<p>Over the last three decades, there has been a precipitous rise in curiosity regarding the clinical use of mindfulness meditation for the self-management of a broad range of chronic health conditions. Despite the ever-growing body of evidence supporting the use of mindfulness-based therapies for both medical and psychological concerns, data on the active ingredients of these mind-body interventions are relatively scarce. Regular engagement in formal mindfulness practice is considered by many to be requisite for generating therapeutic change; however, previous investigations of at-home practice in MBIs have produced mixed results. The equivocal nature of these findings has been attributed to significant methodological limitations, including the lack of standardized, systematic practice monitoring tools, and a singular focus on practice time, with little attention paid to the nature and quality of one’s practice. The present study used a prospective, observational design to assess the effects of home-based practice on dispositional mindfulness, self-compassion, and psychological functioning in twenty-eight people enrolled in an MBSR or MBCT program. To address some of the aforementioned limitations, the present study collected detailed weekly accounts of participants’ home-based practice engagement, including information about practice time (i.e., frequency and duration), exercise type, perceived effort and barriers to participation, and practice quality. Hierarchical multiple regression was used to examine the relative contribution of practice time and practice quality on treatment outcomes, and to explore possible predictors of adherence to at-home practice recommendations. As anticipated, practice quality and perceived effort improved with time; however, rather unexpectedly, practice quality was not a significant predictor of treatment-related improvements in psychological health. Home practice engagement, however, was predictive of change in dispositional mindfulness, in the expected direction. Results of our secondary analyses demonstrated that employment status was predictive of home practice engagement, with those who were unemployed completing more at-home practice on average. Mindfulness self-efficacy at baseline and previous experience with meditation or other contemplative practices were independently predictive of mean practice quality. The results of this study suggest that home practice helps generate meaningful change in dispositional mindfulness, which is purportedly a key mechanism of action in mindfulness-based interventions.</p> / Dissertation

This thesis explored the relationships between 1) Self-compassion 2) Cognitive Emotion Regulation and 3) Mindfulness Based Stress Reduction (MBSR) and teacher stress in a foreign international school setting. The retrospective, multi-tiered study investigated a total of 177 expatriated teachers working in multiple international schools around the globe; at least 17 of whom indicated that they had completed a MBSR course. A mixed-methods approach was used over three stages utilising the following instruments: 1) an adapted stress impact survey, 2) Teacher Interview Protocol (TIP), 3) the short forms of the Cognitive Emotion Regulation Questionnaire (CERQ-SF), the Self-Compassion Scale (SCS-SF), and the Perceived Stress Scale (PSS-4). Results suggest that teachers’ beliefs about stress correlate with job satisfaction; 82.6% of respondents who reported that stress has ‘hardly any effect’ also reported that they liked their job overall; whereas, 76.9% and 36.4% of respondents that believed stress had affected their teaching ‘some’ or ‘a lot’ reported liking their job, respectively. Results also indicate that higher perceived stress is strongly correlated with both 1) decreased self-compassion (r = -.491, p < .001) and 2) increased use of non-adaptive cognitive emotion regulation strategies, such as Catastrophizing (r= < 0.392, p < .001). All five adaptive cognitive coping strategies were positively correlated with Self-Compassion, four were significant; only Refocus on Planning failed to reach significance at p < .05. The data indicated no statistically significant differences between MBSR and non-MBSR participants, regarding perceptions of stress (PSS-4), self-compassion (SCS-SF), and eight of the nine coping strategies (CERQ-S), with the exception being that MBSR participants experienced reduced Self-Blame (p < 0.007). Conclusions find that policies and practices aimed at supporting the three aspects of self-compassion offer one possible avenue to reducing teacher stress and maladaptive thinking strategies, and thereby increasing job satisfaction, for teachers working in a foreign country.

College students are faced with stressors which can negatively impact memory function, thereby, negatively affecting academic performance. This study used a field experiment design to investigate the effects of brief mindfulness on levels of distress and memory functioning between first-year community college students engaging in a brief mindfulness intervention (n = 29) and a control group (n = 28) by using ANCOVA, MANOVA, correlations, and descriptive statistics. Research questions examined whether a brief mindfulness intervention lowered levels of distress in a treatment group. Second, the study examined whether the intervention of brief mindfulness in a treatment group improved memory function. Finally, the findings of this study answered if changes in levels of distress mediated the effects of exposure to mindfulness on memory function. Using the Brief Symptom Inventory, changes pre to postintervention levels of distress were examined. Distress levels decreased in treatment and control groups following 15 minutes of relaxation (MBSR and unstructured). Differences in memory function were examined using the WMS-IV. Positive correlations between the ability to recall visual and verbal materials on a delay in both groups were found. The findings of this study contributed to positive social change by emphasizing the high levels of distress community college students experience. These findings support the importance of implementing brief stress reduction opportunities in a classroom setting, whether structured stress reduction, such as mindfulness based stress reduction (MBSR), or unstructured relaxation-time, as a supportive measure to encourage healthy coping skills in handling stress, thereby improving memory and the projection of improving physical and mental well-being, as well as, educational outcomes.

Providing care for a frail older adult who is suffering from dementia has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. The present study investigated the effectiveness of Mindfulness-Based Stress Reduction (MBSR), among older family caregivers of persons with neurocognitive disorders, compared with an intervention based on progressive muscle relaxation (PMR). Participants were randomly assigned to either MBSR or PMR (n = 28). The MBSR group showed significantly greater reductions in self-reported levels of depression and isolation from pre- to post-intervention, and those changes remained significant at 8 weeks post-intervention. Both groups showed similar decreases in levels of perceived stress, cortisol awakening response, daily average cortisol, and in resting systolic blood pressure from pre- to post-intervention. Results suggest that MBSR and relaxation-based interventions may both be effective for caregivers, however, further research, employing waitlist control participants will be necessary for unambiguous interpretation of the present results.

Background: Mindfulness based interventions are becoming increasingly popular for use with children and adolescents, particularly within the school context. Objectives: The aim of the systematic review was to examine the effectiveness of school-based mindfulness interventions with particular reference to mental health and wellbeing. The main study aimed to determine if beliefs about emotions and mindfulness moderated the relationship between stressors and somatic symptoms in an adolescent population. Method: The literature was systematically searched for mindfulness interventions carried out with children and adolescents within the school context. A cross-sectional survey was carried out in a rural sample of 489 high school students to examine specific a priori anticipated relationships amongst beliefs about emotions, mindfulness, stressors, and somatic symptoms. Results: Six studies met the criteria for inclusion. The study demonstrated that school-based mindfulness interventions produce some evidence of effective outcomes for mental health and wellbeing in children and adolescents. Factors associated with improvements included that the intervention was delivered by an experienced mindfulness trainer, and that home practice formed part of the intervention. Somatic symptoms were significantly correlated with beliefs about emotions and were significantly inversely correlated with dispositional mindfulness. Lower levels of mindfulness were associated with stronger beliefs about the unacceptability of expressing or experiencing negative emotions. Beliefs about emotions and mindfulness did not significantly moderate the relationship between somatic symptoms and stressors within an adolescent population. Conclusion: Further research is necessary to determine if mindfulness as a construct or an intervention is effective in enhancing adolescents’ resilience to stressors by improving mental health and wellbeing.

Stress är i sig inte farlig om den inte blir långvarig och konstant, den här rapporten har tittat på vilka effekter och eventuella konsekvenser stress har på de fysiologiska och kognitiva systemen hos människan. En långvarig aktivering av HPA-axeln, vilken kan kallas prestations/stressaxeln, leder bland annat till kroniskt förhöjda kortisolnivåer vilket har negativa effekter för hälsan. Strukturer i hjärnan vilka ofta kopplas till stressrelaterade sjukdomar är hippocampus och prefrontala kortex. De konsekvenserna som kan följa på långvarig stress är kognitiva nedsättningar och skador på bland annat hippocampus, brister i immunförsvaret, hjärt- och kärlsjukdomar, ångest, kroniskt utmattningssyndrom, mag- och tarmbesvär samt depression. I rapporten visas att stress har stora negativa konsekvenser på individnivå både gällande kognitiva funktioner, så som minne, och även på det fysiologiska systemet. Det finns åtgärder att använda för att reducera upplevelsen av stress samt de negativa effekterna av stress, så som fysisk aktivitet, mindfulness meditation och muskulär avslappning.

Individuals with intellectual developmental disabilities occasionally exhibit challenging behaviors through forms of aggression. Interventions, such as cognitive behavioral therapy, and applied behavioral analysis, have all been shown to be effective in reducing symptoms of aggression. This quantitative study used a secondary analysis of clinical records from an agency that provides day treatment services for adults with intellectual disabilities. To assess the effectiveness of a mindfulness-based stress reduction (MBSR) program in reducing aggression in this population, 18 individuals with various levels of intellectual disabilities participated in an 8-week MBSR while an additional 18 participants served as the wait list control group and received the same intervention soon after the study was completed. The study examined whether a mindfulness-based intervention can reduce aggression based on the Modified Overt Aggression Scale (MOAS) and also increase participants' awareness of meditation based on the Child Adolescent Mindfulness Measure (CAMM). A 2x2 ANOVA was used to determine differences between measures, pretest and posttest. Results indicated no differences in aggression before and after the administration of the mindfulness-based intervention for either the experimental or control group. However, CAMM scores indicated that participants came to understand the concept of mindfulness, even though this did not yield measurable changes in their behavioral outcomes. This study will inform clinicians about mindfulness in programs for adults with disabilities and research indicates that MBSR is a program which is beneficial for adults with developmental disabilities and may serve as an additional coping mechanism in dealing with aggression.

Inom vårdyrken är arbetstakten ofta hög och individens möjlighet att påverka arbetssituationen låg. Vårdpersonal tar dagligen beslut relaterade till etiska och moraliska frågor. Många som arbetar i patientnära arbete påverkas alltså i hög grad av psykosocial stress. Effektiva stressförebyggande åtgärder för dessa professioner är önskvärda. Syftet med denna litteraturstudie var att beskriva effekterna av träning i medveten närvaro hos personer i patientnära arbete med fokus på stressrelaterade tillstånd. En litteraturstudie genomfördes. Studien fann att välbefinnande och livskvalitet ökade genom träning i medveten närvaro för personer i patientnära arbete. Stress, psykisk påfrestning, utbrändhet, ångest och depression minskade i olika utsträckning. Således är träning i medveten närvaro effektivt som stressförebyggande åtgärd för personer i patientnära arbete och borde förslagsvis ingå i dessa professioners utbildning. / In health care professions the work load is often high and the individual degree of control is normally low. Health personnel are constantly making decisions regarding moral and ethical issues. Thus, many health employees are suffering under extensive psychological distress. Effective stress preventive methods for these professions are sought after. The aim of this study was to determine the effects of mindfulness training for persons involved in patient centered care, with focus on stress-related conditions. A literature review was performed. The review found that mindfulness training increases well-being and quality of life for persons involved in patient centered care. A decrease in stress, psychological distress, burnout, anxiety and depression was also evident. Mindfulness has in this study proven to be effective as a stress preventive method for personnel in patient centered care and it can be recommended to be included in the education of these professions.

Bakgrund: Vårdnadsbelastning och stress är vanligt bland anhörigvårdare till personer med demens eller långvarig sjukdom. Minfulness-Based Stress Reduction (MBSR) är en tänkbar fysioterapeutisk intervention för denna grupp. Syfte: Att genomföra en systematisk litteraturstudie i syfte att kartlägga effekt, risk för snedvridning och tillförlitlighet med MBSR som behandlingsmetod för stress och vårdnadsbelastning för anhörigvårdgivare. Metod: En systematisk litteraturöversikt av randomiserade kontrollerade studier genomfördes i databaserna PubMed och PsychInfo. TestEx användes för att bedöma kvaliteten av de utvalda artiklar och tillförlitligheten granskades med granskningsmallen Bedömning av den sammanvägda tillförlitligheten i systematiska översikter. Resultat: Åtta artiklar inkluderades i denna studie och deltagarna var alla anhörigvårdgivare till vuxna personer med långvarig sjukdom. Sju undersökte vårdnadsbelastning och fem undersökte stress. Ingen signifikant skillnad observerades på vårdnadsbelastning. Stress minskades signifikant i tre av fem studier. Kvalitetsgranskning med TextEx resulterade i fyra artiklar med hög kvalitet och fyra med låg. Av de fyra med hög kvalitet gick två att sammanväga för tillförlighet, men dessa bedömdes ha mycket låg tillförlighet. Konklusion: Resultatet baseras på två studier som kunde sammanvägas med kontrollgruppen “ingen behandling”. Dessa visade mycket låg tillförlitlighet för att MBSR hade effekt på stress och vårdnadsbelastning. / Objective: Caregiver burden and stress are common challenges faced by family caregivers of individuals with dementia or chronic illness. Additionally, Mindfulness-Based Stress Reduction (MBSR) is a potential physiotherapeutic intervention for this group. Aim: To assess the effectiveness, risk of bias, and reliability of MBSR as a method of treatment for stress and caregiver burden among informal caregivers. Method: A systematic literature review of randomized controlled trials was conducted using the databases PubMed and PsychInfo. TestEx was used to assess the quality of the chosen studies, and reliability was evaluated using the template to assess the reliability of the results. Results: Eight articles were included in this study and the participants were informal caregivers to adults with chronic illness. Seven investigated caregiver burden, while five examined stress. No significant difference was observed in caregiver burden. However, stress was significantly reduced in three out of five studies. The quality assessment using TestEx resulted in four articles being classified as high quality, and four as low quality. Among the high-quality articles, two could be combined for reliability assessment, but they were deemed to have very low reliability. Conclusion: The results are based on two studies that could be combined with the control group “no treatment”. These studies showed very low reliability regarding MBSR as a treatment of stress and caregiver burden for informal caregivers.

Introduktion: Inom hälso- och sjukvården är arbetsbelastningen ofta hög. Stress är inte ovanligt förekommande i relation till arbetet på grund av hög arbetsbelastning. För att hantera bland annat stress som kan ha uppstått från hög psykisk belastning är mindfulness, eller medveten närvaro, en beprövad metod. Det mindfulness-baserade stressreduceringsprogrammet (MBSR) är en metod som utvecklats av Jon Kabat-Zinn och används för att minska stressymptom. Intentionen med programmet är att utrusta deltagarna med verktyg för att hantera olika typer av stress. Syfte: Syftet med denna litteraturstudie var att undersöka direkta och långvariga effekter på individnivå relaterat till stress och stressrelaterade symtom för vårdpersonal i patientnära arbete som fått genomgå ett mindfulness-baserat stressreducerande program. Metod: Sökningen efter inkluderade studier gjordes på tre databaser: Pubmed, Cinahl och Apa Psykinfo. Studier mellan år 2014-2024 inkluderades. Urvalsprocessen följdes genom ett PRISMA-flödesschema och kvalitetsgranskades genom PEDro-skalan. Resultat: I denna litteraturstudie inkluderades totalt nio studier utifrån litteratursökning och relevansbedömning. Studierna har visat på både direkta psykologiska och fysiologiska förändringar som bibehållits på lång sikt. Majoriteten av studierna som ingått i denna litteraturstudie har funnit att MBSR programmet har signifikant effekt på ett eller flera stressrelaterade symptom. Konklusion: Deltagande i MBSR programmet hade en direkt och långsiktig effekt på stress och stressrelaterade symptom hos vårdpersonal. Programmet kan vara en metod vid fysioterapeutisk behandling. Resultatet visar på att programmet kan minska stress, utmattning, depression och ångest. Denna typ av program kan även öka välmående samt sänkt blodtryck och hjärtfrekvens. Programmet kan vara en metod vid fysioterapeutisk behandling för personer med stressymtom.