BackgroundDistress and burnout among medical and psychology professionals are commonly reported and have implications for the quality of patient care delivered. Already in the course of university studies, medicine and psychology students report mental distress and low life satisfaction. There is a need for interventions that promote better coping skills in students in order to prevent distress and future burnout. This study examines the effect of a seven-week Mindfulness-Based Stress Reduction (MBSR) programme on mental distress, study stress, burnout, subjective well-being, and mindfulness of medical and psychology students.MethodsA total of 288 students (mean age = 23 years, 76% female) from the University of Oslo and the University of Tromsø were randomly allocated to an intervention or control group. The control group continued with their standard university courses and received no intervention. Participants were evaluated using self-reported measures both before and after the intervention. These were: the ‘General Health Questionnaire, Maslach Burnout Inventory Student version, Perceived Medical School Stress, Subjective Well-being, and Five Facet Mindfulness Questionnaire’ and additional indices of compliance.ResultsFollowing the intervention, a moderate effect on mental distress (Hedges’g 0.65, CI = .41, .88), and a small effect on both subjective well-being (Hedges’g 0.40, CI = .27, .63) and the mindfulness facet ‘non-reacting’ (Hedges’g 0.33, CI = .10, .56) were found in the intervention group compared with the control group. A higher level of programme attendance and reported mindfulness exercises predicted these changes. Significant effects were only found for female students who additionally reported reduced study stress and an increase in the mindfulness facet ‘non-judging’. Gender specific effects of participation in the MBSR programme have not previously been reported, and gender differences in the present study are discussed.ConclusionFemale medical and psychology students experienced significant positive improvements in mental distress, study stress, subjective well-being and mindfulness after participating in the MBSR programme.Trial registrationNCT00892138

The majority of mindfulness research to date has reported only on the group-level effects of interventions. Therefore, there is a need to better understand who is most likely to benefit from mindfulness interventions. This study reports on moderation analyses from a two-centre randomised controlled trial of mindfulness-based stress reduction (MBSR) among 288 medical and psychology students. The study investigated whether baseline personality factors (neuroticism, conscientiousness and extroversion) and baseline mindfulness moderated effects on mental distress, study stress and subjective well-being measured after the intervention. An increased effect of the intervention on mental distress and subjective well-being was found in students with higher scores on neuroticism. Students with higher scores on conscientiousness showed an increased effect of mindfulness training on study stress. The training protected students against an increase in mental distress and study stress and a decrease in subjective well-being that was seen in the control group. Baseline mindfulness and extroversion did not moderate the effects of the intervention on the outcomes. The majority of the 288 medical and psychology students in the study sample were female. Female participants scored significantly higher on neuroticism and conscientiousness, and they may therefore be an important target group for mindfulness interventions among students.

Longitudinal research investigating the enduring impact of mindfulness training is scarce. This study investigates the six-year effects of a seven-week mindfulness-based course, by studying intervention effects in the trajectory of dispositional mindfulness and coping skills, and the association between those change trajectories and subjective well-being at six-year follow-up. 288 Norwegian medical and psychology students participated in a randomized controlled trial. 144 received a 15-hour mindfulness course over seven weeks in the second or third semester with booster sessions twice yearly, while the rest continued their normal study curricula. Outcomes were subjective well-being, and dispositional mindfulness and coping assessed using the Five Facet Mindfulness Questionnaire and the Ways of Coping Checklist. Analyses were performed for the intention-to-treat sample, using latent growth curve models. At six-year follow-up, students receiving mindfulness training reported increased well-being. Furthermore, they reported greater increases in the trajectory of dispositional mindfulness and problem-focused coping along with greater decreases in the trajectory of avoidance-focused coping. Increases in problem-focused coping predicted increases in well-being. These effects were found despite relatively low levels of adherence to formal mindfulness practice. The findings demonstrate the viability of mindfulness training in the promotion of well-being and adaptive coping, which could contribute to the quality of care given, and to the resilience and persistence of health care professionals.Trial registration: Clinicaltrials.gov NCT00892138

Objectives. Mindfulness-based stress reduction (MBSR) enhances short-term psychological health in clinical and non-clinical samples, whereas studies examining long-term effects are scarce. This study examined whether the effects of a 7-week MBSR programme on mental health persisted at 2-and 4-year follow up and explored possible mechanisms of effect. Methods. In a two-site randomized controlled trial, 288 medical and psychology students were allocated to an MBSR intervention (n = 144) or a no-treatment control group (n = 144). During the 4-year follow-up period, the MBSR group was offered 90-min booster sessions semi-annually. The primary outcome measures were mental distress (General Health Questionnaire-GHQ) and well-being; these were measured at baseline (T0) and postintervention follow-up at 1 month (T1), 2 years (T1) and again at 4 years (T3). Secondary outcomes included coping, mindfulness, and meditation practice. Results. At 4-year follow up, the MBSR group showed significantly better scores on mental distress, mindfulness, avoidance coping, and problem-focused coping (Cohen's d = 0.23-0.42). Meditation practice positively predicted long-term mindfulness scores. Short-term effects in mindfulness-scores mediated long-term intervention effects in mental distress and coping. However, reversed mediation also was observed (i.e. changes in outcome mediating long-term mindfulness scores), and this indicates that initial changes in outcome and mindfulness are intrinsically intertwined and may both influence long-term effects. Small post-intervention effects on well-being and seeking social support did not persist at follow up. Conclusions. MBSR fostered enduring effects on mental distress and coping in medical and psychology students 4 years post-intervention.

Mindfulness has attracted increased interest in the field of health professionals’ education due to its proposed double benefit of providing self-help strategies to counter stress and burnout symptoms and cultivating attitudes central to the role of professional helpers. The current study explored the experiential aspects of learning mindfulness. Specifically, we explored how first-year medical and psychology students experienced and conceptualized mindfulness upon completion of a 7-week mindfulness-based stress reduction program. Twenty-two students participated in either two focus group interviews or ten in-depth interviews, and we performed an interpretive phenomenological analysis of the interview transcripts. All students reported increased attention and awareness of psychological and bodily phenomena. The majority also reported a shift in their attitudes towards their experiences in terms of decreased reactivity, increased curiosity, affect tolerance, patience and self-acceptance, and improved relational qualities. The experience of mindfulness was mediated by subjective intention and the interpretation of mindfulness training. The attentional elements of mindfulness were easier to grasp than the attitudinal ones, in particular with respect to the complex and inherently paradoxical elements of non-striving and radical acceptance. Some participants considered mindfulness as a means to more efficient instrumental task-oriented coping, whilst others reported increased sensitivity and tolerance towards their own state of mind. A broader range of program benefits appeared dependent upon embracing the paradoxes and integrating attitudinal elements in practising mindfulness. Ways in which culture and context may influence the experiences in learning mindfulness are discussed along with practical, conceptual, and research implications.Electronic supplementary materialThe online version of this article (doi:10.1007/s12671-016-0521-0) contains supplementary material, which is available to authorized users.

The Mindfulness to Meaning Theory provides a detailed process model of the mechanisms by which mindfulness may promote well-being. Central to the Mindfulness to Meaning Theory is the mindful reappraisal hypothesis (MRH), which suggests mindfulness training promotes well-being by facilitating positive reappraisal. Emerging evidence from interconnected domains of research supports the MRH. However, it remains unclear whether mindful reappraisal continues to develop after a mindfulness training course and whether this continued development encourages well-being over time. As such, this randomized controlled study compared participants receiving a mindfulness-based stress reduction (MBSR) course with participants receiving no mindfulness training on positive reappraisal use and well-being over the course of 6 years. Latent growth curve modeling revealed that mindfulness training increased well-being by significantly increasing the trajectory of positive reappraisal over time. The MRH was then unpacked by examining whether MBSR also stimulated decentering and broadened awareness, core components of the MRH. Multivariate path analysis revealed that mindfulness training increased decentering, which in turn broadened awareness, which was then associated with positive reappraisal, ultimately promoting well-being. Taken together, these findings suggest that MBSR cultivates a downstream cascade of adaptive psychological processes that continue to promote quality of life 6-years after mindfulness training. K E Y W O R D S mindfulness, mindfulness based stress reduction, positive reappraisal, well-being 1 | INTRODUCTION Mindfulness training has been shown to encourage enduring positive changes, including the alleviation of emotional distress and the pro-

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health psychology report • volume 5(3), 7 original article background Chronic fatigue syndrome (CFS) is a condition characterized by persistent and unexplained fatigue that may result in severe impairment of daily functioning. Currently, there is no curative treatment for CFS, and many patients experience the existing interventions as ineffective. Thus, there is a need for new approaches that target psychological maintenance factors and coping. Mindfulness is an approach to increasing awareness and acceptance of ongoing mental processes. Mindfulness-based interventions have been shown to reduce stress and enhance quality of life in patients with chronic diseases, to increase the tolerance of unpleasant feelings and bodily dysfunction, as well as to facilitate use of appropriate coping skills. This pilot study examined the effect and acceptability of a mindfulness-based intervention for patients with CFS. participants and procedure Ten patients with CFS (eight women, two men) participated in the study. The mindfulness training had a duration of eight weeks with 2-hour weekly meetings. The effect of the intervention was evaluated using a single case series design with a 3-month follow-up. results All patients completed the intervention. Medium to large effect sizes were found for anxiety, fatigue, rumination, depression, and mindfulness. The participants' feedback indicated increased quality of life and more adaptive coping.