The impact of mindfulness practice on cognition and affective change in psychosis: a multiple baseline design

摘要

This thesis addresses understanding the underlying change that occurs in mindfulness practice.The first paper reviews the literature regarding the processes of change implicated in mindfulness. The paper reviews the literature regarding definition and conceptualisation of mindfulness and the literature regarding therapeutic interventions and applications of mindfulness. The paper then considers in detail literature regarding the proposed processes operating in mindfulness, looking in particular at: cognitive change, exposure, acceptance, attentional control and non-attachment. The review concludes by drawing together the research and discussing the difficulties faced by this developing literature base.The second paper reports the findings of a study looking at the impact of mindfulness practice on cognitive and affective change for individuals with distressing psychosis. A multiple-baseline design assessing changes to twice weekly ratings of: distress, believability, metacognitive belief, personal control, voices control, acceptance of self, and acceptance of voices during baseline and completion of a mindfulness intervention. Visual analyses indicated no clear discernable changes across participants but individual benefits and patterns of cognitive and affective change indicated for each participant are reported. The mediating effect of practice is also highlighted and consideration is given to limitations, future research, and implications for clinicalpractice.