Article

Comparison of Psychological and Physiological Measures of Stress in Health Care Professionals during an Eight-Week Mindfulness Meditation Program

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Abstract

Work stress, burnout, and diminished empathy are prevalent issues for health-care professionals. Mindfulness meditation (MM) is one commonly used strategy to manage stress. Measuring salivary cortisol allows for the assessment of serum cortisol level, a known stress level indicator. This study evaluated the association of subject-reported stress symptoms and salivary cortisol in health-care professionals, in an 8-week MM program, with data collected prospectively at baseline and 8 weeks after program completion. Questionnaires [Profile of Mood States—Short Form (POMS-SF), Maslach Burnout Inventory (MBI), and Interpersonal Reactivity Index (IRI)] measured mood, burnout and empathy.A paired t-test between groups for pre/post-salivary cortisol yielded no significant change. The POMS-SF was most sensitive to change (mean increase 12.4; p = 0.020). Emotional exhaustion, measured in the MBI, was also affected by MM (mean decrease 4.54; p = 0.001). Changes in empathy may not have been captured due to either absence of effect of MM on empathy, subject number or scale sensitivity. Baseline and 8-week correlations between salivary cortisol and survey results, and correlations between changes in these measures, were weak and not statistically significant. Nevertheless, psychometric results present a strong case for additional clinical trials of MM to reduce stress for health-care professionals. Copyright © 2005 John Wiley & Sons, Ltd.

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... Prior interventions have looked at a range of other wellbeing outcome measures including burnout, resilience, vitality, and vigor, often using participants working in healthcare, such as physicians and nurses, and have reported that mindfulness interventions reduce burnout, and increase resilience, vigor, and vitality ( Galantino et al., 2005;Mackenzie et al., 2006;Krasner et al., 2009;Bazarko et al., 2013;see Virgili, 2015 for a meta-analysis). We were interested in whether employees in a non-healthcare setting, who were also not employed in the service industry (which can require large amounts of emotion regulation and surface acting, e.g., Michel et al., 2014;Hülsheger et al., 2013) would show improvements in self-reported resilience following the mindfulness intervention. ...
... Further, if mindfulness enhances the ability to pay attention as evidenced by Jha et al. (2007) and based on accounts of how mindfulness interventions enhance attention and awareness (Shapiro et al., 2006), we expected that the intervention could also increase selfperceived recognition of emotion in others and potentially selfperceived regulation of emotion in others. Prior research on the impact of mindfulness interventions on self-reported empathy has been mixed ( Shapiro et al., 1998;Beddoe and Murphy, 2004;Galantino et al., 2005), so our inclusion and examination of this component was more exploratory, as was the inclusion of selfperceived non-verbal emotional expression. It is possible that some interventions highlight the importance of empathy more than others, for instance, those conducted in healthcare with "helping" occupations such as nurses may be more successful in enhancing empathy than those conducted in office-based organizational settings. ...
... The results show that in addition to enhancing the self-perceived recognition and regulation of emotions in the self, people who completed the mindfulness intervention were more likely to feel they were more likely to display how they were feeling through body language and facial expressions (i.e., non-verbal emotional expression), and more likely to feel they were paying attention to and attempting to regulate the emotions of others (i.e., regulation of emotion in others). Prior research has shown inconsistent effects of mindfulness training on empathy, with some studies reporting increases ( Shapiro et al., 1998;Birnie et al., 2010), and others reporting null results ( Beddoe and Murphy, 2004;Galantino et al., 2005). In the present research self-perceived trait empathy (the tendency to draw upon empathy at work), did not change following the intervention. ...
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A randomized waitlist-controlled trial was conducted to assess the effectiveness of an online 8-week mindfulness-based training program in a sample of adults employed fulltime at a Fortune 100 company in the United States. Baseline measures were collected in both intervention and control groups. Following training, the intervention group (N = 37) showed statistically significant increases in resilience and positive mood, and significant decreases in stress and negative mood. There were no reported improvements in the wait-list control group (N = 65). Trait mindfulness and emotional intelligence (EI) were also assessed. Following the intervention mindfulness intervention participants reported increases in trait mindfulness and increases on all trait EI facets with the exception of empathy. The control group did not report any positive changes in these variables, and reported reductions in resilience and increases in negative mood. Finally, both self and colleague ratings of workplace competencies were collected in the intervention group only and provided preliminary evidence that mindfulness training enhanced performance on key leadership competencies including competencies related to decisiveness and creativity. The present study demonstrates the effectiveness of an online-based mindfulness training program for enhancing well-being, self-perceptions of emotional intelligence, and workplace performance.
... [31][32][33][34][35][36][37] The remaining 18 studies included mixed populations. 17,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] Among the latter, three failed to report the number of participants for each occupation. [40][41][42] Fourteen studies recruited professionals from a single medical specialty (e.g. ...
... 31,32,40,41,48 Three articles failed to report the gender ratio of its sample. 23,33,42 Twenty-one of the reviewed articles reported studies conducted in the USA or Canada (61.8%), 17,18,[23][24][25][26]31,32,34,35,[40][41][42][43][44][45][47][48][49]51,52 seven reported studies in Europe (20.1%), [27][28][29]36,38,46,53 two in Australia, 30,37 one simultaneously in the USA and Israel, 39 one in Iran, 33 one in Brazil, 50 and one in Singapore. ...
... Eleven of the 34 studies (32,4%) applied the full MBSR protocol. 17,18,27,28,33,38,41,42,46,48,51 The other studies altered the original protocol in different ways: ...
Article
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Objective: Healthcare professional burnout affects performance and has a negative impact on healthcare as a whole. Mindfulness-based Interventions (MIs), developed over the last 30 years, are increasingly used by healthcare professionals to reduce the risk of burnout. Yet the impact of MIs on burnout remains to be clarified. This review aimed to summarize and evaluate the existing literature on the potential benefits of MIs to minimize burnout risk. Methods: We conducted a systematic review of the literature, reporting according to the PRISMA standards. PubMed, Psychinfo, Web of Science and Science Direct databases were screened for original articles. Articles in English assessing an MI in combination with burnout measures were included up to September 2018. Results: Thirty-four articles were included. Only four randomised controlled trials concluded to burnout improvement after several weeks of MIs (11,8%). In the remaining five randomised controlled trials, results did not reach statistical significance. Of the four controlled, non-randomised studies, three showed significant improvements on burnout. Twenty-one studies did not report a controlled trial design. Overall the results appeared to be widely heterogeneous and several methodological concerns arose from the review. Conclusion: This review shows the overall insufficient level of evidence offered by the literature assessing the effects of MIs on burnout in health professional populations. However, some studies have reported promising results and future research should address methodological issues and define more precise contexts of interventions and target populations that could benefit from MIs.
... As anxiety levels increase for an individual, whether in the classroom or out, levels of the hormone cortisol increase; conversely, when anxiety levels go down, cortisol levels decrease (Galantino, Baime, Maguire, Szapary, & Farrar, 2005). In addition, positive emotional experiences such as enjoyment can help reduce anxiety and thereby indirectly decrease cortisol production (Ruini & Ryff, 2016). ...
... Physiological signs have been used to measure stress levels (i.e., anxiety levels using our label) in medical and psychological studies (e.g., Galantino et al., 2005). Stress and anxiety have been associated with observable physical manifestations including higher blood pressure; faster breathing and heart rate; changes in leukocyte and adrenaline levels in saliva, urine, or blood samples; and so forth (Langewitz, Rüddel, & Von, 1987;Vincent, Boomsma, & Schalekamp, 1986;Wright, Hickman, & Laudenslager, 2015). ...
Article
Anxiety is among the most frequently studied emotions in second language acquisition (SLA). Study abroad (SA) researchers have examined its effects on SLA in that setting in a number of studies. The current study goes beyond previous SA research by examining how anxiety develops and connects with language proficiency development over SA. Specifically, it uses anxiety-related measures of foreign language classroom anxiety (FLCA), foreign language enjoyment (FLE), and a physiological manifestation of anxiety (hair cortisol). As far as the classroom is concerned, learners grew more comfortable, experiencing less anxiety and more enjoyment over the period of SA. However, learners showed physiological signs of overall elevated anxiety despite these increasing classroom comfort levels. Two key factors that may have influenced their anxiety levels abroad were tendency toward anxiety prior to SA and language proficiency upon departure for SA. The latter provides support for having students more proficient prior to SA, since doing so may lead to less anxiety during SA.
... Una explicación plausible puede ser la escala en sí misma, aunque lo más probable sea que los niveles previos de empatía de la muestra estudiada eran considerablemente altos. Este resultado se encuentra en línea con los de Amutio et al. 23 y Galantino et al. 38 , que tampoco encontraron diferencias significativas en la variable empatía en profesionales de la salud al cabo de 8 semanas de entrenamiento. ...
Article
Objective To evaluate the effect of a mindfulness training program on the levels of burnout, mindfulness, empathy and self-compassion among healthcare professionals in an Intensive Care Unit of a tertiary hospital. Design A longitudinal study with an intrasubject pre–post intervention design was carried out. Setting Intensive Care Unit of a tertiary hospital. Participants A total of 32 subjects (physicians, nurses and nursing assistants) participated in the study. Intervention A clinical session/workshop was held on the practice of mindfulness and its usefulness. The possibility of following an 8-week training program with specifically designed short guided practices supported by a virtual community based on a WhatsApp group was offered. A weekly proposal in audio and text format and daily reminders with stimulating messages of practice were sent. Main measurements Various psychometric measures were self-reported: burnout (MBI), mindfulness (FFMQ), empathy (Jefferson) and self-compassion (SCS), before and after the training program. Demographic and workplace variables were also compiled. Results Among the factors affecting burnout, the level of emotional exhaustion decreased (−3.78 points; p = 0.012), mindfulness levels measured by the FFMQ were not globally modified, though “observation” and “non-reacting” factors increased. Empathy was not modified, and self-compassion levels increased (3.7 points; p = 0.001). Satisfaction and program adherence levels were very high. Conclusions In the population described, this program showed a decrease in emotional exhaustion and an increase in self-compassion — these being factors that can produce well-being and exert a positive impact upon burnout in this vulnerable group.
... 12 Indeed, studies reveal benefits for healthcare providers trained in mindfulness, including increased selfcompassion, improved mood state, as well as reduced stress, burnout, distress, emotional exhaustion, anger, anxiety, and depression. [13][14][15][16][17][18] Additionally, it has been posited that clinician mindfulness may reduce medical errors and enhance patient safety. 12,19 Yet how mindfulness in healthcare providers may enhance patient care has not been well-studied. ...
Article
Concern for the high prevalence and pervasive negative effects of clinician burnout has led to greater focus on clinician wellness programs, such as Mindfulness-Based Stress Reduction (MBSR). Our goal was to study MBSR feasibility and potential impact on clinician burnout, clinician–patient communication, and patient care and safety at a community hospital.
... Findings, however, have been inconsistent. While a number of studies have found that improvements in cortisol regulation are associated with participation in a mindfulness intervention (Brand, Holsboer-Trachsler, Naranjo, & Schmidt, 2012;Galantino, Baime, Maguire, Szapary, & Farrar, 2005;Kang & Oh, 2012;Lengacher et al., 2012), others have failed to find similarly significant results (Klatt, Buckworth, & Malarkey, 2009;Lipschitz, Kuhn, Kinney, Donaldson, & Nakamura, 2013;Matchim, Armer, & Stewart, 2011). Researchers have looked into the impact of mindfulness specifically using the CAR (Brand et al., 2012;Christopher et al., 2015;Daubenmier et al., 2011;Matousek et al., 2010;Matousek et al., 2011), diurnal cortisol slope (Carlson et al., 2013;Daubenmier et al., 2011;Gex-Fabry et al., 2012;Malarkey, Jarjoura, & Klatt, 2013), and cross-sectional cortisol levels (Jacobs et al., 2013;Lengacher et al., 2012). ...
Article
Background Many parents of children with developmental delays (DDs) experience high levels of parental stress, and young children with DDs are likely to exhibit clinical levels of behavioral problems. The reciprocal relationship between the two issues makes these families vulnerable to stress-related health risks. To address this, the current study aims to investigate the effectiveness of mindfulness-based stress reduction (MBSR) at reducing parent stress, as measured by both psychological self-report and a physiological biomarker. Method A pretest–posttest design with a 6-month follow-up assessment was used to establish effectiveness with analyses of within-subject effects. Parents ( N = 47) of children (2.5–5 years of age) with DDs participated in a standard 8-week MBSR intervention. Measures included the Parenting Daily Hassles, a self-report measure of perceived frequency and intensity of parenting stress, and salivary samples for measurement of the cortisol awakening response (CAR), a biological marker of stress response. Results Both self-reported parenting stress and CAR decreased following MBSR for parents of children with DDs. The greatest difference in means over time was between baseline and follow-up, where changes in effect size were even stronger for biological markers than for self-report measures. Conclusion The MBSR intervention reduced both perceived and physiologic stress. Health-care professionals caring for these families might consider encouraging parents to participate in MBSR as both treatment and prevention of parenting stress.
... Mindfulness training can increase mood among employees in high-stress jobs [20] as well as reduce the extent to which they experience emotional exhaustion in their jobs [21]. This effect appears to be pronounced in jobs that are in high-stress fields [22]. Mindfulness also reduces reactivity and improves personal relationships with colleagues [23,24]. ...
Article
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As space missions move from low-earth orbit operations to long duration exploration, the mission's crews will face a different set of experiences and stressors. In order to help prevent the development of cognitive or behavioral symptoms during these missions it is important to define preventative countermeasures. Recent evidence points to mindfulness and relaxation techniques as promising countermeasures for promoting cognitive and behavioral health. We conducted a narrative review of the scientific literature to identify key factors relevant to the role of mindfulness and relaxation techniques in the military and other analog settings, which share some important similarities with the space exploration context. Our results indicate that cognitive (non-meditative) mindfulness is an important psychological construct that can help to promote resilience and to reduce stress in analog environments and particularly in the military. While the literature suggests that mindfulness can be promoted through focused interventions, most of the studied interventions to date are based on meditation. While efficacious, meditation-based interventions generally require a significant amount of time for training. Alternative mindfulness approaches have not yet been explored in these settings but have yielded potentially relevant results for space. Relaxation training is a helpful tool to manage stress and to reduce anxiety. In the military, relaxation techniques are sometimes integrated into psychological training before deployment, leading to improved performance and reduced negative emotions. Even with a lack of specific literature about the application of these concepts in space, literature that describes the experiences from analog environments and military contexts as well as other studies on challenging conditions, suggest further exploration of interventions in these areas.
... 44 It has also been found that mindfulness can reduce cortisol levels. 45 Other studies have shown that these physiological effects increase acceptance and reduce the likelihood of developing psychological disorders in the individual. Some evidence suggests that mindfulness can have a relationship with structural changes in certain regions of the brain that deal with sensory, cognitive and emotional processing, which also reduces negative emotions by labeling negative emotional stimuli. ...
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Background: In recent years, the incidence of depression in people, especially women, has been growing, making it essential to study psychological correlates with the disorder. Therefore, the present study was conducted to investigate the relationship of mindfulness, psychological hardiness and spirituality with depression in mothers. Methods: The statistical population of this correlational study included all mothers aged 30 - 50 years in Isfahan in 2016 - 2017. To this end, 300 mothers were selected by convenience sampling. Data collection instruments were Mindfulness Skills Measures, Psychological Hardiness Questionnaire, Spirituality Questionnaire and Beck Depression Inventory. For data analysis, the descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation coefficient and multiple regression analysis) were used. Results: Mindfulness (-0.48), psychological hardiness (-0.39) and spirituality (-0.55) had a significant, inverse correlation with depression in mothers (P-value < 0.001). These components could significantly predict depression in mothers (P-value < 0.001). Conclusion: Given the significant role of the subscales mindfulness, psychological hardiness and spirituality in predicting mothers' depression, it is suggested that the education of these components to mothers be taken into consideration to prevent the occurrence of depression.
... Una explicación plausible puede ser la escala en sí misma, aunque lo más probable sea que los niveles previos de empatía de la muestra estudiada eran considerablemente altos. Este resultado se encuentra en línea con los de Amutio et al. 23 y Galantino et al. 38 , que tampoco encontraron diferencias significativas en la variable empatía en profesionales de la salud al cabo de 8 semanas de entrenamiento. ...
Article
Objective: To evaluate the effect of a mindfulness training program on the levels of burnout, mindfulness, empathy and self-compassion among healthcare professionals in an Intensive Care Unit of a tertiary hospital. Design: A longitudinal study with an intrasubject pre-post intervention design was carried out. Setting: Intensive Care Unit of a tertiary hospital. Participants: A total of 32 subjects (physicians, nurses and nursing assistants) participated in the study. Intervention: A clinical session/workshop was held on the practice of mindfulness and its usefulness. The possibility of following an 8-week training program with specifically designed short guided practices supported by a virtual community based on a WhatsApp group was offered. A weekly proposal in audio and text format and daily reminders with stimulating messages of practice were sent. Main measurements: Various psychometric measures were self-reported: burnout (MBI), mindfulness (FFMQ), empathy (Jefferson) and self-compassion (SCS), before and after the training program. Demographic and workplace variables were also compiled. Results: Among the factors affecting burnout, the level of emotional exhaustion decreased (-3.78 points; P=.012), mindfulness levels measured by the FFMQ were not globally modified, though "observation" and "non-reacting" factors increased. Empathy was not modified, and self-compassion levels increased (3.7 points; P=.001). Satisfaction and program adherence levels were very high. Conclusions: In the population described, this program showed a decrease in emotional exhaustion and an increase in self-compassion -these being factors that can produce well-being and exert a positive impact upon burnout in this vulnerable group.
... 16 Both programs have been extensively researched and shown to be effective in conditions ranging from affective disorders such as anxiety and depression, 32,37,38 chronic physical conditions such as chronic pain and cancer, [39][40][41] to stress and burnout in healthcare workers. 42,43 Consequently, MBCT has been incorporated into NICE guidance for the management of recurring depression. 44 What are the mechanisms of action? ...
Article
The menopause presents many challenges for middle-aged women worldwide, often highly productive women who are in the prime of their lives juggling busy careers and family responsibilities, when good quality of life and functional ability is an imperative. Some women cope well with their menopausal symptoms and seem to embrace this time of change, while others struggle psychologically to adjust to the changes. Mindfulness-based interventions have a robust evidence base in relation to their efficacy in both physical and psychological conditions. Both programs have been adapted for conditions where difficulties in psychological adjustment to change and/or loss are amongst the core mechanisms that maintain distress. I explored the potential aetiology of distress in the menopause and evaluated existing empirical literature to ascertain whether there is a role for mindfulness-based interventions to facilitate optimal psychological adjustment to changes in the menopause, paying particular attention to the mechanisms that lend themselves to mindfulness training being efficacious. Current available evidence is promising and supports the hypothesis that mindfulness-based interventions may have a role in facilitating psychological adjustment during the menopause transition. The dearth of literature specific to mindfulness-based interventions and the menopause was noted.
... These findings are also consistent with previous studies. For example, Galantino et al. (2010) observed no significant changes in empathy levels after a mindfulness meditation intervention for healthcare professionals when assessed using the IRI. Birnie et al. (2010) found MBSR to be successful at increasing participants' levels of self-compassion but that this occurred in the absence of significant changes in empathic concern. ...
Article
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Objectives In prior studies, mixed results have been obtained regarding the relations between mindfulness, moral judgment, and prosocial behavior. We conducted two studies to better clarify the connections between mindfulness and several moral variables.Methods In Study 1, a cross-sectional survey (N = 554) was conducted to test the possible associations between mindfulness, moral sensitivity, moral identity, and prosocial behavior. In Study 2, a randomized controlled experiment was conducted to examine the impact of a mindfulness intervention on moral identity and prosocial behavior. A total of 99 participants (n = 49, mindfulness group; n = 50, wait-list control group), all of whom were undergraduate students on an optional 11-week mindfulness-based self-exploration course, were recruited via the campus network system.ResultsIn Study 1, we found that mindfulness, moral sensitivity, moral identity, and prosocial behavior were all positively correlated. Results of the mediation analysis suggested that dispositional mindfulness had significant effects on prosocial tendencies both directly and indirectly via the mediator variables of moral sensitivity and moral identity. In Study 2, mindfulness practice was found to significantly improve the levels of mindfulness and self-compassion in participants but only had a significant effect on willingness toward prosocial behavior for those participants with existing high moral identity.Conclusions Study 1 confirmed the predicted links between mindfulness, moral sensitivity, moral identity, and prosocial behavior. Study 2 suggested that moral identity influences the effect of mindfulness practice on willingness toward prosocial behavior. However, the underlying mechanisms and causes of this effect require further study.
... t that depressed patients tend to avoid relapse when they are able to see their emotions and thought processes from a larger perspective. Even in non clinical patients reported increase in mood and affect after practicing mindfulness; Better mood and happiness in employees in stressful jobs (Davidson et. al., 2003) and in health care professionals (Galantino et. al., 2005); enhanced subjective wellbeing (Orzech et al, 2009). ...
Article
This empirical study was conducted to study the relations between Vipassana meditation (VM) and different facets of Psychological well-being (PWB). For this purpose a standardized scale based on Ryff 's PWB scale was used (Ryff & Keyes, 1995). The sample of 240 subjects consisted of regular Vipassana meditator employees, practicing VM in Theravada tradition. The effect of VM is studied with respect to three meditation variables namely; number of courses undertaken, daily practice of VM and overall number of years of practice of VM undertaken. For statistical analysis SPSS 20.0 version was used and the relationship between independent and dependent variables is studied by using univariate (Anova) and multivariate (Manova) analysis of variance. The results obtained are encouraging and agree with the existing literature that VM fosters psychological wellbeing in the practitioners. Thus the practitioner enjoys qualities such as openness, trusting relationships, readiness to continue learning and positive attitude towards life, to name a few. Therefore it can be stated that if employees practice VM it will help to generate a conducive atmosphere in the organizations leading to overall growth and harmony.
... La práctica de la atención plena ha demostrado ser útil para la mejora de la salud mental en general, ya que reduce significativamente el estrés de los empleados (Chu, 2010;Foureur, Besley, Burton, Yu y Crisp, 2013;Galantino, Baime, Maguire, Szapary y Farrar, 2005). También produce disminución de la ansiedad en el trabajo (Orzech, Shapiro, Brown y McKay, 2009;Roeser et al., 2013), reduce la depresión (Farb et al., 2010;McCraty, 2003), y provoca un mayor nivel de humor, bienestar y felicidad en empleados con un trabajo estresante (Wolever et al., 2012) Hallazgos similares se han obtenido en profesionales de la salud (Orzech et al., 2009;McCraty, 2003). ...
... Some researchers and clinicians have suggested that mindfulness practices should be integrated into Western health and social care systems [42]. Mindfulness has been reported as an effective approach for decreasing stress and anxiety levels within individuals [43,44]. ...
Article
Background: Investigations into the use of mindfulness with allied health and social care students, many of whom ultimately work in rehabilitation settings, is in the nascent stages and no systematic mapping of the literature has occurred. The purpose of this scoping review was to identify, summarise, and describe the current state of knowledge on mindfulness in allied health and social care professional education. Methods: Arksey and O’Malley’s scoping review methodology was adopted. Five data bases were searched; inclusion and exclusion criteria were applied; and 50 papers were identified for inclusion in the study. Results: Quantitative studies depicted mindfulness interventions as contributing to: improved capacities for mindfulness; decreases in stress, anxiety, and depression; improvements in academic skills, quality of life and well-being, and empathy; improved physiological measures and emotional regulation; and mixed effects on burn-out. Qualitative studies highlighted: 1) mindfulness and self-care, 2) mindfulness within professional practice placements, 3) mindfulness in the classroom, and 4) the cultivation of mindful qualities. Conclusions: The study has important implications for the education of future rehabilitation professions and suggests that learning about mindfulness may be useful in assisting students to: manage academic stress, anxiety, and depression; cultivate a physical and mental state of calm; be more present and empathetic with clients; and be more focused and attentive in professional practice settings. • Implications for rehabilitation • Further exploration of mindfulness as a promising educational intervention for the professional preparation of future rehabilitation practitioners in allied health and social care fields is recommended. • Education and research about mindfulness and its potential opportunities for students in terms of the mediation of stress, anxiety, depression, and the cultivation of empathy, academic skills, quality of life, and resilience are recommended. • Education and research about mindfulness and its potential for the cultivation of beneficial qualities of mind such as attention, self-awareness, compassion, non-judgment, and acceptance are recommended. • Education and research about mindfulness as a potential means to develop capacities related to self-care, professional practice placements, and classroom performance in students is recommended.
... Nevertheless, the evidence is inconclusive. In fact, some studies that have tested MBSR effects on empathy using the same instruments used in the present study (the four subscales of the Interpersonal Reactivity Index, IRI) have either found no effect in any subscale (Galantino, Baime, Maguire, Szapary, & Farrar, 2005), only reductions in empathic distress (Beddoe & Murphy, 2004), or, similar to the present study, a reduction in empathic distress and an increase in cognitive empathy (Birnie, Speca, & Carlson, 2010). No increases in empathic concern has been found in any of these MBSR studies. ...
Thesis
Although research on contemplative practices has increased in the last few decades, empirical research assessing compassion-based interventions is still in its infancy, and none of this research has been carried out in South America. Using a mixed-method approach, this study investigated the effects of the first implementation in Spanish of the Compassion Cultivation Training (CCT) with a community sample in Santiago de Chile. CCT is a 9-week contemplative group education protocol based on traditional Tibetan Buddhist teachings and contemporary psychology, developed by the Center for Compassion and Altruism in Research and Education at Stanford University. Compassion cultivation training (26 participants) was compared to a randomized waitlist control group (24 participants) and an active matched control group trained in an 8-week Mindfulness-Based Stress Reduction program (MBSR; 32 participants). The groups were assessed using measures of Psychological Wellbeing (depression, anxiety, stress, life satisfaction, and happiness), Contemplative Skills (mindfulness and self-compassion), and Altruistic Orientation (empathic concern, empathic distress, cognitive empathy, compassion for others, and identification with all humanity) at baseline, postintervention, and 2-month follow-up. Semi-structured interviews were carried out with 12 CCT participants. To offset self-report bias, friendly observer reports (questionnaires for friends and family members of participants) of CCT and MBSR participants were contrasted with participant data. Whereas the waitlist group did not show statistically significant pre-post changes in any outcome measure, CCT participants showed significant improvements in all three areas: Psychological Wellbeing (decreased depression and stress [ps < .001], increases in life satisfaction and happiness [ps < .05], and a trend toward significance for decreased anxiety [p < .07]); Contemplative Skills (increased mindfulness and self-compassion; ps < .001), and Altruistic Orientation (increased cognitive empathy, empathic concern, compassion for others, and identification with all humanity; and decreased empathic distress; all ps < .005). The MBSR comparison group also presented significant enhancements in psychological well-being and contemplative skills after the training; however, this group did not significantly change in empathic concern, compassion for others, and identification with all humanity. Friendly observer reports confirmed that cultivating compassion not only enhances personal well-being but also positively impacts relationships with others.
... In their study on employees in two companies, Van Berkel et al. [39] did not find significant differences in work engagement, mental health, need for recovery and mindfulness between the intervention and control groups in 6 or 12-month follow-up. Galantino et al. [40] found significant improvements in reducing work-related stress after mindfulness meditation in health-care professionals; however, they did not find satisfactory significant differences in correlations between salivary cortisol and survey results (mood, burnout, empathy) and correlations between changes in these measures. ...
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Purpose: The aim of the article was to check if mindfulness based stress reduction (MBSR) is an effective intervention in reducing work-related stress in the case of workers of a copper mine. Material and methods: 66 employees were randomized to the experimental group (32 participants) or to the control group (34 participants). Work-related stress was measured using Job Content Questionnaire (JCQ) (Karasek, 1979) and mental health was measured using General Health Questionnaire (GHQ-28) (Goldberg, 1990). Experimental manipulation was 40-hour-long MBSR training. Results: MANOVA has revealed significant increase of JCQ decision latitude (F=17.36, p=.00) and social support (supervisor. F=9.00, p<.004; coworker. F=5.61, p<.02), a significant decrease in GHQ anxiety (F=5.28, p<.079) and depression (F=3.95, p<.048) due to the intervention. Conclusions: The study confirms that MBSR can also be effective in reducing stress resulting from the external risk (and/or imagined fear) of losing one’s health or life. The use of MBSR could be recommended in health & safety activities in difficult and dangerous work conditions, such as mining, to promote workers’ well-being.
... Research on mindfulness-based courses in workplace contexts is growing including successful findings for stress, anxiety, depression, distress and emotional exhaustion in healthcare professionals ( Burton et al. 2017;Galantino et al. 2005; Martín-Asuero and García-Banda 2010; Morgan et al. 2015;Shapiro et al. 1998). One qualitative review also showed perceived benefits to compassion to the self and others and enhanced presence when relating to others (Morgan et al. 2015). ...
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Objectives Healthcare staff can be prone to high levels of stress and research investigating mindfulness-based courses for this population is showing promise. Given the demands of healthcare work, shortened mindfulness courses may be more appropriate. The aim of the study was to evaluate the utility of a workplace-adapted mindfulness course (MBOE) in a hospital setting, including research on workplace-specific outcomes beyond stress reduction and data relating to home practice with a mobile app. Method The effects of assignment to a workplace-adapted, 6-week mindfulness course or a waitlist control condition on dispositional mindfulness, perceived stress and fulfilment of basic psychological needs at work were examined in a sample of 65 hospital staff. Results Compared with waitlist, staff taking the course showed significant increases in mindfulness and psychological need fulfilment and reductions in perceived stress. Mean levels of perceived stress reduced from a high level to within published norms. Reductions in stress and increases in mindfulness, autonomy and competence remained stable at follow-up. Increased mindfulness mediated improvements in need fulfilment and reductions in stress. Attendance and use of a mobile app for home practice were associated with positive outcomes. Social factors (relatedness) associated with the delivery and outcome of the course were also explored. Conclusions The results indicate that a workplace-adapted, short-format mindfulness course can achieve positive results in line with mindfulness courses for other contexts. Questions were raised regarding which distinct elements may improve outcomes, e.g. home practice and dispositional mindfulness vs. learning environment on more general improvements.
... Mindfulness-based practices are thought to encourage the awareness and acceptance of emotions when they arise, so could help improve effective emotion regulation skills in health professionals [21]. Studies have reported a relationship between mindfulness practices and positive results, including increases in empathy, self-awareness, insight, wisdom [22,23]. Moreover, mindful awareness of one's feelings helps to become more aware of emotional processes in general [24]. ...
Article
The aim of this study was to examine the effect of the Mindfulness-Based Empathy Training (MBET) program on nursing students’ empathy and aged discrimination. This study was conducted as a randomized controlled trial (RCT). The 123 participants were randomly allocated to either the training group or the control group in a 1:1 ratio. Participants in the experimental group received the MBET. No intervention was applied to the participants in the control group. “Descriptive Information Form”, “Jefferson Empathy Scale (JSENS)”, and “Age Discrimination Attitude Scale (ADAS)” were used for data collection. General Linear Model repeated measures ANOVAs were used to determine the effect of the MBET on JSENS and ADAS. The analyses revealed that participants in the training group reported a significant increase in empathy level compared to the control group. No significant change in total aged discrimination scores and sub-scale of the ADAS were recorded in either group. This study indicated that empathy can be enhanced over an 8-week duration when mindfulness practices are integrated into a curriculum.
... The results of this study demonstrated a significant increase in mindfulness skills and orientation, which was correlated with lasting improvements in exhaustion, mood disorders, and empathy [68]. In contrast to these findings, but in line with those obtained by Amutio et al. [74] and Galantino et al. [75], none of the training programs carried out in this study significantly increased the levels of self-perceived empathy of tutors and resident intern specialists. Empathetic ability enables a person to grasp and understand the feelings of others, although mismanagement can lead to compassion or empathetic distress [76]. ...
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Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
... 1,6,[12][13][14][15] Additionally, studies consistently show that MBSR has numerous health benefits and is effective at improving the physiological indices of stress. [16][17][18][19] Additionally, MBSR is consistent with the humanistic caring paradigm and holistic elements of nursing theory. 12 Of the various types of MBSR, some literature suggests that guided loving kindness meditation, the practice of mentally directing unconditional love and kindness first to oneself and then to others, is potentially the most effective at increasing compassion satisfaction and empathy, which in turn reduces compassion fatigue and burnout, and thus may be especially well-suited to health care professionals. ...
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This prospective pre-/posttest pilot studied a mindfulness-based stress reduction (MBSR) intervention first, to reduce self-reported stress and improve compassion satisfaction; and second, to reduce physiological indices of stress. Even small interventions of MBSR before a shift effectively reduces the physiological indices of stress and may help reduce compassion fatigue and burnout in nurses.
... After the intervention, the score of emotional exhaustion was significantly reduced in the participants who did the exercise compared to the control group. Mindfulness-Based Stress Reduction intervention in healthcare professionals has also been shown to be effective in increasing positive variables such as positive emotions and quality of life, and reducing negative ones, such as stress, anxiety and burnout (Galantino, Baime, Maguire Szapary, & Farrar, 2005;Goodman & Schorling, 2012;Shapiro, Astin, Bishop, & Cordova, 2005;Shapiro, Brown, & Biegel, 2007). ...
... These instruments are well-established scales shown to be sensitive to short term mind body and other behavioral interventions, and validated in a wide range of populations, including older adults with memory loss [2,38,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]. ...
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Background: Recent studies suggest meditation and music listening (ML) may improve cognitive and psychosocial outcomes in adults with subjective cognitive decline (SCD). However, lack of a usual care group has limited conclusions. Objective: To assess the: 1) feasibility of incorporating an enhanced usual care (EUC) comparator in a trial of Kirtan Kriya meditation (KK) and ML for adults experiencing SCD; and 2) preliminary effects of active treatment (KK/ML) versus an EUC program. Methods: Forty participants with SCD were randomized 1:1:2 to a 12-week KK, ML, or EUC program. KK and ML participants were asked to practice 12 minutes/day; EUC participants were given a comprehensive educational packet regarding healthy aging and strategies for improving/maintaining brain health and asked to record any activities or strategies used. Feasibility was assessed using measures of retention, adherence, treatment expectancies, and participant satisfaction, as well as information from exit questionnaires and daily practice/activity logs. Cognitive functioning, stress, mood, sleep-quality, and health-related quality of life (QOL) were measured pre- and post-intervention using well-validated instruments. Results: Thirty-two participants (80%) completed the 3-month study, with retention highest in the EUC group (p < 0.05). Active treatment participants averaged 6.0±0.4 practice sessions/week, and EUC participants, 7.5±0.6 brain health activities/week. Treatment expectancies were similar across groups. EUC participants indicated high satisfaction with the program and study. Despite limited study power, the active treatment group showed significantly greater gains in subjective memory functioning (ps≤0.025) and nonsignificant improvements in cognitive performance (TMT-B), perceived stress, QOL, and mood (ps≤0.08) compared to the EUC group. Conclusion: Findings of this pilot feasibility trial suggest incorporation of an EUC program is feasible, and that participation in a simple 12-week relaxation program may be helpful for adults with SCD versus engagement in an EUC program.
... A growing body of research has demonstrated benefits of the eight-week MBSR curriculum among health care providers [9][10][11][12]. Mindfulness training generally improved the psychological functioning of health care staff, increased empathy, and improved the quality of interpersonal relations and interactions with others [13]. ...
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Mindfulness-Based Stress Reduction (MBSR) is an evidence-based health education program for medical patients with a variety of chronic conditions. MBSR also benefits health care providers themselves, decreasing work-related stress and preventing burnout. The objectives of this study were to describe an abbreviated MBSR curriculum developed for health care providers and to present initial program evaluation data assessing acceptability and outcomes. This program was implemented outside the research context with an open trial design. Mindfulness training sessions were held in a conference room at the administrative offices of a large, non-profit community health care system. Five clinic providers, three male and two female, included four primary care physicians and one social worker. All five participants participated in and completed the training. A six-session abbreviated MBSR protocol was developed. Participants attended weekly two-hour group sessions scheduled at the end of the workday. Standardized self-report questionnaires included the Perceived Stress Scale (10-item version) and the Copenhagen Burnout Inventory. Participants also completed four rating items designed to assess their personal satisfaction with the program. All five clinicians reported satisfaction with the program and measurable reductions in perceived stress and personal burnout. Statistically significant reductions in perceived stress and personal burnout scores across the group also were found. Abbreviated MBSR programs for clinicians may support clinician welfare by reducing stress and preventing burnout, ultimately impacting the larger health care delivery system in health-promoting ways. Research examining the effectiveness of specific protocols for clinicians is needed to support further dissemination and implementation.
... In a more recent study, Magan et al. demonstrated that long-term meditators have significantly lower plasma cortisol levels when compared to controls [160]. However, it is important to mention that numerous studies have not found any effect of yoga and meditation on cortisol levels [161][162][163]. ...
Article
Alzheimer’s disease (AD) is a complex, multifactorial neurodegenerative disorder that represents a major and increasing global health challenge. In most cases, the first clinical symptoms of AD are preceded by neuropathological changes in the brain that develop years to decades before their onset. Therefore, research in the last years has focused on this preclinical stage of AD trying to discover intervention strategies that might, if implemented effectively, delay or prevent disease progression. Among those strategies, mind-body therapies such as yoga and meditation have gained increasing interest as complementary alternative interventions. Several studies have reported a positive impact of yoga and meditation on brain health in both healthy older adults and dementia patients. However, the underlying neurobiological mechanisms contributing to these effects are currently not known in detail. More specifically, it is not known whether yogic interventions, directly or indirectly, can modulate risk factors or pathological mechanisms involved in the development of dementia. In this article, we first review the literature on the effects of yogic practices on outcomes such as cognitive functioning and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Then, we analyze how yogic interventions affect different risk factors as well as aspects of AD pathophysiology based on observations of studies in healthy individuals or subjects with other conditions than dementia. Finally, we integrate this evidence and propose possible mechanisms that might explain the positive effects of yogic interventions in cognitively impaired individuals.
... It should be noted that the picture is not entirely positive; a small number of studies have reported results inconsistent with the generally positive trends. For instance, there were no significant effects of mindfulness in a few studies utilising physiological outcome measures such as cortisol (Galantino et al., 2005;Klatt et al., 2009;Roeser et al., 2013), blood pressure, and heart rate variability (Roeser et al., 2013). It seems likely that changes evident initially in mental and emotional terms take longer to be seen in the body's physiological systems. ...
... The use of more objective methods, like neuropsychological tests for assessing cognitive flexibility and emotion regulation could be considered. Moreover, the analysis of biomarkers (e.g., cortisol level] could be integrated and has already been applied in previous intervention studies to promote resilience in health professions (e.g., [85,86]). Although the sample consisted of nurses from various medical departments, it cannot be clearly determined whether the results are representative of other hospitals or other cultural circumstances. ...
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In this study, a new group intervention program to foster resilience in nursing professionals was tested for efficacy. In total, 72 nurses were recruited and randomised to either an intervention condition or to a wait list control condition. The study had a pre-test, post-test, follow-up design. The eight-week program targeted six resilience factors: cognitive flexibility, coping, self-efficacy, self-esteem, self-care, and mindfulness. Compared to the control group, the intervention group reported a significant improvement in the primary outcome mental health (measured with the General Health Questionnaire) from pre-test (M = 20.79; SD = 9.85) to post-test (M = 15.81; SD = 7.13) with an estimated medium effect size (p = 0.03, η2 = 0.08) at post-test. Further significant improvements were found for resilience and other resilience related outcomes measures. The individual stressor load of the subjects was queried retrospectively in each measurement. Stress levels had a significant influence on mental health. The intervention effect was evident even though the stress level in both groups did not change significantly between the measurements. Follow-up data suggest that the effects were sustained for up to six months after intervention. The resilience intervention reduced mental burden in nurses and also positively affected several additional psychological outcomes.
Article
Studies investigating perceived stress and mindfulness awareness support mind-body therapy (MBT) effectiveness in reducing stress and anxiety and, thus, has potential to decrease work-related stress. A pre/postexperimental design involved 30 faculty and staff working at Ross University School of Veterinary Medicine, Saint Kitts and Nevis, who experienced a two-day MBT intervention programme. An additional 16 faculty and staff not involved in MBT who went about their daily work schedules served as contemporary controls. Demographics, Perceived Stress Scale 10 (PSS-10), Mindful Attention Awareness Scale (MAAS), 16 Personality Factor (16PF) Openness to Change subscale and saliva cortisol concentrations were analysed. Control participants reported significantly perceived less stress (PSS-10: M=13; sd=1.4) than intervention participants (M=20; sd=6.6) during pretest. However, at post-test the intervention group reported a significant decrease in perceived stress (M=11; sd=6.0). MAAS pretest results indicated the intervention group displayed a lower average score (M=54; sd=15.3) than control participants (M=68; sd=2.0). Post-MAAS intervention scores showed improvements in mindfulness (M=63; sd=15.3). Correlations between the 16PF Openness to Change subscale and MAAS were r=0.03 and r=−0.17 for the intervention and control groups, respectively. Mean concentrations of saliva cortisol indicated a larger and significant decline in cortisol for the intervention group both during day 1 (P=0.0001) and day 2 (P=0.0008). In conclusion, these preliminary results provide support that MBTs in veterinary academia can improve psychological and physiological aspects of personal wellbeing.
Article
Mindfulness, meditation, and other practices that form contemplative interventions are increasingly offered in workplaces to support employee mental health. Studies have reported benefits across various populations, yet researchers have expressed concerns that adoption of such interventions has outpaced scientific evidence. We reappraise the extant literature by meta-analytically testing the efficacy of contemplative interventions in reducing psychological distress in employees (meta-analyzed set: k = 119; N = 6,044). Complementing other reviews, we also examine a range of moderators and the impact of biases that could artificially inflate effect sizes. Results suggested interventions were generally effective in reducing employee distress, yielding small to moderate effects that were sustained at last follow-up. Effects were moderated by the type of contemplative intervention offered and the type of control group utilized. We also found evidence of publication bias, which is likely inflating estimated effects. Uncontrolled single sample studies were more affected by bias than large or randomized controlled trial studies. Adjustments for publication bias lowered overall effects. Overall, our review supports the effectiveness of contemplative interventions in reducing employee distress, but there is a need for proactive strategies to mitigate artificially inflated effect sizes and thus avoid the misapplication of contemplative interventions in work settings.
Article
OBJECTIVE Physician training is associated with stressors which contribute to burnout. Individual and institutional level strategies can be employed to address resident burnout; however, time is an often-reported barrier in initiating recommended well-being activities. We hypothesize that brief bursts of well-being activities that are conducive to a resident schedule can mitigate burnout. DESIGN This is a prospective observational study following burnout after implementation of an institution-wide, well-being initiative called “Take 10.” SETTING In the present study, the “Take 10” initiative, meditating or exercising for a minimum of 10 minutes per day 3 times a week, was encouraged at Vanderbilt University Medical Center, a tertiary care center in Nashville, Tennessee. PARTICIPANTS Following implementation of the initiative, 254 residents from surgical, procedural, and non-procedural specialties were invited to complete surveys assessing compliance with encouraged “Take 10” activities as well as rates of burnout over a 5-month period. A total of 201 surveys were completed during the study period. RESULTS Overall, burnout rates were worse for females (Odds Ratio [OR] = 3.7 | Confidence Interval [CI] = 1.57, 9.05), better for those living with others (OR = 0.22 | CI = 0.07, 0.64), and better for those participating in “Take 10” initiatives (OR = 0.71 | CI = 0.58, 0.86). There was a significant difference in resident-reported burnout (Control = 85.3% vs Intervention = 58.2% | p < 0.01) and Resident Well-Being Index score (Control = 3.73 vs Intervention=2.93 | p < 0.01), when “Take 10” initiatives were employed. CONCLUSIONS “Take 10” is a low cost and low intensity initiative for individuals and programs to use to mitigate burnout.
Article
Introduction: The impact of occupational stress on the mental health and well-being of nurses is a growing concern, magnified by the COVID-19 pandemic. Such compromised health is considered an occupational and patient safety risk. Our aim is to critically examine, analyze, and synthesize the evidence regarding MBSR on the perceived stress levels of nurses including overall mental health and well-being. Methods: An integrative review was conducted. Databases included were PubMed, Embase, PsychINFO, CINAHL, and the Cochrane Library. Inclusion criteria were English only, MBSR, and practicing nurses. Results: We identified 833 articles during database searching. After removal of duplicates and two rounds of screening, 15 articles were included in the final analysis. Several themes were derived with 60% of the studies showing a significant effect of MBSR on decreasing stress. Other significant themes were the decrease in burnout and increase in mindfulness. Conclusions: MBSR may be an effective holistic method of improving mental health for nurses during the COVID-19 pandemic. In both the abbreviated and full, 8-week versions of MBSR, the findings indicate the intervention can reduce depression, anxiety, and stress. Future recommendations include larger sample sizes and measurements other than self-reports to promote generalizability.
Chapter
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Mental health, once defined in terms of absence of illness, has gradually become understood in a more holistic way, which includes the positive qualities that help people flourish. This evolving definition of mental health has led to an exploration of other traditions and practices, including mindfulness meditation, which for thousands of years have been devoted to developing an expanded vision of human potential. One result was the introduction of the practice of mindfulness into Western scientific study. However, the original intentions of mindfulness meditation, to catalyze our potential for healing and development, have been largely ignored by the scientific community. Yet a small number of researchers and theorists have explored and continue to explore the positive effects of mindfulness practice. The chapter focuses on this pioneering work.
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Few studies exploring outcomes for mindfulness training have specifically focused on social service providers such as case managers, juvenile justice (probation/parole) officers, family court liaisons, substance abuse and mental health counselors, and school behavioral health specialists, among others. This study examined whether social service professionals across various agencies in the state of Hawai‘i would be accepting of mindfulness-based training and practices, and explored their personal practice experiences. Participants (N = 97) received mindfulness skills training including mindful breathing, mindful walking, and the body scan. Through post-evaluation surveys, practice logs of homework practices, and reflections, they were then asked to reflect on their experiences with the practice and identify potential changes that they would attribute to mindfulness. Interpretative phenomenological and content analyses revealed that participants generally reported a high level of acceptance of the mindfulness training and practices but progress, continuity, and sustainability were slow. Findings provided some indications of mindfulness resulting in salutary effects for social service professionals, but the training structure was problematic. Future research needs to examine how institutional, cultural milieu facilitate or hinder opportunities for social service professionals to embody and embed mindfulness in daily life; this would require multimodal and qualitative methodologies that seek to highlight and understand the live experiences of social service providers.
Article
Background and Objectives The objective of mindfulness‐based stress reduction (MBSR) programmes is to promote awareness of the present moment without judging, evaluating or reacting to the different thoughts or emotions that may arise. Development of these abilities appears especially important for healthcare professionals. The objective of this study was to evaluate the effectiveness and medium‐ and long‐term effects of a MBSR programme for primary care (PC) health professionals on their health‐related quality of life and quality of work life. Design Randomised clinical trial using an intervention and control group with follow‐up of the experimental group. Setting Primary Care centres in the Alicante Public Health Service (Spain). Participants Participants were PC health professionals (N = 58) divided between an intervention group receiving the 8‐week MBSR programme and a control group receiving a theoretical training session alone. Method Both groups were evaluated at baseline and at 8 weeks, and the intervention group was additionally evaluated at 3‐, 6‐, 9‐ and 12‐month postprogramme. Results In comparison to the control group, the intervention group obtained higher scores postintervention for mindfulness, health‐related quality of life, mood and compassion satisfaction and a lower score for burnout. Improvements in mindfulness, mood and burnout syndrome persisted at 12 months after the programme. Conclusions In conclusion, MBSR is an effective intervention to enhance the health‐related quality of life and quality of work life of Primary Care Health professionals.
Article
Emeritus Professor Alan Glasper, from the University of Southampton, discusses strategies being employed to alleviate stress among NHS staff during the ongoing COVID-19 pandemic
Thesis
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One of the predominant health risks of Primary Health Care (PHC) to the professionals is the Burnout Syndrome (BS). Mindfulness is a psychological state which is positively associated with a variety of mental health indicators. Mindfulness-based interventions (MBI) are alternatives to manage stress and the BS in PHC professioanals. The main objective of this study is to compare the effect of an eight-week MBI (group 1 or G1), on the BS symptoms in PHC professionals, with a brief, four-weeks, Relaxation-based intervention (group 2 or G2), as well as a waiting list type group (group 3 or G3). The initial hypothesis is that IBM is superior to relaxation within the variables of interest of the study. Method: Non-randomized controlled clinical trial, with mixed investigation. Different scales were used for the evaluation of the quantitative data: a MBI-GS to identify the dimensions of SB, sociodemographic data questionnaire, PANAS to evaluate affection; FFMQ to measure the aspects of mindfulness; Experience Scale to measure decentring and rumination and the Self-Compassion Scale. Results: 142 professionals from different PHC profiles took part in the study. The prevalence of Burnout symptoms in the total sample was considered moderate. Exhaustion and depersonalization were correlated with all the negative dimensions of the scales used in this study. Results of the intervention study partially confirmed the hypothesis of superiority of IBM. There was significant superiority compared to the other groups in the measurements of goodness, total self-compassion, non-judgmental and non-reactive subscales and similar results in G1 and G2 in the measurements of exhaustion, self-criticism and isolation. G1 is superior to G3 in the following subscales: cynicism, positive and negative affection, decentring, fixation, mindfulness, describe and observe. G2 is not superior to G3. Regarding qualitative data, two groups, G1 and G2, were compared by the thematic analysis in the pre-test, to understand the characteristics of the professional's suffering. Then, nine different topics were reached: overload, injustice, physical and psichological stress manifestations, stress interfering on the quality of work, conflicts within teams, lack of care for the professional's health, coping strategies (absenteeism and medicalization), expectations with intervention and implementation of health care (barriers and possible facilitators). And in the post-test: perception of the intervention's impact, perception of intervention itself (strengths and weaknesses), engagement in practices (formal and informal) and again, implantation and injustice. All themes were debated with basis on the literature. Conclusion: More and distinct benefits of IBM have become clear, possibly by addressing a wider repertoire of cognitive abilities, but the relaxation intervention demonstrated significant changes in the relief of acute stress and BS symptomatology. It is necessary to design protective measures for the health care professionals of PHC to promote skills like attention and stress management to deal with the adversities, like relaxation, compassion and mindfulness interventions, as proposed in this research. KEYWORDS: Primary Health Care, Occupational Health, Mindfulness, Burnout ClinicalTrials.gov Identifier: NCT02387528
Article
Background and purpose Little data is available on the effect of mindfulness amongst pediatric hematology-oncology professionals. The purpose was to further document change in biological and psychological stress following a mindfulness-based stress reduction (MBSR) program. Materials and methods We led two pre-post interventional studies (n = 12 and n = 25) and measured changes on hair cortisol concentrations, perceived stress, psychological distress and burnout. Results Professionals did not change on biological stress (d = 0.04), but improved on self-reported measures (median d = 0.58). Effects were maintained over 3 months for psychological distress, anxiety, depression, and burnout (median d = 0.66). Effects were larger if trainees participated to the retreat and if they reported higher baseline perceived stress. Conclusion In pediatric hematology-oncology professionals, an MBSR program was related with improvements in self-reported stress over 3 months. Components of the program and characteristics of trainees may influence the impact of MBSR.
Article
Background Stress and compassion fatigue are widely acknowledged as prevalent in workers in ‘caring’ roles, however this has not been widely documented in New Zealand veterinary nurses. Aim This project aimed to investigate the prevalence of stress and compassion fatigue in New Zealand veterinary nurses. Method Using an online survey, veterinary nurses were asked to self-report their incidence of stress or compassion fatigue felt as a result of their working environment. Veterinary nurses were also asked to report the ways in which they cope with stress and compassion fatigue, and their likelihood of changing jobs. Results There were 288 responses to the survey. Of these, 94% of respondents reported feeling stressed and 82% reported experiencing compassion fatigue as a result of their work. 30% of respondents reported an increase in the consumption of alcohol/cigarettes and drugs as a result of stress. Most respondents reported managing their stress and compassion fatigue by talking to colleagues or family. A large number of respondents reported having considered a career change at some stage due to stress or compassion fatigue. Conclusion This research demonstrates a high incidence of stress and compassion fatigue in New Zealand veterinary nurses, with a low percentage of those seeking professional support. Further investigation into combatable causal factors for stress as it differs from compassion fatigue is warranted to ultimately offer support to veterinary nurses to continue their vocation.
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Objectives Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals.Methods Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables.ResultsTwenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component.Conclusions Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators.
Article
This Study focused on identifying psychological variables that could predict academic burnout of college students. In detail, We examined whether hypervigilance and stress mediated in sequential manner in the relationship between attentional control and academic burnout. For this, 234 college students completed Attentional Control Questionnaire, Brief Hypervigilance Scale, Perceived Stress Scale, and Korean Academic Burnout Scale. The data was collected for about two weeks from April 1 to 13, 2020, and the collected data was analyzed using SPSS 21.0 and Process Macro 3.4. The results indicate that hypervigilance and stress both mediated the relationship between attentional control and academic burnout. These findings indicate that hypervigilance and stress can be the possible mechanism for linking attentional control and academic burnout. More so, it was also observed that both hypervigilance and stress mediated sequentially. The study suggested that individuals with low attentional control may become hypervigilance and perceive more stress, which in turn may lead to academic burnout. The implications and limitations for future studies are also discussed.
Article
Habilitation, rehabilitation and promotion of well-being is the ultimate goal of the occupational therapy process. Occupational therapy interventions take advantages from interdisciplinary approach, implying that classic rehabilitative models are constantly enhanced by updated evidences in rehabilitation literature and enriched with competences from different fields. Recent literature has showed how music interventions can improve clinical and rehabilitative outcomes at different levels. Physical or occupational therapists, caregivers and care staffs are frequently involved in providing music interventions with or without the support of a music therapist. In particular, occupational therapists can use music as support to the rehabilitation of daily living activities and, in general, as a complementary tool of their work. This paper wants to stress the implementation of music and music therapy techniques and related specific training programs in the field of occupational therapy, pointing and summarizing main workable evidence-based approaches with music in occupational therapy settings.
Article
The 8-week mindfulness meditation (MM) trainings have proven to be helpful for reducing burnout due to work-related stress. Most studies reported these positive effects with evaluations made immediately before and immediately after the therapeutic interventions. Little is known, however, about the symptoms of burnout in the months following these interventions. In our exploratory study, the effects of an 8-week MM training were assessed in a group of health care professionals (n = 19) with vulnerability to develop burnout; a 9-month follow-up was conducted on the subjects (n=8) who continued to meditate after the end of the training. Other health care professionals of the same company, who did not meditate during this research, served as control group. Burnout, mindfulness abilities and job satisfaction were evaluated through self-reports. Data showed that during the training the levels of burnout did not decrease, but significant reductions were observed during the follow-up. This indicates the possibility of obtaining results with MM even in subjects who do not have standard response time to the therapy and highlights the importance of monitoring the healing process.
Article
Purpose Nationwide, upward trends exist in student issues with anxiety, stress, depression, and lowered classroom performance. As emotional awareness and emotional regulation skills are typically not addressed in professional discipline-specific courses, students experience challenges in their academic performance. This pilot research explored the effect of brief targeted classroom practices within an empowerment-based framework on domains of emotional intelligence. Method Twenty-two students in an undergraduate speech-language pathology class received a 13-week, biweekly, 15-min session of empowerment-based worksheet exercises to develop increased self-esteem, emotional awareness and regulation, and communication. Assessments of self-esteem, emotional intelligence, communication competence, and communication apprehension were conducted using validated scales, namely, the Rosenberg Self-Esteem Scale ( Rosenberg, 1965 ), the Quick Emotional Intelligence Self-Assessment ( Mohapel, 2015 ), the Self-Perceived Communication Competence Scale ( McCroskey & McCroskey, 2013 ), and the Personal Report of Communication Apprehension ( McCroskey, 1982 ), respectively. Midsemester and semester-end student reflections were collected. Results Paired t tests were significant in self-esteem and emotional quotient, including subdomains of emotional awareness, emotional management, social emotional awareness, and relational management. Significance was noted in communication competence in the subdomains of dyad interaction, stranger interaction, and acquaintance. Students' reflection showed significant improvement in empowerment and self-rated improvements in confidence, communication, connections with peers, and trust with instructor. Conclusion Preliminary evidence demonstrates positive outcomes with integration of intentional classroom exercises to build emotional intelligence (including emotional awareness and regulation), self-esteem, and communication. This empowerment model may assist faculty in developing effective pedagogical strategies to build students' self-resiliency.
Article
Despite a recent surge of interest in physician well-being, the discussion remains diffuse and often scattered. Lingering questions of what wellness entails, how it is personally applicable, and what can be done, remain pervasive. In this review, we focus on policy-level, institutional and personal factors that are both obstacles to wellness and interventions for potential remedy. We outline clear obstacles to physician wellness that include dehumanization in medicine, environments and cultures of negativity, barriers to wellness resources, and the effect of second victim syndrome. This is followed by proven and proposed interventions to support physicians in need and foster cultures of sustained well-being from policy, institutional, and personal levels. These include medical liability and licensure policy, peer support constructs, electronic health record optimization, and personal wellness strategies. Where sufficient data exists, we highlight areas specific to anesthesiology. Overall, we offer a pragmatic framework for addressing this critical concern at every level.
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The purpose of this study was to examine whether acute relaxation training, conducted on two separate occasions, would be associated with reliable reduction in subjective and physiological indices of stress. Forty-six experimental subjects were led through Abbreviated Progressive Relaxation Training (APRT) exercises during two laboratory sessions spaced exactly 1 week apart. Fifteen control subjects experienced two laboratory sessions where they sat quietly for an equal amount of time. Results indicated that a brief relaxation exercise led to experimental subjects having significantly lower levels of post-intervention heart rate, state anxiety, perceived stress, and salivary cortisol than control subjects, as well as increased levels of self-report levels of relaxation. The results of this study may have implications for the use of relaxation training in enhancing immune function.
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A scale designed to assess various aspects of the burnout syndrome was administered to a wide range of human services professionals. Three subscales emerged from the data analysis: emotional exhaustion, depersonalization, and personal accomplishment. Various psychometric analyses showed that the scale has both high reliability and validity as a measure of burnout. Since the publication of this article in 1981, more extensive research was done on the MBI, which resulted in some modifications of the original measure. The present article has been re-edited to reflect those modifications. However, it does not include other new additions (which are contained in the MBI Manual distributed by the publisher, Mind Garden).
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Describes the Interpersonal Reactivity Index (IRI) and its relationships with measures of social functioning, self-esteem, emotionality, and sensitivity to others. 677 male and 667 female undergraduates served as Ss. Each of the 4 IRI subscales displayed a distinctive and predictable pattern of relationships with these measures, as well as with previous unidimensional empathy measures. Findings provide evidence for a multidimensional approach to empathy. (29 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
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Thesis--University of Texas at Austin. Vita. Includes bibliographical references (leaves 209-219).
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Mindfulness-based stress reduction (MBSR) has grown in popularity over the last two decades, showing efficacy for a variety of health issues. In the current study, we examined the effects of an MBSR intervention on pain, positive states of mind, stress, and mindfulness self-efficacy. These measures were collected before and following an 8-week intervention. Post-intervention levels of stress were significantly lower than pre-intervention levels, while mindfulness self-efficacy and positive states of mind were at significantly higher levels. The findings underscore the potential for stress management, awareness and attention training, and positive states of mind using MBSR. Copyright © 2004 John Wiley & Sons, Ltd.
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This study examined salivary cortisol and mood during relaxation training in 30 symptomatic, HIV+ gay men participating in a 10-week, group-based cognitive-behavioral stress management intervention. Cortisol levels and mood were assessed within these sessions just before and after 45-min relaxation exercises given as part of each session. Participants also recorded their stress level and compliance with daily home relaxation practice. Presession cortisol levels decreased across the 10-week period and were related to decreases in global measures of total mood disturbance and anxious mood. Reductions in presession cortisol levels were also associated with decreases in self-reported stress level during home practice. Greater reductions in cortisol during the first three sessions were associated with more frequent relaxation practice at home. These findings suggest that salivary cortisol represents an objective neuroendocrine marker for changes in anxiety and distress observed during relaxation training in symptomatic, HIV-seropositive men.
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This article reviews the cognitive therapy of depression. The psychotherapy based on this theory consists of behavioral and verbal techniques to change cognitions, beliefs, and errors in logic in the patient's thinking. A few of the various techniques are described and a case example is provided. Finally, the outcome studies testing the efficacy of this approach are reviewed.
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It is hypothesized that situations requiring continous behavioral adjustment activate an integrated, hypothalamic response, the emergency reaction. The frequent elicitation of the physiologic changes associated with the emergency reaction has been implicated in the development of diseases such as hypertension. Prevention and treatment of these diseases may be through the use of the relaxation response, an integrated hypothalamic response whose physiologic changes appear to be the counterpart of the emergency reaction. This article describes the basic elements of techniques which elicit the relaxation response and discusses the results of clinical investigations which employ the relaxation response as a therapeutic intervention.
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Tai Chi, a moving meditation, is examined for its efficacy in post-stressor recovery. Forty-eight male and 48 female Tai Chi practitioners were randomly assigned to four treatment groups: Tai Chi, brisk walking, mediation and neutral reading. Mental arithmetic and other difficult tests were chosen as mental challenges, and a stressful film was used to produce emotional disturbance. Tai Chi and the other treatments were applied after these stressors. After all treatments, the salivary cortisol level dropped significantly, and the mood states were also improved. In general the stress-reduction effect of Tai Chi characterized moderate physical exercise. Heart rate, blood pressure, and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr. Although Tai Chi appeared to be superior to neutral reading in the reduction of state anxiety and the enhancement of vigour, this effect could be partially accounted for by the subjects' high expectations about gains from Tai Chi. Approaches controlling for expectancy level are recommended for further assessment.
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The aim of this work was to study the clinical utility of salivary cortisol concentrations in a group of depressed patients undergoing the dexamethasone suppression test (DST) and the correlation of these concentrations with plasma ACTH levels. Twenty outpatients from the psychiatric department of a Barcelona hospital who were diagnosed as having nonendogenous (N = 9) or endogenous (N = 11) depression according to DSM-III criteria and the Newcastle scale participated in the study. The comparison group consisted of 12 healthy volunteers. Blood and saliva samples were taken before and after administration of 1 mg of dexamethasone Salivary cortisol and plasma ACTH concentrations were determined by direct iodine-125 radioimmunoassay with commercial kit reagents. Predexamethasone salivary cortisol concentrations were significantly higher in the group with endogenous depression than in the comparison group. A significant correlation was obtained between plasma ACTH and predexamethasone salivary cortisol levels in the group with nonendogenous depression and in the comparison subjects. These preliminary findings indicate that salivary cortisol could substitute for plasma cortisol in clinical studies in which the DST and hypercortisolemia are evaluated. The lack of correlation between ACTH and cortisol levels in saliva in the group of endogenously depressed patients could indicate a disturbance in the regulation of cortisol secretion in major depression.
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Changes in psychological and physiological functioning following participation in Tai Chi were assessed for 33 beginners and 33 practitioners. The variables in the three-way factorial design were experience (beginners vs practitioners), time (morning vs afternoon vs evening), and phase (before Tai Chi vs during Tai Chi vs after Tai Chi). Phase was a repeated measures variable. Relative to measures taken beforehand, practice of Tai Chi raised heart rate, increased noradrenaline excretion in urine, and decreased salivary cortisol concentration. Relative to baseline levels, subjects reported less tension, depression, anger, fatigue, confusion and state-anxiety, they felt more vigorous, and in general they had less total mood disturbance. The data suggest that Tai Chi results in gains that are comparable to those found with moderate exercise. There is need for research concerned with whether participation in Tai Chi has effects over and above those associated with physical exercise.
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Salivary cortisol represents a simple, noninvasive, stress-free measure that can greatly facilitate the longitudinal study of hypothalamic-pituitary-adrenal axis activity in patients with psychiatric disorders. By means of a slight modification of a commercially available radioimmunoassay kit, we studied the stability of salivary cortisol under different conditions, as well as the relationship between plasma and salivary cortisol under basal circadian conditions and following stimulation (CRH) and suppression (dexamethasone). We observed that salivary cortisol was quite stable at room temperature without centrifugation and that salivary and plasma cortisol values were highly correlated. Additionally, we observed a close correspondence in circadian and ultradian fluctuations in salivary and plasma cortisol. The salivary cortisol response to ovine and human CRH was similar to that observed with plasma cortisol, but was greater in magnitude. Finally, employing a plasma criterion as the standard, salivary measures identified 48% of the nonsuppressed Dexamethasone Suppression Tests (DSTs) and 97% of the suppressed DSTs.
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The concept of mechanisms that protect people against the psychological risks associated with adversity is discussed in relation to four main processes: reduction of risk impact, reduction of negative chain reactions, establishment and maintenance of self-esteem and self-efficacy, and opening up of opportunities. The mechanisms operating at key turning points in people's lives must be given special attention.
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This article updates and extends Jeannette Gagan's "Methodological notes on empathy," published in the January 1983 issue of ANS. The evolving conceptualization of empathy as a complex, intrapsychic, and interpersonal process suggests that the inconclusiveness and apparent contradictions of research to date might be substantially clarified by considering data from a multidimensional perspective. Attention to the conceptual bases underlying diverse measurement approaches is key to understanding the data produced. Notwithstanding the limitations of their paradigms and models for nursing, the debates and knowledge accumulated in other disciplines can inform a broad range of inquiry relevant to nursing.
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A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
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There is encouraging evidence that structured psychological treatments for depression, in particular cognitive therapy, can reduce subsequent relapse after the period of initial treatment has been completed. However, there is a continuing need for prophylactic psychological approaches that can be administered to recovered patients in euthymic mood. An information-processing analysis of depressive maintenance and relapse is used to define the requirements for effective prevention, and to propose mechanisms through which cognitive therapy achieves its prophylactic effects. This analysis suggests that similar effects can be achieved using techniques of stress-reduction based on the skills of attentional control taught in mindfulness meditation. An information-processing analysis is presented of mindfulness and mindlessness, and of their relevance to preventing depressive relapse. This analysis provides the basis for the development of Attentional Control Training, a new approach to preventing relapse that integrates features of cognitive therapy and mindfulness training and is applicable to recovered depressed patients.
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Cognitive behavioral treatment has been used extensively in the acute phase of depression. The purpose of this study was to determine the applicability and effectiveness of this treatment modality in addressing the residual symptoms of primary major depressive illness. The subjects were 40 patients with major depressive disorder who were successfully treated with antidepressant drugs. They were then randomly assigned to either cognitive behavioral treatment or clinical management of residual symptoms. In both subgroups, antidepressant drugs were tapered and discontinued. The group that received cognitive behavioral treatment had a significantly lower level of residual symptoms after drug discontinuation in comparison with the clinical management group. Cognitive behavioral treatment also resulted in a lower rate of relapse (15%) at a 2-year follow-up than did clinical management (35%), although this difference did not reach statistical significance. Most of the residual symptoms were found to have occurred also in the prodromal phase of illness. This preliminary study points to the potential clinical advantages of cognitive behavioral treatment targeted to the residual symptoms of depression.
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Central nervous, endocrine and immune systems (IS) are all considered to be important regulators of psychological and physical wellbeing. Research into psychoneuroimmunology became relatively widespread in the 1970s. More and more studies considered these systems to be interactive units. Disciplines ranging from anatomy to psychology revealed the IS as the target of brain and endocrine signals. Findings also suggest that the IS is active even in a bidirectional feedback loop. Today the IS is no longer regarded as autonomous and scientists begin to see the emergence of a new psychosomatic paradigm. So far, evidence for the mind-body interaction paradigm has been collected with regard to the role of nerve fibres in lymphatic tissues, the effects of brain lesions on the IS, the interplay of neurotransmitters, hormones and immunotransmitters in a network of bidirectional feedback loops between the brain and the IS, the effects of ontogeny, learning and conditioning on the development of the IS, the impact of experimental and naturally occurring stressors on the IS, the possible immune modulating effects of personality characteristics, life style and psychodynamic processes and the role of the IS in disease. Research findings in most of the mentioned topics are presented.
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The present study, aimed at investigating effects of film-induced amusement on saliva cortisol levels, was performed on 52 healthy male volunteers, aged 19-31 years. They were assigned to an amusement or a control condition. Saliva cortisol and affective film ratings were the dependent variables. During amusement 50% of the subjects showed changes in saliva cortisol correlated positively with ratings of funniness. Thus, cortisol secretion may be linked to emotional arousal, regardless of the emotional valence.
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The authors' goal was to determine whether cognitive behavioral treatment of residual symptoms of depression might have a significant effect on relapse rate. In an earlier study, 40 patients with primary major depressive disorder who had been successfully treated with antidepressant drugs were randomly assigned to either cognitive behavioral treatment of residual symptoms or standard clinical management. In both types of treatment, antidepressant drugs were gradually tapered and discontinued. In this study, a 4-year follow-up assessment was performed. Cognitive behavioral treatment resulted in a substantially lower relapse rate (35%) than did clinical management (70%). Cognitive behavioral treatment of residual symptoms reduces the risk of relapse in depressed patients, probably by affecting the progression of residual symptoms to prodromes of relapse.
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This study examined the effects of an 8-week stress reduction program based on training in mindfulness meditation. Previous research efforts suggesting this program may be beneficial in terms of reducing stress-related symptomatology and helping patients cope with chronic pain have been limited by a lack of adequate comparison control group. Twenty-eight individuals who volunteered to participate in the present study were randomized into either an experimental group or a nonintervention control group. Following participation, experimental subjects, when compared with controls, evidenced significantly greater changes in terms of: (1) reductions in overall psychological symptomatology; (2) increase in overall domain-specific sense of control and utilization of an accepting or yielding mode of control in their lives, and (3) higher scores on a measure of spiritual experiences. The techniques of mindfulness meditation, with their emphasis on developing detached observation and awareness of the contents of consciousness, may represent a powerful cognitive behavioral coping strategy for transforming the ways in which we respond to life events. They may also have potential for relapse prevention in affective disorders.
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Testosterone (T) and cortisol (C) were determined in serum and saliva, sampled simultaneously, from triathletes and karate athletes, in order to determine the T:C ratios in those body fluids and the relationship between them, as well as to assess the salivary T:C ratio as a measure of the so-called anabolic-catabolic index. Mean salivary T:C (value (1.67 +/- 0.85) was nearly 3-fold lower than that obtained for serum (4.87 +/- 1.86). Salivary and serum values were strongly correlated with one another (r = 0.874, p < 0.001) but the relationship depended on the range of cortisol concentrations in serum, the slope of the salive-serum regression line being significantly lower for serum cortisol concentrations over 600 nmol.l-1 than for concentrations below that value (0.305 and 0.380, p < 0.05, respectively). It has been concluded that the salivary T:C ratio, based on values reflecting the levels of biologically active fractions of T and C in circulation, is a better measure of metabolic equilibrium conditioned by those hormones than the corresponding ratio obtained from total concentrations in serum.
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Salivary cortisol was measured as an alternative to serum cortisol as a marker for adrenocortical function following insulin tolerance test, corticotropin-releasing-hormone stimulation and adreno-corticotrophic hormone stimulation. During insulin tolerance test and corticotropin-releasing-hormone stimulation adreno-corticotrophic hormone was also measured. The tests were performed on healthy control subjects as well as on patients under investigation for various disturbances in the hypothalamic-pituitary-adrenocortical axis (insulin tolerance test: 3 controls on two occasions and 14 patients; corticotropin-releasing-hormone stimulation: 4 controls and 18 patients; adreno-corticotrophic hormone stimulation: 6 controls and 10 patients). Five patients underwent both insulin tolerance test and corticotropin-releasing-hormone stimulation. Using criteria for adequate cortisol response in serum, the patients were classified as good or poor responders. In 42 of the 45 tests performed the same conclusion as to cortisol status was drawn when based on serum and salivary cortisol responses. In healthy subjects and good responders the mean cortisol relative increase was greater in saliva than in serum in all three tests (p < 0.05). Characteristic of the results for the insulin tolerance test was a significant initial mean decrease (p < 0.05), not found in serum, and the highest observed salivary cortisol value was delayed for at least 30 minutes compared to that in serum. Plasma adreno-corticotrophic hormone correlated significantly with the cortisol concentrations determined 15 minutes later in serum (r = 0.54-0.64) and in saliva (r = 0.76-0.85). The more pronounced cortisol response in saliva than in serum and its closer correlation with adreno-corticotrophic hormone offer advantages over serum cortisol, suggesting salivary cortisol measurement may be used as an alternative parameter in dynamic endocrine test.
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Surveys those forms of psychotherapeutic practice in which meditation (i.e., the induction of a trance state) plays a central role. The order in which they are reviewed follows approximately the temporal sequence of their appearance. Autogenic training (J. H. Schultz, 1932; W. Luthe, 1963; and W. Linden, 1990), the relaxation response (H. Benson and M. Z. Zipper, 1976; Benson et al, 1974), and the author's (P. Snaith, 1981, 1991; Snaith et al, 1992) technique of anxiety control training are described. Meditation is a seldom-used therapeutic practice and the reasons for this neglect are worth consideration; however, all reviews of the topic point to benefits reported in reduction in anxiety. The advantages of self-management, by meditation or other means, include the abbreviation of therapist time; perceived self-efficacy; and the importance to the individual of the realization that he or she has played the major part in improvement, with consequent increase in self-esteem having wide implications for generalization of the beneficial effect. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The objective of this study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients. A randomized, wait-list controlled design was used. A convenience sample of eligible cancer patients enrolled after giving informed consent and were randomly assigned to either an immediate treatment condition or a wait-list control condition. Patients completed the Profile of Mood States and the Symptoms of Stress Inventory both before and after the intervention. The intervention consisted of a weekly meditation group lasting 1.5 hours for 7 weeks plus home meditation practice. Ninety patients (mean age, 51 years) completed the study. The group was heterogeneous in type and stage of cancer. Patients' mean preintervention scores on dependent measures were equivalent between groups. After the intervention, patients in the treatment group had significantly lower scores on Total Mood Disturbance and subscales of Depression, Anxiety, Anger, and Confusion and more Vigor than control subjects. The treatment group also had fewer overall Symptoms of Stress; fewer Cardiopulmonary and Gastrointestinal symptoms; less Emotional Irritability, Depression, and Cognitive Disorganization; and fewer Habitual Patterns of stress. Overall reduction in Total Mood Disturbance was 65%, with a 31% reduction in Symptoms of Stress. This program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages. cancer, stress, mood, intervention, mindfulness.</