Mindfulness Training Improves Problem-Focused Coping in Psychology and Medical Students: Results from a Randomized Controlled Trial.

Abstract: Background: Students of clinical psychology and medicine experience high levels of mental distress and low levels of life satisfaction. Using adaptive coping strategies can modify the negative effect of stressors on health. Mindfulness, it has been claimed, more adaptive coping with stress, yet few studies have investigated whether mindfulness training influences the use of coping strategies in non-clinical populations. Objectives: The aim of this study was to investigate the effect of mindfulness training on the use of engagement and disengagement coping strategies in a student population, here measured by problem-focused coping, avoidance focused coping, and the seeking of social support. We also explored whether personality (neuroticism, conscientiousness and extraversion) moderated the effects of the mindfulness intervention on coping. Method: The design was a two-centre randomized controlled trial with pre- and post-intervention data collection. The main effects of this trial with regard to mental distress, study stress, burnout, subjective well-being, and mindfulness have been reported earlier. This paper represents additional analyses of main and moderated effects of the intervention on a new set of coping variables. Two hundred and eighty-eight students of psychology and medicine were randomized to receive either a 7-week mindfulness-based stress reduction (MBSR) programme or the continued standard study curriculum. Results: Students receiving mindfulness training increased their use of problem-focused coping, as compared to the control group. In addition, students with high scores on neuroticism benefitted from the intervention in terms of reduced avoidance-focused coping and an increase in seeking social support, compared to the control group. Conclusion: Mindfulness training may help to improve adaptive coping in students, but some of these effects may be limited to students with high emotional reactivity. Introduction High workload, the pressure to perform, and the psychological challenges inherent in meeting and treating patients may contribute to the high levels of mental distress and low levels of life satisfaction reported by students of psychology and medicine [1-4]. However, there are important differences in how individuals manage stress and these can reduce or enhance its impact on their psychological health [5]. The use of avoidance or other disengagement strategies (such as wishful thinking) by students has been shown to diminish life satisfaction during medical school [3] and, in longitudinal studies, to increase postgraduate mental health problems [6]. Conversely, cross-sectional studies [7] have shown that medical students that use engagement strategies (such as problem-solving) report fewer depressive symptoms. Interventions that improve coping could therefore be of potential value to students. By analysing data from the current trial, we have shown previously that mindfulness training improves mental distress, study stress and subjective well-being among students [8]. But does mindfulness training also help to improve coping? A core purpose of mindfulness training is the cultivation of a wilful, present-oriented and non-judging quality of attention, achieved through various sitting and movement-based meditative practices [9]. Correlational studies indicate that students who practice mindfulness use more engagement and fewer disengagement coping strategies [10,11]. A non-randomized controlled intervention study of 57 students failed to demonstrate significant effects on coping, although the effect sizes were moderate [12]. To our knowledge, our study is the first to investigate the effect of mindfulness training on coping in a student sample. In addition to assessing the possible main effect of mindfulness training, it is also important to study moderators that can identify sub-groups reporting differential effects [13]. …