Cognitive and Emotion Regulation Training in MS
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      The investigators propose to conduct a randomized feasibility study of mindfulness meditation
      training (MMT) relative to an active cognitive training control group and waitlist control
      group in improving emotional regulation in individuals with MS. Individuals will complete
      pre- and post-assessments of emotional functioning through a week of daily diary entries, as
      well as self-report measures and a behavioral paradigm. Additionally, all participants will
      complete an evaluation of neuropsychological functioning, before and after intervention.
    

Detailed description: 
      Epidemiological data provides evidence for the manifold increase in rates of depression and
      anxiety in individuals diagnosed with multiple sclerosis, relative to the general population.
      Such impaired affective processes, including deficits in emotion regulation have been linked
      to greater cognitive deficits, a lower quality of life, and greater disease progression in
      this population. Despite evidence of the deleterious impact of affective functioning on
      prevalence rates of mood and anxiety disorders; on poor cognitive functioning; and reduced
      quality of life, much of the targeted intervention research in MS has not directly tested the
      feasibility, and subsequent efficacy of a psychosocial intervention in improving affective
      regulation in this population. Thus, the investigators propose to conduct a randomized
      feasibility study of mindfulness training relative to an active cognitive training control
      group and waitlist control group in improving emotional regulation in individuals with MS.
      All individuals that contact the Clinical Neuroscience Laboratory (CNLab) with interest in
      this study will undergo a phone screening assessing inclusion/exclusion criteria. Those
      participants meeting I/E criteria will be invited for an online daily diaries portion of the
      study examining daily engagement in worry and rumination. After completing the week-long
      daily diary portion of the study, the participant will attend 1-2 in-person pre-assessment
      sessions, which will also be completed at the completion of the four week intervention. The
      pre-assessment will involve a thorough assessment of emotion regulation skills, both through
      self-report questionnaires and behavioral paradigms, and cognitive functioning. Following the
      assessment sessions, which will be conducted by blind assessors, participants will be
      randomized to the three groups. The 4-week mindfulness program will be closely modeled after
      the protocol developed by Dr. Jon Kabat-Zinn, where investigators will have the participants
      attend once-per-week sessions for 2 hours and complete around 40 minutes a day of homework
      assignments. The four weeks of mindfulness involve the practice of concentrative attention,
      where different objects are used as the focus of practices. For example, for the first two
      weeks, the investigators use breath as an anchor for the mind. With repeated practices, the
      objects of sensations, emotions, and thought processes are introduced. The classes are a
      mixture of experiential practices, discussions surrounding the experiences, and didactics on
      mindfulness. The control group, which will be used to compare the effects of mindfulness
      training on emotional and cognitive functioning of MS patients, will comprise of a cognitive
      training group, which will provide an attentional-training based approach. In this group, our
      focus will be to provide the individuals with cognitive training tasks to complete that have
      been shown to improve attentional ability. Homework will be reading and practicing using the
      cognitive video game exercises for the same duration, around 40 minutes daily, as the
      mindfulness group. Following the four weeks of the intervention, the questionnaires,
      week-long daily diaries, and behavioral tests from the pretest will be repeated a second time
      to obtain post-test data for comparison.
    

Intervention name(s): Mindfulness Meditation; Computerized Cognitive Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The mindfulness meditation-training program is closely modeled after the 8-week mindfulness based stress reduction protocol developed by Dr. Jon Kabat-Zinn. The briefer four weeks of MMT involve the practice of concentrative attention, where different objects are used as the focus of meditative practices. For example, for the first two weeks, the investigators use breath as an anchor for attention. With repeated practices, the objects of sensations, emotions, and thought processes are introduced.; The control group, which will be used to compare the effects of mindfulness training on emotional and cognitive functioning of MS patients, will comprise of a cognitive training group, which will provide an attentional-training based approach. In this group, the focus will be to provide the individuals with cognitive training tasks to complete that have been shown to improve attentional ability. The investigators will also discuss relevant MS-related material on cognitive deficits during these courses.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment