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Reduce Hypertension with a Mindfulness Smartphone App

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Reduce Hypertension with a Mindfulness Smartphone App

 

By John M. de Castro, Ph.D.

 

“Investigators found mindfulness was associated with a significant decrease in systolic blood pressure at 1 year and had other gains including better adherence to a recommended diet, lower salt intake, reduced alcohol consumption, and increased physical activity.” – Damian McNamara

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.

 

In today’s Research News article “Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/), Chandler and colleagues recruited adults with non-medicated stage 1 systolic hypertension; systolic blood pressure of 121–139 mmHg. They were randomly assigned to receive via smartphone app 3 months of either mindfulness training or health education. The mindfulness training app, Tension Tamer, employed twice daily practice of focused meditation for 10-15 minutes. The health education app, Runkeeper, delivered lifestyle health education messages focusing on exercise. They were measured before during and after training and 3 and 9 months later for systolic and diastolic blood pressure.

 

They found that the mindfulness trained group had greater reductions in systolic and diastolic blood pressure at the end of training and 9 months later. In addition, a greater proportion of mindfulness trained participants achieved reductions sufficient to remove them from being classified as having stage 1 systolic hypertension.

 

There were no significant differences found in perceived stress. Even though mindfulness training has been shown in prior studies to reduce perceived stress, it does not appear to be responsible for decrease blood pressure in the present study. Measures of heart rate during the meditation practice revealed significant decreases in heart rate over the session. This suggests that the mindfulness training was successful in reducing blood pressure by increasing relaxation perhaps by increasing the activity of the parasympathetic component of the autonomic nervous system.

 

So, reduce hypertension with a mindfulness smartphone app.

 

“mindfulness meditation in combination with conventional medication treatment reduces blood pressure and stress levels, while improving mindfulness and mood more than medication coupled with health education.” – goamra.org

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Chandler, J., Sox, L., Diaz, V., Kellam, K., Neely, A., Nemeth, L., & Treiber, F. (2020). Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults. International journal of environmental research and public health, 17(6), 1955. https://doi.org/10.3390/ijerph17061955

 

Abstract

(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user’s fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130–139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4–12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (−8.0 vs. −1.9), 6 (−10.0 vs. −0.7), and 12: (−11.6 vs. −0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/

 

Reduce Hallucinations in Schizophrenia with Mindfulness

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Reduce Hallucinations in Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions can give people a greater acceptance and insight into their experiences of psychosis, so they are less bothered by them, even if hallucinations and other symptoms are not eliminated.” – Adrianna Mendrek

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing, hearing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments.

 

Mindfulness training has been shown to be beneficial for patients with psychosis including reducing hallucinations. In today’s Research News article “Mindfulness Mediates the Effect of a Psychological Online Intervention for Psychosis on Self-Reported Hallucinations: A Secondary Analysis of Voice Hearers From the EviBaS Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145894/), Lüdtke and colleagues recruited patients with schizophrenia who have delusions of hearing voices and randomly assigned them to receive online training that included a module on mindfulness or to a waitlist control condition. They completed a online training module online for 8 weeks. The module consisted of trainings on ”mindfulness, worry and rumination, social competence, self-worth, depression, sleep, and metacognitive biases, such as “jumping to conclusions” and took about 1 hour to complete. The mindfulness module consisted of “24 web pages, which contained text, pictures, and audio files.” They were measured before and after training for antipsychotic medication dosage, positive, negative, and global symptoms of schizophrenia, mindfulness, and distress caused by hearing voices.

 

They found that in comparison to baseline and the waitlist control participants that the online modules training group had significantly higher levels of mindfulness and lower levels of hallucinations. In addition, a mediation analysis found that the reduction in hallucinations was, in part, mediated by mindfulness. That is the training reduced hallucinations directly and also indirectly by increasing mindfulness that, in turn, reduced hallucinations. The online modules were a complex of trainings and mindfulness was just one component. So, it is not possible to ascribe the results to mindfulness training alone.

 

It was surprising that the online modules training did not reduce distress from hearing voices as was the intent of the study, but rather unexpectedly reduced overall hallucinations in the schizophrenic patients. Previous research has shown that Mindfulness-Based Cognitive Therapy (MBCT) can reduce the distress caused by hearing voices. This suggests that the cognitive therapy component of the treatment which attempts to alter the thought processes used to judge and interpret experiences was critical. Hence, mindfulness training itself may reduce overall hallucinations while alterations of cognitive process is required to decrease the distress produced by hearing voices.

 

So, reduce hallucinations in schizophrenia with mindfulness.

 

“mindfulness skills can provide these individuals with an alternative way of relating to their symptoms, moving from a judgemental and controlling stance to a more compassionate, accepting view. The effectiveness of mindfulness-based approaches for people with psychosis has been demonstrated in controlled clinical settings and in the community.” – Carly Samson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lüdtke, T., Platow-Kohlschein, H., Rüegg, N., Berger, T., Moritz, S., & Westermann, S. (2020). Mindfulness Mediates the Effect of a Psychological Online Intervention for Psychosis on Self-Reported Hallucinations: A Secondary Analysis of Voice Hearers From the EviBaS Trial. Frontiers in Psychiatry, 11, 228. https://doi.org/10.3389/fpsyt.2020.00228

 

Abstract

Background

Psychological online interventions (POIs) could represent a promising approach to narrow the treatment gap in psychosis but it remains unclear whether improving mindfulness functions as a mechanism of change in POIs. For the present study, we examined if mindfulness mediates the effect of a comprehensive POI on distressing (auditory) hallucinations.

Methods

We conducted a secondary analysis on voice hearers (n = 55) from a randomized controlled trial evaluating a POI for psychosis (EviBaS; trial registration NCT02974400, clinicaltrials.gov). The POI includes a module on mindfulness and we only considered POI participants in our analyses who completed the mindfulness module (n = 16).

Results

Participants who completed the mindfulness module reported higher mindfulness (p = 0.015) and lower hallucinations (p = 0.001) at post assessment, compared to controls, but there was no effect on distress by voices (p = 0.598). Mindfulness mediated the POI’s effect on hallucinations (b = −1.618, LLCI = −3.747, ULCI = −0.054) but not on distress by voices (b = −0.057, LLCI = −0.640, ULCI = 0.915).

Limitations and Discussion

Completion of the mindfulness module was not randomized. Hence, we cannot draw causal inferences. Even if we assumed causality, it remains unclear which contents of the POI could have resulted in increased mindfulness and reduced hallucinations, as participants completed other modules as well. In addition, confounding variables could explain the mediation and the sample size was small. Nonetheless, the overall pattern of results indicates that the POI is likely to improve mindfulness, and that increased mindfulness could partially explain the POI’s efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145894/

 

Improve Psychological Well-Being at Work with a Mindfulness App

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Improve Psychological Well-Being at Work with a Mindfulness App

By John M. de Castro, Ph.D.

“Mindfulness is not about living life in slow motion. It’s about enhancing focus and awareness both in work and in life. It’s about stripping away distractions and staying on track with individual, as well as organizational, goals.” Jacqueline Carter

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. These mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in employees in real-world work settings.

 

In today’s Research News article “Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215525/), Bostock and colleagues recruited healthy adults in the workplace and randomly assigned them to either a wait-list control condition or to 45 days of daily mindfulness training with the “Headspace” app for their smartphones. They were measured before and after the intervention and 8 weeks later for blood pressure and daily well-being at 5 different times during the day, psychological well-being, anxiety, depression, job strain, job status, workplace social support, and mindfulness.

 

They found that in comparison to baseline and the wait-list controls the participants who used the mindfulness training app had significantly higher levels of psychological well-being, daily positive emotions, and workplace social support and significantly lower levels of blood pressure, anxiety, depression, and job strain. They found that these benefits only occurred in participants who completed 10 or more practice sessions. Most of these improvements were maintained at the 8-week follow-up.

 

The research design contained a control condition but the condition was not active. This leaves open the possibility of placebo effects, demand characteristics, and experimenter bias. Employees that used the app less than 10 times, however, could be seen as an active control and they did not show improvements. Nevertheless, the results suggest that using a mindfulness training smartphone app can improve the psychological well-being of employees in the workplace. Since they can receive the training at their own convenience and schedule, it is especially applicable to busy real-world work environments. The low cost of this training suggests that it can be used over large numbers of employees, at diverse locations.

 

So, improve psychological well-being at work with a mindfulness app.

 

“mindfulness and mindfulness-based practices improve self-regulation of thoughts, emotions, and behaviors, linking them to both performance and employee well-being in the workplace.” Theresa Glomb

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Bostock, S., Crosswell, A. D., Prather, A. A., & Steptoe, A. (2019). Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being. Journal of occupational health psychology, 24(1), 127–138. https://doi.org/10.1037/ocp0000118

 

Abstract

We investigated whether a mindfulness meditation program delivered via a smartphone application (app) could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large UK companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 pre-recorded 10–20 minute guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures, and blood pressure throughout one working day, were measured at baseline and 8 weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0 to 45 sessions). The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from pre to post intervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment. This trial suggests that short guided mindfulness meditations delivered via smartphone and practiced multiple times per week can improve outcomes related to work stress and well-being, with potentially lasting effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215525/

 

Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness

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Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People don’t ask to be diagnosed with cancer, but they’re given an opportunity to, in a real sense, experience the vividness and the exquisiteness of the moment.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. The effectiveness of mindfulness training for the psychological symptoms of cancer has been established. But whether it is cost-effective relative to other treatments has not been investigated.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many parents can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the cost effectiveness of these online trainings.

 

In today’s Research News article “Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/), Compen and colleagues recruited past or present cancer patients with high anxiety levels and randomly assigned them to be on a wait-list receiving treatment as usual or Mindfulness-Based Cognitive Therapy (MBCT) either delivered face-to-face or over the internet. Face-to-face MBCT occurred in 8 weekly 2.5-hour sessions with 45 minutes of daily practice at home. The internet version had similar content but was delivered asynchronously personally with email exchanges with therapists.

Costs were calculated by calculating the costs of normal treatment as usual as well as indirect costs from absenteeism, productivity losses etc. and the costs of delivering the services. Quality of life was assessed for each patient.

 

They found that the costs of delivery of Mindfulness-Based Cognitive Therapy (MBCT) was equivalent between face-to-face and internet delivery. The productivity losses and total costs were significantly less with both MBCT deliveries compared to treatment as usual. Quality of life was significantly higher with both MBCT deliveries and was maintained at a 9-month follow-up.

 

The results suggest that delivering Mindfulness-Based Cognitive Therapy (MBCT) either face-to-face or over the internet reduces total costs of treatment and work-related losses and improved the quality of life of cancer patients. This suggests that MBCT is a cost effective way of delivering treatment to cancer patients, making their lives better.

 

So, cost effectively improve cancer patients’ quality of life with mindfulness.

 

“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity. – Erin Murphy-Wilczek

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Compen, F., Adang, E., Bisseling, E., van der Lee, M., & Speckens, A. (2020). Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients. Psycho-oncology, 29(2), 294–303. https://doi.org/10.1002/pon.5246

 

Abstract

Objective

It was previously determined that group‐based face‐to‐face Mindfulness‐Based Cognitive Therapy (MBCT) and individual internet‐based MBCT (eMBCT) are equally efficacious compared with treatment as usual (TAU) in reducing psychological distress. In this study, the incremental cost‐utility of both interventions compared with TAU was assessed.

Methods

This cost‐utility study included 245 self‐referred heterogeneous cancer patients with psychological distress who were randomized to MBCT, eMBCT or TAU. Healthcare costs and (informal) work‐related productivity losses were assessed by interview. Outcomes were expressed in EuroQol‐5D‐3L utility scores and quality‐adjusted life years (QALY). An economic evaluation with a time‐horizon of 3 months was conducted from the societal perspective in the intention‐to‐treat sample. In addition, secondary explorative analyses of costs and quality of life during the 9‐month follow‐up were conducted based on linear extrapolation of TAU.

Results

Paid work‐related productivity losses and societal costs were lower in both intervention conditions compared with TAU during the 3‐month intervention period. Moreover, quality of life (utility scores) improved in eMBCT versus TAU (Cohen’s d: .54) and MBCT versus TAU (.53). At a willingness to pay of €20000 per QALY, the mean incremental net monetary benefit was €1916 (SD=€783) in eMBCT and €2365 (SD=€796) in MBCT versus TAU. Exploration of costs demonstrated an equal pattern of eMBCT and MBCT being superior to TAU. Quality of life at 9‐month follow‐up remained improved in both interventions.

Conclusions

Results indicate that eMBCT and MBCT are cost‐saving treatments whilst simultaneously improving quality of life for distressed cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/

 

Improve College Student Well-Being with Online Mindfulness

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Improve College Student Well-Being with Online Mindfulness

 

By John M. de Castro, Ph.D.

 

“Student life can be stressful, but that doesn’t mean students have to let stress take over their lives. By incorporating mindfulness and meditation into daily routines, students can not only relieve the pressure, but also improve their memory, focus and ultimately their grades.” – Kenya McCullum

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “An Eight-Week, Web-Based Mindfulness Virtual Community Intervention for Students’ Mental Health: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055779/) Ahmad and colleagues examine the effectiveness of an online mindfulness virtual community to improve well-being in college students. They recruited college students and randomly assigned them to a wait list control condition or to receive an 8-week web-based program called Mindfulness Virtual Community that was developed to specifically address the students’ needs. It was implemented in either a full or partial version. The full Mindfulness Virtual Community included 12 modules of mindfulness practice and psychoeducation for student-specific stresses, discussion forums, and group live videoconferences. The partial version contained only the 12 modules. They were measured at baseline and in the middle and end of the 8-week program for anxiety, depression, stress, quality of life, life satisfaction, and mindfulness. They also self-reported their perceived academic performance and class absences.

 

They found that in comparison to baseline and the wait list control condition, both the full and partial Mindfulness Virtual Community interventions produced significant reductions in depression, perceived stress, and self-reported absences and significant increases in mindfulness, quality of life, and self-reported academic performance. Only the partial Mindfulness Virtual Community produced a significant reduction in anxiety.

 

These are encouraging results that suggest that a student-centered mindfulness training over the internet can be effective in improving the mental health of college students and perhaps their performance in school. College life can be difficult and stressful for the students with difficult adjustments and pressure to perform. The fact that mindfulness training can be of help in reducing the perceived levels of stress and improve the psychological health of the students may be very important for their eventual success. Indeed, their self-reported academic performance improved and they self-reported fewer absences, suggesting just such an improvement in success occurred.

 

The facts that this program was web-based and that the presentation of the video modules alone was effective indicates that this program can be implemented inexpensively to large numbers of students even in different colleges over wide geographical regions. Since it is web based the students can conveniently schedule this participation within their busy schedules. In addition, the training can occur anywhere. Hence, web-based mindfulness training may be an almost ideal solution to the psychological health problems encountered by college students.

 

So, improve college student well-being with online mindfulness.

 

“Learning how to meditate and be more mindful was one of the best things I’ve done as a student here. I’ve struggled with anxiety for many years, and became really overwhelmed by everything by my sophomore year. My grades started to fall as I slept less and tried to take on more and more. I’m so thankful for the skills I learned in this class. It’s not only made me a better student, but it’s also made me a happier person!”

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ahmad, F., El Morr, C., Ritvo, P., Othman, N., Moineddin, R., & MVC Team (2020). An Eight-Week, Web-Based Mindfulness Virtual Community Intervention for Students’ Mental Health: Randomized Controlled Trial. JMIR mental health, 7(2), e15520. https://doi.org/10.2196/15520

 

Abstract

Background

Innovative interventions are needed to address the increasing mental health needs of university students. Given the demonstrated anxiolytic and antidepressant benefits of mindfulness training, we developed an 8-week, Web-based Mindfulness Virtual Community (MVC) intervention informed by cognitive behavioral therapy (CBT) constructs.

Objective

This study investigated the efficacy of the MVC intervention in reducing symptoms of depression, anxiety, and stress among undergraduate students in Toronto, Canada. The secondary outcomes included quality of life, life satisfaction, and mindfulness.

Methods

The first 4 weeks of the full MVC intervention (F-MVC) comprised: (1) 12 video-based modules with psycho-education on students’ preidentified stressful topics and topically applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided, 20-min live videoconferences. The second 4 weeks of F-MVC involved access only to video-based modules. The 8-week partial MVC (P-MVC) comprised 12 video-based modules. A randomized controlled trial was conducted with 4 parallel arms: F-MVC, P-MVC, waitlist control (WLC), and group-based face-to-face CBT; results for the latter group are presented elsewhere. Students recruited through multiple strategies consented and were randomized: WLC=40; F-MVC=40, P-MVC=39; all learned about allocation after consenting. The online surveys at baseline (T1), 4 weeks (T2), and 8 weeks (T3) included the Patient Health Questionnaire-9 item, Beck Anxiety Inventory, Perceived Stress Scale, Quality of Life Scale, Brief Multi-Dimensional Students Life Satisfaction Scale, and Five-Facet Mindfulness Questionnaire. Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible confounders (gender, age, birth country, paid work, unpaid work, physical activities, self-rated health, and mental health counseling access).

Results

Of the 113 students who provided T1 data, 28 were males and 85 were females with a mean age of 24.8 years. Participants in F-MVC (n=39), P-MVC (n=35), and WLC (n=39) groups were similar in sociodemographic characteristics at T1. At T3 follow-up, per adjusted comparisons, there were statistically significant reductions in depression scores for F-MVC (score change −4.03; P<.001) and P-MVC (score change −4.82; P<.001) when compared with WLC. At T3, there was a statistically significant reduction in anxiety scores only for P-MVC (score change −7.35; P=.01) when compared with WLC. There was a statistically significant reduction in scores for perceived stress for both F-MVC (score change −5.32; P<.001) and P-MVC (score change −5.61; P=.005) compared with WLC. There were statistically significant changes at T3 for quality of life and mindfulness for F-MVC and P-MVC vs WLC but not for life satisfaction.

Conclusions

Internet-based mindfulness CBT–based interventions, such as F-MVC and P-MVC, can result in significant reductions in symptoms of depression, anxiety, and stress in a student population. Future research with a larger sample from multiple universities would more precisely test generalizability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055779/

 

Online Mindfulness Training Improves Clinical Anxiety and Depression

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Online Mindfulness Training Improves Clinical Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“adding MMB [mindfulness training] to depression care led to greater reductions in depressive and anxious symptoms, higher rates of remission and higher levels of quality of life compared to patients receiving conventional depression care alone.” – Traci Pederson

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. They have been shown to be very helpful in treating anxiety and depression. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training programs have been developed to be implemented over the internet. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But, the question arises as to which forms of online mindfulness trainings are most effective for inducing mindfulness and improving the treatment of anxiety and depression.

 

In today’s Research News article “Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/), Kladnitski and colleagues recruited online adults with a variety of either depression or anxiety disorders and randomly assigned them to receive either a 17-week internet-based cognitive behavioral therapy, mindfulness enhanced internet-based cognitive behavioral therapy, internet-based mindfulness training, or treatment-as-usual. “The programs consisted of six comic-style, story-based lessons, downloadable lesson summaries, reflective worksheets, and extra support materials including frequently asked questions and troubleshooting of common difficulties.” They were measured before, during, and after treatment and 3 months later for psychological illnesses, anxiety, depression, psychological distress, and functional impairment.

 

They found compared to baseline and the treatment-as-usual control group, there were large and highly significant decreases in anxiety, depression, functional impairment and psychological distress. These improvements were present both at the end of treatment and at the 3-month follow-up. There were no significant differences between the effectiveness of the 3 interventions. There were no adverse events reported. At the 3-month follow-up 60% to 73% of the treated participants improved to the point that they no longer met the criteria for a clinical diagnosis of an anxiety or depressive disorder.

 

It is interesting that the 3 different treatments did not differ in effectiveness. Each has been previously been demonstrated to be effective in treating anxiety and depressive disorders and it appears that their efficacy is almost equivalent. This suggests that patients can self-select the treatment that most appeals to them, improving completion rates, compliance, and perhaps effectiveness.

 

These are exciting and important findings. It has been previously demonstrated that mindfulness training can alleviate the symptoms of anxiety and depression. The advance here is in demonstrating that therapy delivered over the internet is safe, effective, and lasting in treating anxiety or depressive disorders. Internet delivery of treatment can be implemented conveniently, at low cost. and over wide areas making the therapy available to large numbers of patients who previously could not access treatment.

 

So, online mindfulness training improves clinical anxiety and depression.

 

“Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kladnitski, N., Smith, J., Uppal, S., James, M. A., Allen, A. R., Andrews, G., & Newby, J. M. (2020). Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial. Internet Interventions, 20, 100310. https://doi.org/10.1016/j.invent.2020.100310

 

Abstract

Aim

To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression.

Method

Individuals (N = 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K−10), and diagnostic status at the 3-month follow-up (intervention groups).

Results

All three programs achieved significant and large reductions in symptoms of depression (g = 0.89–1.53), anxiety (g = 1.04–1.40), and distress (g = 1.25–1.76); and medium to large reductions in functional impairment (g = 0.53–0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89–1.18) and anxiety (g = 1.00–1.23).

Conclusion

Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/

 

Improve Well-Being and Workplace Performance with Online Mindfulness Training

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Improve Well-Being and Workplace Performance with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“online mindfulness intervention seems to be both practical and effective in decreasing employee stress, while improving resiliency, vigor, and work engagement, thereby enhancing overall employee well-being.” – Kimberly Aikens

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological, social, and physical health. But, nearly 2/3 of employees worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress and burnout. Online mindfulness training has the advantage of being convenient and easily integrated into a busy schedule. It is important, though, to verify its effectiveness for improving psychological health and workplace performance.

 

In today’s Research News article “Online Mindfulness Training Increases Well-Being, Trait Emotional Intelligence, and Workplace Competency Ratings: A Randomized Waitlist-Controlled Trial.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00255/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A), Nadler and colleagues recruited healthy adults in their workplace and randomly assigned them to either a wait-list control condition or to receive an 8-week online workplace-based mindfulness training. The training was based upon the Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) programs. Mindfulness training was practiced 6 or 7 days per week. The workers were measured before and after training for mindfulness, perceived stress, resilience, positive and negative emotions, emotional intelligence, and workplace competence.

 

They found that in comparison to baseline and the wait-list control condition, mindfulness training produced significant increases in mindfulness, resilience, and positive emotions and significant decreases in perceived stress and negative emotions. Also, there were significant increase in emotional intelligence, including recognition of emotion in self and recognition of emotion in others, regulation of emotion in self, and regulation of emotion in others. In addition, they found that the greater the change in mindfulness, particularly in the acting with awareness and non-reactivity to inner experience facets of mindfulness, in the intervention group, the greater the increases in resilience, positive emotions, and emotional intelligence and the greater the decreases in negative emotions and perceived stress.  Finally, mindfulness training produced an increase in job performance, including decisiveness, making tough calls, assuming responsibility, interpersonal relationships, and creativity.

 

The present study results suggest the online mindfulness training is effective in improving psychological health, emotional intelligence, and job performance. Mindfulness training has been previously shown to improve resilience, emotions and emotional intelligence, perceived stress, and job performance. It appears that mindfulness training improves the employees ability to act mindfully with awareness and not react to their inner feelings. This means that they pay better attention to their jobs and are less reactive to their emotions during work. This make them better employees and improves their well-being.

 

The contribution of the present work is to demonstrate that these benefits can be produce by online training. This improves the usefulness of mindfulness training for workers as it can be accomplished inexpensively and conveniently with minimal disruption of work. This can make them better at their jobs and mentally and emotionally healthier. It was not studied here but this would predice not only better performance but also less burnout and better employee retention.

 

So, improve well-being and workplace performance with online mindfulness training.

 

“Mindfulness can encourage divergent thinking, enabling you to generate more innovative solutions to business problems.” – Mind Tools

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Nadler R, Carswell JJ and Minda JP (2020) Online Mindfulness Training Increases Well-Being, Trait Emotional Intelligence, and Workplace Competency Ratings: A Randomized Waitlist-Controlled Trial. Front. Psychol. 11:255. doi: 10.3389/fpsyg.2020.00255

 

A randomized waitlist-controlled trial was conducted to assess the effectiveness of an online 8-week mindfulness-based training program in a sample of adults employed fulltime at a Fortune 100 company in the United States. Baseline measures were collected in both intervention and control groups. Following training, the intervention group (N = 37) showed statistically significant increases in resilience and positive mood, and significant decreases in stress and negative mood. There were no reported improvements in the wait-list control group (N = 65). Trait mindfulness and emotional intelligence (EI) were also assessed. Following the intervention mindfulness intervention participants reported increases in trait mindfulness and increases on all trait EI facets with the exception of empathy. The control group did not report any positive changes in these variables, and reported reductions in resilience and increases in negative mood. Finally, both self and colleague ratings of workplace competencies were collected in the intervention group only and provided preliminary evidence that mindfulness training enhanced performance on key leadership competencies including competencies related to decisiveness and creativity. The present study demonstrates the effectiveness of an online-based mindfulness training program for enhancing well-being, self-perceptions of emotional intelligence, and workplace performance.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00255/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1254058_69_Psycho_20200225_arts_A

 

Improve Smartphone Addiction with Mindfulness

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Improve Smartphone Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it. The dominant mode of accessing the internet is through smartphones creating smartphone addictions.

 

Future time perspective is the ability to anticipate and plan to bring about desired outcomes in the future. Most addictions involve being completely driven by present needs. So, future time perspective is contrary to addiction and may help to overcome addiction. Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be associated with a balanced time perspective. It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the relationships of smartphone addiction with future time perspective and mindfulness.

 

In today’s Research News article “Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/), Zhang and colleagues recruited freshman and sophomore college students aged 18-22 years. The completed measures of future time perspective, smartphone use disorder, depression, and mindfulness.

 

They found that the higher the levels of mindfulness the higher the levels of future time perspective and the lower the levels of depression and smartphone use disorder. They also found that the higher the levels of future time perspective the higher the levels of mindfulness and the lower the levels of depression and smartphone use disorder. They then performed a mediation analysis and found that future time perspective had not only a direct and relationship with smartphone use disorder but also was indirectly related via depression such that future time perspective was negatively related to depression which, in turn, was positively related to. smartphone use disorder. Finally, they found that mindfulness moderated the indirect path with high mindfulness decreasing the relationship of future time perspective on depression and decreasing the relationship of depression with smartphone use disorder.

 

This study is correlational and as such causation cannot be determined. Nevertheless, the results suggest that the ability of college students to focus on the future is associated with lower depression and smartphone addictions. Also, college students’ addictions to smartphones are lower when mindfulness is present. This relationship occurs directly and as a result of moderating the relationships between thinking and planning for the future, depression, and smartphone use disorder. It remains for future research to train students in mindfulness to determine if mindfulness can be used to treat addictions to smartphones.

 

So, improve smartphone addiction with mindfulness.

 

“just as technology is increasingly being developed to attract and hold our attention, with mindfulness we can develop the capability to be much more aware of where the spotlight of our attention is being drawn to, and consciously choose to direct and place our attention and energy on an activity of our choosing.” – Neil Tranter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zhang, Y., Lv, S., Li, C., Xiong, Y., Zhou, C., Li, X., & Ye, M. (2020). Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness. Child and adolescent psychiatry and mental health, 14, 3. doi:10.1186/s13034-020-0309-9

 

Abstract

Background

Smartphone use disorder (SUD) of college students has drawn increasing attention. Although future time perspective (FTP) may be an important protective factor for individual SUD, the moderating and mediating mechanisms underlying this relationship remain unknown. We tested the individual roles of depression and mindfulness as moderators of this relationship.

Methods

A cross-sectional study was conducted in two colleges in Shandong and Chongqing in China using a sample of 1304 college students recruited by stratified cluster sampling. Data were collected through a validated self-report instrument. A moderation–mediation model was constructed, and an SPSS PROCESS macro was used to analyse the data.

Results

The correlation analyses showed that FTP was negatively associated with SUD of college students. The mediation model revealed that depression partially mediated the link between FTP and SUD of college students. The moderation–mediation model suggested that mindfulness moderates two direct paths: FTP to depression and depression to SUD. In the first path (FTP to depression), a high level of mindfulness among college students had weakened the relationship between FTP and depression. Here, the relationship is strengthened by a low level of mindfulness. In the second path (depression to SUD), low levels of mindfulness strengthen the link between depression and FTP. In contrast, significant association was not found with high levels of mindfulness.

Conclusions

Results suggest that interventions, such as improving the individual level of FTP and mindfulness, should be conducted. These interventions, in turn, help control the level of depression in college students and ultimately decrease their level of SUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/

 

Effective Online Mindfulness Training Characteristics

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Effective Online Mindfulness Training Characteristics

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness can help all sorts of people no matter what is going on in their lives. Learning mindfulness is very accessible, whether you have a center in your hometown or just an internet connection, whether you have enough money for a retreat or do not have any money at all, or if you want to learn how to teach mindfulness to others. No matter what your situation is, there is a mindfulness training option tailored to your needs.” – Joaquín Selva

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations.

 

The research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. But the question arises as to what is the best way to train mindfulness online for improving psychological health. In today’s Research News article “Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906627/?report=classic), Lippmann and colleagues review the research studies employing online mindfulness training.

 

They focused on the instructional designs used in the online trainings. In particular they focused on formal learning tasks, supportive educational materials, timely support and reminders, and informal practices of targeted skills. There were 18 published research studies of online mindfulness training that fulfilled the criteria. There were a variety of outcome measures that varied with different studies but primarily they measured anxiety, depression, stress, distress, pain, physical fitness, and quality of life.

 

They classified 11 studies as having highly effective outcomes, 6 as less effective, and 1 as ineffective. They found that the studies that produced more and less effective outcomes all implemented formal practice at least twice a week. But the studies with more effective outcomes also had good supportive educational materials, timely support and reminders, and informal practices of targeted skills, while the studies with less effective outcomes had much less robust implementations of supportive educational materials, timely support and reminders, and informal practices of targeted skills. The study that had ineffective outcomes had formal practice only once a week and none of the other instructional design components were present.

 

The results suggest that online mindfulness trainings can be very effective in improving the physical and psychological health of the participants. But there needs to be several instructional components present and well implemented to maximize effectiveness. These components include clear formal mindfulness training occurring at least twice a week, instruction in the ideas underlying the practices, frequent reminders to practice, and an emphasis on practice outside of the formal online instruction. The better these components are implemented in the online instruction the better the improvements in the well-being of the participants.

 

So, online mindfulness training programs are very effective if they are well designed to implement four important instructional components.

 

“participants who completed the online mindfulness course reported significantly lower levels of perceived stress, depression and anxiety. The large effect sizes associated with completing the intervention were maintained for all of the outcome variables at 3- and 6-month follow-up.” – Dawn Querstret

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lippmann, M., Laudel, H., Heinzle, M., & Narciss, S. (2019). Relating Instructional Design Components to the Effectiveness of Internet-Based Mindfulness Interventions: A Critical Interpretive Synthesis. Journal of medical Internet research, 21(11), e12497. doi:10.2196/12497

 

Abstract

Background

Internet-based mindfulness interventions are a promising approach to address challenges in the dissemination and implementation of mindfulness interventions, but it is unclear how the instructional design components of such interventions are associated with intervention effectiveness.

Objective

The objective of this study was to identify the instructional design components of the internet-based mindfulness interventions and provide a framework for the classification of those components relative to the intervention effectiveness.

Methods

The critical interpretive synthesis method was applied. In phase 1, a strategic literature review was conducted to generate hypotheses for the relationship between the effectiveness of internet-based mindfulness interventions and the instructional design components of those interventions. In phase 2, the literature review was extended to systematically explore and revise the hypotheses from phase 1.

Results

A total of 18 studies were identified in phase 1; 14 additional studies were identified in phase 2. Of the 32 internet-based mindfulness interventions, 18 were classified as more effective, 11 as less effective, and only 3 as ineffective. The effectiveness of the interventions increased with the level of support provided by the instructional design components. The main difference between effective and ineffective interventions was the presence of just-in-time information in the form of reminders. More effective interventions included more supportive information (scores: 1.91 in phases 1 and 2) than less effective interventions (scores: 1.00 in phase 1 and 1.80 in phase 2), more part-task practice (scores: 1.18 in phase 1 and 1.60 in phase 2) than less effective interventions (scores: 0.33 in phase 1 and 1.40 in phase 2), and provided more just-in-time information (scores: 1.35 in phase 1 and 1.67 in phase 2) than less effective interventions (scores: 0.83 in phase 1 and 1.60 in phase 2). The average duration of more effective, less effective, and ineffective interventions differed for the studies of phase 1, with more effective interventions taking up more time (7.45 weeks) than less effective (4.58 weeks) or ineffective interventions (3 weeks). However, this difference did not extend to the studies of phase 2, with comparable average durations of effective (5.86 weeks), less effective (5.6 weeks), and ineffective (7 weeks) interventions.

Conclusions

Our results suggest that to be effective, internet-based mindfulness interventions must contain 4 instructional design components: formal learning tasks, supportive information, part-task practice, and just-in-time information. The effectiveness of the interventions increases with the level of support provided by each of these instructional design components.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906627/?report=classic

 

Improve Well-Being with a Smartphone Mindfulness App

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Improve Well-Being with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“What do you do when you can’t afford therapy but are struggling to handle your mental illness alone? You could download an app. In recent years, there’s been a proliferation of mental health apps available to smartphone users. These reasonably-priced, or most often free, mental health apps offer a wealth of resources that make therapeutic techniques more accessible, portable, and cost-effective.” – Jessica Truchel

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many college students can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy college schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these Apps in inducing mindfulness and improving psychological health in college students.

 

In today’s Research News article “Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the “Calm” app’s (mostly positive) effects.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928287/?report=classic), Clarke and Draper recruited healthy college students and had them complete a 7-day mindfulness training with the “Calm” smartphone app. The program consists of once a day 10-minute trainings. The students completed measures before and after training of mindfulness, well-being, and self-efficacy.

 

They found that after the 7-day training there were significant increases in mindfulness, well-being, and self-efficacy. They report that students who only completed 1 or 2 of the 7 “Calm” modules did not obtain the benefits. It appears that completing 3 or more of the modules is necessary to improve the students’ psychological health.

 

This is a brief study without a comparison condition and so the results must be interpreted cautiously. But, a number of prior studies have demonstrated that mindfulness trainings with smartphone apps are effective in improving well-being. In addition, the students who did not complete a significant number of the 7 training modules did not show improvements in psychological health. So, it would appear that the use of smartphone apps are a convenient method to teach mindfulness and this can have a significant impact on the psychological health of the users.

 

So, improve well-being with a smartphone mindfulness app.

 

“Mental health apps can be effective in making therapy more accessible, efficient, and portable.” – Mary Let

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Clarke, J., & Draper, S. (2019). Intermittent mindfulness practice can be beneficial, and daily practice can be harmful. An in depth, mixed methods study of the “Calm” app’s (mostly positive) effects. Internet interventions, 19, 100293. doi:10.1016/j.invent.2019.100293

 

Abstract

Objectives

Despite a weak evidence base, daily use of mindfulness-based self-help smartphone applications (apps) is said to promote wellbeing. However, many do not use these apps in the way that app developers and mindfulness proponents recommend. We sought to determine whether the “Calm” app works, and whether it does so even when it is used intermittently.

Methods

Employing a mixed-methods design, we recruited a self-selected sample of 269 students from a Scottish university (81% female, 84% white, mean age 23.89) to engage with a seven-day introductory mindfulness course, delivered using Calm, currently one of the most popular, yet under-researched, apps.

Results

Daily course engagement was associated with significant gains in wellbeing (p ≤.001, d = 0.42), trait mindfulness (p ≤.001, d = 0.50) and self-efficacy (p ≤.014, d = 0.21). Intermittent course engagement was also associated with significant gains in wellbeing (p ≤.028, d = 0.34), trait mindfulness (p ≤.010, d = 0.47) and self-efficacy (p ≤.028, d = 0.32). This study is therefore the first to demonstrate that the Calm app is associated with positive mental health outcomes. It also shows that regular use is not essential. A thematic analysis of qualitative data supported these quantitative findings. However it also revealed that some participants had negative experiences with the app.

Conclusions for practice

Mindfulness-based self-help apps such as Calm have the potential to both enhance and diminish users’ wellbeing. Intermittent mindfulness practice can lead to tangible benefits. Therefore, mindfulness proponents should not recommend daily practice, should increase awareness of the potential for negative outcomes, and resist the idea that mindfulness practice works for everyone. Developers of mindfulness apps ought to make specific features customisable in order to enhance their effectiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928287/?report=classic