Youth-focused group mindfulness-based intervention in individuals with early psychosis: A randomized pilot feasibility study
Corresponding Author
Arlene G. MacDougall
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Correspondence
Dr Arlene G. MacDougall, Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, Parkwood Institute—Mental Health Care Building, St. Joseph's Health Care London, PO BOX 5777, STN BLondon, ON N6A 4V2, Canada.
Email: [email protected]
Search for more papers by this authorElizabeth Price
Lawson Health Research Institute, London, Ontario, Canada
Search for more papers by this authorMatthew R. J. Vandermeer
Lawson Health Research Institute, London, Ontario, Canada
Search for more papers by this authorChantelle Lloyd
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Search for more papers by this authorRichelle Bird
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Search for more papers by this authorRickinder Sethi
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorAturan Shanmugalingam
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorJason Carr
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Search for more papers by this authorKelly K. Anderson
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorRoss M. G. Norman
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorCorresponding Author
Arlene G. MacDougall
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Correspondence
Dr Arlene G. MacDougall, Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, Parkwood Institute—Mental Health Care Building, St. Joseph's Health Care London, PO BOX 5777, STN BLondon, ON N6A 4V2, Canada.
Email: [email protected]
Search for more papers by this authorElizabeth Price
Lawson Health Research Institute, London, Ontario, Canada
Search for more papers by this authorMatthew R. J. Vandermeer
Lawson Health Research Institute, London, Ontario, Canada
Search for more papers by this authorChantelle Lloyd
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Search for more papers by this authorRichelle Bird
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Search for more papers by this authorRickinder Sethi
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorAturan Shanmugalingam
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorJason Carr
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Search for more papers by this authorKelly K. Anderson
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorRoss M. G. Norman
Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Lawson Health Research Institute, London, Ontario, Canada
Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
Search for more papers by this authorAbstract
Aim
To assess the feasibility of a randomized pilot trial that evaluated the acceptability and potential clinical utility of the Mindfulness Ambassador Program (MAP), a unique, standardized 12-session facilitated group mindfulness-based intervention (MBI) for youth experiencing early psychosis.
Methods
Twenty-one patients of an early psychosis intervention program were randomized to receive MAP (n = 11) or treatment as usual (n = 10). Acceptability was measured by group attendance rate and client satisfaction; feasibility of the study design was measured by the recruitment and retention rate. The means, standard deviations, and 95% confidence intervals were described for outcomes of interest.
Results
MAP is associated with a high degree of acceptability and has beneficial effects for depression and fatigue. The randomized trial design is feasible.
Conclusions
This study provides important pilot data supporting a larger randomized trial of effectiveness for MAP as a group MBI for early psychosis. Details of MAP and study limitations are discussed.
REFERENCES
- Andreasen, N. C. (1983). Scale for the assessment of negative symptoms (SANS). Iowa City, Iowa, The University of Iowa.
- Andreasen, N. C. (1984). Scale for the assessment of positive symptoms (SAPS). Iowa City, Iowa: University of Iowa.
- Ashcroft, K., Barrow, F., Lee, R., & MacKinnon, K. (2012). Mindfulness groups for early psychosis: A qualitative study. Psychology and Psychotherapy: Theory, Research and Practice, 85, 327–334. https://doi.org/10.1111/j.2044-8341.2011.02031.x
- Baer, R. A., Smith, G. T., & Allen, K. B. (2004). Assessment of mindfulness by self-report: The Kentucky inventory of mindfulness skills. Assessment, 11, 191–206. https://doi.org/10.1177/1073191104268029
- Barrowclough, C., Tarrier, N., Humphreys, L., Ward, J., Gregg, L., & Andrews, B. (2003). Self-esteem in schizophrenia: Relationships between self-evaluation, family attitudes, and symptomatology. Journal of Abnormal Psychology, 112, 92–99.
- Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77, 855–866. https://doi.org/10.1037/a0016241
- Birchwood, M. (2003). Pathways to emotional dysfunction in first-episode psychosis. British Journal of Psychiatry, 182, 373–375. https://doi.org/10.1192/bjp.182.5.373
- Birchwood, M., Smith, J. D., Cochrane, R., Wetton, S., & Copestake, S. (1990). The social functioning scale: The development and validation of a new scale of social adjustment for use in family intervention with schizophrenic patients. British Journal of Psychiatry, 157, 853–859.
- Birchwood, M., Trower, P., Brunet, K., Gilbert, P., Iqbal, Z., & Jackson, C. (2007). Social anxiety and the shame of psychosis: A study in first episode psychosis. Behaviour Research and Therapy, 45, 1025–1037. https://doi.org/10.1016/j.brat.2006.07.011
- Brunet, K., Birchwood, M., Upthegrove, R., Michail, M., & Ross, K. (2012). A prospective study of PTSD following recovery from first episode psychosis: The threat from persecutors, voices, and patienthood. British Journal of Clinical Psychology, 12(51), 418–433.
- Chadwick, P. (2014). Mindfulness for psychosis. The British Journal of Psychiatry, 204, 333–334. https://doi.org/10.1192/bjp.bp.113.136044
- Chadwick, P., Strauss, C., Jones, A. M., Kingdon, D., Ellett, L., Dannahy, L., & Hayward, M. (2016). Group mindfulness-based intervention for distressing voices: A pragmatic randomized controlled trial. Schizophrenia Research, 175, 168–173. https://doi.org/10.1016/j.schres.2016.04.001
- Chien, W. T., & Thompson, D. R. (2014). Effects of a mindfulness-based psychoeducation programme for Chinese patients with schizophrenia: 2-year follow-up. British Journal of Psychiatry, 205, 52–59. https://doi.org/10.1192/bjp.bp.113.134635
- Cramer, H., Lauche, R., Haller, H., Langhorst, J., & Dobos, G. (2016). Mindfulness- and acceptance-based interventions for psychosis: A systematic review and meta-analysis. Global Advances in Health and Medicine, 5, 30–43. https://doi.org/10.7453/gahmj.2015.083
- Curran, S. L., Andrykowski, M. A., & Studts, J. L. (1995). Short form of the profile of mood states (POMS-SF): Psychometric information. Psychological Assessment, 7, 80–83.
- Eldridge, S. M., Chan, C. L., Campbell, M. J., Bond, C. M., Hopewell, S., Thabane, L., … Group, PC. (2016). CONSORT 2010 statement: Extension to randomized pilot and feasibility trials. Pilot and Feasibility Studies, 2(64), 64. https://doi.org/10.1186/s40814-016-0105-8
- Kabat-Zinn, J. (2003). Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences, 8(2), 73–107.
- Keilp, J. G., Oquendo, M. A., Stanley, B. H., Burke, A. K., Cooper, T. B., Malone, K. M., & Mann, J. J. (2010). Future suicide attempt and responses to serotonergic challenge. Neuropsychopharmacology, 35, 1063–1072. https://doi.org/10.1038/npp.2008.28
- Khoury, B., Lecomte, T., Comtois, G., & Nicole, L. (2015). Third-wave strategies for emotion regulation in early psychosis: A pilot study. Early Intervention in Psychiatry, 9, 76–83. https://doi.org/10.1111/eip.12095
- Khoury, B., Lecomte, T., Gaudiano, B. A., & Paquin, K. (2013). Mindfulness interventions for psychosis: A meta-analysis. Schizophrenia Research, 150, 176–184. https://doi.org/10.1016/j.schres.2013.07.055
- Knezevic, A. (2008). Overlapping confidence intervals and statistical significance. StatNews: Cornell University Statistical Consulting Unit, 73(1).
- Langer, A. I., Schmidt, C., Mayol, R., Diaz, M., Lecaros, J., Krough, E., … Gaspar, P. A. (2017). The effect of mindfulness-based intervention in cognitive functions and psychological well-being applied as an early intervention in schizophrenia and high risk state in a Chilean sample: Study protocol for a randomized controlled trial. Trials, 18, 23. https://doi.org/10.1186/s13063-017-1967-7
- Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979). Assessment of client/patient satisfaction: Development of a general scale. Evaluation and Program Planning, 2(3), 197–207.
- Lecomte, T., Corbiere, M., Ehmann, T., Addington, J., Abdel-Baki, A., & MacEwan, B. (2014). Development and preliminary validation of the first episode social functioning scale for early psychosis. Psychiatry Research, 216, 412–417. https://doi.org/10.1016/j.psychres.2014.01.044
- Lecomte, T., Leclerc, C., & Wykes, T. (2018). Symptom fluctuations, self-esteem, and cohesion during group cognitive behaviour therapy for early psychosis. Psychology and Psychotherapy: Theory, Research and Practice, 91(1), 15–26.
- Leon, A. C., Davis, L. L., & Kraemer, H. C. (2011). The role and interpretation of pilot studies in clinical research. Journal of Psychiatry Research, 45(5), 626–629. https://doi.org/10.1016/j.jpsychires.2010.10.008
- Lolich, M., & Leiderman, E. (2008). Stigmatization towards schizophrenia and other mental illnesses. Vertex, 19, 165–173.
- Louise, S., Fitzpatrick, M., Strauss, C., Rossell, S. L., & Thomas, N. (2017). Mindfulness- and acceptance-based interventions for psychosis: our current understanding and a meta-analysis. Schizophrenia Research, 192, 57–63. https://doi.org/10.1016/j.schres.2017.05.023
- Norman, R. M. G., & Manchanda, R. (2016). Prevention and early intervention program for psychoses (PEPP). Healthcare Quarterly, 18, 37–41.
- Norman, R. M. G., Windell, D., Lynch, J., & Manchanda, R. (2012). Perceived relational evaluation as a predictor of self-esteem and mood in individuals with a psychotic disorder. Canadian Journal of Psychiatry, 57, 309–316. https://doi.org/10.1177/070674371205700506
- Palmier-Claus, J., Dunn, G., Drake, R., & Lewis, S. (2011). The negative and positive self: A longitudinal study examining self-esteem, paranoia and negative symptoms in individuals with first-episode psychosis. Early Intervention Psychiatry, 5, 150–155. https://doi.org/10.1111/j.1751-7893.2010.00250.x
- Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton UP.
10.1111/j.1559-1816.2002.tb02765.x Google Scholar
- Samson, C., & Mallindine, C. (2014). The feasibility and effectiveness of running mindfulness groups in an early intervention in psychosis service. The Cognitive Behaviour Therapist, 7, e9.
10.1017/S1754470X14000087 Google Scholar
- Sedgwick, P. (2014). Randomized controlled trials: Inferring significance of treatment effects based on confidence intervals. British Journal of Medicine, 349, g5196. https://doi.org/10.1136/bmj.g5196
- Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based Cognitive Therapy for Depression: A new approach to preventing relapse. New York, NY, US: Guilford Press.
- Smith-Carrier, T., & Gallinaro, A. (2013). Putting your mind at ease: Finding from the Mindfulness Ambassador Council in Toronto area schools. Toronto, ON: Factor-Inwentash Faculty of Social Work, University of Toronto.
- Strauss, C., Thomas, N., & Hayward, M. (2015). Can we respond mindfully to distressing voices? A systematic review of evidence for engagement, acceptability, effectiveness and mechanisms of change for mindfulness-based intervention for people distressed by hearing voices. Frontiers in Psychology, 6, 1154. https://doi.org/10.3389/fpsyg.2015.01154
- Tan, L., & Martin, G. (2013). Taming the adolescent mind: Preliminary report of a mindfulness-based intervention for adolescents with heterogeneous mental health diagnoses. Clinical Child Psychology & Psychiatry, 18, 300–312. https://doi.org/10.1177/1359104512455182
- Tong, A. C., Lin, J. J., Cheung, V. Y., Lau, N. K., Chang, W. C., Chan, S. K., … Chen, E. Y. (2016). A low intensity mindfulness-based intervention for mood symptoms in people with early psychosis: Development and pilot evaluation. Clinical Psychology and Psychotherapy, 23, 550–560. https://doi.org/10.1002/cpp.1981
- van der Valk, R., van de Waerdt, S., Meijer, C. J., van den Hout, I., & de Haan, L. (2013). Feasibility of mindfulness-based therapy in patients recovery from a first psychotic episode: A pilot study. Early Intervention in Psychiatry, 7, 64–70. https://doi.org/10.1111/j.1751-7893.2012.00356.x