Do you two know each other? Transitivity, homophily, and the need for (network) closure

The authors investigate whether need for closure affects how people seek order in judging social relations. In Study 1, the authors find that people who have a high need for closure (NFC) were more likely to assume their social contacts were connected to each other (i.e., transitivity) when this was not the case. In Studies 2 and 3, the authors examine another form of order in network relations--racial homophily--and find that high-NFC participants were more inclined to believe that 2 individuals from the same racial category (e.g., African American) were friends than two racially dissimilar individuals. Furthermore, high-NFC individuals were more likely to make errors when judging a racially mixed group of people; specifically, they recalled more racial homophily (racially similar people sitting closer together) than had actually appeared.     

Effects of Mindfulness-Based Therapy for Cancer Patients: A Systematic Review and Meta-analysis

This meta-analysis was a systematic review of evidence on the effects of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on quality of life (QOL), pain, fatigue, anxiety, and depression in cancer patients. Until July 2020, PubMed, Cochrane Library, and Embase were searched for randomized controlled trials (RCTs). The study included 18 RCTs. The MBSR/MBCT intervention resulted in a significant effect on QOL (SMD 0.80, CI 0.28, 1.32, I²?=?94%). In subgroup analysis, MBSR/MBCT interventions had a significant effect in the early cancer stage on anxiety (SMD ? 3.48, CI ? 4.07, ? 2.88), and QOL (SMD 4.30, CI 3.62, 4.99); in alleviating decreasing pain (SMD ? 0.42, CI ? 0.70, ? 0.14) within 4 weeks after the end of intervention, and alleviating fatigue in younger participants (SMD ? 0.64, CI ? 1.09, ? 0.19). MBSR/MBCT has short-term effects on cancer patients, especially in younger patients and early cancer stages.

     

Expanding the Scope of Mindfulness-Based Cognitive Therapy: Evidence for Effectiveness in a Heterogeneous Psychiatric Sample

Mindfulness-based interventions (e.g., MBSR; Kabat-Zinn, 1990; MBCT; Segal, Williams, & Teasdale, 2002) have demonstrated effectiveness in a number of distinct clinical populations. However, few studies have evaluated MBCT within a heterogeneous group of psychiatric adult outpatients. This study examined whether a wider variety of patients referred from a large, tertiary mood and anxiety outpatient clinic could benefit from such a program. Twenty-three psychiatric outpatients with mood and/or anxiety disorders (mean age = 53.65 years, SD = 10.73; 18 women) were included in this study. Each participant completed the Structured Clinical Interview for Diagnosis Axis I and measures of mood, life stress, and mindfulness skills, prior to the start of group and immediately following its completion. Paired t-test analyses were conducted and results revealed a significant improvement in mood and mindfulness skills in addition to a significant reduction in severity and total number of perceived life stressors. In summary, our results indicate that MBCT can effectively be administered to a group of patients whose diagnoses and difficulties may vary, who have significant comorbidity, and who are currently experiencing significant symptoms. This has important practical implications for offering this treatment within broader psychological and psychiatric service systems.     

Extensions and Mechanisms of Mindfulness‐based Cognitive Therapy: A Review of the Evidence

Mindfulness‐based cognitive therapy (MBCT) was originally developed to prevent depressive relapse and recurrence and has also been widely extended to new patient populations and target problems over the last 14 years. We provide a comprehensive review of this literature, examining the strength of the evidence base for specific populations and target problems and identifying questions for future research to address. Specifically, we review studies addressing the use of MBCT for depressive disorders (prevention of depressive relapse and treatment of residual and current depressive symptoms), the use of MBCT in the treatment or management of other mental disorders (bipolar disorder, anxiety disorders, mixed anxiety and depression symptoms, disordered eating, personality disorders, and psychosis), and the use of MBCT in behavioural medicine contexts. Additionally, we discuss the extension of MBCT during specific developmental periods, like childhood, pregnancy and post‐partum, and adult caregiving, and, finally, we address the use of MBCT among clinical health‐care providers. In the second section, we review hypothesised mechanisms of change in MBCT and reflect on implications for theories of how MBCT works in the application to various patient populations and target problems. We also consider research addressing active ingredients and what is known about the “dosage” of meditation practice. We conclude with a summary of recommendations for future research.     

Using the Nominal Group Technique to Identify the Problems Experienced by Persons Living with Severe Physical Disabilities

Changes in health care have dramatically curtailed services to people with severe physical disability and their families. This has placed a greater burden of responsibility on those who live with these conditions and have ongoing care needs. Yet little is known about the subjective problems, challenges, and solutions reported by these people. We demonstrate how the nominal group technique can be used to obtain consumer-oriented information germane to these individuals and their concerns. We conducted nominal group technique meetings with 2 groups for persons with physical disability and a third with a group for family members in caregiving roles. We demonstrate how focus groups can be conducted with the nominal group technique to identify problems experienced by individuals who live with severe physical disability. Recommendations for using the nominal group technique with client populations are presented, and implications for clinical practice are discussed.     

No face is an island: How implicit bias operates in social scenes

Social psychologists have mainly studied implicit attitudes toward faces presented one at a time, whereas, in real life, we often encounter people in the presence of others. These surrounding individuals may alter attitudes toward the focal target of attention. We employed a flanker-IAT task and found that, when black and white targets were presented in racially diverse contexts, bias was decreased. This decrease in bias occurred even when targets previously seen in diverse contexts were presented on their own, suggesting context-free evaluations of the targets had been formed. Experiment 2 showed that the effect of diverse contexts does not affect bias toward a racial category as a whole, but only the specific targets previously seen in the diverse contexts. Quad model analysis (Sherman et al., 2008) revealed that these effects were related to changes in automatic evaluations, and not to changes in inhibition. Implications for implicit bias change and prejudice reduction strategies are discussed.     

Intimate Diversity: The Presentation of Multiculturalism and Multiracialism in a High-Boundary Religious Movement

Researchers studying the small yet significant number (8–10 percent) of U.S. multiracial/ethnic congregations have argued that formal organizational commitment, the development of inclusive worship styles, and the formation of small racially/ethnically mixed groups appear to be significant factors in constructing and maintaining congregational diversity. Drawing from four years of field studies in a racially and ethnically diverse congregation of the International Churches of Christ (ICOC), I address a process about which we know relatively little: the construction and maintenance of multiracial/ethnic networks in high-boundary religious movements. I demonstrate how this type of group is particularly able to present a valuable and rising commodity in our U.S. religious economy, what I have named intimate diversity—the enactment and/or narration of close and caring relationships among a racially and ethnically diverse membership. My comparative analysis here of the ICOC, the People's Temple, and contemporary U.S. Bahá'í communities suggests that membership in such groups offers members greater exposure and involvement with people from different backgrounds, but the terms of involvement in the organization seriously limit and define the manner in which individuals can experience diversity. Furthermore, group commitment to present a face of intimate diversity and strict mechanisms of social control hinder the abilities of the leadership and members to clearly recognize contradictions in group racial/ethnic ideologies and practice.     

Adapting Mindfulness-based Stress Reduction for the Treatment of Obsessive-compulsive Disorder: A Case Report

Obsessive-compulsive disorder (OCD) is an illness characterized by intrusive and distressing thoughts, images, or impulses (i.e., obsessions) and by repetitive mental or behavioral acts (i.e., compulsions) performed to prevent or reduce distress. Efficacious treatments for OCD include psychotropic medications and exposure and response prevention (EX/RP). The following case report presents an individual diagnosed with OCD who refused treatment with medication or EX/RP and was treated using an adapted Mindfulness-Based Stress Reduction (MBSR) program. After an 8-week adapted MBSR program, the endpoint evaluation revealed clinically significant reductions in symptoms of OCD as well as an increased capacity to evoke a state of mindfulness. Discussion includes generalizability of these findings, potential mechanisms of action, and the role of an adapted MBSR in the treatment of OCD.     

Economic Impact of Third-Wave Cognitive Behavioral Therapies: A Systematic Review and Quality Assessment of Economic Evaluations in Randomized Controlled Trials

The term third-wave cognitive behavioral therapy (CBT) encompasses new forms of CBT that both extend and innovate within CBT. Most third-wave therapies have been subject to randomized controlled trials (RCTs) focused on clinical effectiveness; however, the number and quality of economic evaluations in these RCTs has been unknown and may be few. Evidence about efficiency of these therapies may help support decisions on efficient allocation of resources in health policies. The main aim of this study was to systematically review the economic impact of third-wave therapies in the treatment of patients with physical or mental conditions. We conducted a systematic literature search in PubMed, PsycINFO, EMBASE, and CINALH to identify economic evaluations of third-wave therapies. Quality and Risk of Bias (RoB) assessment of economic evaluations was also made using the Drummond 35-item checklist and the Cochrane Collaboration’s tool for assessing risk of bias, respectively. Eleven RCTs were included in this systematic review. Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and extended Behaviour Activation (eBA) showed acceptable cost-effectiveness and cost-utility ratios. No study employed a time horizon of more than 3 years. Quality and RoB assessments highlight some limitations that temper the findings. There is some evidence that MBCT, MBSR, ACT, DBT, and eBA are efficient from a societal or a third-party payer perspective. No economic analysis was found for many third-wave therapies. Therefore, more economic evaluations with high methodological quality are needed.     

Integrating Advocacy for Marginalized Children and Families Into Evidence-Based Care During COVID-19: Clinical Vignettes

The novel coronavirus (COVID-19) has disproportionately impacted the health and socioeconomic outcomes for low-income populations, people of color, and immigrant children and families in the United States. As inequities in resources (i.e., food, internet, housing), health care, and education increased for marginalized families as a result of COVID-19, child-focused clinicians had to broaden their professional scope and implement new advocacy efforts. The current paper uses clinical vignettes taken from a New York State Office of Mental Health–licensed child and adolescent outpatient clinic in the Bronx, New York. The vignettes highlight the social inequities that impacted marginalized children and families during the pandemic, as well as the clinical team’s response through the integration of evidence-base practice and advocacy. Implications for practice with vulnerable populations as the COVID-19 pandemic persists are discussed.     

Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders

ObjectiveTo compare a mindfulness-based intervention with cognitive behavioral therapy (CBT) for the group treatment of anxiety disorders.MethodOne hundred five veterans (83% male, mean age = 46 years, 30% minority) with one or more DSM-IV anxiety disorders began group treatment following randomization to adapted mindfulness-based stress reduction (MBSR) or CBT.ResultsBoth groups showed large and equivalent improvements on principal disorder severity thru 3-month follow up (ps < .001, d = ?4.08 for adapted MBSR; d = ?3.52 for CBT). CBT outperformed adapted MBSR on anxious arousal outcomes at follow up (p < .01, d = .49) whereas adapted MBSR reduced worry at a greater rate than CBT (p < .05, d = .64) and resulted in greater reduction of comorbid emotional disorders (p < .05, d = .49). The adapted MBSR group evidenced greater mood disorders and worry at Pre, however. Groups showed equivalent treatment credibility, therapist adherence and competency, and reliable improvement.ConclusionsCBT and adapted MBSR were both effective at reducing principal diagnosis severity and somewhat effective at reducing self-reported anxiety symptoms within a complex sample. CBT was more effective at reducing anxious arousal, whereas adapted MBSR may be more effective at reducing worry and comorbid disorders.     

New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR’s potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use.     

Cognitive effects of racial diversity: White individuals’ information processing in heterogeneous groups

Two experiments tested the hypothesis that mere anticipation of membership in a racially heterogeneous group can lead White individuals to exhibit more thorough information processing. In Study 1 White participants who expected to discuss a race-relevant topic with a racially diverse group exhibited better comprehension of topical background readings than did Whites assigned to all-White groups. Study 2 replicated these results and indicated that the processing effects were attributable in part to an increase in race-relevant thought activation among White individuals in a diverse setting. No such anticipatory effects of racial composition were observed for Whites expecting to discuss race-neutral topics. Taken together, these studies render untenable the assumption that the observable effects of racial diversity are wholly attributable to the novel contributions of non-White group members. More generally, they emphasize the need for additional empirical investigation of the cognitive processes through which racial heterogeneity influences individual and group performance.     

Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review

The number of acceptance- and mindfulness-based interventions for chronic pain, such as acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), increased in recent years. Therefore an update is warranted of our former systematic review and meta-analysis of studies that reported effects on the mental and physical health of chronic pain patients. Pubmed, EMBASE, PsycInfo and Cochrane were searched for eligible studies. Current meta-analysis only included randomized controlled trials (RCTs). Studies were rated for quality. Mean quality did not improve in recent years. Pooled standardized mean differences using the random-effect model were calculated to represent the average intervention effect and, to perform subgroup analyses. Outcome measures were pain intensity, depression, anxiety, pain interference, disability and quality of life. Included were twenty-five RCTs totaling 1285 patients with chronic pain, in which we compared acceptance- and mindfulness-based interventions to the waitlist, (medical) treatment-as-usual, and education or support control groups. Effect sizes ranged from small (on all outcome measures except anxiety and pain interference) to moderate (on anxiety and pain interference) at post-treatment and from small (on pain intensity and disability) to large (on pain interference) at follow-up. ACT showed significantly higher effects on depression and anxiety than MBSR and MBCT. Studies’ quality, attrition rate, type of pain and control group, did not moderate the effects of acceptance- and mindfulness-based interventions. Current acceptance- and mindfulness-based interventions, while not superior to traditional cognitive behavioral treatments, can be good alternatives.     

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.     

Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study

Objective: Neuroticism, a characteristic associated with increased stress vulnerability and the tendency to experience distress, is strongly linked to risk of different forms of psychopathology. However, there are few evidence-based interventions to target neuroticism. This pilot study investigated the efficacy and acceptability of mindfulness-based cognitive therapy (MBCT) compared with an online self-help intervention for individuals with high levels of neuroticism. The MBCT was modified to address psychological processes that are characteristic of neuroticism. Method: Participants with high levels of neuroticism were randomized to MBCT (n = 17) or an online self-help intervention (n = 17). Self-report questionnaires were administered preintervention and again at 4 weeks postintervention. Results: Intention-to-treat analyses found that MBCT participants had significantly lower levels of neuroticism postintervention than the control group. Compared with the control group, the MBCT group also experienced significant reductions in rumination and increases in self-compassion and decentering, of which the latter two were correlated with reductions in neuroticism within the MBCT group. Low drop-out rates, high levels of adherence to home practice, and positive feedback from MBCT participants provide indications that this intervention may be an acceptable form of treatment for individuals who are vulnerable to becoming easily stressed. Conclusions: MBCT specifically modified to target neuroticism-related processes is a promising intervention for reducing neuroticism. Results support evidence suggesting neuroticism is malleable and amenable to psychological intervention. MBCT for neuroticism warrants further investigation in a larger study.     

Dimensions of distress tolerance and the moderating effects on mindfulness-based stress reduction

Background and Objectives: This study examined the relationship between distress tolerance and psychosocial changes among individuals participating in Mindfulness-Based Stress Reduction (MBSR). The objective of the analysis was to discern whether individuals with lower distress tolerance measured before MBSR showed larger reductions in perceived stress following MBSR. Design and Methods: Data were collected from a sample of convenience (n?=?372) using a quasi-experimental design. Participants completed self-report measures immediately prior to course enrollment and following course completion. Results: Perceived stress, distress tolerance, and mood states showed favorable changes from pre- to post-MBSR in the current study. Baseline distress tolerance significantly moderated reductions on perceived stress, supporting the primary hypothesis that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress following MBSR. For a one-unit increase on the self-reported baseline Distress Tolerance Scale, reported perceived stress scores decreased by 2.5 units (p?Conclusions: The finding that individuals with lower baseline distress tolerance evidenced a greater decline in perceived stress may offer hints about who is most likely to benefit from MBSR and other mindfulness-based treatments. Identifying moderators of treatment outcomes may yield important benefits in matching individuals to treatments that are most likely to work for them.     

Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder

Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a randomized trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive-behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD.     

Selectively friending: Racial stereotypicality and social rejection

Three studies show that people whose physical features are seen as more (versus less) racially stereotypical are more vulnerable to social rejection and exclusion from those outside their group. In Study 1, which used an online social networking site, Blacks perceived as more physically stereotypical were found to have fewer non-Black friends, compared to less-stereotypical Blacks. In Study 2, which used an experimental paradigm, requests for friendship made to non-Blacks by more-stereotypical Blacks were more likely to be rejected than those made by less-stereotypical Blacks. Finally, in a college dormitory, people judged to have more (vs. less) racially stereotypical physical features were found to interact less often with outgroup members. This work substantiates a growing body of research demonstrating that people who are perceived as more physically stereotypical of their racial group are particularly vulnerable to discriminatory treatment by outgroup members across a variety of life domains.     

Cognitive effects of MBSR/MBCT: A systematic review of neuropsychological outcomes

Mindfulness is theorised to improve attention regulation and other cognitive processes. This systematic review examines whether 8-week standardised and manualised mindfulness training programs such as Mindfulness Based Cognitive Therapy (MBCT) and Mindfulness Based Stress Reduction (MBSR) enhances attention, memory and executive function abilities measured by objective neuropsychological tests. Seven databases were searched resulting in 18 studies meeting inclusion criteria for review. Overall studies did not support attention or executive function improvements. We found preliminary evidence for improvements in working memory and autobiographical memory as well as cognitive flexibility and meta-awareness. Short-term mindfulness meditation training did not enhance theorised attentional pathways. Results call into question the theoretical underpinnings of mindfulness, further highlighting the need for a comprehensive theoretical framework.