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Clinical Gerontologist

ISSN: 0731-7115 (Print) 1545-2301 (Online) Journal homepage: http://www.tandfonline.com/loi/wcli20

The Effects of Mindfulness and Self-Compassionon Improving the Capacity to Adapt to StressSituations in Elderly People Living in theCommunity

Josefa Perez-Blasco PhD, Alicia Sales PhD, Juan C Meléndez PhD & TeresaMayordomo PhD

To cite this article: Josefa Perez-Blasco PhD, Alicia Sales PhD, Juan C Meléndez PhD & TeresaMayordomo PhD (2016) The Effects of Mindfulness and Self-Compassion on Improving theCapacity to Adapt to Stress Situations in Elderly People Living in the Community, ClinicalGerontologist, 39:2, 90-103, DOI: 10.1080/07317115.2015.1120253

To link to this article: http://dx.doi.org/10.1080/07317115.2015.1120253

Accepted author version posted online: 16Dec 2015.Published online: 16 Dec 2015.

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ARTICLES

The Effects of Mindfulness and Self-Compassion onImproving the Capacity to Adapt to Stress Situations inElderly People Living in the CommunityJosefa Perez-Blasco, PhD, Alicia Sales, PhD , Juan C Meléndez, PhD ,and Teresa Mayordomo, PhD

University of Valencia, Valencia, Spain

ABSTRACTObjectives: This study aimed to show the effectiveness of mind-fulness and self-compassion therapy in improving coping abilityand adaptation to stressful situations in the elderly.Methods: Forty-five elderly non-institutionalized adults were ran-domized to either treatment or a treatment waiting list. A pre-and post-treatment assessment was performed, consisting of theBrief Resilient Coping Scale (BRCS), Depression Anxiety StressScales (DASS), and Coping Strategies Questionnaire. The programwas developed over 10 sessions lasting 120 minutes each.Results: Analysis of variance for repeated measures showed sig-nificant differences in the time-group interaction for the treat-ment’s effectiveness in improving resilience, positive reappraisaland avoidance strategies, and decreasing anxiety, problem-solvingcoping, negative self-focus, overt emotional expression andreligion.Conclusions: The mindfulness and self-compassion program isuseful for improving resilience and coping strategies and reducinganxiety and stress levels in the elderly.

KEYWORDSAnxiety; coping;mindfulness; resilience; self-compassion

Introduction

Interest in mindfulness and its enhancement has increased in recent years.Derived from ancient Buddhist and Yoga practices, the term mindfulness maybe used to describe a psychological trait, a practice for cultivating mindfulness(e.g., mindfulness meditation), a mode or state of awareness, or a psychologicalprocess. Mindfulness refers to a process that leads to a mental state character-ized by non-judgmental awareness of the present moment experience, includ-ing one’s sensations, thoughts, bodily states, consciousness, and theenvironment, while encouraging openness, curiosity, and acceptance (Bishopet al., 2004). Mindfulness has been broadly conceptualized as a state in whichone is highly aware and focused on the reality of the present moment,accepting and acknowledging it, without getting caught up in thoughts aboutthe situation or emotional reactions to it (Kabat-Zinn, 1990).

CONTACT Alicia Sales alicia.sales@uv.es Department of Developmental Psychology, University of Valencia,Valencia, Spain.

CLINICAL GERONTOLOGIST2016, VOL. 39, NO. 2, 90–103http://dx.doi.org/10.1080/07317115.2015.1120253

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In relation to this concept, compassion involves sensitivity to the experi-ence of suffering, coupled with a deep desire to alleviate that suffering(Goetz, Keltner, & Simon-Thomas, 2010). Neff (2003a) operationalized self-compassion as consisting of three main elements: kindness, commonhumanity, and mindfulness. These components combine and mutuallyinteract to create a self-compassionate frame of mind. Currently, there areprograms for increasing self-compassion whose benefits are being testedexperimentally. Gilbert and Procter (2006) developed a group-based therapyintervention for clinical populations called Compassionate Mind Training(CMT). CMT is designed to help people develop self-compassion skills,especially when their usual way of relating to themselves involves self-attack. Germer and Neff (2013) developed a training program calledMindful Self-Compassion (MSC), designed to teach self-compassion skillsto the general population. Experimental studies that include training inmindfulness and self-compassion for mental health have shown positiveresults (Phillips & Ferguson, 2013)

Mindfulness-based interventions have brought about a revolution in thehealth sciences field in recent years, and their efficacy has been shown innumerous clinical and non-clinical contexts (see meta-analysis by Eberth &Sedlmeier, 2012; Visted, Vøllestad, Nielsen, & Nielsen, 2015).

One demonstrated effect of this type of therapy is increased coping abilityand adaptation to stressful situations (Weinstein, Brown, & Ryan, 2009).Specifically, a person is more likely to face a situation adaptively if he/sheis able to consciously observe the situation and objectively note the internalaspects, thoughts and emotions taking place, instead of focusing on negativethought patterns or distorted past- or future-oriented thoughts (McCullough,Orsulak, Brandon, & Akers, 2007).

Approach coping is generally considered adaptive because an effort ismade to resolve stressful situations or to overcome the stress associatedwith them. Coping based on the Lazarus and Folkman (1984) paradigm isconceptualized as having two dimensions, problem-focused versus emotion-focused coping. The objective of problem-focused coping is to manage orchange the problem that causes the disturbance. Emotion-focused copingmethods regulate the person’s emotional response to the problem. Resilienceis inextricably linked to coping, as it is an outcome of good adaptation tostressful situations. Masten (2001) described it as “a class of phenomenacharacterized by good outcomes in spite of threats to adaptation or develop-ment” (p. 228). Resilience is a positive and adaptive approach to stress.

Throughout life, people have to address various adverse situations andadapt to numerous changes that affect their daily lives. However, elderlyadults experience an age-associated loss of resources, both material andpersonal, that can hinder their ability to adjust to unfortunate situations(loss of loved ones, increased dependency, etc.). Given that the basis for

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successful aging is the ability to adapt and adjust to changes, training inmindfulness and self-compassion creates an emotionally positive self-attitudethat can protect against the negative consequences of self-judgment, isola-tion, and rumination (Neff, 2003b). It is a good tool for working with peoplewho face aging (Neff & Germer, 2013), as it produces benefits in mentalhealth and coping in the presence of stressful events in old age (Allen &Leary, 2014). Furthermore, with a Mindfulness program, people can learn toresolve life’s challenges through methods that are not based on rationality(Kabat-Zinn, 2014).

Studies with older people have found benefits in both physical and physio-logical aspects, such as brain aging (Epel, Daubenmier, Moskowitz, Folkman,& Blackburn, 2009) and chronic pain (Morone, Lynch, Greco, Tindle, &Weiner, 2008); cognitive processes such as attention (McHugh, Simpson, &Reed, 2010), flexibility (Moore & Malinowski, 2009), visuo-spatial processing,working memory and executive functioning (Zeidan, Johnson, Diamond,David, & Goolkasian, 2010); and emotional aspects, such as emotional distress(de Frias & Whyne, 2015; Young & Baime, 2010), levels of depression (Smith,Graham, & Senthinathan, 2007) and anxiety (Manouchehri et al., 2014). Ingeneral, the practice of mindfulness has been found to regulate emotion, evenimproving the self-perception of aging (Turner, 2009) and effective copingwith stressful aging events (Allen & Leary, 2014). However, to date, few studieshave focused on analyzing the effectiveness of mindfulness in healthy olderpeople with variables such as resilience and coping.

Given the number of changes and losses that occur during the normal agingprocess, it is important to develop a type of intervention that can help thesepeople to gain optimal strategies to better adapt to the environment and thesechanges. In addition, given the concept of successful aging, where the seniorcontinues to live an active life despite the typical decline related to aging, suchinterventions in older people are of great interest. If older people develop,maintain and/or enhance their capabilities, they can improve their health and,therefore, their quality of life. These results can be of interest to the literatureand in clinical practice with older adults to improve their quality of life.

In sum, this study evaluates the effectiveness of a mindfulness and self-compassion program with a sample of older people in improving resiliencelevels and reducing the levels of stress, anxiety and depression associatedwith aging, and it explores whether changes occur in coping strategies.

Method

Participants

The initial sample was composed of 45 elderly adults living in a community.The sample was recruited for participation in a mindfulness program offered

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by a senior program at the University of Valencia. This program aims to be alink between society and the university, promoting and conducting activitiesfor the diffusion and dissemination of knowledge, science and culture. Toparticipate, inclusion criteria required that participants had to be 60 years oldor more, could not be under institutional care, and could not have anycognitive impairment that interfered with their daily activities. The partici-pants, who met all the criteria, gave their informed consent to take part in thestudy. They were evaluated individually before being assigned to groups.After this first evaluation, all the participants were randomly assigned toeither the intervention group (N = 22) or the control group (N = 23). Torandomize the groups, a spreadsheet was used where the participants’ codeswere introduced. The program offered an output file with the participantswho would receive the treatment. The other participants became the controlgroup and continued with their usual care. The participants did not knowwhich group they belonged to until the second data collection was com-pleted. Members of the control group were on a waiting list for treatment.Members of the treatment group had to attend at least 90% of the sessions.For health reasons, two participants did not have 90% attendance and wereexcluded from the analyses, leaving a final sample size of 43 participants(N = 20 in the intervention group, and N = 23 in the control group).Following the intervention, post treatment measures were taken in bothgroups. The average age of the group was 63.56 years (SD = 4.1). As forgender, 32.6% were male and 67.4% female. Regarding marital status, 34.9%were married, 14.3% were single, and 19% were widows or widowers. Interms of educational level, 34.9% had only completed elementary education,25.6% had completed secondary education, and 39.5% had higher education.An analysis of the homogeneity of these variables revealed no significantdifferences (see the Results).

Instruments

In addition to collecting socio-demographic data, various tests and scaleswere administered to obtain pre- and post-intervention measures.

The Brief Resilient Coping Scale (BRCS; Sinclair & Wallston, 2004) hasbeen validated in the Spanish elderly population (Tomás, Meléndez, Sancho,& Mayordomo, 2012). The BRCS is a brief 4-item scale designed to assess thetendency to cope with stress in a highly adaptive manner. The scale hasdemonstrated adequate levels of reliability and validity and shows one copingfactor that emerges from the four indicators (Sinclair & Wallston, 2004);reliability obtained by Cronbach’s alpha was .83.

The Depression Anxiety Stress Scales (DASS; Lovibond & Lovibond, 1995)is a 42-item questionnaire that includes three self-report scales. This test isdesigned to measure the negative emotional states of depression, anxiety and

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stress. Each of the three scales contains 14 items. The depression scaleassesses dysphoria, hopelessness, devaluation of life, self-deprecation, lackof interest/involvement, anhedonia and inertia; the Anxiety scale assessesautonomic arousal, skeletal muscle effects, situational anxiety, and the sub-jective experience of anxious affect; the Stress scale is sensitive to levels ofchronic non-specific arousal, and assesses difficulty in relaxing, nervousarousal, and being easily upset/agitated, irritable/over-reactive and impatient.Each item is scored from 0 to 3, according to the degree to which subjectshave experienced each state during the past week (0 = nothing, 3 = veryapplicable). Reliability obtained by Cronbach’s alpha was .96 for depression,.86 for anxiety, and .93 for stress.

The Coping Strategies Questionnaire is a 42-item self-report measuredesigned to assess seven basic coping styles: (1) problem-solving coping,(2) negative self-focused coping, (3) positive reappraisal, (4) overt emo-tional expression, (5) avoidance, (6) seeking social support, and (7) reli-gious coping. The questionnaire was developed and validated by Sandínand Chorot (2003), and its factor structure has been confirmed in anelderly population with satisfactory reliability (Tomás, Sancho, &Meléndez, 2013). The CAE is based on the classic distinction betweenproblem-focused and emotion-focused coping (Lazarus & Folkman, 1984),and confirmatory factor analysis was conducted on the seven copingdimensions to test a two-factor solution of problem- and emotion-focusedcoping (Tomás et al., 2013). Reliability obtained by Cronbach’s alpha forthe dimensions was: problem-solving coping .88; negative self-focused .65;positive reappraisal .65; overt emotional expression, .76; avoidance .64;seeking social support .92; religious .82.

Procedure

The mindfulness training program applied integrates practical and theoreti-cal elements of the following models: Kabat Zinn’s Mindfulness-BasedCognitive Therapy, Salzberg (2010) and the Mindful Self-compassionProgram by Neff (2011). Based on these studies, sessions are held in agroup format, due to the advantages of this type of intervention format.The intervention was carried out for 10 consecutive weeks, with one two-hour session held each week. Each session combined theoretical explanationsand practical exercises, and ended with proposals for daily tasks to be carriedout during that week. These tasks included formal practice—different formsof meditation—and informal practice—daily mindful activities, such asbringing one’s attention to what was being done and what was occurringin the present moment with openness, curiosity, acceptance, and friendliness.We also handed out recordings to enable guided meditations. The differenttopics addressed are:

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(1) Living under automatic pilot versus living with mindfulness: sittingmeditation, eating mindfully, mindful activity;

(2) Breathing as an anchor for living in the present: breathing medita-tion, eating mindfully, mindful activity, 3-minute breathing;

(3) Body sensation awareness: body scan meditation, mindful activity,3-minute breathing;

(4) Sensorial awareness: sound landscape meditation, mindful activityrelated to sounds, 3-minute breathing;

(5) Thinking awareness: mental landscape meditation, mindful pleasantactivity, 3-minute breathing in pleasant moments;

(6) Emotion awareness: meditations: labelling emotions and payingattention to emotions through body sensations, 3-minute breathingand emotions, mindful activity;

(7) Exploring difficult moments: meditation with difficult emotions,3-minute breathing in unpleasant moments, mindful activity;

(8) Unconditional love versus praiseworthy self-esteem: metta meditation(3-minute pause with metta), mindful self-care activity (3-minutepause with metta);

(9) Compassion and forgiveness: Compassion meditations, forgivenessmeditation, 3-minute pause with compassion during difficultmoments, mindful self-care activity.

(10) How to maintain and secure mindful practice: Mountain meditation,Lake meditation.

Data analysis

We performed t-tests for independent samples, chi-squared tests andMann-Whitney U-tests to determine whether the groups were homoge-nous prior to treatment. To analyze the intervention’s effects, repeatedmeasures analyses of variance were conducted. Simple effects and interac-tion effects (group X time) were examined. The level of statistical signifi-cance employed was p < .05; for the interpretation of eta squared, scoresequal to or greater than .50 are considered moderate, and .80 is consideredlarge (Cohen, 1992). All analyses were carried out using the SPSS 19statistical package.

Results

First, tests for homogeneity revealed no significant differences betweengroups at pre-treatment: age (62.06 vs. 64.60; t(37) = 1.99, n.s.), gender (χ2

(1) = .94, n.s.), marital status (Mann-Whitney z = .516, n.s.), educational level(Mann-Whitney z = .72, p = n.s.).

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The resilience (BRCS results) time-group interaction was found to have asignificant effect (F1,35 = 5.35, p = .027, η2 = .133). The groups showed nosignificant differences at pre-treatment, but the treatment group’s scoresincreased significantly between pre-treatment and post-treatment(F1,35 = 10.92, p = .002, η2 = .239). Means and standard deviations of thevariables with significant interactions are presented in Table 1.

Next, we studied the effect of the intervention on the depression, anxietyand stress (DASS) dimensions, and simple effects analysis revealed no sig-nificant differences between pre-treatment measures. Dimensions showedonly time-group interaction effects on anxiety (F1,35 = 8.99, p = .005,η2 = .204), as a significant reduction was observed in the treatment group’sscores between the two measurement points (F1,35 = 15.14, p < .001,η2 = .302). The effect of the interaction on stress was marginally significant(F1,35 = 3.30, p = .078, η2 = .086), and a significant decrease was observed inthe treatment group (F1,35 = 4.19, p = .048, η2 = .107).

Finally, with regard to the coping dimensions, simple effects analysisrevealed no differences at pre-treatment, except on positive reappraisal(p = .001). The coping dimensions showed significant effects on the groupX time interaction strategies: problem-solving coping (F1,35 = 23.25,p < .001, η2 = .392), positive reappraisal (F1,35 = 7.99, p = .008, η2 = .186),negative self-focused coping (F1,35 = 19.65, p < .001, η2 = .360), overtemotional expression (F1,35 = 29.63, p < .001, η2 = .458), avoidance(F1,35 = 5.47, p = .025, η2 = .135) and religion (F1,35 = 37.125, p < .001,η2 = .515) (Table 1). Seeking social support showed no significant interaction.Regarding simple effects, analysis of the groups over time indicated a sig-nificant decrease in the scores of the treatment group on problem-solvingcoping (F1,35 = 32.64, p < .001, η2 = .476), negative self-focused coping(F1,35 = 33.58, p < .001, η2 = .490), overt emotional expression(F1,35 = 55.68, p < .001, η2 = .614) and religion (F1,35 = 68.99, p < .001,η2 = .663), and a significant increase in positive reappraisal (F1,35 = 21.78,p < .001, η2 = .384) and avoidance (F1,28 = 9.44, p = .004, η2 = .212).

Table 1. Means and Standard Deviations of the Groups in Dimensions with Significant Group xTime Interaction.

Tr Gr C Gr

Variable M1 M2 M1 M2

Resilience 2.51(.50) 3.36(.51) 2.87(.51) 2.86(.50)Anxiety .84(.68) .29(.37) .58(.40) .57(.45)Stress .74(.60) .42(.34) .54(.47) .50(.56)Problem-solving coping 3.86(1.17) 2.49(1.13) 3.37(.45) 3.49(.41)Positive reappraisal 1.26(.38) 2.21(.79) 2.55(.72) 2.76(.63)Negative self-focused 2.61(.84) 1.15(.76) 2.13(.71) 2.09(.73)Overt emotional expression 2.19(.56) 1.03(.52) 1.73(.82) 1.64(.77)Avoidance 1.19(.69) 1.83(.81) 1.74(.91) 1.76(.98)Religion 2.04(1.05) .17(.40) 1.87(1.55) 1.74(1.52)

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Discussion

Throughout life, people have to face a variety of adverse situations and adaptto numerous changes that affect their daily lives. However, during aging, theloss of certain resources (loss of health, loss of loved ones, increased depen-dency . . .) and cognitive capacities (memory, processing speed . . .), which isbiologically unavoidable, occur during this developmental period, and it isdifficult to adjust to these unfavorable situations (Martin, Kliegel, Rott, Poon,& Johnson, 2008). Evidence suggests that self-compassion may be beneficialto older adults who are struggling to cope with the aging process (Allen &Leary, 2014). For this reason, it is important to implement mindfulnessinterventions in healthy elderly people because they can improve successfulaging, and this is one of the aims of positive psychology. The main objectiveof this study was to analyze the consequences of the use of a MindfulnessProgram with self-compassion, based on resilience and coping strategies, inimproving elderly people’s adjustment by reducing their anxiety andstress levels. The results obtained suggest that mindfulness practice withself-compassion can be useful in this type of therapy.

Mindfulness practice produces changes at four levels (Shapiro, Carlson,Astin, & Freeman, 2006): self-regulation, values clarification, cognitive, emo-tional and behavioral flexibility, and exposure to internal events that promoteresistance and healthy adaptation to unfavorable situations. These changesare coherent with the improvement observed in resilience values. Regardingthe effects of mindfulness on resilience, de Frias (2014) indicates that mind-fulness may serve as an adaptive strategy that can protect older adults fromthe effects of stress on mental health. Therefore, it can be a mechanism forresiliency late in life.

The increase in resilience levels occurs parallel to the decrease in anxiety andstress levels. The effect of Mindfulness practice on these variables has beenclearly shown in many studies on anxiety (Hofmann, Sawyer, Witt, & Oh,2010) and stress (Shapiro, Astin, Bishop, & Cordova, 2005). This improvementcomes from attention regulation, body awareness and sustained attention tophysical sensations, emotional regulation through acceptance without judg-ment, emotional regulation through exposure, extinction of automaticresponses and reconsolidation, and changes in self-perspective that involve agreater disregard for a rigid image of the self (Hölzel et al., 2011).

Most elderly people have to confront situations such as loss of loved onesor an increase in their dependency. All of these situations will be character-ized as involving damage or loss (Martin et al., 2008). In addition, somestudies indicate that older people have lower scores on self-efficiency, whichmakes them more vulnerable (Bandura, 1977). Thus, interventions in the useof more adaptive coping strategies are fundamental in this last stage of life.As indicated by de Frias and Whyne (2015), mindfulness meditation

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techniques appear to shift cognitive appraisals from threat to challenge,decrease ruminative thought, and reduces stress arousal. They showed thatlife stress was inversely related to mental health and physical health, and thattrait mindfulness had a positive effect on mental health in middle-aged andolder adults.

With Mindfulness practice, people learn to resolve life’s challengesthrough methods that are not based on rationality or the desire to controlor understand all the variables in a life situation (Kabat-Zinn, 2014). Thus, inthe present study, the scores on strategies based on problem-solving alsodecreased. People learn to observe the internal and external reality; they learnto accept it and react without being impulsive. They trust in their owncapacity to find an adequate response with an open and secure attitude.

In the positive re-evaluation strategy, although the statistical analysisshowed differences in the assessment of the intervention, there was only asignificant improvement in the treatment group, while the control groupremained stable. This strategy, defined as cognitive methods that modify themeaning of a stressful situation, also obtained higher scores. It should be keptin mind that Mindfulness produces a change in the meaning of a stressfulsituation by increasing confidence and acceptance of the present situation. AsMindfulness is practiced, a change takes place in the relationship between theindividual and his/her personal beliefs. The change is characterized bygreater flexibility in overcoming beliefs, greater confidence in the capacityto cope with life’s challenges, and greater awareness that all phenomena havea cause and an effect that is not always possible to understand. On the otherhand, and as other authors have stated (Allen & Leary, 2014), people withhigh self-compassion, an aspect worked on in the intervention, tend toconfront painful situations with a more positive approach than those whoare less self-compassionate.

Regarding the decrease produced in negative self-focusing, mindfulnessand self-compassion training is fundamentally based on the acceptance ofsuffering as something universal, a full awareness of painful experiences, anda kind and loving response toward oneself, precisely because of this suffering.Thus, people do not attribute guilt to themselves or to the negative aspects ofthe situation. Elderly people learn to live with the situation by controlling thenegative values that produced discomfort before participating in the program(Neff & Germer, 2013). Our results, therefore, coincide with previous studieswith elderly people, indicating that self-compassion predicted positiveresponses to aging and that self-compassionate thoughts explained the rela-tionship between trait self-compassion and emotional tone, as well as thebelief that their attitude helped them to cope with age-related events (Allen &Leary, 2014).

Another noteworthy effect is the decrease in the open emotion expressionstrategy. After the intervention, participants manifested much less tendency

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to express their emotions in a cathartic way. This result was expected becausethese types of interventions make people less impulsive when facing stressfulsituations, they help them to manage their emotions better (Jazaieri, Urry, &Gross, 2013), and they give them greater capacity for introspection andemotional awareness (Sze, Gyurak, Yuan, & Levenson, 2010).

As far as increasing the avoidance strategy is concerned, mindfulnesstraining produces an increase in the postponing response strategy becauseit teaches qualities such as attentive, kind, receptive and accepting awarenessthat can be applied in everyday stressful situations in order to respond tothem at the appropriate time. Being aware of each moment allows us to avoidworsening the situation or employing inadequate methods to deal with it.Furthermore, as other authors also state (Meléndez, Mayordomo, Sancho, &Tomás, 2012), elderly people use avoidance strategies more often becausethey have more time and are able to choose the best solution more calmly.Therefore, in the short term, this type of transitory and voluntary avoidancecan be beneficial.

Different studies indicate that, as people age, they benefit from religiousand mystic support and turn to religious or magical thoughts as a way tocope with problems (Meléndez et al., 2012). And because some studies findan association between levels of mindfulness and spirituality (Carmody,Reed, Kristeller, & Merriam, 2008), the program was expected to have theeffect of increasing the religion variable. However, our results did not con-firm our hypothesis: the use of this strategy actually declined after participa-tion in the program. One possible explanation for this would be thatmindfulness practice is considered a secular spirituality that is compatiblewith any type of religious belief and has the additional advantage of beingperformed privately. The decline in participation in religious rituals may bedue to the fact that people acquire a tool that allows them to channel theirspiritual concerns more autonomously, without resorting to social religiousceremonies.

Finally, the results for the search for social support are not significant. Thisis reasonable because, although Mindfulness improves satisfaction with socialrelations, promoting the search for social support as a way to deal withstressful situations is not an objective of this type of intervention.

In conclusion, this study provides evidence of beneficial results of mind-fulness intervention with older people, in terms of the capacity to adapt andcope in adverse situations with greater resilience and less stress and anxiety.In other words, these programs promote cognitive, emotional and behavioralflexibility, which is essential for successful adaptation to a new phase andcontext that involves developmental losses. This study ultimately contributesto the identification of strategies that promote well-being and successfulaging, an area of study where research on mindfulness is scarce. Given thatmindfulness and self-compassion training programs could help older adults

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to cope more effectively with the changes associated with aging, as somestudies have already shown (Allen & Leary, 2014; Rejeski, 2008), this fieldshould be studied further. Therefore, these results suggest that the field ofgerontology would benefit from devoting additional attention to self-compassion.

As limitations, we must mention the small sample and the absence of afollow-up study of the benefits acquired through this program, making itdifficult to generalize the results. Furthermore, another limitation is theabsence of double-blind assessment and not controlling for potential covari-ates such as the effects of the therapist. In addition, some of the eta squaredobtained is low. Regarding future studies, as stated by Bishop and colleagues(2004), mindfulness practices provide opportunities to gain insight into thenature of thoughts and feelings as events passing through the mind, ratherthan as inherent aspects of the self or valid reflections on reality. Moreover,mindfulness would probably be associated with more complex descriptionsof one’s thoughts as contextual, relativistic, transient and subjective, as shownby this author (Bishop et al., 2004). Therefore, in future studies in this area, itwould be interesting to set up a mindfulness program adapted to elderlypeople, in order to obtain greater benefits for this population.

ORCID

Alicia Sales http://orcid.org/0000-0002-7070-8130Juan C Meléndez http://orcid.org/0000-0002-6353-6035

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Carmody, J., Reed, G., Kristeller, J., & Merriam, P. (2008). Mindfulness, spirituality, andhealth-related symptoms. Journal of Psychosomatic Research, 64, 393–403. doi:10.1016/j.jpsychores.2007.06.015

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