Attachment and emotional regulation: examining the role of prefrontal cortex functions, executive functions, and mindfulness in their relationship

Attachment is a prominent area of psychological research, with its relevance linked to executive functions, mindfulness, and emotional regulation. The purpose of this study is to examine this relationship among these aforementioned four constructs and propose a model to be tested in the future. Based on the current trends using the Interpersonal Neurobiology approach, which assumes prefrontal cortex functions to include other socioemotional resources such as empathy, morality, insight, behavior, and body regulation. Our study included prefrontal cortical functions alongside executive functions. The assessment instruments used were Attachment-Based Cognitive Representations Scale, Prefrontal Cortex Functions Scale, Webexec, Five Facet Mindfulness Scale, and Difficulties in Emotion Regulation Scale. We hypothesized that attachment would be the strongest predictor of emotional regulation. The participants in the study were 539 college students (mean = 20.21; sd = 1.57); (68% female and 32%, male). Our a priori research hypothesis was supported, with an additional finding that trait mindfulness was also a significant predictor. The strongest correlations with attachment styles were with trait mindfulness and emotional regulation. We conducted path analyses of two different models for secure and insecure attachment. The path analyses showed that secure attachment scores were negatively related, and insecure attachment scores were positively related to difficulties in emotional regulation scores. Furthermore, trait mindfulness and prefrontal cortex functions also mediated this relationship. However, there was no significant relationship between executive functions and difficulties in emotional regulation scores, even though it was significantly related to attachment. Results and implications are discussed.

A mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome: A pilot study

BACKGROUND

People frequently experience physical and psychological challenges (e.g., depression and anxiety) and high risk of poor prognosis after an acute coronary event. Mindfulness-based intervention holds promise as an effective approach to promoting health and well-being.

OBJECTIVES

To explore the feasibility, acceptability, and potential effects on psychological distress, cardiovascular risk factors and health-related quality of life of a mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome.

METHODS

We conducted a pilot randomized controlled trial to test the feasibility, acceptability and potential effects of the intervention in 50 patients with acute coronary syndrome. The intervention included six weekly sessions, including one face-to-face session and five WeChat-delivered sessions that incorporated mindfulness training with health education and lifestyle modification. Eligible patients were recruited in two public hospitals in China and randomly allocated into the intervention group (n = 25) or control group (n = 25).

RESULTS

Intervention feasibility was supported by a relatively high recruitment rate (66.7%) and retention rate (84%) and a smooth and brief data collection procedure (15 to 25 min) of the pilot study. Positive responses of the acceptability dichotomous scale ranged from 81% to 100%, suggesting the intervention was generally acceptable. The intervention had a significant group × time effect on dietary behavior (B = 0.31,95% CI: 0.08, 0.54, P = 0.008) with an effect size (Cohen's d) of -0.72.

CONCLUSIONS

The mindfulness-oriented psycho-behavioral intervention appears to be feasible and acceptable and have a promising effect on dietary behavior in patients with acute coronary syndrome. A fully powered randomized controlled trial is warranted to further assess the efficacy of the intervention.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, No., ChiCTR2000033526.

History of Sexual Assault as a Predictor of Response to a Self-Guided Online Program for Sexual Desire and Arousal Difficulties in Women

Sexual Interest/Arousal Disorder (distressing, long-lasting impairments in sexual desire and/or arousal) is common in women, but few have access to efficacious psychotherapies, including cognitive-behavioral therapy (CBT) and mindfulness-based therapy (MBT). eSense, an online program meant to maximize treatment access, has been shown to be a feasible, satisfactory, and potentially efficacious intervention. However, subpopulations such as sexual assault survivors may find the program less usable or efficacious. The current study compared women with and without a history of sexual assault (SA) regarding their ability to use and benefit from eSense. Forty-four women (22 with a history of SA; M age = 34.20 years) used eSense (CBT or MBT) and completed validated self-report scales of sexual function, sexual distress, treatment satisfaction, and homework compliance. A history of SA did not predict differences in attrition or changes in clinical outcomes. Exploratory analyses suggested that women with a history of SA reported slightly higher difficulty completing homework assignments, but also slightly higher treatment satisfaction. These preliminary results suggest that eSense may be usable and helpful for women with a history of SA. We discuss ways to maximize the acceptability and efficacy of online programs for women with a history of SA.

Rates of attrition and engagement in randomized controlled trials of mindfulness apps: Systematic review and meta-analysis

Randomized controlled trials (RCT) have established the efficacy of mindfulness apps for numerous mental health and behavioral outcomes. However, studies of this kind are characterized by significant problems with attrition and engagement, making it challenging to interpret these findings and realize the full potential of mindfulness app-based solutions. This systematic review and meta-analysis aimed to examine rates of attrition from, and engagement in, mindfulness apps in 70 RCTs located through four databases. The weighted meta-analytic attrition rate from 9258 participants allocated to a mindfulness app was 24.7%. This estimate was higher (38.7%) when restricting analyses to larger studies (n ≥ 100 per condition) and for specific target samples (e.g., general population of adults). Studies that offered participants monetary compensation and required in-person enrolment methods were associated with the lowest attrition rates. Attrition was higher in mindfulness app conditions relative to waitlists, but was not different to placebo or active apps. Although engagement data were inadequately reported, qualitative synthesis highlighted clear problems with sustained user engagement with mindfulness apps. Findings have implications for powering, designing and appraising research trials of mindfulness apps, as well as the development of potentially effective retention and engagement strategies worthy of evaluation in future work.

The influence of mindfulness-based stress reduction on the work life of healthcare professionals - A qualitative study

BACKGROUND

and purpose: Quantitative studies show that mindfulness-based interventions can reduce stress and burnout in healthcare professionals. Few qualitative studies have explored healthcare professionals' experiences with mindfulness training. The aim of the study was to explore healthcare professionals' experiences of how attending a course in Mindfulness-Based Stress Reduction influenced their work life, including their relationship with patients and colleagues.

METHODS

Fifty-six healthcare professionals attended a Mindfulness-Based Stress Reduction course between January and June 2022. Participant observation followed by six semi-structured focus group interviews and 15 individual interviews were conducted. Data were collected in a cardiology department and in an obstetrics and gynaecology department. Thematic data analysis was performed. Reporting followed COREQ guidelines.

RESULTS

Six themes were identified: 1) Allowing a pause and focusing on one thing at a time, 2) Awareness of the freedom to choose, 3) The need for self-compassion, as a prerequisite for taking care of others, 4) The value of presence and calmness in patient encounters, 5) Awareness of how stressful behavior affects oneself and others, 6) The value of practicing mindfulness with colleagues.

CONCLUSION

This study suggests that offering Mindfulness-Based Stress Reduction to healthcare professionals can start a positive process of change from a tendency to neglect personal needs to becoming more compassionate towards oneself and others. Mindfulness training may thus prevent burnout and lead to a more compassionate workplace culture that also manifests in better patient care. However, a collective understanding and knowledge of mindfulness in the work setting may be necessary to sustain these changes.

Investigation of the relationships between mindfulness, emotional eating, weight control self-efficacy, and obesity in adolescents

PURPOSE

This research was conducted to examine the relationships between mindfulness, emotional eating, weight control self-efficacy, and obesity in adolescents.

DESIGN AND METHODS

The research was conducted with 198 adolescents aged 13-18 years in three high schools in the central county of a province in Türkiye. Data were collected using a sociodemographic information form, the Mindful Attention Awareness Scale-Adolescents, the Emotional Eating Scale for Children and Adolescents, and the Weight-Efficacy Lifestyle Questionnaire for Adolescents-Short Form. In this study, adolescents' height and weight were measured to determine the effects of the study variables on their body mass indexes (BMIs).

RESULTS

The variables were analyzed according to BMI. The mean age of the adolescents participating in the research was 15.25 ± 1.01 years; 52% were female, and 85% were ninth-grade high school students. Their mean height was 170.33 ± 8.59 cm, and their mean weight was 62.24 ± 12.84 kg. The adolescents' BMI was found to have a low-level, significant negative correlation with their mindfulness, a low-level, significant positive correlation with their emotional eating, and a low-level significant negative correlation with their weight control self-efficacy. Adolescents' mindfulness, emotional eating, and weight control self-efficacy scores significantly predicted their BMI and explained 14.1% of the variance in their BMI levels.

CONCLUSIONS

Mindfulness, emotional eating, and weight control self-efficacy in adolescents have a facilitating effect on the management of obesity.

IMPLICATIONS TO PRACTICE

Multidimensional programs should be developed that take into account the interaction of parents, children, and the environment, which will pave the way for the development of healthy nutrition behaviors and contribute to the prevention of obesity.

The influence of hatha yoga on stress, anxiety, and suppression: A randomized controlled trial

Engaging in yoga may mitigate stress and anxiety in individuals while potentially enhancing one's capacity to manage distractions. Our research aimed to explore the relation between these two outcomes: Can an eight-week yoga program foster distraction suppression, thereby reducing stress and discomfort? To answer this question, we used Hatha Yoga, the most commonly practiced form of yoga. We tested if the intervention improved participants' ability to suppress distractions and selectively decrease self-reported stress and stress reactivity. In Addition, we investigated whether such an intervention would increase participants' mindfulness. Our study included 98 healthy yoga novices between 18 and 40 years who were randomly assigned to either an experimental or a waitlist condition, with each participant completing pre- and post-intervention assessments, including questionnaires, as well as electrophysiological and behavioral measures. After eight weeks of yoga practice, significant reductions in self-reported stress and stress reactivity levels, as well as increased mindfulness, were observed among those participating in the intervention relative to those in the waitlist control group. There were, however, no significant changes in state or trait anxiety due to the intervention. Changes in stress measures could not be explained by changes in participants' ability to suppress distractors, which was not affected by the intervention. Overall, our findings suggest that regular participation in Hatha Yoga can improve mental health outcomes without impacting cognitive functioning directly related to distractor suppression. CLINICAL TRIAL REGISTRATION NUMBER: NCT05232422.

Social media usage and students' social anxiety, loneliness and well-being: does digital mindfulness-based intervention effectively work?

BACKGROUND

The increasing integration of digital technologies into daily life has spurred a growing body of research in the field of digital psychology. This research has shed light on the potential benefits and drawbacks of digital technologies for mental health and well-being. However, the intricate relationship between technology and psychology remains largely unexplored.

PURPOSE

This study aimed to investigate the impact of mindfulness-based mobile apps on university students' anxiety, loneliness, and well-being. Additionally, it sought to explore participants' perceptions of the addictiveness of these apps.

METHOD

The research utilized a multi-phase approach, encompassing a correlational research method, a pretest-posttest randomized controlled trial, and a qualitative case study. Participants were segmented into three subsets: correlations (n = 300), treatment (n = 60), and qualitative (n = 20). Data were gathered from various sources, including the social anxiety scale, well-being scale, social media use integration scale, and an interview checklist. Quantitative data was analyzed using Pearson correlation, multiple regression, and t-tests, while qualitative data underwent thematic analysis.

RESULTS

The study uncovered a significant correlation between social media use and the variables under investigation. Moreover, the treatment involving mindfulness-based mobile apps led to a reduction in students' anxiety and an enhancement of their well-being. Notably, participants held various positive perceptions regarding the use of these apps.

IMPLICATIONS

The findings of this research hold both theoretical and practical significance for the field of digital psychology. They provide insight into the potential of mindfulness-based mobile apps to positively impact university students' mental health and well-being. Additionally, the study underscores the need for further exploration of the intricate dynamics between technology and psychology in an increasingly digital world.

Self-care strategies for medical students: an uncontrolled mixed-methods evaluation of a mind-body-medicine group course

BACKGROUND

High stress during medical education and its detrimental effects on student health is well documented. This exploratory evaluation study assesses a 10-week Mind-Body-Medicine student course, created to promote student self-care at Charité Universitätsmedizin Berlin, Germany.

METHODS

During 2012-2019, uncontrolled quantitative and qualitative data were gathered from 112 student participants. Outcomes including changes in perceived stress (PSS), mindfulness (FMI/MAAS), self-reflection (GRAS), self-efficacy (GSE), empathy (SPF), and health-related quality of life (SF-12) were measured between the first (T0) and last sessions (T1). Qualitative data were obtained in focus groups at course completion and triangulated with quantitative data.

RESULTS

Quantitative outcomes showed decreases in perceived stress and increased self-efficacy, mindfulness, self-reflection, and empathy. In focus groups, students reported greater abilities to self-regulate stressful experiences, personal growth and new insights into integrative medicine. Triangulation grounded these effects of MBM practice in its social context, creating an interdependent dynamic between experiences of self and others.

CONCLUSION

After completing an MBM course, students reported reduced perceived stress, increased self-efficacy, mindfulness, empathy and positive engagement with integrative concepts of doctor-patient relationships. Further research with larger randomized confirmatory studies is needed to validate these benefits.

The effects of short video app-guided loving-kindness meditation on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation

OBJECTIVE

The study investigated the effects of a short video app guided loving-kindness meditation (LKM) on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation. The purpose of the study is to investigate the intervention effect of LKM training on suicidal ideation among college students with the help of the short video application and to provide an empirical basis for the exploration of early suicide intervention strategies for college students.

METHODS

We recruited 80 college students from a university in China. The final 74 eligible participants were divided into two groups: app use group (n = 37) and the control group (n = 37). The app group accepted an 8-week app use interference, while the control group underwent no interference. We measured four major variable factors (mindfulness, self-compassion, positive psychological capital, and suicide ideation) before and after the app use intervention.

RESULTS

In the app group, self-compassion and positive psychological capital were significantly higher, and suicide ideation was significantly lower than the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test.

CONCLUSIONS

Our findings demonstrate that the short video app guided LKM may help to improve self-compassion, and positive psychological capital, and reduce suicide ideation. The finding of the short video app-guided LKM's effect extends our understanding of the integrative effects of positive psychology and digital media on the reduction of suicide ideation.

Triangulation of Questionnaires, Qualitative Data and Natural Language Processing: A Differential Approach to Religious Bahá'í Fasting in Germany

Approaches to integrating mixed methods into medical research are gaining popularity. To get a holistic understanding of the effects of behavioural interventions, we investigated religious fasting using a triangulation of quantitative, qualitative, and natural language analysis. We analysed an observational study of Bahá'í fasting in Germany using a between-method triangulation that is based on links between qualitative and quantitative analyses. Individual interviews show an increase in the mindfulness and well-being categories. Sentiment scores, extracted from the interviews through natural language processing, positively correlate with questionnaire outcomes on quality of life (WHO-5: Spearman correlation r = 0.486, p = 0.048). Five questionnaires contribute to the first principal component capturing the spectrum of mood states (50.1% explained variance). Integrating the findings of the between-method triangulation enabled us to converge on the underlying effects of this kind of intermittent fasting. TRIAL REGISTRATION: NCT03443739.

Mindfulness interventions for craving reduction in substance use disorders and behavioral addictions: systematic review and meta-analysis of randomized controlled trials

BACKGROUND

High-quality evidence is still required to affirm the efficacy of mindfulness-based interventions (MBIs) in craving reduction. MBIs may be particularly appropriate for this purpose given the neurobiological mechanisms of addiction with automatic behavior in response to the negative affect. In this systematic review and meta-analysis, we aimed to study the efficacy of MBIs in craving reduction and to synthetize the newly published data.

METHODS

We searched four databases and three clinical trial registries for randomized controlled trials (RCTs) up to August 2023, including studies with MBIs in all types of substance use disorders or behavioral addictions. We chose as our outcome of interest the change from the baseline of craving measures at posttreatment. Standardized mean difference was used as an effect size estimator.

RESULTS

We included 17 RCTs with 1228 participants. The overall effect size was estimated at -0.70 (95% CI -1.15, -0.26) in favor of MBIs.

CONCLUSION

Due to the high inconsistency (I2 = 92%), we were unable to conclude that there is a medium to large effect size. Overall risk of bias was high for most studies, and the GRADE approach detected a low quality of evidence. Previous clinical and fundamental research suggest that MBIs have a promising potential in addiction medicine. However, further investigation of whether MBIs effectively reduce craving is needed, and innovative solutions for resolving methodological limitations in MBI research are warranted.

TRIAL REGISTRATION

PROSPERO registration ID CRD42020221141.

The hidden costs of emotional labor on withdrawal behavior: the mediating role of emotional exhaustion, and the moderating effect of mindfulness

BACKGROUND

Employees' withdrawal behavior concerns organization leaders and policymakers in many countries. However, the specific mechanism which emotional labor affects withdrawal behavior has yet to be thoroughly discussed. There needs to be systematic research on how different emotional labor strategies affect work withdrawal, whether directly or through individual perception, and how to respond.

METHODS

A total of 286 hotel and catering service employees participated in our study. A series of hierarchical moderated regression analyses were performed to test the hypothesis.

RESULTS

The results indicated that surface acting positively affected withdrawal behavior, while deep acting had a negative effect. Emotional exhaustion mediated in this relationship of surface acting with withdrawal behavior and deep acting with withdrawal behavior. Mindfulness showed moderation effects between emotional exhaustion and withdrawal behavior.

CONCLUSIONS

Emotional labor and emotional exhaustion are significant in predicting employees' intentions to withdraw, given that emotional exhaustion partially mediates the effects of emotional labor on withdrawal behavior. Significantly, the relationship between emotional exhaustion and withdrawal behavior is weakened by mindfulness.

Mindfulness-based real-time fMRI neurofeedback: a randomized controlled trial to optimize dosing for depressed adolescents

BACKGROUND

Adolescence is characterized by a heightened vulnerability for Major Depressive Disorder (MDD) onset, and currently, treatments are only effective for roughly half of adolescents with MDD. Accordingly, novel interventions are urgently needed. This study aims to establish mindfulness-based real-time fMRI neurofeedback (mbNF) as a non-invasive approach to downregulate the default mode network (DMN) in order to decrease ruminatory processes and depressive symptoms.

METHODS

Adolescents (N = 90) with a current diagnosis of MDD ages 13-18-years-old will be randomized in a parallel group, two-arm, superiority trial to receive either 15 or 30 min of mbNF with a 1:1 allocation ratio. Real-time neurofeedback based on activation of the frontoparietal network (FPN) relative to the DMN will be displayed to participants via the movement of a ball on a computer screen while participants practice mindfulness in the scanner. We hypothesize that within-DMN (medial prefrontal cortex [mPFC] with posterior cingulate cortex [PCC]) functional connectivity will be reduced following mbNF (Aim 1: Target Engagement). Additionally, we hypothesize that participants in the 30-min mbNF condition will show greater reductions in within-DMN functional connectivity (Aim 2: Dosing Impact on Target Engagement). Aim 1 will analyze data from all participants as a single-group, and Aim 2 will leverage the randomized assignment to analyze data as a parallel-group trial. Secondary analyses will probe changes in depressive symptoms and rumination.

DISCUSSION

Results of this study will determine whether mbNF reduces functional connectivity within the DMN among adolescents with MDD, and critically, will identify the optimal dosing with respect to DMN modulation as well as reduction in depressive symptoms and rumination.

TRIAL REGISTRATION

This study has been registered with clinicaltrials.gov, most recently updated on July 6, 2023 (trial identifier: NCT05617495).

The mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes

INTRODUCTION

This study aimed to examine the mediating role of cognitive flexibility in the relationship between cognitive emotion regulation strategies and mindfulness in patients with type 2 diabetes.

METHODS

The research was conducted by correlation method) using Structural Equation Modeling). The statistical population consisted of all women and men with type 2 diabetes. Two hundred fifty-three samples were selected by convenience sampling method. The participants responded to the Cognitive Emotion Regulation Questionnaire, the Kentucky inventory of mindfulness skills, and the Cognitive Flexibility Inventory.

RESULTS

The results showed that the total path coefficient between the adaptive cognitive emotion regulation strategies and mindfulness (β = 0.243, P = 0.005) was positive and significant, and the total path coefficient between the maladaptive cognitive emotion regulation strategies and mindfulness (β = -0.453, P = 0.001) was negative and significant. The path coefficient between cognitive flexibility and mindfulness (β = 0.273, P = 0.009) was positive and significant. The indirect path coefficient between the adaptive cognitive emotion regulation strategies and mindfulness (β = 0.094, P = 0.007) was positive and significant, and the indirect path coefficient between the maladaptive cognitive emotion regulation strategies and mindfulness (β = -0.117, P = 0.009) was negative and significant.

CONCLUSION

Improving emotion regulation skills increases cognitive flexibility and mindfulness in patients with type 2 diabetes.

The effect of an adapted Mindfulness-Based Stress Reduction program on mental health, maternal bonding and birth outcomes in psychosocially vulnerable pregnant women: a study protocol for a randomized controlled trial in a Danish hospital-based outpatient setting

BACKGROUND

Stress and mental disorders in pregnancy can adversely affect the developing fetus. Women with a preconception history of mental disorders or of psychosocial vulnerabilities are at increased risk of experiencing perinatal stress or mental health problems. Mindfulness-Based-Stress-Reduction (MBSR) is an acceptable intervention for pregnant women and has a growing evidence-base with meta-analyses consistently pointing to reductions in symptoms of stress, anxiety and depression. This study protocol aim to address the need for a wider array of evidence-based and non-pharmacological options during pregnancy to reduce stress and improve mental health in a psychosocially highly vulnerable group of women.

METHODS

Pregnant women with a preconception history of mental disorders or psychosocial vulnerabilities (n = 240) will be recruited from an obstetric ambulatory clinic at Copenhagen University Hospital, Hvidovre, Denmark. Recruitment for the study began in March 2022 and will continue until the desired number of participants is reached. Consenting pregnant women will be randomized to one of two study arms, an adapted MBSR program as add on to usual care or usual care alone. The primary outcome is mental wellbeing at nine months post-randomization. Secondary and exploratory outcomes include stress, anxiety, depression, and maternal antenatal attachment, experience of childbirth, delivery and mode of delivery. Mindfulness and self-compassion are examined as possible mediators of the effect on outcomes.

DISCUSSION

Teaching the skills of mindfulness meditation to a psychosocially vulnerable group of pregnant women could prove a viable and non-pharmacological approach to improve mental health and wellbeing during pregnancy, reduce stress and support the transition to parenthood. Mindfulness-Based Stress Reduction does not target a particular group, and results from the study is thus of potential relevance for pregnant women in general as a means of reducing stress and improving perinatal mental health and wellbeing.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05300646 . Registered March 29, 2022.

App-Based Mindfulness for Attenuation of Subjective and Physiological Stress Reactivity in a Population With Elevated Stress: Randomized Controlled Trial

BACKGROUND

Stress-related mental health disorders have steadily increased and contributed to a worldwide disease burden with up to 50% experiencing a stress-related mental health disorder worldwide. Data suggest that only approximately 20%-65% of individuals receive treatment. This gap in receiving treatment may be attributed to barriers such as limited treatment access, negative stigma surrounding mental health treatment, approachability (ie, not having a usual treatment plan or provider), affordability (ie, lack of insurance coverage and high treatment cost), and availability (ie, long waits for appointments) leaving those who need treatment without necessary care. To mitigate the limited access mental health treatment, there has been a rise in the application and study of digital mental health interventions. As such, there is an urgent need and opportunity for effective digital mental health interventions to alleviate stress symptoms, potentially reducing adverse outcomes of stress-related disorders.

OBJECTIVE

This study examined if app-based guided mindfulness could improve subjective levels of stress and influence physiological markers of stress reactivity in a population with elevated symptoms of stress.

METHODS

The study included 163 participants who had moderate to high perceived stress as assessed by the Perceived Stress Scale (PSS-10). Participants were randomly allocated to 1 of 5 groups: a digital guided program designed to alleviate stress (Managing Stress), a digital mindfulness fundamentals course (Basics), digitally delivered breathing exercises, an active control intervention (Audiobook), and a Waitlist Control group. The 3 formats of mindfulness interventions (Managing Stress, Basics, and Breathing) all had a total duration of 300 minutes spanning 20-30 days. Primary outcome measures were perceived stress using the PSS-10, self-reported sleep quality using the Pittsburgh Sleep Quality Index, and trait mindfulness using the Mindful Attention Awareness Scale. To probe the effects of physiological stress, an acute stress manipulation task was included, specifically the cold pressor task (CPT). Heart rate variability was collected before, during, and after exposure to the CPT and used as a measure of physiological stress.

RESULTS

The results showed that PSS-10 and Pittsburgh Sleep Quality Index scores for the Managing Stress (all P<.001) and Basics (all P≤.002) groups were significantly reduced between preintervention and postintervention periods, while no significant differences were reported for the other groups. No significant differences among groups were reported for Mindful Attention Awareness Scale (P=.13). The physiological results revealed that the Managing Stress (P<.001) and Basics (P=.01) groups displayed reduced physiological stress reactivity between the preintervention and postintervention periods on the CPT. There were no significant differences reported for the other groups.

CONCLUSIONS

These results demonstrate efficacy of app-based mindfulness in a population with moderate to high stress on improving self-reported stress, sleep quality, and physiological measures of stress during an acute stress manipulation task.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05832632; https://www.clinicaltrials.gov/ct2/show/NCT05832632.

Effect of music breathing, a program based on mindful breathing and music listening therapy for promoting sense of coherence in young people: study protocol for a randomized controlled trial

BACKGROUND

The negative impacts of the COVID-19 pandemic on public health have affected people socially, psychologically, and physically. Young people particularly are having to adjust many aspects of their personal lives: including transitions to work, college, and independent living. Personal resources are important in mitigating stress and improve mental well-being during pandemic. Sense of coherence-an orientation to life-could be considered as a personal resource. Currently, a number of interventions have been developed to target the reduction of stress in young people. Little emphasis has been placed on developing sense of coherence to reduce stress and promote mental well-being among young people. Young people consider music as a preferred leisure activity and an important means of stress relief in their daily lives. However, little research concerning music therapy and sense of coherence exists.

METHODS

In the proposed randomized controlled trial, a sample of 290 young people (aged 18-30) will be recruited and allocated randomly into one of two groups: the experimental group and the control group. Participants in the experimental group will participate in a 6-week Music Breathing program that will include music listening and mindful breathing guided by a certified music therapist. Participants in the control group will receive a control condition for 6 weeks Mental Health Education Programme. The primary outcome of the study will be measured using Sense of Coherence Scale. The secondary outcomes will be measured using the Coping Self-Efficacy Scale, Difficulties in Emotion Regulation Scale, Mindful Attention Awareness Scale, Depression Anxiety Stress Scales, BBC Subjective Well-being scale, and salivary cortisol levels. Repeated measures analysis will be used to compare the outcomes between the two groups.

DISCUSSION

The results will inform practice in coping with stress through promoting sense of coherence. Individuals will benefit from the long-term effect of this intervention to enhance their sense of coherence to cope with stressful events and promote better mental well-being.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05655234. Registered on December 8, 2022.

Impact of social support and mindfulness in the associations between perceived risk of COVID-19 acquisition and pregnancy outcomes in Iranian population: a longitudinal cohort study

BACKGROUND AND AIMS

Various devastating infection outbreaks including COVID-19, threat both mother and fetus health. These life-threating outbreaks as potential harms are highly associated with relevant perceived risk. Social support and mindfulness are two factors that may moderate the associations between the perceived risk of COVID-19 and pregnancy outcomes. In this study we investigated the potential moderating impact of social support and mindfulness in the aforementioned association.

METHODS

This study is a longitudinal cohort study in which 483 Iranian pregnant women in Tehran have been studied. Perceived risk of COVID-19 questions, Mindful Attention Awareness Scale (MAAS), and Multidimensional Scale of Perceived Social Support (MSPSS) were used through an online platform to assess the independent variables during pregnancy. Neonatal and maternal outcomes including gestational diabetes, gestational hypertension, preeclampsia, abortion, birth weight, and gestational age at birth, was extracted from Electronic Health Record (EHR) after childbirth as the dependent variables. The aim of the study is to investigate whether social support and mindfulness can affect the associations between perceived risk of Covid-19 acquisition and pregnancy outcomes.

RESULTS

Perceived risk of COVID-19 was negatively associated with pregnancy outcomes including birth weight (-28, 95% CI [-53, -3.4], p < .05) and gestational age at birth (-0.9, 95% CI [-2,0.11], p < .05). However, social support could not moderate these associations. Mindfulness, on the other hand, moderated the association between perceived risk and stillbirth meaning that by increasing mindfulness, the association between the perceived risk and stillbirth may also be increased (OR = 0.03; p < .05).

CONCLUSION

The findings of this study showed that social support lacks the moderating impact on the association between perceived risk of COVID-19 and pregnancy outcomes. Mindfulness, on the other hand, indicate a positive moderating impact for the association between perceived risk of Covid-19 and stillbirth. More studies in different populations are suggested to investigate the impact of mindfulness and social support on the association between perceived risk and pregnancy outcomes.

Third-wave cognitive behavioral therapies for caregivers of cancer patients: a scoping review

BACKGROUND

Cancer caregivers extend comprehensive support covering all aspects of patients' daily lives. It has been reported that a significant proportion of cancer caregivers experience emotional distress. As one way to solve this problem, third-wave cognitive behavioral therapies (CBT), which involves integrating acceptance and mindfulness into cognitive‒behavioral therapy, has been applied to improve caregiver outcomes.

METHODS

A scoping review was conducted based on the scoping review guidelines proposed by the Jonna Briggs Institute (JBI). The population was caregivers of cancer patients, the concept was third-wave CBT, and the context remained open. English and Korean publications published from 2001 to June 2022 were identified from PubMed, Embase, CINAHL, PsycINFO, Cochrane, Korea Med, and RISS.

RESULTS

A total of 12 studies were included in this scoping review. Mindfulness-Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy (ACT) was the most frequently applied intervention (n = 3, each). Among the components of third-wave CBT, 'mindfulness' was identified in all the studies reviewed (n = 12). Dyadic interventions comprised the majority (n = 9). Interventions using digital technologies such as mobile application/web page (n = 3), telephone (n = 3), and FaceTime (n = 2) have increased since 2017. Depression was the most frequently evaluated outcome (n = 8), followed by anxiety and mindfulness (n = 6, each).

CONCLUSIONS

The current review explored available third-wave CBT intervention studies for cancer caregivers and targeted outcomes. Most of the interventions were dyadic interventions and utilized mindfulness. Delivery methods were continuously updated with digital technologies. Further RCTs with robust research designs and a synthesis of the results of the trials would provide evidence about how to effectively apply third-wave CBTs for cancer caregivers.

MITIG.RA: study protocol of a tailored psychological intervention for managing fatigue in rheumatoid arthritis randomized controlled trial

BACKGROUND

Despite remarkable medical advances in the treatment of rheumatoid arthritis (RA), a subset of patients fails to achieve complete clinical remission, as the Patient Global Assessment (PGA) of disease activity remains above 1, even after the inflammatory process is brought under control. This so-called state of 'PGA-near-remission' negatively impacts individuals' functioning and potentiates inadequate care. Fatigue is a distressing and disabling symptom frequently reported by patients in PGA-near-remission, and its management remains challenging. While classic cognitive-behavioural interventions show some benefits in managing fatigue, there is potential for improvement. Recently, contextual-cognitive behavioural therapies (CCBT), like mindfulness, acceptance, and compassion-based interventions, have shown promising results in fatigue-associated disorders and their determinants. This study primarily aims to examine the efficacy of the Compassion and Mindfulness Intervention for RA (MITIG.RA), a novel intervention combining different components of CCBT, compared to treatment-as-usual (TAU) in the management of RA-associated fatigue. Secondary aims involve exploring whether MITIG.RA produces changes in the perceived impact of disease, satisfaction with disease status, levels of depression, and emotion-regulation skills.

METHODS

This is a single center, two-arm parallel randomized controlled trial. Patients will be screened for eligibility and willingness to participate and will be assessed and randomized to the experimental (MITIG.RA + TAU) or control condition (TAU) using computer randomization. MITIG.RA will be delivered by a certified psychologist and comprises eight sessions of 2 h, followed by two booster sessions. Outcomes will be assessed through validated self-report measures, including fatigue (primary outcome), perceived impact of disease, depressive symptoms, mindfulness, self-compassion, safety, and satisfaction (secondary outcomes). Assessment will take place at baseline, post-intervention, before the first and second booster sessions (weeks 12 and 20, respectively), and at 32 and 44 weeks after the interventions' beginning.

DISCUSSION

We expect MITIG.RA to be effective in reducing levels of RA-associated fatigue. Secondarily, we hypothesize that the experimental group will show improvements in the overall perceived impact of disease, emotional distress, and emotion regulation skills. Our findings will contribute to determine the benefits of combining CCBT approaches for managing fatigue and associated distress in RA.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05389189. Registered on May 25, 2022.

Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients: Results from a randomized controlled trial

INTRODUCTION

Few controlled trials have assessed the impact of Mindfulness Based Cognitive Therapy (MBCT) on symptoms and functioning in bipolar disorder (BD). This study aims to evaluate the effectiveness of MBCT adjunctive group treatment.

MATERIAL AND METHODS

Randomized, prospective, multicenter, single-blinded trial that included BP-outpatients with subthreshold depressive symptoms. Participants were randomly assigned to three arms: treatment as usual (TAU); TAU plus psychoeducation; and TAU plus MBCT. Primary outcome was change in Hamilton-D score; secondary endpoints were change in anxiety, hypo/mania symptoms and functional improvement. Patients were assessed at baseline (V1), 8 weeks (V2) and 6 months (V3). Main hypothesis was that adjunctive MBCT would improve depressive symptoms more than psychoeducation.

RESULTS

Eighty-four participants were recruited (MBCT=40, Psychoeducation=34, TAU=10). Depressive symptoms improved in the three arms between V1 and V2 (p<0.0001), and between V1 and V3 (p<0.0001), and did not change between V2 and V3. At V3 no significant differences between groups were found. There were no significant differences in other measures either.

CONCLUSIONS

In our BD population we did not find superiority of adjunctive MBCT over adjunctive Psychoeducation or TAU on subsyndromal depressive symptoms; neither on anxiety, hypo/mania, relapses, or functioning.

The relationship between mindfulness and enduring somatic threat severity in long-term cardiac arrest survivors

BACKGROUND

Cardiac arrest (CA) survivors experience continuous exposures to potential traumas though chronic cognitive, physical and emotional sequelae and enduring somatic threats (ESTs) (i.e., recurring somatic traumatic reminders of the event). Sources of ESTs can include the daily sensation of an implantable cardioverter defibrillator (ICD), ICD-delivered shocks, pain from rescue compressions, fatigue, weakness, and changes in physical function. Mindfulness, defined as non-judgmental present-moment awareness, is a teachable skill that might help CA survivors cope with ESTs. Here we describe the severity of ESTs in a sample of long-term CA survivors and explore the cross-sectional relationship between mindfulness and severity of ESTs.

METHODS

We analyzed survey data of long-term CA survivors who were members of the Sudden Cardiac Arrest Foundation (collected 10-11/2020). We assessed ESTs using 4 cardiac threat items from the Anxiety Sensitivity Index-revised (items range from 0 "very little" to 4 "very much") which we summed to create a score reflecting total EST burden (range 0-16). We assessed mindfulness using the Cognitive and Affective Mindfulness Scale-Revised. First, we summarized the distribution of EST scores. Second, we used linear regression to describe the relationship between mindfulness and EST severity adjusting for age, gender, time since arrest, COVID-19-related stress, and loss of income due to COVID.

RESULTS

We included 145 CA survivors (mean age: 51 years, 52% male, 93.8% white, mean time since arrest: 6 years, 24.1% scored in the upper quarter of EST severity). Greater mindfulness (β: -30, p = 0.002), older age (β: -0.30, p = 0.01) and longer time since CA (β: -0.23, p = 0.005) were associated with lower EST severity. Male sex was also associated with greater EST severity (β: 0.21, p = 0.009).

CONCLUSION

ESTs are common among CA survivors. Mindfulness may be a protective skill that CA survivors use to cope with ESTs. Future psychosocial interventions for the CA population should consider using mindfulness as a core skill to reduce ESTs.

Do Unified Protocol modules exert general or unique effects on anxiety, depression, and transdiagnostic targets?

Several transdiagnostic cognitive-behavior therapies include multiple treatment components. However, it is unclear whether some components are more efficacious than others at reducing symptoms or whether these components uniquely influence their putative mechanism of change. Participants (N = 70; Mage = 33.7; 67.1% female, 74.3% White) with a primary anxiety or depressive disorder were randomized to one of three standard or personalized sequences of core Unified Protocol modules. Using hierarchical linear modeling, we tested (a) whether the average session-to-session change in anxiety and depression differed between modules and (b) whether the average session-to-session change in the putative mechanism of each module differed between modules. All modules led to similar changes in anxiety, but Confronting Physical Sensations led to significantly less change in depression than other modules. There were no significant differences among modules predicting putative mechanisms of change, although there was a trend for Mindful Emotion Awareness to predict greater improvements in mindfulness than Understanding Emotions. Consistent with its transdiagnostic nature, UP modules may exert similar effects on anxiety and putative mechanisms of change, although interoceptive exposures may be less impactful for changing depressive symptoms and the mindfulness module may promote relatively specific improvements in mindfulness.

Tübinger Training for Autism Spectrum Disorders (TüTASS): a structured group intervention on self-perception and social skills of children with autism spectrum disorder (ASD)

In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants' self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD.

Psychometric Properties of the Persian Version of Interpersonal Mindfulness in Parenting Scale

Objective: This study was designed to explore the psychometric properties of the Persian version of the Interpersonal Mindfulness in Parenting Scale (IMP-S). Method : This cross-sectional and psychometric study was performed on a sample of 491 parents in Iran who had at least one child in their home and were selected using the convenient sampling method. The Interpersonal Mindfulness in Parenting Scale (IMP-S), Mindful Attention Awareness Scale, Parental Authority Questionnaire, and the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale were ‎conducted on the sample. The validity of the IMP-S was assessed by factor analysis and Pearson correlation coefficients, while reliability was calculated by Cronbach's alpha. Results: At first, the whole data was analyzed using confirmatory factor analysis based on the original English version of the IMP-S. The proposed hypothesized factor solution was not good enough (CMIN / DF = 7.06. RSMEA = 0.081, CFI = 0.732, SRMR = 0.0860). Exploratory factor analysis and parallel analysis led to a three-factor structure for the 28 items, which included mindfulness toward the child, mindfulness about oneself and emotional awareness of parenting. The results of confirmatory factor analysis showed that the data was more fitted with this new three-factor solution (CMIN / DF = 2.06, CFI = 0.82, NFI = 0.715, RMSEA = 0.065, SRMR = 0.0795). The IMP-S was found to have a positive correlation with trait mindfulness, reassured self, and authoritative parenting style, whereas this association for the IMP-S and hatred self, inadequate self, and authoritarian parenting style was negative. The reliability of the whole scale was 0.84 and it was 0.77, 0.83, and 0.68 for the first, second, and third subscales, respectively. Conclusion: It seems that the Persian version of the IMP-S with three factors can better evaluate mindful parenting among the Iranian population. In contrast to people from other countries, Iranian people perceive mindfulness toward themselves and their children during parenting practice as two distinct issues.

A sequential mediation model of perceived social support, mindfulness, perceived hope, and mental health literacy: An empirical study on Taiwanese university students

This study explored the mediation of mindfulness and perceived hope between perceived social support and mental health literacy in university students. Of 568 students (205 males, 363 females, average age 20.97) from 70 Taiwanese universities, tools like the Perceived Social Support Scale, General Health Questionnaire, Mindful Attention Awareness Scale, and State Hope Scale were used, adapted to Traditional Chinese through back-translation. Confirmatory factor analysis affirmed model validity. Hayes' PROCESS Model 6 analyzed the data. The results showed an indirect effect of social support on mental health literacy via mindfulness and hope (B = 0.091, 95 % CI: 0.0613 to 0.1258). Three mediation paths were: (1) mindfulness (B = 0.035); (2) hope (B = 0.052); and (3) a combined effect (B = 0.003). A direct effect of social support on mental health literacy was significant (B = 0.120). The model explained 33.9 % of the variance in mental health literacy. The research underscores the link between social support, mindfulness, hope, and mental health literacy, identifying mindfulness and hope as mediators. It stresses the mediation impact and suggests strategies to boost mental health literacy in university students. Future research should expand to cross-cultural studies, further examine the evolving dynamics of social support, and incorporate both qualitative and experimental methodologies. The inclusion of factors such as alienation, well-being, and resilience can enrich the theoretical framework.

The role of mindfulness on theta inter-brain synchrony during cooperation feedback processing: An EEG-based hyperscanning study

Mindfulness appears to improve empathy and understanding in relationships, which are necessary for successful cooperation. However, the impact of mindfulness on cooperation has not been fully studied. This study used hyperscanning technique to examine the effect of mindfulness on the inter-brain synchrony of interacting individuals during the cooperative tasks. Forty-one dyads were randomly assigned to a mindfulness group or a non-mindfulness group. Dyads of the mindfulness group performed a short mindfulness exercise following a 15-minute mindfulness audio guidance. Dyads of the non-mindfulness group were instructed to rest quietly with their eyes closed. Then, simultaneously and continuously EEG was recorded from all dyads when they completed a computer-based cooperative game task. Reaction times (RTs) and success rates were used to indicate the behavioral performance, and phase locking value (PLV) was used to indicate the inter-brain synchrony. The results showed that (1) Greater theta inter-brain synchrony during the cooperative computer game tasks was observed in the mindfulness group than in the non-mindfulness group; (2) Greater theta inter-brain synchrony was observed in the successful cooperation conditions as compared to those in the failure cooperation conditions; (3) Greater theta inter-brain synchrony was observed at the frontal region as compared to those at the parietal-occipital region in the successful cooperation condition. The results expand the neural basis of the effects of mindfulness on cooperation feedback processing.

Mindfulness influences the psycho-social dimension of chronic pain: A randomized controlled clinical trial in Indian context

Background and Aims

In India, the awareness about the psycho-social dimension of chronic pain is minimal among physicians and patients. The research with community-based group therapies (like mindfulness) to address the psycho-social aspects in chronic pain patients remains limited. The aim of this randomized controlled trial was to see the effects of mindfulness on pain intensity, pain catastrophizing, chronic pain acceptance, perceived stress, well-being, and mindfulness characteristics.

Materials and Methods

In this two-site, parallel group, clinical trial, 170 patients attending pain outdoors of two government hospitals in West Bengal, India, were randomized to attend five weekly in-person mindfulness sessions (cases) or usual care sessions (controls) within the hospital premises. Pre-program and post-program data were collected and analyzed using statistical methods like repeated measures analysis of variance.

Results

In participants of the mindfulness group, significant changes post session were noted in pain intensity [F(1,326) = 15.0122; P = 0.0001291], pain acceptance [F(1,326) = 4.5311; P = 0.03403], and perceived stress score [F(1,326) = 13.2788; P = 0.0003122] compared to pre-session. The changes in pain catastrophizing, World Health Organization well-being and Freiburg mindfulness inventory scores were non-specific.

Conclusion

Mindfulness had a positive influence on pain intensity, pain acceptance, and perceived stress of Indian chronic pain patients. The effects on pain catastrophizing, mindfulness characteristics, and well-being (non-specific) were also encouraging. Further studies will be required to substantiate these results.

Mindfulness and the Mediating Role of Psychological Capital in Predicting the Foreign Language Anxiety

The present study was conducted to investigate the relationship between mindfulness and foreign language anxiety among a sample of 504 University students who were learning English as a foreign language. In addition, the mediating role of psychological capital was examined. Three self-reported questionnaires were administered to the participants and Pearson correlation, path analysis, and structural equation modeling was utilized to test the hypotheses. The results indicated that all five components of mindfulness except observation have a direct and significant effect on foreign language anxiety. However, it should be noted that the two components of description and non-reactivity to inner experiences had a positive while the two components of aware action and non-judgment of inner actions had a negative effect on students' foreign language classroom anxiety. In addition, two of the components of psychological capital, namely self-efficacy and resilience, play a mediating role in the relationship between the components of mindfulness and EFL classroom anxiety. Implications are discussed and suggestions for further research are given.

Young Adult Women and Sexual Awareness in the Digital Age: Examining Pathways Linking Online Dating Debut and Mindfulness with Sexual and Mental Health

Sexual awareness is an understudied phenomenon, despite its known effects on mental health. Little is known about the predictors of sexual awareness, including how early sexual debut and early engagement with online dating and hookup apps might impact the development of sexual mindfulness. Given the conceptual overlap between mindfulness and sexual awareness, this study tested a model that hypothesized that general mindfulness and early sexual and online dating debuts may be associated with mental health outcomes and sexual behavior through pathways involving sexual awareness (assertiveness, consciousness, appeal, and monitoring). A sample of 2,379 heterosexually active young adult women completed an online survey. Path models indicated that both early sexual debut (prior to age 15) and early online dating debut (prior to age 18) had significant, positive direct associations with anxiety and depression scores. Early online dating was also associated with condomless sex with casual male partners. However, both early sexual debut and early online dating debut were indirectly linked to greater sexual risk through greater appeal, and to lower sexual risk through sexual assertiveness. Additionally, greater monitoring contributed to more depression for those with an earlier sexual debut. These findings point to potential risks associated with early online dating. They also highlight benefits of studying sexual awareness as a multi-dimensional construct, especially as it helps to clarify divergent findings in the existing literature on the long-term consequences associated with early sexual debut. While some domains were associated with risk (monitoring and appeal), others were indicative of resilience (assertiveness).

The effectiveness of a single session of mindfulness-based cognitive training on cardiac vagal control and core symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): a preliminary randomized controlled trial

This study examined the effectiveness of a mindfulness-based intervention (MBI) on Conners' continuous performance test scores (CPTs), cardiac vagal control (CVC) assessed by vagally mediated heart rate variability (HRV), and mood in children and adolescents with ADHD. We conducted a randomized controlled trial (RCT) recruiting 70 children and adolescents (M age 11.03, SD 2.78) with a clinical diagnosis of ADHD, which were allocated to either 1 session of mindfulness cognitive training, or an active control condition and were examined at baseline, post-treatment and 4-week follow-up. See clinicaltrials.gov: NCT04316832. There was a significant main effect of time on the primary outcomes measured by CPT scores of attention-related problems (omission errors, reaction time) and hyperactivity-impulsivity (commission errors). However, time-by-group interaction did not achieve statistical significance for commission errors and hit RT, indicating that the changes over time in these outcomes were not significantly different between the MBI and Control conditions. In addition, there was a significant time-by-group interaction for omission errors. Relative to control, MBI resulted in a small (d = 0.011) non-statistically significant reduction in omission errors post-treatment. Furthermore, there were no significant differences in detectability. Secondary outcomes were CVC and mood. A small treatment effect on CVC (d = 0.37) was observed; there was a slight increase in vagally mediated HRV measure post-treatment. There were no significant differences in mood improvement over time between conditions. One brief session of MBI effectively enhances CVC but does not significantly improve CPT scores of attention-related problems and hyperactivity-impulsivity or mood in children with ADHD.Clinicaltrials.gov: NCT04316832.

Living well: Empirically developed structural equation model for healthy and effective self-regulation

The purpose of this study is to develop and empirically test a structural equation model (SEM) for healthy and effective self-regulation based on the propositions of self-determination theory (SDT). A cross-sectional data sample (N = 6,705) is used to test the model. The results of the SEM demonstrate good to excellent global fit indices (RMSEA = 0.06, SRMR = 0.04 CFI = 0.97, TLI/NNFI = 0.95) and excellent local fit indices (p < 0.001). It is acknowledged that longitudinal and experimental research designs will be necessary to infer causal effects. However, based on the strong theoretical and empirical grounding of the model, indications for causal effects are discussed beyond correlational relations. The local fit indices imply that autonomy of goals, intrinsic values orientation, mindfulness, and the newly integrated construct clarity about personal values positively affect psychological needs satisfaction and facets of subjective and psychological well-being. Additionally, they indicate that mindfulness and clarity about personal values have the greatest benefits on individual health, well-being, and effectiveness. These results are crucial as they emphasize the significant role of mindfulness in healthy and effective self-regulation. Furthermore, they put the spotlight on a rather new construct; clarity about personal values. By having transferred the knowledge base of SDT into an empirically derived model of healthy and effective self-regulation, this study provides well-grounded indications of how health, well-being, and effectiveness in individuals may be fostered. These indications offer new insights for theory building and practical interventions in domains like psychotherapy, healthcare, organizations, sports, and education.

Feasibility and efficacy of an at-home, smart-device aided mindfulness program in people with Multiple Sclerosis

BACKGROUND

Multiple Sclerosis (MS) is a chronic disease with a high prevalence of neuropsychiatric symptoms. Mindfulness is a practice that encourages individuals to cultivate a present-focused, acceptance-based approach for managing psychological distress. Its positive effect on MS has been demonstrated, but learning such technique is expensive and time-consuming. In this study, we investigated the feasibility and efficacy of an 8-week, at-home, smart-device aided mindfulness program in a cohort of MS patients. Specifically, we explored the role of a brain-sensing headband providing real-time auditory feedback as supportive tool for meditation exercises.

METHODS

The study included two visits, one at baseline and another after the mindfulness program. We measured adherence to the proposed mindfulness treatment and its effect on questionnaires investigating different psychological domains, cognition, fatigue, quality of life and quantitative EEG parameters. All participants received a smart biofeedback device to be used during the therapeutic program consisting of daily meditative exercises.

RESULTS

Twenty-nine patients were recruited for the present study. Among them, 27 (93%) completed the entire program and 17 (63%) completed more than 80% of the scheduled sessions. We observed a statistically significant reduction of the Ruminative Response Scale score and a significant increase of the Digit Span Backward. Regarding neurophysiological data, we found a significant reduction of the whole-scalp beta and parieto-occipital theta power post intervention.

CONCLUSION

Our results show that an at-home, smart-device aided mindfulness program is feasible for people with MS. The efficacy in terms of reappraisals of stress, cognitive and emotional coping responses is also supported by our neurophysiological data. Further studies are warranted to better explore the role of such approaches in managing the psychological impact of MS diagnosis.

Mindfulness as an early intervention for hazardous alcohol use among non-treatment seeking Latine emerging adults: A mini-review

The age cohort referred to as emerging adults (ages 18-29 years old) demonstrates the most hazardous alcohol use in the United States (U.S.) Approximately one-third of emerging adults regularly engage in heavy episodic drinking (4/5 drinks in two hours females/males). Compared to their non-Latine White peers, Latine emerging adults in the U.S. report lower rates of heavy episodic drinking (HED) yet are at greater risk of developing a substance use disorder and experience more severe negative consequences from drinking alcohol. Despite their high-risk status, Latine emerging adults are less likely to seek treatment and have less access to innovative health-promoting resources, further exacerbating health inequities. Research has shown that practicing mindfulness can interrupt habituated cognitions, intrusive thinking, and automatic behaviors associated with hazardous drinking. However, Latine representation in MBI trials is minimal. This mini-review explores the potential value of mindfulness as an early intervention for hazardous alcohol use among Latine emerging adults. The review provides future directions for research, highlighting the need to design culturally and developmentally tailored MBIs that can provide a respectful, non-judgmental, and discrimination-free environment that appeals to Latine emerging adults. Additionally, conclusions are drawn regarding the possible benefits of pairing MBI with contingency management strategies to decrease attrition rates in MBI trials.

Distress tolerance as a mechanism of mindfulness for depression and anxiety: Cross-sectional and diary evidence

Background

Both trait and state mindfulness are associated with less depression and anxiety, but the mechanisms remain unknown. Distress tolerance, an important transdiagnostic factor of emotional disorders, may mediate the relationship between mindfulness and depression/anxiety.

Method

Study 1 examined the mediation model at the between-person level in a large cross-sectional sample (n = 905). In Study 2, a daily diary study (n = 110) was conducted to examine within-person changes. Participants were invited to complete daily diaries measuring daily mindfulness, distress tolerance, depression and anxiety for 14 consecutive days.

Results

In Study 1, results of simple mediation analyses indicated that distress tolerance mediated the relationship between mindfulness and depression/anxiety at the between-person level. In Study 2, results of multilevel mediation analyses indicated that, in both the concurrent model and time-lagged model, daily distress tolerance mediated the effects of daily mindfulness on daily depression/anxiety at both the within- and between-person level.

Conclusions

Distress tolerance is a mechanism underlying the relationship between mindfulness and depression/anxiety. Individuals with high or fluctuating depression and anxiety may benefit from short-term or long-term mindfulness training to increase distress tolerance.

The effect of universal school-based mindfulness on anhedonia and emotional distress and its underlying mechanisms: A cluster randomised controlled trial via experience sampling in secondary schools

This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and emotional distress among mid-adolescents (15-18 years). It further examined three potential mechanisms: dampening of positive emotions, non-acceptance/suppression of negative emotions, and perceived social pressure not to experience/express negative emotions. Adolescents (ncontrol = 136, nintervention = 95) participated in three assessment points (before, after and two/three months after the in-class MT), consisting of Experience Sampling (ES) assessments and self-report questionnaires (SRQs) to corroborate the ES assessments. Analyses were based on general linear modelling and multilevel modelling. Overall, no evidence was found for a significant beneficial and long-lasting impact of the MT on adolescents' mental health. Importantly, some barriers inherently linked to universal MT approaches (low engagement in and mixed attitudes towards the MT) may have tempered the effectiveness of the MT in the current trial. Further research should prioritise overcoming these barriers to optimise programme implementation. Additionally, given the potential complex interplay of moderators at micro- (home practice), meso- (school climate), and macro-level (broader context), research should simultaneously focus on alternative ways of delivering MT at schools to strengthen adolescents' mental health.

An empirical investigation of the associations between metacognition, mindfulness experiential avoidance, depression, and anxiety

BACKGROUND

The aims of this study were to explore the possible relation between metacognition, mindfulness, and experiential avoidance, as well as their association with symptoms of anxiety and depression.

METHODS

Cross-sectional data was collected from a community sample (N = 364) who completed the Metacognitions Questionnaire-30 (MCQ-30), the Five Facet Mindfulness Questionnaire-24 (FFMQ-24), the Acceptance and Action Questionnaire-II (AAQ-II), the Generalized Anxiety Disorder 7-item (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9).

RESULTS

There were moderate-strong associations between mindfulness (FFMQ-24), metacognition (MCQ-30), and experiential avoidance (AAQ-II) (0.62 - 0.67), and they showed similar relations with symptoms of depression (PHQ-9) and anxiety (GAD-7) (0.57 - 0.71). Mindfulness, experiential avoidance, and the non-judging subscale of FFMQ-24 constituted a latent factor of flexibility in cognition and emotional experience, while three FFMQ-24 subscales (describing, acting with awareness, and observing) constituted a present-centered attention and awareness factor. Regression analyses indicated that flexibility explained more of the variance in symptoms of anxiety and depression than present-centered attention and awareness.

CONCLUSIONS

The results suggest that flexibility in cognitive and emotional regulation skills could be important in explaining symptoms of anxiety and depression.

Understanding The Process of Taoistic-Informed Mindfulness from a Meadian Perspective

In the recent years, mindfulness-based research has experienced a boom. Yet, the majority of those studies treat mindfulness in a positivistic way, thus solely as a variable. Within such a lens of inquiry, we ignore the theoretical and historical underpinnings of mindfulness that are still important, nowadays. For that purpose, I instance a theoretical and historical framework of mindfulness grounded within Taoism - relying on the notion of the polarity of life and wu wei (the principle of not-forcing) and try to bridge that focus with Mead's Social Psychology. By means of an autoethnography, I show that mindfulness-based activities such as meditation unfold the power of an individual to experience and own a new I which then acts in a new fashion upon the demands of the (social) environment (Me). In this process, a new personality is born that integrates wholistically the polar sides of life within himself/herself.

Worry and Mindfulness Differentially Impact Symptom Burden Following Treatment Among Breast Cancer Survivors: Findings From a Randomized Crossover Trial

BACKGROUND

Breast cancer survivors often experience many somatic and cognitive side effects resulting from their cancer diagnosis and treatment, including higher rates of pain, fatigue, and memory/concentration problems. Emotion regulation offers opportunities to either enhance or dampen physical health.

PURPOSE

In a secondary analysis of a double-blind randomized controlled trial (RCT) using a typhoid vaccine to assess factors associated with breast cancer survivors' inflammatory responses, we assessed how two specific aspects of emotion regulation, mindfulness, and worry, corresponded to acute changes in focus problems, memory problems, and fatigue along with performance on pain sensitivity and cognitive tasks across two visits among breast cancer survivors.

METHODS

Breast cancer survivors (N = 149) completed two 8.5-hr visits at a clinical research center. Survivors were randomized to either the vaccine/saline placebo or a placebo/vaccine sequence. Worry and mindfulness questionnaires provided data on trait-level emotion regulation abilities. Fatigue, memory problems, and focus difficulties were assessed via Likert scales six times-once before the injections and then every 90 min for 7.5 hr thereafter. Women also completed a pain sensitivity task and several cognitive tasks at each visit.

RESULTS

Findings from this study showed that breast cancer survivors who worried more and were less mindful experienced subjective memory problems, focus problems, and cold pain sensitivity across two visits and irrespective of injection type. Lower mindfulness also corresponded to higher subjective fatigue and hot pain sensitivity and objective ratings. Emotion regulation skills did not predict objective pain sensitivity or cognitive problems.

CONCLUSION

Results from this study highlight the benefits of adaptive emotion regulation in helping mitigate symptoms associated with breast cancer survivorship.

Psychosocial-spiritual well-being is related to resilience and mindfulness in patients with severe and/or life-limiting medical illness

BACKGROUND

Improvement of psychosocial-spiritual well-being in patients with life-threatening or life-limiting illness is desirable. Resilience and mindfulness are considered to be helpful for enhancing psychosocial-spiritual well-being. Mindfulness-based interventions have been shown to promote resilience to stress and enhance well-being. However, in medical patients, evidence for the associations between mindfulness and resilience is lacking. We hypothesize patients with higher levels of psychosocial-spiritual well-being demonstrate greater resilience and mindfulness.

METHODS

200 patients (mean age = 50.2, SD = 15.5) with serious and or life-limiting illnesses were recruited from the NIH Clinical Center. Patients completed a demographic questionnaire, the NIH-HEALS measure of psychosocial-spiritual well-being, the Connor-Davidson Resilience Scale (CD-RISC-10), and the Mindful Attention Awareness Scale (MAAS). The demographic questionnaire also included a question on current stress level.

RESULTS

The NIH-HEALS was positively correlated to CD-RISC-10 (rs=0.44, p < 0.001) and MAAS (rs=0.32, p < 0.001). These findings were consistent across all three NIH-HEALS factors. Additionally, CD-RISC-10 and MAAS demonstrated a meaningful relationship to each other (rs=0.46, p < 0.001). All three constructs were inversely related to current stress level.

CONCLUSIONS

Findings suggest that there is a meaningful relationship between psychosocial-spiritual well-being, mindfulness, and resilience. Mindfulness and resilience are positively correlated in a medical population. Clinical interventions aimed at enhancing psychosocial-spiritual well-being through mindfulness and resilience can be highly promising for patients with severe and or life limiting illness.

The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Mindfulness yoga is a type of exercise that emphasizes the integration of mindfulness or meditation into yoga. The aim of this study was to determine the effectiveness of mindfulness yoga intervention on major depressive disorder (MDD) patients.

METHODS

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching nine databases, including PubMed, EMBASE, Web of Science, The Cochrane Library, MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang Data knowledge service platform, Chinese Biomedical Literature Database (CBM), and China Science and Technology Journal Database (VIP) from inception to April 2023. Primary outcomes included the severity of depression. Secondary outcomes included anxiety and rumination.

RESULTS

Nine RCTs met our inclusion criteria (n = 581). The meta-analysis showed that mindfulness yoga significantly has a significant effect on depression (SMD = -0.53; 95%CI = -0.96 to -0.11; P < 0.05) among MDD patients. The only two RCTs involved also showed that mindfulness yoga could alleviate the anxiety level of MDD patients after intervention (SMD = -1.08; 95%CI = -1.64 to -0.52; P < 0.05). Meta-analysis did not reveal positive effects of the mindfulness yoga groups on rumination after intervention based on three RCTs (SMD = -0.33; 95%CI = -0.89 to 0.23; P > 0.05), but found a significant difference in the follow-up period based on two RCTs (MD = -7.42; 95%CI = -11.27 to -3.56; P < 0.05), compared with the control groups.

CONCLUSION

Although we were unable to provide conclusive evidence to support the effectiveness of mindfulness yoga in improving symptoms in MDD patients, we found the literature included in this study indicated that mindfulness yoga might have a potential benefit for MDD patients and should be a feasible, acceptable, and promising intervention.

Study protocol for improving mental health during pregnancy: a randomized controlled low-intensity m-health intervention by midwives at primary care centers

BACKGROUND

Pregnancy-related anxiety and depression has received considerable attention worldwide. Mental health problems in pregnant women already since early weeks of gestation may have important consequences to the fetus. The necessity for more effective health care pathways, including some early interventions that reduce the overall burden of the childbearing situation appears a key factor for a successful birth and care of the baby. The few studies focalized in interventions, are focused on delivery and postpartum, without taking into account the whole maternity process. Current literature recommends the use of interventions based on new technologies for the treatment of mood disorders, already during the prenatal period. There have been scarce well-designed intervention studies that test technological low-intensity interventions by midwives to address pregnant women's mental health, diminishing anxiety and depression during pregnancy.

METHODS/DESIGN

Adult pregnant women (weeks 12-14 of gestation) will be recruited and screened from different primary care centers in Catalonia, Spain. Women who pass the initial mental screening will be randomly allocated to the relaxation virtual reality intervention or control group. The intervention aims to improve mental state of pregnant women during pregnancy, work through breathing, mindfulness and muscle relaxation techniques. Women in the control group will receive standard care offered by the public funded maternity services in Catalonia. The primary outcome measures will include the Edinburg Postnatal Depression (EPDS), State Trait Anxiety Inventory (STAI), Symptom Checklist-90 (SCL-90), and the Cambridge Worry Scale (CWS) instruments. Secondary outcome measures will include the Temperament and Character Inventory-Revised (TCI-R) and the Whooley and Generalized Anxiety Disorder-2 (GAD-2) questions. Routinary pregnancy monitoring measures will be also evaluated.

DISCUSSION

This study aims to test the efficacy of a low-intensity, midwife-led e-health intervention based on new technologies to work on women's anxiety and depression during pregnancy. We hypothesize that low-intensity mental health intervention during pregnancy, using an e-health (virtual reality) as a support tool, will be effective in reducing of anxiety, depressive symptoms, and improving satisfaction with pregnancy follow-up.

TRIAL REGISTRATION

Clinical Trials ID NCT05756205.

Cognitive-Based Interventions for Improving Psychological Health and Well-Being for Parents of Children with Developmental Disabilities: A Systematic Review and Meta-analysis

This review aims to systematically summarize existing evidence to determine the effectiveness of cognitive-based interventions (CBIs) on psychological health and well-being among parents of children with developmental disabilities (DD). Six databases were searched to identify eligible randomized controlled trials (RCTs) from their inception to April 2023. The revised Cochrane Risk of Bias tool for RCTs was applied to assess the risk of bias and the certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation. Meta-analyses were conducted using a random-effects model. Twenty-five RCTs involving 1915 participants were identified. The results indicated that CBIs reduced parental stress levels (Hedges' g = - 0.69), depressive symptoms (g = - 0.95), anxiety levels (g = - 0.78), and parental distress (g = - 0.29), and improved parental well-being (g = 0.62) and parent‒child relationships (g = 0.43) postintervention compared with the active/inactive control groups. Subgroup analysis of the effectiveness of interventions using mindfulness-based interventions and cognitive behavioural therapy showed positive effects. The favourable intervention duration and participant targets were also identified in this review. Furthermore, the effects of CBIs were impacted by the different types of DD among the children. This review highlighted the positive effects of CBIs on parental stress levels, depressive symptoms, anxiety levels, parental distress levels, parental well-being levels, and parent‒child relationships. Future well-designed RCTs are needed to further investigate the effects of MBIs and CBT interventions on children with DD and their parents, as well as the factors and mechanisms of action affecting the efficacy of these interventions.

Mindful, mindless, or misunderstood? A critical perspective of the mindfulness concept

Mindfulness is everywhere, but the term is often used mindlessly. This article discusses the growth of mindfulness-based interventions in many countries over the past fifty years and, more recently, the emergence of the idea of 'McMindfulness', with particular emphasis on the concept of 'spiritual bypassing'. Critical discourse is a valuable resource in any discipline. Proportionate, mindful incorporation of reasoned critiques strengthens mindfulness, rather than undermining it. Misunderstandings and misinterpretations of mindfulness highlight a need to counter the notions that mindfulness involves avoiding difficult issues in our lives or simply accepting social problems that need to be addressed. The opposite is true: mindfulness of reality inevitably generates insights about change. Before we change the world, we need to see it. Mindfulness practice is opting in, not opting out.

Integrating Spirituality and Religious Beliefs in a Mindfulness Based Cognitive Behavioral Therapy for PTSD with Latinx Unaccompanied Immigrant Children

Purpose: Unaccompanied immigrant children (UIC) experience significant mental health concerns, particularly posttraumatic stress. This is a vulnerable population, yet little systematic research has examined the effectiveness of evidence-based models such as cognitive behavioral therapy (CBT) to meet their needs. Integrating religious beliefs and spirituality into therapy could elucidate better understandings of traumatic stress, and posttraumatic cognitions when working with UIC with strong faith traditions/beliefs. Methods: We report on modifications made to a pre-existing treatment, consisting of integrating religious and spiritual themes, to engage and work with UIC participants in a pilot study of Mindfulness-Based CBT. Thematic analysis of therapy notes evaluated the implementation process for integrating religious and spiritual themes. Three composite vignettes illustrate how religiosity and spirituality were salient for UIC participants in this pilot study, and how these were integrated into therapy to address posttraumatic cognitions and symptoms. We assessed changes in PTSD symptom severity and posttraumatic cognitions for UIC and in comparison, to non-UIC participants using the Child PTSD Symptom Scale and the Posttraumatic Cognitions Inventory. Results: Religiosity and spirituality were important for coping and conceptualizations of trauma, served as facilitators for engaging UIC in therapy, and related to improving posttraumatic cognitions and symptoms. Conclusion: Religious identity and spirituality can be important for meaning making, trauma cognitions and symptoms, and can be important to explore in therapy with unaccompanied immigrant children and adolescents. Clinical Trial Registration: Not applicable.

"Stop and just breathe for a minute": perspectives of children on the Autism Spectrum and their caregivers on a Mindfulness Group

Children on the autism spectrum often experience anxiety. Mindfulness is growing in popularity as a method to support children with anxiety; however, there is limited evidence on mindfulness for children on the autism spectrum. This study investigated the feasibility of a 10-week group-based mindfulness intervention for 14 children on the autism spectrum. A one-group pre-post design determined outcomes of anxiety (caregiver and child report), mindful attention, and wellbeing (child report). Interviews explored children's and caregivers' perceptions. There were no significant differences in outcomes post-intervention. Five themes were identified from interviews: (1) Children felt calmer; (2) Parents observed differences in anxiety; (3) Breathing and yoga helped; (4) Parents wanted more; and (5) Challenges and benefits of group intervention.

Breastfeeding continuation is associated with trait mindfulness but not with trajectories of postpartum depressive symptoms

OBJECTIVE

The WHO recommends breastfeeding for at least six months as breastfeeding has many benefits for both infant and mother. The association of breastfeeding continuation with trait mindfulness during pregnancy and trajectories of postpartum depressive symptoms has not been examined yet. The current study aimed to assess this association using cox regression analysis.

DESIGN, SETTING AND PARTICIPANTS

The current research is part of a large longitudinal prospective cohort study following women from 12 weeks of pregnancy onwards in the South-East part of the Netherlands.

MEASUREMENTS

A total of 698 participants filled out the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) at 22 weeks of pregnancy and completed both the Edinburgh Postnatal Depression Scale (EPDS) and questions on breastfeeding continuation one week, six weeks, four months, and eight months postpartum. Breastfeeding continuation was defined as exclusive breastfeeding or both breastfeeding and formula. The assessment eight months postpartum was used as a proxy for the WHO recommendation to continue breastfeeding for at least six months.

FINDINGS

Two trajectories (classes) of EPDS scores were determined using growth mixture modeling: 1) low stable (N = 631, 90.4%), and 2) increasing (N = 67, 9.6%). Cox regression analysis showed that the trait mindfulness facet non-reacting was significantly and inversely associated with the risk of breastfeeding discontinuation (HR = 0.96, 95% CI [0.94, 0.99], p = .002), while no significant association was found for belonging to the increasing EPDS class versus belonging to the low stable class (p = .735), adjusted for confounders.

KEY CONCLUSIONS

This study is the first to show that higher trait mindfulness non-reacting scores, but not persistently low levels of postpartum depressive symptoms, increase the likelihood of breastfeeding continuation.

IMPLICATIONS FOR PRACTICE

Improving non-reacting in perinatal women by meditation practice as part of a mindfulness-based intervention may lead to better breastfeeding continuation outcomes. Several mindfulness-based programs may be suitable.

Efficacy of mindfulness-based relapse prevention in a sample of veterans in a substance use disorder aftercare program: A randomized controlled trial

BACKGROUND

Complementary integrative medicine, such as mindfulness-based interventions, (MBI) have demonstrated efficacy in the treatment of depression, anxiety, substance use disorders (SUDs), and pain. Mindfulness-based relapse prevention (MBRP) is an aftercare intervention targeting SUD relapse that integrates cognitive-behavioral relapse prevention and mindfulness meditation practices, raising awareness of substance use triggers and reactive behavioral patterns. This study evaluated the efficacy of MBRP in reducing relapse in veterans following completion of an SUD treatment program.

METHODS

This study was a two-site, randomized controlled trial comparing MBRP to 12-step facilitation (TSF) aftercare in military veterans following completion of intensive treatment for SUDs. The 8 weeks of 90-minute, group-based MBRP or TSF sessions were followed by 3-, 6- and 10-month follow-up periods with assessments of alcohol/substance use and secondary outcomes of depression, anxiety, and mindfulness.

RESULTS

Forty-seven percent of veterans attended ≥75 % of sessions. Veterans in both the MBRP and TSF aftercare groups maintained reductions in alcohol and illicit substance use during the aftercare treatment. Nineteen participants (11 %; 19/174) reported returning to alcohol use during the study treatment period and the study found no difference between study groups [MBRP: 9 % vs. TSF 13 %; p = 0.42]. Thirteen participants (7.5 %; 13/174) reported a return to illicit substance use during study treatment [MBRP: 5.4 % vs. TSF 10.3 % p = 0.34]. The number of days of drinking and illicit substance use was not different between groups (alcohol, p = 0.53; illicit substance use, p = 0.28).

CONCLUSION

Although retention in treatment limits interpretation of the findings, both MBRP and TSF were effective in maintenance of treatment gains following an intensive treatment program for veterans with SUDs. Future studies should focus on strategies to improve treatment participation.

Burnout prevention in healthcare professionals during COVID-19

Introduction

Burnout syndrome represents the pathological outcome of a stressful process that mainly affects the "helping professions". During the COVID-19 pandemic, pressure on healthcare systems has led to an increase in psychological distress among healthcare workers. The aim of this study is to verify whether the practice of relaxation techniques in healthcare workers can improve emotional balance and stem burnout.

Methods

A small sample of 40 female rehabilitation therapists were divided into two groups (20 experimental group subjects and 20 control group subjects). The Maslach Burnout Inventory was administered to both groups, after informed consent, to highlight the correlation between working hours exceeding 30 hours per week and burnout, by subjecting the experimental group to mindfulness sessions between T0 and T1.

Results

The data analysis highlighted a decrease in burnout in the experimental group after the mindfulness sessions.

Conclusions

The findings suggest that these relaxation techniques can be effective in stemming burnout and promoting psychological well-being. It is therefore possible to hypothesize that such increased and prolonged activities could show a more evident and statistically significant improvement.