Differential impact of mindfulness practices on aggression among law enforcement officers.

OBJECTIVES: Home-based mindfulness practice is a common component of formal mindfulness training (MT) protocols. Obtaining objective data from home-based mindfulness practice is challenging. Interpreting associations between home-based mindfulness practice and clinically impactful outcomes is complicated given the variability in recommendations in length, frequency, and type of practice. In this exploratory study, adherence to home-based practices of Mindfulness-Based Resilience Training (MBRT) was studied in order to evaluate associations with clinical outcomes. METHODS: Home practices from 24 (92% male, non-Hispanic white, aged M = 43.20 years) law enforcement officers (LEOs) from the urban Pacific Northwest enrolled in a feasibility and efficacy trial of MBRT were studied using an objective tracking device and self-report data. Outcomes included adherence to home-based mindfulness practices and self-reported aggression. RESULTS: Participants completed 59.12% of the frequency amount of practice assigned in the MBRT curriculum. Frequency of practice was associated with decreased aggression, adjusted R 2 = .41, F(3,23) = 6.14, p = .004. Duration of practice also predicted decreased aggression, adjusted R 2 = .33, F(3,23) = 4.76, p = .011. CONCLUSIONS: Home-based MBRT practices for LEOs, even at low rates of adherence, may reduce aggression. MTs may show beneficial effects for other populations presented with challenges to engage in regular MT practices.

Mindfulness in Thailand and the United States: a case of apples versus oranges?

The study and practice of mindfulness is rapidly expanding in Western psychology. Recently developed self-report measures of mindfulness were derived from Western operationalizations and cross-cultural validation of many of these measures is lacking, particularly in Buddhist cultures. Therefore, this study examined the measurement equivalence of the Kentucky Inventory of Mindfulness Skills (KIMS) and Mindful Attention Awareness Scale (MAAS) among Thai (n=385) and American (n=365) college students. Multigroup confirmatory factor analysis models fit to the data revealed that the KIMS lacked configural invariance across groups, which precluded subsequent invariance tests, and although the MAAS demonstrated configural, metric, and partial scalar invariance, there was no significant latent mean MAAS difference between Thais and Americans. These findings suggest that Eastern and Western conceptualizations of mindfulness may have important differences.

A Brief Mindfulness-Based Intervention for Primary Care Physicians: A Pilot Randomized Controlled Trial.

Primary care physicians experience high rates of burnout, which results in diminished quality of life, poorer quality of care, and workforce attrition. In this randomized controlled trial, our primary aim was to examine the impact of a brief mindfulness-based intervention (MBI) on burnout, stress, mindfulness, compassion, and resilience among physicians. A total of 33 physicians completed the baseline assessment and were randomized to the Mindful Medicine Curriculum (MMC; n = 17) or waitlist control group (n = 16). Participants completed self-report measures at baseline, post-MBI, and 3-month follow-up. We also analyzed satisfaction with doctor communication (DCC) and overall doctor rating (ODR) data from patients of the physicians in our sample. Participants in the MMC group reported significant improvements in stress (P < .001), mindfulness (P = .05), emotional exhaustion (P = .004), and depersonalization (P = .01) whereas in the control group, there were no improvements on these outcomes. Although the MMC had no impact on patient-reported DCC or ODR, among the entire sample at baseline, DCC and ODR were significantly correlated with several physician outcomes, including resilience and personal achievement. Overall, these findings suggest that a brief MBI can have a positive impact on physician well-being and potentially enhance patient care.

Mindfulness-based resilience training to reduce health risk, stress reactivity, and aggression among law enforcement officers: A feasibility and preliminary efficacy trial.

The primary objective of this study was to assess feasibility and gather preliminary outcome data on Mindfulness-Based Resilience Training (MBRT) for law enforcement officers. Participants (n = 61) were randomized to either an 8-week MBRT course or a no intervention control group. Self-report and physiological data were collected at baseline, post-training, and three months following intervention completion. Attendance, adherence, post-training participant feedback, and interventionist fidelity to protocol all demonstrated feasibility of MBRT for law enforcement officers. Compared to no intervention controls, MBRT participants experienced greater reductions in salivary cortisol, self-reported aggression, organizational stress, burnout, sleep disturbance, and reported increases in psychological flexibility and non-reactivity at post-training; however, group differences were not maintained at three-month follow-up. This initial randomized trial suggests MBRT is a feasible intervention. Outcome data suggest MBRT targets key physiological, psychological, and health risk factors in law enforcement officers, consistent with the potential to improve officer health and public safety. However, follow-up training or "booster" sessions may be needed to maintain training gains. A fully powered longitudinal randomized trial is warranted.

A content analysis of personal strivings: associations with substance use.

This study examined relations between personal strivings and frequency of alcohol, marijuana, and any drug use among college students. Personal strivings are ongoing goals that an individual is characteristically trying to achieve through their behavior. Participants generated lists of personal strivings following standard instructions and then completed an assessment of alcohol and marijuana use and days used any drug (aside from tobacco or medication as prescribed). Personal strivings were coded into content categories by trained raters using a coding manual. Four content categories were examined for this study: achievement, affect regulation, self-presentation, and interpersonal. A series of t-tests revealed that participants' achievement strivings were unrelated to substance use. In contrast, participants endorsing more affect regulation goals used all drugs more frequently. Self-presentation goals were positively associated with alcohol use but unrelated to marijuana or other drug use. Finally, interpersonal goals were associated with higher rates of alcohol use, lower rates of marijuana use, and not related to total use days.

An affective-motivational model of marijuana and alcohol problems among college students.

The study examined models of marijuana (n = 309) and alcohol (n = 731) problems. Impulsivity was directly associated with both marijuana- and alcohol-related problems. Negative mood regulation expectancies were indirectly associated with marijuana problems through coping motives. Sensation seeking was indirectly associated with alcohol problems through enhancement motives. Affect lability and negative affect were indirectly associated with alcohol problems though coping motives. In both models, coping motives were directly associated with use-related problems. A multigroup analysis indicated that the association between negative affect and coping motives as well as use and problems was stronger among participants using both alcohol and marijuana relative to alcohol only. Enhancement motives were a stronger predictor of alcohol use among participants using alcohol only.

Fibromyalgia Impact and Mindfulness Characteristics in 4986 People with Fibromyalgia.

CONTEXT AND OBJECTIVE: A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia. A recent systematic review and meta-analysis of six trials indicated improvement in depressive symptoms and quality of life, calling for increased rigor and use of standardized measures in future trials. The purpose of the study was to examine the relationship between mindfulness [as measured by the Five Facet Mindfulness Questionnaire (FFMQ)] and fibromyalgia impact [as measured by the Revised Fibromyalgia Impact Questionnaire (FIQR)]. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey was conducted with adults diagnosed with fibromyalgia from a national fibromyalgia advocacy foundation e-mail list. RESULTS: A total of 4986 respondents represented all 50 states in the United States and 30 countries. FIQR scores demonstrated moderate to severe fibromyalgia with the majority of subjects (59%) scoring ≤60. Scores on the FFMQ subscales ranged from 20.8 to 27.3, with highest scores for the observe subscale. All subscale correlations were small to moderate and indicated that more severe fibromyalgia impact was associated with less mindfulness except in the observe scale (r = .15, P > .000). No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales. CONCLUSIONS: Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions. Baseline values for the observe subscale of the FFMQ were unexpectedly high. Further research is needed to know if this may be due to non-mindful observations and should be noted when the FFMQ is used in fibromyalgia clinical trials.

Personal strivings, binge drinking, and alcohol-related problems.

This study examined relations between personal strivings and alcohol use among college students. Personal strivings are ongoing goals that individuals are characteristically trying to achieve through their behavior. Participants generated lists of personal strivings following standard instructions and then completed an assessment of alcohol use and related problems. Participants returned to complete a follow-up assessment of drinking behavior after 30 days. Personal strivings were coded into content categories by trained raters using a coding manual. Four content categories were examined for this study: achievement, affiliation, health, and self-presentation. A series of t tests revealed that participants endorsing achievement strivings reported less alcohol-related problems and marginally fewer instances of binge drinking during the 30-day follow-up period. In contrast, participants endorsing self-presentation strivings reported more alcohol-related problems during the follow-up period.

Using Cognitive Interviews to Assess the Cultural Validity of State and Trait Measures of Mindfulness among Zen Buddhists.

Although Western psychological mindfulness shares many common features with Buddhist mindfulness, subtle differences in the way in which it is practiced and assessed may have important implications. Therefore, the primary goal of this qualitative study was to evaluate the cultural validity of the Five Facet Mindfulness Questionnaire (FFMQ) and Toronto Mindfulness Scale (TMS) by using cognitive interviews among a sample of Buddhist clergy and laypersons to assess their perceptions of these two scales. Participants were 14 Zen Buddhists (7 laypersons, 6 Zen priests, and 1 in priest the ordination process) recruited from a monastery in the Pacific Northwestern U.S. Each participant completed a cognitive interview using the FFMQ and TMS. We developed a coding schema to identify and categorize participant responses, and then applied the final coding framework to all 14 interviews. Results revealed perceived concerns and strengths of each scale, as well as concerns regarding content deemed missing from both scales and general issues related to mindfulness self-assessment. These findings suggest that Buddhist and Western psychological conceptualizations of mindfulness may have important differences.

Development and validation of the cognitive-behavioral therapy skills questionnaire.

Although several theories exist to describe why patients improve in cognitive-behavioral therapy (CBT), in only a limited number of studies has CBT skill acquisition been examined, particularly among patients with complex clinical profiles. Thus, the overarching aim of this research was to develop a tool to measure patients' use of CBT skills, such that it would have clinical utility for patients and therapists during treatment. In Study 1, the authors developed an initial set of items for the Cognitive-Behavioral Therapy Skills Questionnaire (CBTSQ). They submitted these items to an exploratory factor analysis in an initial administration (n = 350) and to a confirmatory factor analysis in a second administration (n = 378). Results indicated that there were two factors (Behavioral Activation and Cognitive Restructuring) with good factor structure and internal consistency, and both the factors evidenced expected relationships with other constructs. In Study 2, the criterion validity of the CBTSQ was investigated on a patient sample in a CBT-oriented treatment setting. Results showed that CBTSQ scores increased following treatment, and Cognitive Restructuring and Behavioral Activation scores predicted reduction of overall psychiatric symptoms and depression. Thus, the CBTSQ appears to be a promising measure of CBT skill acquisition and treatment outcome as well as an instrument that can help patients and therapists monitor progress specifically related to a CBT skills training treatment approach.

Cognitive and behavioral changes related to symptom improvement among patients with a mood disorder receiving intensive cognitive-behavioral therapy.

OBJECTIVE: To examine the relationship between cognitive and behavioral changes associated with cognitive-behavioral therapy (CBT) and treatment response in an intensive partial hospital (PH) setting. METHODS: Study participants were 105 patients with mood disorders receiving treatment in a private psychiatric PH setting. The flexible treatment model used evidence-based CBT interventions adapted to the PH context, with emphases on psychoeducation and skills training. Participants completed self-report measures at admission and discharge to assess psychological distress, depression, negative automatic thoughts, and behavioral activation. Mean treatment duration was 9 days. RESULTS: Decreased negative automatic thoughts and increased behavioral activation predicted reduction of depressive symptoms; however, only decreased negative automatic thoughts was predictive of patients' overall level of psychological distress. CONCLUSIONS: These results suggest that a CBT intervention adapted for use in a PH setting can be an effective treatment for severe mood disorders. Furthermore, although the design used in this study precludes causal inferences, depressive symptom improvement appears to be associated with decreased negative automatic thoughts and increased behavioral activation. Implications for the delivery of CBT in PH programs and future directions for research are discussed.