Cognitively-Based Compassion Training (CBCT (R)) in Breast Cancer Survivors: A Randomized Clinical Trial Study

Breast cancer (BC) requires a significant psychological adaptation once treatment is finished. There is growing evidence of how compassion training enhances psychological and physical well-being, however, there are very few studies analyzing the efficacy of compassion-based Interventions on BC survivors. Objective. To study the efficacy of the CognitivelyBased Compassion Training (CBCT) protocol in a BC survivor sample on quality of life, psychological well-being, fear of cancer recurrence, self-compassion, and compassion domains and mindfulness facets. Furthermore, enrollment, adherence, and satisfaction with the intervention were also analyzed. Methods. A randomized clinical trial was designed. Participants (n = 56) were randomly assigned to CBCT (n = 28) or a treatment-as-usual control group (TAU; n = 28). Pre-post intervention and 6-month follow-up measures took place to evaluate health-related quality of life, psychological wellbeing; psychological stress, coping strategies, and triggering cognitions; self-compassion and compassion; and mindfulness in both intervention and wait-list groups. Results. Accrual of eligible participants was high (77%), and the drop-out rate was 16%. Attendance to CBCT sessions was high and practice off sessions exceeded expectations). CBCT was effective in diminishing stress caused by FCR, fostering self-kindness and common humanity, and increasing overall self-compassion scores, mindful observation, and acting with awareness skillsets. Conclusion. CBCT could be considered a promising and potentially useful intervention to diminish stress caused by FCR and enhance self-kindness, common humanity, overall selfcompassion, mindful observation, and acting with awareness skillsets. Nevertheless, future randomized trials are needed and a process of deeper cultural adaptation required

Cognitively-Based Compassion Training versus cancer health education to improve health-related quality of life in survivors of solid tumor cancers and their informal caregivers: study protocol for a randomized controlled pilot trial

Background: Cancer survivors and their informal caregivers (family members, close friends) often experience significant impairments in health-related quality of life (HRQOL), including disruptions in psychological, physical, social, and spiritual well-being both during and after primary cancer treatment. The purpose of this in-progress pilot trial is to determine acceptability and preliminary efficacy (as reflected by effect sizes) of CBCT (R) (Cognitively-Based Compassion Training) compared with a cancer health education (CHE) attention control to improve the primary outcome of depressive symptoms and secondary outcomes of other HRQOL domains (e.g., anxiety, fatigue), biomarkers of inflammation and diurnal cortisol rhythm, and healthcare utilization-related outcomes in both cancer survivors and informal caregivers. Methods: Forty dyads consisting of solid tumor survivors who have completed primary treatments (chemotherapy, radiation, surgery) and their informal caregivers, with at least one dyad member with mild depressive symptoms or anxiety, will be recruited from Tucson, Arizona, USA. Survivor-caregiver dyads will be randomized together to complete either CBCT or CHE. CBCT is a manualized, 8-week, group meditation-based intervention that starts with attention and mindfulness and builds to contemplative practices aimed at cultivating compassion to the self and others. The goal of CBCT is to challenge unexamined assumptions about feelings and behaviors, with a focus on generating spontaneous self-compassion and increased empathic responsiveness and compassion for others. CHE is an 8-week, manualized group intervention that provides cancer-specific education on various topics (e.g., cancer advocacy, survivorship wellness). Patient-reported HRQOL outcomes will be assessed before, immediately after (week 9), and 1month after CBCT or CHE (week 13). At the same time points, stress-related biomarkers of inflammation (e.g., plasma interleukin-6) and saliva cortisol relevant for survivor and informal caregiver wellness and healthcare utilization will be measured. Discussion: If CBCT shows acceptability, a larger trial will be warranted and appropriately powered to formally test the efficacy of this dyadic intervention. Interventions such as CBCT directed toward both survivors and caregivers may eventually fill a gap in supportive oncology care programs to improve HRQOL and healthcare utilization in both dyad members. Trial registration Clinicaltrials.gov, NCT03459781. Prospectively registered on 9 March 2018.The Jack Challem Trust [001]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

The neural mediators of kindness-based meditation: a theoretical model

Although kindness-based contemplative practices are increasingly employed by clinicians and cognitive researchers to enhance prosocial emotions, social cognitive skills, and well-being, and as a tool to understand the basic workings of the social mind, we lack a coherent theoretical model with which to test the mechanisms by which kindness-based meditation may alter the brain and body. Here we link contemplative accounts of compassion and loving-kindness practices with research from social cognitive neuroscience and social psychology to generate predictions about how diverse practices may alter brain structure and function and related aspects of social cognition. Contingent on the nuances of the practice, kindness-based meditation may enhance the neural systems related to faster and more basic perceptual or motor simulation processes, simulation of another’s affective body state, slower and higher-level perspective-taking, modulatory processes such as emotion regulation and self/other discrimination, and combinations thereof. This theoretical model will be discussed alongside best practices for testing such a model and potential implications and applications of future work

Efeitos do Treinamento Cognitivo de Compaixão na quebrada: estudo misto

Objective: to analyze the effects of Cognitively Based CompassionTraining (CBCT®) among people in situations of social vulnerability.Method: a mixed, sequential and transformative study with the sameQUAL→QUAN weight. Focus Groups were applied at the beginning(n=24) and three months (n=11) after CBCT®, to understand theparticipants’ knowledge about emotions, (self)care and stresssituations. Content analysis was performed in the WebQDA software.The participants (n=65) were randomized into control (n=31) andintervention (n=34) to assess self-compassion, perceived stress,and positive and negative affects at three time moments. The mixedfactorial ANOVA analysis considered within-participants (time) andbetween-participants (place and group) factors. Results: meanage (37), female gender (88%), single (51%) and black-skinnedpeople (77%). The following thematic categories emerged before thecourse: “Reducing others’ suffering as a bridge to conscious self-care”and “Social vulnerability as a potentiator of low emotional literacy”.Subsequently, self-compassion and awareness of the mental statesfor social activism. The quantitative analysis showed a significantincrease in self-compassion within-participants (p=0.003); groupfactor (p<0.001); perceived stress reduction (p=0.013); negativeaffects group factor (p=0.005); and increase in positive affects(p<0.001) within-participants. Conclusion: CBCT®️ exerted a positiveeffect on individual well-being and a positive impact on communityengagement to promote social well-being in the outskirts. BrazilianRegistry of Clinical Trials (RBR-3w744z.) in April 2019.Objetivo: analizar los efectos del Entrenamiento en CompasiónCognitiva (CBCT®) en personas en situación de vulnerabilidadsocial. Método: estudio mixto del tipo transformativo secuencialcon el mismo peso QUAL→QUAN. Grupos Focales aplicados al inicio(n=24) y tres meses (n=11) después del CBCT®, para comprenderel conocimiento que tienen los participantes sobre emociones, (auto)cuidado y situaciones de estrés. El análisis de contenido utilizó elsoftware WebQDA. Los participantes (n=65) fueron aleatorizadosen el grupo control (n=31) y experimental (n=34) para evaluarla autocompasión, el estrés percibido y los afectos positivos ynegativos en tres momentos. El ANOVA factorial mixto considerófactor de participantes (tiempo) y entre participantes (lugar y grupo).Resultados: edad promedio (37), sexo femenino (88%), solteras(51%) y negras (77%). Las categorías temáticas que surgieronantes del curso fueron: “Reducción del sufrimiento de los demáscomo puente para el autocuidado consciente” y “La vulnerabilidadsocial como potenciadora de la baja alfabetización emocional”.Luego la autocompasión y la conciencia de los estados mentalespara el activismo social. El análisis cuantitativo mostró un aumentosignificativo en la autocompasión de los participantes (p=0,003);factor grupo (p< 0,001); reducción del estrés percibido (p=0,013);afectos negativos factor grupo (p= 0,005); y aumento de los afectospositivos (p< 001) de los participantes. Conclusión: El CBCT®️ tuvo unefecto positivo en el bienestar individual y tuvo un impacto positivo enla participación de la comunidad para promover el bienestar social enla población de los barrios periféricos. Registro Brasileño de EnsayosClínicos (RBR-3w744z.) en abril de 2019.Objetivo: analisar os efeitos do Treinamento Cognitivo de Compaixão(CBCT®) entre pessoas em situação de vulnerabilidade social.Método: estudo misto tipo transformativo sequencial com mesmopeso QUAL→QUAN. Grupos Focais aplicados no início (n=24) e trêsmeses (n=11) após o CBCT®, para compreender o conhecimentodos participantes sobre emoções, (auto)cuidado e situações deestresse. A análise de conteúdo utilizou o software WebQDA®. Osparticipantes (n=65) foram randomizados em controle (n=31) eintervenção (n=34), para avaliação de autocompaixão, estressepercebido e afetos positivos e negativos em três tempos. A ANOVAfatorial mista considerou fator dentre-participantes (tempo) e entreparticipantes(local e grupo). Resultados: idade média (37), sexofeminino (88%), solteiras (51%) e pessoas negras (77%). Emergiram,antes do curso, as categorias temáticas: “Redução do sofrimentoalheio como ponte para o autocuidado consciente” e “Vulnerabilidadesocial como potencializadora do baixo letramento emocional”. Emseguida, autocompaixão e consciência dos estados mentais parao ativismo social. A análise quantitativa demonstrou aumentosignificativo de autocompaixão dentre-participantes (p= 0,003); fatorgrupo (p< 0,001); redução do estresse percebido (p= 0,013); afetosnegativos fator grupo (p= 0,005); e aumento dos afetos positivos(p< 001) dentre-participantes. Conclusão: o CBCT®️ teve efeitopositivo sobre o bem-estar individual e promoveu impacto positivono engajamento comunitário para a promoção do bem-estar socialna quebrada. Registro Brasileiro de Ensaios Clínicos (RBR-3w744z.)em abril de 2019

Implications of a “Null” Randomized Controlled Trial of Mindfulness and Compassion Interventions in Healthy Adults

Objectives: Extensive research suggests that short-term meditation interventions may hold therapeutic promise for a wide range of psychosocial outcomes. In response to calls to subject these interventions to more methodologically rigorous tests, a randomized controlled trial tested the effectiveness of a mindfulness meditation intervention and a compassion meditation intervention against an active control in a demographically diverse sample of medically and psychiatrically healthy adults. Methods: Two hundred and four participants completed a battery of questionnaires to assess psychological experience, participated in a laboratory stress test to measure their biological stress reactivity, and wore the Electronically Activated Recorder (EAR) to assess daily behaviors before and after an eight-week intervention (mindfulness meditation intervention, compassion meditation intervention, or health education discussion group). Results: Neither meditation intervention reliably impacted participants’ subjective psychological experience, biological stress reactivity, or objectively assessed daily behaviors. Furthermore, post hoc moderation analyses found that neither baseline distress nor intervention engagement significantly moderated effects. Conclusions: Results from this trial—which was methodologically rigorous and powered to detect all but small effects—were essentially null. These results are an important data point for the body of research about meditation interventions. Implications of these non-significant effects are discussed in the context of prior studies, and future directions for contemplative intervention research are recommended. Clinical Trial Registry: Registry Number: NCT01643369.Foundation for the National Institutes of Health12 month embargo; published: 21 April 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]