Racial Identity and Mindfulness as Predictors of Posttraumatic Growth in Black Adults Experiencing Race-Based Trauma

Racial discrimination and race-based trauma (RBT) have led to the development of various negative psychological and physiological effects among Black adults in the USA. There is a lack of understanding in relation to how various psychosocial factors influence posttraumatic growth (PTG) in the context of RBT among Black adults. The authors examined associations of RBT, racial identity, and mindfulness with PTG among Black adults while controlling for gender, household income, and duration of trauma. The sample consisted of 134 self-identified Black adults who met the criteria for RBT from the USA. The hierarchical regression analysis showed the final model with all the predictors accounted for 35% of the total variance of PTG, with racial identity and mindfulness facets accounting for 26% of the variance. The study provides a foundation for future research addressing RBT and promoting PTG in Black adults.

Patients' experience with chimeric antigen receptor T-cell therapy for DLBCL in China: a qualitative study

PURPOSE

The experiences of patients with diffuse large B-cell lymphoma (DLBCL) treated with chimeric antigen receptor (CAR) T-cell therapy have received little attention. This study aimed to explore the treatment experiences of patients with relapsed or refractory (R/R) B-cell lymphoma during CAR T-cell therapy in China.

METHODS

This descriptive qualitative study was conducted using face-to-face semi-structured interviews with 21 DLBCL patients 0-2 years after CAR-T infusion. Two researchers independently coded the interviews in MAXQDA 2022, and the original data were analyzed by conventional content analysis.

RESULTS

Four themes emerged from the transcripts: (1) physiological distress, (2) functional impacts, (3) psychological experience, and (4) support requirement. Participants expressed 29 short-term or long-term symptoms related to their disease and treatment, influencing their daily life and function in a social setting. The participants expressed different negative emotions, polarized expectations about efficacy, and over-reliance on authoritative medical care. Their major concerns and hopes were achieving life goals, being treated with respect, obtaining more information about CAR T-cell therapy, and receiving government financial sponsorship.

CONCLUSIONS

The patients experienced short-term and long-term symptoms of physical distress. Patients who have experienced failure in CAR T-cell therapy also experience strong negative emotions, such as dependency and guilt. They also require authentic spiritual and financial information that is authentic. Our study may guide the development of standardized and comprehensive nursing care for R/R DLBCL patients undergoing CAR T-cell therapy in China.

Pathways to post-traumatic growth in Korean female cancer patients: the mediation effects of coping strategies and resilience

ABSTRACTBackground: Cancer is a life-threatening disease in Korean women. Female cancer patients in Korea have reported poor physical functioning and psychological distress after diagnosis. However, some patients experience post-traumatic growth (PTG), which includes positive feelings and changes.Objective: The main purpose of this study was to examine the relationships between PTG and its associated factors in Korean female cancer patients to understand how female cancer patients achieve PTG while experiencing cancer diagnosis and treatment. This study aimed to improve the quality of life of many Korean female patients with cancer.Methods: This study investigated the structural model of the paths from the disruption of core beliefs (CBD), coping strategies, and resilience to PTG in a sample of female cancer patients. In total, 164 middle-aged women diagnosed with cancer were included in the final sample.Results: First, it was determined that the proposed structural model was substantial and had high fit indices. Second, problem-solving was positively associated by the CBD routes. Third, it was also favorably expected that problem-solving would lead to resilience and resilience would lead to PTG. These findings are important for developing future interventions for Korean female cancer patients and can be considered as an important variable to improve their PTG.

Evaluating an online self-distancing intervention to promote emotional regulation and posttraumatic growth during the COVID-19 pandemic

OBJECTIVES

Three online studies were conducted to elucidate the role of emotional regulation (ER) in posttraumatic growth (PTG), evaluate the ability of an online self-distancing intervention to achieve ER, and test whether increasing the use of ER strategies promotes PTG.

DESIGN

Cross-sectional (Study 1) and longitudinal randomized controlled trials (RCT) (Studies 2 and 3).

METHOD

In Study 1, 626 adults completed measures of ER, PTG, and psychosocial functioning during the COVID-19 pandemic. In Study 2, 149 adults participated in a five-week RCT comparing self-immersed, spatially self-distanced, and temporally self-distanced reflection in their ability to regulate negative affect. In Study 3, 117 adults replicated the RCT of Study 2 and completed the measures from Study 1 a week pre- and post-intervention.

RESULTS

Path analyses confirmed that ER strategies were relevant to COVID-19-related PTG. MANOVAs revealed that self-distancing was effective in regulating state negative affect. However, ANOVAs suggest that this was not due to increased use of ER strategies and did not improve PTG or psychosocial functioning.

CONCLUSIONS

These findings support further research into the relevance of ER to PTG, and provide a foundation to understand PTG and develop PTG-promoting interventions within a broader stress-coping framework.

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

The mediating role of positive reappraisal and self-compassion on the relationship between mindfulness and posttraumatic growth in patients with cancer

The beneficial effect of mindfulness in promoting posttraumatic growth has been well established in research, but it remains unclear what psychological mechanisms mediate it. This study examined the mediating roles of positive reappraisal and self-compassion on the relationship between mindfulness and posttraumatic growth in patients with cancer. A random sample of 550 patients drawn from two medical health care institutions in southeast, Nigeria participated in this study. Results of mediation analysis showed that positive reappraisal and self-compassion independently mediated the relationship between mindfulness and posttraumatic growth. These findings underscore the usefulness of mindfulness-based therapies in promoting cognitive emotional processes such as positive reappraisal abilities and self-compassion, which are essential in facilitating posttraumatic growth in patients with cancer.

Association between trait mindfulness and symptoms of post-traumatic stress: A meta-analysis

Mindfulness is characterized by skills such as heightened awareness and acceptance of internal experiences, which may be helpful for people who have experienced trauma. The consistency and strength of the relationship between trait mindfulness and PTSD symptomology, however, is unknown. Studies were included in this review if they were published in an English language peer-reviewed journal, reported on a correlational relationship between validated measures of mindfulness and PTSD, and all participants were over the age of 18. A random effects meta-analysis showed that there was a robust, pooled relationship between total mindfulness and PTSD (r₊ = -0.39, 95% CI [-0.47 to -0.30]), based on 35 datasets with 13,370 participants, with low risk of publication bias. Sixteen articles reported on facets of mindfulness and PTSD symptomology [5,206 to 5,600 participants]: the strongest associations were with Act with Awareness (r₊ = -0.37) and Non-judge (r₊ = -0.37), followed by Describe (r₊ = -0.22) and Non-react (r₊ = -0.21). Observe was not significantly associated with PTSD symptoms. Results from this analysis suggest that people who are more mindful also report fewer symptoms of PTSD ; the strength of the relationship varies across mindfulness facets. There was high heterogeneity across studies.

Psychological resources and flexibility predict resilient mental health trajectories during the French covid-19 lockdown

The implementation of lockdowns and the Covid-19 pandemic situation have negatively impacted mental health (anxiety, depression). However, little is known about individual differences in the longitudinal reactions to lockdown. We designed a longitudinal study (a) to identify the various trajectories of symptoms of depression and anxiety in the general population during and after lockdown; (b) to determine which positive psychological resources prevent individuals from falling into groups with the most severe trajectories; (c) to test the mediating role of psychological flexibility. We collected and analysed longitudinal data on a sample of French participants (N = 1399, M_age = 43.4; SD_age = 12; 87.8% women) during the end of the first lockdown. Participants were asked to report their psychological resources and (in)flexibility at baseline and symptoms of anxiety and depression at each measurment occasion (five weekly observations from 17 March to 11 May 2020, including baseline). Using growth mixture modelling, seven dynamic profiles of symptoms were identified: four for depression and three for anxiety. Resilience emerged as the most frequent trajectory. Wisdom, optimism, hope, self-efficacy and peaceful disengagement significantly prevented individuals from belonging to the symptomatic groups. Moreover, psychological flexibility emerged as a significant mediator of these effects. This study highlights the importance of cultivating protective factors and psychological flexibility to prevent mental health damage during potentially traumatic events (PTE) and to favour resilience trajectories.

Cognitive Coping Reduces Posttraumatic Stress Symptoms, Especially in the Context of Self-Blame

Following a traumatic event, coping strategies may affect the natural course of posttraumatic stress symptoms (PTSS). In particular, cognitive coping strategies (how one thinks about stressors) may reduce PTSS by increasing individuals' perceived control over events, appraising them as less threatening, particularly for individuals who experience self-blame after trauma. Individuals who experience a traumatic event (n =344) completed assessments at baseline (T1), one month (T2), and two months (T3). We tested whether T1 cognitive coping strategies (positive reinterpretation, acceptance, religious coping) predicted reduced T3 PTSS and whether this reduction was mediated by increased perceived control at T2. We tested whether this effect was particularly strong for individuals experiencing self-blame. Positive reinterpretation predicted decreases in, religious coping predicted increases in, and acceptance had no direct effect on PTSS. Overall, acceptance showed the greatest potential for reducing PTSS through increased perceived control over one's life. In a fully moderated mediation model, positive reinterpretation significantly interacted and acceptance marginally interacted with self-blame to predict increased perceived control and, subsequently, decreased T3 PTSS. Specifically, acceptance and positive reinterpretation were most helpful for those with higher levels of self-blame. Religious coping interacted with self-blame to predict decreased perceived control and subsequent increased PTSS. For trauma survivors experiencing self-blame, cognitive coping strategies that utilize compassionate self-talk, such as positive reinterpretation and acceptance, may be particularly helpful at increasing perceived control after trauma, while religious coping may have deleterious effects.

Effects of interventions on rumination among individuals with cancer: A systematic review and meta-analysis

AIM

This study aimed to examine the effects of interventions on rumination among individuals with cancer.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

Six databases (Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), PsyArticles, CINAHL, PubMed and Web of Science) were searched for relevant articles published between January 2000 and April 2020.

REVIEW METHODS

The findings of experimental studies (including both experimental and control groups) related to interventions to effect rumination of individuals with cancer were included. Comprehensive meta-analysis was used to analyse the data. Hedges' g and 95% confidence intervals (CIs) were computed to estimate the effect. Additionally, funnel plots were created and heterogeneity was analysed using the I² test. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used.

RESULTS

Eight studies, which included a total sample of 856 individuals with cancer, were included. Half of the studies (n = 4) were randomised controlled trials, and six of them had conducted mindfulness-based interventions. The interventions had significant effects on rumination among individuals with cancer (z = -2.356, Q = 167.663, p < 0.001, I²  = 95.825%). The effect size was -0.894 (95% CI = [-1.638, -0.150]) and statistically significant (p < 0.001).

CONCLUSION

The interventions had reduced rumination among individuals with cancer. These effects should be interpreted with caution because there was a high level of heterogeneity. However, only a few studies were included, and the findings underscore the need for further research.

IMPACT

Many individuals are likely to benefit from rumination-focused interventions, especially mindfulness-based interventions. Nurses should utilise available opportunities to facilitate the optimal management of cancer-related rumination.

Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience

Background/Objective 'Third-wave' psychotherapies have shown effectiveness for treating psychopathological symptoms such as anxiety and depression. There is burgeoning interest in examining how these therapies' core constructs produce their therapeutic benefits. This study explores the hypothetical mediating effect of resilience in the impact of mindfulness and self-compassion on anxiety and depressive symptoms. Method: Cross-sectional study design. The sample consisted of 860 Spanish general population participants. The measures included the Mindful Attention Awareness Scale (MAAS), the Self-Compassion Scale (SCS-12), the Connor-Davidson Resilience Scale (CD-RISC) and the Goldberg Anxiety and Depression Scale (GADS). Bivariate correlations were calculated, and path analysis models were performed. Results: Significant correlations were found between the study variables, always in the expected direction (all p values <.001). The path analysis models showed significant direct effects of mindfulness and self-compassion on anxiety and depression symptoms, but the only significant indirect effects through resilience were found on depression (MAAS: β = -.05, 95% CI = -.11 to -.02; SCS-12: β = -.06, 95% CI = -.33 to -.07). Conclusions: Resilience might partially mediate the effect of mindfulness and self-compassion on depression, but not on anxiety.

Trait mindfulness is negatively associated with distress related to COVID-19

Research suggests that mindfulness is associated with psychological health including a healthier response to stressors.

Objective

This research tested associations between trait mindfulness and mental health factors related to the novel coronavirus (COVID-19).

Methods

Two studies (Study 1 N = 248 college students; Study 2 N = 300 U.S adults) assessed trait mindfulness, perceived stress and anxiety, worry about the coronavirus, and anticipated negative affect of a coronavirus diagnosis. Additionally, Study 2 assessed depressive symptoms and coping with the coronavirus.

Results

In both studies, findings indicated that individuals higher in trait mindfulness reported less stress and anxiety. Higher mindfulness in both studies was also associated with less worry about the virus and anticipating less negative affect if one gets the virus. In Study 2, trait mindfulness was negatively related to depression, and numerous associations between mindfulness and coping emerged, showing higher trait mindfulness was associated with healthier strategies in coping with coronavirus.

Conclusions

These data are consistent with research that has revealed that those who think and act more mindfully are less stressed and anxious. By revealing these associations with mindfulness in the context of a real-world, novel stressor, this research makes an important contribution to the literature.

Effects of psychosocial factors on posttraumatic growth among lung cancer patients: A structural equation model analysis

OBJECTIVE

The purpose of this study was to investigate how locus of control, coping strategies, emotion regulation strategies and social support affect posttraumatic growth.

METHODS

A cross-sectional study design was adopted. A convenience sample of 540 patients with lung cancer was recruited from November 2016 to July 2017 at two tertiary grade A hospitals in China. The participants completed a series of questionnaires. Structural equation modelling was used to explore the effects of psychosocial factors on posttraumatic growth.

RESULTS

Social support had a direct positive effect on posttraumatic growth (β = 0.318, SE = 0.071, BC 95% CI = 0.252/0.390), and it also had indirect effects on posttraumatic growth (β = 0.112, SE = 0.023, BC 95%CI = 0.088/0.135) through mediating psychological factors. Coping strategies and the cognitive reappraisal emotion regulation strategy were the main mediating variables, explaining approximately 73.1% of the indirect effect between social support and posttraumatic growth.

CONCLUSIONS

Our study suggests that Chinese lung cancer survivors can show relatively high posttraumatic growth. There are many mediating paths between social support and posttraumatic growth. These results may help healthcare professionals to identify the psychosocial factors that may benefit lung cancer patients and develop interventions to promote posttraumatic growth.

Mindfulness, Posttraumatic Stress Symptoms, and Posttraumatic Growth in Aid Workers: The Role of Self-Acceptance and Rumination

ABSTRACT

Objective: The risk for aid workers to develop posttraumatic mental problems highlights the importance of reducing the harm of posttraumatic stress symptoms (PTSS) and promoting the benefits of posttraumatic growth (PTG). This study examined the negative relationship between mindfulness and PTSS, and the positive relationship between mindfulness and PTG, and further explored the mediating roles of self-acceptance, intrusive rumination, and deliberate rumination. Methods: Aid workers from the Red Cross Organization (N = 298) were recruited in the study. They completed a series of questionnaires assessing mindfulness, self-acceptance, rumination, posttraumatic stress disorder (PTSD), and PTG. Results: Results showed that mindfulness was significantly and negatively associated with PTSD through positively predicting self-acceptance and negatively predicting intrusive rumination. Mindfulness was significantly and positively associated with PTG, although the mediating effect did not exist because the path between self-acceptance and deliberate rumination was impassable. Conclusion: The mechanisms between mindfulness, PTSD, and PTG were further explored. Limitations and implications for trauma intervention and future research were discussed.

Approach coping and substance use outcomes following mindfulness-based relapse prevention among individuals with negative affect symptomatology

Objectives

Mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs) appears to be particularly effective among individuals with high levels of co-occurring affective symptoms. We sought to understand whether changes in approach and avoidance coping may explain the effects of MBRP among this subpopulation.

Method

The sample included 286 individuals with SUDs randomized to MBRP, relapse prevention (RP), or treatment-as-usual (TAU) as an aftercare treatment. We conducted conditional indirect effect models with treatment condition as the predictor, baseline affective symptoms as the moderator, changes in approach and avoidance coping over time from baseline through 6-months post-treatment as mediators, and substance use and substance-related problems at 12-months post-treatment as the outcome. Affective symptomatology at baseline was modeled as a latent factor indicated by depression, anxiety, and PTSD symptoms. Change in approach and avoidance coping was modeled using latent growth curve analyses.

Results

We found significant conditional indirect effects of MBRP, such that the interaction of MBRP vs. TAU by affective symptoms predicted increases in approach coping, which in turn predicted fewer heavy drinking days and substance-related problems at month 12. Follow-up analyses showed that increases in approach coping mediated the therapeutic effect of MBRP on these outcomes among those with high, but not low or moderate, affective symptoms. We did not find indirect or conditional indirect effects when comparing RP to TAU, or when avoidance coping was the mediator.

Conclusions

The pronounced therapeutic effects of MBRP among individuals with SUD and relatively higher negative affective symptoms may be due to increases in approach coping over time.

Quality or quantity of coping resources: Why not both? An integration of common stress theories

Threatening situations may cause distress (e.g., armed conflicts, natural disasters, etc.) and provoke Psychological Distress and Post-Traumatic Stress Symptoms. National resources may mitigate threats or damage in certain situations. This research suggests that in doing so, such resources deployed in concert with personal resources, may reduce levels of these symptoms. Two major stress theories are integrated in theoretical support of the role of national resources: The Conservation of Resource theory (Hobfoll, 1989) and the Cognitive Appraisal Theory (Lazarus and Folkman, 1984). Hobfoll's theory is extended beyond personal resources to encompass national resources. We offer the case of the Iron Dome as an example of a national resource. Iron Dome is an Israeli missile defense system successfully used during Operation Protective Edge in 2014 in response to rocket attacks from Gaza. A cross-sectional study was conducted during the operation in the form of an online survey in which 910 Israeli civilians were assessed using a Psychological Distress and the Impact of Event Scale. They reported on their personal resources and perception of the Iron Dome as a national security resource. Our findings revealed that resource quantity significantly predicted Psychological Distress and Post-Traumatic Stress Symptoms. In addition, it was found that the national security resource significantly contributed to decreased Psychological Distress and Post-Traumatic Stress Symptom predictions beyond all personal resources examined. Research contributions and practical implications are discussed.

Longitudinal cross-lagged relationships between mindfulness, posttraumatic stress symptoms, and posttraumatic growth in adolescents following the Yancheng tornado in China

Treatment of posttraumatic stress symptoms and facilitation of posttraumatic growth are two encouraging areas of research, yet little is understood about the relationships between trait mindfulness, posttraumatic stress symptoms, and posttraumatic growth. Previous work suggests the linkages among these variables, but most studies have been conducted in adult samples. The aim of this study was to examine longitudinal cross-lagged relationships between mindfulness, posttraumatic stress symptoms, and posttraumatic growth among adolescent survivors of the 2016 Jiangsu tornado in China. Data was collected at two secondary schools located in Yancheng city, where the severe catastrophic damage occurred during the tornado. The sample included 247 adolescent survivors (59.5% girls) aged 12-14 years who were directly affected by the tornado. Participants self-reported their trait mindfulness, posttraumatic stress symptoms, and posttraumatic growth at two time points: 6-month (T1) and 9-month post-tornado (T2; attrition rate 17.4%). Cross-lagged structural equation modelling analyses were conducted. Results showed that posttraumatic stress symptoms at T1 significantly predicted reduced trait mindfulness at T2 but not posttraumatic growth; trait mindfulness at T1 did not significantly predict posttraumatic stress symptoms nor posttraumatic growth at T2; and posttraumatic growth at T1 did not predict trait mindfulness nor posttraumatic stress symptoms at T2. These findings suggested that posttraumatic stress symptoms may negatively influence the development of trait mindfulness in disaster-affected adolescents in China, and that posttraumatic growth may have unique implications for this young population which was not associated with posttraumatic stress symptoms or trait mindfulness.

A systematic review of randomized trials of mind-body interventions for PTSD

OBJECTIVE

To systematically review outcomes from randomized controlled trials (RCTs) of mind-body treatments for PTSD.

METHODS

Inclusion criteria based on guidelines for assessing risk of bias were used to evaluate articles identified through electronic literature searches.

RESULTS

Twenty-two RCTs met inclusion standards. In most of the nine mindfulness and six yoga studies, significant between-group effects were found indicating moderate to large effect size advantages for these treatments. In all seven relaxation RCT's, relaxation was used as a control condition and five studies reported significant between-group differences on relevant PTSD outcomes in favor of the target treatments. However, there were large within-group symptom improvements in the relaxation condition for the majority of studies.

CONCLUSIONS

Although many studies are limited by methodologic weaknesses, recent studies have increased rigor and, in aggregate, the results for mindfulness, yoga, and relaxation are promising. Recommendations for design of future mind-body trials are offered.