Implementation of a mindfulness-based stress reduction (MBSR) program to reduce stress, anxiety, and depression and to improve psychological well-being among retired Iranian football players

The effect of mindfulness training on the psychological state of high-level athletes: Meta analysis and system evaluation research

To investigate the impact of mindfulness training on mindfulness, psychological resilience, flow state, subjective well-being, sports anxiety, sports depression, and psychological fatigue among elite athletes through a meta-analysis. Databases like PubMed, Web of Science, and others were searched for randomized controlled trials up to October 31, 2024. Included studies compared mindfulness training interventions to non-mindfulness training in elite athletes. The outcome indicators were analyzed using Review Manager 5.4 software. Among 6917 articles, 32 studies with 1108 athletes (560 experimental, 548 control) were included. Mindfulness training significantly improved mindfulness (p<0.01), psychological resilience (p<0.05), flow state (p<0.01), sports anxiety (p<0.01), sports depression (p<0.01), and psychological fatigue dimensions (p<0.01) but not subjective well-being (p>0.05). MAC, MAIC, MBSP, and MT were effective for mindfulness. The best intervention duration was 7 weeks, with sessions lasting over 60 minutes once a week. MAC was best for psychological resilience. MBSP, MT, and MAC improved flow state. MBSP and MT alleviated anxiety, while MBSR was effective for depression. MAIC training mitigated psychological fatigue. Mindfulness training positively impacts elite athletes' psychological state, enhancing mindfulness, resilience, flow, and alleviating anxiety, depression, and psychological fatigue, but not subjective well-being. Optimal methods and durations vary by outcome.

Does mindfulness-based stress reduction training have an impact on the occupational burnout and stress experienced by nurses? A randomized controlled trial

BACKGROUND

In an effort to combat burnout, a study investigates Mindfulness-Based Stress Reduction (MBSR) training for nurses. The goal is to reduce stress and improve job satisfaction, ultimately enhancing patient care. These findings may inspire the development of mindfulness-based support systems for healthcare professionals to promote overall well-being in the workplace.

MATERIALS AND METHODS

A single-blinded, randomized controlled trial with 60 emergency medical center nurses was conducted to assess the effectiveness of an eight-session MBSR program in reducing stress and burnout. The randomization process, utilizing sealed envelopes, ensured unbiased allocation to intervention or control groups. The training program included group sessions focused on meditation, yoga, and discussions, with participants receiving educational materials and CDs for home practice. Collected data included demographics, Maslach Burnout Inventory, and Occupational Stress Questionnaire results. Statistical analysis, utilizing SPSS version 21, featured Kolmogorov-Smirnov, Mann-Whitney U, and Wilcoxon tests to evaluate outcomes.

RESULTS

Following MBSR Training, the intervention group displayed statistically significant differences in all occupational stress subscales compared to the control group (P < 0.05). Post-intervention, the intervention group also exhibited significant differences in burnout subscale scores (P < 0.001) compared to the control group.

CONCLUSION

MBSR can boost resilience and job satisfaction, enhancing patient care. Healthcare organizations should integrate MBSR programs for nursing staff well-being and combat stress and burnout. Research should probe long-term impacts and effective delivery methods for sustained stress relief in nursing.

TRIAL REGISTRATION

This study has registered in Iranian Registry of Clinical Trials by the number of IRCT20131112015390N5 on Jun 2022.

Combined mindfulness-based stress reduction and physical activity improved psychological factors and sleep quality in patients with MDD: A randomized controlled trial study

Non-pharmacological interventions are available to improve sleep quality including mindfulness-based stress reduction (MBSR) and physical activity (PA). The present study aimed to evaluate the effectiveness of the combination of MBSR and PA interventions as an augmentation to treatment as usual with sertraline to improve sleep and psychological factors among patients with MDD. Sixty-seven patients in outpatient care diagnosed with MDD for a minimum of 2 months (mean age: 35.32 ± 7.8; 65 % female) and currently on sertraline treatments were randomized into four groups including: 1) Physical activity, 2) MBSR, 3) Combination MBSR and physical activity (MBSRPA), and 4) Control. All participants completed self-reported questionnaires on sleep quality, depression, anxiety, and perceived stress from baseline to 8 weeks later at post-test and four weeks later at follow-up. Over time, sleep disturbance and psychological problems were reduced in all conditions when compared to the control. Moreover, MBSRPA had a more positive impacts on perceived stress, anxiety, depressive symptoms and sleep quality. The results of the present study confirmed the effectiveness of MBSRPA as an augmentation to standard therapy to help reduce symptoms of depression, anxiety, perceived stress, and sleep problems in patients with MDD.

Exploring the association of mindfulness, confidence, competitive state anxiety, and attention control in soccer penalty shootouts

Introduction

Penalty shootouts are a pivotal factor influencing outcomes in soccer matches. Soccer players face the challenge of overcoming physical fatigue and psychological pressure when taking penalty kicks. Instances of low confidence and competitive state anxiety during matches exacerbate the detrimental impact on attention control, particularly in non-target defined features, leading to suboptimal performance during penalty kicks.

Methods

This cross-sectional survey investigates the relationship between mindfulness and attention control. Convenient sampling was employed to gather a sample of 266 soccer players from sports teams and training bases in Central and South China who had participated in city-level or higher-level competitions. A structural equation model, created using AMOS 26, was employed for hypotheses validation.

Results

Findings reveal a positive correlation between mindfulness and confidence, and a negative correlation between mindfulness and competitive state anxiety. Additionally, confidence positively associates with attention control, while competitive state anxiety shows a negative relationship with attention control. Confidence and competitive state anxiety also function as mediators in the correlation between mindfulness and attention control. To elaborate, soccer penalty kickers with heightened mindfulness demonstrate increased confidence levels, reduced competitive state anxiety, and improved attention control.

Discussion

Mindfulness training positively influences attention control during penalty kicks for soccer players. To boost players' confidence, alleviate competitive state anxiety, and enhance their performance during penalty shootouts, it is recommended that governments increase investment in mindfulness training and talent development. Coaches should enhance their understanding of mindfulness training mechanisms, and athletes themselves should prioritize mindfulness training.

Sleep disturbances and psychological well-being among military medical doctors of the Swiss Armed Forces: study protocol, rationale and development of a cross-sectional and longitudinal interventional study

Background

Compared to civilians and non-medical personnel, military medical doctors are at increased risk for sleep disturbances and impaired psychological well-being. Despite their responsibility and workload, no research has examined sleep disturbances and psychological well-being among the medical doctors (MDs) of the Swiss Armed Forces (SAF). Thus, the aims of the proposed study are (1) to conduct a cross-sectional study (labeled 'Survey-Study 1') of sleep disturbances and psychological well-being among MDs of the SAF; (2) to identify MDs who report sleep disturbances (insomnia severity index >8), along with low psychological well-being such as symptoms of depression, anxiety and stress, but also emotion regulation, concentration, social life, strengths and difficulties, and mental toughness both in the private/professional and military context and (3) to offer those MDs with sleep disturbances an evidence-based and standardized online interventional group program of cognitive behavioral therapy for insomnia (eCBTi) over a time lapse of 6 weeks (labeled 'Intervention-Study 2').

Method

All MDs serving in the SAF (N = 480) will be contacted via the SAF-secured communication system to participate in a cross-sectional survey of sleep disturbances and psychological well-being ('Survey-Study 1'). Those who consent will be provided a link to a secure online survey that assesses sleep disturbances and psychological well-being (depression, anxiety, stress, coping), including current working conditions, job-related quality of life, mental toughness, social context, family/couple functioning, substance use, and physical activity patterns. Baseline data will be screened to identify those MDs who report sleep disturbances (insomnia severity index >8); they will be re-contacted, consented, and randomly assigned either to the eCBTi or the active control condition (ACC) ('Intervention-Study 2'). Individuals in the intervention condition will participate in an online standardized and evidence-based group intervention program of cognitive behavioral therapy for insomnia (eCBTi; once the week for six consecutive weeks; 60-70 min duration/session). Participants in the ACC will participate in an online group counseling (once the week for six consecutive weeks; 60-70 min duration/session), though, the ACC is not intended as a bona fide psychotherapeutic intervention. At the beginning of the intervention (baseline), at week 3, and at week 6 (post-intervention) participants complete a series of self-rating questionnaires as for the Survey-Study 1, though with additional questionnaires covering sleep-related cognitions, experiential avoidance, and dimensions of self-awareness.

Expected outcomes

Survey-Study 1: We expect to describe the prevalence rates of, and the associations between sleep disturbances (insomnia (sleep quality); sleep onset latency (SOL); awakenings after sleep onset (WASO)) and psychological well-being among MDs of the SAF; we further expect to identify specific dimensions of psychological well-being, which might be rather associated or non-associated with sleep disturbances.Intervention-Study 2: We expect several significant condition-by-time-interactions. Such that participants in the eCBTi will report significantly greater improvement in sleep disturbances, symptoms of depression, anxiety, stress reduction both at work and at home (family related stress), and an improvement in the overall quality of life as compared to the ACC over the period of the study.

Conclusion

The study offers the opportunity to understand the prevalence of sleep disturbances, including factors of psychological well-being among MDs of the SAF. Further, based on the results of the Intervention-Study 2, and if supported, eCBTi may be a promising method to address sleep disturbances and psychological well-being among the specific context of MDs in the SAF.

The impact of mindfulness-based stress reduction training on the occupational stress and burnout experienced by nurses in geriatric wards? A randomized controlled trial

In this clinical trial, 60 nurses from three geriatric centers were enlisted and randomly split into two groups: control (n = 30) and intervention (n = 30). Statistical analysis using SPSS version 21 employed Kolmogorov-Smirnov, Chi square, and t-test to assess results. The intervention group received eight training sessions. After the MBSR Training in the intervention groups, results showed there was a statistically significant difference between the two groups concerning the scores of the subscales of death and dying (t = 6.161, P < 0.001), conflicts with physicians (t = 7.962, P < 0.001), inadequate preparation (t = t = 6.524, P < 0.001), lack of support resources (t = 5.532, P < 0.001), conflicts with nurses (t = -6.632, P < 0.001), workload (t = 6.587, P < 0.001), uncertainty of treatment (t = 5.587, P < 0.001) as well as the scores of the subscales of burnout.

A meta-analysis of the intervention effect of mindfulness training on athletes' performance

Objective

To explore the intervention effect of mindfulness training on athletes' performance using meta-analysis method.

Methods

A total of 11 articles and 23 effect sizes were included through retrieval of Chinese and English databases, with a total sample size of 582.

Result

Mindfulness training improves the level of mindfulness [SMD =1.08, 95%CI (0.30, 1.86), p < 0.01], fluency (The optimal competitive psychological state of the athlete, the athlete's attention is all focused on the task, and other things no longer attract their attention) [SMD =1.47, 95%CI (0.87, 2.08), p < 0.001] and performance [SMD =0.92, 95% CI (0.40, 1.43), p < 0.01], reduced psychological anxiety [SMD = -0.87, 95% CI (-1.54, -0.20), p < 0.05], and all reached the level of large effect size.

Conclusion

The effect of mindfulness training on athletes' sports performance is effective, and it can be used as an effective psychological skill intervention method to improve athletes' sports performance. In the future, we should further expand the sample size, strengthen the comparative study of different sports and intervention modes, and pay attention to the difference between the time effect and trait mindfulness level in fluency state.

Mindfully missing myself: Induced mindfulness causes alienation among poor self-regulators

Mindfulness is a popular technique that helps people to get closer to their self. However, recent findings indicate that mindfulness may not benefit everybody. In the present research, we hypothesized that mindfulness promotes alienation from the self among individuals with low abilities to self-regulate affect (state-oriented individuals) but not among individuals with high abilities to self-regulate affect (action-oriented individuals). In two studies with participants who were mostly naïve to mindfulness practices (70% indicated no experience; N1 = 126, 42 men, 84 women, 0 diverse, aged 17-86 years, Mage = 31.87; N2 = 108, 30 men, 75 women, 3 diverse, aged 17-69 years, Mage = 28.00), we tested a mindfulness group (five-minute mindfulness exercise) against a control group (five-minute text reading). We operationalized alienation as lower consistency in repeated preference judgments and a lower tendency to adopt intrinsic over extrinsic goal recommendations. Results showed that, among state-oriented participants, mindfulness led to significantly lower consistency of preference judgments (Study 1) and lower adoption of intrinsic over extrinsic goals (Study 2) compared to text reading. The alienating effect was absent among action-oriented participants. Thus, mindfulness practice may alienate psychologically vulnerable people from their self and hamper access to preferences and intrinsic goals. We discuss our findings within Personality-Systems-Interactions (PSI) theory.

Understanding and Improving Athlete Mental Health: A Social Identity Approach

Understanding and positively influencing athlete mental health have become key goals for researchers and sporting stakeholders (e.g. coaches, support staff, clubs and governing bodies). In this article, we outline a novel perspective for tackling these challenges, drawing on an influential theory of group processes. This social identity approach can, we argue, help explain when and why the characteristics and demands of sport, which is typically a collective endeavour, pose a threat to athlete mental health and provide a guiding framework for efforts to protect and enhance athlete mental health. Here, we seek to illustrate the value of a social identity analysis of athlete mental health through three key points that speak to its analytical and practical value. Specifically, we propose: (1) that social identities can act as psychological resources that support athlete mental health, (2) that social identities are critical to athlete mental health during and after sporting transitions and (3) that leadership informed by a social identity approach can facilitate athlete mental health. With a view to maximising the value of our analysis both for those working with athletes and for researchers, we also identify practical steps that relevant stakeholders could take to support athlete mental health, and key avenues for future research to further test our propositions and advance understanding. Our analysis provides a new lens through which all those invested in understanding and supporting athlete mental health can approach these challenges, and a foundation for novel solutions.

Sporting Mind: The Interplay of Physical Activity and Psychological Health

The symbiotic relationship between sports practice and psychological well-being has, in recent times, surged to the forefront of academic and public attention. The aim of this narrative review is to comprehensively explore the intricate pathways linking physical engagement in sports to its subsequent impacts on mental health and synthesize the multifarious effects of sports on psychological health, offering insights for integrating physical and psychological strategies to enhance well-being. From neurobiological underpinnings to therapeutic applications, this comprehensive manuscript provides an in-depth dive into the multifaceted world of sports and psychology. Highlighting evidence-based interventions, this review aspires to offer actionable insights for practitioners, athletes, and individuals alike, advocating for a holistic approach to mental well-being. This manuscript highlights the profound impact of sports on mental health, emphasizing its role in emotional regulation, resilience, cognitive function, and treating psychological conditions. It details how sports induce neurochemical changes, enhance brain functions like memory and learning, and aid against cognitive decline. This review also notes the benefits of regular exercise in mood improvement, stress management, and social skill enhancement, particularly when combined with mindfulness practices. It underscores the importance of considering cultural and gender perspectives in sports psychology, advocating for an integrated physical-psychological approach to promote overall well-being.

Mindfulness plus physical activity reduces emotion dysregulation and insomnia severity among people with major depression

BACKGROUND

As the disorder progresses, patients with depression suffer from decreased emotional stability, cognitive control and motivation. In the present study, we examined the effectiveness of three interventions on emotion dysregulation and insomnia severity: 1) mindfulness; 2) physical activity, and 3) mindfulness plus physical activity.

METHOD

A total of 50 participants (mean age 33.21 ± 5.72 SD, 59% females) with major depression were randomly assigned to one of the three study conditions. Emotional dysregulation and insomnia severity were assessed at baseline, eight weeks later at study completion, and 4 weeks after that at follow-up.

RESULTS

Emotion regulation and sleep quality improved over time from baseline to study completion and to follow-up. Compared to the mindfulness and physical activity alone conditions, the mindfulness plus physical activity condition led to higher emotion regulation and sleep quality.

CONCLUSION

The combination of physical activity and mindfulness seems to have a beneficial effect on sleep quality and emotion regulation in those with major depression disorder and could be a valuable treatment strategy.

The roles of readiness and dosage in predicting outcomes of a mindful sport performance enhancement intervention with U.S. college student-athletes

Research suggests that Mindfulness- and Acceptance-Based Interventions (MABIs) can impact sport performance and performance-relevant factors, though questions remain regarding when and for whom MABIs are effective. Specifically, inquiries into intervention engagement (i.e., dosage), potentially impacted by participant readiness, are needed. The present study utilized a non-randomized control group design with U.S. collegiate athletes to investigate MABI effects. Four teams from two universities in the Appalachian region (N = 57) engaged in Mindful Sport Performance Enhancement (MSPE) interventions during their offseason or pre-season training period. Participants were assessed on flow, psychological distress, mindfulness, emotion regulation difficulties, life satisfaction, readiness to practice mindfulness, attitudes toward sport psychology, and sport performance and enjoyment. Mindfulness dosage was measured weekly via self-report. Compared to controls, initial MSPE participants reported reductions in depressive symptoms and emotion regulation difficulties, and improvements in self-rated sport performance; at 6-week follow-up, initial MSPE participants reported significant increases in mindfulness and sport enjoyment, in addition to sustained reductions in emotion regulation difficulties. Pre-intervention readiness was not associated with changes across the intervention, though higher post-intervention readiness was associated with improvements in mindfulness, life satisfaction, and sport enjoyment. Higher post-intervention readiness was also associated with significantly more engagement (i.e., dosage), though no evidence indicated that dosage moderated the relationship between readiness and outcomes. These data suggest that post-intervention readiness may impact long-term engagement in mindfulness practice, and that pre-intervention readiness may not be an accurate indicator of engagement in or outcomes of an MABI with athletes.

The Effect of a Modified Mindfulness-Based Stress Reduction (MBSR) Program on Symptoms of Stress and Depression and on Saliva Cortisol and Serum Creatine Kinase among Male Wrestlers

OBJECTIVES

The aims of the present study were two-fold: to investigate whether, compared to an active control condition, a modified mindfulness-based stress reduction (MBSR) program could (1) reduce symptoms of stress and depression, and (2) regulate salivary cortisol and serum creatine kinase (CK) concentrations, two physiological stress markers.

METHODS

Thirty male wrestlers (M_age = 26.73 years) were randomly assigned either to the MBSR intervention or the active control condition. Both at the beginning and at the end of the intervention, the participants completed questionnaires on perceived stress and depression; in parallel, salivary samples were collected to measure cortisol in saliva, while blood samples were collected to assess serum CK. The study lasted for eight consecutive weeks. The intervention consisted of 16 group sessions (90 min each); the active control condition had an identical schedule, though without bona fide interventions. During the study period, the participants kept their sleeping, nutritional and exercising schedules unaltered.

RESULTS

Over time, symptoms of stress and depression decreased; the level of decrease was more prominent in the MBSR condition than the active control condition (significant p values and large effect sizes of interaction). Further, cortisol and creatine kinase concentrations also decreased more in the MBSR condition compared to the active control condition (large effect sizes of interaction).

CONCLUSIONS

The present study's findings suggest that among male wrestlers, a modified MBSR intervention have the potential to reduce both psychological (stress and depression) and physiological (cortisol and creatine kinase) indices as compared to an active control condition.

Mindfulness Intervention for Improving Psychological Wellbeing Among Students During COVID-19 Pandemic: A Scoping Review

The COVID-19 pandemic can cause mental health problems such as stress, social anxiety, depression, and decrease social life on students. Mental health problems need to be taken seriously to develop the stage of development and improve the psychological well-being of students on learning in the school. The aim of this study was to explore mindfulness interventions to improve psychological well-being among students. This study used the Scoping Review method. Literature from CINAHL, PubMed, and Scopus databases. The keywords used in English are psychological wellbeing, students, and mindfulness. The inclusion criteria were full text, study design randomized control trial or quasi-experimental, English language, population and sample were students, and the publication period is the last 10 years (2013-2022). From 2194 articles based on initial research, we found 10 articles were analyzed related to mindfulness interventions consisting of several methods, namely internet-based mindfulness, mindfulness-based intervention, and mindfulness-based stress reduction. Most of samples the study from the United States with the range samples were 20-166 students. Mindfulness interventions can be carried out improve the psychological well-being of students. Mindfulness therapy is done by fully concentrating the mind in meditation so that it can improve psychological health. Providing mindfulness therapy involves health workers such as nurses and psychologists to provide comprehensive therapy covering both physical and psychological aspects.

Influence of Mindfulness on Levels of Impulsiveness, Moods and Pre-Competition Anxiety in Athletes of Different Sports

Training in emotional regulation skills is one of the most important resources for the adaptation of athletes to contexts of sports pressure, especially during competitions. This study explored the effects of a mindfulness programme (Flow Meditation) on levels of impulsivity, mood and pre-competition anxiety-state in a sample of athletes (N = 41, 22.83 ± 5.62 years). Participants were randomly assigned to an intervention group (N = 21; 14 males and 7 females) which received the intervention over 10 weeks (a weekly session) and a control group (wait-list; N = 20; 13 males and 7 females). The variables under study were assessed through different questionnaires at pre- and post-test (T1-T2) in both groups. The mindfulness intervention was effective in reducing impulsivity (cognitive (t = -4.48, p ≤ 0.001, Cohen's d = 1.40), both motor (t = -4.03, p ≤ 0.001, Cohen's d = 1.20) and unplanned (t = -5.32, p ≤ 0.001, Cohen's d = 1.66)), mood (tension (t = -4.40, p ≤ 0.001, Cohen's d = 1.37), depression (t = -4.56, p ≤ 0.001, Cohen's d = 1.42), anger (t = -7.80, p ≤ 0.001, Cohen's d = 2.47), somatic anxiety (t = -5.28, p ≤ 0.001, Cohen's d = 1.65), and cognitive anxiety (t = -6.62, p ≤ 0.001, Cohen's d = 2.07) in the intervention group compared to the control group and with large to very large effect sizes. Mindfulness is a factor that enhances athletes' ability to cope with high sport pressure and the healthy management of competition (e.g., fear of failure), or with their daily life.

Effects of Mindfulness-Based Interventions on Promoting Athletic Performance and Related Factors among Athletes: A Systematic Review and Meta-Analysis of Randomized Controlled Trial

In recent years, mindfulness-based interventions (MBIs) have been widely applied in competition sports with respect to athletic performance and mental health promotion, whereas evidence of randomized controlled trials (RCTs) has not been well summarized. Therefore, this study aimed to systematically review and meta-analyze the existing evidence on the effects of MBIs on improving athletic performance, mindfulness level, mindfulness-related psychological components (e.g., acceptance, self-compassion, flow), and mental health (e.g., burnout, stress, psychological well-being) among athletes. Following the PRISMA guidelines, a literature search was implemented on five electronic databases (Web of Science, PubMed, Scopus, ProQuest, and ScienceDirect) and relevant review papers. The article selection, risk of bias assessment, and data extraction were performed by two investigators independently. The standardized mean difference (SMD) was calculated to evaluate the effects of interventions using the random effect model. Among the 1897 original hits, thirty-two eligible RCT studies were included in the systematic review, of which seven were involved in the meta-analysis. The results showed that MBIs were effective in promoting athletes' athletic performances (by narrative synthesis), mindfulness-level (n = 3; SMD = 0.50, 95% CI = [0.17, 0.83]; I² = 45%, p = 0.16), and mindfulness-related psychological components (n = 5; SMD = 0.81, 95% CI = [0.53, 1.10], I² = 77%, p =0.001), while no significant intervention effects were found on the mental health of athletes (n = 4; SMD = -0.03, 95% CI = [-0.35, 0.29], I² = 89%, p < 0.001). Our findings preliminarily support the potential effectiveness of MBIs, whereas more high-quality RCTs were needed in the future.

Effect of mindfulness-based programmes on elite athlete mental health: a systematic review and meta-analysis

OBJECTIVE

To determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Eight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes.

RESULTS

Of 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedges g=-0.87, number of studies (n)=6, p=0.017, I ²=90) and stress (g=-0.91, n=5, p=0.012, I ²=74) and increasing psychological well-being (g=0.96, n=5, p=0.039., I ²=89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity.

CONCLUSION

MBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport.

PROSPERO REGISTRATION NUMBER

CRD42020176654.

Procesos de transición hacia el retiro deportivo: una revisión sistemática usando la herramienta PRISMA

El fenómeno del retiro deportivo es una temática relativamente nueva en el campo de las ciencias del deporte, por ello se abordan ideas actuales acerca del proceso hacia el retiro deportivo, como la última etapa dentro de sus carreras profesionales y longevidad competitiva en deportistas de alto rendimiento. El objetivo de esta revisión sistemática es identificar las investigaciones que hablan sobre la manera como se asume el proceso de transición hacia el retiro deportivo y desentrenamiento en los deportistas. Para ello se realizó una búsqueda en las bases de datos. Scopus, Ebsco y Sciencedirect durante el mes de agosto del año 2022. La consulta se realizó combinando los términos: Detraining, Retirement y Sport utilizando los criterios de inclusión. Artículos de revisión, publicados en los últimos diez años, en idiomas inglés o español y que se tuviera acceso al texto completo. Durante la búsqueda se encontraron 16.642 artículos. Luego de aplicar los diferentes filtros teniendo en cuenta el título y los objetivos de la investigación se tuvieron en cuenta 165 de ellos, a los cuales se les aplicaron de nuevo los ítems incluidos en el check list de la herramienta PRISMA teniendo como resultado 17 artículos para ser contemplados en esta investigación. De estos, dos son de revisión sistemática, 1 de ellos con metodología PRISMA, además cuatro cuantitativas y once de carácter cualitativo.

Effects of two types of exercise training on psychological well-being, sleep and physical fitness in patients with high-grade glioma (WHO III and IV)

BACKGROUND

There is evidence that regular exercise training has the potential to improve psychological well-being among cancer survivors. However, limited findings are available for individuals with high-grade glioma (HGG; WHO grade III and IV) after neurosurgery and undergoing radiochemotherapy. Given this, endurance and strengths training were employed to investigate their impact on symptoms of depression, feelings of stress and anxiety, fatigue, insomnia, and physical fitness, compared to an active control condition.

METHODS

A total of 29 patients (M = 52.07, SD = 12.45, 55.2% women) participated in this randomized controlled trial (RCT). After neurosurgical treatment and during adjuvant radiotherapy and chemotherapy or combined radiochemotherapy, patients were randomly assigned to the following conditions: Endurance training (n = 10); strengths training (n = 11); active control condition (n = 8). At baseline, three weeks and six weeks later at the end of the study physical fitness was objectively measured with a 6-min walk test (6MWT) and a handgrip test. Participants completed a series of questionnaires covering sociodemographic information, symptoms of depression, stress, anxiety, fatigue, and insomnia. Further, experts rated participants' severity of symptoms of depression.

RESULTS

Over time and compared to the strengths and active control condition, self-rated symptoms of depression, state and trait anxiety, stress and insomnia decreased in the endurance condition. Over time and compared to the endurance and active control condition, no changes on symptoms of depression, anxiety, stress, or insomnia were observed in the strengths condition. Over time and compared to the endurance and strengths condition, symptoms of depression (self-ratings), stress, insomnia and fatigue decreased in the active control condition. Fatigue increased in both exercising conditions. Over time and irrespective from the study condition, physical fitness did neither improve nor decrease.

CONCLUSIONS

The pattern of results suggests that endurance training and an active control condition improved dimensions of depression, stress, and anxiety, while mere strengths training appeared to neither improve, nor decrease dimensions of psychological functioning. Further, exercise interventions did not change physical fitness, but increased fatigue. Overall, endurance training and an active control condition appeared to favorably impact on psychological well-being among patients with high-grade glioma after neurosurgery and undergoing radiochemotherapy.

The Effects of Mindfulness-Based Strategies on Perceived Stress and Psychobiosocial States in Athletes and Recreationally Active People

The mindfulness-based stress reduction (MBSR) programme is gaining increasing attention in sport and physical activity domains. This programme comprises three meditation practices: mindful yoga, body scan, and sitting meditation. In this study, we aimed to examine the effects of a dynamic (mindful yoga) strategy and a static (a combination of body scan/sitting meditation) strategy on participants’ psychobiosocial states (PBS), perceived stress (PS) and mindfulness levels in athletes and recreationally active (RA) people. Thirty-four participants (athletes = 18; RA participants = 16) were assigned to a dynamic intervention strategy, and another 34 (athletes = 19; RA participants = 15) were assigned to the static intervention strategy. Before the intervention, after the intervention and three weeks later, the Italian versions of the PBS scale, the PS scale and the Mindful Attention Awareness scale were administered. RM-(M)ANOVAs revealed that intervention strategies improved functional PBS, reduced PS and enhanced mindfulness levels in both athletes and RA participants after the intervention (p < 0.001, ηp2 = 0.605). However, improved functional PBS after the intervention (p < 0.001; d = 0.62) and stable PS levels at follow-up (p = 1) were observed mainly in athletes. The findings reinforce the view of the importance of the body as a means to improve emotional and health processes, and support the use of mindfulness strategies in sport to enhance individuals’ well-being.

The Effectiveness of Mindfulness-based Stress Reduction Program in Improving Mental Well-being of Patients with COVID-19: A Randomized Controlled Trial

Aim and objective

Mental well-being is one of the most important aspects of health. Life-threatening situations such as diseases affect mental well-being. Mindfulness-based stress reduction (MBSR) program is an effective program for improving well-being. This study aimed to evaluate the effectiveness of MBSR programs on the mental well-being of patients with coronavirus disease-2019 (COVID-19).

Materials and methods

This randomized controlled trial study was conducted in 2021. We used simple random sampling for recruiting 60 patients with COVID-19 and assigned them to the intervention and control groups. The intervention comprised eight sessions of the MBSR and was performed for the experimental group. The control group received routine postdischarge care. We used a self-report demographic and Ryff's Psychological Well-being Scale to collect data. To analyze the data, descriptive statistics and inferential statistics including Covariance, MANCOVA, and effect coefficient were used. The Significance level was considered lower than 0. 05. We used SPSS version 21 for data management.

Results

The mean score of mental well-being in the intervention group was 56.76 ± 6.88 in the pretest stage and 80.76 ± 7.53 in the posttest stage, and that in the control group was 54.40 ± 10.31 in the pretest stage and 51.23 ± 10.08 in the posttest stage. There was no significant difference between the two groups before the intervention (p >0.05) but there was a significant difference (p <0.05) after the intervention. There was also a significant difference (p <0.05) between the dimensions of mental well-being before and after the intervention.

Conclusion

According to our findings, it is recommend to use MBSR program in line with physical treatment for patients with COVID-19.

How to cite this article

Sadooghiasl A, Ghalenow HR, Mahinfar K, Hashemi SS. Effectiveness of Mindfulness-based Stress Reduction Program in Improving Mental Well-being of Patients with COVID-19: A Randomized Controlled Trial. Indian J Crit Care Med 2022;26(4):439–445.

Examining the Effects of Mindfulness-Acceptance-Commitment Training on Self-Compassion and Grit among Elite Female Athletes

BACKGROUND

Mindfulness-based interventions are well-established in the field of psychotherapy, and such interventions have also gained increased attention in the field of sport psychology, either to cope with psychological pressure or to improve an athlete's performance. The goal of the present study was to examine whether a Mindfulness-Acceptance-Commitment (MAC) program could increase self-compassion and grit among elite female athletes compared to an active control condition. To this end, we performed a randomized trial among female adult athletes.

METHODS

Forty female adult athletes (M_age = 22.22, SD = 2.40) were randomly assigned either to the Mindfulness-Acceptance-Commitment group (n = 20; 7 group sessions, 60 min each) or the active control group (n = 20; 7 group sessions, 60 min each). At baseline, seven weeks later at the end of the study and again four weeks later at follow-up, participants completed a series of self-rating questionnaires on mindfulness, self-compassion and grit.

RESULTS

Dimensions of mindfulness, self-compassion and grit improved over time, but more so in the Mindfulness-Acceptance-Commitment condition compared to the active control condition. Improvements remained stable from the study end to follow-up.

CONCLUSIONS

While the active control condition improved dimensions of mindfulness, self-compassion and grit among female adult athletes, improvements were much stronger in the Mindfulness-Acceptance-Commitment condition. Importantly, improvements in the Mindfulness-Acceptance-Commitment condition remained stable over a time lapse of four weeks at follow-up after study completion, suggesting that the Mindfulness-Acceptance-Commitment intervention appeared to improve cognitive-emotional learning processes.

Depressive Symptoms and Burnout in Football Players: A Systematic Review

The purpose of this article was to systematically review and organise the available literature devoted to the topic of depressive symptoms and burnout in football players. A systematic search was conducted in Web of Science, Scopus, SPORTdiscus, PubMed, and Psychinfo for articles published up to June 2020. The searches yielded 1589 articles, and after the screening process, a total of 18 studies met the eligibility criteria and were included for review. Playing position and conflicts with coach/management seems to have a direct influence on the prevalence of depressive symptoms in current players as do the injuries and life events of former players. During the pre-competition phase, most of the athletes displayed reduced rates, indicating burnout. An exploration of the mental health of football players will help to create models of care and guide professionals so that they may help players achieve better performance while also having better wellbeing. Understanding how to prevent and cope with the emotional wellbeing of football players will be possible to guide players and coaches.

Psychological health analysis based on fuzzy assisted neural network model for sports person

Stress is indeed a life aspect that influences everyone, even though athletes seem to suffer from it one step ahead of others because of the extent they are expected to balance between coursework, workouts, and competitions, along with everyday life and family stress. Therefore, an efficient psychological health analysis for sportspersons is crucial in sports training. This paper introduces a Fuzzy-assisted Neural Network model for Psychological Health Analysis (FNN-PHA) to assess mental stress by monitoring the Electro Cardio Gram signal (ECG), Electroencephalogram (EEG), and Pulse rate. This paper integrates the fuzzy assisted Petri nets, fuzzy assisted k-complex detector, and fuzzy assisted transient time analyzer to ensure the psychological health analysis neural network model’s adaptive performance. The strength of the proposed fuzzy model demonstrates interpretability against the accuracy of different criteria. The simulation analysis shows that the FNN-PHA model enhances the prediction ratio of 98.7%, emotional stability of 96.7%, personal growth of 95.7%, physical fitness level of 97.8%, and depression ratio of 12.5% when compared to other existing models.

A systematic review and meta-analysis of psychological interventions to improve mental wellbeing

Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.

Exploring the relationship between mindfulness and rock-climbing: a controlled study

Mindfulness is a meditative practice that has received increasing attention within positive psychology as an effective tool to increase wellbeing and decrease anxiety. Previous research has demonstrated that rock-climbers have a higher endorsement of mindfulness and life satisfaction than the general population; yet to date, no research has empirically explored the relationship between mindfulness and rock-climbing. In the current study fifty-nine participants ($$ \overline{\mathrm{x}} $$ x ¯ = 20.63, SD = 1.60) were asked to complete measures of mindfulness, wellbeing and anxiety before and after participating in an ‘intervention’. The intervention consisted of a mindfulness activity followed by either indoor bouldering (a form of rock-climbing) versus a physical activity control. A mixed ANOVA revealed that participation in bouldering increased the measure of mindfulness significantly more than the control activity; however, no significant group differences were found for the measures of wellbeing and anxiety. A regression analysis then revealed that group condition accounted for 33% of the variance in post-intervention mindfulness levels when controlling for baseline levels of mindfulness. This is the first study to experimentally demonstrate that engagement with rock-climbing increases mindfulness in young adults. Theoretically, the results have implications for our understanding of “flow” and optimal human experience. Practically, the study highlights the potential to implement rock-climbing as a resilience-building activity and integrate the sport within therapeutic frameworks.

Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study

Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60-70 min) or to the active control condition (weekly group meetings for 60-70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia.

Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

There is an urgent need for mental health promotion in nonclinical settings. Mindfulness-based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions.

METHODS AND FINDINGS

Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in-person, expert-defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk-of-Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well-being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta-regression and sensitivity analyses were prespecified. Pairwise random-effects multivariate meta-analyses and prediction intervals (PIs) were calculated. A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = -0.56; 95% confidence interval (CI) -0.80 to -0.33; p-value < 0.001; 95% PI -1.19 to 0.06), depression (14 trials; SMD = -0.53; 95% CI -0.72 to -0.34; p-value < 0.001; 95% PI -1.14 to 0.07), distress (27 trials; SMD = -0.45; 95% CI -0.58 to -0.31; p-value < 0.001; 95% PI -1.04 to 0.14), and well-being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p-value = 0.003; 95% PI -0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = -0.46; 95% CI -0.81 to -0.10; p-value = 0.012, 95% PI -1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well-being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs' superiority. Only effects on distress remained when higher-risk trials were excluded. USA-based trials reported smaller effects. MBPs targeted at higher-risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials.

CONCLUSIONS

Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.

Mental Health Measurement in a Post Covid-19 World: Psychometric Properties and Invariance of the DASS-21 in Athletes and Non-athletes

Psychological science faces a call to action researching the implications of the corona virus disease 2019 (Covid-19) pandemic. Rapid reviews have reported that maintaining rigorous research standards is a priority for the field, such as ensuring reliable and valid measurement, when investigating people’s experience of Covid-19 (O’Connor et al., 2020). However, no research to date has validated a measure mental health symptomology for an athlete population. The current research addresses this gap by examining the internal consistency, factor structure, invariance, and convergent validity of the Depression Anxiety and Stress Scale (DASS-21; Lovibond and Lovibond, 1995) in two athlete samples. Participants completed the DASS-21 and sport-specific measures of mental health such as the Profile of Mood States – Depression subscale (POMS-D), Sport Anxiety Scale-2 (SAS-2), Athlete Burnout Questionnaire (ABQ), and Athlete Psychological Strain Questionnaire (APSQ). In sample one (n = 894), results of exploratory structural equation modeling indicated that a three-factor model provided good fit to the data, but a bifactor model provided better fit. Factor loadings indicated minimal misspecification and higher loadings on the general-factor. Invariance testing suggested equivalence across gender, athletic expertise, sport type, and injury status. Further, latent mean differences analyses indicated that females and injured athletes scored higher than male and non-injured athletes on all DASS-21 factors reporting higher mental health symptomology, those with more expertise scored higher on the general-factor and depression and those with less expertise scored higher on anxiety and stress, and no differences between team and individual athletes. In sample two (n = 589), the bifactor structure was replicated. Results largely supported the scales convergent validity with depression predicting POMS-D scores, whereas all three subscales predicted the SAS-2, ABQ, and APSQ scores. Internal consistency was acceptable in both samples. The current work provides initial support for use of the DASS-21 as an operationalisation of mental health symptomology in athletes. Theoretical and practical implications of these results are discussed.

Moderating Effect of Mindfulness on the Influence of Stress on Depression According to the Level of Stress among University Students in South Korea

Stress and depression are representative of the mental health problems of university students worldwide. This cross-sectional study explored the moderating effect of mindfulness on the influence of stress on depression according to the degree of life stress. The participants were 738 university students in years 2–4 in five 4-year universities in South Korea. Depression was positively correlated with stress and negatively with mindfulness at a statistically significant level. In multiple regression analysis, stress was found to have an effect by increasing depression, and mindfulness by relieving depression. In the moderated multiple regression analysis, mindfulness had a moderating effect on the impact of stress on depression only in low-stress groups, showing that the interaction of stress with mindfulness was significantly negative (β = −0.11, t = −2.52, p = 0.012) and the inclusion of this interaction significantly increased the explanatory power for depression variation (F change 6.36, p = 0.012) in the full model. In conclusion, we suggest considering stress levels in the development of mindfulness-based intervention strategies to effectively manage the depression of university students.

The Effect of Loving-Kindness Meditation on Flight Attendants' Spirituality, Mindfulness and Subjective Well-Being

Background: This study investigated: (1) the effects of the loving-kindness meditation (LKM) on mindfulness, subjective well-being (SWB), and spirituality and (2) the relationships between mindfulness, spirituality, and SWB. Methods: 98 flight attendants from Xiamen Airlines in China were recruited and randomly assigned to the LKM training group (n = 49) or the waiting control group (n = 49). The LKM training group underwent an 8-week LKM training intervention, and the control group did not undergo intervention. The three main variables (SWB, mindfulness, and spirituality) were measured both before (pre-test) and after (post-test) the LKM training intervention. Results: In the experimental group, SWB and spirituality increased significantly. In the control group, no significant differences were observed for the three variables between the pre-test and post-test. Conclusions: Our results indicated that LKM may help to improve SWB and spirituality. However, the mechanisms which underlie the effects of the LKM on mindfulness, spirituality, SWB, and other psychological constructs require further elucidation.