How Does Mindfulness Work? Exploring a Theoretical Model Using Samples of Meditators and Non-meditators

A Meta-Regression of psychosocial factors associated with sleep outcomes in mindfulness-based intervention trials

OBJECTIVES

In this meta-regression, we aimed to explore associations between changes in psychosocial factors and changes in sleep disturbance during mindfulness-based interventions (MBIs). We also investigated participant-specific and methodological factors associated with sleep disturbance during MBIs.

METHOD

We utilized data from a published meta-analysis of 40 randomized controlled trials of MBIs (published from inception to 2020) with a sleep disturbance outcome measure in healthy and clinical adult populations. We conducted meta-regressions to test associations between sleep improvements following MBIs and psychosocial factors, as well as demographic and methodological factors.

RESULTS

MBIs were associated with significant reductions in sleep disturbance (SMD = -0.523; 95% CI = -0.678 to -0.368) and psychosocial factors (SMD = -0.213 - -0.894). Reductions in sleep disturbance were associated with reductions in stress (r = 0.74, p = .02) and depression (r = 0.90, p < .001).

CONCLUSIONS

MBIs improve sleep disturbance across a wide range of healthy and clinical populations. Stress and depression may be important psychosocial factors associated with sleep disturbance. Future RCTs should include measures of additional factors and should investigate longitudinal associations between psychosocial, demographic, and methodological factors with changes in sleep disturbance to test mechanisms and to identify "active ingredients" of MBIs.

Can self-guided colouring improve university student wellbeing, mental health, and mindfulness?

BACKGROUND

Mindfulness-based interventions can successfully improve wellbeing in young adults. Mindful colouring is an applied mindfulness practice and improves short-term wellbeing. Less evidence is available about the effectiveness of regular, self-guided colouring. We investigated a self-guided two-week colouring intervention for university student wellbeing.

METHODS

One-hundred and forty university students completed a minimum of 10-min self-guided colouring, six times over two weeks. Participants were assessed at baseline and two-week follow-up using self-report measures of wellbeing, relating to quality of life, perceived stress, anxiety, depression, and mindfulness.

RESULTS

Colouring significantly improved all measures of mental health, wellbeing and mindfulness in students who completed at least six sessions of self-guided colouring.

CONCLUSION

Colouring is an accessible activity that can improve student wellbeing when carried out regularly over two weeks. Future research should investigate the impact of longer-term colouring practice on wellbeing, and the effect of this intervention in the general adult population.

Dialectical Behavioral Skills Group Therapy for Parents of Adolescents With Borderline Personality Disorder: A Pilot Study

Research has indicated the effectiveness of Dialectical behavior therapy in adolescents (DBT-A) with severe emotion dysregulation and other symptoms of Borderline Personality Disorder (BPD). The objective was to determine if DBT skills group with caregivers only could influence in potential mediators of DBT outcomes including rearing styles, emotion regulation and mindfulness skills, evaluated in both parents and adolescents. We implemented a 12-week group intervention based on DBT-A addressed to seven parents of adolescents with features of BPD. We tested differences after treatment using the non-parametric Wilcoxon test and calculated effect sizes. To understand individual changes, we reported clinical reliable change (CRC). The intervention was effective for improving rearing styles, emotion regulation and mindfulness skills in adolescents. Changes were stable after 6 months. The intervention showed good levels of satisfaction reported by parents. A short DBT group-only intervention with caregivers could modify relevant processes related with features of BPD in adolescents. Early interventions with adolescents with symptoms of BPD could prevent the development of BPD influencing in potential mediation mechanisms.

How mindfulness, self-compassion, and experiential avoidance are related to perceived stress in a sample of university students

University students constitute a population that is highly vulnerable to developing mental health problems, such as distress. The role of different variables associated with the development of states of stress has been studied in order to identify potential risk and protective factors. This study explored whether mindfulness, self-compassion, and experiential avoidance, while controlling for specific sociodemographic and academic variables, were potential significant protective or risk factors explaining perceived stress in a sample of 589 Spanish university students (81.2% female, age range 18-48 years). A hierarchical multiple regression analysis was performed using an exploratory cross-sectional design. Higher experiential avoidance, lower self-compassion, lower mindfulness, not perceiving family support, higher total study hours per week, having a partner (vs. being single), being female (vs. being male), and being older were significantly associated with higher levels of perceived stress. In conclusion, perceived stress in our sample was positively associated with experiential avoidance, which could be regarded as a potential psychological risk variable. In contrast, perceived stress was negatively correlated with self-compassion and mindfulness, which, in turn, could be seen as protective factors. Accordingly, it is concluded that programmes aimed at reducing stress and at improving well-being among university students should include experiential avoidance, self-compassion, and mindfulness as therapeutic targets.

Experiential Avoidance in Primary Care Providers: Psychometric Properties of the Brazilian "Acceptance and Action Questionnaire" (AAQ-II) and Its Criterion Validity on Mood Disorder-Related Psychological Distress

BACKGROUND

A sizeable proportion of Brazilian Primary Care (PC) providers suffer from common mental disorders, such as anxiety and depression. In an effort to cope with job-related distress, PC workers are likely to implement maladaptive strategies such as experiential avoidance (EA). The Acceptance and Action Questionnaire (AAQ-II) is a widely used instrument that evaluates EA but has shown questionable internal consistency in specific populations. This study assesses the psychometric properties of the AAQ-II among Brazilian PC providers, evaluates its convergence and divergence with self-criticism and mindfulness skills, and explores its criterion validity on anxiety and depressive symptoms.

METHODS

A cross-sectional design was conducted in Brazilian PC services, and the sample included 407 PC workers. The measures evaluated EA, self-criticism, mindfulness, depression, and anxiety.

RESULTS

The one-factor model of the AAQ-II replicated the original version structure. The AAQ-II presented good internal consistency among Brazilian PC providers. A multiple regression model demonstrated higher relationships with self-criticism than mindfulness skills. The criterion validity of the AAQ-II on anxiety and depression was stronger in the context of more severe symptoms.

CONCLUSIONS

The AAQ-II is an appropriate questionnaire to measure the lack of psychological flexibility among Brazilian PC workers in the sense of EA.

Wellbeing Training Based on Contemplative Practices in a Sample of Intensive Care and Homecare Professionals: A Pilot and Feasibility Non-Randomized Clinical Trial

BACKGROUND

Intensive care unit (ICU) and homecare unit professionals are susceptible to higher levels of stress and burnout than other healthcare professionals, which has an impact on their well-being, and in turn on their patients. In terms of data, there is not much research about the effects of psychological interventions on ICU and homecare professionals. The aim of this study was to investigate the effectiveness of Wellbeing Training based on Contemplative Practices (WTCP) for the increase of psychological functioning in a sample of ICU and homecare professionals.

METHODS

A pilot and feasibility non-randomized clinical trial was conducted. Participants in the WTCP group (n = 19) attended an at-work 8-session/2 h group WTCP program aimed at directly training four basic skills: (a) sustained positive emotions, (b) recovery from negative emotions, (c) pro-social behavior and generosity, and (d) mind wandering, mindfulness, and "affective stickiness". Nineteen professionals were allocated in the control group.

RESULTS

Results indicated that WTCP had a positive impact on self-compassion, personal accomplishment (burnout), and frequency of negative emotions. Moreover, a thematic analysis of participant interviews (n = 14) was conducted.

CONCLUSIONS

These preliminary results are promising, though future research is needed to evaluate the effectiveness of WTCP using randomized controlled trial methodologies.

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

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

Impact of Mindfulness Training on Spanish Police Officers' Mental and Emotional Health: a Non-Randomized Pilot Study

Objectives

The purpose of this exploratory non-randomized controlled study was to determine the acceptance and effectiveness of an 8-week mindfulness-based intervention (MBI) co-designed by a police officer.

Methods

A pretest-posttest control group design was followed. Participants (MBI group = 20; control group = 18) answered baseline and post-training self-reported measures. In addition, the weekly emotional state of the MBI group was collected. Paired-samples t-test and analysis of covariance were performed for pre-post within-group and between-group differences, respectively, as well as linear mixed effects analysis of repeated measures for week-by-week data.

Results

High acceptance and attendance rates, as well as significant pre-post within-group differences in the MBI group in mindfulness (η² = 0.43), self-compassion (η² = 0.43), depression (η² = 0.54), anxiety (η² = 0.46), stress (η² = 0.51), difficulties in emotion regulation, sleep quality (η² = 0.57), and burnout (η² = 0.31–0.47), were identified. Moreover, police officers who underwent the MBI experienced a week by week decrease of anger, disgust, anxiety, sadness, and desire. Finally, after adjusting for pre-test scores, significant between-group differences were found in the way of attending to internal and external experiences (observing mindfulness facet; η_p² = 0.21), depression symptoms (η_p² = 0.23), general distress (η_p² = 0.24), and the degree of physical and psychological exhaustion (personal burnout; η_p² = 0.20).

Conclusions

The preliminary effectiveness of this MBI on psychopathology and quality of life outcomes in Spanish police officers was discussed. Previous evidence regarding the promising use of MBIs in this population was supported.

Effectiveness of mindfulness-based interventions on psychotherapy processes: A systematic review

In the field of psychotherapy, scientific research has highlighted the importance of empathy and therapeutic alliance in regard to the effectiveness and better results of psychological treatments. In recent years, mindfulness-based interventions (MBIs) have shown to be effective at increasing empathy and therapeutic alliance and how this could affect the patients' symptomatology. In this study, we conducted a systematic review of the effectiveness of MBIs applied to psychotherapists to improve their empathy, the therapeutic alliance and the patients' symptomatology. Sixteen studies evaluating the impact of an MBI on some of these variables were identified, of which six included measures evaluated by the patients whose ahe MBI. The risk of bias of the included studies was analysed following the methodological standards. We found very different designs and methodologies in the studies included in this review, with few of them including a control group. The results show a limited increase in empathy, measured by the psychotherapist, after an MBI. However, the results in therapeutic alliance are not conclusive, as well as the improvements in the perception of patients about their symptomatology. It is concluded that MBIs can have a beneficial effect on the psychotherapeutic practice, through the development of psychotherapists' empathy. Future research would require new studies with a higher methodological quality, and in which the effects of MBIs on empathy, therapeutic alliance and patients' symptomatology and the relationships between them are analyzed.

Relationships Between Mindfulness Facets and Mental and Physical Health in Meditating and Nonmeditating University Students

Abstract. Background: Little is known about the relations of the mindfulness facets to mental and physical health among meditators and nonmeditators. Aim: The main purpose of the present study was to investigate the relationship between the mindfulness facets and mental as well as physical health of university students with and without meditation experience using attentional control, body awareness, nonattachment, and emotion regulation as mediators. Method: Data were collected from a sample of 508 university students (meditators: n = 195, nonmeditators n = 313). Path analysis models were used to examine the associations between the mindfulness facets, all candidate mediators and the outcome variables mental and physical health complaints. Additionally, a bootstrapping procedure was used to test the significance of the indirect effects. Results: Results showed that the associations between the mindfulness facets, the proposed mediators, and mental and physical health complaints were similar between students with and without meditation experience. Nonattachment and body awareness were the most important mediators. Limitations: Only self-report questionnaires were used in the study, and the majority of the sample was women and enrolled in health and social science studies. Conclusion: The results indicated that the investigation of mindfulness at the facet level is worthwhile. The study helps to clarify the associations between the mindfulness facets and mental as well as physical health among students with and without meditation experience. Further, mindfulness mediators should be examined in intervention studies.

Development and Validation of the Four Facet Mindful Eating Scale (FFaMES)

OBJECTIVES

Previous mindful eating scales stress the attentional domains of eating-specific mindfulness, such as present-moment attention to homeostatic cues of hunger and satiety while discounting other important domains such as non-judgment and decentering. The purpose of the series of studies was to develop and evaluate a multifaceted mindful eating scale that assesses several domains of eating-specific mindfulness.

METHODS

A multistep process was used to construct the Four Facet Mindful Eating Scale (FFaMES). Study 1 outlined the initial scale construction and the development of a novel item pool (N = 480). Study 2 examined the internal structure of the observed variables using exploratory analysis (N = 445) and confirmatory analysis in a separate sample (N = 445). Reliability and validity were assessed in Study 3 (N = 166).

RESULTS

The final scale consists of 29 items with 4 factors: Non-Reactance, Non-Judgment, External Awareness, and Internal Awareness. The FFaMES demonstrated good internal consistency, retest reliability as well as preliminary convergent and divergent validity.

CONCLUSIONS

Our findings provide reliability evidence and initial support for the construct validity of the FFaMES and the continued study of multiple facets of eating-specific mindfulness. Future research should continue to investigate the differential effects of various aspects of eating-specific mindfulness in the prevention and treatment of obesity and its comorbidities.

Introducing mindfulness and compassion-based interventions to improve verbal creativity in students of clinical and health psychology

OBJECTIVES

In the field of psychotherapy, verbal creativity has been suggested as an important aspect in psychotherapists' training. In the present study, the effects of a mindfulness and compassion-based intervention (MCBI) on verbal creativity are analysed in students of clinical and health psychology (N = 90).

DESIGN

Students were randomly assigned to an experimental group (n = 37), in which an MCBI was applied, and a waiting list group (n = 26) with no intervention. We also assessed a non-randomized active control group (n = 27), in which students received training in basic psychotherapy skills.

METHODS

Verbal creativity (fluency, flexibility, and originality) was evaluated in a pre-, post-, and follow-up assessment.

RESULTS

Results indicated a significant increase in fluency (p = .001, d = .64), flexibility (p = .017, d = .67), and originality (p = .004, d = .72) in the experimental group, relative to the waiting list group, in the post-assessment. Fluency (p = .010, d = .64) and flexibility (p = .033, d = .62) were also found to be higher in the follow-up assessment. In addition, results indicated a significant increase in flexibility (p = .034, d = .74) in the experimental group, relative to the active control group, in the follow-up assessment.

CONCLUSIONS

Introducing MCBI in the university education of psychotherapists seems to be a useful strategy to improve their verbal creativity, which could positively influence their ability to explore and appropriately respond to their patients' needs.

PRACTITIONER POINTS

Mindfulness and compassion-based interventions (MCBIs) could be a useful strategy to improve verbal creativity in the university education of psychotherapists. After the MCBI, students of clinical and health psychology increased the number of ideas they produced when facing a specific situation, as well as their variety and originality.

Assessing self-criticism and self-reassurance: Examining psychometric properties and clinical usefulness of the Short-Form of the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS-SF) in Spanish sample

The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) was designed to measure self-criticism (SC) through Inadequate Self (IS) and Hated Self (HS) factors, as well as self-reassurance (RS). However, its long and short forms have yet to be validated in the Spanish Population. The present study examines the psychometric properties of the short form (FSCRS-SF) and its clinical usefulness in a sample of 576 adult individuals, 77 with psychiatric disorders and 499 without. Non-clinical participants were split according to their previous experience with meditation (active meditators, n = 133; non-active meditators, n = 41; and non-meditators, n = 325) and differences between these subgroups were explored. Additionally, a subsample of 20 non-clinical participants took part in a mindfulness- and compassion- based intervention (MCBI) to assess the usefulness of the scale as an outcome measure. Results confirmed the original three-factorial structure, good internal consistency, acceptable test-retest reliability, and a pattern of correlations consistent with previous literature. Regarding differences between groups, the clinical subsample showed significant higher SC and lower RS levels than non-clinical participants and active meditators had significant lower IS and higher RS levels than non-meditators. Participants who participated in the MCBI showed significant RS improvement and a decrease in IS and HS levels. Moreover, a hierarchical multiple regression showed that RS made a significant predictive contribution to distress at three months’ time. In conclusion, results show that the Spanish version of the FSCRS-SF is a reliable and valid measure of SC and RS in non-clinical populations and an adequate instrument to detect changes after MCBIs.

Psychological comorbidity in gastrointestinal diseases: Update on the brain-gut-microbiome axis

The high comorbidity of psychological disorders in both functional and organic gastrointestinal diseases suggests the intimate and complex link between the brain and the gut. Termed the brain-gut axis, this bidirectional communication between the central nervous system and enteric nervous system relies on immune, endocrine, neural, and metabolic pathways. There is increasing evidence that the gut microbiome is a key part of this system, and dysregulation of the brain-gut-microbiome axis (BGMA) has been implicated in disorders of brain-gut interaction, including irritable bowel syndrome, and in neuropsychiatric disorders, including depression, Alzheimer's disease, and autism spectrum disorder. Further, alterations in the gut microbiome have been implicated in the pathogenesis of organic gastrointestinal diseases, including inflammatory bowel disease. The BGMA is an attractive therapeutic target, as using prebiotics, probiotics, or postbiotics to modify the gut microbiome or mimic gut microbial signals could provide novel treatment options to address these debilitating diseases. However, despite significant advancements in our understanding of the BGMA, clinical data is lacking. In this article, we will review current understanding of the comorbidity of gastrointestinal diseases and psychological disorders. We will also review the current evidence supporting the key role of the BGMA in this pathology. Finally, we will discuss the clinical implications of the BGMA in the evaluation and management of psychological and gastrointestinal disorders.

Co-emergence Reinforcement and Its Relevance to Interoceptive Desensitization in Mindfulness and Therapies Aiming at Transdiagnostic Efficacy

Interoception, the ability to feel the body's internal sensations, is an essential aspect of emotional experience. There is mounting evidence that interoception is impaired in common mental health disorders and that poor interoceptive awareness is a major contributor to emotional reactivity, calling for clinical interventions to address this deficit. The manuscript presents a comprehensive theoretical review, drawing on multidisciplinary findings to propose a metatheory of reinforcement mechanisms applicable across a wide range of disorders. We present a reconsideration of operant conditioning through the co-emergence model of reinforcement, which is a neurophenomenological account of the interaction between cognition and interoception, and its consequences on behavior. The model suggests that during memory processing, the retrieval of autobiographical memory (including maladaptive cognition) is dependent upon its co-emerging interoceptive cues occurring at the encoding, consolidation and reconsolidation stages. Accordingly, "interoceptive reinforcement" during emotional distress is a common factor to all emotional disorders and a major cause for relapse. We propose that interoceptive desensitization has transdiagnostic benefits, readily achievable through the cultivation of equanimity during mindfulness training and can be integrated in cognitive and behavioral interventions to permit a transdiagnostic applicability. We summarize the contributions of this approach into 10 specific and testable propositions.

Brief mindfulness session improves mood and increases salivary oxytocin in psychology students

Mindfulness-based interventions (MBI) have been shown to be effective in increasing empathy in health professionals. Yet, more research is needed to analyse the specific influence of mindfulness exercises on biological variables involved in empathy, such as the biological system of oxytocin activity. In this study, we analyse the effects of a brief mindfulness session on positive and negative affect, state anxiety and salivary oxytocin (sOXT) in psychology students (N = 68). In the experimental group (n = 42), a mindfulness session was performed that included different guided meditation exercises. In the control group (n = 26), an emotion recognition exercise was carried out, along with a series of creative activities. Results showed that the mindfulness session was effective, because there was a significant reduction in negative affect (d = -.56, p < .001) and state anxiety (d = -.54, p = .007) in the experimental group. Likewise, there was an increase in sOXT (d = .99, p < .001) in this group, compared with the control group. Guided mindfulness meditation practice could be useful to reach an emotional and biological state that facilitates empathy. In this regard, the increase in sOXT after the mindfulness session adds further evidence about the biological mechanisms underlying the benefits of MBI on empathy.

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

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

Putting Oneself in the Body of Others: A Pilot Study on the Efficacy of an Embodied Virtual Reality System to Generate Self-Compassion

Compassion-based interventions (CBIs) have been shown to be effective for increasing empathy and compassion, and reducing stress, anxiety, and depression. CBIs are based on constructive meditations where imagery abilities are essential. One of the major difficulties that participants report during the training is the difficulty related to imagery abilities. Virtual reality (VR) can be a useful tool to overcome this limitation because it can facilitate the construction and sustainment of mental images. The machine to be another (TMTBA) uses multi-sensory stimulation to induce a body swap illusion. This system allows participants to see themselves from a third perspective and have the illusion of touching themselves from outside. The main objective of the present study was to analyze the efficacy of a self-compassion meditation procedure based on the TMTBA system versus the usual meditation procedure (CAU) in increasing positive affect states, mindful self-care, and adherence to the practice, and explore the influence of imagery abilities as moderators of the effects of the condition on adherence. A sample of 16 participants were randomly assigned to two conditions: TMTBA-VR and CAU. All participants had to listen to an audio meditation about self-compassion and answer questionnaires before and after the training. The TMTBA-VR condition also had a body swap experience at the end of the meditation while listening to self-compassionate messages. Afterward, they were invited to practice this meditation for 2 weeks and then measured again. After the compassion practice, both conditions significantly increased positive qualities toward self/others, decreased negative qualities toward self, and increased awareness and attention to mental events and bodily sensations, with no differences between the conditions. After 2 weeks, both conditions showed a similar frequency of meditation practice and increases in specific types of self-care behaviors, with the frequency of clinical self-care behaviors being significantly higher in TMTBA. Finally, lower imagery ability in the visual and cutaneous modality were moderators of the efficacy of the TMTBA (vs. CAU) condition in increasing adherence to the practice. Embodied VR could be an interesting tool to facilitate and increase the efficacy of CBIs by facilitating the construction of positive and powerful mental images.

Past Discrimination, Race-Related Vigilance, and Depressive Symptoms: The Moderating Role of Mindfulness

Objectives

African Americans experience numerous adverse health consequences due to race-related stress. Yet, mindfulness may serve as a relevant and vital protective factor in the link between race-related stressors and depressive symptoms for this population.

Methods

Data from 190 African American participants, ages 18-53, were used to investigate if past discrimination and race-related vigilance, two types of race-related stressors, interactively predicted greater depressive symptomatology among this sample. We also assessed if mindfulness moderated the association between race-related stressors, as indicated by past discrimination and race-related vigilance, and depressive symptomatology.

Results

Our results indicated that past discrimination and race-related vigilance did not interactively predict depressive symptomatology in our sample; however, these stressors were independently related to greater depressive symptoms. Additionally, we found that greater levels of mindfulness were associated with lower levels of depressive symptoms, and mindfulness significantly moderated the association between both race-related stressors and depressive symptoms.

Conclusions

These findings support mindfulness' ability to buffer the negative health consequences of past discrimination and race-related vigilance for African Americans. Additional conclusions and future research directions are discussed.

New Avenues for Promoting Mindfulness in Adolescence using mHealth

There is a large evidence base supporting the efficacy of mindfulness interventions in adulthood, and growing support for the efficacy of these interventions in adolescence. Historically mindfulness interventions have been delivered in person and in groups, with recommendations for home practice being a critical part of the intervention. However, compliance with these practice recommendations in adolescence is very poor. Past studies indicate that using mobile technology to promote skill transfer to real life can be an effective strategy, particularly when used as a supplement to an in-person intervention strategy. To date, however, mobile technology has largely been used to create stand-alone mindfulness interventions. The goals of the current paper are to discuss the potential opportunities and challenges with a mobile-technology-enhanced mindfulness intervention, and to present the rationale that such an approach is not only theoretical and empirically sound but also a critical next step to increase the efficacy and developmental appropriateness of mindfulness interventions for adolescents. This discussion is grounded in a specific example of a mindfulness intervention supplemented by momentary interventions we are developing.

Wearable Sensors for Measuring Movement in Short Sessions of Mindfulness Sitting Meditation: A Pilot Study

Mindfulness techniques are useful tools in health and well-being. To improve and facilitate formal training, beginners need to know if they are in a stable sitting posture and if they can hold it. Previous monitoring studies did not consider stability during sitting meditation or were specific for longer traditional practices. In this paper, we have extended and adapted previous studies to modern mindfulness practices and posed two questions: (a) Which is the best meditation seat for short sessions? In this way, the applications of stability measures are expanded to meditation activities, in which the sitting posture favors stability, and (b) Which is the most sensitive location of an accelerometer to measure body motion during short meditation sessions? A pilot study involving 31 volunteers was conducted using inertial sensors. The results suggest that thumb, head, or infraclavicular locations can be chosen to measure stability despite the habitual lumbar or sacral region found in the literature. Another important finding of this study is that zafus, chairs, and meditation benches are suitable for short meditation sessions in a sitting posture, although the zafu seems to allow for fewer postural changes. This finding opens new opportunities to design very simple and comfortable measuring systems.