Τρίτη 3 Σεπτεμβρίου 2019

Self-Compassion and Suicide Risk in Veterans: When the Going Gets Tough, Do the Tough Benefit More from Self-Compassion?

Abstract

Objectives

Veterans are at particular risk for suicide due to psychopathological, emotional, and interpersonal risk factors. However, the presence of individual-level protective factors, such as self-compassion, may reduce risk, becoming more salient at increasing levels of distress and psychopathology, per theory. We examined the relation between self-compassion and suicide risk, and the moderating effects of depression, PTSD symptoms, anger, shame, and thwarted interpersonal needs.

Methods

Our sample of US veterans (n = 541) in our cross-sectional study were mostly male (69.1%) with an average age of 49.90 (SD = 16.78), who completed online self-report measures: Suicidal Behaviors Questionnaire-Revised, Multidimensional Health Profile-Psychosocial Functioning Screening Tool, PTSD Checklist-Military Version, Differential Emotions Scale-IV, and the Interpersonal Needs Questionnaire.

Results

The linkage between self-compassion and suicidal behavior in our veteran sample was moderated by distress-evoking risk factors, including depression, anger, shame, and thwarted interpersonal needs, such that, as level of risk severity increases, the inverse association between self-compassion and suicidal behavior is strengthened.

Conclusions

Our findings highlight an emergent protective process that may prevent suicide in times of distress. Therapeutically bolstering the ability for self-compassion may provide a proactive coping strategy that can be brought to bear in times of crisis, reducing suicide risk for veterans.

Mindfulness Training, Implicit Bias, and Force Response Decision-Making

Abstract

Objectives

The goal of this study was to assess the preliminary efficacy of a mindfulness-based training (mindfulness-based resilience training; MBRT) in improving weapon identification among law enforcement officers (LEOs).

Methods

Participants (N = 61) were randomly assigned to either MBRT or a no-intervention control (NIC) group. A self-report questionnaire assessing mindfulness and a computerized measure assessing implicit stereotype reliance were administered at baseline, post-training, and 3 months following intervention completion. We also collected information about meditation practice outside of the training for LEOs in the MBRT group.

Results

Inferential analyses yielded improvements in mindfulness in the MBRT group compared to NIC. Analyses did not provide evidence for implicit stereotype reliance at baseline and therefore did not yield a significant impact of MBRT versus NIC on implicit stereotype reliance, ps > .05; however, participants across both conditions exerted more control when responding to Black male targets compared to White male targets, F(1,74) = 3.98, p = .05, 95% CI [− .05, − .01], d = .36.

Conclusions

Our results do not provide evidence for the impact of MBRT on weapon identification but do suggest that LEOs exerted more effort when responding to images of Black males compared to White males. We discuss recommendations for future clinical trials assessing implicit stereotype reliance, viz., that researchers utilize measures more sensitive to a wider range of LEO samples and with higher ecological validity, and we discuss potential reasons why our results do not align with past research.

A Systematic Review and Meta-Analysis of Cultural Adaptations of Mindfulness-Based Interventions for Hispanic Populations

Abstract

Objectives

The present study is a systematic review which aims to evaluate the current state of the literature on the effectiveness and cultural adaptations of mindfulness-based interventions (MBIs) for Hispanics. MBIs are widely used psychological therapies, yet little is known about their effectiveness or appropriateness with the Hispanic population, the fastest growing ethnic minority population in the USA.

Methods

We identified and reviewed twenty-two studies, across the USA, Spain, and South America. Eight of these studies were coded for meta-analysis. Studies were also rated using methodological rigor and cultural adaptation ratings, developed for this study.

Results

Culturally adapted MBIs are associated with depression symptom improvement, stress reduction, stress management, and chronic illness management. Results from meta-analysis suggest a moderate to large effect of the interventions on psychiatric distress relative to scores in the comparison group.

Conclusions

Findings from this study suggest there is clear evidence that cultural adaptations can improve evidence-based treatment implementation among Hispanics, but more methodologically rigorous studies are needed. Recommendations for clinical practice and future research are discussed.

Effects of an 8-Week Body Scan Intervention on Individually Perceived Psychological Stress and Related Steroid Hormones in Hair

Abstract

Objectives

An increased psychosocial stress level is a continuously growing public health problem. While previous studies investigated the stress-related effects of mindfulness-based stress reduction (MBSR), it is still largely unknown, whether chronic stress decreases after an 8-week training of a body scan meditation. This study aimed at closing this gap by examining the effects of a body scan on chronic stress markers.

Methods

In this study, 47 healthy students were randomly assigned to an intervention group (n = 24) and a control group (n = 23). Participants in the intervention group used a 20-min long audio recording of a guided body scan. The control group listened to an audio book for the same amount of time. On the biological level, stress was assessed by selected stress hormones (cortisol, dehydroepiandrosterone (DHEA), and its ratio) from hair samples. Psychological stress load was measured by the Screening of the Trier Inventory of Chronic Stress.

Results

The body scan group showed a decreased level of cortisol, and cortisol/DHEA ratio, as well as an increased level of DHEA compared with the audio book group. Regarding psychological stress, a decreased value was observed in both groups. Additional correlation analyses demonstrate no relationship between biological and psychological chronic stress markers.

Conclusions

Overall, data suggest positive effects of an 8-week body scan, especially for biological stress markers. Investigating the effects of this intervention in populations with a high risk for increased levels of stress (e.g., unemployment) would be particularly interesting.

Mindfulness Training Offered In-person and in a Virtual World—Weekly Self-reports of Stress, Energy, Pain, and Sleepiness among US Military Active Duty and Veteran Personnel

Abstract

Objectives

The purpose of this paper is to present research findings on the effects of mindfulness meditation training on four weekly self-report measures among three groups: those receiving training delivered in-person (M-IP) or in a virtual world (M-VW), and a waitlist control group (WLC).

Methods

Participants (n = 191) were US military active duty service members and veterans. The M-IP and M-VW groups reported their stress, energy, pain, and sleepiness before/after each mindfulness training class, while the control group answered the same questions once a week for the 8-week duration of training.

Results

The M-IP and M-VW groups showed greater reductions in stress over the 8 weeks than the control group (1.70, 0.80, and 0.30 points, respectively; p = .028). Meaningful improvements (> 20%) pre- to post-training were seen for stress, pain, and sleepiness in the M-IP group, for pain only in the VW group, and for none in the WLC group. Those experiencing high levels of stress or pain before training experienced reductions in their stress or pain post mindfulness training, while those with lower initial levels did not (p < .001). Within class improvements were seen for both intervention groups; however, improvements were greater for those attending M-IP for energy, pain, and sleepiness (p < .034).

Conclusions

In-person mindfulness training yielded statistically and meaningfully superior results; however, both IP and VW delivery methods were effective in reducing stress among healthy US military active duty and veteran participants. Mindfulness was particularly helpful for those experiencing initially high levels of stress or pain.

The Beneficial Role of Mindfulness Facets in Relatives of People with Intellectual and Developmental Disabilities

Abstract

Objectives

Providing support to people with intellectual and developmental disabilities (IDD) can be a major source of stress for the family caregivers. It is therefore important to identify resilient and protective factors for caregivers. This study examined whether mindfulness facets predict over time fewer symptoms of anxiety and depression and better quality of life for the family caregivers of people with IDD.

Methods

A sample of 143 Spanish relatives of people with IDD (122 women and 21 men), aged between 18 and 78 (M = 46.87, SD = 12.16), participated in a two-time 6-month longitudinal study. Participants completed measures of anxiety, depression, quality of life, and mindfulness facets at the beginning of the study. Six months later, they again completed measures of psychological symptoms and quality of life.

Results

The findings indicated that acting with awareness and non-reacting were the most beneficial mindfulness facets for caregivers. Acting with awareness predicted a reduction of anxiety (β = − 0.16, p < 0.01) and depression (β = − 0.17, p < 0.05) and an increase in quality of life (β = 0.19, p < 0.05) at the follow-up. Non-reacting predicted a reduction of anxiety (β = − 0.16, p < 0.05) and depression (β = − 0.13, p < 0.05) over time.

Conclusions

The results of the study show the beneficial role of mindfulness facets and suggest the importance of studying the effect of mindfulness-based interventions for the relatives of people with IDD.

Mixed Experiences of a Mindfulness-Informed Intervention: Voices from People with Intellectual Disabilities, Their Supporters, and Therapists

Abstract

Objectives

Mindfulness-based programs have been delivered to people with intellectual disabilities (ID) and aggressive behaviour with some success. The current study is part of a wider feasibility study, which aimed to test the adaptation of the Soles of the Feet (SoF) meditation practice to a six-session, one-to-one intervention delivered within the UK National Health Service. It was designed for adults with ID to help reduce their aggressive behaviour.

Methods

Eighteen stakeholders were interviewed from three groups: (1) people with ID who took part in the intervention, (2) their supporters, and (3) therapists who delivered the intervention. Thematic analysis was used to analyse the data.

Results

The intervention had high acceptability among participants, although they reported mixed outcomes, these outcomes aligned closely with reports on effectiveness from supporters and therapists. Some people with ID and their supporters reported positive changes, such as reduced aggression, increased sociability, and higher quality of life. Some participants reported no change.

Conclusions

Four participants and their supporters reported clear benefits from the SoF intervention. For the three that did not report benefits, this appeared to be related to whether the person with ID understood the intervention and/or were motivated to reduce their aggressive behaviour. There was also evidence of supporters needing more direct instruction on how to facilitate the SoF intervention with the person they care for. Suggestions for future research are made, and clinical implications explored.

Past Discrimination, Race-Related Vigilance, and Depressive Symptoms: the Moderating Role of Mindfulness

Abstract

Objectives

African Americans experience numerous adverse health consequences due to race-related stress. Yet, mindfulness may serve as a relevant and vital protective factor in the link between race-related stressors and depressive symptoms for this population.

Methods

Data from 190 African American participants, ages 18–53, were used to investigate if past discrimination and race-related vigilance, two types of race-related stressors, interactively predicted greater depressive symptomatology among this sample. We also assessed if mindfulness moderated the association between race-related stressors, as indicated by past discrimination and race-related vigilance, and depressive symptomatology.

Results

Our results indicated that past discrimination and race-related vigilance did not interactively predict depressive symptomatology in our sample; however, these stressors were independently related to greater depressive symptoms. Additionally, we found that greater levels of mindfulness were associated with lower levels of depressive symptoms, and mindfulness significantly moderated the association between both race-related stressors and depressive symptoms.

Conclusions

These findings support mindfulness’ ability to buffer the negative health consequences of past discrimination and race-related vigilance for African Americans. Additional conclusions and future research directions are discussed.

A Pilot Randomized Controlled Trial of a Mindfulness-Based Intervention for Caregivers of Veterans

Abstract

Objectives

Informal caregivers of veterans are providing care for a population whose specialized care needs require increased investments on the part of caregivers and for longer durations. Empirical evidence shows negative mental health effects on these caregivers at rates that outpace those seen in caregivers in the general population. With a growing need and limited resources, effective interventions are needed to improve mental health outcomes in this special population of caregivers.

Methods

This pilot, randomized control trial tested the effectiveness of a mindfulness-based intervention at improving perceived stress, depressive symptoms, anxiety, and worry compared to waitlist controls in a sample of 23 caregivers of veterans.

Results

The Mann-Whitney U tests used to determine whether groups differed in change scores (post minus pre) indicated that there were significant differences between the mindfulness and waitlist control group in perceived stress (U = 21.5, p = .006, r = .57), anxiety (U = 24.0, p = .009, r = .54), and worry (U = 29.5, p = .024, r = .47). Results from the Wilcoxon signed-rank tests indicated that caregivers in the mindfulness group reported a significant reduction in perceived stress (Z = − 2.50, p = .013, r = .75) and anxiety (Z = − 2.81, p = .005, r = .85), whereas the waitlist control group reported higher mean symptoms at the end of the intervention period.

Conclusions

Given these promising results, policymakers, health practitioners, and veteran-related programs should increase efforts to provide caregivers of veterans with mindfulness-based interventions to improve mental health outcomes.

Mindfulness-Based Program for Autism Spectrum Disorder: a Qualitative Study of the Experiences of Children and Parents

Abstract

Objectives

Mindfulness-based programs could support children with autism spectrum disorder (ASD) and their parents to cope with autism spectrum symptoms and reduce comorbid mental health problems. In this study, we aimed to explore which change processes are involved in a mindfulness-based program for children with ASD and their parents (MYmind), according to a qualitative analysis of the families’ experiences.

Method

Fourteen children aged 9–17 years and 31 parents (18 mothers, 11 fathers, 2 caring relatives) participated in an interview 2 to 5 months after the 9-week MYmind training, about their experiences with the training, experienced changes, and how mindfulness works for them. We used constructivist grounded theory methodology to develop a theory of the key change processes and their relations.

Results

Eight main change processes resulted from the analysis, namely connecting with peers, pausing, being aware, being in the here and now, letting be, determining a strategy, being and responding calm, and attuning to others. We proposed a model reflecting the interdependency and direction of these change processes.

Conclusion

The findings deepen our understanding of how multiple change processes are involved in the MYmind program for children with ASD and their parents. Theoretical and research implications are discussed.

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