Objectives
Given the complex demands of many workplaces, there is growing interest in the potential beneficial effects of mindfulness-based programs (MBPs) for employees. This meta-analysis ...systematically synthesizes the results of randomized controlled studies conducted in various workplace settings.
Methods
Eligible studies were identified by a systematic literature search in four electronic databases and complementary manual search strategies through 11/2018. Random-effects models were used to synthesize data across 56 studies including
n
= 2689 participants and
n
= 2472 controls. The validity of synthesized effect size estimates was analyzed for heterogeneity and influential cases (outliers). Risk of bias was assessed following Cochrane recommendations.
Results
Analyses of between-group effects indicated that MBPs effectively reduce stress, burnout, mental distress, and somatic complaints, while improving mindfulness, well-being, compassion, and job satisfaction—all with small to large effect sizes ranging from Hedge’s
g
= 0.32 to 0.77. Results were maintained in follow-up assessments ≤ 12 weeks. Heterogeneity among primary studies was not explained consistently by program or participant characteristics in the exploratory moderator analyses. Results on work engagement and productivity were limited by low numbers of primary studies with outliers among their effect sizes.
Conclusions
Our meta-analysis provides evidence that MBPs effectively promote the health and well-being of employees in various occupational settings. Further research is needed to investigate potential benefits on work-related outcomes and effects for longer-term follow-ups.
During the Covid-19 pandemic, the negative effects of wearing a mouth-nose cover (MNC) on interpersonal functioning have been discussed in public media but empirical studies on how wearing MNCs ...affect social judgements are sparse. In the present study, we investigated the effects of MNCs on trustworthiness appraisals, the influence of changes due to MNCs in evaluating joy, and the relationship between a social-cognitive appraisal bias and a participant's characteristics.
All participants (N = 165) judged the intensity of happiness and trustworthiness in calm facial stimuli presented with and without a surgical mask covering part of the face. We analysed the relationship of changes in judgements evoked by MNCs to participants' evaluations of MNCs as protective tools and explored their associations with the burden experienced by wearing MNCs, compliance to behaviour recommendations, their risk associated with the pandemic, and their levels of psychological distress.
Overall, calm facial stimuli covered with MNCs were evaluated as less trustworthy and, to an even stronger extent, less happy than uncovered facial stimuli. However, participants varied in whether they showed a negative or positive evaluation of faces with MNCs; the negative bias was stronger in those participants who attributed lower protective potential to MNCs, experienced a higher burden while wearing MNCs, wore MNCs less often, and experienced a higher level of psychological distress.
A negative bias in trustworthiness appraisals of faces with a positive emotional expression covered by MNCs is linked to a participant's evaluation of MNCs as inefficient and burdening and their experience of high psychological distress.
The Borderline Symptom List (BSL-23) is a well-established self-rating instrument to assess the severity of borderline typical psychopathology. However, a classification of severity levels for the ...BSL-23 is missing.
Data from 1.090 adults were used to develop a severity classification for the Borderline Symptom List (BSL-23). The severity grading was based on the distribution of the BSL-23 in 241 individuals with a diagnosis of BPD. Data from three independent samples were used to validate the previously defined severity grades.These validation samples included a group of treatment seeking patients with a diagnosis of BPD (
= 317), a sample of individuals with mental illnesses other than BPD (
= 176), and a healthy control sample (
= 356). The severity grades were validated from comparisons with established assessment instruments such as the International Personality Disorders Examination, the Structured Clinical Interview for DSM-IV, the global severity index of the Symptom Checklist (GSI, SCL-90), the Global Assessment of Functioning (GAF), and the Beck Depression Inventory (BDI-II).
Six grades of symptom severity were defined for the BSL-23 mean score:
: 0-0.3;
: 0.3-0.7;
: 0.7-1.7;
: 1.7-2.7;
: 2.7-3.5; and
: 3.5-4. These grades received consistent empirical support from the independent instruments and samples. For instance, individuals with a severity grade of
were virtually free from diagnostic BPD-criteria, had a GSI below the normative population, and a high level of global functioning corresponding to few or no symptoms. Severity grades indicating
to
levels of BPD symptoms were observed at a much higher rate in treatment-seeking patients (70.0%) than in clinical controls (17.6%) and healthy controls (0.0%). The BSL-23 score that best separated treatment-seeking BPD patients and clinical controls was 1.50, whereas the clearest discrimination of BPD patients and healthy controls was found at a score of 0.64.
The grades of BPD-specific symptom severity derived from the distribution of the BSL-23 scores received consistent empirical validation from established assessments for psychopathology. Future studies should expand this validation by including additional instruments e.g., to assess self-esteem, loneliness, connectedness, and quality of life.
Dialectical behavior therapy for posttraumatic stress disorder (DBT‐PTSD) is tailored for adults with PTSD from childhood sexual abuse (CSA). It uses principles from DBT and trauma‐focused ...cognitive–behavioral approaches. To evaluate acceptance and safety, the authors treated 29 women with chronic CSA‐related PTSD plus at least one other comorbid diagnosis. The Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90‐Revised, Beck Depression Inventory, and State Trait Anxiety Inventory were administered prior to, at the end of, and 6 weeks after 3 months of intensive residential treatment. An effect size of 1.22 on the PDS was found between baseline and follow‐up. Effect sizes for secondary outcomes ranged from medium to large. The results suggest that DBT‐PTSD has promise for reducing severe and chronic PTSD after CSA.
Traditional and Simplified Chinese s by AsianSTSS
Observational studies have suggested that physical activity may be associated with improved survival after cancer treatment. However, data from controlled clinical trials are required. We analyzed ...survival data of 103 patients from a previously published randomized controlled trial in allogeneic stem cell transplant patients who were randomized to either an exercise intervention (EX) or to a social contact control group. EX patients trained prior to hospital admission, during inpatient treatment, and for 6–8 weeks after discharge. Survival analyses were used to compare both total mortality (TM) and non‐relapse mortality (NRM) after discharge and transplantation during an observation period of 2 years after transplantation. Analyses were corroborated with Cox and Fine & Gray regression models adjusting for potential confounders. After discharge, EX patients had a significantly lower TM rate than controls (12.0 vs. 28.3%, p = 0.030) and a numerically lower NRM rate (4.0 vs. 13.5%, p = 0.086). When the inpatient period was included, absolute risk reductions were similar but not significantly different (TM: 34.0 vs. 50.9%, p = 0.112; NRM: 26.0 vs. 36.5%, p = 0.293). The number needed to treat (NNT) to prevent one death with EX was about 6. Furthermore, regression analyses revealed that baseline fitness was protective against mortality. The data suggest that exercise might improve survival in patients undergoing allo‐HCT. However, the results should be interpreted with caution as the study was not designed to detect differences in survival rates, and as no stratification on relevant prognostic factors was carried out.
What's new?
Exercise can benefit cancer patients by improving quality of life, but it may also prolong survival after cancer treatment, according to observational data. The present study lends clinical evidence to that idea, using a randomized controlled trial to investigate outcomes among exercising patients undergoing allogeneic stem cell transplantation. Exercising patients showed reductions in total mortality and non‐relapse mortality rates over a two‐year observation period following transplantation. Baseline physical fitness offered significant protection against mortality. The results are of major clinical relevance and should encourage oncologists and hematologists to promote exercise in this patient group.
Patients with Borderline Personality Disorder (BPD) showed reduced volume of amygdala and hippocampus, but similar findings are evident in Posttraumatic Stress Disorder (PTSD). Applying voxel-based ...morphometry (VBM) in a larger cohort of patients with BPD, we sought to extend earlier findings of volume abnormalities in limbic regions and to evaluate the influence of co-occurring PTSD in BPD patients. We used voxel-based morphometry to study gray matter volume (GMV) in 60 healthy controls (HC) and 60 patients with BPD. Subgroup analyses on 53 patients concerning the role of co-occurring PTSD were conducted. Additionally, regression analyses were calculated to assess the relation between borderline symptom severity as well as dissociative experiences and GMV. Differences in local GMV between patients with BPD and HC were observed in the amygdale and hippocampus as well as in the fusiform and cingulate gyrus. Co-occurring PTSD was accompanied by increased GMV in the superior temporal gyrus and dorsolateral prefrontal cortex. Independent of co-occurring PTSD, severity of BPD symptoms predicted smaller GMV in the amygdala and dorsal ACC. Dissociation was positively related to GMV in the middle temporal gyrus. We could replicate earlier findings of diminished limbic GMV in patients with BPD and additionally show that patients with co-morbid PTSD feature increased GMV in prefrontal regions associated with cognitive control.
Before, during, and after allogeneic hematopoietic stem cell transplantation (allo-HSCT), patients experience considerable physical and psychologic distress. Besides graft-versus-host disease and ...infections, reduced physical performance and high levels of fatigue affect patients' quality of life. This multicenter randomized controlled trial examined the effects of a partly self-administered exercise intervention before, during, and after allo-HSCT on these side effects. After randomization to an exercise and a social contact control group 105 patients trained in a home-based setting before hospital admission, during inpatient treatment and a 6- to 8-week period after discharge. Fatigue, physical performance, quality of life, and physical/psychologic distress were measured by standardized instruments at baseline, admission to, and discharge from hospital and 6 to 8 weeks after discharge. The exercise group showed significantly improvement in fatigue scores (up to 15% improvement in exercise group vs up to 28% deterioration in control; P < .01-.03), physical fitness/functioning (P = .02-.03) and global distress (P = .03). All effects were at least detectable at one assessment time point after hospitalization or repeatedly. Physical fitness correlated significantly with all reported symptoms/variables. In conclusion, this partly supervised exercise intervention is beneficial for patients undergoing allo-HSCT. Because of low personnel requirements, it might be valuable to integrate such a program into standard medical care.
Background: Post-traumatic stress disorder (PTSD) with co-occurring severe psychopathology such as borderline personality disorder (BPD) is a frequent sequel of childhood sexual abuse (CSA). ...CSA-related PTSD has been effectively treated through cognitive-behavioural treatments, but it remains unclear whether success can be achieved in patients with co-occurring BPD. The aim of the present study was to determine the efficacy of a newly developed modular treatment programme (DBT-PTSD) that combines principles of dialectical behaviour therapy (DBT) and trauma-focused interventions. Methods: Female patients (n = 74) with CSA-related PTSD were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. About half of the participants met the criteria for co-occurring BPD. Individuals with ongoing self-harm were not excluded. The primary outcomes were reduction of PTSD symptoms as assessed by the Clinician-Administered PTSD Scale (CAPS) and by the Posttraumatic Stress Diagnostic Scale (PDS). Hierarchical linear models were used to compare improvements across treatment groups. Assessments were carried out by blinded raters at admission, at end of treatment, and at 6 and 12 weeks post-treatment. Results: Under DBT-PTSD the mean change was significantly greater than in the control group on both the CAPS (33.16 vs. 2.08) and the PDS (0.70 vs. 0.14). Between-group effect sizes were large and highly significant. Neither a diagnosis of BPD nor the severity or the number of BPD symptoms was significantly related to treatment outcome. Safety analyses indicated no increase in dysfunctional behaviours during the trial. Conclusion: DBT-PTSD is an efficacious treatment of CSA-related PTSD, even in the presence of severe co-occurring psychopathology such as BPD.
Previous research has suggested that patients meeting criteria for borderline personality disorder (BPD) display altered self-related information processing. However, experimental studies on ...dysfunctional self-referential information processing in BPD are rare. In this study, BPD patients (N = 30) and healthy control participants (N = 30) judged positive, neutral, and negative words in terms of emotional valence. Referential processing was manipulated by a preceding self-referential pronoun, an other-referential pronoun, or no referential context. Subsequently, patients and participants completed a free recall and recognition task. BPD patients judged positive and neutral words as more negative than healthy control participants when the words had self-reference or no reference. In BPD patients, these biases were significantly correlated with self-reported attributional style, particularly for negative events, but unrelated to measures of depressive mood. However, BPD patients did not differ from healthy control participants in a subsequent free recall task and a recognition task. Our findings point to a negative evaluation bias for positive, self-referential information in BPD. This bias did not affect the storage of information in memory, but may be related to self-attributions of negative events in everyday life in BPD.
Trust is a prerequisite for successful social relations. People tend to form a first impression of people's trustworthiness based on their facial appearance. The sex of the judging person and its ...congruency with the sex of the judged people influence these appraisals. Moreover, trustworthiness and happiness share some facial features, which has led to studies investigating the interplay between both social judgments. Studies revealed high correlation in judging happiness and trustworthiness across different facial identities. However, studies are missing that investigate whether this relationship exists on a within-subject level and whether in-group biases such as the congruency between the sex of the judging and judged individual influence this relationship. In the present study, we addressed these questions.
Data were collected in an online-survey in two separate samples (N = 30, German sample, N = 107 Dutch sample). Subjects assessed the intensity of happiness and trustworthiness expressed in neutral and calm facial expression of the same characters (50% males, 50% females). Statistical analyses comprised rm-Anova designs based on rating scores and estimates of within-subject associations between both judgments.
Our findings replicate high correlations between happiness and trustworthiness ratings across facial identities based on average scores across participants. However, the strength of this association was strongly dependent on the methodological approach and inter-subject variability was high. Our data revealed an in-group advantage for trustworthiness in women. Moreover, the faces' sex and emotional expressions differentially influenced the within-subject correlation between both judgments in men and women.
Our findings replicate previous studies on the association between happiness and trustworthiness judgments. We extend our understanding of the link between both social judgments by uncovering that within-subject variability is high and influenced by sex and the availability and appraisal of positive emotional facial cues.
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