Rectifying Misconceptions: A Comprehensive Response to “Some Concerns About the Psychological Implications of Mindfulness: A Critical Analysis”

The present article attempts to address misconceptions and mischaracterizations of mindfulness-based interventions found in the article “Some Concerns about the Psychological Implications of Mindfulness: A Critical Analysis,” written by Daniel David. The paper, we contended, suffers as a result of its reductive presentation of mindfulness, the relationship of mindfulness to Buddhist thought, the empirical support for mindfulness-based interventions, and the presumed mechanisms of change and clinical utility of those interventions. Such misconceptions and mischaracterizations can unfortunately have a powerful effect on both the literature base, and on those providing direct psychological services. As such, the purpose of this response article is to stimulate a clear and accurate discussion of the concepts and applications of mindfulness, so that practitioners have the information they need to make sound treatment decisions for their clientele

Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial.

BACKGROUND: Corticosteroids have been used to treat head injuries for more than 30 years. In 1997, findings of a systematic review suggested that these drugs reduce risk of death by 1-2%. The CRASH trial--a multicentre international collaboration--aimed to confirm or refute such an effect by recruiting 20000 patients. In May, 2004, the data monitoring committee disclosed the unmasked results to the steering committee, which stopped recruitment. METHODS: 10008 adults with head injury and a Glasgow coma score (GCS) of 14 or less within 8 h of injury were randomly allocated 48 h infusion of corticosteroids (methylprednisolone) or placebo. Primary outcomes were death within 2 weeks of injury and death or disability at 6 months. Prespecified subgroup analyses were based on injury severity (GCS) at randomisation and on time from injury to randomisation. Analysis was by intention to treat. Effects on outcomes within 2 weeks of randomisation are presented in this report. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN74459797. FINDINGS: Compared with placebo, the risk of death from all causes within 2 weeks was higher in the group allocated corticosteroids (1052 [21.1%] vs 893 [17.9%] deaths; relative risk 1.18 [95% CI 1.09-1.27]; p=0.0001). The relative increase in deaths due to corticosteroids did not differ by injury severity (p=0.22) or time since injury (p=0.05). INTERPRETATION: Our results show there is no reduction in mortality with methylprednisolone in the 2 weeks after head injury. The cause of the rise in risk of death within 2 weeks is unclear