Baseline Mindfulness Research Articles

The Effects of Mandala Coloring and Free Coloring on Mindfulness and the Score of Posttraumatic Stress Disorder in Veterans: A Randomized Controlled Trial.

Due to the nature of the events in war, posttraumatic stress disorder (PTSD) is more difficult to treat in veterans than in other people. Nowadays, using art-making methods such as mandala coloring has attracted the attention of researchers. This randomized controlled trial was conducted with 84 male veterans diagnosed with PTSD. Veterans were recruited by convenience sampling method and randomly assigned to an intervention group (n=42) and a control group (n=42). Participants in the intervention group colored a mandala, whereas the control group colored freely for 15minutes 2 times a week for 3weeks. All participants completed Brown and Ryan's Mindful Attention Awareness Scale and Posttraumatic Stress Disorder Checklist for diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Mean baseline mindfulness scores were not significantly different between the mandala coloring group and the free coloring group (41.73±5.29 vs 40.23±4.59, P =.169). After the intervention, the mean mindfulness score was significantly higher in the mandala coloring group than in the free coloring group (52.23±5.89 vs 46.04±7.28, P <.001). Mean baseline PTSD scores were not significantly different between the mandala coloring group and the free coloring group (65.45±5.89 vs 67.47±4.66, P =.085). After the intervention, the mean PTSD score was significantly lower in the mandala coloring group than in the free coloring group (47.21±5.77 vs 52.38±5.52, P <.001). Both mandala coloring and free coloring increase mindfulness and decrease PTSD symptom severity. However, the mandala coloring method was more effective.

Mediating Effects of Resilience Between Mindfulness, Self-compassion, and Psychological Distress in a Longitudinal Study

Recent years have witnessed increasing research interest in the collective impact of resilience, mindfulness, and self-compassion on individuals’ mental health. This longitudinal study examined the mediating effects of resilience approximately one year after the baseline assessment on baseline mindfulness, baseline self-compassion, and psychological distress approximately two years after the baseline assessment. The study involved 486 Japanese participants, surveyed at three different time points, spaced one year apart. Mediation analysis revealed two distinct pathways: (1) an indirect effect of mindfulness on psychological distress mediated by resilience, and (2) an indirect effect of self-compassion on psychological distress mediated by resilience. However, no statistically significant direct effects of mindfulness and self-compassion on psychological distress were observed. These findings suggest a fully mediated model for psychological distress with resilience serving as the mediator. The mediation model promotes mindfulness and self-compassion as practices that foster the expansion of psychological resources associated with resilience, such as attentional control and emotional regulation, ultimately leading to fewer psychological distress.

Examining Mental Health Benefits of a Brief Online Mindfulness Intervention: A Randomised Controlled Trial

ObjectivesThe objective of this study is to assess the effectiveness of a brief online mindfulness intervention in reducing depression, rumination, and trait anxiety among university students.MethodThe sample consisted of 486 participants including 205 (42%) in the experimental group and 281 (58%) in the control group. For a period of 28 days, participants in the experimental group engaged in daily mindfulness meditation during their free time. Additionally, they practised mindfulness meditation once a week during regular class hours. The control group was involved in regular class activities without practising mindfulness. The outcomes were assessed at pre- and post-intervention using well-validated measures of mindfulness, depression, rumination, and trait anxiety. The data were analysed using mixed-model ANCOVA while controlling for baseline mindfulness levels as co-variates.ResultsOur results demonstrated the effectiveness of a brief online mindfulness intervention in reducing depression, rumination, and trait anxiety of university students. Moreover, higher baseline mindfulness levels predicted better effectiveness of the brief online mindfulness intervention at an individual level and were inversely linked to depression, trait anxiety, and rumination.ConclusionsThis study conclusively demonstrated that a brief online mindfulness intervention significantly reduces depression, rumination, and trait anxiety among university students, with reductions observed in specific measures of these conditions, highlighting the role of initial mindfulness levels in moderating outcomes. These findings underscore the effectiveness of brief online mindfulness programs in mitigating mental health issues in a university setting and the importance of baseline psychological states in intervention outcomes.PreregistrationThis study is not preregistered

Moderators and mediators of change of an internet-based mindfulness intervention for college students: secondary analysis from a randomized controlled trial.

Existing evidence suggests internet- and mobile-based interventions (IMIs) improve depressive symptoms in college students effectively. However, there is far less knowledge about the potential mechanisms of change of mindfulness-based IMIs, which could contribute to optimizing target groups and interventions. Hence, within this secondary analysis of data from a randomized controlled trial (RCT), potential moderators and mediators of the effectiveness of the IMI StudiCare Mindfulness were investigated. Moderation and mediation analyses were based on secondary data from a RCT that examined the effectiveness of the 7-module IMI StudiCare Mindfulness in a sample of college students (intervention group: n = 217; waitlist control group: n = 127). Assessments were collected before (t0; baseline), 4 weeks after (t1; during intervention), and 8 weeks after (t2; post-intervention) randomization. Longitudinal mediation analyses using structural equation modeling were employed, with depressive symptom severity as the dependent variable. For moderation analyses, bilinear interaction models were calculated with depressive symptom severity and mindfulness at t2 as dependent variables. All data-analyses were performed on an intention-to-treat basis. Mediation analyses showed a significant, full mediation of the intervention effect on depressive symptom severity through mindfulness (indirect effect, a*b = 0.153, p < 0.01). Only the number of semesters (interaction: β = 0.24, p = 0.035) was found to moderate the intervention's effectiveness on depressive symptom severity at t2, and only baseline mindfulness (interaction: β = -0.20, p = 0.047) and baseline self-efficacy (interaction: β = -0.27, p = 0.012) were found to be significant moderators of the intervention effect on mindfulness at t2. Our results suggest a mediating role of mindfulness. Moderation analyses demonstrated that the intervention improved depressive symptom severity and mindfulness independent of most examined baseline characteristics. Future confirmatory trials will need to support these findings. The trial was registered a priori at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (TRN: DRKS00014774; registration date: 18 May 2018).

The role of emotion regulation in the relationship between mindfulness and risk factors for disordered eating: A longitudinal mediation analysis.

Evidence suggests mindfulness may reduce risk factors for disordered eating. However, mechanisms of change in this relationship are unclear. This longitudinal study tested whether emotion regulation mediates the prospective associations between mindfulness and two proximal risk factors for disordered eating: weight and shape concerns, and negative affect. This study is a secondary analysis of data collected within an eating disorder prevention trial. Adolescent girls (N=374, Mage =15.70, SD=0.77) completed self-report measures of mindfulness, emotion regulation, weight and shape concerns, and negative affect at baseline, 2months following baseline, and 7months following baseline. Path analyses were computed to test hypothesized indirect effects using confidence intervals based on 5000 bootstrap samples. Higher baseline mindfulness predicted lower weight and shape concerns and negative affect at 7months via a mediator of better emotion regulation at 2months. This effect remained while controlling for earlier measurements of the mediator and outcome in the model of negative affect but not weight and shape concerns. Emotion regulation may be an important mechanism explaining how mindfulness influences negative affect. Efforts should be made to intervene on mindfulness and emotion regulation in prevention and early intervention programmes for eating disorders and other psychiatric conditions. Research has shown that mindfulness can help to reduce some of the risk of developing an eating disorder. This study explored whether mindfulness reduces some of this risk by helping people to better manage their emotions. Understanding this process can help us to develop better mindfulness-based strategies to support people who are at risk of developing an eating disorder.

The Impact of Baseline Mindfulness Scores on Mindfulness-Based Intervention Outcomes: Toward Personalized Mental Health Interventions.

A growing body of evidence has portrayed mindfulness as a useful tool for dealing with a broad range of psychological problems and disorders. This has created the impression that mindfulness-based interventions (MBIs) can be used to treat nearly all psychological difficulties, in all cases. Nonetheless, little research has been done on how individual differences may contribute to intervention outcomes. The goal of this study was to evaluate the role of baseline mindfulness on participants’ outcomes by examining three prior Randomized Controlled Trials that addressed the impact of MBIs on mental health and mindfulness measures. The participants were 164 people, aged between 12 and 45, from both clinical and non-clinical samples. Our findings indicate that at least two thirds of the change produced by these interventions in terms of mindfulness scores can be predicted by the baseline scores of the same variables. We also found that many trajectories are not only strongly influenced by the initial status of the participants, but also by the intervention performed, as attested to by the significant interactions found. These results stress the need to continue doing research in a way that considers the diversity of participants’ trajectories, increasing the room for intervention improvements aligned with a more personalized health care model.

Dispositional Mindfulness May Have Protected Athletes from Psychological Distress During COVID-19 in Australia.

Promoting athlete wellbeing has become a priority in elite sport, and the COVID-19 pandemic has accentuated the need for a comprehensive understanding of risk and protective factors. Existing sport research has not yet considered whether specific cognitive factors such as dispositional mindfulness and executive function may protect athletes against psychological distress. In a sample of high-performance Australian football athletes (n = 27), we administered measures of dispositional mindfulness (MAAS), executive function (AOSPAN; eStroop), and psychological distress (APSQ) at pre-season, coinciding with the initial (2020) COVID-19-related sport shutdown in Australia. Measures of executive function and psychological distress were re-administered at the end of the COVID-19 affected competitive season in 2020. Athletes reported significantly elevated psychological distress relative to previous estimates of distress among high-performance athletes established in prior studies. Executive functions, including working memory and inhibitory control were not significantly associated with psychological distress or dispositional mindfulness at either timepoint. However, baseline mindfulness was associated with reduced distress at both pre-season (r = −0.48, p = .03) and end of season (r = −0.56, p = .004), suggesting that dispositional mindfulness may have afforded protective buffering against symptoms of distress. Correlation data alone does not establish a directional connection from mindfulness to reduced distress, and future research is required to elucidate this association and/or establish the mechanism/s by which dispositional mindfulness may protect against psychological distress in this population.

The Effect of Baseline Patient and Caregiver Mindfulness on Dementia Outcomes.

Mindfulness is the practice of awareness and living in the present moment without judgment. Mindfulness-based interventions may improve dementia-related outcomes. Before initiating interventions, it would be beneficial to measure baseline mindfulness to understand targets for therapy and its influence on dementia outcomes. This cross-sectional study examined patient and caregiver mindfulness with patient and caregiver rating scales and patient cognitive performance and determined whether dyadic pairing of mindfulness influences patient outcomes. Individuals (N = 291) underwent comprehensive evaluations, with baseline mindfulness assessed using the 15-item Applied Mindfulness Process Scale (AMPS). Correlation, regression, and mediation models tested relationships between patient and caregiver mindfulness and outcomes. Patients had a mean AMPS score of 38.0±11.9 and caregivers had a mean AMPS score of 38.9±11.5. Patient mindfulness correlated with activities of daily living, behavior and mood, health-related quality of life, subjective cognitive complaints, and performance on episodic memory and attention tasks. Caregiver mindfulness correlated with preparedness, care confidence, depression, and better patient cognitive performance. Patients in dyads with higher mindfulness had better cognitive performance, less subjective complaints, and higher health-related quality of life (all p-values<0.001). Mindfulness effects on cognition were mediated by physical activity, social engagement, frailty, and vascular risk factors. Higher baseline mindfulness was associated with better patient and caregiver outcomes, particularly when both patients and caregivers had high baseline mindfulness. Understanding the baseline influence of mindfulness on the completion of rating scales and neuropsychological test performance can help develop targeted interventions to improve well-being in patients and their caregivers.

An Exploratory Study on the Relations Between Mindfulness and Mindfulness-Based Intervention Outcomes

We explored whether baseline individual differences in mindfulness related to changes in mindfulness and emotional outcomes, following a mindfulness-based intervention (MBI). Self-reported and behavioral mindfulness, as measured with a breath counting tool, and self-reported emotional outcomes were assessed in fifty community participants, previous to being randomly allocated to a group MBI (or to a waiting list control condition). At post-intervention, participants initially allocated in the control condition started group MBI training and a 3-month follow-up was available for the full sample. MBI increased self-reported and behavioral mindfulness both from pre- to post-intervention (p < .001, d ranging from 1.16 to 2.11) and from pre-intervention to follow-up (p < .001, d ranging from 0.97 to − 1.87), as well as reduced distress and perseverative thinking, and increased well-being (p < .001, d ranging from 2.16 to 2.22 and from 2.12 to 2.43, from pre- to post-intervention and to follow-up, respectively). Lower baseline mindfulness was associated with higher increase in mindfulness indexes following MBI (p < .001), while baseline mindfulness measures did not predict emotional outcomes neither at post-intervention nor at follow-up. Higher baseline psychological distress and perseverative thinking and lower psychological well-being were related, respectively, to greater reductions in emotional symptoms and a higher increase in well-being. Although participants with lower baseline mindfulness showed greater increase in mindfulness than their higher counterparts, the more the emotional symptoms and the lower the well-being at pre-intervention, the more benefit could be gained from an MBI irrespective of baseline mindfulness.

Associations Between Gender, Resiliency Factors, and Anxiety in Neuro-ICU Caregivers: a Prospective Study.

Informal caregivers of patients admitted to the neuroscience intensive care unit (Neuro-ICU) are at risk for developing chronic anxiety. Resiliency factors may reduce risk, yet their differential effects for female and male caregivers have not been studied in this population. We aim to examine interactions between gender and baseline resiliency factors and anxiety at baseline, 3months, and 6months. Prospectively studied caregivers (N = 96) of patients admitted to the Neuro-ICU completed baseline sociodemographics and resiliency measures (coping, mindfulness, self-efficacy, intimate care, and caregiver preparedness), and anxiety severity at baseline (hospitalization), 3months, and 6months. Baseline anxiety predicted future anxiety (3 and 6months). Caregivers who reported high (versus low) baseline coping, mindfulness, self-efficacy, and preparedness for caregiving reported lower baseline anxiety (ps ≤ 0.012). An interaction between caregiver gender and baseline mindfulness was seen at 3months (p = 0.021), with high mindfulness males reporting lower anxiety than high mindfulness females, and low mindfulness males reporting higher anxiety than low mindfulness females. Results emphasize the protective role of resilience in the trajectory of anxiety among informal caregivers. Findings emphasize the need to rapidly deploy skills-based treatment to Neuro-ICU caregivers to prevent future development and maintenance of anxiety, specifically emphasizing mindfulness in male caregivers.

The Impact of Resilience Factors and Anxiety During Hospital Admission on Longitudinal Anxiety Among Dyads of Neurocritical Care Patients Without Major Cognitive Impairment and Their Family Caregivers.

Anxiety is common in patients experiencing neurocritical illness and their family caregivers. Resilience factors like mindfulness and coping skills may be protective against symptoms of emotional distress, including anxiety. Less is known about the interplay of anxiety symptoms and resilience factors between patients and caregivers. The purpose of this study is to examine the trajectory of anxiety symptoms among dyads of neurocritical care patients without major cognitive impairment and their family caregivers and to elucidate the relationship between resiliency (e.g., mindfulness and coping) and anxiety in these dyads. Prospective, longitudinal study of adults admitted to the neurological intensive care unit (Neuro-ICU) and their caregivers. Dyads of patients (N = 102) and family caregivers (N = 103) completed self-report measures of mindfulness (Cognitive Affective Mindfulness Scale-Revised) and coping (Measure of Current Status-Part A) during Neuro-ICU hospitalization and anxiety symptoms (anxiety subscale of the Hospital Anxiety and Depression Scale) during hospitalization and at 3- and 6-month follow-up. We used actor-partner interdependence modeling to predict the effect of one's own baseline characteristics on one's own and one's partner's future anxiety symptoms. Rates of clinically significant anxiety symptoms were 40% for patients and 42% for caregivers at baseline. Of these, 20% of patients and 23% of caregivers showed moderate and severe symptoms. Approximately, one-third of patients and caregivers reported clinically significant anxiety symptoms at 3- and 6-month follow-ups, with more than 20% endorsing moderate or severe symptoms. Patients' own baseline mindfulness, coping, and anxiety symptoms were associated with lower anxiety symptoms at all time points (ps < 0.001)-this was also true for caregivers. For both patients and caregivers, one's own baseline mindfulness predicted their partner's anxiety symptoms 3months later (p = 0.008), but not at 6-month follow-up. Anxiety symptoms in Neuro-ICU patient-caregiver dyads are high through 6months following admission. Mindfulness is interdependent and protective against anxiety in dyads at 3-month but not 6-month follow-up. Early, dyad-based interventions may prevent the development of chronic anxiety in patients without major cognitive impairment and caregivers.

Mindfulness as a predictor of cognitive-behavioral therapy outcomes in inner-city adults with posttraumatic stress and substance dependence

The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is highly prevalent and difficult-to-treat. Mindfulness, defined as nonjudgmental attention to and awareness of present-moment experiences, represents a targetable mechanism with potential to predict and improve treatment outcomes for PTSD/SUD populations. We hypothesized that greater self-reported mindfulness at baseline (pre-treatment) would predict (a) lower end-of-treatment PTSD severity and (b) greater longest sustained abstinence during a 12-week cognitive-behavioral treatment program. Participants included 53 inner-city adults meeting at least four current symptoms of DSM-5 PTSD and current (DSM-IV) substance dependence (51% women; 75.5% African American; Mage = 45.42, SD = 9.99). Hierarchical regression analysis results indicated that higher levels of baseline mindfulness predicted lower end-of-treatment PTSD severity but not longest sustained abstinence from the primary substance of choice. Post hoc exploration of end-of-treatment PTSD symptom clusters indicated that higher baseline mindfulness predicted lower intrusion, negative alterations in cognitions and mood, and arousal and reactivity symptoms but not avoidance symptoms. Clinical and research implications are discussed.

Baseline resilience and depression symptoms predict trajectory of depression in dyads of patients and their informal caregivers following discharge from the Neuro-ICU

ObjectiveTo explore the impact of resiliency factors on the longitudinal trajectory of depressive symptoms in patients admitted to the Neuroscience Intensive Care Unit (Neuro-ICU) and their family caregivers. Materials and methodsPatients (N = 102) and family caregivers (N = 103) completed self-report assessments of depressive symptoms (depression subscale of the Hospital Anxiety and Depression Scale; HADS-D) and resiliency factors (i.e., mindfulness and coping) during Neuro-ICU hospitalization. The HADS-D was administered again at 3 and 6 months after discharge. The Actor-Partner Interdependence Model (APIM) was used to assess patient-caregiver interdependence. ResultsBaseline rates of clinically significant depressive symptoms were high among patients (23%) and caregivers (19%), and remained elevated through 6-months. Higher depressive symptoms predicted higher levels of symptoms at the subsequent timepoint (ps < 0.05). Higher baseline mindfulness and coping were associated with lower levels of depressive symptoms at all timepoints (ps < 0.001). APIM analysis showed that one's own higher baseline mindfulness was associated with concurrent levels of depressive symptoms in a partner (p < 0.05). ConclusionsDepressive symptoms in Neuro-ICU patient-caregiver dyads are high through 6 months. Mindfulness is protective against depressive symptoms and interdependent between patients and caregivers. Early, dyadic, mindfulness-based interventions may prevent the development of chronic depression in both patients and caregivers.

Baseline Resilience and Posttraumatic Symptoms in Dyads of Neurocritical Patients and Their Informal Caregivers: A Prospective Dyadic Analysis

Admission to a neuroscience intensive care unit (Neuro-ICU) is sudden and often traumatic for both patients and their informal caregivers. No prior studies have assessed prospectively risk and resiliency factors for chronic posttraumatic symptoms, as well as the potential interdependence between patients' and caregivers' symptoms over time. To analyze the impact of baseline resiliency factors on symptoms of posttraumatic stress (PTS) longitudinally in dyads of patients admitted to the Neuro-ICU and their primary family caregivers. We recruited dyads (M= 108) of patients admitted to the Neuro-ICU (total N=102) and their family caregivers (total N=103). Dyads completed self-report assessments of PTS and resiliency factors (mindfulness and coping) at baseline in the Neuro-ICU. PTS was measured again at 3- and 6-month follow-up. Clinically significant PTS symptoms were high at baseline in both patients (20%) and caregivers (16%) and remained high through 6 months (25% in patients; 14% in caregivers). Actor-partner interdependence modeling demonstrated that severity of PTS symptoms was predictive of PTS symptoms at subsequent time points (P<0.001). High baseline mindfulness and coping predicted less severe PTS symptoms in patients and caregivers (P<0.001) at all time points. Own degree of PTS symptoms at 3 months predicted worse PTS symptoms in one's partner at 6 months, for both patients and caregivers (P= 0.02). Findings highlight the need to prioritize assessment and treatment of PTS in Neuro-ICU patients and their informal caregivers through a dyadic approach.

The Association Between Mindfulness and Postoperative Pain: A Prospective Cohort Study of Gynecologic Oncology Patients Undergoing Minimally Invasive Hysterectomy

To describe the association between preoperative dispositional mindfulness (the personality trait of being mindful) and postoperative pain in gynecologic oncology patients undergoing minimally invasive hysterectomy. Prospective cohort study. University-affiliated teaching hospital. Gynecologic oncology patients (n = 126) planning minimally invasive hysterectomy. Minimally invasive hysterectomy. Baseline mindfulness was assessed at the preoperative visit using the Five Facet Mindfulness Questionnaire (FFMQ). Postoperative pain and opioid usage were evaluated via chart review and surveys at postoperative visits at 1 to 2 weeks and 4 to 6 weeks. Higher baseline mindfulness was correlated with lower postoperative pain as measured by both the average and highest numeric pain scores during the inpatient stay (r = -.23, p = .020; r = -.21, p = .034). At the initial postoperative visit, pain score was also inversely correlated with preoperative mindfulness score (r = -.26, p = .008). This relationship was not observed at the final postoperative visit (r = -.08, p = .406). Pre-operative mindfulness and opioid usage were also inversely associated, though this relationship did not reach statistical significance (r = -.18, p = .066). Mindfulness was previously shown to be a promising intervention for chronic pain treatment. Our study demonstrates that higher preoperative dispositional mindfulness is associated with more favorable postoperative pain outcomes, including lower pain scores but not lower opioid consumption. This relationship provides an opportunity to target the modifiable personality characteristic of mindfulness, to reduce postoperative pain in patients following gynecologic surgery.

The Role of Mindfulness in Reactivity to Daily Stress in Urban Firefighters

The purpose of this study was to test the hypotheses that mindfulness would be related to reduced reactivity to daily stress in urban firefighters. Participants were 78 members from an urban fire department who completed an initial questionnaire and a 21-day daily diary. Mindfulness was assessed at baseline using the Mindful Attention and Awareness Scale. The daily diary included measures of stress (total stress, work stress, partner stress) and measures of negative affect, positive affect, and loneliness. Multilevel analyses adjusting for the dependent variable on the previous day were used to test the hypotheses. Higher daily total, partner, and work stress were associated with increased negative affect. Higher daily, total, and partner stress were associated with increased loneliness and decreased positive affect. Mindfulness appeared to buffer against stress reactivity as higher baseline mindfulness was related to (a) less negative affect on days of greater total stress, (b) more positive affect on days of greater total, work, and partner stress, and (c) less loneliness on days of greater total, work, and partner stress. Mindfulness may improve the health and wellbeing of urban firefighters by reducing reactivity to daily stress, especially in relation to positive affect and loneliness. Future research should determine whether mindfulness-based interventions may be enhanced by focusing more closely on reducing reactivity to stress, especially in fire service populations.

Which aspects of mindfulness are important to include in adolescent interventions?

Despite widespread enthusiasm to adopt universal mindfulness-based interventions (MBIs) for youth, high-quality evidence is still lacking. It remains unknown how best to modify the successful adult curricula to render them accessible for young people but still effective. Specifically, it is unclear whether particular elements of mindfulness are key ingredients. The aim of this research was to identify the relation between aspects of baseline mindfulness and longitudinal trajectories related to well-being in adolescence. We examined associations between eight aspects of mindfulness at baseline and longitudinal trajectories of depression, anxiety, well-being, weight concern and shape concern over a 12-month period in early adolescents (N = 499; 46% female; Mage at baseline 13.45 years; SD = .33). We found a transdiagnostic protective effect for those high in Accepting and Nonjudgmental Orientation, Decentering and Nonreactivity and Acting with Awareness, with effect sizes across the variables ranging from small to large (Cohen's d = .29-1.26) although this benefit reduced over time, especially for weight and shape concerns in girls. This natural but waning protective effect strengthens the case for MBIs in youth. The isolation of three key elements is an important preliminary step in identifying ways to improve the effectiveness of current adolescent curricula. Of the three, the current study suggests that teaching young adolescents to respond to their mistakes with kindness and non-judgement should be a prime focus.

The many facets of mindfulness and the prediction of change following mindfulness-based stress reduction (MBSR).

Mindfulness-based stress reduction (MBSR) promotes numerous psychological benefits, but few studies have identified for whom MBSR is most effective. The current study tested the hypothesis that lower baseline mindfulness invites more "room to grow" and, thus, predicts greater improvement during MBSR. We examined three facets of mindfulness (awareness, acceptance, decentering) among 131 MBSR participants prior to enrollment, to test the hypothesis that lower baseline mindfulness predicts greater improvements in perceived stress, positive affect (PA), and negative affect (NA) following MBSR. Lower acceptance and decentering predicted greater decreases in perceived stress. Higher awareness, acceptance, and decentering predicted greater increases in PA. Higher awareness predicted greater reductions in NA. Lower decentering predicted greater reductions in NA. Findings partly supported the hypothesis that lower baseline mindfulness predicts greater improvement following MBSR and emphasize the importance of assessing multiple mindfulness facets given their unique, contrasting relations to outcomes.

The association between mindfulness and post-operative pain in gynecologic oncology patients undergoing minimally invasive hysterectomy.

10079 Background: Studies demonstrate an inverse relationship between mindfulness and chronic pain. However, the relationship between mindfulness and acute post-operative pain has not yet been thoroughly investigated. The objective of this study is to determine if there is an association between pre-operative level of mindfulness and post-operative pain outcomes in women undergoing minimally invasive hysterectomy. Methods: For this prospective cohort study, women planning to undergo laparoscopic or robotic hysterectomy were prospectively recruited at the gynecologic oncology outpatient clinic at our institution. Baseline mindfulness was assessed at the pre-operative clinic visit using the Five Facet Mindfulness Questionnaire (FFMQ). Post-operative pain, using the Visual Numeric Rating Scale (VNRS-11), and opiate pain medication usage were evaluated via chart review and post-operative surveys completed at 1 to 2 week and 4 to 6 week post-operative clinic visits. Results: One hundred twenty four women completed the 6 week post-operative follow-up period, of which 80% were undergoing surgery for malignancy. Baseline mindfulness was inversely correlated with post-operative pain as measured by both the average and highest reported VNRS-11 values during the inpatient stay (r = -0.21, p = 0.019; r = -0.21, p = 0.016). At the 1 to 2 week post-operative visit, self-reported pain score was also inversely correlated with pre-operative mindfulness score (r = -0.24, p = 0.009). This relationship was not observed at the 4 to 6 week post-operative visit (r = -0.08, p = 0.403). Higher pre-operative mindfulness was also associated with lower opiate usage (r = -0.16, p = 0.077), though this relationship was not statistically significant. Conclusions: Higher pre-operative mindfulness is associated with more favorable post-operative pain outcomes, including lower reported numeric pain scores, in gynecologic oncology patients undergoing minimally invasive hysterectomy. This relationship provides an opportunity to target the modifiable personality characteristic of mindfulness, to improve post-operative pain in women planning gynecologic surgery.

Mindfulness Is Associated With Treatment Response From Nonpharmacologic Exercise Interventions in Knee Osteoarthritis

ObjectiveTo examine the association between baseline mindfulness and response from exercise interventions in knee osteoarthritis (OA). DesignCohort study; responder analysis of a clinical trial subset. SettingUrban tertiary care academic hospital. ParticipantsParticipants with symptomatic, radiographic knee OA (N=86; mean age, 60y; 74% female; 48% white). InterventionsTwelve weeks (twice per week) of Tai Chi or physical therapy exercise. Main Outcome MeasuresTreatment response was defined using Osteoarthritis Research Society International criteria indicating meaningful improvements in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, WOMAC function, or Patient Global Assessment scores. At baseline, participants completed the Five Facet Mindfulness Questionnaire (mean total score, 142±17) and were grouped into 3 categories of total mindfulness: higher, medium, or lower. Relative risk (RR) ratios were used to compare treatment response across groups. ResultsParticipants with higher total mindfulness were 38% (95% confidence interval [CI], 1.05–1.83) more likely to meet responder criteria than those with lower mindfulness. We found no significant difference between medium and lower mindfulness groups (RR=1.0; 95% CI, 0.69–1.44). Among the 5 mindfulness facets, medium acting-with-awareness was 46% (95% CI, 1.09–1.96) more likely to respond than lower acting-with-awareness, and higher acting-with-awareness was 34% more likely to respond, but this did not reach significance (95% CI, 0.97–1.86). ConclusionsIn this study, higher mindfulness, primarily driven by its acting-with-awareness facet, was significantly associated with a greater likelihood of response to nonpharmacologic exercise interventions in knee OA. This suggests that mindfulness-cultivating interventions may increase the likelihood of response from exercise.