What is mindfulness and how does it work?, Study Guides, Projects, Research for Psychology, Exams of Nursing

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What is mindfulness and how does it work?, Study Guides, Projects, Research for Psychology Mindfulness -ANS paying attention in a particular way: on purpose, in the present moment, and non-judgmentally Kabat-Zinn -ANS brought mindfulness from the east to the west, three particular purposes in the description Five facets to measure a sense of mindfulness -ANS -describing -non-reactivity -observing -acting with awareness -non-judging being mode -ANS -being focused on what you are doing in the moment -mindful mode, wide attention and acceptance of what is, allowing things as they are doing mode -ANS -not paying direct attention to what you are doing/focusing on -goal directed, getting things done, not necessarily with full awareness, focus on change mindfulness as a trait -ANS something persons varying in, your personality trait can be more mindful the others mindfulness as a state -ANS refers to differing over situations mindfulness as a practice -ANS meditations, yoga, practice you want to do 7 attitudinal foundations -ANS non-judging, patience, beginner's mind, trust, non- striving, acceptance, letting go 4 parts of mindfulness training -ANS -psychoeducation -experimental learning -inquiry -group training Cognitive behavior therapy (CBT) -ANS -evaluation of thoughts and attempts to change them -clear goal (e.g. changing behavior or thoughts) -therapists are not expected to engage in regular practice Mindfulness training (MFT) -ANS -observation of thoughts, no evaluation, let them pass -no specific goal, non-striving, non-judging -teachers are expected to engage in their own regular mindfulness practice Mindfulness based stress reduction (MBSR) -ANS -Kabatt Zinn, UMass -professor of medicine (initial focus on physical) -since late 1970s -populations with wide range of problems, mainly physical -more generic application for stress (i.e., chronic pain, MS, cancer, etc.) Mindfulness based cognitive therapy (MBCT) -ANS -Segal, Williams, Teasdale, UK, Canada -professor of clinical psych (initial focus on RCT, research) -came after MBSR; integration of MBSR with CBT (mental health care) -specifically for depression -greater emphasis on psychological aspects of experience (CBT elements) Mindfulness training -ANS -3 minute breathing space (Zandloper) 1) focus on wide world, thoughts 2) focus on breathtaking (bring mind back when your thoughts are taking over) 3) opening up again MBCT and depression - I -ANS TAU (treatment as usual) vs. TAU + MBCT? (Teasdale et al., 2000) Main findings: -1 year later: TAU -> relapse, but TAU +MBCT -> 37% relapse -MBCT effective for patients with three or more episodes of depressions, but not/less for those with less or 2 episodes -different depressions: patients with three or more episodes had more adverse early life experiences (AELEs) (rejection, abuse, etc.), autonomous (from within) depression. those with two or less episodes had much less of AELEs, more reactive depression (as a reaction to event, like a divorce or someone who loses his job) MBCT and depression - II -ANS MBCT vs. antidepressants (Kuyken et al., 2015) Research design: -prevention of depressive relapse or recurrence over 24 months -N = 425 patients using antidepressant medication -RCT with two groups: -MBCT + support to taper or discontinue antidepressant medication (doctor helped to reduce medicine) -maintenance of antidepressant medication Main outcome: -MBCT-TS (with support to taper or discontinue meds): 44% relapse after 24 months -m-ADM (maintenance antidepressant meds): 47% relapse after 24 months -thus; MBCT as affective as medication in relapse prevention -MBCT maintenance treatment after medication for acute state of depression Mindfulness based interventions -ANS Meta-analytic review (compilation of all studies in the field, effect sizes of all those studies, indication of how big the effects, .50 is medium, .80 is large effect size) (Hoffman et al., 2010) -ES = 0.63 anxiety symptoms; ES = 0.59 mood symptoms in overall sample (difference: all people together ES range around the medium, population in the whole, for all of us, we all have some depressive symptoms -ES = 0.97 anxious symptoms; ES = 0.95 depressive symptoms in patients with disorder (only people with depressive disorder, more room for improvement if you suffer) How does MBCT achieve its effects? -ANS potential mediators -mindfulness -decentering -self-compassion watching meditation with focus on the child -ANS -watching with full attention to the child -notice distraction and go back to watching -widen the attention when it narrows -quality of attention -noticing what (emotional) experiences come up when looking -empathize with the child -theme of the session Research: mindful with your baby -ANS -Potharst, ES, Aktas, E, Rexwinkel, M, Rifterink, M, Bögels, SM (2017) Mindful baby training effective in improving -ANS -mindfulness, mindful parenting, and self-compassion -psychopathology, and wellbeing mothers -parental stress and sense of competence -responsivity and hostility -positive affectivity baby Mindful baby research: methods -ANS -questionnaires -pretest -posttest -follow-up 8 weeks after the training -follow-up 1 year after the training participants (N=44) mothers: -mean age: 34 y/o (SD 5) -non-Dutch cultural background: 15 (34%) -single: 7 (16%) -level of education high: 66% -working in a job: 14 (32%) babies: -mean age: 10 months (SD 5) -sex boy: 22 (50%) -first child: 28 (64%) stress factors mothers (mindful baby) -ANS -depression 19 (43%) -anxiety disorder 13 (30%) -PTSD 10 (23%) -sleeping problems 7 (16%) -OCD 4 (9%) -burn-out 4 (9%) -ADHD 3 (7%) -physical problems 3 (7%) -low intelligence 3 (7%) stress factors babies (mindful baby) -ANS -sleeping problems 12 (27%) -crying 8 (18%) -medical problems 6 (14%) -severe acid reflux 4 (9%) -feeding problems 4 (9%) -worries about development 3 (7%) -separation anxiety 3 (7%) -breath holding spells 2 (5%) stress factors pregnancy/birth (mindful baby) -ANS -mental health problems during pregnancy 9 (21%) -complications during birth 7 (16%) -problems breastfeeding 7 (16%) -preterm birth 5 (11%) -medical problems 5 (11%) -miscarriages (unprocessed) 4 (9%) -problems becoming pregnant 3 (7%) -unwanted pregnancy 2 (5%) -not knowing about pregnancy 1 (2%) -death of older sibling 1 (2%) -severe pregnancy sickness 1 (2%) -alcohol use during pregnancy 1 (2%) Research: mindful with your toddler -ANS Potharst, ES, Aktar, E, Rexwinkel, M, Bögels, SM mindful with your toddler effective in improving -ANS -observed maternal sensitivity and acceptance -child psychopathology and dysregulation -maternal internalizing psychopathology and stress -maternal mindfulness and self-compassion -listening with full attention mindful with toddler methods -ANS 22 participants mothers: -age 37.3 y/o (SD=3.9) -ethnicity Dutch: 15 (68%) -single mothers: 5 (23%) -working: 9 (41%) -education: masters - 11 (50%), bachelors - 9 (41%), high school 2 (9%) toddlers: -age 2.4 y/o (SD=0.6) -sex boy: 15 (68%) -firstborns: 17 (77%) regulation problems (mindful toddler) -ANS -maternal overactivity (7, 32%) -separation anxiety/demandingness of the child (9, 41%) -child sleeping problems (4, 18%) -child eating problems (3, 14%) -excessive crying (3, 14%) -14 (64%) of the mothers had a mental disorder (depression, anxiety, PTSD) mindful toddler study design -ANS -10-5 weeks before training, n=14 -directly before training, n=17 -directly after training, n=18 -two months after training, n=17 -eight months after training, n=12 Research: mother-child interaction -ANS Zeegers, MP, Potarst, ES, Veering, IK, Aktar, E, Goris, M, Bövels, SM, Colonnesi, C mother-child interaction training effective in improving -ANS -maternal acceptance -mind-mindedness: non-attuned mind related comments -child responsiveness mother-child interaction participants -ANS -43 mother-baby dyads (age = 10.2 months, 23 boys) -15 mother-toddler dyads (age = 31.2 months, 11 boys) -37 first-born -72% mothers Dutch nationality -education level = 6.1 (scale 1-7) mother-child interaction methods -ANS -free-play observations -4 observers (blinded to measurement time) -Ainsworth's maternal sensitivity scales -sensitivity -acceptance mind-mindedness (mother-child) -ANS -free-play observations -transcribing mind-related speech -categorize speech: 1) mind-related or not 2) appropriate or non-attuned emotional communication (mother-child) -ANS -face to face interactions -3 observers (blinded to measurement time) -moment to moment coding outcome measures: -coordination of gaze -coordination of positive facial expression -maternal and child responsiveness Autism Spectrum Disorders (ASD) -ANS -impaired social contact/communication and restricted behavior/stereotyped interests -pervasive and chronic -different style of information processing -high prevalence: 1/70 boys, 1/315 girls (overall 1/110) -high comorbidity: anxiety, OCD, ADHD, depression -high family costs: 3-5 mln $ extra to raise a child with ASD -high rate of stress, anxiety, depression, burn-out in parents -hardly any evidence-based treatment available, particularly for ASD teens MFT for children and MP for their parents: why? -ANS -improvement self and other's awareness, empathic ability -improved flexibility, letting things pass, widening/narrowing lens of attention -reduction of anxiety, depression, attention problems in other populations -reduction in parenting stress anxiety, depression, burn-out findings so far: training for individuals with ASD -ANS meditation on the soles of the feet for adolescents with autisms: decrease in physical aggression (Singh et al, 2011) RCT design MFT vs waitlist -ANS -decrease in depression, anxiety, rumination -increase in positive affect -breath, flesh, bones, and skin 2) mindfulness of the feeling toons -affective tone of experience 3) mindfulness of mind (heart) -made not on ideas but real experiences 4) mindfulness of dharma -the way things are the role of mindfulness -ANS -fear and anxiety disorders -somatoform disorders -personality disorders -depression -eating disorders -addiction -attitude disorders -psychosis -cancer -pain -stress -end of life -childbirth -parenting tocophobia -ANS fear of childbirth e.g. bodily harm child/woman, labor pain, losing sense of control tocophobia etiology -ANS -previous traumatic childbirth -anxiety and mood disorders -weak self-perception -social kitchen culture -eating disorders, negative body perception, sexuality, abuse tocophobia prevalence -ANS -extreme fear of childbirth 6% -severe fear 20% -high fear in NL 34% -fear of labour pain in NL 38% related to: -^ stress and distress, ^ cortisol -^ mental problems in mother and child -^ negative birth outcomes for mother and child -V bonding with child understanding tocophobia -ANS qualitative study -N=54 tocophobic pregnant women -semi-structure in-depth interviews -Perinatal Catastrophic Beliefs Scale (PCBS) validation study -psychometric properties of PCBS mindfulness and psych -ANS -wisdom of body and mind -embodied cognitions and emotions -bodily symptoms are early markers -awareness of imprint - how in body? -awareness of body - breath and mass -focus on breath - first attention practice -quality of attention: non-judgmental, non-reactive -ability to observe breath -> body -> cognitive-emotional processing -> behaviors w/o reactivity -wisdom from insight mindful childbirth and parenting -ANS Duncan L and Bardacke N (2010) -N = 27 pregnant couples -MBCP program Results -^ nonreactivity -^ mindfulness -V childbirth anxiety -V depression -^ positive affect -V negative affect mindfulness-based childbirth and parenting (MBCP) -ANS -9 weekly 3 hour session + 1 day of silent retreat -6 days a week 30 min formal meditation -everyday an informal meditation Sessions: -teachings on backgrounds of mindfulness; neurology of childbirth and parenting -practice on formal meditations, e.g. eating, body scan, yoga, sitting, 3 minutes breathing, pain, speaking and listening about fear and joys, walking, loving-kindness, being with the baby goals of MBCP -ANS body and mind: -present moment awareness -open attention -non-judgmental acceptance -responsivity stressor: -identification + awareness + acceptance -thoughts are not facts attitudes: -don't know mind -kindness Why parenting is stressful -ANS obstacles: offspring mental problems, parents own mental problems, marital and coparenting problems, divorce and starting over, sibling relation problems, school and learning problems, transition into parenthood, complexity evolution of parenting: inherently stressful -ANS -long period of dependance - takes huge resources to raise one child to maturity -evolved in communities of shared care: "it takes a village to raise a child" -affect regulation system - threat detection -we are evolved parents information processing biases in parenting -ANS -the effects of seeing our children through the lens of diagnoses -other biases: the responsible one, the smart one, the sporty one -parental biases based on own psychopathology mindful parenting: targeting parents only in child mental health care settings -ANS (Bögels, Hellemans, Deursen, Römer, Meulen, 2014) -10 groups, 7 moms, 9 dads (7 couples) -referred to secondary child mental health care -waitlist of 8 weeks, 8 weekly sessions of 3 hours, followup session 8 weeks later effects of mindful parenting on parental and partner relation -ANS improvements on co- parenting but not on partner relation satisfaction Attention Deficit Hyperactivity Disorder (ADHD) key symptoms -ANS Inattention; difficulties with -planning/organizing -maintaining attention for longer periods of time hyperactivity; examples -running/climbing in inappropriate situations -fidgeting or tapping with hands/feet -excessive talking impulsivity; difficulties with -inhibiting proponent responses -making decisions without forethought prevalence is 5% (DSM-5) Why mindfulness for children with ADHD? -ANS improves attention/concentration -focus on bodily sensations (breath, senses, thoughts, emotions) -noticing when you are distracted -bring attention back -attention muscle less hyperactive/impulsive -becoming aware of your intentions (move, speak) -automatic pilot -being conscious of own behavior why a parallel mindful parent training? -ANS -being more conscious of their own parenting practices -cultivating on accepting, non-judgmental attitude towards their child -reduce own attention problems/psychopathology -lower over-reactivity -lower stress levels -parents are a role model -a more holistic approach MYmind training -ANS key aspects of training: -8 weeks; 1.5 hour sessions -Children: 9-12, groups of 6 -Adolescents: 12-18, groups of 8 -Parallel Mindful Parenting training -Follow-up session after 2 months Why mindfulness and stress? -ANS -under stress -> fight - flight - freeze response (automatic) -under stress we still react like we did thousands of years ago (i.e. tiger -> flight) -not always helpful for 21st century stress that is not life threatening (i.e. deadlines) Rationale Mindful2Work Assumptions -ANS -physical exercise, yoga, mindfulness all have the potential to effectively reduce stress-symptoms -stress expresses itself through body and mind - reciprocally connected -the combination of three elements attracts a wider range of people -the combination of three elements might have a synergetic effect Rationale Mindful2Work - combination of three effective elements -ANS -mindful physical exercises (20 min) - 70% of max, outdoor/nature -yoga (30 min) - restorative, attentive to bodily limits, also exercises at work -mindfulness (40 min) - emphasis on how to relate to stress (at work), kindness to self Three phases of Mindful2Work -ANS 1) Feasibility and acceptability 2) Quantitative approach (top-down measurements) 3) Qualitative approach (bottom-up measurements) Phase 1 - Feasibility and Acceptability -ANS -N=26 (4 males) -89% followed up 5-6 session -69% took part in FU session -0% drop-out rate (<4 sessions) -average grade M2W training 8.1 (1-10) -average grade M2W trainers 8.4 (1-10) -83% wants to carry on with 2-3 elements after training -Positive effects: 55% due to M2W training, 35% M2W + other life factors -87% very positive about the order of PE, yoga, mindfulness Mindful2Work program -ANS -physical exercise (20 min.), yoga (20 min.), mindfulness (80 min.) -6 weekly session of 2 hours + 1 FU-session 1. automatic pilot 2. the body 3. the breath 4. stress 5. coping with obstacles 6. taking care of yourself 7. FU-session Feasibility and Acceptability M2W -ANS -89% of participants followed 5-6 sessions -69% of participants took part in FU session -0% drop-out rate (<4 sessions) -average grade M2W training: 8.1 (1-10) -average grade M2W trainers: 8.4 (1-10) Mindful2Work summary and the future -ANS -M2W is acceptable and feasible for people with (work-)stress related complaints -no significant changes (apart from NA) during waitlist period -large effects on stress and risk for drop-out -medium to large effects on well-being and functioning at work -very large improvements on people's self-formulated goals -effects up to a year later (new findings), effects grow larger over time CBT and MFT are different approaches but also have characteristics in common. Which statement below is correct? a. In CBT one tries to change the client's thoughts, whereas in MFT thoughts are just observed. b. In CBT as well as in MFT therapists are expected to engage in their own regular practice. c. In CBT as well as in MFT the main goal is non-striving and non-striving. -ANS A Research into Mindful Parenting training as described by Bögels and colleagues (2013) indicates that Mindful Parenting: a. Reduces parental psychopathology, but not child psychopathology. b. Reduces parental psychopathology, but not marital satisfaction. c. Reduces child psychopathology, but not parental psychopathology. -ANS B Mindful2Work: a study for referred employees -ANS participants: -N=26 (22 females) -(work)stress-related complaints via company doctors -mean age=44.9 (SD=10.59) -exclusion: current psychotic symptoms, suicidal ideation, drug abuse, BPD