Universal Mindfulness Training in Schools for Adolescents: a Scoping Review and Conceptual Model of Moderators,Mediators, and Implementation Factors

Prevention Science - There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such...     

The Relation of Early Abuse to Cognition and Coping in Depression

An investigation was conducted to assess theattributional style, self-esteem, and coping ofcurrently depressed women with and without a reportedhistory of childhood physical or sexual abuse. Whereas a history of abuse showed few associations withthese cognitions, individuals reporting more intrusivememories of abuse had lower self-esteem, a more negativeattributional style, and coped through more avoidance. When severity of depression wascontrolled, abuse history and intrusive memories stillwere associated with lower levels of positiveself-esteem.     

Trainee clinical psychologists' adaptation and professional functioning: a longitudinal study

Clinical psychology training is a professionally formative period, which provides an opportunity to enable trainees to learn good self‐care skills and mature approaches to learning. If realized, this can support lifelong learning and high levels of professional functioning. This study sought to use transactional coping theory and experiential learning theory to improve our understanding of what factors predict changes in psychological adaptation and professional functioning over the course of clinical psychology training. A mixed prospective within‐persons and cross‐sectional between‐persons design was used. A sample of 183 trainee clinical psychologists (60.2% response rate) from 15 British clinical psychology training programmes participated at time one, 167 of whom participated at time 2 a year later (91.3% of the time 1 sample). They completed measures of appraisal, coping, social support and professional functioning at times 1 and 2. Path analyses suggested that trainees who appraised the demands of training as manageable, and reported greater access to appropriate support, engaged in less avoidance coping, reported fewer problems of psychological adaptation and were more likely to approach the task of learning and working appropriately and resiliently. Implications for clinical psychology training are suggested. Copyright © 2003 John Wiley & Sons, Ltd.     

Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomised controlled trials

Objective

To determine the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on psychological and physical outcomes for people with vascular disease.

Design

Systematic review and meta-analysis of randomised controlled trials.

Data sources

AMED, CINAHL, EMBASE, British Nursing Index, Medline, Web of Science, PsycINFO, Cochrane Database of Systematic Reviews, Central, Social Sciences Citation Index, Social Policy and Practice, and HMIC from inception to January 2013.

Review methods

Articles were screened for inclusion independently by two reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Random-effects meta-analyses were performed.

Results

Nine articles (from eight original randomised controlled trials) met eligibility criteria and were included in the final review. In total, 578 participants were enrolled across the trials, with participants presenting with prehypertension/hypertension (n = 3 trials), type 1 or 2 diabetes (n = 2), heart disease (n = 2) and stroke (n = 1). Meta-analyses, using standardised mean differences, showed evidence of reductions in stress (− 0.36; 95% CI − 0.67 to − 0.09; p = 0.01), depression (− 0.35; 95% CI − 0.53 to − 0.16; p = 0.003) and anxiety (− 0.50; 95% CI − 0.70 to − 0.29; p < 0.001). Effects on physical outcomes (blood pressure, albuminuria, stress hormones) were mixed.

Conclusion

Whilst populations with vascular disease appear to derive a range of psychological benefits from MBSR/MBCT intervention, the effects on physical parameters of disease are not yet established. More robust studies, with longer term follow-up, are required to ascertain full effectiveness of such intervention.     

Mindfulness-based cognitive therapy: a promising new approach to preventing depressive relapse

Mindfulness-based cognitive therapy (MBCT) was developed as a psychological approach for people at risk for depressive relapse who wish to learn how to stay well in the long-term. In this article we set out the rationale for MBCT, outline the treatment approach, overview the efficacy research to date and look to future challenges.     

The experiences of parents in mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy (MBCT) is a relatively new intervention that has been developed to help people with recurrent depression stay well in the long term. Although there is evidence that depression impacts negatively on parenting, little is known regarding MBCT's potential impact on parenting. This study used a qualitative design to explore how parents with a history of recurrent depression experience their relationships with their children one year after MBCT. We interviewed 16 parents who had participated in MBCT as part of a randomized controlled trial (RCT) (Kuyken et al., 2008). Thematic analysis was used to identify prevalent themes in parents' accounts, including: (i) emotional reactivity and regulation; (ii) empathy and acceptance; (iii) involvement; (iv) emotional availability and comfort; and (v) recognition of own needs. Based on these exploratory findings, we suggest that some components of MBCT may help parents with a history of depression with emotional availability, emotion regulation and self-care and set out avenues of further research.     

Cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment resistant depression in primary care: the CoBalT randomised controlled trial protocol

BackgroundAntidepressants are often the first-line treatment for depression but only one third of patients respond fully to pharmacotherapy. This paper describes the protocol for a randomised controlled trial (RCT) designed to evaluate the clinical and cost effectiveness of cognitive behavioural therapy (CBT) as an adjunct to pharmacotherapy for patients with treatment resistant depression in primary care.Methods/designCoBalT is a two parallel group multi-centre pragmatic RCT. Eligible participants were those who: (i) were aged 18–75 years; (ii) were currently taking antidepressant medication (for at least 6 weeks at an adequate dose); (iii) scored ≥ 14 on the Beck Depression Inventory (BDI-II); (iv) had adhered to their medication; and (v) met ICD-10 criteria for depression (assessed using the Clinical Interview Schedule — revised version). Those who gave written informed consent were randomised to one of two treatment groups: usual care or usual care plus CBT. The primary outcome is depressive symptoms assessed using the BDI-II at 6 months post-randomisation. Secondary outcomes measured at 6 and 12 months include quality of life, antidepressant use and health care utilisation. Outcomes will be analysed on an intention-to-treat basis.DiscussionThe CoBalT trial will provide evidence on the clinical and cost effectiveness of CBT as an adjunct to antidepressant medication in the treatment of depression that has not responded to pharmacotherapy. Given the move to widen access to ‘talking therapies’, the results of this study will be timely.     

The psychological sequelae of childhood sexual abuse: A review of the literature and implications for treatment

The current paper aims to bring together some of the literature on the long-term effects of childhood sexual abuse (CSA) in a way that will be useful to clinical practitioners and researchers in this field. The issues surrounding the definition of CSA and work on the prevalence, background and context in which abuse occurs is evaluated. In addition a selection of the relevant research relating to the psychological effects of early abuse in the domains of self-esteem, symptomatology resembling post-traumatic stress disorder, depression and anxiety is reviewed and examined. The key methodological issues are reported and some of the worries facing researchers portrayed. Although much of the research to date has been largely atheoretical, some of the theoretical thinking in this area is reviewed. Finally some of the clinical implications of this body of work are outlined.     

Assessing health care students’ intentions and motivations for learning: the Healthcare Learning and Studying Inventory (HLSI)

Inventories that measure approaches to learning have revealed that certain approaches are associated with better academic performance. However, these inventories were developed primarily with higher education students on non-vocational courses and recent research shows they fail to capture the full range of healthcare students’ intentions and motivations for learning. To develop a new inventory measuring approaches to learning that addresses these shortfalls and is relevant to students on vocational courses in healthcare. In depth interviews with healthcare students were performed to understand the full range of healthcare students’ intentions and motivations. The data were used to create a draft inventory, which was reviewed by interview participants and then tested with medical students. The final inventory was piloted with 303 healthcare students across six disciplines. Exploratory factor analysis was used to identify groups of related items within the inventory. The research produced a 32 item scale based on rich qualitative data, with a four factor structure and good internal consistency. A desire to link theory and practice was a distinctive feature of healthcare students. The new inventory contains nuanced items that enable a better understanding of their common and distinctive intentions and motivations. This study suggests that healthcare student populations have some unique intentions and motivations for learning and therefore require a bespoke inventory to ensure that important aspects are not missed. It offers a new tool for meaningful future research, the Healthcare Learning and Studying Inventory (HLSI).