Compassion Meditation for Older Adults

Not Applicable

Completed

Interventions: Other: Healthy Aging Psychoeducation
Behavioral: Compassion Meditation (CM) intervention

Brief Summary: Some older Veterans with psychological distress may under-utilize mental health services due to perceived stigma of symptom-focused interventions. This study was designed to examine the feasibility of a strengths-based compassion training intervention with Veterans ages \> 55 years with anxiety or depressive symptoms. Although this study was focused on feasibility if successful, this line of research could open the door to a novel and effective treatment that widens acceptance by older Veterans with psychological distress.

Detailed Description: Many older Veterans in VA primary care clinics experience anxiety and depressive symptoms, but only a minority of these Veterans seek care through VA mental health services. Research suggests that some older Veterans with psychological distress under-utilize mental health services due to perceived stigma of treatments focused on mental health symptoms. However, prior research with civilians, including one study of Veterans with PTSD, suggests a strengths-focused intervention that provides group training in compassion meditation may be effective in reducing negative emotions and increasing positive emotions and well-being. This project was designed to examine the feasibility of this approach with Veterans ages \> 55 years with anxiety or depression. The study was designed to guide and support development of a future larger-size, more definitive follow-up project. . If successful, this line of research could open the door to a novel and effective treatment that widens acceptance by older Veterans with psychological distress.

Recruitment & Eligibility

Inclusion Criteria

VA San Diego Healthcare System (VASDHS) patient
current mild-to-moderate anxiety or depressive symptoms as defined by scores between 5 and 14 on the Patient Health Questionnaire (PHQ-9) and or Generalized Anxiety Disorders scale (GAD-7).
stated intention to attend the 10 group sessions at the scheduled times at the VASDHS in addition to the baseline and follow-up study assessment visits, as well as to complete the outside homework assignments
provides written informed consent for participation

Exclusion Criteria

no active suicidality/homicidality in the preceding six months
untreated alcohol or substance use disorders
changes to psychiatric medications within six months prior to the baseline evaluation
medical and/or psychiatric instability interfering with current ability to engage in the group sessions and outside homework assignments

Arm && Interventions

Group	Intervention	Description
Psychoeducational healthy aging group	Healthy Aging Psychoeducation	10-week group focused on review and discussion of psychoeducational videos related to healthy aging topics
Compassion Meditation (CM) intervention group	Compassion Meditation (CM) intervention	10-week group intervention consisting of compassion meditation training.

Primary Outcome Measures

Name	Time	Method
Completion Rate	12 weeks	The proportion of subjects who complete 6 or more sessions (out of a total of 10 sessions) of intervention among those who start the intervention.
Enrollment Rate	36 months	The proportion of consented subjects among all screened and eligible patients.
Initiation Rate	4 months	The proportion of subjects who initiate the intervention among all consented subjects.
Practice Time at Home	12 weeks	Unanticipated COVID-related restrictions necessitated changing certain outcome measures. Data was not collected for this measure

Secondary Outcome Measures

Name	Time	Method
Change in Social Connection (SCS-R) From Baseline to Post-intervention	Baseline and 14 weeks	Social Connectedness Scale (SCS-R), 20-items scores, possible range = 20 to 120, higher scores reflect more connectedness
Change in Depression and Anxiety From Baseline to Post-intervention	Baseline and 14 weeks	Brief Symptom Inventory-18 (BSI; depression, anxiety, and somatization) Global Severity Index (GSI). Each of the 18 items range from a score of 0-4; total score ranges from 0-72 with higher scores indicating worse function.
Mean (and SD) Change Scores for Each Inflammatory Biomarker (Hs-CRP, IL-6, and TNF- )	14 weeks	The investigators will also examine the mean (and SD) change scores for each inflammatory biomarker (hs-CRP, IL-6, and TNF- ), as well as the association of these changes with practice time.
Satisfaction With Life (SWLS) From Baseline to Post-intervention	Baseline and 14 weeks	Satisfaction With Life Scale (SWLS); 5-items, range 5 to 35, higher scores represent greater satisfaction
Change in Positive Emotions (mDES) From Baseline to Post-intervention	Baseline and 14 weeks	10-item positive emotions subscale of the 20-item modified Differential Emotions Scale (mDES); scores on this subscale have a potential range of 0 to 40 with higher scores reflecting more positive emotions.