Article Review: Khoury, B., Lecomte, T., Gaudiano, B. A., & Paquin, K. (2013) Mindfulness interventions for schizophrenia: A meta-analysis.

Mindfulness is a diverse concept which originated in the eastern traditions and has taken on new life in operational definitions in psychology, including de-centering, awareness of sensations, and openness to inner experiences. These labels for mindfulness have a strong place in the “third wave” of cognitive behavioral interventions such as Acceptance and Commitment Therapy (Khoury, Lecomte, Gaudiano, Paquin, 2013). The purpose of these treatments is not on reduction of symptoms such as eliminating or lessening presence of hallucinations or delusions. Instead, the focus of interventions is addressing the interplay of the individual and their psychotic experiences. An example of this concept would be making individuals aware of their experiences and to identify them as transient but also as separate and have a feeling of “not me” from their other parts of their life.

Cognitive Behavioral Therapy for psychosis (CBTp) is one of the more widely studied and approved treatments (Khoury et al., 2013). It is designed to have individuals test and challenge their beliefs in behavioral experiments. In contrast, mindfulness interventions have three main areas to address these symptoms. The first area is for mindfulness mediation-based protocols, the second is acceptance-based protocols, and the third is compassion-based. It is belief that, through refocusing attention, one’s emotions can be better regulated.  Therefore, treatment is based on reduction of distress.

Meta-analysis of 13 studies are moderately effective in pre-post studies. The effect sizes were shown to be small to moderate. Schizophrenia is hallmarked by two sets of symptoms either lacking something such as motivation (negative symptoms) or the presence of symptoms in everyday living (positive symptoms). Treatment for positive symptoms was shown to have a weaker effect than treatment for negative symptoms, affective symptoms, and quality of life. The researchers suggested that, to achieve these effects, therapy is recommended to be tailored to the severity of the individual’s issues. Unfortunately, the meta-analysis could not determine the mechanism for the improvements in quality of living or why these mindfulness interventions are effective. Future research was suggested to determine any moderating factors and other influences on why mindfulness works against distress in schizophrenia.

References:
Khoury, B., Lecomte, T., Gaudiano, B. A., & Paquin, K. (2013) Mindfulness interventions for schizophrenia: A meta-analysis. Schizophrenia Research, 150(1), 175-184.

Andrew Goebel, MS, LPA (Temp)
WKPIC Doctoral Intern