Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT)

Individual Differences in the Contents and Form of Present-Moment Awareness: The Multidimensional Awareness Scale

Decentering, a detached, observer perspective on one's mental activity, is an important concept for understanding mental health. Meta-awareness, people's awareness of their own current mental activity, is thought to facilitate decentering. However, trait measures of these concepts are not available or have validity concerns. We sought to create a theoretically derived measure of meta-awareness and decentering that allowed an exploration of questions in the literature regarding whether there are multiple forms of decentered awareness and whether meta-awareness and external awareness are distinct. Across six samples and 2,480 participants, we developed the 25-item Multidimensional Awareness Scale, with subscales assessing meta-awareness (present moment awareness of mental activity), decentered awareness (meta-awareness from a psychologically distant perspective), and external awareness (present moment awareness of the world outside of oneself). The scales demonstrated acceptable reliability and validity. Results are discussed in terms of the conceptual implications of the scale structure and its potential uses.

Understanding Engagement in and Affective Experiences During Physical Activity: The Role of Meditation Interventions

OBJECTIVE

Meditation interventions promote an array of well-being outcomes. However, the way in which these interventions promote beneficial outcomes is less clear. Here, we expanded on prior work by examining the influence of mindfulness and loving-kindness meditation on a key health behavior: physical activity.

METHODS

To test our hypotheses, we drew upon two randomized intervention studies. In the first study, 171 adults (73.0% female) received 6 weeks of training in either mindfulness meditation or loving-kindness meditation, or were assigned to a control condition. In the second study, 124 adults (60.0% female) were assigned to a 6-week mindfulness or loving-kindness meditation group.

RESULTS

Study 1 demonstrated that individuals who received mindfulness training reported sustained levels of physical activity across the intervention period (Pre: mean [standard deviation], or M [SD] = 4.09 [2.07]; Post: M [SD] = 3.68 [2.00]; p = .054), whereas those in the control (Pre: M [SD] = 3.98 [2.25]; Post: M [SD] = 3.01 [2.07]; p < .001) and loving-kindness (Pre: M [SD] = 4.11 [2.26]; Post: M [SD] = 3.45 [1.96]; p < .001) conditions reported lower levels. Study 2 demonstrated those who received mindfulness training experienced increases in positive emotions during physical activity from preintervention to postintervention (Pre: M [SD] = 6.06 [2.51]; Post: M [SD] = 6.54 [2.43]; p = .001), whereas those trained in loving-kindness meditation experienced decreases in positive emotions during physical activity (Pre: M [SD] = 6.45 [2.35]; Post: M [SD] = 6.09 [2.46]; p = .040).

CONCLUSIONS

These results suggest mindfulness training (but not loving-kindness training) promotes sustained physical activity, and one plausible reason why this occurs is enhanced positive emotion during physical activity.

Mindfulness, depression, and emotional eating: The moderating role of nonjudging of inner experience

Emotional eating is defined as the tendency to increase food consumption in order to modify negative emotional states. Theories on emotional eating attribute its cause to inadequate emotion regulation, specifically an inability to draw awareness to and accept distress. Mindfulness, or the ability to pay attention to and accept internal and external experiences, is thought to attenuate the association between internalizing distress and emotional eating. Nevertheless, there has been little research examining the moderating role of mindfulness in the relationship between psychological distress and emotional eating. The present study used a cross-sectional design to probe the effects of specific facets of mindfulness, as measured by the Five Factor Mindfulness Questionnaire, on the relationship between internalizing distress (i.e., depression and anxiety) and emotional eating in a diverse community sample (N = 248). Results showed that depression significantly interacted with nonjudging of inner experience to predict emotional eating. Those who were high in nonjudging endorsed less emotional eating than those who were average or low in nonjudging. This was significant only at low levels of depression. These findings delineate the moderating role of specific aspects of trait mindfulness in the association between depression and emotional eating and may inform more targeted intervention and prevention efforts.

Savor the moment: Willful increase in positive emotion and the persistence of this effect across time

Savoring is an emotion regulation technique that aims to increase, sustain, and deepen positive emotion. It has been incorporated into several novel, "positive affect" interventions for anxiety, depression, and chronic pain, but has not been studied in a laboratory setting. As such, it is unknown whether savoring can modulate subjective and neural correlates of emotion-processing and whether savoring might exert a persistent effect on stimulus processing (i.e., modulating response at subsequent encounter). Here, 49 participants savored or viewed positive and neutral pictures, before seeing the same pictures again approximately 20 min later without instructions to savor (or view) pictures. Subjective valence and arousal ratings and the picture-elicited late positive potential (LPP) were assessed during both tasks. Results showed that savoring increased participant ratings of picture pleasantness and arousal as well as a picture-elicited LPP. Moreover, pictures that had previously been savored continued to elicit higher ratings during the subsequent picture viewing task. A larger LPP was observed for previously savored positive and neutral pictures during an early portion of picture viewing; later on during picture viewing, this effect was limited to positive pictures only (i.e., it was not evident for neutral pictures). Results validate savoring as an effective and durable means of increasing positive emotion and are discussed in the context of a broader emotion regulation literature, which has primarily examined the downregulation of negative picture processing.

Psychological Resources Protect Well-Being During the COVID-19 Pandemic: A Longitudinal Study During the French Lockdown

This longitudinal study investigated the capability of various positive psychological resources to directly or indirectly protect specific well-being outcomes and moderate the effects on well-being of health and economic threats in a lockdown situation during the 2020 health crisis in France. At the beginning of lockdown (wave 1), participants (N = 470) completed self-assessment questionnaires to document their initial level of well-being and state of nine different well-established psychological resources, measured as traits: optimism, hope, self-efficacy, gratitude toward the world, self-transcendence, wisdom, gratitude of being, peaceful disengagement, and acceptance. Three weeks later, a weekly follow-up was started to record changes in well-being and reported threats for a duration of 5 weeks (waves 2-6). Results show that psychological resources efficiently protected well-being in a variety of ways: they buffered the adverse effects of reported threats to health and wealth, increased the well-being averages, and reduced the decline in well-being over time. More specifically, emotional well-being was positively predicted by hope, gratitude of being, and, to a lesser level, by acceptance; psychological well-being by self-efficacy, personal wisdom, and gratitude of being; social well-being only by gratitude toward the world; and inner well-being by optimism, gratitude of being, and acceptance. The study emphasizes the importance of cultivating psychological resources in ordinary times to protect individuals' well-being when difficult and extraordinary circumstances occur. It also offers clues to the kind of resources one may want to develop.

“Be Mindful Even Though It Hurts”: A Single-Case Study Testing the Effects of a Mindfulness- and Acceptance-Based Intervention on Injured Athletes’ Mental Health

Injury is a serious setback for athletes and might jeopardize mental health. The aim of this study is to investigate if a mindfulness- and acceptance-based intervention can improve mindfulness (nonreactivity and acting with awareness), acceptance, and well-being, and decrease the level of symptoms of anxiety and depression. A single-case design with multiple, staggered, and nonconcurrent baselines was used. Six seriously injured athletes took part in an 8-week intervention and repeatedly completed questionnaires on all variables for the duration of the study. The results showed that, on average, there were significant clinical changes between phases in nonreactivity, well-being, and acceptance. No effect was seen in the two remaining scales. On an individual level, two participants showed effects in all scales, two participants in some of the scales, and two participants in the scale nonreactivity. Results are discussed in light of existing research, and implications for practitioners’ clinical methods are presented.

A systematic review and meta-analysis of mindfulness- and acceptance-based interventions for affect intolerance/sensitivity

Affect intolerance/sensitivity, defined as one's sensitivity to, or inability to tolerate, affective states, is a transdiagnostic process implicated in the development and maintenance of numerous forms of psychopathology. Mindfulness and acceptance interventions are posited to improve affect intolerance/sensitivity; however, there has been no quantitative synthesis of this research to date. Seven electronic databases were searched up until November 2018. Hedges' g values, 95% confidence intervals, p-values, and Q-values were calculated for a series of random-effects models. Twenty-five studies (pooled N = 1778) met eligibility criteria and were included in the qualitative synthesis (n = 22 included in the meta-analysis). There was a small, significant effect of mindfulness and acceptance interventions on improving affect intolerance/sensitivity from pre-to post-intervention (Hedges' g = -0.37, 95% CI = -0.52 to -0.23, p < .001), with effects maintained up to 6-months (Hedges' g = -0.35, 95% CI = -0.61 to -0.09, p < .01). There was a significantly larger effect for studies with inactive compared to active controls. No significant effect size differences were found for intervention length (<8 vs. ≥ 8 sessions), intervention type (mindfulness vs. acceptance) or sample type (clinical vs. non-clinical). Mindfulness and acceptance interventions modestly improve affect intolerance/sensitivity.

Dismantling Mindfulness-Based Programs: A Systematic Review to Identify Active Components of Treatment

Objectives

Elucidating the active ingredients of psychological treatments is an important step in the scientific validation of these interventions. Component studies are one way to test which aspects of psychological treatments impact outcomes, or in other words, are the active ingredients of treatment. As research and popular interest in mindfulness-based programs grows, it is important to evaluate the active ingredients of these programs and to continually refine theorized models of the mechanisms of mindfulness. Studying active ingredients may help clarify which elements of mindfulness-based programs are most important for dissemination.

Methods

We conducted a systematic review of component studies of mindfulness-based programs for adults with psychological conditions. PRISMA guidelines for systematic reviews were followed.

Results

Eight component studies were identified. These studies dismantled mindfulness-based stress reduction, mindfulness-based cognitive therapy, unified mindfulness, and core mindfulness processes. The eight studies differed with respect to types of programs and populations studied, yet similarities emerged. Notably, acceptance coupled with awareness and mindfulness meditation training may be two promising active ingredients of these different programs.

Conclusions

Future studies examining mindfulness-based programs should continue to attempt to dismantle active ingredients of treatment and use the findings to update theoretical models of mindfulness.

When enhanced awareness threatens: Interactive effects of domain-specific awareness and acceptance manipulations on cardiovascular indices of challenge and threat

Mindfulness includes acceptance and awareness subcomponents, and emerging theories imply that cultivating both acceptance and awareness may benefit health by diminishing stress reactivity. Yet, no prior work has examined the effects of mindful acceptance and awareness on cardiovascular markers of threat and challenge-cardiac output and total peripheral resistance-despite the unique insights these indices yield into stress-related evaluations and motivation. The current research integrates Monitor and Acceptance Theory with the Biopsychosocial Model of Challenge and Threat to elucidate how an awareness manipulation and a brief acceptance training are associated with cardiovascular stress responses underlying states of challenge and threat. Healthy young adults (N = 202) were enrolled in a 2 × 2 between-subjects experimental design manipulating both awareness (enhanced awareness vs. no enhanced awareness) and acceptance (acceptance training vs. no acceptance training) of physiological responses to a social-evaluative cold pressor test. Cardiovascular indices were recorded throughout. The combination of enhanced awareness and acceptance training led to higher cardiac output and lower total peripheral resistance (indexing greater challenge, less threat) to the cold pressor test than the combination of enhanced awareness and no acceptance training. However, the combination of no enhanced awareness and no acceptance training also led to higher cardiac output and lower total peripheral resistance than the combination of enhanced awareness and no acceptance training. These results add to a growing body of work suggesting that mindful awareness and acceptance subcomponents interact to influence stress reactivity and imply that enhanced stressor awareness without acceptance may lead to increased threat.

Evaluation of a novel application of a mindfulness phone application for patients with brain tumours: a feasibility study

PURPOSE

Despite the large clinical interest in mindfulness, little is known about its effects in patients with brain tumours. Novel delivery methods such as App based Mindfulness training (AMT) may assist in the delivery of mindfulness treatment to this group of patients.

METHODS

We aimed to determine the feasibility of administering an 8-week mindfulness treatment by AMT in patients operated on for brain tumours in a publically funded hospital. As a secondary aim we collected preliminary data regarding changes in self-reported psychological distress, quality of life and mindfulness capacity.

RESULTS

Uptake was of 40 potentially eligible participants. Of the 20 entering the study, only 10 completed the 8-week post group assessment and only 3 completed the follow-up assessment. There was a positive direction of pre-post change in almost all completers with statistically significant improvement in several mindfulness scales and illness-related quality of life however there was a deterioration in the social/family quality of life domain. The significant variability in individual usage of the AMT appeared to be related more to individual differences rather than tumour histology, progression or treatment. The treatment was well received by those completing the study.

CONCLUSIONS

Recruitment and retention feasibility issues were identified. Promising preliminary change and treatment satisfaction scores however suggest that further research with the AMT is warranted. Reduced assessment burden and more regular engagement during treatment is recommended to enhance retention. Large sample sizes however will be needed to address the heterogeneity of this group.

Testing the Intermediary Role of Perceived Stress in the Relationship between Mindfulness and Burnout Subtypes in a Large Sample of Spanish University Students

The burnout syndrome is the consequence of chronic stress that overwhelms an individual’s resources to cope with occupational or academic demands. Frenetic, under-challenged, and worn-out are different burnout subtypes. Mindfulness has been recognized to reduce stress, comprising five facets (observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience). This cross-sectional study aimed to assess the relationship between mindfulness facets, perceived stress, and burnout subtypes in a sample of 1233 students of Education, Nursing, and Psychology degrees from different universities of Valencia (Spain). Structural Equation Modelling (SEM) was computed showing an adequate fit (Chi-square, CFI, TLI, RMSEA, and SRMR). Four mindfulness facets (all but observing) significantly correlated with general second-order mindfulness. Unexpected results were found: Acting with awareness facet was positively associated with frenetic subtype, while the non-reacting facet was positively associated with frenetic and under-challenged subtype. Ultimately, mindfulness facets negatively predicted the perceived stress levels, which in turn, predicted burnout. However, mindfulness plays different roles in the early stages of burnout syndrome (i.e., frenetic and under-challenged).

Mindfulness and shooting performance in biathlon. A prospective study

The aim of the study was to examine the temporal relationship between facets of sport-specific dispositional mindfulness (i e., Awareness, Refocusing, Nonjudgemental attitude) and shooting performance in actual competitions, in a population of 25 elite biathlon athletes. Findings indicated that mindfulness facets were positively associated with shooting performance, with higher levels of Awareness, Refocusing, and Awareness being related to better shooting performance in competitions. In spite of the fact that the explained variance was quite small, even a minor shooting performance enhancement may increase an athlete's chance of winning a biathlon competition.

Sustainable Compassion Training: Integrating Meditation Theory With Psychological Science

Meditation programs continue to proliferate in the modern world, with increasing participation from scientists and many others who seek to improve physical, mental, relational, and social flourishing. In developing such programs, the meditation practices have been adapted to meet the needs of modern cultures. However, through that adaptation, important contextual factors of traditional contemplative cultures are often dropped or forgotten. This article presents a system of compassion and mindfulness training, Sustainable Compassion Training (SCT), which is designed to help people cultivate increasingly unconditional, inclusive, and sustainable care for self and others. SCT aims to recover important contextual factors of meditation that flexibly meet the diverse needs of modern secular and religious participants. SCT draws on Tibetan Buddhism in dialogue with caregivers, other contemplative traditions and relevant scientific theories to inform meditative transformation for secular contexts. We provide an overview of SCT meditations that includes both contemplative and scientific theories that draw out important features of them. Each meditation includes novel hypotheses that are generated from this dialogical process. We also provide links to audio-guided meditations.

Approach coping and substance use outcomes following mindfulness-based relapse prevention among individuals with negative affect symptomatology

Objectives

Mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs) appears to be particularly effective among individuals with high levels of co-occurring affective symptoms. We sought to understand whether changes in approach and avoidance coping may explain the effects of MBRP among this subpopulation.

Method

The sample included 286 individuals with SUDs randomized to MBRP, relapse prevention (RP), or treatment-as-usual (TAU) as an aftercare treatment. We conducted conditional indirect effect models with treatment condition as the predictor, baseline affective symptoms as the moderator, changes in approach and avoidance coping over time from baseline through 6-months post-treatment as mediators, and substance use and substance-related problems at 12-months post-treatment as the outcome. Affective symptomatology at baseline was modeled as a latent factor indicated by depression, anxiety, and PTSD symptoms. Change in approach and avoidance coping was modeled using latent growth curve analyses.

Results

We found significant conditional indirect effects of MBRP, such that the interaction of MBRP vs. TAU by affective symptoms predicted increases in approach coping, which in turn predicted fewer heavy drinking days and substance-related problems at month 12. Follow-up analyses showed that increases in approach coping mediated the therapeutic effect of MBRP on these outcomes among those with high, but not low or moderate, affective symptoms. We did not find indirect or conditional indirect effects when comparing RP to TAU, or when avoidance coping was the mediator.

Conclusions

The pronounced therapeutic effects of MBRP among individuals with SUD and relatively higher negative affective symptoms may be due to increases in approach coping over time.

The Mediating Role of Non-reactivity to Mindfulness Training and Cognitive Flexibility: A Randomized Controlled Trial

Mindfulness training has been shown to have a beneficial effect on cognitive flexibility. However, little is known about the mediators that produce this effect. Cross-sectional studies show that there might be a link between Non-judgment, Non-reactivity and cognitive flexibility. Longitudinal studies examining whether Non-judgment or Non-reactivity mediate the effectiveness of mindfulness training on improving cognitive flexibility are lacking. The present study aims to test the effect of mindfulness training on increasing cognitive flexibility and to test whether this effect is mediated by Non-judgment or Non-reactivity. We conducted a single-blind randomized controlled trial in 54 nonclinical high-stress participants between October 2018 and January 2019. Participants were randomly assigned to a Mindfulness Based Stress Reduction (MBSR) group or a waitlist control group. The experimenters were blind to the group assignment of participants. The MBSR group received 8-weekly sessions (2.5-h per week) and a one-day retreat (6-h), and was required to accomplish a 45-min daily formal practice during the intervention. The waitlist control group did not receive any intervention during the waiting period and received a 2-day (6-h per day) mindfulness training after the post-intervention. The primary outcome was self-report cognitive flexibility and perceived stress administered before and after MBSR. The secondary outcome was self-report mindfulness skills (including Non-reactivity and Non-judgment) measured at pre-treatment, Week 3, Week 6, and post-intervention. For cognitive flexibility, mixed-model repeated-measure ANOVA results showed that there were significant main effects of Time, Group and a significant interaction of Time by Group. Follow-up ANOVA indicated that the MBSR group was associated with greater improvements in cognitive flexibility than the waitlist. Path analysis results showed that the effect of the treatment on cognitive flexibility at post-treatment was fully mediated by Non-reactivity at Week 6. The mediation effects of Non-reactivity at Week 3, and Non-judgment at Week 3 and Week 6 were not significant. Our findings support the efficacy of MBSR on improving cognitive flexibility. Non-reactivity is an important element of the effectiveness of MBSR training on cognitive flexibility.

Mindfulness, self-reported health, and cortisol: A latent profile analysis

This study utilized a latent profile analysis approach to examine the relationship between mindfulness profiles and self-reported mental and physical health, as well as salivary cortisol levels in a sample of 85 undergraduate students. Consistent with theory, the Judgmentally Observing (high monitoring, low acceptance) reported poorer mental health and exhibited flatter diurnal cortisol slopes than the Unobservant Accepting (low monitoring, high acceptance) and Average Mindfulness profiles. No differences in self-reported physical health, cortisol response to awakening, or diurnal mean cortisol were observed among the profiles. Future directions are discussed.

Effects of an Online Mindfulness Intervention Focusing on Attention Monitoring and Acceptance in Pregnant Women: A Randomized Controlled Trial

INTRODUCTION

Attention monitoring and acceptance underlie the effects of mindfulness meditation. This study tested the feasibility and acceptability of an online mindfulness intervention for pregnant women as an approach to reduce depressive and anxious symptoms.

METHOD

We developed an 8-week mindfulness intervention program that trained participants to monitor their internal and external experiences in an accepting way. The mindfulness course was based on the Wechat platform. This study was conducted in a women's hospital in China. A total of 123 women with scores on the Generalized Anxiety Disorder Scale and Patient Health Questionnaire suggesting mild or moderate symptoms of depression and anxiety were recruited from the outpatient department between April and June 2018. The participants were randomized to receive the mindfulness intervention or routine prenatal care. The Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, and the Five Facets of Mindfulness Questionnaire were used to evaluate the levels of anxiety, depression, and mindfulness, respectively, before and after the intervention.

RESULTS

Of the 123 women enrolled in this study, 10 in the intervention group and 11 in the control group did not complete the intervention. The retention rate and feedback suggested that the mindfulness intervention was feasible and acceptable among pregnant women. Participants in the intervention group showed greater declines in depressive and anxious symptoms compared with those in the control group, as well a significant improvement in mindfulness skills (eg, attention monitoring and acceptance).

DISCUSSION

These results suggest that an online mindfulness intervention may be a promising technique to help women use mindfulness skills to reduce depressive and anxious symptoms. The mindfulness intervention could constitute part of the psychological care provided to pregnant women.

How mindfulness shapes the situational use of emotion regulation strategies in daily life

Mindfulness is associated with a wide range of beneficial outcomes such as well-being. However, less is known about the mechanisms underlying these benefits. Some researchers suggest that the benefits could be driven by emotion regulation, either by improving the effectiveness of emotion regulation or by lessening the need for effortful emotion regulation. By using two longitudinal Ambulatory Assessment data sets (N_Study1  = 125, N_Study2  = 175), based on a six-week randomised controlled trial and a one-week study, we tested these competing notions in daily life and found support for the latter: Mindfulness, and especially its non-judgmental acceptance facet, was significantly associated with less use of emotion regulation strategies. However, mindfulness was not significantly associated with more effective emotion regulation strategy implementation. Moreover, the mindfulness training focusing on present-moment attention and awareness did not significantly influence emotion regulation. These findings demonstrate the importance of the non-judgmental acceptance component for emotion regulation and affective well-being.

How is Mindfulness Linked to Negative and Positive Affect? Rumination as an Explanatory Process in a Prospective Longitudinal Study of Adolescents

Research shows greater mindfulness is associated with less negative affect and more positive affect. Fewer studies have examined the mediating psychological processes linking mindfulness to these outcomes in adolescents. This three-wave, prospective longitudinal study examines rumination-the tendency to engage in repetitive and negative self-focused thinking-as one potential explanatory process. High school students (N = 599, M_age = 16.3 years; 49% girls) completed a short-form version of the Five Facet Mindfulness Questionnaire, in addition to self-report measures of rumination and negative and positive affect three times over the course of a school year. Autoregressive, cross-lagged panel models tested reciprocal, prospective associations between mindfulness, rumination, and negative and positive affect, while accounting for prior levels of each construct, within-wave covariances, and gender and grade level. The results showed that the nonjudgment mindfulness facet (and the total mindfulness score) predicted cross-wave reductions in rumination, that in turn predicted cross-wave reductions in negative affect. No evidence for mediation was found for positive affect, or for any of the other mindfulness facets (describe, acting with awareness, and nonreactivity). This study provides suggestive evidence that individual differences in mindfulness, and in particular nonjudgmental acceptance, prospectively predict less negative affect through lower rumination.

Wearable sensor-based detection of stress and craving in patients during treatment for substance use disorder: A mixed methods pilot study

AIMS

To determine the accuracy of a wearable sensor to detect and differentiate episodes of self-reported craving and stress in individuals with substance use disorders, and to assess acceptability, barriers, and facilitators to sensor-based monitoring in this population.

METHODS

This was an observational mixed methods pilot study. Adults enrolled in an outpatient treatment program for a substance use disorder wore a non-invasive wrist-mounted sensor for four days and self-reported episodes of stress and craving. Continuous physiologic data (accelerometry, skin conductance, skin temperature, and heart rate) were extracted from the sensors and analyzed via various machine learning algorithms. Semi-structured interviews were conducted upon study completion, and thematic analysis was conducted on qualitative data from semi-structured interviews.

RESULTS

Thirty individuals completed the protocol, and 43 % (N = 13) were female. A total of 41 craving and 104 stress events were analyzed. The differentiation accuracies of the top performing models were as follows: stress vs. non-stress states 74.5 % (AUC 0.82), craving vs. no-craving 75.7 % (AUC 0.82), and craving vs. stress 76.8 % (AUC 0.8). Overall participant perception was positive, and acceptability was high. Emergent themes from the exit interviews included a perception of connectedness and increased mindfulness related to wearing the sensor, both of which were reported as helpful to recovery. Barriers to engagement included interference with other daily wear items, and perceived stigma.

CONCLUSIONS

Wearable sensors can be used to objectively differentiate episodes of craving and stress, and individuals in recovery from substance use disorder are accepting of continuous monitoring with these devices.

Worry alters speed-accuracy tradeoffs but does not impair sustained attention

Worry has been experimentally linked to a range of cognitive consequences, including impairments in working memory, inhibition, and cognitive control. However, findings are mixed, and the effects of worry on other phenomenologically-relevant constructs, such as sustained attention, have received less attention. Potential confounds such as speed-accuracy tradeoffs have also received little attention, as have psychometric and related design considerations, and potential moderators beyond trait worry. The present study investigated the effects of experimentally-induced worry versus a neutral control condition on speed-accuracy tradeoff-corrected performance on a validated measure of sustained attention (88 participants; within-subjects). Moderation by trait worry and trait mindfulness was probed in confirmatory and exploratory analyses, respectively. Worry led to faster and less accurate responding relative to the neutral comparison condition. There was no main effect of condition or trait worry on sustained attention after accounting for speed-accuracy tradeoffs. In exploratory analyses, higher trait mindfulness was robustly related to better post-worry performance, including after controlling for trait worry, general distress, and post-neutral performance, and correction for multiple comparisons. Follow-up analyses exploring dissociable mindfulness facets found a robust relationship between present-moment attention and post-worry performance. Future research should experimentally manipulate mindfulness facets to probe causality and inform treatment development.

Understanding How Virtual Reality Can Support Mindfulness Practice: Mixed Methods Study

Background

Regular mindfulness practice has been demonstrated to be beneficial for mental health, but mindfulness can be challenging to adopt, with environmental and personal distractors often cited as challenges. Virtual reality (VR) may address these challenges by providing an immersive environment for practicing mindfulness and by supporting the user to orient attention to the present moment within a tailored virtual setting. However, there is currently a limited understanding of the ways in which VR can support or hinder mindfulness practice. Such an understanding is required to design effective VR apps while ensuring that VR-supported mindfulness is acceptable to end users.

Objective

This study aimed to explore how VR can support mindfulness practice and to understand user experience issues that may affect the acceptability and efficacy of VR mindfulness for users in the general population.

Methods

A sample of 37 participants from the general population trialed a VR mindfulness app in a controlled laboratory setting. The VR app presented users with an omnidirectional video of a peaceful forest environment with a guided mindfulness voiceover that was delivered by a male narrator. Scores on the State Mindfulness Scale, Simulator Sickness Questionnaire, and single-item measures of positive and negative emotion and arousal were measured pre- and post-VR for all participants. Qualitative feedback was collected through interviews with a subset of 19 participants. The interviews sought to understand the user experience of mindfulness practice in VR.

Results

State mindfulness (P<.001; Cohen d=1.80) and positive affect (P=.006; r=.45) significantly increased after using the VR mindfulness app. No notable changes in negative emotion, subjective arousal, or symptoms of simulator sickness were observed across the sample. Participants described the user experience as relaxing, calming, and peaceful. Participants suggested that the use of VR helped them to focus on the present moment by using visual and auditory elements of VR as attentional anchors. The sense of presence in the virtual environment (VE) was identified by participants as being helpful to practicing mindfulness. Interruptions to presence acted as distractors. Some uncomfortable experiences were discussed, primarily in relation to video fidelity and the weight of the VR headset, although these were infrequent and minor.

Conclusions

This study suggests that an appropriately designed VR app can support mindfulness practice by enhancing state mindfulness and inducing positive affect. VR may help address the challenges of practicing mindfulness by creating a sense of presence in a tailored VE; by allowing users to attend to visual and auditory anchors of their choice; and by reducing the scope of the content in users’ mind-wandering. VR has the unique capability to combine guided mindfulness practice with tailored VEs that lend themselves to support individuals to focus attention on the present moment.

Exploring How Trait Mindfulness Relates to Perceived Stress and Cardiovascular Reactivity

BACKGROUND

Mindfulness interventions have been associated with less global perceived stress as well as attenuated cardiovascular reactivity. The aim of the present study was to evaluate whether high levels of trait mindfulness would also be associated with these benefits.

METHODS

Participants were 99 healthy young adults aged 18-25 years. Self-report measures included the Five Facet Mindfulness Questionnaire and the Perceived Stress Scale. Participants completed a laboratory stress protocol comprised of a resting baseline, a mental arithmetic stress task, and a resting recovery period. Blood pressure, heart rate, and heart rate variability were measured throughout the protocol. Regressions were used to analyze whether trait mindfulness predicted global perceived stress, cardiovascular reactivity, and cardiovascular recovery.

RESULTS

Two trait mindfulness facets were found to be associated with less global perceived stress, Acting with Awareness (β = - .306, p = .002) and Nonjudgment (β = - .342, p < .001). Exploratory analyses also revealed an interaction between the Observe and Nonreactivity facets (p = .002), such that the Observe facet was associated with less stress only when Nonreactivity scores were also high. Although trait mindfulness was not a significant predictor of the physiological variables (p > .05, Cohen's f² < .060), exploratory analyses revealed an interaction between the Awareness and Nonjudgment facets (p < .001), such that Awareness is associated with lower diastolic blood pressure reactivity only when Nonjudgment scores are also high.

CONCLUSIONS

Like mindfulness interventions, trait mindfulness is associated with less global perceived stress. Interactions between trait mindfulness facets that reflect attention monitoring and acceptance might predict physiological reactivity in certain contexts, though a mindful state might be necessary for most real-time cardiovascular benefits.

Differential impact of mindfulness practices on aggression among law enforcement officers

Objectives

Home-based mindfulness practice is a common component of formal mindfulness training (MT) protocols. Obtaining objective data from home-based mindfulness practice is challenging. Interpreting associations between home-based mindfulness practice and clinically impactful outcomes is complicated given the variability in recommendations in length, frequency, and type of practice. In this exploratory study, adherence to home-based practices of Mindfulness-Based Resilience Training (MBRT) was studied in order to evaluate associations with clinical outcomes.

Methods

Home practices from 24 (92% male, non-Hispanic white, aged M = 43.20 years) law enforcement officers (LEOs) from the urban Pacific Northwest enrolled in a feasibility and efficacy trial of MBRT were studied using an objective tracking device and self-report data. Outcomes included adherence to home-based mindfulness practices and self-reported aggression.

Results

Participants completed 59.12% of the frequency amount of practice assigned in the MBRT curriculum. Frequency of practice was associated with decreased aggression, adjusted R ² = .41, F(3,23) = 6.14, p = .004. Duration of practice also predicted decreased aggression, adjusted R ² = .33, F(3,23) = 4.76, p = .011.

Conclusions

Home-based MBRT practices for LEOs, even at low rates of adherence, may reduce aggression. MTs may show beneficial effects for other populations presented with challenges to engage in regular MT practices.

Mindfulness facets predict quality of life and sleep disturbance via physical and emotional distresses in Chinese cancer patients: A moderated mediation analysis

OBJECTIVE

Colorectal cancer survivors are at risk of symptom burden and emotional distress. Dispositional mindfulness has been linked with better sleep quality and quality of life (QoL) in these patients. This longitudinal study aimed to examine the associations among mindfulness facets, symptom burden, emotional distress, and functional outcomes.

METHODS

Study sample of this three-wave, 2-month survey was 127 Chinese colorectal cancer survivors. The participants completed the Five Facet Mindfulness Questionnaire, Memorial Symptom Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and SF-12 health survey. Moderated mediation analyses examined the direct and indirect effects of mindfulness facets on QoLs and sleep quality via symptom burden and emotional distress, using acting with awareness as a moderator.

RESULTS

The mindfulness facets had no significant direct effects on functional outcomes 2 months later. Awareness and nonreacting showed significant and positive indirect effects on physical and mental QoL via symptom burden and emotional distress 1 month later, respectively. Awareness, nonjudging, and nonreacting significantly predicted better sleep quality indirectly via emotional distress. Nonreacting showed stronger indirect effects on the functional outcomes among patients with greater awareness.

CONCLUSIONS

This study demonstrates longitudinal linkages between dispositional mindfulness and functioning in cancer survivors via symptom burden and emotional distress. Acting with awareness and nonreacting are the two facets that displayed clinical relevance in predicting better sleep quality and QoL.

Self-compassion, meaning in life, and experiential avoidance explain the relationship between meditation and positive mental health outcomes

OBJECTIVE

Despite consistent evidence for the beneficial effects of meditation on mental health, little is known about the mechanisms that make mindfulness meditation effective.

METHOD

The levels of mental health, self-compassion, presence of meaning in life, and experiential avoidance of meditators (n = 414) and nonmeditators (n = 414) were measured and compared. Bootstrap-based structural equation modeling (SEM) modeling analyses were used to test multiple-step multiple-mediator models.

RESULTS

Meditation was positively associated with mental health, although the regularity of practice was an influential element to be considered. Significant indirect effects of meditation on mental health through self-compassion, meaning in life, and experiential avoidance were found. SEM models were able to account for 58% of the variance in mental health scores.

CONCLUSIONS

Self-compassion, presence of meaning in life, and reduced experiential avoidance may be active components of healthy meditation practices. Identifying the mechanisms involved in effective meditation practices has relevant implications for well-being and mental health-promoting interventions.

Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness

BACKGROUND

Smartphone use disorder (SUD) of college students has drawn increasing attention. Although future time perspective (FTP) may be an important protective factor for individual SUD, the moderating and mediating mechanisms underlying this relationship remain unknown. We tested the individual roles of depression and mindfulness as moderators of this relationship.

METHODS

A cross-sectional study was conducted in two colleges in Shandong and Chongqing in China using a sample of 1304 college students recruited by stratified cluster sampling. Data were collected through a validated self-report instrument. A moderation-mediation model was constructed, and an SPSS PROCESS macro was used to analyse the data.

RESULTS

The correlation analyses showed that FTP was negatively associated with SUD of college students. The mediation model revealed that depression partially mediated the link between FTP and SUD of college students. The moderation-mediation model suggested that mindfulness moderates two direct paths: FTP to depression and depression to SUD. In the first path (FTP to depression), a high level of mindfulness among college students had weakened the relationship between FTP and depression. Here, the relationship is strengthened by a low level of mindfulness. In the second path (depression to SUD), low levels of mindfulness strengthen the link between depression and FTP. In contrast, significant association was not found with high levels of mindfulness.

CONCLUSIONS

Results suggest that interventions, such as improving the individual level of FTP and mindfulness, should be conducted. These interventions, in turn, help control the level of depression in college students and ultimately decrease their level of SUD.

Trait Mindfulness and Anger in the Family: A Dyadic Analysis of Male Service Members and their Female Partners

Anger-related problems have been documented among post-deployed service members who returned home, posing risks to their well-being and increasing distress in their families. Trait mindfulness (acting with awareness, nonjudging, and nonreactivity) has been associated with lower self-reported anger. Using actor-partner interdependence models, we tested the association between trait mindfulness and parental anger observed in parent-child and couple interactions. The sample consisted of 155 dyads of male National Guard/Reserve members who had been recently deployed and returned, and their female non-deployed partners. Results showed that fathers' and mothers' nonreactivity was negatively associated with their own observed anger, indicating that parents who reported higher nonreactivity exhibited lower anger. Mothers' nonreactivity was also negatively associated with observed fathers' anger in the same family such that fathers exhibited lower anger when their female partner reported higher nonreactivity. Nonreactivity facilitates emotion regulation and its cultivation may reduce anger in post-deployed military families.

The relationship between trait mindfulness and affective symptoms: A meta-analysis of the Five Facet Mindfulness Questionnaire (FFMQ)

Trait mindfulness appears to be related to lower levels of negative affective symptoms, but it remains uncertain which facets of mindfulness are most important in this relationship. Accordingly, the present meta-analysis examined studies reporting correlations between affective symptoms and trait mindfulness as assessed by the Five Facet Mindfulness Questionnaire. A comprehensive search yielded 148 eligible studies, comprising 157 distinct samples and 44,075 participants. The weighted mean correlation for affective symptoms and overall trait mindfulness was r = -0.53. Among mindfulness facets, Nonjudge (r = -0.48) and Act with Awareness (r = -0.47) demonstrated the largest correlations, followed by Nonreact (r = -0.33) and Describe (r = -0.29). Observe was not significantly correlated with affective symptoms. No significant differences in the strength of correlations were found between anxiety, depression and posttraumatic stress disorder (PTSD) symptoms, though symptoms of generalized anxiety disorder exhibited a weaker negative relationship with the Describe facet compared to PTSD symptoms. Describe also showed a stronger relationship with affective symptoms in Eastern samples compared to Western samples, whereas Western samples had a stronger relationship with Nonjudge. These results provide insight into the nature of the association between trait mindfulness and negative affect.

A Psychometric Review and Conceptual Replication Study of the Five Facets Mindfulness Questionnaire Latent Structure

The Five Facets Mindfulness Questionnaire (FFMQ) is a popular tool in mindfulness research. However, its psychometric qualities and its replicability have caused controversy. This study carried out a psychometric review and a conceptual replication of the FFMQ latent structure. The review showed that previous validation studies of the FFMQ used nonoptimal methods. In addition, this conceptual replication study tested the structure of the FFMQ using frequentist and Bayesian techniques. The original structure did not provide a good fit with both techniques, while the proposed alternative provided mixed results. We also found systematic fit improvements in both techniques when the Observe facet was excluded and method factors were included. With these findings, we conclude that the conceptual replication of the FFMQ's structure failed. Alternatively, we propose a new provisional FFMQ model with a set of recommendations regarding its application. Future research proposals on improving techniques and models toward mindfulness assessment are also presented and discussed.

Effects of a Brief Strange Loop Task on Immediate Word Length Comparison: A Mindfulness Study on Non-striving

Non-striving is an important aspect of mindfulness practice, but it has not been sufficiently researched. This study examines whether a strange loop-based task - Infinite Water Scooping Task - performed for 10 min, has an effect on non-striving behavior and performance in a subsequent word length comparison task. Results showed that performance (number of correct trials) did not differ significantly between the two groups, though the experimental group tended to perform worse. However, participants in the experimental group took a significantly shorter time to respond to the word length comparison task than those in the control group. It is inferred that shorter time taken reflects response without investing much effort to count with care, i.e., non-striving. The present study demonstrates that the brief strange loop task implemented in this study elicited non-striving behavior compared to the effects of the control task, and this adds to the understanding of non-striving in the context of mindfulness. The Infinite Water Scooping Task may be useful for illustrating and teaching non-striving within mindfulness practice.

The effect of a brief mindfulness-based intervention on personal recovery in people with bipolar disorder: a randomized controlled trial (study protocol)

BACKGROUND

With the advent of the recovery movement in mental health, a humanistic paradigm shift has occurred, placing the focus on personal recovery (i.e., hope, identity, and life meaning) instead of functional or clinical recovery only (i.e., symptom reduction or increases in physical function). Along the journey of recovery, people with bipolar disorder (BD) struggle to cope with recurring mood fluctuations between depression and mania. Mindfulness-based interventions (MBIs) have the potential to result in improvements in personal recovery outcomes. Thus, this protocol will evaluate the efficacy and mechanisms of a brief MBI for helping individuals with BD with their personal recovery. It is hypothesized that adults with BD randomly assigned to a brief MBI intervention will report greater improvements in personal recovery than those in a waiting list control condition. In addition, it is hypothesized that such benefits will be mediated by improvements in emotion awareness, emotion regulation, and illness acceptance. Moreover, the specific stage of BD is hypothesized to moderate the beneficial effects of the brief MBI, such that those in the early stage of BD will report more benefits regarding emotion awareness and emotion regulation, whereas those in the late stage of BD will report more advantages concerning illness acceptance.

METHOD

One hundred and fifty-four adults with BD will be recruited from hospitals and community settings for this research project. This study will use a mixed methods design. A randomized-controlled trial will be conducted to compare a brief MBI (four sessions in total) group and a waiting list control group. Assessments will be made at baseline, after intervention, and at six-month follow-up. In addition, a qualitative and participatory research method called Photovoice will be employed to further understand the experiences of the participants who receive the brief MBI along their personal recovery journey.

DISCUSSION

If the study hypotheses are supported, the findings from this research project will provide empirical support for an alternative treatment. Moreover, by identifying the mechanisms of the beneficial effects of the brief MBI, the findings will highlight process variables that could be specifically targeted to make MBI treatment even more effective in this population.

TRIAL REGISTRATION

This study is registered with the Chinese Clinical Trial Registry ( ChiCTR- 1900024658 ). Registered 20th July 2019.

All together now: utilizing common functional change principles to unify cognitive behavioral and mindfulness-based therapies

Cognitive behavior therapy (CBT) and mindfulness-based interventions (MBI) have made important contributions to resolving the global burden of mental illness. However, response rates are comparatively more modest for the distress disorders. Newer CBTs enriched with MBI components have emerged with promising findings for distress disorders but with a high degree of heterogeneity and, subsequently, an unclear path for determining the unique and synergistic contributions from CBTs and MBIs. We propose that one way to elucidate and improve upon this union is to identify common overarching principles (i.e. attention change; metacognitive change) that guide both approaches and to refine therapeutic processes to optimally reflect these common targets and their interplay (e.g. sequencing and dosing).

Mindfulness, acceptance, and emotion regulation: perspectives from Monitor and Acceptance Theory (MAT)

Experiential acceptance-an orientation of receptivity and noninterference with present-moment experiences-is described as central to mindfulness interventions, yet little experimental work has tested acceptance as a mechanism for mindfulness intervention effects. Guided by Monitor and Acceptance Theory (MAT), this review situates acceptance as an emotion regulation mechanism and reviews self-report mindfulness literature showing that attention monitoring skills are only associated with beneficial mental and physical health outcomes when accompanied by acceptance skills. New experimental dismantling work shows that removing acceptance training from mindfulness interventions reduces their efficacy for improving stress, positive emotion, and social relationship outcomes. Overall, converging evidence demonstrates that acceptance is a critical emotion regulation mechanism of mindfulness interventions. This work advances basic research, has translational value, and offers opportunities for future research.

Psychological mechanisms driving stress resilience in mindfulness training: A randomized controlled trial

OBJECTIVE

Mindfulness interventions have been shown to reduce stress; however, the mechanisms driving stress resilience effects are not known. Mindfulness interventions aim to teach individuals how to: (a) use attention to monitor present moment experiences; with (b) an attitude of acceptance and equanimity. A randomized controlled dismantling trial (RCT) was conducted to test the prediction that the removal of acceptance skills training would eliminate stress-reduction benefits of a mindfulness intervention.

METHOD

This preregistered RCT randomly assigned stressed community adults to 1 of 3 conditions: (a) Monitor and Accept (MA) mindfulness training, a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention that provided explicit instruction in developing both monitoring and acceptance skills; (b) Monitor Only (MO) mindfulness training, a well-matched 8-week MBSR intervention that taught monitoring skills only; or (c) No Treatment (NT) control. Stress and nonjudgment were measured using ecological momentary assessment (EMA) for 3 days at baseline and 3 days at postintervention.

RESULTS

Consistent with predictions, MA participants increased in nonjudgment and decreased in both stress ratings and the proportion of assessments that they reported experiencing feelings of stress in daily life, relative to both MO and NT participants.

CONCLUSIONS

This RCT provides one of the first experimental tests of the mechanisms linking mindfulness interventions with stress resilience. These findings suggest that acceptance skills training may be a necessary active ingredient and support the value of integrating acceptance skills training into stress-reduction interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Using mindfulness to reduce the health effects of community reaction to aircraft noise

Aim:

This paper investigates whether mindfulness-based interventions might ameliorate the detrimental health effects of aircraft noise on residential communities.

Review:

Numerous empirical studies over the past 50 years have demonstrated the increasing negative impact of aircraft noise on residents worldwide. However, extensive database searches have revealed no published studies on psychological interventions that reduce residents’ reactivity to environmental noise. By contrast, there has been extensive research over several decades confirming the effectiveness of mindfulness-based stress reduction training in lowering people’s stress from work and life. Considering that stress is a major component of aircraft noise reaction, it would seem worth assessing whether mindfulness-based interventions might be effective in reducing the health effects of aircraft noise. It appears that no existing conceptualization of mindfulness specifically accounts for noise as a stressor.

Conceptual Analysis:

A new conceptual model is presented here which explains how mindfulness can reduce noise reactivity. Two types of mindfulness are distinguished: an active form (meta-mindfulness) and a passive form (supra-mindfulness). It is posited that meta-mindfulness can facilitate “cognitive defusion” which research has confirmed as enabling people to disconnect from their own dysfunctional thoughts. In the case of aircraft noise, negative thinking associated with residents’ reactive experiences can exacerbate the health effects they suffer. The present model further proposes that supra-mindfulness can enable an individual to disengage their own sense of identity from the often overwhelming negative thoughts which can define their existence when they are consumed by extreme noise annoyance.

Conclusion:

The mindfulness processes of defusion and disidentification are postulated to be the key efficacy mechanisms potentially responsible for reducing reactivity to aircraft noise. This approach can be evaluated by extending previous research on the health benefits of mindfulness training.

Mindfulness training and systemic low-grade inflammation in stressed community adults: Evidence from two randomized controlled trials

Mindfulness interventions have garnered significant attention as a complementary health treatment for many physical and psychological conditions. While some research has shown that mindfulness training can decrease psychological and physiological stress responses, it remains unclear whether mindfulness training impacts inflammation—a predictor of poor health outcomes. In addition, little research has examined the active components of mindfulness that may drive health-related improvements. Here, we provide data from two 3-arm randomized controlled trials that examined the effect of mindfulness training on inflammation in stressed community adults. Specifically, we examined whether training individuals to have an accepting attitude towards present moment experiences is a key emotion regulation skill that can lead to decreases in inflammation. Both studies randomly assigned participants to one of three conditions: mindfulness training that taught both attention monitoring and acceptance skills (Monitor+Accept); mindfulness training teaching monitoring without the acceptance component (Monitor Only); or a control condition. Study 1 employed a novel 2-week smartphone-based intervention and Study 2 employed a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention. We hypothesized that Monitor+Accept training would lead to reductions in the inflammatory biomarker C-Reactive Protein (CRP) compared to Monitor Only training and control groups. Contrary to this hypothesis, we found that Monitor+Accept mindfulness training did not lead to reductions in CRP. Exploratory analyses combining study subsamples, however, suggest that both mindfulness interventions may reduce CRP in populations at risk for systemic inflammation—midlife-to-older adults and individuals with high BMI. Overall, the present studies contribute significantly to the question of whether mindfulness interventions can reduce systemic markers of low-grade inflammation.

Can Mindfulness-Based Training Improve Positive Emotion and Cognitive Ability in Chinese Non-clinical Population? A Pilot Study

OBJECTIVE

Based on eastern philosophy, mindfulness is becoming popular for human being's mental health and well-being in western countries. In this study, we proposed to explore the effectiveness and potential pathway of mindfulness-based training (MBT) on Chinese Non-clinical higher education students' cognition and emotion.

METHODS

A paired control design was used. 48 higher education students (24 in MBT group, 24 in control group) were recruited in the study. The MBT group engaged in a 12-week MBT. A package of measurements, including sustained attention tasks (The Continuous Performance Test, CPT), executive function task (Stroop) for cognitive functions, the self-reported mindfulness levels (The Mindful Attention Awareness Scale, MAAS) and emotion (The Profile of Mood States, POMS), were apply for all participants at baseline and every 4 weeks during next 12 weeks.

RESULTS

There were no differences in baseline demographic variables between two groups. Over the 12-week training, participants assigned to MBT group had a significantly greater reduction in CPT reaction time (Cohen's d 0.72), significantly greater improvement in positive emotion (Vigor-Activity, VA) (Cohen's d 1.08) and in MAAS (Cohen's d 0.49) than those assigned to control group. And, MAAS at 4th week could significantly predict the CPT RT and VA at 8th week in the MBT group. VA at 4th week could significantly predict the CPT RT at 8th week (B = 4.88, t = 2.21, p = 0.034, R2 = 0.35).

CONCLUSION

This study shows the efficiency of 12-week MBT on Chinese Non-clinical students' cognition and emotion. Mindfulness training may impact cognition and emotion through the improvement in mindfulness level, and may impact cognition through the improvement in positive emotion.

The relationship between acceptance of cancer and distress: A meta-analytic review

Acceptance of cancer has long been recognized as playing a critical role in psychological adjustment to the illness, but its associations with distress outcomes have not been quantitatively reviewed. Informed by coping theory and third wave conceptualizations of acceptance, we first propose an integrated model of acceptance of cancer. Then we examine the strength of the relationships between acceptance of cancer and general and cancer-specific distress in cancer patients and potential moderators of these relationships. CINAHL, Embase, MEDLINE, PsycINFO, PsycARTICLES, and Web of Science databases were searched. Random-effects meta-analyses were conducted on 78 records (N = 15,448). Small-to-moderate, negative, and significant relationships were found between acceptance of cancer and general distress (r = -0.31; 95% CI: -0.36 to -0.26, k = 75); cancer-specific distress (r = -0.18; 95% CI: -0.21 to -0.14, k = 13); depressive symptoms (r = -0.25; 95% CI: -0.31 to -0.19, k = 41); and anxiety symptoms (r = -0.22; 95% CI: -0.30 to -0.15, k = 29). Age, marital status, and stage of cancer were identified as significant moderators. Findings suggest that acceptance of cancer may be important to target in interventions to reduce general and cancer-specific distress in cancer patients. Future research should focus on developing multifaceted measures of acceptance and identifying theory-based psychological and social processes that lead to greater acceptance.

Effect of Acceptance versus Attention on Pain Tolerance: Dissecting Two Components of Mindfulness

OBJECTIVES

Previous studies have shown that brief mindfulness trainings can have significant analgesic effects. However, the effects of the various components of mindfulness on pain analgesia are not well understood. The objective of this study was to examine the effects of two components of mindfulness interventions - attention and acceptance on pain analgesia.

METHODS

One hundred and nineteen healthy college students without prior mindfulness experience underwent a cold pressor test to measure pain tolerance before and after the training. Pain intensity, tolerance, distress, threshold and endurance time were also tested. Participants were randomly assigned to one of four conditions: (1) acceptance of pain, (2) attention to pain, (3) acceptance of and attention to pain, or (4) control.

RESULTS

The results showed that both the acceptance strategy and the combined acceptance and attention group increased pain endurance and tolerance after training. Furthermore, acceptance group had longer pain endurance time and tolerance time than attention group and control group.

CONCLUSIONS

These results suggest that acceptance of pain is more important than attention to pain. Study limitations and future research directions are discussed.

Cognitive behavioral therapy, mindfulness, and cortisol habituation: A randomized controlled trial

BACKGROUND

Hypothalamic-pituitary-adrenocortical (HPA) axis dysregulation is associated with disease and may be indexed by poor cortisol habituation (i.e., a failure to show decreased responding with repeated stressor exposure). Thus, stress management training that can enhance HPA axis habituation may benefit health. To date, the effects of Mindfulness Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT) interventions on HPA axis habituation remain untested. To test the effects of MBSR and CBT on HPA axis habituation, the present study used a parallel arm randomized controlled trial.

METHODS

Healthy adults reporting moderate-to-high stress (n = 138) were randomly assigned to a 6-week MBSR intervention, a 6-week CBT intervention, or Waitlist control group. Post-intervention, participants completed a social-evaluative performance stressor during each of two laboratory visits scheduled 48-h apart. Salivary cortisol was collected pre-stressor, and 25, 35, and 60 min post-stressor onset during each visit. Final analyses included 86 participants who completed procedures up to the first laboratory visit.

RESULTS

Relative to the control condition, both MBSR and CBT groups showed greater cortisol habituation. The MBSR group exhibited marginally greater habituation than the Waitlist group in cortisol samples corresponding to the recovery time points (35 and 60 min post-stressor onset). In contrast, the CBT group showed greater habituation than the Waitlist across all sampling timepoints collected (pre-stressor, 25, 35, and 60 min post-stressor onset). Yet, the CBT group also demonstrated elevated pre-stressor cortisol during the first visit.

CONCLUSIONS

Results suggest that MBSR and CBT interventions promote greater HPA axis habituation relative to no training, but do not reduce overall cortisol output (i.e., across both visits). Observed differences between CBT and MBSR training in relation to cortisol habituation are discussed.