Distress tolerance as a mechanism of mindfulness for depression and anxiety: Cross-sectional and diary evidence

The time-lagged effect of noise exposure on noise annoyance: The role of temporal, spatial and social contexts

While some research has examined the time-lagged effect of restorative soundscape in specific contexts (e.g., parks), how the time-lagged effect of noise annoyance during people's daily activities may vary across different temporal, spatial, and social contexts remains largely unknown. To address this research gap, we utilized Ecological Momentary Assessment (EMA) data to measure people's real-time noise annoyance and activity diary data to assess their time-lagged noise annoyance. Real-time noise exposure was captured by portable noise sensors. We employed fixed effects ordered panel logistic regression to examine the effects of different thresholds of noise levels on people's time-lagged noise annoyance, and how it varied across different temporal, spatial, and social contexts. The results indicated that: (1) there were significant time-lagged effects between participants' real-time noise exposure and their time-lagged noise annoyance; (2) participants' time-lagged noise annoyance associated with an activity was influenced by its temporal, spatial, and social contexts, particularly on weekdays; (3) participants' time-lagged noise annoyance was significantly associated with measured noise levels, with the highest coefficient for 65 dB, followed by 70 dB; and (4) there were significant interaction effects between noise levels and temporal-spatial-social contexts on participants' time-lagged noise annoyance (particularly when noise levels exceeded 70 dB). These findings enhance our understanding and have crucial implications for the implementation of noise control policies, which should consider not only noise levels but also the time-lagged effects of noise, particularly on weekdays, at outdoor recreational activity sites, as well as the potential vulnerabilities of individuals experiencing noise exposure in isolation.

Rumination and Self-Compassion Moderate Mindfulness-Based Cognitive Therapy for Patients With Recurrent and Persistent Major Depressive Disorder: A Controlled Trial

Background: Mindfulness-based cognitive therapy (MBCT) is effective in reducing depressive symptoms in patients with major depressive disorder (MDD). Understanding for whom and how MBCT works may allow for improvements in treatment allocation and effectiveness. In this study, our aim was to investigate depressive rumination, content-independent perseverative thinking, mindfulness skills, and self-compassion as potential moderators and mediators of MBCT. Methods: In this non-randomized controlled trial, patients with persistent (n = 53) or recurrent MDD with (n = 31) or without (n = 51) a current depressive episode were assigned to an intervention (MBCT plus treatment as usual [TAU], n = 94) or control group (TAU only, n = 40) based on the time between the date of inclusion and the start of MBCT. Assessments were carried out before, halfway, and after 8 weeks of MBCT + TAU or TAU. Latent growth models were employed to examine moderation, while cross-lagged structural equation models were used to assess the mediating effects of several possible mediators of MBCT-induced change in depressive symptoms and overall functional impairment. Results: MBCT + TAU was more effective in reducing depressive symptoms (and overall functional impairment than TAU with a medium [d = -0.54] and small [d = 0.44] effect size, respectively). Higher baseline levels of rumination and perseverative thinking and lower levels of self-compassion moderated the effect of MBCT on depressive symptoms and overall functional impairment. Task-based negative intrusive thoughts moderated the effects of MBCT on overall functional impairment. No mediators were established, particularly due to a lack of effect of MBCT on all assessed mediators at mid-treatment. For interpretative purposes, a sample split (based on Johnson-Newman values) showed moderate-to-large effects in depressive symptom reduction for those with high rumination, high perseverative thinking, and low self-compassion, while negative-to-small nonsignificant effects were found for the opposite traits. Conclusion: In the future, MBCT allocation based on levels of rumination and self-compassion might lead to a more efficient reduction in depressive symptoms. Directions for mediation analysis within the context of MBCT for depression are discussed. Preregistration: This study was initially preregistered in the Dutch National Trial Register (NL7842). However, due to the NTR no longer being available since June 2022, the trial was reregistered at ClinicalTrials.gov (NCT05802966, dd 09-Apr-2023). The statistical analysis plan was adjusted after the start of the trial but before the finalization of data collection (NCT05802966; ClinicalTrials.gov).

Feasibility and effects of mindfulness-based stress reduction (MBSR) for improving resilience, posttraumatic stress disorder symptoms and posttraumatic growth among military medical college students

BACKGROUND

Increased stress among medical students in military college has been a challenge in the field of education. One approach to addressing stress reduction is mindfulness training. MBSR has been verified to improve the health status of different individuals. The aim of this study was to examine whether MBSR improves the psychological resilience, posttraumatic stress and posttraumatic growth of medical students in military college.

METHODS

MBSR was performed with students from a military medical university. A total of 372 students were surveyed by questionnaires, including the 10-item of Connor-Davidson Resilience Scale, Posttraumatic Growth Inventory, PTSD Checklist for DSM-5, Satisfaction with Life Scale, and Mindful Attention Awareness Scale, before the intervention, after the intervention and one month later. A control group of students also answered the questionnaires at the three time points but did not participate in the MBSR intervention. Statistical analyses were performed using repeated-measures ANOVA.

RESULTS

The results suggest that the MBSR group experienced significant improvements in resilience, posttraumatic growth, life satisfaction, and mindful attention awareness scores, as well as significant reductions in depression, anxiety, and PTSD intrusive symptoms scores after the intervention. These results were not found in the control group. One month after the intervention, all of these variables showed varying degrees of maintenance effects in the MBSR group.

CONCLUSION

The MBSR intervention was effective, as the medical students in military college in the MBSR group exhibited improvements in psychological resilience, posttraumatic growth, satisfaction with life and mindful attention awareness, depression, anxiety and intrusive symptoms.

Mindfulness as a therapeutic option for obsessive-compulsive disorder

INTRODUCTION

Obsessive-compulsive disorder (OCD) is a prevalent mental health issue characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that can cause significant life impairment. Despite cognitive-behavioral therapy (CBT) being the most effective treatment, some individuals experience insufficient symptom reduction or relapse.

AREAS COVERED

This special report explores the potential of mindfulness-based interventions as complementary treatments for OCD, examining the specific techniques used and their practical application. In the initial section, the authors examine ten randomized control trial studies included in the meta-analysis conducted by Chien et al. (2022), demonstrating the effectiveness of mindfulness interventions. The authors focus on elucidating the specific mindfulness techniques used in these studies. Then, the authors discuss the integration of these mindfulness strategies into CBT, focusing on enhancing emotional regulation, cognitive flexibility, and acceptance of intrusive thoughts.

EXPERT OPINION

While mindful based interventions (MBIs) show promise as adjunctive treatments for OCD, variability in OCD symptoms and treatment responses necessitate individualized therapeutic approaches. Further research is required to refine mindfulness-based techniques and optimize their effectiveness. Incorporating MBIs into standard CBT protocols may improve outcomes for patients with persistent OCD symptoms.

Distress tolerance as a mediator of mindfulness-based intervention for anxiety and depression: Evidence from two randomized controlled trials

Objective

We aimed to investigate whether distress tolerance mediated the effects of mindfulness-based intervention (MBI) on anxiety and depression with two randomized controlled studies.

Method

In Study 1, 374 participants with at least moderate emotional distress were randomized to an intervention group (N = 174) and a waitlist control group (N = 173). Mindfulness, distress tolerance, anxiety, and depression were measured at the pre-test, week 3, week 5, and post-test. In Study 2, 170 participants with emotional disorders were randomized to an intervention group (N = 86) and a control group (N = 84). The same variables were assessed at pre-test, weekly during the intervention, and post-test.

Results

In both studies, linear mixed effect models showed that compared to the control group, mindfulness, distress tolerance, anxiety, and depression significantly improved in the intervention group. Parallel process latent growth curve models showed that changes in distress tolerance mediated the effects of the MBI on changes in anxiety and depression. Random-intercept cross-lagged panel models found that distress tolerance temporally preceded depression, but not anxiety.

Conclusions

Distress tolerance is a potential mechanism underlying MBIs. Interventions targeting distress tolerance could be embedded in MBIs to enhance the intervention effects for emotional distress.