Impact of mindfulness training on emotion regulation in multiple sclerosis: Secondary analysis of a pilot randomized controlled trial.

The study is a small pilot, and 9 of the 61 participants had no daily diary data after training. It was far too small to test whether a person's thinking skills changed the effect of the training, and the authors say a much larger trial is needed. The mindfulness group was already using acceptance about ten points less often than the other two groups before training began. Randomisation alone did not balance the groups on this, so part of the apparent gain is likely regression to the mean, and the adjusted comparison did not reach the usual threshold for significance. Training lasted four weeks, half the dose of the standard eight-week mindfulness-based stress reduction programme, so this tells you nothing about the full-length version, and it is brief even by the standards of other short programmes. Almost everyone had relapsing-remitting MS and was still walking, and the sample was 77% female and 72% white, so it may not represent the people on your caseload. People with more disability or progressive disease were not studied. Emotion regulation was measured by what participants wrote in self-report diaries, not by observed behaviour, and the authors suggest the way emotion regulation was measured may explain why their result differed from earlier studies.

The text supplied does not include a funding statement or a conflict-of-interest declaration, so it is not possible to tell from this article who paid for the trial or whether the authors had competing interests. Participants were paid $8 per hour for the neuropsychological assessment and $10 for the daily diaries.

Do not read the greater acceptance use in the mindfulness group as proof that mindfulness training reduced emotion dysregulation. The mindfulness group was already using acceptance about ten points less often than the other two groups before training started, the comparison with the waitlist after adjusting for that difference did not reach significance (p = .055), and the three groups did not differ at all in their use of avoidance, suppression or distraction.