Use Of Mindfulness-based Interventions Research Articles

A Systematic Review and Meta-analysis of the Impact of Mindfulness-Based Interventions on the Well-Being of Healthcare Professionals

Efforts to improve the wellbeing of healthcare professionals include mindfulness-based interventions (MBIs). To understand the value of such initiatives, we conducted a systematic review and meta-analysis of empirical studies pertaining to the use of MBIs with healthcare professionals. Databases were reviewed from the start of records to January 2016 (PROSPERO registration number: CRD42016032899). Eligibility criteria included empirical analyses of wellbeing outcomes acquired in relation to MBIs. Forty-two papers met the eligibility criteria, consisting of a total of 2,101 participants. Studies were examined for two broad classes of wellbeing outcomes: (a) “negative” mental health measures such as anxiety, depression, and stress; (b) “positive” indices of wellbeing, such as life satisfaction, together with outcomes associated with wellbeing, such as emotional intelligence. MBIs were generally associated with positive outcomes in relation to most measures, and mindfulness does appear to improve the wellbeing of healthcare professionals. However, the quality of the studies was inconsistent, so further research is needed, particularly high-quality randomised control trials.

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications.

Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.

Mindfulness-based interventions for youth in the criminal justice system: a review of the research-based literature

Mindfulness is a technique and sense of being present in the moment that incorporates aspects of acceptance, openness and meditation with the ultimate intention of improving well-being. Research indicates that mindfulness can significantly improve negative personality traits, reduce stress, increase attention, alleviate chronic pain and enhance mental health. Mindfulness-based interventions in correctional facilities have resulted in reduced hostility and improved self-esteem for adults, but less is known about its applicability amongst youth. This article reviews the research-based literature on the use of mindfulness-based interventions for youths (aged 13 to 24 years) involved in the justice system. A total of ten studies were located and synthesised into four themes of stress reduction, self-regulation, anger management and acceptance. The article concludes by considering the methodological rigour of the reviewed studies, providing recommendations for future research and contemplating the positive impact that mindfulness interventions might have on youth in the criminal justice system.

Trial Protocol: The use of mindfulness-based intervention for improving bracing compliance for adolescent idiopathic scoliosis patients: protocol for a randomised, controlled trial

Adolescent idiopathic scoliosis (AIS) is the most prevalent deforming orthopaedic condition; it causes significant disability when spinal curves progress beyond 45deg. Bracing is the primary treatment prescribed for adolescents with an immature skeleton who have spinal curves between 25 and 45deg. New evidence suggests that compliance with bracing significantly decreases the progression of high-risk curves to the threshold for surgery. Nonetheless, bracing is a stressful experience. Therefore, interventions that mediate health-related quality of life for AIS patients are of great interest. In the past few decades, numerous studies have documented the benefits of mindfulness training on chronic pain, stress management, anxiety and emotional disorders. Mindfulness might additionally provide AIS patients with psychosocial support. This study will investigate the effects of a mindfulness-based intervention on bracing compliance and quality of life among AIS patients with poor bracing compliance. The study also plans to evaluate if the mindfulness-based intervention effect is sustained after the intervention period. The potential mechanism by which mindfulness affects bracing compliance will be explored. Single-blind, two-arm, randomised, controlled trial. The study will recruit 120 AIS patients aged between 10 and 15 years with non-satisfactory bracing compliance. Patients who have previously practised or are currently practising meditation or mindful yoga or who cannot finish the whole intervention will be excluded. The study will take place at the Jockey Club School of Public Health and Primary Care building. Patients in the mindfulness-based intervention group will join weekly sessions for 8 weeks. This program is a short version of a mindfulness-based stress relaxation program to address the specific issues of AIS patients. Two to three experienced instructors will deliver the program. Control group patients will participate in an 8-week physiotherapy exercise program as recommended in the International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2011 guideline. The primary outcome is the 6-month post-intervention total score of bracing compliance. Secondary measures are non-bracing-specific quality of life, bracing-specific quality of life, self-compassion, emotional regulation, mindful awareness and acceptance, self-efficacy, perception of stress, and general measure of health outcome. 120 participants will be assigned to either an intervention or control arm by simple randomisation, and the randomisation result will only be revealed once participants have confirmed availability to attend intervention classes. Clinicians of the scoliosis clinic and research staff will be blinded to the treatment allocation. ANCOVA will be conducted to compare the effect of mindfulness-based intervention versus physiotherapy exercise on the outcome measures. To investigate significant change over time, linear mixed models analyses will be conducted following the intention-to-treat principle. The R-package lavaan will be used to conduct structural equation modelling to study the potential mechanism of mindfulness. This will be the first psychosocial intervention study conducted on braced AIS patients with the aim of improving patients' bracing compliance and quality of life. The results from this study will potentially carry significant impact on future AIS treatment by emphasising psychosocial care for braced AIS patients.

Mindfulness and Self-Compassion Based Interventions for Substance Use Disorders: A Literature Review

This literature review examines eight peer reviewed studies reporting on the efficacy of mindfulness-based and self-compassion-based interventions for adults diagnosed with substance use disorders. Prevalence of substance use disorders is provided, and relevant definitions are discussed. The syndrome model of addiction is advanced as an etiological explanation, and the search methodology described. Results of this literature review support mindfulness training as an effective intervention for substance use disorders. Only one study supporting self-compassion as an effective intervention for substance use disorders was reviewed so it is not possible at this time to make a judgment regarding the efficacy of that intervention. Limitations of this body of literature include attrition, unmatched treatment conditions, and lack of fidelity measures. Recommendations include more self-compassion research, more use of fidelity scales in intervention research, and greater use of mindfulness-based interventions in substance use disorder treatment.

Mindfulness – seeping through the cracks in the American context of teacher education

ABSTRACTIn the context of the United States, we provide our rationale for infusing mindfulness-based interventions (MBIs) into a graduate-level teacher education course. In our philosophy and pedagogical approach we attempt to counterbalance an individualistic, divisive, oppressive, and often dehumanising nature of education. Adopting Richard Davidson’s wellness framework, we describe how our use of MBIs, including breathing meditation, heuristics, free-writing, and cogenerative dialogues, may contribute to cultivating components of integrated teacher well-being. Mindfulness is framed as a relational construct and as a part of a toolkit which educators may access in their professional and personal lives. Drawing on data obtained through an end-of-semester feedback survey, we provide a brief analysis of students’ perceptions of the value of mindfulness practices in teacher preparation and beyond.

Mindfulness interventions in medical education: A systematic review of their impact on medical student stress, depression, fatigue and burnout

Introduction: Mindfulness-based interventions (MBIs) have gained popularity in medical education. A systematic review was conducted to determine the effectiveness of MBIs for reducing psychological distress in undergraduate medical students.Methods: A search protocol was conducted using online databases Embase, PubMed, PsycINFO, and MEDLINE. Articles were required to meet the following criteria to be included: (1) describe a MBI or use of mindfulness exercises as part of an intervention, (2) include at least one of: stress, burnout, fatigue, or depression, as an outcome, (3) include quantitative outcomes, and (4) published in English in a peer-reviewed journal.Results: Twelve articles were reviewed. Seven studies reported improvements in at least one targeted outcome. Four of seven studies exploring the impact on stress reported improvements. Five articles studying depression reported reductions. One study exploring burnout reported a decrease on a single subscale. Only one study measured the impact on fatigue (no change reported). Half of studies reviewed included predominantly female samples.Conclusions: Mixed evidence was found for the use of MBIs for reducing psychological distress in undergraduate medical students. Future work should aim to clarify the impact of mindfulness on burnout and fatigue, and explore the replicability of improvements in male medical students alone.

Moment-by-Moment in Women's Recovery: Randomized controlled trial protocol to test the efficacy of a mindfulness-based intervention on treatment retention and relapse prevention among women in residential treatment for substance use disorder

Although therapeutic treatments exist for substance use disorder (SUD), about half of individuals who enter treatment leave early and relapse to substance use. Early dropout from residential treatment places individuals at risk of relapse, and women in SUD residential treatment represent a vulnerable population. Evidence gaps persist for the use of mindfulness-based interventions (MBIs) among racially and ethnically diverse women with SUDs, especially regarding the efficacy of MBIs adapted to prevent residential dropout and relapse. We previously developed and pilot tested an MBI, Moment-by-Moment in Women's Recovery (MMWR), adapted to support women with SUD during residential treatment. The 12-session MMWR program tested in the present study integrates relapse prevention, addresses literacy level and trauma experiences and mental health problems, and is relevant to issues surrounding treatment- and relapse-related stressors among women. The primary objective of the current Phase II randomized controlled trial is to adequately test the efficacy of MMWR on residential treatment retention and substance use relapse and determine psychosocial and neural mechanisms of action underlying MMWR. Participants are women in residential SUD treatment from a community-based residential site that serves mainly women who are low-income and racially and ethnically diverse. A subgroup of participants from each treatment group also completes functional and structural neuroimaging assessments before and after the intervention to explore possible structural and functional brain correlates of change associated with participation in the MMWR program. Findings are expected to inform the utility of adapting MBIs to improve treatment success among vulnerable women in SUD residential treatment.

18 Mindfulness based interventions

Niels Detert is a Clinical Neuropsychologist in the Psychological Medicine service at the John Radcliffe Hospital in Oxford. He studied Philosophy and Psychology at St Anne’s College, Oxford, and went on to complete doctoral training as a Clinical Psychologist, also in Oxford. He has special interests in using Mindfulness training with people with Neurological conditions and psychotherapy with people with Functional Neurological Symptoms. Group Mindfulness based interventions (MBIs) such as Mindfulness Based Cognitive Therapy have received increasing interest as a cost-effective long-term treatment for recurrent depression and for symptoms of depression, anxiety and stress in health conditions, and more recently as potential first-line treatments for mild-moderate depression. In depression the literature in diverse patient groups reveals superiority over wait-list and treatment as usual, and equivalence with active controls. For anxiety symptoms the outcomes are similar in the literature as a whole, although one meta-analysis with a small number of studies showed no effect in studies with a primary diagnosis of anxiety disorder. In healthcare populations the evidence supports the use of MBIs as an adjunct for alleviation of mental and physical symptoms and for prevention. Evidence in neurological populations is of outcomes broadly consistent with the rest of the literature, in MS and epilepsy, with preliminary promising results in Parkinson’s disease, traumatic brain injury, stroke and other neurological conditions. Areas of ongoing research include psychological mechanisms, neural correlates, and alternative delivery models. Areas for further research include a need for high quality studies where there is preliminary evidence, and investigation of the specific characteristics of this treatment which may guide treatment selection. Pragmatically the resource efficiency of MBIs as group interventions and their generic applicability suggests their utility in the management of larger numbers of patients with diverse physical and psychological needs. Use of an MBI as a long-term coping strategy is a relevant option in the management of patients with long-term conditions who are also suffering with stress, anxiety and depression. References . Gotink RA, Chu P, Busschbach JJV, Benson H, Fricchione GL, Hunink MGM. Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs. Plos One2015:10(4);e0124344–17. http://doi.org/10.1371/journal.pone.0124344 . Grossman P, Kappos L, Gensicke H, D’Souza M, Mohr DC, Penner IK, Steiner C. MS quality of life, depression, and fatigue improve after mindfulness training: a randomised trial. Neurology2010;75(13):1141–1149. http://doi.org/10.1212/WNL.0b013e3181f4d80d

Can Mindfulness Beat Alzheimer's Disease?

Abstract:The purpose of this paper is to identify to what extent the development of Alzheimer’s disease can be delayed or prevented by the use of mindfulness-based interventions. Alzheimer’s disease (AD) is a progressive neurodegenerative disease in which accumulation of amyloid plaques and neurofibrillary tangles (NFTs) plays an important role. This leads to neuronal cell death and synaptic degeneration, especially in the default-mode network (DMN). No current effective treatment is available. Mindfulness has been related to an increase in volume and connectivity of the exact brain areas affected in AD. Therefore, mindfulness-based interventions (MBIs), such as mindfulness-based stress reduction (MBSR), meditation and yoga have been tested in people with mild cognitive impairment (MCI). MCI is seen as a transitional state between healthy age-related cognitive decline and AD pathology, hence an open window for early intervention. In this paper it is found that mindfulness has great potential to prevent AD-related pathology of the DMN, hence decreasing cognitive decline in people with MCI.

Incorporating mindfulness in secular and spiritually oriented psychotherapy: Ethical concerns.

Mindfulness has increasingly been incorporated in psychotherapy and spiritually oriented psychotherapy. This incorporation raises important ethical concerns for both practitioners and the psychology profession. Three specific ethical questions underlying the use of mindfulness-based interventions in

Effects of Mindfulness on Diabetes Mellitus: Rationale and Overview.

a narrative review of the current and updated literature available on online database and which came up using the terms "mindfulness" and "diabetes mellitus". Mindfulness-based Interventions (MBIs) can be seen as preventive and complementary interventions in DM, particularly for the relief of symptoms related to depression and anxiety in diabetic patients and also in the management of other factors, including mindful eating, physical exercises and treatment adherence. Although many studies only present research protocols, mindfulness seems to have beneficial effects on all aspects of diabetes, including incidence, control and complications. Furthermore, longer term and more carefully controlled trials are necessary in order to draw consistent conclusions on the beneficial role of MBIs on DM.

Mindfulness-Based CBT for Treatment of PTSD

Experiencing traumatic events may often lead individuals to post-traumatic stress disorder (PTSD). Traditional psychotherapies (e.g., CBT) and their variations have proven efficacious in their ability to target PTSD symptoms. Moreover, recent research integrating mindfulness within psychotherapeutic interventions has shown promising results. This paper briefly highlights the importance and use of mindfulness-based interventions in treating PTSD and trauma-related symptoms.

What and who? Mindfulness in the mental health setting.

A strong and growing evidence base exists for the use of mindfulness-based interventions to prevent relapse in major depression and for the self-management of chronic physical health conditions (e.g. pain), but the evidence in other domains of mental health work is still emerging. Much work is being conducted outside the evidence base and standardised protocols, and by individuals with varied levels of experience and training. The (mis)perception of mindfulness as a ‘simple technique’ belies the complexity and skill needed to deliver a mindfulness training that has real therapeutic and transformative power. We propose a framework to help clinicians think through the suitability of mindfulness for their particular client group with the intention of providing guidance for thoughtful decision-making.

EFFECTS OF MINDFULNESS‐BASED INTERVENTIONS ON DISRUPTIVE BEHAVIOR: A META‐ANALYSIS OF SINGLE‐CASE RESEARCH

The popularity of mindfulness‐based interventions (MBIs) is growing rapidly in schools. Decisions regarding the use of these interventions must be based on empirical evidence. There is robust evidence for the use of MBIs with adults, but research on MBIs with youth is nascent. The purpose of this meta‐analytic review was to add to the literature by synthesizing single‐case research on MBIs with children and adolescents. Specifically, the effect of MBIs on youths’ disruptive behavior was examined in 10 studies published between 2006 and 2014. Results indicated that, on average, MBIs had a medium effect on disruptive behavior during treatment, g = 1.04, 95% confidence interval (CI) [0.30–1.78]; TauU = 0.59, 95% CI [0.40–0.77]. The average effect of MBIs during maintenance phases was larger, g = 1.41, 95% CI [0.55–2.28]; TauU = 0.71, 95% CI [0.59–0.83]. Potential moderators of intervention effects were also explored. Implications for future research and practice regarding MBIs with youth and in schools are discussed.

Effects of Mindfulness-Based Interventions in High School and College Athletes for Reducing Stress and Injury, and Improving Quality of Life.

Does the use of mindfulness-based interventions for student-athletes aged 13-24 years reduce stress and injury as well as improve overall quality of life? The literature was searched for studies that investigated the use of mindfulness-based strategies for student-athletes specifically for reducing stress and injury and/or improving quality of life. The literature search returned 8 possible studies related to the clinical question and 3 studies met the inclusion criteria (1 randomized control trial, 2 nonrandomized control cohort studies). All 3 included studies demonstrated overall improved levels of mindfulness among student-athletes after the use of a mindfulness-based intervention. Mindfulness-based interventions had positive effects for reducing negative thoughts and levels of perceived stress. The number of injury occurrences were found to decrease following the integration of a mindfulness-based intervention within an athletic population. Clinical Bottom Line: There is sufficient evidence supporting the use of mindfulness-based interventions with student-athletes for increasing mindfulness, managing negative emotions and perceived stress, as well as improving overall well-being. There is also current literature that advocates the use of mindfulness-based interventions for reducing injury, but further research is needed for support. Strength of Recommendation: Grade B evidence exists to support that the use of mindfulness-based interventions for student-athletes will reduce stress and improve overall well-being as well as support the possibility that if a student-athlete is more mindful, it may help decrease risk of injury incurred if the student-athlete is under mental stress.

Pilot Study of a Mindfulness-Based Group Intervention for Individuals with Parkinson’s Disease and Their Caregivers

This pilot study assessed the feasibility and impact of an 8-week mindfulness-based group intervention on cognitive and emotional functioning for individuals with Parkinson’s disease (PD) and their caregivers. Twenty-five percent of those initially recruited dropped out before completing the study. The final sample (N = 39; 29 patients/10 caregivers) was 53.8 % male, 89.7 % Caucasian, with a mean level of education of 16.77 years (SD = 2.51), and ranged in age from 50 to 82 (M = 65.64, SD = 7.62). Mindfulness levels significantly increased for all participants from pre- to immediate-post. A significant improvement was seen for self-reported symptoms of depression and self-reported language functioning. Patient participants uniquely showed significant improvement on mental flexibility and complex attention tasks and reported significantly fewer emotional and cognitive symptoms associated with PD. Participant compliance with assigned home mindfulness practice was measured with homework tracking logs, and participants reported an average of 20 min/day, 6 days/week. Participants attended an average of six classes. Homework compliance significantly correlated with improvement in mindfulness levels, apathy and anxiety symptoms, and on working memory and mental flexibility tasks. Better class attendance was also associated with increased mindfulness and reduced apathy symptoms. Increased mindfulness was related to fewer symptoms of apathy and anxiety and better PD-related quality of life. These results show promise for the use of mindfulness-based interventions to improve emotional and cognitive functioning in individuals with PD and their caregivers and suggest that efforts to increase participant retention and encourage homework compliance and class attendance are important for optimizing outcomes in future trials.

Mindfulness-Based Interventions for Older Adults: A Review of the Effects on Physical and Emotional Well-being.

This comprehensive review examined the effects of mindfulness-based interventions on the physical and emotional wellbeing of older adults, a rapidly growing segment of the general population. Search procedures yielded 15 treatment outcome studies meeting inclusion criteria. Support was found for the feasibility and acceptability of mindfulness-based interventions with older adults. Physical and emotional wellbeing outcome variables offered mixed support for the use of mindfulness-based interventions with older adults. Potential explanations of mixed findings may include methodological flaws, study limitations, and inconsistent modifications of protocols. These are discussed in detail and future avenues of research are discussed, emphasizing the need to incorporate geriatric populations into future mindfulness-based empirical research.

A Systematic Review of Mindfulness-Based Interventions for Youth in School Settings

There is a growing interest in the use of mindfulness-based interventions (MBI) on youth, which has recently expanded to include the study of students in school settings. This article systematically reviewed the existing literature of applied studies using MBI with students in school settings in order to identify limitations in the scientific literature and inform future research directions. Twenty-eight studies were selected for review and were coded across multiple domains, including methodologies employed, student characteristics, intervention characteristics, and outcome variables. Results quantitatively summarized the coded variables, and strengths and limitations in the literature were subsequently identified. We conclude with specific recommendations for future interventions scientists wishing to study the utility of MBI in school settings.

Research Findings Using Mindfulness-Based Interventions for Chronic Pain

Chronic pain is a complex condition that is very detrimental to physical and psychological wellbeing. It carries a significant level of disability and economic burden. Pain patients frequently experience comorbid mental illness (e.g. depression, anxiety, PTSD, insomnia) and often require psychotherapeutic interventions in addition to medication management. Mindfulness-based interventions (MBIs) have emerged as a means to treat several chronic conditions (e.g. chronic pain, depression, anxiety, substance abuse, stress, insomnia). The objective of this review is to evaluate the current research on the use of MBIs in chronic pain managment. Although there are several controlled trials on the use of MBIs in chronic pain management, only a few studies were found that demonstrated significant effects on pain intensity, quality of life, as well as physical and psychological functioning. Therefore, the current evidence is mixed and there are insufficient data to definitively confirm the full impact of the use of MBIs in chronic pain conditions such as fibromyalgia, chronic low back pain, rheumatoid arthritis, and chronic musculoskeletal pain. The lack of compelling evidence at this time signals a demand for higher quality investigations in this area. Research examining MBIs and concomitant CBT may be of great value in order to synergize and strengthen patient outcomes.