Loving-Kindness Meditation to Target Affect in Mood Disorders: A Proof-of-Concept Study

Stefan G Hofmann, Nicola Petrocchi, James Steinberg, Muyu Lin, Kohki Arimitsu, Shelley Kind, Adriana Mendes, Ulrich Stangier, Stefan G Hofmann, Nicola Petrocchi, James Steinberg, Muyu Lin, Kohki Arimitsu, Shelley Kind, Adriana Mendes, Ulrich Stangier

Abstract

Conventional treatments for mood disorders primarily focus on reducing negative affect, but little on enhancing positive affect. Loving-kindness meditation (LKM) is a traditional meditation practice directly oriented toward enhancing unconditional and positive emotional states of kindness towards oneself and others. We report here two independent and uncontrolled studies carried out at different centers, one in Boston, USA (n = 10), and one in Frankfurt, Germany (n = 8), to examine the potential therapeutic utility of a brief LKM group intervention for symptoms of dysthymia and depression. Results at both centers suggest that LKM was associated with large-sized effects on self-reported symptoms of depression (d = 3.33 and 1.90), negative affect (d = 1.98 and 0.92), and positive affect (d = 1.63 and 0.94). Large effects were also found for clinician-reported changes in depression, rumination and specific positive emotions, and moderate effects for changes in adaptive emotion regulation strategies. The qualitative data analyses provide additional support for the potential clinical utility of the intervention. This proof-of-concept evaluation of LKM as a clinical strategy warrants further investigation.

References

    1. Grossman P., Niemann L., Schmidt S., Walach H. Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research. 2004;57(1):35–43. doi: 10.1016/s0022-3999(03)00573-7.
    1. Hofmann S. G., Sawyer A. T., Witt A. A., Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology. 2010;78(2):169–183. doi: 10.1037/a0018555.
    1. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice. 2003;10(2):144–156. doi: 10.1093/clipsy/bpg016.
    1. Khoury B., Lecomte T., Fortin G., et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review. 2013;33(6):763–771. doi: 10.1016/j.cpr.2013.05.005.
    1. Allen N. B., Chambers R., Knight W., et al. Mindfulness-based psychotherapies: a review of conceptual foundations, empirical evidence and practical considerations. Australian and New Zealand Journal of Psychiatry. 2006;40(4):285–294. doi: 10.1111/j.1440-1614.2006.01794.x.
    1. Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York, NY, USA: Delta; 1991.
    1. Greeson J. M., Smoski M. J., Suarez E. C., et al. Decreased symptoms of depression after mindfulness-based stress reduction: potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age. The Journal of Alternative and Complementary Medicine. 2015;21(3):166–174. doi: 10.1089/acm.2014.0285.
    1. Kuyken W., Hayes R., Barrett B., et al. Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. The Lancet. 2015 doi: 10.1016/s0140-6736(14)62222-4.
    1. Gu J., Strauss C., Bond R., Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review. 2015;37:1–12. doi: 10.1016/j.cpr.2015.01.006.
    1. Buddhaghosa B. The Path of Purification. Kandy, Sri Lanka: Buddhist Publication Society; 1975.
    1. The Dalai Lama. An Open Heart: Practicing Compassion in Everyday Life. Boston, Mass, USA: Little Brown and Company; 2001.
    1. Hofmann S. G., Grossman P., Hinton D. E. Loving-kindness and compassion meditation: potential for psychological interventions. Clinical Psychology Review. 2011;31(7):1126–1132. doi: 10.1016/j.cpr.2011.07.003.
    1. Hopkins J. Cultivating Compassion. New York, NY, USA: Broadway Books; 2001.
    1. Salzberg S. Loving-Kindness. Boston, Mass, USA: Shambhala; 1995.
    1. The Dalai Lama, Cutler H. C. The Art of Hhappiness: A Handbook for Living. New York, NY, USA: Riverhead Books; 1998.
    1. Analayo V. Satipatthana: The Direct Path to Realization. Birmingham, UK: Windhorse; 2003.
    1. Sheng-Yen M. Hoofprints of the Ox: Principles of the Chan Buddhist Path as Taught by Modern Chinese Master. Oxford, UK: Oxford University Press; 2001.
    1. Hutcherson C. A., Seppala E. M., Gross J. J. Loving-kindness meditation increases social connectedness. Emotion. 2008;8(5):720–724. doi: 10.1037/a0013237.
    1. Fredrickson B. L., Cohn M. A., Coffey K. A., Pek J., Finkel S. M. Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology. 2008;95(5):1045–1062. doi: 10.1037/a0013262.
    1. Carson J. W., Keefe F. J., Lynch T. R., et al. Loving-kindness meditation for chronic low back pain: results from a pilot trial. Journal of Holistic Nursing. 2005;23(3):287–304. doi: 10.1177/0898010105277651.
    1. Kearney D. J., Malte C. A., Mcmanus C., Martinez M. E., Felleman B., Simpson T. L. Loving-kindness meditation for post-traumatic stress disorder: a pilot study. Journal of Traumatic Stress. 2013;26(4):426–434. doi: 10.1002/jts.21832.
    1. Johnson D. P., Penn D. L., Fredrickson B. L., et al. A pilot study of loving-kindness meditation for the negative symptoms of schizophrenia. Schizophrenia Research. 2011;129(2-3):137–140. doi: 10.1016/j.schres.2011.02.015.
    1. Diedrich A., Grant M., Hofmann S. G., Hiller W., Berking M. Self-compassion as an emotion regulation strategy in major depressive disorder. Behaviour Research and Therapy. 2014;58:43–51. doi: 10.1016/j.brat.2014.05.006.
    1. Gilbert P., Procter S. Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy. 2006;13(6):353–379. doi: 10.1002/cpp.507.
    1. Neff K. D., Germer C. K. A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology. 2013;69(1):28–44. doi: 10.1002/jclp.21923.
    1. Werner-Seidler A., Banks R., Dunn B. D., Moulds M. L. An investigation of the relationship between positive affect regulation and depression. Behaviour Research and Therapy. 2013;51(1):46–56. doi: 10.1016/j.brat.2012.11.001.
    1. Hofmann S. G., Sawyer A. T., Fang A., Asnaani A. Emotion dysregulation model of mood and anxiety disorders. Depression and Anxiety. 2012;29(5):409–416. doi: 10.1002/da.21888.
    1. Watson D., Clark L. A., Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology. 1988;54(6):1063–1070. doi: 10.1037/0022-3514.54.6.1063.
    1. Beck A. T., Steer R. A., Brown G. K. Manual for the Beck Depression Inventory—II. San Antonio, Tex, USA: Psychological Corporation; 1996.
    1. Brown T. A., DiNardo P. A., Barlow D. H. Anxiety Disorders Interview Schedule for DSM-IV (AIDS-IV) San Antonio, Tex, USA: Psychological Corporation; 1994.
    1. Treynor W. F. C., Gonzalez R., Nolen-Hoeksema S. Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research. 2003;27(3):247–259. doi: 10.1023/a:1023910315561.
    1. Shiota M. N., Keltner D., John O. P. Positive emotion dispositions differentially associated with Big Five personality and attachment style. The Journal of Positive Psychology. 2006;1(2):61–71. doi: 10.1080/17439760500510833.
    1. Wittchen H. U., Fydrich T. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II) Göttingen, Germany: Hogrefe; 1997.
    1. Hamilton M. A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry. 1960;23:56–62. doi: 10.1136/jnnp.23.1.56.
    1. Stangier U. The psychiatric status rating for chronic depression. Unpublished Manuscript, Department of Clinical Psychology and Psychotherapy, University of Frankfurt, 2013.
    1. Keller M. B., Lavori P. W., Friedman B., et al. The longitudinal interval follow-up evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry. 1987;44(6):540–548. doi: 10.1001/archpsyc.1987.01800180050009.
    1. Graser J., Bohn C., Kelava A., Schreiber F., Hofmann S. G., Stangier U. The ‘affective style questionnaire (ASQ)’: German adaptation and validity. Diagnostica. 2012;58(2):100–111. doi: 10.1026/0012-1924/a000056.
    1. Kühner C., Huffziger S., Nolen-Hoeksema S. Der Response Styles Questionnaire—RSQ-D, Deutsche Version. Göttingen, Germany: Hogrefe; 2007.
    1. Mayring P. Qualitative content analysis. Forum: Qualitative Social Research. 2000;1(2)
    1. Mathews A., MacLeod C. Cognitive vulnerability to emotional disorders. Annual Review of Clinical Psychology. 2005;1:167–195. doi: 10.1146/annurev.clinpsy.1.102803.143916.
    1. Matt G. E., Vazquez C., Campbell W. K. Mood-congruent recall of affectively toned stimuli: a meta-analytic review. Clinical Psychology Review. 1992;12(2):227–255. doi: 10.1016/0272-7358(92)90116-p.
    1. Raes F., Smets J., Nelis S., Schoofs H. Dampening of positive affect prospectively predicts depressive symptoms in non-clinical samples. Cognition and Emotion. 2012;26(1):75–82. doi: 10.1080/02699931.2011.555474.
    1. Lyubomirsky S., King L., Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychological Bulletin. 2005;131(6):803–855. doi: 10.1037/0033-2909.131.6.803.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren