Effectiveness of meditation retreats: meta-analysis

Khoury, B., at al. (2017). Effectiveness of traditional meditation retreats: A systematic review and meta-analysis. Journal of psychosomatic research92, 16-25, https://doi.org/10.1016/j.jpsychores.2016.11.006. Taken from the Abstract.

Background. An increasing number of studies are investigating traditional retreats. Very little, however, is known about their effectiveness.

Objective. To evaluate the effectiveness of meditation retreats on improving in general population. A total of 20 papers (N = 2912) were included.

Results suggested large effects on measures of anxiety, depression, stress, and moderate effects on measures of emotional regulation and quality of life. As to potential mechanisms of actions, results showed large effects on measures of  mindfulness and compassion, and moderate effects on measures of acceptance. 

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Reducing burnout in police officers

Trombka, Marcelo, et al., Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers. BMC Psychiatry, 2018, vol. 18. no. 151, https://doi.org/10.1186/s12888-018-1726-7. Full text.

Background. Police officers experience a high degree of chronic stress. Policing ranks among the highest professions in terms of disease and accident rates. Mental health is particularly impacted, evidenced by elevated rates of burnout, anxiety and depression, and poorer quality of life than the general public.

Mindfulness training has been shown to reduce stress, anxiety, burnout and promote quality of life in a variety of settings, although its efficacy in this context has yet to be systematically evaluated. Therefore, this trial will investigate the efficacy of a mindfulness-based intervention versus a waitlist control in improving quality of life and reducing negative mental health symptoms in police officers.

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.

Reducing adverse effects of childhood Stress and trauma

Ortiz, Robin, and Erica M. Sibinga. “The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma.” Children, vol. 4, no. 3, 2017, pp. 16. Full text.

Abstract. Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood.

In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes.

Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.

Reduction of depressive symptoms

Fissler, M., et al. (2016). An Investigation of the Effects of Brief Mindfulness Training on Self-Reported Interoceptive* Awareness, the Ability to Decenter, and Their Role in the Reduction of Depressive Symptoms. Mindfulness, 1-12.

Abstract. Mindfulness-based interventions for the prevention and treatment of depression are predicated on the idea that interoceptive awareness represents a crucial foundation for the cultivation of adaptive ways of responding to negative thoughts and mood states such as the ability to decenter.

The current study used a multi-dimensional self-report assessment of interoceptive awareness, including regulatory and belief-related aspects of the construct, in order to characterize deficits in interoceptive awareness in depression, investigate whether brief mindfulness training could reduce these deficits, and to test whether the training unfolds its beneficial effects through the above-described pathway.

Currently depressed patients (n = 67) were compared to healthy controls (n = 25) and then randomly allocated to receive either a brief training in mindfulness (per-protocol sample of n = 32) or an active control training (per-protocol sample of n = 28). Patients showed significant deficits across a range of regulatory and belief-related aspects of interoceptive awareness, mindfulness training significantly increased regulatory and belief-related aspects of interoceptive awareness, and reductions in depressive symptoms were mediated through a serial pathway in which training-related increases in aspects of interoceptive awareness were positively associated with the ability to decenter, which in turn was associated with reduced symptoms of depression. These results support the role of interoceptive awareness in facilitating adaptive responses to negative mood.

* interoceptive: relating to stimuli produced within an organism, especially in the gut and other internal organs. 

Loving-kindness meditation for symptoms of depression

Hofmann, S.G. at al. (2015). Loving-Kindness Meditation to Target Affect in Mood Disorders: A Proof-of-Concept Study. Evidence-Based Complementary and Alternative Medicine, Article ID 269126, doi:10.1155/2015/269126. Full text.

Conventional treatments for mood disorders primarily focus on reducing negative affect, but little on enhancing positive affect. Loving-kindness meditation (LKM) is a traditional meditation practice directly oriented toward enhancing unconditional and positive emotional states of kindness towards oneself and others.

We report here two independent and uncontrolled studies carried out at different centers, one in Boston, USA (n = 10), and one in Frankfurt, Germany (n = 8), to examine the potential therapeutic utility of a brief LKM group intervention for symptoms of dysthymia and depression.

Results at both centers suggest that LKM was associated with large-sized effects on self-reported symptoms of depression , negative affect, and positive affect. Large effects were also found for clinician-reported changes in depression, rumination and specific positive emotions, and moderate effects for changes in adaptive emotion regulation strategies. The qualitative data analyses provide additional support for the potential clinical utility of the intervention.

Medical imaging evidence supports meditation in the treatment of depression

Annells, S., Kho, K., & Bridge, P. (2015). Meditate don’t medicate: How medical imaging evidence supports the role of meditation in the treatment of depression. Radiography. Published prior to inclusion in an issue.

Depression is a debilitating psychiatric disorder that affects a large proportion of the population. The current treatment for depression involves anti-depressant medication which is associated with side effects and a heightened risk of relapse.

Method. A systematic literature review was performed to determine the value of medical imaging studies in measuring the impact of meditation on depression.

Results. Medical imaging studies have successfully demonstrated that meditation may counteract or prevent the physiological cause of depression by decreasing amygdala activity and increasing grey matter volume and activity of the hippocampus, prefrontal cortex and other brain regions associated with attention and emotional self-regulation.

Recent advances in functional imaging have enabled visualisation of neural plasticity within the brain. This has shown that for meditators, practice-induced alterations could be due to micro-anatomical processes that may represent an increased functional capacity within the brain regions activated. These changes within brain physiology in association with the skills gained during meditation such as self-regulation, mental processing of negative information and relaxation techniques could potentially lead to a permanent cure for depression and thus prevent relapse.

Conclusions. The results of this review suggest that medical imaging has a valuable role to play in evidencing the physiological changes within the brain caused by meditation that counteract those that cause depression. These studies indicate that meditation is a viable alternative to medication for clinical treatment of patients with depression. More rigorous longitudinal imaging studies are proposed to enhance understanding of the neural pathways and mechanisms of meditation.