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

A Mindfulness-Based Brain-Computer Interface to Augment Mandala Coloring for Depression: Protocol for a Single-Case Experimental Design

BACKGROUND

The regular practice of mindfulness has been shown to provide benefits for mental well-being and prevent depression relapse. Technology-mediated interventions can facilitate the uptake and sustained practice of mindfulness, yet the evaluation of interactive systems, such as brain-computer interfaces, has been little explored.

OBJECTIVE

The objective of this paper is to present an interactive mindfulness-based technology to improve mental well-being in people who have experienced depression. The system, Anima, is a brain-computer interface that augments mandala coloring by providing a generative color palette based on the unfolding mindfulness states during the practice. In addition, this paper outlines a multiple-baseline, single-case experimental design methodology to evaluate training effectiveness.

METHODS

Adult participants who have experienced depression in the past, have finished treatment within the last year, and can provide informed consent will be able to be recruited. The Anima system, consisting of 2 tablets and a nonintrusive mental activity headband, will be delivered to participants to use during the study. Measures include state and trait mindfulness, depression symptoms, mental well-being, and user experience, and these measures will be taken throughout the baseline, intervention, and monitoring phases. The data collection will take place in the form of a questionnaire before and after each mandala-coloring session and a semistructured interview every 2 weeks. Trial results will be analyzed using structured visual analysis, supplemented with statistical analysis appropriate to single-case methodology.

RESULTS

Study results will offer new insights into the deployment and evaluation of novel interactive brain-computer interfaces for mindfulness training in the context of mental health. Moreover, findings will validate the effectiveness of this training protocol to improve the mental well-being of people who have had depression. Participants will be recruited locally through the National Health Service.

CONCLUSIONS

Evidence will assist in the design and evaluation of brain-computer interfaces and mindfulness technologies for mental well-being and the necessary services to support people who have experienced depression.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/20819.

Corpus callosum size, hypnotic susceptibility and empathy in women with alleged mediumship: a controlled study

AIM

Evidence indicates that highly hypnotizable subjects may have larger area of the rostrum of the corpus callosum (CC). Mediumship can be defined as the alleged ability to communicate regularly with deceased personalities, and self-hypnosis is postulated as an underlying mechanism for this ability. Therefore, we aimed to investigate the CC area, hypnotic susceptibility, self-reported dissociation, and empathy in alleged mediums in comparison with healthy, non-medium controls.

METHODS

The study sample consisted of 16 Spiritist mediums (medium group (MG)) and 16 non-medium controls. Magnetic resonance imaging scans were performed to measure the CC areas (total and subdivisions). The Harvard Group Scale of Hypnotic Susceptibility was used to assess hypnotizability, and self-reported measures were used to investigate anomalous experiences, mental health using the Self-Reporting Questionnaire-SRQ, dissociative experiences using the Dissociative Experiences Scale, and empathy using the Interpersonal Reactivity Index.

RESULTS

No between-group differences were found in the total or subdivided CC areas or in hypnotizability, with both groups showing intermediate levels. The rostrum of the CC area and hypnotizability were not correlated. The MG presented with significantly more anomalous experiences, but the two groups had similar scores for dissociation, empathy, and mental health.

CONCLUSION

The normal CC areas found in the MG are in contrast with the abnormal results typically observed in subjects with psychotic and dissociative disorders. Although hypnotizability was not different between groups, further studies are needed to replicate these findings in other samples.

Being Mindful at University: A Pilot Evaluation of the Feasibility of an Online Mindfulness-Based Mental Health Support Program for Students

University study can be a life period of heightened psychological distress for many students. The development of new preventive and intervention programs to support well-being in university students is a fundamental challenge for mental health professionals. We designed an 8-week online mindfulness-based program (eMBP) combining a face-to-face approach, text, audio, video components, and support psychotherapy principles with a unique intensive reminder system using the Facebook Messenger and Slack applications in two separate runs (N = 692). We assessed the program's effect on mindful experiencing, perceived stress, emotion regulation strategies, self-compassion, negative affect, and quality of life. The results of the presented pilot study confirmed that eMBP is a feasible and effective tool in university students' mental health support. The students who completed the eMBP reported a reduction of perceived stress with a large effect size ( _p η² = 0.42) as well as a decrease of negative affect experience frequency and intensity ( _p η² = 0.31), an increase of being mindful in their life (Five Facet Mindfulness Questionnaire subscales: _p η² = 0.21, 0.27, 0.25, 0.28, 0.28), and a higher rate of self-compassion ( _p η² = 0.28) with a medium effect size. A small effect size was found in the frequency of using a cognitive reappraisal strategy ( _p η² = 0.073). One new result is the observation of an eMBP effect ( _p η² = 0.27) on the decrease in attributed importance to the quality-of-life components replicated in two consecutive runs of the program. The study affirms that mindfulness-based interventions can be effectively delivered in an eHealth form to university students.

Mediators for the Effect of Compassion Cultivating Training: A Longitudinal Path Analysis in a Randomized Controlled Trial Among Caregivers of People With Mental Illness

Background: There is a paucity of research on mediators of change, within compassion training programs. The aim was to investigate the mediators, of an 8-week compassion cultivation training (CCT) program, on the effect of psychological distress on caregivers of people with a mental illness. Method: Longitudinal path models in a randomized controlled trial (RCT). One hundred ninety-two participants were assessed for eligibility, and 161 participants were included into the trial and randomized. The main outcome was psychological distress measured by the Depression, Anxiety and Stress scale at 6 months. Mediators included self-compassion (SC), mindfulness (FM), emotion regulation (ER), emotion suppression (ES), and cognitive reappraisal (CR). Baseline, post, and 3- and 6-month follow-up measurements were collected. Results: The mediated effects for CCT are as follows: depression at 6 months: SC: -1.81 (95% CI: -3.31 to -0.31); FM: -1.98 (95% CI: -3.65 to -0.33); ER: -0.14 (95% CI: -1.31 to 1.02); anxiety at 6 months: SC: -0.71 (95% CI: -1.82 to 0.40); FM: -1.24 (95% CI: -2.39 to -0.09); ER: 0.18 (95% CI: -1.04 to 1.40); stress at 6 months: SC: -1.44 (95% CI: -2.84 to -0.05); FM: -2.17 (95% CI: -3.63 to -0.71); ER: -0.27 (95% CI: -1.51 to 0.98). Conclusion: Mindfulness and self-compassion are important components in reducing psychological distress experienced by informal caregivers of people with a mental illness. Results contribute to the knowledge about the underlying mechanisms of CCT.

Is Training with the N-Back Task More Effective Than with Other Tasks? N-Back vs. Dichotic Listening vs. Simple Listening

Cognitive training most commonly uses computerized tasks that stimulate simultaneous cognitive processing in two modalities, such as a dual n-back task with visual and auditive stimuli, or on two receptive channels, such as a listening task with dichotically presented stimuli. The present study was designed to compare a dual n-back task and a dichotic listening (DL) task with an active control condition (a simple listening task) and a no-training control condition for their impact on cognitive performance, daily life memory, and mindfulness. One hundred thirty healthy adults aged 18–55 years were randomly assigned to one of the four conditions. The training consisted of twenty 15-min sessions spread across 4 weeks. The results indicated some improvement on episodic memory tasks and a trend for enhanced performance in an untrained working memory (WM) span task following cognitive training relative to the no-training control group. However, the only differential training effects were found for the DL training in increasing choice reaction performance and a trend for self-reported mindfulness. Transfer to measures of fluid intelligence and memory in daily life did not emerge. Additionally, we found links between self-efficacy and n-back training performance and between emotion regulation and training motivation. Our results contribute to the field of WM training by demonstrating that our listening tasks are comparable in effect to a dual n-back task in slightly improving memory. The possibility of improving attentional control and mindfulness through dichotic listening training is promising and deserves further consideration.

Practice Matters: Pro-environmental Motivations and Diet-Related Impact Vary With Meditation Experience

Mindfulness has emerged as a potential motivator for sustainable lifestyles, yet few studies provide insight into the relationship between mindfulness practice levels and individual engagement in pro-environmental behaviors. We also lack information about the significance of meditators' behavioral differences in terms of their measurable environmental impact and the motivational processes underlying these differences in pro-environmental performance. We classified 300 individuals in three groups with varying meditation experience and compared their pro-environmental motivations and levels of animal protein consumption. Exceeding prior attempts to compare high-impact behaviors of mindfulness practitioners and non-practitioners, we created the most detailed classification of practice engagement by assessing frequency, experience and type of meditation practice. This nuanced view on mindfulness practice reveals that advanced meditators, who reported high levels of connectedness with nature (CWN), subjective happiness and dispositional mindfulness showed significantly more concern for the environment. They also demonstrated the lowest levels of greenhouse gas emissions, land occupation and water use related to their animal-protein consumption. This study is the first to follow a self-determination theory perspective to deepen our understanding of the motivational differences between meditator groups. We revealed that advanced meditators reported significantly more integrated motivation toward the environment than non-meditators. We also provided preliminary evidence for a new theoretical framework suggesting that experiential strategies such as mindfulness practices could strengthen the relational pathway of pro-environmental behaviors. Using sequential mediation analysis, we confirmed that the negative effect of mindful compassion practice on greenhouse gas emissions from animal-protein consumption is partially mediated by CWN and integrated motivation toward the environment. While our study does not support assumptions of causality, it shows that much can be learned by studying the motivations of advanced meditators for maintaining high levels of pro-environmental behavior.

Reduced anxiety and changes in amygdala network properties in adolescents with training for awareness, resilience, and action (TARA)

Mindfulness-based approaches show promise to improve emotional health in youth and may help treat and prevent adolescent depression and anxiety. However, there is a fundamental gap in understanding the neural reorganization that takes place as a result of such interventions. The Training for Awareness, Resilience, and Action (TARA) program, initially developed for depressed adolescents, uses a framework drawn from neuroscience, mindfulness, yoga, and modern psychotherapeutic techniques to promote emotional health. The goal of this study was to assess the effects of the TARA training on emotional health and structural white matter brain networks in healthy youth. We analyzed data from 23 adolescents who underwent the 12-week TARA training in a controlled within-subject study design and whose brain networks were assessed using diffusion MRI connectomics. Compared to the control time period, adolescents showed a significant decrease in anxiety symptoms with TARA (Cohen's d = -0.961, p = 0.006); moreover, the node strength of the Right Amygdala decreased significantly after TARA (Cohen's d = -1.026, p = 0.004). Post-hoc analyses indicated that anxiety at baseline before TARA was positively correlated with Right Amygdala node strength (r = 0.672, p = 0.001). While change in Right Amygdala node strength with TARA was not correlated with change in anxiety (r = 0.146, p = 0.51), it was associated with change in depression subscale of Anhedonia / Negative Affect (r = 0.575, p = 0.004, exploratory analysis), possibly due to overlapping constructs captured in our anxiety and depression scales. Our results suggest that increased structural connectivity of Right Amygdala may underlie increased anxiety in adolescents and be lowered through anxiety-reducing training such as TARA. The results of this study contribute to our understanding of the neural mechanisms of TARA and may facilitate neuroscience-based prevention and treatment of adolescent anxiety and depression.

Network Analysis of Mindfulness Facets, Affect, Compassion, and Distress

Objectives

Mindfulness, positive affect, and compassion may protect against psychological distress but there is lack of understanding about the ways in which these factors are linked to mental health. Network analysis is a statistical method used to investigate complex associations among constructs in a single network and is particularly suitable for this purpose. The aim of this study was to explore how mindfulness facets, affect, and compassion were linked to psychological distress using network analysis.

Methods

The sample (n = 400) included equal numbers from general and student populations who completed measures of five mindfulness facets, compassion, positive and negative affect, depression, anxiety, and stress. Network analysis was used to explore the direct associations between these variables.

Results

Compassion was directly related to positive affect, which in turn was strongly and inversely related to depression and positively related to the observing and describing facets of mindfulness. The non-judgment facet of mindfulness was strongly and inversely related to negative affect, anxiety, and depression, while non-reactivity and acting with awareness were inversely associated with stress and anxiety, respectively. Strong associations were found between all distress variables.

Conclusions

The present network analysis highlights the strong link between compassion and positive affect and suggests that observing and describing the world through the lens of compassion may enhance resilience to depression. Taking a non-judging and non-reacting stance toward internal experience while acting with awareness may protect against psychological distress. Applicability of these findings can be examined in experimental studies aiming to prevent distress and enhance psychological well-being.

A Review on Research and Evaluation Methods for Investigating Self-Transcendence

Self-transcendence has been characterized as a decrease in self-saliency (ego disillusionment) and increased connection, and has been growing in research interest in the past decade. Several measures have been developed and published with some degree of psychometric validity and reliability. However, to date, there has been no review systematically describing, contrasting, and evaluating the different methodological approaches toward measuring self-transcendence including questionnaires, neurological and physiological measures, and qualitative methods. To address this gap, we conducted a review to describe existing methods of measuring self-transcendence, evaluate the strengths and weaknesses of these methods, and discuss research avenues to advance assessment of self-transcendence, including recommendations for suitability of methods given research contexts.

Correlates of Silence: Enhanced Microstructural Changes in the Uncinate Fasciculus

Silence is an important aspect of various meditation practices, but little work has focused specifically on the underlying neurophysiology of silence-related meditative practice, and on how it relates to the self-reported experiences of practitioners. To expand current knowledge regarding the neurophenomenology of silence in meditation, we directly investigated first-person reports of silence-related experiences during the practice of Quadrato Motor Training (QMT) and their association with changes in fractional anisotropy (FA). Participants recorded their cognitive, emotional, and physical experiences upon beginning QMT and again after 6 weeks of QMT practice. These reports were evaluated qualitatively and quantitatively. Findings showed that change between the two time points in self-reported silence-related experiences was negatively correlated with change in attentional effort, and positively correlated with changes in the left uncinate fasciculus. These results expand current knowledge regarding the neuroanatomical correlates of silence-related experiences during meditation.

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised several concerns for patients with chronic immune-mediated diseases, including inflammatory bowel disease (IBD). As the outbreak appears to be in the descending phase, at least in some part of the world, as in most European countries, guidance is urgently needed to provide optimal care for our IBD patients in order to gradually and safely reduce the gap in care that has been accumulated in the months of lockdown and to face all the backlogs. Therefore, we have provided a decalogue of practical recommendations for gastroenterologists to manage patients with IBD in the post-peak phase of the COVID-19 pandemic. They include all the aspects of IBD care, not only pharmacological ones but also endoscopy, surgery, psychological treatment, telemedicine, diagnostics and educational tasks provided by doctors and patient associations.

Mindfulness and cardiovascular health: Qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study

Background

Mindfulness-based programs hold promise for improving cardiovascular health (e.g. physical activity, diet, blood pressure). However, despite theoretical frameworks proposed, no studies have reported qualitative findings on how study participants themselves believe mindfulness-based programs improved their cardiovascular health. With an emphasis on in-depth, open-ended investigation, qualitative methods are well suited to explore the mechanisms underlying health outcomes. The objective of this qualitative study was to explore the mechanisms through which the mindfulness-based program, Mindfulness-Based Blood Pressure Reduction (MB-BP), may influence cardiovascular health.

Methods

This qualitative study was conducted as part of a Stage 1 single arm trial with one-year follow-up. The MB-BP curriculum was adapted from Mindfulness-Based Stress Reduction to direct participants’ mindfulness skills towards modifiable determinants of blood pressure. Four focus group discussions were conducted (N = 19 participants), and seven additional participants were selected for in-depth interviews. Data analysis was conducted using the standard approach of thematic analysis. Following double-coding of audio-recorded transcripts, four members of the study team engaged in an iterative process of data analysis and interpretation.

Results

Participants identified self-awareness, attention control, and emotion regulation as key mechanisms that led to improvements in cardiovascular health. Within these broader themes, many participants detailed a process beginning with increased self-awareness to sustain attention and regulate emotions. Many also explained that the specific relationship between self-awareness and emotion regulation enabled them to respond more skillfully to stressors. In a secondary sub-theme, participants suggested that higher self-awareness helped them engage in positive health behaviors (e.g. healthier dietary choices).

Conclusion

Qualitative analyses suggest that MB-BP mindfulness practices allowed participants to engage more effectively in self-regulation skills and behaviors lowering cardiovascular disease risk, which supports recent theory. Results are consistent with quantitative mechanistic findings showing emotion regulation, perceived stress, interoceptive awareness, and attention control are influenced by MB-BP.

Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study

BACKGROUND

Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits.

PURPOSE

To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample.

METHODS

We examined data from a controlled trial comparing adults with chronic pain and long-term prescription opioid use randomized to either MORE (n = 27) treatment or to an active support group comparison condition (n = 30). Participants completed an Emotional Go/NoGo Task at pre- and post-treatment, which measured response inhibition in neutral and clinically relevant, negative affective contexts (i.e., exposure to pain-related visual stimuli).

RESULTS

Repeated-measures analysis of variance indicated that compared with the support group, participants in MORE evidenced significantly greater reductions from pre- to post-treatment in errors of commission on trials with pain-related distractors relative to trials with neutral distractors, group × time × condition F(1,55) = 4.14, p = .047, η2partial = .07. Mindfulness practice minutes and increased nonreactivity significantly predicted greater emotional response inhibition. A significant inverse association was observed between improvements in emotional response inhibition and treatment-related reductions in pain severity by 3-month follow-up.

CONCLUSIONS

Study results provide preliminary evidence that MORE enhances inhibitory control function in the context of negative emotional interference.

Be Aware Not Reactive: Testing a Mediated-Moderation Model of Dark Triad and Perceived Victimization via Self-Regulatory Approach

Generally, it is difficult to work efficiently in a toxic environment. Surprisingly, leaders are found to be liable for such toxic atmosphere because they possess certain traits that employees perceive as victimization. This research assesses the relationship between the dark triad (narcissism, Machiavellianism, and psychopathy) and perceived victimization with a focus on the mediating effect of abusive supervision and the moderating effect of mindfulness. For this purpose, we surveyed 274 employees in the healthcare sector of Pakistan by using random sampling technique in three waves. To analyze the data, the structural equation model with partial least squares and PROCESS were used. The findings suggest that abusive supervision plays a mediating role in the association between the dark triad and perceived victimization. The results did not support the mediating role of abusive supervision in the association between narcissism and perceived victimization, however, the mediated moderation model was supported. Further, the findings suggest that mindfulness weakens the effect of abusive supervision on perceived victimization. Finally, the theoretical and practical implications of the results are also discussed.

Mindfulness-oriented recovery enhancement reduces opioid dose in primary care by strengthening autonomic regulation during meditation

The current opioid crisis was fueled by escalation of opioid dosing among patients with chronic pain. Yet, there are few evidence-based psychological interventions for opioid dose reduction among chronic pain patients treated with long-term opioid analgesics. Mindfulness-Oriented Recovery Enhancement (MORE), which was designed to target mechanisms underpinning chronic pain and opioid misuse, has shown promising results in 2 randomized clinical trials (RCTs) and could facilitate opioid sparing and tapering by bolstering self-regulation. Here we tested this hypothesis with secondary analyses of data from a Stage 2 RCT. Chronic pain patients (N = 95) on long-term opioid therapy were randomized to 8 weeks of MORE or a support group (SG) control delivered in primary care. Opioid dose was assessed with the Timeline Followback through 3-month follow-up. Heart rate variability (HRV) during mindfulness meditation was quantified as an indicator of self-regulatory capacity. Participants in MORE evidenced a greater decrease in opioid dosing (a 32% decrease) by follow-up than did the SG, F(2, 129.77) = 5.35, p = .006, d = 1.07. MORE was associated with a significantly greater increase in HRV during meditation than was the SG. Meditation-induced change in HRV partially mediated the effect of MORE on opioid dose reduction (p = .034). MORE may boost self-regulatory strength via mindfulness and thereby facilitate self-control over opioid use, leading to opioid dose reduction in people with chronic pain. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Daily change patterns in mindfulness and psychological health: A pilot intervention

OBJECTIVE

This study examined the differences in first-year college students' daily change trajectories in subjective happiness, depression, anxiety, stress, and state mindfulness.

METHOD

A 5-day, online mindfulness-based intervention (MI) condition and stress management (SM) condition were employed in 247 first-year college students.

RESULTS

Students in both the MI and SM conditions displayed similar significant linear declines in anxiety and stress, but there were significant differences between the two conditions, including: (1) the MI condition showing a significant linear increase in subjective happiness compared with no change in the SM condition and (2) the SM condition showed a significant linear decrease in depression compared to no significant change in the MI condition.

CONCLUSION

Brief online interventions-whether MI or SM-can promote better mental health and reduce psychological distress. The results also lend support for MI's differential influence on first-year college students' happiness and SM's differential influence on their depression.

An electrophysiological investigation on the emotion regulatory mechanisms of brief open monitoring meditation in novice non-meditators

Despite a growing literature supporting the salutary effects of mindfulness meditation on emotion regulation, the underlying mechanisms linking neural and subjective changes occurring during the actual practice of meditation with emotion regulatory effects observed after meditation remains virtually unexplored. The current study sought to address this gap in knowledge by testing the hypothesis that adoption of internally-directed focused attention, indexed by increased alpha and theta spectral power, during brief open monitoring (OM) mindfulness meditation predicts reduced emotional reactivity, as measured by the late positive potential (LPP). Results revealed that the OM meditation did not produce demonstrable differences in alpha and theta power but did increase self-reported sleepiness relative to controls. Follow-up analyses showed that sleepiness uniquely moderated the effect of meditation on the LPP, such that less sleepiness during meditation, but not the control audio, corresponded to smaller LPPs to negative images. Change in theta, but not alpha power, between meditation and rest was positively correlated with the LPP even after controlling for sleepiness. Although the primary hypothesis was unsupported, the findings demonstrate that phenomenological and neural changes occurring during OM meditation may modulate its subsequent “off-the-cushion” effects on emotional reactivity.

Mindfulness induction and cognition: A systematic review and meta-analysis

Mindfulness meditation might improve a variety of cognitive processes, but the available evidence remains fragmented. This preregistered meta-analysis (PROSPERO-CRD42018100320) aimed to provide insight into this hypothesis by assessing the effects of brief mindful attention induction on cognition. Articles were retrieved from Pubmed, PsycInfo and Web of Science up until August 1, 2018. A total of 34 studies were included. The outcomes were categorized into four cognitive domains: attentional functioning, memory, executive functioning and higher-order function. A small effect was found across all cognitive domains (Hedges' g = 0.18, 95% IC = 0.07-0.29). Separated analyses for each cognitive domain revealed an effect only in higher-order cognitive functions (k = 10, Hedges' g = 0.35, 95% IC = 0.20-0.50). Results suggest that mindfulness induction improves cognitive performance in tasks involving complex higher-order functions. There was no evidence of publication bias, but studies generally presented many methodological flaws.

Onwards and upwards: The development, piloting and validation of a new measure of academic tenacity- The Bolton Uni-Stride Scale (BUSS)

What factors determine success at University? For many years the construct of intelligence was felt to be critical. More recently, the construct of grit, has attracted the attention of many researchers, along with related concepts such as self-control, growth mind-sets and resilience. The authors of this paper have developed a specific measure of tenacity and self-composure, two constructs crucial to academic achievement. This measure comprises of 12 items drawn from the above constructs, but also including mental well-being and strengths use. In the first study, the authors report on the psychometric properties of the Bolton Uni-Stride Scale (BUSS). The new scale was administered to 1117 university students. Exploratory factor analysis (EFA) revealed two underlying factors, one labelled "tenacity" had seven items and accounted for 30% of the variance. The second was labelled "self-composure," and accounted for 14% of the variance. In the second study the BUSS was given to 340 undergraduate students along with the Grit Scale, the Self-Control Scale, the Mind-sets Quiz, the Connor Davidson Resilience Scale (CD-RISC 10) and the short Warwick Edinburgh Mental Well-being Scale (WEMWBS). This study presented evidence for good internal consistency reliability (.74) and test-retest reliability over three weeks was .70 for Tenacity and .77 for Self-composure. BUSS Academic Tenacity correlated highly with grit (.63), self-control (.59), resilience (.52), mind-sets (.35) and mental well-being (.54). The study also evidences good discriminative validity of the BUSS. A second study conducted confirmatory factor analysis (CFA), explaining a total of 44% of the variance. The authors have shown good support for the reliability and validity of the BUSS scale. It now needs to be tested in other universities and in different countries. It is the contention of the authors that academic tenacity will be a better measure of academic success than other competing measures, such as grit, on their own. Further research is needed to test this assertion.

Structural equation modeling of the associations between amygdala activation, personality, and internalizing, externalizing symptoms of psychopathology

There is an expanding literature on the theoretical and empirical connections between personality and psychopathology, and their shared neurobiological correlates. Recent cybernetic theories of personality and psychopathology, as well as affective neuroscience theory, provide grounding for understanding neurobiological-personality-psychopathology (NPP) associations. With the emergence of large sample datasets (e.g., Human Connectome Project) advanced quantitative modeling can be used to rigorously test dynamic statistical representations of NPP connections. Also, research suggests that these connections are influenced by sex, and large samples provide the opportunity to examine how NPP associations might be moderated by sex. The current study used a large sample from the Duke Neurogenetics Study (DNS) to examine how amygdala activation to facial expressions was linked with self-report of personality traits and clinical interviews of internalizing and externalizing symptoms of psychopathology. Structural equation modeling results revealed direct associations of amygdala activation with personality trait expression, as well as indirect associations (though personality) with symptoms of psychopathology. Moreover, the NPP links were moderated by sex. The current results are in line with research that identifies a broader role played by the amygdala in personality and provide potential insights for continued research in personality neuroscience and recent theories on the neurobiology of personality.

Reliability and validity of an equanimity questionnaire: the two-factor equanimity scale (EQUA-S)

Background

Many studies have revealed the positive impact of mindfulness training on mental health and proposed equanimity as a general outcome in contemplative research. Despite recent interest, relatively few studies have empirically examined equanimity and measurement instruments are still lacking. The main goal of this study was to develop an Equanimity Scale (the EQUA-S) in a Western population with or without meditation experience, based on previous definitions of equanimity, in order to investigate its relations with the relevant psychological constructs and health outcomes.

Methods

Adults from the general population (N = 265; M _age = 34.81) completed various measures: the EQUA-S, mindfulness, hyper-sensitivity, avoidance and fusion, impulsivity, personality, alexithymia, sensitivity to punishment and reward and frequency of problematic addictive behaviors. The dimensionality of the EQUA-S was examined using Factor Analyses. The convergent validity of this new scale was investigated using Pearson's Correlations.

Results

The results of a factor analysis revealed two dimensions of equanimity: an even-minded state of mind (E-MSM) and a hedonic independence (HI) component. While the E-MSM was positively related to emotional stability, adaptive emotional regulation and several mindfulness-related abilities, HI was found to correlate negatively with addictive issues.

Discussion

The relations with personality constructs and possible related cognitive processes are discussed.

The Way Forward in Mindfulness and Sustainability: a Critical Review and Research Agenda

The ecological crisis demands new strategies to rapidly transform our society into a more sustainable one. A growing amount of research points towards the potential of mindfulness to help transform people’s motivations for sustainability. This article reviews 30 years of research in mindfulness and sustainability and disentangles theoretical knowledge from empirical evidence. We identified six leading theoretical links between mindfulness and sustainability which find backing in empirical work: reduced automaticity, enhanced health and subjective well-being, greater connectedness with nature, improved pro-sociality, recognition of intrinsic values and openness to new experiences. Many of the studies involve considerable methodological caveats, most importantly a lack of mindfulness practice indicators and environmental impact measures. To reach the point where policy makers could embrace mindfulness-based policies to promote societal well-being and sustainability, the research must go beyond the present focus on correlative research. The proof of causality posits the greatest challenge for the next decade of research. Inspired by principles from policy evaluation, we propose a research agenda that offers direction for collaborative efforts and innovative interdisciplinary study designs in a logical model: (how) does the practice of mindfulness contribute to individual behaviour change and (how) does this individual change translate into societal change?

Eat Like a Chef: A Mindful Eating Intervention for Health Care Providers

OBJECTIVE

To compare changes in mindful eating habits between students receiving a mindful eating intervention (MEI) vs those who were engaged in usual course work.

METHODS

From 2017 to 2019, 109 nutrition and medical students completed a quasi-experimental study, including usual course work either with or without the addition of a 5-week MEI. The Mindful Eating Questionnaire (MEQ) was completed before and after the MEI. Repeated measures MANOVA was used to detect differences in changes in the overall MEQ score and its 5 subscales between groups.

RESULTS

Within the MEI group (n = 64), overall MEQ, disinhibition, and eating with awareness scores increased significantly (P < .001, P < .001, and P = .004, respectively). No significant changes were noted within the comparison group (n = 45). Significant between-group differences were noted for the changes in the overall MEQ (P = .03) and disinhibition scores (P = .01).

CONCLUSIONS AND IMPLICATIONS

MEI participation may improve students' overall mindful eating scores. Future research could assess a larger cohort of participants, including health care professionals from other disciplines, assess additional mindfulness measures, and follow students for a longer period to determine the long-term effects on participants' mindful eating.

Meditation and the Wandering Mind: A Theoretical Framework of Underlying Neurocognitive Mechanisms

During the practice of meditation, the tendency of the mind to wander away from the object of focus is ubiquitous. The occurrence of mind wandering in the context of meditation provides individuals a unique and intimate opportunity to closely examine the nature of the wandering mind by cultivating an awareness of ongoing thought patterns, while simultaneously aiming to cultivate equanimity (evenness of temper or disposition) and compassion toward the content of thoughts, interpretations, and bodily sensations. In this article we provide a theoretical framework that highlights the neurocognitive mechanisms by which contemplative practices influence the neural and phenomenological processes underlying spontaneous thought. Our theoretical model focuses on several converging mechanisms: the role of meta-awareness in facilitating an increased moment-to-moment awareness of spontaneous thought processes, the effects of meditation practice on key structures underlying both the top-down cognitive processes and bottom-up sensory processes implicated in attention and emotion regulation, and the influence of contemplative practice on the neural substrates underlying perception and perceptual decoupling.

Predicting Individual Preferences in Mindfulness Techniques Using Personality Traits

The growing popularity of mindfulness-based interventions (MBIs) has prompted exciting scientific research investigating their beneficial effects on well-being and health. Most mindfulness programs are provided as multi-faceted packages encompassing a set of different mindfulness techniques, each with distinct focus and mechanisms. However, this approach overlooks potential individual differences, which may arise in response to practicing various mindfulness techniques. The present study investigated preferences for four prototypical mindfulness techniques [focused attention (FA), open monitoring (OM), loving-kindness (LK), and body scan (BS)] and identified factors that may contribute to individual differences in these preferences. Participants without prior mindfulness experiences were exposed to each technique through audio-guided instructions and were asked to rank their preferences at the end of all practices. Results indicated that preferences for loving-kindness were predicted by empathy, and that females tended to prefer loving-kindness more than males. Conversely, preferences for open monitoring were predicted by nonreactivity and nonjudgment of present moment experiences. Additionally, higher state mindfulness was detected for individuals’ preferred technique relative to other alternatives. These findings suggest that individuals tend to prefer techniques compatible with their personalities, as the predictor variables encompass trait capacities specifically relevant to practicing these techniques. Together, our results suggest the possibility that assessing individual difference and then tailoring MBIs to individual needs could be a useful way to improve intervention effectiveness and subsequent outcomes.

Mindful Awareness: Can a Neuro-Developmentally Timed Approach Prevent Youth Substance Misuse

Youth substance use remains a significant public health issue. Although there are numerous evidence-based substance use preventive interventions, room for program improvement remains. Mindfulness practice, due to its feasibility of implementation, capacity to promote neuro-networks associated with delayed substance use initiation and progression to substance use disorders, and efficacy in promoting protective and reducing risk factors associated with substance use, may constitute one strategy for increasing the effectiveness of substance use preventive interventions. However, mindfulness-based approaches to substance use prevention have yet to be systematically tested with youth. In this conceptual paper, we first define mindfulness and its potential, through practice, to strengthen neuro-circuitry associated with substance use disorders. We then review evidence supporting the effectiveness of mindfulness-based preventive interventions to promote protective factors and reduce risk factors known to predict youth substance use. Thus, a case is made for neuro-developmentally timed, mindfulness-based substance use preventive interventions, with the ultimate goal of preventing future substance misuse and associated health consequences.

Let it be: mindful acceptance down-regulates pain and negative emotion

Mindfulness training ameliorates clinical and self-report measures of depression and chronic pain, but its use as an emotion regulation strategy—in individuals who do not meditate—remains understudied. As such, whether it (i) down-regulates early affective brain processes or (ii) depends on cognitive control systems remains unclear. We exposed meditation-naïve participants to two kinds of stimuli: negative vs. neutral images and painful vs. warm temperatures. On alternating blocks, we asked participants to either react naturally or exercise mindful acceptance. Emotion regulation using mindful acceptance was associated with reductions in reported pain and negative affect, reduced amygdala responses to negative images and reduced heat-evoked responses in medial and lateral pain systems. Critically, mindful acceptance significantly reduced activity in a distributed, a priori neurologic signature that is sensitive and specific to experimentally induced pain. In addition, these changes occurred in the absence of detectable increases in prefrontal control systems. The findings support the idea that momentary mindful acceptance regulates emotional intensity by changing initial appraisals of the affective significance of stimuli, which has consequences for clinical treatment of pain and emotion.

Does the MRI/fMRI Procedure Itself Confound the Results of Meditation Research? An Evaluation of Subjective and Neurophysiological Measures of TM Practitioners in a Simulated MRI Environment

Early research into meditation, including Transcendental Meditation (TM), relied exclusively on EEG to measure brain activity during meditation practice. Since the advent of neural imaging, MRI, and later fMRI, have dominated this field. Unfortunately, the use of this technology rests on the questionable assumption that lying down in a confining tube while exposed to very loud sounds would not interfere with the meditation practice. The present study was designed to assess the effects of the fMRI procedure on both the subjective and neurophysiological responses of short and long-term TM practitioners. Twenty-three TM practitioners volunteered to participate in this study: 11 short-term meditators, averaging 2.2 years practice, and 12 long-term meditators, averaging 34.8 years. The repeated-measures design included two activities for each participant, eyes-closed rest, and TM practice, in each of three conditions: sitting quietly in an upright position (normal TM practice); lying quietly in a supine position; and lying, with earplugs, inside a simulated fMRI tube (simMRI), while exposed to 110 dB recordings of an actual fMRI machine. Subjective experiences were collected after each activity in each condition. Physiological arousal was recorded using skin conductance levels. Scalp EEG was averaged into eight frequency bands within frontal and parietal leads; eLORETA software was used to explore the 3-D cortical distribution of EEG sources. During the simMRI condition, participants reported having more shallow meditation experiences, and greater agitation/distraction. Skin conductance levels paralleled self-reports, decreasing least during the simMRI condition. Frontal and parietal power decreased from sitting to simMRI in the alpha2 through gamma bands. Parietal power was higher during rest compared to TM in the alpha1 through beta2 bands. Frontal and parietal alpha1 coherence were highest during the simMRI condition. The eLORETA analysis revealed that the default mode network was more active during TM when sitting compared to the simMRI condition. The responses to the supine condition were generally between sitting and simMRI, with some significant exceptions. In conclusion, these data indicate that the fMRI procedure itself (high dB noise; lying down) strongly influences subjective and neurophysiological responses during meditation practice, and may therefore confound the interpretation of results from fMRI studies.

Internet-Risk Classes of Adolescents, Dispositional Mindfulness and Health-Related Quality of Life: A Mediational Model

This study was primarily aimed at identifying classes of adolescents in relation to their probability of endorsing several risks associated with the Internet (cyberbullying victimization and perpetration, cyberdating abuse victimization, and perpetration, sexting, and grooming). The second objective was to examine a mediational model linking dispositional mindfulness, risk perception, exposure to antisocial content in the media, Internet-risk classes of adolescents, and health-related quality of life (HRQL). The sample comprised 3,076 adolescents (46.2% boys, ages between 12 and 21). Latent class analyses indicated the existence of five classes related to the probability of endorsing Internet risks: No risk (60.75%), only cyberbullying (25.5%), cyberbullying and cyberdating abuse (6.7%), all risks (4.3%), and sexual risk (2.9%). Three mindfulness facets, namely, acting with awareness, nonreacting, and nonjudging, were associated with all the classes of risks. This association was partially explained by the degree of exposure to antisocial content in the media and risk perception. Finally, membership in the Internet-risk classes was associated with a lower HRQL.

Common and distinct lateralised patterns of neural coupling during focused attention, open monitoring and loving kindness meditation

Meditation has been integrated into different therapeutic interventions. To inform the evidence-based selection of specific meditation types it is crucial to understand the neural processes associated with different meditation practices. Here we explore commonalities and differences in electroencephalographic oscillatory spatial synchronisation patterns across three important meditation types. Highly experienced meditators engaged in focused attention, open monitoring, and loving kindness meditation. Improving on previous research, our approach avoids comparisons between groups that limited previous findings, while ensuring that the meditation states are reliably established. Employing a novel measure of neural coupling – the imaginary part of EEG coherence – the study revealed that all meditation conditions displayed a common connectivity pattern that is characterised by increased connectivity of (a) broadly distributed delta networks, (b) left-hemispheric theta networks with a local integrating posterior focus, and (c) right-hemispheric alpha networks, with a local integrating parieto-occipital focus. Furthermore, each meditation state also expressed specific synchronisation patterns differentially recruiting left- or right-lateralised beta networks. These observations provide evidence that in addition to global patterns, frequency-specific inter-hemispheric asymmetry is one major feature of meditation, and that mental processes specific to each meditation type are also supported by lateralised networks from fast-frequency bands.

The effect of a mindfulness-based therapy on different biomarkers among patients with inflammatory bowel disease: a randomised controlled trial

Mindfulness-based interventions have shown some efficacy in decreasing stress levels and improving quality of life. However, so far, only a few studies have studied this type of intervention among patients with inflammatory bowel disease and none of them have studied their effects on inflammatory biomarkers. This current study was a two-armed, single-centre, randomised (2:1 ratio) controlled trial used to evaluate the effects of a mindfulness-based intervention (n = 37) compared to standard medical therapy (n = 20) in patients with Crohn’s disease or ulcerative colitis. The mindfulness intervention blended four internet-based therapy modules with four face-to-face support sessions. The outcomes we assessed were faecal calprotectin (primary outcome), C-reactive protein, and cortisol levels measured in hair samples at several timepoints. The between-group analysis highlighted significant decreases in faecal calprotectin and in C-reactive protein levels in the mindfulness-based intervention group compared to the standard medical therapy group at the six-month follow-up (faecal calprotectin: −367, [95% CI: −705, −29], P = 0.03; C-reactive protein: −2.82, [95% CI: −5.70, 0.08], P = 0.05), with moderate to large effect sizes (faecal calprotectin: ηp² = 0.085; C-reactive protein: ηp² = 0.066). We concluded that mindfulness-based therapy administered as part of standard clinical practice effectively improves inflammatory biomarkers in patients diagnosed with inflammatory bowel disease.

Application of Mindfulness-Based Psychological Interventions in Infertility

Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.

Immune dysregulation among students exposed to exam stress and its mitigation by mindfulness training: findings from an exploratory randomised trial

Psychological distress persisting for weeks or more promotes pro-inflammatory immune dysregulation, a risk factor for a range of chronic diseases. We have recently shown that mindfulness training reduces distress among university students. Here we present an exploratory trial to study immune dysregulation in a cohort of students who were exposed to progressively greater stress as the exam period approached, and to explore whether mindfulness training mitigated this dysregulation. Healthy University of Cambridge students were randomised to join an 8-week mindfulness course (N = 27), or to mental health support as usual (N = 27). Psychological distress, immune cell proportions, cytokines, CRP and serum cortisol were measured at baseline and during the exam period. Increased distress was associated with statistically significant increases in the proportion of B cells, regardless of trial arm (*p = 0.027). There were no other associations between any of the measured parameters, distress or mindfulness. Our finding that the proportion of B cells increases with psychological distress supports the findings of other studies. However, we found no evidence that mindfulness training is able to buffer the effects of psychological distress on healthy participants' immune system. In order to detect these effects, should they exist, larger randomised trials will be required.

Depression, Mindfulness, and Psilocybin: Possible Complementary Effects of Mindfulness Meditation and Psilocybin in the Treatment of Depression. A Review

Depression is a major public health problem that affects approximately 4.4% of the global population. Since conventional pharmacotherapies and psychotherapies are only partially effective, as demonstrated by the number of patients failing to achieve remission, alternative treatments are needed. Mindfulness meditation (MM) and psilocybin represent two promising novel treatments that might even have complementary therapeutic effects when combined. Since the current literature is limited to theoretical and empirical underpinnings of either treatment alone, the present review aimed to identify possible complementary effects that may be relevant to the treatment of depression. To that end, the individual effects of MM and psilocybin, and their underlying working mechanisms, were compared on a non-exhaustive selection of six prominent psychological and biological processes that are well known to show impairments in patients suffering from major depression disorder, that is mood, executive functioning, social skills, neuroplasticity, core neural networks, and neuroendocrine and neuroimmunological levels. Based on predefined search strings used in two online databases (PubMed and Google Scholar) 1129 articles were identified. After screening title and abstract for relevance related to the question, 82 articles were retained and 11 were added after reference list search, resulting in 93 articles included in the review. Findings show that MM and psilocybin exert similar effects on mood, social skills, and neuroplasticity; different effects were found on executive functioning, neural core networks, and neuroendocrine and neuroimmune system markers. Potential mechanisms of MM's effects are enhanced affective self-regulation through mental strategies, optimization of stress reactivity, and structural and functional adjustments of prefrontal and limbic areas; psilocybin's effects might be established via attenuation of cognitive associations through deep personal insights, cognitive disinhibition, and global neural network disintegration. It is suggested that, when used in combination, MM and psilocybin could exert complementary effects by potentiating or prolonging mutual positive effects, for example, MM potentially facilitating psilocybin-induced peak experiences. Future placebo-controlled double-blind randomized trials focusing on psilocybin-assisted mindfulness-based therapy will provide knowledge about whether the proposed combination of therapies maximizes their efficacy in the treatment of depression or depressive symptomatology.

Serious Gaming During Multidisciplinary Rehabilitation for Patients With Chronic Pain or Fatigue Symptoms: Mixed Methods Design of a Realist Process Evaluation

BACKGROUND

Serious gaming could support patients in learning to cope with chronic pain or functional somatic syndromes and reduce symptom burdens.

OBJECTIVE

To realize this potential, insight is needed into how, why, for whom, and when it works in actual treatment circumstances.

METHODS

Following a realist approach, process evaluations were performed before, during, and after a two-armed, natural quasi-experiment (n=275). A group of patients with interfering chronic pain or fatigue symptoms received a short additional blended mindfulness-based serious gaming intervention during a multidisciplinary rehabilitation program. A control group only received the regular rehabilitation program. During two sessions before and one session after the experiment, expectations about serious gaming processes were discussed in focus groups with local care providers, implementers, and experts. Patients participated in a survey (n=114) and in semistructured interviews (n=10). The qualitative data were used to develop tentative expectations about aspects of serious gaming that, in certain patients and circumstances, trigger mechanisms of learning and health outcome change. Hypotheses about indicative quantitative data patterns for tentative expectations were formulated before inspecting, describing, and analyzing-with regression models-routinely collected clinical outcome data. An updated program theory was formulated after mixing the qualitative and quantitative results.

RESULTS

Qualitative data showed that a subset of patients perceived improvement of their self-awareness in moments of daily social interactions. These results were explained by patients, who played the serious game LAKA, as a "confrontation with yourself," which reflected self-discrepancies. Important characteristics of serious gaming in the study's context included innovation factors of relative advantage with experiential learning opportunity, compatibility with the treatment approach, and the limited flexibility in regard to patient preferences. Perceived patient factors included age and style of coping with stress or pain. Learning perceptions could also depend on care provider role-taking and the planning and facilitating (ie, local organization) of serious gaming introduction and feedback sessions in small groups of patients. Quantitative data showed very small average differences between the study groups in self-reported depression, pain, and fatigue changes (-.07<beta<-.17, all 95% CI upper bounds <0), which were mediated by small group differences in mindfulness (beta=.26, 95% CI .02-.51). Mindfulness changes were positively associated with patient involvement in serious gaming (n=114, beta=.36, P=.001). Acceptance of serious gaming was lower in older patients. Average health outcome changes went up to a medium size in patients that reported lower active coping with stress and lower pain coping before serious gaming. Mindfulness changes and gaming acceptance perceptions covaried with group structure and immediate feedback sessions after serious gaming.

CONCLUSIONS

This study developed transferable insight into how and why serious gaming can facilitate additional learning about coping in order to reduce burdens of chronic pain or fatigue symptoms in certain patients and in actual treatment circumstances. Future studies are needed to continue the development of this fallible theory. Such research will further support decisions about using, designing, allocating, and tailoring serious gaming to optimize important patient health benefits.

TRIAL REGISTRATION

Netherlands Trial Register NTR6020; https://www.trialregister.nl/trial/5754.