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

The 'Self' Aspects: the Sense of the Existence, Identification, and Location

The present article is limited to research studies focused on understanding the phenomenon and construction of the concept of 'Self.' When we look at one's experience of the Self, as a whole, it involves various components associated with different aspects like self-identification, self-location and the sense of the existence of oneself or the sense of Self. While exploring the Self phenomenon, many scientific studies consider only partial aspects of the experience, and hence any understanding resulting from such an evaluation makes it difficult to comment on the nature of the Self. We emphasize that while studying the Self, to understand it totally, one would need to include all the components of the Self. In this connection, we raise the following two theses: a) Ontologically, the Self is conceived as a sentient entity, the bearer of the "what it is like to be" type of feeling, and b) Phenomenologically, we do not have a direct apprehension of the Self, but experience various aspects of the Self through the Senses of Existence, Identification, and Location.

Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients

Prescription opioid misuse among chronic pain patients is undergirded by self-regulatory deficits, affective distress, and opioid-cue reactivity. Dispositional mindfulness has been associated with enhanced self-regulation, lower distress, and adaptive autonomic responses following drug-cue exposure. We hypothesized that dispositional mindfulness might serve as a protective factor among opioid-treated chronic pain patients. We examined heart-rate variability (HRV) during exposure to opioid cues and depressed mood as mediators of the association between dispositional mindfulness and opioid craving. Data were obtained from a sample of chronic pain patients (N = 115) receiving long-term opioid pharmacotherapy. Participants self-reported opioid craving and depression, and HRV was measured during an opioid-cue dot-probe task. Dispositional mindfulness was significantly positively correlated with HRV, and HRV was significantly inversely associated with opioid craving. Dispositional mindfulness was significantly negatively correlated with depression, and depression was significantly positively correlated with opioid craving. Path analysis revealed significant indirect effects of dispositional mindfulness on craving through both HRV and depression. Dispositional mindfulness may buffer against opioid craving among chronic pain patients prescribed opioids; this buffering effect may be a function of improved autonomic and affective responses. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study

The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals' cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.

The neuroscience of meditation: classification, phenomenology, correlates, and mechanisms

Rising from its contemplative and spiritual traditions, the science of meditation has seen huge growth over the last 30 years. This chapter reviews the classifications, phenomenology, neural correlates, and mechanisms of meditation. Meditation classification types are still varied and largely subjective. Broader models to describe meditation practice along multidimensional parameters may improve classification in the future. Phenomenological studies are few but growing, highlighting the subjective experience and correlations to neurophysiology. Oscillatory EEG studies are not conclusive likely due to the heterogeneous nature of the meditation styles and practitioners being assessed. Neuroimaging studies find common patterns during meditation and in long-term meditators reflecting the basic similarities of meditation in general; however, mostly the patterns differ across unique meditation traditions. Research on the mechanisms of meditation, specifically attention and emotion regulation is also discussed. There is a growing body of evidence demonstrating positive benefits from meditation in some clinical populations especially for stress reduction, anxiety, depression, and pain improvement, although future research would benefit by addressing the remaining methodological and conceptual issues. Meditation research continues to grow allowing us to understand greater nuances of how meditation works and its effects.

Positive psychological states in the arc from mindfulness to self-transcendence: extensions of the Mindfulness-to-Meaning Theory and applications to addiction and chronic pain treatment

The Mindfulness-to-Meaning Theory (MMT) is a temporally dynamic process model of mindful positive emotion regulation that elucidates downstream cognitive-affective mechanisms by which mindfulness promotes health and resilience. Here we review and extend the MMT to explicate how mindfulness fosters self-transcendence by evoking upward spirals of decentering, attentional broadening, reappraisal, and savoring. Savoring is highlighted as a key, potential means of inducing absorptive experiences of oneness between subject and object, amplifying the salience of the object while imbuing the sensory-perceptual field with affective meaning. Finally, this article provides new evidence that inducing self-transcendent positive emotions and nondual states of awareness through mindfulness-based interventions may restructure reward processing and thereby produce therapeutic effects on addictive behavior (e.g. opioid misuse) and chronic pain syndromes.

Contemplative neuroscience, self-awareness, and education

Accumulating research in education shows that contemplative practices contribute to and foster well-being of individuals in sustainable ways. This bears special importance for teachers, as it affects not only them but also their students. Based on accumulating behavioral and neuroscientific findings, it has been suggested that a key process by which mindfulness meditation enhances self-regulation is the altering of self-awareness. Indeed, accumulated work shows that the underlying networks supporting various types of self-awareness are malleable following meditative practice. However, the field of education has developed independently from the study of the self and its relation to contemplative neuroscience thus far, and to date there is no systematic account linking this accumulating body of knowledge to the field of education or discussing how it might be relevant to teachers. Here we show how incorporating insights from contemplative neuroscience-which are built on the conceptualization and neuroscience of the self-into contemplative pedagogy can inform the field and might even serve as a core underlying mechanism tying together different empirical evidence. This review points to potential neural mechanisms by which mindfulness meditation helps teachers manage stress and promote supportive learning environments, resulting in improved educational outcomes, and thus it has significant implications for educational policy regarding teachers.

Sensory neurologic disorders: Tinnitus

Tinnitus is the sensation of hearing a sound with no external auditory stimulus present. It is a public health issue correlated with multiple comorbidities and precipitating factors such as noise exposure, military service, and traumatic brain injury, migraine, insomnia, small vessel disease, smoking history, stress exposure, anxiety, depression, and socioeconomic status. Clinical experience and a recent literature review point at tinnitus as a neuropsychiatric condition involving both auditory and nonauditory cortical areas of the brain and affecting brain-auditory circuitry. In fact, brain-ear connections have been highlighted in different models. Forward management of this disorder should take this body of research into consideration as tinnitus remains a challenging condition to evaluate and treat with current management protocols still symptomatic at best. With a better understanding of the etiologic factors and comorbidities of tinnitus, additional research trials and new therapeutic approaches could see the light to tackle this public health disability bringing hope to patients and doctors.

Examining interpersonal self-transcendence as a potential mechanism linking meditation and social outcomes

Distinct types of meditation practice addressed in this review can help cultivate skills people may bring to later social interactions. We examine self-transcendence, or the drive to benefit others beyond the self, as a key mechanism through which meditation may promote positive social outcomes. Self-transcendence cultivated through various styles of meditation can impact social outcomes through two main pathways: First, self-transcendence can turn rigid, defensive self-focus into flexible and receptive self-construals. Second, it can increase positive other-focus by integrating reward and social signals in the brain. These accounts offer one practical solution of positively transforming social relations and highlight potential usefulness of considering self-transcendence in researching social effects of meditation.

Divergent effects of brief contemplative practices in response to an acute stressor: A randomized controlled trial of brief breath awareness, loving-kindness, gratitude or an attention control practice

Mindfulness practices are increasingly being utilized as a method for cultivating well-being. The term mindfulness is often used as an umbrella for a variety of different practices and many mindfulness-based interventions (MBIs) contain multiple styles of practice. Despite the diversity of practices within MBIs, few studies have investigated whether constituent practices produce specific effects. We randomized 156 undergraduates to one of four brief practices: breath awareness, loving-kindness, gratitude, or to an attention control condition. We assessed practice effects on affect following brief training, and effects on affect and behavior after provocation with a stressor (i.e., Cold pressor test). Results indicate that gratitude training significantly improved positive affect compared to breath awareness (d = 0.58) and loving-kindness led to significantly greater reductions in implicit negative affect compared to the control condition (d = 0.59) immediately after brief practice. In spite of gains in positive affect, the gratitude group demonstrated increased reactivity to the stressor, reporting the CPT as significantly more aversive than the control condition (d = 0.46) and showing significantly greater increases in negative affect compared to the breath awareness, loving-kindness, and control groups (ds = 0.55, 0.60, 0.65, respectively). Greater gains in implicit positive affect following gratitude training predicted decreased post-stressor likability ratings of novel neutral faces compared to breath awareness, loving-kindness, and control groups (ds = - 0.39, -0.40, -0.33, respectively) as well. Moreover, the gratitude group was significantly less likely to donate time than the loving-kindness group in an ecologically valid opportunity to provide unrewarded support. These data suggest that different styles of contemplative practice may produce different effects in the context of brief, introductory practice and these differences may be heightened by stress. Implications for the study of contemplative practices are discussed.

Does Emotional Intelligence Mediate the Relation Between Mindfulness and Anxiety and Depression in Adolescents?

High anxiety and depression are often observed in the Australian adolescent population, and if left untreated, can have long-term negative consequences impacting educational attainment and a range of important life outcomes. The utilization of mindfulness techniques has been associated with decreased anxiety and depression, but the underlying mechanisms for this is only beginning to be understood. Previous research with adult samples has suggested that the development of emotional intelligence (EI) may be one mechanism by which mindfulness confers its benefits on wellbeing. This study is the first to examine the relation between mindfulness, EI, anxiety, and depression in an adolescent population. It was hypothesized that EI would mediate the relationships between mindfulness and anxiety, as well as mindfulness and depression. The sample consisted of 108 adolescents from a public secondary school, aged between 13 and 15 years (M_age = 13.68, SD_age = 0.56, 51 males and 57 females). Participants completed an online self-report questionnaire which measured dispositional mindfulness, EI, anxiety, and depression. The results indicated that one subscale of EI – Emotional Recognition and Expression (ERE) mediated the relation between mindfulness and anxiety, while two subscales of EI – ERE and Emotional Management and Control (EMC) mediated the relation between mindfulness and depression. Future research utilizing a mindfulness intervention should be conducted to examine whether the use of mindfulness increases EI and decreases anxiety and depression in adolescents.

Mindfulness Meditation and Psychopathology

Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.

Mindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis

Mindfulness-Based Stress Reduction practices increase the capacity for concentration and attention, and these practices are particularly effective for people with breast cancer. To analyze the effects of the application of Mindfulness-Based Stress Reduction on breast cancer symptoms. Systematic review and meta-analysis were carried out. To find suitable studies, the PubMed/ MEDLINE database was searched using the keywords "breast cancer" and "Mindfulness-Based Stress Reduction". Studies included were published between 2013 and 2017, written in English and showed methodological quality through the PEDro scale (score greater than 3). They also presented empirical evidence, had an experimental study design (randomized or non-randomized), and had full text available. For the meta-analysis, we used a random-effects model, with standardized mean differences and 95% confidence intervals. Seven studies were included, one non-randomized and containing only an intervention group of Mindfulness-Based Stress Reduction, and six randomized including samples of two or three groups. The non-randomized study showed 6 points on the PEDro scale, the randomized studies of two groups 6 to 7 points and studies with three groups showed 7 points. In the meta-analysis of the two randomized studies, the results, although not significant, revealed a moderate effect for Mindfulness-Based Stress Reduction on the outcome of fatigue, with a mean difference of -0.42 (95%CI -0.92- -0.07; p=0.09). Mindfulness-Based Stress Reduction seems to be a promising alternative for treatment of this disease's symptoms.

Atypical Anxiety-Related Amygdala Reactivity and Functional Connectivity in Sant Mat Meditation

While meditation has drawn much attention in cognitive neuroscience, the neural mechanisms underlying its emotional processing remains elusive. Sant Mat meditators were recruited, who adopt a loving-kindness mode of meditation along with a vegetarian diet and an alcohol-restricted lifestyle and novices. We assessed their State-Trait Anxiety Inventory (STAI) and scanned their amygdala reactivity in response to an explicit and implicit (backward masked) perception of fearful and happy faces. In contrast with novices, meditators reported lower STAI scores. Meditators showed stronger amygdala reactivity to explicit happiness than to fear, whereas novices exhibited the opposite pattern. The amygdala reactivity was reduced in meditators regardless of implicit fear or happiness. Those who had more lifetime practice in meditation reported lower STAI and showed a weaker amygdala response to fear. Furthermore, the amygdala in meditators, relative to novices, had a stronger positive functional connectivity with the ventrolateral prefrontal cortex (PFC) to explicit happiness, but a more negative connectivity with the insula and medial orbitofrontal cortex (OFC) to explicit fear. Mediation analysis indicated the amygdala reactivity as the mediator for the linkage between meditation experience and trait anxiety. The findings demonstrate the neural correlates that underpin the beneficial effects of meditation in Sant Mat. Long-term meditation could be functionally coupled with the amygdala reactivity to explicit and implicit emotional processing, which would help reduce anxiety and potentially enhance well-being.

Meditation experience predicts negative reinforcement learning and is associated with attenuated FRN amplitude

Focused attention meditation (FAM) practices are cognitive control exercises where meditators learn to maintain focus and attention in the face of distracting stimuli. Previous studies have shown that FAM is both activating and causing plastic changes to the mesolimbic dopamine system and some of its target structures, particularly the anterior cingulate cortex (ACC) and striatum. Feedback-based learning also depends on these systems and is known to be modulated by tonic dopamine levels. Capitalizing on previous findings that FAM practices seem to cause dopamine release, the present study shows that FAM experience predicts learning from negative feedback on a probabilistic selection task. Furthermore, meditators exhibited attenuated feedback-related negativity (FRN) as compared with nonmeditators and this effect scales with meditation experience. Given that reinforcement learning and FRN are modulated by dopamine levels, a possible explanation for our findings is that FAM practice causes persistent increases in tonic dopamine levels which scale with amount of practice, thus altering feedback processing.

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.

Computational modelling approaches to meditation research: why should we care?

Computational modeling and meditation are not frequently mentioned in the same breath. However, in this article we argue that computational modeling can provide insights into the mechanisms by which meditation produces its effects on cognition. Moreover, computational modeling allows the researcher to make predictions about how effects of meditation will generalize to other contexts such as other tasks, which can be tested in subsequent experiments. In addition, computational theories can help to clarify similarities and differences between meditation practices, which is crucial for mapping out the space of contemplative practices. In short, even though computational modeling has not yet been used extensively, we think this approach can make important contributions to the field of meditation research.

Does Meditation Alter Brain Responses to Negative Stimuli? A Systematic Review

Background: Despite several attempts to review and explain how meditation alters the brain and facilitates emotion regulation, the extent to which meditation and emotion regulation strategies share the same neural mechanisms remains unclear.

Objective: We aim to understand the influence of meditation on the neural processing of negative emotional stimuli in participants who underwent meditation interventions (naive meditators) and long-term meditators.

Methodology: A systematic review was conducted using standardized search operators that included the presence of terms related to emotion, meditation and neuro-imaging techniques in PsycInfo, PubMed, Scopus, and Web of Science databases.

Results: Searches identified 882 papers, of which 11 were eligible for inclusion. Results showed a predominance of greater prefrontal/frontal activity related to meditation, which might indicate the increased recruitment of cognitive/attentional control resources in naïve and long-term meditators. This increased frontal activity was also observed when participants were asked to simply react to negative stimuli. Findings from emotion-related areas were scarce but suggested increased insular activity in meditators, potentially indicating that meditation might be associated with greater bodily awareness.

Conclusions: Meditation practice prompts regulatory mechanisms when participants face aversive stimuli, even without an explicit request. Moreover, some studies reported increased insular activity in meditators, consistent with the hypothesis that meditation helps foster an interoceptive awareness of bodily and emotional states.

Future directions in meditation research: Recommendations for expanding the field of contemplative science

The science of meditation has grown tremendously in the last two decades. Most studies have focused on evaluating the clinical effectiveness of mindfulness-based interventions, neural and other physiological correlates of meditation, and individual cognitive and emotional aspects of meditation. Far less research has been conducted on more challenging domains to measure, such as group and relational, transpersonal and mystical, and difficult aspects of meditation; anomalous or extraordinary phenomena related to meditation; and post-conventional stages of development associated with meditation. However, these components of meditation may be crucial to people's psychological and spiritual development, could represent important mediators and/or mechanisms by which meditation confers benefits, and could themselves be important outcomes of meditation practices. In addition, since large numbers of novices are being introduced to meditation, it is helpful to investigate experiences they may encounter that are not well understood. Over the last four years, a task force of meditation researchers and teachers met regularly to develop recommendations for expanding the current meditation research field to include these important yet often neglected topics. These meetings led to a cross-sectional online survey to investigate the prevalence of a wide range of experiences in 1120 meditators. Results show that the majority of respondents report having had many of these anomalous and extraordinary experiences. While some of the topics are potentially controversial, they can be subjected to rigorous scientific investigation. These arenas represent largely uncharted scientific terrain and provide excellent opportunities for both new and experienced researchers. We provide suggestions for future directions, with accompanying online materials to encourage such research.

Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity

Contemplative practices, such as meditation and yoga, are increasingly popular among the general public and as topics of research. Beneficial effects associated with these practices have been found on physical health, mental health and cognitive performance. However, studies and theories that clarify the underlying mechanisms are lacking or scarce. This theoretical review aims to address and compensate this scarcity. We will show that various contemplative activities have in common that breathing is regulated or attentively guided. This respiratory discipline in turn could parsimoniously explain the physical and mental benefits of contemplative activities through changes in autonomic balance. We propose a neurophysiological model that explains how these specific respiration styles could operate, by phasically and tonically stimulating the vagal nerve: respiratory vagal nerve stimulation (rVNS). The vagal nerve, as a proponent of the parasympathetic nervous system (PNS), is the prime candidate in explaining the effects of contemplative practices on health, mental health and cognition. We will discuss implications and limitations of our model.

"Smoking Does Not Go With Yoga:" A Qualitative Study of Women's Phenomenological Perceptions During Yoga and Smoking Cessation

INTRODUCTION

Smoking cessation is often accompanied by withdrawal symptoms, cigarette craving, increased negative affect, and increased experience of stress. Because yoga has been shown to reduce stress and negative affect, it may be an effective aid to smoking cessation. The objective of this study was to examine women's phenomenological experiences of vinyasa yoga as part of a smoking cessation program.

METHODS

Focus groups were conducted post-intervention with women (n = 20) who participated in a pilot randomized controlled trial of yoga as a complementary therapy for smoking cessation. The 8-week vinyasa yoga intervention included twice weekly 60-minute classes that involved breathing exercises, postures (asanas), and relaxation techniques. Focus groups were audio recorded and transcribed. Thematic analysis focused on descriptions of yoga, breathing, and bodily sensations including cigarette craving.

RESULTS

Focus group participants described vinyasa yoga as physically challenging. Most reported deliberate use of yogic breathing to cope with cigarette craving and stress. Other perceived effects included relaxation and an increased sense of body awareness and wellbeing.

CONCLUSIONS

Participants viewed yoga as positive and potentially helpful for quitting smoking. Yoga may be an effective adjunct for smoking cessation.

Toward New Therapeutic Mechanisms in Bipolar Disorder: Analog Investigation of Self-Compassion and Nonattachment to Self

There is growing interest in psychological processes that might be targeted in treatments for bipolar disorder (BD). One such process is a vulnerability at the level of self-concept, characterized by presence of, and fluctuations between positive and negative self-concept. The aim of the present study was to advance this literature by investigating the role of two emerging meta-cognitive processes – self-compassion and nonattachment to self – which have potential to therapeutically modulate this unstable self-concept in BD. Using an analog design, it was hypothesized that both variables would mediate the relationship between bipolar tendencies and psychological distress in a general population sample. Participants (N = 372 Australian university students) completed self-report measures of manic and depressive tendencies, self-compassion, nonattachment to self and psychological distress. To investigate the specificity of the two hypothesized mediators, a better-researched psychological variable – rumination – was also included in mediation analyses. Bivariate analyses found tendencies toward mania and depression to be associated with diminished self-compassion and nonattachment to self, while both psychological processes were negatively associated with psychological distress. Mediation analyses showed, as expected, self-compassion and nonattachment to self mediated the relationship between bipolar tendencies and psychological distress after controlling for the effects of rumination. The present findings add incrementally to this literature by demonstrating that two meta-cognitive processes – self-compassion and nonattachment to self – act as mediators, and may be modifiable mechanisms linking bipolar vulnerability to negative mood outcomes. Future research should tackle longstanding conceptual issues in this domain, including the relationship between contents of self-concept (an established focus of BD research) and the person’s meta-cognitive approach to their self-concept (the focus here).

Feasibility of yoga as a complementary therapy for patients with type 2 diabetes: The Healthy Active and in Control (HA1C) study

OBJECTIVES

This study:Healthy Active and in Control (HA1C), examined the feasibility and acceptability of yoga as a complementary therapy for adults with Type-2 Diabetes (T2DM).

DESIGN

A 2-arm randomized clinical trial comparing Iyengar yoga with a supervised walking program.

SETTING

Hospital based gym-type facility and conference rooms.

INTERVENTIONS

Participants were randomized to a 12-week program of either; (1) a twice weekly Iyengar yoga, or (2) a twice-weekly program of standard exercise (SE).

MAIN OUTCOME MEASURES

Primary outcomes assessed feasibility and acceptability, including enrollment rates, attendance, study completion, and participant satisfaction. Secondary outcomes included HbA1c, physical activity, and measures of diabetes-related emotional distress, self-care and quality of life (QOL). Assessments were conducted at baseline, end of treatment, 6-months and 9-months post-enrollment.

RESULTS

Of 175 adults screened for eligibility, 48 (30 women, 18 men) were eligible and enrolled. The most common reasons for ineligibility were orthopedic restrictions, HbA1c levels <6.5 and BMI > 42. Session attendance was high (82% of sessions attended), as was follow-up completion rates (92%). Program satisfaction rated on a 5-point scale, was high among both Yoga (M = 4.63, SD = 0.57) and SE (M = 4.77, SD = 0.52) participants. Overall 44 adverse events (26 Yoga, 18 SE) were reported. Of these, six were deemed "possibly related" (e.g., neck strain, back pain), and 1 "probably related" (ankle pain after treadmill) to the study. Yoga produced significant reductions in HbA1c. Median HbA1c at 6 months was 1.25 units lower for Yoga compared to SE (95% CI: -2.54 -0.04). Greater improvements in diabetes self-care, quality of life, and emotional distress were seen among Yoga participants than among SE participants. Increases in mindfulness were seen in Yoga but not in SE.

CONCLUSIONS

The yoga intervention was highly feasible and acceptable, and produced improvements in blood glucose and psychosocial measures of diabetes management.

Psychedelics, Meditation, and Self-Consciousness

In recent years, the scientific study of meditation and psychedelic drugs has seen remarkable developments. The increased focus on meditation in cognitive neuroscience has led to a cross-cultural classification of standard meditation styles validated by functional and structural neuroanatomical data. Meanwhile, the renaissance of psychedelic research has shed light on the neurophysiology of altered states of consciousness induced by classical psychedelics, such as psilocybin and LSD, whose effects are mainly mediated by agonism of serotonin receptors. Few attempts have been made at bridging these two domains of inquiry, despite intriguing evidence of overlap between the phenomenology and neurophysiology of meditation practice and psychedelic states. In particular, many contemplative traditions explicitly aim at dissolving the sense of self by eliciting altered states of consciousness through meditation, while classical psychedelics are known to produce significant disruptions of self-consciousness, a phenomenon known as drug-induced ego dissolution. In this article, we discuss available evidence regarding convergences and differences between phenomenological and neurophysiological data on meditation practice and psychedelic drug-induced states, with a particular emphasis on alterations of self-experience. While both meditation and psychedelics may disrupt self-consciousness and underlying neural processes, we emphasize that neither meditation nor psychedelic states can be conceived as simple, uniform categories. Moreover, we suggest that there are important phenomenological differences even between conscious states described as experiences of self-loss. As a result, we propose that self-consciousness may be best construed as a multidimensional construct, and that "self-loss," far from being an unequivocal phenomenon, can take several forms. Indeed, various aspects of self-consciousness, including narrative aspects linked to autobiographical memory, self-related thoughts and mental time travel, and embodied aspects rooted in multisensory processes, may be differently affected by psychedelics and meditation practices. Finally, we consider long-term outcomes of experiences of self-loss induced by meditation and psychedelics on individual traits and prosocial behavior. We call for caution regarding the problematic conflation of temporary states of self-loss with "selflessness" as a behavioral or social trait, although there is preliminary evidence that correlations between short-term experiences of self-loss and long-term trait alterations may exist.

Does Mindfulness Training Enhance the Professional Development of Residents? A Qualitative Study

PURPOSE

In addition to developing diagnostic and clinical skills, postgraduate medical education should stimulate residents' professional development. Teaching medical professionalism is challenging and is often left largely to the informal and hidden curricula. An intervention that might be beneficial for medical residents is mindfulness-based stress reduction (MBSR). The authors implemented MBSR as an optional course for residents and qualitatively explored how it influenced residents professionally.

METHOD

Between 2014 and 2016, the authors conducted 19 in-depth, face-to-face interviews with residents who had participated in an MBSR course at Radboud university medical center, The Netherlands. Medical and surgical residents, across a range of disciplines, participated. The authors used the constant comparison method to analyze the data.

RESULTS

The analysis of the data resulted in five themes: awareness of thoughts, emotions, bodily sensations, and behavior; increased self-reflection; acceptance and nonjudgment; increased resilience; and relating to others. Residents indicated that the MBSR training increased their awareness and self-reflection at work, and they were more accepting toward themselves and toward their limitations. Furthermore, they mentioned being more resilient and better at setting priorities and limits. They improved their self-care and work-life balance. In addition, residents indicated that the training made them more aware of how they communicated. They asked for help more often and seemed to be more open toward feedback. Lastly, they indicated an increased sense of compassion for others.

CONCLUSIONS

This study indicated that mindfulness training can serve as a tool to cultivate important professional competencies for residents.

Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and in Control (HA1C) Study

Diabetes is the seventh leading cause of death in the United States. For most patients, medication alone is not sufficient to achieve glycemic control; attention must also be paid to multiple healthy behaviors including diet, regular physical activity, and stress management. Yoga, a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, may have special relevance to people with type 2 diabetes mellitus (T2DM). Yoga practice may positively affect stress and other self-care tasks that will contribute to improved glycemic control. The Healthy, Active, and in Control (HA1C) study is designed to examine the feasibility and acceptability of yoga among adult patients with T2DM. In this pilot randomized controlled trial, adults with T2DM were randomly assigned to either a 12-week Iyengar Yoga intervention given twice weekly, or a twice-weekly 12-week program of traditional exercise (e.g., walking, stationary cycling). Assessments are conducted at the end of treatment (12 weeks) and at 3 and 6 months postintervention. The HA1C study will assess feasibility and acceptability (e.g., attendance/retention rates, satisfaction with program), glycemic outcomes (e.g., HbA1c, fasting blood glucose, postprandial blood glucose), and changes in physiological (e.g., salivary cortisol) and behavioral factors (e.g., physical activity, diet) relevant to the management of T2DM. Focus groups are conducted at the end of the intervention to explore participants' experience with the program and their perception of the potential utility of yoga for diabetes management.

Effectiveness of Serious Gaming During the Multidisciplinary Rehabilitation of Patients With Complex Chronic Pain or Fatigue: Natural Quasi-Experiment

BACKGROUND

Current evidence for the effectiveness of specialist multidisciplinary programs for burdensome chronic pain and functional somatic syndromes drives the effort to improve approaches, strategies, and delivery modes. It remains unknown to what extent and in what respect serious gaming during the regular outpatient rehabilitation can contribute to health outcomes.

OBJECTIVE

The objectives of our study were to determine the effect of additional serious gaming on (1) physical and emotional functioning in general; (2) particular outcome domains; and (3) patient global impressions of change, general health, and functioning and to determine (4) the dependency of serious gaming effects on adherence.

METHODS

We conducted a naturalistic quasi-experiment using embedded qualitative methods. The intervention group patients received an additional guided (mindfulness-based) serious gaming intervention during weeks 9-12 of a 16-week rehabilitation program at 2 sites of a Dutch rehabilitation clinic. Simultaneously, 119 control group patients followed the same program without serious gaming at 2 similar sites of the same clinic. Data consisted of 10 semistructured patient interviews and routinely collected patient self-reported outcomes. First, multivariate linear mixed modeling was used to simultaneously estimate a group effect on the outcome change between weeks 8 and 16 in 4 primary outcomes: current pain intensity, fatigue, pain catastrophizing, and psychological distress. Second, similar univariate linear mixed models were used to estimate effects on particular (unstandardized) outcomes. Third, secondary outcomes (ie, global impression of change, general health, functioning, and treatment satisfaction) were compared between the groups using independent t tests. Finally, subgroups were established according to the levels of adherence using log data. Influences of observed confounding factors were considered throughout analyses.

RESULTS

Of 329 eligible patients, 156 intervention group and 119 control group patients (N=275) with mostly chronic back pain and concomitant psychosocial problems participated in this study. Of all, 119 patients played ≥75% of the game. First, the standardized means across the 4 primary outcomes showed a significantly more favorable degree of change during the second part of the treatment for the intervention group than for the control group (beta=-0.119, SE=0.046, P=.009). Second, the intervention group showed a greater outcome change in depressive mood (b=-2.748, SE=1.072, P=.011) but not in "insufficiency" or concentration problems. Third, no significant group effects on secondary outcomes were found. Fourth, adherence was generally high and invariant.

CONCLUSIONS

The findings of this study suggest a very small favorable average effect on relevant health outcomes of additional serious gaming during multidisciplinary rehabilitation. The indication that serious gaming could be a relatively time-efficient component warrants further research into if, when, how, and for which patients serious gaming could be cost-effective in treatment and why.

TRIAL REGISTRATION

Netherlands Trial Registry NTR6020; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6020 (Archived by WebCite at http://www.webcitation.org/71IIoTXkj).

Relationships between health literacy, motivation and diet and physical activity in people with type 2 diabetes participating in peer-led support groups

AIMS

To investigate associations between health literacy (HL) and diet and physical activity, and motivation and diet and physical activity in Danish people with type 2 diabetes.

METHODS

We used a cross-sectional design including 194 individuals with type 2 diabetes participating in peer-led support groups provided by the Danish Diabetes Association between January-December 2015. The participants completed a questionnaire at the first meeting including; The Summary of Diabetes Self-Care Activities (SDSCA) measure, The Treatment Self-Regulation Questionnaire (TSRQ) (Self-Determination Theory) measuring type of motivation, and two HL scales: The HLS-EU-Q16, and the Diabetes Health Literacy scale (Ishikawa, H). Data were analyzed using linear regression models adjusting for age, gender, educational level, diabetes duration, motivation and HL.

RESULTS

The adjusted β (95%CI) showed that autonomous motivation and functional HL were associated with following recommended diet: autonomous motivation; 0.43 (0.06; 0.80) and functional HL; 0.52 (0.02; 1.00). Autonomous motivation was related to following physical activity recommendations; β (95%CI) 0.56 (0.16; 0.96).

CONCLUSIONS

This study indicates that, for people with type 2 diabetes, functional HL and autonomous motivation may be important drivers for following diet recommendations, and autonomous motivation may be the most important factor for following recommendations regarding physical activity. These concepts may therefore be highly relevant to address in interventions to people with type 2 diabetes. Different interventions are suggested.

Assessment of Patient Self-awareness and Related Neural Correlates in Frontotemporal Dementia and Corticobasal Syndrome

OBJECTIVE

We compared two different methods of assessing self-awareness (clinician-rated vs. self- and caregiver report) in participants with neurodegenerative conditions. Additionally, we examined the contribution of memory dysfunction to assessment of self-awareness.

METHOD

Sixty-seven participants with various neurodegenerative disorders participated in this study. Data were collected on brain volume, neurocognitive function, demographic characteristics, and two measures of patient self-awareness, defined as (1) the discrepancy between patient and caregiver ratings of dysexecutive syndrome and (2) clinician-observed rating of patient insight. Penalized regression with best subset variable selection and 10-fold cross-validation was used to evaluate three neurocognitive frameworks: self-regulation, language, and perspective-taking, each predicting the results from the two methods of self-awareness measurement.

RESULTS

The self-regulation framework was more robustly predictive for both the clinician rating and discrepancy method than language or perspective-taking. Frameworks in which the clinician rating was the criterion were more robust than those with the discrepancy method as criterion. When a measure of memory functioning was added to the framework, there was no appreciable improvement in the prediction of self-awareness.

CONCLUSIONS

A self-regulation neurocognitive framework, consisting of regions of interest and neuropsychological test scores, was more effective in understanding patient self-awareness than perspective-taking or language frameworks. Compared to the discrepancy method, a clinician rating of self-awareness was more robustly associated with relevant clinical variables of regional brain volume and neuropsychological performance, suggesting it may be a useful measure to aid clinical diagnosis.

The Nondual Awareness Dimensional Assessment (NADA): New tools to assess nondual traits and states of consciousness occurring within and beyond the context of meditation

This article details the development of two measures of nondual awareness, the Nondual Awareness Dimensional Assessment-Trait (NADA-T) and the Nondual Awareness Dimensional Assessment-State (NADA-S). Principal component analysis (N = 528) revealed two, interpretable dimensions of the NADA-T: self-transcendence and bliss. Bifactor exploratory structural equation modeling, conducted in three independent samples (N = 338, N = 221, N = 166), indicated that both NADA-T dimensions were components of a second-order nondual awareness construct. Convergent validity was observed between the NADA-T and theoretically aligned constructs, including interdependent self-construals and dispositional mindfulness. Given theoretical and observed relationships between nondual awareness and mindfulness, additional analyses examined the relationship between mindfulness practice and nondual awareness. Results indicated that mindfulness practitioners reported higher NADA-T scores than nonpractitioners, and mindfulness practice frequency was positively associated with nondual awareness. To assess the immediate effect of meditation practice on nondual awareness, items retained in the final version of the NADA-T were modified to create the NADA-S. A randomized controlled experiment (N = 53) comparing participants receiving a mindfulness induction (i.e., body scan) with those in an attention control group revealed state effects of mindfulness on nondual awareness using two, alternate forms of the NADA-S. Thus, the NADA-T appears to be psychometrically sound, representing a novel, standardized instrument capable of facilitating quantitative investigation of nondual awareness. Furthermore, the NADA-S may be useful for measuring fluctuations in nondual states of awareness evoked during mindfulness meditation practice and other contemplative techniques designed to transform consciousness. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effects of a 7-Day Meditation Retreat on the Brain Function of Meditators and Non-Meditators During an Attention Task

Meditation as a cognitive enhancement technique is of growing interest in the field of health and research on brain function. The Stroop Word-Color Task (SWCT) has been adapted for neuroimaging studies as an interesting paradigm for the understanding of cognitive control mechanisms. Performance in the SWCT requires both attention and impulse control, which is trained in meditation practices. We presented SWCT inside the MRI equipment to measure the performance of meditators compared with non-meditators before and after a meditation retreat. The aim of this study was to evaluate the effects of a 7-day Zen intensive meditation training (a retreat) on meditators and non-meditators in this task on performance level and neural mechanisms. Nineteen meditators and 14 non-meditators were scanned before and after a 7-day Zen meditation retreat. No significant differences were found between meditators and non-meditators in the number of the correct responses and response time (RT) during SWCT before and after the retreat. Probably, due to meditators training in attention, their brain activity in the contrast incongruent > neutral during the SWCT in the anterior cingulate, ventromedial prefrontal cortex/anterior cingulate, caudate/putamen/pallidum/temporal lobe (center), insula/putamen/temporal lobe (right) and posterior cingulate before the retreat, were reduced compared with non-meditators. After the meditation retreat, non-meditators had reduced activation in these regions, becoming similar to meditators before the retreat. This result could be interpreted as an increase in the brain efficiency of non-meditators (less brain activation in attention-related regions and same behavioral response) promoted by their intensive training in meditation in only 7 days. On the other hand, meditators showed an increase in brain activation in these regions after the same training. Intensive meditation training (retreat) presented distinct effects on the attention-related regions in meditators and non-meditators probably due to differences in expertise, attention processing as well as neuroplasticity.

A mind full of self: Self-referential processing as a mechanism underlying the therapeutic effects of mindfulness training on internalizing disorders

The aim of the current review is to advance the hypothesis that change in self-referential processing is a key but under-examined mechanism through which mindfulness training confers its therapeutic benefits for individuals with internalizing disorders. Consequently, we integrated neuroscientific studies on aberrant self-referential processing in internalizing disorders with contemplative science scholarship examining the effects of mindfulness training on the self-referential system. Reviewing these literatures yielded four major conclusions: (1) internalizing disorders can be characterized by excessive self-referential processing and emotion dysregulation; (2) mindfulness training has moderate effects on reducing internalizing symptoms; (3) mindfulness training promotes the shifting from narrative self-focus to present-centered experiential awareness; (4) such mindfulness-induced changes in self-reference is accompanied by reduced activation in overactive self-referential brain regions that have been implicated in internalizing disorders. Clinical and research implications related to delineating the role of self-referential processing in producing the therapeutic effects of mindfulness training are discussed.

Meditation Effects on the Control of Involuntary Contingent Reorienting Revealed With Electroencephalographic and Behavioral Evidence

Prior studies have reported that meditation may improve cognitive functions and those related to attention in particular. Here, the dynamic process of attentional control, which allows subjects to focus attention on their current interests, was investigated. Concentrative meditation aims to cultivate the abilities of continuous focus and redirecting attention from distractions to the object of focus during meditation. However, it remains unclear how meditation may influence attentional reorientation, which involves interaction between both top-down and bottom-up processes. We aimed to investigate the modulating effect of meditation on the mechanisms of contingent reorienting by employing a rapid serial visual presentation (RSVP) task in conjunction with electrophysiological recording. We recruited 26 meditators who had an average of 2.9 years of meditation experience and a control group comprising 26 individuals without any prior experience of meditation. All subjects performed a 30-min meditation and a rest condition with data collected pre- and post-intervention, with each intervention given on different days. The state effect of meditation improved overall accuracy for all subjects irrespective of their group. A group difference was observed across interventions, showing that meditators were more accurate and more efficient at attentional suppression, represented by a larger Pd (distractor positive) amplitude of event related modes (ERMs), for target-like distractors than the control group. The findings suggested that better attentional control with respect to distractors might be facilitated by acquiring experience of and skills related to meditation training.

Emotion dysregulation as a transdiagnostic mechanism of opioid misuse and suicidality among chronic pain patients

BACKGROUND

Chronic pain is a prevalent condition that causes functional impairment and emotional suffering. To allay pain-induced suffering, opioids are often prescribed for chronic pain management. Yet, chronic pain patients on opioid therapy are at heightened risk for opioid misuse-behaviors that can lead to addiction and overdose. Relatedly, chronic pain patients are at elevated risk for suicidal ideation and suicidal behaviors.

MAIN BODY

Opioid misuse and suicidality are maladaptive processes aimed at alleviating the negative emotional hyperreactivity, hedonic hyporeactivity, and emotion dysregulation experienced by chronic pain patients on opioid therapy. In this review, we explore the role of emotion dysregulation in chronic pain. We then describe why emotionally dysregulated chronic pain patients are vulnerable to opioid misuse and suicidality in response to these negative affective states.

CONCLUSION

Emotion dysregulation is an important and malleable treatment target with the potential to reduce or prevent opioid misuse and suicidality among opioid-treated chronic pain patients.

The Mindful Personality II: Exploring the Metatraits from a Cybernetic Perspective

Relationships between dispositional mindfulness and the personality metatraits, stability and plasticity, remain unexplored despite continued efforts to more accurately characterize associations between dispositional mindfulness and personality. The metatraits are theorized to constitute basic requirements for biological survival and their expression is believed to be a strong determinant of well-being. As such, this study used path analysis to explore associations between dispositional mindfulness, the metatraits and psychological well-being in a sample of 403 American adults. Results indicate that dispositional mindfulness is principally associated with stability, or the capacity to sustain currently operative schemas and goals. Results further suggest a positive relationship between dispositional mindfulness and plasticity, or the tendency to flexibly adapt to changing circumstances. A more granular investigation of these associations demonstrated that the facets of dispositional mindfulness are differentially related with the metatraits. Ultimately, the metatraits were found to fully mediate the relationship between dispositional mindfulness and psychological well-being.

Contemplative Meditation and Neuroscience: Prospects for Mental Health

Numerous studies show that personal spirituality developed through prayer positively influences mental health. Phenomenological and neuroscientific studies of mindfulness, an Eastern meditative prayer form, reveal significant health benefits now yielding important insights useful for guiding treatment of psychological disorders. By contrast, and despite its practice for millennia, Christian meditation is largely unrepresented in studies of clinical efficacy. Resemblances between mindfulness and disciplinary acts in Christian meditation taken from the ancient Greek practice of askesis suggest that Christian meditation will prove similarly beneficial; furthermore, psychological and neuroscientific studies suggest that its retention of a dialogical and transcendent praxis will additionally benefit social and existential psychotherapy. This paper thus argues that study of contemplative meditation for its therapeutic potential is warranted.

Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs

OBJECTIVE

We investigated common and dissociable neural and psychological correlates of two widely used meditation-based stress reduction programs.

METHODS

Participants were randomized to the Relaxation Response (RR; n = 18; 56% female) or the Mindfulness-Based Stress Reduction (MBSR; n = 16; 56% female) programs. Both programs use a "bodyscan" meditation; however, the RR program explicitly emphasizes physical relaxation during this practice, whereas the MBSR program emphasizes mindful awareness with no explicit relaxation instructions. After the programs, neural activity during the respective meditation was investigated using functional magnetic resonance imaging.

RESULTS

Both programs were associated with reduced stress (for RR, from 14.1 ± 6.6 to 11.3 ± 5.5 [Cohen's d = 0.50; for MBSR, from 17.7 ± 5.7 to 11.9 ± 5.0 [Cohen's d = 1.02]). Conjunction analyses revealed functional coupling between ventromedial prefrontal regions and supplementary motor areas (p < .001). The disjunction analysis indicated that the RR bodyscan was associated with stronger functional connectivity of the right inferior frontal gyrus-an important hub of intentional inhibition and control-with supplementary motor areas (p < .001, family-wise error [FWE] rate corrected). The MBSR program was uniquely associated with improvements in self-compassion and rumination, and the within-group analysis of MBSR bodyscan revealed significant functional connectivity of the right anterior insula-an important hub of sensory awareness and salience-with pregenual anterior cingulate during bodyscan meditation compared with rest (p = .03, FWE corrected).

CONCLUSIONS

The bodyscan exercises in each program were associated with both overlapping and differential functional coupling patterns, which were consistent with each program's theoretical foundation. These results may have implications for the differential effects of these programs for the treatment of diverse conditions.

Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research

Contemporary advances in addiction neuroscience have paralleled increasing interest in the ancient mental training practice of mindfulness meditation as a potential therapy for addiction. In the past decade, mindfulness-based interventions (MBIs) have been studied as a treatment for an array addictive behaviors, including drinking, smoking, opioid misuse, and use of illicit substances like cocaine and heroin. This article reviews current research evaluating MBIs as a treatment for addiction, with a focus on findings pertaining to clinical outcomes and biobehavioral mechanisms. Studies indicate that MBIs reduce substance misuse and craving by modulating cognitive, affective, and psychophysiological processes integral to self-regulation and reward processing. This integrative review provides the basis for manifold recommendations regarding the next wave of research needed to firmly establish the efficacy of MBIs and elucidate the mechanistic pathways by which these therapies ameliorate addiction. Issues pertaining to MBI treatment optimization and sequencing, dissemination and implementation, dose–response relationships, and research rigor and reproducibility are discussed.

Change in emotional self-concept following socio-cognitive training relates to structural plasticity of the prefrontal cortex

INTRODUCTION

Self-referential processing is a key component of the emotional self-concept. Previous studies have shown that emotional self-referential processing is related to structure and function of cortical midline areas such as medial prefrontal cortex (mPFC), and that it can be altered on a behavioral level by specific mental training practices. However, it remains unknown how behavioral training-related change in emotional self-concept content relates to structural plasticity.

METHODS

To address this issue, we examined the relationship between training-induced change in participant's emotional self-concept measured through emotional word use in the Twenty Statement Test and change in cortical thickness in the context of a large-scale longitudinal mental training study called the ReSource Project.

RESULTS

Based on prior behavioral findings showing increased emotional word use particularly after socio-cognitive training targeting perspective-taking capacities, this study extended these results by revealing that individual differences in the degree to which participants changed their emotional self-concept after training was positively related to cortical thickness change in right mPFC extending to dorsolateral PFC (dlPFC). Furthermore, increased self-related negative emotional word use after training was positively associated with cortical thickness change in left pars orbitalis and bilateral dlPFC.

CONCLUSIONS

Our findings reveal training-related structural brain change in regions known to be involved in self-referential processing and cognitive control, and could indicate a relationship between restructuring of the emotional self-concept content as well as reappraisal of negative aspects and cortical thickness change. As such, our findings can guide the development of psychological interventions targeted to alter specific facets of the self-concept.

Review of the Neural Oscillations Underlying Meditation

Objective: Meditation is one type of mental training that has been shown to produce many cognitive benefits. Meditation practice is associated with improvement in concentration and reduction of stress, depression, and anxiety symptoms. Furthermore, different forms of meditation training are now being used as interventions for a variety of psychological and somatic illnesses. These benefits are thought to occur as a result of neurophysiologic changes. The most commonly studied specific meditation practices are focused attention (FA), open-monitoring (OM), as well as transcendental meditation (TM), and loving-kindness (LK) meditation. In this review, we compare the neural oscillatory patterns during these forms of meditation.

Method: We performed a systematic review of neural oscillations during FA, OM, TM, and LK meditation practices, comparing meditators to meditation-naïve adults.

Results: FA, OM, TM, and LK meditation are associated with global increases in oscillatory activity in meditators compared to meditation-naïve adults, with larger changes occurring as the length of meditation training increases. While FA and OM are related to increases in anterior theta activity, only FA is associated with changes in posterior theta oscillations. Alpha activity increases in posterior brain regions during both FA and OM. In anterior regions, FA shows a bilateral increase in alpha power, while OM shows a decrease only in left-sided power. Gamma activity in these meditation practices is similar in frontal regions, but increases are variable in parietal and occipital regions.

Conclusions: The current literature suggests distinct differences in neural oscillatory activity among FA, OM, TM, and LK meditation practices. Further characterizing these oscillatory changes may better elucidate the cognitive and therapeutic effects of specific meditation practices, and potentially lead to the development of novel neuromodulation targets to take advantage of their benefits.

Learning Empathy Through Virtual Reality: Multiple Strategies for Training Empathy-Related Abilities Using Body Ownership Illusions in Embodied Virtual Reality

Several disciplines have investigated the interconnected empathic abilities behind the proverb "to walk a mile in someone else's shoes" to determine how the presence, and absence, of empathy-related phenomena affect prosocial behavior and intergroup relations. Empathy enables us to learn from others' pain and to know when to offer support. Similarly, virtual reality (VR) appears to allow individuals to step into someone else's shoes, through a perceptual illusion called embodiment, or the body ownership illusion. Considering these perspectives, we propose a theoretical analysis of different mechanisms of empathic practices in order to define a possible framework for the design of empathic training in VR. This is not intended to be an extensive review of all types of practices, but an exploration of empathy and empathy-related phenomena. Empathy-related training practices are analyzed and categorized. We also identify different variables used by pioneer studies in VR to promote empathy-related responses. Finally, we propose strategies for using embodied VR technology to train specific empathy-related abilities.

Exploring daily affective changes in university students with a mindful positive reappraisal intervention: A daily diary randomized controlled trial

Brief and cost-effective interventions focused on emotion regulation techniques can buffer against stress and foster positive functioning. Mindfulness and positive reappraisal are two techniques that can mutually enhance one another to promote well-being. However, research testing the effectiveness of interventions combining mindfulness and reappraisal is lacking. The current pilot examined the effect of a combined mindful-reappraisal intervention on daily affect in a 5-day diary study with 106 university students. Participants were randomized to a mindful-reappraisal intervention (n = 36), a reappraisal-only intervention (n = 34), or an active control activity (n = 36). All participants described a negative event each day but only reappraised the event in the intervention conditions. Using multilevel growth modelling, results indicated that negative affect in both interventions declined over 5 days compared to the control; however, there were no differences in the growth of positive affect. Compared to reappraisal-only, the mindful-reappraisal group reported overall lower daily negative affect and marginally higher daily positive affect over the 5-day intervention. These findings suggest that brief daily practice combining mindfulness and positive reappraisal can be trained as a self-regulatory resource to promote positive affect and buffer negative affect above and beyond reappraisal practice alone.

Dismantling Mindfulness-Based Cognitive Therapy: Creation and validation of 8-week focused attention and open monitoring interventions within a 3-armed randomized controlled trial

BACKGROUND

While mindfulness-based interventions (MBIs) employ two distinct practices, focused attention (FA) and open monitoring (OM), the integrated delivery of these practices in MBIs precludes understanding of their practice-specific effects or mechanisms of action. The purpose of this study is to isolate hypothesized active ingredients and practice-specific mechanistic target engagement by creating structurally equivalent interventions that differ only by the active ingredient (meditation practice) offered and to test whether the hypothesized components differentially engage the mechanistic targets that they are purported to engage.

METHODS

Participants were intended to be representative of American meditators and had mild to severe affective disturbances. Measures of structural equivalence included participant-level (sample characteristics), treatment-level (program structure and duration, program materials, class size, attendance, homework compliance, etc.), and instructor-level variables (training, ratings and adherence/fidelity). Measures of differential validity included analysis of program materials and verification of differential mechanistic target engagement (cognitive and affective skills and beliefs about meditation acquired by participants after the 8-week training).

RESULTS

The results indicate successful creation of structurally equivalent FA and OM programs that were matched on participant-level, treatment-level, and instructor-level variables. The interventions also differed as expected with respect to program materials as well as mechanistic targets engaged (skills and beliefs acquired).

CONCLUSIONS

These validated 8-week FA and OM training programs can be applied in future research to assess practice-specific effects of meditation.

Mindfulness-Based Interventions in Psychiatry

Mindfulness meditation has a longstanding history in eastern practices that has received considerable public interest in recent decades. Indeed, the science, practice, and implementation of Mindfulness Based Interventions (MBIs) have dramatically increased in recent years. At its base, mindfulness is a natural human state in which an individual experiences and attends to the present moment. Interventions have been developed to train individuals how to incorporate this practice into daily life. The current article will discuss the concept of mindfulness and describe its implementation in the treatment of psychiatric disorders. We further identify for whom MBIs have been shown to be efficacious and provide an up-to-date summary of how these interventions work. This includes research support for the cognitive, psychological, and neural mechanisms that lead to psychiatric improvements. This review provides a basis for incorporating these interventions into treatment.