Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d=0.55), minimal treatment (d=0.37), non-specific active controls (d=0.35), and specific active controls (d=0.23). Mindfulness conditions did not differ from evidence-based treatments (d=-0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d=0.50), non-specific active controls (d=0.52), and specific active controls (d=0.29). Mindfulness conditions did not differ from minimal treatment conditions (d=0.38) and evidence-based treatments (d=0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.
Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d = 0.55), minimal treatment (d = 0.37), non-specific active controls (d = 0.35), and specific active controls (d = 0.23). Mindfulness conditions did not differ from evidence-based treatments (d = -0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d = 0.50), non-specific active controls (d = 0.52), and specific active controls (d = 0.29). Mindfulness conditions did not differ from minimal treatment conditions (d = 0.38) and evidence-based treatments (d = 0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.
BackgroundDespite an exponential growth in research on mindfulness-based interventions, the body of scientific evidence supporting these treatments has been criticized for being of poor methodological quality.ObjectivesThe current systematic review examined the extent to which mindfulness research demonstrated increased rigor over the past 16 years regarding six methodological features that have been highlighted as areas for improvement. These feature included using active control conditions, larger sample sizes, longer follow-up assessment, treatment fidelity assessment, and reporting of instructor training and intent-to-treat (ITT) analyses.Data sourcesWe searched PubMed, PsychInfo, Scopus, and Web of Science in addition to a publically available repository of mindfulness studies.Study eligibility criteriaRandomized clinical trials of mindfulness-based interventions for samples with a clinical disorder or elevated symptoms of a clinical disorder listed on the American Psychological Association’s list of disorders with recognized evidence-based treatment.Study appraisal and synthesis methodsIndependent raters screened 9,067 titles and abstracts, with 303 full text reviews. Of these, 171 were included, representing 142 non-overlapping samples.ResultsAcross the 142 studies published between 2000 and 2016, there was no evidence for increases in any study quality indicator, although changes were generally in the direction of improved quality. When restricting the sample to those conducted in Europe and North America (continents with the longest history of scientific research in this area), an increase in reporting of ITT analyses was found. When excluding an early, high-quality study, improvements were seen in sample size, treatment fidelity assessment, and reporting of ITT analyses.Conclusions and implications of key findingsTaken together, the findings suggest modest adoption of the recommendations for methodological improvement voiced repeatedly in the literature. Possible explanations for this and implications for interpreting this body of research and conducting future studies are discussed.
Objective: The present study reports on the long-term effects of a mindfulness-based stress reduction (MBSR) program for adult survivors of childhood sexual abuse. Method: Of the study participants, 73% returned to the clinic for a single-session follow-up assessment of depression, posttraumatic stress disorder (PTSD), anxiety, and mindfulness at 2.5 years. Results: Repeated measures mixed regression analyses revealed significant long-term improvements in depression, PTSD, anxiety symptoms, and mindfulness scores. The magnitude of intervention effects at 128 weeks ranged from d = .5 to d = 1.1. Conclusion: MBSR may be an effective long-term treatment for adults who have experienced childhood sexual abuse. Further investigation of MBSR with this population is warranted given the durability of treatment effects described here. C 2014 Wiley Periodicals, Inc. J. Clin. Psychol. 00:1-9, 2014.
Simpson, T.L. (in press). Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: A meta-analysis. Cognitive Behaviour Therapy.
Because they provide data on responsiveness to experimental manipulation, clinical trials involving mindfulness-based interventions are a source of evidence for the construct validity of self-report measures of mindfulness. Within-group and between-group changes in mindfulness were examined from randomized clinical trials comparing mindfulness interventions to other bona fide treatment comparison conditions or waitlist control conditions. We also examined changes in clinical outcomes and the magnitude of these changes relative to changes in mindfulness. We included 69 published studies representing 55 unique samples (n = 4,743). Self-report mindfulness measures showed relatively larger gains in mindfulness intervention conditions vis-à-vis waitlist comparison conditions at both post-treatment (effect size [ES] = 0.52, 95% CI [0.40, 0.64]) and follow-up (ES = 0.52 [0.20, 0.84]), although the effect at followup diminished to non-significance in a trim-and-fill analysis intended to account for publication bias (ES = 0.35 [-0.03, 0.72]). Measures of mindfulness also showed relatively larger gains in mindfulness intervention conditions vis-à-vis bona fide comparison conditions, but only at post
Introduction: Many barriers exist to integrating smoking cessation into delivery of lung cancer screening including limited provider time and patient misconceptions.Aims: To demonstrate that proactive outreach from a telephone counsellor outside of the patient's usual care team is feasible and acceptable to patients.Methods: Smokers undergoing lung cancer screening were approached for a telephone counselling study. Patients agreeing to participate in the intervention (n = 27) received two telephone counselling sessions. A 30-day follow-up evaluation was conducted, which also included screening participants receiving usual care (n = 56).Results/Findings: Most (89%) intervention participants reported being satisfied with the proactive calls, and 81% reported the sessions were helpful. Use of behavioural cessation support programs in the intervention group was four times higher (44%) compared to the usual care group (11%); Relative Risk (RR) = 4.1; 95% CI: 1.7 to 9.9), and seven-day abstinence in the intervention group was double (19%) compared to the usual care group (7%); RR = 2.6; 95% CI: 0.8 to 8.9).Conclusions: This practical telephone-based approach, which included risk messages clarifying continued risks of smoking in the context of screening results, suggests such messaging can boost utilisation of evidence-based tobacco treatment, self-efficacy, and potentially increase the likelihood of successful quitting.
Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1,046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to non-specific controls at post-treatment (k = 10, d = 0.71, 95% CI [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [-0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [-0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [-0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.
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