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OBJECTIVES:Previous studies have identified different, but highly correlated variables explaining the effects of mindfulness training. Many of them are limited by tautological explanation. Under the framework of the mind-body connection, mindfulness training cultivates body awareness and promotes self-management of illness. Stagnation, a concept from Chinese medicine, may help explain the mechanism of change in mindfulness training. METHODS: Individuals with depressive and anxiety symptoms (n=82) were randomized to either a Compassion-Mindfulness Therapy (C-MT) program or a waitlist control condition. The effect of stagnation as a mediator was investigated for dependent variables including depression, anxiety, and other physical and mental health variables. MAJOR OUTCOME MEASURES: Depression, anxiety, stagnation, physical distress, daily functioning, positive affect, negative affect. RESULTS: Compared with the participants in the control group, those who completed C-MT demonstrated significant decreases in depression, F(1, 78)=15.67, p<.001, anxiety, F(1, 78)=7.72, p<.001, stagnation, F(1, 78)=4.96, p<.001, and other body-mind-spirit well-being measures. After entering the change in stagnation as the mediator, the effect of treatment reduced: depression (.35-.22), anxiety (.33-.05), and same patterns in other three secondary measures. The Sobel test was administered and significant reductions between group and depression (z=2.18, p=.029), anxiety (z=2.21, p=.027), and three secondary other measures (p<.05) were indicated. CONCLUSION: The study provides initial support for the role of stagnation in mediating changes in mindfulness training. It adds evidence to body-mind nondualism and offers new possibilities in studying treatment process and change mechanism.

OBJECTIVES:Previous studies have identified different, but highly correlated variables explaining the effects of mindfulness training. Many of them are limited by tautological explanation. Under the framework of the mind-body connection, mindfulness training cultivates body awareness and promotes self-management of illness. Stagnation, a concept from Chinese medicine, may help explain the mechanism of change in mindfulness training. METHODS: Individuals with depressive and anxiety symptoms (n=82) were randomized to either a Compassion-Mindfulness Therapy (C-MT) program or a waitlist control condition. The effect of stagnation as a mediator was investigated for dependent variables including depression, anxiety, and other physical and mental health variables. MAJOR OUTCOME MEASURES: Depression, anxiety, stagnation, physical distress, daily functioning, positive affect, negative affect. RESULTS: Compared with the participants in the control group, those who completed C-MT demonstrated significant decreases in depression, F(1, 78)=15.67, p<.001, anxiety, F(1, 78)=7.72, p<.001, stagnation, F(1, 78)=4.96, p<.001, and other body-mind-spirit well-being measures. After entering the change in stagnation as the mediator, the effect of treatment reduced: depression (.35-.22), anxiety (.33-.05), and same patterns in other three secondary measures. The Sobel test was administered and significant reductions between group and depression (z=2.18, p=.029), anxiety (z=2.21, p=.027), and three secondary other measures (p<.05) were indicated. CONCLUSION: The study provides initial support for the role of stagnation in mediating changes in mindfulness training. It adds evidence to body-mind nondualism and offers new possibilities in studying treatment process and change mechanism.

Introduction Mindfulness is one of the potential alternative interventions for children with attention-deficit hyperactivity disorder (ADHD). Some evidence suggests that mindfulness is related to changes in brain regions associated with ADHD. The potential benefits of mindfulness on children with ADHD, as well as the feasibility of this intervention approach, are warranted through prior local and foreign studies. This study aims to evaluate the effect of mindfulness-based group intervention for children with ADHD and their respective parents through a robust research design.Methods and analysis This study will adopt a randomised controlled trial design including 140 children aged 8–12 years with ADHD together with one of their parents (n=140). These families will be randomised into intervention group (n=70) who will be offered the MYmind programme delivered by trained healthcare professionals, and an active control group (n=70) who will be offered the CBT programme. The intervention includes 8 weekly 90 min group sessions for children with ADHD (aged 8–12 years) and their respective parents. The primary and secondary outcomes will include children’s attention, ADHD-related symptoms, behaviours, executive function and mindfulness levels measured by validated objective measures and parent’s reported instruments. Parents’ parental stress, parenting styles, ADHD related symptoms, well-being, rumination level and mindfulness levels will also be measured. Analysis is by intention to treat. The effects of intervention will be evaluated by comparing outcomes between the two arms, as well as comparing outcomes within subject through comparing measurements at baseline (T0), immediately after the 8 week intervention (T1) and at 3 (T2) and 6 (T3) months postintervention. Ethics and dissemination Ethics approval has been granted by the Joint Chinese University of Hong Kong – New Territories East Cluster Clinical Research Ethics Committee (The Joint CUHK-NTEC CREC). Participants will be required to sign informed consent form from both parents and children. Findings will be reported in conferences and peer-reviewed publications in accordance with recommendations of Consolidated Standards of Reporting Trials.

<h3>Objective</h3><p>To conduct a systematic review of reports on the physical and psychological effects of Tai Chi on various chronic medical conditions.</p><h3>Data Sources</h3><p>Search of 11 computerized English and Chinese databases.</p><h3>Study Selection</h3><p>Randomized controlled trials, nonrandomized controlled studies, and observational studies published in English or Chinese.</p><h3>Data Extraction</h3><p>Data were extracted for the study objective, population characteristics, study setting, type of Tai Chi intervention, study design, outcome assessment, duration of follow-up, and key results.</p><h3>Data Synthesis</h3><p>There were 9 randomized controlled trials, 23 nonrandomized controlled studies, and 15 observational studies in this review. Benefits were reported in balance and strength, cardiovascular and respiratory function, flexibility, immune system, symptoms of arthritis, muscular strength, and psychological effects.</p><h3>Conclusions</h3><p>Tai Chi appears to have physiological and psychosocial benefits and also appears to be safe and effective in promoting balance control, flexibility, and cardiovascular fitness in older patients with chronic conditions. However, limitations or biases exist in most studies, and it is difficult to draw firm conclusions about the benefits reported. Most indications in which Tai Chi was applied lack a theoretical foundation concerning the mechanism of benefit. Well-designed studies are needed.</p>

Disseminating mindfulness-based cognitive therapy (MBCT), an evidence-based group treatment, in the workplace may help employees who have recovered from depression to prevent depressive relapse and stay well. Employees’ potential confidentiality concerns about participating in a group-based workplace MBCT intervention may be alleviated by delivering MBCT in alternative formats that would maintain the employees’ anonymity. The aim of the current study was to determine the stated preferences of employees from large healthcare organizations for four different MBCT delivery methods (i.e., group, online group, individual, and individual via the telephone). We determined the stated preferences of 151 health authority employees for the four MBCT delivery methods using a discrete choice experiment comprised of 18 choice sets of five attributes. A latent class model was used to evaluate the heterogeneity of respondents' preferences. This analysis suggested that four classes existed in the sample. The most important preferences were the effectiveness of MBCT, the type of interaction, face-to-face delivery, and receipt of MBCT on their own time. These results suggest strong preferences for the four different MBCT delivery methods. The presence of latent classes also shows that preferences for alternative modes of delivery vary in association with differences in sociodemographic variables between groups of employees. The overall findings of this study have the potential to influence the development of institutional programs that could make workplace MBCT more appealing to a greater number of employees, thereby improving participant uptake, decreasing the potential for depressive relapse, and minimizing absenteeism.

In many countries, university students experience various stressors that may negatively affect their psychological well-being (PWB). Hence, they are at risk for physical and mental problems. This research aimed to examine the predicting effects of mindfulness, self-efficacy, and social support on psychological well-being among undergraduate students. A non-experimental research was conducted at a university in the Philippines. Power analysis was used to calculate an adequate sample size and a convenience sampling of 630 was recruited. Data were collected through online self-reported questionnaires from year 2013 to 2015. Descriptive statistics, correlational analyses, and structural equation modelling were performed to analyse the research data. Results showed that the participants were mostly Filipino, female, Christian, and in Schools of Nursing and Medicine. Mindfulness, self-efficacy, support from family, support from friends, and support from significant others were significant predictors of psychological well-being. Mindfulness was the strongest predictor of positive psychological well-being whereas self-efficacy was the strongest predictor of negative PWB. Psychosocial interventions, with the focus on strengthening mindfulness and self-efficacy, could be delivered to students to help enhance psychological well-being among undergraduate students. More studies can be undertaken to test the interventions and multi-centred research can be conducted to enhance generalisability of research findings.

Using data for 25,780 species categorized on the International Union for Conservation of Nature Red List, we present an assessment of the status of the world’s vertebrates. One-fifth of species are classified as Threatened, and we show that this figure is increasing: On average, 52 species of mammals, birds, and amphibians move one category closer to extinction each year. However, this overall pattern conceals the impact of conservation successes, and we show that the rate of deterioration would have been at least one-fifth again as much in the absence of these. Nonetheless, current conservation efforts remain insufficient to offset the main drivers of biodiversity loss in these groups: agricultural expansion, logging, overexploitation, and invasive alien species.Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation. Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.

Recent innovations in psychological treatments have integrated mindfulness meditation techniques with traditional cognitive and behavioural therapies, challenging traditional cognitive and behavioural therapists to integrate acceptance- and change-based strategies. This article details how 2 treatments, mindfulness-based cognitive therapy and dialectical behaviour therapy, have met this challenge. We review the integration rationale underlying the 2 treatments, how the treatments combine strategies from each modality to accomplish treatment goals, implications for therapist training, and treatment effectiveness. In addition, we discuss the challenges of assessing the benefits of incorporating acceptance-based strategies. Both therapies have integrated acceptance-based mindfulness approaches with change-based cognitive and behavioural therapies to create efficacious treatments.

Schizophrenia is associated with an increased violence risk, particularly homicide. One possible, but scarcely explored, contributor to the increased violence risk is social cognitive impairment. Individuals with schizophrenia show impairments in social cognition that are associated with poor functional outcome. This study examined social cognition among homicide offenders with schizophrenia (HOS), applying validated measures of emotion perception and theory of mind (ToM). Two groups of individuals with schizophrenia were compared, one had committed homicide (HOS, n = 26), and the other had no violence history (non-HOS, n = 28). Healthy controls (HC, n = 71) were included as reference group for one measure. Emotion perception was indexed by the Emotion in Biological Motion (Emotion) and Pictures of Facial Affect (PFA) tests. ToM was assessed with the Hinting Task and Movie for the Assessment of Social Cognition (MASC). The results showed that HOS participants had significantly poorer performance than non-HOS in both emotion perception and ToM. For the MASC test, HOS participants showed large deficits compared to HC (-4 standard deviations). Particularly, HOS participants made a substantial number of undermentalizing errors. The results suggest that emotion perception deficits and a tendency to undermentalize may be important for understanding homicide in schizophrenia.

BACKGROUND:Perinatal stress is associated with adverse maternal and infant outcomes. Mindfulness training may offer a safe and acceptable strategy to support perinatal mental health. AIM: To critically appraise and synthesise the best available evidence regarding the effectiveness of mindfulness training during pregnancy to support perinatal mental health. METHODS: The search for relevant studies was conducted in six electronic databases and in the grey literature. Eligible studies were assessed for methodological quality according to standardised critical appraisal instruments. Data were extracted and recorded on a pre-designed form and then entered into Review Manager. FINDINGS: Nine studies were included in the data synthesis. It was not appropriate to combine the study results because of the variation in methodologies and the interventions tested. Statistically significant improvements were found in small studies of women undertaking mindfulness awareness training in one study for stress (mean difference (MD) -5.28, 95% confidence intervals (CI) -10.4 to -0.42, n=22), two for depression (for example MD -5.48, 95% CI -8.96 to -2.0, n=46) and four for anxiety (for example, MD -6.50, 95% CI -10.95 to -2.05, n=32). However the findings of this review are limited by significant methodological issues within the current research studies. CONCLUSION: There is insufficient evidence from high quality research on which to base recommendations about the effectiveness of mindfulness to promote perinatal mental health. The limited positive findings support the design and conduct of adequately powered, longitudinal randomised controlled trials, with active controls.

<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 &amp; Sons, Ltd.</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-weekMindfulness-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 laborative 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.

OBJECTIVE: To describe self-reported menopausal symptom priorities and their association with demographics and other symptoms among participants in an intervention trial for vasomotor symptoms (VMS). METHODS: Cross-sectional study embedded in the MsFLASH 02 trial, a three-by-two factorial design of yoga vs. exercise vs. usual activity and omega-3-fatty acid vs. placebo. At baseline, women (n = 354) completed hot flush diaries, a card sort task to prioritize symptoms they would most like to alleviate, and standardized questionnaires. RESULTS: The most common symptom priorities were: VMS (n = 322), sleep (n = 191), concentration (n = 140), and fatigue (n = 116). In multivariate models, women who chose VMS as their top priority symptom (n = 210) reported significantly greater VMS severity (p = 0.004) and never smoking (p = 0.012), and women who chose sleep as their top priority symptom (n = 100) were more educated (p </= 0.001) and had worse sleep quality (p < 0.001). ROC curves identified sleep scale scores that were highly predictive of ranking sleep as a top priority symptom. CONCLUSIONS: Among women entering an intervention trial for VMS and with relatively low prevalence of depression and anxiety, VMS was the priority symptom for treatment. A card sort may be a valid tool for quickly assessing symptom priorities in clinical practice and research.

<p>This special issue focuses on new developments that make up the expanding envelope of mindfulness-based psychological research. Briefly, the articles in this issue include the description and validation of a trait version of the Toronto Mindfulness Scale, an exploration of the mechanisms underlying the association between increased mindfulness and psychological adjustment, an investigation of whether practicing mindfulness between sessions contributes to symptom improvement, a study of the neural mechanisms underlying increased mindfulness in social anxiety disorder (SAD), and finally an evaluation of whether attachment style moderates participant response to mindfulness-based stress reduction (MBSR). The articles in this current special issue provide examples of recent areas of investigation in the pursuit of better understanding the growing clinical application of mindfulness-based interventions in Western health care. Potentially, these ongoing efforts will further improve the effectiveness of these treatments to reduce suffering.</p>

While the field of empirical study on religion and spirituality in relation to mental health has rapidly expanded over the past decade, little is known about underlying dimensions of spirituality cross-culturally conceived. We aimed to bridge this gap by inductively deriving potential universal dimensions of spirituality through a large-scale, multi-national data collection, and examining the relationships of these dimensions with common psychiatric conditions. Five-thousand five-hundred and twelve participants from China, India, and the United States completed a two-hour online survey consisting of wide-ranging measures of the lived experience of spirituality, as well as clinical assessments. A series of inductive Exploratory Factor Analysis (EFA) and cross-validating Exploratory Structural Equation Modeling (ESEM) were conducted to derive common underlying dimensions of spirituality. Logistic regression analyses were then conducted with each dimension to predict depression, suicidal ideation, generalized anxiety, and substance-related disorders. Preliminary EFA results were consistently supported by ESEM findings. Analyses of 40 spirituality measures revealed five invariant factors across countries which were interpreted as five dimensions of universal spiritual experience, specifically: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined. Love, interconnectedness, and altruism were associated with less risk of psychopathology for all countries. Religious and spiritual reflection and commitment and contemplative practice were associated with less risk in India and the United States but associated with greater risk in China. Education was directly associated with dimensions of spiritual awareness in India and China but inversely associated with dimensions in the United States. Findings support the notion that spirituality is a universal phenomenon with potentially universal dimensions. These aspects of spirituality may each offer protective effects against psychiatric symptoms and disorders and suggest new directions for treatment.

This study examined the feasibility and efficacy of a 12-week mindfulness intervention in a wait-list controlled trial of 19 Latino-American and Asian-American middle school students with elevated mood symptoms. ANCOVA analyses indicated that immediate treatment was associated with significant reductions in parent-reported externalizing problems at post-treatment and marginally significant reductions in youth-reported internalizing problems. The pooled pre-to-post treatment analyses revealed that mindfulness led to a reduction in parent-reported externalizing problems, youth-reported internalizing problems, and youth-reported use of expressive suppression. Overall, this pilot study offers feasibility and efficacy data for mindfulness-based program as a potential treatment for behavior problems for ethnic minority youth with elevated mood symptoms. Implications of the findings, as well as considerations in engaging low-income ethnic minority families are discussed.

<p>Mindfulness-based intervention with adults has been found to be highly effective and as such it has been the subject of much research in the past few decades. However, the study of mindfulness-based approaches with adolescents, especially in the Asian context, is still under-explored. This paper reports findings from a pilot controlled trial assessing preliminary outcomes of a mindfulness-based programme in schools in Hong Kong. Fourteen to 16-year-old adolescents with low academic performance from two secondary schools were invited to take part in intervention and control groups (n = 48). It was hypothesised that a six-week mindfulness-based programme would increase well-being, reduce stress and symptoms of depression. Well-being, stress and depressive symptoms of both intervention and control groups were assessed at baseline and post-intervention. The findings showed that there was a significant decrease in symptoms of depression and a significant increase in one dimension of well-being among both groups. Qualitative data reflected that the mindfulness programme was beneficial and feasible to adolescents at schools. The results support conducting a randomised controlled trial with a larger sample and a long term follow-up.</p>
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Mindfulness-based intervention with adults has been found to be highly effective and as such it has been the subject of much research in the past few decades. However, the study of mindfulness-based approaches with adolescents, especially in the Asian context, is still under-explored. This paper reports findings from a pilot controlled trial assessing preliminary outcomes of a mindfulness-based programme in schools in Hong Kong. Fourteen to 16-year-old adolescents with low academic performance from two secondary schools were invited to take part in intervention and control groups (n = 48). It was hypothesised that a six-week mindfulness-based programme would increase well-being, reduce stress and symptoms of depression. Well-being, stress and depressive symptoms of both intervention and control groups were assessed at baseline and post-intervention. The findings showed that there was a significant decrease in symptoms of depression and a significant increase in one dimension of well-being among both groups. Qualitative data reflected that the mindfulness programme was beneficial and feasible to adolescents at schools. The results support conducting a randomised controlled trial with a larger sample and a long term follow-up.

Mindfulness-based intervention with adults has been found to be highly effective and as such it has been the subject of much research in the past few decades. However, the study of mindfulness-based approaches with adolescents, especially in the Asian context, is still under-explored. This paper reports findings from a pilot controlled trial assessing preliminary outcomes of a mindfulness-based programme in schools in Hong Kong. Fourteen to 16-year-old adolescents with low academic performance from two secondary schools were invited to take part in intervention and control groups (n = 48). It was hypothesised that a six-week mindfulness-based programme would increase well-being, reduce stress and symptoms of depression. Well-being, stress and depressive symptoms of both intervention and control groups were assessed at baseline and post-intervention. The findings showed that there was a significant decrease in symptoms of depression and a significant increase in one dimension of well-being among both groups. Qualitative data reflected that the mindfulness programme was beneficial and feasible to adolescents at schools. The results support conducting a randomised controlled trial with a larger sample and a long term follow-up.

<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>

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.

The stress that negatively affects teachers has been found to influence the turnover rate in the teaching profession. Recent research has shown that mindfulness-based programmes effectively promote well-being while addressing psychological distress. In this study, the authors investigated the effects of a six-week mindfulness-based programme on pre-service teachers in Hong Kong (N = 70). The authors hypothesised that a six-week mindfulness-based programme would increase mindfulness and well-being while reducing stress and symptoms of depression. Both intervention and control groups were assessed at baseline and post-intervention. A univariate analysis revealed a significant increase in mindfulness and well-being. A regression analysis indicated that mindfulness was a significant predictor of well-being, stress, anxiety and depressive symptoms. Qualitative data reflected that the mindfulness programme was beneficial to and feasible for pre-service teachers. Such a programme could be implemented in teaching education to promote well-being and stress management while preventing burnout among teaching professionals.

The stress that negatively affects teachers has been found to influence the turnover rate in the teaching profession. Recent research has shown that mindfulness-based programmes effectively promote well-being while addressing psychological distress. In this study, the authors investigated the effects of a six-week mindfulness-based programme on pre-service teachers in Hong Kong (N = 70). The authors hypothesised that a six-week mindfulness-based programme would increase mindfulness and well-being while reducing stress and symptoms of depression. Both intervention and control groups were assessed at baseline and post-intervention. A univariate analysis revealed a significant increase in mindfulness and well-being. A regression analysis indicated that mindfulness was a significant predictor of well-being, stress, anxiety and depressive symptoms. Qualitative data reflected that the mindfulness programme was beneficial to and feasible for pre-service teachers. Such a programme could be implemented in teaching education to promote well-being and stress management while preventing burnout among teaching professionals.

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