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Intervenções Baseadas em Mindfulness para Idosos: uma revisão integrativa
Abstract
Este estudo buscou sintetizar os resultados das intervenções baseadas em mindfulness com idosos, a partir de uma revisão integrativa de literatura realizada nas bases Scopus, PubMed e BVS. Foram encontrados 121 artigos, dos quais 12 compuseram a amostra final desta revisão, mediante critérios de inclusão e exclusão. Os resultados apontaram que as intervenções, com destaque para o MBSR e MBCT, contribuíram para a redução dos sintomas de depressão, ansiedade, estresse e insônia, gerando uma melhor percepção de bem-estar subjetivo, aumento da qualidade de vida e redução dos sintomas psicológicos. Recomenda-se que as futuras intervenções implementem critérios de avaliação e acompanhamento de suas respectivas propostas, além da utilização de métodos longitudinais e correlacionais.
... Both mindfulness and self-compassion appear to contribute to the promotion of higher positive affectivity, lower negative affectivity, and greater life satisfaction, consequently improving SWB indicators (Neff, 2003a;Phillips & Ferguson, 2013;Russell-Williams et al., 2018;MacAulay et al., 2021;Souza & Silva, 2022). Consequently, considering that both mindfulness and self-compassion involve mechanisms of emotional regulation that contribute to reducing rumination and self-criticism and introducing attitudes of acceptance, fostering a better emotional balance (Brown & Ryan, 2003;Hölzel et al., 2011;Trompetter et al., 2017), it was hypothesized that these variables would be predictors of the components of SWB, while the components of this dimension of well-being would act as mediators of SA. ...
Objectives: Aimed to test an association model for Successful Aging (SA), with mindfulness and self-compassion factors as predictor variables, and components of subjective well-being (SWB) as mediating variables in older adults. Method: This cross-sectional, descriptive study was conducted using the Google Forms platform and printed questionnaires, applied in an interview format with older adult participants from the Brazilian states of Bahia and Sergipe. A total of 233 older adults participated, residing in the states of Bahia (34.8%) and Sergipe (65.2%), with a mean age of 69.2 years (SD = 7.33). Results: The multiple linear regression (MLR) results indicated that SA was associated with mindfulness, the positive factor of self-compassion, and positive affect (PA). Subsequently, structural equation modeling (SEM) suggested that both mindfulness and self-compassion, which positively correlated with each other, were significantly and positively associated with PA, while PA was positively and significantly associated with SA. Conclusion: Mindfulness and the positive facet of self-compassion, mediated by PA, were indirectly associated with SA, while PA was significantly and more strongly associated with SA. Finally, mindfulness and the positive facet of self-compassion were positively correlated with each other.
Background: The elderly are individuals who have entered the age of 60 years (Hurlock, 2004). One of the most common elderly problems that is more commonly found is depression. Currently increasing research and reviews support the efficiency of psychotherapy treatments for depression. Based on traditional interventions Mindfulness Based Stress Reduction (MBSR) therapy is recommended for geriatric depression. MBSR therapy focuses on is one type of mindfulness-based therapy that focuses on training awareness through meditation techniques. By practicing observing body sensations (body scan meditation), individuals can achieve a mindful condition in their daily lives, including when carrying out routine activities such as walking, eating, standing. MBSR aims to change individual relationships with stressful situations and thoughts. This is achieved by decreasing emotional reactions and increasing.
Purpose: This study aimed to determine the effectiveness of MBSR therapy on the level of depression in the elderly.
Methods: Literature searches conducted through Google Scholar and PubMed studies published in English, there were 778 articles obtained but only 5 journals met the search criteria.
Results: The results of this review show that MBSR therapy has an influence to reduce the level of depression in the elderly and MBSR therapy has no side effects compared to pharmacological therapy.
Conclusion: It is hoped that health workers can implement MBSR therapy to reduce the level of depression in the elderly
Objective: the aim of this multiple case study was to to
evaluate the applicability of the group protocol of an 8-week
Mindfulness-Based Cognitive Therapy program adapted for
the individual clinical care of patients with symptoms of
depression. Method: the method used was to study multiple
cases, in which 11 cases of patients with a diagnosis of
mild to moderate depression who underwent intervention
adapted from this protocol were evaluated in the results of
measures of depression, anxiety, stress and mindfulness.
Results: the results indicated a significant reduction in
these symptoms, as well as an increase in mindfulness in
everyday life. Conclusion: the benefits of the Mindfulness-
Based Cognitive Therapy intervention can be presented
both in the context of group clinical care, as well as in
the individual. In this study, all study participants had
significant improvement in the symptoms of depression,
as well as in the levels of anxiety and stress, consistent
with the data presented in the literature. There is an urgent
need for a greater number of studies of this nature. Future
research, especially those of an empirical nature, controlled
and randomized, will consolidate the external validity of the
results found by studies with nature such as this one.
Descriptors: Mindfulness; Meditation; Depression; Anxiety.
Objectives
Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs.
Methods
Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants.
Results
Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes.
Conclusions
MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.
The purpose of the present study was to describe the case of a 73-year-old elderly woman patient with severe sleep bruxism and social anxiety treated with cognitive-behavioral therapy combined with mindfulness and social skills training. Single case was assessed in pre- and post-intervention and 6-month follow-up. The treatment was carried out for 21 sessions of 60 minutes of psychotherapy in a school-clinic. The following measures were used: Questionnaire for Detecting Sleep Bruxism (QDSB), The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS-14), Beck Anxiety Inventory (BAI), Brunel Mood Scale (BRUMS), and daily measures. Results indicated improvement for all variables: reduction in sleep bruxism episodes, anxiety and stress levels and improvement in humor level. In summary, these significant changes in patient’ well-being and quality of life were evident. Therefore, cognitive-behavioral therapies such as psychotherapy, physical exercise and lifestyle changes, which are aimed at stress and anxiety reduction, may be auxiliary in the treatment of sleep bruxism.
Background: Anxiety is one of the psychological problems which can develop in the elderly. If left untreated, it can decrease the productivity and quality of life. Mindfulness with Gayatri mantra is such a complementary therapy which is effective to reduce anxiety in the elderly. Objective: The purpose of this study was to determine the effects of mindfulness with Gayatri mantra on decreasing anxiety in the elderly Hindus in Bali, Indonesia. Methods: This study employed a one group pre and posttest quasi-experimental design and involved 34 elderly people recruited using a purposive sampling technique. Anxiety was measured using the Geriatric Anxiety Scale (GAS). A t-test statistical analysis was used to analyze the data. Results: Results showed that there were significant effects of mindfulness with Gayatri mantra on decreasing the anxiety in the elderly Hindus in Bali with a p-value of 0.000 (α-value = 0.05). Conclusion: Mindfulness with Gayatri mantra could decrease anxiety in the elderly Hindus. This therapy can be used as an alternative to prevent the recurrence of anxiety in the elderly.
AIMS: To verify the profile of the elderly and their main diagnoses in the geriatrics psychiatric outpatient clinic and the psychiatric hospitalization unit of a tertiary hospital. METHODS: A cross-sectional study of population-based was performed in a tertiary referral hospital, with individuals aged ≥55 years attending the geriatric psychiatric outpatient clinic and psychiatric hospitalization, from 2014 to 2018. Data were collected through interviews. The studied variables were sociodemographic and clinical aspects. RESULTS: A total of 497 individuals were evaluated, 269 from the psychiatric outpatient clinic and 228 from the psychiatric hospital. The mean age was 69.34±8.87 years. Most of the patients were female (75.8%), had no partner (56.3%), had primary education (50.3%), lived in Porto Alegre (75.6%) and were retired (66.5%). According to the clinical variables studied, 89.6% of the individuals had some morbidity, 36.9% had already been admitted to the psychiatric ward, the most common diagnosis was depression (40.8%), followed by bipolar disorder (19%) and anxiety (14.1%). CONCLUSIONS: With the population aging, it is expected to increase morbidity and mental disorders, requiring more specific diagnostic tools and better treatment approaches. There are still no consistent data on the management of mood disorders in the elderly, so our study can guide a better care for elderly and aging individuals, improving the planning of health services and policies.
Objectives: In a rapidly aging world population, an increasingly large group faces age-related decline in cognitive functioning. Cognitive complaints of older adults are often related to worries and concerns associated with age-related functional decline. Mindfulness-Based Stress Reduction (MBSR) can successfully target stress, worry and ruminative thinking, but the applicability of this method in middle-aged and older adults with memory complaints is unclear.
Method: Patients of a university hospital memory clinic (n = 13), aged 45–85 years, with memory complaints but no diagnosis of cognitive disorder, participated in a standard 8-week MBSR program, consisting of weekly group meetings and a one-day silent retreat. After completion, semi-structured qualitative interviews were conducted. Questionnaires (administered before, one week after and five weeks after the intervention) assessed quality of life, psychological distress (stress, anxiety and depressive symptoms), mindfulness, self-compassion, and subjective memory functioning. Neurocognitive functioning was assessed online, before and after the intervention.
Results: The qualitative analysis showed positive effects of the training (e.g. increased serenity), many participants worrying less about memory complaints. The self-reported measures were in line with the results of the qualitative analysis.
Conclusion: This exploratory mixed-methods study suggests that MBSR is feasible and well received among older individuals with cognitive complaints.
Objetivo: O objetivo do presente estudo foi analisar a eficácia da Terapia Cognitiva Baseada em Mindfulness na prevenção de recaída em pacientes com remissão de episódio depressivo maior. Método: Realizou-se uma revisão de 9 artigos publicados encontrado nos periódicos SciELO, Pubmed e LILACS. Os resultados dos artigos selecionados foram divididos em tópicos envolvendo participantes, instrumentos utilizados, eficácia na depressão, ideação suicida, ruminação e benefícios da MBCT. Resultados e discussão: Os artigos revisados apresentaram resultados efetivos diante de seus objetivos a partir do uso da Terapia Cognitiva Baseada em Mindfulness com prevenção de recaída e melhora dos sintomas residuais em pacientes com depressão. Nos resultados mais modestos, com o uso da MBCT, foi pelo menos tão efetivo quanto uso de antidepressivos em comparação a outros tratamentos. Considerações finais: A Terapia Cognitiva Baseada em Mindfulness se apresenta como uma alternativa efetiva na prevenção de recaídas para pacientes com depressão maior reincidente e diminuição dos sintomas depressivos residuais. Além disso, apresentou diversos benefícios para vida do sujeito envolvendo melhora na qualidade de vida, humor e diminuição de risco de suicídio sem os efeitos colaterais dos medicamentos antidepressivos. Ressalta-se, entretanto a limitação na falta de artigos brasileiros e a necessidade da realização de um estudo mais amplo e que envolva análises estatísticas mais criteriosas como a metánalise para corroborar os dados e resultados obtidos.
Objetivo
Avaliar a prevalência de transtornos ansiosos e fatores associados em uma amostra populacional de idosos do Sul de Santa Catarina.
Métodos
Estudo transversal com base em dados populacionais, que avaliou 1.021 indivíduos idosos entre 60 e 79 anos. Foram realizadas entrevistas domiciliares para aferição de variáveis sobre transtornos ansiosos, por meio do questionário MINI, dados sociodemográficos, hipertensão arterial sistêmica (HAS), infarto agudo do miocárdio (IAM) e dosagem de colesterol.
Resultados
As prevalências entre os transtornos ansiosos foram de 22,0% para o transtorno de ansiedade generalizada (TAG); 14,8% para fobia social (FS); 10,5% para transtorno do pânico (TP); e 8,5% para o transtorno obsessivo-compulsivo (TOC). Além disso, 40,5% dos indivíduos apresentaram pelo menos um transtorno de ansiedade. A distribuição dos transtornos foi semelhante nos dois gêneros; TAG foi mais prevalente nos indivíduos de menor escolaridade; TOC foi mais presente em indivíduos casados ou em união estável. Em relação às variáveis clínicas, HAS foi associada à presença de TOC; FS foi associada com IAM; TOC e FS foram associados com HDL > 40 mg/dL.
Conclusão
Os dados demonstram que os quadros de ansiedade são muito frequentes em idosos da comunidade, se sobrepõem de forma significativa e estão associados a algumas variáveis clínicas cardiovasculares.
This comprehensive review examined the effects of
mindfulness-based interventions on the physical and emotional
well-being of older adults, a rapidly growing segment of the
general population. Search procedures yielded 15 treatment
outcome studies meeting inclusion criteria. Support was found
for the feasibility and acceptability of mindfulness-based interventions
with older adults. Physical and emotional wellbeing
outcome variables offered mixed support for the use
of mindfulness-based interventions with older adults.
Potential explanations of mixed findings may include methodological
flaws, study limitations, and inconsistent modifications
of protocols. These are discussed in detail and future
avenues of research are discussed, emphasizing the need to
incorporate geriatric populations into future mindfulnessbased
empirical research.
This study is conducted to compare the metacognition treatment and the mindfulness-based stress reduction treatment on life quality of women with breast cancer.
In a quasi-experimental design, with pre-test, post-test and control group, 36 patients with diagnosis of breast cancer, among patients who referred to the Division of Oncology and Radiotherapy of Imam Hossein hospital in Tehran, were selected in accessible way and were assigned randomly to three experimental groups, the first group receiving meta-cognition treatment (n=12), the second one receiving mindfulness-based stress reduction program (n=12), and the other was the control group. Participants completed global life quality in cancer patient's questionnaire and specific quality of life in breast cancer patient's questionnaire in three stages: baseline, after intervention and two-month follow-up. Data were analyzed using the multivariate repeated measurement model.
Findings showed both treatments were effective in improving global and specific quality of life in patients with breast cancer. The mindfulness -based stress reduction treatment excelled in functions and roles, fatigue, pain, future perspective and treatment side effects symptoms at the end of the treatment and follow-up in comparison to the metacognition treatment.
Results of this research showed the mindfulness-based stress reduction treatment can be effective in improving global and specific life quality of women with breast cancer and is a selective method for improving quality of life in patients.
A number of cognitive interventions have been developed to enhance cognitive functioning in the growing population of the elderly. We describe the Mindfulness-Based Cognitive Approach for Seniors (MBCAS), a new training program designed especially for seniors. It was conceived in the context of self-development for seniors who wish to enhance their relationship with their inner and outer selves in order to navigate their aging process more easily and fluently. Physical and psychosocial problems related to aging, as well as some temporal issues, were taken into account in developing this program. Unlike clinically oriented mindfulness-based programs, which are generally delivered during an 8-week period, the MBCAS training program is presented over a period of 8 months. The main objectives of this program are to teach seniors to observe current experiences with nonjudgmental awareness, to identify automatic behaviors or reactions to current experiences that are potentially nonadaptive, and to enhance and reinforce positive coping with typical difficulties that they face in their daily lives. Details of the program development and initial implementation are presented, with suggestions for evaluating the program's effectiveness.
In Brazil, the epidemiological transition has not followed the model experienced by most developed countries. There is coexistence of old and new health problems, where despite the predominance of the chronical and degenerative diseases, the communicable ones still play an important role. In this study the differentials in relation to the epidemiological pattern are described not only for the country as a whole, but also for its major regions, using the Disability Adjusted Life Years (DALY), the health indicator of the studies of burden of disease. Amongst the main results found we stand out that the group of chronical and degenerative diseases is responsible for 66,3% of the national burden of disease; 23,5% are responded by the communicable diseases, perinatal and maternal conditions and nutritional deficiencies; and 10,2% is due to the injuries. The use of DALY permits the identification of health priorities based on the epidemiological profile, making easier the process of decision make and the use of resources by the managers.
Interventions based on training in mindfulness skills are becoming increasingly popular. Mindfulness involves intentionally bringing one's attention to the internal and external experiences occurring in the present moment, and is often taught through a variety of meditation exercises. This review summarizes conceptual approaches to mind-fulness and empirical research on the utility of mindfulness-based interventions. Meta-analytic techniques were incorporated to facilitate quantification of findings and comparison across studies. Although the current empirical literature includes many methodological flaws, findings suggest that mindfulness-based interventions may be helpful in the treatment of several disorders. Methodologically sound investigations are recommended in order to clarify the utility of these interventions.
There has been substantial interest in mindfulness as an approach to reduce cognitive vulnerability to stress and emotional distress in recent years. However, thus far mindfulness has not been defined operationally. This paper describes the results of recent meetings held to establish a consensus on mindfulness and to develop conjointly a testable operational definition. We propose a two-component model of mindfulness and specify each component in terms of specific behaviors, experiential manifestations, and implicated psychological processes. We then address issues regarding temporal stability and situational specificity and speculate on the conceptual and operational distinctiveness of mindfulness. We conclude this paper by discussing implications for instrument development and briefly describing our own approach to measurement.
We address 3 critiques raised by Grossman (2011) of self-report measures of mindfulness and the Mindful Attention Awareness Scale (MAAS) and Mindful Attention Awareness Scale-Adolescent (MAAS-A) in particular. Grossman questioned whether self-report measures actually assess mindfulness, whether the construct of mindfulness can be understood apart from mindfulness training, and whether there is empirical evidence to support the validity of mindfulness measures. In response we discuss established theory that attention (and secondarily meta-awareness) is core to the meaning of mindfulness and is the central feature of the MAAS and MAAS-A. We then argue that mindfulness is an inherent capacity that varies between and within persons and is not, as Grossman claimed, a concept applicable to only a trained few. Further, as assessed by the MAAS and MAAS-A, mindfulness is associated with the same variety of outcomes as mindfulness training is theorized to yield. Finally, we provide considerable evidence that the MAAS and MAAS-A are valid instruments. We conclude that although construct measurement is inevitably imperfect, such efforts are critical to building basic knowledge and refining effective interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
Introduction:
The integrative review is the methodology that provides synthesis of knowledge and applicability of results of significant studies to practice.
Objective:
To present the phases of an integrative review and the relevant aspects to be taken into account when using this methodological resource.
Methods:
This study was based on bibliographic search and on the experience of the authors when performing an integrative review.
Results:
Presentation of the six stages of the integrative review process: preparing the guiding question, searching or sampling the literature, data collection, critical analysis of the studies included, discussion of results and presentation of the integrative review.
Conclusions:
Considering the need to assure care based on scientific evidence, the integrative review has been identified as a unique tool in healthcare for it synthesizes investigations available on the given topic and guides practice based on scientific knowledge.
Introduction: Mindfulness Meditation means that a person pays attention to thoughts and feelings withoutjudging them and without believing on them. It can be the key to deal with stress, emotional issues andeven health problems. Objectives: To evaluate the effectiveness of mindfulness meditation technique on thepromotion of subjective well-being among elderly. Pre- test evaluation of subjective well being was doneby using subjective well being inventory (SUBI) before demonstrating mindfulness meditation technique.Methodology: The study was conducted on 30 elderly. Mindfulness meditation technique was demonstratedfor one month for 20 minutes daily. Results: It revealed that the pre test mean score was 61.63 with SD 10.82and post test mean score was 86.76 with SD 6.56. Mean difference between pre test and post test subjectivewell being score was 25.13.Conclusion: The pre-test revealed that there was low well being score amongelderly. After demonstration of mindfulness meditation technique there was a highly significant increase inthe well being score among elderly. Mindfulness meditation technique was more effective in increasing wellbeing score.
This chapter proposes several alternative conceptualizations and methodologies regarding the measurement of mindfulness. Contemporary approaches to the measurement of the construct are reviewed and critically analyzed. Following this, several procedures are detailed to introduce novel measurement approaches. This chapter argues for a critical reexamination of how the field of contemplative science currently measures the construct of mindfulness in both basic and applied settings, and proposes innovative conceptualizations and methodologies for how to advance the scientific investigation of mindfulness.
Objective
We examined the effects of MMIs on depression in older adults and explored the moderating effects of participant, methods, and intervention characteristics.
Methods
We systematically searched 15 databases through June 2019 without date restrictions using the following search terms: (mindful* OR meditat*) AND depress* AND (older adult* OR elder OR aging OR senior OR geriatric*). Inclusion criteria were primary studies evaluating MMIs with adults ≥65 years old with depression measured as an outcome, a control group, and written in English. Two researchers independently coded each study and compared for discrepancies and consulted a third researcher in cases of disagreement. We used random-effects model to compute effect sizes (ESs) using Hedges’ g, a forest plot, and Q and I² statistics as measures of heterogeneity; we also examined moderator analyses.
Results
Nineteen studies included 1,076 participants (71.8 ± 5.2 years old). Overall, MMIs showed significantly improved depression (ES=.65, 95%CI 0.35, 0.94) compared to controls. With regards to moderators, Asians had a greater improvement in depression (1.28) than Europeans (.59) and North Americans (.32). Less than 5 weeks of MMIs showed greater improvement in depression (1.47) than longer periods (.55). MMIs with guided meditation reduced depression (.91) more than MMIs without (.42). Only one quality indicator, a priori power analysis, showed greater effects on depression (g = 1.0) than no power analysis (g=.35).
Conclusion
MMIs improved depressive symptoms in older adults. MMIs might be used as adjunctive or alternative to conventional treatment for depressed older adults.
We investigated the influence of detached mindfulness (DM) in treating symptoms of depression and anxiety among elderly women. Thirty-four elderly females (mean age: 69.23 years) suffering from moderate major depressive disorders (MDD) and treated with a standard medication (citalopram) at therapeutic doses were randomly assigned either to an intervention condition (DM; group treatment, twice weekly) or to a control condition (with leisure activities, twice weekly). At baseline (BL), four weeks later at study completion (SC), and four weeks after that at follow-up (FU), participants completed ratings for symptoms of depression and anxiety; experts blind to patients’ group assignments rated patients’ symptoms of depression. Symptoms of depression (self and experts’ ratings) and anxiety declined significantly over time in the DM, but not in the control condition. Effects remained stable at FU. The pattern of results suggests that, compared to a control condition, a specific psychotherapeutic intervention such as DM can have a beneficial effect in elderly female patients with MDD.
Objective:
To determine whether neurocognitive performance and clinical outcomes can be enhanced by a mindfulness intervention in older adults with stress disorders and cognitive complaints. To explore decreased hypothalamic-pituitary-adrenal (HPA) axis activity as a possible mechanism.
Methods:
103 adults aged 65 years or older with an anxiety or depressive disorder (diagnosed according to DSM-IV criteria) and subjective neurocognitive difficulties were recruited in St. Louis, Missouri, or San Diego, California, from September 2012 through August 2013 and randomly assigned in groups of 5-8 to mindfulness-based stress reduction (MBSR) or a health education control condition matched for time, attention, and credibility. The primary outcomes were memory (assessed by immediate and delayed paragraph and list recall) and cognitive control (Delis-Kaplan Executive Function System Verbal Fluency Test and Color Word Interference Test). Other outcomes included clinical symptoms (worry, depression, anxiety, and global improvement). HPA axis activity was assessed using peak salivary cortisol. Outcomes were measured immediately post-intervention and (for clinical outcomes only) at 3- and 6-month follow up.
Results:
On the basis of intent-to-treat principles using data from all 103 participants, the mindfulness group experienced greater improvement on a memory composite score (P = .046). Groups did not differ on change in cognitive control. Participants receiving MBSR also improved more on measures of worry (P = .042) and depression (P = .049) at posttreatment and on worry (P = .02), depression (P = .002), and anxiety (P = .002) at follow-up and were more likely to be rated as much or very much improved as rated by the Clinical Global Impressions-Improvement scale (47% vs 27%, χ² = 4.5, P = .03). Cortisol level decreased to a greater extent in the mindfulness group, but only among those participants with high baseline cortisol.
Conclusions:
In this population of older adults with stress disorders and neurocognitive difficulties, a mindfulness intervention improves clinical outcomes such as excessive worry and depression and may include some forms of immediate memory performance.
Trial registration:
ClinicalTrials.gov identifier: NCT01693874.
To assess the effectiveness of mindfulness-based stress reduction (MBSR) for chronic insomnia and combined depressive or anxiety symptoms of older adults aged 75 years and over.
A randomized, controlled, single-blind clinical trial.
Participants included 60 adults aged 75 years and over with chronic insomnia. Participants were randomly assigned to the eight-week MBSR group or the wait-list control group. Assessments using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Sale (SAS), and Geriatric Depression Scale (GDS) were taken at baseline and post-treatment. For each outcome measure, a repeated measures analysis of variance was used to detect changes across assessments.
There was a significant time × group interaction for the PSQI global score (P = .006); the MBSR group had a decrease in the PSQI global score (Cohen׳s d = 1.12), while the control group did not (Cohen׳s d = -0.06). Among the PSQI components, there was a significant time × group interaction for daytime dysfunction (P = .048); Cohen׳s d of the MBSR group was 0.76, while Cohen׳s d of control group was -0.04. There was no significant time × group interaction for the SAS score (P = .116), while for the GDS there was a significant time × group interaction (P = .039); the Cohen׳s d value for the MBSR group was 1.20, and it was 0.12 for the control group.
This study demonstrated that the MBSR program could be a beneficial treatment for chronic insomnia in adults aged 75 years and older.
Copyright © 2015 Elsevier Inc. All rights reserved.
Objectives:
To examine the effects of age and depressive symptom severity on changes in positive affect among older adults randomly assigned to a Mindfulness-Based Stress Reduction (MBSR) program or a Waitlist Control group. Drawing from the Motivational Theory of Life-Span Development, we hypothesized that lower levels of depressive symptom severity and older age would be associated with greater positive affect in response to the MBSR intervention.
Methods:
Data were collected from a sample of community-dwelling English-speaking adults (n = 200) aged ≥ 65, randomly assigned to an eight-week MBSR program or a Waitlist Control group. Our main outcome variable was a five-item measure of positive affect, which was measured at study entry as well as eight weeks and six months later.
Results:
At the six-month follow-up, we observed group by baseline depressive symptom severity (β = -.17, p = .02) and group by baseline depressive symptom severity by age (β = -.14, p = .05) interactions. Among MBSR participants, greater baseline depressive symptom severity was also associated with less improvement in positive affect at the six-month follow-up (β = -.30, p = .003). Findings were qualified by a significant depressive symptom severity by age interaction (β = -.25, p = .01), such that MBSR participants who were 70 and over with lower baseline depressive symptom severity having the greatest improvement in positive affect at the six-month follow-up.
Conclusion:
MBSR improves positive affect for older adults with lower depressive symptom severity, perhaps because it capitalizes on naturalistic changes in control strategies.
Lonely older adults have increased expression of pro-inflammatory genes as well as increased risk for morbidity and mortality. Previous behavioral treatments have attempted to reduce loneliness and its concomitant health risks, but have had limited success. The present study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N=40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition×time interaction: F(1,35)=7.86, p=.008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-κB-related gene expression in circulating leukocytes, and MBSR downregulated this NF-κB-associated gene expression profile at post-treatment. Finally, there was a trend for MBSR to reduce C Reactive Protein (treatment condition×time interaction: (F(1,33)=3.39, p=.075). This work provides an initial indication that MBSR may be a novel treatment approach for reducing loneliness and related pro-inflammatory gene expression in older adults.
Since its inception in 1979, mindfulness-based stress reduction Mindfulness-Based Stress Reduction (MBSR) has been introduced
into many community and institutional settings with a variety of populations. There is an understood caveat that the participants
are able to understand and follow instructions, have a good attention span, are able to commit to the experience, and to participate
in some form of exercise. In this chapter, I discuss group and individual interventions offered to populations who often are
not able to meet the above criteria.
Within the past few decades, there has been a surge of interest in the investigation of mindfulness as a psychological construct and as a form of clinical intervention. This article reviews the empirical literature on the effects of mindfulness on psychological health. We begin with a discussion of the construct of mindfulness, differences between Buddhist and Western psychological conceptualizations of mindfulness, and how mindfulness has been integrated into Western medicine and psychology, before reviewing three areas of empirical research: cross-sectional, correlational research on the associations between mindfulness and various indicators of psychological health; intervention research on the effects of mindfulness-oriented interventions on psychological health; and laboratory-based, experimental research on the immediate effects of mindfulness inductions on emotional and behavioral functioning. We conclude that mindfulness brings about various positive psychological effects, including increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation. The review ends with a discussion on mechanisms of change of mindfulness interventions and suggested directions for future research.
Por que e para que praticar mindfulness? Mecanismos de ação e eficácia
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ciência: da tradição à modernidade (pp. 57-71). São Paulo, SP: Palas Athena.
Mindfulness e ciência: da tradição à modernidade
- A Cebolla
- M Demarzo
Cebolla, A., & Demarzo, M. (2016). O que é mindfulness?. In A. C. I. Martí, J. García-Compayo, & M. Demarzo (Eds), Mindfulness e ciência: da tradição à modernidade (pp.
19-35). São Paulo, SP: Palas Athena.
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