The effects of mindfulness-based interventions for health and social care undergraduate students – a systematic review of the literature

Health and social care undergraduate students experience stress due to high workloads and pressure to perform. Consequences include depression and burnout. Mindfulness may be a suitable way to reduce stress in health and social care degree courses. The objective of this systematic review is to identify and critically appraise the literature on the effects of Mindfulness-Based Interventions for health and social care undergraduate students. PubMed, EMBASE, Psych Info, CINAHL, The Cochrane Library and Academic Search Complete were searched from inception to 21st November 2016. Studies that delivered Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, or an intervention modelled closely on these, to health or social care undergraduate students were included. Eleven studies, representing medicine, nursing and psychology students met the inclusion criteria. The most commonly used measurement tools were; the Five Facet Mindfulness Questionnaire and the General Health Questionnaire. Short term benefits relating to stress and mood were reported, despite all but one study condensing the curriculum. Gender and personality emerged as factors likely to affect intervention results. Further research with long-term follow-up is required to definitively conclude that mindfulness is an appropriate intervention to mentally prepare health and social care undergraduate students for their future careers.     

What outcomes have mindfulness and meditation interventions for managers and leaders achieved? A systematic review

No systematic review had previously been conducted examining the benefits mindfulness or meditation interventions for leaders and managers. However, the literature suggested that such interventions would have a positive impact on leaders’ own well-being, their leadership capability, their “post-conventional” leadership capacity, and their direct reports. The purpose of this study was therefore to systematically review research on mindfulness or meditation interventions for managers and leaders. Our review identified 19 studies that met the inclusion criteria. Findings indicate some encouraging signs that mindfulness and meditation interventions may improve aspects of leaders’/managers’ well-being and resilience, and leadership capability, possibly including their “post-conventional” leadership, but research results are very variable in quality and strength, and there was no evidence on benefits for participants’ direct reports. The studies reviewed explored a diversity of interventions, but provided little insight into which mindfulness and meditation interventions for managers and leaders are most effective, in what context they are best applied, or for whom they are most suitable. While the sub-set of studies that measured mindfulness found that the interventions used did increase participants’ mindfulness, there was no exploration of whether improved mindfulness was the mechanism by which other positive outcomes were achieved.     

Do logistic regression and signal detection identify different subgroups at risk? Implications for the design of tailored interventions

Identifying subgroups of high-risk individuals can lead to the development of tailored interventions for those subgroups. This study compared two multivariate statistical methods (logistic regression and signal detection) and evaluated their ability to identify subgroups at risk. The methods identified similar risk predictors and had similar predictive accuracy in exploratory and validation samples. However, the 2 methods did not classify individuals into the same subgroups. Within subgroups, logistic regression identified individuals that were homogeneous in outcome but heterogeneous in risk predictors. In contrast, signal detection identified individuals that were homogeneous in both outcome and risk predictors. Because of the ability to identify homogeneous subgroups, signal detection may be more useful than logistic regression for designing distinct tailored interventions for subgroups of high-risk individuals.     

Designing road safety interventions for young drivers – The power of peer influence

Peer passengers are associated with risky driving behaviour and increased collision rate in young drivers, but the mechanism by which young drivers are influenced by their peers is not well understood. Here we report two studies that explore the effect of peer influence on young drivers. The first explored the relationship between susceptibility to peer influence and young drivers’ engagement in risky driving behaviour. 163 young drivers completed self-report measures of risky driving behaviour and susceptibility to different forms of peer influence. Results showed that young drivers who were influenced by their peers to attain social prestige and through peers intervening in their decisions committed more driving violations. The second study sought to utilise the susceptibility of young drivers to peer influence by using peers to design and deliver a safety intervention, following the ‘U in the Driver Seat’ model from the US. When compared to a traditional fear appeal and a control, the peer intervention group reported safer attitudes and intentions to drive safely at follow-up. Together these studies provide insight into how peers influence young drivers’ risky behaviour, and support the notion of using peer education tools in young driver safety interventions.     

The perceived effectiveness of road safety interventions: Regulation of drivers’ behavioral intentions and self-consciousness

We consider road safety interventions to be potential sources of social influence, altering the intentions and behaviors of drivers when they are perceived by the latter as effective. We also consider that perceiving their effectiveness depends on drivers’ self-consciousness. 852 drivers replied to a questionnaire measuring dispositional self-consciousness, the perception of the effectiveness of 10 road safety interventions, and reported intentions and behaviors related to speeding and drinking and driving. The results revealed several phenomena: (1) interventions were perceived as related to penalty/surveillance or social communication (factor analysis); (2) the former were perceived as more effective than the latter; (3) the perceived effectiveness of road safety interventions was moderately correlated with intentions and behaviors; (4) this link was stronger for interventions of the penalty/surveillance type; (5) age, level of education, frequency of use of a vehicle and gender were moderately associated with the perception of these interventions; (6) self-consciousness (in particular its public dimension) had an additional positive association with this perceived effectiveness. These results are discussed from a practical and methodological point of view.     

Modes of action of family interventions in depression and schizophrenia: the same or different?

The role of relatives' expressed emotion (EE) in mediating the efficacy of family interventions has been studied in randomized controlled trials (RCTs) involving people with schizophrenia and depression. Reanalysis of two RCTs (n=48) by Leff (1989) indicated that lowering relatives' EE and/or reducing social contact between the patient and family members accounted for the efficacy of the intervention for schizophrenia. However, this relationship has not been investigated previously with regard to depression, and this paper presents the results of a recent RCT which included measurement of EE and other possible mediating variables. In this study, amelioration of the critical attitude of the partner did not account for the superiority of couples therapy over antidepressant medication, since the same change occurred in the drug group. However, reducing the patient's exposure to the partner's hostility partially explained the efficacy of couples therapy. Further research on the process of change in families undergoing therapy is indicated to identify the variables that account for the efficacy of therapy.     

Should medicare reimburse providers for weight loss interventions?

This issue of the American Psychologist (April 2007) includes two reviews of the literature on the effects of behavioral programs to reduce body weight. One review (T. Mann et al., 2007) concentrates on dietary interventions and finds little evidence that diets are of benefit. The second review (L. H. Powell, J. E. Calvin III, & J. E. Calvin Jr., 2007) concentrates on multicomponent interventions and reports some significant achievements of behavioral interventions. Although the reviews come to different conclusions about the value of supporting weight loss interventions, there appears to be agreement that diet alone results in little or no long-term benefit. Evidence-based multicomponent behavioral interventions or interventions that combine behavioral with medical or surgical treatments may offer better chances of long-term weight control. Evidence-based studies are needed to inform policy on provider reimbursement for weight loss programs.     

Comparing implementation intention interventions in relation to young adults’ intake of fruit and vegetables

This study tests whether the effectiveness of implementation intention-based interventions to increase fruit and vegetable intake in a young adult population can be enhanced using additional pre-intervention instructions and alternative formats; namely, an ‘if-then’ implementation intention versus a more general, ‘global’ plan that does not explicitly link a situational cue with a goal-directed response. Participants (N?=?557) completed pre-test measures of planning, motivation and behaviour with respect to increasing their fruit and vegetable intake before being randomised to a 3 (intervention format: control vs. ‘if-then’ vs. ‘global’ implementation intentions)?×?2 (pre-intervention instruction vs. no pre-intervention instruction) between-participants design. Results revealed a significant intervention format by time interaction, such that intake significantly increased by 0.50 portions in the if-then format condition compared with 0.31 in the global format and 0.01 in the control condition. These results suggest that ‘if-then’ manipulations are superior in promoting behaviour change in an applied setting. The use of pre-intervention instructions had no additional effect on behaviour, providing evidence for the efficacy of implementation intentions even when experimenter demand is reduced. Evidence is also presented to suggest that reported increases in intake are not related to demand characteristics.     

Tables of d’ for detection and localization

A detection and localization (DAL) procedure (Hershman and Lichtenstein, 1967) is one in which at most one of k noisy observation intervals contains a signal. The observer must detect the signal (if present) and locate it in the proper interval. Tables are given for the extraction of d’ values from the percentage of correct responses made in such experiments.     

Vilification of the “batterer”: How blame shapes domestic violence policy and interventions

This article explores ways in which the vilification of the “batterer” — the popular, policy, and “scientific” legitimization of the dismissive and degrading categorization of perpetrators — has influenced research, policy, and intervention in the field of domestic violence. The historical, political, ideological, legal, and theoretical bases of this process are reviewed. Factors behind the convergence of feminist and law enforcement perspectives are discussed. Current policies and practices are described as being unnecessarily constrained and unresponsive to a wide range of families and relationships. Vilification exerts its impact on policy through a rhetoric of blame, portraying perpetrators as undeserving of a broader range of interventions and services.     

Body image and disordered eating prevention in girls’ sport: A partner-driven and stakeholder-informed scoping review of interventions

Despite the evidenced benefits of participating in organized sport, adolescent girls consistently report lower rates of sport participation, worse sport experiences, and higher dropout rates, compared to boys. Body image concerns have been linked to this gender disparity and established as a critical predictor of disordered eating, thus necessitating effective prevention efforts to mitigate the negative impacts of body image concerns and disordered eating for adolescent girls. In partnership with the National Eating Disorder Information Centre (NEDIC; Canada), the present scoping review was conducted to examine the nature and characteristics of sport-specific body image and disordered eating interventions for adolescent girls. Fourteen studies were identified through various search strategies. Over half of the studies demonstrated modest yet worthwhile effects on various body image and disordered eating outcomes. Intervention characteristics (i.e., frequency, modes of delivery, topics, material, outcomes measured) varied across initiatives. Fifty-nine national, provincial, and local sport system representatives were consulted as stakeholders and provided practical input to the results of the scoping review. Sport stakeholders favoured the delivery of a multidimensional, multicomponent program, with a combination of evidence-based techniques. This synthesis of knowledge will shape the development and dissemination of future programs, and contribute to the development of equitable sport participation opportunities for Canadian girls.     

Which psychological resilience attributes are associated with lower aspects of anxiety in boys with an autism spectrum disorder? Implications for guidance and counselling interventions

The effect of psychological resilience as a buffer against anxiety was investigated in a sample of 39 boys with high-functioning autism spectrum disorder (ASD) via individual online questionnaire responses to standardised inventories for assessing anxiety and psychological resilience. Ability to handle problems, make good decisions, think before acting and help others were the most powerful buffers against Generalised Anxiety Disorder, while thinking before acting significantly buffered social phobia. Believing that they were able to handle problems was significantly associated with less emotional anxiety about school, work or social activities, being irritable, unable to relax and fatigue. As well as describing the pathways between the components of psychological resilience and anxiety, these findings also suggest several specific directions for training programmes aimed at equipping boys with an ASD with skills to cope more effectively with anxiety.     

Organization and predictive power of general and relationship-specific attachment models: one for all, and all for one?

Given recent evidence for multiple attachment models, we examined the organization and predictive power of general and relationship-specific attachment representations in two samples using two distinct measures of attachment models. With regard to associations among relationship-specific models, peer models (romantic partner and friend) and parental models (mother and father) were more similar to each other than to any other models, and anxiety/self-model representations were more consistent across relationships than avoidance/other-model representations. With regard to links between general and specific models, romantic and friend models made the strongest and independent contributions to general models, and romantic relationship involvement moderated the importance of romantic models to general models. With regard to differential predictive power of multiple models, general, romantic partner, and mother attachment made unique contributions to well-being indicators; relationship outcomes, however, were only predicted by individuals' corresponding relationship-specific models. Implications for the measurement and conceptualization of adult attachment are discussed.     

Ignorance and knowledge regarding humans’ purposeful interventions in environments

This paper presents and discusses a model for environmental decision making. The model defines ends, means, subjects, objects and contexts in relation to particular decisions, and hence in relation to particular problems. This entails definition that is flexible with regard to content—for example, whether a particular entity is subject or object. To improve understanding of the limits of applied knowledge, likely types and levels of ignorance regarding ends, means, subjects, objects, and contexts are discussed. This provides guidance to the selection of appropriate means for defining and addressing environmental problems. where she teaches in architectural science and design, and is also concerned with broader environmental education. With colleagues, she has been involved for ten years on research into thermal performance of buildings, thermal and other preferences of occupants, and the application of environmental and human sciences in decision making.     

Minor miracles or logical process? Therapeutic interventions and techniques

This paper highlights the construction of Therapeutic Interventions. The ideas presented here, many in the form of techniques, are intended to provide therapists–experienced and not so experienced–with a new focus for problems that are frequently seen in general family therapy practice.
A detailed format has been included on how the author routinely goes about constructing interventions.     

Matching therapeutic interventions to drug and alcohol abusers’ stage of motivation: The clients’ perspective

The present study aims to explore the issue of matching the appropriate therapeutic intervention according to the stage of readiness for change in addictive clients, following the model proposed by Prochaska and DiClemente in the 1980s. The study focuses solely on the perspectives of people with drug and alcohol problems, in contrast to previous ones which have been concerned with the researchers’ understandings and postulations of the issue under exploration. One of the most important findings of this study is that participants in the “early” stages of their readiness to change their addictive behaviour, irrespective of their gender or whether they had seen a therapist significantly prefer non-action-oriented therapeutic interventions than action-oriented interventions. Similarly, participants in the “later” stages, showed a significant preference to action-oriented than non-action interventions, irrespective of their gender or previous experience of counselling. It is suggested then that careful assessment of the stage of motivation and individual-tailored intervention should be an essential element of any treatment program for drug and alcohol addicted clients.     

Can the effectiveness of health promotion campaigns be improved using self-efficacy and self-affirmation interventions? An analysis of sun protection messages

Health-risk communications frequently target self-efficacy in order to encourage adaptive responses. Research has also indicated that self-affirmation may be a useful supplementary or alternative intervention technique. This study compared the effects of self-efficacy, self-affirmation and a combination of these techniques for two risk messages. Young British females (N=677) read about ultraviolet light and skin cancer or skin ageing ('photoageing') and were randomly assigned to a single intervention (self-affirmation/self-efficacy), the combined intervention or no intervention. The efficacy intervention led to greater message acceptance and perceived risk in both the cancer and photoageing conditions, while the only main effect of self-affirmation was on acceptance of the photoageing message. However, self-affirmation moderated the effect of efficacy information. For photoageing messages, efficacy information was associated with greater message acceptance only amongst self-affirmed participants, but the opposite occurred for skin cancer messages. Although these findings should be interpreted cautiously, they imply that health promoters should select efficacy information if only one intervention is used but that self-affirmation can influence responsiveness to efficacy interventions for particular messages.