Mindfulness and insomnia (zzzzz)

Ong, Jason C., and Christine E. Smith. Current Sleep Medicine Reports, first online 2017, pp. 1-9, doi:10.1007/s40675-017-0068-1. [See also: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3060715/%5D

Abstract. The goal of this review is to provide an update on the use of mindfulness meditation for the treatment of insomnia, including conceptual models and empirical evidence from randomized controlled trials.

A metacognitive model of insomnia has been proposed as a conceptual model to explain the application of mindfulness principles for reducing insomnia-related arousal. Furthermore, the evidence base for mindfulness-based therapies has grown with the results of several randomized controlled trials published in the past 3 years. Treatment effects appear to be strongest on self-report measures compared to objective measures of sleep.

Treatment programs featuring mindfulness meditation appear to be viable treatment options for people with insomnia. Further research is needed to determine who is likely to benefit from mindfulness-based therapies and how these interventions work. Additionally, further work is needed to resolve issues related to the delivery and implementation of mindfulness-based therapies.

Youth with anxiety (review & meta-analysis)

Borquist-Conlon, Debra S., et al. Mindfulness-Based Interventions for Youth With Anxiety: A Systematic Review and Meta-Analysis. Research on Social Work Practice, 2017, pp. 1-11, DOI 10.1177/1049731516684961. Full text.

Purpose: To examine the effects on anxiety of mindfulness-based interventions (MBIs) among youth with anxiety disorders.

Method: Systematic review and meta-analytic procedures were employed to synthesize experimental and quasi-experimental studies authored between 1980 and 2015.

Results: The search yielded five studies from five countries reporting results for a total of 188 youth between the ages of 5 and 18 (mean age 13.26) who met criteria for an anxiety disorder.

Discussion: The findings of this review suggest that MBIs for the treatment of anxiety in youth with anxiety disorders are effective.

Mindfulness-based interventions in schools (review & analysis)

Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools-A systematic review and meta-analysis. Frontiers in Psychology, 5, 603. Full text.

From the Abstract. Mindfulness programs for schools are popular. We systematically reviewed the evidence regarding the effects of school-based mindfulness interventions on psychological outcomes, using a comprehensive search strategy designed to locate both published and unpublished studies.

Systematic searches in 12 databases were performed in August 2012. Further studies were identified via hand search and contact with experts. Two reviewers independently extracted the data, also selecting information about intervention programs (elements, structure etc.), feasibility, and acceptance. Twenty-four studies were identified, of which 13 were published. Nineteen studies used a controlled design. In total, 1348 students were instructed in mindfulness, with 876 serving as controls, ranging from grade 1 to 12.

All in all, mindfulness-based interventions in children and youths hold promise, particularly in relation to improving cognitive performance and resilience to stress. However, the diversity of study samples, variety in implementation and exercises, and wide range of instruments used require a careful and differentiated examination of data. There is great heterogeneity, many studies are underpowered, and measuring effects of Mindfulness in this setting is challenging. The field is nascent and recommendations will be provided as to how interventions and research of these interventions may proceed.

Does mindfulness reduce symptoms of fibromyalgia?

Tobin, J. (2014). Effect of mindfulness-based interventions on symptoms of fibromyalgia: A meta-analysis (Doctoral dissertation, California State University, Fullerton). 

From the Abstract. Mindfulness provides an alternative or supplement to traditional pharmacological treatment of fibromyalgia, but it is not yet clear how effective it is in reducing symptoms. The purpose of this meta-analysis was to explore the efficacy of mindfulness-based interventions on fibromyalgia impact, pain severity, and psychological distress in adults diagnosed with fibromyalgia. A total of 11 randomized controlled trials were included in the analysis, all of which measured at least one of the designated outcomes.

Studies’ data was pooled and standardized mean differences were calculated. Results showed a moderate to large intervention effect for each outcome. Subgroup analyses were conducted for each outcome based on control group type (active versus wait list), and for each outcome, all subgroups’ SMD significantly favored the experimental condition, with the exception of the active controls for psychological distress.

… While this analysis yielded results suggesting the efficacy of mindfulness in reducing symptoms of fibromyalgia, future meta-analyses may consider including studies of more diverse methodological quality to create more robust and powerful effect sizes, while exploring methodology as a potential moderator.

Effective for reducing anxiety, depression, and stress (based on 209 studies).

Khoury, B., et al. (2013). Mindfulness-Based Therapy: A Comprehensive Meta-Analysis. Clinical Psychology Review. Abstract. Online ahead of publication June 7.

Highlights: • We conducted a meta-analysis to provide a review of mindfulness-based therapy which includes Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). It includes 209 studies enrolling 12,145 participants with a variety of disorders. • When compared with other treatments, we obtained smaller effect. The results obtained are robust and are maintained at follow-up.

Conclusion: Mindfulness-based therapy is an effective treatment for a variety of psychological problems, and is especially effective for reducing anxiety, depression, and stress.