Depression

Reduce Depression in Older Adults with Mind-Body Practices and Exercise

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Reduce Depression in Older Adults with Mind-Body Practices and Exercise

 

By John M. de Castro, Ph.D.

 

“Complementary use of mindful exercise, such as Tai Chi and yogic meditation, can improve clinical outcomes of mood disorders in older adults-as demonstrated in brain scans, biomarkers of cellular aging, and mental health rating scales.” – Arline Kaplan

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our cognitive (mental) abilities and mood. It is inevitable and cannot be avoided. There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, contemplative practices such as meditation, yoga, and Tai Chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging and with improving depression. The research has been accumulating. So, it makes sense to pause and review and summarize what has been learned.

 

In today’s Research News article “Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191520/ ) Miller and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mind-body practices, aerobic exercise, and resistance exercise on depression in older adults (over 65 years of age). They identified 69 published research studies including a total of 5,379 elderly participants.

 

They report that the published research found that in comparison to usual care, wait-list controls, or attention controls that mind-body practices, aerobic exercise, and resistance exercise all significantly reduced depression in the elderly participants. Although no significant differences were found between the practices, on average, the effectiveness of the practices were rank ordered mind-body practices followed by aerobic exercise followed by resistance exercise.

 

All three practices involve exercise. Mind-body practices include yoga, Tai Chi, and Qigong all of which provide gentle mild exercise intensity. Aerobic exercise on the other hand provides moderate intensity exercise. This suggests that the intensity of exercise is not important for the relief of depression. What does appear to be important is that exercise be incorporated into the activities of the elderly to raise mood and reduce depression. Hence, the results suggest that the depression that is common in the elderly can be ameliorated with exercise.

 

So, reduce depression in older adults with mind-body practices and exercise.

 

“Higher physical activity levels among older adults in particular may have a preventive effect on the development of depression.36 Recent findings point to the potential efficacy of exercise as a treatment of depression in older adults, in some cases with similar efficacy to antidepressants.” – Maren Nyer

 

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

 

Miller, K. J., Areerob, P., Hennessy, D., Gonçalves-Bradley, D. C., Mesagno, C., & Grace, F. (2020). Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials. F1000Research, 9, 1325. https://doi.org/10.12688/f1000research.27123.2

 

Abstract

Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years.

Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups.

Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’ g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’ g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’ g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges’ g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment.

Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191520/

 

Reduce Adolescent Internalizing Symptoms, and Impulsivity with Mindfulness

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Reduce Adolescent Internalizing Symptoms, and Impulsivity with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness appears to be a way of engaging with our internal and external environment and approaching emotion that is an asset for avoiding excessively heightened internalizing symptoms.” – Sarah Clear

 

Adolescence is a time of mental, physical, social, and emotional growth. But it 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. This can lead to emotional and behavioral problems. Indeed, up to a quarter of adolescents suffer from internalizing symptoms such as depression or anxiety disorders, and an even larger proportion struggle with subclinical symptoms. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents

 

In today’s Research News article “Longitudinal Associations between Internalizing Symptoms, Dispositional Mindfulness, Rumination and Impulsivity in Adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416885/ ) Royuela-Colomer and colleagues recruited healthy adolescents (aged 11 to 17 years) and had them complete measures of mindfulness, rumination, impulsivity, and internalizing symptoms, including anxiety, depression, and perceived stress. The measures were completed again one year later.

 

They found that adolescent boys had significantly lower levels of rumination, impulsivity, and internalizing symptoms and higher levels of mindfulness than girls. They also found that at both measurement periods the higher the levels of mindfulness the lower the levels of all dependent variables. They further found that the higher the levels of mindfulness at the first measurement the lower the levels of depression, perceived stress, and impulsivity a year later. This latter finding was true both for boys and girls.

 

These findings are correlational. So, no conclusions about causation can be made. But in previous controlled studies mindfulness has been found to improve the psychological well-being of adolescents and to produce lower levels of depression, perceived stress, and impulsivity. So, the correlations obtained here likely occurred due to causal connections between the variables. These results then suggest that mindfulness may be protective against internalizing symptoms and impulsivity in adolescents. This further suggests that mindfulness training should be made part of the education of adolescents to improve their psychological well-being and reducing their destructive tendencies toward impulsive behavior.

 

So, reduce adolescent internalizing symptoms, and impulsivity with mindfulness.

 

“Mindfulness not only directly impacted on adolescents’ internalizing problems, but also indirectly improved their anxious and depression emotions via the reduction of rumination and the increase of acceptance.” – Meng Yu

 

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

 

Royuela-Colomer, E., Fernández-González, L., & Orue, I. (2021). Longitudinal Associations between Internalizing Symptoms, Dispositional Mindfulness, Rumination and Impulsivity in Adolescents. Journal of youth and adolescence, 50(10), 2067–2078. https://doi.org/10.1007/s10964-021-01476-2

 

Abstract

Mindfulness has been associated with fewer negative mental health symptoms during adolescence, but fewer studies have examined longitudinal associations between mindfulness and symptoms in conjunction with two vulnerability factors for psychopathology with mindfulness: rumination and impulsivity. This study examined longitudinal associations between internalizing symptoms (depression, anxiety, stress), mindfulness, rumination, and impulsivity over a one-year period among 352 Spanish adolescents (57.4% girls; M = 14.47, SD = 1.34). Participants completed self-reported measures of symptoms, mindfulness, rumination, and impulsivity at two time points. Mindfulness negatively predicted stress and depressive symptoms, and a bidirectional negative association was found between mindfulness and impulsivity. Impulsivity positively predicted stress, and anxiety positively predicted depressive symptoms, stress, and rumination. This study highlights the importance of mindfulness as a protective factor and impulsivity and anxiety as risk factors for internalizing symptoms throughout adolescence. These findings build on previous studies that examined longitudinal associations between mindfulness and symptoms by including rumination and impulsivity’s roles.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416885/

 

Improve the Psychological Health of College Students with Mindfulness

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Improve the Psychological Health of College Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness can help students who might be struggling, in particular medical students, find new ways of relating to the difficulties that arise in their clinical work, studying and wellbeing.” – Alice Malpass

 

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 lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students. So, it would seem important to summarize what has been learned about mindfulness-based approaches to improve the psychological well-being of college students studying to become health professionals.

 

In today’s Research News article “Mindfulness-Based Approaches for Managing Stress, Anxiety and Depression for Health Students in Tertiary Education: a Scoping Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435111/ ) Parsons and colleagues review and summarize the published research studies investigating the effectiveness of mindfulness-based approaches to improve the psychological well-being of college students studying to become health professionals. They identified 24 published research studies.

 

They report that the published research studies found that mindfulness-based training produced significant reductions in perceived stress, anxiety, and depression in the health students. Hence, these health students had similar responses to mindfulness training as has been observed in a large number of studies with a variety of healthy and ill participants. This suggests that it would be beneficial to incorporate mindfulness training in the curriculum of college students studying to become health professionals. This should improve their ability to learn their professions and become more resilient and effective professionals.

 

So, improve the psychological health of college health students with mindfulness.

 

“Mindfulness-based interventions decrease stress, anxiety, and depression and improve mindfulness, mood, self-efficacy, and empathy in health profession students.” – Janet McConville

 

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

 

Parsons, D., Gardner, P., Parry, S., & Smart, S. (2021). Mindfulness-Based Approaches for Managing Stress, Anxiety and Depression for Health Students in Tertiary Education: a Scoping Review. Mindfulness, 1–16. Advance online publication. https://doi.org/10.1007/s12671-021-01740-3

 

Abstract

Objectives

High rates of depression, anxiety and stress are reported in tertiary health students. Mindfulness-based programs have been included in the training of health students to help them manage depression, anxiety and stress; however, to date, there has been no review of best practice implementation of mindfulness for health students. The aim of this review was to evaluate the outcomes of mindfulness-based practice for health students to inform best practice with this population.

Methods

A comprehensive search was conducted of three electronic databases (PsychINFO, Medline and Embase) guided by the five-step systematic process for conducting scoping reviews to investigate mindfulness-based intervention programs for students enrolled in a tertiary institution in a health-related course.

Results

Twenty-four papers met the eligibility criteria and were reviewed in detail. Findings suggested that mindfulness-based intervention approaches are useful in decreasing depression, anxiety and stress in health students; however, challenges exist in student engagement and retention. Generalization of results was limited by the heterogeneous population, intervention designs and delivery methods, as well as a lack of standardized outcome measures.

Conclusion

The inclusion of mindfulness-based programs within tertiary curricula can be an effective approach to assist with managing depression, stress and anxiety in health students. Providing academic credit to students, improving translation of skills to working with future clients, and embedding mindfulness-based programs within the curriculum could improve engagement and retention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8435111/

 

Improve Eating Disorders with Dialectical Behavior Therapy

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Improve Eating Disorders with Dialectical Behavior Therapy

 

By John M. de Castro, Ph.D.

 

“Dialectical behavioral therapy encourages change but also promotes acceptance. The term dialectic means that two opposite ideas can be correct at the same time. This is helpful for individuals in eating disorder treatment as most of these clients adopt an “all or nothing view”. The dialectical view appeals to many as they navigate recovery; they can accept their difficulties and work towards changing them.” – Discovery

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Binge eating disorder involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating.

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. Dialectical Behavior Therapy (DBT) produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings, and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. It is likely, then that DBT is effective in treating eating sidorders.

 

There is accumulating evidence of the effectiveness of Dialectical Behavior Therapy (DBT) for the treatment of eating disorders. So, it makes sense to review what has been learned. In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470932/ ) Rozakou-Soumalia and colleagues review, summarize, and perform a meta-analysis of the published controlled research studies of the effectiveness of DBT in the treatment of eating disorders.

 

They identified 11 published studies, 10 of which were randomized controlled trials. They report that the published research found that Dialectical Behavior Therapy (DBT) produced a significant increase in emotion regulation and a significant decrease in depression, body mass index, and the severity of eating disorders symptoms, including binge eating episodes.

 

These findings of the published research suggest that Dialectical Behavior Therapy (DBT) is an effective treatment for eating disorders, reducing the severity of the symptoms. A core issue for patients with eating disorders is an inability to effectively deal with their emotions. The findings suggest that one way that DBT improves eating disorders is by increasing the patient’s ability to effectively regulate their emotions. Mindfulness training, which is contained in DBT has been shown in a wide range of research studies to improve emotion regulation and this may be the mechanism by which DBT improves eating disorders.

 

So, improve eating disorders with Dialectical Behavior Therapy.

 

“DBT techniques equip eating disorder sufferers with methods for identifying triggers and improving responses to stress, (such as engaging in breathing and relaxation exercises), and applying mindful eating.” – Eating Disorders Hope

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Rozakou-Soumalia, N., Dârvariu, Ş., & Sjögren, J. M. (2021). Dialectical Behaviour Therapy Improves Emotion Dysregulation Mainly in Binge Eating Disorder and Bulimia Nervosa: A Systematic Review and Meta-Analysis. Journal of Personalized Medicine, 11(9), 931. https://doi.org/10.3390/jpm11090931

 

Abstract

Emotion dysregulation is a transdiagnostic phenomenon in Eating Disorders (ED), and Dialectical Behaviour Therapy (DBT) (which was developed for reducing dysregulated emotions in personality disorders) has been employed in patients with ED. This systematic review and meta-analysis investigated whether the effect of DBT was stronger on emotion dysregulation, general psychopathology, and Body Mass Index (BMI) in participants with ED, when compared to a control group (active therapy and waitlist). Eleven studies were identified in a systematic search in accordance with PRISMA guidelines. Most studies included participants with Binge Eating Disorder (BED) (n = 8), some with Bulimia Nervosa (BN) (n = 3), and only one with Anorexia Nervosa (AN). The pooled effect of DBT indicated a greater improvement in Emotion Regulation (ER) (g = −0.69, p = 0.01), depressive symptoms (g = −0.33, p < 0.00001), ED psychopathology (MD = −0.90, p = 0.005), Objective Binge Episodes (OBE) (MD = −0.27, p = 0.003), and BMI (MD = −1.93, p = 0.01) compared to the control group. No improvement was detected in eating ER following DBT (p = 0.41). DBT demonstrated greater efficacy compared with the control group in improving emotion dysregulation, ED psychopathology, and BMI in ED. The limitations included the small number of studies and high variability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470932/

 

Improve Post-Traumatic Stress Disorder (PTSD) Symptoms with Loving Kindness Meditation

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Improve Post-Traumatic Stress Disorder (PTSD) Symptoms with Loving Kindness Meditation

 

By John M. de Castro, Ph.D.

 

“You probably know that symptoms of posttraumatic stress disorder (PTSD) often include anxiety, unwanted memories, anger and avoidance. But did you know that meditation may be able to help? Meditative practices have been linked to decreases in hyperarousal, depression and insomnia.” – Jill Bormann

 

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. But only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel, it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.

 

PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Obviously, these are troubling symptoms 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.  Increasing self-compassion is important for improvement in PTSD symptoms. Mindfulness has been shown to increase self-compassion.  In Loving Kindness Meditation the individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being. So, Loving Kindness Meditation may be an effective treatment for the symptoms of PTSD.

 

In today’s Research News article “Loving-Kindness Meditation vs Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052593/ ) Kearney and colleagues recruited military veterans who were diagnosed with Post-Traumatic Stress Disorder (PTSD) and randomly assigned them to receive 2 weekly 90-minute group sessions of either Loving Kindness Meditation or Cognitive Processing Therapy (CPT). CPT “combines cognitive restructuring with emotional processing of trauma-related content”. They were measured before and after treatment and 3 and 6 months later for PTSD symptom severity and depression.

 

They found that in comparison to baseline both groups had significant but modest reductions in PTSD symptom severity and depression that were maintained 6 months after the end of treatment. The therapy groups did not differ in PTSD symptom severity but the group that practiced Loving Kindness Meditation had significantly lower level of depression after treatment and 6 months later.

 

These are interesting findings that suggest that both Loving Kindness Meditation and Cognitive Processing Therapy (CPT) produce modest relief of the symptoms of PTSD and depression in military veterans. But Loving Kindness Meditation produces better outcomes in relieving depression. Loving Kindness Meditation is known to improve mindfulness and compassion for the self and others, and this appears to help relieve the psychological consequences of trauma. This suggests that trauma, to some extent, produces a degree of self-blame which may be responsible for some of the symptoms. But these therapies produce only modest improvements suggesting that Loving Kindness Meditation is not a cure but may be useful as a component in the treatment of PTSD.

 

So, improve Post-Traumatic Stress Disorder (PTSD) symptoms with Loving Kindness Meditation.

 

“veteran participants self-reported a significant decrease in their PTSD symptoms and a high degree of satisfaction with the compassion meditation program.” – Laura McArdle

 

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

 

Kearney, D. J., Malte, C. A., Storms, M., & Simpson, T. L. (2021). Loving-Kindness Meditation vs Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial. JAMA network open, 4(4), e216604. https://doi.org/10.1001/jamanetworkopen.2021.6604

 

Question

Is group loving-kindness meditation noninferior to group cognitive processing therapy for treatment of posttraumatic stress disorder (PTSD) among veterans?

Findings

In this randomized clinical trial, 184 veterans with PTSD were assigned to group loving-kindness meditation or group cognitive processing therapy; the differences in the decrease from baseline to 6-month follow-up for measures of PTSD and depression were very similar and within predefined margins considered not meaningfully different. Attendance was better for loving-kindness meditation.

Meaning

This study adds to the evidence indicating that interventions without a specific focus on trauma, including meditation-based interventions, can yield results similar to trauma-focused therapies.

Importance

Additional options are needed for treatment of posttraumatic stress disorder (PTSD) among veterans.

Objective

To determine whether group loving-kindness meditation is noninferior to group cognitive processing therapy for treatment of PTSD.

Design, Setting, and Participants

This randomized clinical noninferiority trial assessed PTSD and depression at baseline, posttreatment, and 3- and 6-month follow-up. Veterans were recruited from September 24, 2014, to February 5, 2018, from a large Veternas Affairs medical center in Seattle, Washington. A total of 184 veteran volunteers who met Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for PTSD were randomized. Data collection was completed November 28, 2018, and data analyses were conducted from December 10, 2018, to November 5, 2019.

Interventions

Each intervention comprised 12 weekly 90-minute group sessions. Loving-kindness meditation (n = 91) involves silent repetition of phrases intended to elicit feelings of kindness for oneself and others. Cognitive processing therapy (n = 93) combines cognitive restructuring with emotional processing of trauma-related content.

Main Outcomes and Measures

Co–primary outcomes were change in PTSD and depression scores over 6-month follow-up, assessed by the Clinician-Administered PTSD Scale (CAPS-5; range, 0-80; higher is worse) and Patient-Reported Outcome Measurement Information System (PROMIS; reported as standardized T-score with mean [SD] of 50 [10] points; higher is worse) depression measures. Noninferiority margins were 5 points on the CAPS-5 and 4 points on the PROMIS depression measure.

Results

Among the 184 veterans (mean [SD] age, 57.1 [13.1] years; 153 men [83.2%]; 107 White participants [58.2%]) included in the study, 91 (49.5%) were randomized to the loving-kindness group, and 93 (50.5%) were randomized to the cognitive processing group. The mean (SD) baseline CAPS-5 score was 35.5 (11.8) and mean (SD) PROMIS depression score was 60.9 (7.9). A total of 121 veterans (66%) completed 6-month follow-up. At 6 months posttreatment, mean CAPS-5 scores were 28.02 (95% CI, 24.72-31.32) for cognitive processing therapy and 25.92 (95% CI, 22.62-29.23) for loving-kindness meditation (difference, 2.09; 95% CI, −2.59 to 6.78), and mean PROMIS depression scores were 61.22 (95% CI, 59.21-63.23) for cognitive processing therapy and 58.88 (95% CI, 56.86-60.91) for loving-kindness meditation (difference, 2.34; 95% CI, −0.52 to 5.19). In superiority analyses, there were no significant between-group differences in CAPS-5 scores, whereas for PROMIS depression scores, greater reductions were found for loving-kindness meditation vs cognitive processing therapy (for patients attending ≥6 visits, ≥4-point improvement was noted in 24 [39.3%] veterans receiving loving-kindness meditation vs 9 (18.0%) receiving cognitive processing therapy; P = .03).

Conclusions and Relevance

Among veterans with PTSD, loving-kindness meditation resulted in reductions in PTSD symptoms that were noninferior to group cognitive processing therapy. For both interventions, the magnitude of improvement in PTSD symptoms was modest. Change over time in depressive symptoms was greater for loving-kindness meditation than for cognitive processing therapy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8052593/

 

Improve the Psychological Health of Obstetrics and Gynecology Patients during Covid-19 with a Mindfulness App

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The COVID-19 vaccine and pregnancy — what women need to know | Keck School of Medicine of USC

Improve the Psychological Health of Obstetrics and Gynecology Patients during Covid-19 with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation might be a viable low-cost intervention to mitigate the psychological impact of the COVID-19 crisis and future pandemics.” – Julie Lei Zhu

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress. The Covid-19 pandemic is extremely stressful particularly for patients who are pregnant or awaiting surgery. This training has been shown to improve the well-being of a wide variety of individuals. So, it should be helpful with these patients.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at scheduled times that may or may not be compatible with their 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. These should be particularly useful during the Covid-19 pandemic as attending in-person therapy sessions may not be safe or practicable. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in real-world medical patients.

 

In today’s Research News article “Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132566/ ) Smith and colleagues recruited adult

obstetrics and gynecology patients who were either pregnant or awaiting gynecological surgery delayed due to the Covid-19 pandemic. They were randomly assigned to receive either standard care or to practice mindfulness for 10 minutes per day for 30 days with a commercially available smartphone app “Calm”. They were measured before training, at 14 days into training, and after training for perceived stress, anxiety, depression, and sleep disturbance.

 

They found that in comparison to baseline and the usual care control group, the group that practiced mindfulness with the “Calm” app had significantly lower levels of perceived stress, anxiety, depression, and sleep disturbance at 14 days and 30 days. The mindfulness group also reported lower levels of perceived stress due to Covid-19 and less worry about infections in their families. A high degree of satisfaction with the “Calm” app was reported.

 

Covid-19 has affected the psychological health of virtually everyone and past research has shown that mindfulness improves their psychological health. The present study demonstrates that this occurs in pregnant women and women awaiting gynecological surgery. An important aspect of the present study was the use of a smartphone app to do the mindfulness training. These apps are particularly useful during the Covid-19 pandemic as attending in-person therapy sessions may not be safe or practicable. This allows for mindfulness training with its benefits for the well-being of the patients to occur even in the midst of a pandemic.

 

So, improve the psychological health of obstetrics and gynecology patients during covid-19 with a mindfulness app.

 

“Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not.“ – Michigan Medicine

 

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

 

Smith, R. B., Mahnert, N. D., Foote, J., Saunders, K. T., Mourad, J., & Huberty, J. (2021). Mindfulness Effects in Obstetric and Gynecology Patients During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Randomized Controlled Trial. Obstetrics and gynecology, 137(6), 1032–1040. https://doi.org/10.1097/AOG.0000000000004316

 

Abstract

OBJECTIVE:

To assess the effect of a consumer-based mobile meditation application (app) on wellness in outpatient obstetric and gynecology patients during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:

We conducted a randomized controlled trial at a university outpatient clinic of obstetric and gynecology patients during the COVID-19 pandemic. Women were randomly assigned to the intervention group, who was prescribed a mobile meditation app for 30 days, or the control group, which received standard care. The primary outcome was self-reported perceived stress. Secondary outcomes included self-reported depression, anxiety, sleep disturbance, and satisfaction with the meditation app. A sample size of 80 participants (40 per group) was calculated to achieve 84% power to detect a 3-point difference in the primary outcome.

RESULTS:

From April to May 2020, 101 women were randomized in the study—50 in the meditation app group and 51 in the control group. Analysis was by intention-to-treat. Most characteristics were similar between groups. Perceived stress was significantly less in the intervention group at days 14 and 30 (mean difference 4.27, 95% CI 1.30–7.24, P=.005, d=0.69 and mean difference 4.28, 95% CI 1.68–6.88, P=.002, d=0.69, respectively). Self-reported depression and anxiety were significantly less in the intervention group at days 14 and 30 (depression: P=.002 and P=.04; anxiety: P=.01, and P=.04, respectively). Sleep disturbance was significantly less in the intervention group at days 14 and 30 (P=.001 and P=.02, respectively). More than 80% of those in the intervention group reported high satisfaction with the meditation app, and 93% reported that mindfulness meditation improved their stress.

CONCLUSION:

Outpatient obstetric and gynecology patients who used the prescribed consumer-based mobile meditation app during the COVID-19 pandemic had significant reductions in perceived stress, depression, anxiety, and sleep disturbance compared with standard care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132566/

Improve the Psychological Health of Women with Unwanted Pregnancies with Mindfulness

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Improve the Psychological Health of Women with Unwanted Pregnancies with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period.” – Anjulie Dhillon

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. These feelings can be amplified if the pregnancy is unplanned and unwanted. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy and to relieve postpartum depression. It is possible, then, that mindfulness training may be helpful for the psychological health of women with unwanted pregnancies.

 

In today’s Research News article “The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283654/ ) Nejad and colleagues recruited pregnant women with an unplanned pregnancy who had symptoms of anxiety, depression, or stress. They were randomly assigned to receive either standard care or 8 weekly 2-hour sessions of Mindfulness-Based Stress Reduction (MBSR) with additional home practice. MBSR includes training and practice in meditation, body scan, and yoga and includes group discussion. They were measured before and after training for anxiety, depression, and stress.

 

They found that in comparison to baseline and the usual care group, the group that received Mindfulness-Based Stress Reduction (MBSR) had significant reductions in anxiety, depression, and stress. Previous research has demonstrated in a wide variety healthy and ill groups that mindfulness training produces reductions in perceived stress, anxiety and depression. The present research demonstrates that MBSR is similarly effective in women with unwanted pregnancies, improving their well-being.

 

The study, however, did not include an active control condition or follow up. So, it is not known whether the training had lasting effects and whether the benefits may have been due to confounding factors such as attentional effects, placebo effects, or experimenter bias. Future research should include an active comparison condition such as stretching exercises and follow up with the women several weeks later.

 

So, improve the psychological health of women with unwanted pregnancies with mindfulness.

 

“mindfulness practices can help anxiety, depression, and stress during the perinatal period.” – Carrie Murphy

 

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

 

Nejad, F. K., Shahraki, K. A., Nejad, P. S., Moghaddam, N. K., Jahani, Y., & Divsalar, P. (2021). The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial. Journal of preventive medicine and hygiene, 62(1), E82–E88. https://doi.org/10.15167/2421-4248/jpmh2021.62.1.1691

 

Summary

Background

Individuals with unwanted pregnancies often experience high levels of anxiety, stress and depression that associated with maternal-neonatal outcomes. Mindfulness training is a safe and acceptable strategy to support mental health before parturition.

Purpose

The main objective of present study was to evaluate the influence of eight-week application of mindfulness-based stress reduction on stress, anxiety and depression caused by unplanned pregnancy.

Method

In this study, 60 women with unwanted pregnancy before 32 weeks of gestational age were selected and randomly divided into two groups. Intervention group received MBSR sessions, practice at home and the recorded sound. Mental health was evaluated before intervention and at the end of the eight sessions by standard stress, anxiety and depression DASS-21 questionnaire. Data were analyzed using Chi-square, Mann-Whitney U and Wilcoxon tests.

Findings

In order to compare pre-test and post-test scores in each group, the Wilcoxon Test was used. The results revealed that the participants in the intervention group reported a significant decrease in mean scores of stress, anxiety and depression compared to baseline (P = 0.0). Whereas no significant decrease in mean stress, anxiety and depression score were found in control group. P-value was estimated to be 0.346, 0.212 and 0.343 respectively.

Conclusions

The mindfulness program has effectively reduced stress, anxiety and depression. Further research is needed to investigate the mechanisms and effects of mindfulness on maternal-neonatal outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283654/

 

Improve Chronic Fatigue with Mind-Body Practices

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Improve Chronic Fatigue with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mindfulness can be a powerful tool for overcoming fatigue. It allows you to recognize when fatigue is the cause of a current problem, and it offers you an intuition-based problem-solving ability. Furthermore, regular mindfulness practice is itself a source of energy.” – Ronya Banks

 

Myalgic encephalomyelitis/Chronic Fatigue Syndrome (CFS) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness that is not corrected by rest. When severe, it can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. It produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion.

 

Unfortunately, there are no known cures for CFS. The usual treatments for fatigue are targeted at symptom relief and include exercise and drugs. As an alternative to these traditional treatments, mindfulness training has been shown to reduce fatigue. The evidence has been accumulating. So, it makes sense to review and summarize what has been learned.

 

In today’s Research News article “Systematic Review of Mind-Body Interventions to Treat Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305555/ ) Ardestani and colleagues review and summarize the published research studies of the effectiveness of mindfulness training as a treatment for Chronic Fatigue Syndrome (CFS).

 

They identified 12 published research studies. Thee report that the published research found that mindfulness training produced significant reductions in mental and physical fatigue, anxiety, and depression and a significant increase in quality of life. Hence, the published research demonstrates that mindfulness training is an effective treatment to improve the mental and physical health of patients with Chronic Fatigue Syndrome (CFS). It is safe and effective and therefore should be recommended for patients with CFS.

 

So, improve chronic fatigue with mind-body practices.

 

“mindfulness certainly shows promise as an effective approach to assist with overcoming chronic fatigue syndrome.” – Mindful Way

 

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

 

Khanpour Ardestani, S., Karkhaneh, M., Stein, E., Punja, S., Junqueira, D. R., Kuzmyn, T., Pearson, M., Smith, L., Olson, K., & Vohra, S. (2021). Systematic Review of Mind-Body Interventions to Treat Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Medicina (Kaunas, Lithuania), 57(7), 652. https://doi.org/10.3390/medicina57070652

 

Abstract

Background and Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic condition distinguished by disabling fatigue associated with post-exertional malaise, as well as changes to sleep, autonomic functioning, and cognition. Mind-body interventions (MBIs) utilize the ongoing interaction between the mind and body to improve health and wellbeing. Purpose: To systematically review studies using MBIs for the treatment of ME/CFS symptoms. Materials and Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane CENTRAL were searched (inception to September 2020). Interventional studies on adults diagnosed with ME/CFS, using one of the MBIs in comparison with any placebo, standard of care treatment or waitlist control, and measuring outcomes relevant to the signs and symptoms of ME/CFS and quality of life were assessed for inclusion. Characteristics and findings of the included studies were summarized using a descriptive approach. Results: 12 out of 382 retrieved references were included. Seven studies were randomized controlled trials (RCTs) with one including three reports (1 RCT, 2 single-arms); others were single-arm trials. Interventions included mindfulness-based stress reduction, mindfulness-based cognitive therapy, relaxation, Qigong, cognitive-behavioral stress management, acceptance and commitment therapy and isometric yoga. The outcomes measured most often were fatigue severity, anxiety/depression, and quality of life. Fatigue severity and symptoms of anxiety/depression were improved in nine and eight studies respectively, and three studies found that MBIs improved quality of life. Conclusions: Fatigue severity, anxiety/depression and physical and mental functioning were shown to be improved in patients receiving MBIs. However, small sample sizes, heterogeneous diagnostic criteria, and a high risk of bias may challenge this result. Further research using standardized outcomes would help advance the field.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305555/

 

Mindfulness is Associated with Improved Symptoms of Schizophrenia

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Mindfulness is Associated with Improved Symptoms of Schizophrenia

 

By John M. de Castro, Ph.D.

 

“schizophrenia patients may benefit from mindfulness-based interventions because they . . . demonstrate strong relationships between mindfulness and psychological constructs related to adaptive functioning.” – Naomi T. Tabak

 

Schizophrenia is the most common form of psychosis. Its effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. So, it makes sense to study the relationships of mindfulness with the symptoms of schizophrenia.

 

In today’s Research News article “The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.708808/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1721400_a0P58000000G0YfEAK_Psycho_20210909_arts_A ) Bergmann and colleagues recruited patients who were diagnosed with schizophrenia and measured them for mindfulness, anxiety, depression, perceived stress, and quality of life.

 

They found that the higher the levels of mindfulness, the lower the levels of anxiety, depression, and perceived stress and the higher the levels of quality of life. In addition, they found that the higher the levels of anxiety, depression, and perceived stress the lower the levels of quality of life. A mediation analysis found that mindfulness was positively related to quality of life directly and also indirectly by being associated with lower levels of anxiety and depression that were in turn associated with higher quality of life.

 

This study is correlational and as such causation cannot be determined. But, previous controlled research has demonstrated the mindfulness training produces lower levels of anxiety and depression and higher levels of quality of life. So the present results are likely due to causal effects of mindfulness. Hence, being mindful improves quality of life and decreases anxiety and depression which then also improve quality of life. These are similar findings to those seen in healthy individuals. So, the present findings suggest that mindfulness affects people with schizophrenia in a similar fashion. They further suggest that mindfulness training might improve the psychological health and well-being of patients with schizophrenia.

 

So, mindfulness is associated with improved symptoms of schizophrenia.

 

“mindfulness-based interventions for psychotic symptoms can afford people a greater acceptance and insight into their experiences. They can also reduce the symptoms of anxiety and depression which often accompany, and may exacerbate, psychotic disorders.” – Adrianna Mendrek

 

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

 

Bergmann N, Hahn E, Hahne I, Zierhut M, Ta TMT, Bajbouj M, Pijnenborg GHM and Böge K (2021) The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders. Front. Psychol. 12:708808. doi: 10.3389/fpsyg.2021.708808

 

Background: Schizophrenia spectrum disorders (SSD) are frequently accompanied by comorbid depressive and anxiety symptoms, as well as impaired quality of life (QoL). A growing body of evidence has demonstrated the relevance of mindfulness for SSD in recent years. The study examined the association between mindfulness, depression, anxiety, and QoL.

Materials and Methods: A total of 83 participants with SSD were recruited at the in- and outpatient psychiatric hospital care. Participants completed the Southampton Mindfulness Questionnaire, Comprehensive Inventory for Mindful Experiences, and Freiburger Mindfulness Inventory, the Depression, Anxiety, Stress Scale to assess depression and anxiety, and the WHO-QoL Questionnaire. Multiple regression analyses examined the relationship between mindfulness and QoL and the mediating role of depression and anxiety.

Results: Mindfulness had a significant statistical positive effect on QoL domains physical health, psychological, and environmental QoL in patients with SSD. Depression was identified as a significant mediator of this relationship.

Conclusion: This study provides novel insight into mindfulness’ mechanisms and paves the way for a process-oriented approach to treat SSD. The results provide first evidence for the process-based value of mindfulness for SSD; future studies can focus on the role of mindfulness for central therapeutic processes of change by employing longitudinal designs.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.708808/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1721400_a0P58000000G0YfEAK_Psycho_20210909_arts_A

 

Improve Psychological Health with Online Mindfulness Training

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Improve Psychological Health with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Virtual mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress.” – Suzan Farris

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health. But 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 online has been developed. This has 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. The research has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “New Evidence in the Booming Field of Online Mindfulness: An Updated 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/PMC8329762/ ) Sommers-Spijkerman and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness on online mindfulness training to improve psychological health. They identified 97 randomized controlled trials, including a total of 17,464 participants.

 

They report that the published randomized controlled trials found that online mindfulness training produced significant moderate reductions of perceived stress anxiety and depression and increases in mindfulness and well-being. One to 3 months after training there were still significant reductions in anxiety and depression remaining. Although the effects were larger when comparing online mindfulness training to passive control conditions, they were still present in significant when compared to active control conditions.

 

A very large amount of research has accumulated on the effectiveness of online mindfulness training for psychological health. This meta-analysis revealed that this research clearly demonstrates that online mindfulness training has similar effectiveness as face-to-face mindfulness training in improving psychological health. Hence, online training is safe, effective convenient, scalable, and inexpensive, and doesn’t require a trained therapist making it an excellent option for improving psychological health.

 

So, improve psychological health with online mindfulness training.

 

“The fear, anxiety and stress associated with the COVID-19 pandemic has taken a toll on mental health. But . . . these symptoms may be alleviated through safe and convenient online mindfulness practices.” – Wake Forest Baptist Health

 

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

 

Sommers-Spijkerman, M., Austin, J., Bohlmeijer, E., & Pots, W. (2021). New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials. JMIR mental health, 8(7), e28168. https://doi.org/10.2196/28168

 

Abstract

Background

There is a need to regularly update the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing.

Objective

This study presents an updated meta-analysis of randomized controlled trials assessing the effects of online MBIs on mental health and the potential moderators of these effects.

Methods

We conducted a systematic literature search in PsycINFO, PubMed, and Web of Science up to December 4, 2020, and included 97 trials, totaling 125 comparisons. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges g) were calculated for depression, anxiety, stress, well-being, and mindfulness using a random effects model.

Results

The findings revealed statistically significant moderate pre-to-post effects on depression (g=0.34, 95% CI 0.18-0.50; P<.001), stress (g=0.44, 95% CI 0.32-0.55; P<.001), and mindfulness (g=0.40, 95% CI 0.30-0.50; P<.001) and small effects on anxiety (g=0.26, 95% CI 0.18-0.33; P<.001). For well-being, a significant small effect was found only when omitting outliers (g=0.22, 95% CI 0.15-0.29; P<.001) or low-quality studies (g=0.26, 95% CI 0.12-0.41; P<.001). Significant but small follow-up effects were found for depression (g=0.25, 95% CI 0.12-0.38) and anxiety (g=0.23, 95% CI 0.13-0.32). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. In terms of stress and mindfulness, studies that used inactive control conditions yielded larger effects. For anxiety, populations with psychological symptoms had higher effect sizes. Adherence rates for the interventions ranged from 35% to 92%, but most studies lacked clear definitions or cut-offs.

Conclusions

Our findings not only demonstrate that online MBIs are booming but also corroborate previous findings that online MBIs are beneficial for improving mental health outcomes in a broad range of populations. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence, and long-term follow-up measurements.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329762/