Depression, anxiety, fatigue, and sleep disturbances are relatively common conditions among MS patients, and they have a negative impact on their quality of life and general well-being.
Mindfulness, which has been defined as the psychological process that draws one’s attention to the present moment, has been gaining relevance in the area of chronic diseases due to its association with patients’ well-being.
However, longitudinal long-term data documenting the impact of mindfulness on MS patients’ quality of life, in particular, are rare.
Therefore, a team of researchers at Harvard University and collaborators set out to evaluate the long-term impact of two different types of mindfulness — Langerian and contemplative — on MS patients’ quality of life, anxiety, depression, fatigue, and sleep problems.
Langerian mindfulness “emphasizes the awareness of external stimuli, with no need to attend to one’s own thought processes,” the researchers wrote. It “does not involve meditation and is framed as a set of techniques or skills that can be transmitted through educational sessions that employ simple cognitive reframing exercises.”
In contrast, the contemplative type includes a meditation-based intervention that “calls attention to both internal and external stimuli, requiring metacognitive and introspective awareness.”
According to the team, the two models focus on different qualities of mindfulness, “with the Langerian construct accentuating novelty seeking, flexibility, curiosity, and creativity,” while the contemplative approach “stresses the moment-to-moment awareness, the acceptance and non-judgmental instance, and the involved meta-cognitive processes.”
The team analyzed 156 MS patients from a larger randomized controlled trial (NCT02364505) of an online mindfulness-based intervention. In the trial, participants were divided into two groups: those included in the mindfulness-based stress reduction program, and those included in the psycho-education group (the control group).
All participants were asked to complete two questionnaires: one for the Langerian approach (Langer Mindfulness Scale, or LMS), and the other for the contemplative approach (Five Facet Mindfulness Questionnaire, or FFMQ).
The patients’ quality of life was assessed using the Multiple Sclerosis Quality of Life-54 (MSQOL) survey, their depression and anxiety levels using the Hospital Anxiety and Depression Scales (HADS-D and HADS-A), their level of fatigue using the 5-item Modified Fatigue Impact Scale (MFIS-5), and their sleep habits with the Medical Outcomes Study-Sleep Measure (MOS-SM).
All assessments were performed at the start of the study, at the end of treatment two months later, and six months after treatment.
Results showed no significant differences between the two groups.
“Comparing the models resulting from the two mindfulness instruments (LMS and FFMQ) for each outcome, no statistical differences were found,” researchers wrote.
However, the data showed that both types of mindfulness approaches were associated with higher quality of life and lower incidence of depression, anxiety, fatigue, and sleep issues in MS patients.
“The results confirm and extend the importance that mindfulness can have on the general quality of life of people with MS including meditation-based approaches and, for the first time, the same results using the Langerian mindfulness framework [which does not include meditation],” the team concluded.