Mark Griffiths

Although clinical interest has predominantly focused on mindfulness meditation, interest into the clinical utility of Buddhist-derived loving-kindness meditation (LKM) and compassion meditation (CM) is also growing. This paper follows the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines and provides an evaluative systematic review of LKM and CM intervention studies. Five electronic academic databases were systematically searched to identify all intervention studies assessing changes in the symptom severity of Diagnostic and Statistical Manual of Mental Disorders (text revision fourth edition; DSM-IV-TR) Axis I disorders in clinical samples and/or known concomitants thereof in sub-clinical/healthy samples. The comprehensive database search yielded 342 papers and 20 studies (comprising a total of 1312 participants) were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was then used to assess study quality. Participants demonstrated significant improvements across five psychopathology-relevant outcome domains: (i) positive and negative affect, (ii) psychological distress, (iii) positive thinking, (iv) interpersonal relations, and (v) empathic accuracy. It is concluded that LKM and CM interventions may have utility for treating a variety of psychopathologies. However, to overcome obstacles to clinical integration, a lessons-learned approach is recommended whereby issues encountered during the (ongoing) operationalization of mindfulness interventions are duly considered. In particular, there is a need to establish accurate working definitions for LKM and CM.

Aims and Methods: The general conceptual issues involved in psychiatric classification seem to be increasingly neglected in contrast to a focus on specific and empirical aspects which appear to have come to dominate the study of classification in the field. This article explores how the psychiatric field (in the UK and US) has chosen to analyse classification over time. Publication trends of articles in both The American Journal of Psychiatry and The British Journal of Psychiatry over a fifty year period (1960-2010) can be viewed as indicators of the levels of interest within the psychiatric field toward classification. In an exploratory analysis, articles explicitly focusing on classification were counted and further sub-divided according to whether they focused on empirical or conceptual aspects and whether they adopted a general perspective or focused on a more specific aspect of classification. Results: Interest in classification was apparent in a minority of published articles (4.7% of all published articles). Interest in conceptual aspects dropped throughout the fifty years and was found to be considerably less than for empirical approaches which steadily increased over time. General papers about classification have been gradually on the decline and have been increasingly outnumbered by more specifically-focused articles. Clinical Implication: Classification, as a foundational endeavour within the psychiatric field, requires increased attention in the literature. This literature should address conceptual as well as empirical issues.