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Mindfulness recent research

Mindfulness recent research. Summary. Mindfulness Why focus on depression MBCT update of the trials ‘How does it work?’ Qualitative studies Mindfulness and Neuroscience MBCT and other clinical groups. Mindfulness. Translation of ancient Pali word “sati” - “awareness”

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Mindfulness recent research

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  1. Mindfulness recent research

  2. Summary • Mindfulness • Why focus on depression • MBCT • update of the trials • ‘How does it work?’ • Qualitative studies Mindfulness and Neuroscience • MBCT and other clinical groups

  3. Mindfulness • Translation of ancient Pali word “sati” - “awareness” • direct, open-hearted “knowing” • Traditionally cultivated by meditation practices • Learning to pay attention • Moment by moment • Intentionally • With curiosity and compassion

  4. Research Publications

  5. Overview of MBCT • Eight weekly classes plus all-day session. Each 2 - 2.5 hours. • Pre-class interview • to explain, motivate and point out the commitment that will be necessary • Up to 12 in each class (Kabat-Zinn – 30 in each class) • Homework, up to one hour per day, 6 days a week - mostly audiotapes of mindfulness practice + generalisation practice • Pattern • First half - concentration/steadying the mind • Second half – wider awareness; relapse prevention

  6. First outcome trial: results • For patients with only 2 previous episodes (23% of sample) - No effect of MBCT on relapse • For patients with 3 or more previous episodes (77% of sample) - Significant effects • TAU: 66% relapsed in 12 months • MBCT: 37% relapsed in 12 months

  7. Teasdale, Segal, Williams et al., 2000, JCCPSurvival Curve (for patients with 3 or more previous episodes - 60 weeks)

  8. MBCT as alternative to Continued AntidepressantsKuyken et al., 2008 JCCP • Two group RCT • All patients on long term ADMs • All in remission or partial remission • N = 62 - Continued with ADMs • N = 61 – MBCT and help in coming off ADMs (75% succeeded)

  9. Kuyken et al (2008) MBCT vs m-ADMs

  10. MBCT for prevention of depressive relapse: summary • First RCTs of preventative clinical intervention based on mindfulness • For more serious patients (history of >3 episodes), MBCT halves chances of relapse • MBCT effective for “autonomous” relapse processes • Highly cost effective (because class-based approach): Clinician time per patient < 5 hours on average • Appears equivalent to continued medication • Especially relevant when recovery is ‘unstable’

  11. Application to Treatment resistant depression (TRD) • Kenny & Williams (2007) • All symptomatic, despite ADM (74%) and CBT (68%) • N = 50 (49 completers) • 43% in remission at end (<10 on BDI)

  12. How does it work ? • Mindfulness • Why focus on depression • MBCT • update of the trials • ‘How does it work?’ • Theoretical models • Clinical observation • Qualitative studies • Mindfulness and Neuroscience • MBCT and other clinical groups

  13. John Teasdale Implicational meaningEvoke sad feeling Cognitive loops Bodily feedback loopsinner collapse

  14. “ The patterns of mind that keep people trapped in emotional suffering are, fundamentally the same patterns of mind that stand between all of us , and the flowering of our potential for a more deeply satisfying way of being”

  15. Changes in three domains • What the mind is processing ( attentional training shifting mental gear from doing to being mode ) • How the mind is processing (openness to experience , acceptance, curiosity , compassion, i.e. panic attacks ) • View or perspective ( of self and others - behavioural changes)

  16. Changes in self compassion

  17. Qualitative studies • “ greater awareness of warning signals” • “coming to terms with depression – sense of acceptance “ • “ feeling empowered to change” • Changes in relationships • Group effect very important • Sense of struggle – hitting barriers

  18. Neuroscience • Mindfulness • Why focus on depression • MBCT • update of the trials • ‘How does it work?’ • Qualitative studies Mindfulness and Neuroscience • MBCT and other clinical groups

  19. Lazar et al 2005 Meditation experience is associated with cortical thickness Neuroreport, 16, 1893- 1897

  20. Mindfulness training increases ‘viscero-somatic’ processing and uncouples ‘narrative-based’ processing (Farb et al, 07)

  21. Einstein • “ A Human being is a part of the whole, a part limited in time and space. He experiences himself, his thoughts and feelings as something separated from the rest a kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all, and the whole of nature in its beauty.”

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