The thesis deals with the topic of mindfulness. In the theoretical part of the thesis, the latest research on mindfulness in work (non-clinical) environments and ways to promote and develop mindfulness in people are reviewed. Standardized and non- standardized ways of increasing mindfulness are mentioned. The research section consists of several sub-researches. The first, qualitative research explores how people understand the concept of mindfulness and how they think it can be increased. The qualitative research was conducted in the form of a questionnaire (N = 54). The results of the analysis show that how people understand the concept of mindfulness is not too far from the professional definition of the term, but primarily people understand the term as mindfulness of the environment, less mindfulness of the self. The second, quantitative research project involves the adaptation of the Five Facet Mindfulness Questionnaire into Czech and its new standardization, which was carried out by comparing parallel translations and subsequent back-translation checked by the author of the questionnaire, Ruth Baer. The standardization was performed on a quota representative sample of the population (N = 240). Norms were created for both the overall mindfulness score and for the individual scales of the...

Depressioner återkommer ofta och varje ny depressionsepisod ökar risken för en ny beroende på en allt större känslighet för inre och yttre triggers. Mindfulnessbased Cognitive Therapy (MBCT) har utarbetats av Z. Segal, M. Williams och J. Teasdale som en gruppbaserad behandlingmodell för att förebygga återinsjuknande kombinerar mindfulnesstekniker och kognitiv terapi (KBT) för depression. I en studie publicerad 2000 visade sig MBCT signifikant halvera återinsjuknandet jämfört med sedvanlig behandling. Resultatet har upprepats och ett flertal studier har undersökt effekter av MBCT. Syftet med denna systematiska litteraturstudie är att undersöka vilka effekter som de olika studierna tagit fasta på och vilka effekter som setts inom de olika aspekterna i Christine Padeskys femfaktorsmodell, tanke-känsla-fysiologi-beteende och i relation till sammanhang mot bakgrund av den ständiga interaktion som råder mellan dessa1. Resultatet visar positiva resultat inom alla aspekter men att de kognitiva och känslomässiga aspekterna är de mest välstuderade medan fysiologiska effekter som trots den stora betydelse kroppen har i MBCT-träningen är mindre studerat. Det framgår att fortsatt och mer forskning behövs om verksamma mekanismer, kausalsamband  och processer. 1  Femfaktormodell refererar till ”five aspects of life ” modellen enligt Christine Padesky. Se sid.15.

Au regard des conséquences du stress sur la santé des travailleurs sont apparues des méthodes visant à modifier la perception des situations stressantes telle la MBSR et ses pratiques méditatives de pleine conscience. Ce constat laisse entrevoir la pertinence potentielle de la MBCT combinant des éléments de la MBSR et de la thérapie cognitive dans la prise en charge du stress professionnel.Objectif : Expliciter les concepts de mindfulness et d’awareness par une démarche sémantique et réaliser un état de l’art de la MBCT. Vérifier son applicabilité au stress professionnel via deux études-pilotes auprès de populations non cliniques. Méthode : Conception d’un programme manualisé adapté au stress professionnel puis application à une étude comparative MBCT/Contrôle randomisée et à une étude de cas. Administration Pré-Post d’échelles relatives au stress (PSS, Indice de Stress au Travail de Légeron), à ses symptômes associés (MBI, GHQ-28, BDI-13), aux stratégies de coping (Brief COPE) et aux compétences de pleine conscience (PHLMS) et recueil de témoignages.Résultats : Améliorations Pré-Post significatives sur la quasi-totalité des mesures à l’exception de l’accomplissement personnel du MBI et du stress perçu (PSS). Significativité statistique de l’épuisement émotionnel au MBI et du stress perçu contextualisé au travail dans la comparaison intergroupe. Amélioration des compétences psychosociales en situation de stress au travail.Conclusion : Potentiel d’applicabilité de la MBCT à la prise en charge du stress professionnel. Malgré des limites, ces études montrent un intérêt indéniable tant pour la recherche que les entreprises en quête de rapports coût/bénéfice optimaux. / Methods aimed at altering the perception of stressful situations such as the MBSR have come into being following the stress after-effects involved for workers. This problematic situation let us anticipate the possible relevance to the occupational stress management of the MBCT program combining both the MBSR mindfulness meditative practices and cognitive therapy elements.Objective : To shed light on the concepts of mindfulness and awareness through semantic research and to achieve a MBCT scientific litterature review. To check its applicability to the context of occupational stress by means of two pilot experimentations in non-clinical populations. Method : Design of an occupational stress-adapted manualized program and implementation as a randomized MBCT/Control comparative study and as a case study. Filling of scales relative to stress (PSS, Indice de Stress au Travail de Légeron), stress-associated symptoms (MBI, GHQ-28, BDI-13), coping strategies (Brief COPE) and mindfulness skills (PHLMS) Pre- and Post-program and gathering of accounts.Results : Significative Pre-Post improvements at almost all of the measures except for the personal accomplishment subscale of the MBI and for perceived stress (PSS). Statistical significance on the MBI emotional exhaustion subscale and on the work-contextualized perceived stress measures in the inter-group comparison. Improvement of psychosocial skills in work stress situations. Conclusion : Applicability potential of the MBCT to occupational stress management. Despite a number of limitations, these studies express an indisputable interest both for the research and for companies on the look-out for optimal cost-benefit ratios.

Background. Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention treatment for people in remission from major depression (rMDD). The neuropsychological mechanisms of MBCT are largely unknown. The key theoretical mechanisms of MBCT include self-compassion and rumination, with other mindfulness-based studies suggesting mechanisms across domains of attention, emotional processing, and cognitive flexibility. The aims of this thesis were to investigate the neuropsychological and neuroimaging mechanisms of MBCT in rMDD and to investigate relationships with relapse six months beyond MBCT. Paper One. 40 MBCT, 33 Treatment As Usual (TAU), and 42 healthy volunteers (HVs) took part. Experimental tasks for self-compassion and rumination were completed at baseline and post-session, alongside self-report questionnaires. Results showed increases for self-compassion following MBCT, with non-specific reductions for rumination. Paper Two. 40 MBCT, 33 TAU, and 42 HV participants took part. Tasks of attention, emotional processing, and cognitive flexibility were completed at baseline and post-session. Results showed increases in positive emotions post-MBCT, with non-specific changes for face emotion recognition and affective attentional bias tasks both post-MBCT and TAU. There were no changes over time for sustained attention or cognitive flexibility. Paper Three. 16 rMDD participants completed baseline and post-MBCT fMRI tasks of sustained attention and self-blame. Results showed reduced activation over time in the bilateral dACC in self-blame contrasts but no activation changes for sustained attention. Paper Four. 69 rMDD participants (38 MBCT & 31 TAU) completed task-based and self-report assessments up to six months follow-up. Non-relapsing MBCT participants showed increased self-compassion post-session which was maintained in follow-up. MBCT non-relapsing and TAU participants showed reduced rumination post-session and in follow-up. Conclusions. MBCT encourages a move towards more self-compassionate, positive processing but does not alter more automatic, bottom-up levels of processing. MBCT initiates a process for change beyond the course, particularly for self-compassion. Findings have theoretical and clinical implications and extend our understanding of the mechanisms of MBCT in rMDD participants.

This study investigated the discharge practice of a Community Mental Health Team (CMHT) by examining records (electronic and file) of clients discharged between April 2005 and March 2006. Out of a total of 211 discharged clients a random sample of 20 clients was selected to examine the extent to which records and reasons for discharge adhere to current CMHT policies and guidelines. In addition, a sample of clients who had been engaged by the CMHT for 6 months or less was compared to a sample of clients who have been engaged for 1 year or longer to establish whether these differed in sociodemographic characteristics, diagnoses and extent of service provision. The majority of clients discharged during the specified period consisted of clients engaged for 6 months or less. The sampling process revealed that a proportion of these included clients seen for one-off assessments or duty calls, indicating that there is room for improvement to clarify referral criteria (e.g. to GPs) and the role of the CMHT. Similarly, the examination of recording practice also revealed room for improvement in the closing of care packages electronically and inclusion of required information in discharge letters. Almost 50% of clients in the sample were discharged following a decline of any further intervention the reasons for which it will be important to investigate in the form of an audit or survey of service user’s views. Clients engaged for 6 months or less and 1 year or longer seemed to differ mostly in terms of employment rates, diagnosis and previous inpatient admission and mental health act sections. The findings are discussed in relation to the limitations of this study, implications for the service and further research.

Background: Mindfulness-based cognitive therapy (MBCT) is a promising new alternative to anti-depressant medication (Kuyken et al., 2015) and whilst some qualitative studies have explored participants' experiences of MBCT, none yet have explored experiences of participants who are considering coming off their antidepressant medication alongside MBCT or how patients experience change in relationships with self, others and illness. Aim: To examine MBCT participants' experience of change across 24 months, particularly in relation to change in views of their self and their illness over time. Method: Thematic analysis of in-depth retrospective interviews with 42 participants, two years after attending an 8 week MBCT group with an invitation to taper their antidepressant medication (ADM). Each participant took part in one retrospective interview which was semi-structured and focused on experiences of MBCT and ADM over the previous two years since attending an MBCT group and how these have impacted on a change in self and experience of illness. Findings and conclusion: Four over-arching themes were found: taking control, relationships (with self, other and illness), rebuilding the self and shifts in perspective. The findings in the current study are very similar to those found in transformation in the physical chronic illness literature (e.g. Paterson et al., 1999). Perhaps MBCT could be the challenge which lead patients suffering from chronic depression towards change and creates a context in which patients can consider self and identity.

Bakgrund Vid år 2020 så beräknas depression att utgöra den näst största sjukdomsbördan i världen. Rådande situation ställer nya krav på vården och sjuksköterskan att lindra psykisk ohälsa. Nuvarande standardbehandling för depression och ångest utgörs av farmakologisk behandling samt olika former av psykoterapi, emedan ett växande antal studier påvisar behandlingseffekt av mindfulness. Väsentliga frågetecken om hur och när mindfulness har behandlingseffekt kvarstår emellertid, vilket föranleder ytterligare forskning inom området. Syfte Syftet med studien var att undersöka vilka faktorer som påverkar effekten av mindfulness hos personer med depression och/eller ångest. Metod En allmän litteraturöversikt användes som metod i denna studie för att bearbeta och sammanställa en del av tidigare forskning. Datainsamling i form av artikelsökning genomfördes i CINAHL, PubMed och PsychINFO. Innehållsanalys utfördes på 15 vetenskapliga artiklar och fyra teman identifierades. Resultat Resultatet uppvisade att mindfulness har behandlingseffekt vid depression och/eller ångest, varvid fyra faktorer som påverkade behandlingseffekten identifierades. Faktorerna var följande: individuell motivation, diagnos, samverkan med andra behandlingar samt kompetens bland pedagoger. Individuell motivation påverkade behandlingseffekten mest. Slutsats Mindfulness uppvisade behandlingseffekt vid depression och/eller ångest, emedan fyra faktorer påverkade behandlingseffekten: individuell motivation, diagnos, samverkan med andra behandlingar samt kompetens bland pedagoger. Individuell motivation påverkade behandlingseffekten mest, då mindfulness ställer väsentliga krav på mobilisering av egna resurser. Utökad forskning krävs för att bättre kartlägga behandlingseffekten vid specifika tillstånd samt vid specifik behandlingslängd.

Mindfulness-based Cognitive Therapy (MBCT) is a promising approach aimed at the prevention of relapse in people suffering from recurrent depression. However little is known about what factors support gains in the longer-term. This study examines participants’ experiences of the perceived benefits and barriers to MBCT reunion attendance. Thirteen people, who had participated in MBCT classes for recurrent depression within a primary care setting, were interviewed about their experiences of the reunion meetings or their reasons for not attending. Seven of these had completed their program within the previous 12 to 18 months at the time of interview, and six had completed their program between 20 months and 4 years prior to the time of the interview. Interpretative phenomenological analysis (IPA) was used to analyze participants’ accounts. Four themes highlighted the participants’ experiences: In terms of benefits, reunion attendees experienced the reunions as a booster reminding them of their mindfulness practices and as a sanctuary where these practices were further nurtured within an accepting and compassionate environment. Barriers to reunion attendance were difficulties around the group experience and wanting to put the experience behind them. This related to the memory of depression as well as to the program and group experience for some individuals. Theoretical, clinical and research implications are discussed.

<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

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.