Herman H. M. Lo

The Effects of Mindfulness-Based Stress Reduction Program on the Mental Health of Family Caregivers: A Randomized Controlled Trial

Background: Caregivers of people with chronic conditions are more likely than non-caregivers to have depression and emotional problems. Few studies have examined the effectiveness of mindfulness-based stress reduction (MBSR) in improving their mental well-being. Methods: Caregivers of persons with chronic conditions who scored 7 or above in the Caregiver Strain Index were randomly assigned to the 8-week MBSR group (n = 70) or the self-help control group (n = 71). Validated instruments were used to assess the changes in depressive and anxiety symptoms, quality of life, self-efficacy, self-compassion and mindfulness. Assessments were conducted at baseline, post-intervention and at the 3-month follow-up. Results: Compared to the participants in the control group, participants in the MBSR group had a significantly greater decrease in depressive symptoms at post-intervention and at 3 months post-intervention (p < 0.01). The improvement in state anxiety symptoms was significantly greater among participants in the MBSR group than those of the control group at post-intervention (p = 0.007), although this difference was not statistically significant at 3 months post-intervention (p = 0.084). There was also a statistically significant larger increase in self-efficacy (controlling negative thoughts; p = 0.041) and mindfulness (p = 0.001) among participants in the MBSR group at the 3-month follow-up compared to the participants in the control group. No statistically significant group effects (MBSR vs. control) were found in perceived stress, quality of life or self-compassion. Conclusions: MBSR appears to be a feasible and acceptable intervention to improve mental health among family caregivers with significant care burden, although further studies that include an active control group are needed to make the findings more conclusive.

Validation of a Chinese version of the Five Facet Mindfulness Questionnaire in Hong Kong and development of a short form.

Mindfulness-based interventions are increasingly being used in various populations to improve well-being and reduce psychological afflictions. However, there is lack of a validated mindfulness measurement in the Chinese language. This study validated the Chinese version of the Five Facet Mindfulness Questionnaire (FFMQ-C) in both a community sample of 230 adults and a clinical sample of 156 patients with significant psychological distress. Results showed a good test–retest reliability (.88) and a high internal consistency (.83 in the community sample and .80 in the clinical sample). Mindfulness as measured by FFMQ-C has moderate to large correlations with psychological distress and mental well-being. Two of the five subscales (describing and acting with awareness) showed incremental validity over the others in predicting psychological symptoms and mental health. Confirmatory factor analysis confirmed the five-factor structure of the FFMQ-C and demonstrated adequate model fit. A 20-item short form scale (FFMQ-SF) was developed using the proposed comprehensive criteria. These findings indicate that the FFMQ-C is reliable and valid to measure mindfulness in a Chinese population. Further study is needed to evaluate the psychometric properties of FFMQ-SF.

Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: randomised controlled trial

BACKGROUND Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD). AIMS To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive-behavioural therapy-based psychoeducation and usual care. METHOD In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. RESULTS Linear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only. CONCLUSIONS These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms.

The association between smartphone dating applications and college students' casual sex encounters and condom use

OBJECTIVE This study aims to explore the association between using smartphone dating applications (apps) and having unprotected sex with a casual sex partner. STUDY DESIGN This is a cross-sectional study. Students were recruited from four university campuses in Hong Kong by convenience sampling. MAIN OUTCOME MEASURES Subjects completed a structured questionnaire asking about the use of dating apps, sexual history and socio-demographic information. Multiple logistic regressions were used to explore the association between using dating apps and having unprotected sex with a casual sex partner. RESULTS Six hundred and sixty-six subjects were included in the analysis. Users of dating apps were more likely to have had unprotected sex with a casual sex partner the last time they engaged in sexual intercourse (aOR: 10.06). Using dating apps for more than 12 months was associated with having a casual sex partner in the last sexual intercourse (aOR: 3.21), as well as having unprotected sex with that casual partner (aOR: 13.56). CONCLUSION We found a robust association between using dating apps and having unprotected sex with a casual sex partner, implying that using dating apps is an emerging sexual risk factor. We recommend that interventions promoting the safe use of dating apps should be implemented.

The Chinese medicine construct “stagnation” in mind–body connection mediates the effects of mindfulness training on depression and anxiety

OBJECTIVES Previous studies have identified different, but highly correlated variables explaining the effects of mindfulness training. Many of them are limited by tautological explanation. Under the framework of the mind-body connection, mindfulness training cultivates body awareness and promotes self-management of illness. Stagnation, a concept from Chinese medicine, may help explain the mechanism of change in mindfulness training. METHODS Individuals with depressive and anxiety symptoms (n=82) were randomized to either a Compassion-Mindfulness Therapy (C-MT) program or a waitlist control condition. The effect of stagnation as a mediator was investigated for dependent variables including depression, anxiety, and other physical and mental health variables. MAJOR OUTCOME MEASURES Depression, anxiety, stagnation, physical distress, daily functioning, positive affect, negative affect. RESULTS Compared with the participants in the control group, those who completed C-MT demonstrated significant decreases in depression, F(1, 78)=15.67, p<.001, anxiety, F(1, 78)=7.72, p<.001, stagnation, F(1, 78)=4.96, p<.001, and other body-mind-spirit well-being measures. After entering the change in stagnation as the mediator, the effect of treatment reduced: depression (.35-.22), anxiety (.33-.05), and same patterns in other three secondary measures. The Sobel test was administered and significant reductions between group and depression (z=2.18, p=.029), anxiety (z=2.21, p=.027), and three secondary other measures (p<.05) were indicated. CONCLUSION The study provides initial support for the role of stagnation in mediating changes in mindfulness training. It adds evidence to body-mind nondualism and offers new possibilities in studying treatment process and change mechanism.

When cognitive-behavioral group therapy works and when it doesn't: clinical data mining on good and poor CBGT outcomes for depression and anxiety among Hong Kong Chinese

The present study is a review of 672 participants who joined a cognitive-behavioral group therapy program in the community. In addition to the overall positive outcome, the researcher goes further to investigate two negative outcomes of the program as well as their predictors. The absence of using individual counseling and social workers scoring of low energy were identified as predictors of dropout. Some cognitive and interpersonal pretreatment symptoms are found to be poor treatment outcome. Implications to social work practice and research are discussed.

The impacts of using smartphone dating applications on sexual risk behaviours in college students in Hong Kong

Dating applications (apps) on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. Factors associated with having unprotected sexual intercourse with more lifetime sexual partners included use of dating apps (β = 0.93, p<0.01), having one’s first sexual intercourse before 16 years of age (β = 1.74, p<0.01), being older (β = 0.4, p<0.01), currently being in a relationship (= 0.69, p<0.05), having a monthly income at least HKD

The Effects of Family-Based Mindfulness Intervention on ADHD Symptomology in Young Children and Their Parents: A Randomized Control Trial:

5,000 (β = 1.34, p<0.01), being a current smoker (β = 1.52, p<0.01), and being a current drinker (β = 0.7, p<0.01). The results of a multiple logistic regression analysis found that users of dating apps (adjust odds ratio: 0.52, p<0.05) and current drinkers (adjust odds ratio: 0.40, p<0.01) were less likely to have consistent condom use. Users of dating apps (adjust odds ratio: 1.93, p<0.05), bisexual/homosexual subjects (adjust odds ratio: 2.57, p<0.01) and female subjects (adjust odds ratio: 2.00, p<0.05) were more likely not to have used condoms the last time they had sexual intercourse. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.

Evaluating Compassion-Mindfulness Therapy for Recurrent Anxiety and Depression: A Randomized Control Trial

Objective: The aim of the study is to investigate the feasibility of a family-based mindfulness intervention in improving children with inattention and hyperactivity symptoms. Method: A total of 100 children aged 5 to 7 years with ADHD symptoms and their parents were randomly assigned to a family-based mindfulness intervention (n = 50) or a wait-list control group (n = 50). Results: Families from intervention group had greater improvements in children’s ADHD symptoms, with medium effect sizes of −0.60 for inattention and −0.59 for hyperactivity; overall behaviors; and parenting stress and well-being than those in wait-list control group. Conclusion: The positive results on the child primary outcome measures have provided initial evidence of the family-based mindfulness intervention as a treatment option to ADHD. The reduction of parental stress and increase in psychological well-being has demonstrated the value of mindfulness in enhancing parent’s self-management.

Applications of Buddhist Compassion Practices Among People Suffering from Depression and Anxiety in Confucian Societies in East Asia

Objective: To evaluate the effects of compassion–mindfulness therapy (C-MT), an adapted version of mindfulness-based cognitive therapy that integrates compassion training. Method: Individuals aged 17–69 with recurrent depressive and anxiety symptoms were recruited from a community mental health service unit. Half of the participants were randomized to an 8-week C-MT program (n = 41) and the other half to a wait-list control condition (n = 41). Results: Intent-to-treat analyses showed significant improvements in all measures in the treatment group. The effect sizes for depression and anxiety were 1.11 and 1.10, respectively, and those for physical distress, daily functioning, positive affect, and negative affect ranged from 0.71 to 1.04. All improvements were sustained at the 3-month follow-up. Conclusions: The results provide preliminary support for C-MT as a viable treatment option for individuals with recurrent depression and anxiety symptoms. Time-limited treatments such as C-MT should be promoted in social work practice.