Examining the Occurrence and Clinical Impact of Difficult Experiences that Emerge during a Mindfulness-Based Intervention among Individuals at High-Risk of Suicide.
Alejandro Interian, Rachael B Miller, Chintan V Dave, Miriam Latorre, Lauren M St Hill, Arlene King, Dianna R. Boschulte, Anna Kline, David Siegel, Megan M Sedita, Megan S Chesin
Mindfulness June 18, 2024 DOI: 10.1016/j.cpr.2019.01.001 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a randomized clinical trial Preregistered Peer reviewed |
|---|---|
| Sample size | 50 |
| Population | High suicide risk adults (mean age 49 years, 84% male, 24% Latinx) from the Mindfulness Based Cognitive Therapy for Suicide Prevention (MBCT-S) trial |
| Intervention | Mindfulness Based Cognitive Therapy for Suicide Prevention (MBCT-S) |
| Duration | 12-month follow-up |
| Topics | Meditation |
| Registration | NCT01872338 |
| Key findings | Difficulties during mindfulness practice were common (18% of participants) but did not increase the risk of suicidal events or psychiatric hospitalizations among high suicide risk participants. |
Abstract
Experiences of difficulty (e.g., anxiety, difficult emotions) can occur during mindfulness practice. This study characterized the occurrence of such difficulties, defined as abnormal distress, dysregulation or agitation, among high suicide risk participants during a mindfulness-based intervention. The study also evaluated whether mindfulness difficulties were associated with baseline differences or poorer outcomes during follow-up. Participants (n=50; mean age=49 years, 84% male, 24% Latinx) were from the Mindfulness Based Cognitive Therapy for Suicide Prevention (MBCT-S) trial. Occurrences of mindfulness difficulties were identified via systematic review of progress notes. Serious clinical outcomes (suicidal events, suicide attempts, and psychiatric hospitalizations) were tracked over 12-months follow-up. Participants experiencing difficulties during MBCT-S were compared to those who did not on baseline characteristics and serious clinical outcomes. Incidence density sampling and Cox proportional regression analyses tested whether experiencing difficulties during mindfulness increased the risk of subsequent serious clinical outcomes. 18% of participants had difficulty during mindfulness practice, which mostly included experiences of anxiety or hallucinations. Those experiencing difficulty showed several diagnostic differences at baseline, but were not at significantly greater risk of a suicidal event, HR 0.62 (95% confidence interval [CI]: 0.14 - 2.71) or an acute psychiatric hospitalization, HR 0.85 (95% CI: 0.19 - 3.82). There were no suicide attempts among the 9 participants who experienced mindfulness difficulty, compared to 5 suicide attempts in those without mindfulness difficulty. Difficulties during mindfulness practice were common, but did not show increased risk of serious clinical outcomes in participants at high-risk of suicide. This study reports findings from a secondary analyses of a randomized clinical trial that was preregistered at clinicaltrials.gov (NCT01872338).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 136
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials Perspectives on Psychological Science February 16, 2021
- Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials Psycho-Oncology September 11, 2019
- Prevalence of meditation-related adverse effects in a population-based sample in the United States Psychotherapy Research June 2, 2021
- A Framework for the Empirical Investigation of Mindfulness Meditative Development Mindfulness April 13, 2023
and 131 more in the library
Cites 36
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Journal of Consulting and Clinical Psychology 2004
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
and 31 more in the library