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A Systematic Review Exploring the Effectiveness of Mindfulness for Sexual Functioning in Women with Cancer. PSYCH 2023. [DOI: 10.3390/psych5010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Sexual intimacy is a basic human need that is associated with quality of life whereby its absence can significantly impact both interpersonal and personal wellbeing. This systematic review aimed to provide an up-to-date evaluation of the available literature on mindfulness treatments for sexual functioning in women diagnosed with cancer. Electronic searches including PubMed, PsycINFO, Web of Science and registered clinical trials yielded 10 studies that met the inclusion criteria. The results showed that treatment intervention designs varied and included mixed methods, randomised clinical trials, single arm non-randomised trials and those with the absence of any control. Furthermore, both brief and longer-term mindfulness interventions were trialled across different sexual domains. Whilst inconclusive, mindfulness-based interventions appear to support sexual function and quality of life in both early- and post-cancer survivors. However, in some instances, there were outcome inconsistencies in sexual desire, arousal and orgasm. This review has identified a current shortage in research on the effectiveness of mindfulness-based treatments for supporting sexual functioning in women with cancer; and so far, no research has been conducted in palliative care. This unmet need in supporting sexual functioning in women with cancer, including palliative care, carries important implications for both psychosexual and oncological healthcare services as sexual intimacy does not end with cancer diagnosis or prognosis.
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Sparks KV, Ring C. A rowing-specific mindfulness intervention: Effects on mindfulness, flow, reinvestment, and performance. Front Psychol 2022; 13:871804. [PMID: 36160525 PMCID: PMC9491153 DOI: 10.3389/fpsyg.2022.871804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Mindfulness can benefit athletes’ mindset and performance. These benefits may be enhanced by sport-specific mindfulness interventions. Accordingly, our objectives were 2-fold: first, to develop a rowing-specific mindfulness intervention, and second, to investigate its effects on mindfulness, flow, reinvestment, and rowing performance. Rowers were randomly assigned to either a 6-week rowing-specific mindfulness intervention (n = 23), which included generic and rowing-specific practices, or a control group (n = 21). Rowers completed pre-test and post-test measures of performance, mindfulness, flow, and rowing-specific reinvestment. Lastly, rowers completed an evaluation form following the intervention. The results demonstrated that the intervention group increased flow, mindfulness, and improved performance, additionally conscious motor processing decreased from pre-test to post-test. However, the intervention did not preferentially change mindfulness or reinvestment compared to control. Participants provided favorable feedback and evaluated the intervention positively. Our 6-week rowing-specific mindfulness intervention promoted flow, encouraged mindfulness, and aided performance. Thus, we provide preliminary explorative evidence that a sport-specific mindfulness intervention can benefit athletes. We recommend that future research, with large sample sizes and improved home practice, should examine mediators and moderators of the mindfulness-performance relationship.
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From many to (n)one: Meditation and the plasticity of the predictive mind. Neurosci Biobehav Rev 2021; 128:199-217. [PMID: 34139248 DOI: 10.1016/j.neubiorev.2021.06.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/21/2022]
Abstract
How profoundly can humans change their own minds? In this paper we offer a unifying account of deconstructive meditation under the predictive processing view. We start from simple axioms. First, the brain makes predictions based on past experience, both phylogenetic and ontogenetic. Second, deconstructive meditation brings one closer to the here and now by disengaging anticipatory processes. We propose that practicing meditation therefore gradually reduces counterfactual temporally deep cognition, until all conceptual processing falls away, unveiling a state of pure awareness. Our account also places three main styles of meditation (focused attention, open monitoring, and non-dual) on a single continuum, where each technique relinquishes increasingly engrained habits of prediction, including the predicted self. This deconstruction can also permit certain insights by making the above processes available to introspection. Our framework is consistent with the state of empirical and (neuro)phenomenological evidence and illuminates the top-down plasticity of the predictive mind. Experimental rigor, neurophenomenology, and no-report paradigms are needed to further understanding of how meditation affects predictive processing and the self.
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Crane, PhD C, Ganguli, PhD P, Ball, MSc S, Taylor, PhD L, Blakemore, PhD SJ, Byford, PhD S, Dalgleish, PhD T, Ford, PhD T, Greenberg, PhD M, Kuyken, PhD W, Lord, MA L, Montero-Marin, PhD J, Sonley, MEd A, Ukoumunne, PhD OC, Williams, PhD JMG. Training School Teachers to Deliver a Mindfulness Program: Exploring Scalability, Acceptability, Effectiveness, and Cost-effectiveness. Glob Adv Health Med 2020; 9:2164956120964738. [PMID: 33403157 PMCID: PMC7745556 DOI: 10.1177/2164956120964738] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND There is growing research support for the use of mindfulness training (MT) in schools, but almost no high-quality evidence about different training models for people wishing to teach mindfulness in this setting. Effective dissemination of MT relies on the development of scalable training routes. OBJECTIVE To compare 4 training routes for school teachers wishing to deliver MT differing in intensity and potential scalability, considering teaching competency, training acceptability, and cost-effectiveness. METHODS Schools were randomized to an existing route comprising an 8-session instructor-led personal mindfulness course, combined with 4-day MT program training, or 1 of 3 more scalable, lower intensity, alternatives: an instructor-led personal mindfulness course combined with 1-day MT program training, a self-taught personal mindfulness course (delivered through a course book) combined with 4-day MT program training, and a self-taught personal mindfulness course combined with 1-day MT program training. RESULTS Attrition from training was substantial across all routes. The instructor-led course was more effective than the self-taught course in increasing teachers' personal mindfulness skills. Even the most intensive (existing) training route brought only 29% of the teachers commencing training, and 56% of those completing the study protocol, to the required minimum competency threshold (an advanced beginner rating on an adapted version of the Mindfulness-based Interventions Teaching Assessment Criteria). The differences in levels of competency achieved by existing training compared with the more scalable alternatives were modest, with economic evaluation suggesting that the existing route was both more expensive and more effective than lower intensity alternatives, but with no statistically significant differences between routes. CONCLUSIONS This research questions the move toward abbreviating teacher training to increase scalability and suggests instead that many teachers require additional support to ensure competency from first delivery of MT in the classroom.
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Affiliation(s)
| | - Poushali Ganguli, PhD
- King’s Health Economics, Institute of Psychiatry, Psychology and Neuroscience at King’s College London, London, UK
| | - Susan Ball, MSc
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Laura Taylor, PhD
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | | | - Sarah Byford, PhD
- King’s Health Economics, Institute of Psychiatry, Psychology and Neuroscience at King’s College London, London, UK
| | - Tim Dalgleish, PhD
- Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Tamsin Ford, PhD
- St Luke's Campus, University of Exeter Medical School, Exeter, UK
| | - Mark Greenberg, PhD
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, University Park, Pennsylvania Current address: Tamsin Ford is now with the Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Willem Kuyken, PhD
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Liz Lord, MA
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | | | - Anna Sonley, MEd
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Obioha C Ukoumunne, PhD
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
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Goldberg SB, Imhoff-Smith T, Bolt DM, Wilson-Mendenhall CD, Dahl CJ, Davidson RJ, Rosenkranz MA. Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial. JMIR Ment Health 2020; 7:e23825. [PMID: 33245288 PMCID: PMC7732708 DOI: 10.2196/23825] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques. OBJECTIVE This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app-the Healthy Minds Program (HMP)-which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight). METHODS A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood. RESULTS A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=-0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified. CONCLUSIONS This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement. TRIAL REGISTRATION ClinicalTrials.gov NCT04139005; https://clinicaltrials.gov/ct2/show/NCT04139005.
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Affiliation(s)
- Simon B Goldberg
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Daniel M Bolt
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Cortland J Dahl
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Healthy Minds Innovations Inc, Madison, WI, United States
| | - Richard J Davidson
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - Melissa A Rosenkranz
- Center for Healthy Minds, University of Wisconsin, Madison, WI, United States
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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Rycroft-Malone J, Gradinger F, Owen Griffiths H, Anderson R, Crane RS, Gibson A, Mercer SW, Kuyken W. 'Mind the gaps': the accessibility and implementation of an effective depression relapse prevention programme in UK NHS services: learning from mindfulness-based cognitive therapy through a mixed-methods study. BMJ Open 2019; 9:e026244. [PMID: 31501097 PMCID: PMC6738673 DOI: 10.1136/bmjopen-2018-026244] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 05/28/2019] [Accepted: 06/03/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Mindfulness-based cognitive therapy (MBCT) is an evidence-based approach for people at risk of depressive relapse to support their long-term recovery. However, despite its inclusion in guidelines, there is an 'implementation cliff'. The study objective was to develop a better explanation of what facilitates MBCT implementation. SETTING UK primary and secondary care mental health services. DESIGN, PARTICIPANTS AND METHODS A national two-phase, multi-method qualitative study was conducted, which was conceptually underpinned by the Promoting Action on Research Implementation in Health Services framework. Phase I involved interviews with stakeholders from 40 service providers about current provision of MBCT. Phase II involved 10 purposively sampled case studies to obtain a more detailed understanding of MBCT implementation. Data were analysed using adapted framework analysis, refined through stakeholder consultation. RESULTS Access to MBCT is variable across the UK services. Where available, services have adapted MBCT to fit their context by integrating it into their care pathways. Evidence was often important to implementation but took different forms: the NICE depression guideline, audits, evaluations, first person accounts, experiential taster sessions and pilots. These were used to build a platform from which to develop MBCT services. The most important aspect of facilitation was the central role of the MBCT implementers. These were generally self-designated individuals who 'championed' grass-roots implementation. Our explanatory framework mapped out a prototypical implementation journey, often over many years with a balance of bottom-up and top-down factors influencing the fit of MBCT into service pathways. 'Pivot points' in the implementation journey provided windows of either challenge or opportunity. CONCLUSIONS This is one of the largest systematic studies of the implementation of a psychological therapy. While access to MBCT across the UK is improving, it remains patchy. The resultant explanatory framework about MBCT implementation provides a heuristic that informed an implementation resource.
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Affiliation(s)
| | - Felix Gradinger
- Institute of Health Research, University of Exeter, Exeter, UK
| | | | - Rob Anderson
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
| | | | - Andy Gibson
- Health and Social Sciences, University of the West of England, Bristol, UK
| | - Stewart W Mercer
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Mindfulness in politics and public policy. Curr Opin Psychol 2019; 28:87-91. [DOI: 10.1016/j.copsyc.2018.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/26/2018] [Accepted: 11/05/2018] [Indexed: 01/13/2023]
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Segal Z, Dimidjian S, Vanderkruik R, Levy J. A maturing mindfulness-based cognitive therapy reflects on two critical issues. Curr Opin Psychol 2019; 28:218-222. [PMID: 30798103 PMCID: PMC6661222 DOI: 10.1016/j.copsyc.2019.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/13/2019] [Accepted: 01/21/2019] [Indexed: 12/21/2022]
Abstract
Mindfulness-Based Cognitive Therapy (MBCT) is a multimodal intervention that integrates training in mindfulness meditation and the cognitive theory of affective disorder. This hybrid nature may provide an advantage in the prevention field that addresses the critical need for enhancing wellness among people with recurrent mood disorders. Despite the robust evidence base for MBCT, its penetration at the population health level and in routine clinical settings has been limited. Addressing the gap between the science of MBCT and public access requires grappling with two questions: what is the role of home practice of mindfulness skills in realizing the benefits of MBCT? And, what role do digital platforms play in the delivery of mindfulness programs? Addressing these two questions is overdue in the field and the answers generated have the potential to optimize future research and practice on the ways, in which contemplative practices can support agentic self-care.
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Affiliation(s)
- Zindel Segal
- Department of Psychological Clinical Science, University of Toronto Scarborough, Canada.
| | - Sona Dimidjian
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States
| | - Rachel Vanderkruik
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States
| | - Joseph Levy
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States
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Wilde S, Sonley A, Crane C, Ford T, Raja A, Robson J, Taylor L, Kuyken W. Mindfulness Training in UK Secondary Schools: a Multiple Case Study Approach to Identification of Cornerstones of Implementation. Mindfulness (N Y) 2019; 10:376-389. [PMID: 31186817 PMCID: PMC6558285 DOI: 10.1007/s12671-018-0982-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This paper examined the facilitators and barriers to implementation of mindfulness training (MT) across seven secondary/high schools using a qualitative case study design. Schools varied in level of implementation. Within schools, head teachers, members of school senior leadership teams, and staff members involved in the implementation of MT were interviewed individually. In addition, focus groups were conducted with other members of school staff to capture a broad range of views and perspectives. Across the case studies, several key themes emerged, which suggested four corner stones to successful implementation of MT in schools. These were: people, specifically the need for committed individuals to champion the approach within their schools, with the support of members of the senior leadership teams; resources, both time and financial resources required for training and delivery of MT; journey, reflecting the fact that implementation takes time, and may be a non-linear process with stops and starts; and finally perceptions, highlighting the importance of members of the school community sharing an understanding what MT is and why it is being introduced in each school context. Similarities and differences between the current findings and those of research on implementation of other forms of school mental health promotion programs, and implementation of MT in healthcare settings, are discussed.
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Affiliation(s)
- Stephanie Wilde
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
| | - Anna Sonley
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
| | - Catherine Crane
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
| | - Tamsin Ford
- Medical School, University of Exeter, Exeter, UK
| | - Anam Raja
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
| | - James Robson
- Department of Education, University of Oxford, Oxford, UK
| | - Laura Taylor
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
| | - Willem Kuyken
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
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Tickell A, Ball S, Bernard P, Kuyken W, Marx R, Pack S, Strauss C, Sweeney T, Crane C. The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services. Mindfulness (N Y) 2019; 11:279-290. [PMID: 32064009 PMCID: PMC6995449 DOI: 10.1007/s12671-018-1087-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Depression is common with a high risk of relapse/recurrence. There is evidence from multiple randomised controlled trials (RCTs) demonstrating the efficacy of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence, and it is included in several national clinical guidelines for this purpose. However, little is known about whether MBCT is being delivered safely and effectively in real-world healthcare settings. In the present study, five mental health services from a range of regions in the UK contributed data (n = 1554) to examine the impact of MBCT on depression outcomes. Less than half the sample (n = 726, 47%) entered with Patient Health Questionnaire (PHQ-9) scores in the non-depressed range, the group for whom MBCT was originally intended. Of this group, 96% sustained their recovery (remained in the non-depressed range) across the treatment period. There was also a significant reduction in residual symptoms, consistent with a reduced risk of depressive relapse. The rest of the sample (n = 828, 53%) entered treatment with PHQ-9 scores in the depressed range. For this group, 45% recovered (PHQ-9 score entered the non-depressed range), and overall, there was a significant reduction in depression severity from pre-treatment to post-treatment. For both subgroups, the rate of reliable deterioration (3%) was comparable to other psychotherapeutic interventions delivered in similar settings. We conclude that MBCT is being delivered effectively and safely in routine clinical settings, although its use has broadened from its original target population to include people experiencing current depression. Implications for implementation are discussed.
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Affiliation(s)
- Alice Tickell
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Susan Ball
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Paul Bernard
- Tees Esk and Wear Valleys NHS Foundation Trust, Durham, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Robert Marx
- Sussex Partnership NHS Foundation Trust, Sussex, UK
| | | | - Clara Strauss
- Sussex Partnership NHS Foundation Trust & School of Psychology, University of Sussex, Sussex, UK
| | - Tim Sweeney
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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