Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial

Patterns of Respiration Rate Reactivity in Response to a Cognitive Stressor Associate With Self-Reported Mental Health Outcomes

Many studies have examined physiological responses to acute stress in healthy and clinical populations. Some have documented exaggerated physiological stress reactivity in response to acute stress, while others have reported blunted physiological stress reactivity. Although the literature is conflicted, the relationship between abnormal physiological stress reactivity and negative outcomes is well-established. However, past research has neglected a critical aspect of physiological stress response - respiration - and it is unclear whether differences in respiration rate responses to acute stress are related to health outcomes. This secondary cross-sectional analysis explored differences in outcomes between three subgroups: blunted, moderate, and exaggerated respiration rate reactivity to an acute stress task. In a sample of at least mildly-stressed older adults (n = 55), we found that perceived stress (b = -7.63; p = .004) and depression (b = -9.13; p = .007) were significantly lower in the moderate reactivity group compared to the high reactivity group, and that self-reported mindfulness (b = 10.96; p = .008) was significantly lower in the moderate reactivity group as compared to the low reactivity group. Across outcomes, participants in the moderate range of physiological reactivity showed less negative and more positive psychological attributes and better health outcomes, while the blunted subgroup demonstrated more negative and less positive psychological attributes and worse health outcomes overall, when compared to the exaggerated and moderate groups. This study extends the literature by adding respiration to markers of acute physiological stress reactivity and demonstrating the effects of blunted respiration reactivity on negative psychological attributes and health outcomes.

Maternal interpretation of infant emotions related to mothers' mindfulness and mother-infant stress

We aimed to identify maternal characteristics predicting interpretation of infant emotions, as well as relations between such interpretations and mother-infant stress. Specifically, we investigated (1) prospective associations between maternal dispositional mindfulness and interpretation of infant emotions, and (2) concurrent associations between maternal interpretation of infant emotions and mothers' and infants' cortisol during a dyadic stressor in a non-clinical community sample (n = 78) of mother-infant dyads. Mothers completed the Five Facet Mindfulness Questionnaire at 3 months postnatal, and the IFEEL Picture infant emotion interpretation task at 6 months postnatal. At 6-months, mother-infant dyads completed the Face-to-Face Still Face paradigm, and physiological stress was assessed via salivary cortisol. Regression analyses revealed significant links between aspects of maternal mindfulness - specifically, Observing, Describing, and Acting with Awareness facets - and infant emotion interpretation; more mindful mothers' emotion ratings were less negatively biased and covered the full spectrum of infant emotions, congruent with the range of responses given by a low-risk reference sample. In turn, less negativity bias and greater interpretive congruence predicted lower infant and mother cortisol during the stress session, with effects small-medium in size. Findings highlight the potential role of maternal interpretation of infant emotions in mindful parenting.

Are mind-body therapies beneficial for older people with dementia? A Systematic Review and meta-analysis of randomized controlled trials

Objective

This systematic review and meta-analysis aimed to evaluate the potential multidomain benefits of mind-body therapies (MBTs) for behavioral and psychological symptoms of dementia (BPSD) in older people with dementia (OPWD).

Methods

Relevant randomized controlled trials (RCTs) were identified using electronic databases and manual searches. Two independent researchers evaluated the risk of bias in the included trials using the Revised Cochrane Risk-of-Bias tool for randomized trials. A standardized mean difference (SMD) with a 95% confidence interval (CI) was used to combine effect sizes.

Results

This review included 35 RCTs comprising 4,043 patients, of whom 24 were included in the meta-analyses. MBTs effectively improved BPSD (SMD = -0.33; 95% CI -0.49 to -0.16; p < 0.01), anxiety (SMD = -0.82; 95% CI -1.53 to -0.10; p = 0.02), and depression (SMD = -0.57; 95% CI -1.06 to -0.08; p = 0.02), with no significant improvements observed in agitation (SMD = -0.09; 95% CI -0.25 to 0.07; p = 0.27) among patients with dementia. The certainty of evidence across the outcomes ranged from low to very low, based on the Grading of Recommendations, Assessment, Development, and Evaluations ratings.

Conclusion

Effective nursing for patients with dementia is vital, as they are undergoing a major transition in their physical and mental health. In clinical practice, healthcare and social care therapists should develop personalized intervention programs based on patient individual differences and the actual dose-response relationship, which will help maximize the clinical benefits of non-pharmacological treatments in the context of limited medical resources. More high-quality RCTs could be conducted to compare the differential efficacy of non-pharmacological treatments on various aspects of BPSD in OPWD to provide a better evidence base to guide individual care and policy guidance.

Systematic review registration

PROSPERO, identifier CRD42024559809.

The associations and effects of mindfulness on anger and aggression: A meta-analytic review

Dispositional mindfulness and mindfulness-based interventions have been linked to emotion regulation and may reduce anger and aggression. The present set of four meta-analyses examined and quantified correlational relationships between trait mindfulness, trait anger, and trait aggression, as well as the effects of experimental mindfulness-based interventions on anger and aggression. These meta-analyses contained data from 118 correlational (dispositional mindfulness) and experimental (mindfulness-based intervention) studies. For the subset of self-report correlational studies (kanger = 243, kaggression = 286), we found small-to-medium inverse relationships between dispositional mindfulness and both anger (r = -0.23, p < .001) and aggression (r = -0.19, p < .001). For experimental studies (kanger = 95, kaggression = 38), we found medium effects. Specifically, mindfulness-based interventions produced lower anger (d = -0.48, p < .001) and aggression (d = -0.61, p < .001) relative to the control groups. In sum, results suggest that mindfulness can curb angry and aggressive responses. Effect sizes for the interventions were largest in Asia. Studies with passive versus active control groups showed larger effect sizes. Effect sizes were largely equivalent for all populations studied (e.g., clinical, forensic, healthy adults, medical, students). Our meta-analytic findings suggest that mindfulness training may aid the effective regulation of anger and aggression for diverse populations. They also highlight the need for more rigorous control groups in future research.

Enhancing Equanimity With Noninvasive Brain Stimulation: A Novel Framework for Mindfulness Interventions

Mindfulness has gained widespread recognition for its benefits for mental health, cognitive performance, and well-being. However, the multifaceted nature of mindfulness, which encompasses elements such as attentional focus, emotional regulation, and present-moment awareness, complicates its definition and measurement. A key component that may underlie its broad benefits is equanimity-the ability to maintain an open and nonreactive attitude toward all sensory experiences. Empirical research suggests that mindfulness works through a combination of top-down attentional control and bottom-up sensory and emotional processes and that equanimity's role in regulating those bottom-up processes drives the psychological and physiological benefits, making it a promising target for both theoretical and practical exploration. Given these findings, the development of interventions that specifically augment equanimity could improve the impact of mindfulness practices. Research into noninvasive brain stimulation (NIBS) suggests that it is a potential tool for altering neural circuits involved in mindfulness. However, most NIBS studies reported to date have focused on improving cognitive control systems and have left equanimity relatively unexplored. Preliminary findings from focused ultrasound interventions targeting the posterior cingulate cortex suggest that NIBS can directly facilitate equanimity by inhibiting self-referential processing in the default mode network to promote a more present-centered state of awareness. Future research should prioritize the integration of NIBS with well-defined mindfulness training protocols, focusing on equanimity as a core target. This approach could provide a novel framework for advancing both contemplative neuroscience and clinical applications, offering new insights into the mechanisms of mindfulness and refining NIBS methodologies to support individualized, precision wellness interventions.

The impact of experimentally instructed suppression on cardiovascular habituation during repeated stress

Experimental research has shown instructed suppression is associated with heightened physiological responses during a single active stress exposure, with heightened responses to stress being a potential underlying mechanism linking suppression to cardiovascular disease (CVD). However, no research to date has examined instructed suppression with cardiovascular habituation to repeated stress. This study extends prior research by introducing a novel experimental paradigm, which incorporates a traditional suppression manipulation protocol within an active stress habituation framework. Between September 2022 and May 2023, participants (N = 244; mean (SD) age = 19.04 (1.9) years; 50.4 % women; 65.6 % White) completed a 10-min baseline, 5-min speech preparation, and 5-min speech delivery, which was repeated after a 10-min recovery. Participants were randomly assigned to either suppression or control instructions before the second speech prep. Heart rate (HR), systolic/diastolic blood pressures (SBP/DBP), and pre-ejection period (PEP) were measured throughout. State affect, perceived psychological stress, and state suppression were self-reported after each task. Habitual use of suppression was assessed using the Emotion Regulation Questionnaire. All participants exhibited significant cardiovascular habituation, irrespective of condition, suggesting instructed suppression did not hinder habituation. Instructed suppression was not associated with changes in perceived psychological stress or positive affect across tasks; however, instructed suppression was associated with greater habituation of negative affect. Neither state nor habitual suppression interacted with instructed suppression in influencing task responses. This is the first study to examine the relationship between experimentally instructed suppression and cardiovascular habituation, providing new perspective of the interplay between suppression and cardiovascular stress responding.

Effectiveness of an Internet-Based, Self-Guided, Short-Term Mindfulness Training (ISSMT) Program for Relieving Depressive Symptoms in the Adult Population in China: Single-Blind, Randomized Controlled Trial

BACKGROUND

Depression is a significant global public health issue, and in China, access to mental health services remains limited despite high demand. Research has shown that mindfulness can effectively alleviate depressive symptoms and that telehealth solutions offer a promising avenue for addressing this service gap. Despite this potential, there are currently few studies in China focusing on short-term online mindfulness training. Most existing online mindfulness studies relied on traditional 8-week programs, which can be challenging for participant adherence due to limited accessibility and high dropout rates. Additionally, limited research exists on short-term online mindfulness interventions, and findings remain inconsistent.

OBJECTIVE

This study aimed to develop and evaluate an internet-based, self-guided, short-term mindfulness training (ISSMT) program based on the Monitor and Acceptance Theory (MAT) to reduce depression symptoms.

METHODS

The ISSMT program was delivered via an online platform, "Hi Emotion," and was accessible to the general public. Interested individuals aged 18 years and older were randomized into either the ISSMT group or a wait-list control group. Participants in the ISSMT group received daily reminders to participate in a 15- to 20-minute session over a 14-day training period. Measurements, including mindfulness and depressive symptoms, were collected at baseline and weekly for the subsequent 3 weeks.

RESULTS

A total of 205 adults participated in the 14-day online intervention. Linear mixed models were used to analyze both per-protocol (PP) and intention-to-treat (ITT) samples. Compared with the wait-list control group, participants in the ISSMT group showed significant improvements in mindfulness (Cohen d=0.44 for ITT; Cohen d=0.55 for PP) and reductions in depressive symptoms (Cohen d=0.50 for ITT; Cohen d=0.53 for PP). Furthermore, participants expressed high acceptance of this training format with a relatively low dropout rate (<40%).

CONCLUSIONS

The ISSMT program based on the MAT effectively enhanced mindfulness and alleviated depressive symptoms. This intervention could be considered for integration into psychosocial service systems to improve mental health outcomes and help bridge the gap between limited resources and the high demand for services in China. Future research should focus on personalizing these programs and incorporating advanced technologies to enhance their effectiveness and user engagement.

TRIAL REGISTRATION

Open Science Framework; https://doi.org/10.17605/OSF.IO/8P4V6.

Examining emotion reactivity to politically polarizing media in a randomized controlled trial of mindfulness training versus active coping training

Emotional appraisals of political stimuli (e.g., videos) have been shown to drive shared neural encoding, which correspond to shared, yet divisive, interpretations of such stimuli. However, mindfulness practice may entrain a form of emotion regulation that de-automatizes social biases, possibly through alteration of such neural mechanisms. The present study combined a naturalistic neuroimaging paradigm and a randomized controlled trial to examine the effects of short-term mindfulness training (MT) (n = 35) vs structurally equivalent Cognitive Reappraisal training (CT) (n = 37) on politically-situated emotions while evaluating the mechanistic role of prefrontal cortical neural synchrony. Participants underwent functional near-infrared spectroscopy (fNIRS) recording while viewing inflammatory partisan news clips and continuously rating their momentary discrete emotions. MT participants were more likely to respond with extreme levels of anger (odds ratio = 0.12, p < 0.001) and disgust (odds ratio = 0.08, p < 0.001) relative to CT participants. Neural synchrony-based analyses suggested that participants with extreme emotion reactions exhibited greater prefrontal cortical neural synchrony, but that this pattern was less prominent in participants receiving MT relative to CT (CT > MT; channel 1 ISC = 0.040, p = 0.030).

Autonomic modulation with mindfulness-based stress reduction in chronic kidney disease: a randomized controlled trial

Chronic kidney disease (CKD) is characterized by overactivation of the sympathetic nervous system (SNS) that leads to increased risk of cardiovascular disease. This study was conducted to evaluate the effects of a Mindfulness-Based Stress Reduction (MBSR) programme on SNS activity in CKD patients. Participants with CKD stages III-IV were randomized to the 8 week MBSR programme or Health Enhancement Program (HEP; a structurally parallel, active control group). Intraneural measures of SNS activity directed to muscle [muscle sympathetic nerve activity (MSNA)] via microneurography was recorded at rest and during stress manoeuvres (mental arithmetic, handgrip exercise and cold pressor test). Data analyses were performed based on the intent-to-treat principle. In total, 29 participants (64 ± 9 years; 86% males) completed the intervention with 17 in the MBSR and 12 in the HEP groups. There was a significant Group (MBSR vs. HEP) by Time (baseline vs. post-intervention) interaction in MSNA reactivity to mental stress (P = 0.029), with a significant reduction in the mean ∆MSNA over 3 min of mental arithmetic at post-intervention (10.3 ± 4.2-5.9 ± 5.6 bursts/min, P < 0.001; Hedges' g = -0.858, 95% confidence interval [-1.578, -0.167]), while no change was observed within the HEP group (P = 0.818). Reduced ∆MSNA during handgrip exercise was also observed, while ∆MSNA during the cold pressor test and resting MSNA remained unchanged in both groups from baseline to post-intervention. In this randomized controlled trial, patients with CKD had a reduction of sympathetic reactivity during mental stress and static handgrip exercise following 8 weeks of MBSR but not after HEP. Our findings demonstrate that mindfulness training is feasible and may have clinically beneficial effects on autonomic function in CKD. KEY POINTS: Question: Does the Mindfulness-Based Stress Reduction (MBSR) programme reduce sympathetic activity in patients with chronic kidney disease (CKD)? Finding: In this randomized controlled trial including 29 patients with CKD, 8 weeks of MBSR decreased sympathetic reactivity to mental stress compared to the control Health Enhancement Program (HEP). Meaning: These finding suggest that mindfulness training may have clinically beneficial effects on autonomic function in CKD.

Examining the association between habitual emotion regulation strategies and cardiovascular stress reactivity across three studies

Poor emotion regulation is associated with cardiovascular disease risk, with altered cardiovascular responses to psychological stress a possible underlying mechanism. However, prior research has predominantly focused on instructed (laboratory-based) emotion regulation; there is limited conclusive research on the relationship between every-day (habitual) emotion regulation and cardiovascular responses to active psychological stress. As such, this study aimed to examine the associations between two common habitual emotion regulation strategies-cognitive reappraisal and expressive suppression-and cardiovascular stress responses across three independent laboratory studies, each involving a different active acute psychological stress task. Participants (Study 1: N = 239, 64.9 % female; Study 2: N = 289, 51.9 % female, Study 3: N = 169, 50.9 % female) underwent cardiovascular monitoring during a 10-min baseline and subsequent stress task (Study 1: mental arithmetic task; Study 2: speech task; Study 3: Multisource Interference/Stroop tasks). Participants also completed the Emotion Regulation Questionnaire and ratings of perceived task stressfulness. Cardiovascular reactivity (stress mean - baseline mean) was calculated for systolic/diastolic blood pressure and heart rate for each study. Across all three studies, regression analyses demonstrated no statistically significant linear associations between habitual emotion regulation and cardiovascular reactivity (ps ≥ .10) or self-reported perceived stress (ps ≥ .06), both before and after controlling for demographic covariates. This investigation furthers our understanding of how habitual emotion regulation strategies may-or may not-impact cardiovascular stress responses, thus providing valuable insights into the complex relationship between emotion regulation and long-term cardiovascular health.

Are We Sailing in the Right Direction for Deeper Insights Into Acceptance? Evidence From a Systematic Review of Research in Laboratory Settings

This systematic review aims to review and update the current state of research on the acceptance strategy for a healthy population in a laboratory setting. Using a previously defined search strategy, the PsycInfo, PubMed, and Web of Science databases were searched from 1961 to May 2020 for articles on this topic. Twenty-five high-quality articles, involving a total of 2265 participants, met inclusion criteria. According to these results, acceptance is a strategy with promising outcomes for handling pain in healthy populations, although its superiority over other strategies to reduce negative affect, anger, and other pain variables is unclear. The instructions and outcome variables vary widely between studies, and few studies compare acceptance with mindfulness. We discuss these findings and provide information to guide future researchers for designing fine-grained investigations that can address the gaps in this area.

Challenge or Threat? The Effects of the Standard and a Second-Generation Mindfulness Intervention with Buddhist Practices on Cognitive Appraisals of Stress: Secondary Analysis of a Randomized Controlled Experiment Performed in Switzerland

Contemplative approaches rooted in Buddhist traditions have been linked to the attenuation of response to social stress. Anticipatory cognitive appraisals of social situations potentially represent a mechanism explaining the stress-reducing effects of contemplative practices. The cognitive appraisal of threat is associated with an anticipated loss of social self-esteem. In contrast, the cognitive appraisal of challenge involves recognizing the potential for gain or growth in stressful situations and is associated with a more adaptive cardiovascular response. In this secondary analysis of a randomized controlled experiment performed in Switzerland, we evaluated the effects of two contemplative interventions on cognitive appraisals of challenge and threat and associated physiological profiles. The interventions were a standard Mindfulness-Based Stress Reduction (MBSR) program and a new program (MBSR-B), which included several elements from Buddhist practices. After an eight-week intervention, participants completed the Trier Social Stress Test (TSST) and underwent the assessment of primary cognitive appraisals and cardiovascular response to stress. The results demonstrated greater challenge appraisal in the MBSR (n = 20) and MBSR-B (n = 21) groups compared to Control (n = 24), and MBSR-B participants scored higher on the challenge than threat appraisal. At the physiological level, the groups did not differ on changes in cardiac output and total peripheral resistance. Still, an exploratory analysis demonstrated that the MBSR-B group's cardiovascular profile best resembled challenge appraisal. The results suggest that contemplative approaches foster challenge appraisal, contributing to a more adaptive response to stress.

Relationship between coping strategies and change in symptom severity in contamination-focused OCD patients during the COVID-19: a one-year follow-up

OBJECTIVE

To examine the relationship between coping strategies and the change in symptom severity in contamination-focused OCD patients during the COVID-19 pandemic over a one-year follow-up.

METHODS

In March 2020, a one-year follow-up study was initiated with 56 contamination-focused OCD patients in Turkey. Coping strategies were evaluated using the COPE scale. OCD symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at the beginning and end of the year. The Fear of COVID-19 Scale was administered mid-year.

RESULTS

One year post the onset of COVID-19, 68% of patients showed increased OCD symptom severity, while 32% displayed a decrease. Higher scores on the fear of COVID-19 scale and lower acceptance scores from COPE subscales were correlated with increased OCD symptom severity.

CONCLUSIONS

The COVID-19 pandemic has intensified OCD symptoms in a substantial proportion of patients, particularly those with heightened fears related to the pandemic, and reduced acceptance-based coping strategies. Tailored interventions emphasising adaptive coping mechanisms may benefit OCD patients in managing their symptoms during external stressors like pandemics.

Promoting salutogenic pathways to health through complementary and integrative health approaches

Health restoration and disease prevention are important strategies to achieve health and well-being. This Perspective provides a conceptual overview of the key concepts of salutogenesis (health restoration), chronic stress, resilience, and emotional well-being, and describes how they are distinct and interrelated. We posit, and demonstrate through scientific evidence, that complementary and integrative health approaches, including mind and body interventions, can be used to mitigate the effects of chronic stress and promote salutogenic pathways. Our goal is to identify research gaps and opportunities and suggest ways to advance the knowledge base for mechanistic and clinical research in this field.

Psychological mechanisms and neural correlates of trait mindfulness in emotion regulation: Testing a novel approach to the monitor and acceptance theory

Background

The ongoing mental health crisis warrants investigations to understand why trait mindfulness is associated with beneficial mental health outcomes. This study examined attention monitoring and acceptance as psychological mechanisms underlying the relationship between trait mindfulness and emotion regulation and connectivity between the dorsolateral prefrontal cortex (dlPFC) and posterior cingulate cortex (PCC) as a potential neural mechanism.

Methods

A cross-sectional study was conducted with 501 adult participants (age range: 17-79, M = 31, SD = 11.3) representing the general population. To assess emotion regulation and trait mindfulness, participants completed the Difficulties in Emotion Regulation Scale (DERS) and Five Facets Mindfulness Questionnaire (FFMQ). Resting-state functional MRI was acquired in a subsample of 20 participants to explore the role of dlPFC-PCC functional connectivity.

Results

Higher levels of acceptance, as measured using the Non-judging and Non-reactivity subscales of the FFMQ, were significantly associated with fewer overall emotion regulation difficulties and predicted all emotion regulation subscales. In contrast, higher levels of attention monitoring, measured using the Observe subscale, predicted only three DERS subscales and with mixed effects: higher emotional awareness and clarity, but greater difficulties in goal-directed behaviour. The interaction between monitoring and acceptance was not significant, and no correlation was found between these variables and dlPFC-PCC functional connectivity.

Conclusions

These findings challenge previous theories that argue that attention monitoring is crucial for effective emotion regulation. Instead, we conclude that acceptance is the key psychological mechanism, indicating that the traditional focus on attention monitoring in mindfulness training may be less effective than a primary emphasis on acceptance. This study provides a critical review of past research, highlighting issues with operationalising acceptance, and offers recommendations for future studies and practical implications for developing mindfulness interventions.

A brief nonattachment intervention based on the three marks of existence: development, rationale, and initial evidence

BACKGROUND

The practices described in Buddhist philosophy are essentially a suite of non-theistic cognitive and behavioral interventions designed to induce nonattachment (N-A), which can be defined in terms of the absence of a need for one's personal reality to be other than it is. Although meditative practices have received attention in multiple literatures, the cognitive analogs to these behaviorally-oriented practices have not.

DESIGN

Two experiments involving undergraduate participants (total N = 239; M age = 19.04) investigated whether the provision of wisdom related to the Three Marks of Existence (i.e., some degree of suffering is inevitable, there is impermanence, and many events are not in our control) could result in (1) higher nonattachment attitudes, (2) lower threat appraisals, (3) lower stressor reactivity, and (4) shorter emotion reaction durations.

RESULTS

With moderate to large effect sizes, the Three Marks trainings (relative to placebo or control conditions) resulted in (1) higher nonattachment attitudes, (2) lower threat appraisals, (3) no differences in negative emotional intensity, but 4) shorter emotion durations.

CONCLUSIONS

These results provide preliminary evidence that enduring cognitive trainings such as the Three Marks can be an effective tool to increase acceptance-related attitudes while attenuating negative reactivity.

Can heart rate variability demonstrate progression of mindfulness through two-week repeated practice?

Mindfulness could benefit on mental and physical health. Through repeated practice, progression of mindfulness could be found. Except for self-report questionnaires, heart rate variability (HRV) is a potential biomarker to demonstrate the effects of mindfulness. However, few studies focus on the changes in HRV which may vary through repeated practice. This study aims to explore whether HRV could demonstrate progression of mindfulness through repeated practice. 20 experienced practitioners and 26 novices were enrolled to practice two-week mindfulness and completed the Five Facet Mindfulness Questionnaire pre and post the training. ECG signals were collected by holter monitors, covering baseline to training and 9 HRV metrics were extracted. The results indicate that the experienced group showed significantly increased parasympathetic activity during mindfulness training and the effects were stable through repeated practice, while the novice group showed high cognitive load, with inconspicuous but probably progressive effects. The findings indicate that HRV could demonstrate progression of mindfulness through repeated practice, suggesting the possibility of assessing mindfulness based on HRV.

How do the mindfulness and sensory-behavioural-emotional aspects influence the painful experience related to temporomandibular disorder?

BACKGROUND

Chronic pain is persistent or recurrent pain lasting longer than 3 months. The experience of temporomandibular disorder (TMD)-related pain is modulated by emotional and social factors, with mindfulness encapsulating these aspects.

OBJECTIVE

To investigate the association between cognitive-behavioural-emotional characteristics, mindfulness and the painful experience in women with chronic pain-related TMD.

METHODS

A cross-sectional study was conducted, including 90 women aged between 18 and 61 years old, diagnosed with chronic pain-related TMD according to the Diagnostic Criteria for Temporomandibular Disorder, considering both temporomandibular joint and muscle pain. Specific instruments were employed to assess cognitive-behavioural-emotional aspects. The Mindful Attention Awareness Scale and the Five Facets of Mindfulness Questionnaire scales evaluated the level and construct of mindfulness. The relationship between variables was analysed using bivariate association tests (.05 > p < .20), followed by multiple regression tests (p < .05).

RESULTS

The heightened experience of pain correlated with increasing age, a low level of education, the attribution of the locus of control by chance, and lower levels of mindfulness (p < .05). The heightened experience of pain was negatively influenced by mindfulness levels (p < .05). On the other hand, the painful experience was mainly influenced by facets describing negative formulation, distraction, non-reactivity and non-judgement (p < .05).

CONCLUSION

Demographic, cognitive-behavioural-emotional data and levels of mindfulness and its facets presented different influence weights on the painful experience. These findings provide support for future studies focusing on mindfulness strategies, education and pain management in women with chronic pain-related TMD.

Unique and interactive effects of threat and deprivation on latent trait cortisol among emerging adults

Though considerable work supports the Dimensional Model of Adversity and Psychopathology, prior research has not tested whether the dimensions-threat (e.g., abuse) and deprivation (e.g., neglect)-are uniquely related to salivary trait indicators of hypothalamic pituitary adrenal (HPA) axis activity. We examined the unique and interactive effects of threat and deprivation on latent trait cortisol (LTC)-and whether these effects were modified by co-occurring adversities. Emerging adults (n = 90; Mage = 19.36 years; 99.88% cisgender women) provided salivary cortisol samples four times a day (waking, 30 min and 45 min postwaking, bedtime) over three 3-day measurement waves over 13 weeks. Contextual life stress interviews assessed early adversity. Though the effects varied according to the conceptualization of early adversity, overall, threat-but not deprivation, nor other co-occurring adversities-was uniquely associated with the across-wave LTC. Specifically, the incidence and frequency of threat were each negatively related to the across-wave LTC. Threat severity was also associated with the across-wave LTC, but only among those with no deprivation. Finally, the effects of threat were modified by other co-occurring adversities. Findings suggest that threat has unique implications for individual differences in HPA axis activity among emerging adults, and that co-occurring adversities modify such effects.

Comparing Transdiagnostic Risk Factors: Predicting Emergence of Significant Depressive, Anxiety, and Substance Abuse Symptoms Among Juvenile Delinquents

In a 7-year 11-wave study of low-SES adolescents (N = 856, age = 15.98), we compared multiple well-established transdiagnostic risk factors as predictors of first incidence of significant depressive, anxiety, and substance abuse symptoms across the transition from adolescence to adulthood. Risk factors included negative emotionality, emotion regulation ability, social support, gender, history of trauma, parental histories of substance abuse, parental mental health, and socioeconomic status. Machine learning models revealed that negative emotionality was the most important predictor of both depression and anxiety, and emotion regulation ability was the most important predictor of future significant substance abuse. These findings highlight the critical role that dysregulated emotion may play in the development of some of the most prevalent forms of mental illness.

Autonomic Modulation with Mindfulness-Based Stress Reduction in Chronic Kidney Disease: A Randomized Controlled Trial

Background

Chronic kidney disease (CKD) is characterized by overactivation of the sympathetic nervous system (SNS) that leads to increased cardiovascular disease risk. Despite the deleterious consequences of SNS overactivity, there are very few therapeutic options available to combat sympathetic overactivity.

Aim

To evaluate the effects of Mindfulness-Based Stress Reduction (MBSR) on SNS activity in CKD patients.

Method

Participants with CKD stages III-IV were randomized to an 8-week MBSR program or Health Education Program (HEP; a structurally parallel, active control group). Primary outcomes were direct intraneural measures of SNS activity directed to muscle (MSNA) via microneurography at rest and during stress maneuvers.

Results

28 participants (63 ±9 years; 86% males) completed the intervention with 16 in MBSR and 12 in HEP. There was a significant Group (MBSR vs. HEP) by Time (baseline vs. post-intervention) interaction in the change in MSNA reactivity to mental stress (p=0.026), with a significant reduction in the mean change in MSNA over 3 minutes of mental arithmetic at post-intervention (10.6 ± 7.1 to 5.0 ± 5.7 bursts/min, p<0.001), while no change was observed within the HEP group (p=0.773).

Conclusions

In this randomized controlled trial, patients with CKD had an amelioration of sympathetic reactivity during mental stress following 8-weeks of MBSR but not after HEP. Our findings demonstrate that mindfulness training is feasible and may have clinically beneficial effects on autonomic function in CKD.

A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers

BACKGROUND

Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs.

METHODS

This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes.

RESULTS

We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures.

CONCLUSIONS

Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03784846 . Registered on December 24th, 2018.

Managing emotions in the age of political polarization: A randomized controlled trial comparing mindfulness to cognitive reappraisal

Emotional appraisals of political stimuli (e.g., videos) have been shown to drive shared neural encoding, which correspond to shared, yet divisive, interpretations of such stimuli. However, mindfulness practice may entrain a form of emotion regulation that de-automatizes social biases, possibly through alteration of such neural mechanisms. The present study combined a naturalistic neuroimaging paradigm and a randomized controlled trial to examine the effects of short-term mindfulness training (MT) (n = 35) vs structurally equivalent Cognitive Reappraisal training (CT) (n = 37) on politically-situated emotions while evaluating the mechanistic role of prefrontal cortical neural synchrony. Participants underwent functional near-infrared spectroscopy (fNIRS) recording while viewing inflammatory partisan news clips and continuously rating their momentary discrete emotions. MT participants were more likely to respond with extreme levels of anger (odds ratio = 0.12, p < .001) and disgust (odds ratio = 0.08, p < .001) relative to CT participants. Neural synchrony-based analyses suggested that participants with extreme emotion reactions exhibited greater prefrontal cortical neural synchrony, but that this pattern was less prominent in participants receiving MT relative to CT (CT > MT; channel 1 ISC = .040, p = .030).

Effect of emotional freedom technique on the fear of childbirth in Iranian primiparous women: a randomized controlled trial

Background

Fear of childbirth is one of the main causes of women's emotional difficulty experienced in the perinatal period, especially those having their first child.

Objective

The aim of this study was to investigate the effect of emotional freedom technique (EFT) on the fear of childbirth among primiparous women in Ahvaz, Iran.

Materials and methods

This randomized clinical trial was conducted on 116 primiparous women. The participants were randomly divided into intervention (n = 58) or control (n = 58) groups. The intervention group received daily stimulation of certain points in their body for 12 weeks using EFT. The fear of childbirth was measured at the beginning of the study and 12 weeks after the intervention using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A) and at the first postpartum visit with WDEQ-B. Data were analyzed using independent t-test, paired t-test, Chi-square or Fisher's exact test, and analysis of covariance (ANCOVA).

Results

After intervention, the mean score of fear of childbirth in the intervention group decreased from 49.39 ± 8.21 to 40.42 ± 13.43 (p < 0.0001), while the same rate in the control group increased from 49.47 ± 9.06 to 52.09 ± 7.73 (p = 0.002). The mean score of fear of childbirth after delivery in the control group (45.88 ± 7.10) was higher than that in the intervention group (27.13 ± 5.08) (p < 0.0001).

Conclusion

Based on the findings of this study, EFT can be considered as an effective method to reduce the fear of childbirth score in primiparous women.

Testing the monitor and acceptance theory: the role of training-induced changes in monitoring- and acceptance-related capacities after attention-based, socio-emotional, or socio-cognitive mental training in reducing cortisol stress reactivity

Mindfulness-based interventions have become a popular means to reduce stress. However, the specific mechanisms driving observed stress reduction remain understudied. The Monitor and Acceptance Theory suggests that the cultivation of monitoring and acceptance skills are necessary moderators of practice-induced stress reduction. In the context of the ReSource Project, a large healthy adult sample underwent three 3-month mental training modules targeting either attentional (Presence module), socio-affective (Affect module) or socio-cognitive skills (Perspective module). In the current study, the development of a range of inter-individual differences in mindfulness-, interoception- and compassion-related traits - which mapped to either monitoring or acceptance categories - was tracked. The relationship of these training-induced changes with cortisol stress reactivity after the three distinct 3-month training modules was explored. We found that stress sensitivity was particularly modulated by a differential adaptivity of one cultivated attentional capacity - Attention regulation - which predicted higher cortisol reactivity after mere attention training (Presence) but was associated with lower stress-induced cortisol release after additional socio-affective and socio-cognitive practice (Affect and Perspective). However, this effect did not survive multiple comparisons correction, and analyses were limited by the sample size available. We conclude that our study provides preliminary support of the Monitor and Acceptance Theory, lending weight to the advantage of primary attentional increases in order to fully harness the beneficial effects of socio-affective training, ultimately leading to stress reduction. Although training-induced increases in acceptance were not directly shown to contribute to lowering cortisol stress reactivity, the data suggest an additional benefit of socio-affective and socio-cognitive training that is not directly captured within the current analyses. Our study corroborates the importance of going beyond the training of attention monitoring to foster stress resilience, and highlights that mental training relies on the co-development of several interacting processes to successfully attenuate stress. Further exploring the overarching concept of acceptance in future research may prove beneficial to the theoretical framework of MAT, and in understanding the processes by which stress reduction occurs.

Trait Mindfulness in Psychotic Disorders: Dimensions Predicting Symptoms, Cognition, and Functional Outcome

Mindfulness-based treatments are efficacious for psychotic disorders (PD). However, which components of mindfulness (i.e., attentive monitoring and nonjudgmental acceptance) are most relevant treatment targets is unclear. Further, there is a dearth of literature examining clinical correlates of mindfulness in people with PD. The present study aimed to examine group differences and clinical correlates of mindfulness in people with PD. We hypothesized that PD would report lower monitoring and acceptance than CN and that mindfulness components would be associated with symptoms including dysfunctional beliefs, alexithymia, neurocognitive ability, positive symptoms, and mood symptoms. Groups included individuals with PD (n = 54) and nonpsychiatric controls (n = 55). Participants completed self-report measures of mindfulness and related constructs and clinical interviews of symptoms. Results of ANOVA models indicated that global mindfulness was lower in PD relative to CN, with greatest differences evident for acceptance in the affective psychosis group. Regression models found that greater monitoring was associated with improved neurocognitive performance, while acceptance was associated with lower defeatist beliefs, alexithymia, and depression/anxiety symptoms. Results highlight the importance of targeting acceptance in the psychosocial treatment of PDs, especially for those with mood symptoms.

Emotion regulation tendencies and cardiovascular responses to repeated acute psychological stress

Poor emotion regulation has been associated with cardiovascular disease (CVD) through maladaptive cardiovascular responses to psychological stress. However, there has been scant research examining the relationship between emotion regulation and habituation of cardiovascular responses to recurrent stress, which may be more directly applicable to the experience of stress in everyday life. The aims of the current study were to examine the associations between emotion regulation tendencies and cardiovascular stress reactivity, as well as habituation of cardiovascular reactivity across repeated stressors. A sample of 453 participants (mean (SD) age = 19.5 (1.3) years; 62 % women) completed a repeated stress paradigm, which consisted of two 10-minute baselines and two identical 4-minute stress tasks, separated by a 10-minute recovery period. Heart rate (HR) was measured continuously; systolic/diastolic blood pressures (SBP/DBP) were measured every 2 min. At the end of the visit, participants completed the Emotion Regulation Questionnaire (ERQ) and Difficulties in Emotion Regulation Scale (DERS). Results indicate that impulse control difficulties when distressed (a DERS subscale) were significantly associated with blunted SBP, DBP, and HR reactivity to both stressors, as well as impaired HR habituation across the stressors. None of the ERQ subscales (cognitive reappraisal, expressive suppression) were found to be associated with cardiovascular stress reactivity or habituation. The outcomes of this study demonstrate a potential underlying physiological pathway through which impulse control difficulties when distressed may contribute to CVD risk. This study also reveals the importance of extending traditional cardiovascular stress reactivity protocols to include multiple exposures of the same stress task.

The Mind Body Connection in Dermatologic Conditions: A Literature Review

Psychodermatology pertains to the relationship between the skin and brain. This review aims to summarize the evidence of the mind body connection in four psychophysiological conditions: rosacea, atopic dermatitis (AD), acne vulgaris (AV), and psoriasis. A literature search was conducted using several English language databases. All four conditions share similar psychiatric co-morbidities, including but not limited to anxiety, depression, and suicidality. In rosacea, the upregulation of transient receptor potential vanilloid type 1, Toll like receptor 2, and Th17 cells releases downstream products that are simultaneously implicated in mood disorders. Stress exacerbates AV through the hypothalamic-pituitary-adrenal (HPA) system, which alters functioning of sebocytes and Cutibacterium acnes. In AD and psoriasis, the HPA axis influences Th1, Th2, Th22, and Th1, Th17 immune mediated responses, respectively. This leads to the secretion of pro-inflammatory cytokines which are also involved in the pathogenesis of anxiety and depression. Neurotransmitters implicated in mental illness, such as gamma-aminobutyric acid and serotonin, may also play a role in the development of AD and psoriasis. The management of cutaneous disease may mitigate psychological distress, and future research may show the corollary to also be true.

Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions

This review provides an overview of the most prominent neurocognitive effects of cognitive bias modification (CBM), cue-exposure therapy and mindfulness interventions for targeting addictive responses. It highlights the key insights that have stemmed from cognitive neuroscience and brain imaging research and combines these with insights from behavioural science in building a conceptual model integrating mindfulness with response-focused CBM or cue-exposure interventions. This furthers our understanding of whether and how mindfulness strategies may i) facilitate or add to the induced response-focused effects decreasing cue-induced craving, and ii) further weaken the link between craving and addictive responses. Specifically, awareness/monitoring may facilitate, and decentering may add to, response-focused effects. Combined awareness acceptance strategies may also diminish the craving-addiction link. The conceptual model presented in this review provides a specific theoretical framework to deepen our understanding of how mindfulness strategies and CBM or cue-exposure interventions can be combined to greatest effect. This is important in both suggesting a roadmap for future research, and for the further development of clinical interventions.

Psychophysiological stress response after a 6-week Mindful Self-Compassion training in psychiatric rehabilitation inpatients: a randomized post-test only study

Objectives

Mindfulness-based interventions (including self-compassion interventions) are effective in improving stress management at psychological and physical levels. Mindful Self-Compassion (MSC) is a newly developed program particularly aimed at increasing self-compassion. The main objective of this study was to determine whether the psychophysiological stress response during a social-evaluative speaking task differs in inpatients participating in the MSC or the Progressive Muscle Relaxation (PMR) program at the end of their 6-week psychiatric rehabilitation stay (i.e., post-test only design).

Method

Data from 50 inpatients (25 MSC, 25 PMR, 35 female) aged 19 to 76 years (M = 47.22, SD = 12.44) were analyzed in terms of psychophysiological stress response. For this purpose, heart rate variability, heart rate, and blood pressure were assessed together with several psychometric variables: positive and negative affect (PANAS), subjective stress perception (Visual Analog Scale), self-compassion (Self-Compassion Scale), cognitive reappraisal and suppression (Emotion Regulation Questionnaire), psychological distress (Brief Symptom Inventory-18), and appraisal and rumination (selected items).

Results

After correction for alpha inflation no differences in the psychophysiological stress response and psychometric parameters between the MSC and PMR group were found.

Discussion

In general, our results indicate that MSC is not superior to PMR training. However, more research with clinical randomized controlled trials investigating larger samples are needed to further affirm these initial findings.

Effect of brief mindfulness and relaxation inductions on anxiety, affect and brain activation in athletes

The mindfulness-based intervention and psychological skills training are often used for maintaining the mental health or reducing undesirable mental states in athletes. However, their differences in acute effects on mental health and underlying neural mechanism are not well understood. Therefore, the purpose of the current study was to examine the differential effects of brief mindfulness induction (MI) and relaxation induction (RI) on state anxiety, affect and brain activation. Thirty-five track and field athletes were recruited for this study. Using a within-subjects crossover design, participants underwent three conditions that incorporated two 30-min experimental conditions (i.e., MI or RI) and a control condition. State anxiety and affect were assessed before and after intervention, and brain activation (i.e., theta, alpha bands) were recorded by electroencephalography (EEG) during each 30-min condition. Repeated measures analysis of variance revealed that MI and RI similarly reduced state anxiety and negative affect from pre-test to post-test compared to the control condition. In terms of positive affect, there were no significant differences among the three conditions across times. Furthermore, participants exhibited higher frontal theta power during the MI and RI than control condition, whereas no differences in alpha power were observed among conditions. The current study provides initial evidence from an electrophysiological perspective that brief MI and RI both improve the negative psychological states in individual sport athletes through similar neural mechanisms. Nevertheless, the moderating effects of training experiences and long-term interventions on mental state and EEG activity in athletes need further investigation in future studies.

A Pilot Open Trial of a Digital Mindfulness-Based Intervention for Anorexia Nervosa

Anorexia nervosa (AN) is a chronic and debilitating psychiatric disorder. Unfortunately, current treatments are lacking, with only 30-50% of individuals with AN recovering after treatment. We developed a beta-version of a digital mindfulness-based intervention for AN called Mindful Courage-Beta, which includes: (a) one foundational multimedia module; (b) 10 daily meditation mini-modules; (c) emphasis on a core skill set called the BOAT (Breathe, Observe, Accept, Take a Moment); and (d) brief phone coaching for both technical and motivational support. In this open trial, we aimed to evaluate (1) acceptability and feasibility; (2) intervention skill use and its association with state mindfulness in daily life; and (3) pre-to-post changes in target mechanisms and outcomes. Eighteen individuals with past-year AN or past-year atypical AN completed Mindful Courage-Beta over 2 weeks. Participants completed measures of acceptability, trait mindfulness, emotion regulation, eating disorder symptoms, and body dissatisfaction. Participants also completed ecological momentary assessment of skill use and state mindfulness. Acceptability ratings were good (ease-of-use: 8.2/10, helpfulness: 7.6/10). Adherence was excellent (100% completion for foundational module and 96% for mini-modules). Use of the BOAT in daily life was high (1.8 times/day) and was significantly associated with higher state mindfulness at the within-person level. We also found significant, large improvements in the target mechanisms of trait mindfulness (d = .96) and emotion regulation (d = .76), as well as significant, small-medium to medium-large reductions in eating disorder symptoms (ds = .36-.67) and body dissatisfaction (d = .60). Changes in trait mindfulness and emotion regulation had medium-large size correlations with changes in global ED symptoms and body dissatisfaction (rs = .43 - .56). Mindful Courage-Beta appears to be promising and further research on a longer, refined version is warranted.

Validation of online mindfulness-enhanced course for stress reduction in teachers

Background

Mindfulness-based interventions have gained popularity as a means of reducing stress and increasing resilience among the preclinical population. The present study aimed to investigate the effects of an online mindfulness-enhanced course on stress reduction in teachers, especially since online learning and teaching have been frequently applied to respond to emergencies such as COVID-19-relevant school suspension.

Methods

The study consisted of two phases. Phase 1 aimed to explore the relationship between teachers' perceived stress and mindfulness traits. In total of 6,252 teachers completed assessments of stress symptoms using the Chinese Perceived Stress Scale (CPSS) and occupational stress sources, as well as mindfulness using the Five Factor Mindfulness Questionnaire (FFMQ). Phase 2 aimed to examine the effectiveness of the online mindfulness-enhanced course. In total of 132 teachers were randomly assigned to either receive a 3-week online mindfulness course specifically designed for stress reduction and emotion regulation (N = 66) or a matched active control group (N = 66) and their pre-training and post-training self-reported states (e.g., perceived stress, mindfulness level, practice time) were measured.

Results

The detection rate of Health Risk Stress (≥26 scores) was as high as 61.72%, and a negative association between the score of FFMQ and perceived stress level was found. Importantly, compared to the control group, the mindfulness training group showed a significant decrease in perceived stress and negative emotion, as well as an increase in understanding of the core mechanisms of mindfulness after training. Additionally, individual improvement in FFMQ scores was predicted by practice time.

Conclusions

The study showed a high percentage of teachers experiencing stress, and the data supported the reliability and validity of the brief online mindfulness-enhanced course designed to reduce stress and regulate emotion for frontline teachers.

Mindfulness Initiatives for Students, Teachers, and Parents: a Review of Literature and Implications for Practice During COVID-19 and Beyond

The use of mindfulness in schools has greatly expanded over the past 10 years. Research has demonstrated positive psychological effects of mindfulness for students as well as teachers (Emerson et al., Mindfulness 8:1136-1149, 2017; Semple et al., Psychology in the Schools 54:29-52, 2017). Similarly, studies focusing on mindfulness interventions for parents of children with disabilities and/or psychosocial difficulties have also yielded a variety of positive outcomes, including reduced parenting stress, increases in quality of life, and improved parent-child interactions (Bögels et al., 2016; Rayan and Ahmad, Research in Developmental Disabilities 55:185-196, 2016). Although there has been a proliferation of mindfulness research, and mindfulness has become a buzzword in popular culture, it has not been systematically examined or applied as an approach to improving psychosocial functioning in children, school personnel, and families during COVID-19 and in online settings. This article provides a preliminary framework for this examination by reviewing relevant research and providing practical strategies and resources for school psychologists.

Cardiovascular stress reactivity, habituation, and adiposity

The relationship between adiposity and cardiovascular disease morbidity and mortality is complex. One pathway through which adiposity may influence future health outcomes is by altering how biological systems respond to stress. The current study aimed to examine the association between two metrics of adiposity (body mass index and waist-hip ratio) and two indices of cardiovascular stress responses (reactivity and habituation). A sample of 455 participants (Mean age = 19.47, SD = 1.25 years; BMI = 24.32, SD = 5.04 kg/m² ; 62% female; 17.9% Hispanic/Latino; 65.2% White, 18.7% Asian, 7.9% Black, 0.2% American Indian/Alaska Native, and 7% other) completed two acute psychosocial stress tasks. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded throughout each stressor. In unadjusted and adjusted models, there were no statistically significant associations between adiposity and HR, SBP, or DBP stress reactivity or habituation. The current data do not support the hypothesis that adiposity influences health by altering cardiovascular responses to acute psychological stress. Results are at odds with prior population-level studies and the single prior study examining adiposity and habituation. At the same time, results are in line with mounting evidence that adiposity itself does not drive poor cardiovascular outcomes seen in people classified as overweight or obese.

Cortisol and cardiometabolic disease: a target for advancing health equity

Stress, in both intrinsic psychosocial and extrinsic physical environmental forms, can impact the development of, and outcomes in, cardiovascular disease (CVD) through allostatic load. Cortisol is a core hormonal mediator of allostatic load produced in response to various stresses. Alterations in morning serum cortisol and daily diurnal cortisol have been associated with adiposity, dyslipidemia, incident diabetes, and CVDs such as hypertension. The review examines the role of cortisol as a key mechanistic link between stress physiology and cardiometabolic disease. Importantly, we discuss the role of targeting cortisol through pharmacological, behavioral, and environmental interventions to advance health equity in cardiometabolic disease.

App-based mindfulness meditation reduces perceived stress and improves self-regulation in working university students: A randomised controlled trial

We investigated whether a brief mindfulness meditation programme delivered via a smartphone app improves perceived stress, self-regulation and life satisfaction in part-time working university students. Mindfulness and cognitive reappraisal were analysed as potential mediators. A total of 64 university students working at least 20 h per week during the semester were randomised to either a mindfulness-based mobile intervention or a wait-list control condition. Participants in the intervention group were asked to complete one training session of 10-15 min per day using the app. Psychological measures were assessed via a self-report questionnaire at baseline and after 8 weeks. The online mindfulness programme was found to significantly decrease perceived stress (η_p ²  = .180, a large effect). It also increased self-regulation (η_p ²  = .195, a large effect), mindfulness (η_p ²  = .174; a large effect) and cognitive reappraisal (η_p ²  = .136, a medium effect). Increments in life satisfaction were not significant. Changes in self-regulation were mediated by increased mindfulness. Overall, the mobile application was effective in improving mental well-being and coping abilities in a non-clinical sample, encouraging further development of digital health treatments.

Electrophysiological correlates of mindfulness in patients with major depressive disorder

Objectives

Mindfulness-based interventions (MBI) can reduce both stress and depressive symptoms. However, the impact of mindfulness on stress level in depressed subjects remains unclear. This study aims to assess electrophysiological correlates of mindfulness in patients with major depressive disorder (MDD) at baseline, under stress exposure, and in relaxation following stress exposure.

Methods

Perceived mindfulness was assessed with the Freiburger Mindfulness Inventory (FMI) in 89 inpatients (mean age 51) with MDD [mean Beck Depression Inventory (BDI) 30]. Electrophysiological parameters [resting heart rate (RHR), heart rate variability (HRV), respiration rate, skin conductance, and skin temperature] were recorded at 5-min baseline, 1-min stress exposure, and 5-min self-induced relaxation.

Results

Freiburger Mindfulness Inventory was strongly inversely correlated with symptom severity measured by BDI (r = –0.53, p < 0.001). No correlations between FM score and electrophysiological parameters in any of the three conditions (baseline, stress exposure, relaxed state) could be found. The factor openness was associated with higher VLF (very low frequency of HRV) in the baseline condition. However, this correlation was no more significant after regression analysis when corrected for respiratory rate, age, and sex.

Conclusion

Autonomous nervous reactivity in depression was not associated with perceived mindfulness as measured by FMI score and presented electrophysiological parameters, despite the strong inverse correlation between state mindfulness and symptom severity.

A common factors perspective on mindfulness-based interventions

Mindfulness-based interventions (MBIs) have entered mainstream Western culture in the past four decades. There are now dozens of MBIs with varying degrees of empirical support and a variety of mindfulness-specific psychological mechanisms have been proposed to account for the beneficial effects of MBIs. Although it has long been acknowledged that non-specific or common factors might contribute to MBI efficacy, relatively little empirical work has directly investigated these aspects. In this Perspective, I suggest that situating MBIs within the broader psychotherapy research literature and emphasizing the commonalities rather than differences between MBIs and other treatments might help guide future MBI research. To that end, I summarize the evidence for MBI efficacy and several MBI-specific psychological mechanisms, contextualize MBI findings within the broader psychotherapy literature from a common factors perspective, and propose suggestions for future research based on innovations and challenges occurring within psychotherapy research.

Understanding familial liability for emotion regulation difficulties in bipolar disorder

BACKGROUND

There has been relatively limited work focused on understanding whether relatives of individuals with bipolar disorder (BD) have difficulties in the regulation of emotion, particularly in relation to perceptions about whether emotions can be effectively regulated, or trait behaviours that acknowledge emotions as self-regulators themselves. In this study, we assessed the presence and extent of difficulties in these dimensions of emotion regulation in individuals with BD compared to unaffected first-degree biological relatives (FDR) for the first time.

METHODS

In total, 161 participants, including euthymic individuals with BD, unaffected FDRs, and healthy controls, were compared on the Difficulties in Emotion Regulation Scale (DERS) - a multi-dimensional measure of habitual emotion regulation. Clinical data were also collected and examined in relation to DERS scores in a secondary analysis.

RESULTS

In the BD group, difficulties were evident for most dimensions of emotion regulation as measured by the DERS; and correlated with an earlier onset of illness and more mood episodes. FDRs displayed generally normal emotion regulation, except in terms of their beliefs that emotions can be effectively regulated; on this dimension, their reported difficulty was intermediate to the BD group and controls.

CONCLUSION

Habitual emotion regulation difficulties in BD persist irrespective of mood state, are related to the course of illness, and should be targeted in psychological interventions. Further, the perception that emotions cannot be effectively regulated during times of distress seems to represent an endophenotype for BD.

Self-compassion, Mindfulness, Stress, and Self-esteem Among Vietnamese University Students: Psychological Well-being and Positive Emotion as Mediators

Objectives

Theory and prior research suggest that improving self-esteem is a promising way to improve students’ academic performance and mental health. This study empirically examines the mediating effect of psychological well-being and positive emotion in the relationships between self-compassion, mindfulness, stress, and self-esteem.

Methods

An explanatory sequential mixed-method design was employed. Quantitative data collected through a two-wave survey from 654 Vietnamese students were analyzed to test the hypotheses using SPSS 22.0 and AMOS 24.0. Data from 19 in-depth interviews were used to explain the quantitative findings and explore students’ experiences in practicing mindfulness and self-compassion.

Results

Findings revealed that psychological well-being and positive emotion fully mediated the relationships between self-compassion, mindfulness, stress, and self-esteem.

Conclusions

Results of this study highlight the importance of psychological well-being and positive emotion in the self-compassion, mindfulness, stress, and self-esteem relationship, as well as explain a possible process by which factors help university students achieve and sustain a sense of high self-esteem. Ultimately, this study has identified several potential targets for intervention strategies in mental health, such as mindfulness and self-compassion among university students.

Within-Person variations in mindfulness mediate effects of daily stressors on psychological distress in adolescence

OBJECTIVE

We tested two competing models linking daily stress, mindfulness, and psychological distress in adolescence: 1) whether daily mindfulness moderates the impact of daily stressors on psychological distress or 2) whether mindfulness mediates the relationship between greater daily stressors and psychological distress.

METHODS

Every evening for a week, 138 adolescents completed ecological momentary assessments (EMAs). Daily diaries assessed negative events, work-school conflict, mindfulness, and perceived stress. Multilevel mediation and moderation were tested.

RESULTS

Results indicated that there were meaningful variations in adolescent mindfulness from day-to-day, and supported mediation rather than moderation; the within-person association between stressors and psychological distress was mediated by mindfulness at the daily level.

CONCLUSION

It may be too challenging for adolescents to remain in a mindful state during stress to effectively use mindfulness as a buffer. Instead, daily stressors may indirectly impact psychological distress through decreasing mindfulness.

Investigating the impact of distinct contemplative mental trainings on daily life stress, thoughts and affect-Evidence from a nine-month longitudinal ecological momentary assessment study

Mindfulness-based mental training interventions have become a popular means to alleviate stress and stress-associated health risks. Previous scientific investigations emphasize the importance of exploring the effects of such interventions in naturalistic settings to evaluate their implementation into daily life. Therefore, the current study examined the effects of three distinct mental training modules on a range of measures of daily life experience in the scope of the ReSource Project, a 9-month longitudinal mental training study comparing modules targeting attention and interoception (Presence), socio-affective (Affect) or socio-cognitive abilities (Perspective). We used ecological momentary assessment (EMA) to repeatedly probe levels of stress and stress-coping efficacy combined with stress-reactive cortisol levels, and further explored arousal, affective states, and thought patterns in the daily lives of 289 healthy adults (172 women; 20-55 years). We found increased presence-focused thought and heightened arousal after a training duration of 3-6 months, independent of the type of prior training. Increased coping efficacy emerged specifically after socio-cognitive Perspective training, following 6-9 months of training duration. No training effects were found for subjective stress, stress-reactive cortisol levels, or daily life affect. Our findings corroborate and add ecological validity to previous ReSource findings by showing that they replicate in participants' everyday environment. Regarding endocrine and subjective stress markers, our results suggest caution in generalizing acute laboratory findings to individuals' everyday routines. Overall, the current study provides substantiated insights into how cultivating one's mind through contemplative mental training translates to daily life experience, enhances stress-coping, and may ultimately aide in maintaining health.

Mindfulness-based stress reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial

Loneliness is a potent psychosocial stressor that predicts poor health and mortality among older adults, possibly in part by accelerating age-related declines in immunocompetence. Mindfulness interventions have shown promise for reducing loneliness and improving markers of physical health. In a sample of lonely older adults, this two-arm parallel trial tested whether mindfulness training enhances stimulated interleukin-6 (IL-6) production, a measure of innate immune responsivity. Lonely older adults (65-85 years; N = 190) were randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) or control Health Enhancement Program (HEP) intervention. Lipopolysaccharide (LPS)-stimulated production of IL-6 was measured in vitro by blinded outcome assessors at pre-intervention, post-intervention, and 3-month follow-up. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR vs. HEP) effects. As predicted, a significant time × condition effect on stimulated IL-6 production was observed across pre, post, and follow-up timepoints. Significant MBSR vs. HEP differences emerged from pre- to post-intervention (p =.009, d = 0.38) and from pre-intervention to 3-month follow-up (p =.017, d = 0.35), with larger increases in IL-6 production following MBSR compared to HEP. No study-related adverse events were reported. Results show that mindfulness training may be effective for boosting innate immunocompetence among lonely older adults. Given that immunocompetence tends to decline with age, mindfulness training may help to counteract the effects of aging and psychosocial stress on infection risk and recovery from injury.

Perceived Stress Mediates the Relationship Between Trait Mindfulness and Physical Symptoms of Stress: a Replication Study Using Structural Equation Modeling

Objectives

The mindfulness stress buffering account posits mindfulness may benefit physical health by reducing stress. Previous research supports this account and suggests the non-judging facet of mindfulness may be most strongly associated with physical symptoms of stress, via lower perceived stress. The current replication study used structural equation modeling to analyze relationships between multiple facets of mindfulness, perceived stress, and physical symptoms of stress.

Methods

Undergraduate students (n = 534, 68% White, 65% female) completed surveys measuring trait mindfulness (Five Facet Mindfulness Questionnaire—Short Form), perceived stress (Perceived Stress Scale), and physical symptoms of stress (Cohen-Hoberman Inventory of Physical Symptoms).

Results

As hypothesized, results showed the negative relationship between four facets of mindfulness (describing, non-judging, non-reactivity, and acting with awareness) and physical symptoms of stress was partially mediated by lower perceived stress. Observing, however, was associated with more physical symptoms of stress.

Conclusions

The current findings successfully replicated the results of two previous studies in an independent sample, using a more parsimonious analytic strategy that included all variables in a single path model. Results confirm the stress-buffering effect of trait mindfulness, particularly non-judging. Future research may test whether changes in trait mindfulness, particularly non-judging, explain individual differences in objective measures of stress and physical health.

Smartphone mindfulness meditation training reduces Pro-inflammatory gene expression in stressed adults: A randomized controlled trial

Mindfulness meditation training has been shown to be an effective stress reduction strategy, but less is known about its immunoregulatory impact. In a randomized controlled trial of stressed customer service workers, the present study tested whether a 30-day smartphone-based mindfulness meditation training program (compared to a problem-solving control program) would affect pro-inflammatory gene expression. Both interventions led to reductions in stress levels, but there was no difference in stress reduction between conditions. Consistent with predictions, mindfulness training reduced activity of the pro-inflammatory NF-κB transcription control pathway compared to the active control. These results suggest that mindfulness training may be a particularly effective method for improving immune cell gene expression in stressful work environments.

Emphasizing mindfulness training in acceptance relieves anxiety and depression during pregnancy

Mindfulness intervention, which trains participants to monitor momentary experiences with an accepting attitude, is effective for reducing maternal anxiety and depression. Monitoring and acceptance are two central components of mindfulness training. The aim of the study is to clarify whether adding acceptance component to monitoring training can help improve the mental health of pregnant people by comparing the effects between mindfulness training on monitoring with an emphasis on acceptance training and training on monitoring alone. Pregnant people with depressive or anxious symptoms (N = 149) were randomized to either a 4-week online intervention of (1) monitoring training (MT), (2) monitoring with an emphasis on acceptance training (MAT), or (3) emotional regulation course conditions as an active control group. All mindfulness training was based on the WeChat platform. We used the Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), Five Facets of Mindfulness Questionnaire (FFMQ), and Regulatory Emotional Self-Efficacy Scale (RESE) to evaluate symptoms of anxiety and depression, mindfulness monitoring and acceptance skills, and the self-efficacy of emotional regulation pre-and postintervention. Of the 149 people enrolled in this study, 10 in the MT training group, 9 in the MAT group, and 15 in the control group did not complete the intervention. Monitoring with an emphasis on acceptance training significantly reduced symptoms of anxiety and depression and improved perceived self-efficacy in managing depression/distress compared with the monitoring training alone and the control group. In addition, participants in the monitoring group showed a downward trend in GAD-7 scores and an upward trend in scores of perceived self-efficacy in managing anger/irritation. This study not only shows that the 4-week online mindfulness training could be a promising technique to help people improve mental health; moreover, it provides evidence that emphasizing acceptance skills on mindfulness training may play a critical role because of its positive effects. We suggest that the online mindfulness intervention should be added as part of psychological care and recommend emphasizing acceptance training during pregnancy.