Distress

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

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Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Central sensitization, in short, is a hypersensitivity to stimuli from things that are not typically painful. . . Stress can heighten pain even more, so various forms of stress management may be recommended to patients. This may include practices such as yoga, mindfulness, or meditation.” – Southern Pain

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Central Pain Sensitization Syndromes such as fibromyalgia and Migraine headaches are particularly difficult to deal with as they have triggers that are not normally painful.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain. There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain.

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

The research on the effectiveness of Acceptance and Commitment Therapy (ACT) for  Central Pain Sensitization Syndromes has been accumulating. So, it makes sense to pause and review what has been learned. In today’s Research News article “Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235706/ ) Galvez-Sánchez and colleagues review and summarize the published research evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) for  Central Pain Sensitization Syndromes. They identified 21 published studies that included a total of 1090 adult participants.

 

They report that 8 studies found that Acceptance and Commitment Therapy (ACT) significantly improved the symptoms of fibromyalgia especially anxiety and depression and improved pain acceptance, self-efficacy, and psychological flexibility. Six studies found that ACT improved the patient’s acceptance of irritable bowel syndrome and the psychological distress produced by IBS. In 7 studies ACT was shown to significantly improve migraine pain and the affective distress resulting from the disease including anxiety and depression. These improvements were greater than those seen with pharmacological and psychoeducational interventions.

 

Mindfulness training has been shown to improve the symptoms of fibromyalgia, irritable bower syndrome, and migraine headache. The finding from the currently published research studies of the effectiveness of the mindfulness training of Acceptance and Commitment Therapy (ACT) suggests that it is similarly effective in treating the symptoms from Central Pain Sensitization Syndromes particularly the psychological distress produced by them and improve the patients’ health related quality of life.

 

So, improve the symptoms of Central Pain Sensitization Syndromes with mindfulness.

 

“The goal of meditation is not to eliminate pain or anxiety, but rather to get patients to focus on breathing and relaxation techniques. . . to reverse some of the negative central sensitization that can occur with chronic pain.” – Mel Pohl

 

MCS – 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

 

Galvez-Sánchez, C. M., Montoro, C. I., Moreno-Padilla, M., Reyes Del Paso, G. A., & de la Coba, P. (2021). Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review. Journal of clinical medicine, 10(12), 2706. https://doi.org/10.3390/jcm10122706

 

Abstract

Objectives: Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). Methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. Results: The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., “waiting list”) conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. Conclusions: There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235706/

Improve the Psychological Well-Being of Social Care Workers with Mindfulness

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Improve the Psychological Well-Being of Social Care Workers with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness also helps social workers with self-care . . . allowing them to notice when they’re getting overwhelmed and recognize signs of burnout earlier. Social workers . . . deal with extremely difficult things, and mindfulness can help them not feel overloaded.” – Kate Jackson

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like social work, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. Improving the psychological health of individuals involved in social care, then, has to be a priority.

 

Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep.  It makes sense that intervening early in the training for professional social care workers would help prevent later stress effects and burnout. Hence, it is reasonable to examine the ability of mindfulness training to improve the well-being of students preparing for careers as social care professionals.

 

In today’s Research News article “Effects of Mindfulness-Based Stress Reduction on Health and Social Care Education: a Cohort-Controlled Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190752/ ) Lo and colleagues recruited postgraduate students in social work, family therapy, or counseling and assigned them to either a no-treatment control or to receive 8 weekly, 2.5-hour sessions of Mindfulness-Based Stress Reduction (MBSR). The MBSR program consists of practice with meditation, yoga, and body scan, along with discussion and home practice. They were measured before and after training for burnout, perceived stress, work engagement, physical stress, empathy, and time in home practice.

 

They found that in comparison to baseline and the no-treatment control group the group that received Mindfulness-Based Stress Reduction (MBSR) had significantly lower levels of perceived stress, physical distress, burnout, emotional exhaustion, and depersonalization of the client, and significantly higher levels of vigor. Hence, they found that participation in the MBSR program resulted in significant improvement in the psychological health of social care postgraduate students.

 

It should be noted that the present study used a weak research design that lacked random assignment of participants to groups, an active control condition, and follow-up measurements. This leave the interpretation open to confounding explanations and does not determine if the effects are lasting. Future studies should employ random assignment, an active control condition, e.g. exercise, and follow-up measurements.

 

But previous better controlled research has demonstrated that mindfulness training increases vigor and reduces perceived stress, distress, burnout, and emotional exhaustion. So, the present results, at least in part, are likely due to the ability of Mindfulness-Based Stress Reduction (MBSR) training to improve psychological health. This suggests that the psychological health and resistance to stress and burnout in students preparing for careers as social care professionals can be strengthened by mindfulness training. This may better prepare them to deal with the stresses of their professional careers and make them more effective professionals.

 

So, improve the psychological well-being of social care workers with mindfulness.

 

“mindfulness-based strategies . . .  will not prevent stress completely or take it away when it occurs, but doing them with care and attention on a regular basis can help us manage more effectively.” – Deborah Lisansky Beck

 

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

 

Lo, H., Ngai, S., & Yam, K. (2021). Effects of Mindfulness-Based Stress Reduction on Health and Social Care Education: a Cohort-Controlled Study. Mindfulness, 1–9. Advance online publication. https://doi.org/10.1007/s12671-021-01663-z

 

Abstract

Objectives

Mindfulness practice has been recommended as part of health and social care education and training because of its potential benefits in fostering clinical skills and attitudes, increasing self-care, and reducing the effect of stress in education and occupation. The objectives of this study were to evaluate the effects of a mindfulness-based stress reduction (MBSR) program on stress, physical distress, job burnout, work engagement, and empathy for health and social care education.

Methods

Students (N = 124) from postgraduate programs in social work, counseling, and family therapy were recruited. Sixty-four students participated in an 8-week MBSR program as an elective course. Sixty students were recruited from other elective courses in the same cohort as control group participants. All participants completed self-report assessments.

Results

The results suggested that MBSR was associated with significant improvements in perceived efficacy and vigor and significant reductions in physical distress, total job burnout, emotional exhaustion, and depersonalization of clients compared with the control group.

Conclusions

This study contributes to the growing body of literature highlighting the potential use of mindfulness practice to improve students’ personal well-being and professional growth in health and social care education. Mindfulness practice should be further promoted in health and social care education and training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190752/

 

Improve Psychological Well-Being and Sleep in Police with Mindfulness

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Improve Psychological Well-Being and Sleep in Police with Mindfulness

 

By John M. de Castro, Ph.D.

 

“increased mindfulness was related to increased resilience and decreased burnout among police officers.” – John Kim

 

Policing is a very stressful occupation. Stress in police can result from role conflicts between serving the public, enforcing the law, and upholding ethical standards and personal responsibilities as spouse, parent, and friend. Stress also results from, threats to health and safety, boredom, responsibility for protecting the lives of others, continual exposure to people in pain or distress, the need to control emotions even when provoked, the presence of a gun, even during off-duty hours, and the fragmented nature of police work, with only rare opportunities to follow cases to conclusion or even to obtain feedback or follow-up information.

 

This stress can have serious consequences for the individual and in turn for society. Police officers have one of the highest suicide rates in the nation, possibly the highest. They have a high divorce rate, about second in the nation. They are problem drinkers about twice as often as the general population. This is a major problem as stress and the resultant complications can impact job performance, which sometimes involve life or death situations.

 

Mindfulness training has been shown to improve the physiological and psychological responses to stress and it has been found to reduce burnout in first responders. So, it is likely that mindfulness training with police can help them cope with the stress and thereby improve their psychological well-being.

 

In today’s Research News article “The Impact of Mindfulness Training on Police Officer Stress, Mental Health, and Salivary Cortisol Levels.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.720753/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1721400_a0P58000000G0YfEAK_Psycho_20210909_arts_A ) Grupe and colleagues recruited police officers and randomly assigned them to either a wait-list control condition or to receive 18 hours over 8 weeks of mindfulness training. The program was based upon the Mindfulness-Based Stress Reduction (MBSR) program. They were measured before and after training and 3 months later for stress, mental health, physical health, anxiety, depression, fatigue, sleep disturbances, ability to participate in social roles and activities, physical function, pain interference, and pain intensity, sleep, alcohol use, burnout, and work limitations. They also had blood and hair samples collected for analysis of levels of cortisol and markers of inflammation.

 

They found that in comparison to baseline and the wait-list control group, the police who received mindfulness training had significantly lower levels of perceived stress, distress, and mental illness symptoms. These improvements were maintained at the 3-month follow up. Sleep quality was significantly improved, and cortisol levels were lower at the 3-month follow up.

 

The comparison, control, condition was a wait-list control which is passive and doesn’t control for many confounding factors such as expectancy, experimenter bias, and attentional effects. But previous controlled research has shown that mindfulness training produces lower levels of stress, distress, anxiety, depression, and cortisol levels, and improved sleep. So, the present findings were likely due to the mindfulness training rather than confounding factors.

 

Policing is a highly stressful difficult job that can have mental health consequences. So, the findings that mindfulness training produces lasting improvements in psychological health in the police are encouraging. They suggest that mindfulness training can help the officers withstand the stress and maintain psychological health and reduce burnout.

 

So, improve psychological well-being and sleep in police with mindfulness.

 

“Meditation is helping police officers to de-escalate volatile situations, improve community relations—and improve their own well-being.” – JILL SUTTIE

 

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

 

Grupe DW, Stoller JL, Alonso C, McGehee C, Smith C, Mumford JA, Rosenkranz MA and Davidson RJ (2021) The Impact of Mindfulness Training on Police Officer Stress, Mental Health, and Salivary Cortisol Levels. Front. Psychol. 12:720753. doi: 10.3389/fpsyg.2021.720753

 

Unaddressed occupational stress and trauma contribute to elevated rates of mental illness and suicide in policing, and to violent and aggressive behavior that disproportionately impacts communities of color. Emerging evidence suggests mindfulness training with police may reduce stress and aggression and improve mental health, but there is limited evidence for changes in biological outcomes or the lasting benefits of mindfulness training. We conducted a randomized controlled trial (RCT) of 114 police officers from three Midwestern U.S. law enforcement agencies. We assessed stress-related physical and mental health symptoms, blood-based inflammatory markers, and hair and salivary cortisol. Participants were then randomized to an 8-week mindfulness intervention or waitlist control (WLC), and the same assessments were repeated post-intervention and at 3-month follow-up. Relative to waitlist control, the mindfulness group had greater improvements in psychological distress, mental health symptoms, and sleep quality post-training, gains that were maintained at 3-month follow-up. Intervention participants also had a significantly lower cortisol awakening response (CAR) at 3-month follow-up relative to waitlist control. Contrary to hypotheses, there were no intervention effects on hair cortisol, diurnal cortisol slope, or inflammatory markers. In summary, an 8-week mindfulness intervention for police officers led to self-reported improvements in distress, mental health, and sleep, and a lower CAR. These benefits persisted (or emerged) at 3-month follow-up, suggesting that this training may buffer against the long-term consequences of chronic stress. Future research should assess the persistence of these benefits over a longer period while expanding the scope of outcomes to consider the broader community of mindfulness training for police.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.720753/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1721400_a0P58000000G0YfEAK_Psycho_20210909_arts_A

 

Spirituality Modifies Coping with Covid-19 Evoked Psychological Distress

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Spirituality Modifies Coping with Covid-19 Evoked Psychological Distress

 

By John M. de Castro, Ph.D.

 

“COVID-19 . . . patients are suffering greatly from spiritual distress as well: existential distress, struggles with uncertainty, despair, hopelessness, isolation, feelings of abandonment by God or others, grief, and the need for reconciliation.” – GW School of Medicine

 

The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress for frontline workers but also for people simply isolating at home. Religion and spirituality have been promulgated as solutions to the challenges of life. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Perhaps, then, spirituality can be helpful in relieving stress and improve coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “Coping with COVID-19: An Examination of the Role of (Non)Religiousness/(Non)Spirituality.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140577/ ) Abbott and Franks recruited adults over the internet and had them complete measures of coping strategies, psychological distress (anxiety, depression, and perceived stress), religiousness, spirituality, and pandemic related trauma.

 

They found that the higher the levels of pandemic related trauma and dysfunctional coping, the higher the levels of psychological distress experienced by the participants. Trauma was found to be both directly and indirectly associated with psychological distress via dysfunctional coping. This was true for religious, non-religious, and high and moderate spirituality participants but not for low spirituality participants.

 

These results are correlational and as such caution must be exercised in forming conclusions regarding causation. But the relationship is clear between the trauma created by the pandemic and psychological distress, people who are traumatized experience high levels of anxiety, depression, and stress. The trauma is also related to dysfunctional coping suggesting that traumatized individual tend to engage in maladaptive coping strategies. Dysfunctional coping involves coping with difficulties by behavioral disengagement, denial, self-distraction, self-blame, substance use and venting and these strategies are associated with heightened levels of trauma. Finally, the analysis suggests that pandemic related trauma is associated with psychological distress directly and also indirectly by being associated with higher levels of dysfunctional coping which in turn is associated with higher levels of distress.

 

These results suggest that religion and spirituality are helpful in coping with trauma produced by the Covid-19 pandemic. But not with those having low levels of spirituality. Spirituality generally implies a feeling or belief in something beyond the physical. Conversely, low spirituality would imply a focus solely on the physical. So, the results suggest that trauma does not affect coping’s effects on psychological distress when there’s a belief that only physical forces are involved. This then suggests that spirituality increases the individual’s attempts to deal with trauma with coping strategies.

 

So, spirituality modifies coping with covid-19 evoked psychological distress.

 

“during a major crisis such as the Covid-19 pandemic, we need to make sure that everyone is getting spiritual care.” – Eric Hall

 

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

 

Abbott, D. M., & Franks, A. S. (2021). Coping with COVID-19: An Examination of the Role of (Non)Religiousness/(Non)Spirituality. Journal of religion and health, 60(4), 2395–2410. https://doi.org/10.1007/s10943-021-01284-9

 

Abstract

Psychological distress and coping strategies employed during collective trauma events may vary for theists and atheists, as well as others along the (non)religious spectrum. The present study explored these differences via data collected from a US-based sample during the COVID-19 pandemic. Statistical models suggested relationships between maladaptive coping and distress for all participants and potential differences in coping and, in turn, distress between participants high and low in institutional religiousness and individual spirituality. Additionally, all participants, though especially nonreligious participants, appeared less able to engage in adaptive emotion-focused coping strategies. Implications for future research are provided.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140577/

 

Mindfulness Practice at Home is Related to Improved Distress in Cancer Survivors

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Mindfulness Practice at Home is Related to Improved Distress in Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“Cancer and its treatment can be stressful for people with cancer and their caregivers. Relaxation techniques and other mind/body practices can help calm your mind and sharpen your ability to focus. These techniques offer creative ways to reduce stress caused by cancer and maintain inner peace.” Rachel Barnhart

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. Most mindfulness training programs include daily practice at home. Although it is assumed that home practice is important for the effectiveness of the intervention, it is not known how important home practice is to the effects of mindfulness practice on the physical and psychological well-being of cancer survivors.

 

In today’s Research News article “Mindfulness-Based Interventions in Cancer Survivors: A Systematic Review of Participants’ Adherence to Home Practice.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200136/ ) Baydoun and colleagues review and summarize the published research studies of the relationship of home practice to the physical and psychological effects of mindfulness practice on cancer survivors.

 

They identified 21 published research studies that included a total of 1811 participants. They report that these published studies found that on average participants reported 23.5 minutes of daily home mindfulness practice, which was about 60% of what was recommended in the studies. They also report that the greater the amount of home practice by cancer survivors the greater the reduction in psychological distress.

 

These results suggest that adherence to recommended home practice is substantially less than recommended in the studies. But adherence is related to the psychological benefits obtained by cancer survivors. It has been assumed that home practice was important and this study suggests that it is indeed important. This suggests that future research protocols should include methods to optimize the amount of home mindfulness practice.

 

In addition, the results are correlative and as such causation cannot be determined. It is possible that people who tend to adhere to home practice recommendations are also the types of people who benefit the most from mindfulness-based interventions. So, future studies should manipulate the amount of home practice to determine causal relationships between this practice and the benefits obtained.

 

So, mindfulness practice at home is related to improved distress in cancer survivors.

 

“Cancer and its treatment can be stressful—for you and your caregivers. Practicing mindfulness and relaxation can help calm your mind, reduce stress, and sharpen your ability to focus.” – American Cancer Society

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Baydoun, M., Moran, C., McLennan, A., Piedalue, K. L., Oberoi, D., & Carlson, L. E. (2021). Mindfulness-Based Interventions in Cancer Survivors: A Systematic Review of Participants’ Adherence to Home Practice. Patient preference and adherence, 15, 1225–1242. https://doi.org/10.2147/PPA.S267064

 

Abstract

Background

Although mindfulness-based interventions (MBIs) have demonstrated efficacy for alleviating psychological distress in cancer survivors, little is known about the extent to which participants adhere to assigned home practice. The purpose of this systematic review was to summarize and appraise the literature on rates and correlates of adherence to mindfulness home practice among cancer survivors.

Methods

Four databases (PubMed, Psychology and Behavioral Sciences, PsycInfo, and CINAHL) were searched for studies published before October 15, 2020. Articles were included if they evaluated the benefits of an MBI program for adults with cancer.

Results

Twenty-one studies (N=1811 participants) meeting the inclusion criteria were identified (randomized controlled trials (n=13), non-randomized controlled designs (n=2), single-group studies (n=6)). The pooled adherence rate for participants’ home practice was 60% of the assigned amount, which equated to 27 min per day during the intervention period. There was some evidence for a relationship between home practice of mindfulness techniques and improvements in mood, stress, anxiety, depression, and fear of cancer recurrence (correlation coefficients ranged from 0.33 to 0.67). Factors including marital status, mood disturbance at baseline, intervention modality, and personality traits were evaluated in relation to adherence to home practice, but the current literature was inadequate to evaluate whether a relationship exists.

Conclusion

Adherence to mindfulness home practice among cancer survivors is suboptimal, and most of the correlates of adherence studied to date are non-modifiable. More research is warranted to scrutinize the role of home practice in mindfulness-based interventions, including assessment of modifiable factors influencing adherence to improve benefits for this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8200136/

 

Improve the Psychological Well-Being of Medical Students with Mindfulness

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Improve the Psychological Well-Being of Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Medical students are being trained to have 100 things on their mind at all times. It’s harder and harder to focus on one thing explicitly. [Mindfulness] gives you that skill to know that you can focus on everything at once, but when you need to focus on one thing, you can be present with it.” – Chloe Zimmerman

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Studying medicine can be extremely stressful and many students show distress and express burnout symptoms. The undergraduate medical student level may be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-based stress reduction for medical students: a narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/ )  Polle and colleagues review and summarize the published research on the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program to improve the psychological well-being of undergraduate medical students. MBSR includes training in meditation, body scan, and yoga, and group discussions normally over an 8-week period. They identified 9 published studies.

 

They report that the published research found that Mindfulness-Based Stress Reduction (MBSR) produced significant increases in undergraduate medical students mood, mental health, satisfaction with life, and self-compassion and significant reductions in psychological distress, perceived stress, and depression. One study followed up these students 6 years later and found persisting effects of MBSR.

 

The published research paints a clear picture that participating in a Mindfulness-Based Stress Reduction (MBSR) program produces lasting benefits for the psychological health of undergraduate medical students. This is important as stress and burnout is prevalent in the medical professions and intervening early may prevent or ameliorate future problems. Incorporation of MBSR into the undergraduate medical curriculum should be considered.

 

So, improve the psychological well-being of medical students with mindfulness.

 

“in medical students, higher empathy, lower anxiety, and fewer depression symptoms have been reported by students after participating in MSBR. In summary, mindfulness meditation may be used to elicit positive emotions, minimize negative affect and rumination, and enable effective emotion regulation.”- Michael Minichiello

 

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

 

Polle, E., & Gair, J. (2021). Mindfulness-based stress reduction for medical students: a narrative review. Canadian medical education journal, 12(2), e74–e80. https://doi.org/10.36834/cmej.68406

 

Abstract

Background

Medical students are at high risk of depression, distress and burnout, which may adversely affect patient safety. There has been growing interest in mindfulness in medical education to improve medical student well-being. Mindfulness-based stress reduction (MBSR) is a commonly used, standardized format for teaching mindfulness skills. Previous research has suggested that MBSR may be of particular benefit for medical students. This narrative review aims to further investigate the benefits of MBSR for undergraduate medical students.

Methods

A search of the literature was performed using MedLine, Embase, ERIC, PSYCInfo, and CINAHL to identify relevant studies. A total of 102 papers were identified with this search. After review and application of inclusion and exclusion criteria, nine papers were included in the study.

Results

MBSR training for medical students was associated with increased measures of psychological well-being and self-compassion, as well as improvements in stress, psychological distress and mood. Evidence for effect on empathy was mixed, and the single paper measuring burnout showed no effect. Two studies identified qualitative themes which provided context for the quantitative results.

Conclusions

MBSR benefits medical student well-being and decreases medical student psychological distress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/

 

Improve Psychological Well-Being in Patients with Fever Undergoing Covid-19 Screening with Mindfulness

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Improve Psychological Well-Being in Patients with Fever Undergoing Covid-19 Screening with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based approaches appear well-suited to deal with the challenges presented by the time of unpresented uncertainty, change, and loss, which can take many forms in the context of COVID-19 pandemic.” – Elena Antonova

 

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 running a fever and being screened for Covid-19.  So, mindfulness, because of its ability to improve stress responding, may be helpful in coping with the mental challenges of awaiting COVID-19 test results.

 

In today’s Research News article “Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.664964/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1651992_69_Psycho_20210603_arts_A )  Liu and colleagues recruited adult patients who had a fever and were undergoing screening in a hospital for Covid-19. They were randomly assigned either to no-treatment or a very brief (25 minute) mindfulness instruction while awaiting test results. They were measured at the time of admissions and again just before test results for positive and negative emotions, distress, satisfaction with life, anger, anxiety, and depression.

 

They found that in comparison to baseline and the no-treatment controls, the participants who had received brief mindfulness instruction had significantly lower anger, distress, anxiety, depression, and need for help and higher satisfaction with life. Hence, the brief mindfulness instruction improved the mood and psychological well-being of these patients during a very stressful time of awaiting Covid-19 test results.

 

Mindfulness has been previously found to be effective in reducing anger, distress, anxiety, and depression, and increasing satisfaction with life. What the present study demonstrates is that these benefits can occur after a very brief instruction for patients in a very stressful situation. This suggests that brief mindfulness instruction should be incorporated into the routine treatment of patients under high short-term stress.

 

So, improve psychological well-being in patients with fever undergoing Covid-19 screening with mindfulness.

 

“mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis.” – Susan Farris

 

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

 

Liu Y, Huyang S, Tan H, He Y, Zhou J, Li X, Ye M, Huang J and Wu D (2021) Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak. Front. Psychol. 12:664964. doi: 10.3389/fpsyg.2021.664964

 

The coronavirus disease 2019 (COVID-19) continues to spread globally. This infectious disease affects people not only physically but also psychologically. Therefore, an effective psychological intervention program needs to be developed to improve the psychological condition of patients screened for fever during this period. This study aimed to investigate the effect of a brief mindfulness intervention on patients with suspected fever in a screening isolation ward awaiting results of the COVID-19 test. The Faces Scale and the Emotional Thermometer Tool were used to investigate 51 patients who were randomly divided into an intervention group and a control group. All patients completed self-rating questionnaires online at the time they entered the isolation ward and before they were informed of the results. The intervention group listened to the mindfulness audios through hospital broadcasts in the isolation ward before their lunch break and while they slept. Compared with the control group, the intervention group’s life satisfaction score increased (F = 4.02, p = 0.051) and the emotional thermometer score decreased (F = 8.89, p = 0.005). The anxiety scores (F = 9.63, p = 0.003) and the needing help scores decreased significantly (F = 4.95, p = 0.031). Distress (F = 1.41, p = 0.241), depression (F = 1.93, p = 0.171), and anger (F = 3.14, p = 0.083) also decreased, but did not reach significance. Brief mindfulness interventions can alleviate negative emotions and improve the life satisfaction of patients in the isolation ward who were screened for COVID-19 during the waiting period.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.664964/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1651992_69_Psycho_20210603_arts_A

 

Improve Anxiety and Depression with an Abbreviated Mindfulness-Based Cognitive Therapy

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Improve Anxiety and Depression with an Abbreviated Mindfulness-Based Cognitive Therapy

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

Anxiety disorders are the most common mental illness, affecting 40 million adults in the U.S., or 18% of the population. Depression affects over 6% of the population. And anxiety and depression often co-occur. Anxiety and depression are generally treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety and depression. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been shown to be very effective. MBCT, however, is an 8-week program delivered in relatively small groups. It is not clear if a briefer program to larger groups might also be effective.

 

In today’s Research News article “A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057287/ )  Burgess and colleagues recruited adult patients with an anxiety or mood disorders and provided them with 5 weekly 2-hour group based session of Mindfulness-Based Cognitive Therapy (MBCT) with daily home practice. The group size was larger than the typical MBCT program (i.e., 16–20 participants rather than 12 participants) and meditation practice was reduced to 10-15 minutes compared to the traditional 40 minutes. They were measured before and after training for anxiety, depression, self-compassion, perceived stress, mental well-being, and disability.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there was significant reductions in anxiety, depression, worry, and acute distress, and significant increases in self-compassion and mental well-being. There were large clinically significant changes such that 50% of the patients had remissions of depression and 20% had remissions of anxiety.

 

It should be noted that there was no control condition in the present study. But previous controlled studies have routinely demonstrated that Mindfulness-Based Cognitive Therapy (MBCT) produces significant improvements in anxiety, depression, worry, distress, self-compassion, and mental well-being. So, the present results are unlikely to be due to confounding factors. The present study demonstrates that the significant benefits of MBCT can be produced with an abbreviated program delivered to a large group. This reduces the amount of time clinicians have to devote to the program, thereby reducing cost. It would also be likely that the abbreviated program would improve adherence to the program requirements and reduce drop-outs. This allows more patients at lower cost to have their suffering reduced.

 

So, improve anxiety and depression with an abbreviated Mindfulness-Based Cognitive Therapy.

 

“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com

 

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

 

Emilee E. Burgess, Steven Selchen, Benjamin D. Diplock, Neil A. Rector. A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression. Int J Cogn Ther. 2021 Apr 20 : 1–19. doi: 10.1007/s41811-021-00105-x

 

Abstract

Mindfulness-based interventions (MBIs) have emerged as clinically effective interventions for anxiety and depression although there are significant barriers to their access in the general population. The present study examined the effectiveness of a 5-week abbreviated mindfulness-based cognitive therapy (MBCT) intervention for a physician-referred, treatment-seeking, community sample (N = 54) with mood and/or anxiety symptom burden. Treatment effects demonstrated significant reductions in mood and anxiety symptom severity and significant increases in general well-being. Observed effect sizes were generally large, with high response and remission rates. The present study offers preliminary support that an abbreviated MBCT protocol can offer large treatment effects for decreasing mood and anxiety symptoms and could potentially offer an effective population-level strategy to improve cost-effectiveness and access to care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057287/

 

Improve Psychological Well-Being in Covid-19 Lockdown with Online Mindfulness Training

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Improve Psychological Well-Being in Covid-19 Lockdown with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“mindfulness is one tool that can help promote mental wellness throughout the COVID-19 pandemic and beyond.” – Julie Dunn

 

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. The COVID-19 pandemic has challenged the mental and physical health of the population. It has created intense stress both for frontline workers but also for people simply isolating at home. Mindfulness is known to decrease the psychological and physical responses to stress. So, mindfulness training may be helpful in coping with the mental and physical challenges resulting from the COVID-19 pandemic.

 

In today’s Research News article “A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025/ ) Zhang and colleagues recruited online Chinese adults who were staying at home during the Covid-19 lockdown. They were randomly assigned to a wait-list control condition or to receive online mindfulness training with an abbreviated group version of Mindfulness-Based Stress Reduction (MBSR). The training consisted of a 2-hour training followed by 13 days of 1.5 hours per day of practice separated into 3 30-minute sessions. Once training was complete for the mindfulness group, the wait-list group received the same 2-week mindfulness training. They were measured before and after the training for mindfulness and psychological distress, including somatization, depression, and anxiety.

 

They found that in comparison to baseline and the wait-list control group, the mindfulness training produced significantly higher mindfulness levels and significantly lower levels of psychological distress, including somatization, depression, and anxiety levels. The wait-list group after they received the mindfulness training had similar significant improvements in their psychological well-being.

 

These results are consistent with previous findings that mindfulness training produces decreases in distress, including somatization, depression, and anxiety. But the present study demonstrates that online mindfulness training can produce similar benefits for individuals locked down during a pandemic. Since the training is online, it could be made available to widespread individuals at low cost and thus would be ideal for maintaining the psychological health of people in lock down.

 

So, improve psychological well-being in covid-19 lockdown with online mindfulness training.

 

“In many ways, COVID-19 has shown us just how connected and how much the same we really are. All of us—and some of us more than others—are vulnerable to getting sick and none of us wants to become ill. Viewed through the lens of interconnectedness, practicing mindfulness as the coronavirus spreads is not only a way to care for ourselves but a way to care for everyone around us.” – Kelly Barron

 

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

 

Hui Zhang, Anao Zhang, Chengbin Liu, Jian Xiao, Kaipeng Wang. A Brief Online Mindfulness-Based Group Intervention for Psychological Distress Among Chinese Residents During COVID-19: a Pilot Randomized Controlled Trial, Mindfulness (N Y) 2021 Mar 18 : 1–11. doi: 10.1007/s12671-021-01618-4

 

Abstract

Objectives

The coronavirus (COVID-19) global pandemic has increased psychological distress among the general population. The objective of this study is to evaluate a mindfulness-based intervention for psychological distress among Chinese residents during COVID-19.

Methods

This study used a switching replications design to test the feasibility and efficacy of a brief online mindfulness-based intervention for Chinese residents’ psychological distress. Fifty-one residents in the Hubei province were randomly allocated to two groups (experimental group and waitlist control group) with three waves of measurement at time 1, time 2, and time 3 for changes in mindfulness and psychological distress.

Results

In addition to significant within-group improvements over time for both groups, OLS linear regression with full information likelihood estimation revealed statistically significant between-group treatment effects across outcome domains, including mindfulness awareness, b = 2.84, p < 0.001, g = 6.92, psychological distress, b = −21.33, p < 0.001, g = 6.62, somatic symptoms, b = −6.22, p < 0.001, g = 4.42, depressive symptoms, b = −7.16, p < 0.001, g = 5.07, and anxiety symptoms, b = −8.09, p < 0.001, g = 6.84.

Conclusions

Results suggest that a brief online mindfulness-based intervention can be a feasible and promising intervention for improving mindfulness and decreasing psychological distress among Chinese residents staying at home during the COVID-19 outbreak. The study used a small convenience sample which led to a concern of external generalizability and with limited evaluation of long-term change.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972025/

 

Improve Mental Health with Mindfulness

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Improve Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is recommended as a treatment for people with mental ill-health as well as those who want to improve their mental health and wellbeing.” – Mental Health Foundation

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity.

 

The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. Mindfulness appears to work well in clinical settings. But does it work well when mindfulness is trained in groups in community settings. It makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and 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/PMC7799763/ ) Galante and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mindfulness-based programs to improve mental health. They identified 136 trials including a total of 11,605 participants of the effectiveness of community-based group mindfulness programs.

 

They report that in comparison to no treatment controls, mindfulness-based programs produced significant improvements in anxiety, depression, psychological distress, and mental well-being. In comparison to non-therapeutic active controls mindfulness-based programs produced significant improvements in depression, and mental well-being. Finally, mindfulness-based programs did not appear to improve mental health to a greater extent that other therapeutic treatments. They further found that mindfulness-based programs appeared to work best for high-risk participants or those with subclinical levels of mental disorders.

 

There appears to be extensive research findings that suggest that group mindfulness-based programs in non-clinical, community, are as effective in improving mental health as other therapies. In particular they appear to decrease symptoms of anxiety, depression, and psychological distress and increase mental well-being. But, these programs do not appear to further improve mental health in people who already have excellent mental health. This suggests that mindfulness-based community programs should be implemented to improve the mental health of at-risk individuals or those who have metal health issues.

 

So, improve mental health with mindfulness.

 

“simple changes in lifestyle can lead to improved mental health and wellbeing.  Mindfulness is one such practice—with strong research supporting its usefulness for those suffering from anxiety, depression, or even just daily stress.” – U Minnesota

 

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

 

Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., & Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLoS medicine, 18(1), e1003481. https://doi.org/10.1371/journal.pmed.1003481

 

Abstract

Background

There is an urgent need for mental health promotion in nonclinical settings. Mindfulness–based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions.

Methods and findings

Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in–person, expert–defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk–of–Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well–being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta–regression and sensitivity analyses were prespecified. Pairwise random–effects multivariate meta–analyses and prediction intervals (PIs) were calculated.

A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = −0.56; 95% confidence interval (CI) −0.80 to −0.33; p–value < 0.001; 95% PI −1.19 to 0.06), depression (14 trials; SMD = −0.53; 95% CI −0.72 to −0.34; p–value < 0.001; 95% PI −1.14 to 0.07), distress (27 trials; SMD = −0.45; 95% CI −0.58 to −0.31; p–value < 0.001; 95% PI −1.04 to 0.14), and well–being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p–value = 0.003; 95% PI −0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = −0.46; 95% CI −0.81 to −0.10; p–value = 0.012, 95% PI −1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well–being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs’ superiority. Only effects on distress remained when higher–risk trials were excluded. USA–based trials reported smaller effects. MBPs targeted at higher–risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials.

Conclusions

Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.

Author summary

Why was this study done?

Mindfulness courses to increase well–being and reduce stress have become very popular; most are in community settings.

Many randomised controlled trials (RCTs) tested whether mindfulness courses show benefit, but results are varied and, to our knowledge, there are no reviews combining the data from these studies to show an overall effect.

What did the researchers do and find?

Worldwide, we identified 136 RCTs on mindfulness training for mental health promotion in community settings. We reviewed them all, assessed their quality, and calculated their combined effects.

We showed that, compared with doing nothing, mindfulness reduces anxiety, depression, and stress, and increases well–being, but we cannot be sure that this will happen in every community setting.

In these RCTs, mindfulness is neither better nor worse than other feel–good practices such as physical exercise, and RCTs in this field tend to be of poor quality, so we cannot be sure that our combined results represent the true effects.

What do these findings mean?

Mindfulness courses in the community need to be implemented with care, because we cannot assume that they work for everyone, everywhere.

We need good quality collaborative research to find out which types of communities benefit from the different types of mindfulness courses available.

The courses that work best may be those aimed at people who are most stressed or in stressful situations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799763/