Distress

Therapeutic Alliance is Important for Mindfulness Training to Improve the Psychological Health of Cancer Patients

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Therapeutic Alliance is Important for Mindfulness Training to Improve the Psychological Health of Cancer Patients

 

By John M. de Castro, Ph.D.

 

“Both face-to-face and internet-based mindfulness-based cognitive therapy (MBCT) reduced psychological distress compared with usual care in patients with cancer.” – Matthew Stenger

 

Receiving a diagnosis of cancer has a huge impact on most people. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. It is thought that the alliance between therapist and patient that is formed during treatment is important for the effectiveness of therapy. So, it would make sense to study the effectiveness of MBCT and the therapeutic alliance on the psychological distress of cancer patients.

 

In today’s Research News article “Development of the Therapeutic Alliance and its Association With Internet-Based Mindfulness-Based Cognitive Therapy for Distressed Cancer Patients: Secondary Analysis of a Multicenter Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827984/), Bisseling and colleagues recruited adult cancer patients and randomly assigned them to either a wait list control condition or to receive Mindfulness-Based Cognitive Therapy (MBCT) in a group setting in 8 weekly 2.5 hour sessions with daily homework or online in 8 weekly practice sessions with therapist feedback emails. The participants were measured before and after training for anxiety, depression, mental well-being, and therapeutic alliance consisting of questions on “(1) how closely client and therapist agree on and are mutually engaged in the goals of treatment; (2) how closely client and therapist agree on how to reach the treatment goals; and (3) the degree of mutual trust, acceptance, and confidence between the client and therapist.”

 

Of the Mindfulness-Based Cognitive Therapy (MBCT) participants significantly more dropped out of the online version (12.1%) than the group version(5.6%). The therapeutic alliance increased significantly over the intervention and did not differ between MBCT groups. They found that relative to baseline and the wait list control group MBCT training produced significant reductions in psychological distress and increases in mental well-being. In addition, the higher the level of therapeutic alliance at week 2 of the intervention the greater the reduction in psychological distress and increase in mental well-being over the program. Finally, they found that if the therapeutic alliance was weak at week 2 then there was less improvement in psychological distress in the group version of MBCT than the online version.

 

These results are in line with previous findings that mindfulness training produces improves mental well-being and decreases psychological distress in cancer patients, that online mindfulness training is effective, and that therapeutic alliance is important for the effectiveness of mindfulness training. These results suggest that the development of therapeutic alliance be emphasized in mindfulness training. It is interesting that therapeutic alliance can be just as effectively developed online as in person and that it is less responsive to early low therapeutic alliance. This may explain, in part, why online mindfulness training is very effective.

 

So, therapeutic alliance is important for mindfulness training to improve the psychological health of cancer patients.

 

“mindfulness-based therapy is an effective way of treating anxiety and depression in cancer patients.” – Robert Zachariae

 

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

 

Bisseling, E., Cillessen, L., Spinhoven, P., Schellekens, M., Compen, F., van der Lee, M., & Speckens, A. (2019). Development of the Therapeutic Alliance and its Association With Internet-Based Mindfulness-Based Cognitive Therapy for Distressed Cancer Patients: Secondary Analysis of a Multicenter Randomized Controlled Trial. Journal of medical Internet research, 21(10), e14065. doi:10.2196/14065

 

Abstract

Background

Mindfulness-based cognitive therapy (MBCT) is an evidence-based group-based psychological treatment in oncology, resulting in reduction of depressive and anxiety symptoms. Internet-based MBCT (eMBCT) has been found to be an effective alternative for MBCT. The therapeutic alliance (the bond between therapist and patient,) is known to have a significant impact on psychological treatment outcomes, including MBCT. A primary concern in the practice of eMBCT is whether a good therapeutic alliance can develop. Although evidence for the beneficial effect of therapist assistance on treatment outcome in internet-based interventions (IBIs) is accumulating, it is still unclear whether the therapeutic alliance is related to outcome in IBIs.

Objective

This study aimed to (1) explore whether early therapeutic alliance predicts treatment dropout in MBCT or eMBCT, (2) compare the development of the therapeutic alliance during eMBCT and MBCT, and (3) examine whether early therapeutic alliance is a predictor of the reduction of psychological distress and the increase of mental well-being at posttreatment in both conditions.

Methods

This study was part of a multicenter randomized controlled trial (n=245) on the effectiveness of MBCT or eMBCT for distressed cancer patients. The therapeutic alliance was measured at the start of week 2 (ie, early therapeutic alliance), week 5, and week 9. Outcome measures were psychological distress, measured with the Hospital Anxiety and Depression Scale, and mental well-being, measured with the Mental Health Continuum-Short Form.

Results

The strength of early therapeutic alliance did not predict treatment dropout in MBCT or eMBCT (B=−.39; P=.21). Therapeutic alliance increased over time in both conditions (F2,90=16.46; Wilks λ=0.732; P<.001). This increase did not differ between eMBCT and MBCT (F1,91=0.114; P=.74). Therapeutic alliance at week 2 predicted a decrease in psychological distress (B=−.12; t 114=−2.656; P=.01) and an increase in mental well-being (B=.23; t 113=2.651; P=.01) at posttreatment. The relationship with reduction of psychological distress differed between treatments: a weaker early therapeutic alliance predicted higher psychological distress at posttreatment in MBCT but not in eMBCT (B=.22; t 113=2.261; P=.03).

Conclusions

A therapeutic alliance can develop in both eMBCT and MBCT. Findings revealed that the strength of early alliance did not predict treatment dropout. Furthermore, the level of therapeutic alliance predicted reduced psychological distress and increased mental well-being at posttreatment in both conditions. Interestingly, the strength of therapeutic alliance appeared to be more related to treatment outcome in group-based MBCT than in eMBCT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827984/

 

Improve Well-Being in Nurses with Mindfulness

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Improve Well-Being in Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For nurses, many of them went into the field because of their ability to connect with people and make a difference in their lives. Mindfulness is a path to help us reconnect with what brings meaning to the profession. It brings humanity back to healthcare.” – Susan Bauer-Wu

 

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. 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. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout and improve well-being in nurses.

 

In today’s Research News article “Mindfulness to promote nurses’ well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716566/), Penque recruited Registered Nurses (RNs). They participated in a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consists of 8 weekly 1-hour group sessions involving meditation, yoga, body scan, and discussion. The participants were also encouraged to perform daily practice at home. They were measured before and after training and 3 months later for mindfulness, self-compassion, serenity, interpersonal reactivity, work satisfaction, and burnout.

 

She found that following the Mindfulness-Based Stress Reduction (MBSR) program there were significant increases in mindfulness, self-compassion including  self-kindness, common humanity, mindfulness, serenity, and interpersonal reactivity including perspective taking, and empathetic concern. There were also significant decreases in burnout, isolation, overidentification, self-judgment, and personal distress. She also found that the higher the levels of mindfulness, the higher the levels of self-compassion and serenity.

 

The results must be interpreted with caution as there wasn’t a control, comparison, group. So, potential confounds such as placebo effects, experimenter bias, Hawthorne effects, etc. were present. Other, better controlled studies, however, have demonstrated that mindfulness training increases self-compassion and reduces burnout. So, it is likely that these same benefits of mindfulness training occurred here irrespective of confounding conditions.

 

The Mindfulness-Based Stress Reduction (MBSR) program is a complex of meditation, yoga, and body scan practices. It is not possible to determine which components or combination of components were responsible for the benefits. Regardless, the results suggest that MBSR training is a safe and effective program to improve the well-being of nurses and reduce burnout. This can not only improve the psychological health of the nurses but also improve the retention of these valuable and important healthcare workers.

 

So, improve well-being in nurses with mindfulness.

 

“Mindfulness can positively affect how nurses feel and cope with the pressures of their work, thereby resulting in better self-care and improved patient outcomes.” – Nursing Times

 

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

 

Penque S. (2019). Mindfulness to promote nurses’ well-being. Nursing management, 50(5), 38–44. doi:10.1097/01.NUMA.0000557621.42684.c4

 

This article examines the effects of MBSR on job-relevant factors, including mindfulness, self-compassion, empathy, serenity, work satisfaction, incidental overtime, and job burnout. Nursing is a high-stress profession that may be taking a toll on our nurses. Mindfulness-based programs can help nurses develop skills to manage clinical stress and improve their health; increase overall attention, empathy, and presence with patients and families; and experience work satisfaction, serenity, decreased incidental overtime, and reduced job burnout.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716566/

 

Improve the Psychological Well-Being of Lupus Patients with Mindfulness

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Improve the Psychological Well-Being of Lupus Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For someone with lupus who suffers from persistent joint or muscular pain, the struggle to find relief can be stressful and exhausting. But mindfulness meditation is not about fighting. It’s all about acceptance. And once you have achieved calm, it can help you regain a much-needed sense of control when your disease brings you discomfort.” – Lupus Foundation

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S.

 

The symptoms of Lupus can look like a number of other diseases so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is possible that mindfulness training could improve Lupus and its symptoms.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT 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.

 

In today’s Research News article “Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/), Sahebari and colleagues recruited female lupus patients and were randomly assigned to receive 8 weekly sessions of Acceptance and Commitment Therapy (ACT) or treatment as usual. They were measured before and after treatment for depression, psychological distress, fatigue, disappointment, and psychasthenia.

 

They found that in comparison to baseline and the treatment as usual control condition, the lupus patients who received Acceptance and Commitment Therapy (ACT) had significantly lower levels of psychological distress, psychasthenia, and disappointment with large effect sizes. psychasthenia is a psychological disorder characterized by phobias, obsessions, compulsions, or excessive anxiety. Hence, ACT appears to be effective in improving the psychological state of lupus patients. It can be speculated that ACT has its benefits for lupus patients by increasing mindfulness and the patients’ ability to accept their situation without judgement.

 

So, improve the psychological well-being of lupus patients with mindfulness.

 

“Improvement was observed in several areas: patients’ increased ability to differentiate between themselves and the disease; increased ability to accept, rather than to actively fight the fact that one must live with the disease; and decreased behavioral avoidance. These observations speak to the significant therapeutic potential of mindfulness practice among SLE patients” – Danny Horash

 

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

 

Sahebari, M., Asghari Ebrahimabad, M. J., Ahmadi Shoraketokanlo, A., Aghamohammadian Sharbaf, H., & Khodashahi, M. (2019). Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients. Iranian Journal of Psychiatry, 14(2), 130–136.

 

Abstract

Objective: The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE).

Method : This quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory.

Results: Mean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001).

Conclusion: According to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/

 

Improve Psychological Functioning with Mindfulness

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Improve Psychological Functioning with Mindfulness

 

By John M. de Castro, Ph.D.

 

” the positive potential benefits of mindfulness practice are more attentional control, more effective emotional regulation, enhanced social relationships, reduced risk for physical ailments, enhanced immune system functioning, and better sleep quality.” – Jason Linder

 

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.

 

The clustering of these benefits may supply a clue as to how mindfulness training is working to improve mental health. This can be investigated by looking at the interrelationships between the effects of mindfulness training. In today’s Research News article “Does mindfulness change the mind? A novel psychonectome perspective based on Network Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638953/), Roca and colleagues apply network analysis to investigate the interrelationships between a large number of effects of Mindfulness-Based Stress Reduction (MBSR) training.

 

They recruited healthy adult participants in a Mindfulness-Based Stress Reduction (MBSR) program. The MBSR program consisted of 32 hours of training separated into 8 weekly group sessions involving meditation, yoga, body scan, and discussion. The patients were also encouraged to perform daily practice. They were measured before and after MBSR training for meditation experience, and psychological and physical health problems, and 5 categories of mindfulness effects; 1) Mindfulness, including five facets, decentering, non-attachment, and bodily awareness, 2) Compassion, including compassion towards oneself and others and empathy, 3) Psychological well-being, including satisfaction with life, optimism, and overall well-being, 4) Psychological distress, including anxiety, stress, and depression, and 5) Emotional and cognitive control, including emotional regulation, rumination, thought suppression and attentional control.

 

They found that after MBSR training there were significant improvements in effectively all of the five categories. This is not new as much research has demonstrated that mindfulness training produces improvements in mindfulness, compassion, psychological well-being, psychological distress, and emotional and cognitive control.

 

These data were then subjected to network analysis. Prior to MBSR training the network analysis revealed clustering in three paths “mindfulness and self-compassion; clinical symptoms and rumination; and most of FFMQ mindfulness components with attentional control measure.” After MBSR training, however, there was a network reorganization such that the three paths disappeared and were replaced by two paths, psychopathological and adaptive.

 

Centrality measures in the network analysis indicated that both prior to and after MBSR training the most central, fundamental, and interrelated components were all facets of mindfulness and all well-being measures. In addition, Community Analysis revealed that mindfulness, compassion, and emotional regulation were the most highly associated components.

 

The results are complex but suggest that Mindfulness-Based Stress Reduction (MBSR) training reorganizes the associations of psychological variables, simplifying them into two categories representing distress and adaptation. The training may help the individual see the interrelationships of the problems they have and the solutions employed. The results further suggest, not surprisingly, that mindfulness, compassion, and emotion regulation are central to the benefits of mindfulness training. Many other benefits flow from these.

 

So, improve psychological functioning with mindfulness.

 

“Mindfulness-Based Stress Reduction . . . Participants experienced significant decreases in perceived stress, depression, anxiety, emotional dysregulation, and post-traumatic stress symptoms.” – Carolyn McManus

 

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

 

Roca, P., Diez, G. G., Castellanos, N., & Vazquez, C. (2019). Does mindfulness change the mind? A novel psychonectome perspective based on Network Analysis. PloS one, 14(7), e0219793. doi:10.1371/journal.pone.0219793

 

Abstract

If the brain is a complex network of functionally specialized areas, it might be expected that mental representations could also behave in a similar way. We propose the concept of ‘psychonectome’ to formalize the idea of psychological constructs forming a dynamic network of mutually dependent elements. As a proof-of-concept of the psychonectome, networks analysis (NA) was used to explore structural changes in the network of constructs resulting from a psychological intervention. NA was applied to explore the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program in healthy participants (N = 182). Psychological functioning was measured by questionnaires assessing five key domains related to MBSR: mindfulness, compassion, psychological well-being, psychological distress and emotional-cognitive control. A total of 25 variables, covering the five constructs, were considered as nodes in the NA. Participants significantly improved in most of the psychological questionnaires. More interesting from a network perspective, there were also significant changes in the topological relationships among the elements. Expected influence and strength centrality indexes revealed that mindfulness and well-being measures were the most central nodes in the networks. The nodes with highest topological change after the MBSR were attentional control, compassion measures, depression and thought suppression. Also, cognitive appraisal, an adaptive emotion regulation strategy, was associated to rumination before the MBSR program but became related to mindfulness and well-being measures after the program. Community analysis revealed a strong topological association between mindfulness, compassion, and emotional regulation, which supports the key role of compassion in mindfulness training. These results highlight the importance of exploring psychological changes from a network perspective and support the conceptual advantage of considering the interconnectedness of psychological constructs in terms of a ‘psychonectome’ as it may reveal ways of functioning that cannot be analyzed through conventional analytic methods.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638953/

 

Reduce Psychological Distress Produced by Critical Thinking with Mindfulness

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Reduce Psychological Distress Produced by Critical Thinking with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

Improve Workplace Wellness with Mindful Meditation

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Improve Workplace Wellness with Mindful Meditation

 

By John M. de Castro, Ph.D.

 

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

 

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

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. These programs attempt to increase the employees’ mindfulness at work and thereby reduce stress and burnout. The research has been accumulating. So, it is important to step back and summarize what has been learned.

 

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

 

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

 

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

 

So, improve workplace wellness with mindful meditation.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

BACKGROUND:

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

OBJECTIVE:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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

 

Improve Physical and Mental Health with Musculoskeletal Disorders with Mindfulness Practices

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Improve Physical and Mental Health with Musculoskeletal Disorders with Mindfulness Practices

 

By John M. de Castro, Ph.D.

 

“Musculoskeletal disorders (MSDs) is the term given to a variety of painful conditions that affect the muscles, bones, and joints, which are a leading cause of long term sickness absence. . .MSDs are also at risk of developing symptoms of depression . . . Being off work for a significant period of time, whether due to an musculoskeletal disorder or other condition, can cause many other repercussions – including mental health issues.” – Fit for Work

 

Orthopedic Disorders consist of a wide range of problems that are concerned with muscles, ligaments and joints. Disorders are ailments, injuries or diseases that cause knee problems, whiplash, dislocated shoulder, torn cartilages, foot pain and fibromyalgia. The most common forms of orthopedic disorders are arthritis, and back and neck pain.

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers.

 

The most common forms of chronic pain are back and neck pain. Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. Back and neck pain interferes with daily living and with work, decreasing productivity and creating absences. Arthritis and back pain can have very negative psychological effects and may lead to depression, isolation, and withdrawal from friends and social activities.

 

There are many different treatments for pain, but few are both safe and effective for chronic musculoskeletal pain conditions. So, alternative treatments are needed. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of arthritis, low back pain and neck pain. In addition, mindfulness practices have been shown to improve mental health. So, it is likely that mindfulness practices will be effective for both the physical and mental health issues that accompany musculoskeletal disorders.

 

In today’s Research News article “Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196876/ ), Lorenc and colleagues review and summarize the published research studies on the effectiveness of mindfulness practices for the treatment of the psychological problems that accompany musculoskeletal disorders.

 

They summarize the evidence from 111 published research studies and report that these studies support the effectiveness of yoga for low back pain, and anxiety; Tai Chi for osteoarthritis, depression, anxiety, and sleep disorders; meditation for depression, anxiety, and sleep disorders; and mindfulness for stress and distress. There were no safety problems found with any of these mindfulness techniques.

 

This review indicates that there has accumulated a large body of evidence for the safety and effectiveness of mindfulness practices for the physical and mental health issues that accompany musculoskeletal disorders. Hence the published research to date supports the use of mindfulness practices in the package of treatments for musculoskeletal disorders.

 

So, improve physical and mental health with musculoskeletal disorders with mindfulness practices.

 

“Yoga has been used to alleviate musculoskeletal pain and has been associated with significant improvement in range of motion and function, decreased tenderness, lower levels of depressive symptoms, and decreased pain during activity in patients with musculoskeletal disorders.” – Ruth McCaffrey

 

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

 

Lorenc, A., Feder, G., MacPherson, H., Little, P., Mercer, S. W., & Sharp, D. (2018). Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions. BMJ open, 8(10), e020222. doi:10.1136/bmjopen-2017-020222

 

Abstract

Objective

To identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs).

Design

Scoping review of SRs.

Methods

We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring >50% on Assessing the Methodological Quality of Systematic Reviews (AMSTAR); quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, sample size and indication of cost-effectiveness and safety.

Results

We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK–MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind–body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety—only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data.

Conclusions

Only one SR studied MSK–MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196876/

 

Reduce Psychological Distress Levels of Prison Inmates with Yoga

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Reduce Psychological Distress Levels of Prison Inmates with Yoga

 

By John M. de Castro, Ph.D.

 

“Ninety percent of the prison population will be released, and if we provide people with skills to reinforce the deeper good in their nature and their stronger, better selves while they are in prison, they will take that with them.” – Kath Meadows

 

Around 2 ¼ million people are incarcerated in the United States. Even though prisons are euphemistically labelled correctional facilities very little correction actually occurs. This is supported by the rates of recidivism. About three quarters of prisoners who are released commit crimes and are sent back to prison within 5-years. The lack of actual treatment for the prisoners leaves them ill equipped to engage positively in society either inside or outside of prison. Hence, there is a need for effective treatment programs that help the prisoners while in prison and prepares them for life outside the prison.

 

Contemplative practices are well suited to the prison environment. Mindfulness training teaches skills that may be very important for prisoners. In particular, it puts the practitioner in touch with their own bodies and feelings. It improves present moment awareness and helps to overcome rumination about the past and negative thinking about the future. It’s been shown to be useful in the treatment of the effects of trauma and attention deficit disorder. It also relieves stress and improves overall health and well-being. Finally, mindfulness training has been shown to be effective in treating depression, anxiety, and anger. It has also been shown to help overcome trauma in male prisoners.

 

Yoga practice, because of its mindfulness plus physical exercise characteristics, would seem to be ideal for the needs of an incarcerated population. Indeed, it has been shown to be beneficial for prisoners. In today’s Research News article “Yoga Practice Reduces the Psychological Distress Levels of Prison Inmates.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129942/ ), Sfendla and colleagues recruited adult male and female prison inmates and randomly assigned them to either engage in 10 weeks, once a week for 90 minutes, of hatha yoga practice or free choice exercise, including gym, walking, basketball, or football. They were measured before and after training for anxiety, depression, interpersonal sensitivity, hostility, obsessive-compulsive, psychoticism, paranoid ideation, phobic anxiety, and somatization.

 

They report that the yoga group significantly improved in global psychological symptoms and on each of the symptom dimensions. The exercise group also improved in global severity and all symptom dimensions except obsessive-compulsive, phobic anxiety, and somatization. In all cases the degree of improvement was greater in the yoga practice group and in the cases of obsessive-compulsive, phobic anxiety, and somatization the differences were statistically significant.

 

Hence, exercise in general and especially yoga practice significantly improved psychological distress levels in prison inmates. These results are particularly important as the yoga practice effects were compared to an appropriate active control condition. The results suggest that practicing yoga while in prison may improve the mental health of the prisoners and better prepare them for returning to society. It remains for future research to determine is the benefits are lasting or only occur in the immediate aftermath of training.

 

So, reduce psychological distress levels of prison inmates with yoga.

 

“We’ve got two and a quarter million people who are incarcerated and a 60 percent recidivism rate. That’s a dismal failure. So while we’ve got them, I think we should be allocating resources to give them the tools so that they don’t come back to prison.” – Jessica Rizzo

 

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

Sfendla, A., Malmström, P., Torstensson, S., & Kerekes, N. (2018). Yoga Practice Reduces the Psychological Distress Levels of Prison Inmates. Frontiers in psychiatry, 9, 407. doi:10.3389/fpsyt.2018.00407

Abstract

Background: Psychiatric ill-health is prevalent among prison inmates and often hampers their rehabilitation. Rehabilitation is crucial for reducing recidivistic offending. A few studies have presented evidence of the positive effect of yoga on the well-being of prison inmates. The conclusion of those previous studies that yoga is an effective method in the rehabilitation process of inmates, and deserves and requires further attention.

Aims: The current study aimed to evaluate the effect of 10 weeks of yoga practice on the mental health profile, operationalized in the form of psychological distress, of inmates.

Methods: One hundred and fifty-two volunteer participants (133 men; 19 women) were randomly placed in either of two groups: to participate in weekly 90-min yoga class (yoga group) or a weekly 90-min free-choice physical exercise (control group). The study period lasted for 10 weeks. Prior to and at the end of the study period the participants completed a battery of self-reported inventories, including the Brief Symptom Inventory (BSI).

Results: Physical activity (including yoga) significantly reduced the inmates’ levels of psychological distress. Yoga practice improved all primary symptom dimensions and its positive effect on the obsessive-compulsive, paranoid ideation, and somatization symptom dimensions of the BSI stayed significant even when comparing with the control group.

Conclusions: Yoga as a form of physical activity is effective for reducing psychological distress levels in prison inmates, with specific effect on symptoms such as suspicious and fearful thoughts about losing autonomy, memory problems, difficulty in making decisions, trouble concentrating, obsessive thought, and perception of bodily dysfunction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129942/

Improve Tolerance of Distress and Psychological State with Mindfulness

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Improve Tolerance of Distress and Psychological State with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Distress Tolerance skills are used to help us cope and survive during a crisis, and helps us tolerate short term or long term pain (physical or emotional). Tolerating distress includes a mindfulness of breath and mindful awareness of situations and ourselves.” – DBT Self Help

 

Psychological distress is related to an increase in physiological stress responses. That is, when the individual is anxious, ruminating, or having negative emotions, the physiology including the hormonal system reacts. The increased activity can be measured in heightened stress hormones in the blood and increased heart rate, blood pressure etc. These physiological stress responses on the short-term are adaptive and help to fight off infection, toxins, injury, etc. Unfortunately, psychological distress is often persistent and chronic and resulting in chronic stress which in turn can produce disease.

 

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness. Anxiety is often rooted in a persistent dread of future negative events while rumination is rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions. So, mindfulness would appear to be an antidote to psychological distress.

 

In today’s Research News article “Dimensions of distress tolerance and the moderating effects on mindfulness-based stress reduction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130202/ ), Gawrysiak and colleagues recruited participants in an 8-week Mindfulness-Based Stress Reduction (MBSR) program. The program was specifically developed to improve coping with stress and consisted of weekly 2.5-hour group training sessions with home practice and included meditation, body scan, yoga practices, and discussion. They were measured before and after training for distress tolerance, perceived stress, and positive and negative emotions.

 

They found that following the MBSR program the participants demonstrated significant increases in distress tolerance and vigor and decreases in perceived stress, anger, confusion, depression, fatigue, and tension. In addition, they found that participants who were low in distress tolerance had the greatest decreases in perceived stress after the program while those high in distress tolerance had the least change.

 

Hence, they found that the MBSR program improved the psychological state in the participants. This is in line with previous research that demonstrated that mindfulness training improves psychological and physiological responses to stress and improves emotions. What this study contributes is the understanding that MBSR  improves that participants  ability to cope with psychological distress. Importantly, they also found that the participants who benefited the most were the ones who had the least ability to cope with distress to begin with. This suggests that one of the reasons that MBSR training is beneficial is that it improves the individuals ability to deal effectively with tough emotions and situations which, in turn, improves the individuals ability to deal effectively with stress. This, then, improves their emotional state.

 

So, improve tolerance of distress and psychological state with mindfulness.

 

“Mindfulness helps you go home to the present. And every time you go there and recognize a condition of happiness that you have, happiness comes.” — Thich Nhat Hanh

 

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

 

Gawrysiak, M. J., Leong, S. H., Grassetti, S. N., Wai, M., Shorey, R. C., & Baime, M. J. (2016). Dimensions of distress tolerance and the moderating effects on mindfulness-based stress reduction. Anxiety, Stress, and Coping, 29(5), 552–560. http://doi.org/10.1080/10615806.2015.1085513

 

Abstract

Background and Objectives:

This study examined the relationship between distress tolerance and psychosocial changes among individuals participating in Mindfulness-Based Stress Reduction (MBSR). The objective of the analysis was to discern whether individuals with lower distress tolerance measured before MBSR showed larger reductions in perceived stress following MBSR.

Design and Methods:

Data were collected from a sample of convenience (n = 372) using a quasi-experimental design. Participants completed self-report measures immediately prior to course enrollment and following course completion.

Results:

Perceived stress, distress tolerance, and mood states showed favorable changes from pre- to post-MBSR in the current study. Baseline distress tolerance significantly moderated reductions on perceived stress, supporting the primary hypothesis that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress following MBSR. For a one-unit increase on the self-reported baseline Distress Tolerance Scale, reported perceived stress scores decreased by 2.5 units (p < .0001).

Conclusions:

The finding that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress may offer hints about who is most likely to benefit from MBSR and other mindfulness-based treatments. Identifying moderators of treatment outcomes may yield important benefits in matching individuals to treatments that are most likely to work for them.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130202/

Improve Student Resilience to Stress with Mindfulness

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Improve Student Resilience to Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“This is, to the best of our knowledge, the most robust study to date to assess mindfulness training for students, and backs up previous studies that suggest it can improve mental health and wellbeing during stressful periods.” – Julieta Galante

 

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 students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s 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 individuals’ 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, mindfulness has been shown to be helpful in increasing resilience and coping with the school environment and for both students and teachers. So, perhaps, mindfulness training may be helpful for college students to better cope with stress and improve their well-being.

 

In today’s Research News article “A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813792/ ), Galante and colleagues recruited healthy college students and randomly assigned them to receive either 8 weeks of mindfulness training or to support as usual from the university counseling center. The mindfulness course consisted of 8 weekly sessions of 75-90 minutes teaching mindfulness skills adapted for college students. The mindfulness students were encouraged to practice for 15 minutes daily at home. They were measured before and after training and during the examination period for psychological distress, mental health problems, well-being, sleep and activity levels, examination scores, and altruism.

 

They found that after training and during the examination period the students who had received the mindfulness training had significantly less psychological distress and greater well-being than the support as usual students. Hence mindfulness training appeared to improve the students psychological state in general and particularly during the stressful examination period. This suggests that the training improved the students’ resilience in the face of stress and this in turn improved their psychological state. Training in mindfulness may be an important component in education to improve the students’ abilities to cope with the pressure and stresses of higher education.

 

So, improve student resilience to stress with mindfulness.

 

“Students who had been practising mindfulness had distress scores lower than their baseline levels even during exam time, which suggests that mindfulness helps build resilience against stress.” – Julieta Galante

 

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

 

Julieta Galante, Géraldine Dufour, Maris Vainre, Adam P Wagner, Jan Stochl, Alice Benton, Neal Lathia, Emma Howarth, Prof Peter B Jones. A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial. Lancet Public Health. Author manuscript; available in PMC 2018 Feb 15. Published in final edited form as: Lancet Public Health. 2018 Feb; 3(2): e72–e81. Published online 2017 Dec 19. doi: 10.1016/S2468-2667(17)30231-1

 

Summary

Background

The rising number of young people going to university has led to concerns about an increasing demand for student mental health services. We aimed to assess whether provision of mindfulness courses to university students would improve their resilience to stress.

Methods

We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18 years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via remote survey software using computer-generated random numbers, to receive either an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental health support as usual, or mental health support as usual alone. Participants and the study management team were aware of group allocation, but allocation was concealed from the researchers, outcome assessors, and study statistician. The primary outcome was self-reported psychological distress during the examination period, as measured with the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE–OM), with higher scores indicating more distress. The primary analysis was by intention to treat. This trial is registered with the Australia and New Zealand Clinical Trials Registry, number ACTRN12615001160527.

Findings

Between Sept 28, 2015, and Jan 15, 2016, we randomly assigned 616 students to the MSS group (n=309) or the support as usual group (n=307). 453 (74%) participants completed the CORE–OM during the examination period and 182 (59%) MSS participants completed at least half of the course. MSS reduced distress scores during the examination period compared with support as usual, with mean CORE–OM scores of 0·87 (SD 0·50) in 237 MSS participants versus 1·11 (0·57) in 216 support as usual participants (adjusted mean difference –0·14, 95% CI –0·22 to –0·06; p=0·001), showing a moderate effect size (β –0·44, 95% CI –0·60 to –0·29; p<0·0001). 123 (57%) of 214 participants in the support as usual group had distress scores above an accepted clinical threshold compared with 88 (37%) of 235 participants in the MSS group. On average, six students (95% CI four to ten) needed to be offered the MSS course to prevent one from experiencing clinical levels of distress. No participants had adverse reactions related to self-harm, suicidality, or harm to others.

Interpretation

Our findings show that provision of mindfulness training could be an effective component of a wider student mental health strategy. Further comparative effectiveness research with inclusion of controls for non-specific effects is needed to define a range of additional, effective interventions to increase resilience to stress in university students.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813792/