Mindfulness

, Volume 6, Issue 6, pp 1356–1365 | Cite as

Mindfulness-Based Stress Reduction (MBSR) Delivered Live on the Internet to Individuals Suffering from Mental Fatigue After an Acquired Brain Injury

  • Birgitta Johansson
  • Helena Bjuhr
  • Magdalena Karlsson
  • Jan-Olof Karlsson
  • Lars Rönnbäck
ORIGINAL PAPER

Abstract

An acquired brain injury often leads to long-lasting mental fatigue, which can have a considerable effect on work and social interactions. Fortunately, the Mindfulness-Based Stress Reduction (MBSR) program has been found to alleviate mental fatigue. The purpose of this feasibility study was to evaluate the success of an interactive MBSR program delivered live online to individuals who have experienced a traumatic brain injury or stroke. We included the following three groups in our study: an Internet group, a face-to-face MBSR group, and an active control group who took weekly walks in natural environments. Thirty-four participants completed the study, and all were suffering from long-lasting mental fatigue after either a traumatic brain injury (16 participants) or a stroke (18 participants). However, seven did not accept to attend an Internet MBSR, and Internet was the only choice for others. We found that, according to the Mental Fatigue Scale (MFS), the program leads to significantly reduced mental fatigue in the Internet group compared with the face-to-face and the control group. Individuals in the MBSR groups also exhibited an improved ability to process two temporally close targets (attentional blink task), while this was not detected in the control group. In conclusion, we believe that it is possible for individuals suffering from mental fatigue after an acquired brain injury to obtain positive results through enrollment in a live, interactive, online MBSR program. This is promising, as the Internet is accessible to many individuals, irrespective of where they live. Further randomized control studies comparing are warranted.

Keywords

Mindfulness Internet Mental fatigue Attention TBI Stroke 

References

  1. Belmont, A., Agar, N., Hugeron, C., Gallais, B., & Azouvi, P. (2006). Fatigue and traumatic brain injury. Annales de Réadaptation et de Médecine Physique, 49, 283–288.CrossRefPubMedGoogle Scholar
  2. Boettcher, J., Åström, V., Påhlsson, D., Schenström, O., Andersson, G., & Carlbring, P. (2014). Internet-based mindfulness treatment for anxiety disorders: a randomized controlled trial. Behavior Theraphy, 45, 241–253.CrossRefGoogle Scholar
  3. Bushnik, T., Englander, J., & Wright, J. (2008). Patterns of fatigue and its correlates over the first 2 years after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 23(1), 25–32.CrossRefPubMedGoogle Scholar
  4. Carlson, L. E., & Garland, S. N. (2005). Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients. International Journal of Behavioral Medicine, 12(4), 278–285.CrossRefPubMedGoogle Scholar
  5. Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23–33.CrossRefPubMedGoogle Scholar
  6. Davidson, R. J., Kabat-Zinn, J., Schmacher, J., Rosenkranz, M., Muller, D., Santorelli, S., & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.CrossRefPubMedGoogle Scholar
  7. Detry, M. A., & Lewis, R. J. (2014). The intention-to-treat principle. How to assess the true effect of choosing a medical treatment. The Journal of the American Medical Association, 312(1), 85–86.CrossRefPubMedGoogle Scholar
  8. Dux, P. E., & Marois, R. (2009). The attentional blink: a review of data and theory. Attention, Perception, & Psychophysics, 71(8), 1683–1700.CrossRefGoogle Scholar
  9. Glück, T. M., & Maercker, A. (2011). A randomized controlled pilot study of a brief web-based mindfulness training. BioMedCentral Psychiatry, 11(175), 1–12. doi:10.1186/1471-244X-11-175.Google Scholar
  10. Hansson, E., & Rönnbäck, L. (2004). Altered neuronal-glial signaling in glutamatergic transmission as a unifying mechanism in chronic pain and mental fatigue. Neurochemical Research, 29, 989–996.CrossRefPubMedGoogle Scholar
  11. Johansson, B., & Rönnbäck, L. (2012). Mental Fatigue and Cognitive Impairment after an Almost Neurological Recovered Stroke. International Scholarly Research Network Psychiatry, 2012(Article ID 686425), 7 pages. doi: 10.5402/2012/686425
  12. Johansson, B., & Rönnbäck, L. (2014a). Evaluation of the mental fatigue scale and its relation to cognitive and emotional functioning after traumatic brain injury or stroke. International Journal of Physical Medicine & Rehabilitation, 2, 182. doi:10.4172/2329-9096.1000182.Google Scholar
  13. Johansson, B., & Rönnbäck, L. (2014b). Long-lasting mental fatigue after traumatic brain injury – a major problem most often neglected diagnostic criteria, assessment, relation to emotional and cognitive problems, cellular background, and aspects on treatment. In F. Sadaka (Ed.), Traumatic brain injur. Rijeka, Croatia: INTECH.Google Scholar
  14. Johansson, B., Berglund, P., & Rönnbäck, L. (2009). Mental fatigue and impaired information processing after mild and moderate traumatic brain injury. Brain Injury, 23(13–14), 1027–1040.CrossRefPubMedGoogle Scholar
  15. Johansson, B., Starmark, A., Berglund, P., Rödholm, M., & Rönnbäck, L. (2010). A self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries. Brain Injury, 24(1), 2–12.CrossRefPubMedGoogle Scholar
  16. Johansson, B., Bjuhr, H., & Rönnbäck, L. (2012). Mindfulness based stress reduction improves long-term mental fatigue after stroke or traumatic brain injury. Brain Injury, 26(13–14), 1621–1628.CrossRefPubMedGoogle Scholar
  17. Kabat-Zinn, J. (2001). Full Full catastrophe living: How to cope with stress, pain and illness using mindfulness meditation. London, 15th ed.: Piatkus Books.Google Scholar
  18. Kilpatrick, L. A., Suyenobu, B. Y., Smith, S. R., Bueller, J. A., Goodman, T., Creswell, J. D., & Naliboff, B. D. (2011). Impact of mindfulness-based stress reduction training on intrinsic brain connectivity. NeuroImage, 1(56), 290–298.CrossRefGoogle Scholar
  19. Kohl, A. D., Wylie, G. R., Genova, H. M., Hillary, F., & Deluca, J. (2009). The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI. Brain Injury, 23(5), 420–432.CrossRefPubMedGoogle Scholar
  20. Kornfield, J., & Goldstein, J. (2014). What makes us free? Shambhala Sun, 36-42.Google Scholar
  21. Krusche, A., Cyhlarova, E., King, S., & Williams, J. M. G. (2012). Mindfulness online: a preliminary evaluation of the feasibility of a web-based mindfulness course and the impact on stress. BioMedJournal Open. doi:10.1136/bmjopen-2011-000803.Google Scholar
  22. Lindqvist, G., & Malmgren, H. (1993). Organic mental disorders as hypothetical pathogenetic processes. Acta Psychiatrica Scandinavica, 88(suppl 373), 5–17.CrossRefGoogle Scholar
  23. Ljótsson, B., Falk, L., Wibron Vesterlund, A., Hedman, E., Lindfors, P., Rück, C., & Andersson, G. (2010). Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome—a randomized controlled trial. Behaviour Research and Therapy, 48(6), 531–539.CrossRefPubMedGoogle Scholar
  24. Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Sciences, 12(4), 163–169.PubMedCentralCrossRefPubMedGoogle Scholar
  25. McCown, D., Reibel, D., & Micozzi, M. S. (2011). Teaching mindfulness. A practical guide for clinicians and educators. New York: Springer.Google Scholar
  26. Montgomery, S. A., & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefPubMedGoogle Scholar
  27. Morledge, T. J., Allexandre, D., Fox, E., Fu, A. Z., Higashi, M. K., Kruzikas, D. T., & Reese, P. R. (2013). Feasibility of an online mindfulness program for stress management—a randomized controlled trial. Annals of Behavioral Medicine. doi:10.1007/s12160-013-9490-x.PubMedCentralPubMedGoogle Scholar
  28. Neff, K. D. (2003). The development and validation of scale to measure self-compassion. Self and Identity, 2, 223–250.CrossRefGoogle Scholar
  29. Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and factorial validation of a short form of the self-compassion scale. Clinical Psychology & Psychotherapy, 18(3), 250–255.CrossRefGoogle Scholar
  30. Reitan, R. M., & Wolfson, D. (1999). The two faces of mild head injury. Archives of Clinical Neuropsychology, 14(2), 191–202.CrossRefPubMedGoogle Scholar
  31. Rödholm, M., Starmark, J.-E., Svensson, E., & von Essen, C. (2001). Asteno-emotional disorder after aneurysmal SAH: reliability, symptomatology and relation to outcome. Acta Neurologica Scandinavica, 103, 379–385.CrossRefPubMedGoogle Scholar
  32. Ronnback, L., & Hansson, E. (2004). On the potential role of glutamate transport in mental fatigue. Journal of Neuroinflammation, 1, 22.PubMedCentralCrossRefPubMedGoogle Scholar
  33. Rönnbäck, L., & Johansson, B. (2012). Long-lasting mental fatigue after traumatic brain injury or stroke – e new perspective. Saarbrucken: LAP Lambert Academic Publishing.Google Scholar
  34. Slagter, H. A., Lutz, A., Greischar, L. L., Francis, A. D., Nieuwenhuis, S., Davis, J. M., & Davidson, R. J. (2007). Mental training affects distribution of limited brain resources. Public Library of Science (PLOS) Biology, 5(6), e138. doi:10.1371/journal.pbio.0050138.
  35. Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Cooper, H., Strauman, T. A., Welsh-Bohmer, K., & Sherwood, A. (2010). Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosomatic Medicine, 72(3), 239–252.PubMedCentralCrossRefPubMedGoogle Scholar
  36. Snaith, R. P., Harrop, F. M., Newby, D. A., & Teale, C. (1986). Grade scores of the montgomery-asberg depression and the clinical anxiety scales. British Journal of Psychiatry, 148, 599–601.CrossRefPubMedGoogle Scholar
  37. Staub, F., & Bogousslavsky, J. (2001). Fatigue after stroke: a major but neglected issue. Cerebrovascular Diseases, 12, 75–81.CrossRefPubMedGoogle Scholar
  38. Surawy, C., Roberts, J., & Silver, A. (2005). The effect of mindfulness training on mood and measures of fatigue, activity, and quality of life in patients with chronic fatigue syndrome on a hospital waiting list: a series of exploratory studies. Behavioural and Cognitive Psychotherapy, 33(01), 103–109.CrossRefGoogle Scholar
  39. Svanborg, P., & Åsberg, M. (1994). A new self-rating scale for depression and anxiety states based on the comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica, 89(1), 21–28.CrossRefPubMedGoogle Scholar
  40. Wechsler, D. (2003). Wechsler Adult Intelligence Scale—third edition, WAIS-III, Swedish version: Pearson Assessment. Stockholm: Pearson Education Ltd.Google Scholar
  41. Winward, C., Sackley, C., Metha, Z., & Rothwell, P. M. (2009). A population-based study of the prevalence of fatigue after transient ischemic attack and minor stroke. Stroke, 40, 757–761.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Birgitta Johansson
    • 1
  • Helena Bjuhr
    • 1
  • Magdalena Karlsson
    • 1
  • Jan-Olof Karlsson
    • 2
  • Lars Rönnbäck
    • 1
  1. 1.Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  2. 2.Department of Economics and InformaticsUniversity WestTrollhättanSweden

Personalised recommendations