Evaluation of a Brief Mindfulness Program for People with Multiple Sclerosis Delivered in the Community Over Five Years

This study evaluated the effectiveness, change mechanisms, and sustainability of a brief mindfulness intervention for people with multiple sclerosis (PwMS) delivered in the community through a frontline service over five years. Participants were 126 PwMS. A single intervention condition design was used with pre-intervention, post-intervention and 2-month follow-up assessments. The primary outcome was distress. Secondary outcomes were perceived stress, quality of life (QoL) and fatigue, and the proposed change mechanisms: mindfulness, self-compassion, psychological inflexibility. Intention-to-treat analyses showed the primary outcome, distress (Cohen’s d = .25), and all secondary outcomes improved: perceived stress (d = .38), mental health QoL (d = .39), physical health QoL (d = .47), fatigue (d = .30), mindfulness (d = .29), self-compassion (d = .37), psychological flexibility (d = .44). Distress, stress and perceived stress continued to improve post-intervention to follow-up. Mindfulness emerged as a temporal mediator of perceived stress (BCa 95% CI). Self-compassion mediated concurrent improvements in distress, perceived stress, fatigue and physical health QoL, while greater psychological flexibility mediated concurrent reductions in distress (BCa 95% CI). Mindfulness home practice was unrelated to improvements on all outcomes except a marginal association with mindfulness. Of the socio-demographic and illness factors, lower disease severity predicted improvements in physical health QoL (p = .046). Improvements in outcomes were supported by qualitative feedback and participant satisfaction ratings. Twenty-one groups were offered with good participant engagement and wide geographical reach, suggesting sustained feasibility of the Mindfulness for MS program over five years. Findings support the delivery of the Mindfulness for MS program through a community-based service in partnership with a local university.

     

Teachers' dispositional mindfulness and the quality of their relationships with children in Head Start classrooms

The quality of teachers' relationships with children is a key predictor of children's later social emotional competence and academic achievement. Interventions to increase mindfulness among teachers have focused primarily on the impacts on teachers' subjective well-being, but not on the quality of their relationships with children. Furthermore, none of these interventions have involved preschool teachers. To consider the potential of mindfulness-based interventions to improve the quality of teachers' relationships with preschool-aged children, we examined data from an online survey of 1001 classroom teachers in 37 Pennsylvania Head Start Programs. Using path analysis we investigated the association between teachers' dispositional mindfulness and the quality of their relationships with children (conflict and closeness). We further examined whether this association was mediated by teacher depressive symptoms and moderated by perceived workplace stress. Higher levels of dispositional mindfulness among teachers were associated with higher quality relationships with children (less conflict and greater closeness). The association between greater dispositional mindfulness and less conflict was partially mediated by lower depressive symptoms, and the conditional direct effect of mindfulness on conflict was stronger when perceived workplace stress was lower. These findings suggest that preschool teachers who have higher levels of dispositional mindfulness may experience higher quality relationships with children in their classrooms. Interventions to increase levels of dispositional mindfulness among early childhood educators may improve their well-being along with the quality of their relationships with children, potentially impacting children's educational outcomes. The potential impacts of such interventions may be even stronger if structural and systemic changes are also made to reduce workplace stress.     

Can Acceptance,Mindfulness, and Self-Compassion Be Learned by Smartphone Apps? A Systematic and Meta-Analytic Review of Randomized Controlled Trials

The potential health benefits of acceptance, mindfulness, and self-compassion are well-documented. However, interventions that teach these principles typically rely on face-to-face delivery, which can limit their dissemination. Delivering these interventions through smartphone apps could help overcome this. This meta-analysis examined whether principles of acceptance, mindfulness, and self-compassion can be learned through smartphone apps. Twenty-seven randomized controlled trials were included. Smartphone apps that included acceptance and/or mindfulness components resulted in significantly higher levels of acceptance/mindfulness than comparison conditions (k = 33; g = 0.29; 95% CI = 0.17, 0.41). These effects were moderated by the type of comparison and whether reminders to engage were offered. Smartphone apps also resulted in significantly lower levels of psychological distress than comparisons (k = 22; g = −0.32; 95% CI = −0.48, −0.16). Meta-regression revealed a negative relationship between the effect sizes for mindfulness/acceptance and the effect sizes for distress. Smartphone apps produced significantly greater increases in self-compassion than comparisons (k = 9; g = 0.31; 95% CI = 0.07, 0.56), although the quality of RCTs in this analysis was poor. Findings suggest that principles of acceptance, mindfulness, and self-compassion may be learned through cheap, easily accessible, and low-intensity interventions delivered via smartphone apps. However, the quality of available evidence is poor, as low risk of bias was noted in few trials (18%) and the observed effects were likely explained by a digital placebo.     

Effects of Mindfulness-Based Stress Reduction on Psychological Symptoms and Telomere Length: A Randomized Active-Controlled Trial

Much research has demonstrated the beneficial effects of mindfulness-based stress reduction (MBSR) on psychological and physical health, but it is not known whether MBSR may impact cellular aging in healthy populations. Further, little research has evaluated MBSR against an active control condition, which precludes strong conclusions regarding the unique effects of mindfulness on psychological functioning. The present study examined the effects of MBSR versus music therapy–based stress reduction (MTSR) on trait mindfulness, self-compassion, and several psychological health outcomes, as well as leukocyte telomere length (LTL). One hundred and fifty eight Singaporean Chinese adults were recruited and randomly assigned to an eight-week MBSR or MTSR course. Participants provided blood samples and completed a battery of self-report measures pre- and post-intervention. Analyses showed that participants in the MBSR condition demonstrated significantly greater improvements in depressive symptoms, trait mindfulness, and self-compassion compared to the control condition. Treatment condition did not predict changes in LTL, anxiety, stress, or happiness, though there was a trend for duration of home mindfulness practice to predict increases in LTL. Overall, the study demonstrated MBSR’s unique effects in reducing depressive symptoms. Improvements in trait mindfulness and self-compassion correspond with theorized mechanisms of change underlying mindfulness training. The lack of intervention effect with regards to LTL suggests that a more intensive intervention may be required for mindfulness to exert noticeable impact on aging at the cellular level, or that the effect may only emerge over a longer term.     

Mindfulness training effects for parents and educators of children with special needs

Parents and teachers of children with special needs face unique social-emotional challenges in carrying out their caregiving roles. Stress associated with these roles impacts parents' and special educators' health and well-being, as well as the quality of their parenting and teaching. No rigorous studies have assessed whether mindfulness training (MT) might be an effective strategy to reduce stress and cultivate well-being and positive caregiving in these adults. This randomized controlled study assessed the efficacy of a 5-week MT program for parents and educators of children with special needs. Participants receiving MT showed significant reductions in stress and anxiety and increased mindfulness, self-compassion, and personal growth at program completion and at 2 months follow-up in contrast to waiting-list controls. Relational competence also showed significant positive changes, with medium-to-large effect sizes noted on measures of empathic concern and forgiveness. MT significantly influenced caregiving competence specific to teaching. Mindfulness changes at program completion mediated outcomes at follow-up, suggesting its importance in maintaining emotional balance and facilitating well-being in parents and teachers of children with developmental challenges. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Mindfulness and Self-Compassion: Exploring Pathways to Adolescent Emotional Well-Being

Adolescents today are confronted with the compounded stressors of life in our high-pressured society and the cognitive, physiological, and emotional changes characteristic of this stage of development. To explore ways to promote well-being in this population, mindfulness, defined as paying attention in the moment in an intentional and purposeful way, was examined in terms of its associations with aspects of emotional well being. It has been reported to have positive effects on emotional well-being in adults, and shows promise for similar results in research with youth. Moreover, the mechanisms through which being mindful may influence positive outcomes have only recently been explored, and have not been investigated with adolescents. Self-compassion, defined by the three components of self-kindness, sensing oneself as part of a common humanity, and maintaining perspective in challenging circumstances, was examined as a potential mediator of the relationship of mindfulness to various outcome measures. Measures assessing mindfulness, self-compassion, and aspects of emotional well-being comprised an online survey that was administered to 67 adolescents in an urban high school. Path analysis was utilized to explore relationships among the variables. An alternate model with self-compassion as the predictor and mindfulness as the mediator was also investigated. Results suggested that both mindfulness and self-compassion functioned as mediators in the pathway to emotional well-being. A theorized model is presented which depicts a reciprocal relationship between mindfulness and self-compassion and describes an iterative process that takes place between these two constructs, promoting emotional well-being. Implications for research and practice include conducting longitudinal studies, which assess constructs at three time points to definitively establish mediation, and developing a self-compassion program tailored for adolescents to facilitate improvements in emotional well-being.     

基于正念的干预与自我同情的关系：一项元分析

运用元分析方法对国内外有关基于正念的干预与自我同情的关系问题进行了探讨, 通过文献检索, 纳入文献65篇, 总样本量为8103。异质性检验发现, 选择随机效应模型比较合适; 敏感性分析显示, 使用One-study removed逐步删除异质性较高研究, 基于正念的干预与自我同情呈显著正相关; 次群体检验表明, 基于正念的干预与自我同情关系受对比方式的调节与影响, 但不受群体和测量工具的影响。研究结果表明, 正念对自我同情水平会产生不同程度的积极影响, 同时随着对比方式的不同对基于正念的干预与自我同情的关系会产生不同的调节作用, 而群体和测量工具对基于正念的干预与自我同情的关系并无调节效应。     

An integrated mindfulness and acceptance-based program for young elite female basketball players: Exploratory study of how it works and for whom it works best

In order to better understand how an integrated mindfulness and acceptance-based intervention works and for whom it works best, study objectives were to examine (i) the trajectories of mindfulness skills and performance-related outcomes during the intervention, and athletes’ perceptions of the impact of the intervention; and (ii) the potential moderating effects of personality characteristics on changes in targeted variables associated with the intervention. The sample consisted of 40 young elite female basketball players (M = 16.33, SD = 0.75 years) from three incoming groups at the French Federal Basketball Center over a 3-year period. All players participated in a 15-week Mindfulness BasketBall Integrated program. They completed online questionnaires measuring personality traits 10 months before the intervention, as well as pre-, mid- and post-intervention measurements of mindfulness skills, intensity and directional interpretation of stress, and performance satisfaction. They also participated in semi-structured social validation interviews conducted one month after the intervention. The results of the multilevel growth curve (MGCA) and thematic analyses revealed how the mindfulness skills and performance-related outcomes evolved over the course of the intervention and how these changes were perceived by the athletes. Specifically, the MGCA showed significant linear increases in acceptance, positive stress direction, and performance satisfaction. The complementary social validation data indicated perceived improvements in mindfulness skills and performance. The MGCA also showed that baseline personality traits moderated the effects of the program on acceptance and experience of stress. These findings may be used to inform the design of more effective integrated mindfulness and acceptance-based interventions.     

Exploring Associations Between Self-Compassion,Self-Criticism,Mental Health,and Quality of Life in Adults with Cystic Fibrosis: Informing Future Interventions

Self-compassion is increasingly recognised as an important and beneficial factor in quality of life and mental health-related research, but research within the adult cystic fibrosis (CF) population is scarce. In a cross-sectional study, 114 (56 female, 58 male) adults with CF completed and returned a series of validated questionnaires that assessed CF-related quality of life, negative emotional states (depression, anxiety and stress), self-compassion, and self-criticism. Quality of life and self-compassion were positively correlated, and each in turn were inversely correlated with negative emotional states and self-criticism. Negative emotional states correlated positively to self-criticism. Self-compassion and/or self-criticism moderated ten relationships between various sub-domains of quality of life and negative emotions. Psychological interventions that increase self-compassion may be beneficial for enhancing mental health and quality of life for adults with CF.

     

How does mindfulness-based cognitive therapy work?

Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression ( [Kuyken et?al., 2008], [Ma and Teasdale, 2004] and [Teasdale et?al., 2000]). To date, no compelling research addresses MBCT’s mechanisms of change. This study determines whether MBCT’s treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with ≥3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction.MBCT’s effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group.MBCT’s treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.     

A daily diary study of the relationships among daily self-compassion,perceived stress and health-promoting behaviours

Previous studies consistently found that trait self-compassion is positively associated with health-promoting behaviours, and perceived stress mediates the relationship. The current study primarily aimed at examining whether state self-compassion varying from day to day (daily self-compassion) played the same role as trait self-compassion in improving health-promoting behaviours and whether or not perceived stress would be the mediator in this relationship. Eighty-nine Chinese employees were recruited to finish demographic information and the trait measure of self-compassion first, and then finish daily diaries for seven consecutive days. Daily diary measures included daily self-compassion, perceived stress and health-promoting behaviours including both eating behaviours and exercise behaviours. The results of 1-1-1 multilevel mediation analyses showed that, at both the within- and between-person level, daily self-compassion could positively predict daily eating behaviour through the reduction of perceived stress. However, daily self-compassion did not influence exercise behaviour at both levels. The results of 2-1-1 multilevel mediation analyses cross-validated the between-person relationships in the 1-1-1 multilevel mediation models. These results suggest that, both short-term interventions aiming at increasing state self-compassion and long-term interventions aiming at increasing trait self-compassion can benefit one's eating behaviours through the reduction of stress.     

Mindfulness training reduces neuroticism over a 6-year longitudinal randomized control trial in Norwegian medical and psychology students

Reducing neuroticism in young adults is likely to reduce future psychopathology and improve quality of life. One method of reducing neuroticism may be mindfulness training. This randomized control study examined the effect of mindfulness training on neuroticism and psychological distress over a six-year time period in a sample of Norwegian medical and clinical psychology students receiving either a modified Mindfulness-Based Stress Reduction (MBSR) training (n = 144) or no intervention (n = 144). Mindfulness training decreased neuroticism and psychological distress over the six-year follow-up period, and decreases in neuroticism were associated with reduced psychological distress at the six-year follow-up. These findings suggest that mindfulness training can have a durable impact on neuroticism, and that mindfulness-based interventions may effectively reduce clinical symptomology linked with neuroticism.     

How does mindfulness modulate daily stress response: evidences from ambulatory assessment

Objective: Mindfulness has been found to be associated with less adverse stress response. However, little is known about how mindfulness modulates stress response in the real daily life. The current study investigated the relation between daily stress and negative emotions, and explored a mediational link via perceived loss of control, and moderation by dispositional mindfulness, to better understand this association. Design: A total of 95 college students were recruited to complete a questionnaire and to report on their stress, perceived loss of control and negative emotions in daily life. Main Outcome Measures: Mindful Attention Awareness Scale (MAAS) was used to assess dispositional mindfulness. Stress, perceived loss of control and negative emotions were assessed by ambulatory assessment. Results: Stress was positively related with negative emotions at within-person level. Perceived loss of control mediated the relationship between stress and negative emotions. Furthermore, participants with higher levels of dispositional mindfulness showed an attenuated association between stress and anger, and also attenuated associations between perceived loss of control, and anger and fatigue at within-person level. Conclusion: These findings point to perceived loss of control as an important key factor in daily stress effects. Dispositional mindfulness appears to have beneficial effects in that it attenuates the impact of daily stressors on individuals’ wellbeing. Clinical implications and limitations are discussed.     

Mindfulness and self-compassion as predictors of psychological wellbeing in long-term meditators and matched nonmeditators

Mindfulness training has well-documented effects on psychological health. Recent findings suggest that increases in both mindfulness and self-compassion may mediate these outcomes; however, their separate and combined effects are rarely examined in the same participants. This study investigated cross-sectional relationships between self-reported mindfulness, self-compassion, meditation experience, and psychological wellbeing in 77 experienced meditators and 75 demographically matched nonmeditators. Most mindfulness and self-compassion scores were significantly correlated with meditation experience and psychological wellbeing. Mindfulness and self-compassion accounted for significant independent variance in wellbeing. A significant relationship between meditation experience and wellbeing was completely accounted for by a combination of mindfulness and self-compassion scores. Findings suggest that both mindfulness and self-compassion skills may play important roles in the improved wellbeing associated with mindfulness training; however, longitudinal studies are needed to confirm these findings.     

Comparing the Effects of Loving-Kindness Meditation (LKM), Music and LKM Plus Music on Psychological Well-Being

Loving-kindness meditation (LKM), a meditative practice directing caring feelings toward self and others, is a popular, evidence-base approach to increasing well-being. Music listening is also a popular form of emotion regulation used to enhance well-being. This interdisciplinary study evaluated a novel intervention called Convergence—combining LKM with accompanying classical guitar music—and its effects on adults’ well-being, mindfulness, compassion and self-compassion outcomes. Convergence was compared to active control groups LKM-only and Music-only regarding their relative effectiveness in improving these outcomes. Participants (N?=?78; aged 18 to 69?years; 90% females; recruited from the general public) were assigned to either the Convergence, LKM-only, or Music-only condition. Each condition received a 2-hour workshop, involving psychoeducation, three prerecorded meditations, and group enquiry and discussion. Participants were assessed at pre-program, post-program, and 4-week follow-up. Findings revealed that Convergence, LKM-only and Music-only were equally effective interventions, producing improvements in dependent variables with small effect sizes. There was no additive effect of the components when delivered together as Convergence. Significant correlations were found between the amount of home practice, and mindfulness and self-compassion at follow-up. LKM, music listening and Convergence all provide brief, evidence-based alternatives for improving well-being. Practical and theoretical implications are provided, as well as recommendations for future research.     

特质正念与控制点调节日常生活中知觉压力对消极情绪的影响

考察日常生活中知觉压力对消极情绪的动态影响,检验特质正念的调节作用,并进一步探索正念的调节作用是否在不同控制点的个体中存在差异。共有95名在校大学生完成正念注意觉知量表（MAAS）,罗特控制点量表（LOCS）,并通过动态评估的方式,完成每天2次,持续14天的在日常生活情境中针对知觉压力和消极情绪的密集型追踪测量。多层线性模型结果表明：（1）在个体内水平,个体某一时刻的知觉压力可以显著预测个体下一时刻的消极情绪;（2）个体的正念水平越高,日常生活中知觉压力对消极情绪的预测力越低;（3）个体越倾向于内控,日常生活中知觉压力对消极情绪的预测力越低;（4）个体越倾向于外控,正念对日常生活中知觉压力影响消极情绪的调节作用越强。本研究验证了正念对日常生活中压力反应的保护作用,并提示外控者在面临压力时更有可能从正念中获益。     

The effects of four days of intensive mindfulness meditation training (Templestay program) on resilience to stress: a randomized controlled trial

The interest in mindfulness meditation interventions has surged due to their beneficial effects in fostering resilience and reducing stress in both clinical and non-clinical populations. However, the relaxation benefits that may occur while practicing mindfulness meditation and long-term benefits of these interventions remain unclear. Fifty-one participants were recruited and randomized into the experimental and control groups, which underwent 4 days of Intensive Meditation (Templestay program, n = 33) and Relaxation (Control, n = 18), respectively. The self-report measures of Cognitive and Affective Mindfulness Scale-Revised (CAMS) and the modified Korean version of the Resilience Quotient Test (RQT) were administered pre-, post- and 3 months after the intervention to measure participants’ levels of mindfulness and resilience. Participants in both the Templestay program and Control groups showed significant increases in their scores on CAMS and RQT after completing the program. During the 3-month follow-up, a significant interaction effect of the intervention method and time was revealed for the individuals’ CAMS and RQT scores. Our findings support the hypothesis that while relaxation practices may have certain stress reduction effects, the effects are predominantly mediated by the mindfulness meditation practice. Furthermore, the long-term benefits of increased resilience observed in the Templestay program group suggest that the practice may be a possible treatment strategy in clinical populations, such as patients with depression and anxiety.     

Making concrete construals mindful: A novel approach for developing mindfulness and self-compassion to assist weight loss

Research on the usefulness of mindfulness and self-compassion for dieting has focused on meditative practices. However, meditation can be difficult to maintain, especially while dieting. Thus, the present research attempted to induce mindfulness and self-compassion by using food diaries that required the participant to either focus on concrete (i.e. how they are eating) construals or abstract (i.e. why they are eating) construals. The concrete construals were expected to increase mindfulness and self-compassion, as well as decrease avoidance and negative thoughts (which would further aid the development of mindfulness and self-compassion). Study 1 found that mindfulness and self-compassion mediated the inverse relationship of avoidance and negative thoughts with weight loss. Study 2 showed that concrete construal diaries increased mindfulness and self-compassion, decreased avoidance and negative thoughts, and supported weight loss significantly more than the abstract construal diaries. Study 3, then, compared the concrete construal diaries with a mindful self-compassionate meditation programme. There was no difference in weight loss at the end of the intervention, but at a three-month follow-up, the diaries performed better at weight maintenance. Thus, the concrete construal diaries may promote mindfulness and self-compassion and potentially promote long-term weight loss.     

Processes of change in a school-based mindfulness programme: cognitive reactivity and self-coldness as mediators

The underlying mechanisms of the effectiveness of mindfulness-based interventions for emotional well-being remain poorly understood. Here, we examined the potential mediating effects of cognitive reactivity and self-compassion on symptoms of depression, anxiety and stress using data from an earlier randomised controlled school trial. A moderated time-lagged mediation model based on multilevel modelling was used to analyse the data. The findings showed that post-treatment changes in cognitive reactivity and self-coldness, an aspect of self-compassion, mediated subsequent changes in symptoms of depression, anxiety and stress. These results suggest that cognitive reactivity and self-coldness may be considered as transdiagnostic mechanisms of change of a mindfulness-based intervention programme for youth.     

Insecure Attachment and Subclinical Depression,Anxiety, and Stress: A Three-Dimensional Model of Personality Self-Regulation As a Mediator

Although the effects of insecure attachment on vulnerability, incidence, and developing mental disorders have been confirmed by many studies, the mechanism of this effect is still unknown. Therefore, the main aim of this study was to investigate the mediating and moderating role of the three-dimensional model of personality self-regulation in the relationship between insecure attachment and subclinical depression, anxiety, and stress. Four hundred Iranian students at Shiraz University were recruited and completed the following scales: the Revised Adult Attachment, Depression Anxiety Stress, Integrative Self-Knowledge, Mindful Attention Awareness, Self-Control, and Self-Compassion. Results showed that there was a moderate correlation among all the variables under study in the expected directions. Multiple mediating models analyses indicated that regarding the relationship between insecure attachment and depression, the components of integrative self-knowledge, self-control, and self-compassion functioned as mediators. However, regarding the relationship between insecure attachment and anxiety and stress, the components of integrative self-knowledge, mindfulness, and self-compassion relatively functioned as mediators. Further, our results showed that only mindfulness and self-compassion were identified as moderators in the relationship between insecure attachment and depression. It is concluded that insecure attachment may cause psychological damage due to deficiency in the components of the three-dimensional model of personality self-regulation, and that mindfulness and self-compassion may play a protective role in the relationship between insecure attachment and depression.