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The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

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Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews: The Impact of Mindfulness-Based Interventions on Depression

1                                                          Introduction

  • The idea of evidence-based practice (EBP)
  • The distinction between best and typical practices
  • The methodology of clinical inquiry
  • Statement of purpose

The term evidence-based practice, or EBP, describes the practice of using only interventions that respectable academic research has demonstrated to be successful. The gold standard for therapeutic practice in the industry is EBP. Clinical research that contradicts accepted wisdom is used to generate EBP (Melnyk & Fineout-Overholt, 2023). This work presents four papers on clinical research into the prevention and management of depression by using mindfulness-based interventions. The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

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2                                                   The Clinical Issue

  • The effect of the healthcare issue.
  • Depression and trauma among the adult population (Boland et al., 2021).
  • Recognition and characterization of depression risk (APA, 2022).
  • The PHQ-9 screening tool for depression.

There is a public health issue with depression, and we need adaptable, reasonably priced solutions. Despite the fact that a lot of psychological interventions work, not much is known about how long-term, sustained effects they may have on wellbeing. Depending on its intensity, depression is a mental illness that can present itself in a variety of ways (Boland et al., 2021). Depression can manifest on its own or in conjunction with disorders brought on by traumatic experiences and conditions, such posttraumatic stress disorder (PTSD).

The Diagnostic and Statistical Manual of Mental Disorders-Text Revision, or DSM-5-TR, has undergone a recent revision. The fifth edition of the handbook groups together mental illnesses under the diagnostic category of “Depressive Disorders” that use depression as a distinguishing indicator (APA, 2022). Many depressive disorders are listed in the DSM-5-TR, such as major depressive disorder, substance/medication-induced depressive disorder, disruptive mood dysregulation disorder, dysthymia (persistent depressive disorder), and persistent depressive disorder.

One of the most commonly used assessment tool for depression is the Patient Health Questionnaire or PHQ-9. The other is the Beck Depression Inventory or BDI-II. The primary objective of the clinical concerns of interest is on mindfulness and depression, specifically examining the efficacy of mindfulness-based therapies in treating depression. Barr et al. (2019) claim that mindfulness is a contemplative practice with roots that show potential for improving mental health and providing a different approach to established therapy approaches for depression sufferers. The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

3                                     PICOT Question Development

  • Population (adults diagnosed with depression and trauma such as PTSD)
  • Comparison (standard treatment approaches or common practice);
  • Intervention (a mindfulness-based cognitive therapy – MBCT – intervention);
  • Outcome (a reduced incidence of depressive symptoms).
  • Duration (six months).

The PICOT question was selected for the population demographic of adults aged 18-99 years. This PICOT investigation aims to compare the efficacy of mindfulness-based therapies to conventional therapy approaches in reducing adult depressive symptoms over a specified duration. The approach in question is mindfulness-based therapy, and the target demographic is adults. It is feasible to evaluate the relative efficacy of mindfulness techniques by utilizing standard therapy procedures in the comparison group. Reducing depressive symptoms is the aim, which is consistent with the pertinent clinical condition. The allotted six months offer a reasonable length of time to monitor any alterations and assess whether the advantages will endure.

The PICOT question: In adults (P), how does the implementation of mindfulness-based interventions (I) compared to traditional therapeutic interventions (C) influence the reduction of depressive symptoms (O) over six months (T)? The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

Explanation

Population (P): Adults with depression.

Intervention (I): Mindfulness-based interventions.

Comparison (C): Traditional therapeutic interventions (common practice).

Outcome (O): Reduction of depressive symptoms.

Timeframe (T): Six months.

4                                              The Databases Searched

  • PubMed
  • Cochrane Database of Systematic Reviews
  • CINAHL
  • ProQuest
  • Embase

I looked through a total of five (5) credible research databases to find data supporting the recommended preventative therapy’s intervention of mindfulness-based cognitive therapy. PubMed, CINAHL, ProQuest, Embase, and the Cochrane Database of Systematic Reviews are the databases searched. The articles retrieved are all current (published within the last five years) and offer strong evidence for the efficacy of the proposed depression prevention therapy.

More than 1,500 hits were found in the first search using the terms “mindfulness,” “depression,” and “mindfulness-based interventions.” While some addressed the subject matter or problem at hand, a sizable portion did not concentrate on the precise connection or effect of mindfulness therapies on melancholy. Consequently, it became necessary to hone the search by adding more phrases or Boolean operators. The ensuing searches used Boolean operators for refinement, which assisted in concentrating the search. The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

5                                              The Articles Cited

Cerna, C., Demarzo, M., Garci­a, F. E., Aravena, V., & Wlodarczyk, A. (2021). Brief Mindfulness Therapy and Mental Health in People Exposed to a Recent Stressful Event: A Study of Multiple Cases with Follow-Up. Journal of Contemporary Psychotherapy, 51(2), 117-124. https://doi.org/10.1007/s10879-020-09483-3

Elliot, A. J., Gallegos, A. M., Moynihan, J. A., & Chapman, B. P. (2019). Associations of mindfulness with depressive symptoms and well-being in older adults: The moderating role of neuroticism. Aging & mental health, 23(4), 455-460. https://doi.org/10.1080/13607863.2017.1423027

Powers, A., Lathan, E.C., Dixon, H.D., Mekawi, Y., Hinrichs, R., Carter, S., Bradley, B., & Kaslow, N.J. (2022). Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among Black adults: A pilot feasibility and acceptability randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001390

Roubinov, D.S., Epel, E.S., Coccia, M., Coleman-Phox, K., Vieten, C., Adler, N.E., Laraia, B., & Bush, N.R. (2022). Long-term effects of a prenatal mindfulness intervention on depressive symptoms in a diverse sample of women. Journal of Consulting and Clinical Psychology, 90(12), 942-949. https://doi.org/10.1037/ccp0000776  The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

6                                              Levels of Evidence (LOE)

  • Cerna et al. (2021): Level II evidence
  • Elliot et al. (2019): Level II evidence
  • Powers et al., (2022): Level II evidence
  • Roubinov et al. (2022): Level II evidence

In this instance, there is substantial evidence to support the measure suggested for the prevention of depression in adults. Of the four studies, all are classified as level II evidence because they are unfiltered primary studies. Some are mixed method studies, others quantitative/ cohort studies, while the rest are randomized controlled trials (RCTs).

7                      Strengths of Using Systematic Reviews for Clinical Research

  • Reproducible
  • Specific
  • Reliable
  • Exhaustive

The rise in evidence-based medicine has made systematic reviews more common. They want a comprehensive analysis of all available studies in order to support a certain treatment plan. In an effort to address a particular research topic, a systematic review compiles all available data (Gray & Grove, 2021). Clinicians use systematic reviews of relevant literature as a basis for decision-making when developing guidelines or prescribing novel treatment methods. At the pinnacle of the evidence pyramid are systematic reviews. The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

Because systematic reviews are thorough, repeatable, and accurate in reporting their findings, they are regarded as reliable sources. The research’s aims and objectives determine the kind of review method to be employed as well as the strategy (Gray & Grove, 2021). To choose the best review system, researchers must be aware of the benefits and drawbacks of each approach. Systematic reviews have gained appeal due to their decreased risk of partiality, accuracy, transparency, and repeatability.

Investigators are able to respond to certain, highly significant research issues. The question of whether a specific medication is effective when used to treat a specific illness is one example. Meticulous planning is necessary when conducting a systematic review. According to Gray and Grove (2021), every stage of the review is planned out in great detail. The study query is formulated using the PICOT approach. Next, a strict eligibility criterion is developed for both the inclusion and exclusion criteria in order to choose the primary studies for the review. The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

A systematic review’s findings are either statistically assessed using methods like meta-analyses and numeric effect estimates, or they are qualitatively analyzed and then presented as a textual narrative. A comprehensive analysis of all the available data on a particular subject is required for a systematic review. The results are combined in a thorough manner, taking into account all pertinent information (Gray & Grove, 2021). Prior to the review’s commencement, every stage of the systematic review procedure is organized and documented. The review protocol is the name of this publication. This aids in the evaluation of the reviews’ reproducibility by peer reviewers. Replicability contributes to the credibility of the review.  The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

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References

American Psychiatric Association [APA] (2022). Diagnostic and Statistical Manual of Mental Disorders-Text Revision (DSM-5-TR), 5th ed. Author.

Barr, N., Davis, J.P., Diguiseppi, G., Keeling, M., & Castro, C. (2019). Direct and indirect effects of mindfulness, PTSD, and depression on self-stigma of mental illness in OEF/OIF veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 14(6). https://doi.org/10.1037/tra0000535

Boland, R., Verdiun, M., & Ruiz, P. (Eds) (2021). Kaplan and Sadock’s synopsis of psychiatry, 12th ed. Wolters Kluwer.

Cerna, C., Demarzo, M., Garci­a, F. E., Aravena, V., & Wlodarczyk, A. (2021). Brief Mindfulness Therapy and Mental Health in People Exposed to a Recent Stressful Event: A Study of Multiple Cases with Follow-Up. Journal of Contemporary Psychotherapy, 51(2), 117-124. https://doi.org/10.1007/s10879-020-09483-3

Elliot, A. J., Gallegos, A. M., Moynihan, J. A., & Chapman, B. P. (2019). Associations of mindfulness with depressive symptoms and well-being in older adults: The moderating role of neuroticism. Aging & mental health, 23(4), 455-460. https://doi.org/10.1080/13607863.2017.1423027

Gray, J.R., & Grove, S.K. (2021). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence, 9th ed. Elsevier.

Melnyk, B.M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice, 5th ed. Wolters Kluwer.

Powers, A., Lathan, E.C., Dixon, H.D., Mekawi, Y., Hinrichs, R., Carter, S., Bradley, B., & Kaslow, N.J. (2022). Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among Black adults: A pilot feasibility and acceptability randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001390

Roubinov, D.S., Epel, E.S., Coccia, M., Coleman-Phox, K., Vieten, C., Adler, N.E., Laraia, B., & Bush, N.R. (2022). Long-term effects of a prenatal mindfulness intervention on depressive symptoms in a diverse sample of women. Journal of Consulting and Clinical Psychology, 90(12), 942-949. https://doi.org/10.1037/ccp0000776  The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.
The Assignment (Evidence-Based Project) The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples. The Impact of Mindfulness-Based Interventions on Depression Discussion Paper

 

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