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Sun L, Dai X, Zhu S, Liu Z, Zhongming Z. Psychotherapies for social anxiety disorder in adults: A systematic review and Bayesian network meta-analysis. J Affect Disord 2025; 378:301-319. [PMID: 40023260 DOI: 10.1016/j.jad.2025.02.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 02/23/2025] [Accepted: 02/25/2025] [Indexed: 03/04/2025]
Abstract
Psychotherapies for social anxiety disorder (SAD) encompass various protocols and delivery formats; consequently, an investigation into the relative efficacy of different treatments is needed. This study aimed to compare the efficacy of different common psychotherapies for SAD and identify the most effective psychotherapies for SAD. Using a Bayesian network meta-analysis, we compared the relative efficacy of six common psychotherapies: cognitive behavioral therapy (CBT), cognitive restructuring (CR), exposure therapy (ET), psychodynamic therapy (PDT), interpersonal therapy (IPT), and mindfulness-based interventions (MBI). Sensitivity analyses were conducted to test the robustness of the results. This network meta-analysis included 92 studies up to June 2024, covering 90 randomized controlled trials. The findings suggested that, compared with the waitlist control group, all included psychotherapies showed varying degrees of efficacy in reducing SAD symptoms severity. Specifically, CBT was generally the most effective psychotherapy. The Clark and Wells CBT protocol showed the highest efficacy (SMD: 1.42, 95 % CrI: [1.14, 1.70]), while Andersson and Carlbring's Internet-based CBT ranked highly (SMD: 1.15, 95 % CrI: [0.87, 1.42]). PDT was the most effective non-CBT treatment (SMD: 0.98, 95 % CrI: [0.61, 1.36]). Guided therapies appeared more effective than unguided ones, and Internet-based treatments were comparable to face-to-face therapies. This study can aid clinicians in optimizing treatment choices and selecting appropriate formats when treating patients with SAD.
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Affiliation(s)
- Linghan Sun
- Southwest University, Faculty of Psychology, Chongqing, China
| | - Xu Dai
- Southwest University, Faculty of Psychology, Chongqing, China
| | - Shunshun Zhu
- Southwest University, Faculty of Psychology, Chongqing, China
| | - Zhengjie Liu
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Zhang Zhongming
- Southwest University, Faculty of Psychology, Chongqing, China.
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Noda S, Nishiuchi M, Andreoli G, Shirotsuki K, Hofmann SG. Network structure of social anxiety in patients with social anxiety disorder and university students: Examining the cognitive behavioral model and the role of mindfulness. J Affect Disord 2025; 387:119498. [PMID: 40441626 DOI: 10.1016/j.jad.2025.119498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 05/01/2025] [Accepted: 05/25/2025] [Indexed: 06/02/2025]
Abstract
Self-focused attention, cost/probability bias, and avoidance behavior are maintaining factors of social anxiety. The manipulation of dispositional mindfulness has been shown to reduce social anxiety and its maintaining factors. This study examined the associations among dispositional mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety to explore the mechanism of mindfulness and its relationship with social anxiety in patients with social anxiety disorder (SAD) and university students. Data from 412 patients with SAD and 367 students were analyzed using psychometric network analysis. Both groups completed self-report measures assessing dispositional mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. A weak negative association was found between non-judging in dispositional mindfulness and self-focused attention to one's behavior in the SAD patients' network. In the students' network, a weak negative association was observed between non-judging and self-focused attention to one's behaviors, as well as between describing and social anxiety. In the SAD patients' network, nodes with the highest strength centrality were probability bias and social anxiety. In the students' network, nodes with the highest strength centrality were social anxiety and cost bias. The global network structure and connectivity differed between patients with SAD and students. The findings support the cognitive-behavioral model of SAD and highlight the heterogeneity of social anxiety, necessitating tailored intervention strategies.
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Affiliation(s)
- Shota Noda
- Department of Psychology, Philipps University of Marburg, Schulstraße 12, 35032 Marburg, Germany; Research Institute of Cognitive Behavior Therapy, Musashino University, 3-3-3 Ariake, Tokyo 135-8181, Koutou-Ku, Japan.
| | - Motohiro Nishiuchi
- Graduate School of Human and Social Sciences, Musashino University, 3-3-3 Ariake, Tokyo 135-8181, Koutou-Ku, Japan.
| | - Giovanbattista Andreoli
- Department of Psychology, Philipps University of Marburg, Schulstraße 12, 35032 Marburg, Germany; Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy.
| | - Kentaro Shirotsuki
- Faculty of Human Sciences, Musashino University, 3-3-3 Ariake, Koutouku, Tokyo 135-8181, Japan.
| | - Stefan G Hofmann
- Department of Psychology, Philipps University of Marburg, Schulstraße 12, 35032 Marburg, Germany.
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Simione L. Effects of Dispositional Mindfulness and Mindfulness-Based Interventions on the Psychosocial Consequences of Burn Injuries: A Systematic Review. EUROPEAN BURN JOURNAL 2025; 6:25. [PMID: 40407681 PMCID: PMC12101291 DOI: 10.3390/ebj6020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 05/05/2025] [Accepted: 05/12/2025] [Indexed: 05/26/2025]
Abstract
Burn injuries lead to significant physical and psychological consequences, including chronic pain, post-traumatic stress, depression, and social isolation. Mindfulness-based interventions (MBIs) have been proposed as a holistic approach to address these challenges in burn rehabilitation. This systematic review evaluates the efficacy of dispositional mindfulness and MBIs, including mindfulness meditation, yoga, and self-compassion training, in managing pain, emotional distress, and psychosocial adaptation in burn survivors. A comprehensive literature search was conducted through MEDLINE and Web of Science, covering studies up to February 2025, with additional papers retrieved from Google Scholar and Semantic Scholar. Studies were included if they reported quantitative data on the effects of MBIs in burn patients and/or their families, excluding opinion pieces, editorials, reviews, and qualitative studies. After screening 91 studies retrieved from the databases and adding a compelling paper retrieved from the other sources explored, 12 studies were included in the final pool, categorized into cross-sectional studies (n = 6), and intervention studies (n = 6). The extracted data included publication year, research design, sample characteristics, intervention details, main findings, and data for quality assessment. The synthesis of the results suggests that mindfulness is associated with reduced psychological symptoms, improved emotional regulation, and enhanced self-compassion, leading to better coping strategies and social reintegration. However, the long-term efficacy of MBIs remains inconclusive, and further research is needed to differentiate mindfulness-specific effects from those of general physical exercise. Evidence also suggests that mindfulness interventions may reduce anxiety and secondary trauma in children with burns and their caregivers. This review highlights the potential of MBIs as adjuncts to conventional burn rehabilitation programs, but further high-quality trials are needed to establish their sustained efficacy and to understand the specific benefits of mindfulness.
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Affiliation(s)
- Luca Simione
- Dipartimento di Scienze Umanistiche e Sociali Internazionali, Università degli Studi Internazionali, 00147 Rome, Italy; or
- Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, 00196 Rome, Italy
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4
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Zainal NH, Tan HH, Hong RYS, Newman MG. Prescriptive Predictors of Mindfulness Ecological Momentary Intervention for Social Anxiety Disorder: Machine Learning Analysis of Randomized Controlled Trial Data. JMIR Ment Health 2025; 12:e67210. [PMID: 40359509 PMCID: PMC12117280 DOI: 10.2196/67210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Revised: 01/09/2025] [Accepted: 01/15/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND Shame and stigma often prevent individuals with social anxiety disorder (SAD) from seeking and attending costly and time-intensive psychotherapies, highlighting the importance of brief, low-cost, and scalable treatments. Creating prescriptive outcome prediction models is thus crucial for identifying which clients with SAD might gain the most from a unique scalable treatment option. Nevertheless, widely used classical regression methods might not optimally capture complex nonlinear associations and interactions. OBJECTIVE Precision medicine approaches were thus harnessed to examine prescriptive predictors of optimization to a 14-day fully self-guided mindfulness ecological momentary intervention (MEMI) over a self-monitoring app (SM). METHODS This study involved 191 participants who had probable SAD. Participants were randomly assigned to MEMI (n=96) or SM (n=95). They completed self-reports of symptoms, risk factors, treatment, and sociodemographics at baseline, posttreatment, and 1-month follow-up (1MFU). Machine learning (ML) models with 17 predictors of optimization to MEMI over SM, defined as a higher probability of SAD remission from MEMI at posttreatment and 1MFU, were evaluated. The Social Phobia Diagnostic Questionnaire, structurally equivalent to the Diagnostic and Statistical Manual SAD criteria, was used to define remission. These ML models included random forest and support vector machines (radial basis function kernel) and 10-fold nested cross-validation that separated model training, minimal tuning in inner folds, and model testing in outer folds. RESULTS ML models outperformed logistic regression. The multivariable ML models using the 10 most important predictors achieved good performance, with the area under the receiver operating characteristic curve (AU-ROC) values ranging from .71 to .72 at posttreatment and 1MFU. These prerandomization and early-stage prescriptive predictors consistently identified which participants had the highest probability of optimization of MEMI over SM after 14 days and 6 weeks from baseline. Significant predictors included 4 strengths (higher trait mindfulness, lower SAD severity, presence of university education, no current psychotropic medication use), 2 weaknesses (higher generalized anxiety severity and clinician-diagnosed depression or anxiety disorder), and 1 sociodemographic variable (Chinese ethnicity). Emotion dysregulation and current psychotherapy predicted remission with inconsistent signs across time points. CONCLUSIONS The AU-ROC values indicated moderately meaningful effect sizes in identifying prescriptive predictors within multivariable models for clients with SAD. Focusing on the identified notable client strengths, weaknesses, and Chinese ethnicity may enhance our ability to predict future responses to scalable treatments. Estimating the likelihood of SAD remission with a "prescriptive predictor calculator" for each client may help clinicians and policymakers allocate scarce treatment resources effectively. Clients with high remission probability may benefit from receiving the MEMI as a vigilant waitlist strategy before intensive therapist-led psychotherapy. These efforts may aid in creating actionable treatment selection tools to optimize care for clients with SAD in routine health care settings that use stratified care principles. TRIAL REGISTRATION OSF Registries 10.17605/OSF.IO/M3KXZ; https://osf.io/m3kxz.
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Affiliation(s)
- Nur Hani Zainal
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Hui Han Tan
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Ryan Yee Shiun Hong
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Michelle Gayle Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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Dong SW, Yang L, Lin YF, Yang LW, Li D, Zhu LW, Zhang CY, Li YZ, Wang WX, Lu CY, Yan B. Sex and age differences in depression and anxiety networks among adolescents with idiopathic scoliosis: A network analysis. World J Psychiatry 2025; 15:102790. [PMID: 40110004 PMCID: PMC11886344 DOI: 10.5498/wjp.v15.i3.102790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 12/11/2024] [Accepted: 01/06/2025] [Indexed: 02/26/2025] Open
Abstract
BACKGROUND Depression and anxiety are prevalent psychological challenges among patients with adolescent idiopathic scoliosis (AIS), affecting individuals across both sex and age groups. AIM To explore the network structure of depression and anxiety symptoms, with a focus on identifying differences at the symptom level between sex and age subgroups. METHODS A total of 1955 participants diagnosed with AIS aged 10-18 years were assessed using the Patient Health Questionnaire Depression Scale (PHO-9) and the Generalized Anxiety Disorder Scale (GAD-7), and 765 patients exhibiting PHQ-9 or GAD-7 scores ≥ 5 were enrolled in our study. Network analysis and network comparison tests were utilized to construct and compare the depression-anxiety symptoms networks among sex and age subgroups. RESULTS The results revealed GAD3 "Excessive worry" and PHQ2 "Sad mood" were the most significant central symptoms in all subgroups, while "Sad mood" had higher strength than "Excessive worry" in the lower age group. In the network comparisons, the female network exhibited tighter connectivity, especially on GAD6 "Irritability" and GAD2 "Uncontrollable worry", while only PHQ3 "Sleep" and PHQ9 "Suicidal ideation" had differences at the local level in the lower age group. CONCLUSION Several interventions targeting excessive worry and sad mood could reduce the risk of depression and anxiety symptoms in the AIS population. Furthermore, specific anxiety symptoms in females, along with sleep disturbances and suicidal ideation in the lower age group, should be addressed at an early stage to prevent significant disruptions in mental health trajectories.
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Affiliation(s)
- Shu-Wen Dong
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Lei Yang
- Department of Spine Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China
- Medical Innovation Technology Transformation Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
- Department of Spine Surgery, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Yi-Fan Lin
- Department of Spine Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China
- Medical Innovation Technology Transformation Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
- Department of Spine Surgery, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Li-Wen Yang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Dan Li
- Department of Spine Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China
- Medical Innovation Technology Transformation Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
- Department of Spine Surgery, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Li-Wan Zhu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Cai-Yun Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Yan-Zhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Wan-Xin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Ci-Yong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
| | - Bin Yan
- Department of Spine Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China
- Medical Innovation Technology Transformation Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
- Department of Spine Surgery, The First Affiliated Hospital, Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
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Hu YZ, Beggs M, Xue Y, Gao S, Seok J, Xiao Y, Zhou Z, Zhou Y, Mariakakis A, Chignell M. Are Virtual Forests Just for Relaxation, or Can They Enhance the Benefits of Therapy? Healthcare (Basel) 2025; 13:621. [PMID: 40150471 PMCID: PMC11942069 DOI: 10.3390/healthcare13060621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2025] [Revised: 03/04/2025] [Accepted: 03/07/2025] [Indexed: 03/29/2025] Open
Abstract
Forest bathing (Shinrin-Yoku in Japanese) is used as an intervention for improving mental health, with VR being used to create virtual forests for relaxation. BACKGROUND/OBJECTIVES In this research, we added therapeutic intent to a virtual forest with the goal of reducing social anxiety, with and without therapeutic instruction. METHODS Fifty-eight first-year psychology students were randomly assigned to one of three conditions: virtual forest only, therapeutic exercises only, and both combined. RESULTS All three conditions enhanced restorative effects equally. However, only the therapeutic exercise-only condition showed a tendency to reduce social anxiety. Participants in the combined condition reported more positive experiences and showed better comprehension of therapy content in the virtual forest. CONCLUSIONS While the non-VR approach may offer immediate relaxation and possible anxiety reduction, combining the virtual forest with therapeutic exercises may yield better outcomes for sustained engagement and understanding over multiple therapeutic sessions.
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Affiliation(s)
- You Zhi Hu
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada; (Y.Z.H.); (M.B.); (Y.Z.)
| | - Max Beggs
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada; (Y.Z.H.); (M.B.); (Y.Z.)
| | - Yu Xue
- Department of Computer Science, University of Toronto, Toronto, ON M5S 2E4, Canada; (Y.X.); (J.S.); (Y.X.); (A.M.)
| | - Sinuo Gao
- Faculty of Information, University of Toronto, Toronto, ON M5S 3G6, Canada;
| | - Junyoung Seok
- Department of Computer Science, University of Toronto, Toronto, ON M5S 2E4, Canada; (Y.X.); (J.S.); (Y.X.); (A.M.)
| | - Yawen Xiao
- Department of Computer Science, University of Toronto, Toronto, ON M5S 2E4, Canada; (Y.X.); (J.S.); (Y.X.); (A.M.)
| | - Ziqi Zhou
- Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada;
| | - Yifei Zhou
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada; (Y.Z.H.); (M.B.); (Y.Z.)
| | - Alex Mariakakis
- Department of Computer Science, University of Toronto, Toronto, ON M5S 2E4, Canada; (Y.X.); (J.S.); (Y.X.); (A.M.)
| | - Mark Chignell
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada; (Y.Z.H.); (M.B.); (Y.Z.)
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Abu Khait A, Menger A, Al-Atiyyat N, Hamaideh SH, Al-Modallal H, Rayapureddy H. The Association Between Proneness to Smartphone Addiction and Social Anxiety Among School Students and the Mediating Role of Social Support: A Call to Advance Jordanian Adolescents' Mental Health. J Am Psychiatr Nurses Assoc 2025; 31:183-196. [PMID: 39044424 DOI: 10.1177/10783903241261047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
BACKGROUND Social anxiety is an emerging public health issue associated with significant impairment of social functioning during adolescence. Among many determinants of social anxiety, proneness to smartphone addiction may significantly contribute to the development of social anxiety. To cope with the consequential development of social anxiety, adolescent school students may rely on various forms of social support. Particularly in the Middle East, including Jordan, the relationship between proneness to smartphone addiction and adolescent social anxiety is understudied. AIM To examine the mediating role of social support in the relationship between proneness to smartphone addiction and social anxiety in a sample of adolescent school students. METHODS In this cross-sectional study, 432 adolescents were recruited via a random cluster sample from public schools across three provinces in Jordan. The data were collected face-to-face using the Social Anxiety Scale for Adolescents, the Smartphone Addiction Proneness Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS Significantly higher levels of social anxiety were associated with females of lower economic status who reported more gaming hours and higher levels of proneness to smartphone addiction. Familial social support significantly mediated the relationship between proneness to smartphone addiction and social anxiety, controlling for the other covariates in the social anxiety model. CONCLUSIONS Familial social support reduced the impact of proneness to smartphone addiction on social anxiety. Nurses may supplement treatment for reducing social anxiety in adolescents suffering from proneness to smartphone addiction by fostering sources of familial social support.
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Affiliation(s)
- Abdallah Abu Khait
- Abdallah Abu Khait, PhD, RN, PMHCNS, MSN, BSN, Department of Community & Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Austin Menger
- Austin Menger, PhD, MSc, Menger Analytics, New York, NY, USA
| | - Nijmeh Al-Atiyyat
- Nijmeh Al-Atiyyat, PhD, MSN, RN, Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Shaher H Hamaideh
- Shaher H. Hamaideh, PhD, MSN, RN, Department of Community & Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Hanan Al-Modallal
- Hanan Al-Modallal, PhD, MSN, RN, Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Adamis AM, Boyne AS, Harper C, Olatunji BO. Specificity of attentional control deficits in predicting symptoms of social anxiety. J Affect Disord 2025; 368:8-15. [PMID: 39265865 DOI: 10.1016/j.jad.2024.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/22/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND The extent to which individuals can flexibly allocate their attention towards adaptive cues in the social environment may play an important role in the maintenance of social anxiety. Attentional control (AC) describes the top-down ability to regulate one's attention and cognitive resources. Although low AC has been linked to psychopathology broadly, the specific relation between AC and social anxiety disorder (SAD) remains poorly understood. The present study aimed to clarify the role of AC in SAD by examining unique associations between AC and several facets of social anxiety, above and beyond general psychological distress. METHODS Adults endorsing elevated SAD symptoms (n = 123) were assessed for levels of AC, inhibitory control, social anxiety severity, social anxiety sensitivity, social avoidance/safety behaviors, stress, and depression. RESULTS Partial correlations revealed that self-reported AC was negatively associated with all dimensions of SAD (rs = -0.20 to -0.29, ps < 0.05) after controlling for symptoms of stress and depression. Similarly, structural equation models showed that latent AC negatively predicted latent social anxiety (β = -0.21, p < .05), even after controlling for latent psychological distress. LIMITATIONS The study used a cross-sectional design, an analogue sample, and solely self-report measures in structural equation models. CONCLUSIONS Results converge to suggest that subjective (but not objective) deficits in AC have a unique relation with several mechanisms involved in the development and maintenance of SAD. These findings partially support the applicability of Attentional Control Theory to SAD and point to AC as a potential treatment target.
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Affiliation(s)
- Alexandra M Adamis
- Vanderbilt University, 111 21(st) Avenue South, Nashville, TN 37203, USA.
| | - Ashley S Boyne
- Vanderbilt University, 111 21(st) Avenue South, Nashville, TN 37203, USA
| | - Colten Harper
- Vanderbilt University, 111 21(st) Avenue South, Nashville, TN 37203, USA
| | - Bunmi O Olatunji
- Vanderbilt University, 111 21(st) Avenue South, Nashville, TN 37203, USA
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9
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Cui J, Zhang G, Xianyu Y, Zhang X, Cheng YX, Liu YJ, Xiong W, Liu W, Liu Q, Yang BX, Zou H. Mechanisms of a mindfulness psyCho-behAvioRal intErvention (MCARE) on depression and anxiety symptoms in patients with acute coronary syndrome: A longitudinal mediation analysis. J Psychosom Res 2024; 187:111913. [PMID: 39260138 DOI: 10.1016/j.jpsychores.2024.111913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 08/27/2024] [Accepted: 08/31/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE This study aimed to explore the mediating roles of mindfulness and illness perception in the effects of a social media-based Mindfulness psyCho-behAvioRal intErvention (MCARE) on depressive and anxiety symptoms among patients with ACS. METHODS This study conducted a secondary longitudinal mediation analysis using data from a randomized controlled trial of the MCARE grogram in patients with ACS. Participants were recruited at two tertiary hospitals in Jinan, China. The MCARE program consisted of six weekly sessions addressing mindfulness training and disease management to facilitate understanding and management of emotions and illness. The analytical sample included participants who completed measures of the primary outcomes, i.e., depression (PHQ-9) and anxiety (GAD-7) and potential mediators, i.e., mindfulness (CAMS-R) and illness perception (Brief-IPQ) at baseline (T0), immediate post-intervention (T1), and 12-week after the commencement of the intervention (T2). RESULTS This study included 146 participants (mean age 58.9 years (SD = 8.9), 69.2 % male), including both intervention and control groups. The mediation analysis revealed a significant mediating effect of T1 mindfulness in the relationship between the group and T2 depression symptoms (indirect effect: -0.109, 95 % CI: -0.191, -0.041; P = 0.004), accounting for 26 % of the effect. For T2 anxiety symptoms, T1 illness perception exhibited a significant mediating effect (indirect effect: -0.055, 95 % CI: -0.110, -0.005; P = 0.035), accounting for 22 % of the effect. CONCLUSIONS This study found that mindfulness and illness perception played a mediating role in the effects of the MCARE program on depressive and anxiety symptoms among patients with ACS.
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Affiliation(s)
- Jiatong Cui
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Guiqin Zhang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Yunyan Xianyu
- Department of Nursing, Renmin Hospital of Wuhan University, No.238 Jiefang Road, Wuchang District, Wuhan 430060, China
| | - Xiaohong Zhang
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei, Xiangyang, Hubei, China
| | - Yu Xin Cheng
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Yu Jia Liu
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Wei Xiong
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Liu
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Bing Xiang Yang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China; Population and Health Research Center, Wuhan University, Wuhan, China
| | - Huijing Zou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China.
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10
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Antos Z, Zackiewicz K, Tomaszek N, Modzelewski S, Waszkiewicz N. Beyond Pharmacology: A Narrative Review of Alternative Therapies for Anxiety Disorders. Diseases 2024; 12:216. [PMID: 39329885 PMCID: PMC11431799 DOI: 10.3390/diseases12090216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/01/2024] [Accepted: 09/12/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Anxiety disorders significantly reduce patients' quality of life. Current pharmacological treatments, primarily benzodiazepines and antidepressants, are associated with numerous side effects. Consequently, there is a continual search for alternative methods to traditional therapies that are less burdensome for patients and broaden their therapeutic options. Our objective was to determine the role of selected alternative methods in the treatment of anxiety disorders. METHODS In this review, we examined recent evidence on alternative treatments for anxiety disorders, including physical activity, mindfulness, virtual reality (VR) technology, biofeedback, herbal remedies, transcranial magnetic stimulation (TMS), cryotherapy, hyperbaric therapy, vagus nerve stimulation (VNS), 3,4-methylenedioxymethamphetamine (MDMA), electroconvulsive therapy (ECT), and eye movement desensitization and reprocessing (EMDR) therapy. For this purpose we reviewed PubMed and after initial search, we excluded works unrelated to our aim, non-orginal data and animal studies. We conducted second search to cover all minor methods. RESULTS We included 116 studies, which data is presented in Tables. We have investigated which methods can support treatment and which can be used as a stand-alone treatment. We assessed the risks to benefits of using alternative treatments. CONCLUSION Alternative treatments significantly expand the options available to patients and clinicians, with many serving as adjuncts to traditional therapies. Among the methods presented, mindfulness has the most significant therapeutic potential.
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Affiliation(s)
- Zuzanna Antos
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Klaudia Zackiewicz
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Natalia Tomaszek
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Stefan Modzelewski
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
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11
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Zheng Q, Feng Y, Li J, Xu S, Ma Z, Wang Y. Distinct characteristics of social anxiety among youths with childhood sexual abuse: A latent profile analysis. CHILD ABUSE & NEGLECT 2024; 155:106967. [PMID: 39173507 DOI: 10.1016/j.chiabu.2024.106967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 07/20/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Childhood sexual abuse (CSA) is one type of childhood trauma that has long-term effects on physical and mental health, predisposing to social anxiety. OBJECTIVE This study attempted to investigate the characteristics of different subgroups of social anxiety among youths with CSA experiences. PARTICIPANTS AND SETTING 83,219 participants were recruited in a cross-sectional study from 63 colleges and universities in Jilin Province, China. METHODS The main variables were measured by a series of self-report questionnaires. Latent profile analysis was used to classify different subgroups of social anxiety, and multiple logistic regression was employed to investigate factors influencing transitions between different subgroups. RESULTS 3022 (3.63 %) youths who suffered from CSA (46.8 % were male, Mage = 19.57, SD = 1.76) could be divided into four subgroups of social anxiety: low-risk social anxiety (16.4 %), medium-risk social anxiety with high public speaking anxiety (30.3 %), medium-risk social anxiety with no prominent characteristics (22.9 %), and high-risk social anxiety (30.4 %). Shy bladder and bowel and virtual life orientation increased the level of social anxiety from low to medium and high risk. Smoking and drinking were more prevalent in the low- and medium-risk subgroups than in the high-risk subgroup. CONCLUSIONS There was heterogeneity in different subgroups of social anxiety among youths with CSA experiences. Potential targeted prevention and intervention suggestions could be beneficial in mitigating the risk of social anxiety and further preventing the aggravation of risk between subgroups.
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Affiliation(s)
- Qiaoqing Zheng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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12
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He M, Li Y, Ju R, Liu S, Hofmann SG, Liu X. The role of experiential avoidance in the early stages of an online mindfulness-based intervention: Two mediation studies. Psychother Res 2024; 34:736-747. [PMID: 37459843 DOI: 10.1080/10503307.2023.2232528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/25/2023] [Indexed: 06/11/2024] Open
Abstract
Objectives There is evidence to suggest that only 2-4 weeks of mindfulness-based interventions (MBIs) can already alleviate emotional stress. The current studies sought to examine whether experiential avoidance mediated the effects of MBIs on emotional distress during an early stage of the intervention. Methods: Chinese participants with high emotional distress were recruited. Study 1 included 324 participants, randomly assigned to an online MBI (N = 171) or a control group (N = 153). Experiential avoidance and general emotional distress were measured at baseline and after the 3rd week of the intervention. Study 2 included 158 participants, randomly assigned to an online MBI (N = 79) or a control group (N = 79). Experiential avoidance and emotional distress were measured at baseline and weekly in the first three weeks. Results: Compared to the control group, experiential avoidance and emotional distress were significantly improved in the MBI group during the first three weeks of the intervention (Cohen's d = 0.22-0.63). Moreover, changes in experiential avoidance mediated the effects of MBI on emotional distress in the early stage in both contemporary and lagged mediation models. Discussion: Experiential avoidance is an important mediator during the early-stage of MBIs for alleviating emotional distress.
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Affiliation(s)
- Mengyao He
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, People's Republic of China
| | - Yanjuan Li
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, People's Republic of China
| | - Ruilin Ju
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, People's Republic of China
| | - Shu Liu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, People's Republic of China
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Marburg, Germany
| | - Xinghua Liu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, People's Republic of China
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13
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de Ponti N, Matbouriahi M, Franco P, Harrer M, Miguel C, Papola D, Sicimoğlu A, Cuijpers P, Karyotaki E. The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis. J Anxiety Disord 2024; 104:102881. [PMID: 38815481 DOI: 10.1016/j.janxdis.2024.102881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/19/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Given the growth in research examining the effects of psychotherapy on social anxiety disorder (SAD), an up-to-date comprehensive meta-analysis in this field is needed. METHODS We selected studies from a database of randomized trials (RCTs) on psychotherapies for anxiety disorders (last updated search of PubMed, PsycINFO, Embase, and Cochrane (CENTRAL): 1 January 2024) We included RCTs comparing psychotherapy to a control condition for adults with SAD and conducted random effects meta-analyses to examine the efficacy of psychotherapy compared to control conditions at post-treatment. RESULTS Sixty-six RCTs were included with 5560 participants and 98 comparisons between psychotherapy and control groups. Psychotherapy was effective in reducing SAD symptoms, with a large effect size (g = 0.88; 95 % CI: 0.76 to 1.0; I2 = 74 %; 95 % CI: 69 to 79, NNT = 3.8). Effects remained robust across sensitivity analyses. However, there was evidence for significant risk of bias in the included trials. The multivariable meta-regression indicated significant differences in treatment delivery formats, type of recruitment strategy, target group, and number of sessions. CONCLUSION Psychotherapy is an effective treatment for SAD, with moderate to large effect sizes across all treatment types and formats. Future research is needed to determine the long-term effects.
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Affiliation(s)
- Nino de Ponti
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Minoo Matbouriahi
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pamela Franco
- Department of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Davide Papola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Ayşesu Sicimoğlu
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Babes,-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania; WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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14
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Morrison AS, Goldin PR, Gross JJ. Fear of negative and positive evaluation as mediators and moderators of treatment outcome in social anxiety disorder. J Anxiety Disord 2024; 104:102874. [PMID: 38754336 DOI: 10.1016/j.janxdis.2024.102874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/29/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Elevated fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are thought to play key roles in the maintenance of social anxiety disorder (SAD). Although efficacious therapies exist for SAD, the potential mediating and moderating effects of FNE and FPE on social anxiety treatment outcome have not been examined. METHODS This sample comprised a secondary analysis of 210 individuals who participated in one of three randomized controlled trials for the treatment of SAD. Participants were randomized to: individual cognitive behavioral therapy (CBT), group CBT, community mindfulness-based stress reduction (MBSR), group MBSR, or they were randomized to waitlist and offered treatment after waitlist. Assessments were completed pre- and post-treatment/waitlist and, for the treatment groups, at three-month follow-up. RESULTS CBT and MBSR led to greater reductions in FNE and FPE than waitlist, with CBT more efficacious in reducing FPE than MBSR. For both CBT (vs. waitlist) and MBSR (vs. waitlist), there were significant indirect effects on post-treatment social anxiety through both FNE and FPE, and the indirect effect through FPE was greater for CBT than MBSR. However, in the fully longitudinal model testing mediation, CBT and MBSR were not differentially mediated by FPE. Baseline FNE and FPE each moderated CBT treatment outcome compared to waitlist - higher baseline FNE and FPE were associated with higher baseline social anxiety and greater reductions in social anxiety during CBT. DISCUSSION FNE and FPE contributed in sometimes similar and sometimes distinct ways to the mediation and moderation of psychosocial approaches for treating SAD. This supports the importance of distinguishing between fears of negative and positive evaluation in the assessment and treatment of SAD.
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Affiliation(s)
- Amanda S Morrison
- Department of Psychology, California State University, East Bay, Hayward, CA 94542, USA.
| | - Philippe R Goldin
- UC Davis Medical Center, University of California, Davis, Davis, CA, 95616, USA
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, 94305, USA
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15
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Zainal NH, Tan HH, Hong RY, Newman MG. Is a brief mindfulness ecological momentary intervention more efficacious than a self-monitoring app for social anxiety disorder? A randomized controlled trial. J Anxiety Disord 2024; 104:102858. [PMID: 38657408 PMCID: PMC11411489 DOI: 10.1016/j.janxdis.2024.102858] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 04/26/2024]
Abstract
Despite their proliferation, limited knowledge exists regarding possible benefits of brief mindfulness ecological momentary interventions (MEMIs) for social anxiety disorder (SAD). Propositions that MEMIs could alleviate SAD symptoms and related clinical outcomes remain untested. This trial evaluated a 14-day MEMI for SAD. Participants with self-reported SAD were randomized to MEMI (n = 96) or self-monitoring app (SM; n = 95). Whereas MEMI instructed mindfulness exercises, SM prompted only self-monitoring five times daily for 14 days. Participants completed state-level self-reports of depression, anxiety, and mindfulness pre-post-mindfulness practice and SAD symptoms, worry, depression severity, repetitive negative thinking, and trait mindfulness at pre-randomization, post-intervention, and 1-month follow-up (1MFU). Hierarchical linear modeling was conducted. The MEMI yielded statistically significantly larger improvements in momentary depression, anxiety, and mindfulness (Cohen's d = -0.10-0.11). Although no between-group effects emerged in alleviating SAD fear and avoidance, excessive worry, depression severity, repetitive negative thinking, and trait mindfulness (-0.13-0.15), within-group effects were significantly small-to-large from pre-post and pre-1MFU (-4.62-0.67). A significant reduction in depression severity occurred in MEMI (-0.63--0.60) but not SM (-0.31--0.29). Brief MEMI and SM yielded nondifferent sustained effects on SAD, comorbid symptoms, and risk factors, highlighting its potential value within stepped-care delivery settings.
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Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School (HMS), Department of Health Care Policy, USA; National University of Singapore (NUS), Department of Psychology, USA.
| | - Hui Han Tan
- National University of Singapore (NUS), Department of Psychology, USA
| | - Ryan Y Hong
- National University of Singapore (NUS), Department of Psychology, USA
| | - Michelle G Newman
- The Pennsylvania State University (PSU), Department of Psychology, USA
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16
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Molteni L, Gosling CJ, Fagan HA, Hyde J, Benatti B, Dell'Osso B, Cortese S, Baldwin DS, Huneke NTM. Effects of mindfulness-based interventions on symptoms and interoception in trauma-related disorders and exposure to traumatic events: Systematic review and meta-analysis. Psychiatry Res 2024; 336:115897. [PMID: 38636333 DOI: 10.1016/j.psychres.2024.115897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024]
Abstract
Interoception is defined as the sense of the internal state of the body. Dysfunctions in interoception are found in several mental disorders, including trauma-related conditions. Mindfulness-Based Interventions (MBIs) have been shown to influence interoceptive processes. Randomised controlled trials (RCTs) have investigated whether MBIs impact symptoms and interoception in patients with trauma-related disorders. We undertook a systematic review and meta-analysis to synthesize these data. We included RCTs with an MBI arm which enrolled adult patients with trauma related-disorders or exposure to a traumatic experience, and addressed changes in interoception and trauma-related symptoms. A random-effects multivariate meta-analytic model was performed to quantify group differences in score change from baseline to follow-up. Twelve studies were included in the systematic review, and eleven in the meta-analysis. Overall, MBIs showed small to moderate positive effects on both interoception and symptoms. Despite a high heterogeneity in results, sensitivity analyses confirmed the robustness of the findings. We conclude that the efficacy of MBIs on trauma-related symptoms and interoception is supported by randomised evidence. However, further research is needed to understand whether changes in interoception might underpin the effectiveness of MBIs in trauma-related disorders.
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Affiliation(s)
- L Molteni
- University Department of Psychiatry, Academic Centre, College Keep, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK; Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences "Luigi Sacco", ASST Fatebenefratelli-Sacco, Milan, Italy
| | - C J Gosling
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Université Paris Nanterre, DysCo Lab, Nanterre F-92000, France; Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, Boulogne-Billancourt F-92100, France
| | - H A Fagan
- University Department of Psychiatry, Academic Centre, College Keep, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK
| | - J Hyde
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - B Benatti
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences "Luigi Sacco", ASST Fatebenefratelli-Sacco, Milan, Italy; Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan 20142, Italy
| | - B Dell'Osso
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences "Luigi Sacco", ASST Fatebenefratelli-Sacco, Milan, Italy; Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan 20142, Italy; Department of Psychiatry, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA, USA
| | - S Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent National Health Service Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; DiMePRe-J-Department of Precision and Regenerative Medicine-Jonic Area, University "Aldo Moro", Bari, Italy
| | - D S Baldwin
- University Department of Psychiatry, Academic Centre, College Keep, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK; University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - N T M Huneke
- University Department of Psychiatry, Academic Centre, College Keep, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK.
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17
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Yang X, Wang X, Li Z, Yi B, Liang C, Liu X, Li Y, He W. The change of state-trait anxiety among patients undergoing orthognathic surgery: A longitudinal study. Am J Orthod Dentofacial Orthop 2024; 165:628-637. [PMID: 38466249 DOI: 10.1016/j.ajodo.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 03/12/2024]
Abstract
INTRODUCTION This study aimed to assess state-trait anxiety level changes in Chinese patients with dentofacial discrepancies before and after orthognathic surgery and to explore the feasibility of developing a reference index for the preoperative screening of postoperative patients with high anxiety. METHODS A total of 96 Chinese patients with dentofacial discrepancies who underwent orthognathic surgery were included in this study. Data were collected before orthognathic surgery and at 2 weeks (T2), 3 months, and 6 months (T4) after surgery using the State-Trait Anxiety Inventory. Receiver operating characteristic and linear regression analyses were performed to screen for preoperative indicators of postoperative high-state anxiety. RESULTS State-trait anxiety levels in patients with dentofacial discrepancies decreased after surgery (F = 18.95, P <0.01; F = 6.90, P <0.01). Trait Anxiety Inventory can be used to screen patients with high-state anxiety from T2 to T4 (area under cover 95% confidence interval: T2, 0.74 [0.62-0.86]; 3 months, 0.79 [0.69-0.90]; T4, 0.77 [0.66-0.87], P <0.01), corresponding to cutoff values of 48.5, 46.5, and 45.5, respectively. CONCLUSIONS All participants' state-trait anxiety levels improved after surgery compared with their preoperative levels. Preoperative trait anxiety levels can be used as a reference indicator to screen patients who may have high-state anxiety levels after orthognathic surgery. The creation of a screening scale will assist health care professionals to more pertinently help patients with high anxiety.
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Affiliation(s)
- Xin Yang
- Department of Oral and Maxillofacial Surgery, The affiliated Yantai Stomatological Hospital, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaoxia Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
| | - Zili Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Biao Yi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Cheng Liang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiaojing Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yang Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wei He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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18
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Nandarathana N, Ranjan JK. The Efficacy and Durability of Mindfulness-Based Cognitive Therapy in the Treatment of Anxiety and Depressive Disorders: A Systematic Review and Meta-analysis. Indian J Psychol Med 2024:02537176241249375. [PMID: 39564271 PMCID: PMC11572415 DOI: 10.1177/02537176241249375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2024] Open
Abstract
Background There is a dearth of meta-analytical studies measuring the durability of mindfulness-based cognitive therapy (MBCT) in the treatment of anxiety and depressive disorders. Therefore, the present study was conducted to evaluate both the effectiveness and durability of MBCT in the treatment of depression and anxiety disorders. Methods We systematically searched six databases from June 11, 2023 to September 16, 2023 for randomized control trials (RCTs) of adults diagnosed with anxiety or depressive disorders as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision or the Tenth Revision of the International Classification of Diseases and Related Health Problems diagnostic criteria; the treatment group received the complete form of MBCT, whereas the control group received other interventions or treatment as usual; the treatment outcome focused on symptoms of depression or anxiety. Two independent reviewers included studies, assessed quality, and extracted data. The Cochrane Risk-of-Bias 2.0 tool was applied to appraise the methodological quality of the included studies. R 4.2.1 software and the "metafor" package were used to estimate the effect sizes based on mean and standard deviation of anxiety and depressive disorders at baseline and postintervention, and at postintervention and follow-up periods for both the treatment and control groups. Result A total of 1,470 studies were reviewed, and 21 RCTs met the inclusion criteria. The meta-analysis showed an overall standardized mean difference of -0.4806 [CI: -0.7185; -0.2428] and -0.3817 [CI: -0.5407; -0.2228] for reducing anxiety and depression symptoms, respectively indicating the effectiveness of MBCT. Comparison between postintervention and follow-up or follow-up measurement showed a small and nonsignificant effect size for depression (0.0130 [CI: -0.2109; 0.2369]) and anxiety (0.0198 [CI: -0.0660; 0.1057]), suggesting that recovered symptoms in the treatment group were maintained until the follow-up evaluation. Conclusion MBCT produces long-term treatment effects in the management of both depressive and anxiety disorders. Protocol preregistration The current meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and got registered with PROSPERO (CRD42023465494).
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Affiliation(s)
| | - Jay Kumar Ranjan
- Dept. of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Xue T, Sheng J, Gao H, Gu Y, Dai J, Yang X, Peng H, Gao H, Lu R, Shen Y, Wang L, Wang L, Shi Y, Li Z, Cui D. Eight-month intensive meditation-based intervention improves refractory hallucinations and delusions and quality of life in male inpatients with schizophrenia: a randomized controlled trial. Psychiatry Clin Neurosci 2024; 78:248-258. [PMID: 38318694 DOI: 10.1111/pcn.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/10/2023] [Accepted: 12/25/2023] [Indexed: 02/07/2024]
Abstract
AIM This study investigated the impact of an 8-month daily-guided intensive meditation-based intervention (iMI) on persistent hallucinations/delusions and health-related quality of life (QoL) in male inpatients with schizophrenia with treatment-refractory hallucinations and delusions (TRHDs). METHODS A randomized controlled trial assigned 64 male inpatients with schizophrenia and TRHD equally to an 8-month iMI plus general rehabilitation program (GRP) or GRP alone. Assessments were conducted at baseline and the third and eighth months using the Positive and Negative Syndrome Scale (PANSS), 36-Item Short Form-36 (SF-36), and Five Facet Mindfulness Questionnaire (FFMQ). Primary outcomes measured PANSS reduction rates for total score, positive symptoms, and hallucinations/delusions items. Secondary outcomes assessed PANSS, SF-36, and FFMQ scores for psychotic symptoms, health-related QoL, and mindfulness skills, respectively. RESULTS In the primary outcome, iMI significantly improved the reduction rates of PANSS total score, positive symptoms, and hallucination/delusion items compared with GRP at both the third and eighth months. Treatment response rates (≥25% reduction) for these measures significantly increased in the iMI group at the eighth month. Concerning secondary outcomes, iMI significantly reduced PANSS total score and hallucination/delusion items, while increasing scores in physical activity and mindfulness skills at both the third and eighth months compared with GRP. These effects were more pronounced with an 8-month intervention compared with a 3-month intervention. CONCLUSIONS An iMI benefits patients with TRHDs by reducing persistent hallucinations/delusions and enhancing health-related QoL. Longer iMI duration yields superior treatment outcomes.
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Affiliation(s)
- Ting Xue
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Jialing Sheng
- The First Minzheng Mental Health Center, Shanghai, China
| | - Hui Gao
- The First Minzheng Mental Health Center, Shanghai, China
| | - Yan Gu
- The First Minzheng Mental Health Center, Shanghai, China
| | - Jingjing Dai
- The First Minzheng Mental Health Center, Shanghai, China
| | - Xianghong Yang
- The First Minzheng Mental Health Center, Shanghai, China
| | - Hong Peng
- The First Minzheng Mental Health Center, Shanghai, China
| | - Hongrui Gao
- The First Minzheng Mental Health Center, Shanghai, China
| | - Ruping Lu
- The First Minzheng Mental Health Center, Shanghai, China
| | - Yi Shen
- The First Minzheng Mental Health Center, Shanghai, China
| | - Li Wang
- The First Minzheng Mental Health Center, Shanghai, China
| | - Lijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yuan Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Donghong Cui
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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20
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Noda S, Shirotsuki K, Nakao M. Low-intensity mindfulness and cognitive-behavioral therapy for social anxiety: a pilot randomized controlled trial. BMC Psychiatry 2024; 24:190. [PMID: 38454396 PMCID: PMC10921717 DOI: 10.1186/s12888-024-05651-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) effectively improves the clinical symptoms of social anxiety disorder. However, there are non-responders who cannot decrease their cost/probability bias significantly; hence, their social anxiety symptoms remain unaddressed. Mindfulness training and cognitive-behavioral approaches promote a reduction in cost/probability bias and social anxiety symptoms. This study examines the effectiveness of a four-session program of mindfulness and CBT (M-CBT) in a non-clinical sample of individuals with high social anxiety. METHODS Participants were 50 Japanese undergraduate students (37 women and 13 men) randomly allocated to an intervention group (n = 27) and a control group (n = 23). The intervention group underwent a four-session M-CBT program, while the control group did not receive any treatment. RESULTS A group × time analysis of covariances showed significant interactions in the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. M-CBT also produced significant pre-post improvements in the above outcomes with moderate to high effect sizes (ds = .51-1.55). Conversely, there were no interactions in social anxiety symptoms and self-focused attention. CONCLUSIONS These results indicate that M-CBT was effective for the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. The combination of mindfulness training with cognitive restructuring is proposed as potentially helpful for individuals with probability bias, leading to negative cognition from paying attention to others. TRIAL REGISTRATION University Hospital Medical Information Network (UMIN CTR) UMIN000036763. Registered May 16, 2019.
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Affiliation(s)
- Shota Noda
- Department of Psychology, Translational Clinical Psychology, Philipps University Marburg, Schulstraße 12, Marburg, 35032, Germany.
- Research Institute of Cognitive Behavior Therapy, Musashino University, 3-3-3 Ariake, Koutou-Ku, Tokyo, 135-8181, Japan.
| | - Kentaro Shirotsuki
- Faculty of Human Sciences, Musashino University, 3-3-3 Ariake, Koutou-Ku, Tokyo, 135-8181, Japan
| | - Mutsuhiro Nakao
- Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita-Shi, Chiba, 286-8686, Japan
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21
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Donohue HE, Modini M, Abbott MJ. Psychological interventions for pre-event and post-event rumination in social anxiety: A systematic review and meta-analysis. J Anxiety Disord 2024; 102:102823. [PMID: 38142483 DOI: 10.1016/j.janxdis.2023.102823] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.
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Affiliation(s)
| | - Matthew Modini
- School of Psychology, The University of Sydney, Australia; Concord Centre for Mental Health, Sydney Local Health District, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Australia.
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22
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Holas P, Kamińska J. Mindfulness meditation and psychedelics: potential synergies and commonalities. Pharmacol Rep 2023; 75:1398-1409. [PMID: 37926796 PMCID: PMC10661803 DOI: 10.1007/s43440-023-00551-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
There has been increasing scientific and clinical interest in studying psychedelic and meditation-based interventions in recent years, both in the context of improving mental health and as tools for understanding the mind. Several authors suggest neurophysiological and phenomenological parallels and overlaps between psychedelic and meditative states and suggest synergistic effects of both methods. Both psychedelic-assisted therapy and meditation training in the form of mindfulness-based interventions have been experimentally validated with moderate to large effects as alternative treatments for a variety of mental health problems, including depression, addictions, and anxiety disorders. Both demonstrated significant post-acute and long-term decreases in clinical symptoms and enhancements in well-being in healthy participants, in addition. Postulated shared salutogenic mechanisms, include, among others the ability to alter self-consciousness, present-moment awareness and antidepressant action via corresponding neuromodulatory effects. These shared mechanisms between mindfulness training and psychedelic intervention have led to scientists theorizing, and recently demonstrating, positive synergistic effects when both are used in combination. Research findings suggest that these two approaches can complement each other, enhancing the positive effects of both interventions. However, more theoretical accounts and methodologically sound research are needed before they can be extended into clinical practice. The current review aims to discuss the theoretical rationale of combining psychedelics with mindfulness training, including the predictive coding framework as well as research findings regarding synergies and commonalities between mindfulness training and psychedelic intervention. In addition, suggestions how to combine the two modalities are provided.
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Affiliation(s)
- Paweł Holas
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
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Zhang Y, Ding Y, Chen X, Li Y, Li J, Hu X. Effectiveness of acceptance and commitment therapy on psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer: A meta-analysis of randomized controlled trials. Worldviews Evid Based Nurs 2023; 20:582-592. [PMID: 37194163 DOI: 10.1111/wvn.12652] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Current studies have revealed that acceptance and commitment therapy (ACT) can alleviate the adverse effects of cancer; however, its effectiveness on the psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer remains unclear. AIMS The aims of this study were to identify the effectiveness of ACT on psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer, and to explore moderators. METHODS PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL, CNKI, VIP, and Wanfang electronic databases were searched from inception to September 29, 2022. The Cochrane Collaboration's risk-of-bias assessment tool II and the Grading of Recommendations Assessment, Development, and Evaluation approach were used to evaluate evidence certainty. The data were analyzed using R Studio. The study protocol was registered with PROSPERO (CRD42022361185). RESULTS The study included 19 relevant studies (1643 patients) published between 2012 and 2022. The pooled results showed that ACT significantly improved psychological flexibility (mean difference [MD] = -4.22, 95% CI [-7.86, -0.58], p = .02) and quality of life (Hedges' g = 0.94, 95% CI [0.59, 1.29], Z = 5.31, p < .01) but did not significantly improve fatigue (Hedges' g = -0.03, 95% CI [-0.24, 0.18], p = .75) or sleep disturbance (Hedges' g = -0.26, 95% CI [-0.82, 0.30], p = .37) in patients with cancer. Additional analyses revealed a 3-month sustainable effect on psychological flexibility (MD = -4.36, 95% CI [-8.67, -0.05], p < .05), and moderation analysis showed that intervention duration (β = -1.39, p < .01) and age (β = 0.15, p = .04) moderated the effects of ACT on psychological flexibility and sleep disturbance, respectively. LINKING EVIDENCE TO ACTION Acceptance and commitment therapy demonstrates effectiveness for psychological flexibility and quality of life of patients with cancer, but there is a lack of evidence regarding its effects on fatigue and sleep disturbance. In clinical practice, ACT should be designed in more detail and rounded to achieve better results.
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Affiliation(s)
- Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuxin Ding
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Zhou Y, Cao Y, Xu S, Li S, Liang Y, Zhang W, Xiao Y. Randomized controlled trial on the effects of mindfulness-based respiratory decompression therapy in claustrophobic patients undergoing MRI inspection. Front Med (Lausanne) 2023; 10:1253824. [PMID: 38076233 PMCID: PMC10702764 DOI: 10.3389/fmed.2023.1253824] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/25/2023] [Indexed: 10/24/2024] Open
Abstract
BACKGROUND Claustrophobia is a psychological disease. It is estimated to occur in 2.1-14.3% of all magnetic resonance imaging (MRI) examinations. Mindfulness decompression is an effective means to treat and reduce fear and anxiety. There is a rare report on the application of mindfulness-based stress reduction therapy in the magnetic resonance examinations of patients with claustrophobia to date. PURPOSE The purpose of this study is to explore the intervention effect of mindfulness respiratory decompression therapy on the MRI inspection of patients with claustrophobia. METHODS A total of 86 patients with claustrophobia requiring MRI in our hospital from January 2018 to December 2020 were divided into two groups. The control group was given routine psychological nursing, and the observation group was given a mindfulness breathing technique on the basis of the control group. Before and after the intervention, we compared the intervention effect, satisfaction with nurses' psychological intervention technique, severe autonomic nervous symptoms during the examination, self-rating anxiety scale (SAS) scores, and profile of mood states revised (POMS-R) scores. RESULTS The total effective rate of intervention in the observation group was 90.90%, which was significantly higher (χ2 = 6.857, p = 0.00004) than that in the control group (26.19%). Severe autonomic nervous symptoms in the observation group were significantly lower than those in the control group (p < 0.05). After the intervention, SAS scores and POMS-R scores in the observation group decreased with statistical significance (p < 0.05). CONCLUSION Mindfulness respiratory decompression therapy can effectively help claustrophobic patients complete an MRI examination, which may be worthy of wide promotion and application in the clinic.
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Affiliation(s)
| | | | | | | | | | - Wei Zhang
- Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, China
| | - Yunping Xiao
- Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, China
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Pei G, Xiao Q, Pan Y, Li T, Jin J. Neural evidence of face processing in social anxiety disorder: A systematic review with meta-analysis. Neurosci Biobehav Rev 2023; 152:105283. [PMID: 37315657 DOI: 10.1016/j.neubiorev.2023.105283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/16/2023]
Abstract
Numerous previous studies have used event-related potentials (ERPs) to examine facial processing deficits in individuals with social anxiety disorder (SAD). However, researchers still need to determine whether the deficits are general or specific and what the dominant factors are behind different cognitive stages. Meta-analysis was performed to quantitatively identify face processing deficits in individuals with SAD. Ninety-seven results in 27 publications involving 1032 subjects were calculated using Hedges' g. The results suggest that the face itself elicits enlarged P1 amplitudes, threat-related facial expressions induce larger P2 amplitudes, and negative facial expressions lead to enhanced P3/LPP amplitudes in SAD individuals compared with controls. That is, there is face perception attentional bias in the early phase (P1), threat attentional bias in the mid-term phase (P2), and negative emotion attentional bias in the late phase (P3/LPP), which can be summarized into a three-phase SAD face processing deficit model. These findings provide an essential theoretical basis for cognitive behavioral therapy and have significant application value for the initial screening, intervention, and treatment of social anxiety.
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Affiliation(s)
- Guanxiong Pei
- Research Center for Multi-Modal Intelligence, Research Institute of Artificial Intelligence, Zhejiang Lab, 1818# Wenyixi Road, Hangzhou 311121, China
| | - Qin Xiao
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), 550# Dalian West Road, Shanghai 200083, China; School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China
| | - Yu Pan
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), 550# Dalian West Road, Shanghai 200083, China; School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China
| | - Taihao Li
- Research Center for Multi-Modal Intelligence, Research Institute of Artificial Intelligence, Zhejiang Lab, 1818# Wenyixi Road, Hangzhou 311121, China.
| | - Jia Jin
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), 550# Dalian West Road, Shanghai 200083, China; School of Business and Management, Shanghai International Studies University, 550# Dalian West Road, Shanghai 200083, China; Guangdong Institute of Intelligence Science and Technology, Joint Lab of Finance and Business Intelligence, 2515# Huandao North Road, Zhuhai 519031, China.
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Reangsing C, Trakooltorwong P, Maneekunwong K, Thepsaw J, Oerther S. Effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults: a systematic review and meta-analysis. BMC Complement Med Ther 2023; 23:269. [PMID: 37507747 PMCID: PMC10386675 DOI: 10.1186/s12906-023-04102-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND An increasing number of studies have documented the effectiveness on various types of face-to-face and online mindfulness-based interventions (MBIs) in reducing anxiety among general population, but there is a scarcity of systematic reviews evaluating evidence of online MBIs on anxiety in adults. Therefore, we examined the effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults and explored the moderating effects of participant, methods, and intervention characteristics. METHODS We systematically searched nine databases through May 2022 without date restrictions. Inclusion criteria were primary studies evaluating online mindfulness-based interventions with adults with anxiety measured as an outcome, a comparison group, and written in English. We used random-effects model to compute effect sizes (ESs) using Hedges' g, a forest plot, and Q and I2 statistics as measures of heterogeneity; we also examined moderator analyses. RESULTS Twenty-six primary studies included 3,246 participants (39.9 ± 12.9 years old). Overall, online mindfulness-based interventions showed significantly improved anxiety (g = 0.35, 95%CI 0.09, 0.62, I2 = 92%) compared to controls. With regards to moderators, researchers reported higher attrition, they reported less beneficial effects on anxiety symptoms (β=-0.001, Qmodel=4.59, p = .032). No other quality indicators moderated the effects of online mindfulness-based interventions on anxiety. CONCLUSION Online mindfulness-based interventions improved anxiety symptoms in adult population. Thus, it might be used as adjunctive or alternative complementary treatment for adults. However, our findings must be interpreted with caution due to the low and unclear power of the sample in primary studies; hence, high-quality studies are needed to confirm our findings.
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Affiliation(s)
| | | | | | - Jintana Thepsaw
- School of Nursing, Mae Fah Laung University, Chiangrai, Thailand
| | - Sarah Oerther
- Trudy Busch Valentine, School of Nursing, Saint Louis University, Missouri, MO, USA
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Kundarti FI, Titisari I, Rahayu DE, Kiswati, Jamhariyah. Mindfulness improves the mental health of infertile women: A systematic review. J Public Health Res 2023; 12:22799036231196693. [PMID: 37711728 PMCID: PMC10498716 DOI: 10.1177/22799036231196693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/04/2023] [Indexed: 09/16/2023] Open
Abstract
Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study's purpose was to analyze mindfulness's effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.
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Affiliation(s)
- Finta Isti Kundarti
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Ira Titisari
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Dwi Estuning Rahayu
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Kiswati
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
| | - Jamhariyah
- Department of Midwifery, Polytechnic of Health, Ministry of Health, Malang, Indonesia
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Bartos LJ, Posadas MP, Wrapson W, Krägeloh C. Increased Effect Sizes in a Mindfulness- and Yoga-Based Intervention After Adjusting for Response Shift with Then-Test. Mindfulness (N Y) 2023; 14:953-969. [PMID: 37090850 PMCID: PMC10019420 DOI: 10.1007/s12671-023-02102-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/18/2023]
Abstract
Objectives
Response shift refers to variations in self-reported evaluations at different times from changes in one’s internal standards, values, and meanings. The current study explored the utility of the then-test to detect a potential mindfulness-based response shift occurrence during a mindfulness- and yoga-based intervention for student musicians, and to ascertain to what extent effect sizes could differ when adjusting for it. Method Participants (n = 31) completed the Five Facet Mindfulness Questionnaire (FFMQ) halfway through the intervention (Time 1-FFMQ), post-intervention (Time 2-FFMQ), and immediately after Time 2-FFMQ with a then-test approach that asked participants to rate the FFMQ based on retrospective reflections on their mindfulness at Time 1 (then-test-FFMQ). Paired t-tests and Hedges’ g effect sizes were computed to estimate three potential effects: response shift (Time 1-FFMQ minus then-test-FFMQ), the conventional intervention effect (Time 2-FFMQ minus Time 1-FFMQ), and the effect after adjusting for response shift (i.e., actual intervention effect = Time 2-FFMQ minus then-test-FFMQ). Results Response shift was significant for the FFMQ Observe subscale (g = 0.41) and total scale (g = 0.37). The adjusted scores in all subscales (Observe, g = 0.47; Describe, g = 0.25; Act Aware, g = 0.40; Non-judge, g = 0.28; Non-react, g = 0.57) and total scale (g = 0.60) achieved significance and yielded larger effect sizes than the conventional results, for which only Act Aware (g = 0.28), Non-react (g = 0.36), and total scale (g = 0.28) were significant. Conclusions Notwithstanding some methodological limitations, this study lends support to the utility of the then-test to quantify response shift. When adjusting for it, effect sizes from a mindfulness- and yoga-based intervention were generally amplified. Preregistration This study was not preregistered.
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Affiliation(s)
- L. Javier Bartos
- Department of Psychology and Neuroscience, Auckland University of Technology, 90 Akoranga Drive, Auckland, 1142 New Zealand
| | - M. Pilar Posadas
- Department of Pedagogy and Singing, Royal Conservatory of Music Victoria Eugenia, 46 San Jerónimo Street, 18001 Granada, Spain ,Faculty of Education, Camilo Jose Cela University, 11 Marqués del Riscal Street, 28010 Madrid, Spain
| | - Wendy Wrapson
- School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Auckland, 1142 New Zealand
| | - Chris Krägeloh
- Department of Psychology and Neuroscience, Auckland University of Technology, 90 Akoranga Drive, Auckland, 1142 New Zealand
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Li J, Xu C, Wan K, Liu Y, Liu L. Mindfulness-based interventions to reduce anxiety among Chinese college students: A systematic review and meta-analysis. Front Psychol 2023; 13:1031398. [PMID: 36687872 PMCID: PMC9853980 DOI: 10.3389/fpsyg.2022.1031398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Mindfulness-based interventions are found to have a positive effect on an individual's mental health. Using a meta-analysis method, this study examined the effects of mindfulness-based interventions on alleviating anxiety among Chinese college students. Using six international and two Chinese electronic databases, we comprehensively researched literature published between 1 January 2012 and 31 December 2021. The literature was then carefully selected and classified. The literature selection, data extraction, and quality assessment were all independently conducted by two members of the research team; any disagreements were resolved through consultation with a third researcher. A total of 11 original articles met all the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that mindfulness-based interventions have a positive effect on the remission of anxiety among Chinese college students. This confirms the need to generalize mindfulness-based interventions as a form of treatment and prevention for anxiety among Chinese college students.
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Affiliation(s)
- Jun Li
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Can Xu
- Monetware Inc., Shanghai, China
| | - Keyan Wan
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Yihong Liu
- Department of Sociology, School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Liu Liu
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
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Noda S, Shirotsuki K, Sasagawa S. Self-focused attention, cost/probability bias, and avoidance behavior mediate the relationship between trait mindfulness and social anxiety: A cross-sectional study. Front Psychol 2022; 13:942801. [PMID: 36033088 PMCID: PMC9399945 DOI: 10.3389/fpsyg.2022.942801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Self-focused attention, cost/probability bias, and avoidance behavior are maintaining factors for social anxiety. In particular, cost bias and avoidance behavior predict social anxiety. It has been shown that the enhancement of trait mindfulness improves these maintaining factors. This study examines the relationships among trait mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety, and clarifies whether they mediate the relationship between trait mindfulness and social anxiety. A cross-sectional design was used to examine the relationships among these variables. Participants were recruited from three universities in Japan (January 2019–December 2019). Undergraduate students (N = 367) completed a set of self-report measures assessing trait mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. Results of path analyses revealed that the hypothesized model’s goodness-of-fit indices had high values. Trait mindfulness showed a direct negative association with self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. Moreover, trait mindfulness was negatively associated with social anxiety via self-focused attention, cost/probability bias, and avoidance behavior. These findings indicate that mindfulness plays an important role in social anxiety and provide impetus for future research involving clinical studies of mindfulness-based interventions for social anxiety.
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Affiliation(s)
- Shota Noda
- Graduate School of Human and Social Sciences, Musashino University, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- *Correspondence: Shota Noda,
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Van't Westeinde A, Patel KD. Heartfulness Meditation: A Yogic and Neuroscientific Perspective. Front Psychol 2022; 13:806131. [PMID: 35619781 PMCID: PMC9128627 DOI: 10.3389/fpsyg.2022.806131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/21/2022] [Indexed: 12/05/2022] Open
Abstract
Today, as research into the contemplative sciences is being widely referenced, the research community would benefit from an understanding of the Heartfulness method of meditation. Heartfulness offers an in-depth experiential practice focused on the evolution of human consciousness using the ancient technique of Pranahuti (yogic Transmission) during Meditation, in combination with the more active mental practice of “Cleaning.” Both are enabled by initiation into the Heartfulness practices. These unique features distinguish Heartfulness from other paths that have been described in the scientific literature thus far. In this introductory paper, we present the Heartfulness practices, the philosophy upon which the practices are based, and we reflect on the putative mechanisms through which Heartfulness could exert its effects on the human body and mind in the light of scientific research that has been done in other meditation systems. We conclude with suggestions for future research on the Heartfulness way of meditation.
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Affiliation(s)
- Annelies Van't Westeinde
- Pediatric Endocrinology Unit (QB83), Department of Women's and Children's Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Kamlesh D Patel
- Heartfulness Institute, Kanha Shanti Vanam, Hyderabad, India
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Effectiveness of a Mindfulness-Based Group Intervention for Chinese University Students with Sleep Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020755. [PMID: 35055577 PMCID: PMC8775412 DOI: 10.3390/ijerph19020755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 11/17/2022]
Abstract
The increasing prevalence of sleep disorders among university students should be taken seriously. Group counseling involving a mindfulness-based strategy may help prevent students from developing insomnia and subsequent mental health disorders. This study aimed to evaluate the ameliorating effects of a mindfulness-based group intervention on sleep problems and emotional symptoms in university students in China. Twenty-one university students (16 females, 22.71 ± 4.28 years) who were not on medication were recruited and assigned to the intervention group based on the criterion of high levels of sleep problems. Additionally, twenty-four university students (19 females, 24.50 ± 0.93 years) were included as a nonrandomized control group. Individuals in the intervention group participated in a two-hour group intervention once a week for eight sessions. All participants completed self-reported questionnaire baseline tests, postintervention tests, and one-month follow-ups on mindfulness, sleep quality, anxiety and depressive symptoms. Repeated-measures ANOVA was performed. The results revealed significant intervention effects, with significant differences observed between the two groups in mindfulness and sleep quality. However, there was no significant effect of the intervention on anxiety and depressive symptoms. This study contributes to a better understanding of the effectiveness of mindfulness-based intervention in addressing sleep problems in university students.
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Luan YS, Zhan-Ling G, Mi L, Ying L, Lan B, Tong L. The Experience Among College Students with Social Anxiety Disorder in Social Situations: A Qualitative Study. Neuropsychiatr Dis Treat 2022; 18:1729-1737. [PMID: 35996629 PMCID: PMC9391929 DOI: 10.2147/ndt.s371402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Few individuals have focused on the experience of students during social events, especially among college students with social anxiety disorder. This study aimed to explore the anxiety experience among college students with social anxiety disorder in social situations. METHODS This qualitative interpretive study was conducted on college students who were diagnosed with social anxiety disorder (SAD) and recruited from two colleges in Heilongjiang Province, China. A total of 7 participants were selected by purposive sampling with maximum variability. Data were collected through semistructured individual interviews, and data analysis was performed by using Colaizzi's 7-step analysis method. RESULTS The findings from the analysis of the interviews were classified into 4 themes and several main categories, including distorted self-awareness (3 main categories), fear of negative reaction from others (2 main categories), adverse reaction of body and mind (4 main categories) and strong desire to seek treatment. CONCLUSION In our study, we sought to understand the anxiety experience among college students with social anxiety disorder in social situations. The study results provide a reference for psychologists and clinical medical staff and establish a scientific basis for the prevention and intervention of social anxiety disorder.
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Affiliation(s)
- Ya-Song Luan
- Department of Nursing Science, Shandong Traditional Chinese Medicine College, YanTai, People's Republic of China
| | - Gao Zhan-Ling
- Department of Nursing Science, Shandong Traditional Chinese Medicine College, YanTai, People's Republic of China
| | - Li Mi
- Department of Nursing Science, Shandong Traditional Chinese Medicine College, YanTai, People's Republic of China
| | - Liu Ying
- Department of Neurosurgery, YanTai Affiliated Hospital of Binzhou Medical College, YanTai, People's Republic of China
| | - Bai Lan
- Department of Nursing Science, Shandong Traditional Chinese Medicine College, YanTai, People's Republic of China
| | - Li Tong
- Department of Nursing Science, Shandong Traditional Chinese Medicine College, YanTai, People's Republic of China
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Soziale Phobie: Achtsamkeitsbasierte Interventionen überprüft. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021. [DOI: 10.1055/a-1540-0464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Neben medikamentöser Therapie wird die soziale Phobie häufig mit kognitiver Verhaltenstherapie behandelt. Wird die Therapie allerdings nicht fortgesetzt, kann es zu Residualsymptomen kommen. Achtsamkeitsbasierte Interventionen haben sich bereits bei Depressionen, Angststörungen und Psychosen als wirksam erwiesen. Eine aktuelle Metaanalyse untersuchte nun Effekte von achtsamkeitsbasierten Interventionen auf die Symptome der sozialen Phobie.
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Abstract
Abstract
Fear of evaluation and a negative view of the self are the core aspects of social anxiety. Self-compassion and self-esteem are two distinct positive attitudes toward the self, which are positively related to each other, well-being and good psychological functioning. It is less clear, however, how they interplay in socially anxious individuals and if self-compassion may reduce the negative effect of low self-esteem on social anxiety. The current research aimed at evaluating the directional links between those constructs to check if self-compassion mediates the effect of self-esteem on social anxiety. In this study, 388 adult participants with elevated social anxiety completed measures of self-compassion, self-esteem and social anxiety. As expected, both self-esteem and self-compassion correlated negatively with social anxiety and positively with one another, with lower self-esteem being a stronger predictor of social anxiety. Importantly, self-compassion partially mediated the relationship between self-esteem and social anxiety. These findings suggest that self-compassion partially explains the negative effects of deficits in self-esteem on social anxiety. Practical implications of the research are discussed.
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