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Mindfulness-based cognitive therapy (MBCT) has been demonstrated to be successful in the prevention of relapse in patients with recurrent major depressive disorder (MDD). With regard to its working mechanisms, it is hypothesized that mindfulness meditation influences the processing of emotional information and that it could therefore reduce cognitive vulnerability factors that are observed during and after remission of depressive episodes. In this study we investigated the effects of an 8 week MBCT training versus no intervention on the facilitation and inhibition of attention for sad versus happy faces in a group of people with a history of MDD, N = 45. The comparison group consisted of a non-treatment seeking group with a history of MDD, recruited from the community, N = 26. At baseline, we found that formerly depressed patients who applied for MBCT training inhibited attention for positive information, and showed facilitation of attention for negative information. However, the comparison group did not show similar attentional characteristics. After MBCT, participants showed a reduced facilitation of attention for negative information and a reduced inhibition of attention for positive information, which is indicative of open attention towards all emotional information.
Mindfulness-based cognitive therapy (MBCT) has been demonstrated to be successful in the prevention of relapse in patients with recurrent major depressive disorder (MDD). With regard to its working mechanisms, it is hypothesized that mindfulness meditation influences the processing of emotional information and that it could therefore reduce cognitive vulnerability factors that are observed during and after remission of depressive episodes. In this study we investigated the effects of an 8 week MBCT training versus no intervention on the facilitation and inhibition of attention for sad versus happy faces in a group of people with a history of MDD, N = 45. The comparison group consisted of a non-treatment seeking group with a history of MDD, recruited from the community, N = 26. At baseline, we found that formerly depressed patients who applied for MBCT training inhibited attention for positive information, and showed facilitation of attention for negative information. However, the comparison group did not show similar attentional characteristics. After MBCT, participants showed a reduced facilitation of attention for negative information and a reduced inhibition of attention for positive information, which is indicative of open attention towards all emotional information.
Self-compassion, or the ability to kindly accept oneself while suffering, is a topic of significant and growing scientific interest. Past research has shown, for example, that self-compassion is associated with less concurrent depression. So far, however, it remained untested whether self-compassion also prospectively predicts depression symptoms. Three hundred and forty-seven first-year psychology students (303 women; 44 men), ages 17–36, completed measures of self-compassion and depression symptoms at two assessments separated by a 5-month period. Results showed that self-compasion significantly predicted changes in depression symptoms, such that higher levels of self-compassion at baseline were significantly associated with greater reductions and/or smaller increases in such symptoms over the 5-month interval. These findings are consistent with the idea that self-compassion respresents a potentially important protective factor for emotional problems such as depression. Additional analyses further suggest that self-compassion is a relatively stable trait-like characteristic.
A teacher's ability to foster and sustain high quality learning environments for their students relies largely on their own coping abilities and mental health. However, due to the emotionally taxing nature of their profession, teachers are at increased risk for developing elevated levels of occupational stress and burnout. To help teachers cope with their occupational stress and other negative emotions related to their occupation, mindfulness-based stress reduction programs for teachers have been introduced through schools. Evidence for the effectiveness of such programs is promising, however few studies have considered underlying mechanisms that may be driving these effects. Using data collected as part of a randomized controlled trial, this thesis examines the impact of mindfulness training on three coping resources, namely, somatic body awareness, executive function, and emotion regulation. Additionally, this thesis examines whether development of these resources translate into improvements in teachers' occupational well-being--specifically indicated through reductions in their anxiety, depression, stress, and burnout. Results suggest that the mindfulness training significantly improves teachers' somatic body awareness, with evidence for improvements in teachers' emotion regulation reappraisal as well. Additionally, some mediation results were promising, however, no significant mediations were found for any of the coping resources on any of the well-being outcomes for teachers. By addressing these topics, the results of this thesis contribute to the current field's understanding of how mindfulness training works to improve well-being in teachers.
Cognitive Reactivity (CR) refers to the degree to which a mild dysphoric state reactivates negative thinking patterns, and it has been found to play a key causal role in depressive relapse. Although Mindfulness-Based Cognitive Therapy (MBCT) directly aims to address this mechanism of CR, the relationship between mindfulness and CR has not been tested to date. Using a cross-sectional design (Study 1; n = 164) and a non-randomized waiting list controlled design (Study 2; MBCT [n = 18] vs. waiting list [n = 21]), the authors examined the relationship between naturally occurring levels of mindfulness (Study 1) and MBCT (Study 2) on the one hand, and CR on the other hand. In line with predictions, it was found that (a) trait mindfulness is significantly negatively correlated with CR, even when controlled for current depressive symptoms and prior history of depression (Study 1), and that (b) MBCT, compared to a matched control group, significantly reduces CR, and that this effect of MBCT on reduction of CR is mediated by a positive change in mindfulness skills (Study 2). Results provide first evidence for the claim that mindfulness practices in MBCT are designed to address the process of CR.
Cognitive Reactivity (CR) refers to the degree to which a mild dysphoric state reactivates negative thinking patterns, and it has been found to play a key causal role in depressive relapse. Although Mindfulness-Based Cognitive Therapy (MBCT) directly aims to address this mechanism of CR, the relationship between mindfulness and CR has not been tested to date. Using a cross-sectional design (Study 1; n = 164) and a non-randomized waiting list controlled design (Study 2; MBCT [n = 18] vs. waiting list [n = 21]), the authors examined the relationship between naturally occurring levels of mindfulness (Study 1) and MBCT (Study 2) on the one hand, and CR on the other hand. In line with predictions, it was found that (a) trait mindfulness is significantly negatively correlated with CR, even when controlled for current depressive symptoms and prior history of depression (Study 1), and that (b) MBCT, compared to a matched control group, significantly reduces CR, and that this effect of MBCT on reduction of CR is mediated by a positive change in mindfulness skills (Study 2). Results provide first evidence for the claim that mindfulness practices in MBCT are designed to address the process of CR.
The chronic exposure to stress of living with less money than one needs affects people’s well-being. Studies show that mental un-well-being is associated with socioeconomic inequalities and that poverty-related stress is directly related to symptoms of anxiety and depression. We offered a mindfulness-based intervention (MBI) between September 2011 and September 2012 to a sample of low-income urban adults in Brussels and Antwerp, Belgium. The impact on symptoms of stress, anxiety, and depression was examined together with the effects on cognitive vulnerability processes of cognitive reactivity and overgeneralization and on the development of mindfulness skills. Results suggest that the MBI significantly reduced symptoms of stress, anxiety, and depression and cognitive reactivity and overgeneralization and significantly improved mindfulness skills. Greater improvement in mindfulness skills caused by MBIs might result in greater reduction in both symptoms and cognitive vulnerabilities. These findings provide promising evidence of the effectiveness of MBIs to promote economically disadvantaged people’s well-being. The results are consistent with previous studies that have examined the effectiveness of MBIs in other populations and show that a MBI is feasible in social welfare centers that serve low-income adults.
The chronic exposure to stress of living with less money than one needs affects people’s well-being. Studies show that mental un-well-being is associated with socioeconomic inequalities and that poverty-related stress is directly related to symptoms of anxiety and depression. We offered a mindfulness-based intervention (MBI) between September 2011 and September 2012 to a sample of low-income urban adults in Brussels and Antwerp, Belgium. The impact on symptoms of stress, anxiety, and depression was examined together with the effects on cognitive vulnerability processes of cognitive reactivity and overgeneralization and on the development of mindfulness skills. Results suggest that the MBI significantly reduced symptoms of stress, anxiety, and depression and cognitive reactivity and overgeneralization and significantly improved mindfulness skills. Greater improvement in mindfulness skills caused by MBIs might result in greater reduction in both symptoms and cognitive vulnerabilities. These findings provide promising evidence of the effectiveness of MBIs to promote economically disadvantaged people’s well-being. The results are consistent with previous studies that have examined the effectiveness of MBIs in other populations and show that a MBI is feasible in social welfare centers that serve low-income adults.
We discuss the multidimensional nature of mindfulness and its relation to interpersonal feelings and performance. We examined the factor structure and internal reliability of a self-report measure of mindfulness, the Kentucky Inventory of Mindfulness Skills (KIMS; Baer, Smith, & Allen, 2004), in Dutch speaking Psychology students (n = 113) and parents (n = 246). We replicated the four factors proposed by Baer et al. (2004): Observe, Describe, Act With Awareness and Accept Without Judgement. The Dutch KIMS and all elements of mindfulness appeared invariant across samples. All elements of mindfulness were positively associated with expressing oneself in various social situations. A greater tendency for mindful observation was associated with more engagement in empathy. Mindful description, acting with awareness, and non-judgemental acceptance were associated with better identification and description of feelings, more body satisfaction, less social anxiety, and less distress contagion.
An essential step to wide-scale dissemination is to investigate moderators of intervention effectiveness. This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms. Based on theory and previous research, we identified the following potential moderators: (1) severity of symptoms of depression at baseline, (2) gender, (3) age, and (4) school track. The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium. Results on effectiveness based on the first trial were published in this journal (Raes et al. 2014). A second consecutive trial was conducted to obtain a more equal distribution between school tracks and to enlarge power, yielding a total of 605 students from nine schools. In each school, parallel classes were randomized to the mindfulness condition or usual curriculum control condition. Data were collected 1 week before and 1 week after delivery of the training and at 6-month follow-up. Moderation was tested longitudinally with multilevel models across the three repeated measures and across condition. We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.
An essential step to wide-scale dissemination is to investigate moderators of intervention effectiveness. This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms. Based on theory and previous research, we identified the following potential moderators: (1) severity of symptoms of depression at baseline, (2) gender, (3) age, and (4) school track. The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium. Results on effectiveness based on the first trial were published in this journal (Raes et al. 2014). A second consecutive trial was conducted to obtain a more equal distribution between school tracks and to enlarge power, yielding a total of 605 students from nine schools. In each school, parallel classes were randomized to the mindfulness condition or usual curriculum control condition. Data were collected 1 week before and 1 week after delivery of the training and at 6-month follow-up. Moderation was tested longitudinally with multilevel models across the three repeated measures and across condition. We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.
Using a cross-sectional design, we examined the relationship between naturally occurring levels of mindfulness and rumination in students (n = 164). As predicted, we found that, when controlling for current depressive symptoms and prior history of depression, mindfulness was significantly negatively correlated with rumination, but it was only associated with the extent to which rumination was experienced as uncontrollable, not with global levels of rumination. Furthermore, mindfulness moderated the relationship between global levels of rumination and uncontrollability of rumination, consistent with the suggestion that high dispositional mindfulness reduces the extent to which ruminative reactions tend to escalate into self-perpetuating and uncontrollable ruminative cycles.
Our objective was to conduct the first randomized controlled trial of the efficacy of a group mindfulness program aimed at reducing and preventing depression in an adolescent school-based population. For each of 12 pairs of parallel classes with students (age range 13–20) from five schools (N = 408), one class was randomly assigned to the mindfulness condition and one class to the control condition. Students in the mindfulness group completed depression assessments (the Depression Anxiety Stress Scales) prior to and immediately following the intervention and 6 months after the intervention. Control students completed the questionnaire at the same times as those in the mindfulness group. Hierarchical linear modeling showed that the mindfulness intervention showed significantly greater reductions (and greater clinically significant change) in depression compared with the control group at the 6-month follow-up. Cohen's d was medium sized (>.30) for both the pre-to-post and pre-to-follow-up effect for depressive symptoms in the mindfulness condition. The findings suggest that school-based mindfulness programs can help to reduce and prevent depression in adolescents.
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Our objective was to conduct the first randomized controlled trial of the efficacy of a group mindfulness program aimed at reducing and preventing depression in an adolescent school-based population. For each of 12 pairs of parallel classes with students (age range 13–20) from five schools (N = 408), one class was randomly assigned to the mindfulness condition and one class to the control condition. Students in the mindfulness group completed depression assessments (the Depression Anxiety Stress Scales) prior to and immediately following the intervention and 6 months after the intervention. Control students completed the questionnaire at the same times as those in the mindfulness group. Hierarchical linear modeling showed that the mindfulness intervention showed significantly greater reductions (and greater clinically significant change) in depression compared with the control group at the 6-month follow-up. Cohen's d was medium sized (>.30) for both the pre-to-post and pre-to-follow-up effect for depressive symptoms in the mindfulness condition. The findings suggest that school-based mindfulness programs can help to reduce and prevent depression in adolescents.
Our objective was to review the current body of evidence supporting the efficacy of self-management programs in individuals with multiple sclerosis (MS) and other chronic neurological conditions. We reviewed published literature using standardized search terms; examined self-management interventions in a variety of chronic neurological disorders, including MS; and classified studies using the evidence classification established by the American Academy of Neurology. We reviewed 527 abstracts, of which 39 met our inclusion criteria for evaluation. Of the 39 studies, 3 provided class I evidence assessing the efficacy of self-management interventions: a randomized controlled trial of a telephone counseling program for health promotion in MS, a home-based exercise program for reducing falls in people with Parkinson disease, and the comparison of a fitness center program versus a home-based exercise program for people with traumatic brain injury. The remaining studies provided additional support for self-management interventions with a lesser degree of methodologic rigor (class II, class III, or class IV evidence). We concluded that self-management strategies are applicable to chronic neurological diseases, but a need exists for more rigorous studies in this area. We provide recommendations for future intervention study methodologies with a specific emphasis on MS care.