Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness

Using PhotoVoice to understand mindfulness in health care practitioners

Background

The disruptions of the coronavirus disease 2019 (COVID-19) pandemic have placed added stress on health care practitioners’ (HCPs) mental health. Mindfulness-based interventions (MBIs) have been reported to increase the awareness of burnout and promote self-care practices that enhance mental well-being.

Aim

To gain insight into the use of mindfulness through the lens of PhotoVoice on how HCPs reflected on their stressors and sense of self whilst working as frontline workers during the COVID-19 pandemic.

Setting

This study was conducted online with HCPs working in South Africa during the first wave of COVID-19.

Method

A four-week MBI intervention was implemented using Zoom. An exploratory qualitative analysis was conducted using a PhotoVoice methodology. Interpretative phenomenological analysis was used to generate themes. Fifty-five HCPs consented to participate in this study.

Results

The major themes identified were operating on autopilot, feeling a sense of overwhelm because of COVID-19, using faith to cope and being able to attain a sense of self-compassion by the end of the intervention.

Conclusions

Using visual representations, HCPs were able to share the development of their reperceived lived experiences of increased self-compassion as they navigated the dilemmas and disruptions of the pandemic.

Contribution

A brief online MBI was impactful enough to show a reappraisal of the stressors of COVID-19, such that HCPs felt calmer, more competent and more compassionate. PhotoVoice methodology is recommended for future studies and mindfulness courses. It facilitates a deeper understanding of the practice of imbuing mindfulness and its impact on stressors and the self.

Respiratory sinus arrhythmia during biofeedback is linked to persistent improvements in attention, short-term memory, and positive self-referential episodic memory

Background

Heart rate variability (HRV) biofeedback, an intervention based on the voluntary self-regulation of autonomic parameters, has been shown to affect prefrontal brain functioning and improve executive functions. The interest in using HRV biofeedback as cognitive training is typically ascribed to parasympathetic activation and optimized physiological functioning deriving from increased cardiac vagal control. However, the persistence of cognitive effects is poorly studied and their association with biofeedback-evoked autonomic changes has not yet been explored. In addition, no study has so far investigated the influence of HRV biofeedback in adults on long-term episodic memory, which is particularly concerned with self-referential encoding processing.

Methods

In the present study, a novel training system was developed integrating HRV and respiratory biofeedback into an immersive virtual reality environment to enhance training efficacy. Twenty-two young healthy adults were subjected to a blinded randomized placebo-controlled experiment, including six self-regulation training sessions, to evaluate the effect of biofeedback on autonomic and cognitive changes. Cardiac vagal control was assessed before, during, and 5 min after each training session. Executive functions, episodic memory, and the self-referential encoding effect were evaluated 1 week before and after the training program using a set of validated tasks.

Results

Linear mixed-effects models showed that HRV biofeedback greatly stimulated respiratory sinus arrhythmia during and after training. Moreover, it improved the attentional capabilities required for the identification and discrimination of stimuli ( η p 2 = 0.17), auditory short-term memory ( η p 2 = 0.23), and self-referential episodic memory recollection of positive stimuli ( η p 2 = 0.23). Episodic memory outcomes indicated that HRV biofeedback reinforced positive self-reference encoding processing. Cognitive changes were strongly dependent on the level of respiratory sinus arrhythmia evoked during self-regulation training.

Conclusion

The present study provides evidence that biofeedback moderates respiration-related cardiac vagal control, which in turn mediates improvements in several cognitive processes crucial for everyday functioning including episodic memory, that are maintained beyond the training period. The results highlight the interest in HRV biofeedback as an innovative research tool and medication-free therapeutic approach to affect autonomic and neurocognitive functioning. Finally, a neurocognitive model of biofeedback-supported autonomic self-regulation as a scaffolding for episodic memory is proposed.

Introspective self-narrative modulates the neuronal response during the emphatic process: an event-related potentials (ERPs) study

Empathy is the ability to perceive and understand others' emotional states generating a similar mental state in the self. Previous behavioural studies have shown that self-reflection can enhance the empathic process. The present event-related potentials' study aims to investigate whether self-reflection, elicited by an introspective self-narrative task, modulates the neuronal response to eye expressions and improves the accuracy of empathic process. The 29 participants included in the final sample were divided into two groups: an introspection group (IG) (n = 15), who received an introspective writing task, and a control group (CG) (n = 14), who completed a not-introspective writing task. For both groups, the electroencephalographic and behavioural responses to images depicting eye expressions taken from the "Reading the Mind in the Eyes" Theory of Mind test were recorded pre- (T0) and post- (T1) 7 days of writing. The main result showed that only the IG presented a different P300 amplitude in response to eye expressions at T1 compared to T0 on the left centre-frontal montage. No significant results on accuracy at T1 compared to T0 were found. These findings seem to suggest that the introspective writing task modulates attention and implicit evaluation of the socio-emotional stimuli. Results are discussed with reference to the hypothesis that such neuronal modulation is linked to an increase in the embodied simulation process underlying affective empathy.

Effects of a mindfulness-based versus a health self-management intervention on objective cognitive performance in older adults with subjective cognitive decline (SCD): a secondary analysis of the SCD-Well randomized controlled trial

Background

Older individuals with subjective cognitive decline (SCD) perceive that their cognition has declined but do not show objective impairment on neuropsychological tests. Individuals with SCD are at elevated risk of objective cognitive decline and incident dementia. Non-pharmacological interventions (including mindfulness-based and health self-management approaches) are a potential strategy to maintain or improve cognition in SCD, which may ultimately reduce dementia risk.

Methods

This study utilized data from the SCD-Well randomized controlled trial. One hundred forty-seven older adults with SCD (MAge = 72.7 years; 64% female) were recruited from memory clinics in four European countries and randomized to one of two group-based, 8-week interventions: a Caring Mindfulness-based Approach for Seniors (CMBAS) or a health self-management program (HSMP). Participants were assessed at baseline, post-intervention (week 8), and at 6-month follow-up (week 24) using a range of cognitive tests. From these tests, three composites were derived—an “abridged” Preclinical Alzheimer’s Cognitive Composite 5 (PACC5Abridged), an attention composite, and an executive function composite. Both per-protocol and intention-to-treat analyses were performed. Linear mixed models evaluated the change in outcomes between and within arms and adjusted for covariates and cognitive retest effects. Sensitivity models repeated the per-protocol analyses for participants who attended ≥ 4 intervention sessions.

Results

Across all cognitive composites, there were no significant time-by-trial arm interactions and no measurable cognitive retest effects; sensitivity analyses supported these results. Improvements, however, were observed within both trial arms on the PACC5Abridged from baseline to follow-up (Δ [95% confidence interval]: CMBAS = 0.34 [0.19, 0.48]; HSMP = 0.30 [0.15, 0.44]). There was weaker evidence of an improvement in attention but no effects on executive function.

Conclusions

Two non-pharmacological interventions conferred small, non-differing improvements to a global cognitive composite sensitive to amyloid-beta-related decline. There was weaker evidence of an effect on attention, and no evidence of an effect on executive function. Importantly, observed improvements were maintained beyond the end of the interventions. Improving cognition is an important step toward dementia prevention, and future research is needed to delineate the mechanisms of action of these interventions and to utilize clinical endpoints (i.e., progression to mild cognitive impairment or dementia).

Trial registration

ClinicalTrials.gov, NCT03005652.

Effectiveness of a Mindful Compassion Care Program in reducing burnout and psychological distress amongst frontline hospital nurses during the COVID-19 pandemic: a study protocol for a randomized controlled trial

BACKGROUND

Recent studies have shown that nurses have been more affected by the COVID-19 pandemic than any other group of hospital workers in terms of anxiety, depression, and burnout. Several clinical studies had previously demonstrated the effectiveness of mindfulness and compassion interventions in reducing burnout and emotional distress amongst healthcare professionals.

METHODS AND ANALYSIS

A parallel-group randomized controlled trial will assess the feasibility, acceptability, and efficacy of a mindfulness and compassion-focused programme on frontline nurses who had been working during the COVID-19 pandemic. Seventy-two participants will be recruited from Verona University Hospital Trust (Veneto Region, north-east Italy) and will be divided equally into an intervention group and a control group. Primary outcome will be assessed using the Emotional Exhaustion subscale of the Maslach Burnout Inventory General Survey (MBI-GS). Secondary outcomes will be measured by the Cynicism and Professional Efficacy subscales of the MBI-GS, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), the Insomnia Severity Index (ISI), the Impact of Stressful Events (IES-R), the Perceived Stress Scale (PSS), the Five Facet Mindfulness Questionnaire (FFMQ), and the Forms of Self-Criticising/attacking and Self-Reassuring Scale (FSCRS).

DISCUSSION

The study aims to fill a gap in the literature and present a scientifically validated intervention for those healthcare professionals most exposed to the stressful conditions of working during the COVID-19 pandemic.

TRIAL REGISTRATION

ClinicalTrials.gov; Identifier: NCT05308537.

The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis

Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].

The Value of Contemplative Practices: A Mixed Methods Approach Exploring Associations between Resilience and Experiences of the COVID-19 Pandemic among Older Adults

The aim of this study was to explore the association between resilience and experiences of the COVID-19 pandemic among older adults. We used a sequential explanatory mixed methods study design to recruit older adults who spoke English and were 60 and above during the pandemic. Survey data investigated older adults' resilience, post-traumatic growth, well-being, and demographics. Extreme case purposeful sampling of their resilience score was used to select interviewees. Qualitative data sought to understand the relationship between resilience and how older adults responded to the COVID-19 pandemic. Exploring the relationship between resilience (well-being in the face of challenge) and one's experience of the COVID-19 pandemic revealed that participants categorized as having high resilience had long held behaviors of contemplative practices that helped them effectively adapt to the COVID-19 pandemic. As we continue to face global challenges, we must redefine care, guide interventions, and promote healthy aging by incorporating contemplative practices into the lives of older adults.

The role of attention control in complex real-world tasks

Working memory capacity is an important psychological construct, and many real-world phenomena are strongly associated with individual differences in working memory functioning. Although working memory and attention are intertwined, several studies have recently shown that individual differences in the general ability to control attention is more strongly predictive of human behavior than working memory capacity. In this review, we argue that researchers would therefore generally be better suited to studying the role of attention control rather than memory-based abilities in explaining real-world behavior and performance in humans. The review begins with a discussion of relevant literature on the nature and measurement of both working memory capacity and attention control, including recent developments in the study of individual differences of attention control. We then selectively review existing literature on the role of both working memory and attention in various applied settings and explain, in each case, why a switch in emphasis to attention control is warranted. Topics covered include psychological testing, cognitive training, education, sports, police decision-making, human factors, and disorders within clinical psychology. The review concludes with general recommendations and best practices for researchers interested in conducting studies of individual differences in attention control.

Mind full of kindness: self-awareness, self-regulation, and self-transcendence as vehicles for compassion

BACKGROUND

We investigated the relationship between mindfulness and compassion in a broader way than is typically done by (a) using a recent, comprehensive conceptualization of mindfulness as a manifold of self-awareness, self-regulation, and self-transcendence, and (b) by casting a wide net of compassion measures [i.e., the Compassionate Love for Humanity Scale (Sprecher and Fehr in J Soc Pers Relatsh 22(5):629-651, 2005); Compassion Scale (Martins et al. in J Health Care Poor Underserved 24:1235-1246, 2013); Compassion Scale (Pommier in Assessment 27:21-39, 2020); Relational Compassion Scale (Hacker in The relational compassion scale: Development and validation of a new self-rated scale for the assessment of self-other compassion, University of Glasgow, 2008); and the SOCS-O scale (Gu et al. in Clin Psychol Rev 37:1-12, 2020)]. Additionally, we examined the interplay between mindfulness, compassion, and ethical sensitivities by assessing the influence of the moral foundations (individualizing and binding) on compassion, and the influence of mindfulness, the moral foundations, and compassion on awareness of privilege.

METHODS

We surveyed 407 undergraduate students. Factor analysis was used to examine the dimensionality of the compassion measures; path analysis to examine the relationships between all variables.

RESULTS

Factor analysis revealed distinct affective (empathy, indifference), cognitive (common humanity, recognizing suffering), and motivational (willingness to act) aspects of compassion. Mindfulness, under its aspects of reflective awareness, self-compassion, and self-transcendence, was associated with compassion, with reflective awareness predicting multiple aspects of compassion over and beyond the normal mechanisms of the mindfulness manifold and the moral foundations. Individualizing was associated with all aspects of compassion; binding was only connected to recognizing suffering and a willingness to act. Awareness of privilege was positively connected to mindfulness through individualizing and the recognition of common humanity; it was also directly negatively related to the moral foundation of binding.

CONCLUSIONS

Mindfulness and compassion have synergistic and distinct positive effects on ethical sensitivities. Given that both compassion and ethical sensitivities have roots in mindfulness, mindfulness interventions might be one possible venue to enhance these positive aspects of individuals' psychology.

Exploring the past, present, and future of the mindfulness field: A multitechnique bibliometric review

This paper provides an overview of the mindfulness literature up until the end of 2020 by (a) uncovering its underlying intellectual structure, (b) identifying the most influential and popular themes, and (c) presenting new directions for future research on mindfulness. To this end, a systematic quantitative review based on bibliometric methods was conducted, which is perhaps less prone to researcher bias and can complement existing meta-analyses and qualitative (narrative) structured reviews as an objective approach. Three bibliometric techniques—document co-citation analysis, co-word (co-occurrence and content) analysis, and bibliographic coupling—were applied to explore the past, present, and future of mindfulness research. The co-citation analysis showed that measurement, mechanisms, mindfulness-based interventions, and examinations of the efficacy of mindfulness interventions are among the key theoretical knowledge bases from which the field of mindfulness is derived. The content analysis demonstrated the beneficial effects of mindfulness meditation for physical and mental health conditions. The bibliographic coupling revealed novel directions in cognitive behavioral therapy, emotion regulation, the application of mindfulness practice to children and adolescents, mindfulness at work, and the role of mindfulness in positive psychology. The large sample of articles that was analyzed allowed us to provide a broader and more objective overview than possible with other forms of literature reviews. The combination of the three bibliometric techniques granted deeper insights into the complex multidisciplinary field of mindfulness, along with specific suggestions for future research.

Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity

This meta-analysis sought to expand upon neurobiological models of mindfulness through investigation of inherent brain network connectivity outcomes, indexed via resting state functional connectivity (rsFC). We conducted a systematic review and meta-analysis of rsFC as an outcome of mindfulness training (MT) relative to control, with the hypothesis that MT would increase cross-network connectivity between nodes of the Default Mode Network (DMN), Salience Network (SN), and Frontoparietal Control Network (FPCN) as a mechanism of internally-oriented attentional control. Texts were identified from the databases: MEDLINE/PubMed, ERIC, PSYCINFO, ProQuest, Scopus, and Web of Sciences; and were screened for inclusion based on experimental/quasi-experimental trial design and use of mindfulness-based training interventions. RsFC effects were extracted from twelve studies (mindfulness n = 226; control n = 204). Voxel-based meta-analysis revealed significantly greater rsFC (MT > control) between the left middle cingulate (Hedge's g = .234, p = 0.0288, I2 = 15.87), located within the SN, and the posterior cingulate cortex, a focal hub of the DMN. Egger's test for publication bias was nonsignificant, bias = 2.17, p = 0.162. In support of our hypothesis, results suggest that MT targets internetwork (SN-DMN) connectivity implicated in the flexible control of internally-oriented attention.

The Effect of Yoga on the Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Objectives

Yoga is a mind-body stress-relieving exercise that increases mental and physical health, which may have a role in the improvement of metabolic disorders. The present study has reviewed the effect of yoga on lipid profiles as a systematic review and meta-analysis.

Methods

We evaluated the available randomized controlled trials on the effects of yoga-based programs, and lipid profiles by searching PubMed/Medline, Scopus, Web of Science, and the Cochrane central register of control trials up to January 2022. Both fixed and random effect analyses were used to find the relationships. Subgroup analysis was performed based on the continent, duration of the included studies, gender, and health condition of participants to discover the sources of heterogeneity.

Result

Fifty-three studies were included in the current systematic review and meta-analysis with a total sample size of 13,191. There was a striking association between yoga and total cholesterol (−10.31 mg/dl; 95% CI: −14.16, −6.45; I² = 82.5%, P < 0.001), low-density lipoprotein cholesterol (−8.64 mg/dl; 95% CI: −12.03, −5.25; I² = 75.0%, P < 0.001), high-density lipoprotein cholesterol (1.98 mg/dl; 95% CI: 0.81, 3.14; I² = 91.6%, P < 0.001), triglycerides (−13.50 mg/dl; 95% CI: −20.09, −6.92; I² = 90.7%, P < 0.001) and very low-density lipoprotein (−3.94 mg/dl; 95%CI: −6.31, −1.56; I² = 72.2%, P < 0.001).

Conclusion

It seems yoga interventions had a substantial effect on lipid profiles, however, more qualified trials or cohort studies are needed to conclude exactly.

Online Mindfulness Intervention, Mental Health and Attentional Abilities: A Randomized Controlled Trial in University Students During COVID-19 Lockdown

The COVID-19 pandemic has led to worldwide restrictive measures, raising concerns about mental health in young adults who were not particularly vulnerable to the virus itself. This study investigated the impact of these restrictions on mental and cognitive health of university students, and tested the efficacy of a brief online mindfulness meditation intervention in countering psychological distress and improving attentional abilities. Ninety-six university students forced into remote learning due to COVID-19 pandemic restrictions and with no experience in meditation were randomly assigned to either a passive control group (n = 48) or to an experimental group (n = 48) following daily, for 17 days, an online mindfulness intervention (10–20 min per day). Due to drop-out, 38 participants in each group were finally analyzed. Pre- and post-tests assessed participants’ mental health (psychological well-being, depression, anxiety, stress) and attentional abilities. The analysis of baseline data in comparison with normative scores and pre-pandemic statistics confirmed the expected psychological distress, but it did not reveal any attentional deficits in our participants. Pre-post change scores analyses showed a reduction in stress (p = 0.006, η_p² = 0.10), anxiety (p = 0.002, η_p² = 0.13), and depression (p = 0.025, η_p² = 0.07), and an improvement in well-being (p = 0.013, η_p² = 0.12) in the experimental group, but not in the control group. In both groups, no significant effect was found on attentional abilities. Our results confirmed the psychological vulnerability of higher education students in the midst of the remote learning period during the second COVID-19 lockdown in France, while suggesting preservation of attentional functioning. Although the tested mindfulness intervention did not enhance the attentional abilities in already good performing students, it did promote their mental health. This study offers additional evidence on the feasibility and efficacy of mindfulness-based interventions in students during psychologically straining periods, like the COVID-19 pandemic.

EcoMeditation Modifies Brain Resting State Network Activity

Background

The tendency of the mind to wander, a characteristic of the brain's default mode network (DMN), correlates with increased unhappiness and self-referential processing and is a deterrent to establishing a consistent meditation practice. The objective of this study was to test the impact of a secular physiological method of meditation. We hypothesized that EcoMeditation would produce increases in neural communication in brain regions associated with compassion and prosociality and decreases in self-referencing networks, such as the DMN, and that these changes would be found in the experimental group, but not the control group.

Methods

Participants (n=38) were randomized into two groups, and the final sample consisted of 25 participants. One group listened daily to a 22-minute EcoMeditation audio track, while the other used an active control. Functional magnetic resonance imaging (fMRI) was used to assess brain function before and after four weeks of practice. Mystical experiences, as well as psychological conditions, such as anxiety and depression, were measured.

Results

Participants in the EcoMeditation group showed significantly increased connectivity between the bilateral hippocampus and the bilateral insula, compared to pre-intervention. In addition, significant decreases of connectivity between the bilateral hippocampus and the midprefrontal and left dorsolateral prefrontal cortices occurred. EcoMeditation participants also scored significantly higher for mystical experiences than the control group. The results for emotional states were mixed, with one assessment finding increased positive mood, but another finding increased negative affect.

Conclusion

After only four weeks, participants using EcoMeditation demonstrated brain states similar to meditation adepts with thousands of hours of traditional practice.

Nonattachment mediates the associations between mindfulness, well-being, and psychological distress: A meta-analytic structural equation modeling approach

Research on nonattachment, a Buddhist psychological construct closely related to mindfulness, has burgeoned since the development of the Nonattachment Scale. The aim of the current meta-analysis was to investigate the mediating role of nonattachment in the relationship between mindfulness and well-being and psychological distress using a meta-analytic structural equation modeling approach. The respective associations of nonattachment and mindfulness with well-being and psychological distress, after controlling for each other, were also examined. Forty-one independent cross-sectional data sets with 24,704 individuals were coded. Results showed that nonattachment partially mediated the associations between mindfulness and well-being and psychological distress. Nonattachment and mindfulness were both significantly positively associated with well-being and negatively associated with psychological distress after controlling for each other. Given the present findings were based on cross-sectional data, more studies with rigorous research design, such as longitudinal, experimental, and intervention studies, should be conducted to further investigate the mediating effect of nonattachment between mindfulness with well-being and distress outcomes and establish causal relations between them. Future research directions regarding nonattachment and its application in mindfulness-based interventions were discussed.

Extending the Transformative Potential of Mindfulness Through Team Mindfulness Training, Integrating Individual With Collective Mindfulness, in a High-Stress Military Setting

Mindfulness has come to be considered an important approach to help individuals cultivate transformative capacity to free themselves from stress and suffering. However, the transformative potential of mindfulness extends beyond individual stress management. This study contributes to a broadening of the scope of contemplative science by integrating the prominent, individually focused mindfulness meditation literature with collective mindfulness scholarship. In so doing, it aims to illuminate an important context in which mindfulness interventions are increasingly prevalent: workplaces. Typically, the intended effect of workplace mindfulness training is to help workers manage stress better. Since mindfulness in organizations impacts individual and collective processes, the study blends the above literatures to create a cross-level “next-generation” Team Mindfulness Training (TMT) pilot. Its potential in helping individuals and teams to manage work stress better is investigated via a two-phase mixed-methods research study in high-stress military work populations, and compared to a conventional (“first-generation”) 8-week mindfulness meditation program based on mindfulness-based stress reduction (MBSR). Results suggest that compared to the “first-generation” mindfulness program, TMT seems no less effective in raising individual stress management skills, and may hold more promise in generating collective capacity to manage stress and unexpected difficulty, linked to an apparent interdependence between collective and individual mindfulness capacity development. Based on these empirical results, the study contributes to theory in three important ways: first, it outlines how individual and collective mindfulness in workplaces may be interdependent. Second, it explains why “next-generation” workplace training interventions should apply a cross-level approach. And third, it illustrates how its transformative potential for people at work, individually as well as collectively, can be extended by moving beyond an inward-looking meditation focus in mindfulness training. The study contributes to practice by providing a detailed outline of the pilot TMT program, and offers a series of follow-up research opportunities to inspire further scientific innovation in workplace mindfulness training, especially for high-stress work populations. The study’s ultimate aim is to prompt a shift away from adapting clinically oriented, self-focused “first-generation” mindfulness training protocols, and towards mindfulness as team sport: a more prosocially oriented mindfulness science intent on generating wisdom and compassion, for one and all.

A Randomized Controlled Trial Study of a Multimodal Intervention vs. Cognitive Training to Foster Cognitive and Affective Health in Older Adults

Research over the past few decades has shown the positive influence that cognitive, social, and physical activities have on older adults' cognitive and affective health. Especially interventions in health-related behaviors, such as cognitive activation, physical activity, social activity, nutrition, mindfulness, and creativity, have shown to be particularly beneficial. Whereas most intervention studies apply unimodal interventions, such as cognitive training (CT), this study investigates the potential to foster cognitive and affective health factors of older adults by means of an autonomy-supportive multimodal intervention (MMI). The intervention integrates everyday life recommendations for six evidence-based areas combined with psychoeducational information. This randomized controlled trial study compares the effects of a MMI and CT on those of a waiting control group (WCG) on cognitive and affective factors, everyday life memory performance, and activity in everyday life. Three groups, including a total of 119 adults aged 65-86 years, attended a 5- or 10-week intervention. Specifically, one group completed a 10-week MMI, the second group completed 5-week of computer-based CT followed by a 5-week MMI, whereas the third group paused before completing the MMI for the last 5 weeks. All participants completed online surveys and cognitive tests at three test points. The findings showed an increase in the number and variability of activities in the everyday lives of all participants. Post hoc analysis on cognitive performance of MMI to CT indicate similar (classic memory and attention) or better (working memory) effects. Furthermore, results on far transfer variables showed interesting trends in favor of the MMI, such as increased well-being and attitude toward the aging brain. Also, the MMI group showed the biggest perceived improvements out of all groups for all self-reported personal variables (memory in everyday life and stress). The results implicate a positive trend toward MMI on cognitive and affective factors of older adults. These tendencies show the potential of a multimodal approach compared to training a specific cognitive function. Moreover, the findings suggest that information about MMI motivates participants to increase activity variability and frequency in everyday life. Finally, the results could also have implications for the primary prevention of neurocognitive deficits and degenerative diseases.

Self-Actualization and the Integration of Psychedelic Experience: The Mediating Role of Perceived Benefits to Narrative Self-Functioning

There is a growing need in the field of psychedelic science for a unifying perspective of overall well-being to join seemingly disparate findings across clinical and non-clinical populations, and account for the unique role of post-psychedelic integration for promoting benefits. According to the eudaimonic perspective of well-being, the stories we create about who we are (self-insight) and who we can become (personal development) are key aspects of narrative self-functioning that either constrain or facilitate well-being. The present paper draws upon this perspective to investigate the relationship between extent of post-psychedelic integration and optimal well-being ( self-actualization), with perceived benefits to narrative self-functioning ( self-insight and personal development) as a mediator. The data for testing this model was collected from roughly 750 participants recruited from websites and social media forums. Because the sample contained clinical and non-clinical individuals, the model was able to be tested with mental health condition as a moderator. Results indicated that perceived benefits to narrative self-functioning is one pathway through which integration of psychedelic experience may promote optimal well-being for both clinical and non-clinical populations. Exploratory analyses indicated that integration techniques that are more self-referential in nature are the ones that indirectly relate to optimal well-being via perceived benefits. The results of the present study should be interpreted as a preliminary model for future longitudinal research to test, as our cross-sectional methods preclude any causal inferences to be made from these mediation analyses.

Mindfulness-Based Cognitive Therapy: A Preliminary Examination of the (Event-Related) Potential for Modifying Threat-Related Attentional Bias in Anxiety

Objectives

Mindfulness-based cognitive therapy (MBCT) can reduce anxiety and depression symptoms in adults with anxiety disorders, and changes in threat-related attentional bias may be a key mechanism driving the intervention's effects on anxiety symptoms. Event-related potentials (ERPs) can illuminate the physiological mechanism through which MBCT targets threat bias and reduces symptoms of anxiety. This preliminary study examined whether P1 ERP threat-related attentional bias markers in anxious adults change from pre- to post-MBCT delivered in-person or virtually (via Zoom) and investigated the relationship between P1 threat-related attentional bias markers and treatment response.

Methods

Pre- and post-MBCT, participants with moderate to high levels of anxiety (N = 50) completed a dot-probe task with simultaneous EEG recording. Analyses focused on pre- and post-MBCT P1 amplitudes elicited by angry-neutral and happy-neutral face pair cues, probes, and reaction times in the dot-probe task and anxiety and depression symptoms.

Results

Pre- to post-MBCT, there was a significant reduction in P1-Probe amplitudes (d = .23), anxiety (d = .41) and depression (d = .80) symptoms, and reaction times (d = .10). Larger P1-Angry Cue amplitudes, indexing hypervigilance to angry faces, were associated with higher levels of anxiety both pre- and post-MBCT (d = .20). Post-MBCT, anxiety symptoms were lower in the in-person versus virtual group (d = .80).

Conclusions

MBCT may increase processing efficiency and decreases anxiety and depression symptoms in anxious adults. However, changes in threat bias specifically were generally not supported. Replication with a comparison group is needed to clarify whether changes were MBCT-specific.

Clinical Trials Registration

NCT03571386, June 18, 2018.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-022-01910-x.

The Comparative Effect of Reduced Mindfulness-Based Stress on Heart Rate Variability among Patients with Breast Cancer

Heart rate variability (HRV) is a powerful tool for observing interactions between the sympathetic and parasympathetic nervous systems. This study evaluated HRV during a mindfulness-based stress reduction (MBSR) program among women with breast cancer after receiving treatment. A quasi-experimental, nonrandomized design was used. Patients were allocated to usual care (n = 25) and MBSR (n = 25) groups. HRV was measured using recognized methods to assess the autonomic nervous system. Two-way ANOVA and t-tests were used to examine HRV changes between and within groups, respectively. A significant interaction effect of time with group was observed on heart rate (F (1, 96) = 4.92, p = 0.029, η2 = 0.049). A significant difference was also observed within the MBSR group preintervention and postintervention with regard to heart rate (t (24) = −3.80, p = 0.001), standard deviation of the RR interval (t (24) = 5.40, p < 0.001), root-mean-square difference in the RR interval (t (24) = 2.23, p = 0.035), and high-frequency power (t (24) = 7.73, p < 0.001). Large effect sizes for heart rate and SDNN of 0.94 and 0.85, respectively, were observed between the MBSR and usual care groups. This study provides preliminary evidence that an MBSR program may be clinically useful for facilitating parasympathetic activity associated with feelings of relaxation in treated breast cancer survivors.

Tackling the Electro-Topography of the Selves Through the Sphere Model of Consciousness

In the current hypothesis paper, we propose a novel examination of consciousness and self-awareness through the neuro-phenomenological theoretical model known as the Sphere Model of Consciousness (SMC). Our aim is to create a practical instrument to address several methodological issues in consciousness research. We present a preliminary attempt to validate the SMC via a simplified electrophysiological topographic map of the Self. This map depicts the gradual shift from faster to slower frequency bands that appears to mirror the dynamic between the various SMC states of Self. In order to explore our hypothesis that the SMC's different states of Self correspond to specific frequency bands, we present a mini-review of studies examining the electrophysiological activity that occurs within the different states of Self and in the context of specific meditation types. The theoretical argument presented here is that the SMC's hierarchical organization of three states of the Self mirrors the hierarchical organization of Focused Attention, Open Monitoring, and Non-Dual meditation types. This is followed by testable predictions and potential applications of the SMC and the hypotheses derived from it. To our knowledge, this is the first integrated electrophysiological account that combines types of Self and meditation practices. We suggest this electro-topographic framework of the Selves enables easier, clearer conceptualization of the connections between meditation types as well as increased understanding of wakefulness states and altered states of consciousness.

The effect of mindfulness training on resting-state networks in pre-adolescent children with sub-clinical anxiety related attention impairments

Mindfulness training has been associated with improved attention and affect regulation in preadolescent children with anxiety related attention impairments, however little is known about the underlying neurobiology. This study sought to investigate the impact of mindfulness training on functional connectivity of attention and limbic brain networks in pre-adolescents. A total of 47 children with anxiety and/or attention issues (aged 9-11 years) participated in a 10-week mindfulness intervention. Anxiety and attention measures and resting-state fMRI were completed at pre- and post-intervention. Sustained attention was measured using the Conners Continuous Performance Test, while the anxiety levels were measured using the Spence Children’s Anxiety Scale. Functional networks were estimated using independent-component analysis, and voxel-based analysis was used to determine the difference between the time-points to identify the effect of the intervention on the functional connectivity. There was a significant decrease in anxiety symptoms and improvement in attention scores following the intervention. From a network perspective, the results showed increased functional connectivity post intervention in the salience and fronto-parietal networks as well as the medial-inferior temporal component of the default mode network. Positive correlations were identified in the fronto-parietal network with Hit Response Time and the Spence Children’s Anxiety Scale total and between the default mode network and Hit Response Time. A 10-week mindfulness intervention in children was associated with a reduction in anxiety related attention impairments, which corresponded with concomitant changes in functional connectivity.

Psychedelic Experiences and Mindfulness are Associated with Improved Wellbeing

Both psychedelics and mindfulness are recently emerging topics of interest in academia and popular culture. The Prevalence of personal meditation practices and recreational psychedelic use has consistently increased in the past decade. While clinical work has shown both to improve long-term wellbeing, data on naturalistic applications of psychedelics and mindfulness are lacking. The current study examined the relationship between psychedelic use, mindfulness, and multi-faceted wellbeing as an outcome. Hierarchical regression was used to quantify these associations on a sample of people (N = 1,219) who engage in both meditation practices and psychedelic use. Results show that both mindfulness and mystical experiences are associated with substantial increases in wellbeing. Psychedelics were found to be a moderator of the relationship between mystical experience wellbeing. These data are among the first to establish a strong relationship between personal mindfulness practice, recreational psychedelic use, and overall psychological wellbeing in a naturalistic framework.

A Mini-Review of Work Stress and Mindfulness: A Neuropsychological Point of View

Work stress is consistently linked with the deterioration of cognitive and mental health, limitations in everyday workplace performance, and an increased risk of developing diseases. A common thread binding these consequences appears to be stress-associated alterations in neuropsychological functions and affective domains, especially those reliant on hippocampal, prefrontal, and amygdala brain area. Although research broadly supports the claim that the practice of mindfulness meditation for the reduction of the consequences of stress and the promotion of health exert positive effects on workplaces, the precise neuropsychological benefits of Mindfulness-based interventions (MBIs) in the context of organizations remain elusive. In this review, we will analyze the impairments imposed by stress on the brain areas and functions and the benefits of MBIs from a neuropsychological point of view. This is significant since there is a centrality of cognitive functions in core processes necessary for work achievements, such as emotion regulation, problem-solving, and learning. The promotion of wellbeing is a responsibility shared between workers and organizations. Developing healthy environments allows workers to exercise greater control over their work, face work challenges, work productively and develop their talent.

Awe Narratives: A Mindfulness Practice to Enhance Resilience and Wellbeing

It is necessary to have available a variety of evidence-based resilience practices as we experience life’s stressors including the ongoing COVID-19 pandemic. Evoking, experiencing, and reflecting on awe moments by developing and sharing an “awe narrative” are a type of mindfulness technique that can have the potential to help someone flourish, enhance their resilience, and have a positive impact on their overall wellbeing. This paper explores how constructing an awe narrative can assist the individual while also possibly having a positive impact on others.

Mindfulness practice improves managers’ job demands-resources, psychological detachment, work-nonwork boundary control, and work-life balance – a randomized controlled trial

Purpose

Contemporary workplaces undergo frequent reorganizations in order to stay competitive in a working life characterized by globalization, digitalization, economic uncertainty, and ever-increased complexity. Managers are in the frontline of these challenges, leading themselves, organizations and their employees in high stress environments. This raises questions on how to support managers’ work-life sustainability, which is crucial for organizational sustainability. Mindfulness has been related to enhanced capacities to cope with challenges that are associated with organizational change. The authors evaluated short- and long-term effects of an eight-week mindfulness-based intervention in a company setting, which was going through reorganization.

Design/methodology/approach

Forty managers (42.5% males), mean age 54.53 (SD 5.13), were randomized to the mindfulness intervention or a non-active wait-list control. Self-report data were provided on individual sustainability factors in a work context: job demands and resources, psychological detachment, i.e. possibilities for letting go of work-related thoughts during leisure, control over work-nonwork boundaries, work-life balance, and mindfulness at baseline, postintervention, and at 6-month follow-up.

Findings

Linear mixed models (LMMs) analysis (all ps < 0.005 to 0.05) showed that the intervention group had a larger decrease in job demands and a smaller decrease in job resources, a larger increase in psychological detachment, work-nonwork boundary control, work-life balance, and mindfulness from baseline to postintervention when compared with the reference group. These initial effects were sustained at 6-month follow-up.

Originality/value

The study provides evidence that mindfulness practice can enhance managers’ long-term capacity to cope with challenging working conditions, and increase their work-life sustainability in times of organizational change and disruption.

Resting-state fMRI functional connectivity and mindfulness in clinical and non-clinical contexts: A review and synthesis

This review synthesizes relations between mindfulness and resting-state fMRI functional connectivity of brain networks. Mindfulness is characterized by present-moment awareness and experiential acceptance, and relies on attention control, self-awareness, and emotion regulation. We integrate studies of functional connectivity and (1) trait mindfulness and (2) mindfulness meditation interventions. Mindfulness is related to functional connectivity in the default mode (DMN), frontoparietal (FPN), and salience (SN) networks. Specifically, mindfulness-mediated functional connectivity changes include (1) increased connectivity between posterior cingulate cortex (DMN) and dorsolateral prefrontal cortex (FPN), which may relate to attention control; (2) decreased connectivity between cuneus and SN, which may relate to self-awareness; (3) increased connectivity between rostral anterior cingulate cortex region and dorsomedial prefrontal cortex (DMN) and decreased connectivity between rostral anterior cingulate cortex region and amygdala region, both of which may relate to emotion regulation; and lastly, (4) increased connectivity between dorsal anterior cingulate cortex (SN) and anterior insula (SN) which may relate to pain relief. While further study of mindfulness is needed, neural signatures of mindfulness are emerging.

Integrating mindfulness and connection practices into preservice teacher education results in durable automatic race bias reductions

Automatic race bias, which is the tendency to associate positive attributes more quickly with White as compared to Black faces, reflects enculturation processes linked to inequitable teaching behaviors. In sample of undergraduate preservice teachers (N = 88), we examined whether a novel mindfulness and connection practice intervention without anti-bias content incorporated into undergraduate teacher education would result in reduced automatic race bias favoring White faces. Random assignment to the intervention predicted significantly reduced race preference for White child faces immediately after the intervention. These significant reductions persisted at the 6-month follow-up, which are the most durable reductions in automatic race bias reported to date in adults. Data from semi-structured interviews indicated that the intervention enhanced self-awareness and self-regulation while reducing automatic responding among preservice teachers. These qualities are instrumental to adaptive teaching and putative mechanisms for reducing automatic race bias. The potential value of integrating mindfulness and connection practices into undergraduate preservice teacher education is discussed.

Towards a mechanistic understanding of mindfulness-based stress reduction (MBSR) using an RCT neuroimaging approach: Effects on regulating own stress in social and non-social situations

Although much research has shown that mindfulness-based interventions (MBIs) can reduce psychological stress, it is less clear if effects generalize to everyday social situations, which range among the largest stress triggers. Furthermore, mechanisms of MBIs have not been fully established. Emotion regulation (ER) has been suggested as one key mechanism, yet the role of cognitive reappraisal and acceptance strategies is still under debate. To address these questions, a neuroimaging-based randomized controlled trial (RCT) was performed (n=68), comparing mindfulness-based stress reduction (MBSR) with a reading/listening intervention (READ), using a novel dyadic paradigm for self and other emotion regulation under stress as primary outcome on behavior and brain levels and established empathy measures (clinicatrials.gov NCT03035669). Compared to READ, MBSR led to self-reported stress reduction through both cognitive reappraisal and acceptance only when regulating self and not when regulating others' distress. In addition, MBSR led to increased brain activation over time for regulating own (parietal cortex) and others' (precuneus, TPJ) emotions through cognitive reappraisal and acceptance, albeit this effect was also seen for the reading intervention for regulating own stress via reappraisal. Brain changes did not scale with subjective stress reduction and amount of meditation practice. More distant generalization effects of MBSR on socio-emotional functioning (cognitive empathy and compassion) could also not be shown. This study identified both cognitive reappraisal and acceptance as two ER mechanisms of MBSR, but indicates that effects do not extend to social settings.

Enhanced Resting-State Functional Connectivity With Decreased Amplitude of Low-Frequency Fluctuations of the Salience Network in Mindfulness Novices

Mindfulness and accordant interventions are often used as complementary treatments to psychological or psychosomatic problems. This has also been gradually integrated into daily lives for the promotion of psychological well-being in non-clinical populations. The experience of mindful acceptance in a non-judgmental way brought about the state, which was less interfered by a negative effect. Mindfulness practice often begins with focused attention (FA) meditation restricted to an inner experience. We postulate that the brain areas related to an interoceptive function would demonstrate an intrinsic functional change after mindfulness training for the mindful novices along with paying more attention to internal processes. To further explore the influence of mindfulness on the organization of the brain regions, both functional connectivity (FC) in the voxel and the region of interest (ROI) level were calculated. In the current study, 32 healthy volunteers, without any meditation experiences, were enrolled and randomly assigned to a mindfulness-based stress reduction group (MBSR) or control group (CON). Participants in the MBSR group completed 8 weeks of mindfulness-based stress reduction (MBSR) and rated their mindfulness skills before and after MBSR. All subjects were evaluated via resting-state functional MRI (rs-fMRI) in both baselines and after 8 weeks. They also completed a self-report measure of their state and trait anxiety as well as a positive and negative affect. Pre- and post-MBSR assessments revealed a decreased amplitude of low-frequency fluctuations (ALFF) in the right anterior cingulate gyrus (ACC.R), left anterior and posterior insula (aIC.L, pIC.L), as well as left superior medial frontal gyrus (SFGmed.L) in MBSR practitioners. Strengthened FC between right anterior cingulate cortex (ACC.R) and aIC.R was observed. The mean ALFF values of those regions were inversely and positively linked to newly acquired mindful abilities. Along with a decreased negative affect score, our results suggest that the brain regions related to attention and interoceptive function were involved at the beginning of mindfulness. This study provides new clues in elucidating the time of evaluating the brain mechanisms of mindfulness novices.

[Investigacion de mindfulness en neurociencia cognitiva]

Mindfulness is a term that has become part of our society's vocabulary and its practice has become firmly established in educational, therapeutic and clinical contexts and as a tool for fostering well-being and personal growth. In this article we review the most relevant research conducted on mindfulness in cognitive neuroscience, classifying it in three broad areas: a) differential changes in default network activity due to the practice of mindfulness; b) functional or structural changes in the attentional network, and c) functional or structural changes in the frontal limbic network and the amygdala, related to emotion regulation. There is enough evidence in the literature to affirm the effect of mindfulness practice on the brain, but we still need to produce better experimental designs that allow us to find the mechanisms of action underlying specific practices.

Effects of Mind-Body Interventions on Adolescents’ Cooperativeness and Emotional Symptoms

Background: Mind-body interventions may support the development of adolescents’ self-regulation and provide a protective effect against maladaptive outcomes, e.g., internalizing and externalizing problems. The present study aimed at evaluating the effects of mindfulness-oriented meditation training (MOM) and autogenic training (AT) on a group of healthy Italian adolescents’ character dimensions, emotional and behavioral difficulties. Methods: 72 adolescents were randomly assigned to MOM/AT conditions and tested before and after the 8-week trainings through self-report measures (Temperament and Character Inventory 125, TCI; Strengths and Difficulties Questionnaire for Adolescents, SDQ-A). Main analyses involved robust and repeated measures ANOVAs, carried out separately for character TCI and SDQ-A scales. Results: After trainings, we found increased levels of cooperativeness and reduced emotional symptoms. Changes in these dimensions were negatively correlated: the more participants increased in their cooperativeness the greater decrease they showed in emotional symptoms. Conclusion: Both MOM and AT enhanced a cooperative attitude in adolescents and helped reducing their emotional problems. Therefore, it may be useful to apply these mind-body interventions in school settings as they can have a protective effect on the well-being and psychosocial adjustment of youths, through fostering their character maturity and helping them to better regulate their emotions.

Meditation for adults with non-specific low back pain: a systematic review and meta-analysis

OBJECTIVES

We aim to determine the effectiveness of meditation for adults with non-specific low back pain.

METHODS

We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability.

RESULTS

We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = -0.22; 95% CI = -0.42 to -0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = -0.28; 95% CI = -0.54 to -0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period.

CONCLUSIONS

We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.

Classic Psychedelic Drugs: Update on Biological Mechanisms

Renewed interest in the effects of psychedelics in the treatment of psychiatric disorders warrants a better understanding of the neurobiological mechanisms underlying the effects of these substances. During the past two decades, state-of-the-art studies of animals and humans have yielded new important insights into the molecular, cellular, and systems-level actions of psychedelic drugs. These efforts have revealed that psychedelics affect primarily serotonergic receptor subtypes located in cortico-thalamic and cortico-cortical feedback circuits of information processing. Psychedelic drugs modulate excitatory-inhibitory balance in these circuits and can participate in neuroplasticity within brain structures critical for the integration of information relevant to sensation, cognition, emotions, and the narrative of self. Neuroimaging studies showed that characteristic dimensions of the psychedelic experience obtained through subjective questionnaires as well as alterations in self-referential processing and emotion regulation obtained through neuropsychological tasks are associated with distinct changes in brain activity and connectivity patterns at multiple-system levels. These recent results suggest that changes in self-experience, emotional processing, and social cognition may contribute to the potential therapeutic effects of psychedelics.

Personality Traits Induce Different Brain Patterns When Processing Social and Valence Information

This paper shows the brain correlates of Cloninger’s personality model during the presentation of social scenarios under positive or negative valence situations. Social scenarios were constructed when participants played the Dictator game with two confederates that had two opposites roles as the cooperator (Coop) and non-cooperator (NoCoop). Later the same day during a fMRI scanning session, participants read negative (Neg) and positive (Pos) situations that happened to confederates in the past. Participants were asked to think “how do you think those people felt during that situation?” A dissimilarity matrix between stimuli were obtained from fMRI results. Results shown that Harm Avoidance trait people make use of right middle frontal gyrus and left superior frontal gyrus to discriminate between Coop and NoCoop. Cooperation as a trait makes use of the right superior temporal gyrus and the right precuneus to discriminate between Coop and NoCoop in positive social scenarios. Finally, Self-directedness trait people make use of the right inferior parietal lobe to discriminate between Coop and NoCoop in negative social scenarios and the right precuneus to discriminate between Coop and Strangers. An intuitive link between discrimination findings and behavioral patterns of those personality traits is proposed.

Rethinking Mindfulness in Education within Two Frameworks: Articulating the “Threefold Model of Mindful Wisdom” with the “Theory of Mental Interference”

The existent trend of implementing mindfulness-based programs (MBPs) into public education came along with an increasing scientific record regarding the definitional construct of mindfulness, effects of various mindfulness-based interventions and their basic mechanisms. In terms of the rising definitional discourse in the interdisciplinary field of mindfulness, the “threefold model of mindful wisdom” (TMMW) was proposed. In the present paper’s quest of rethinking mindfulness in education, the relevance of the TMMW for didactics in modern Western educational systems (with special interest on the region of Germany) is examined, affirmed in several points and—with the aid of the “Theory of Mental Interference” (TMI)—methodically linked to individual learners’ needs. The TMI has been developed at the University of Hamburg since 1984 by Wagner and colleagues. This is compatible with the TMMW with regard to the concept of self and basic psychological mechanisms of “mindful exercises”. Its basic approach conceives the epistemic level of cognitive processes (1) to be unbiased by affect and (2) to be different from a level of mental interference, which in case of an arising default habitually interferes with the cognitive processes. Implications for further research, for modern educational systems and for MBPs in education are discussed.

Effect of an Intensive Mindful Practice Workshop on Patient-Centered Compassionate Care, Clinician Well-Being, Work Engagement, and Teamwork

INTRODUCTION

Mindfulness-based interventions for health professionals have been linked to improvements in burnout, well-being, empathy, communication, patient-centered care, and patient safety, but the optimal formats and intensity of training have been difficult to determine because of the paucity of studies and the heterogeneity of programs. A 4-days residential "Mindful Practice" workshop for physicians and medical educators featuring contemplative practices, personal narratives, and appreciative dialogs about challenging experiences may hold promise in improving participants' well-being while also improving compassionate care, job satisfaction, work engagement, and teamwork.

METHODS

We collected baseline and 2-month follow-up data during four workshops conducted in 2018 to 2019 at conference centers in the United States and Europe. Primary outcomes were burnout, work-related distress, job satisfaction, work engagement, patient-centered compassionate care, and teamwork.

RESULTS

Eighty-five of 120 participants (71%) completed both surveys (mean age was 49.3 and 68.2% female). There were improvements (P < .01) in two of three burnout components (emotional exhaustion and depersonalization), work-related distress, job satisfaction, patient-centered compassionate care, work engagement and meaning, teamwork, well-being, positive emotion, mindfulness, somatic symptoms, and spirituality. Effect sizes (standardized mean difference of change) ranged from 0.25 to 0.61. With Bonferroni adjustments (P < .0031), teamwork, general well-being, and mindfulness became nonsignificant.

DISCUSSION

An intensive, multiday, mindfulness-based workshop for physicians had clinically significant positive effects on clinician well-being, quality of interpersonal care and work satisfaction, and meaning and engagement, all important indicators of improved health and sustainability of the health care workforce. Future iterations of the program should increase the focus on teamwork.

Mindfulness Practice Is Associated With Subjective Wellbeing Homeostasis Resilience in People With Crohn's Disease but Not Ulcerative Colitis

OBJECTIVES

People with Crohn's disease and ulcerative colitis (inflammatory bowel disease: IBD), commonly experience high levels of depressive symptoms and stress and low levels of subjective wellbeing (SWB). Mindfulness is increasingly considered an adjuvant IBD treatment. The relationships between depression, disease symptoms and mindfulness have not previously been considered within the theory of SWB homeostasis. This theory states that SWB is normally maintained by a homeostatic system around a setpoint range but can fail when psychological challenges dominate consciousness. This study explored the relationship among SWB and patient-reported psychological and IBD symptoms and investigated whether mindfulness practice is independently associated with SWB homeostatic resilience.

DESIGN

This cross-sectional study recruited participants through online IBD support groups.

METHODS

Participants (n = 739; 62% Crohn's disease) detailed symptoms of depression and stress, patient-reported disease symptoms, and regularity of mindfulness practice.

RESULTS

The sample had significantly lower SWB (hedges g = -0.98) than normative data. A logistic regression found mindfulness practice doubled the Crohn's disease participants' odds of reporting SWB within the normal homeostatic range, after controlling for psychological, physical, and demographic variables (OR 2.15, 95% CI: 1.27, 3.66). A one-point increase of patient-reported bowel symptoms reduced the participant's odds of reporting SWB in the normal homeostatic range by about a third (OR 0.66, 95% CI: 0.50, 0.85). However, the influence of mindfulness or disease symptoms on SWB was not observed for people with ulcerative colitis.

CONCLUSION

These findings provide initial evidence for an association between mindfulness and SWB homeostatic resilience in a clinical population.

Mindfulness and Savoring: A Commentary on Savoring Strategies and Their Implications for Addiction Treatment

Background: A central facet of the popular understanding of mindfulness practice is the non-judgmental observation of all thoughts and feelings. Savoring is a cognitive practice developed out of economics and positive psychology, which involves the conscious mental engagement with positively-valenced interoceptive and exteroceptive stimuli, which in turn amplifies the derived pleasure experience. Results: When incorporated into mindfulness-based interventions (MBIs), savoring holds promise in improving outcomes related to reward processing, such as positive affect and well-being. The growing body of mindfulness literature also suggests that the inclusion of savoring in MBIs may be key in treating disorders of reward dysregulation, such as addiction. If savoring does indeed reduce craving, this phenomenon offers a point of union for divergent neurobiological theories of addiction. Conclusion: In this commentary, we explore the existing literature on savoring and mindfulness practices as it relates to addictive disorders, posit underlying neurocognitive mechanisms, and present future areas of research.

Magical thinking in individuals with high polygenic risk for schizophrenia but no non-affective psychoses-a general population study

A strong genetic background for psychoses is well-established. Most individuals with a high genetic risk for schizophrenia, however, do not develop the disorder. We investigated whether individuals, who have a high genetic risk for schizophrenia but no non-affective psychotic disorders, are predisposed to develop milder forms of deviant thinking in terms of magical thinking. Participants came from the population-based Young Finns Study (n = 1292). The polygenic risk score for schizophrenia (PRS) was calculated on the basis of the most recent genome-wide association study (GWAS). Psychiatric diagnoses over the lifespan were collected up to 2017 from the registry of hospital care. Magical thinking was evaluated with the Spiritual Acceptance Scale (e.g., beliefs in telepathy, miracles, mystical events, or sixth sense) of the Temperament and Character Inventory in 1997, 2001, and 2012 (participants were 20-50-year-olds). We found that, among those who did not develop non-affective psychotic disorders, high PRS predicted higher magical thinking in adulthood (p = 0.001). Further, PRS predicted different developmental courses: a low PRS predicted a steady decrease in magical thinking from age 20 to 50 years, while in individuals with high PRS the decrease in magical thinking ceased in middle age so that their level of magical thinking remained higher than expected for that age. These findings remained when controlling for sex, childhood family environment, and adulthood socioeconomic factors. In conclusion, if high PRS does not lead to a non-affective psychotic disorder, it predicts milder forms of deviant thinking such as elevated magical thinking in adulthood, especially in middle age. The finding enhances our understanding of different outcomes of high genetic psychosis risk.

The Effects of a Mindfulness Program on Mental Health in Students at an Undergraduate Program for Teacher Education: A Randomized Controlled Trial in Real-Life

Background: In this study, we aimed to investigate the effects of a mindfulness program including Mindfulness-Based Stress Reduction (MBSR) on the mental health of student teachers when offered at their educational institution in a real-life context.

Methods: A parallel randomized controlled trial (RCT) was conducted among self-selected student teachers at a Danish undergraduate program for teacher education in the autumns of 2019 and 2020. Participation was not recommended in case of (1) clinical depression or a diagnosis of psychosis or schizophrenia, (2) abuse of alcohol, drugs, and/or medicine. Randomization was performed by a Statistician who was blinded to the identity of the students. Data was collected using self-reported questionnaires. The primary outcome was a change in perceived stress 3 months from baseline. Secondary outcome measures were symptoms of anxiety and depression, well-being, resilience, mindfulness, and thoughts and feelings during rest. The effects were analyzed according to the intention-to-treat principle using mixed-effect linear regression models. Mediating effects of mindfulness skills on the mental health outcomes were explored using structural equation modeling.

Results: The study group included 67 student teachers with 34 allocated to the intervention group (median age: 25 years; women: n = 24, 71%); and 33 students (median age: 25 years; women: n = 25, 76%) allocated to a waiting list control group. At baseline, mean Perceived Stress Scale (PSS) scores were 18.88 (SD: 5.75) in the intervention group and 17.91 (SD: 6.36) in the waiting list control group. A total of 56 students completed the questionnaire at a 3-month follow-up (28 in both the intervention- and the control group). Statistically significant effects of the intervention were found on perceived stress, symptoms of anxiety and depression, well-being, and on three of seven resting-state dimensions. No effects were found on resilience or mindfulness. Statistically significant mediated effects via resting-state dimensions were found.

Conclusion The findings suggested that offering a mindfulness program at an undergraduate program for teacher education could significantly improve the mental health among self-selected students within 3 months. Results of mediation analysis supported the hypothesis that some of the effects might be explained by reduced distracting thoughts.

Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04558099].

Mindfulness-Informed Guided Imagery to Target Physical Activity: A Mixed Method Feasibility and Acceptability Pilot Study

Physical activity offers substantial mind-body health benefits and reduced mortality, yet many individuals are chronically underactive. Physical activity interventions may benefit from integrative approaches that join components of mindfulness and neurobiological models of behavior. Mindfulness increases one’s awareness of cognitions and physical sensations to potentially facilitate self-regulation, while neurobiological models such as the dual system model of health behavior offer guidance on improving physical activity intervention targets. This 2-phase study includes an initial development process to create brief (∼4 min) mindfulness informed guided imagery audio files that target distinct cognitive and affective processes to promote physical activity. In the second phase, participants completed a 2-week pilot intervention study to gather qualitative and quantitative data on intervention feasibility and acceptability. Participants endorsed the mindfulness informed guided imagery as easy to use, enjoyable and helpful. Over a 2-week intervention period participants reported positive shifts in behavior change, physical activity enjoyment, increased mindfulness during physical activity, and increased physical exercise self-efficacy and satisfaction. Interview data revealed that participants increased their frequency of physical activity and tended to experience positive affect during physical activity, engaged in future oriented thinking and were able to view physical activity in a more positive light. Findings support the feasibility and acceptability of an integrative online mindfulness informed guided imagery intervention to promote physical activity enjoyment and engagement. This study extends health behavior change intervention research and provides supporting evidence for a flexible and tailorable online mindfulness-based intervention.

A Bibliometric and Visualization Analysis of Mindfulness and Meditation Research from 1900 to 2021

This study comprehensively summarizes research in the field of meditation, especially mindfulness meditation from 1900 to 2021, by analyzing the knowledge map through CiteSpace and VOSviewer software. Using "mindfulness *" or "meditation *" as the topic, articles included in the Science Citation Index Expanded and Social Sciences Citation Index were searched in the web of science core database, resulting in the selection of 19,752 articles. Over half a century ago, Deikman published the field's first article in the Journal of Nervous and Mental Disease in 1963, and publications have soared in subsequent decades. The USA is in the core position in terms of global collaboration, total publication numbers, and total citations. The Mindfulness journal ranked first for the most published articles and citations. "The benefits of being present: Mindfulness and its role in psychological well-being," written by Brown and Ryan, was the most cited article. Mindfulness, meditation, depression, intervention, stress reduction, stress, and anxiety are the top co-occurrence keywords. The timeline of cluster analysis discloses that before 2010, hypertension, cancer, mindfulness, generalized anxiety disorder, and other topics received great attention. In the decade since 2010, scholars have shown interest in meta-analysis, attention, and self-assessment, and keen attention to mindfulness-based interventions. These findings provide an important foundation to direct future research.

Neural Correlates of Music Listening: Does the Music Matter?

The last decades have seen a proliferation of music and brain studies, with a major focus on plastic changes as the outcome of continuous and prolonged engagement with music. Thanks to the advent of neuroaesthetics, research on music cognition has broadened its scope by considering the multifarious phenomenon of listening in all its forms, including incidental listening up to the skillful attentive listening of experts, and all its possible effects. These latter range from objective and sensorial effects directly linked to the acoustic features of the music to the subjectively affective and even transformational effects for the listener. Of special importance is the finding that neural activity in the reward circuit of the brain is a key component of a conscious listening experience. We propose that the connection between music and the reward system makes music listening a gate towards not only hedonia but also eudaimonia, namely a life well lived, full of meaning that aims at realizing one's own "daimon" or true nature. It is argued, further, that music listening, even when conceptualized in this aesthetic and eudaimonic framework, remains a learnable skill that changes the way brain structures respond to sounds and how they interact with each other.

The Relationship between Mindful Attention Awareness, Perceived Stress and Subjective Wellbeing

It has been suggested that mindfulness is a predictive factor in self-reported perceived stress. The present study aimed to investigate the link between mindful attention awareness, perceived stress and subjective wellbeing without the presence of a complementary intervention to promote mindfulness-based strategies.

METHODS

The online survey participants (N = 257) were university students enrolled in initial teacher training. Self-report measures included the Mindful Attention Awareness Scale (MAAS), Perceived Stress Scale (PSS) and Personal Wellbeing Index (PWI).

RESULTS

PWI was negatively correlated with PSS (r = -0.550, p = .001), MAAS was negatively correlated with PSS (r = -0.567, p = .001) and positively correlated with PWI (r = 0.336, p = .001). The mean score for PSS (M = 20.61, SD = 6.62) was above the reported norm (14.2).

CONCLUSIONS

The findings suggest that higher levels of mindful attention awareness may be associated with lower levels of perceived stress and higher subjective wellbeing levels and lower levels of perceived stress may be associated with higher subjective wellbeing. The findings confirm that pre-service teachers are a demographic that experiences elevated levels of perceived stress regardless of the stage in initial teacher training programs.