Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic ...review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and survivors. Method: Electronic databases were searched, and researchers were contacted for further relevant studies. Twenty-two independent studies with a total of 1,403 participants were included. Studies were coded for quality (range: 0-4), and overall effect size analyses were performed separately for nonrandomized studies (K = 13, n = 448) and randomized controlled trials (RCTs; K = 9, n = 955). Effect sizes were combined using the random-effects model. Results: In the aggregated sample of nonrandomized studies (average quality score: 0.5), MBT was associated with significantly reduced symptoms of anxiety and depression from pre- to posttreatment corresponding to moderate effect sizes (Hedges\'s g) of 0.60 and 0.42, respectively. The pooled controlled effect sizes (Hedges\'s g) of RCTs (average quality score: 2.9) were 0.37 for anxiety symptoms (p < .001) and 0.44 for symptoms of depression (p < .001). These effect sizes appeared robust. Furthermore, in RCTs, MBT significantly improved mindfulness skills (Hedges\'s g = 0.39). Conclusion: While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression.
Objective
Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the ...number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.
Methods
Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.
Results
Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges's g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.
Conclusions
MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.
To assess the efficacy of mindfulness-based cognitive therapy (MBCT) for late post-treatment pain in women treated for primary breast cancer.
A randomized wait list-controlled trial was conducted ...with 129 women treated for breast cancer reporting post-treatment pain (score ≥ 3 on pain intensity or pain burden assessed with 10-point numeric rating scales). Participants were randomly assigned to a manualized 8-week MBCT program or a wait-list control group. Pain was the primary outcome and was assessed with the Short Form McGill Pain Questionnaire 2 (SF-MPQ-2), the Present Pain Intensity subscale (the McGill Pain Questionnaire), and perceived pain intensity and pain burden (numeric rating scales). Secondary outcomes were quality of life (World Health Organization-5 Well-Being Index), psychological distress (the Hospital Depression and Anxiety Scale), and self-reported use of pain medication. All outcome measures were assessed at baseline, postintervention, and 3-month and 6-month follow-up. Treatment effects were evaluated with mixed linear models.
Statistically significant time × group interactions were found for pain intensity (d = 0.61; P = .002), the Present Pain Intensity subscale (d = 0.26; P = .026), the SF-MPQ-2 neuropathic pain subscale (d = 0.24; P = .036), and SF-MPQ-2 total scores (d = 0.23; P = .036). Only pain intensity remained statistically significant after correction for multiple comparisons. Statistically significant effects were also observed for quality of life (d = 0.42; P = .028) and nonprescription pain medication use (d = 0.40; P = .038). None of the remaining outcomes reached statistical significance.
MBCT showed a statistically significant, robust, and durable effect on pain intensity, indicating that MBCT may be an efficacious pain rehabilitation strategy for women treated for breast cancer. In addition, the effect on neuropathic pain, a pain type reported by women treated for breast cancer, further suggests the potential of MBCT but should be considered preliminary.
Objective To evaluate the evidence on the efficacy of psychosocial interventions for improving pregnancy rates and reducing distress for couples in treatment with assisted reproductive technology ...(ART). Design Systematic review and meta-analysis. Data sources PsycINFO, PubMed, EMBASE, CINAHL, Web of Science and The Cochrane Library between 1978 and April 2014. Study selection Studies were considered eligible if they evaluated the effect of any psychosocial intervention on clinical pregnancy and/or distress in infertile participants, used a quantitative approach and were published in English. Data extraction Study characteristics and results were extracted and the methodological quality was assessed. Effect sizes (ES; Hedges g) were pooled using a random effects model. Heterogeneity was assessed using the Q statistic and I2, and publication bias was evaluated using Egger’s method. Possible moderators and mediators were explored with meta-analyses of variances (ANOVAs) and meta-regression. Results We identified 39 eligible studies (total N=2746 men and women) assessing the effects of psychological treatment on pregnancy rates and/or adverse psychological outcomes, including depressive symptoms, anxiety, infertility stress and marital function. Statistically significant and robust overall effects of psychosocial intervention were found for both clinical pregnancy (risk ratio=2.01; CI 1.48 to 2.73; p<0.001) and combined psychological outcomes (Hedges g=0.59; CI 0.38 to 0.80; p=0.001). The pooled ES for psychological outcomes were generally larger for women (g: 0.51 to 0.73) than men (0.13 to 0.34), but the difference only reached statistical significance for depressive symptoms (p=0.004). Meta-regression indicated that larger reductions in anxiety were associated with greater improvement in pregnancy rates (Slope 0.19; p=0.004). No clear-cut differences were found between effects of cognitive–behavioural therapy (CBT; g=0.84), mind–body interventions (0.61) and other intervention types (0.50). Conclusions The present meta-analysis suggests that psychosocial interventions for couples in treatment for infertility, in particular CBT, could be efficacious, both in reducing psychological distress and in improving clinical pregnancy rates.
‘Complicated grief reactions’ is an umbrella term covering symptoms of prolonged grief disorder (PGS) and other post-loss complications, including symptoms of depression, anxiety, and posttraumatic ...stress (PTS). While PGS often co-occurs with symptoms of depression, anxiety, and PTS, no pooled prevalence estimates of their co-occurrence have yet been established.
The present systematic review and meta-analysis provided pooled prevalence estimates of co-occurrence of PGS and symptoms of depression, anxiety, and PTS based on the available literature, and examined possible moderators and risk of bias.
Based on the 23 included studies, the pooled prevalence estimates indicated that 70% of adults with PGS experienced one or more other type of complicated grief reaction, and 46% experienced two or more other types of complicated grief reactions. Estimates of PGS with co-occurring depression, anxiety, and PTS were 63%, 54%, and 49%, respectively. Heterogeneity was considerable (I2=92.5–95.6), and subsequent moderator-analyses showed that higher estimates of co-occurrence were found in studies with longer mean time since loss, and when co-occurrence was assessed with interviews compared with questionnaires.
The results should be considered preliminary due to high risk of bias of the included studies.
Co-occurring cases of PGS and other types of complicated grief reactions were more prevalent than ‘pure’ cases of PGS with no co-occurrence. More population-based studies of symptom co-occurrence in non-traumatic bereavement are needed.
To quantify the available evidence for the hypothesis that reduced resistance caused by psychological stress may influence the development of clinical disease in those exposed to an infectious agent.
...We conducted a systematic review and meta-analysis of 27 prospective studies examining the association between psychological stress and subsequent upper respiratory infection (URI).
The results revealed a significant overall main effect of psychological stress on the risk of developing URI (effect size correlation coefficient, 0.21; 95% confidence interval, 0.15-0.27). Further analyses showed that effect sizes for the association did not vary according to type of stress, how URI was assessed, or whether the studies had controlled for preexposure.
The meta-analytical findings confirmed the hypothesis that psychological stress is associated with increased susceptibility to URI, lending support to an emerging appreciation of the potential importance of psychological factors in infectious disease.
Questionable research practices (QRP) are believed to be widespread, but empirical assessments are generally restricted to a few types of practices. Furthermore, conceptual confusion is rife with use ...and prevalence of QRPs often being confused as the same quantity. We present the hitherto most comprehensive study examining QRPs across scholarly fields and knowledge production modes. We survey perception, use, prevalence and predictors of QRPs among 3,402 researchers in Denmark and 1,307 in the UK, USA, Croatia and Austria. Results reveal remarkably similar response patterns among Danish and international respondents (τ = 0.85). Self-reported use indicates whether respondents have used a QRP in recent publications. 9 out of 10 respondents admitted using at least one QRP. Median use is three out of nine QRP items. Self-reported prevalence reflects the frequency of use. On average, prevalence rates were roughly three times lower compared to self-reported use. Findings indicated that the perceived social acceptability of QRPs influenced self-report patterns. Results suggest that most researchers use different types of QRPs within a restricted time period. The prevalence estimates, however, do not suggest outright systematic use of specific QRPs. Perceived pressure was the strongest systemic predictor for prevalence. Conversely, more local attention to research cultures and academic age was negatively related to prevalence. Finally, the personality traits conscientiousness and, to a lesser degree, agreeableness were also inversely associated with self-reported prevalence. Findings suggest that explanations for engagement with QRPs are not only attributable to systemic factors, as hitherto suggested, but a complicated mixture of experience, systemic and individual factors, and motivated reasoning.
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