<p>This book presents an innovative eight-session program designed to prevent relapse in clients who have recovered from depression.</p>
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<p>Recovered recurrently depressed patients were randomized to treatment as usual (TAU) or TAU plus mindfulness-based cognitive therapy (MBCT). Replicating previous findings, MBCT reduced relapse from 78% to 36% in 55 patients with 3 or more previous episodes; but in 18 patients with only 2 (recent) episodes corresponding figures were 20% and 50%. MBCT was most effective in preventing relapses not preceded by life events. Relapses were more often associated with significant life events in the 2-episode group. This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group, suggesting that these groups represented distinct populations. MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes.</p>
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<p>Baer's review (2003; this issue) suggests that mindf ulness-based interventions are clinically efficacious, but that better designed studies are now needed to substantiate the field and place it on a firm foundation for future growth. Her review, coupled with other lines of evidence, suggests that interest in incorporating mindfulness into clinical interventions in medicine and psychology is growing. It is thus important that professionals coming to this field understand some of the unique factors associated with the delivery of mindfulness-based interventions and the potential conceptual and practical pitfalls of not recognizing the features of this broadly unfamiliar landscape. This commentary highlights and contextualizes (1) what exactly mindfulness is, (2) where it came from, (3) how it came to be introduced into medicine and health care, (4) issues of cross-cultural sensitivity and understanding in the study of meditative practices stemming from other cultures and in applications of them in novel settings, (5) why it is important for people who are teaching mind-fulness to practice themselves, (6) results from 3 recent studies from the Center for Mindfulness in Medicine, Health Care, and Society not reviewed by Baer but which raise a number of key questions about clinical applicability, study design, and mechanism of action, and (7) current opportunities for professional training and development in mindfulness and its clinical applications.</p>
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<p>This study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non-directed attention. Healthy adults were tested before and after random assignment to an 8-week Mindfulness-Based Stress Reduction (MBSR) course (n = 39) or a wait-list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of elaborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non-directed attention), as well as self-report measures of emotional well-being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well-being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after MBSR were correlated with improvements in object detection. We discuss the implications of these results as they relate to the role of attention in mindfulness. Copyright © 2007 John Wiley & Sons, Ltd.</p>
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Objective: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. The program, nonreligious and nonesoteric, is based upon a systematic procedure to develop enhanced awareness of moment-to-moment experience of perceptible mental processes. The approach assumes that greater awareness will provide more veridical perception, reduce negative affect and improve vitality and coping. In the last two decades, a number of research reports appeared that seem to support many of these claims. We performed a comprehensive review and meta-analysis of published and unpublished studies of health-related studies related to MBSR. Methods: Sixty-four empirical studies were found, but only 20 reports met criteria of acceptable quality or relevance to be included in the meta-analysis. Reports were excluded due to (I) insufficient information about interventions, (2) poor quantitative health evaluation, (3) inadequate statistical analysis, (4) mindfulness not being the central component of intervention, or (5) the setting of intervention or sample composition deviating too widely from the health-related MBSR program. Acceptable studies covered a wide spectrum of clinical populations (e.g., pain, cancer, heart disease, depression, and anxiety), as well as stressed nonclinical groups. Both controlled and observational investigations were included. Standardized measures of physical and mental well-being constituted the dependent variables of the analysis. Results: Overall, both controlled and uncontrolled studies showed similar effect sizes of approximately 0.5 (P <.0001) with homogeneity of distribution. Conclusion: Although derived from a relatively small number of studies, these results suggest that MBSR may help a broad range of individuals to cope with their clinical and nonclinical problems.
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OBJECTIVE: To determine whether completing a mindfulness-based stress reduction (MBSR) program would affect the general health, health-related quality of life, sleep quality, and family harmony of Spanish- and English-speaking medical patients at an inner-city health center.
MATERIALS AND METHODS: An intervention group of 68 patients (48 Spanish-speaking and 20 English-speaking) completed the SF-36 Health Survey and two additional questions about sleep quality and family harmony before and after completing the 8-week MBSR program. A comparison group of 18 Spanish-speaking patients who received no intervention completed the same questionnaire at the same intervals.
RESULTS: Sixty-six percent of the total intervention group completed the 8-week MBSR program. There was significant comorbidity of medical and mental health diagnoses among the intervention and comparison groups, with no differences in the mean number of diagnoses of the total intervention group, the comparison group, or the Spanish- or English-speaking intervention subgroups. Compared with the comparison group, the intervention group showed statistically significant improvement on five of the eight SF-36 measures, and no improvement on the sleep quality or family harmony items.
CONCLUSIONS: MBSR may be an effective behavioral medicine program for Spanish- and English-speaking inner-city medical patients. Suggestions are given for future research to help clarify the program’s effectiveness for this population.
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This study examined the effects of mindfulness-based stress reduction (MBSR) on health-related quality of life and physical and psychological symptomatology in a heterogeneous patient population. Patients (n=136) participated in an 8-week MBSR program and were required to practice 20 min of meditation daily. Pre- and post-intervention data were collected by using the Short-Form Health Survey (SF-36), Medical Symptom Checklist (MSCL) and Symptom Checklist-90 Revised (SCL-90-R). Health-related quality of life was enhanced as demonstrated by improvement on all indices of the SF-36, including vitality, bodily pain, role limitations caused by physical health, and social functioning (all P<.01). Alleviation of physical symptoms was revealed by a 28% reduction on the MSCL (P<.0001). Decreased psychological distress was indicated on the SCL-90-R by a 38% reduction on the Global Severity Index, a 44% reduction on the anxiety subscale, and a 34% reduction on the depression subscale (all P<.0001). One-year follow-up revealed maintenance of initial improvements on several outcome parameters. We conclude that a group mindfulness meditation training program can enhance functional status and well-being and reduce physical symptoms and psychological distress in a heterogeneous patient population and that the intervention may have long-term beneficial effects.
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<p>The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stress reduction (MBSR), on health care professionals. Results from this prospective randomized controlled pilot study suggest that an 8-week MBSR intervention may be effective for reducing stress and increasing quality of life and self-compassion in health care professionals. Implications for future research and practice are discussed.</p>
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<p>Background: Medical students confront significant academic, psychosocial, and existential stressors throughout their training. Mindfulness-based stress reduction (MBSR) is an educational intervention designed to improve coping skills and reduce emotional distress. Purpose: The purpose of this study was to examine the effectiveness of the MBSR intervention in a prospective, nonrandomized, cohort-controlled study. Methods: Second-year students (n = 140) elected to participate in a 10-week MBSR seminar. Controls (n = 162) participated in a didactic seminar on complementary medicine. Profile of Mood States (POMS) was administered preintervention and postintervention. Results: Baseline total mood disturbance (TMD) was greater in the MBSR group compared with controls (38.7 ±33.3 vs. 28.0 ±31.2; p <. 01). Despite this initial difference, the MBSR group scored significantly lower in TMD at the completion of the intervention period (31.8 ±33.8 vs. 38.6 ±32.8; p < . 05). Significant effects were also observed on Tension-Anxiety, Confusion-Bewilderment, Fatigue-Inertia, and Vigor-Activity subscales. Conclusion: MBSR may be an effective stress management intervention for medical students.</p>
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- Contemplation by Applied Subject,
- Medical Learning and Contemplation,
- Heath Care Workers & Organizations and Contemplation,
- Psychiatry and Contemplation,
- Mindfulness-Based Stress Reduction / Cognitive Therapy,
- Psychotherapy and Contemplation,
- Higher Education and Contemplation,
- Health Care and Contemplation,
- Education and Contemplation
<p>Mindfulness-Based Stress Reduction (MBSR) is a potential candidate for learning to cope with stress in a high-stress professional environment. In a pilot study the authors evaluated the potential of MBSR for stress management. Workers participated in an MBSR training for stress-related problems (treatment, n = 12) or waited for such a course (control, n = 11). The authors conducted interviews and measured coping and well-being. Qualitative interviews indicated that subjects had attained more awareness of work-related problems contributing to stress and had grown more critical toward their work environment. In the treatment group, positive strategies of coping with stress increased and negative strategies of coping decreased (significant difference at post treatment: p = .039 compared to control). Eighty-two percent of the participants reported having reached their personal goal.</p>
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<p>"Everyday life is so frantic and full of troubles that we have largely forgotten how to live a joyful existence. We try so hard to be happy that we often end up missing the most important parts of our lives. In Mindfulness, Oxford professor Mark Williams and award-winning journalist Danny Penman reveal the secrets to living a happier and less anxious, stressful, and exhausting life. Based on the techniques of Mindfulness-Based Cognitive Therapy, the unique program developed by Williams and his colleagues, the book offers simple and straightforward forms of mindfulness meditation that can be done by anyone--and it can take just 10 to 20 minutes a day for the full benefits to be revealed"-- "From one of the leading thinkers on Mindfulness-Based Cognitive Therapy, a pioneering set of simple practices to dissolve anxiety, stress, exhaustion, and unhappiness. Everyday life is so frantic and full of troubles that we have largely forgotten how to live a joyful existence. We try so hard to be happy that we often end up missing the most important parts of our lives. In Mindfulness, Oxford professor Mark Williams and award-winning journalist Danny Penman reveal the secrets to living a happier and less anxious, stressful, and exhausting life. Based on the techniques of Mindfulness-Based Cognitive Therapy, the unique program developed by Williams and his colleagues, the book offers simple and straightforward forms of mindfulness meditation that can be done by anyone--and it can take just 10 to 20 minutes a day for the full benefits to be revealed. "--</p>
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Objective: ADHD is a childhood-onset psychiatric condition that often continues into adulthood. Stimulant medications are the mainstay of treatment; however, additional approaches are frequently desired. In recent years, mindfulness meditation has been proposed to improve attention, reduce stress, and improve mood. This study tests the feasibility of an 8-week mindfulness training program for adults and adolescents with ADHD. Method: Twenty-four adults and eight adolescents with ADHD enrolled in a feasibility study of an 8-week mindfulness training program. Results: The majority of participants completed the training and reported high satisfaction with the training. Pre—post improvements in self-reported ADHD symptoms and test performance on tasks measuring attention and cognitive inhibition were noted. Improvements in anxiety and depressive symptoms were also observed. Conclusion: Mindfulness training is a feasible intervention in a subset of ADHD adults and adolescents and may improve behavioral and neurocognitive impairments. A controlled clinical study is warranted. (J. of Att. Dis. 2008; 11(6) 737-746)
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Mindfulness interventions within adult populations are becoming increasingly popular. Research suggests that mindfulness can deliver lasting improvements in self-awareness and emotional stability to adults with severe and chronic conditions. As yet, research within child and adolescent populations is in its initial stages, although mindfulness shows great clinical promise for young people. This article aims to provide an overview of mindfulness to professionals who are working in child or adolescent settings. Initially, it will provide the reader with some orientation to and definitions from the field, before summarizing the current evidence for the utility of the approach. The article recommends specific clinical modifications for mindfulness with children and adolescents, as well as reviewing how to monitor and enhance the development of this skill. Finally, it highlights important differences among mindfulness, relaxation and other meditative techniques.
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Prenatal psychopathology may have an adverse impact on mother and baby, but few women receive treatment. We offered a 10-week mindfulness yoga (M-Yoga) intervention to psychiatrically high-risk pregnant women as an alternative to pharmacological treatment. Participants (N = 18) were primiparous, 12–26 weeks pregnant, and had elevated scores (>9) on the Edinburgh Postnatal Depression Screen at baseline. In addition to a baseline diagnostic assessment, women completed self-ratings on depression, mindfulness, and maternal-fetal attachment before and after M-Yoga. Findings suggest that M-Yoga was feasible, accepted and effective. Symptoms of depression were significantly reduced (p = 0.025), while mindfulness (p = 0.007) and maternal-fetal attachment (p = 0.000) significantly increased. Overall, this pilot study is the first to demonstrate that M-Yoga may be an effective treatment alternative or augmentation to pharmacotherapy for pregnant women at high risk for psychopathology.
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After years of meditating, are you still saddled with many of the same personal conflicts and interpersonal inhibitions that plagued you before you began? Rubin explores the hidden flaws in the meditative method itself. He explores Buddhism's ambivalent relationship to emotional life, and the negative consequences of "letting go" of experience. Detaching from experience may result in renouncing vital aspects of ourselves, such as constructive passion. The author argues that real meditation is transformative not tranquilizing, fostering a dynamic way of living.
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Objectives: To examine whether mindfulness meditation (MM) was associated with changes in objectively measured polysomnographic (PSG) sleep profiles and to relate changes in PSG sleep to subjectively reported changes in sleep and depression within the context of a randomized controlled trial. Previous studies have indicated that mindfulness and other forms of meditation training are associated with improvements in sleep quality. However, none of these studies used objective PSG sleep recordings within longitudinal randomized controlled trials of naïve subjects.
Methods: Twenty-six individuals with partially remitted depression were randomized into an 8-week Mindfulness-Based Cognitive Therapy (MBCT) course or a waitlist control condition. Pre-post measurements included PSG sleep studies and subjectively reported sleep and depression symptoms.
Results: According to PSG sleep, MM practice was associated with several indices of increased cortical arousal, including more awakenings and stage 1 sleep and less slow-wave sleep relative to controls, in proportion to amount of MM practice. According to sleep diaries, subjectively reported sleep improved post MBCT but not above and beyond controls. Beck Depression Inventory scores decreased more in the MBCT group than controls. Improvements in depression were associated with increased subjective sleep continuity and increased PSG arousal.
Conclusions: MM is associated with increases in objectively measured arousal during sleep with simultaneous improvements in subjectively reported sleep quality and mood disturbance. This pattern is similar to the profiles of positive responders to common antidepressant medications.
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<p>This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients ( n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.</p>
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Objective: A cross-sectional survey of quality of life of people attending a self-development course involving psychophysiological mind-body medicine (MBM) activities. Design: A questionnaire study using a health-related quality of life (HRQoL) instrument, the SWED-QUAL, with 13 subscales scored 0-100, and questions about utilisation of alternative and standard health care, medication and sick leave. Setting: A training centre for MBM, established 15 years ago. Study group: One hundred and seven eligible course attendants (response rate 88%, age 20-70 years) during the year 2000 assessed their HRQoL just before entering the course. Attendance was self-initiated, without referral. The results on HRQoL were compared with those of control subjects from the general Swedish population. Results: Six of the thirteen HRQoL subscales were strongly and significantly reduced (p < 0.0001) in the study group: Negative affectivity, Role limitation due to emotional health, Positive affectivity, Cognitive functioning, Family functioning and Marital functioning. Long-term sick leave (>6 months) was three times as frequent in the study group as in the general population. Use of psychotropic medication was slightly increased compared to the general population, at least among the younger male participants. The education level was high, health care utilisation was average and body functioning was good. Conclusions: This group of well-educated men and women gave their emotional health an unexpectedly low rating, on a par with that given by people with chronic diseases.
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