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Cheng L, Luo M, Ge J, Fu Y, Gan Q, Chen Z. Effects of brief mindfulness training on smoking cue-reactivity in tobacco use disorder: Study protocol for a randomized controlled trial. PLoS One 2024; 19:e0299797. [PMID: 38648252 PMCID: PMC11034654 DOI: 10.1371/journal.pone.0299797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The prevalence of Tobacco Use Disorder (TUD) represents a significant and pressing global public health concern, with far-reaching and deleterious consequences for individuals, communities, and healthcare systems. The craving caused by smoking cue is an important trigger for relapse, fundamentally hindering the cessation of cigarette smoking. Mindfulness interventions focusing on cue-reactivity was effective for the treatment of related dependence. Brief mindfulness training (BMT) meets the short-term needs for intervention but the effects still need to be examined. The objective of the present study is to investigate the impact of BMT intervention on smoking cue-reactivity among Chinese college students with TUD, to uncover the dynamic models of brain function involved in this process. METHOD A randomized control trial (RCT) based on electroencephalography (EEG) was designed. We aim to recruit 90 participants and randomly assign to the BMT and control group (CON) with 1:1 ratio. A brief mindfulness training will be administered to experimental group. After the intervention, data collection will be conducted in the follow-up stage with 5 timepoints of assessments. EEG data will be recorded during the smoking cue-reactivity task and 'STOP' brief mindfulness task. The primary outcomes include subjective reports of smoking craving, changes in EEG indicators, and mindfulness measures. The secondary outcomes will be daily smoking behaviours, affect and impulsivity, as well as indicators reflecting correlation between mindfulness and smoking cue-reactivity. To evaluate the impact of mindfulness training, a series of linear mixed-effects models will be employed. Specifically, within-group effects will be examined by analysing the longitudinal data. Additionally, the effect size for all statistical measurements will be reported, offering a comprehensive view of the observed effects. DISCUSSION The current study aims to assess the impact of brief mindfulness-based intervention on smoking cue-reactivity in TUD. It also expected to enhance our understanding of the underlying processes involved in brain function and explore potential EEG biomarkers at multiple time points. TRIAL REGISTRATION Trial registration number: ChiCTR2300069363, registered on 14 March 2023. Protocol Version 1.0., 10 April 2023.
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Affiliation(s)
- Linlin Cheng
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Miaoling Luo
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Jie Ge
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Students Counseling and Mental Health Center, Kunming University of Science and Technology, Kunming, China
| | - Yu Fu
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Quan Gan
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Faculté de médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Zhuangfei Chen
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
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Francis SEB, Shawyer F, Cayoun BA, Grabovac A, Meadows G. Differentiating mindfulness-integrated cognitive behavior therapy and mindfulness-based cognitive therapy clinically: the why, how, and what of evidence-based practice. Front Psychol 2024; 15:1342592. [PMID: 38384351 PMCID: PMC10880191 DOI: 10.3389/fpsyg.2024.1342592] [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: 11/22/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
It is important to be able to differentiate mindfulness-based programs in terms of their model, therapeutic elements, and supporting evidence. This article compares mindfulness-based cognitive therapy (MBCT), developed for relapse prevention in depression, and mindfulness-integrated cognitive behavior therapy (MiCBT), developed for transdiagnostic applications, on: (1) origins, context and theoretical rationale (why), (2) program structure, practice and, professional training (how), and (3) evidence (what). While both approaches incorporate behavior change methods, MBCT encourages behavioral activation, whereas MiCBT includes various exposure procedures to reduce avoidance, including a protocol to practice equanimity during problematic interpersonal interactions, and a compassion training to prevent relapse. MBCT has a substantial research base, including multiple systematic reviews and meta-analyses. It is an endorsed preventative treatment for depressive relapse in several clinical guidelines, but its single disorder approach might be regarded as a limitation in many health service settings. MiCBT has a promising evidence base and potential to make a valuable contribution to psychological treatment through its transdiagnostic applicability but has not yet been considered in clinical guidelines. While greater attention to later stage dissemination and implementation research is recommended for MBCT, more high quality RCTs and systematic reviews are needed to develop the evidence base for MiCBT.
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Affiliation(s)
- Sarah E. B. Francis
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Bruno A. Cayoun
- Mindfulness-integrated Cognitive Behavior Therapy Institute, Hobart, TAS, Australia
| | - Andrea Grabovac
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Graham Meadows
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
- Mental Health Program, Monash Health, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
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Williams JMG, Baer R, Batchelor M, Crane RS, Cullen C, De Wilde K, Fennell MJV, Kantor L, Kirby J, Ma SH, Medlicott E, Gerber B, Johnson M, Ong EL, Peacock JW, Penman D, Phee A, Radley L, Watkin M, Taylor L. What Next After MBSR/MBCT? An Open Trial of an 8-Week Follow-on Program Exploring Mindfulness of Feeling Tone (vedanā). Mindfulness (N Y) 2022; 13:1931-1944. [PMID: 35818377 PMCID: PMC9261229 DOI: 10.1007/s12671-022-01929-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/09/2022]
Abstract
Objectives
The effectiveness of mindfulness-based programs (MBPs) has been established in many randomized controlled trials. However, effect sizes are often modest, and there remains ample scope to improve their effectiveness. One approach to this challenge is to offer a “follow-on” course to people who have completed an MBP and are interested in further skill development. We developed and tested a new 8-week course for this purpose based on awareness of feeling tone (vedanā), an understudied aspect of mindfulness in many current MBPs, incorporating new developments in neuroscience and trauma sensitivity. We examined its effectiveness and the frequency and severity of unpleasant experience and harm. Methods In an open trial, 83 participants, 78 of whom had previously taken part in an MBP (majority MBSR or MBCT), completed the program in nine groups. Participants completed questionnaires before and after and gave qualitative written feedback at completion. Results Participants reported significantly reduced depression (d = 0.56), stress (d = 0.36), and anxiety (d = 0.53) and increased well-being (d = 0.54) and mindfulness (d = 0.65) with 38% meeting criteria for reliable change on anxiety and depression. As expected, about three-quarters of participants reported some unpleasant experiences associated with mindfulness practice during the course, but none reported harm. Five participants showed “reliable deterioration” (an increase) in either depression or anxiety, but four of these five also gave anonymous qualitative feedback describing benefits of the course. Conclusions Findings support the added value of a follow-on course based on the exploration of feeling tone for participants who have a range of previous mindfulness experience. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-022-01929-0.
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Kim J, Esteves JE, Cerritelli F, Friston K. An Active Inference Account of Touch and Verbal Communication in Therapy. Front Psychol 2022; 13:828952. [PMID: 35668964 PMCID: PMC9163786 DOI: 10.3389/fpsyg.2022.828952] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 05/02/2022] [Indexed: 11/23/2022] Open
Abstract
This paper offers theoretical explanations for why “guided touch” or manual touch with verbal communication can be an effective way of treating the body (e.g., chronic pain) and the mind (e.g., emotional disorders). The active inference theory suggests that chronic pain and emotional disorders can be attributed to distorted and exaggerated patterns of interoceptive and proprioceptive inference. We propose that the nature of active inference is abductive. As such, to rectify aberrant active inference processes, we should change the “Rule” of abduction, or the “prior beliefs” entailed by a patient’s generative model. This means pre-existing generative models should be replaced with new models. To facilitate such replacement—or updating—the present treatment proposes that we should weaken prior beliefs, especially the one at the top level of hierarchical generative models, thereby altering the sense of agency, and redeploying attention. Then, a new prior belief can be installed through inner communication along with manual touch. The present paper proposes several hypotheses for possible experimental studies. If touch with verbal guidance is proven to be effective, this would demonstrate the relevance of active inference and the implicit prediction model at a behavioral level. Furthermore, it would open new possibilities of employing inner communication interventions, including self-talk training, for a wide range of psychological and physical therapies.
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Affiliation(s)
- Joohan Kim
- Department of Communication, Yonsei University, Seoul, South Korea
| | - Jorge E Esteves
- Clinical-Based Human Research Department, Foundation Center for Osteopathic Medicine Collaboration (COME) Collaboration, Pescara, Italy.,Malta ICOM Educational Ltd., St. Julian's, Gzira, Malta.,Research Department, University College of Osteopathy, London, United Kingdom
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation Center for Osteopathic Medicine Collaboration (COME) Collaboration, Pescara, Italy
| | - Karl Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, London, United Kingdom
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Francis SEB, Shawyer F, Cayoun B, Enticott J, Meadows GN. Group Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT) Reduces Depression and Anxiety and Improves Flourishing in a Transdiagnostic Primary Care Sample Compared to Treatment-as-Usual: A Randomized Controlled Trial. Front Psychiatry 2022; 13:815170. [PMID: 35711582 PMCID: PMC9193586 DOI: 10.3389/fpsyt.2022.815170] [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: 11/15/2021] [Accepted: 04/26/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study investigated the effectiveness of a group-based 8-week intervention, Mindfulness-integrated Cognitive Behavior Therapy (MiCBT), to decrease psychological distress and increase wellbeing in a heterogeneous population in primary health care. MiCBT focuses on the importance of interoception and its interaction with cognition in emotional experience. These interactions are represented in the co-emergence model of reinforcement, in which non-reactivity (equanimity) to interoceptive signals facilitates adaptive behavior. METHODS Participants (n = 125, aged 20-72) were randomized to two groups (MiCBT), and treatment-as-usual (TAU). Outcomes were assessed at pre-, mid-, and post-intervention and at 6-month follow-up. The primary outcome was psychological distress, measured by the Depression, Anxiety and Stress Scale (DASS-21). Secondary outcome measures were the Kessler Psychological Distress Scale-10 (K10), Satisfaction with Life Scale (SWLS), and Flourishing Scale (FS). Mediator or process measures of interoceptive awareness, metacognitive awareness (decentering), equanimity, and social functioning were included to investigate putative mediators. RESULTS The MiCBT intervention significantly reduced DASS-21 scores at mid and post-treatment and the gains were maintained at 6-month follow-up (p < 0.0001, d = 0.38). Flourishing scores also showed significant improvement post-treatment and at 6-month follow-up (d = 0.24, p < 0.0001). All measures selected showed a similar pattern of positive change, with the exception of the SWLS, which failed to reach significance. Mediation analysis suggested equanimity to be the most influential mediator of the primary outcome. CONCLUSIONS The results support the effectiveness of MiCBT in creating rapid and sustainable reduction of psychological distress and improvement in flourishing in a primary mental health care setting with heterogenous groups. These promising results support the scaled-up implementation of this intervention. CLINICAL TRIAL REGISTRATION This trial is registered with the Australian and New Zealand Clinical Trial Registry: https://www.anzctr.org.au/ACTRN12617000061336.
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Affiliation(s)
- Sarah E B Francis
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Bruno Cayoun
- Mindfulness-Integrated Cognitive Behavior Therapy Institute, Hobart, TAS, Australia
| | - Joanne Enticott
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.,Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Graham N Meadows
- Southern Synergy, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.,Mental Health Program, Monash Health, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
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Grabli FE, Quesque F, Borg C, Witthöft M, Michael GA, Lucas C, Pasquier F, Lebouvier T, Bertoux M. Interoception and social cognition in chronic low back pain: a common inference disturbance? An exploratory study. Pain Manag 2021; 12:471-485. [PMID: 34894713 DOI: 10.2217/pmt-2021-0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Lower interoceptive abilities are a characteristic of chronic pain conditions. Social support plays an important role in chronic low back pain (cLBP) but social cognitive skills have rarely been investigated. This study aimed to characterize interoceptive and social cognitive abilities in cLBP and to study the relationship between both domains that have been brought closer together by brain predictive coding models. Materials & methods: Twenty-eight patients with cLBP and 74 matched controls were included. Interoceptive accuracy (Heart Beat Perception Task), sensibility/awareness (Multidimensional Assessment of Interoceptive Awareness) and mental-states inference abilities (Mini-Social Cognition and Emotional Assessment) were assessed. Results: cLBP Patients had lower interoceptive accuracy and mentalizing performance. Conclusion: Less efficient interoceptive accuracy and mentalizing abilities were found in cLBP patients without correlation between these performances.
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Affiliation(s)
- Florent El Grabli
- Inserm, U1172 - CHU Lille, Lille Neuroscience & Cognition, Centre of Excellence in Neurodegenerative Disease, Univ. Lille, Labex DISTAlz, F-59000, Lille, France.,Centre d'Evaluation et de Traitement de la Douleur, Service de Neurochirurgie, CHU Lille, F-59000, Lille, France
| | - François Quesque
- Inserm, U1172 - CHU Lille, Lille Neuroscience & Cognition, Centre of Excellence in Neurodegenerative Disease, Univ. Lille, Labex DISTAlz, F-59000, Lille, France
| | - Céline Borg
- Neurology/Neuropsychology CMRR Unit, Hospital Nord, Saint-Priest-en-Jarez, 42270, France.,Department of Psychology, University of Lyon, Lyon, 69500, France
| | - Michael Witthöft
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, 55122, Germany
| | - George A Michael
- Laboratoire d'Etude des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Bron Cedex, 69676, France
| | - Christian Lucas
- Centre d'Evaluation et de Traitement de la Douleur, Service de Neurochirurgie, CHU Lille, F-59000, Lille, France
| | - Florence Pasquier
- Inserm, U1172 - CHU Lille, Lille Neuroscience & Cognition, Centre of Excellence in Neurodegenerative Disease, Univ. Lille, Labex DISTAlz, F-59000, Lille, France
| | - Thibaud Lebouvier
- Inserm, U1172 - CHU Lille, Lille Neuroscience & Cognition, Centre of Excellence in Neurodegenerative Disease, Univ. Lille, Labex DISTAlz, F-59000, Lille, France
| | - Maxime Bertoux
- Inserm, U1172 - CHU Lille, Lille Neuroscience & Cognition, Centre of Excellence in Neurodegenerative Disease, Univ. Lille, Labex DISTAlz, F-59000, Lille, France
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