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.     

Randomized controlled trial of mindfulness-based stress reduction (MBSR) on posttraumatic growth of Chinese breast cancer survivors

Breast cancer (BC) patients in China suffered from a variety of psychology stress such as perceived stress and anxiety, posttraumatic growth (PTG) as a positive factor could promote their psychology health and quality of life. This study aimed to investigate the efficacy of mindfulness-based stress reduction (MBSR) on promoting PTG, decreasing perceived stress and anxiety of Chinese BC patients. A randomized controlled trial of 60 BC patients (Stages I–III) was conducted. They were randomly divided to the 8-week MBSR group or usual care (UC) group. PTG inventory, Perceived Stress Scale of Chinese version (CPSS) and State Trait Anxiety Inventory (STAI) evaluated the PTG level, perceived stress and anxiety at three times(before intervention-T1, after intervention-T2 and follow up at 3 months-T3). A repeated-measures analysis of variance model was used to compare each outcome measure of two groups at the three times. There was one patient discontinued the intervention and one lose to follow up in MBSR group, finally 58 BC patients completed the research. There was no difference between two groups before the intervention. The results showed significant improvements in MBSR group comparing with the UC group that PTG level was much higher after the 8-week intervention and the follow up (F = 34.73, p < .00). At the same time, CPSS (F = 14.41, p < .00) and STAI (F = 15.24, p < .00) scores were significant decreased at T2 and T3. The results showed that MBSR promoted the level of PTG and decreased perceived stress and anxiety state of Chinese BC patients, and the results persisted at three months after intervention. The research preliminary proved that MBSR was suitable to Chinese BC patients. MBSR should be recommending to BC survivors in China.     

An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial

Increased levels of self-criticism and a lack of self-compassion have been associated with the development and maintenance of a range of psychological disorders. In the current study, we tested the efficacy of an online version of a compassion-focused intervention, mindfulness-based compassionate living (MBCL), with guidance on request. A total of 122 self-referred participants with increased levels of self-criticism were randomly assigned to care as usual (CAU) or the intervention group (CAU + online intervention). Primary endpoints were self-reported depressive, anxiety and distress symptoms (DASS-21) and self-compassion (SCS) at 8 weeks. Secondary endpoints were self-criticism, mindfulness, satisfaction with life, fear of self-compassion, self-esteem, and existential shame. At posttreatment, the intervention group showed significant changes with medium to large effect sizes compared to the control group regarding primary outcomes (Cohen’s d: 0.79 [DASS] and -1.21 [SCS]) and secondary outcomes (Cohen’s ds: between 0.40 and 0.94 in favor of the intervention group). The effects in the intervention group were maintained at 6-months postrandomization. Adherence measures (number of completed modules, self-reported number of completed exercises per week) predicted postintervention scores for self-compassion but not for depressive, anxiety, and distress symptoms in the intervention group. The current study shows the efficacy of an online intervention with a transdiagnostic intervention target on a broad range of measures, including depressive and anxiety symptoms and self-compassion.     

Mindfulness-Based Stress Reduction (MBSR) for Primary School Teachers

Stress within the teaching profession has a negative impact on the health and well-being of individual teachers and on retention and recruitment for the profession as a whole. There is increasing literature to suggest that Mindfulness is a useful intervention to address a variety of psychological problems, and that Mindfulness-Based Stress Reduction (MBSR) is a particularly helpful intervention for stress. We investigated the effects of teaching a MBSR course to primary school teachers to reduce stress. The MBSR course was taught to a group of primary school teachers and evaluated to establish its effects on levels of anxiety, depression, and stress, as well as movement towards a stated goal and changes in awareness. The results showed improvement for most participants for anxiety, depression, and stress, some of which were statistically significant. There were also significant improvements on two of the four dimensions of a mindfulness skills inventory. These results suggest that this approach could be a potentially cost-effective method to combat teacher stress and burnout.     

Effects of mindfulness-based stress reduction on prenatal stress,anxiety and depression

Low well-being is common among Chinese pregnant women but few effective interventions currently exist to improve prenatal stress and negative emotions. Mindfulness-based stress reduction (MBSR) has been proved to be effective in reducing stress and rarely studies were focused on Chinese pregnant women. The aim of the current paper is to investigate the effects of 8-week MBSR on prenatal stress, anxiety and depression among Chinese pregnant women. A sample of 66 pregnant women randomly allocated into either the MBSR group (n=34) or the control group (n=32). Participants in the MBSR group received a group 8-week, 90-min each time intervention. The results found a significant interaction between time and condition for prenatal stress (F=45.51, p<0.001, η ²=0.427), anxiety (F=19.30, p<0.001, η ²=0.240), while depression showed no time-by-group interaction (F=0.29, p=0.589, η ²=0.005). As for the sub-scale of state anxiety, while there was only no time effect (F=3.68, p=0.060, η ²=0.057). The findings of this study preliminary indicated effects of the MBSR intervention on self-reported prenatal stress and anxiety in comparison to a treatment-as-usual control. Effect on depression was not observed may due to the low level of depression of participants. This study provides preliminary evidence that MBSR is suitable for Chinese pregnant women and be effective in decreasing prenatal stress, anxiety.     

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.

     

Mindfulness-Based Stress Reduction and Sense of Coherence Among Women with Fibromyalgia

Sense of Coherence (SOC) is conceptualized as a disposition to experience life as meaningful and manageable. Research suggests a protective effect of SOC on psychological health in stressful circumstances. This study assessed the capacity of SOC to buffer the effect of illness symptoms on psychological distress among patients with fibromyalgia. Self-reported changes in SOC after participation in a Mindfulness-Based Stress Reduction (MBSR) program were also examined. Ninety-one women with fibromyalgia provided baseline data pertaining to illness symptoms, perceived stress, and depression prior to participation in a randomized trial of MBSR. SOC and fibromyalgia symptoms were independently related to perceived stress and depression at baseline. SOC was not a statistically significant moderator of symptom effects on psychological distress. In comparison with wait-listed controls, program participants reported a significant increase in SOC after MBSR participation. These results provide the first demonstration from a randomized trial that SOC may be enhanced via intervention.     

Self-compassion protects against the negative effects of low self-esteem: A longitudinal study in a large adolescent sample

Low self-esteem is usually linked to negative outcomes such as poor mental health, but is this always the case? Based on a contextual behavioural model, we reasoned that self-compassion would weaken the link between low self-esteem and low mental health. Self-compassion involves accepting self-doubt, negative self-evaluations and adversity as part of the human condition. In a longitudinal study of 2448 Australian adolescents, we assessed how self-esteem interacted with self-compassion in Grade 9 to predict changes in mental health over the next year. As hypothesized, self-compassion moderated the influence of self-esteem on mental health. Amongst those high in self-compassion, low self-esteem had little effect on mental health, suggesting a potentially potent buffering affect. We discuss the possibility that fostering self-compassion among adolescents can reduce their need for self-esteem in situations that elicit self-doubt.     

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.

     

Examining the Factor Structure of the Self-Compassion Scale in Four Distinct Populations: Is the Use of a Total Scale Score Justified?

This study examined the factor structure of the Self-Compassion Scale (SCS) using a bifactor model, a higher order model, a 6-factor correlated model, a 2-factor correlated model, and a 1-factor model in 4 distinct populations: college undergraduates (N = 222), community adults (N = 1,394), individuals practicing Buddhist meditation (N = 215), and a clinical sample of individuals with a history of recurrent depression (N = 390). The 6-factor correlated model demonstrated the best fit across samples, whereas the 1- and 2-factor models had poor fit. The higher order model also showed relatively poor fit across samples, suggesting it is not representative of the relationship between subscale factors and a general self-compassion factor. The bifactor model, however, had acceptable fit in the student, community, and meditator samples. Although fit was suboptimal in the clinical sample, results suggested an overall self-compassion factor could still be interpreted with some confidence. Moreover, estimates suggested a general self-compassion factor accounted for at least 90% of the reliable variance in SCS scores across samples, and item factor loadings and intercepts were equivalent across samples. Results suggest that a total SCS score can be used as an overall mesure of self-compassion.     

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.     

Self-compassion mediates the link between dependency and depressive symptomatology in college students

Depression is highly prevalent among college students and is associated with significant morbidity and mortality. Dependency is among the known personality traits that predict an elevated risk for depression. Prior research has focused on the depressogenic role of self-critical thoughts among destructive overdependent (DO) individuals but has not considered other internal processes (such as self-compassion) that might influence mental health. The current report examined whether self-compassion had either moderating or mediating effects on the links between dependency and depression in college students. In a cross-sectional study, 85 college students completed measures of dependency, self-compassion, and depressive symptoms. Analyses suggested that self-compassion mediated both the effect of DO on depressive symptoms and the effect of healthy dependency (HD) on lower depressive symptoms; self-compassion did not moderate links between dependency and depressive symptoms. Our exploratory findings suggest that positive self-schema (in the form of self-compassion) may contribute to the downstream mental health effects of both adaptive HD and maladaptive DO.     

Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial

The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen’s d = 0.55–0.97), and a large effect size for symptoms of depression (Cohen’s d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen’s d = 0.32–0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.     

The forest and the trees: Examining the association of self-compassion and its positive and negative components with psychological functioning

ABSTRACT

This paper presents two studies focusing on the link between psychological functioning and self-compassion as measured by the Self-Compassion Scale (SCS), especially in terms of SCS components that represent increased compassionate and reduced uncompassionate behavior. Study One examined this association in seven domains – psychopathology, positive psychological health, emotional intelligence, self-concept, body image, motivation, and interpersonal functioning – and found that while reduced negative self-responding had a stronger link to negative emotionality and self-evaluation than positive self-responding, they were roughly equivalent predictors in other domains. Study Two examined the association of compassionate and reduced uncompassionate behavior with sympathetic nervous system and inflammatory activity after stress, and found they equally predicted salivary alpha amylase and interleukin-6 levels in individuals after a stressful situation. Overall, results suggest that both compassionate and reduced uncompassionate self-responding are central to self-compassion and that both help to explain its link to healthy psychological functioning.     

Self-compassion and responses to negative social feedback: The role of fronto-amygdala circuit connectivity

ABSTRACT

Self-compassion has been shown to have significant relationships with psychological health and well-being. Despite the increasing growth of research on the topic, no studies to date have investigated how self-compassion relates to neural responses to threats to the self. To investigate whether self-compassion relates to threat-regulatory mechanisms at the neural level of analysis, we conducted a functional MRI study in a sample of college-aged students. We hypothesized that self-compassion would relate to greater negative connectivity between the ventromedial prefrontal cortex (VMPFC) and amygdala during a social feedback task. Interestingly, we found a negative correlation between self-compassion and VMPFC-amygdala functional connectivity as predicted; however, this seemed to be due to low levels of self-compassion relating to greater positive connectivity in this circuit (rather than high levels of self-compassion relating to more negative connectivity). We also found significant relationships with multiple subcomponents of self-compassion (Common Humanity, Self-Judgment). These results shed light on how self-compassion might affect neural responses to threat and informs our understanding of the basic psychological regulatory mechanisms linking a lack of self-compassion with poor mental health.     

A pilot exploration of the use of compassionate images in a group of self-critical people

Self-criticism has long been associated with a variety of psychological problems and is often a key focus for intervention in psychotherapy. Recent work has suggested that self-critics have underelaborated and underdeveloped capacities for compassionate self-soothing and warmth. This pilot study developed a diary for monitoring self-attacking and self-soothing thoughts and images. It also explored the personal experiences of a group of volunteer self-critics from the local depression support group who were given training in self-soothing and self-compassion. Although using small numbers, this study suggests the potential value of developing more complex methodologies for studying the capacity for self-compassion, interventions to increase self-compassion (including imagery techniques), and their effects on mental health.     

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.

     

Depression and anxiety among war-widows of Nepal: a post-civil war cross-sectional study

Thousands of Nepalese women were widowed as a consequence of a decade (1996–2006) long civil war in Nepal. These women are at grave risk of mental health problems due to both traumatic experiences and violation of natural order of widowhood. The present study explores the depression and anxiety among war-widows. In 2012, a cross-sectional study was designed to interview 358 war-widows using validitated Beck Depression Inventory and Beck Anxiety Inventory in four districts of Nepal – Bardiya, Surkhet, Sindhupalchowk and Kavrepalanchowk with history of high conflict intensity. The prevalence of depression and anxiety was 53% and 63% respectively. Financial stress was significantly associated with depression (2.67, 95% CI: 1.40–5.07) and anxiety (2.37, 95% CI: 1.19–4.72). High autonomy of women as compared to low autonomy, high social support as compared to low social support and literacy as opposed to illiteracy was associated with less likelihood of depression and anxiety. Our results suggest high magnitude of depression and anxiety among war-widows in Nepal. Future policy efforts should be directed at providing mental health services to identify mental health issues among conflict affected individuals with focus on education, employment and activities to promote social support and autonomy at community.     

Good and Bad Sides of Self-Compassion: A Face Validity Check of the Self-Compassion Scale and an Investigation of its Relations to Coping and Emotional Symptoms in Non-Clinical Adolescents

To demonstrate that the positive and negative subscales of Self-Compassion Scale (SCS) are very different in nature, we conducted a series of face validity checks on the items of this questionnaire among psychologists and psychology students (Study 1). Furthermore, a survey was administered to a convenience sample of non-clinical adolescents to examine the relations between various SCS subscales and symptoms of anxiety and depression as well as coping styles (Study 2). The results of the face validity checks revealed that the positive subscales seem to be well in line with the protective nature of self-compassion as they were mainly associated with cognitive coping and healthy functioning, whereas the negative subscales were chiefly associated with psychopathological symptoms and mental illness. The survey data demonstrated that the positive SCS subscales were positively correlated with adaptive coping (r’s between .22 and .50) and negatively correlated with symptoms of anxiety and depression (r’s between ?.19 and ?.53), while the negative subscales were positively correlated with symptoms (r’s between .49 and .61) and maladaptive coping strategies such as passive reacting (r’s between .53 and .56). Additional analyses indicated the negative subscales of the SCS accounted for a significant proportion of the variance in symptoms, whereas the unique contribution of the positive SCS subscales was fairly marginal. We caution to employ the total SCS score that includes the reversed negative subscales as such a procedure clearly inflates the relation between self-compassion and psychopathology.     

Exploring the mediating role of integrative self-knowledge in the relationship between mindfulness and well-being in the context of a mindfulness-based stress reduction program

Mindfulness-based stress reduction (MBSR) is an effective program for improving well-being. A growing body of studies is exploring the mechanisms mediating its beneficial effects. Integrative self-knowledge (ISK) is the construct of focus in this study. The primary goal of the current study was to investigate the mediating role of ISK in the relationship between improved mindful observing (MO), non-judging inner experience (NJ), and well-being following an MBSR program with an Iranian sample. Participants (n = 118) enrolled in MBSR and completed depression, anxiety, stress (DASS), Bartone Symptoms Checklist (BSC), Five-Facet Mindfulness Questionnaire, and ISK scale before and after the program. Results showed significant reductions in BSC, DASS, and improvements in MO, NJ, and ISK at the end of the program. Mediation analyses revealed that changes in ISK significantly mediated the relationship between changes in MO and NJ and symptoms (MO indirect effect on DASS: β = 0.11, confidence interval [CI] [0.003, 0.29]; NJ indirect effect on DASS: β = 0.12, CI [−0.16, 0.45]; MO indirect effect on BSC: β = 0.08, CI [0.001, 0.27]; NJ indirect effect on BSC: β = 0.09, CI [0.01, 0.22]). Improvements in MO and NJ may provide a pathway to cultivating ISK in MBSR, which may lead to enhanced well-being.