Two studies of mindfulness-based interventions

Today, I present two articles that address mindfulness. First, Mak, Wong & Ng (2023) published “The Use of Mindfulness-Based Interventions in Stroke Rehabilitation: A scoping review” in Rehabilitation Psychology. Here are the edited abstract and impact statements:

There is emerging evidence for the use of mindfulness-based interventions (MBIs) to improve health outcomes in the context of stroke rehabilitation. This scoping review identified recently available evidence and possible research gaps regarding how MBIs affect psychological and physical rehabilitation outcomes in individuals poststroke. Electronic searches were performed using the four major databases, CINAHL, MEDLINE, PsycINFO, and Web of Science. Sixteen studies out of a total of 404 relevant studies met the selection criteria for inclusion in this review. Results: Our findings indicate diverse results on the benefits of MBIs in individuals poststroke across a range of rehabilitative outcomes. For instance, significant improvements in mental fatigue, cognition, and quality of life were observed for most of the studies while the outcomes for mood and physical functioning were mixed. The available evidence lends qualified support to the view that mindfulness has the potential to be a therapeutic intervention that offers health benefits to individuals poststroke. Yet, the diversity of results highlights the need for a more rigorous examination in further research. We also identified several knowledge gaps in mindfulness research in the stroke population, such as the limited amount of evidence for mindfulness-based cognitive therapy (MBCT), inadequate evaluations of physical outcomes, and the lack of methodologically robust trials. Further investigations are warranted to strengthen the evidence for the feasibility and effectiveness of MBIs. 

There is a pressing need to develop effective rehabilitative interventions for poststroke recovery of physical and/or psychological function. Mindfulness has the potential to be a therapeutic intervention that offers health benefits, such as the improvement in mental fatigue, cognition, and quality of life, to individuals poststroke. The knowledge gaps regarding mindfulness-based interventions in stroke rehabilitation identified in this study, including the limited number of investigations of mindfulness-based cognitive therapy, few assessments of physical outcomes, and the lack of methodologically robust trials, need to be addressed in future research for more solid recommendations.

I like the thoroughness of their review and the findings. Certainly, the benefits in terms of mental fatigue, cognition, and quality of life are important, but it’s interesting that the impacts on mood and physical health are mixed. This makes their suggested research all the more important. Next, Lathan, McAfee, Spivey, Garcia, Kaslow & Powers (2024) published “Risk for Posttraumatic Stress Disorder Symptoms by Trauma Type: The role of self-compassion” in Psychological Trauma: Theory, Research, Practice, and Policy. Their abstract and impact statements follow:

Public health systems need evidence-based, feasible, and acceptable preventive interventions for trauma-exposed Black Americans. Self-compassion often serves as a protective factor following trauma exposure, but whether it alleviates risk for posttraumatic stress disorder (PTSD) symptoms and the extent to which it buffers against the deleterious effects of particular trauma types in a high-risk, community sample remains unknown. The present study examined whether the association between various trauma types (noninterpersonal vs. physical vs. sexual) and PTSD symptom severity was moderated by self-compassion in a sample of trauma-exposed Black Americans seeking primary care. Participants (n = 77; 87.5% female; Mage = 45.3 years; SDage = 12.8) were recruited from a large, publicly funded health care system. Participants completed self-report measures assessing trauma history and self-compassion and a structured clinical interview administered by a trained clinician. Cumulative sexual violence, r(77) = .32, p < .01, was positively associated with PTSD symptom severity, whereas cumulative noninterpersonal trauma was not; the relation between cumulative physical violence and PTSD symptom severity was trending toward significance, r = .22, p = .06. The interactions between noninterpersonal trauma/sexual violence, self-compassion, and PTSD symptom severity were trending toward significance, and a significant interaction between physical violence and self-compassion was observed, B = 1.94, SE = .67, p< .01, at high, t = 3.21, p < .01, levels of self-compassion. Implementing brief, mindfulness-based psychotherapies that enhance self-compassion in the primary care setting may help mitigate PTSD risk among Black Americans with lower levels of physical violence and noninterpersonal trauma exposure and those with higher levels of sexual violence exposure. 

Black Americans with trauma exposure and related symptoms tend to seek care from public health systems, necessitating evidence-based preventive interventions to protect against posttraumatic stress disorder (PTSD) symptoms. Cumulative physical violence exposure interacted with self-compassion to predict severity of PTSD symptoms, specifically negative alterations in cognitions and mood and arousal/reactivity clusters. Brief, mindfulness-based interventions that foster self-compassion may help ameliorate PTSD risk among health care-seeking Black Americans exposed to lower levels of physical violence. More intensive trauma-focused psychotherapies may be needed among those with more severe levels of physical violence.

This is a small sample but I thought the findings were helpful in differentiating the benefits of mindfulness intervention. Like the previous study, the interventions are not universally successful, in this case with clients who have endured high levels of physical violence. I continue to see mindfulness interventions as low risk, high reward strategies for working with a range of clients.