia Cox
- Heart Division, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ranil de Silva
- Heart Division, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Mark Mason
- Heart Division, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Winston Banya
- Department of Medical Statistics, Research & Development, Royal Brompton and Harefield Hospitals, London, UK
| | | | - Peter Tyrer
- Centre of Psychiatry, Imperial College London, London, UK
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KANG MY, NAN JKM. Effects and mechanisms of an online short-term audio-based mindfulness program on negative emotions in a community setting: A study protocol for a randomized controlled trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kranenburg LW, Gillis J, Mayer B, Hoogendijk WJG. The Effectiveness of a Nonguided Mindfulness App on Perceived Stress in a Nonclinical Dutch Population: Randomized Controlled Trial. JMIR Ment Health 2022; 9:e32123. [PMID: 35302504 PMCID: PMC8976249 DOI: 10.2196/32123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/26/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mindfulness has become increasingly popular, and positive outcomes have been reported for mindfulness-based interventions (MBIs) in reducing stress. These findings make room for innovative perspectives on how MBIs could be applied, for instance through mobile health (mHealth). OBJECTIVE The aim of this study is to investigate whether a nonguided mindfulness mobile app can decrease perceived stress in a nonclinical Dutch population over the course of 8 weeks, with follow-up at 6 months. METHODS A randomized controlled trial was performed to compare an experimental group that made use of a structured 8-week mHealth mindfulness program and a control group after 8 weeks, with follow-up after 6 months. Participants were recruited via a national television program. The primary outcome measure was perceived stress as measured by the Perceived Stress Scale, secondary outcomes were symptoms of burnout (measured using the visual analog scale [VAS]) and psychological symptoms (measured using the Four-Dimensional Symptom Questionnaire [4DSQ] at follow-up). Outcomes were analyzed using a multilevel regression model. RESULTS At baseline, 587 respondents were included. Results showed no postintervention differences between groups for the level of perceived stress. With regard to the secondary outcome measures, the VAS for emotional exhaustion and physical exhaustion showed significantly lower scores for the experimental group after 8 weeks (P=.04 and P=.01, respectively), but not at follow-up. There were no differences between groups for psychological symptoms measured using the 4DSQ. CONCLUSIONS These findings do not support our hypothesis that using the mindfulness app would reduce stress levels. However, our findings related to diminished exhaustion at 8 weeks are encouraging and require further investigation. TRIAL REGISTRATION ClinicalTrials.gov NCT05246800; https://clinicaltrials.gov/show/NCT05246800.
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Affiliation(s)
- Leonieke W Kranenburg
- Section of Medical Psychology, Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jamie Gillis
- Section of Medical Psychology, Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Birgit Mayer
- Department of Psychology, Education and Child studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
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Austin J, Drossaert CHC, van Dijk J, Sanderman R, Børøsund E, Mirkovic J, Schotanus-Dijkstra M, Peeters NJ, Van 't Klooster JWJR, Schroevers MJ, Bohlmeijer ET. Integrating top-down and bottom-up requirements in eHealth development: The case of a mobile self-compassion intervention for people with newly diagnosed cancer (Preprint). JMIR Cancer 2022; 8:e37502. [PMID: 35916691 PMCID: PMC9379787 DOI: 10.2196/37502] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Judith Austin
- Section of Psychology, Health & Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Constance H C Drossaert
- Section of Psychology, Health & Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Jelle van Dijk
- Faculty of Engineering Technology, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Jelena Mirkovic
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Marijke Schotanus-Dijkstra
- Section of Psychology, Health & Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Nienke J Peeters
- Section of Psychology, Health & Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Jan-Willem J R Van 't Klooster
- Behavioural Management and Social Sciences Lab, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Maya J Schroevers
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ernst T Bohlmeijer
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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47
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Mindfulness in Health Education: From Physical to Virtual Presence during the Pandemic, an Anthropological Study in Spain. SUSTAINABILITY 2022. [DOI: 10.3390/su14052547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Research on traditional mindfulness-based interventions supports the position that they are effective in treating psychological problems and benefiting healthy people. However, more research is needed on the effectiveness of online interventions, a field that is growing and developing rapidly, especially with the onset of the pandemic, as many meditation groups have moved into cyberspace. There is little research on the difficulties that these groups face and the effectiveness of online mindfulness practice. In this work, we analyze the effects of the transition from training with physical presence to virtual training in mindfulness during the lockdown and subsequent period of social distancing due to SARS-CoV-2. Specifically, we analyze the changes in the means and the methodology and the effects of the transition to virtual presence; finally, we evaluate the results obtained through both training models. The investigation was carried out in a center where face-to-face training has been provided for twelve years and that, with the onset of the pandemic, moved its practice groups to cyberspace. The methodology is anthropological and is supported by quantitative and qualitative techniques. The results show that online training breaks the traditional chrono-topo complex and opens up new access possibilities, but limits bodily practices, decreases the intensity of the experience, and slows down the pace of learning. However, the effectiveness is maintained by showing equivalent result rates at the end of the training.
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Schiele C, Goetz M, Hassdenteufel K, Müller M, Graf J, Zipfel S, Wallwiener S. Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study. Front Psychiatry 2022; 13:939577. [PMID: 36072461 PMCID: PMC9444059 DOI: 10.3389/fpsyt.2022.939577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Anxiety disorders and depression during pregnancy are highly prevalent. Hospitalized pregnant women with high maternal or fetal risk represent a particularly vulnerable population often excluded from research samples. Screening for mental health disorders is not routinely offered for this particular patient group. Electronic mindfulness-based interventions constitute an accessible, convenient, and cost-effective mental health resource but have not yet been evaluated for acceptance in inpatient settings. To date, little is known about the needs and perceptions of this group of women. OBJECTIVE The aim of this study was to examine whether a brief electronic mindfulness-based intervention (eMBI) is accepted among hospitalized high-risk pregnant women. We assessed personal motivation and barriers, experiences, usability requirements, and overall acceptance of the eMBI, as well the specific needs and demands of patients with high-risk pregnancies regarding mental health services. METHODS An exploratory pilot study with a mixed-methods study design was carried out among 30 women hospitalized with a high obstetric risk. The study participants were given access to an eMBI with a 1-week mindfulness program on how to deal with stress, anxiety, and depressive symptoms. Semi-structured interviews were conducted with the 30 participants and analyzed using systematic content analysis. In addition, acceptance and usability were assessed via questionnaires. RESULTS Study findings showed a high level of acceptance of the eMBI. Most of the respondents were satisfied with the usability and considered the eMBI program to be helpful. The greatest barriers to using the eMBI were a general negative attitude toward using apps, preference for personal contact, or no current need for psychotherapy. Participants criticized the lack of awareness of mental health issues during pregnancy and expressed a need for low-threshold treatment offers, especially during hospitalization. CONCLUSIONS There is a strong need for mental health services in pregnancy care, especially for pregnant women with risk profiles. An eMBI offers an acceptable means of providing mental health support for hospitalized women with a severe obstetric risk.
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Affiliation(s)
- Claudia Schiele
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Maren Goetz
- Department of General Pediatrics, University of Heidelberg, Heidelberg, Germany
| | - Kathrin Hassdenteufel
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Ludwig Maximilian University, Munich, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
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Leung C, Pei J, Hudec K, Shams F, Munthali R, Vigo D. The effects of non-clinician guidance on effectiveness and process outcomes of digital mental health interventions: A systematic review and meta-analysis (Preprint). J Med Internet Res 2021; 24:e36004. [PMID: 35511463 PMCID: PMC9244656 DOI: 10.2196/36004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 01/22/2023] Open
Abstract
Background Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (ie, psychologists and physicians) into digital mental health interventions has become common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other nonclinicians) can help reduce costs and increase accessibility. Objective This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of nonclinician-guided digital mental health interventions. Methods Four databases (MEDLINE, Embase, CINAHL, and PsycINFO) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals that focus on digital intervention were hand searched; gray literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane risk-of-bias tool version 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Nonclinician-guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. Results Thirteen studies qualified for inclusion. Nonclinician-guided interventions yielded higher posttreatment effectiveness outcomes when compared to conditions involving control programs (eg, online psychoeducation and monitored attention control) or wait-list controls (k=7, Hedges g=–0.73; 95% CI –1.08 to –0.38). There were also significant differences between nonclinician-guided interventions and unguided interventions (k=6, Hedges g=–0.17; 95% CI –0.23 to –0.11). In addition, nonclinician-guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08; 95% CI –0.01 to 0.17). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualifications of the individual performing the intervention, and that the presence of a nonclinician guide improves effectiveness outcomes compared to having no guide. Nonclinician-guided interventions did not yield significantly different adherence outcomes when compared with unguided interventions (k=3, odds ratio 1.58; 95% CI 0.51 to 4.92), although a general trend of improved adherence was observed within nonclinician-guided interventions. Conclusions Integrating paraprofessionals and nonclinicians appears to improve the outcomes of digital mental health interventions, and may also enhance adherence outcomes (though this trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (ie, psychosocial support, therapeutic alliance, and technical augmentation) and their associated outcomes. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020191226; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=191226
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Affiliation(s)
- Calista Leung
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julia Pei
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kristen Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Farhud Shams
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Ramos G, Aguilera A, Montoya A, Lau A, Wen CY, Cruz Torres V, Chavira D. App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (Preprint). JMIR Res Protoc 2021; 11:e35196. [PMID: 35436228 PMCID: PMC9052031 DOI: 10.2196/35196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/08/2022] [Accepted: 03/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background People of color (POC) who experience race-related stress are at risk of developing mental health problems, including high levels of stress, anxiety, and depression. Mindfulness meditation may be especially well suited to help POC cope, given its emphasis on gaining awareness and acceptance of emotions associated with discriminatory treatment. However, mindfulness meditation rarely reaches POC, and digital approaches could reduce this treatment gap by addressing traditional barriers to care. Objective This study will test the effectiveness of a self-directed app-based mindfulness meditation program among POC who experience elevated levels of race-related stress. Implementation outcomes such as treatment acceptability, adherence, and satisfaction will be examined. Methods Participants (n=80) will be recruited online by posting recruitment materials on social media and sending emails to relevant groups. In-person recruitment will consist of posting flyers in communities with significant POC representation. Eligible participants will be block randomized to either the intervention group (n=40) that will complete a self-directed 4-week mindfulness meditation program or a wait-list control condition (n=40) that will receive access to the app after study completion. All participants will complete measures at baseline, midtreatment, and posttreatment. Primary outcomes include changes in stress, anxiety, and depression, and secondary outcomes constitute changes in mindfulness, self-compassion, rumination, emotion suppression, and experiential avoidance. Exploratory analyses will examine whether changes in the secondary outcomes mediate changes in primary outcomes. Finally, treatment acceptability, adherence, and satisfaction will be examined descriptively. Results Recruitment began in October 2021. Data will be analyzed using multilevel modeling, a statistical methodology that accounts for the dependence among repeated observations. Considering attrition issues in self-directed digital interventions and their potential effects on statistical significance and treatment effect sizes, we will examine data using both intention-to-treat and per-protocol analyses. Conclusions To our knowledge, this will be the first study to provide data on the effectiveness of a self-directed app-based mindfulness meditation program for POC recruited based on elevated race-related stress, a high-risk population. Similarly, meaningful clinical targets for POC affected by stressors related to race will be examined. Findings will provide important information regarding whether this type of intervention is an acceptable treatment among these marginalized groups. Trial Registration ClinicalTrials.gov NCT05027113; https://clinicaltrials.gov/ct2/show/NCT05027113 International Registered Report Identifier (IRRID) DERR1-10.2196/35196
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Affiliation(s)
- Giovanni Ramos
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adrian Aguilera
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Amanda Montoya
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anna Lau
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Chu Yin Wen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Denise Chavira
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
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