scholarly journals Practicing Other-Focused Kindness and Self-Focused Kindness Among Those at Risk for Mental Illness: Results of a Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
S. Katherine Nelson-Coffey ◽  
Ernst T. Bohlmeijer ◽  
Marijke Schotanus-Dijkstra

People with reduced levels of mental well-being might be at risk for developing future mental illness. Although several positive psychology interventions successfully improve mental well-being and psychological distress, less is known about their efficacy in a sample at risk for mental disorders. A Dutch sample of 289 participants with low or moderate levels of well-being were randomly assigned to other-focused kindness with reflection, other-focused kindness without reflection, self-focused kindness, or waitlist control (Trial register: NTR6786). Results of multilevel growth curve analyses revealed that other-focused kindness, but not self-focused kindness, led to improvements in the primary outcome mental well-being relative to waitlist control up to 6-week follow-up. By contrast, only other-focused kindness without reflection led to improvements in psychological distress. The three kindness conditions mainly did not differ from one another, and mainly no differences were found up to 6-months follow-up. An exception was that perceived stress was significantly more reduced up to 6-week and 6-months follow-up when people practiced other-focused kindness without reflection then when participants had practiced self-focused kindness. These findings point to the benefits of practicing kindness for others when people might be at risk for future mental illness. The study also indicates that reflecting about practicing kindness does not seem to have added value.

2017 ◽  
Author(s):  
Winnie Wing Sze Mak ◽  
Alan Chun Yat Tong ◽  
Sindy Ying Chi Yip ◽  
Wacy Wai Sze Lui ◽  
Floria Hin Ngan Chio ◽  
...  

BACKGROUND Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, the present study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile applications in the improvement of mental health. OBJECTIVE Our aim was to examine the efficacy of three mobile application-based programs: mindfulness-based program (MBP), self-compassion program (SCP), and cognitive behavioral psychoeducation control (CBP) in improving well-being and reducing psychological distress. To further delineate the suitability of each program for which type of individuals, individual difference variables (i.e., nonattachment, self-criticism, discomfort with emotion, and tolerance for ambiguity) were explored for potential moderation. METHODS The present study was a three-arm randomized controlled trial examining the efficacy of MBP, SCP with CBP. The course contents of the three programs were composed by a clinical psychologist and the mobile application was fully automated. Participants were recruited online and offline via mass mail, advertisements in newspapers and magazines, and social networking site. They were randomized into either one of the three conditions and completed pre-program survey assessment. Throughout the 4-week, 28-session program, participants spent 10 minutes daily in reviewing the course content and practicing various related exercises. Post-assessment and 3-month follow-up surveys were administered to measure changes over time. Indicators of mental health and psychological distress, as well as proposed moderators were self-assessed online at pre-program, post-program, and 3-month follow-up. RESULTS Among the 2,161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment respectively. All three conditions (MBP, N = 703; CBP, N = 753; SCP, N = 705) were found to be efficacious in improving mental well-being and reducing psychological distress. No significant differences regarding usage and users’ satisfaction were found among the three conditions. None of the proposed moderators were found to be significant. CONCLUSIONS Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile applications were efficacious in improving mental health and reducing psychological distress among young adults at post-program, and such improvements were maintained at 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rate that are common in app-based health promotion programs. CLINICALTRIAL Chinese Clinical Trial Registry (ChiCTR) ChiCTR-TRC-13003468; https://www2.ccrb.cuhk.edu.hk/registry/public/217 (Archived by WebCite at http://www.webcitation.org/6oaPwga7z).


Author(s):  
Kristina Bixler ◽  
Jeffrey Alvin Anderson

Students with significant emotional-behavioral concerns and mental illness tend to experience poor educational and social outcomes. This chapter describes some of the challenges facing schools that are responsible for educating students with and at-risk for mental health challenges. Although some students encounter numerous risks, thereby increasing the chances of developing mental illness and failing school, there are also protective factors that can be identified and harnessed to counterbalance such risks and promote higher levels of resilience. By examining relationships among factors such as poverty, mental well-being, family engagement, resiliency, and school performance, a school-focused, community-based framework is suggested for responding to and overcoming these challenges. This chapter provides practical guidelines for schools, community agencies, and families to work together to support and engage young people who are at-risk for school failure due to emotional-behavioral concerns and mental health challenges.


10.2196/14065 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14065 ◽  
Author(s):  
Else Bisseling ◽  
Linda Cillessen ◽  
Philip Spinhoven ◽  
Melanie Schellekens ◽  
Félix Compen ◽  
...  

Background Mindfulness-based cognitive therapy (MBCT) is an evidence-based group-based psychological treatment in oncology, resulting in reduction of depressive and anxiety symptoms. Internet-based MBCT (eMBCT) has been found to be an effective alternative for MBCT. The therapeutic alliance (the bond between therapist and patient,) is known to have a significant impact on psychological treatment outcomes, including MBCT. A primary concern in the practice of eMBCT is whether a good therapeutic alliance can develop. Although evidence for the beneficial effect of therapist assistance on treatment outcome in internet-based interventions (IBIs) is accumulating, it is still unclear whether the therapeutic alliance is related to outcome in IBIs. Objective This study aimed to (1) explore whether early therapeutic alliance predicts treatment dropout in MBCT or eMBCT, (2) compare the development of the therapeutic alliance during eMBCT and MBCT, and (3) examine whether early therapeutic alliance is a predictor of the reduction of psychological distress and the increase of mental well-being at posttreatment in both conditions. Methods This study was part of a multicenter randomized controlled trial (n=245) on the effectiveness of MBCT or eMBCT for distressed cancer patients. The therapeutic alliance was measured at the start of week 2 (ie, early therapeutic alliance), week 5, and week 9. Outcome measures were psychological distress, measured with the Hospital Anxiety and Depression Scale, and mental well-being, measured with the Mental Health Continuum-Short Form. Results The strength of early therapeutic alliance did not predict treatment dropout in MBCT or eMBCT (B=−.39; P=.21). Therapeutic alliance increased over time in both conditions (F2,90=16.46; Wilks λ=0.732; P<.001). This increase did not differ between eMBCT and MBCT (F1,91=0.114; P=.74). Therapeutic alliance at week 2 predicted a decrease in psychological distress (B=−.12; t114=−2.656; P=.01) and an increase in mental well-being (B=.23; t113=2.651; P=.01) at posttreatment. The relationship with reduction of psychological distress differed between treatments: a weaker early therapeutic alliance predicted higher psychological distress at posttreatment in MBCT but not in eMBCT (B=.22; t113=2.261; P=.03). Conclusions A therapeutic alliance can develop in both eMBCT and MBCT. Findings revealed that the strength of early alliance did not predict treatment dropout. Furthermore, the level of therapeutic alliance predicted reduced psychological distress and increased mental well-being at posttreatment in both conditions. Interestingly, the strength of therapeutic alliance appeared to be more related to treatment outcome in group-based MBCT than in eMBCT. Trial Registration ClinicalTrials.gov NCT02138513; https://clinicaltrials.gov/ct2/show/NCT02138513


2018 ◽  
Vol 5 (4) ◽  
pp. e60 ◽  
Author(s):  
Winnie WS Mak ◽  
Alan CY Tong ◽  
Sindy YC Yip ◽  
Wacy WS Lui ◽  
Floria HN Chio ◽  
...  

Background Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health. Objective The aim of this study was to examine the efficacy of 3 mobile app–based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation. Methods This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators. Results Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users’ satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant. Conclusions Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs. Trial Registration Chinese Clinical Trial Registry (ChiCTR) ChiCTR-TRC-13003468; http://www.chictr.org.cn/hvshowproject.aspx?id=6220 (Archived by WebCite at http://www.webcitation.org/734PlOz50)


2020 ◽  
Author(s):  
Sonia Ponzo ◽  
Davide Morelli ◽  
Jamie M Kawadler ◽  
Nicola Rose Hemmings ◽  
Geoffrey Bird ◽  
...  

BACKGROUND University students in the United Kingdom are experiencing increasing levels of anxiety. A program designed to increase awareness of one’s present levels of well-being and suggest personalized health behaviors may reduce anxiety and improve mental well-being in students. The efficacy of a digital version of such a program, providing biofeedback and therapeutic content based on personalized well-being metrics, is reported here. OBJECTIVE The aim of this study was to test the efficacy and sustained effects of using a mobile app (BioBase) and paired wearable device (BioBeam), compared with a waitlist control group, on anxiety and well-being in university students with elevated levels of anxiety and stress. METHODS The study employed a randomized, waitlist-controlled trial with assessments at baseline, 2 weeks, postintervention (4 weeks), and follow-up (6 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored &gt;14 points on the Depression, Anxiety, and Stress Scale-21 items (DASS-21) stress subscale or &gt;7 points on the DASS-21 anxiety subscale, (3) owned an iOS mobile phone, (4) did not have any previous psychiatric or neurological conditions, (6) were not pregnant at the time of testing, and (7) were able to read and understand English. Participants were encouraged to use BioBase daily and complete at least one course of therapeutic content. A <i>P</i> value ≤.05 was considered statistically significant. RESULTS We found that a 4-week intervention with the BioBase program significantly reduced anxiety and increased perceived well-being, with sustained effects at a 2-week follow-up. Furthermore, a significant reduction in depression levels was found following the 4-week usage of BioBase. CONCLUSIONS This study shows the efficacy of a biofeedback digital intervention in reducing self-reported anxiety and increasing perceived well-being in UK university students. Results suggest that digital mental health interventions could constitute a novel approach to treat stress and anxiety in students, which could be combined or integrated with existing therapeutic pathways. CLINICALTRIAL Open Science Framework (OSF.io) 2zd45; https://osf.io/2zd45/


Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 796
Author(s):  
Sarahmarie Kuroko ◽  
Katherine Black ◽  
Themis Chryssidis ◽  
Rosie Finigan ◽  
Callum Hann ◽  
...  

Cooking is frequently associated with a healthier diet, however few youth cooking intervention studies have used control groups or follow-ups. Additionally, although cooking is associated with better mental well-being among adolescents, this has not been examined experimentally. This randomised controlled trial investigated whether a five-day intensive holiday cooking program, followed by six weeks of weekly meal kits with Facebook support groups, affected the cooking-related outcomes, diet quality and mental well-being among adolescents, with a 12-month follow-up. Adolescents aged 12–15 years (intervention: n = 91, 60% female; control: n = 27, 78% female) completed baseline, post-intervention and 12-month follow-up anthropometric measures, and questionnaire measures of mental well-being, diet quality and cooking attitudes, self-efficacy and behaviours. The intervention group’s post-intervention outcomes improved significantly more for mental well-being, diet quality, helping make dinner, cooking self-efficacy and positive cooking attitude, however body mass index (BMI) z-scores also increased. Differences were maintained at 12 months for self-efficacy only. Group interviews showed that participants’ cooking behaviours were strongly influenced by family factors. Adolescent cooking interventions may have many short-term benefits, however cooking self-efficacy appears most responsive and stable over time. Effects on BMI need further investigation. Family factors influence whether and what adolescents cook post-intervention.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017721 ◽  
Author(s):  
Louise Mewton ◽  
Antoinette Hodge ◽  
Nicola Gates ◽  
Rachel Visontay ◽  
Maree Teesson

IntroductionA broad range of mental disorders are now understood as aberrations of normal adolescent brain development. In both adolescents and adults, executive dysfunction has been implicated across a range of mental illnesses, and enhancing executive functioning may prove to be a useful prevention strategy for adolescents at risk for a range of psychopathology.Methods and analysisThis study will consist of a double-blind, randomised controlled trial with a 12-month follow-up period. Participants will consist of 200 people aged 16–24 years who are at risk for a range of mental disorders based on personality risk factors, but have not experienced a lifetime mental illness as determined by a structured diagnostic interview. Participants will be randomly allocated to either an intervention group who complete an online cognitive training programme specifically targeting executive functioning ability or a control group who complete an online cognitive training programme that has limited executive functioning training potential. Superiority of the executive functioning training programme compared with the control training programme will be assessed at baseline, post-training and at 3-month, 6-month and 12-month follow-up. All assessments will be conducted online. The primary outcome of the study will be general psychopathology as measured by the Strengths and Difficulties Questionnaire. Secondary outcomes will include executive functioning ability, day-to-day functioning and alcohol consumption. All analyses will be undertaken using mixed-model repeated measures analysis of variance with planned contrasts.Ethics and disseminationEthics approval has been obtained from the University of New South Wales Human Research Ethics Committee (HC15094). Results of the trial immediately post-treatment and at 12 months follow-up will be submitted for publication in peer-reviewed journals.Trial registration numberACTRN12616000127404; Pre-results.


10.2196/23655 ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. e23655
Author(s):  
Jin Han ◽  
Lauren McGillivray ◽  
Quincy JJ Wong ◽  
Aliza Werner-Seidler ◽  
Iana Wong ◽  
...  

Background Self-help smartphone apps offer a new opportunity to address youth suicide prevention by improving access to support and by providing potentially high fidelity and cost-effective treatment. However, there have been very few smartphone apps providing evidence-based support for suicide prevention in this population. To address this gap, we developed the LifeBuoy app, a self-help smartphone app informed by dialectical behavior therapy (DBT), to help young people manage suicidal thoughts in their daily life. Objective This study describes the protocol for a randomized controlled trial to evaluate the efficacy of the LifeBuoy app for reducing suicidal thoughts and behaviors, depression, anxiety, and psychological distress, and improving general mental well-being in young adults aged 18 to 25 years. Methods This is a randomized controlled trial recruiting 378 young adults aged between 18 and 25 years and comparing the LifeBuoy app with a matched attention control (a placebo app with the same display but no DBT components). The primary outcome is suicidal thoughts measured by the Suicidal Ideation Attributes Scale (SIDAS). The secondary outcomes are suicidal behavior, depression, anxiety, psychological distress, and general mental well-being. The changes in the levels of insomnia, rumination, suicide cognitions, distress tolerance, loneliness, and help seeking before and after using the app are evaluated in this study. The study also addresses risk factors and responses to the intervention. A series of items assessing COVID-19 experiences is included in the trial to capture the potential impact of the pandemic on this study. Assessments will occur on the following three occasions: baseline, postintervention, and follow-up at 3 months postintervention. A qualitative interview about user experience with the LifeBuoy app will take place within 4 weeks of the final assessment. Using linear mixed models, the primary analysis will compare the changes in suicidal thoughts in the intervention condition relative to the control condition. To minimize risks, participants will receive a call from the team clinical psychologist by clicking a help button in the app or responding to an automated email sent by the system when they are assessed with elevated suicide risks at the baseline, postintervention, and 3-month follow-up surveys. Results The trial recruitment started in May 2020. Data collection is currently ongoing. Conclusions This is the first trial examining the efficacy of a DBT-informed smartphone app delivered to community-living young adults reporting suicidal thoughts. This trial will extend knowledge about the efficacy and acceptability of app-based support for suicidal thoughts in young people. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12619001671156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378366. International Registered Report Identifier (IRRID) PRR1-10.2196/23655


Author(s):  
Kristina Bixler ◽  
Jeffrey Alvin Anderson

Students with significant emotional-behavioral concerns and mental illness tend to experience poor educational and social outcomes. This chapter describes some of the challenges facing schools that are responsible for educating students with and at-risk for mental health challenges. Although some students encounter numerous risks, thereby increasing the chances of developing mental illness and failing school, there are also protective factors that can be identified and harnessed to counterbalance such risks and promote higher levels of resilience. By examining relationships among factors such as poverty, mental well-being, family engagement, resiliency, and school performance, a school-focused, community-based framework is suggested for responding to and overcoming these challenges. This chapter provides practical guidelines for schools, community agencies, and families to work together to support and engage young people who are at-risk for school failure due to emotional-behavioral concerns and mental health challenges.


2020 ◽  
pp. jech-2020-214390
Author(s):  
Julieta Galante ◽  
Jan Stochl ◽  
Géraldine Dufour ◽  
Maris Vainre ◽  
Adam Peter Wagner ◽  
...  

BackgroundThere is concern that increasing demand for student mental health services reflects deteriorating student well-being. We designed a pragmatic, parallel, single-blinded randomised controlled trial hypothesising that providing mindfulness courses to university students would promote their resilience to stress up to a year later. Here we present 1-year follow-up outcomes.MethodsUniversity of Cambridge students without severe mental illness or crisis were randomised (1:1, remote software-generated random numbers), to join an 8-week mindfulness course adapted for university students (Mindfulness Skills for Students (MSS)), or to mental health support as usual (SAU).ResultsWe randomised 616 students; 53% completed the 1-year follow-up questionnaire. Self-reported psychological distress and mental well-being improved in the MSS arm for up to 1 year compared to SAU (p<0.001). Effects were smaller than during the examination period. No significant differences between arms were detected in the use of University Counselling Service and other support resources, but there was a trend for MSS participants having milder needs. There were no differences in students’ workload management; MSS participants made more donations. Home practice had positive dose–response effects; few participants meditated. No adverse effects related to self-harm, suicidality or harm to others were detected.ConclusionLoss to follow-up is a limitation, but evidence suggests beneficial effects on students’ average psychological distress that last for at least a year. Effects are on average larger at stressful times, consistent with the hypothesis that this type of mindfulness training increases resilience to stress.Trial registration numberACTRN12615001160527.


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