Other MARC Affiliated Research

Examining the transprofessional competencies of mindfulness teachers across clinical, organizational, and educational settings

What are the key competency domains for mindfulness teachers and their associated teaching activities and performance indicators?

This paper explores mindfulness-based teaching and learning (MBTL) as an emerging field of transprofessional practice spanning educational, organizational, and clinical professions. Recognising the need for a more robust set of transprofessional MBTL teacher competencies to serve this emerging specialization, the authors developed and validated the Mindfulness-Based Teaching and Learning – Teacher Competency Framework (MBTL-TCF). Building on the pre-existing Mindfulness-Based Interventions-Teaching Assessment Criteria (MBI-TAC), the researchers developed a teaching framework for mindfulness specialists to reflect teacher agency, autonomy, and self-determination consistent with the purposes, traditions, and effects of what MBTL teaches: that is, mindfulness. The paper presents the sequence of construct, face, and content validation procedures, including the alignment of the MBTL-TLC with Dreyfus and other teacher competency frameworks from a range of sectors and countries. Finally, using an adapted Delphi process, a six-member international expert panel plus one diversity reviewer were invited to review and refine the emerging framework. The resulting MBTL-TCF presents 12 competency domains with associated activities and performance indicators.

MacPherson, S. A., Grabovac, A. D., Collins, E. J., Heah, T., Rockman, P., & Winston, D. (2022). Transprofessional competencies across clinical, organizational, and educational professions: the case of mindfulness-based teaching and learning (MBTL). Professional Development in Education, 1-17. https://doi.org/10.1080/19415257.2022.2143863

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Comparing impact of use of the Calm app to a waitlist control group on insomnia and other related sleep issues

Compared to a waitlist control group, how does practicing mindfulness using a mindfulness app, ten minutes a day for eight weeks impact: fatigue, daytime sleepiness, and pre-sleep arousal?

The objective of this randomized controlled trial was to test whether a commercially available, mindfulness meditation mobile app, (i.e., Calm app), was effective in reducing fatigue (primary outcome), pre-sleep arousal, and daytime sleepiness (secondary outcomes) in adults with sleep disturbance (Insomnia Severity Index Score >10) as compared to a waitlist control group. Associations between the use of the Calm app (i.e., adherence to the intervention) and changes in sleep quality was also explored in the intervention group only. Adults with sleep disturbance were recruited (N = 640). Eligible and consenting participants (N = 263) were randomly assigned to the intervention (n = 124) or a wait-list control (n =139) group. Intervention participants were asked to meditate using the Calm app 10 minutes/day for eight weeks. Fatigue, daytime sleepiness, and pre-sleep arousal were assessed at baseline, mid- (4-weeks) and post-intervention (8-weeks) in both groups, whereas sleep quality was evaluated only in the intervention group. Findings from intent-to treat analyses suggest the use of the Calm app for eight weeks significantly decreased daytime fatigue (p = .018) as well as daytime sleepiness (p = .003) and cognitive (p = .005) and somatic (p < .001) pre-sleep arousal as compared to the wait-list control group. Within the intervention group, use of the Calm app was associated with improvements in sleep quality (p < .001). This randomized controlled trial demonstrates that the Calm app can be used to treat fatigue, daytime sleepiness, and pre-sleep arousal in adults with sleep disturbance. Given that the Calm app is affordable and widely accessible, these data have implications for community level dissemination of a mobile app to improve sleep-related symptoms associated with sleep disturbance.

Huberty, J.L., Green, J., Puzia, M.E., Larkey, L., Laird, B., Vranceanu, A.M., Vlisides-Henry, R., Irwin, M.R., (2021). Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial. PLoS One, 16(1). https://doi.org/10.1371/journal.pone.0244717 

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Comparing the impact of moderate intensity exercise to Mindfulness Based Stress Reduction (MBSR) on sleep quality

How does exercise versus meditation, learned through Mindfulness Based Stress Reduction (MBSR), impact quality of sleep?

Objectives: To assess the benefits of training in mindfulness-based stress reduction (MBSR) or moderate intensity exercise (EX) for improving sleep quality. Design: Randomized controlled trial. Setting: Outpatient, community-based. Participants: Healthy adults (n = 413) aged 3069 who did not regularly exercise or practice meditation, and who had no known prior sleep problems. Interventions: 1) 8-weeks of MBSR training; 2) matched EX training; or 3) wait-list control. Measurements: The Pittsburgh Sleep Quality Index (PSQI) was administered at baseline and at 1, 3, 5, and 7-month follow-up visits. Analysis: Total PSQI scores and three PSQI factors (perceived sleep quality; daily disturbance, sleep efficiency) were assessed using linear mixed effects regression models for longitudinal data. Results: Compared to controls, PSQI global scores improved significantly for EX (mean change -0.98 points [95% CI -1.56, -0.41] p = 0.001) and marginally for MBSR (-0.53 [-1.10, 0.04] p = 0.07). The perceived sleep quality factor improved for both EX (-0.18 [-0.30, -0.07] p = 0.002) and MBSR (-0.12 [-0.24, -0.01] p = 0.035). The daily disturbance factor improved slightly more for MBSR (-0.13 [-0.22, -0.033] p = 0.008) than EX (-0.09 [-0.19, 0.004] p = 0.06). The sleep efficiency factor did not improve after MBSR (0.08 [-0.045, 0.21] p = 0.2) or EX (-0.07 [-0.20, 0.06] p = 0.3). Improvements in the sleep quality were sustained over 7 months for both groups. Conclusions: Training in MBSR and EX produced small but statistically significant and sustained improvements in sleep quality. For EX participants, this improvement was due primarily to improvements in perceived sleep quality. For MBSR, the decrease in daily disturbance was more important.

Barrett, B., Harden, C.M., Brown, R.L., Coe, C.L., Irwin, M.R., (2020). Mindfulness meditation and exercise both improve sleep quality: Secondary analysis of a randomized controlled trial of community dwelling adults. Sleep Health, 6, 804-813. https://doi.org/10.1016/j.sleh.2020.04.003 

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Teaching Mindfulness Based Stress Reduction (MBSR) to older adults, exploring impact on loneliness and pro-inflammatory gene expression

How does learning Mindfulness Based Stress Reduction (MBSR), compared to a waitlist control group, impact loneliness and pro-inflammatory gene expression in older adults?

This study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N = 40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition time interaction: F(1,35) = 7.86, p = .008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-jB-related gene expression in circulating leukocytes, and MBSR downregulated this NF-jB-associated gene expression profile at post-treatment. Finally, there was a trend for MBSR to reduce C Reactive Protein (treatment condition  time interaction: (F(1,33) = 3.39, p = .075). This work provides an initial indication that MBSR may be a novel treatment approach for reducing loneliness and related pro-inflammatory gene expression in older adults.

Creswell, J.D., Irwin, M.R., Burklund, L.J., Lieberman, M.D., Arevalo, J.M., Ma, J., Breen, E.C., & Cole, S.W., (2012). Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behavior and Immunity, 26, 1095-1101. http://dx.doi.org/10.1016/j.bbi.2012.07.006 

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Exploring the impact of mindful awareness practices (MAPs) on executive functions in elementary school children

For children, aged 7-9 years old, how does participating in Mindful Awareness Practices (MAPs) impact executive functioning, compared to a control group?

A school-based program of mindful awareness practices (MAPs) was evaluated in a randomized control study of 64 second- and third-grade children ages 7–9 years. The program was delivered for 30 minutes, twice per week, for 8 weeks. Teachers and parents completed questionnaires assessing children's executive function immediately before and following the 8-week period. Multivariate analysis of covariance on teacher and parent reports of executive function (EF) indicated an interaction effect between baseline EF score and group status on posttest EF. That is, children in the MAPs group who were less well regulated showed greater improvement in EF compared with controls. Specifically, those children starting out with poor EF who went through the MAPs training showed gains in behavioral regulation, metacognition, and overall global executive control. These results indicate a stronger effect of MAPs on children with executive function difficulties. The finding that both teachers and parents reported changes suggests that improvements in children's behavioral regulation generalized across settings. Future work is warranted using neurocognitive tasks of executive functions, behavioral observation, and multiple classroom samples to replicate and extend these preliminary findings.

Flook, L., Smalley, S. L., Kitil, M. J., Galla, B. M., Kaiser-Greenland, S., Locke, J., Ishijima, E., & Kasari, C.. (2010). Effects of Mindful Awareness Practices on Executive Functions in Elementary School Children. Journal of Applied School Psychology26(1), 70–95. https://doi.org/10.1080/15377900903379125 

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Mindfulness meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults

Compared to a one day control seminar, how does participating in Mindfulness Based Stress Reduction (MBSR) impact CD4+ T lymphocyte counts in HIV infected adults?

This study tested the efficacy of an 8-week Mindfulness-based stress reduction (MBSR) meditation program compared to a 1-day control seminar on CD4+ T lymphocyte counts in stressed HIV infected adults. A single-blind randomized controlled trial was conducted with enrollment and follow-up occurring between November 2005 and December 2007. A diverse community sample of 48 HIV-1 infected adults was randomized and entered treatment in either an 8-week MBSR or a 1-day control stress reduction education seminar. The primary outcome was circulating counts of CD4+ T lymphocytes. Participants in the 1-day control seminar showed declines in CD4+ T lymphocyte counts whereas counts among participants in the 8-week MBSR program were unchanged from baseline to post-intervention (time x treatment condition interaction, p=.02). This effect was independent of antiretroviral (ARV) medication use. Additional analyses indicated that treatment adherence to the mindfulness meditation program, as measured by class attendance, mediated the effects of mindfulness meditation training on buffering CD4+ T lymphocyte declines. These findings provide an initial indication that mindfulness meditation training can buffer CD4+ T lymphocyte declines in HIV-1 infected adults. 

Creswell, J. D., Myers, H. F., Cole, S. W., & Irwin, M. R.. (2009). Mindfulness meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults: A small randomized controlled trial. Brain, Behavior, and Immunity23(2), 184–188. https://doi.org/10.1016/j.bbi.2008.07.004 

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A feasibility study on mindfulness meditation training in adults and adolescents with ADHD

For adolescents and adults with ADHD, is mindfulness an appropriate intervention to address symptoms of ADHD and associated impairments? 

This study tested the feasibility of an 8-week mindfulness training program for adults and adolescents with ADHD. Twenty-four adults and eight adolescents with ADHD enrolled in a feasibility study of an 8-week mindfulness training program. The majority of participants completed the training and reported high satisfaction with the training. Pre-post improvements in self-reported ADHD symptoms and test performance on tasks measuring attention and cognitive inhibition were noted. Improvements in anxiety and depressive symptoms were also observed. Mindfulness training is a feasible intervention in a subset of ADHD adults and adolescents and may improve behavioral and neurocognitive impairments. A controlled clinical study is warranted.

Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., Pataki, C., & Smalley, S. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD: a feasibility study. Journal of attention disorders11(6), 737–746. https://doi.org/10.1177/1087054707308502 

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Comparing cognitive behavioral therapy, mindfulness meditation emotion regulation therapy, and education for rheumatoid arthritis for patients with and without history of recurrent depression

For patients with rheumatoid arthritis, with and without recurring depression, how does cognitive behavioral therapy compare to a mindfulness intervention, or education as a means for reducing pain and improving overall quality of life?

This research examined whether cognitive behavioral therapy and mindfulness interventions that target responses to chronic stress, pain, and depression reduce pain and improve the quality of everyday life for adults with rheumatoid arthritis (RA). The 144 RA participants were clustered into groups of 6 –10 participants and randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P); mindfulness meditation and emotion regulation therapy (M); or education-only group (E), which served as an attention placebo control. The authors took a multimethod approach, employing daily diaries and laboratory assessment of pain and mitogen-stimulated levels of interleukin-6 (IL-6), a proinflammatory cytokine. Participants receiving P showed the greatest Pre to Post improvement in self-reported pain control and reductions in the IL-6; both P and M groups showed more improvement in coping efficacy than did the E group. The relative value of the treatments varied as a function of depression history. RA patients with recurrent depression benefited most from M across several measures, including negative and positive affect and physicians’ ratings of joint tenderness, indicating that the emotion regulation aspects of that treatment were most beneficial to those with chronic depressive features.

Zautra, A.J., Davis, M.C., Reich, J.W., Tennen, H., Irwin, M.R., Nicassio, P., Finan, P., Kratz, A., & Parrish, B., (2008). Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. Journal of Consulting and Clinical Psychology, 76(3), 408-421. DOI: 10.1037/0022-006X.76.3.408  

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