1
|
Macrynikola N, Mir Z, Gopal T, Rodriguez E, Li S, Cox M, Yeh G, Torous J. The impact of mindfulness apps on psychological processes of change: a systematic review. NPJ MENTAL HEALTH RESEARCH 2024; 3:14. [PMID: 38609511 PMCID: PMC10955957 DOI: 10.1038/s44184-023-00048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/08/2023] [Indexed: 04/14/2024]
Abstract
Mindfulness-based interventions (MBIs) have demonstrated therapeutic efficacy for various psychological conditions, and smartphone apps that facilitate mindfulness practice can enhance the reach and impact of MBIs. The goal of this review was to summarize the published evidence on the impact of mindfulness apps on the psychological processes known to mediate transdiagnostic symptom reduction after mindfulness practice. A literature search from January 1, 1993, to August 7, 2023 was conducted on three databases, and 28 randomized controlled trials involving 5963 adults were included. Across these 28 studies, 67 outcome comparisons were made between a mindfulness app group and a control group. Between-group effects tended to favor the mindfulness app group over the control group in three psychological process domains: repetitive negative thinking, attention regulation, and decentering/defusion. Findings were mixed in other domains (i.e., awareness, nonreactivity, non-judgment, positive affect, and acceptance). The range of populations examined, methodological concerns across studies, and problems with sustained app engagement likely contributed to mixed findings. However, effect sizes tended to be moderate to large when effects were found, and gains tended to persist at follow-up assessments two to six months later. More research is needed to better understand the impact of these apps on psychological processes of change. Clinicians interested in integrating apps into care should consider app-related factors beyond evidence of a clinical foundation and use app databases to identify suitable apps for their patients, as highlighted at the end of this review.
Collapse
Affiliation(s)
- Natalia Macrynikola
- Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA.
| | - Zareen Mir
- Teacher's College, Columbia University, New York, NY, USA
| | | | | | - Sunnie Li
- Northeastern University, Boston, MA, USA
| | - Milann Cox
- Penn State College of Medicine, Hershey, PA, USA
| | - Gloria Yeh
- Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA
| | - John Torous
- Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Mas-Cuesta L, Baltruschat S, Cándido A, Verdejo-Lucas C, Catena-Verdejo E, Catena A. Brain changes following mindfulness: Reduced caudate volume is associated with decreased positive urgency. Behav Brain Res 2024; 461:114859. [PMID: 38216057 DOI: 10.1016/j.bbr.2024.114859] [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: 05/19/2023] [Revised: 11/22/2023] [Accepted: 01/06/2024] [Indexed: 01/14/2024]
Abstract
Mindfulness training has been shown to improve psychological health and general well-being. However, it is unclear which brain and personality systems may be affected by this practice for improving adaptive behavior and quality of life. The present study explores the effects of a 5-week mindfulness-based intervention (MBI) at the neuroanatomical level and its relationship with dispositional mindfulness and impulsivity. Sixty-six risky drivers were quasi-randomly assigned to a mindfulness training group (MT) or a control group (N). Participants underwent magnetic resonance imaging and completed the Five Facet Mindfulness Questionnaire (FFMQ) and the UPPS-P impulsivity scale twice, at baseline and after receiving the MBI. We observed that MBI changes dispositional mindfulness in the non-reactivity and observing facets. Further, we observed that the magnitude of change in impulsivity was associated with the change in dispositional mindfulness. Whole-brain voxel-wise analysis revealed that the volume of the right caudate nucleus of the MT group (n = 27) showed a reduction compared to that of the control group (n = 33), which increased in terms of the pre-post measurement (MT=-1.76 mm3; N = 6.31 mm3). We also observed that reduced caudate nucleus volume correlated with decreased positive urgency in the MT group. Taken together, our results show that MBI improves the skills of observing and non-reactivity to inner experience, while producing changes in the structure of the caudate nucleus. These structural changes are associated with a reduction in impulsivity levels, decreasing the tendency to act rashly in situations that generate positive emotions and thus facilitating more adaptive behavior.
Collapse
Affiliation(s)
- Laura Mas-Cuesta
- Mind, Brain and Behavior Research Center, University of Granada, Campus de Cartuja s/n, 18011 Granada, Spain.
| | - Sabina Baltruschat
- Brain Research Imaging Centre, Cardiff University, Maindy Rd, Cardiff CF24 4HQ, UK
| | - Antonio Cándido
- Mind, Brain and Behavior Research Center, University of Granada, Campus de Cartuja s/n, 18011 Granada, Spain
| | | | | | - Andrés Catena
- School of Psychology, University of Granada, Campus de Cartuja s/n, 18011 Granada, Spain
| |
Collapse
|
3
|
Ekbäck E, Rådmark L, Granåsen G, Svärling R, Sörlin M, Schönbeck C, Henje E. Clinical effectiveness of training for awareness, resilience, and action for adolescents and young adults with depression: The pilot phase of a multicenter randomized controlled trial. Front Psychiatry 2023; 14:1130035. [PMID: 37065894 PMCID: PMC10102586 DOI: 10.3389/fpsyt.2023.1130035] [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: 12/22/2022] [Accepted: 03/10/2023] [Indexed: 04/18/2023] Open
Abstract
Background Depression is a top-ranking global health concern increasing in magnitude. Available treatments for adolescents and young adults are not convincingly effective and relapse rates remain high. Training for Awareness, Resilience and Action (TARA) is a group treatment program targeting specific pathophysiological mechanisms of depression in young people. TARA is feasible, acceptable, preliminarily efficacious in depressed American adolescents, and it affects postulated brain-circuitry. Methods As an initial step of a multicenter randomized controlled trial (RCT) we performed a single-arm multicenter pilot-study on TARA. Thirty-five depressed individuals (15-21 years old, 28 females) received TARA for 12 weeks face-to-face or online. Data was collected before (T0), during, and after the intervention (T1). The trial was pre-registered at clinicaltrials.gov, NCT Registration: identifier [NCT04747340]. Feasibility outcomes included recruitment, attendance rates, and session ratings. Adverse events were recorded weekly and extracted from medical records at the end of the trial. Primary effectiveness outcome was self-rated depression severity on Reynolds Adolescent Depression scale 2nd ed. at T1. Secondary outcomes were Children's Depression Rating Scale-revised (CDRS-R) and Multidimensional Anxiety Scale for Children (MASC) at T1. Results TARA was feasible and safe in the present trial. No significant RADS-2-change was seen (adjusted mean difference -3.26, 95 % CI -8.35 to 1.83; p= 0.20), however a significant decrease in CDRS-R scores is reported (adjusted mean difference -9.99, 95% CI -14.76 to -5.22; p < 0.001). MASC-scores did not change significantly (adjusted mean difference 1.98, 95% CI -0.96 to 4.91; p=0.18). Additional feasibility aspects are presented and discussed. Discussion Limitations include substantial loss-to-follow-up, no randomization to control, and that some participants received concomitant treatment(s). The Coronavirus pandemic complicated both implementation and interpretation of the trial. In conclusion TARA was feasible and safe in depressed adolescents and young adults. Preliminary signs of effectiveness were seen. The initiated RCT will be important and worthwhile to conduct, and several improvements to the design are suggested based on the present results. Clinical Trial Registration clinicaltrials.gov, identifier NCT04747340.
Collapse
Affiliation(s)
- Erik Ekbäck
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
- *Correspondence: Erik Ekbäck,
| | - Lina Rådmark
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Gabriel Granåsen
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rachel Svärling
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Matilda Sörlin
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Caspar Schönbeck
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Eva Henje
- Child and Adolescent Psychiatry, Department of Clinical Science, Umeå University, Umeå, Sweden
| |
Collapse
|
4
|
Tymofiyeva O, Hu MY, Sipes BS, Jakary A, Glidden DV, Jariwala N, Bhandari S, Parks KC, Nguyen C, Henje E, Yang TT. A Feasibility Study of a Remotely-Delivered Mindfulness-Based Training for Adolescents During the COVID-19 Pandemic. Front Psychiatry 2022; 13:838694. [PMID: 35633797 PMCID: PMC9133427 DOI: 10.3389/fpsyt.2022.838694] [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: 12/18/2021] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Social distancing, home confinement, economic challenges, and COVID-19-related illness and deaths during the COVID-19 pandemic can significantly affect mental health in youth. One promising approach to reduce anxiety and depression in adolescents is the neuroscience-based mindfulness intervention Training for Awareness, Resilience, and Action (TARA). The objective of this individually randomized waitlist-controlled trial (RCT) was (1) to test the feasibility of TARA, delivered partially over Zoom, and (2) to assess changes in the emotional wellbeing in healthy adolescents between the ages of 14-18 years old during the COVID-19 pandemic. METHODS Twenty-one healthy adolescents were randomized to the TARA intervention or to the waitlist control group in February 2020, just before the start of the pandemic. The TARA group intervention was delivered in person for the first five sessions and remotely over Zoom for the remaining seven sessions due to the pandemic. The participants' acceptability of TARA was assessed weekly using the Child Session Rating Scale (CSRS). The primary outcome was the emotional wellbeing measured using emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) pre/post-TARA. We also explored weekly changes in TARA participants' wellbeing using the Child Outcome Rating Scale (CORS). RESULTS The overall session rating in TARA participants improved after the switch to Zoom (Cohen's d = 1.2, p = 0.008). The results of the two-way ANOVA showed no statistically significant difference in the change of the SDQ emotional symptoms during the 12 weeks between the TARA group and waitlist-control group (timepoint × group interaction: F = 0.77, p = 0.38). The exploratory analysis using the CORS in the TARA participants showed a significant improvement in their functioning over the weeks of training. CONCLUSION Our results support the feasibility of TARA delivered over Zoom. While our primary outcome did not provide support for the improvement of the emotional wellbeing with TARA compared to a passive control group, our exploratory analysis in the intervention group indicated an improved functioning over the weeks of TARA training. The important general positive impact of this study lies in the possibility of offering a neuroscience-based mindfulness intervention remotely to youth living in remote areas and for all youth during pandemic times.
Collapse
Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Melody Y. Hu
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Benjamin S. Sipes
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Angela Jakary
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Namasvi Jariwala
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Sarina Bhandari
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Kendall C. Parks
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Ca Nguyen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Eva Henje
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Tony T. Yang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| |
Collapse
|
5
|
Ekbäck E, von Knorring J, Burström A, Hunhammar D, Dennhag I, Molin J, Henje E. Training for Awareness, Resilience and Action (TARA) for medical students: a single-arm mixed methods feasibility study to evaluate TARA as an indicated intervention to prevent mental disorders and stress-related symptoms. BMC MEDICAL EDUCATION 2022; 22:132. [PMID: 35227281 PMCID: PMC8883651 DOI: 10.1186/s12909-022-03122-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/13/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND Medical students have a higher risk for depression, anxiety, stress-related symptoms, burnout, and suicide, and more rarely seek professional help or treatment than the general population. Appeals are being made to address the mental health and resilience of physicians-to-be. The novel program Training for Awareness, Resilience, and Action (TARA) was originally developed to treat depressed adolescents, targeting specific neuroscientific findings in this population. TARA has shown feasibility and preliminary efficacy in clinically depressed adolescents and corresponding brain-changes in mixed community adolescent samples. The present study investigated the feasibility and acceptability of TARA as a potential indicated prevention program for symptoms of depression, anxiety, stress and burnout in Swedish medical students. METHODS We conducted a single-arm trial with 23 self-selected students in their early semesters of medical school (mean age 25.38 years, 5 males and 18 females), with or without mental disorders. All participants received TARA. Self-reported symptoms of depression, anxiety, perceived stress and psychological inflexibility were collected before (T0) and after the intervention (T1). Qualitative data on the participants' experiences of TARA were collected in focus-group interviews conducted halfway through the program and upon completion of the program. Individual interviews were also conducted 2 years later. Qualitative content analysis was performed. RESULTS The mean attendance rate was 61.22% and the dropout rate was 17.40%. The Child Session Rating Scale administered after every session reflected an overall acceptable content, mean total score 34.99 out of 40.00. Trends towards improvement were seen across all outcome measures, including the Hospital Anxiety and Depression Scale Anxiety (t = 1.13, p = 0.29) and Depression (t = 1.71, p = 0.11) subscales, Perceived Stress Scale (t = 0.67, p = 0.51) and Avoidance and Fusion Questionnaire for youth (t = 1.64, p = 0.10). None of the participants deteriorated markedly during the intervention. Qualitative content analysis resulted in a main theme labeled: "An uncommon meeting-ground for personal empowerment", with 4 themes; "Acknowledging unmet needs", "Entering a free zone", "Feeling connected to oneself and others" and "Expanding self-efficacy". CONCLUSION TARA is feasible and acceptable in a mixed sample of Swedish medical students. The students' reports of entering an uncommon meeting-ground for personal empowerment supports effectiveness studies of TARA in this context.
Collapse
Affiliation(s)
- Erik Ekbäck
- Department of Clinical Science, Umeå University, Umeå, Sweden.
| | | | - Anna Burström
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - David Hunhammar
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Inga Dennhag
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Jenny Molin
- Department of Nursing, Department of Clinical Science, Umeå university, Umeå, Sweden
| | - Eva Henje
- Department of Clinical Science, Umeå University, Umeå, Sweden
| |
Collapse
|
6
|
Wilson NA, Kenny MA, Peña AS. Role of meditation to improve children's health: Time to look at other strategies. J Paediatr Child Health 2021; 57:178-181. [PMID: 33217077 DOI: 10.1111/jpc.15275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/18/2023]
Abstract
In the United States, it is reported that up to 7 million of the population practice some form of meditation with the main purpose of improving emotional wellbeing and reducing stress. As the prevalence of mental health conditions continues to climb, other forms of health management strategies, including meditation practices, are increasingly used in adults. The evidence continues to emerge for the use of meditation as a way of managing health conditions in adults as demonstrated in systematic reviews and randomised controlled trials. There is also growing evidence evaluating the use of meditation practices and their potential benefits for child and adolescent health. Studies have identified improvements in mood and mental health conditions, school attendance and attention in the classroom in children and adolescents. This article aims to provide a perspective on commonly evaluated meditation types, such as Transcendental Meditation and mindfulness-based stress reduction. The article also aims to discuss the available evidence for the use of meditation to improve health and general wellbeing of children, including the use of meditation programs in schools, the current downfalls and limitations to the existing literature around meditation, and important points that healthcare practitioners need to consider when discussing the use of meditation as an additional strategy to manage and improve health and wellbeing in children and adolescents.
Collapse
Affiliation(s)
- Nina A Wilson
- Discipline of Paediatrics, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, SA Health, Government of South Australia, Adelaide, South Australia, Australia
| | - Maura A Kenny
- Centre for the Treatment of Anxiety and Depression, Central Adelaide Local Health Network, SA Health, Government of South Australia, Thebarton, South Australia, Australia
| | - Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, SA Health, Government of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
7
|
Tymofiyeva O, Gaschler R. Training-Induced Neural Plasticity in Youth: A Systematic Review of Structural and Functional MRI Studies. Front Hum Neurosci 2021; 14:497245. [PMID: 33536885 PMCID: PMC7848153 DOI: 10.3389/fnhum.2020.497245] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 12/01/2020] [Indexed: 01/17/2023] Open
Abstract
Experience-dependent neural plasticity is high in the developing brain, presenting a unique window of opportunity for training. To optimize existing training programs and develop new interventions, it is important to understand what processes take place in the developing brain during training. Here, we systematically review MRI-based evidence of training-induced neural plasticity in children and adolescents. A total of 71 articles were included in the review. Significant changes in brain activation, structure, microstructure, and structural and functional connectivity were reported with different types of trainings in the majority (87%) of the studies. Significant correlation of performance improvement with neural changes was reported in 51% of the studies. Yet, only 48% of the studies had a control condition. Overall, the review supports the hypothesized neural changes with training while at the same time charting empirical and methodological desiderata for future research.
Collapse
Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, United States.,Department of Psychology, University of Hagen, Hagen, Germany
| | - Robert Gaschler
- Department of Psychology, University of Hagen, Hagen, Germany
| |
Collapse
|
8
|
Ekbäck E, Granåsen G, Svärling R, Blomqvist I, Henje E. Clinical Effectiveness of Training for Awareness Resilience and Action Online Compared to Standard Treatment for Adolescents and Young Adults With Depression: Study Protocol and Analysis Plan for a Pragmatic, Multi-Center Randomized Controlled Superiority Trial. Front Psychiatry 2021; 12:674583. [PMID: 34707516 PMCID: PMC8542661 DOI: 10.3389/fpsyt.2021.674583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/10/2021] [Indexed: 01/21/2023] Open
Abstract
Depression in adolescents and young adults is an increasing global health concern. Available treatments are not sufficiently effective and relapse rates remain high. The novel group-treatment program "Training for Awareness, Resilience and Action" (TARA) targets specific mechanisms based on neuroscientific findings in adolescent depression. TARA is framed within the National Institute of Mental Health's Research Domain Criteria and has documented feasibility and preliminary efficacy in the treatment of adolescent depression. Since neurodevelopment continues well into the mid-twenties, age-adapted treatments are warranted also for young adults. Patients 15-22 years old, with either major depressive disorder (MDD) or persistent depressive disorder (PDD) according to the DSM-IV/5 or a rating >40 on the clinician rating scale Children's Depression Rating Scale-Revised (CDRS-R), will be recruited from specialized Child and Adolescent Psychiatry and local Youth-Clinics and randomized to either TARA or standard treatment, including but not limited to antidepressant medication and/or psychotherapy. Outcome measures will be obtained before randomization (T0), after 3 months of treatment (T1) and at 6-months- (T2) and 24-months- (T3) follow-up. Additionally, dose-response measures will be obtained weekly in the TARA-arm and measures for mediation-analysis will be obtained halfway through treatment (T0.5). Primary outcome measure is Reynolds Adolescent Depression Scale (RADS-2) score at T1. Secondary outcome measures include RADS-2 score at T2, Multidimensional Anxiety Scale for Children at T1 and T2, and CDRS-R at T1. Additional outcome measures include self-report measures of depression-associated symptoms, systemic bio-indicators of depression from blood and hair, heartrate variability, brain magnetic resonance imaging, as well as three-axial accelerometry for sleep-objectivization. Qualitative data will be gathered to reach a more comprehensive understanding of the factors affecting adolescents and young adults with depression and the extent to which the different treatments address these factors. In summary, this article describes the design, methods and statistical analysis plan for pragmatically evaluating the clinical effectiveness of TARA. This will be the first RCT to examine the effects of TARA compared to standard treatment for adolescents and young adults with MDD or PDD. We argue that this study will extend the current knowledgebase regarding the treatment of depression. NCT Registration: identifier [NCT04747340].
Collapse
Affiliation(s)
- Erik Ekbäck
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Gabriel Granåsen
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rachel Svärling
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Ida Blomqvist
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Eva Henje
- Department of Clinical Science, Umeå University, Umeå, Sweden
| |
Collapse
|
9
|
Xie C, Li X, Zeng Y, Hu X. Mindfulness, emotional intelligence and occupational burnout in intensive care nurses: A mediating effect model. J Nurs Manag 2020; 29:535-542. [PMID: 33103273 DOI: 10.1111/jonm.13193] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/01/2020] [Accepted: 10/12/2020] [Indexed: 02/06/2023]
Abstract
AIM(S) To construct structural equation models to test the mediating role of emotional intelligence in the relationship between mindfulness and occupational burnout. BACKGROUND Reports assessing the relationships among mindfulness, emotional intelligence and burnout, specifically in ICU nurses, are scarce. METHODS This was a descriptive, correlational, cross-sectional research design with 883 ICU nurses enrolled by convenience sampling from 29 ICUs in seven tertiary hospitals in urban areas of Chengdu, China. Mediation analysis was performed by structural equation modelling. Indirect effects were evaluated through bootstrapping. RESULTS The associations among mindfulness, emotional intelligence, emotional exhaustion, depersonalization and personal accomplishment were all significant (p < .001). In the mediation models, emotional intelligence partially mediates the relationships between mindfulness and emotional exhaustion (indirect effect 0.118, p = .006; direct effect -0.374, p = .010; total effect -0.492, p = .011) and between mindfulness and depersonalization (indirect effect -0.182, p = .006; direct effect -0.452, p = .015; total effect -0.633, p = .018). Emotional intelligence plays a total mediating role between mindfulness and personal accomplishment (indirect effect 0.293, p = .004; direct effect 0.119, p = .053). CONCLUSIONS The results suggest that nursing manager could implement mindfulness training to improve occupational burnout in ICU nurses. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers could help create a more favourable working environment by providing mindfulness training. Such mindfulness training could help improve nursing quality, reduce errors and ensure patient safety, possibly improving patient prognosis and probably satisfaction.
Collapse
Affiliation(s)
- Caixia Xie
- Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyu Li
- Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanli Zeng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
10
|
Tymofiyeva O, Henje E, Yuan JP, Huang CY, Connolly CG, Ho TC, Bhandari S, Parks KC, Sipes BS, Yang TT, Xu D. Reduced anxiety and changes in amygdala network properties in adolescents with training for awareness, resilience, and action (TARA). Neuroimage Clin 2020; 29:102521. [PMID: 33316764 PMCID: PMC7735968 DOI: 10.1016/j.nicl.2020.102521] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/13/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022]
Abstract
Mindfulness-based approaches show promise to improve emotional health in youth and may help treat and prevent adolescent depression and anxiety. However, there is a fundamental gap in understanding the neural reorganization that takes place as a result of such interventions. The Training for Awareness, Resilience, and Action (TARA) program, initially developed for depressed adolescents, uses a framework drawn from neuroscience, mindfulness, yoga, and modern psychotherapeutic techniques to promote emotional health. The goal of this study was to assess the effects of the TARA training on emotional health and structural white matter brain networks in healthy youth. We analyzed data from 23 adolescents who underwent the 12-week TARA training in a controlled within-subject study design and whose brain networks were assessed using diffusion MRI connectomics. Compared to the control time period, adolescents showed a significant decrease in anxiety symptoms with TARA (Cohen's d = -0.961, p = 0.006); moreover, the node strength of the Right Amygdala decreased significantly after TARA (Cohen's d = -1.026, p = 0.004). Post-hoc analyses indicated that anxiety at baseline before TARA was positively correlated with Right Amygdala node strength (r = 0.672, p = 0.001). While change in Right Amygdala node strength with TARA was not correlated with change in anxiety (r = 0.146, p = 0.51), it was associated with change in depression subscale of Anhedonia / Negative Affect (r = 0.575, p = 0.004, exploratory analysis), possibly due to overlapping constructs captured in our anxiety and depression scales. Our results suggest that increased structural connectivity of Right Amygdala may underlie increased anxiety in adolescents and be lowered through anxiety-reducing training such as TARA. The results of this study contribute to our understanding of the neural mechanisms of TARA and may facilitate neuroscience-based prevention and treatment of adolescent anxiety and depression.
Collapse
Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, 1700 4th Street, BH102, San Francisco, CA 94143, USA.
| | - Eva Henje
- Department of Psychiatry and Behavioral Sciences, The Langley Porter Psychiatric Institute, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Clinical Science/Child- and Adolescent Psychiatry, Umeå University, SE-901 87 Umeå, Sweden
| | - Justin P Yuan
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, 1700 4th Street, BH102, San Francisco, CA 94143, USA; Department of Psychology, Stanford University, 450 Jane Stanford Way, Bldg 420, Jordan Hall, Stanford, CA 94305-2130, USA
| | - Chiung-Yu Huang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA 94143, USA
| | - Colm G Connolly
- Department of Psychiatry and Behavioral Sciences, The Langley Porter Psychiatric Institute, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Biomedical Sciences, Florida State University College of Medicine, 1115 West Call Street, Tallahassee, FL 32306, USA
| | - Tiffany C Ho
- Department of Psychiatry and Behavioral Sciences, The Langley Porter Psychiatric Institute, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Sarina Bhandari
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, 1700 4th Street, BH102, San Francisco, CA 94143, USA
| | - Kendall C Parks
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, 1700 4th Street, BH102, San Francisco, CA 94143, USA
| | - Benjamin S Sipes
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, 1700 4th Street, BH102, San Francisco, CA 94143, USA
| | - Tony T Yang
- Department of Psychiatry and Behavioral Sciences, The Langley Porter Psychiatric Institute, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Duan Xu
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, 1700 4th Street, BH102, San Francisco, CA 94143, USA
| |
Collapse
|