Risk factors for suicide reattempt: a systematic review and meta-analysis.

BACKGROUND: Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor. METHODS: This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury). RESULTS: The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt. CONCLUSION: Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.

Exploring the Relationship Between Self-Compassion and Compassion for Others: The Role of Psychological Distress and Wellbeing.

We addressed construct validity and explored the relationship between self-compassion and compassion for others using the two main current operationalizations of compassion (Neff's and the Sussex-Oxford Compassion Scales, SOCSs). Relationships with psychological distress and wellbeing, and potential differences in the association between self-compassion and compassion for others by level of psychological distress and wellbeing were also explored. Participants (n = 811) completed the Spanish adaptations of the Self-Compassion Scale (SCS), the Compassion Scale (CS), the SOCSs (for the self/others), the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and the Depression Anxiety Stress Scales-21 (DASS-21). We fitted bifactor models to estimate the general factor of each construct for the different operationalizations, and calculated correlations between them. Relationships between self-compassion and compassion for others from the same operationalization were intermediate, while those between the same constructs from different operationalizations were large. Both constructs showed positive associations with wellbeing, while only self-compassion was associated with decreased psychological distress. Participants with good mental health showed higher associations between self-compassion and compassion for others than those with poorer mental health. Self-compassion and compassion for others appear to be dimensional constructs that can converge or diverge. When they converge, it is associated with better mental health.

Efficacy of Videoconference Group Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) for Chronic Low Back Pain (CLBP) Plus Comorbid Depressive Symptoms: A Randomized Controlled Trial (IMPACT Study).

This study examined the efficacy of adding a remote, synchronous, group, videoconference-based form of acceptance and commitment therapy (ACT) or behavioral activation therapy for depression (BATD) to treatment-as-usual (TAU) in 234 patients with chronic low back pain (CLBP) plus comorbid depressive symptoms. Participants were randomly assigned to ACT, BATD, or TAU. Compared to TAU, ACT produced a significant reduction in pain interference at posttreatment (d = .64) and at follow-up (d = .73). BATD was only superior to TAU at follow-up (d = .66). A significant reduction in pain catastrophizing was reported by patients assigned to ACT and BATD at posttreatment (d = .45 and d = .59, respectively) and at follow-up (d = .59, in both) compared to TAU. Stress was significantly reduced at posttreatment by ACT in comparison to TAU (d = .69). No significant between-group differences were found in depressive or anxiety symptoms. Clinically relevant number needed to treat (NNT) values for reduction in pain interference were obtained at posttreatment (ACT vs TAU = 4) and at follow-up (ACT vs TAU = 3; BATD vs TAU = 5). In both active therapies, improvements in pain interference at follow-up were significantly related to improvements at posttreatment in psychological flexibility. These findings suggest that new forms of cognitive-behavioral therapy are clinically useful in improving pain interference and pain catastrophizing. Further research on evidence-based change processes is required to understand the therapeutic needs of patients with chronic pain and comorbid conditions. TRIAL NUMBER: NCT04140838. PERSPECTIVE: Group videoconference-based ACT and BATD showed greater efficacy than TAU for reducing pain interference and pain catastrophizing in patients with CLBP plus clinically relevant depression. Psychological flexibility appeared to be the main contributor to treatment effects for both ACT and BATD.

A Systematic Review of the Adherence to Home-Practice Meditation Exercises in Patients with Chronic Pain.

Mindfulness-, compassion-, and acceptance-based (i.e., "third wave") psychotherapies are effective for treating chronic pain conditions. Many of these programs require that patients engage in the systematic home practice of meditation experiences so they can develop meditation skills. This systematic review aimed at evaluating the frequency, duration, and effects of home practice in patients with chronic pain undergoing a "third wave" psychotherapy. A comprehensive database search for quantitative studies was conducted in PubMed, Embase, and Web of Sciences Core Collection; 31 studies fulfilled the inclusion criteria. The reviewed studies tended to indicate a pattern of moderately frequent practice (around four days/week), with very high variability in terms of time invested; most studies observed significant associations between the amount of practice and positive health outcomes. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy were the most common interventions and presented low levels of adherence to home practice (39.6% of the recommended time). Some studies were conducted on samples of adolescents, who practiced very few minutes, and a few tested eHealth interventions with heterogeneous adherence levels. In conclusion, some adaptations may be required so that patients with chronic pain can engage more easily and, thus, effectively in home meditation practices.

How mindfulness, self-compassion, and experiential avoidance are related to perceived stress in a sample of university students.

University students constitute a population that is highly vulnerable to developing mental health problems, such as distress. The role of different variables associated with the development of states of stress has been studied in order to identify potential risk and protective factors. This study explored whether mindfulness, self-compassion, and experiential avoidance, while controlling for specific sociodemographic and academic variables, were potential significant protective or risk factors explaining perceived stress in a sample of 589 Spanish university students (81.2% female, age range 18-48 years). A hierarchical multiple regression analysis was performed using an exploratory cross-sectional design. Higher experiential avoidance, lower self-compassion, lower mindfulness, not perceiving family support, higher total study hours per week, having a partner (vs. being single), being female (vs. being male), and being older were significantly associated with higher levels of perceived stress. In conclusion, perceived stress in our sample was positively associated with experiential avoidance, which could be regarded as a potential psychological risk variable. In contrast, perceived stress was negatively correlated with self-compassion and mindfulness, which, in turn, could be seen as protective factors. Accordingly, it is concluded that programmes aimed at reducing stress and at improving well-being among university students should include experiential avoidance, self-compassion, and mindfulness as therapeutic targets.

Risk of suicide attempt repetition after an index attempt: A systematic review and meta-analysis.

OBJECTIVES: To estimate the risk of suicide attempt repetition among individuals with an index attempt. It also aims to study the role of risk factors and prevention programme in repetition. METHODS: This systematic review and meta-analysis was conducted in keeping with the PRISMA 2020 guidelines. Studies on attempt repetition (both cohort studies and intervention studies) were searched from inception to 2022. RESULTS: A total of 110 studies comprising 248,829 attempters was reviewed. The overall repetition rate was 0.20 (0.17, 0.22). Repetition risk linearly increased over time. A higher risk of attempt repetition was associated with female sex and index attempts in which self-cutting methods were used. Moreover, a mental disorder diagnosis was associated with an increasing repetition risk (OR = 2.02, p < .01). The delivery of a preventive programme reduced the repetition risk, OR = 0.76, p < .05; however, this effect was significant for psychotherapy interventions, OR = 0.38, p < .01. CONCLUSION: One in five suicide attempters will engage in a new suicide attempt. An elevated repetition risk is associated with being female, more severe index methods and psychiatric disorder diagnosis. Preventive programmes, particularly psychotherapy, may contribute to reducing repetition risk and eventually save lives.

Effects of eHealth interventions on stress reduction and mental health promotion in healthcare professionals: A systematic review.

AIMS: To evaluate the effectiveness of eHealth interventions to reduce stress and promote mental health in healthcare professionals, and to compare the efficacy of different types of programs (guided vs. self-guided; 'third-wave' psychotherapies vs. other types). BACKGROUND: Healthcare workers present high levels of stress, which constitutes a risk factor for developing mental health problems such as depression and anxiety. eHealth interventions have been designed to reduce these professional's stress considering that the characteristics of this delivery method make it a cost-effective and very appealing alternative because of its fast and easy access. DESIGN: A systematic review of quantitative studies. METHODS: A comprehensive database search for quantitative studies was conducted in PubMed, EMBASE and Cochrane (until 1 April 2022). The systematic review was conducted in accordance with the PRISMA and SWiM reporting guidelines. The quality of the studies was assessed using the National Heart, Lung and Blood Institute tools. RESULTS: The abstracts of 6349 articles were assessed and 60 underwent in-depth review, with 27 fulfilling the inclusion criteria. The interventions were classified according to their format (self-guided vs. guided) and contents ('third-wave' psychotherapies vs. others). Twenty-two interventions emerged, 13 of which produced significant posttreatment reductions in stress levels of health professionals (9 self-guided, 8 'third wave' psychotherapies). Significant effects in improving depressive symptomatology, anxiety, burnout, resilience and mindfulness, amongst others, were also found. CONCLUSION: The evidence gathered in this review highlights the heterogeneity of the eHealth interventions that have been studied; self-guided and 'third-wave' psychotherapy programs are the most common, often with promising results, although the methodological shortcomings of most studies hinder the extraction of sound conclusions. PROTOCOL REGISTRATION: PROSPERO CRD42022310199. No Patient or Public Contribution.

'Mindful eating' for reducing emotional eating in patients with overweight or obesity in primary care settings: A randomized controlled trial.

OBJECTIVE: The primary aim of this study was to analyse the efficacy of a 'mindful eating' programme for reducing emotional eating in patients with overweight or obesity. METHOD: A cluster randomized controlled trial (reg. NCT03927534) was conducted with 76 participants with overweight/obesity who were assigned to 'mindful eating' (7 weeks) + treatment as usual (TAU), or to TAU alone. They were assessed at baseline, posttreatment and 12-month follow-up. The main outcome was 'emotional eating' (Dutch Eating Behaviour Questionnaire, DEBQ); other eating behaviours were also assessed along with psychological and physiological variables. RESULTS: 'Mindful eating' + TAU reduced emotional eating both at posttreatment (B = -0.27; p = 0.006; d = 0.35) and follow-up (B = -0.53; p < 0.001; d = 0.69) compared to the control group (TAU alone). 'External eating' (DEBQ) was also significantly improved by the intervention at both timepoints. Significant effects at follow-up were observed for some secondary outcomes related to bulimic behaviours, mindful eating, mindfulness, and self-compassion. Weight and other physiological parameters were not significantly affected by 'mindful eating' + TAU. CONCLUSIONS: These findings support the efficacy of the 'mindful eating' + TAU programme for reducing emotional and external eating, along with some other secondary measures, but no significant changes in weight reduction were observed.

Implementation of a psychological online intervention for low to moderate depression in primary care: study protocol.

Background: Depression affects millions of people all over the world and implies a great socioeconomic burden. Despite there are different effective evidence-based interventions for treating depression, only a small proportion of these patients receives an appropriate treatment. In this regard, information and communication technologies (ICTs) can be used with therapeutic aims and this can contribute to make interventions more accessible. One example is "Smiling is fun", an internet-based treatment which has proved to be effective and cost-effective for treating depression in Spanish Primary Care (PC). However, the "know-do gap" between research and clinical settings implies that the actual implementation of such interventions could last up to 20 years. To overcome this obstacle, the implementation research establishes the methodology to implement the advances developed in the laboratories to the health care services maintaining the validity of the intervention and offering specific strategies for the implementation process. Objective: This is the protocol of an implementation study for the Internet-based program "Smiling is fun", which will be conducted on patients with mild-to-moderate depression of Spanish PC settings. In the implementation study, the feasibility, efficacy, cost-efficacy, acceptability, adoption, appropriateness, fidelity, penetration, normalization, and sustainability will be assessed. Methods: The current investigation is a Hybrid Effectiveness-Implementation Type II design. A Stepped Wedge randomized controlled trial design will be used, with a cohort of 420 adults diagnosed with depression (mild-to-moderate) who will undergo a first control phase (no treatment) followed by the intervention, which will last 16 weeks, and finishing with an optional use of the intervention. All patients will be assessed at baseline, during the treatment, and at post-treatment. The study will be conducted in three Spanish regions: Andalusia, Aragon, and the Balearic Islands. Two primary care centers of each region will participate, one located in the urban setting and the other in the rural setting. The primary outcome will be implementation success of the intervention assessing the reach, clinical effect, acceptability, appropriateness, adoption, feasibility, fidelity, penetration, implementation costs and sustainability services. Discussion: "Smiling is Fun", which has already been established as effective and cost-effective, will be adapted according to users' experiences and opinions, and the efficacy and cost-efficacy of the program will again be assessed. The study will point out barriers and facilitators to consider in the implementation process of internet-based psychological interventions in health services. The ultimate goal is to break the research-to-practice split, which would undoubtedly contribute to reduce the high burden of depression in our society. Trial registration: ClinicalTrials.gov, Identifier: NCT05294614.

Effectiveness and implementation of an online intervention (MINDxYOU) for reducing stress and promote mental health among healthcare workers in Spain: a study protocol for a stepped-wedge cluster randomized trial.

BACKGROUND: The World Health Organization has formally recognized that healthcare professionals are at risk of developing mental health problems; finding ways to reduce their stress is mandatory to improve both their quality of life and, indirectly, their job performance. In recent years, particularly since the COVID-19 pandemic outbreak, there has been a proliferation of online interventions with promising results. The purpose of the present study is twofold: to test the effectiveness of an online, self-guided intervention, MINDxYOU, to reduce the stress levels of healthcare workers; and to conduct an implementation study of this intervention. Additionally, an economic evaluation of the intervention will be conducted. METHODS: The current study has a hybrid effectiveness-implementation type 2 design. A stepped wedge cluster randomized trial design will be used, with a cohort of 180 healthcare workers recruited in two Spanish provinces (Malaga and Zaragoza). The recruitment stage will commence in October 2022. Frontline health workers who provide direct care to people in a hospital, primary care center, or nursing home setting in both regions will participate. The effectiveness of the intervention will be studied, with perceived stress as the main outcome (Perceived Stress Scale), while other psychopathological symptoms and process variables (e.g., mindfulness, compassion, resilience, and psychological flexibility) will be also assessed as secondary outcomes. The implementation study will include analysis of feasibility, acceptability, adoption, appropriateness, fidelity, penetration, and sustainability. The incremental costs and benefits, in terms of quality-adjusted life years, will be examined by means of cost-utility and cost-effectiveness analyses. DISCUSSION: MINDxYOU is designed to reduce healthcare workers' stress levels through the practice of mindfulness, acceptance, and compassion, with a special focus on how to apply these skills to healthy habits and considering the particular stressors that these professionals face on a daily basis. The present study will show how implementation studies are useful for establishing the framework in which to address barriers to and promote facilitators for acceptability, appropriateness, adoption, feasibility, fidelity, penetration, and sustainability of online interventions. The ultimate goal is to reduce the research-to-practice gap. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov on 29/06/2022; registration number: NCT05436717.

Attachment-Based Compassion Therapy for Reducing Anxiety and Depression in Fibromyalgia.

Fibromyalgia patients often experience anxiety and depressive symptoms; however, validated interventions show only limited efficacy. This pilot study analyzed the effects of a 16-session version of attachment-based compassion therapy (ABCT-16) for improving anxiety and depressive symptomatology, as well as self-compassion and decentering, in 11 fibromyalgia patients. Scales were assessed at four time points: baseline, after sessions 8 and 16, and 3.5 months after the completion of the program. Significant improvements were found in all outcomes after the program, and most remained significant in the follow-up assessment. Our preliminary results suggest that ABCT-16 can be effective for improving anxiety and depressive symptomatology in fibromyalgia patients. Nonetheless, further studies with larger samples and control groups are necessary to confirm these results.

Examining the Relation Between Practicing Meditation and Having Peak Experiences and Lucid Dreams. A Cross-Sectional Study.

The aim of this study was to compare meditators and non-meditators in terms of their tendency to have peak experiences and their dream lucidity, while examining the associations between these outcomes and some related variables such as non-dual awareness, mindfulness facets and absorption. In this cross-sectional study, 237 participants from general Spanish population completed an online survey that included ad hoc questions related to the study aim, along with the Five Facet Mindfulness Questionnaire (FFMQ), the Non-dual Embodiment Thematic Inventory (NETI), the Tellegen Absorption Scale (TAS) and the Lucidity and Consciousness in Dreams Scale (LUCID). Of the total, 110 participants were identified as meditators and 127 as non-meditators. More than half of the sample (58.2%) reported having experienced at least one peak experience in their life; these showed no differences in the number, intensity, or self-inducing ability of these experiences between both groups but were significantly more common among meditators (71.8% vs. 46.8%; p < 0.001), who also presented higher scores in most of the questionnaires, except for some LUCID subscales. Regression models demonstrated that being a meditator was a significant predictor of having had a peak experience, but not of LUCID scores. These results, which need to be interpreted considering the study limitations, support the potential of meditation to facilitate having peak experiences, while its impact on lucid dreams remains unclear.

The Gambling Habits of University Students in Aragon, Spain: A Cross-Sectional Study.

Gambling has become a routine form of entertainment for many young people. The aim of this study was to describe the gambling behavior that university students are developing in Aragon, Spain, and to analyze whether these habits are more common among students of sports science, on the assumption that they are more likely to have a higher exposure to betting company marketing. A cross-sectional design was applied, with data collected on advertising exposure, gambling habits and experiences, and opinions on the impact of gambling and its regulation from 516 undergraduate students from the University of Zaragoza. The online survey included ad hoc questions and the "Pathological Gambling Short Questionnaire" to screen for potential gambling disorders. Almost half of the sample had bet money at least once in their life (48.1%), and 2.4% screened positive for consideration of a possible diagnosis of pathological gambling. Betting shops (44.2%) were the most common gambling option, and students of sports science showed a higher prevalence of pathological gambling and had greater tendencies to make bets. Gambling is perceived as a normal leisure activity by a significant part of university students. The development of transversal strategies is required to raise awareness towards the potential dangers of gambling.

Experiential Avoidance in Primary Care Providers: Psychometric Properties of the Brazilian "Acceptance and Action Questionnaire" (AAQ-II) and Its Criterion Validity on Mood Disorder-Related Psychological Distress.

BACKGROUND: A sizeable proportion of Brazilian Primary Care (PC) providers suffer from common mental disorders, such as anxiety and depression. In an effort to cope with job-related distress, PC workers are likely to implement maladaptive strategies such as experiential avoidance (EA). The Acceptance and Action Questionnaire (AAQ-II) is a widely used instrument that evaluates EA but has shown questionable internal consistency in specific populations. This study assesses the psychometric properties of the AAQ-II among Brazilian PC providers, evaluates its convergence and divergence with self-criticism and mindfulness skills, and explores its criterion validity on anxiety and depressive symptoms. METHODS: A cross-sectional design was conducted in Brazilian PC services, and the sample included 407 PC workers. The measures evaluated EA, self-criticism, mindfulness, depression, and anxiety. RESULTS: The one-factor model of the AAQ-II replicated the original version structure. The AAQ-II presented good internal consistency among Brazilian PC providers. A multiple regression model demonstrated higher relationships with self-criticism than mindfulness skills. The criterion validity of the AAQ-II on anxiety and depression was stronger in the context of more severe symptoms. CONCLUSIONS: The AAQ-II is an appropriate questionnaire to measure the lack of psychological flexibility among Brazilian PC workers in the sense of EA.

The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance.

Objectives: Evidence suggests the efficacy of mindfulness-based cognitive therapy (MBCT) to prevent depression relapse and decrease depressive symptoms during the acute phase. However, the effectiveness of MBCT in real-world heterogeneous samples treated in clinical health settings, including primary care, has received little attention. This study had two aims: (1) to evaluate the effectiveness of MBCT delivered in primary care considering pre-treatment depression scores and (2) to explore the role of participants' characteristics on symptom improvement. Methods: Data were obtained from 433 individuals who received MBCT. Participants completed the Personality Inventory for ICD-11 (PiCD) pretreatment and the Beck Depression Inventory (BDI-II) pre- and post-treatment. Results: Sixty percent presented moderate-to-severe depression according to scores on the BDI-II, 18.1% presented mild depression, and 21.7% were in the non-depressed range. The severity of pre-treatment depressive symptoms was associated with outcomes. Most individuals who lacked depressive symptoms at baseline remained in the non-clinical range after the treatment. Those in the severe group benefited the most from the intervention, since 35.6% were considered recovered. Rates of deterioration ranged from 2.1 to 2.7%, depending on the depression-baseline scores. Depression severity at the entrance, attendance, and age, but not personality traits, appear to be related to symptom improvement. Conclusions: According to our results, MBCT can be effectively and safely delivered in primary care.

Effectiveness of mindfulness-based stress reduction and attachment-based compassion therapy for the treatment of depressive, anxious, and adjustment disorders in mental health settings: A randomized controlled trial.

OBJECTIVES: To study the effectiveness of attachment-based compassion therapy (ABCT) for reducing affective distress in a sample of outpatients with depressive, anxiety, or adjustment disorders, and to explore its mechanisms of action. METHODS: This randomized controlled trial involved the assessment time points of pretreatment, posttreatment and 6-month follow-up. A total of 90 patients from three mental health units in Castellón, Spain, were recruited and randomly assigned to "ABCT + treatment as usual (TAU)," "Mindfulness-based stress reduction (MBSR) + TAU" or "TAU" alone. Affective distress, as measured by the "Depression, Anxiety and Stress Scales" (DASS-21) was the main outcome; self-compassion and mindfulness were also assessed. Multilevel mixed-effects models were used to estimate the effectiveness of the program, and path analyses were conducted to study the potential mechanistic role of mindfulness and self-compassion. RESULTS: ABCT was not superior to MBSR in any outcome or at any assessment point. ABCT was superior to TAU alone both posttreatment (B = -13.20; 95% confidence interval [CI]: -19.57, -6.84) and at 6-month follow-up (B = -7.20; 95% CI: -13.63, -0.76) for reducing DASS-21, and MBSR was superior to TAU alone both posttreatment (B = -11.51; 95% CI: -17.97, -5.05) and at 6-month follow-up (B = -8.59; 95% CI: -15.09, -2.10), with large effects (d ≥ 0.90). Changes produced by ABCT in DASS-21 were mediated by self-compassion, whereas changes produced by MBSR were mediated by both mindfulness and self-compassion. CONCLUSION: ABCT is effective for reducing affective distress in patients with anxiety, depressive and adjustment disorders, although its effect is not superior to that offered by MBSR. Self-compassion seems to be a significant mediator of the effects of ABCT.

Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: A randomized controlled trial.

OBJECTIVES: To evaluate the efficacy of a mindfulness-based programme (MBP) for reducing stress in university students and its action mechanisms and to explore the capacity of virtual reality (VR) exposure to enhance adherence to the intervention. METHODS: This randomized controlled trial (RCT) involved assessment time points of baseline, posttreatment, and 6-month follow-up. A total of 280 students from two Spanish universities were randomly assigned to 'MBP', 'MBP + VR', or 'Relaxation' (active controls). Perceived stress posttreatment was the primary outcome; wellbeing and academic functional outcomes were assessed as well. Multilevel mixed-effects models were performed to estimate the efficacy of the programme. RESULTS: Both 'MBP' (B = -2.77, d = -0.72, p = .006) and 'MBP + VR' (B = -2.44, d = -0.59, p = .014) were superior to 'Relaxation' in improving stress, as well as most of the secondary outcomes, with medium-to-large effects posttreatment and at follow-up. The long-term effects of MBPs on stress were mediated by mindfulness and self-compassion in parallel. Treatment adherence was improved in the 'MBP + VR' group, with higher retention rates and session attendance (p < .001). CONCLUSIONS: This RCT supports the efficacy of an MBP compared to relaxation for reducing stress in university students through mindfulness and self-compassion as mechanisms of change. VR exposure may enhance treatment adherence. TRIAL REGISTRATION: ClinicalTrials.gov NCT03771300.

Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience / Impacto del mindfulness y de la autocompasión en la ansiedad y la depresión: rol mediador de la resiliencia

Background/Objective: ‘Third-wave’ psychotherapies have shown effectiveness for treating psychopathological symptoms such as anxiety and depression. There is burgeoning interest in examining how these therapies’ core constructs produce their therapeutic benefits. This study explores the hypothetical mediating effect of resilience in the impact of mindfulness and self-compassion on anxiety and depressive symptoms. Method: Cross-sectional study design. The sample consisted of 860 Spanish general population participants. The measures included the Mindful Attention Awareness Scale (MAAS), the Self-Compassion Scale (SCS-12), the Connor-Davidson Resilience Scale (CD-RISC) and the Goldberg Anxiety and Depression Scale (GADS). Bivariate correlations were calculated, and path analysis models were performed. Results: Significant correlations were found between the study variables, always in the expected direction (all p values <.001). The path analysis models showed significant direct effects of mindfulness and self-compassion on anxiety and depression symptoms, but the only significant indirect effects through resilience were found on depression (MAAS: β = -.05, 95% CI = -.11 to -.02; SCS-12: β = -.06, 95% CI = -.33 to -.07). Conclusions: Resilience might partially mediate the effect of mindfulness and self-compassion on depression, but not on anxiety. (AU)

Antecedentes/Objetivo: Las terapias de “tercera generación” han probado ser eficaces para tratar síntomas psicopatológicos como la ansiedad y la depresión. Hay un interés creciente en examinar cómo los constructos nucleares de estas terapias producen beneficios terapéuticos. Este estudio explora el hipotético efecto mediador de la resiliencia en la relación del mindfulness y la autocompasión sobre los síntomas de ansiedad y depresión. Método: Estudio de diseño transversal. Muestra formada por 860 participantes españoles de la población general. Las medidas incluidas fueron: MAAS, SCS-12, CD-RISC y GADS. Se calcularon correlaciones bivariadas y se realizaron modelos de análisis del camino. Resultados: Se hallaron correlaciones significativas entre las variables, siempre en la dirección esperada (p < 0,001). El modelo de análisis del camino mostró efectos directos significativos de mindfulness y autocompasión sobre síntomas de ansiedad y depresión, pero el único efecto indirecto significativo a través de la resiliencia se encontró en depresión (MAAS: β = -0,05, 95% CI = -0,11 ‒ -0,02; SCS-12: β = -0,06, 95% CI = -0,33 ‒ -0,07). Conclusiones: La resiliencia puede mediar parcialmente el efecto de mindfulness y autocompasión sobre la depresión, pero no sobre la ansiedad. (AU)

Protective role of mindfulness, self-compassion and psychological flexibility on the burnout subtypes among psychology and nursing undergraduate students.

AIMS: To explore the relationship between mindfulness, self-compassion and psychological flexibility, and the burnout subtypes in university students of the Psychology and Nursing degrees, and to analyse possible risk factors for developing burnout among socio-demographic and studies-related characteristics. DESIGN: Cross-sectional study conducted on a sample of 644 undergraduate students of Nursing and Psychology from two Spanish universities. METHODS: The study was conducted between December 2015 and May 2016. Bivariate Pearson's correlations were computed to analyse the association between mindfulness facets, self-compassion and psychological flexibility, and levels of burnout. Multivariate linear regression models and bivariate and multivariate binary logistic regressions were also computed. RESULTS: The three subtypes of burnout presented significant correlations with psychological flexibility, self-compassion and some mindfulness facets. Psychological flexibility, self-compassion and the mindfulness facets of observing and acting with awareness were significantly associated to burnout. Among the risk factors, 'year of study' was the only variable to show significantly higher risk for every burnout subtype. CONCLUSION: The significant associations found between mindfulness, self-compassion, psychological flexibility and burnout levels underline the need of including these variables as therapeutic targets when addressing the burnout syndrome in university students. IMPACT: Undergraduate students, especially those of health sciences, often experience burnout. This study delves into the protective role of some psychological variables: mindfulness, self-compassion and psychological flexibility. These should be considered as potentially protective skills for developing burnout, and therefore, undergraduate students could be trained on these abilities to face their studies and their future profession to prevent experiencing burnout syndrome.

Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience.

Background/Objective 'Third-wave' psychotherapies have shown effectiveness for treating psychopathological symptoms such as anxiety and depression. There is burgeoning interest in examining how these therapies' core constructs produce their therapeutic benefits. This study explores the hypothetical mediating effect of resilience in the impact of mindfulness and self-compassion on anxiety and depressive symptoms. Method: Cross-sectional study design. The sample consisted of 860 Spanish general population participants. The measures included the Mindful Attention Awareness Scale (MAAS), the Self-Compassion Scale (SCS-12), the Connor-Davidson Resilience Scale (CD-RISC) and the Goldberg Anxiety and Depression Scale (GADS). Bivariate correlations were calculated, and path analysis models were performed. Results: Significant correlations were found between the study variables, always in the expected direction (all p values <.001). The path analysis models showed significant direct effects of mindfulness and self-compassion on anxiety and depression symptoms, but the only significant indirect effects through resilience were found on depression (MAAS: ß = -.05, 95% CI = -.11 to -.02; SCS-12: ß = -.06, 95% CI = -.33 to -.07). Conclusions: Resilience might partially mediate the effect of mindfulness and self-compassion on depression, but not on anxiety.

Antecedentes/Objetivo: Las terapias de "tercera generación" han probado ser eficaces para tratar síntomas psicopatológicos como la ansiedad y la depresión. Hay un interés creciente en examinar cómo los constructos nucleares de estas terapias producen beneficios terapéuticos. Este estudio explora el hipotético efecto mediador de la resiliencia en la relación del mindfulness y la autocompasión sobre los síntomas de ansiedad y depresión. Método: Estudio de diseño transversal. Muestra formada por 860 participantes españoles de la población general. Las medidas incluidas fueron: MAAS, SCS-12, CD-RISC y GADS. Se calcularon correlaciones bivariadas y se realizaron modelos de análisis del camino. Resultados: Se hallaron correlaciones significativas entre las variables, siempre en la dirección esperada (p < 0,001). El modelo de análisis del camino mostró efectos directos significativos de mindfulness y autocompasión sobre síntomas de ansiedad y depresión, pero el único efecto indirecto significativo a través de la resiliencia se encontró en depresión (MAAS: ß = -0,05, 95% CI = -0,11 ‒ -0,02; SCS-12: ß = -0,06, 95% CI = -0,33 ‒ -0,07). Conclusiones: La resiliencia puede mediar parcialmente el efecto de mindfulness y autocompasión sobre la depresión, pero no sobre la ansiedad.