The effect of a brief mindfulness-based intervention on personal recovery in people with bipolar disorder: A randomized controlled trial (study protocol)

Chan, Sunny H. W.; Tse, Samson; Chung, K. F.; Yu, C. H.; Chung, Raymond C. K.; Lo, Herman H. M.

Abstract

Background: With the advent of the recovery movement in mental health, a humanistic paradigm shift has occurred, placing the focus on personal recovery (i.e., hope, identity, and life meaning) instead of functional or clinical recovery only (i.e., symptom reduction or increases in physical function). Along the journey of recovery, people with bipolar disorder (BD) struggle to cope with recurring mood fluctuations between depression and mania. Mindfulness-based interventions (MBIs) have the potential to result in improvements in personal recovery outcomes. Thus, this protocol will evaluate the efficacy and mechanisms of a brief MBI for helping individuals with BD with their personal recovery. It is hypothesized that adults with BD randomly assigned to a brief MBI intervention will report greater improvements in personal recovery than those in a waiting list control condition. In addition, it is hypothesized that such benefits will be mediated by improvements in emotion awareness, emotion regulation, and illness acceptance. Moreover, the specific stage of BD is hypothesized to moderate the beneficial effects of the brief MBI, such that those in the early stage of BD will report more benefits regarding emotion awareness and emotion regulation, whereas those in the late stage of BD will report more advantages concerning illness acceptance. Method: One hundred and fifty-four adults with BD will be recruited from hospitals and community settings for this research project. This study will use a mixed methods design. A randomized-controlled trial will be conducted to compare a brief MBI (four sessions in total) group and a waiting list control group. Assessments will be made at baseline, after intervention, and at six-month follow-up. In addition, a qualitative and participatory research method called Photovoice will be employed to further understand the experiences of the participants who receive the brief MBI along their personal recovery journey. Discussion: If the study hypotheses are supported, the findings from this research project will provide empirical support for an alternative treatment. Moreover, by identifying the mechanisms of the beneficial effects of the brief MBI, the findings will highlight process variables that could be specifically targeted to make MBI treatment even more effective in this population. Trial registration: This study is registered with the Chinese Clinical Trial Registry (ChiCTR- 1900024658). Registered 20th July 2019.

• Journal Article Type: Article
• Online Publication Date: Aug 22, 2019
• Publication Date: Aug 22, 2019
• Deposit Date: Oct 30, 2022
• Publicly Available Date: Oct 31, 2022
• Journal: BMC Psychiatry
• Electronic ISSN: 1471-244X
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• DOI: https://doi.org/10.1186/s12888-019-2242-0
• Keywords: Psychiatry and Mental health
• Public URL: https://uwe-repository.worktribe.com/output/10110582
• Publisher URL: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2242-0
• Additional Information: Received: 23 July 2019; Accepted: 15 August 2019; First Online: 22 August 2019; : This proposal has been approved by Human Subjects Ethics Sub-committee of the Hong Kong Polytechnic University (Reference number: HSEARS20190327010). An information sheet and a written consent form which has been formally approved by the ethics committee will be distributed to participants when they are invited to take part in the research project. In obtaining informed consent from the participants, no undue pressure will be applied. In addition, the principal investigator will also answer any questions the potential participants may have. Participants are free to decide whether to participate in this study, and they can revoke their consent and withdraw from the study at any time during the study, without any reason. This decision will not affect their medical care, nor will it cause any unpleasant results. Participation in this study will not make excessive discomfort or other injuries. Observation of mental state and any potential of self harm behaviors will be closely taken throughout the processes of respective interventions or assessments. When necessary, participants would be advised to consult a professional.Regarding data monitoring, any information obtained in this study will remain very strictly confidential, will be known to no-one, and will be used for research purposes only. Codes, not names, are used on all test instruments to protect confidentiality. Data will be stored in encrypted file in the computer and they would be locked in cabinets for keeping participants’ confidential information.; : Not applicable.; : The authors declare that they have no competing interests.