外来患者に対する禅的瞑想プログラムの効果に関する実験的検討  [in Japanese] The Effect of Stress Reduction of Zen Meditation Program on Outpatients  [in Japanese]

目的: 外来患者に対して,簡便で手軽なマインドフルネスに基づくストレスリダクションプログラムの効果を検討することを目的とした.方法: 外来患者8名を対象に,1カ月間,自宅での瞑想訓練の実施と,毎回の練習前後の気分状態と,ベースラインから3カ月後フォローアップまでの6段階における特性指標(心身の健康度,認知的スキル,認知スタイル,スピリチュァルな精神的態度)の測定を行った.結果と考察: 瞑想訓練による気分への即時的改善効果は認められなかった.特性指標の変化として,心配に関するネガティブな信念といったメタ認知的信念の改善が認められた.また,これらの効果の媒介要因である破局的思考を緩和させる認知的スキルの向上と,自動的処理思考が減少した.さらに訓練を十分に行えた患者のほうが,認知的スキルの獲得が促進された.本プログラムが医療現場における日常臨床を補完する可能性が示唆された.

Objectives: The purpose of this study is to examine the effectiveness of the simple and easy program based on mindfulness or Zen meditation we developed on stress reduction for outpatients. Method: Eight voluntary outpatients who satisfied the initial screening criteria were recruited for this study. They underwent mindfulness training for one month, and answered a questionnaire measuring their mood right before and after each practice and other questionnaires measuring one's trait such as general health, cognitive skills, cognitive styles, the spiritual attitude in life at 6 stages, from baseline to 3 month follow-up (3 mFU). Results: This program had little immediate effect on reducing anxious and depressed mood state. As for effects on trait indices, the program improved negative belief on worry. As a mediator of this result, cognitive skills which mitigate a catastrophizing thought and Affect-related Automatic Thought improved. Also, patients who did appropriate and enough practices improved cognitive skills such as cognitive control and Affect-related Automatic Thought compared with patients with inadequate practice. Conclusion: Although the program has little immediate effect on improving negative mood, it has consistent effect on cultivating cognitive skills and style. The result suggests the MT might be compliment to the daily practice of psychotherapy.