Effectiveness of mindful self-compassion therapy on psychopathology symptoms, psychological distress and life expectancy in infertile women treated with in vitro fertilization: a two-arm double-blind parallel randomized controlled trial.

OBJECTIVES: Infertility is a prominent problem affecting millions of couples worldwide. Recently, there has been a hightened emphasis on elucidating the subtle linkages between infertility treatment leveraging assisted reproductive technology and the complex realm of psychological challenges, as well as efforts in implementation of psychological interventions.The Mindful Self-Compassion (MSC) program seeks to improve self-compassion, compassion for others, mindfulness, and life satisfaction while reducing depression, anxiety, and stress. In the current study, an MSC intervention was performed on infertile women (IW) undergoing in vitro fertilization (IVF) to assess the effectiveness of this intervention in reducing psychological distress and psychopathological symptoms and enhancing life expectancy. METHODS: Fifty-seven IW undergoing IVF were randomly allocated to two groups: MSC (n = 29) or treatment as usual (TAU; n = 28). Participants in MSC met once a week for two hours for eight weeks and attended a half-day meditation retreat. The Synder's Hope questionnaire and the Revised 90-Symptom Checklist (SCL-90-R) were used as the primary outcome measures. Data were obtained before the intervention, immediately after the intervention, and two months post-intervention. Repeated measures of ANCOVA and paired t-tests in all assessment points were used to compare the MSC and the TAU groups in outcomes. RESULTS: In the MSC group, hopelessness, anger-hostility, anxiety, interpersonal sensitivity difficulties, and depression were significantly reduced compared with the TAU group, and those improvements persisted at the two-month follow-up. Reliable change index revealed that the MSC group's gains were both clinically significant and durable. CONCLUSIONS: MSC can facilitate higher life satisfaction and mental well-being for IW undergoing IVF by reducing psychological distress, psychopathological symptoms, and hopelessness. These encouraging findings call for more research into the effectiveness of mindfulness-based therapies in addressing psychological problems among IW undergoing IVF.

Evolving an idionomic approach to processes of change: Towards a unified personalized science of human improvement.

The wide variety of "third wave" cognitive behavioral therapy (CBT) methods (e.g., Acceptance and Commitment Therapy or "ACT", Compassion Focused Therapy, Meta-Cognitive therapy, Functional Analytic Therapy, Dialectic Behavior Therapy, Mindfulness-Based Cognitive Therapy) have left a mark on the field that appears to be growing. As ACT enters its 40th year, the present paper examines key features of its development strategy as a ground from which to consider the future of CBT and evidence-based therapy. We discuss four key features of ACT development: universalism, multi-level and multi-dimensional processes linked to basic principles, idiographic concepts and methods, and an evolutionary approach. We argue that these features have facilitated the development of Process-Based Therapy (PBT) and its Extended Evolutionary Meta-Model (EEMM) of processes of change, but that idiographic methods need special contemporary emphasis, because traditional methodological and statistical approaches to processes of change are based on mathematical assumptions that cannot be met and thus limit progress in this area. We argue we need to target multi-level, multi-dimensional biopsychosocial processes of change evaluated via a functional, idionomic approach that begins with frequent idiographic assessment, and then scales to nomothetic (group level) findings when it improves idiographic fit. To identify candidate processes of change, we review the world's literature on mediational findings of randomized trials of psychological interventions for mental health outcomes. After examining nearly 55,000 studies, we identify 72 measures that have successfully mediated intervention outcomes and have been replicated. The EEMM can readily summarize and understand that set of findings, and idionomic statistical methods are available to turn these processes into a new empirical form of functional analysis applicable to the individual's goals and needs. PBT frees intervention science from the unhelpful latent disease model and creates an approach that promises more rapid progress toward a unified, personalized science of human improvement.

Mindfulness and Its Association With Varied Types of Motivation: A Systematic Review and Meta-Analysis Using Self-Determination Theory.

Mindfulness has been shown to have varied associations with different forms of motivation, leading to a lack of clarity as to how and when it may foster healthy motivational states. Grounded in self-determination theory, the present study proposes a theoretical model for how mindfulness supports different forms of human motivation, and then tests this via meta-analysis. A systematic review identified 89 relevant studies (N = 25,176), comprising 104 independent data sets and 200 effect sizes. We used a three-level modeling approach to meta-analyze these data. Across both correlational and intervention studies, we found consistent support for mindfulness predicting more autonomous forms of motivation and, among correlational studies, less controlled motivation and amotivation. We conducted moderation analyses to probe heterogeneity in the effects, including bias within studies. We conclude by highlighting substantive and methodological issues that need to be addressed in future research in this area.

Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial.

This study i⁠nvestigated if an Acceptance and Commitment Therapy (ACT) intervention (ACT-Adjust) can facilitate psychological adjustment and reduce psychological distress following severe traumatic brain injury (TBI). The study design comprised a single centre, two-armed, Phase II pilot randomized controlled trial. Nineteen individuals with severe TBI (PTA ≥7 days) who met a clinical threshold for psychological distress (Depression Anxiety Stress Scales-21; DASS > 9) were randomly allocated to either ACT-Adjust (n = 10) or an active control, Befriending Therapy (n = 9), in conjunction with a holistic rehabilitation programme. Primary (psychological flexibility, rehabilitation participation) and secondary (depression, anxiety & stress) outcomes were measured at three-time points (pre, post and follow up). Significant decreases were found for DASS-depression (group by time interaction, F 1,17 = 5.35, p = .03) and DASS-stress (group by time interaction, F 1,17 = 5.69, p = .03) in comparison to the Befriending group, but not for the primary outcome measures. The reduction in stress post-treatment was classed as clinically significant, however interaction differences for stress and depression were not maintained at one month follow up. Preliminary investigations indicate potential for ACT in decreasing psychological distress for individuals with a severe TBI with further sessions required to maintain treatment gains. The pilot results suggest further investigation is warranted in a larger scale clinical trial.

Does your mindfulness benefit others? A systematic review and meta-analysis of the link between mindfulness and prosocial behaviour.

Mindfulness-based meditation practices have received substantial scientific attention in recent years. Mindfulness has been shown to bring many psychological benefits to the individual, but much less is known about whether these benefits extend to others. This meta-analysis reviewed the link between mindfulness - as both a personality variable and an intervention - and prosocial behaviour. A literature search produced 31 eligible studies (N = 17,241) and 73 effect sizes. Meta-analyses were conducted using mixed-effects structural equation models to examine pooled effects and potential moderators of these effects. We found a positive pooled effect between mindfulness and prosocial behaviour for both correlational (d = .73 CI 95% [0.51 to 0.96]) and intervention studies (d = .51 CI 95% [0.37 to 0.66]). For the latter, medium-sized effects were obtained across varying meditation types and intensities, and across gender and age categories. Preliminary evidence is presented regarding potential mediators of these effects. Although we found that mindfulness is positively related to prosociality, further research is needed to examine the mediators of this link and the contexts in which it is most pronounced.

Emotion regulation strategies in daily life: mindfulness, cognitive reappraisal and emotion suppression.

Most empirical studies of emotion regulation have relied on retrospective trait measures, and have not examined the link between daily regulatory strategies and every day emotional well-being. We used a daily diary methodology with multilevel modelling data analyses (n = 187) to examine the influence of three emotion regulation strategies (mindfulness, cognitive reappraisal and emotion suppression) on the experience of daily negative and positive affect. Our results suggested that daily mindfulness was associated with lower negative and higher positive affect whereas the converse pattern was found for daily emotion suppression; cognitive reappraisal was related to daily positive, but not negative affect. When daily mindfulness, suppression and reappraisal were included in the same models, these strategies predicted unique variance in emotional well-being. Random slope analyses revealed substantial variability in the utility of these strategies. Indeed the presumably "adaptive" cognitive reappraisal strategy seemed to confer no benefit to the regulation of negative affect in approximately half the sample. Additional analyses revealed that age moderates the effect of cognitive reappraisal on daily negative affect: Higher use of reappraisal was associated with more negative affect for adolescents (aged 17 to 19) but became associated with less negative affect with increasing age. We interpret these results in line with a contextual view of emotion regulation where no strategy is inherently "good" or "bad".

Nonattachment and mindfulness: Related but distinct constructs.

In this study, we examined whether nonattachment, a relatively new construct in the mindfulness literature, showed convergent, discriminant, and incremental validity in relation to the well-studied 5 facets of mindfulness. Mindfulness was defined as a multifaceted construct including observing, describing, acting with awareness, nonjudging, and nonreactivity; and measured using the recently validated, 20-item Five Facet Mindfulness Questionnaire (FFMQ; Tran, Glück, & Nader, 2013; Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006). Nonattachment was defined as a flexible, balanced way of relating to one's experiences without clinging to or suppressing them, and measured using the 7-item Nonattachment Scale (NAS-7; Elphinstone, Sahdra, & Ciarrochi, 2015; Sahdra, Shaver, & Brown, 2015). In a large nationally representative sample of Americans (N = 7,884; 52% women; age, M = 47.9, SD = 16), nonattachment was positively related to all 5 aspects of mindfulness. Structural equation modeling showed that the 20-item FFMQ and NAS-7 showed good fit; their factor structures were invariant across genders and age groups; and NAS-7 was empirically distinguishable from the 5 mindfulness facets. Hierarchical regression models provided evidence of the incremental validity of NAS-7. Finally, mediation models showed that nonattachment substantially mediated the links between the mindfulness facets and the outcome variables of satisfaction with life and life effectiveness. (PsycINFO Database Record

A study protocol for Truce: a pragmatic controlled trial of a seven-week acceptance and commitment therapy program for young people who have a parent with cancer.

BACKGROUND: This paper presents the rationale and study protocol for a pragmatic controlled effectiveness trial of Truce, a prevention-based selective intervention targeting the significant mental health needs of young people who have a parent with cancer. METHODS/DESIGN: Truce is a seven week, facilitated, face-to-face group program. The design is a 2 groups (intervention vs control) x 3 (pre-treatment vs post-treatment vs 2 month follow-up) repeated measures. Allocation to groups will be dependent upon recruitment; when groups have sufficient numbers, they will be assigned to the intervention condition, but participants recruited without a viable group will be assigned to the wait-list control condition. Eligible participants are young people aged 14 to 22 years who have a parent diagnosed with cancer within the last 5 years. Wait-list controls are offered the opportunity to participate in the program once they have completed their follow-up questionnaires. The target sample size is 65 participants in each condition. The primary hypothesis is that participants in the intervention will show significant reductions in distress and increases in psychological well-being relative to participants in the wait-list control group, and these effects will continue through two-month follow-up. Mixed-models analysis of variance will be used to measure differences between the two conditions. Secondary analyses will focus on variables which may relate to the effectiveness of the intervention: ACT-related concepts of experiential avoidance and mindfulness, family functioning, unmet needs and demographic variables. We will also assess program fidelity and satisfaction. DISCUSSION: The development and evaluation of a manualised intervention for young people with a parent with cancer responds to a gap in the provision of empirically-based psychological support for this vulnerable group. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12615000761561. Registered 22(nd) July 2015.