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Evanger LN, Flo-Groeneboom E, Sørensen L, Schanche E. Mindfulness-based cognitive therapy improves insomnia symptoms in individuals with recurrent depression: secondary analyses from a randomized controlled trial. Front Psychiatry 2024; 14:1231040. [PMID: 38312915 PMCID: PMC10834689 DOI: 10.3389/fpsyt.2023.1231040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024] Open
Abstract
Background Embedded within a randomized efficacy trial, the present study aimed to investigate whether mindfulness-based cognitive therapy (MBCT) for recurrent depression improved symptoms of insomnia. Methods Sixty-eight remitted participants with at least three prior episodes of depression were randomized to 8 weeks of MBCT (n = 33) or a waitlist control condition (n = 35). The Bergen Insomnia Scale was used to screen for insomnia symptoms before and after the intervention. The analyses were conducted using one-way between-groups analyses of covariance. Results Twenty-five MBCT participants and 30 waitlist controls completed the study (74.5% females; mean age 40.7 ± 12.9 years). At baseline, 83.6% screened positive for the insomnia diagnosis. Following the intervention and after controlling for corresponding insomnia parameters at baseline, MBCT completers reported significantly less severe insomnia symptoms (p = 0.017), as well as less problems with prolonged sleep onset (p = 0.047) and nocturnal awakenings (p = 0.023), relative to controls. No group differences were found on early morning awakening, daytime impairment, or dissatisfaction with sleep. Conclusion The results suggest that MBCT improves certain insomnia symptoms. However, additional sleep-specific interventions may be needed to further improve this population's sleep.Clinical Trial Registration: ISRCTN, ISRCTN18001392, registered 22/11/2018. URL: 10.1186/ISRCTN18001392.
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Affiliation(s)
- Linn Nyjordet Evanger
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | | | - Lin Sørensen
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Elisabeth Schanche
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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Chan SH, Cheung MY, Chiu AT, Leung MH, Kuo MC, Yip DY, Hui CC, Kam SW, Yeung K, Mui DS, Wang SM, Yip CC. Clinical effectiveness of mindfulness-based music therapy on improving emotional regulation in blind older women: A randomized controlled trial. Integr Med Res 2023; 12:100993. [PMID: 37915438 PMCID: PMC10616413 DOI: 10.1016/j.imr.2023.100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 11/03/2023] Open
Abstract
Background This study aimed to investigate clinical effectiveness of a structured eight-week mindfulness-based music therapy (MBMT) program on improving mood regulation in older women with blindness. This investigation compared a MBMT group with a mindfulness intervention (MI) group and a control group. Methods Ninety-two older females with blindness from a residential setting in Hong Kong were recruited and randomly allocated to a MBMT (n = 31), MI (n = 30), or control (n = 31) group. Psychological measurements regarding mood regulation and general mood states (namely, Difficulties in Emotion Regulation Scale [DERS], Geriatric Depression Scale [GDS], and Depression Anxiety Stress Scales-21), were taken at pretest and posttest. Outcome assessors were blinded to group assignment. Results Data was analyzed based on intention-to-treat basis. At posttest, DERS scores in the MBMT group (mean differences and 95% confidence interval: 12.1, 5.5 to 18.8) and the MI group (7.2, 0.5 to 13.8) were lower than that in the control group. GDS scores in the MBMT group (2.9, 1.7 to 4.0) and the MI group (1.7, 0.6 to 2.9) were lower than those in the control group. Compared with the MI group, the MBMT group improved emotional awareness sub-scores in DERS (2.1, 0.2 to 4.1) and appeared to lower depression in GDS scores (1.1, -0.0 to 2.3; p = 0.053). Conclusion MBMT seems more beneficial than MI alone for improving emotional regulation in older women with blindness. The combination of mindfulness and music can generate a synergetic effect by enhancing both attention and appraisal components within the emotional-regulation process. Trial registration ClinicalTrials.gov, NCT05583695.
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Affiliation(s)
- Sunny H.W. Chan
- School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom
| | - Meryl Y.C. Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | | | - Mimi H.T. Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Michael C.C. Kuo
- School of Medical and Health Sciences, Tung Wah College, Hong Kong
| | - Donald Y.C. Yip
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Carole C.Y. Hui
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Sally W.I. Kam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - King Yeung
- The Hong Kong Society for the Blind, Hong Kong
| | | | - Shu-Mei Wang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Calvin C.K. Yip
- School of Medical and Health Sciences, Tung Wah College, Hong Kong
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Imhoff-Smith TP, Grupe DW. The impact of mindfulness training on posttraumatic stress disorder symptoms, subjective sleep quality, and objective sleep outcomes in police officers. Psychol Trauma 2023:2024-02812-001. [PMID: 37650805 PMCID: PMC10902185 DOI: 10.1037/tra0001566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Sleep disturbances cooccur with posttraumatic stress disorder (PTSD) and are often correlated with PTSD severity. Previous research has shown that sleep problems mediate the relationship between PTSD and negative physical and mental health outcomes but has relied on self-reported sleep quality. We tested the effects of mindfulness training-previously shown to improve sleep quality and reduce PTSD symptoms-on subjective and objective sleep metrics and relationships with reduced PTSD symptoms. METHOD Following baseline data collection in 114 law enforcement officers, we randomly assigned participants to either an 8-week mindfulness training group or a waitlist control group. We repeated assessments immediately posttraining and at 3-month follow-up. Self-reported PTSD symptoms and subjective sleep quality were measured at each visit with the PTSD checklist and Pittsburgh Sleep Quality Index (PSQI), respectively. Participants also wore a Fitbit Charge 2 continuously over the course of a 4- to 6-day work week following each visit, from which we extracted two distinct objective sleep metrics: total minutes of sleep and sleep efficiency. RESULTS At baseline, PTSD symptoms were correlated with PSQI scores but not objective Fitbit metrics. Relative to waitlist, mindfulness training led to improved subjective sleep quality and reduced PTSD symptoms. Reduced PTSD symptoms mediated the improvement in subjective sleep quality following mindfulness training. Neither objective sleep metric demonstrated improvements following mindfulness training, nor did these metrics mediate reduced PTSD symptoms. CONCLUSIONS This study provides evidence linking improved subjective sleep quality, but not objective sleep markers, to reductions in PTSD symptoms following mindfulness training. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison
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Abstract
Mindfulness meditation is rapidly being integrated into many different forms of counseling and psychotherapy, and there is a growing evidence base for its effectiveness. It is important to understand the spiritual roots of mindfulness, and to apply it in a patient-centered manner, sensitive to the patient's own faith tradition rather than taking a one-size-fits-all approach, assuming that mindfulness-based practice is a purely secular approach. The philosophical underpinning of mindfulness lies squarely in the Buddhist faith tradition. Indeed, mindfulness is the 7th step on the Eightfold Path, which is the heart of Buddhist teachings. Many practitioners, however, may not realize that there are Western meditative techniques that are very similar to mindfulness and that have deep roots within Christian, Jewish, and Muslim faith traditions. Patient-centered mindfulness involves the use of mindfulness and other meditation methods that are based on the patient's own faith tradition, rather than applying Eastern forms of mindfulness claiming these are a secular approach appropriate for everyone regardless of religious beliefs, even if those beliefs are not consistent with the Buddhist religious or philosophical approach. In this article, I briefly examine the evidence for the clinical effectiveness of mindfulness meditation, and then go into greater depth on Hindu, Buddhist, Christian, Jewish, and Muslim forms of mindfulness or similar meditative practices, providing resources that will better equip clinicians and researchers to provide patient-centered culturally-sensitive care.
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Affiliation(s)
- Harold G Koenig
- Departments of Psychiatry and Medicine, Duke University Health System, Durham, NC, 27705, USA.
- Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
- School of Public Health, Ningxia Medical University, Yinchuan, People's Republic of China.
- Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Minichiello V, Webber S. Resident Physician Perspectives on Mindfulness Education in Residency: A Multispecialty Qualitative Assessment of Clinical Care Impact. J Grad Med Educ 2023; 15:356-364. [PMID: 37363667 PMCID: PMC10286909 DOI: 10.4300/jgme-d-22-00492.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 10/18/2022] [Accepted: 03/27/2023] [Indexed: 06/28/2023] Open
Abstract
Background Mindfulness training positively influences residents personally and professionally. Routine integration into residency may be impacted by limited understanding of the ways in which mindfulness training enhances clinical care. Objective We explored residents' direct experience and personal application of mindfulness in their clinical work following 10 hours of mindfulness training. Methods Mindfulness training sessions were facilitated between 2017 and 2019 for 5 groups of residents: pediatrics, ophthalmology, postgraduate year (PGY)-1 anesthesiology, and 2 different years of PGY-1 family medicine residents. Training was integrated into resident protected didactic time and attendance was expected, although not mandated, with the exception of pediatrics, in which the department mandated the training. Qualitative evaluation was conducted using a voluntary, semi-structured, de-identified phone interview within 2 months post-training. Reviewers independently coded the transcripts and then dialogued to reach consensus around emergent themes. Results Thirty-six of 72 residents (50%) who participated in the training completed interviews. Themes were similar across specialties. All residents acknowledged the potential usefulness of mindfulness training during residency. Six residents (17%) reported they had not applied the mindfulness training to their daily work by the end of the course. There were 4 emergent themes related to clinical application of mindfulness training: integrating brief moments of mindfulness practice, self-awareness, relational presence with patients, and maintaining perspective during clinical encounters and residency training as a whole. Conclusions After completing a 10-hour mindfulness training program, residents reported enhanced perspective-taking and relationship-building with themselves and their patients in clinical settings across medical and procedural specialties.
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Affiliation(s)
- Vincent Minichiello
- All authors are with the University of Wisconsin-Madison School of Medicine and Public Health
- Vincent Minichiello, MD, is Family Physician, Assistant Professor, and Director, Academic Integrative Health Fellowship, Department of Family Medicine and Community Health
| | - Sarah Webber
- All authors are with the University of Wisconsin-Madison School of Medicine and Public Health
- Sarah Webber, MD, is a Pediatric Hospitalist, Associate Professor, and Division of Hospital Medicine and Pediatric Sedation Provider, Department of Pediatrics
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Gallego J, Cangas AJ, Mañas I, Aguilar-Parra JM, Langer ÁI, Navarro N, Lirola MJ. Effects of a Mindfulness and Physical Activity Programme on Anxiety, Depression and Stress Levels in People with Mental Health Problems in a Prison: A Controlled Study. Healthcare (Basel) 2023; 11. [PMID: 36833089 DOI: 10.3390/healthcare11040555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Recent studies in the general population have shown an inverse relationship between mindfulness and symptoms of anxiety and depression, as well as the benefits of physical activity on these symptoms. These relationships have not yet been studied in a population with severe mental disorder (SMD) in prison, where symptoms of anxiety and depression and impulsive behaviours have a high incidence. A controlled study was developed to assess the benefits of a mindfulness-based protocol whereby elements of Acceptance and Commitment Therapy were evaluated and compared to an adapted sport program. Twenty-two inmates from the "El Acebuche" prison aged between 23 and 58 years old participated in this study, which included a pre-, post-, and follow-up; the majority of participants had SMD and were distributed in both conditions. The DASS-21 was obtained for its evaluation. The results of the Mann-Whitney U test for independent samples indicated a significant reduction in the levels of stress and depression in the mindfulness intervention group compared to the control group in which no significant changes were observed, providing evidence on the effect of this practice in prison contexts.
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Wu H, Li F, Zhang F. The efficacy of mindfulness-based stress reduction vs. standard or usual care in patients with breast cancer: a systematic review and meta-analysis of randomized controlled trials. Transl Cancer Res 2022; 11:4148-4158. [PMID: 36523321 PMCID: PMC9745358 DOI: 10.21037/tcr-22-2530] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/18/2022] [Indexed: 09/29/2023]
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) has become an alternative intervention for cancer patients, but its impact on depression and quality of life (QOL) of breast cancer patients remains controversial. The aim of this study was to evaluate the effects of MBSR vs. standard or usual care to relieve psychological stress in patients with breast cancer. METHODS According to the PICOS principles, databases [PubMed, Cochrane Database, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (VIP), and Wanfang Database] were searched for randomized controlled trials (RCTs) on the evaluation of MBSR vs. standard or usual care for patients with breast cancer, the outcome variables included depression, stress, anxiety, fatigue, sleep and QOL. Review Manager 5.4 was used to evaluate the effects of the results among selected articles. Forest plots and funnel plots were also performed. The risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS The final analysis included 14 studies with a total of 2,224 patients (1,138 in the MBSR group and 1,086 in the control group). The overall results of risk of bias assessment showed that the reporting bias among articles was high, and other bias was relatively moderate. Funnel plots and Egger's tests showed that there was no significant publication bias. Compared with standard or usual care, MBSR effectively relieved the psychological stress [mean difference (MD), -1.72; 95% confidence interval (CI): (-2.53, -0.92); P<0.0001] and anxiety [standardized mean difference (SMD), -1.36; 95% CI: (-2.13, -0.60); P=0.0005] of breast cancer patients, and improved depression [SMD, -0.62; 95% CI: (-1.20, -0.03); P=0.04] and sleep status [MD, -0.42; 95% CI: (-0.73, -0.10), P=0.009]. However, it had no significant effect on fatigue [SMD, -0.97; 95% CI: (-2.24, 0.31); P=0.14] or QOL [MD, 1.95; 95% CI: (-3.15, 7.05); P=0.45]. CONCLUSIONS MBSR was better than standard or usual care for relieving psychological stress, anxiety, depression, and sleep in patients with breast cancer. Considering the limitations of this article, such as high risk of bias and high heterogeneity of included studies, the interpretation of this conclusion should be cautious.
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Affiliation(s)
| | | | - Fenghao Zhang
- Oncology Department, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Peters AL, Saunders WJ, Jackson ML. Mindfulness-Based Strategies for Improving Sleep in People with Psychiatric Disorders. Curr Psychiatry Rep 2022; 24:645-60. [PMID: 36227451 DOI: 10.1007/s11920-022-01370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF THE REVIEW To review the recent literature on mindfulness-based strategies for improving self-report and objective measures of sleep, in individuals with psychiatric disorders. RECENT FINDINGS Currently, research provides some support for the use of mindfulness-based interventions to improve sleep amongst individuals with psychiatric comorbidities. The strongest evidence was for the use of standardized programs, particularly for improving sleep in anxiety and depressive disorders. There is a paucity of well-controlled studies using validated subjective or objective measures of sleep. As these interventions were not specifically designed to target sleep, observed improvements may be an indirect consequence of reduced psychiatric symptoms. There is insufficient research into the application of mindfulness-based strategies to improve sleep or treat sleep disorders in people with psychiatric disorders. Well-controlled studies using standardized, mindfulness-based interventions developed to target sleep, such as mindfulness-based therapy for insomnia, may optimize the potential benefits of mindfulness for sleep in psychiatric populations.
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