title: Mind-Body Skills Training to Improve Distress Tolerance in Medical Students: A Pilot Study.
abstract: OBJECTIVE
  Medical students face rigorous and stressful work environments, resulting in high rates of psychological distress. However, there has been a dearth of empirical work aimed at modifying risk factors for psychopathology among this at-risk group. Distress tolerance, defined as the ability to withstand emotional distress, is one factor that may be important in promoting psychological well-being in medical students. Thus, the aim of the current mixed-methods study was (a) to describe changes in facets of distress tolerance (i.e., emotional tolerance, absorption, appraisal, regulation) for medical students who completed a mind-body skills training group, and a no-intervention control group of students; (b) to examine the relationship between changes in psychological variables and changes in distress tolerance; and (c) to report students' perceptions of the mind-body group, with an emphasis on how the group may have affected personal and professional functioning due to improvements in distress tolerance.
  
  
  METHODS
  The mind-body program was an 11-week, 2-hour skills training group that focused on introducing, practicing, and processing mind-body skills such as biofeedback, guided imagery, relaxation, several forms of meditation (e.g., mindfulness), breathing exercises, and autogenic training.
  
  
  BACKGROUND
  Participants were 52 first- and second-year medical students (62.7% female, Mage = 23.45, SD = 1.51) who participated in a mind-body group or a no-intervention control group and completed self-report measures before and after the 11-week period.
  
  
  RESULTS
  Students in the mind-body group showed a modest improvement in all distress tolerance subscales over time (ΔM = .42-.53, p = .01-.03, d = .44-.53), whereas the control group showed less consistent changes across most subscales (ΔM = .11-.42, p = .10-.65, d = .01-.42). Students in the mind-body group qualitatively reported an improved ability to tolerate affective distress. Overall, improvements in psychological symptoms were associated with improvements in distress tolerance in the mind-body group but not in the control group.
  
  
  CONCLUSIONS
  These preliminary findings provide support for the notion that improving distress tolerance through mind-body skills training might serve to protect medical students from becoming functionally impaired by psychological distress. Thus, implementing mind-body skills training into medical school education may help to improve the psychological well-being of medical students. Future studies utilizing more methodologically rigorous designs are warranted.
authors.affiliation: a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kraemer
authors.affiliation: b Department of Psychiatry , Massachusetts General Hospital/Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Luberto
authors.affiliation: a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA.
authors.forename: Emily M
authors.initials: EM
authors.lastname: O'Bryan
authors.affiliation: c Department of Family and Community Medicine , University of Cincinnati , Cincinnati , Ohio , USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Mysinger
authors.affiliation: c Department of Family and Community Medicine , University of Cincinnati , Cincinnati , Ohio , USA.
authors.forename: Sian
authors.initials: S
authors.lastname: Cotton
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D006801:Humans; D008297:Male; D064866:Mindfulness; D010865:Pilot Projects; D013315:Stress, Psychological / Q000517:prevention & control*; D013337:Students, Medical / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: medical students; mind–body; stress tolerance