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

Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation

During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and "key to building more resilient soldiers." Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.

Exploration of Lower Frequency EEG Dynamics and Cortical Alpha Asymmetry in Long-term Rajyoga Meditators

BACKGROUND

Rajyoga meditation is taught by Prajapita Brahmakumaris World Spiritual University (Brahmakumaris) and has been followed by more than one million followers across the globe. However, rare studies were conducted on physiological aspects of rajyoga meditation using electroencephalography (EEG). Band power and cortical asymmetry were not studied with Rajyoga meditators.

AIMS

This study aims to investigate the effect of regular meditation practice on EEG brain dynamics in low-frequency bands of long-term Rajyoga meditators.

SETTINGS AND DESIGN

Subjects were matched for age in both groups. Lower frequency EEG bands were analyzed in resting and during meditation.

MATERIALS AND METHODS

Twenty-one male long-term meditators (LTMs) and same number of controls were selected to participate in study as par inclusion criteria. Semi high-density EEG was recorded before and during meditation in LTM group and resting in control group. The main outcome of the study was spectral power of alpha and theta bands and cortical (hemispherical) asymmetry calculated using band power.

STATISTICAL ANALYSIS

One-way ANOVA was performed to find the significant difference between EEG spectral properties of groups. Pearson's Chi-square test was used to find difference among demographics data.

RESULTS

Results reveal high-band power in alpha and theta spectra in meditators. Cortical asymmetry calculated through EEG power was also found to be high in frontal as well as parietal channels. However, no correlation was seen between the experience of meditation (years, hours) practice and EEG indices.

CONCLUSION

Overall findings indicate contribution of smaller frequencies (alpha and theta) while maintaining meditative experience. This suggests a positive impact of meditation on frontal and parietal areas of brain, involved in the processes of regulation of selective and sustained attention as well as provide evidence about their involvement in emotion and cognitive processing.

Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data

Background and objective

The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation.

Design

We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis.

Results

Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p<.01) that in turn predicted increases in broadened awareness of interoceptive and exteroceptive data by 6 months post-treatment (p<.001). In turn, broadened awareness predicted increases in the use of reappraisal by 9 months post-treatment (p<.01), which culminated in greater positive affect at 12 months post-treatment (p<.001). MBSR led to significantly greater increases in decentering (p<.05) and broadened awareness than CBT (p<.05). Significant indirect effects indicated that increases in decentering mediated the effect of mindfulness training on broadening awareness, which in turn mediated enhanced reappraisal efficacy.

Conclusion

Results suggest that the mechanisms of change identified by the MMT form an iterative chain that promotes long-term increases in positive affectivity. Though these mechanisms may reflect common therapeutic factors that cut across mindfulness-based and cognitive-behavioral interventions, MBSR specifically boosts the MMT cycle by producing significantly greater increases in decentering and broadened awareness than CBT, providing support for the foundational assumption in the MMT that mindfulness training may be a key means of stimulating downstream positive psychological processes.

The mindful personality: A meta-analysis from a cybernetic perspective

Dispositional mindfulness (DM), or the tendency to attend to present moment experience, may have important implications for the structure of human personality. However, relationships between DM and the Big Five Model of Personality (BF) have not been definitively established. Therefore, the purpose of this meta-analysis was to extend previous investigations of the relationship between DM and the BF, utilizing a larger sample of studies, attending to relational inconsistencies potentially associated with alternative methods of operationalizing DM, conducting the first meta-analysis of the DM subdomains in relation to the BF, and situating the results in a cybernetic model. Results indicate that neuroticism evidenced the strongest, negative relationship with DM and conscientiousness evidenced the strongest, positive relationship with DM, suggesting the mindful personality may be characterized principally by emotional stability and conscientious self-regulation - potentially reflective of an inclination towards the personality metatrait stability. Measurement differences were also observed, with the mindful personality arrived at through the FFMQ differing to some extent from the mindful personality emerging from the MAAS. Broadly, the mindful personality associated with the FFMQ appears to reflect greater personality complexity, with the FFMQ evidencing associations with all five personality factors while the MAAS appears primarily linked with only three personality factors (Neuroticism, Conscientiousness and Agreeableness). Examination of the relationships between the BF and DM at the facet level also suggest unique patterns of association between the DM facets and each of the personality factors.

The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis

BACKGROUND

Some evidence suggests that heart rate variability (HRV) biofeedback might be an effective way to treat anxiety and stress symptoms. To examine the effect of HRV biofeedback on symptoms of anxiety and stress, we conducted a meta-analysis of studies extracted from PubMed, PsycINFO and the Cochrane Library.

METHODS

The search identified 24 studies totaling 484 participants who received HRV biofeedback training for stress and anxiety. We conducted a random-effects meta-analysis.

RESULTS

The pre-post within-group effect size (Hedges' g) was 0.81. The between-groups analysis comparing biofeedback to a control condition yielded Hedges' g = 0.83. Moderator analyses revealed that treatment efficacy was not moderated by study year, risk of study bias, percentage of females, number of sessions, or presence of an anxiety disorder.

CONCLUSIONS

HRV biofeedback training is associated with a large reduction in self-reported stress and anxiety. Although more well-controlled studies are needed, this intervention offers a promising approach for treating stress and anxiety with wearable devices.

Self-interest may not be entirely in the interest of the self: Association between selflessness, dispositional mindfulness and psychological well-being

The association between mindfulness and selflessness is firmly grounded in classical Indo-Sino-Tibetan contemplative traditions, but has received limited empirical attention from Western researchers. In Buddhism, the relationship between mindfulness and the self is of central concern to the cultivation of well-being. Mindfulness is believed to encourage insight into the truly insubstantial nature of the self, an understanding that is thought to encourage well-being. The present study explores these relationships, attending to dispositional mindfulness, the self as it exists on a continuum from self-centered to selfless, and psychological well-being. Results indicate a positive relationship between selflessness, dispositional mindfulness, and psychological well-being. It appears that construing the self as interdependent and interconnected with a broader social, natural, and cosmic context is linked with greater psychological well-being and dispositional mindfulness. Path analyses revealed that selflessness mediated the relationship between dispositional mindfulness and psychological well-being.

Scale of Body Connection: A multi-sample construct validation study

The Scale of Body Connection (SBC) was created to address the need for a self-report measure to examine body awareness and bodily dissociation in mind-body research. Developed in the U.S.A., it has been translated into many languages and tested for validity of scale translation. The burgeoning of mind-body research and the widespread use of the SBC scale underscored the need for critical assessment of the instrument’s measurement properties. Thus, a broader evaluation of the SBC was designed using large samples from eight international, cross-sectional studies drawn from community (i.e., non-clinical) populations. Specifically, we assessed scale distribution properties and internal consistency reliabity, and using confirmatory factory analysis we evaluated scale contruct validity and compared male/female measurement models. The results indicated acceptable reliability for both the body awareness and bodily dissociation scales, and a good fit between the proposed theoretic model and the data, providing evidence of construct validity across all samples. Mean differences in body awareness were observed for males vs. females in most samples, with females generally showing higher body awareness compared to males. Multi-group structural equation modeling demonstrated a stable latent factor structure and factor loadings, indicating equivalent measurement models for males and females. In summary, this multi-sample study demonstrated SBC construct validity that supports its use in clinical research as a brief, readily translated, easy to administer measure of body awareness and bodily dissociation.

The Mindful Self: A Mindfulness-Enlightened Self-view

This paper analyzes studies of mindfulness and the self, with the aim of deepening our understanding of the potential benefits of mindfulness and meditation for mental health and well-being. Our review of empirical research reveals that positive changes in attitudes toward the self and others as a result of mindfulness-enabled practices can play an important role in modulating many mental and physical health problems. Accordingly, we introduce a new concept-the "mindful self"-and compare it with related psychological constructs to describe the positive changes in self-attitude associated with mindfulness meditation practices or interventions. The mindful self is conceptualized as a mindfulness-enlightened self-view and attitude developed by internalizing and integrating the essence of Buddhist psychology into one's self-system. We further posit that the mindful self will be an important intermediary between mindfulness intervention and mental health problems, and an important moderator in promoting well-being. More generally, we suggest that the mindful self may also be an applicable concept with which to describe and predict the higher level of self-development of those who grow up in the culture of Buddhism or regularly engage in meditation over a long period of time.

Mindfulness and dynamic functional neural connectivity in children and adolescents

BACKGROUND

Interventions that promote mindfulness consistently show salutary effects on cognition and emotional wellbeing in adults, and more recently, in children and adolescents. However, we lack understanding of the neurobiological mechanisms underlying mindfulness in youth that should allow for more judicious application of these interventions in clinical and educational settings.

METHODS

Using multi-echo multi-band fMRI, we examined dynamic (i.e., time-varying) and conventional static resting-state connectivity between core neurocognitive networks (i.e., salience/emotion, default mode, central executive) in 42 children and adolescents (ages 6-17).

RESULTS

We found that trait mindfulness in youth relates to dynamic but not static resting-state connectivity. Specifically, more mindful youth transitioned more between brain states over the course of the scan, spent overall less time in a certain connectivity state, and showed a state-specific reduction in connectivity between salience/emotion and central executive networks. The number of state transitions mediated the link between higher mindfulness and lower anxiety, providing new insights into potential neural mechanisms underlying benefits of mindfulness on psychological health in youth.

CONCLUSIONS

Our results provide new evidence that mindfulness in youth relates to functional neural dynamics and interactions between neurocognitive networks, over time.

The brain on silent: mind wandering, mindful awareness, and states of mental tranquility

Mind wandering and mindfulness are often described as divergent mental states with opposing effects on cognitive performance and mental health. Spontaneous mind wandering is typically associated with self-reflective states that contribute to negative processing of the past, worrying/fantasizing about the future, and disruption of primary task performance. On the other hand, mindful awareness is frequently described as a focus on present sensory input without cognitive elaboration or emotional reactivity, and is associated with improved task performance and decreased stress-related symptomology. Unfortunately, such distinctions fail to acknowledge similarities and interactions between the two states. Instead of an inverse relationship between mindfulness and mind wandering, a more nuanced characterization of mindfulness may involve skillful toggling back and forth between conceptual and nonconceptual processes and networks supporting each state, to meet the contextually specified demands of the situation. In this article, we present a theoretical analysis and plausible neurocognitive framework of the restful mind, in which we attempt to clarify potentially adaptive contributions of both mind wandering and mindful awareness through the lens of the extant neurocognitive literature on intrinsic network activity, meditation, and emerging descriptions of stillness and nonduality. A neurophenomenological approach to probing modality-specific forms of concentration and nonconceptual awareness is presented that may improve our understanding of the resting state. Implications for future research are discussed.

Mindfulness meditation-based pain relief: a mechanistic account

Pain is a multidimensional experience that involves interacting sensory, cognitive, and affective factors, rendering the treatment of chronic pain challenging and financially burdensome. Further, the widespread use of opioids to treat chronic pain has led to an opioid epidemic characterized by exponential growth in opioid misuse and addiction. The staggering statistics related to opioid use highlight the importance of developing, testing, and validating fast-acting nonpharmacological approaches to treat pain. Mindfulness meditation is a technique that has been found to significantly reduce pain in experimental and clinical settings. The present review delineates findings from recent studies demonstrating that mindfulness meditation significantly attenuates pain through multiple, unique mechanisms-an important consideration for the millions of chronic pain patients seeking narcotic-free, self-facilitated pain therapy.

Multi-Level Family Factors and Affective and Behavioral Symptoms of Oppositional Defiant Disorder in Chinese Children

Given the important role of family environment in children's psychological development, the objective of this study was to examine the linkages between family factors at the whole, dyadic, and individual levels and two dimensions (affective and behavioral) of Oppositional Defiant Disorder (ODD) symptoms in Chinese children. Participants comprised of 80 father-child dyads and 169 mother-child dyads from families with ODD children. The results indicated that multilevel family factors were differently associated with children's affective and behavioral ODD symptoms. All the family factors at the dyadic and individual levels were significantly associated with child affective ODD symptoms. However, only the most proximal factors (parent-child relationship and child emotion regulation, which were directly related to child) were significantly related to child behavioral ODD symptoms. The present study extends the current knowledge regarding the relationships between family factors and two dimensions of child ODD symptoms by testing the comprehensive multilevel family factors model. This study also recommends that future interventions for ODD children should consider the multi-level family factors to enhance intervention efficacy.

A mindfulness-based intervention for self-management of verbal and physical aggression by adolescents with Prader-Willi syndrome

PURPOSE

There is a dearth of clinical and research literature on the treatment of maladaptive behaviors in adolescents with Prader-Willi syndrome (PWS). The purpose of this study was to evaluate the effectiveness of a mindfulness-based intervention, Meditation on the Soles of the Feet (SoF), to facilitate self-management of verbal and physical aggression.

METHOD

We utilized a multiple-baseline design across participants to test the intervention with three adolescents diagnosed with PWS.

RESULTS

Relative to baseline, verbal aggression decreased to minimal levels following mindfulness-based practice and physical aggression was nearly eliminated. Intervention effects were maintained at 12-month follow-up. Quantitative analytics confirmed statistically significant outcomes.

CONCLUSIONS

The SoF mindfulness intervention was effective in reducing verbal and physical aggression in three adolescents with PWS. Future research should test the SoF intervention with this clinical population in a larger clinical trial, and the SoF intervention may be applicable to other pediatric populations.

Relationship of mindful awareness to neural processing of angry faces and impact of mindfulness training: A pilot investigation

Mindfulness is paying attention, non-judgmentally, to experience in the moment. Mindfulness training reduces depression and anxiety and influences neural processes in midline self-referential and lateralized somatosensory and executive networks. Although mindfulness benefits emotion regulation, less is known about its relationship to anger and the corresponding neural correlates. This study examined the relationship of mindful awareness and brain hemodynamics of angry face processing, and the impact of mindfulness training. Eighteen healthy volunteers completed an angry face processing fMRI paradigm and measurement of mindfulness and anger traits. Ten of these participants were recruited from a Mindfulness-Based Stress Reduction (MBSR) class and also completed imaging and other assessments post-training. Self-reported mindful awareness increased after MBSR, but trait anger did not change. Baseline mindful awareness was negatively related to left inferior parietal lobule activation to angry faces; trait anger was positively related to right middle frontal gyrus and bilateral angular gyrus. No significant pre-post changes in angry face processing were found, but changes in trait mindful awareness and anger were associated with sub-threshold differences in paralimbic activation. These preliminary and hypothesis-generating findings, suggest the analysis of possible impact of mindfulness training on anger may begin with individual differences in angry face processing.

Yoga, breast cancer-related lymphoedema and well-being: A descriptive report of women's participation in a clinical trial

AIMS AND OBJECTIVES

To describe the experiences of women taking part in a yoga intervention trial for breast cancer-related lymphoedema.

BACKGROUND

Around 20% of women will experience lymphoedema as a consequence of treatment for breast cancer. Specialist lymphoedema clearing, along with self-management, remains the mainstay of therapy. Yoga, an increasingly popular complementary therapeutic practice, may provide another tool to augment self-management.

DESIGN

A qualitative, descriptive design.

METHODS

Interviews were conducted with 15 women with stage one breast cancer-related lymphoedema who had completed an 8-week yoga intervention trial. The intervention consisted of a weekly teacher-led 1.5-hr yoga class and a daily home practice using a 45-min DVD. Interviews were audio-taped and transcribed. These data were then analysed using an iterative-thematic approach.

RESULTS

Participants reported improved well-being, increased awareness of their physical body as well as improved physical, mental and social functioning. They gained from being part of the yoga group that also provided a forum for them to share their experiences. Nine women felt empowered to describe their yoga participation as a transformative journey through illness.

CONCLUSION

When safe to do so, the holistic practice of yoga may augment and provide additional benefit to current self-management and treatment practices for women with breast cancer-related lymphoedema.

RELEVANCE TO CLINICAL PRACTICE

Patients with breast cancer-related lymphoedema may seek advice and guidance from nurses and other healthcare professionals on a range of complementary therapies to help relieve symptoms and promote recovery. Patients who choose to augment their treatment of breast cancer-related lymphoedema by practicing yoga should be carefully assessed, be taught an appropriate technique by a qualified yoga teacher/therapist and its impact monitored by their yoga teacher/therapist, breast care nurse, lymphoedema therapist or treating clinician.

Serious gaming during multidisciplinary rehabilitation for patients with complex chronic pain or fatigue complaints: study protocol for a controlled trial and process evaluation

INTRODUCTION

Many individuals suffer from chronic pain or functional somatic syndromes and face boundaries for diminishing functional limitations by means of biopsychosocial interventions. Serious gaming could complement multidisciplinary interventions through enjoyment and independent accessibility. A study protocol is presented for studying whether, how, for which patients and under what circumstances, serious gaming improves patient health outcomes during regular multidisciplinary rehabilitation.

METHODS AND ANALYSIS

A mixed-methods design is described that prioritises a two-armed naturalistic quasi-experiment. An experimental group is composed of patients who follow serious gaming during an outpatient multidisciplinary programme at two sites of a Dutch rehabilitation centre. Control group patients follow the same programme without serious gaming in two similar sites. Multivariate mixed-modelling analysis is planned for assessing how much variance in 250 patient records of routinely monitored pain intensity, pain coping and cognition, fatigue and psychopathology outcomes is attributable to serious gaming. Embedded qualitative methods include unobtrusive collection and analyses of stakeholder focus group interviews, participant feedback and semistructured patient interviews. Process analyses are carried out by a systematic approach of mixing qualitative and quantitative methods at various stages of the research.

ETHICS AND DISSEMINATION

The Ethics Committee of the Tilburg School of Social and Behavioural Sciences approved the research after reviewing the protocol for the protection of patients' interests in conformity to the letter and rationale of the applicable laws and research practice (EC 2016.25t). Findings will be presented in research articles and international scientific conferences.

TRIAL REGISTRATION NUMBER

A prospective research protocol for the naturalistic quasi-experimental outcome evaluation was entered in the Dutch trial register (registration number: NTR6020; Pre-results).

Mindfulness-Based Heroism: Creating Enlightened Heroes

The field of mindfulness and the emerging science of heroism have a common interest in the causes and conditions of selfless altruism though up to this point there has been little cross-pollination. However, there is increasing evidence that mindfulness training delivers heroically relevant qualities such as increased attentional functioning, enhanced primary sensory awareness, greater conflict monitoring, increased cognitive control, reduced fear response, and an increase in loving kindness and self-sacrificing behaviors. Predicated on the notion of a “no self,” traditional mindfulness and its focus on enlightenment and selfless service may in fact be ideally suited to the development of the elusive “trait” (predictable) versus “state” (intermittent) heroic character. Interweaving observations and questions drawn from the science of heroism, the article explores the relevant theory, practices, and scientific outcomes of mindfulness. It finds that there is evidence that heroically relevant qualities are trainable with the suite of mindfulness techniques and that an enduring experience of selflessness and service of others (the enlightened hero) may well be within the grasp of the serious practitioner.

The Varieties of Self-Transcendent Experience

Various forms of self-loss have been described as aspects of mental illness (e.g., depersonalization disorder), but might self-loss also be related to mental health? In this integrative review and proposed organizational framework, we focus on self-transcendent experiences (STEs)—transient mental states marked by decreased self-salience and increased feelings of connectedness. We first identify common psychological constructs that contain a self-transcendent aspect, including mindfulness, flow, peak experiences, mystical-type experiences, and certain positive emotions (e.g., love, awe). We then propose psychological and neurobiological mechanisms that may mediate the effects of STEs based on a review of the extant literature from social psychology, clinical psychology, and affective neuroscience. We conclude with future directions for further empirical research on these experiences.

Distinguishing the cognitive processes of mindfulness: Developing a standardised mindfulness technique for use in longitudinal randomised control trials

A capacity model of mindfulness is adopted to differentiate the cognitive faculty of mindfulness from the metacognitive processes required to cultivate this faculty in mindfulness training. The model provides an explanatory framework incorporating both the developmental progression from focussed attention to open monitoring styles of mindfulness practice, along with the development of equanimity and insight. A standardised technique for activating these processes without the addition of secondary components is then introduced. Mindfulness-based interventions currently available for use in randomised control trials introduce components ancillary to the cognitive processes of mindfulness, limiting their ability to draw clear causative inferences. The standardised technique presented here does not introduce such ancillary factors, rendering it a valuable tool with which to investigate the processes activated in mindfulness practice.

Compassion Fatigue and Mindfulness: Comparing Mental Health Professionals and MSW Student Interns

The relationship between compassion fatigue and mindfulness in mental health professionals compared to Master of Social Work (MSW) students is explored. A convenience sample of mental health professionals (n = 40) and MSW students (n = 111) completed the Five Facet Mindfulness Questionnaire and Professional Quality of Life Scale. Results indicate a medium, negative correlation between compassion fatigue and mindfulness, with high levels of compassion fatigue associated with lower levels of mindfulness. There was no statistically significant difference between mental health workers and MSW students on the combined dependent variables. Results suggest that mindfulness protects against compassion fatigue regardless of professional or student status.

Differential Effects of Attention-, Compassion-, and Socio-Cognitively Based Mental Practices on Self-Reports of Mindfulness and Compassion

Research on the effects of mindfulness- and compassion-based interventions is flourishing along with self-report scales to assess facets of these broad concepts. However, debates remain as to which mental practices are most appropriate to develop the attentional, cognitive, and socio-affective facets of mindfulness and compassion. One crucial question is whether present-moment, attention-focused mindfulness practices are sufficient to induce a cascade of changes across the different proposed facets of mindfulness, including nonjudgmental acceptance, as well as compassion or whether explicit socio-affective training is required. Here, we address these questions in the context of a 9-month longitudinal study (the ReSource Project) by examining the differential effects of three different 3-month mental training modules on subscales of mindfulness and compassion questionnaires. The “Presence” module, which aimed at cultivating present-moment-focused attention and body awareness, led to increases in the observing, nonreacting, and presence subscales, but not to increases in acceptance or nonjudging. These latter facets benefitted from specific cultivation through the socio-cognitive “Perspective” module and socio-affective, compassion-based “Affect” module, respectively. These modules also led to further increases in scores on the subscales affected by the Presence module. Moreover, scores on the compassion scales were uniquely influenced by the Affect module. Thus, whereas a present-moment attention-focused training, as implemented in many mindfulness-based programs, was indeed able to increase attentional facets of mindfulness, only socio-cognitive and compassion-based practices led to broad changes in ethical-motivational qualities like a nonjudgmental attitude, compassion, and self-compassion.

Facilitating Self-Transcendence: An Intervention to Enhance Well-Being in Late Life

This randomized controlled pilot study evaluated the effects of the Psychoeducational Approach to Transcendence and Health (PATH) Program, an 8-week intervention hypothesized to increase self-transcendence and improve well-being in community-dwelling women aged 60 years and older ( N = 20). The PATH combined mindfulness exercises, group processes, creative activities, and at-home practice using community engaged research methods. Findings provided some support for the effectiveness of PATH. Although there was no significant Group × Time interaction, self-transcendence, psychological well-being, and life satisfaction differed significantly pre- and postintervention in the wait-listed control group, which received a revised version of the program. Further study is needed with a larger sample to determine the effectiveness of PATH. Potentially, PATH may be a convenient and affordable activity to support personal development and improve well-being among older adults at senior centers, retirement communities, nursing homes, church groups, and other places where older adults gather.

Improving Communication between Physicians and Their Patients through Mindfulness and Compassion-Based Strategies: A Narrative Review

Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, and other-focused concern, and reduce the chances of distress and burnout. There is substantial evidence for the contribution of different management strategies to achieve these aims. The goal of this article is to review the potential effect of mindfulness and compassion-based strategies for the improvement of physician-patient interactions. The acquisition of the necessary skills by physicians requires continuous education. Future research will be useful for identifying more evidence on the cost-effectiveness of this type of intervention.

Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies

There is increasing interest in the beneficial clinical effects of mindfulness-based interventions (MBIs). Research has demonstrated their efficacy in a wide range of psychological conditions characterized by emotion dysregulation. Neuroimaging studies have evidenced functional and structural changes in a myriad of brain regions mainly involved in attention systems, emotion regulation, and self-referential processing. In this article we review studies on psychological and neurobiological correlates across different empirically derived models of research, including dispositional mindfulness, mindfulness induction, MBIs, and expert meditators in relation to emotion regulation. From the perspective of recent findings in the neuroscience of emotion regulation, we discuss the interplay of top-down and bottom-up emotion regulation mechanisms associated with different mindfulness models. From a phenomenological and cognitive perspective, authors have argued that mindfulness elicits a "mindful emotion regulation" strategy; however, from a clinical perspective, this construct has not been properly differentiated from other strategies and interventions within MBIs. In this context we propose the distinction between top-down and bottom-up mindfulness based emotion regulation strategies. Furthermore, we propose an embodied emotion regulation framework as a multilevel approach for understanding psychobiological changes due to mindfulness meditation regarding its effect on emotion regulation. Finally, based on clinical neuroscientific evidence on mindfulness, we open perspectives and dialogues regarding commonalities and differences between MBIs and other psychotherapeutic strategies for emotion regulation.

User value and usability of a web-based mindfulness intervention for families living with mental health problems

Mental health problems affect the patients and their families, who may also need therapeutic interventions. Mindfulness interventions have shown beneficial health effects for clinical and healthy populations. A web-based mindfulness intervention was tailored to address families' needs of support and tested in a pilot intervention study. The aim of this study was to explore the participants' experiences of using an 8-week web-based mindfulness programme in terms of user value and usability. Qualitative semi-structured interviews were carried out over the phone (Spring 2015, Sweden) with 15 randomly selected participants after the 3-month follow-up as part of the pilot study. Data were also collected through usability surveys online post intervention and at the 3-month follow-up. Qualitative data were analysed with content analysis and quantitative data with descriptive statistics. The analysis of the interviews resulted in four categories describing the participants' experiences of the programme's usability and value: A valuable and flexible tool that requires time and discipline, New perspective and coping strategies for an enhanced well-being, I'm important too - my limits, my responsibility, and Taming the inner critic. The programme's usability was satisfactory and largely corroborated by the surveys. The programme was experienced as a valuable tool to cope with stress in both private and professional contexts, making it a viable option to support families living with mental health problems. Time for self-care, a widened perspective, a less judgmental and more accepting attitude, deterring automatic reactions and setting limits helped the participants to deal with their situation and health. The programme's ease and flexibility of use were major advantages, although the training requires discipline. Motivators and barriers to use were illuminated, which should be considered in the development of further online services and study designs.

Being While Doing: An Inductive Model of Mindfulness at Work

Mindfulness at work has drawn growing interest as empirical evidence increasingly supports its positive workplace impacts. Yet theory also suggests that mindfulness is a cognitive mode of "Being" that may be incompatible with the cognitive mode of "Doing" that undergirds workplace functioning. Therefore, mindfulness at work has been theorized as "being while doing," but little is known regarding how people experience these two modes in combination, nor the influences or outcomes of this interaction. Drawing on a sample of 39 semi-structured interviews, this study explores how professionals experience being mindful at work. The relationship between Being and Doing modes demonstrated changing compatibility across individuals and experience, with two basic types of experiences and three types of transitions. We labeled experiences when informants were unable to activate Being mode while engaging Doing mode as Entanglement, and those when informants reported simultaneous co-activation of Being and Doing modes as Disentanglement. This combination was a valuable resource for offsetting important limitations of the typical reliance on the Doing cognitive mode. Overall our results have yielded an inductive model of mindfulness at work, with the core experience, outcomes, and antecedent factors unified into one system that may inform future research and practice.

Exploring relations among mindfulness facets and various meditation practices: Do they work in different ways?

Several meditation practices are associated with mindfulness-based interventions but little is known about their specific effects on the development of different mindfulness facets. This study aimed to assess the relations among different practice variables, types of meditation, and mindfulness facets. The final sample was composed of 185 participants who completed an on-line survey, including information on the frequency and duration of each meditation practice, lifetime practice, and the Five Facet Mindfulness Questionnaire. A Multiple Indicators Multiple Causes structural model was specified, estimated, and tested. Results showed that the Model's overall fit was adequate: χ² (1045)=1542.800 (p<0.001), CFI=0.902, RMSEA=0.042. Results revealed that mindfulness facets were uniquely related to the different variables and types of meditation. Our findings showed the importance of specific practices in promoting mindfulness, compared to compassion and informal practices, and they pointed out which one fits each mindfulness facet better.

Psychological Effects of a 1-Month Meditation Retreat on Experienced Meditators: The Role of Non-attachment

Background: There are few studies devoted to assessing the impact of meditation-intensive retreats on the well-being, positive psychology, and personality of experienced meditators. We aimed to assess whether a 1-month Vipassana retreat: (a) would increase mindfulness and well-being; (b) would increase prosocial personality traits; and (c) whether psychological changes would be mediated and/or moderated by non-attachment.

Method: A controlled, non-randomized, pre-post-intervention trial was used. The intervention group was a convenience sample (n = 19) of experienced meditators who participated in a 1-month Vipassana meditation retreat. The control group (n = 19) comprised matched experienced meditators who did not take part in the retreat. During the retreat, the mean duration of daily practice was 8–9 h, the diet was vegetarian and silence was compulsory. The Experiences Questionnaire (EQ), Non-attachment Scale (NAS), Positive and Negative Affect Schedule (PANAS), Satisfaction With Life Scale (SWLS), Temperament Character Inventory Revised (TCI-R-67), Five Facets Mindfulness Questionnaire (FFMQ), Self-Other Four Immeasurables (SOFI) and the MINDSENS Composite Index were administered. ANCOVAs and linear regression models were used to assess pre-post changes and mediation/moderation effects.

Results: Compared to controls, retreatants showed increases in non-attachment, observing, MINDSENS, positive-affect, balance-affect, and cooperativeness; and decreases in describing, negative-others, reward-dependence and self-directedness. Non-attachment had a mediating role in decentring, acting aware, non-reactivity, negative-affect, balance-affect and self-directedness; and a moderating role in describing and positive others, with both mediating and moderating effects on satisfaction with life.

Conclusions: A 1-month Vipassana meditation retreat seems to yield improvements in mindfulness, well-being, and personality, even in experienced meditators. Non-attachment might facilitate psychological improvements of meditation, making it possible to overcome possible ceiling effects ascribed to non-intensive practices.

A Synthesis of Spiritual Intelligence Themes from Islamic and Western Philosophical Perspectives

Spiritual intelligence is an emerging term that is widely discussed and accepted as one of the main components that addresses and solves many life problems. Nonetheless there is no specific study being done to synthesize the spiritual intelligence themes from Western and Islamic philosophical perspectives. This research aimed to identify common spiritual intelligence themes from these two perspectives and elucidated its contents by the view of two well-known Islamic scholars; al-Ghazali and Hasan Langgulung. Seven spiritual intelligence themes were identified through thematic analysis; meaning/purpose of life, consciousness, transcendence, spiritual resources, self-determination, reflection-soul purification and spiritual coping with obstacles. These findings will be the groundwork for centered theory of spiritual intelligence themes that synthesize the Islamic and Western philosophical perspectives. It is hoped that this study will contribute significantly to the development of valid and reliable spiritual intelligence themes beyond the social and cultural boundaries.

Defining Contemplative Science: The Metacognitive Self-Regulatory Capacity of the Mind, Context of Meditation Practice and Modes of Existential Awareness

The term 'contemplative' is now frequently used in the fast growing field of meditation research. Yet, there is no consensus regarding the definition of contemplative science. Meditation studies commonly imply that contemplative practices such as mindfulness or compassion are the subject of contemplative science. Such approach, arguably, contributes to terminological confusions in the field, is not conducive to the development of an overarching theory in contemplative science, and overshadows its unique methodological features. This paper outlines an alternative approach to defining contemplative science which aims to focus the research on the core capacities, processes and states of the mind modified by contemplative practices. It is proposed that contemplative science is an interdisciplinary study of the metacognitive self-regulatory capacity (MSRC) of the mind and associated modes of existential awareness (MEA) modulated by motivational/intentional and contextual factors of contemplative practices. The MSRC is a natural propensity of the mind which enables introspective awareness of mental processes and behavior, and is a necessary pre-requisite for effective self-regulation supporting well-being. Depending on the motivational/intentional and contextual factors of meditation practice, changes in the metacognitive self-regulatory processes enable shifts in MEA which determine our sense of self and reality. It is hypothesized that changes in conceptual processing are essential mediators between the MSRC, motivational/intentional factors, context of meditation practice, and the modulations in MEA. Meditation training fosters and fine-tunes the MSRC of the mind and supports development of motivational/intentional factors with the ultimate aim of facilitating increasingly advanced MEA. Implications of the proposed framework for definitions of mindfulness and for future systematic research across contemplative traditions and practices are discussed. It is suggested that the proposed definition of contemplative science may reduce terminological challenges in the field and make it more inclusive of varied contemplative practices. Importantly, this approach may encourage development of a more comprehensive contemplative science theory recognizing the essential importance of first- and second-person methods to its inquiry, thus uniquely contributing to our understanding of the mind.

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

Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of one's experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying one's relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research.

Self-specific processing in the meditating brain: a MEG neurophenomenology study

Self-specific processes (SSPs) specify the self as an embodied subject and agent, implementing a functional self/nonself distinction in perception, cognition, and action. Despite recent interest, it is still undetermined whether SSPs are all-or-nothing or graded phenomena; whether they can be identified in neuroimaging data; and whether they can be altered through attentional training. These issues are approached through a neurophenomenological exploration of the sense-of-boundaries (SB), the fundamental experience of being an 'I' (self) separated from the 'world' (nonself). The SB experience was explored in collaboration with a uniquely qualified meditation practitioner, who volitionally produced, while being scanned by magnetoencephalogram (MEG), three mental states characterized by a graded SB experience. The results were then partly validated in an independent group of 10 long-term meditators. Implicated neural mechanisms include right-lateralized beta oscillations in the temporo-parietal junction, a region known to mediate the experiential unity of self and body; and in the medial parietal cortex, a central node of the self's representational system. The graded nature as well as the trainable flexibility and neural plasticity of SSPs may hold clinical implications for populations with a disturbed SB.

Deconstructing the Emotion Regulatory Properties of Mindfulness: An Electrophysiological Investigation

The present study sought to uncover the emotion regulatory properties of mindfulness by examining its effects—differentiated as a meditative practice, state of mind and dispositional trait—on the late positive potential (LPP), an event-related potentials (ERPs) indexing emotional processing. Results revealed that mindfulness as a meditative practice produced a reduction in the difference between the LPP response to negative high arousing and neutral stimuli across time. In contrast, a state mindfulness induction (i.e., instructions to attend to the stimuli mindfully) failed to modulate the LPP. Dispositional mindfulness, however, was related to modulation of the LPP as a function of meditation practice. Dispositional mindfulness was associated with a reduction of the LPP response to negative high arousal stimuli and the difference between negative high arousal and neutral stimuli in participants who listened to a control audio recording but not for those who engaged in the guided meditation practice. Together, these findings provide experimental evidence demonstrating that brief mindfulness meditation, but not deliberate engagement in state mindfulness, produces demonstrable changes in emotional processing indicative of reduced emotional reactivity. Importantly, these effects are akin to those observed in individuals with naturally high dispositional mindfulness, suggesting that the benefits of mindfulness can be cultivated through practice.

Task-related functional connectivity of the caudate mediates the association between trait mindfulness and implicit learning in older adults

Accumulating evidence shows a positive relationship between mindfulness and explicit cognitive functioning, i.e., that which occurs with conscious intent and awareness. However, recent evidence suggests that there may be a negative relationship between mindfulness and implicit types of learning, or those that occur without conscious awareness or intent. Here we examined the neural mechanisms underlying the recently reported negative relationship between dispositional mindfulness and implicit probabilistic sequence learning in both younger and older adults. We tested the hypothesis that the relationship is mediated by communication, or functional connectivity, of brain regions once traditionally considered to be central to dissociable learning systems: the caudate, medial temporal lobe (MTL), and prefrontal cortex (PFC). We first replicated the negative relationship between mindfulness and implicit learning in a sample of healthy older adults (60-90 years old) who completed three event-related runs of an implicit sequence learning task. Then, using a seed-based connectivity approach, we identified task-related connectivity associated with individual differences in both learning and mindfulness. The main finding was that caudate-MTL connectivity (bilaterally) was positively correlated with learning and negatively correlated with mindfulness. Further, the strength of task-related connectivity between these regions mediated the negative relationship between mindfulness and learning. This pattern of results was limited to the older adults. Thus, at least in healthy older adults, the functional communication between two interactive learning-relevant systems can account for the relationship between mindfulness and implicit probabilistic sequence learning.

Development of a self-distancing task and initial validation of responses

Mindfulness-based interventions are believed to counteract cognitive biases that exacerbate cognitive and physiological reactivity to emotional experiences and that contribute to the development and persistence of psychopathology. One process by which mindful practices may produce such salutary effects is by enhancing the capacity to "decenter"-or to adopt a self-distanced, nonjudgmental perspective on conscious experiences (e.g., thoughts, memories, and feelings). Findings consistently indicate that decentering, assessed via self-report, represents an important aspect of mental health and well-being; however, numerous researchers have called for more objective measures of skills associated with mindfulness and decentering to further evaluate the mechanisms and benefits of mindfulness-based practices. Thus, in the current investigation, we developed a behavioral task that requires mental manipulation of negative emotional (and neutral) material away from the self (self-distancing), as a means to assess the skills associated with mindfulness and decentering that likely underlie healthy emotional processing. In 2 nonmeditating, university samples, we found that higher levels of self-reported mindfulness and higher levels of 1 facet of decentering (the capacity to adopt a distanced perspective on experiences) predicted behavioral indicators of self-distancing. Results suggest that the self-distancing task shows considerable promise for capturing skills associated with mindfulness and at least 1 element of decentering. (PsycINFO Database Record