Questions that warrant research attention

Davidson, R. J., & Dahl, C. J. (2018). Outstanding challenges in scientific research on mindfulness and meditation. Perspectives on Psychological Science, vol 13, no. 1, pp. 62-5, DOI: 10.1177/1745691617718358. Full text.

From the Introduction. The article by Van Dam and colleagues (see previous post in this blog) presents a very useful corrective to the hype and claims associated with the burgeoning interest in mindfulness and meditation. The authors review a number of key issues and concerns with research in this domain including the problematic meaning of the term “mindfulness,” the differing measures of mindfulness and challenges to their construct validity, challenges for clinical intervention methodology including the variations in the types and content of various mindfulness-based interventions (MBIs) that have been examined, the growing evidence of potential adverse effects in a small subset of individuals who partake of MBIs, and the challenge of conducting neuro-scientific research in this area. For each of these topics, the authors also provide a prescriptive vision for the types of research that are needed to address the concerns and challenges that are described.

While we wholeheartedly agree with the central issues highlighted in this article and believe that this article, along with several other critical articles that have appeared recently, will provide an important recalibration of the claims and conclusions that are warranted from the contemporary scientific literature on this topic, we believe that the prescriptive agenda offered in their article can be usefully expanded.

In this commentary, we address a few of the specific concerns raised by the authors and show that they are not specific to mindfulness or meditation research and that attention to the broader context of these challenges can be helpful in addressing them. Second, we widen the prescriptive agenda offered in their article and underscore several key questions that the authors did not raise that warrant serious research attention for this
field to have impact. In this commentary we make five key points that build from the issues raised by Van Dam and colleagues.

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Promising psychological treatments for fibromyalgia

Pérez-Aranda, A., et al. (2017). Description and narrative review of well-established and promising psychological treatments for fibromyalgia. Mindfulness & Compassion, http://www.sciencedirect.com/science/article/pii/S2445407917300319

Abstract. Fibromyalgia (FMS) is a prevalent, disabling syndrome characterized by chronic widespread musculoskeletal pain and symptoms such as sleep disturbance, fatigue, stiffness, distress, cognitive impairments and a high comorbidity with anxiety and depressive disorders. Although no curative treatment has yet been found, various therapeutic approaches have been developed in the fields of pharmacology and psychology.

The present paper aims to offer a narrative review and a description for clinicians and researchers of psychological therapies that have been applied in a format group in FMS with strong or promising empirical support: i.e., Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness-Based Stress Reduction (MBSR), Psychoeducational program for FMS (FibroQoL), Amygdala Retraining Therapy (ART), and Attachment-Based Compassion Therapy (ABCT).

This review will offer a brief practical summary of each therapy protocol (session-by-session), their rationale and available evidence of their effectiveness.

Effect of online mindfulness intervention on well-being

Bailey, N. W., et al. (2018). Effect on Well-Being from an Online Mindfulness Intervention: “Mindful in May”. Mindfulness, 1-11. First online March 18, 2018. DOI: https://doi.org/10.1007/s12671-018-0910-7.

Abstract (excerpt). Mindfulness has been shown to improve mental health and well-being both in clinical populations and in healthy controls. However, while most mindfulness interventions have been assessed in a research context, demonstrating efficacy, the majority of mindfulness interventions in the public sphere are not assessed, and there has been little research examining the effectiveness of these interventions in the public context.

As such, this study explored whether a public online mindfulness intervention providing 10-min daily guided meditations was associated with improvements in well-being, and whether these improvements were related to the number of days participants practiced mindfulness meditation. Two hundred and nineteen participants took part in the study. Participants were aged 22–75, and the majority of participants were female. The majority of participants undertook mindfulness practice on 25+ days.

Participants completed both baseline and post-intervention assessments of perceived stress, positive and negative affect, mindfulness, flourishing, and self-compassion. Results indicated that all measures improved from baseline to post-intervention and that number of days practiced predicted increased mindfulness, and increased mindfulness predicted improvements in positive affect. These results suggest that online mindfulness interventions may be effective at improving mental health in the general population.

Integrity in mindfulness-based research

Crane, R.S. & Hecht, F.M. “Intervention Integrity in Mindfulness-Based Research.” Mindfulness (2018). https://doi.org/10.1007/s12671-018-0886-3. Full Text.

From the Abstract. Assessing program or intervention fidelity/integrity is an important methodological consideration in clinical and educational research. These critical variables influence the degree to which outcomes can be attributed to the program and the success of the transition from research to practice and back again.

Research in the Mindfulness-Based Program (MBP) field has been expanding rapidly over the last 20 years, but little attention has been given to how to assess intervention integrity within research and practice settings. The proliferation of different program forms, inconsistency in adhering to published curriculum guides, and variability of training levels and competency of trial teachers all pose grave risks to the sustainable development of the science of MBPs going forward.

Mindfulness-based psycho-education for people with schizophrenia

Chien, W., Bressington, D., Yip, A., & Karatzias, T. (2017). An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia. Psychological Medicine, 47(12), 2081-2096. doi:10.1017/S0033291717000526. Full access. 

From the Abstract. Compared with treatment as usual (TAU) and conventional psychoeducation group (CPEG0), mindfulness-based psychoeducation group (MBPEG) improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.

 

Online mindfulness-based intervention: feasibility and effectiveness

Cavanagh, K., et al. “A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention in a Non-clinical Population: Replication and Extension.” Mindfulness, 2018, online, https://doi.org/10.1007/s12671-017-0856-1. Full text

From the Abstract. Building on previous research, this study compared the effects of two brief, online mindfulness-based interventions (MBIs; with and without formal meditation practice) and a no intervention control group in a non-clinical sample.

One hundred and fifty-five university staff and students were randomly allocated to a 2-week, self-guided, online MBI with or without mindfulness meditation practice, or a wait list control. Measures of mindfulness, perceived stress, perseverative thinking and anxiety/depression symptoms within were administered before and after the intervention period. Intention to treat analysis identified significant differences between groups on change over time for all measured outcomes.

… Change in perseverative thinking was found to mediate the relationship between condition and improvement on perceived stress and anxiety/depression symptom outcomes. Contrary to our hypotheses, no differences between the intervention conditions were found. Limitations of the study included reliance on self-report data, a relatively high attrition rate and absence of a longer-term follow-up.

This study provides evidence in support of the feasibility and effectiveness of brief, self-guided MBIs in a non-clinical population and suggests that reduced perseverative thinking may be a mechanism of change. Our findings provide preliminary evidence for the effectiveness of a mindfulness psychoeducation condition, without an invitation to formal mindfulness meditation practice. Further research is needed to confirm and better understand these results and to test the potential of such interventions.

Well-being of parents of children with autism and related disabilities

Jones, L., et al. (2018). A mindfulness parent well-being course: Evaluation of outcomes for parents of children with autism and related disabilities recruited through special schools. European Journal of Special Needs Education33(1), 16-30.

Abstract. Parents of children with intellectual disabilities and/or autism have been shown to experience higher levels of distress than other parents. Despite such data having been available for several decades, the evidence base for psychological interventions to support parental well-being is small. Recent data suggest that both mindfulness and acceptance processes are associated with decreased psychological distress for parents of children with intellectual disability and/or autism. In addition, some controlled evaluations of mindfulness-based interventions for these parents have resulted in positive outcomes for mothers in particular.

In the present study 18 mothers and 3 fathers were recruited via special schools who then attended a Mindfulness Based Well-Being for Parents (MBW-P) group over eight weeks. Parents completed questionnaire measures before and at the end of the course. Statistical analysis showed significant reported increases in mindfulness and self-compassion, and reduced general stress. Parents also reported reductions in anxiety and depression, although these changes were not statistically significant.

No significant reductions in their child’s behaviour problems or increases in the child’s prosocial behaviour were found. Parents also reported high levels of satisfaction with the course. These preliminary data suggest that further research studies testing the effectiveness of the MBW-P course are warranted.