Mindfulness-Based Interventions for Anxiety and Depression

In the paper

“These outcomes include clinical disorders and symptoms such as anxiety,8,12,13 risk of relapse for depression,14,15 current depressive symptoms,9 stress,16–18 medical and well-being outcomes such as chronic pain,19 quality of life,14,20 and psychological or emotional distress.21,22”

What the sources say

• Supported

  The Discussion states that the review's findings support mindfulness-based therapy for anxiety and depression in clinical populations. The citing sentence assigns separate citations to relapse risk, stress, chronic pain, quality of life, and distress; those outcomes are not treated as claims supported by this source. (LLM, conf=0.88)

  cites [8] Hofmann, 2010, The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review, J Consult Clin Psychol source
• ?Not checked — no full text of the sourcecites [12] Green SM, Bieling PJ. Expanding the scope of mindfulness-based cognitive therapy: evidence for effectiveness in a heterogeneous psychiatric sample. Cogn Behav Pract. http://dx.doi.org/10.1016/j.cbpra.2011.02.006. source
• ?Not checked — no full text of the sourcecites [13] Hinton, 2013, Acceptance and mindfulness techniques as applied to refugee and ethnic minority populations with PTSD: examples from “culturally adapted CBT”, Cogn Behav Pract source
• ?Not checked — no full text of the sourcecites [14] Kuyken, 2008, Mindfulness-based cognitive therapy to prevent relapse in recurrent depression, J Consult Clin Psychol source
• ?Not checked — no full text of the sourcecites [15] Teasdale, 2000, Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy, J Consult Clin Psychol source
• Supported

  The citation is attached to “current depressive symptoms,” not the sentence’s other outcomes. The Results (Meta-Analysis Findings) report a statistically significant reduction in depressive symptom severity after MBIs compared with controls among people diagnosed with a current depressive or anxiety disorder. (LLM, conf=0.93)

  cites [9] Strauss, 2014, Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials, PLoS One source

In the paper

“ACT does not include meditation practices, and rarely uses the term ‘mindfulness’ in its treatment protocol, but the therapeutic strategies of ACT are practically identical to mindfulness skills as described in this review.”

What the sources say

• Partly supported

  The sections on establishing self as context and letting go of the struggle describe observing thoughts and experiencing feelings without trying to change or escape them, supporting a resemblance to mindfulness skills. But the paper does not compare ACT with the skills in the citing review, establish that its strategies are practically identical to them, or substantiate claims about meditation and use of the word ‘mindfulness’ in the full treatment protocol. The Examples of Specific ACT Techniques section says that protocol is a book-length document and offers only a sample of its procedures (page numbers unavailable). (LLM, conf=0.82)

  cites [26] Hayes, 1994, Acceptance and commitment therapy: altering the verbal support for experiential avoidance, Behav Anal sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [45] Baer, 2003, Mindfulness training as a clinical intervention: a conceptual and empirical review, Clin Psychol Sci Pract source

In the paper

“Furthermore, studies looking at individual moderators of treatment outcomes have found that MBCT may be most effective in preventing relapse among individuals with the greatest risk of relapse. These high-risk individuals include those with four or more previous major depressive episodes (Cohen’s h = 0.88),53 and those who suffered from maltreatment during childhood.53,54”

What the sources say

• ?Not checked — no full text of the sourcecites [53] Ma, 2004, Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects, J Consult Clin Psychol source
• Partly supported

  The Results and Discussion report that childhood trauma moderated MBCT’s effect on relapse, with benefit among participants reporting more childhood trauma. The paper also discusses greater benefit in vulnerable patients with three or more prior episodes, but our copy does not support the specific threshold of four or more episodes or Cohen’s h = 0.88. (LLM, conf=0.88)

  cites [54] Williams, 2014, Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial, J Consult Clin Psychol sourceExperimental — accuracy not yet measured

In the paper

“The MBSR group demonstrated a pre-post treatment effect size (Cohen’s d) of 1.06, which is comparable to the effect sizes seen in CBT for anxiety.”

What the sources say

• Supported

  The Discussion reports a pre- to post-treatment Cohen’s d of 1.06 for the MBSR group on the HAM-A and explicitly compares it with effect sizes of 0.73–1.37 in CBT studies. (LLM, conf=0.95)

  cites [46] Hoge, 2013, Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity, J Clin Psychiatry source

In the paper

“These programs have not been examined as thoroughly as the standard 8-week interventions; however, preliminary evidence indicates that these modest interventions can have beneficial effects on a variety of symptoms, including compassion58 and working memory capacity.59”

What the sources say

• Supported

  The Procedure describes a three-week mindfulness program, and the Results report significantly more compassionate helping in that group than in the active control group (37% versus 14%). In the citing sentence, this paper is cited for compassion; working memory capacity has a separate citation. (LLM, conf=0.93)

  cites [58] Lim, 2015, Mindfulness and compassion: an examination of mechanism and scalability, PLoS One source
• ?Not checked — no full text of the sourcecites [59] Mrazek, 2013, Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering, Psychol Sci source

In the paper

“These results are supported by select meta-analyses that have demonstrated superiority of MBSR in reducing anxiety and stress relative to heterogenous control conditions.8,47,48 Pre-post treatment effect sizes for these meta-analyses all fall in the moderate-large range (Hedge’s g ranging from 0.24 – 1.54).”

What the sources say

• Partly supported

  The Results report a moderate pre–post reduction in anxiety for MBSR (Hedges’ g = 0.55) and significant anxiety effects for mindfulness-based therapy against several types of control. But the controlled analyses pool mindfulness-based therapies rather than isolate MBSR, the measured outcomes are anxiety and depression rather than stress, and this paper does not report 0.24–1.54 as its range of pooled pre–post effects. The Discussion also cautions that most controlled-effect estimates were unreliable. (LLM, conf=0.88)

  cites [8] Hofmann, 2010, The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review, J Consult Clin Psychol sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [47] Bohlmeijer, 2010, The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis, J Psychosom Res source
• ?Not checked — no full text of the sourcecites [48] Fjorback, 2011, Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials, Acta Psychiatr Scand source

In the paper

“However, as noted by Dimidjian and Segal, 65 the field has been limited by a number of methodological gaps that restrict both the reach and relevance of the conclusions that can be drawn from the current literature.”

What the sources say

• Supported

  Recommendation 1 identifies gaps in specifying intervention targets and testing mechanisms, while Recommendation 4 explains how poorly matched controls complicate interpretation of findings. Recommendation 7 calls the lack of implementation research a serious gap. Together, these sections support the claim that methodological gaps limit what can be concluded from the mindfulness-based intervention literature and its broader relevance; page numbers are unavailable in our copy. (LLM, conf=0.90)

  cites [65] Dimidjian, 2015, Prospects for a clinical science of mindfulness-based intervention, Am Psychol source

In the paper

“Though these technology-delivered interventions are still in their infancy, a recent meta-analysis of 15 RCTs found that, relative to control or waitlist conditions, technology-delivered MBIs had a significant beneficial impact on depression, anxiety, stress, well-being, and mindfulness (Hedge’s g ranging from 0.22 for anxiety to 0.51 for stress).64”

What the sources say

• Supported

  Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  cites [64] Spijkerman, 2016, Effectiveness of online mindfulness-based interventions in improving mental health: a review and meta-analysis of randomised controlled trials, Clin Psychol Rev sourceExperimental — accuracy not yet measured

In the paper

“Mindfulness-based treatments and traditional (Beckian) CBT share many similar characteristics.45 Both aim to reduce psychopathological suffering, and approach this goal with a combination of cognitive and behavioral therapeutic exercises. Both involve a desensitization of conditioned fear responses, though MBIs approach this effect through sustained attention, while traditional CBT directly focus”

What the sources say

• ?Not checked — no full text of the sourcecites [45] Baer, 2003, Mindfulness training as a clinical intervention: a conceptual and empirical review, Clin Psychol Sci Pract source
• Partly supported

  Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

  cites [66] Hofmann, 2008, Cognitive processes during fear acquisition and extinction in animals and humans: implications for exposure therapy of anxiety disorders, Clin Psychol Rev sourceExperimental — accuracy not yet measured
• ?Not checked — no full text of the sourcecites [67] Longmore, 2007, Do we need to challenge thoughts in cognitive behavior therapy?, Clin Psychol Rev source

In the paper

“Though these mindfulness interventions are too truncated to expect any long-term effects, studies indicate that they can have immediate effects on psychological and neuroendocrine responses to social stress,60 and perceived pain severity in response to noxious heat stimulation.61”

What the sources say

• ?Not checked — no full text of the sourcecites [60] Creswell, 2014, Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress, Psychoneuroendocrinology source
• Supported

  Citation 61 is attached to the noxious-heat pain finding, not the social-stress finding, which has a separate citation. The Methods describe four days of mindfulness training and heat stimulation; the Results report reduced pain intensity and unpleasantness ratings during meditation after training. (LLM, conf=0.94)

  cites [61] Zeidan, 2011, Brain mechanisms supporting the modulation of pain by mindfulness meditation, J Neurosci source

In the paper

“In a large study using ecological momentary assessment data, 37 it was found that approximately 47% of subjects’ waking hours were spent in a state of mind wandering; furthermore, the authors demonstrated that mind wandering predicts subsequent unhappiness.”

What the sources say

• ?Not checked — no full text of the sourcecites [37] Killingsworth, 2010, A wandering mind is an unhappy mind, Science source

In the paper

“As we will discuss throughout this review, mindfulness targets one such core processes that has demonstrated efficacy in reducing anxiety and depression symptom severity, both as the core treatment ingredient, as well as when integrated into other treatments.”

In the paper

“Despite the popularity of these interventions, the evidence base is still not fully established, in part because this literature is oversaturated with cross-sectional studies, waitlist-controlled trials, and other methodological shortcomings that limit the strength of conclusions that can be drawn from these studies.”

What the sources say

• ?Not checked — no full text of the sourcecites [1] Gu, 2015, How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies, Clin Psychol Rev source

In the paper

“Lastly, both treatments involve relaxation and improvements in self-modulatory efforts,45 though it is unclear whether these effects are attributable to a specific treatment component, or simply engaging in a therapeutic process.”

What the sources say

• ?Not checked — no full text of the sourcecites [45] Baer, 2003, Mindfulness training as a clinical intervention: a conceptual and empirical review, Clin Psychol Sci Pract source

In the paper

“Nevertheless, these retreats are a relatively cost-effective way of delivering intensive and well-controlled doses of a mindfulness intervention, and recent trials have demonstrated promising effects on anxiety, stress, and other measures of psychosocial well-being and health.56,57”

What the sources say

• ?Not checked — no full text of the sourcecites [56] Cohen, 2017, The immediate and long-term effects of an intensive meditation retreat, Mindfulness source
• ?Not checked — no full text of the sourcecites [57] Rosenberg, 2015, Intensive meditation training influences emotional responses to suffering, Emotion source

In the paper

“Post-treatment effect sizes were largest for psychological outcomes, relative to physical or medical outcomes, with the strongest effects found for anxiety, followed by depression.”

What the sources say

• ?Not checked — no full text of the sourcecites [6] Khoury, 2013, Mindfulness-based therapy: a comprehensive meta-analysis, Clin Psychol Rev source

In the paper

“These beneficial effects remained relatively stable after follow-up periods (ranging from 3 weeks to 3 years, with a median of 28 weeks), though the comparative effect sizes for MBI versus control treatment conditions diminished at follow-up.6”

What the sources say

• ?Not checked — no full text of the sourcecites [6] Khoury, 2013, Mindfulness-based therapy: a comprehensive meta-analysis, Clin Psychol Rev source

In the paper

“Until recent years, most trials compared MBIs to waitlist controls, which introduce a multitude of confounding factors that limit the strength of conclusions that can be drawn from these trials.”

In the paper

“MBSR appears to be a safe and effective treatment for the reduction of emotional dysregulation.”

In the paper

“Whichever mechanisms truly underlie mindfulness (see below for a review of key mechanisms), mindfulness practices appear to demonstrate therapeutic effects on emotional well-being, and thus continue to capture the interest of myriad clients, practitioners, and researchers.”

In the paper

“The use of mindfulness in these treatment protocols is markedly different from MBSR and MBCT, in that mindfulness is merely a component of these interventions, whereas it is the core skill taught in mindfulness-based treatments.”

What the sources say

• ?Not checked — no full text of the sourcecites [1] Gu, 2015, How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies, Clin Psychol Rev source
• ?Not checked — no full text of the sourcecites [28] Chiesa, 2011, Mindfulness-based approaches: are they all the same?, J Clin Psychol source

In the paper

“The overarching theoretical premise of MBIs is that, by practicing mindfulness (e.g. through sitting meditation, yoga, or other mindfulness exercises), individuals will become less reactive to unpleasant internal phenomena but more reflective, which in turn will lead to positive psychological outcomes.3,33”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [3] Segal, 2002
• ?Not checked — no full text of the sourcecites [33] Kabat-Zinn, 1992, Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders, Am J Psychiatry source

In the paper

“Mindfulness and acceptance strategies are consistent with general CBT principles, because they target core processes, such as increased emotional awareness and regulation, cognitive flexibility, and goals-based behaviors.31,32”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [31] Hayes SC, Hofmann SG. The third wave of CBT and the rise of process-based care. World Psychiatry, in press.
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [32] Hofmann, 2017

In the paper

“The stronger one’s ability to adopt a mindful state throughout the perpetual ups and downs of life, the less suffering one will experience. This basic premise remains the foundation of mindful practices, as it has for centuries;42”

What the sources say

• ?Not checked — no full text of the sourcecites [42] Bodhi, 2011, What does mindfulness really mean? A canonical perspective, Contemporary Buddhism source

In the paper

“As we will now discuss, these similarities may perhaps be responsible for the compatibility of mindfulness and cognitive-behavioral treatments.”

In the paper

“Despite these differences, the result of both approaches is ultimately quite similar: By changing one’s perspective on unpleasant thoughts, feelings, or sensations, the individual comes to realize that these internal phenomena are not as dangerous or powerful as previously believed, and the cycle of maladaptive cognitions, emotions, and behaviors gradually weakens.”

In the paper

“Taken together, these findings suggest that mindfulness is a difficult state to achieve, but is ultimately beneficial.”

In the paper

“Mindfulness skills taught in DBT are similar to those in MBSR, particularly the nonjudgmental observation of internal phenomena; however, the format in which these skills are taught differs considerably.”

What the sources say

• ?Not checked — no full text of the sourcecites [25] Linehan, 1993 source
• ?Not checked — no full text of the sourcecites [45] Baer, 2003, Mindfulness training as a clinical intervention: a conceptual and empirical review, Clin Psychol Sci Pract source

In the paper

“Mindfulness- and acceptance-based interventions – including DBT, ACT, MBSR, and MBCT – are examples of the so-called “third-wave” of cognitive-behavioral therapies.70”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [70] 2004

In the paper

“The result is a call to redirect clinical practice away from treating medical syndromes and toward focusing on processes and core competencies. Mindfulness-based interventions target one such process.”

What the sources say

• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [31] Hayes SC, Hofmann SG. The third wave of CBT and the rise of process-based care. World Psychiatry, in press.
• ?Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  cites [32] Hofmann, 2017

In the paper

“Clients may choose which mindfulness exercises they wish to practice and when, which allows all individuals to benefit from mindfulness training regardless of their severity or willingness to meditate.45”

What the sources say

• ?Not checked — no full text of the sourcecites [45] Baer, 2003, Mindfulness training as a clinical intervention: a conceptual and empirical review, Clin Psychol Sci Pract source