Mindfulness and Behavior Change.

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

Mindfulness-based cognitive therapy for bipolar disorder: A systematic review.

BACKGROUND: Persisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of first-line, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that it may have effects on some of the theorized pathophysiological processes in BD. METHODS: We conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD. RESULTS: This search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control. LIMITATIONS: As meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated. CONCLUSIONS: MBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.

Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: a pilot study.

In spite of the existence of evidence-based treatments for hypochondriasis, or severe health anxiety, recovery rates are low and morbidity is high. Therefore, more treatment options are needed for this prevalent condition. Mindfulness-based cognitive therapy (MBCT) interventions have been gaining research and clinical attention for the treatment of mood, and more recently anxiety disorders. A small, uncontrolled pilot study of an 8-week group MBCT intervention for hypochondriasis was conducted. Ten subjects (five females and five males) with a mean age of 35.6 (range=25-59) recruited from an academic community health network met criteria and completed the study. There were significant improvements in measures of health anxiety, disease-related thoughts, somatic symptoms, and mindfulness at the end of treatment, and these benefits were sustained at 3-month follow-up. Participants evidenced high treatment satisfaction, with no drop-outs or adverse events. These findings provide the basis for a larger, more rigorous, controlled trial of this promising treatment approach.

Mindfulness and professionalism in dentistry.

To improve the effectiveness of teaching professionalism, the authors propose introducing mindfulness practice into the dental curriculum. The qualities cultivated through mindfulness meditation practice closely resemble the global attitudes of professionalism. Professionalism and mindfulness are broad overlapping constructs with a common prosocial aim: letting go of selfish, short-sighted rewards and promoting the long-term common good. Both constructs also aim for the highest quality of life for practitioners and patients alike. Based on a selective review of the medical literature, we suggest that mindfulness practice should help improve attentiveness, self-awareness, acceptance, wisdom, and self-care in dentistry. We briefly review the role of mindfulness in higher education, as well as current attempts at Dalhousie University to integrate mindfulness into the dental and dental hygiene curricula.

Rapid relaxation--practical management of preoperative anxiety.

Rapid relaxation (RR) is a brief set of suggestions, given while applying topical anesthetic, to reduce anxiety during local anesthesia and subsequent dental treatment. RR is recommended for managing mild dental anxiety, which is almost universal. RR combines elements of hypnosis, meditation and good basic chairside manner. It is noninvasive, takes little additional time, and empowers patients by providing them with an attractive, immediate alternative to catastrophization. We have found that RR markedly improves the quality of the dental experience.