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Reduce Stress and Improve the Psychological Health of Teachers with Mindfulness

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Reduce Stress and Improve the Psychological Health of Teachers with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness training for teachers can help them cope better with stress on the job while also making the classroom environment more productive for learning.” – Jill Suttie

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. This often produces burnout; fatigue, cynicism, emotional exhaustion, and professional inefficacy. Teachers experience burnout at high rates. Roughly a half a million teachers out of a workforce of three million, leave the profession each year and the rate is almost double in poor schools compared to affluent schools. Indeed, nearly half of new teachers leave in their first five years.

 

Burnout frequently results from emotional exhaustion. This exhaustion not only affects the teachers personally, but also the students, as it produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to schools and their students. In fact, it is a threat to the entire educational systems as it contributes to the shortage of teachers. Hence, methods of reducing stress and improving teacher psychological health needs to be studied.

 

In today’s Research News article “Mixed-methods evaluation comparing the impact of two different mindfulness approaches on stress, anxiety and depression in school teachers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615820/), Todd and colleagues recruited primary and secondary school teachers who were attending mindfulness courses of Mindfulness-Based Stress Reduction (MBSR) or .b Foundations. The MBSR program consists of 8 weekly 2-hour group sessions involving meditation, yoga, body scan, and discussion. The teachers are also encouraged to perform daily practice. The .b Foundations program consists of 8 weekly 1.5-hour group sessions involving mindfulness training in a classroom setting. The teachers are similarly encouraged to perform daily practice. They were measured before and after training for anxiety, depression, perceived stress, and completed semi-structured interviews.

 

They found that teachers who participated in the Mindfulness-Based Stress Reduction (MBSR) program had significant reductions in anxiety, depression, and perceived stress, while the teachers who participated in the .b Foundations program had significant reductions in anxiety and perceived stress, but not depression. The qualitative interviews revealed that both programs were found to be acceptable and a good experience and having profound impacts with no significant differences between the programs.

 

The weaknesses of this study were that there wasn’t a no-treatment or active control group and participants were not randomly assigned to conditions. As such the benefits of the training could have been due to subject expectancy effects, Hawthorne effects, experimenter bias, or just the effects of attending a social group for 8 weeks. But a large number of previous better controlled studies have shown that mindfulness training improves anxiety, depression, and perceived stress. So, it is likely that the reductions seen in the present study were due to the mindfulness training.

 

So, reduce stress and improve the psychological health of teachers with mindfulness.

 

“When administrators call you, you never know what they want. It could be a parent is upset with you, or you forgot something. I used to rush to meetings, grab a seat, and jump in. Now, I practice mindful walking. I think about where I’m going. When I arrive, I’m not revved up. I’m able to receive criticism or conversation without being triggered.” – Nicole Willheimer

 

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

 

Todd, C., Cooksey, R., Davies, H., McRobbie, C., & Brophy, S. (2019). Mixed-methods evaluation comparing the impact of two different mindfulness approaches on stress, anxiety and depression in school teachers. BMJ open, 9(7), e025686. doi:10.1136/bmjopen-2018-025686

 

Strengths and limitations of this study

  • This study is unique as there are currently no published studies comparing the two mindfulness courses in terms of acceptability, experience and effects on stress, anxiety and depression, despite current roll-out.
  • Strengths lie in the mixed-methods approach used to explore differences between .b and Mindfulness-Based Stress Reduction.
  • Limitations lie in the numbers lost to follow-up, with future research needed to explore this further.

Abstract

Objectives

This study compared the impact of two different 8-week mindfulness based courses (.b Foundations and Mindfulness-Based Stress Reduction (MBSR)), delivered to school teachers, on quantitative (stress, anxiety and depression) and qualitative (experience, acceptability and implementation) outcomes.

Design

A mixed-methods design was employed. Matched-paired t-tests were used to examine change from baseline, with imputation conducted to account for those lost to follow-up. Qualitative methods involved 1:1 semistructured interviews (n=10). Thematic analysis was used to explore differences in experience between courses.

Setting

Courses took place in UK primary schools or nearby leisure centres, 1:1 interviews took place via telephone.

Participants

44/69 teachers from schools in the UK were recruited from their attendance at mindfulness courses (.b and MBSR).

Interventions

Participants attended either an MBSR (experiential style learning, 2 hours per week) or .b Foundations (more classroom focused learning, 1.5 hours per week) 8-week mindfulness course.

Outcome measures

Stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Scale) were evaluated in both groups at baseline (n=44), end of intervention (n=32) and 3-month follow-up (n=19).

Results

Both courses were associated with significant reductions in stress (.b 6.38; 95% CI 1.74 to 11.02; MBSR 9.69; 95% CI 4.9 to 14.5) and anxiety (.b 3.36; 95% CI 1.69 to 5.0; MBSR 4.06; 95% CI 2.6 to 5.5). MBSR was associated with improved depression outcomes (4.3; 95% CI 2.5 to 6.11). No differences were found in terms of experience and acceptability. Four main themes were identified including preconceptions, factors influencing delivery, perceived impact and training desires/practical application.

Conclusion

.b Foundations appears as beneficial as MBSR in anxiety and stress reduction but MBSR may be more appropriate for depression. Consideration over implementation factors may largely improve the acceptability of mindfulness courses for teachers. Further research with larger samples is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615820/

 

Improve Well-Being, Attention, and Emotions with Meditation

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Improve Well-Being, Attention, and Emotions with Meditation

 

By John M. de Castro, Ph.D.

 

“How are you feeling? Meditation gives us a chance to entertain that question at a deeper level. It can give us the room to fully experience an emotion for what it is.” – Mindful

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

There are, however, a number of different meditation techniques. Two common forms are focused and open monitoring meditation practices. In focused attention meditation, the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future. In open monitoring meditation, the individual opens up awareness to everything that’s being experienced regardless of its origin. These include bodily sensations, external stimuli, and even thoughts. The meditator just observes these thoughts and lets them arise and fall away without paying them any further attention.

 

What forms of meditation work best to improve emotions and over what period of time is necessary for practice to produce benefits have not been well studied. In today’s Research News article “The Effects of Different Stages of Mindfulness Meditation Training on Emotion Regulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610260/), Zhang and colleagues recruited young adults (aged 19-32) who had not engaged in meditation practice previously and randomly assigned them to either a wait list control condition or an 8-week mindfulness training program. The mindfulness training consisted of 4 weeks of focused meditation followed by 4 weeks of open monitoring meditation. They met for 2 hours once a week and were requested to practice at home daily for 20-30 minutes. They were measured before training, at the 4-week point of training and after training for mindfulness, positive and negative emotions, anxiety, depression, rumination, and a cognitive attention task (Stroop task).

 

They found that the meditation group significantly increased in mindfulness from baseline to the 4-week point with further increases observed at 8 weeks, while the control group did not increase. For the meditation group positive emotions were significant higher at both 4 and 8 weeks while rumination, negative emotions, anxiety, and depression were significant lower. The meditation group also had significantly improved ability to attend to stimuli amid interference at 4- and 8-weeks post-training while the control group did not.

 

The results are interesting and suggest that 4 weeks of focused meditation practice improves the psychological well-being of young adults while an additional 4 weeks of open monitoring meditation practice either maintains or further increases the benefits. These results replicate many previous findings that mindfulness training significantly improves mindfulness, attention, and emotions, and significantly reduces rumination, anxiety, and depression. This strongly supports providing meditation training for young adults to improve their psychological health and well-being.

 

So, improve well-being, attention, and emotions with meditation.

 

“in order to successfully navigate life, you need to be able to both name the emotion you’re experiencing and describe the feelings that make up your experience. This is where meditation can help, by teaching us to observe, identify, and respond instead of just react.” – Richard Miller

 

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, Q., Wang, Z., Wang, X., Liu, L., Zhang, J., & Zhou, R. (2019). The Effects of Different Stages of Mindfulness Meditation Training on Emotion Regulation. Frontiers in human neuroscience, 13, 208. doi:10.3389/fnhum.2019.00208

 

Abstract

This study examined mood enhancement effects from 4-week focusing attention (FA) meditation and 4-week open monitoring (OM) meditation in an 8-week mindfulness training program designed for ordinary individuals. Forty participants were randomly assigned to a training group or a control group. All participants were asked to perform cognitive tasks and subjective scale tests at three time points (pre-, mid-, and post-tests). Compared with the participants in the control group, the participants in the meditation training group showed significantly decreased anxiety, depression, and rumination scores; significantly increased mindfulness scores; and significantly reduced reaction times (RTs) in the incongruent condition for the Stroop task. The present study demonstrated that 8-week mindfulness meditation training could effectively enhance the level of mindfulness and improve emotional states. Moreover, FA meditation could partially improve individual levels of mindfulness and effectively improve mood, while OM meditation could further improve individual levels of mindfulness and maintain a positive mood.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610260/

 

Reduce Psychological Distress Produced by Critical Thinking with Mindfulness

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Reduce Psychological Distress Produced by Critical Thinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The most active form of developing critical thinking is through meditation. Meditation makes you exercise control of mind over matter. Your mind becomes an active place for several activities such as: cleansing of mind from rubbish which may lead to wrong actions and decisions; accepting healthy thoughts into the cleansed mind; and letting the good ideas come to work and change the way you think.” – Operation Meditation

 

We tend to believe that the ability to think critically is a major positive characteristic that should be trained. For intellectual tasks this is probably true. But in the emotional realm, critical thinking might actually be negative and lead to greater emotional distress. Disordered, self-critical, thinking is associated with a variety of mental illnesses. This form of thinking can produce cognitive distortions that consist of dysfunctional reasoning including arbitrary inference, false dichotomy, selective abstraction, and overgeneralization. Mindfulness has been shown to improve thought processes and also the individual’s ability to regulate their emotions. So, mindfulness may counteract the negative emotional consequences of critical thinking.

 

In today’s Research News article “The Moderating Effect of Mindfulness on the Mediated Relation Between Critical Thinking and Psychological Distress via Cognitive Distortions Among Adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606771/), Su and Shum recruited high school seniors and had them complete measures of anxiety, depression, cognitive distortions, mindfulness, and critical thinking. They then subjected these measures to regression analysis.

 

They found that the higher the levels of cognitive distortions the higher the levels of stress, anxiety, and depression, and lower levels of mindfulness. In other words, psychological distress (anxiety, depression, and stress) were associated with faulty thinking. They then performed linear structural modelling and found that critical thinking was associated with psychological distress directly and indirectly by being associated with cognitive distortions which is, in turn, is associated with psychological distress. They found that mindfulness moderates the relationship between critical thinking and psychological distress. It does so by being related to lower cognitive distortions and by being related to lower psychological distress.

 

These results are interesting and suggest that having high critical thinking can lead to distorted thinking that can, in turn, lead to greater anxiety, depression, and stress. This faulty thinking may be related to thinking about the self, being overly critical of the self and thereby producing psychological problems. The results also suggest that mindfulness can to some extent blunt this process by making it less likely that distorted thinking will develop and also by directly reducing anxiety, depression, and stress. Hence, mindfulness may allow for critical thinking without producing psychological distress.

 

So, reduce psychological distress produced by critical thinking with mindfulness.

 

“The capacity to be mindful is associated with higher well-being in daily life.” – David Creswell

 

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

 

Michael Ronald Su, Kathy Kar-man Shum. The Moderating Effect of Mindfulness on the Mediated Relation Between Critical Thinking and Psychological Distress via Cognitive Distortions Among Adolescents. Front Psychol. 2019; 10: 1455. Published online 2019 Jun 26. doi: 10.3389/fpsyg.2019.01455

 

Abstract

Critical thinking has been widely regarded as an indispensable cognitive skill in the 21st century. However, its associations with the affective aspects of psychological functioning are not well understood. This study explored the interrelations between trait mindfulness, critical thinking, cognitive distortions, and psychological distress using a moderated mediation model. The sample comprised 287 senior secondary school students (57% male and 43% female) aged 14–19 from a local secondary school in Hong Kong. The results revealed that high critical thinking was significantly associated with high levels of psychological distress when mindful awareness was low among adolescents. Trait mindfulness was found to moderate the indirect effects of critical thinking on psychological distress via cognitive distortions as the mediator. Specifically, in low trait mindfulness conditions, critical thinking was found to associate positively with cognitive distortions and psychological distress. Such associations were not observed in high trait mindfulness conditions. The findings reveal that though critical thinking has positive associations with cognitive functioning, its associations with affective well-being might be negative. The results also suggest that mindfulness might play an important role in preventing the possible psychological distress associated with critical thinking. Educational implications relating to the fostering of critical thinking and mindful awareness are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606771/

Improve Workplace Wellness with Mindful Meditation

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Improve Workplace Wellness with Mindful Meditation

 

By John M. de Castro, Ph.D.

 

“If your workforce deals with stress, emotional health issues, or low morale, you’ll likely benefit from implementing a meditation program. Meditation programs have a lot of amazing health and wellness benefits that will have a positive impact on your employees.” – Robyn Whalen

 

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 and physical health. 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. 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. The research has been accumulating. So, it is important to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness meditation for workplace wellness: An evidence map.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598008/), Hilton and colleagues reviewed and summarized published systematic reviews of the research on mindfulness training in the workplace and its effects on employee health and well-being. They identified 175 reviews that focused on health care workers, caregivers, educators, and general workplace workers.

 

They report that the reviews demonstrated that mindfulness-based interventions were effective in treating chronic conditions producing relief of psychological distress, anxiety, and depression symptoms. Mindfulness was found to produce small decreases in chronic pain but significant improvements in pain-related quality of life. Mindfulness training was found to reduce substance abuse and help prevent relapse, reduce negative emotions, anxiety, depression, somatization, irritable bowel syndrome, and stress effects. Mindfulness training also was effective in cancer care, including reducing stress, anxiety, depression, and fatigue, and improving sleep and quality of life. for support of caregivers.

 

These findings are remarkable. The wide range of positive benefits on physical and mental health are breathtaking. To this authors knowledge there is no other treatment that has such broad application and effectiveness. This suggests that workplace mindfulness training is safe and highly effective and should be implemented throughout the workplace.

 

So, improve workplace wellness with mindful meditation.

 

“The ancient art of meditation has many benefits, especially in the workplace. Studies have shown that meditation practiced in the workplace has a direct impact on increased productivity, creativity, focus, and the overall happiness of employees.” – The Lotus

 

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

 

Hilton, L. G., Marshall, N. J., Motala, A., Taylor, S. L., Miake-Lye, I. M., Baxi, S., … Hempel, S. (2019). Mindfulness meditation for workplace wellness: An evidence map. Work (Reading, Mass.), 63(2), 205–218. doi:10.3233/WOR-192922

 

Abstract

BACKGROUND:

Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing, and performance.

OBJECTIVE:

In support of evidence-based decision making in workplace contexts, we created an evidence map summarizing physical and mental health, cognitive, affective, and interpersonal outcomes from systematic reviews of randomized controlled trials (RCTs) of mindfulness interventions.

METHODS:

We searched nine electronic databases to July 2017, dually-screened all reviews, and consulted topic experts to identify systematic reviews on mindfulness interventions. The distribution of evidence is presented as an evidence map in a bubble plot.

RESULTS:

In total, 175 systematic reviews met inclusion criteria. Reviews included a variety of mindfulness-based interventions. The largest review included 109 randomized controlled trials. The majority of these addressed general health, psychological conditions, chronic illness, pain, and substance use. Twenty-six systematic reviews assessed studies conducted in workplace settings and with healthcare professionals, educators, and caregivers. The evidence map shows the prevalence of research by the primary area of focus. An outline of promising applications of mindfulness interventions is included.

CONCLUSIONS:

The evidence map provides an overview of existing mindfulness research. It shows the body of available evidence to inform policy and organizational decision-making supporting employee wellbeing in work contexts.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598008/

 

Improve Psychopathology with Meditation

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Improve Psychopathology with Meditation

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

There are vast numbers of people who suffer with mental illnesses; psychopathology. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxiety, depression, psychoses, addictions, etc.. Since there has accumulated a large amount of research, it makes sense to step back and summarize what has been discovered.

 

In today’s Research News article “Mindfulness Meditation and Psychopathology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/), Wielgosz and colleagues review and summarize the published research studies investigating the efficacy of mindfulness meditation practices for the treatment of a variety of psychopathologies.

 

They report that mindfulness meditation produces significant improvements in depression and in anxiety disorders in comparison to inactive and active control conditions. Efficacy is equivalent to that of other evidence-based treatments. The research suggests that meditation reduces depression by decreasing rumination and anxiety by reducing repetitive negative thinking. Hence, meditation training is an excellent safe and effective treatment for these prevalent mental illnesses.

 

They also report that mindfulness meditation produces significant improvements in chronic pain intensity and unpleasantness in comparison to inactive but not active control conditions. Efficacy is equivalent to that of other evidence-based treatments. This is true for chronic low back pain fibromyalgia, migraine, and chronic pelvic pain. Meditation also appears to improve the quality of life of chronic pain patients. The research suggests that meditation reduces chronic pain by decreasing negative emotional reactivity. Such reactivity appears to intensify pain and meditation reduces this reactivity and thereby reduces pain.

 

They report that mindfulness meditation produces significant improvements in substance abuse disorders in comparison to inactive and active control conditions and even in comparison to other evidence-based treatments. It appears to reduce substance use frequency, use-related problems, and craving. This is important as addictions are very difficult to treat and frequently relapse.

 

There is evidence that mindfulness meditation is effective in the treatment of attention deficit hyperactivity disorder (ADHD) both in children and adults and also post-traumatic stress disorder (PTSD). But there are currently no comparisons to the effects of other active or evidence-based treatments. It will be important to have randomized controlled trials with active controls to better assess the efficacy of meditation for the treatment of ADHD and PTSD.

 

There is emerging evidence that mindfulness meditation may be effective for eating disorders, and major mental illnesses such as bipolar disorder, major depression, and psychosis. But there is a need for more, better controlled research.

 

Hence, this comprehensive review suggests that mindfulness meditation is a useful treatment for a variety of types of psychopathology. It is amazing that such a simple practice as meditation can have such wide-ranging benefits for such diverse mental illnesses. Meditation appears to act indirectly by strengthening cognitive, emotional, and stress related process that in turn have beneficial effects on the psychopathologies. Hence, it is clear that mindfulness meditation is a safe and effective treatment for psychopathologies that can be used alone or in combination with other treatments.

 

So, improve psychopathology with meditation.

 

“When they’re depressed, people are locked in the past. They’re ruminating about something that happened that they can’t let go of. When they’re anxious, they’re ruminating about the future — it’s that anticipation of what they can’t control. In contrast, when we are mindful, we are focused on the here and now. Mindfulness trains individuals to turn their attention to what is happening in the present moment.” – Carolyn Gregoire

 

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

 

Wielgosz, J., Goldberg, S. B., Kral, T., Dunne, J. D., & Davidson, R. J. (2019). Mindfulness Meditation and Psychopathology. Annual review of clinical psychology, 15, 285–316. doi:10.1146/annurev-clinpsy-021815-093423

 

Abstract

Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/

Mindfulness is Associated with Better Mental Health in Firefighters

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Mindfulness is Associated with Better Mental Health in Firefighters

 

By John M. de Castro, Ph.D.

 

“mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). First responders such as firefighters and police experience traumatic events as part of their jobs and many develop symptoms of PTSD. This is responsible for the fact that wore firefighters and police officers die by suicide than all line-of-duty deaths combined. 103 firefighters and 140 police officers died by suicide in 2017, compared to 93 firefighter and 129 officer line-of-duty deaths.

 

Obviously, stress and trauma effects are troubling problems for firefighters that need to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective.  Indeed, mindfulness has been shown to has been shown to reduce the physiological and psychological responses to stress, to reduce suicidality and to reduce the impact of trauma on the individual. So, a firefighter’s level of mindfulness may be associated with better mental health.

 

In today’s Research News article “Mental health and mindfulness amongst Australian fire fighters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/), Counson and colleagues recruited healthy firefighters who had experienced trauma in the last 6 months. The firefighters completed measures of mindfulness, anxiety, depression, and psychological well-being.

 

They found that the higher the firefighters’ levels of mindfulness, the lower the levels of anxiety and depression and the higher the levels of psychological well-being. Hence, mindfulness was found to be associated with better mental health in these firefighters who are exposed to trauma. This study is correlational and no conclusions regarding causation can be reached. But previous research has demonstrated that mindfulness has causal effects on anxiety, depression, and psychological well-being. So, it is likely that the associations seen here were due to causal connections.

 

These results suggest that mindful firefighters are resistant to the effects of trauma. It has been shown the mindfulness is effective in treating Post-Traumatic Stress Disorder (PTSD). The present results then combined with these previous findings suggest that mindfulness may help to protect firefighters from trauma making it less likely that they’ll develop PTSD.

 

So, mindfulness is associated with better mental health in firefighters.

 

“targeted mindfulness training program increases some aspects of firefighter resilience (distress tolerance, positive adjustment, and perseverance). . . . The more lessons firefighters completed, the greater their improvements in both mindfulness and resilience.” – AMRA

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Counson, I., Hosemans, D., Lal, T. J., Mott, B., Harvey, S. B., & Joyce, S. (2019). Mental health and mindfulness amongst Australian fire fighters. BMC psychology, 7(1), 34. doi:10.1186/s40359-019-0311-2

 

Abstract

Background

While extensive research has highlighted the positive mental health outcomes associated with mindfulness, little work has examined how mindfulness may protect the mental health of first responders exposed to trauma. This is important as there is increasing evidence that mindfulness skills, if protective, can be taught to groups of at-risk workers. The purpose of the current research was to examine the potential role mindfulness may have in supporting the mental health of Australian fire fighters.

Methods

The sample consisted of 114 professional fire fighters who completed demographic and job-related questions followed by measures of mindfulness (FMI-14), well-being (WHO-5), depression (HADS-D) and anxiety (HADS-A). Hierarchical multiple linear regressions were performed to determine whether levels of mindfulness were associated with anxiety, depression and wellbeing after accounting for age and number of years of fire service.

Results

High levels of mindfulness were associated with decreased depression (p ≤ .001) and anxiety (p ≤ .001) as well as increased psychological well-being (p ≤ .001). Measures of mindfulness were able to explain a substantial amount of the variability in well-being (26.8%), anxiety (23.6%) and depression (22.4%), regardless of age and years of fire service.

Conclusions

The present study provides evidence for robust associations between dispositional mindfulness and mental health markers of depression, anxiety and well-being in Australian fire fighters recently exposed to trauma. Mindfulness is a psychological characteristic that may be able to be modified, although further research is required to substantiate these findings and to formally test mindfulness interventions. Such studies would allow greater insight into the underlying mechanisms through which mindfulness may exert its beneficial effects.

Electronic supplementary material

The online version of this article (10.1186/s40359-019-0311-2) contains supplementary material, which is available to authorized users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570940/

 

Improve Adolescent Emotion Regulation and Mental Health with Mindfulness

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Improve Adolescent Emotion Regulation and Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“But a growing body of evidence suggests that mindfulness practice could be beneficial to teens, helping them cultivate empathy, as well as skills for concentration and impulse control. In short, mindfulness can help adolescents navigate the challenges of adolescence.” – Sarah Rudell Beach

 

Adolescence is a time of mental, physical, social, and emotional growth. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required. Indeed, up to a quarter of adolescents suffer from depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms.

 

Mindfulness training in adults has been shown to reduce anxiety, depression, and perceived stress levels and improve emotional regulation. In addition, in adolescents it has been shown to improve emotion regulation and to benefit the psychological and emotional health. There is a need to explore the relationship between these effects of mindfulness training in adolescents.

 

In today’s Research News article “Adolescents’ Mindfulness and Psychological Distress: The Mediating Role of Emotion Regulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567674/), Ma and Fang recruited middle school students between the ages of 12-18 years and had them complete scales measuring mindfulness, anxiety, depression, perceived stress, difficulties with emotion regulation, and emotion regulation.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, perceived stress, and difficulties with emotion regulation, including all subscales; “lack of emotional clarity (Clarity), difficulty in engaging in goal-directed behavior under negative emotions (Goals), loss of control under negative emotions (Impulse), limited strategies for emotion regulation (Strategies), and non-acceptance of emotional responses (Non-acceptance).” Using a mediation model, they found that high levels of mindfulness were related to lower levels of anxiety, depression, and perceived stress directly and indirectly as a results of mindfulness’ negative relationship with difficulties with emotion regulation. In other words, mindfulness was directly related to lower levels of psychological distress and also indirectly by its relationship with lower levels of difficulties with emotion regulation which were in turn related to less psychological distress.

 

The study is correlational and as such causation cannot be concluded. But prior research has demonstrated that mindfulness causes reductions in anxiety, depression, perceived stress, and difficulties with emotional regulation. Hence, it would be reasonable to conclude that the present findings were also due to the effects of mindfulness on psychological health.

 

Adolescence is a time of strong emotions that the adolescents have not yet learned how to effectively regulate. This makes this period of life very difficult with high levels of emotional distress. The finding though indicate that mindfulness may be a way to mitigate the emotional upheavals of adolescence of improve the psychological health of the teens by improving their ability to deal with their emotions.

 

So, improve adolescent emotion regulation and mental health with mindfulness.

 

“Mindfulness teaches teenagers to recognize the downward spiral of thoughts before it gets out of hand, perhaps learning to label it as simply “worrying.” They can acknowledge the anxiety without getting caught up in it, without it leading to the rumination that ultimately ruins their mood.” – Sarah Rudell Beach

 

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

 

Ma, Y., & Fang, S. (2019). Adolescents’ Mindfulness and Psychological Distress: The Mediating Role of Emotion Regulation. Frontiers in psychology, 10, 1358. doi:10.3389/fpsyg.2019.01358

 

Abstract

Mindfulness has been widely linked with psychological well-being in general population. There are emerging studies supporting the relationship between adolescents’ mindfulness and their mental health. However, the mechanisms through which mindfulness may influence adolescents’ psychological distress have only recently been explored, and more related research is still needed. This study investigated the relationship between adolescents’ dispositional mindfulness and psychological symptoms of depression, anxiety and stress. The mediating variables were also explored in perspective of two common emotion regulation theories, which were measured through Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ). DERS has been used as a comprehensive assessment of emotion regulation difficulties. ERQ is also widely accepted to measure the emotion regulation process including dimensions of cognitive reappraisal and expressive suppression. Measures assessing mindfulness, emotion regulation, and psychological distress were administered to 1067 adolescents in mainland China. The results confirmed that adolescents’ dispositional mindfulness was negatively associated with depression, anxiety, and stress. DERS, especially the sub-dimensions of Acceptance and Strategies, significantly mediated the relationship between mindfulness and symptoms of depression, anxiety and stress. Whereas, ERQ including subscales of cognitive reappraisal and expressive suppression exerted limited mediating effect. These findings provided insights for the potential underlying mechanism between adolescents’ mindfulness and psychological distress, demonstrating that DERS might be more pervasive than ERQ. Further research was suggested to explore other mediating variables underlying mindfulness and psychological distress among adolescents and develop mindfulness-based programs to improve adolescents’ mindfulness and emotion regulation ability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567674/

 

Improve Mental Health Postpartum with Perinatal Mindfulness Training

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Improve Mental Health Postpartum with Perinatal Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“the ideal treatment plan for perinatal depression and anxiety often includes mindfulness techniques. Exercises such as deep breathing, progressive muscle relaxation, and meditation, for example, have been shown to reduce blood pressure and promote recovery from many illnesses.” – Edith Gettes

 

The birth of a child is most often a joyous occasion. But often the joy turns to misery. Immediately after birth it is common for the mother to experience mood swings including what has been termed “baby blues,” a sadness that may last for as much as a couple of weeks. But some women experience a more intense and long-lasting negative mood called postpartum depression. This occurs usually 4-6 weeks after birth in about 15% of births; about 600,000 women in the U.S. every year. For 50% of the women the depression lasts for about a year while about 30% are still depressed 3 years later.

 

Mindfulness training has been shown to improve anxiety and depression in general and to relieve maternal anxiety and depression during pregnancy. But it is not known if the effectiveness of mindfulness training during the perinatal period carries over to the postpartum period. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying depression. So, it would make sense to study the effectiveness of MBCT administered during the perinatal period on postpartum mental health issues.

 

In today’s Research News article “Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/), Luberto and colleagues recruited pregnant women (average of 15.5 weeks pregnant) and provide them with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training and 3 months postpartum for anxiety, depression, worry, mindfulness, self-compassion, meditation frequency, and home practice.

 

They found that after treatment there were significant increases in mindfulness and self-compassion and significant decreases in anxiety, depression, and worry. These improvements were maintained at 3-months postpartum except for depression that had a further significant decline. After the intervention 91% of the women continued to practice meditation and 65% continued practicing yoga. During the postpartum period 55% of the women continued to practice meditation and 25% continued practicing yoga. There were no significant differences in the outcomes for women who continued to practice versus those that didn’t.

 

These results are important in that they demonstrate that Mindfulness-Based Cognitive Therapy (MBCT)  produces important benefits for the mental health of pregnant women that endure into the postpartum period. This is important as “baby blues” and postpartum depression are frequent and difficult consequences of childbirth. The findings suggest that MBCT training during pregnancy may help to prevent “baby blues” and postpartum depression. Hence, MBCT the produces lasting improvements in the psychological state of women during both the perinatal and postpartum periods.

 

So, improve mental health postpartum with perinatal mindfulness training.

 

“By paying attention, by being mindful, I was able to accept things that spun me out previously. I still had low points, but I was better equipped to manage and accept them as feelings and moments, and move on. . . . What I thought was caused by hormone fluctuations and “baby blues” was actually much more severe.” – Kristi Pahr

 

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

 

Luberto, C. M., Park, E. R., & Goodman, J. H. (2018). Postpartum Outcomes and Formal Mindfulness Practice in Mindfulness-Based Cognitive Therapy for Perinatal Women. Mindfulness, 9(3), 850–859. doi:10.1007/s12671-017-0825-8

 

Abstract

Anxiety is common during pregnancy and associated with poorer outcomes for mother and child. Our single-arm pilot study of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) intervention for pregnant women with elevated anxiety showed significant pre- to post-intervention improvements in anxiety, depression, worry, mindfulness, and self-compassion. It remains unclear whether these improvements are maintained post-partum and whether amount of formal mindfulness practice is correlated with outcomes. The current study examined whether 1) improvements in psychosocial outcomes were maintained three months postpartum; 2) women were adherent to formal practice recommendations; and 3) amount of mindfulness practice was correlated with outcomes. Twenty-three pregnant women (Mage=33.5, SD=4.40; 75% White; 71% with Generalized Anxiety Disorder) completed home practice logs throughout the intervention, and self-report measures before and after the intervention and three months postpartum. Results indicated that previously reported post-intervention improvements in anxiety, worry, mindfulness, and self-compassion were maintained postpartum (p’s<.05), and reductions in depression further improved (p<.001). Participants were generally adherent to mindfulness practice recommendations during the intervention (54%-80% weekly adherence; M=17.31 total practice hours [SD=7.45]), and many continued practicing one-week post-intervention (91%) and postpartum (55%). Mindfulness practice during the intervention was not significantly correlated with any outcome at post-intervention or postpartum. Mindfulness practice postpartum was only marginally related to improved worry postpartum (p=.05). MBCT may be associated with maintained improvements in psychosocial outcomes for women during pregnancy and postpartum, but the role of mindfulness practice is unclear. Research using larger samples and randomized controlled designs is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070304/

 

Improve Children and Adolescents Mental Health with Mindfulness

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Improve Children and Adolescents Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“In the last few years mindfulness has emerged as a way of treating children and adolescents with conditions ranging from ADHD to anxiety, autism spectrum disorders, depression and stress. And the benefits are proving to be tremendous.” – Julianne Garey

 

Childhood is a miraculous period during which the child is dynamically absorbing information from every aspect of its environment. This occurs almost without any intervention from the adults as the child appears to be programmed to learn. It is here that behaviors, knowledge, skills, and attitudes are developed that shape the individual.

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and unable to cope with all that is required.

 

Mindfulness training for children and adolescents has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents. Importantly, mindfulness training with children and adolescents appears to improve the self-concept, improves attentional ability and reduces stress. The research findings and evidence are accumulating. So, it makes sense to step back and review and summarize what has been learned regarding the effectiveness of mindfulness training for the cognitive growth and mental health and well-being of children and adolescents.

 

In today’s Research News article “Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546608/), Dunning and colleagues review, summarize and perform a meta-analysis of randomized controlled trials of the effects of mindfulness training on the cognitive ability, psychological health, and well-being of children and adolescents. They identified 33 published randomized controlled trials, 17 of which had active control conditions.

 

They found that over all published studies, mindfulness training resulted in improved cognition and executive function, with larger effects for older children and adolescents. Mindfulness training also produced significantly increased mindfulness and decreased negative behaviors, stress, anxiety and depression. increased mindfulness and decreased stress, anxiety and depression were still significant. But when mindfulness practices were compared to active control conditions cognitive improvements were no longer significant but there were still significant increases in mindfulness and decreases in stress, anxiety and depression.

 

These results are interesting and suggest that mindfulness training produces significant improvements in the mental health of children and adolescents. The results, however, suggest that reported improvements in cognition and behavior may be due to placebo or experimenter bias effects as these same improvements occurred with active control conditions. The improvements in cognitive ability appears to be maximized in adolescents when high level executive functions are developing. The lack of significant effects in studies with active control conditions may have been due to the small number of studies, 7, that had active controls and studied cognition.

 

Regardless, the accumulated research suggests that training children and adolescents in mindfulness may help them navigate the difficult emotional challenges confronting them during development.

 

So, improve children and adolescents’ mental health with mindfulness.

 

“For children, mindfulness can offer relief from whatever difficulties they might be encountering in life. It also gives them the beauty of being in the present moment.” – Annaka Harris

 

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

 

Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials. Journal of child psychology and psychiatry, and allied disciplines, 60(3), 244–258. doi:10.1111/jcpp.12980

 

Abstract

Background

Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design.

Methods

A systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition.

Results

Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen’s d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only.

Conclusions

This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

Key points

  • Mindfulness based interventions (MBIs) are a popular way of attempting to improve the mental and physical health outcomes of children and adolescents.
  • This is the first meta-analysis of MBIs with youth composed exclusively of randomized controlled trials (RCTs) including RCTs with active control groups – the gold standard in intervention studies.
  • When using the gold standard research design results showed that MBIs are useful in improving Depression and Anxiety outcomes, but not behavioural or cognitive outcomes,
  • The meta-analysis advocates the use of MBIs for improving mental health in young people.
  • Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546608/

 

Improve Psychological Well-Being of Recovered Cardiorespiratory Patients with Mindfulness

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Improve Psychological Well-Being of Recovered Cardiorespiratory Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation can be a useful part of cardiovascular risk reduction. I do recommend it, along with diet and exercise. It can also help decrease the sense of stress and anxiety.” – Deepak Bhatt

 

Patients who experience cardiorespiratory failure have now a high likelihood of survival if they are treated promptly in an intensive care unit. Unfortunately, after physical recovery and discharge the patients often experience negative physical and psychological consequences. These include physical symptoms and psychological issues such as depression, anxiety, and post-traumatic stress symptoms, stress, fear and foreboding, emotional disability, and social disruption. Treatments are needed to help alleviate these troubling residual symptoms.

 

Mindfulness practices have been shown to improve depression, anxiety, and post-traumatic stress disorder (PTSD), stress, fear and foreboding, emotional disability, and social function. It would seem reasonable then to project that mindfulness practice may be beneficial for the psychological well-being of patients who have recovered from cardiorespiratory failure. But such patients generally find it difficult or impossible to come to a clinic for treatment. As an alternative, mindfulness training can be delivered remotely with smartphone apps. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations for treatment. But the question arises as to the effectiveness of these programs.

 

In today’s Research News article “Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460929/ ), Cox and colleagues recruited patients who had been released from the intensive care unit following cardiorespiratory failure and were at home. They were randomly assigned to receive a 4-session mindfulness training either by phone or smartphone app, or receive a web-based education program. They completed online measures of acceptability, feasibility, and usability and also were measured before and 3 months after the intervention for anxiety, depression, symptom severity, post-traumatic stress, physical distress, quality of life, coping skills, stress, and mindfulness.

 

The program was found to be acceptable, feasible, and usable as 83% of the patients completed the study with no significant differences between conditions. They found that in comparison to baseline and the education group, both mindfulness training groups had significant improvements in physical symptoms, posttraumatic stress symptoms, depression and anxiety. They also found that the greater the use of the mobile app the greater the improvement in depression.

 

The results of the study are encouraging and show that mindfulness training delivered either by telephone or a smartphone app is acceptable, feasible, and usable and is effective for the treatment of patients who were recovering from cardiorespiratory failure improving their physical and mental health. This is important as these patients are suffering and, like many others, have difficulty coming to a particular location at a particular time to receive therapist delivered mindfulness training. So, smartphone and phone-based programs are a valuable solution.

 

So, improve psychological well-being of recovered cardiorespiratory patients with mindfulness.

 

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – John Denninger

 

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

 

Cox, C. E., Hough, C. L., Jones, D. M., Ungar, A., Reagan, W., Key, M. D., … Porter, L. S. (2019). Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial. Thorax, 74(1), 33–42. doi:10.1136/thoraxjnl-2017-211264

 

Abstract

Background:

Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs.

Methods:

Pilot randomized clinical trial with 3-month follow up conducted at two academic medical centers. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomized after discharge home to one of three month-long interventions: a self-directed mobile app-based mindfulness program; a therapist-led telephone-based mindfulness program; or a web-based critical illness education program.

Results:

Among 80 patients allocated to mobile mindfulness (n= 31), telephone mindfulness (n=31), or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomization 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 [standard deviation 3.8]), and usability (mean Systems Usability Score 89.1 [SD 11.5]). For secondary outcomes, mean values (and 95% confidence intervals) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (−4.8 [−6.6, −2.9]), telephone (−3.9 [−5.6, −2.2]), education (−3.0 [−5.3, 0.8]); the Generalized Anxiety Disorder scale (mobile −2.1 [−3.7, −0.5], telephone −1.6 [−3.0, −0.1], education −0.6 [−2.5, 1.3]), the Post-Traumatic Stress Scale (mobile −2.6 [−6.3, 1.2], telephone −2.2 [−5.6, 1.2], education −3.5 [−8.0, 1.0]), and the Patient Health Questionnaire physical symptom scale (mobile −5.3 [−7.0, −3.7], telephone −3.7 [−5.2, 2.2], education −4.8 [−6.8, 2.7]).

Conclusions:

Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability, and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led program. A larger trial is warranted to formally test the efficacy of this approach.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460929/