Monday, January 31, 2011

In Opening Monologue, Jay Leno Refers to Dr. Twohig's Study of Acceptance and Commitment Therapy for OCD

Back in October, I posted about a study by Dr. Michael Twohig of Utah State. The study focused on the use of Acceptance and Commitment Therapy (ACT) in the treatment of obsessive-compulsive disorder.

I haven't seen it myself, but apparently Jay Leno made a joke about the study in a recent Tonight Show monologue. According to The Utah Statesman: 

A few weeks ago, Jay Leno's opening monologue mentioned a study that recently began here at USU focusing on scrupulosity. He joked that researchers are looking into people obsessed with morals and religion and the punch line was, "Yeah, we call those people parents."

While this is probably a footnote in Dr. Twohig's career, I still think it's really neat that the study is well-known enough to catch the attention of Leno or his cadre of joke writers.

The title of the article is "Leno-Featured Prof Sudies [SIC] Moral Obsessions." (That's a pretty glaring typo in the title!--I presume the writer meant "studies," not "sudies." College newspapers...)

To read the Utah Statesman article, click here.

To read my post of the actual study, click here.

Friday, January 28, 2011

A Novel Application of Acceptance and Commitment Therapy for Psychosocial Problems Associated with Multiple Sclerosis

In a previous post, I wrote about an 8-week mindfulness-based intervention for multiple sclerosis. Here's one that's even shorter: it's a one-shot 5-hour workshop.

This study is from Dr. John Forsyth's lab at the University of Albany - SUNY. His lab is also currently investigating the effectiveness of Dr. Forsyth's self-help book, from which some preliminary data looking at mindfulness and self-compassion was recently published.

Dr. Forsyth and another psychologist led a 5-hour Acceptance and Commitment Therapy (ACT) workshop for people with multiple sclerosis (MS). At the end of the workshop, participants were given a CD of various mindfulness exercises and a bunch of worksheets and exercises from the workshop. They also received daily practice logs to track what they did following the workshop. Fifteen people with MS completed a battery as part of the workshop, and 11 completed the battery again 12 weeks later.

According to the authors, MS is the most common cause of neurologic disability in the US. MS is incurable and associated with pain, fatigue, depression, and anxiety.

For a one-short 5-hour workshop, the results are very promising. Depression decreased over time, showing a large effect. (Depression went from the moderate-severe range down to the mild-moderate range.) Although the effect of pain itself did not change, the impact of pain on behavior and mood decreased at follow-up. Mindfulness did not improve, but people reported a reduced tendency to suppress thoughts, which suggests increased mindful acceptance. Lastly, overall quality of life improved at the follow-up. Participants reported practicing exercises from the workshop or listening to the mindfulness CD nearly 3 hours per week, which is pretty good.

Because of the design of the study, the findings are preliminary. With only 15 people, 4 of whom dropped out, it's difficult to know how representative the sample is; however, with such a small sample size, it's impressive the researchers found significant results at all, as the results had to be very strong to be detected. Also, without a comparison group, it's impossible to know if ACT was the active ingredient. The authors acknowledged these weaknesses and others in the paper.

Limitations aside, the results are extremely promising. If a 5-hour group could lead to some pretty strong improvements for people with a painful, incurable disease, this is well worth exploring further. According to the authors, traditional cognitive behavioral treatments have shown mixed results for people with MS, and even the positive results weren't all that impressive. By contrast, this is a short, inexpensive group intervention that may have made a real different in the lives of people with MS.

To download a pdf of the article, click on the citation below:

Sheppard, S.C., Forsyth, J.P., Hickling, E.J., & Bianchi, J.M. (2010). A Novel Application of Acceptance and Commitment Therapy for Psychosocial Problems Associated with Multiple Sclerosis: Results from a Half-Day Workshop Intervention. International Journal of MS Care, 12, 200-206.

Friday, January 21, 2011

Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhancing Psychological Flexibility

Within the past few years, I've been coming across more and more studies of time-limited, group interventions of mindfulness and acceptance-based treatments. Recently, a group of Dutch researchers designed and implemented a brief Acceptance and Commitment Therapy (ACT) intervention for people with mild to moderate distress.

From an initial pool of 140, 93 people were randomly assigned to either an ACT and mindfulness intervention (n = 49) or a wait list (n = 44). They completed measures before the intervention, immediately after the intervention, and 3 months after the intervention.

The ACT and mindfulness intervention consisted of eight 2-hour groups with about 7 people each. Facilitators taught each of the 6 core ACT processes, and mindfulness exercises were woven in each session. After the study ended, the wait list participants were allowed to take part in the intervention.

The researchers found that emotional and psychological well-being improved following the intervention. There was no change in social well-being. Psychological flexibility--defined as the ability to move towards meaningful change in the present moment--did not increase immediately after the intervention but showed improvement at the 3-month follow-up. I always find these sort of delayed effects interesting, as it suggests an active intervention beyond the basic group effects. Moreover, improvements in psychological flexibility appeared to impact improvements in mental health.

As the authors acknowledge, a wait list control group is not ideal, as it doesn't eliminate the possibility that improvements were related to the fact that people received eight session of something; that is, it's hard to tell if improvements are unique to the particular intervention. This caveat aside, the study joins a growing body of literature suggesting that comparatively brief, mindfulness-based intervention can have a significant impact on people.

Member of the Association for Contextual Behavioral Science can download the article here.

See below for the full citation:

Fledderus, M., Bohlmeijer, E.T., Smit, F., & Westerhof, G.J. (2010). Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhancing Psychological Flexibility. American Journal of Public Health, 100(12), 2372-2378.

Friday, January 14, 2011

On Being Mindful, Emotionally Aware, and More Resilient: Longitudinal Pilot Study of Police Recruits

I don't tend to read much research about the study of law enforcement. Consequently, it was with great curiosity that I came across a recent study by a group of researchers at the University of Wollongong in New South Wales, Australia.

Dr. Williams--along with Dr. Ciarrochi, who authored another study I recently wrote about on adolescent well-being--examined changes in police recruits between becoming trainees to being "probationary constables." Of the 592 recruits who completed the initial assessment through a Bachelor of Policing course, 60 completed the follow-up measures.

According to the authors, police are encouraged to not show emotions within the law enforcement culture. Research has shown that police become more emotionally detached within 18 months of service. As there's a large body of research suggesting that detachment from emotions can have detrimental consequences to emotional health, the researchers were interested in the interaction of these variables over time.

Perhaps the most striking finding of this study was that police recruits showed an increase in depression and other mental health problems after starting the job. What's really interesting, though, is that officers who were more mindful, less likely to suppress thoughts, and more able to identify feelings, showed smaller increases in depression. Moreover, of the variables measured by the researchers, low mindfulness was the strongest predictor of depression. (This indirectly supports the Mindfulness-Based Cognitive Therapy research.) Results suggest that mindfulness and the ability to identify one's feelings may have a protective factor for police recruits.

This study measured dispositional mindfulness. As the authors suggest, it would be really interesting to see if a mindfulness-based intervention may help to foster these abilities in police recruits. There could be significant long-term benefits for law enforcement agencies.

To download a copy of the study, click on the citation below:

Williams, V., Ciarrochi, J., & Deane, F.P. (2010). On Being Mindful, Emotionally Aware, and More Resilient: Longitudinal Pilot Study of Police Recruits. Australian Psychologist, 45(4), 274-282.

Monday, January 10, 2011

University of California-San Diego Center for Mindfulness

The Center for Mindfulness at UCSD has opened up a number of social networking opportunities.

For professionals interested in mindfulness-based treatments, there's a Mindfulness-Based Interventions Linked In group. (Click on the link to access.) From there, one can join subgroups, including Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Mindfulness-Based Relapse Prevention, among others.

In addition, there's a Center for Mindfulness Facebook Fan Page. (Click on the link to access.)

I just became aware of these sites today, so I haven't had a chance to fully explore them. However, the Center for Mindfulness has been an excellent resource for mindfulness-based training an resources for several years now. Their resources are well-worth checking out!

Tuesday, January 4, 2011

The Wall Street Journal Article on Mindfulness-Based Treatments

The 01/02/2011 issue of the The Wall Street Journal features an article by Melinda Beck on mindfulness-based treatments. The article quotes Dr. Steven Hayes, the prime originator of Acceptance and Commitment Therapy (ACT), Dr. Zindel Segal, one of the developers of Mindfulness-Based Cognitive Therapy (MBCT), and Dr. Marsha Linehan, the prime originator of Dialectical Behavior Therapy (DBT). According to the article:

This new psychology movement centers on mindfulness—the increasing popular emphasis on paying attention to the present moment. One of its key tenets is that urging people to stop thinking negative thoughts only tightens their grip—"like struggling with quicksand," Dr. Hayes says. But simply observing them like passing clouds can diffuse their emotional power, proponents say, and open up more options. ("Here's that old fat feeling again. You know, this happens every time I look at fashion magazines. I am sure judging myself harshly. Do I want to go to the gym? Or I could go to a movie. Or I could stop reading magazines.")

To read the full article, click here.

Self-Compassion is a Better Predictor Than Mindfulness of Symptom Severity and Quality of Life in Mixed Anxiety and Depression

Way back in June, I wrote about some data Dr. John Forsyth had collected about his self-help book, The Mindfulness and Acceptance Workbook for Anxiety. Dr. Forsyth's lab is still collecting data for the second part of the study; in the meantime, they've used some of it to look at the relationship between mindfulness and self-compassion to anxiety and depression. Self-compassion, which SM has posted about before, was developed by Dr. Kristin Neff and is based on Buddhist notions of compassion. The three components of self-compassion are mindfulness, kindness to one's self (as opposed to self-judgment), and feeling part of a common humanity (as opposed to isolation).

Dr. Forsyth's lab analyzed some of the data they've been collecting from 504 people to look at what processes may be most important to anxiety and depression. They used Dr. Neff's Self-Compassion Scale (SCS; Neff, 2003) and--for their measure of mindfulness--the Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003). The articles uses some very precise statistical terms that I'll try to translate for a more general audience, but please bear in mind that my descriptions below lose some of the nuance of the original.

Interestingly, self-compassion was a much better measure than mindfulness in accounting for problems with anxiety, depression, and overall quality of life. The SCS has several subscales: the most important one for anxiety and depression was the self-judgment subscale. Greater self-judgment showed a comparatively larger relationship with greater anxiety and depression. What this means is that the SCS appears to be a better than the MAAS in measuring treatment outcomes for people with anxiety and depression. It also suggests that awareness of thoughts and emotions may be less important than how one relates to them. What this means is that self-compassion may be a particularly important component in mindfulness-based treatments, and that it is a useful predictor of psychological health.

A caveat to these findings is that the MAAS is only one of several mindfulness measures. Some of the other mindfulness measures such as the Kentucky Inventory of Mindfulness Skills (KIMS) and the Five Facet Mindfulness Questionnaire (FFMQ) measure 4-5 aspects of mindfulness whereas the MAAS measures one. What is does suggest, though, is that self-compassion, as it is measured by the SCS, may be an extremely important construct in measuring treatment outcome for mindfulness-based therapies. This study contributes to a growing body of literature suggesting the importance of self-compassion as a construct.

To download a copy of the article, click on the full citation below:

Van Dam, N.T., Sheppard, S.C., Forsyth, J.P., & Earlywine, M. (2011). Self-Compassion is a Better Predictor Than Mindfulness of Symptom Severity and Quality of Life in Mixed Anxiety and Depression. Journal of Anxiety Disorders, 25, 123-130.