A Mindfulness-Based Compassionate Living Training in a Heterogeneous Sample of Psychiatric Outpatients: a Feasibility Study

Mindfulness - 2016
Agna A. Bartels-Velthuis1,2, Maya J. Schroevers3, Karen van der Ploeg1, Frits Koster1, Joke Fleer3, Erik van den Brink1
1Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
2University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
3Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

Tóm tắt

We developed a novel compassion-focused training (mindfulness-based compassionate living; MBCL) and examined its effects in a heterogeneous psychiatric outpatient population with regard to feasibility and changes in levels of depression, anxiety, mindfulness and compassion. The training consisted of nine weekly 2.5-h sessions. Thirty-three patients, who had followed a mindfulness-based stress reduction (MBSR) program or a mindfulness-based cognitive therapy (MBCT) program beforehand, participated in the study (mean age 48.1 years; 82 % female). Participants completed self-report questionnaires before and directly after the MBCL training. Levels of depression, but not of anxiety, reduced, and levels of mindfulness and self-compassion increased. Serious limitations of this study are the small sample size, the lack of a control group and the fact that about half of the participants did not complete the posttraining questionnaires. However, we determined that it is feasible to conduct further research on this novel MBCL training program as a basis for more robust empirical investigation in the future, more specifically examining the effects of MBCL and preferably also the underlying working mechanisms.

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Tài liệu tham khảo

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: American Psychiatric Association.

Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. doi:10.1177/1073191107313003.

Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. (1996). Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67(3), 588–597.

Bohlmeijer, E., ten Klooster, P. M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment, 18(3), 308–320. doi:10.1177/1073191111408231.

Bos, E. H., Merea, R., Van den Brink, E., Sanderman, R., & Bartels-Velthuis, A. A. (2014). The effectiveness of mindfulness training in heterogeneous psychiatric patient groups. Journal of Clinical Psychology, 70(1), 60–71. doi:10.1002/jclp.22008.

Brach, T. (2004). Radical acceptance. New York: Bantam.

Braehler, C., Gumley, A., Harper, J., Wallace, S., Norrie, J., & Gilbert, P. (2013). Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. The British Journal of Clinical Psychology, 52(2), 199–214. doi:10.1111/bjc.12009.

Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research, 187(3), 441–453. doi:10.1016/j.psychres.2010.08.011.

Donker, T., van Straten, A., Marks, I., & Cuijpers, P. (2011). Quick and easy self-rating of generalized anxiety disorder: validity of the Dutch web-based GAD-7, GAD-2 and GAD-SI. Psychiatry Research, 188(1), 58–64. doi:10.1016/j.psychres.2011.01.016.

Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5), 1045–1062. doi:10.1037/a0013262.

Gale, C., Gilbert, P., Read, N., & Goss, K. (2014). An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clinical Psychology & Psychotherapy, 21(1), 1–12. doi:10.1002/cpp.1806.

Germer, C. K. (2009). The mindful path to self-compassion. New York: Guilford Press.

Gilbert, P. (2010). Compassion focused therapy. London: Routledge.

Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6–41.

Gilbert, P., & Irons, C. (2005). Focused therapies and compassionate mind training for shame and self-attacking. In P. Gilbert (Ed.), Compassion: conceptualisations, research and use in psychotherapy (pp. 263–325). London: Routledge.

Gilbert, P & Procter, S (2006). Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy. doi:10.1002/cpp.507.

Hanson, R. (2013). Hardwiring happiness—the new brain science of contentment, calm, and confidence. New York: Harmony.

Hayes, S., Strohsal, K., & Wilson, K. (1999). Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press.

Hoenders, H. J. R., Bos, E. H., Bartels-Velthuis, A. A., Van der Ploeg, K., Vollbehr, N. K., De Jonge, P., & De Jong, J. T. V. M. (2014). Pitfalls in the assessment, analysis, and interpretation of routine outcome monitoring (ROM) data: results from an outpatient clinic for integrative mental health. Administration and Policy in Mental Health and Mental Health Services Research, 41(5), 647–59. doi:10.1007/s10488-013-0511-7.

Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183. doi:10.1037/a0018555.

Jazaieri, H., Jinpa, G. T., McGonigal, K., Rosenberg, E. L., Finkelstein, J., Simon-Thomas, E., Cullen, M., Doty, J. R., Gross, J. J., & Goldin, P. R. (2013). Enhancing compassion: a randomized controlled trial of a compassion cultivation training program. Journal of Happiness Studies, 14(4), 1113–1126. doi:10.1007/s10902-012-9373-z.

Johnson, D. P., Penn, D. L., Fredrickson, B. L., Meyer, P. S., Kring, A. M., & Brantley, M. (2009). Loving-kindness meditation to enhance recovery from negative symptoms of schizophrenia. Journal of clinical psychology, 65, 499–509. doi:10.1002/jclp.20591.

Judge, L., Cleghorn, A., McEwan, K., & Gilbert, P. (2012). An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy, 5(4), 420–429.

Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27. doi:10.1146/annurev.clinpsy.3.022806.091432.

Khoury, B., Lecomte, T., Gaudiano, B. A., & Paquin, K. (2013). Mindfulness interventions for psychosis: a meta-analysis. Schizophrenia Research, 150(1), 176–184. doi:10.1016/j.schres.2013.07.055.

Klainin-Yobas, P., Cho, M. A., & Creedy, D. (2012). Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. International Journal of Nursing Studies, 49(1), 109–121. doi:10.1016/j.ijnurstu.2011.08.014.

Kok, B. E., & Fredrickson, B. L. (2010). Upward spirals of the heart: autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness. Biological Psychology, 85(3), 432–436. doi:10.1016/j.biopsycho.2010.09.005.

Kuyken, W., Watkins, E., Holden, E., White, K., Taylor, R. S., Byford, S., Evans, A., Radford, S., Teasdale, J. D., & Dalgleish, T. (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy, 48(11), 1105–1112. doi:10.1016/j.brat.2010.08.003.

Laithwaite, H., O'Hanlon, M., Collins, P., Doyle, P., Abraham, L., Porter, S., & Gumley, A. (2009). Recovery after psychosis (RAP): a compassion focused programme for individuals residing in high security settings. Behavioural and Cognitive Psychotherapy, 37(5), 511–526. doi:10.1017/S1352465809990233.

Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: an early systematic review. Psychological medicine, 45(05), 927–945.

Loewe, B., Decker, O., Mueller, S., Braehler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medical Care, 46(3), 266–274.

Longe, O., Maratos, F. A., Gilbert, P., Evans, G., Volker, F., Rockliff, H., & Rippon, G. (2010). Having a word with yourself: neural correlates of self-criticism and self-reassurance. NeuroImage, 49(2), 1849–1856. doi:10.1016/j.neuroimage.2009.09.019.

Lucre, KM & Corten, N (2013). An exploration of group compassion-focused therapy for personality disorder. Psychology and Psychotherapy: Theory, Research and Practice. doi:10.1111/j.2044-8341.2012.02068.x.

MacBeth, A., & Gumley, A. (2012). Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552. doi:10.1016/j.cpr.2012.06.003.

Mayhew, S. L., & Gilbert, P. (2008). Compassionate mind training with people who hear malevolent voices: a case series report. Clinical Psychology & Psychotherapy, 15(2), 113–138. doi:10.1002/cpp.566.

Mercadillo, R. E., Luis Diaz, J., Pasaye, E. H., & Barrios, F. A. (2011). Perception of suffering and compassion experience: brain gender disparities. Brain and Cognition, 76(1), 5–14. doi:10.1016/j.bandc.2011.03.019.

Neff, K. D. (2003). Development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250.

Neff, K. (2011). Self-compassion: stop beating yourself up and leave insecurity behind. New York: HarperCollins.

Neff, KD, & Dahm, KA (in press). Self-compassion: what it is, what it does, and how it relates to mindfulness. To appear in M. Robinson, B. Meier & B. Ostafin (Eds.), Mindfulness and Self-Regulation. New York: Springer.

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44. doi:10.1002/jclp.21923.

Neff, K. D., & Vonk, R. (2009). Self-compassion versus global self-esteem: two different ways of relating to oneself. Journal of Personality, 77(1), 23–50. doi:10.1111/j.1467-6494.2008.00537.x.

Olff, M., Frijling, J. L., Kubzansky, L. D., Bradley, B., Ellenbogen, M. A., Cardoso, C., Bartz, J. A., Yee, J. R., & Van Zuiden, M. (2013). The role of oxytocin in social bonding, stress regulation and mental health: an update on the moderating effects of context and interindividual differences. Psychoneuroendocrinology, 38(9), 1883–1894. doi:10.1016/j.psyneuen.2013.06.019.

O'Reilly, G. A., Cook, L., Spruijt-Metz, D., & Black, D. S. (2014). Mindfulness-based interventions for obesity-related eating behaviours: a literature review. Obesity Reviews, 15(6), 453–461. doi:10.1111/obr.12156.

Pace, T. W. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D., Issa, M. J., & Raison, C. L. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology, 34(1), 87–98. doi:10.1016/j.psyneuen.2008.08.011.

Pace, T. W. W., Negi, L. T., Sivilli, T. I., Issa, M. J., Cole, S. P., Adame, D. D., & Raison, C. L. (2010). Innate immune, neuroendocrine and behavioral responses to psychosocial stress do not predict subsequent compassion meditation practice time. Psychoneuroendocrinology, 35(2), 310–315. doi:10.1016/j.psyneuen.2009.06.008.

Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clinical Psychology Review, 31(6), 1032–1040. doi:10.1016/j.cpr.2011.05.002.

Porges, SW (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. doi:S0301- 0511(06)00176-1 [pii].

Quilty, L. C., Zhang, K. A., & Bagby, R. M. (2010). The latent symptom structure of the Beck Depression Inventory-II in outpatients with major depression. Psychological Assessment, 22(3), 603–608. doi:10.1037/a0019698.

Rockliff, H, Karl, A, McEwan, K, Gilbert, J, Matos, M, & Gilbert, P (2008). Effects of intranasal oxytocin on 'Compassion Focused Imagery'. Emotion. doi:10.1037/a0023861.

Ruths, F. A., De Zoysa, N., Frearson, S. J., Huton, J., Williams, J. M. G., & Walsh, J. (2013). Mindfulness-based cognitive therapy for mental health professionals—a pilot study. Mindfulness, 4, 289–295. doi:10.1007/s12671-012-0127-0.

Segal, S. V., Williams, J. M., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press.

Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomized trial. International Journal of Stress Management, 12, 164–176.

Shapiro, S. L., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105–115. doi:10.1037/1931-3918.1.2.105.

Spitzer, RL, Kroenke, K, Williams, JB, & Lowe, B (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. doi:166/10/1092.

Steer, R., Ball, R., Ranieri, W., & Beck, A. (1999). Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. Journal of Clinical Psychology, 55(1), 117–128. doi:10.1002/(SICI)1097-4679(199901)55:1<117::AID-JCLP12>3.0.CO;2-A.

Van den Brink, E, & Koster, F (2012). Compassievol leven—van mindfulness tot heartfulness. Amsterdam: Boom. (English edition in press: Mindfulness-based compassionate living —a new training programme to deepen mindfulness with heartfulness). London: Routledge.

Van der Does, A. J. W. (2002). BDI-II-NL. Handleiding. De Nederlandse versie van de Beck Depression Inventory-2nd edition. Lisse: Harcourt Test Publishers.

Vollestad, J., Nielsen, M. B., & Nielsen, G. H. (2012). Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. The British Journal of Clinical Psychology, 51(3), 239–260. doi:10.1111/j.2044-8260.2011.02024.x.

Wallmark, E., Safarzadeh, K., Daukantaitė, D., & Maddux, R. E. (2013). Promoting altruism through meditation: an 8-week randomized controlled pilot study. Mindfulness, 4, 223–234.

Wanden-Berghe, R. G., Sanz-Valero, J., & Wanden-Berghe, C. (2011). The application of mindfulness to eating disorders treatment: a systematic review. Eating Disorders, 19(1), 34–48. doi:10.1080/10640266.2011.533604.

Yarnell, L. M., Stafford, R. E., Neff, K. D., Reilly, E. D., Knox, M. C., & Mullarkey, M. (2015). Meta-analysis of gender differences in self-compassion. Self and Identity, 14(5), 499–520. doi:10.1080/15298868.2015.1029966.

Zgierska, A., Rabago, D., Chawla, N., Kushner, K., Koehler, R., & Marlatt, A. (2009). Mindfulness meditation for substance use disorders: a systematic review. Substance Abuse, 30(4), 266–294. doi:10.1080/08897070903250019.

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