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Journal of Attention Disorders Nov 2021We describe qualitative results on facilitators and barriers to participating in a family mindfulness-based intervention (MBI) for youth with ADHD and their parents and...
We describe qualitative results on facilitators and barriers to participating in a family mindfulness-based intervention (MBI) for youth with ADHD and their parents and perceived effects on child and parent. Sixty-nine families started the 8-week protocolized group-based MBI called "MYmind." After the MBI, individual semi-structured interviews were conducted with a purposive sample of parents ( = 20), children ( = 17, ages 9-16 years), and mindfulness teachers ( = 3). Interviews were analyzed using Grounded Theory. Facilitators and barriers regarding contextual factors (e.g., time investment), MBI characteristics (e.g., parallel parent-child training), and participant characteristics (e.g., ADHD-symptoms) are described. Perceived effects were heterogeneous: no/adverse effects, awareness/insight, acceptance, emotion regulation/reactivity, cognitive functioning, calmness/relaxation, relational changes, generalization. MYmind can lead to a variety of transferable positively perceived effects beyond child ADHD-symptom decrease. Recommendations on MYmind participant inclusion, program characteristics, mindfulness teachers, and evaluating treatment efficacy are provided.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Feasibility Studies; Humans; Mindfulness; Parenting; Parents
PubMed: 32727260
DOI: 10.1177/1087054720945023 -
Headache Mar 2023To understand the mechanisms of mindfulness' impact on migraine.
OBJECTIVE
To understand the mechanisms of mindfulness' impact on migraine.
BACKGROUND
Promising mindfulness research demonstrates potential benefit in migraine, but no data-driven model exists from the lived experiences of patients that explains the mechanisms of mindfulness in migraine.
METHODS
Semi-structured qualitative interviews were conducted with adults with migraine who participated in two mindfulness-based stress reduction (MBSR) clinical trials (n = 43). Interviews were audio-recorded, transcribed, and summarized into a framework matrix with development of a master codebook. Constructivist grounded theory approach was used to identify themes/subthemes.
RESULTS
Participants who learned mindfulness techniques through MBSR experienced altered pain perception, altered response to migraine attacks and disease, increased awareness of external and internal experiences, improved overall well-being, and group benefits. Mindfulness resulted in earlier stress-body awareness and increased interoceptive awareness resulting in earlier attack recognition, leading to earlier and more effective management. Interictal factors of self-blame, guilt, and stigma decreased while migraine acceptance, hope, empowerment, self-efficacy, and self-compassion increased. Improved emotion regulation resulted in decreased fear of migraine, pain catastrophizing, anticipatory anxiety, and pain reactivity. Although taught as prevention, mindfulness was used both acutely and prophylactically. We created a conceptual model hypothesizing that MBSR skills led to an infusion of mindfulness in daily life, resulting in altered pain perception and experience, ultimately leading to improvement in overall well-being, which may positively feed back to the infusion of mindfulness in daily life. The therapeutic benefit of learning mindfulness in a group setting may moderate these effects.
CONCLUSIONS
This study identified several new potential mechanisms of mindfulness' effect on migraine. After learning MBSR skills, participants reported altered pain and migraine perception and experiences. Increased stress-body and interoceptive awareness resulted in earlier migraine awareness and treatment. Mindfulness may target important interictal factors that affect disease burden such as fear of migraine, pain catastrophizing, and anticipatory anxiety. This is the first data-driven study to help elucidate the mechanisms of mindfulness on migraine from patient voices and can help direct future research endeavors.
Topics: Adult; Humans; Mindfulness; Stress, Psychological; Qualitative Research; Pain; Migraine Disorders
PubMed: 36853655
DOI: 10.1111/head.14481 -
BMC Complementary Medicine and Therapies Oct 2023Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces...
OBJECTIVES
Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention, .b, has been shown to lower stress among youth. While a pilot study of .b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach.
METHODS
We used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the .b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications.
RESULTS
Adaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components.
CONCLUSIONS
Youth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability.
Topics: Humans; Male; Female; Adolescent; Mindfulness; Pilot Projects; Gender Identity; Adaptation, Psychological; Ill-Housed Persons
PubMed: 37848846
DOI: 10.1186/s12906-023-04203-5 -
International Journal of Environmental... Jan 2022Meditation has been increasingly adapted for healthy populations and participants with diseases. Its beneficial effects are still challenging to determine due to the... (Review)
Review
BACKGROUND
Meditation has been increasingly adapted for healthy populations and participants with diseases. Its beneficial effects are still challenging to determine due to the heterogeneity and methodological obstacles regarding medical applications. This study aimed to integrate the features of therapeutic meditation in randomized controlled trials (RCTs).
METHODS
We conducted a systematic review of RCTs with meditation for populations with diseases using the PubMed database through June 2021. We analyzed the characteristics of the diseases/disorders, participants, measurements, and their overall benefits.
RESULTS
Among a total of 4855 references, 104 RCTs were determined and mainly applied mindfulness-based (51 RCTs), yoga-based (32 RCTs), and transcendental meditation (14 RCTs) to 10,139 patient-participants. These RCTs were conducted for participants with a total of 45 kinds of disorders; the most frequent being cancer, followed by musculoskeletal and connective tissue diseases and affective mood disorder. Seven symptoms or signs were frequently assessed: depressive mood, feeling anxious, quality of life, stress, sleep, pain, and fatigue. The RCTs showed a higher ratio of positive outcomes for sleep (73.9%) and fatigue (68.4%).
CONCLUSIONS
This systematic review produced the comprehensive features of RCTs for therapeutic meditation. These results will help physicians and researchers further study clinical adaptations in the future as reference data.
Topics: Anxiety; Humans; Meditation; Mindfulness; Randomized Controlled Trials as Topic; Yoga
PubMed: 35162267
DOI: 10.3390/ijerph19031244 -
Current Pain and Headache Reports Aug 2023We aim to present current understanding and evidence for meditation, mostly referring to mindfulness meditation, for the management of acute pain and potential... (Review)
Review
PURPOSE OF REVIEW
We aim to present current understanding and evidence for meditation, mostly referring to mindfulness meditation, for the management of acute pain and potential opportunities of incorporating it into the acute pain service practice.
RECENT FINDINGS
There is conflicting evidence concerning meditation as a remedy in acute pain. While some studies have found a bigger impact of meditation on the emotional response to a painful stimulus than on the reduction in actual pain intensities, functional Magnet Resonance Imaging has enabled the identification of various brain areas involved in meditation-induced pain relief. Potential benefits of meditation in acute pain treatment include changes in neurocognitive processes. Practice and Experience are necessary to induce pain modulation. In the treatment of acute pain, evidence is emerging only recently. Meditative techniques represent a promising approach for acute pain in various settings.
Topics: Humans; Acute Pain; Meditation; Mindfulness; Pain Management; Brain
PubMed: 37285010
DOI: 10.1007/s11916-023-01119-0 -
Journal of General Internal Medicine Sep 2023Improving access to evidence-based psychotherapies (EBPs) is a Veterans Health Administration (VHA) priority. Cognitive behavioral therapy (CBT), acceptance and...
Evaluation of Implementation Strategies for Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Stress Reduction (MBSR): a Systematic Review.
BACKGROUND
Improving access to evidence-based psychotherapies (EBPs) is a Veterans Health Administration (VHA) priority. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) are effective for chronic pain and several mental health conditions. We synthesized evidence on implementation strategies to increase EBP access and use.
METHODS
We searched MEDLINE, Embase, PsycINFO, and CINAHL from inception until March 2021 for articles on EBP implementation within integrated health systems to treat chronic pain or chronic mental health conditions. Reviewers independently screened articles, extracted results, coded qualitative findings, and rated quality using modified criteria from Newcastle-Ottawa (quantitative results) or Critical Appraisal Skills Programme (qualitative results). We categorized implementation strategies using the Expert Recommendations for Implementing Change (ERIC) framework and classified outcomes using RE-AIM domains (Reach, Effectiveness, Adoption, Implementation, Maintenance).
RESULTS
Twelve articles (reporting results from 10 studies) evaluated CBT (k = 11) and ACT (k = 1) implementation strategies in large integrated healthcare systems. No studies evaluated MBSR implementation. Eight articles evaluated strategies within VHA. Six articles reported on national VHA EBP implementation programs; all involved training/education, facilitation, and audit/feedback. CBT and ACT implementation demonstrated moderate to large improvements in patient symptoms and quality of life. Trainings increased mental health provider self-efficacy in delivering EBPs, improved provider EBP perceptions, and increased provider EBP use during programs, but had unclear impacts on Reach. It was unclear whether external facilitation added benefit. Provider EBP maintenance was modest; barriers included competing professional time demands and patient barriers.
DISCUSSION
Multi-faceted CBT and ACT implementation programs increased provider EBP Adoption but had unclear impacts on Reach. Future implementation efforts should further evaluate Reach, Adoption, and Maintenance; assess the added value of external facilitation; and consider strategies targeting patient barriers. Future work should use implementation frameworks to guide evaluations of barriers and facilitators, processes of change, and outcomes.
REGISTRATION
PROSPERO registration number CRD42021252038.
Topics: Humans; Acceptance and Commitment Therapy; Mindfulness; Chronic Pain; Quality of Life; Cognitive Behavioral Therapy
PubMed: 37012538
DOI: 10.1007/s11606-023-08140-4 -
Psychology & Health Sep 2022We tested two competing models linking daily stress, mindfulness, and psychological distress in adolescence: 1) whether daily mindfulness moderates the impact of daily...
OBJECTIVE
We tested two competing models linking daily stress, mindfulness, and psychological distress in adolescence: 1) whether daily mindfulness moderates the impact of daily stressors on psychological distress or 2) whether mindfulness mediates the relationship between greater daily stressors and psychological distress.
METHODS
Every evening for a week, 138 adolescents completed ecological momentary assessments (EMAs). Daily diaries assessed negative events, work-school conflict, mindfulness, and perceived stress. Multilevel mediation and moderation were tested.
RESULTS
Results indicated that there were meaningful variations in adolescent mindfulness from day-to-day, and supported mediation rather than moderation; the within-person association between stressors and psychological distress was mediated by mindfulness at the daily level.
CONCLUSION
It may be too challenging for adolescents to remain in a mindful state during stress to effectively use mindfulness as a buffer. Instead, daily stressors may indirectly impact psychological distress through decreasing mindfulness.
Topics: Adolescent; Biological Variation, Individual; Humans; Interpersonal Relations; Mindfulness; Psychological Distress; Stress, Psychological
PubMed: 34139904
DOI: 10.1080/08870446.2021.1929982 -
Journal of Psychosomatic Research Nov 2020Military veterans report high rates of psychiatric and physical health symptoms that may be amenable to mindfulness-based interventions (MBIs). Inconsistent prior... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Military veterans report high rates of psychiatric and physical health symptoms that may be amenable to mindfulness-based interventions (MBIs). Inconsistent prior findings and questions of fit between MBIs and military culture highlight the need for a systematic evaluation of this literature.
OBJECTIVE
To quantify the efficacy and acceptability of MBIs for military veterans.
DATA SOURCES
We searched five databases (MEDLINE/PubMed, CINAHL, Scopus, Web of Science, PsycINFO) from inception to October 16th, 2019.
STUDY SELECTION
Randomized controlled trials (RCTs) testing MBIs in military veterans.
RESULTS
Twenty studies (k = 16 unique comparisons, N = 898) were included. At post-treatment, MBIs were superior to non-specific controls (e.g., waitlist, attentional placebos) on measures of posttraumatic stress disorder (PTSD), depression, general psychological symptoms (i.e., aggregated across symptom domains), quality of life / functioning, and mindfulness (Hedges' gs = 0.32 to 0.80), but not physical health. At follow-up (mean length = 3.19 months), MBIs continued to outperform non-specific controls on general psychological symptoms, but not PTSD. MBIs were superior to specific active controls (i.e., other therapies) at post-treatment on measures of PTSD and general psychological symptoms (gs = 0.19 to 0.25). Participants randomized to MBIs showed higher rates of attrition than those randomized to control interventions (odds ratio = 1.98). Several models were not robust to tests of publication bias. Study quality and risk of bias assessment indicated several areas of concern.
CONCLUSIONS
MBIs may improve psychological symptoms and quality of life / functioning in veterans. Questionable acceptability and few high-quality studies support the need for rigorous RCTs, potentially adapted to veterans.
Topics: Adult; Humans; Internet-Based Intervention; Middle Aged; Mindfulness; Quality of Life; Veterans
PubMed: 32906008
DOI: 10.1016/j.jpsychores.2020.110232 -
International Journal of Environmental... Sep 2022Usually, both external environmental factors and internal psychological factors affect the self-efficacy of athletes returning to sports after an injury. Based upon COR...
Usually, both external environmental factors and internal psychological factors affect the self-efficacy of athletes returning to sports after an injury. Based upon COR theory, this study investigated mindfulness interventions' effects on competitive state anxiety and burnout in injured athletes who are returning to sports. The study was conducted in South China from March to April 2022. The snowball and convenience sampling methods were used to select high-level sports teams' injured athletes returning to sports, and a questionnaire survey was administered, from which 433 valid samples were obtained. Amos v. 26 was used to analyze the data. The results showed that mindfulness has a significant negative effect on competitive state anxiety and burnout, such that after strengthening the mindfulness intervention, athletes' competitive state anxiety and burnout decreased and regulatory emotional self-efficacy increased. Further, this study indicated that athletes are prone to negative emotions after injury, and among athletes who returned to sports after injury, those with mindfulness interventions reported lower levels of competitive state anxiety and burnout. Hence, the study demonstrated that mindfulness can improve regulatory emotional self-efficacy in injured athletes who are returning to sports by reducing competitive state anxiety and burnout.
Topics: Anxiety; Athletes; Burnout, Professional; Burnout, Psychological; Emotions; Humans; Mindfulness; Self Efficacy
PubMed: 36141969
DOI: 10.3390/ijerph191811702 -
Scientific Reports Dec 2022People cooperate every day in ways that range from largescale contributions that mitigate climate change to simple actions such as leaving another individual with choice...
People cooperate every day in ways that range from largescale contributions that mitigate climate change to simple actions such as leaving another individual with choice - known as social mindfulness. It is not yet clear whether and how these complex and more simple forms of cooperation relate. Prior work has found that countries with individuals who made more socially mindful choices were linked to a higher country environmental performance - a proxy for complex cooperation. Here we replicated this initial finding in 41 samples around the world, demonstrating the robustness of the association between social mindfulness and environmental performance, and substantially built on it to show this relationship extended to a wide range of complex cooperative indices, tied closely to many current societal issues. We found that greater social mindfulness expressed by an individual was related to living in countries with more social capital, more community participation and reduced prejudice towards immigrants. Our findings speak to the symbiotic relationship between simple and more complex forms of cooperation in societies.
Topics: Humans; Mindfulness; Emigrants and Immigrants
PubMed: 36543793
DOI: 10.1038/s41598-022-25538-y