| Objective:Mindfulness-Based Interview(MBI)has been used in psychosomatic disease treatment and the improvement of mental health,but the application of MBI on schizophrenia has lagged behind.Some foreign studies have shown that mindfulness is more suitable for patients with schizophrenia,and it has a positive impact on the patient’s symptoms,mood,compliance and social function.There are few reports on the application of mindfulness in patients with schizophrenia in China.Therefore,this study is based on patients with schizophrenia during rehabilitation: 1.To explore the relationship between the patient’s mindfulness and mental symptoms,emotions,and attention;2.To test the positive effects of MBI on the patient’s mental symptoms,mood and cognitive function;3.To evaluate the patient’s subjective experience of MBI,explore the ways and means of MBI implementation,and develop an optimal MBI program for patients.Methods:1.A cross-sectional survey of 125 patients with schizophrenia during the rehabilitation period was conducted by using the Positive Negative Symptoms Scale(PANSS),the Mindfulness Five-Factor Scale(FFMQ),the Positive and Negative Sentiment Scale(PANAS),and the Attention Control Scale(ACS),in order to explore the relationship between mindfulness and mental symptoms,positive and negative emotions and attention control.2.A prospective study was designed using conventional therapy combined with a mindfulness psychological intervention group(intervention or experimental group)and a conventional treatment group(control group).A total of 74 male patients with convalescent schizophrenia were recruited,and 64 patients completed the experiment,including 31 in the experimental group and 33 in the control group.Patients in the intervention group were divided into 3 groups with 11 persons,10 persons,and 10 persons,respectively,and received MBI group counseling including 12 times,3 times/week*4 weeks.To detect the beneficial effects of MBI on mental symptoms,emotions,and attention,PANSS,FFMQ,PANAS,and ACS were used to assess the status of the two groups of patients before the intervention(pre-test),after the intervention(post-test),and 1 month after the end of the intervention(the follow-up).3.In order to test the impact of MBI on cognitive function in patients,the first two batches patients with 21 in the intervention group and 23 in the control group conducted a behavioral test of the task switching paradigm before and after the MBI.4.Semi-structured interviews were used to assess the patient’s subjective experience of mindfulness psychological intervention.Results:1.Cross-sectional survey revealed:(1)The level of mindfulness of patients was significantly negatively correlated with negative emotions and general psychopathological symptoms(r=-0.21,-0.35,respectively,p<0.05),and significant positive correlation with attention control(r=0.50,p<0.01);Attention control was significantly negatively correlated with general psychopathological symptoms and negative emotions(r=-0.46,-0.30,respectively,p<0.01);(2)Stepwise regression analysis of negative psychology,attention control,and mindfulness on general psychopathological symptoms showed that negative emotions and attention control can explain 22% of the variation of general psychopathological symptoms;(3)The analysis of mediating effect showed that attention control plays a completely mediating role in the influence of mindfulness on negative emotion and general psychopathological symptoms.2.The controlled study of MBI showed:(1)The repeated measures MANOVA revealed that the interaction effects between groups(experimental group,control group)and time(pre-test,post-test,follow-up)of mindfulness,negative emotion,general psychopathology,and attention control is significant.However,the interaction effects of positive symptoms,negative symptoms,and positive emotion were not significant;(2)Further simple effect analysis indicated that group effect was significant in mindfulness,negative emotion,general psychopathology,and attention control at post-test and follow-up;The intervention group was significantly higher than the control group in the level of mindfulness and attention control,but significantly lower than the control group in negative emotion and general psychopathology;(3)Detection of long-term effects of MBI found that the scores of mindfulness,general psychopathology,attention control,and negative emotions of the intervention group at the time of follow-up were significantly differ from those of the previous test.To sum up,after the MBI,there was no significant difference in positive symptoms,negative symptoms and positive emotions between the intervention group and the control group.Mindfulness and attention control were significantly improved,while negative emotions and general psychopathological symptoms were alleviated.And these effects were still significant at the end of the intervention.3.Task switching test found that the interaction effect and time main effect of the accuracy were not significant;But the interaction effect of the response time was significant(F=23.364,p < 0.01).Compared with the patients of the control group(1439.61±216.15ms),the response time of the intervention group(1069.63±170.91ms)were significantly reduced.That is,MBI could improve the cognitive flexibility of patients,which could be reflected in the shortening of response time in the task switching test.4.Semi-structured interview analysis: The repeated measures MANOVA of five aspects of self-assessment scores of patients in two groups indicated the interaction between time(pre-test,post-test)and group(intervention group,control group)was significant.The patients in the intervention group had a good improvement in adapting to the ward environment,reassuring hospitalization,degree of mood pleasure,feeling the pleasure of the surrounding things,and the subjective feeling in the overall state.Semi-structured interviews with 31 patients in the intervention group revealed that 67.74% of patients believed that mindfulness exercises promoted their own change,and 96.77% of the patients thought that integrating mindfulness into daily life was an effective way to keep practicing.The practice methods that patients are most willing to choose are informal exercises,observational breathing,and mindfulness walking.Conclusion:1.The level of mindfulness in patients with schizophrenia during rehabilitation was closely related to negative emotions,general psychopathology,and attention control;Increased attention control might be an important intermediary mechanism for mindfulness to promote mental health: MBI could alleviate the patient’s negative emotions and general psychopathological symptoms by improving their attention control ability.2.MBI could improve the level of mindfulness and attention control in patients with schizophrenia,relieve their negative emotional experience and general psychopathological symptoms.These effects could last at least one month.3.MBI could improve patients’ attention control ability and cognitive flexibility,thereby improving patients’ cognitive function.4.Patients have generally accepted and benefited from the MBI,and were willing to continue practicing through appropriate forms. |
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