Anxiety is a high-prevalence disorder, and it is often treated by medication which can be costly, has side effects, and is not available for everyone in need. Mindfulness-based interventions (MBIs) such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are great alternatives to treat anxiety. Both MBIs are not only more accessible but have no side effects as well. To establish whether MBIs can become a main treatment for anxiety, the associated neural correlates and changes should be investigated further. The aim of this systematic review is to investigate whether neural correlates of MBIs are mainly caused by emotional or attentional neural mechanisms, or if both are involved. There were five studies selected and included according to a set of inclusion and exclusion criteria. The results suggest that MBIs are in fact effective in alleviating anxiety symptoms by enhancing both emotion and attention regulation. However, several of the included studies came with limitations such as having no significance in p-values, no control groups, and small samples. Thus, further research is needed to draw a conclusion on whether MBIs are the best alternative for the alleviation and treatment of anxiety.

Dans le courant des alternatives thérapeutiques et de l'approche corps/esprit, la méditation comme objet de recherche dans le champ des prises en charge thérapeutique et de la psychologie de la santé fait état d'un grand nombre de recherches aux États-Unis depuis les vingts dernières années, Un développement embryonnaire voit le jour dans les pays francophone. S'inscrivant dans cette optique, l'objectif de cette thèse est dans un premier temps de montrer l'intérêt de ce concept en psychothérapie en le clarifiant dans ces trois approches principales (concentration, pleine conscience, méditation en mouvement), de focaliser sur la méditation de pleine conscience en l'articulant au sein de la troisième vague des TTC et de l'éclairer sous l'angle neurologique et physiologique. Dans un second temps, nous développerons de façon pratique l'approche MBSR issue des travaux de J Kabat Zinn (1990) et de ses successeurs en la testant sur la gestion du stress, de l'anxiété, de la qualité de vie, du coping et de la dépression sur une population d'étudiant et de diabétique de type 1. A cela s'ajoutera des études de cas. Enfin, nous amènerons la discussion sur l'efficacité de la pratique MBSR au regard des recherches neurologiques dans un souci futures dans l'intégration en psychothérapie / AIn the feld of the alternative therapy and of the mind body approche, meditation as a new object of research in this aera show a lot of improvment in the last twenty years, with a new development in Europe. The objective of this thesis is to show the great interest of this concept inpsychotherapy with a clarification in its three main areas (concentration, mindfulness, and movement meditation), with a focus on mindfulness meditation linked to the behavioural and cognitive therapies, and with an neurological and physiological highlights. Additionnaly to that, we will develop on a pratical way, the MBSR (Mindfulness based stress reduction) approach linked to the work of J Kabat Zinn (1990) with experimental assessment on stress, anxiety, quality of life, coping and depression on two populations (student and diabetic type 1), and case studies. At the end, we will focus the discussion ont the effectiveness of MBSR linked to neurological researches and integration with psuchotherpies

Mindfulness-based interventions have been shown to effectively alleviate psychological suffering. The current study compares the effectiveness of a mindfulness-based intervention with an interpersonal support group and a notreatment condition in relieving psychological distress. Participants in this study comprised 112 college students from two universities who contacted the University Counseling Center on their respective college campus to access mental health services. Clients completed written measures at 3 time points; pre- intervention, postintervention, and at 6 months. The overall findings of this study indicate greater reductions over time in the mindfulness-based intervention on measures of anxiety, depression, academic problems, and increase in mindfulness skills compared to the interpersonal support group and no-treatment condition. Conversely, among participants in the interpersonal support group, findings reveal greater reductions in interpersonal problems. Further, results document a positive association between time spent in home mindfulness practice and change in mindfulness skills, and reductions in psychological distress. Mindfulness-based programs may prove to be a time and cost-effective intervention for addressing the needs of University Counseling Centers at a time when there is a shortage of mental health services.

*LITERATURE REVIEW* Abstract Background: Insomnia is an increasing public health epidemic, affecting healthy, sub-clinical and clinical populations. Cognitive Behaviour Therapy for insomnia (CBT-I) is the most evidence-based treatment endorsed by the National Institute of Clinical Excellence (NICE) which provides guidance to health and social services in England. Research has demonstrated, however, that CBT-I has low or uncertain efficacy within various populations including those with coexisting health problems and clinical diagnoses. Furthermore, CBT-I is not accessible to most people due to poor prioritisation within services and a paucity of clinicians skilled in insomnia treatment. There is an urgent need to develop alternative interventions for this persistent and highly debilitating complaint. Acceptance based approaches to insomnia including mindfulness-based stress reduction (MBSR) provide an alternative model for holistic treatment of sleep distress. Objectives: This review summarises and synthesises the available literature investigating the effectiveness of MBSR as a treatment for insomnia in community and clinical populations (with some specific populations excluded). Method: Systematic review of all relevant quantitative and qualitative literature to date using PsycINFO, PsycARTICLES and Web of Knowledge databases. Results: 13 relevant articles were included (3 abstracts): randomised control trials (RCTs), experimental, quasi-experimental and qualitative studies. Conclusions: Overall, the limited research in this area was assessed to be of moderate quality and to provide preliminary evidence that MBSR offers an effective intervention for insomnia symptoms and disorder in various populations. The review highlighted the paucity of research specifically MBSR AND INSOMNIA SYMPTOMS 10 investigating the acceptability of MBSR as an insomnia treatment, particularly for more complex presentations. It is possible that MBSR provides holistic and bi-directional benefits for sleep and emotional well-being, however, further research is required to determine how participants experience the course process in relation to their sleep. Keywords: Insomnia, CBT-I, MBSR. *EMPIRICAL PAPER* Abstract: There is an urgent need to improve the availability and acceptability of interventions for insomnia. Low-levels of help-seeking and high levels of functional impairment are often characteristic of individuals with unremitting complaints. Ambivalence about the significance of insomnia and/or a helpless resignation can be further compounded by lack of available treatments and socio-cultural attitudes towards sleep. Insomnia is often complicated with coexisting mental and physical health problems, a syndromal presentation. Theoretical and empirical evidence suggests that eight-week, mindfulness-based stress reduction (MBSR) programmes may offer a holistic intervention to relieve emotional disturbance that may underlie the complaint. This research sought to understand the experience of MBSR for individuals in the community with persistent insomnia, to gain insight into its acceptability. Methods: Holloway and Jefferson’s psychosocial method was used which posits the ‘defended subject’ as key to data construction and analysis (2013). Defences, free associations, researcher-interviewee dynamic, textual information, cultural and sociological knowledge all contributed to an understanding of the ‘whole’ of the experience of interviewees as communicated within Free Association Narrative Interviewing. Results: Results indicate that for highly defended individuals with insomnia, MBSR can be a challenging intervention to engage with and to embody. Barriers to acceptability included: limited insight into emotional distress, (unconscious) relational secondary gains to insomnia, limited understanding of sleep as a physiological process, restricted understanding or misconceptions about mindfulness prior to participation, resistance to acknowledging insomnia MBSR AND INSOMNIA SYMPTOMS 66 as a mental health complaint and practical issues of delivery. Researcher-interviewee dynamics suggested significant unmet relational needs of many interviewees. An exceptional case was discussed where relational distress was not understood to underlie insomnia and where significant benefits to sleep were reported from MBSR. Conclusion: The methodology enabled novel insights into the challenges for highly defended individuals with complex insomnia for accessing MBSR. By contrast, it is possible that for less complex but acute and recurrent insomnia, MBSR is more readily acceptable. Study limitations, future research needs and recommendations for improving the acceptability of MBSR for complex cases of insomnia are discussed.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2010. / Typescript. Includes bibliographical references (p. 64-67).

Mindfulness meditation is increasingly being incorporated into psychotherapeutic interventions. However, whilst much research has addressed the question of whether mindfulness-based interventions work, less has been directed at how they work. The current thesis describes four studies that explored potential mechanisms by which mindfulness interventions may bring about change. Study 1 employed a correlational design to examine whether mindfulness practice is associated with increased attentional control. Studies 2 to 4 used experimental methods to examine the ways in which individual mindfulness-based techniques might exert their effects on a health- related behaviour (chocolate consumption). Study 1 (N=125) showed no evidence that meditation practice was associated with reduced attentional bias (assessed using dot-probe and emotional Stroop tasks). Study 2 (N=135) showed that a cognitive defusion task (but not an acceptance task) helped individuals to resist chocolate over a five-day period. There was evidence to indicate that the defusion task worked by interrupting automatic links between chocolate-related thoughts and chocolate consumption. Study 3 (N=108). however, failed to find evidence that the defusion strategy worked either by reducing automaticity or increasing the accessibility of competing goals. Study 4 (N=60) further showed that the defusion strategy did not influence chocolate cravings. In conclusion, the current research demonstrated the need to go beyond merely describing the positive effects of mindfulness on changing self-control related behaviours. The findings also highlighted the potential problems of current mindfulness-based interventions due to their complexity, and that one mindfulness-based intervention does not 'fit' all health-related behaviours to bring about change. Ensuring the population maintains a healthy diet is important. Brief mindfulness training may be a useful means of helping people choose more healthy options. Further dismantling design studies were however advised before the evidence can be used to inform public health policy and services.

This study explored and described the experiences of students with self-reported symptoms of anxiety and depression who participated in a mindfulness-based intervention. The study was conducted in collaboration with the Student Counselling Career and Development Centre (SCCDC) at the Nelson Mandela Metropolitan University (NMMU). The study utilised a qualitative research approach and nine participants were selected through purposive, non-probability sampling. The data were collected by means of semi-structured interviews and participants‟ brief written reflections of their individual experiences. Content analysis produced ten themes categorised according to the components of the biopsychosocial/spiritual (BPSS) model. The most prevalent theme identified, describing participants‟ experience of the mindfulness-based intervention, was an enhanced perception of emotional regulation. This finding confirmed the outcomes of previous studies that also found an increase in emotional regulation related to mindfulness-based interventions. Results also shed new light on the perceived personal changes participants experienced in relation to body awareness, increased attentional regulation, social interactions, and spiritual experiences. In addition, participants verbalised present moment awareness and an accepting non-judgmental attitude as central to the biopsychosocial/spiritual changes and benefits they experienced. Recommendations for further research include investigating the impact of mindfulness-based interventions on attentional control and social interactions.

Submitted by Daniella Santos (daniella.santos@ufma.br) on 2017-09-12T14:52:30Z No. of bitstreams: 1 AnaCostaNeta.pdf: 757915 bytes, checksum: 3232fac494ac242711aca6433e3a9afc (MD5) / Made available in DSpace on 2017-09-12T14:52:30Z (GMT). No. of bitstreams: 1 AnaCostaNeta.pdf: 757915 bytes, checksum: 3232fac494ac242711aca6433e3a9afc (MD5) Previous issue date: 2017-05-25 / Mindfulness practices have been used in the treatment of clinical problems, for some time, with the use of the pioneer program of Kabat-Zinn, Mindfulness-based Stress Reductions (MBSR), program that served as a prototype for the development of other mindfulness-based, among them the of Segal, Williams and Teasdale, MindfulnessBased Cognitive Therapy (MBCT), which integrates mindfulness practices with strategies of Cognitive Therapy. From these integrations mindfulness practices have been inserted in the process of Cognitive Behavioral Therapy (CBT) increasingly, even the two clinical models showing-philosophical and theoretical principles of methods different interventions. Therefore, this study aimed to discuss how the theoretical fundaments of MBSR and CBT are integrated in MBCT, as well as possible reasons and implications of the inclusion of mindfulness strategies in CBT. For this we used articles available on the internet, books and chapters of books on the subject, in English, Portuguese and Spanish, without restriction to year of publication. The theoretical comparison was accomplished through four conceptions that supports the theoretical models: cognition, behavior, and environment of pathology. In addition, he likened himself, through the analysis of two sections, the interventions carried out in TCC and MBCT. Overall, they identified some similarities and compatibilities between the theoretical assumptions of CBT and MBCT, MBSR programs and being a significant difference how understand the cognitions, because while in TCC she is seen as deterministic and causal, MBSR programs and MBCT is just another mental event. It appeared also, controversies clear when one considers the classical cognitive model of Aaron Beck. / As práticas de mindfulness vêm sendo utilizadas no tratamento complementar de problemas clínicos, há algum tempo, com o uso do programa pioneiro de Kabat-Zinn, o Mindfulness-Basead Stress Reductions (MBSR), programa que serviu de protótipo para o desenvolvimento de outros baseados em mindfulness, dentre eles o de Segal, Williams e Teasdale, o Mindfulness-Based Cognitive Therapy (MBCT), que integra práticas de mindfulness com estratégias da Terapia Cognitiva. A partir dessas integrações as práticas de mindfulness vêm sendo inseridas no processo da Terapia CognitivoComportamental (TCC) de modo crescente, mesmo os dois modelos clínicos apresentando princípios teóricos-filosóficos e métodos de intervenções diferentes.Diante disso, este estudo objetivou discutir como os fundamentos teóricos do MBSR e da TCC são integrados no MBCT, bem como possíveis razões e implicações da inclusão de estratégias mindfulness na TCC. Para isso foram utilizados artigos disponibilizados na internet, livros e capítulos de livros sobre a temática, no idioma inglês, português e espanhol, sem restrição de ano de publicação. A comparação teórica foi realizada por meio de quatro concepções: cognição, comportamento, ambiente e visão de patologia. Além disso, comparou-se, por meio da análise de dois trechos de sessão, as intervenções realizadas na TCC e no MBCT. De modo geral, foram identificadas algumas semelhanças e compatibilidades entre os pressupostos teóricos da TCC e dos programas MBSR e MBCT, sendo a diferença significativa o modo como entendem as cognições, pois enquanto na TCC ela é vista como causal e determinista, nos programas MBSR e MBCT é apenas mais um evento mental. Verificou-se também, controvérsias claras quando se considera o modelo cognitivo clássico de Aaron Beck.

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.

Thesis advisor: Joyce Pulcini / This randomized intervention study examined the efficacy and feasibility of a stress reduction program using mindful movement to decrease levels of perceived stress, facilitate coping, enhance self-esteem, and self-regulation in school-age girls. School-age children experience stressors with serious sequelae and need to respond with multiple coping strategies. Girls use maladaptive coping strategies and report lower self-esteem. Evidence-based interventions for stress management in children are scant, contributing to missed opportunities for preventing illness and promoting health. Mindfulness-based stress reduction is a training program of awareness-based practices, including yoga, which was adapted to the development of school-age girls. The questions included: (1) To what extent do school-age girls who participate in an eight week mindful movement intervention report significantly different levels of perceived stress, effectiveness and number of coping strategies, levels of self-esteem, and self-regulation than girls in a wait-list control group? (2) To what extent is the dose of mindful movement inversely correlated with perceived stress and positively correlated with effectiveness and number of coping strategies, self-esteem, and self-regulation? A sample of fourth and fifth grade girls was recruited from two public schools randomized as intervention and wait-list control. The intervention group met one hour a week for eight weeks and completed ten minutes of daily homework. Repeated Measures Analysis of Variance with an intention to treat analysis (n=155) was used. No differences between groups were found. Both groups reported increased self-esteem and self-regulation over time. Compared to the control group, the intervention group was more likely to increase their frequency of coping (p< .05). The amount of home yoga practice predicted an increase in stress scores. Supplemental analyses found the intervention group was more likely to report increasing stress appraisals (p<.01). Coping frequency and stress appraisal scores were not correlated at Time 1 in the intervention group, but were positively correlated at Time 2. The intervention group may have become more aware of feelings associated with stress and generated coping, or may have experienced increasing stress as part of mindfulness training. School-based mindfulness interventions are feasible and may be coordinated by school nurses, but require more investigation. Limitations, implications, and suggestions for future research are discussed. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.