Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials

Objective Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder. Method Post-intervention between-group Hedges g effect sizes were calculated using a random effects model. Moderator analyses of primary diagnosis, intervention type and control condition were conducted and publication bias was assessed. Results Twelve studies met inclusion criteria (n = 578). There were significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = −0.59, 95% CI = −0.12 to −1.06). Effects were demonstrated for depressive symptom severity (Hedges g = −0.73, 95% CI = −0.09 to −1.36), but not for anxiety symptom severity (Hedges g = −0.55, 95% CI = 0.09 to −1.18), for RCTs with an inactive control (Hedges g = −1.03, 95% CI = −0.40 to −1.66), but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to −0.48) and effects were found for MBCT (Hedges g = −0.39, 95% CI = −0.15 to −0.63) but not for MBSR (Hedges g = −0.75, 95% CI = 0.31 to −1.81). Conclusions This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population

Inspiring altruism: reflecting on the personal relevance of emotionally evocative prosocial media characters

Educators have proposed that admired behavior by media characters evokes audience emulation if subsequent personal reflection results in audience members realizing that they want to and are able to behave in a similar manner. Two experiments investigated this. In Study 1, exposure to prosocial media models increased altruistic inclinations among teenagers only if they were also instructed to reflect on the personal significance of what they had seen. In Study 2, medical students exposed to prosocial media models had higher empathic and altruistic intentions if they reflected on the personal rather than the professional significance of what they had seen. Personal inspiration and recognition of enactment possibilities seemed key determinants of emulation

Psychological interventions for depression among informal caregivers of older adult populations: protocol of a systematic review and meta-analysis of randomised controlled trials

Introduction Increased life expectancy has led to an increased demand for family members to provide informal care for their older relatives in the home. Many studies suggest informal caregivers are at greater risk of experiencing symptoms of depression. However, there is a lack of research examining the effectiveness of psychological interventions targeting these symptoms alongside clinical and methodological moderators potentially associated with intervention effectiveness. This review aims to address this gap and will inform the development of a psychological intervention targeting depression among adult-child caregivers of older parents, given many studies show that among informal caregivers of older adults, adult children experience specific difficulties and needs for psychological support. Further, the lack of studies targeting adult children specifically necessitates conducting this review targeting caregivers of older adults in general.Methods and analysis Randomised controlled trials of psychological interventions targeting symptoms of depression among informal caregivers will be identified via a systematic search of electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica DataBase, PsycINFO, Cochrane Library and Web of Science) and supplemented by handsearching of previous systematic reviews, reference and forward citation checking, and expert contact. If possible, a meta-analysis will be conducted to examine the: (1) effectiveness of psychological interventions for depression among informal caregivers of older adults, (2) effectiveness of psychological interventions for secondary outcomes such as anxiety, stress, caregiver burden, psychological distress, quality of life, well-being and self-efficacy and (3) moderating effects of clinical and methodological factors on effectiveness.Ethics and dissemination Ethical approval will not be necessary for this study given primary data will not be collected. Results will inform the development of a psychological intervention for adult-child caregivers of older parents and will be disseminated through publication in peer-reviewed journals and conference presentations.PROSPERO registration number CRD42020157763

Psychological interventions for depression among informal caregivers of older adult populations : protocol of a systematic review and meta-analysis of randomised controlled trials.

Introduction: Increased life expectancy has led to an increased demand for family members to provide informal care for their older relatives in the home. Many studies suggest informal caregivers are at greater risk of experiencing symptoms of depression. However, there is a lack of research examining the effectiveness of psychological interventions targeting these symptoms alongside clinical and methodological moderators potentially associated with intervention effectiveness. This review aims to address this gap and will inform the development of a psychological intervention targeting depression among adult-child caregivers of older parents, given many studies show that among informal caregivers of older adults, adult children experience specific difficulties and needs for psychological support. Further, the lack of studies targeting adult children specifically necessitates conducting this review targeting caregivers of older adults in general. Methods and analysis: Randomised controlled trials of psychological interventions targeting symptoms of depression among informal caregivers will be identified via a systematic search of electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica DataBase, PsycINFO, Cochrane Library and Web of Science) and supplemented by handsearching of previous systematic reviews, reference and forward citation checking, and expert contact. If possible, a meta-analysis will be conducted to examine the: (1) effectiveness of psychological interventions for depression among informal caregivers of older adults, (2) effectiveness of psychological interventions for secondary outcomes such as anxiety, stress, caregiver burden, psychological distress, quality of life, well-being and self-efficacy and (3) moderating effects of clinical and methodological factors on effectiveness. Ethics and dissemination: Ethical approval will not be necessary for this study given primary data will not be collected. Results will inform the development of a psychological intervention for adult-child caregivers of older parents and will be disseminated through publication in peer-reviewed journals and conference presentations. PROSPERO registration number: CRD42020157763

PRISMA (2009) Flow Diagram.

<p>PRISMA (2009) Flow Diagram.</p

Forest Plot of the effect of MBIs in comparison to control conditions on primary symptom severity by control condition type (active versus inactive) for people with depressive disorder and anxiety disorder diagnoses.

<p>Forest Plot of the effect of MBIs in comparison to control conditions on primary symptom severity by control condition type (active versus inactive) for people with depressive disorder and anxiety disorder diagnoses.</p

Forest Plot of the effect of MBIs in comparison to control conditions on depressive symptom severity for people with depressive disorder and anxiety disorder diagnoses.

<p>Forest Plot of the effect of MBIs in comparison to control conditions on depressive symptom severity for people with depressive disorder and anxiety disorder diagnoses.</p

Forest Plot of MBIs in comparison to control conditions on severity of primary symptom for people with depressive disorder and anxiety disorder diagnoses.

<p>Forest Plot of MBIs in comparison to control conditions on severity of primary symptom for people with depressive disorder and anxiety disorder diagnoses.</p

Forest Plot of the effect of MBIs in comparison to control conditions on anxiety symptom severity for people with depressive disorder and anxiety disorder diagnoses.

<p>Forest Plot of the effect of MBIs in comparison to control conditions on anxiety symptom severity for people with depressive disorder and anxiety disorder diagnoses.</p