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This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction. The study also investigated the effects of a history of recurrent depression on intervention effects and testing effects due to

This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction. The study also investigated the effects of a history of recurrent depression on intervention effects and testing effects due to the Solomon-6 study design utilized. The 144 RA patients were assessed for a history of major depressive episodes by diagnostic interview and half of the participants completed a laboratory study before the intervention began. The RA patients were randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P), mindfulness meditation and emotion regulation therapy (M), or education only attention control group (E). Upon completion of the intervention, 128 of the RA patients participated in a laboratory session designed to induce stress in which they were asked to report on their PA and NA throughout the laboratory study. Patients in the M group exhibited dampened negative and positive affective reactivity to stress, and sustained PA at recovery, compared to the P and E groups. PA increased in response to induced stress for all groups, suggesting an "emotional immune response." History of recurrent depression increased negative affective reactivity, but did not predict reports of PA. RA patients who underwent a pre-intervention laboratory study showed less reactivity to stressors for both NA and PA during the post-intervention laboratory study. The M intervention demonstrated dampened emotional reactions to stress and lessened loss of PA after stress induction, displaying active emotion regulation in comparison to the other groups. These findings provide additional information about the effects of mindfulness on the dynamics of affect and adaptation to stress in chronic pain patients.
ContributorsArewasikporn, Anne (Author) / Zautra, Alex J (Thesis advisor) / Davis, Mary C. (Committee member) / Karoly, Paul (Committee member) / Arizona State University (Publisher)
Created2012
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Description
A child’s death evokes intense and long-lasting grief in parents. However, few interventions exist to address the needs of this population. This mixed methods project used secondary data to evaluate the impact of a four-day, grief-focused mindfulness-based retreat on bereaved parents.

A quasi-experimental design with two nonequivalent groups (intervention grou

A child’s death evokes intense and long-lasting grief in parents. However, few interventions exist to address the needs of this population. This mixed methods project used secondary data to evaluate the impact of a four-day, grief-focused mindfulness-based retreat on bereaved parents.

A quasi-experimental design with two nonequivalent groups (intervention group n = 25, comparison group n = 41) and three observations (pretest and two posttests) was used. Mixed-model repeated-measures analyses of variance were used to assess change over time for the intervention group and relative to a no-intervention comparison group. Outcome measures were depressive and anxious responses, measured by the Hopkins Symptom Checklist-25 (HSCL-25); trauma responses, measured by the Impact of Event Scale-Revised (IES-R); mindfulness, measured by the Five Facet Mindfulness Questionnaire (FFMQ); and self-compassion, measured by the Self-Compassion Scale-Short Form (SCS-SF). The intervention group was expected to show significant decreases in psychological distress and significant increases in mindfulness and self-compassion over time and relative to the comparison group.

The qualitative component consisted of semi-structured interviews with nineteen retreat participants using a constructivist phenomenological approach in order to obtain a richer understanding of the retreat’s impact on participants’ lives.

There were significant time by condition interactions with small to medium effect sizes for the IES-R and its subscales, the HSCL-25 and its depression subscale, and three FFMQ scales (describe, act with awareness, and nonjudge), all favoring the intervention group. However, not all benefits were maintained at follow-up.

Psychoeducation and relationships emerged as key qualitative themes. Psychoeducation included benefits related to present-moment awareness, fully inhabiting grief, self-compassion, emotional equanimity, and reduced distress or judgment of distress. Relationships included benefits related to giving and receiving social support, emotional expression and sharing, validation and normalization of grief-related experiences, resonance and self-other awareness, self-appraisal, changes in relationships, and connection to a deceased child. Mindfulness seemed to be a key component in reducing trauma responses. Relationship factors, combined with psychoeducation and present-moment awareness, seemed responsible for increasing participants’ capacity for nonjudgmental acceptance of experiences.

The retreat may be an effective intervention for helping parents cope with and express their grief and warrants further study.
ContributorsThieleman, Kara (Author) / Cacciatore, Joanne (Thesis advisor) / Segal, Elizabeth (Committee member) / Hodge, David (Committee member) / Arizona State University (Publisher)
Created2019