Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference

The role of endogenous opioids in mindfulness and sham mindfulness-meditation for the direct alleviation of evoked chronic low back pain: a randomized clinical trial

Chronic low back pain (cLBP) is the most prevalent chronic pain condition. There are no treatments that haven been found to directly assuage evoked cLBP. To this extent, mindfulness-meditation is a promising pain therapy. Yet, it is unclear if meditation can be utilized to directly attenuate evoked chronic pain through endogenous opioids. A double-blind, randomized, and placebo-controlled clinical trial with a drug crossover design examined if mindfulness-meditation, as compared to sham mindfulness-meditation, attenuated straight leg-raise test evoked chronic pain during intravenous (0.15 mg/kg bolus + 0.15 mg/kg/hour maintenance) naloxone (opioid antagonist) and placebo-saline infusion. Fifty-nine individuals with cLBP (mean age = 46 years; 30 females) completed all study procedures. After the pre-intervention pain testing session, patients were randomized to a four-session (20-min/session) mindfulness (n = 30) or sham mindfulness-meditation (n = 29) intervention. After the interventions, mindfulness and sham mindfulness-meditation were associated with significant reductions in back pain during saline and naloxone infusion when compared to rest (non-meditation) in response to the cLBP-evoking straight leg-raise test. These results indicate that meditation directly reduces evoked chronic pain through non-opioidergic processes. Importantly, after the interventions, the mindfulness group reported significantly lower straight leg-raise induced pain than the sham mindfulness-meditation group during rest (non-meditation) and meditation. Mindfulness and sham mindfulness-meditation training was also associated with significantly lower Brief Pain Inventory severity and interference scores. The pain-relieving effects of mindfulness meditation were more pronounced than a robust sham-mindfulness meditation intervention, suggesting that non-reactive appraisal processes may be uniquely associated with improvements in chronic low-back pain.Trial Registration: ClinicalTrials.gov identifier: NCT04034004.

Cultivating Self-Transcendence Through Meditation Practice: A Test of the Role of Meta-Awareness, (Dis)identification and Non-Reactivity

In this paper, we present a study comprising two distinct stages to examine the extent to which metacognitive processes of decentering facilitate the emergence of self-transcendence experiences in everyday life (i.e., the frequency of self-transcendent emotions, flow proneness, and adopting an interconnected identity). In the course of conducting this research, the first stage (N = 374) focused on assessing the structure and validity of the French version of the Metacognitive Processes of Decentering Scale (MPoD-t). Building on this, the second stage (N = 294) examined the potential relationship between meditative practices and psychological decentering processes (i.e., meta-awareness, (dis)identification with internal experiences, and (non)reactivity to thought content) and explored whether these mechanisms explain the association between meditative practices and the experience of self-transcendent states. Overall, the results demonstrated satisfactory psychometric properties of the French version of the MPoD and provided enhanced insights into the distinct mediating roles played by various decentering components in the manifestation of self-transcendence experiences in daily life. Indeed, the findings revealed that the relationship between practice and the occurrence of self-transcendent emotions or flow was mediated by the meta-awareness component, while the association between practice and the development of an interconnected identity was explained by the (dis)identification with internal experiences component. The implications of these findings are discussed.

Mindfulness Affects the Boundaries of Bodily Self-Representation: The Effect of Focused-Attention Meditation in Fading the Boundary of Peripersonal Space

Peripersonal space (PPS) is a dynamic multisensory representation of the space around the body, influenced by internal and external sensory information. The malleability of PPS boundaries, as evidenced by their expansion after tool use or modulation through social interactions, positions PPS as a crucial element in understanding the subjective experiences of self and otherness. Building on the existing literature highlighting both the cognitive and bodily effects of mindfulness meditation, this study proposes a novel approach by employing focused-attention meditation (FAM) and a multisensory audio-tactile task to assess PPS in both the extension and sharpness of its boundaries. The research hypothesis posits that FAM, which emphasizes heightened attention to bodily sensations and interoception, may reduce the extension of PPS and make its boundaries less sharp. We enrolled 26 non-meditators who underwent a repeated measure design in which they completed the PPS task before and after a 15-min FAM induction. We found a significant reduction in the sharpness of PPS boundaries but no significant reduction in PPS extension. These results provide novel insights into the immediate effects of FAM on PPS, potentially shedding light on the modulation of self-other representations in both cognitive and bodily domains. Indeed, our findings could have implications for understanding the intricate relationship between mindfulness practices and the subjective experience of self within spatial contexts.

Mindfulness and time perception: A systematic integrative review

Several recent studies have explored the relationships between mindfulness and time perception, an area of research that has become increasingly popular in the last 10-15 years. In this article, we present a systematic integrative review of the evidence on this subject. We also integrate the field's findings into a conceptual framework which considers the multifaceted nature of both mindfulness, and time perception research. To identify the relevant literature, we searched the following databases using relevant keywords: PsycINFO; Medline; EBSCO Host Psychology and Behavioral Sciences Collection; and Web of Science. These searches were last performed on the 4th of May 2022, and additional hand searches were also conducted. To be included, articles had to be in English and contain original data about the potential relationship(s) between mindfulness and time perception. Articles which did not present usable data about the relationship(s) between the variables of interest were excluded. In total, 47 research articles were included in the review (combined sample size of ∼5800 participants). Risks of bias in the selected studies were evaluated using two separate assessment tools designed for this purpose. Through an integrative narrative synthesis, this article reviews how mindfulness may relate to time perception for various reference frames, and for various time perception measures and methods. It also provides new insights by exploring how a wide range of findings can be integrated into a coherent whole, in light of some relevant time perception models and mindfulness theories. Altogether, the reviewed data suggest the existence of complex and multifaceted relationships between mindfulness and time perception, highlighting the importance of considering many factors when planning research or interpreting data in this field. Limitations of the current review include the scarceness of data for certain categories of findings, and the relatively low prevalence of studies with a randomized controlled design in the source literature. This research was partly funded by a grant from the Natural Science and Engineering Research Council of Canada.

Neurophysiological brain function predicts response to cognitive rehabilitation and mindfulness in multiple sclerosis: a randomized trial

BACKGROUND

Cognitive treatment response varies highly in people with multiple sclerosis (PwMS). Identification of mechanisms is essential for predicting response.

OBJECTIVES

This study aimed to investigate whether brain network function predicts response to cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT).

METHODS

PwMS with cognitive complaints completed CRT, MBCT, or enhanced treatment as usual (ETAU) and performed three measurements (baseline, post-treatment, 6-month follow-up). Baseline magnetoencephalography (MEG) measures were used to predict treatment effects on cognitive complaints, personalized cognitive goals, and information processing speed (IPS) using mixed models (secondary analysis REMIND-MS study).

RESULTS

We included 105 PwMS (96 included in prediction analyses; 32 CRT, 31 MBCT, 33 ETAU), and 56 healthy controls with baseline MEG. MEG did not predict reductions in complaints. Higher connectivity predicted better goal achievement after MBCT (p = 0.010) and CRT (p = 0.018). Lower gamma power (p = 0.006) and higher connectivity (p = 0.020) predicted larger IPS benefits after MBCT. These MEG predictors indicated worse brain function compared to healthy controls (p < 0.05).

CONCLUSIONS

Brain network function predicted better cognitive goal achievement after MBCT and CRT, and IPS improvements after MBCT. PwMS with neuronal slowing and hyperconnectivity were most prone to show treatment response, making network function a promising tool for personalized treatment recommendations.

TRIAL REGISTRATION

The REMIND-MS study was prospectively registered in the Dutch Trial registry (NL6285; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6459 ).

Electroencephalography microstates highlight specific mindfulness traits

The present study aimed to investigate the spontaneous dynamics of large-scale brain networks underlying mindfulness as a dispositional trait, through resting-state electroencephalography (EEG) microstates analysis. Eighteen participants had attended a standardized mindfulness-based stress reduction training (MBSR), and 18 matched waitlist individuals (CTRL) were recorded at rest while they were passively exposed to auditory stimuli. Participants' mindfulness traits were assessed with the Five Facet Mindfulness Questionnaire (FFMQ). To further explore the relationship between microstate dynamics at rest and mindfulness traits, participants were also asked to rate their experience according to five phenomenal dimensions. After training, MBSR participants showed a highly significant increase in FFMQ score, as well as higher observing and non-reactivity FFMQ sub-scores than CTRL participants. Microstate analysis revealed four classes of microstates (A-D) in global clustering across all subjects. The MBSR group showed lower duration, occurrence and coverage of microstate C than the control group. Moreover, these microstate C parameters were negatively correlated to non-reactivity sub-scores of FFMQ across participants, whereas the microstate A occurrence was negatively correlated to FFMQ total score. Further analysis of participants' self-reports suggested that MBSR participants showed a better sensory-affective integration of auditory interferences. In line with previous studies, our results suggest that temporal dynamics of microstate C underlie specifically the non-reactivity trait of mindfulness. These findings encourage further research into microstates in the evaluation and monitoring of the impact of mindfulness-based interventions on the mental health and well-being of individuals.

The Effectiveness of Mindfulness in the Treatment of Methamphetamine Addiction Symptoms: Does Neuroplasticity Play a Role?

INTRODUCTION

Methamphetamine is a highly stimulating psychoactive drug that causes life-threatening addictions and affects millions of people around the world. Its effects on the brain are complex and include disturbances in the neurotransmitter systems and neurotoxicity. There are several known treatment methods, but their effectiveness is moderate. It must be emphasised that no drugs have been approved for treatment. For this reason, there is an urgent need to develop new, effective, and safe treatments for methamphetamine. One of the potential treatments is mindfulness meditation. In recent years, this technique has been researched extensively in the context of many neurological and psychiatric disorders.

METHODS

This review explores the use of mindfulness in the treatment of methamphetamine addiction. Searches were conducted in the PubMed/Medline, Research Gate, and Cochrane databases.

RESULTS

Ten studies were identified that used mindfulness-based interventions in the treatment of methamphetamine addiction. The results show that mindfulness is an effective form of reducing hunger, risk of relapses, stress indicators, depression, and aggression, alone or in combination with transcranial direct current stimulation (tDCS). Mindfulness also improved the cognitive function in addicts. The included studies used only behavioural measures. The potential mechanisms of mindfulness in addiction were explained, and it was proposed that it can induce neuroplasticity, alleviating the symptoms of addiction.

CONCLUSIONS

Evidence from the studies suggest that mindfulness may be an effective treatment option for methamphetamine addiction, used alone or in combination with tDCS. However, further high-quality research is required to establish the role of this treatment option in this field. The use of neuroimaging and neurophysiological measures is fundamental to understand the mechanisms of mindfulness.

The mindful leader: a review of leadership qualities derived from mindfulness meditation

Mindfulness has been practiced by global leaders and companies as an efficient way to build effective leadership. Because of its popularity, plus the lack of a comprehensive theoretical framework that explains it in a leadership context, the research literature has called for a coherent account of the qualities that is derived by those leaders that practice mindfulness. Here, we aim to answer that call, by clarifying what leadership qualities can develop from practicing mindfulness. We report on a semi-systematic literature review of extant research, covering 19 research articles published between 2000 and 2021, plus other relevant supporting literature from the disciplines of leadership and neuropsychology. Our proposed framework consists of three main qualities of the mindful leader: attention, awareness, and authenticity. We call them the "three pillars of mindful leaders." We also propose that mindfulness meditation must be integrated into our proposed framework, as we are convinced that leaders who hope to benefit from these qualities must integrate a regular mindfulness meditation practice into their daily leadership life.

Assessing a Structured Mental Fitness Program for Academic Acute Care Surgeons: A Pilot Study

INTRODUCTION

There is a well-established positive correlation between improved physician wellness and patient care outcomes. Mental fitness is a component of wellness that is understudied in academic medicine. We piloted a structured mental fitness Positive Intelligence (PQ) training program for academic surgeons, hypothesizing this would be associated with improvements in PQ scores, wellness, sleep, and trainee evaluations.

METHODS

This is a single-institution, prospective, mixed-methods pilot study. All active Burn/Trauma/Acute & Critical Care Surgical faculty and fellows in our division were offered the PQ program and the option to participate in this research study. The 6-wk program consists of daily exercises on a smartphone application, weekly readings, and small-group meetings with a trained mindfulness coach. Study outcomes included changes in pretraining versus post-training PQ scores, sleep hygiene, wellness, and teaching scores. A Net Promoter Score was calculated to measure user overall experience (range -100 to 100; positive scores being supportive). For secondary analysis, participants were stratified into high versus low user groups by "muscle" scores, which were calculated by program use over time. A postintervention focus group was also held to evaluate perceptions of wellness and experience with the PQ program.

RESULTS

Data were analyzed for 15 participants who provided consent. The participants were primarily White (73.3%), Assistant Professors (66.7%) with Surgical Critical Care fellowship training (86.7%), and a slight female predominance (53.3%). Comparison of scores pretraining versus post-training demonstrated statistically significant increases in PQ (59 versus 65, P = 0.004), but no significant differences for sleep (24.0 versus 29.0, P = 0.33) or well-being (89.0 versus 94.0, P = 0.10). Additionally, there was no significant difference in teaching evaluations for both residents (9.1 versus 9.3, P = 0.33) and medical students (8.3 versus 8.5, P = 0.77). High versus low user groups were defined by the median muscle score (166 [Interquartile range 95.5-298.5]). High users demonstrated a statistically higher proportion of ongoing usage (75% versus 14%, P < 0.05). The final Net Promoter Score score was 25, which demonstrates program support within this group. Focus group content analysis established eight major categories: current approaches to wellness, preknowledge, reasons for participation, expected gains, program strengths, suggestions for improvement, recommendations for approaches, and sustainability.

CONCLUSIONS

Our pilot study highlighted certain benefits of a structured mental fitness program for academic acute care surgeons. Our mixed-methods data demonstrate significant improvement in PQ scores, ongoing usage in high user participants, as well as interpersonal benefits such as improved connectedness and creation of a shared language within participants. Future work should evaluate this program on a higher-powered scale, with a focus on intentionality in wellness efforts, increased exposure to mental fitness, and recruitment of trainees and other health-care providers, as well as identifying the potential implications for patient outcomes.

Brief mindfulness-based meditation enhances the speed of learning following positive prediction errors

Recent research has demonstrated that mindfulness-based meditation facilitates basic aspects of cognition, including memory and attention. Further developing this line of inquiry, here we considered the possibility that similar effects may extend to another core psychological process-instrumental learning. To explore this matter, in combination with a probabilistic selection task, computational modelling (i.e., reinforcement drift diffusion model analysis) was adopted to establish whether and how brief mindfulness-based meditation influences learning under conditions of uncertainty (i.e., choices based on the perceived likelihood of positive and negative outcomes). Three effects were observed. Compared with performance in the control condition (i.e., no meditation), mindfulness-based meditation (1) accelerated the rate of learning following positive prediction errors; (2) elicited a preference for the exploration (vs. exploitation) of choice selections; and (3) increased response caution. Collectively, these findings elucidate the pathways through which brief meditative experiences impact learning and decision-making, with implications for interventions designed to debias aspects of social-cognitive functioning using mindfulness-based meditation.

Trauma, early life stress, and mindfulness in adulthood

This article is a review that was inspired by recent studies investigating the effects of childhood trauma or early life stress (ELS) and mindfulness in adulthood. One recent study found that some forms of abuse and neglect led to higher scores in several subscales of a self-report measure of mindfulness. The authors concluded that some forms of ELS can help cultivate certain aspects of mindfulness in adulthood. However, and in contrast to this recent finding, much of the extant literature investigating ELS and trauma are linked to emotional dysregulation, alexithymia, and a host of psychopathologies in adulthood which makes the results of this study surprising. Central to the mindfulness literature is cultivating an open, non-reactive, or non-judgment awareness of inner experiences which are important for emotional regulation. In this paper, I review some of the effects of trauma or ELS on critical neural circuits linked to mindfulness, interoception, attachment, and alexithymia which I hope may clarify some of the conflicting findings from this study and throughout the literature and provide additional context and a framework that may inform research investigating these two constructs going forward.

Neural correlates of impaired cognitive processes underlying self-unawareness in Alzheimer's disease

Self-unawareness concerning current symptoms remains a clinical challenge in Alzheimer's disease. Reduced self-awareness likely depends on complex biopsychosocial mechanisms that comprise multiple cognitive processes, regulated by personal goals and values. We specifically reviewed the cognitive processes impaired in unaware participants with AD by emphasizing the related impaired brain activity observed during task-based fMRI. Unawareness can be explained by a failure in functioning of or in connection between brain regions that intervene in access, retrieval and updating of (present or extended) self-information (posterior midline, medial temporal, inferior parietal cortices), or in its monitoring, evaluation, or control (medial and lateral prefrontal cortices). Although one must be cautious when relating function to brain regions, impaired processes were tentatively related to the Cognitive Awareness Model. Although brain function depends on neural networks, impaired brain activity during cognitive processes was discussed according to previous studies reporting correlations between brain regions and scores of anosognosia. The review provides a framework to help clinicians considering processes that can explain unawareness in dementia. In patients at early stages of AD, different levels of awareness of cognitive or social clinical changes might be described as impairment in the interaction between specific cognitive processes and contents.

Virtual Exercise in Medicine: A Proof of Concept in a Healthy Population

BACKGROUND

Science is beginning to establish the benefits of the use of virtual reality (VR) in health care. This therapeutic approach may be an appropriate complementary treatment for some mental illnesses. It could prevent high levels of morbidity and improve the physical health of patients. For many years, the literature has shown the health benefits of physical exercise. Physical exercise in a VR environment may improve the management of mild to moderate mental health conditions. In this context, we developed a virtual environment combined with an ergocycle (the augmented physical training for isolated and confined environments [APTICE] system).

OBJECTIVE

This study aims to investigate the impact of physical exercise in a VR environment.

METHODS

A total of 14 healthy participants (11 men and 3 women; mean age 43.28, SD 10.60 years) undertook 15 minutes of immersive physical exercise using the system. Measures included mindfulness and immersion disposition, subjective perceptions of sensory information, user experience, and VR experience (ie, psychological state, flow, and presence).

RESULTS

First, the APTICE system appears to be a useful tool because the user experience is positive (subscales in the AttrakDiff questionnaire: pragmatic quality=0.99; hedonic quality-stimulation=1.90; hedonic quality-identification=0.67; attractiveness=1.58). Second, the system can induce a positive psychological state (negative emotion, P=.06) and an experience of flow and presence (P values ranging from <.001 to .04). Third, individual immersive and mindful disposition plays a role in the VR experience (P values ranging from <.02 to .04). Finally, our findings suggest that there is a link between the subjective perception of sensory information and the VR experience (P values ranging from <.02 to .04).

CONCLUSIONS

These results indicate that the device is well accepted with positive psychological and exteroceptive outcomes. Overall, the APTICE system could be a proof of concept to explore the benefits of virtual physical exercise in clinical medicine.

How anxiety relates to blood donation intention of non-donors: the roles of moral disengagement and mindfulness

Blood donation anxiety is a major psychological obstacle for blood donation. However, it remains unclear what the mechanism underlying the relationship between anxiety and blood donation intention is and what factor(s) will buffer the negative effects of anxiety. Based on social cognitive theory, we theorized a model delineating the mechanism with which blood donation anxiety was related to blood donation intention. Data were collected in a three-wave online survey including 425 individuals and was analyzed using hierarchical multiple regression with SPSS 24.0 software. The results indicated that the negative relationship between blood donation anxiety and blood donation intention was mediated by moral disengagement. Meanwhile, mindfulness was found to play a buffering role in the relationship between blood donation anxiety and moral disengagement as well as the indirect relationship between blood donation anxiety and blood donation intention via moral disengagement. Our findings advanced the understanding of the detrimental consequences of blood donation anxiety and demonstrated that while blood donation anxiety came at a high cost, it can be managed.

Association between time perspective and metacognition among Lebanese adults: the mediating role of mindfulness

BACKGROUND

Mindfulness may serve as a component of metacognitive beliefs and can also be viewed as a form of time perspective. The interplay between time perspective and metacognitive beliefs remains understudied. Both aspects, however, display considerable stability over time and significantly influence an individual's life and well-being. Lebanon, marked by its diverse and complex history, struggles with various political, social, and economic challenges. This study offers a valuable and unprecedented opportunity to examine these connections within a distinct cultural context, shedding light on the unique experiences of the Lebanese population. Therefore, our research aims to investigate the connection between time perspective and metacognition, with a focus on the role of mindfulness as a mediator.

METHODS

This cross-sectional study was conducted from August to November 2022 and involved participants from various regions of Lebanon. The questionnaire included sociodemographic data and scales such as the Arabic versions of the 15-item Short Form of the Zimbardo Time Perspective Inventory, the Metacognitions Questionnaire, the Freiburg Mindfulness Inventory and the Acceptance and Action Questionnaire (AAQ-2).

RESULTS

Our investigation recruited 423 participants. The analysis showed that individuals with a positive stance on their past, a hedonistic present, or a future-oriented outlook exhibited heightened levels of mindfulness. This elevated state of mindfulness, in turn, demonstrated a significant link to augmented cognitive self-consciousness (An increased introspection into one's own thoughts). We also observed a direct association between a future-focused time perspective and high scores of cognitive self-consciousness. Furthermore, mindfulness emerged as a crucial mediator in the relationships between time perspectives and negative beliefs about the danger of worry. Similarly, individuals with a positive view on their past, a hedonistic present orientation, or a future-focused mindset demonstrated elevated levels of mindfulness, which was correlated with less negative beliefs about the danger of worry. Notably, a positive past perspective was directly associated with less negative views on worry and the subsequent loss of control, whereas higher future focused time perspective scores was significantly and directly associated with more negative beliefs about worry, whereas more future focused time perspective was significantly and directly associated with more negative beliefs about worry.

CONCLUSION

Our findings found several meaningful associations between our variables, but it primarily underscored the significance of considering distinct subcomponents within mindfulness and psychopathological metacognition that may overlap, shedding light on their differential impacts on psychological well-being. We were also able to mirror the dual pathway theory of time perspective suggested in previous studies. These insights carry notable implications for the development and refinement of mindfulness-based and metacognitive interventions, emphasizing the need for tailored approaches that consider varying time perspectives. Continued investigation in this area promises to advance our understanding of these constructs and refine their practical applications in mental health interventions and well-being enhancement strategies.

A randomized controlled trial of mindfulness-based cognitive therapy for body dysmorphic disorder: Impact on core symptoms, emotion dysregulation, and executive functioning

BACKGROUND AND OBJECTIVES

Mindfulness-based cognitive therapy (MBCT) is garnering increasing empirical interest as an intervention for Body Dysmorphic Disorder (BDD), although no studies of mindfulness as a standalone treatment have included a sample composed entirely of patients with BDD or a comparison group. The aim of this study was to investigate the improvement of MBCT intervention on the core symptoms, emotional dysfunction, and executive function of BDD patients, as well as the feasibility and acceptability of MBCT training.

METHOD

Patients with BDD were randomized into an 8-week MBCT group (n = 58) or treatment-as-usual (TAU) control group (n = 58) and were assessed at pre-treatment, post-treatment, and 3-month follow-up.

RESULTS

Participants who received MBCT showed greater improvement on self-reported and clinician ratings of BDD symptoms, self-reported emotion dysregulation symptoms and executive function compared with TAU participants. Improvement for executive function tasks was partially supported. In addition, feasibility and acceptability of MBCT training were positive.

LIMITATIONS

There is no systematic assessment of the severity of key potential outcome variables associated with BDD.

CONCLUSION

MBCT may be a useful intervention for patients with BDD, improving patients' BDD symptoms, emotion dysregulation, and executive functioning.

Does mindfulness reduce perceived stress in healthcare professionals?

BACKGROUND

Healthcare professionals (HCPs) are exposed to multiple psychosocial risks that may lead to high levels of stress and low levels of life satisfaction and well-being. Mindfulness, defined as the awareness that arises by intentionally paying attention in the present moment and in a non-judgmental way, seems to be a moderator in the causal association between life stressors and well-being.

AIMS

The aim of the present study was to test the model of relationships between self-reported mindfulness, perceived stress, well-being index and life satisfaction in a sample of Tunisian HCPs.

METHODS

We performed a correlational cross-sectional study on a sample of HCPs at Hedi Chaker University Hospital, Tunisia. We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), the World Health Organisation Well-Being Index (WHO-5) and the Satisfaction with Life Scale (SWLS). For data analysis, the SPSS version 23 program was used.

RESULTS

Participants (n=297) included staff nurses (49.2%), medical technicians (19.2%) and doctors (31.6%). The overall model revealed that reduced perceived stress (β=-0.30, P<0.000) and high levels of well-being (β=0.13, P=0.03) were associated with mindfulness, explaining 14% of the variance. Individually, perceived stress significantly predicted mindfulness explaining 13% of the variance.

CONCLUSION

The study explores a variety of elements that can support the development of mindfulness interventions for stress prevention, staff well-being, and improvement of services as a whole.

Effect of Meditation on Brain Activity during an Attention Task: A Comparison Study of ASL and BOLD Task fMRI

Focused attention meditation (FAM) training has been shown to improve attention, but the neural basis of FAM on attention has not been thoroughly understood. Here, we aim to investigate the neural effect of a 2-month FAM training on novice meditators in a visual oddball task (a frequently adopted task to evaluate attention), evaluated with both ASL and BOLD fMRI. Using ASL, activation was increased in the middle cingulate (part of the salience network, SN) and temporoparietal (part of the frontoparietal network, FPN) regions; the FAM practice time was negatively associated with the longitudinal changes in activation in the medial prefrontal (part of the default mode network, DMN) and middle frontal (part of the FPN) regions. Using BOLD, the FAM practice time was positively associated with the longitudinal changes of activation in the inferior parietal (part of the dorsal attention network, DAN), dorsolateral prefrontal (part of the FPN), and precentral (part of the DAN) regions. The effect sizes for the activation changes and their association with practice time using ASL are significantly larger than those using BOLD. Our study suggests that FAM training may improve attention via modulation of the DMN, DAN, SN, and FPN, and ASL may be a sensitive tool to study the FAM effect on attention.

Mindfulness-based therapy improves brain functional network reconfiguration efficiency

Mindfulness-based interventions are showing increasing promise as a treatment for psychological disorders, with improvements in cognition and emotion regulation after intervention. Understanding the changes in functional brain activity and neural plasticity that underlie these benefits from mindfulness interventions is thus of interest in current neuroimaging research. Previous studies have found functional brain changes during resting and task states to be associated with mindfulness both cross-sectionally and longitudinally, particularly in the executive control, default mode and salience networks. However, limited research has combined information from rest and task to study mindfulness-related functional changes in the brain, particularly in the context of intervention studies with active controls. Recent work has found that the reconfiguration efficiency of brain activity patterns between rest and task states is behaviorally relevant in healthy young adults. Thus, we applied this measure to investigate how mindfulness intervention changed functional reconfiguration between rest and a breath-counting task in elderly participants with self-reported sleep difficulties. Improving on previous longitudinal designs, we compared the intervention effects of a mindfulness-based therapy to an active control (sleep hygiene) intervention. We found that mindfulness intervention improved self-reported mindfulness measures and brain functional reconfiguration efficiency in the executive control, default mode and salience networks, though the brain and behavioral changes were not associated with each other. Our findings suggest that neuroplasticity may be induced through regular mindfulness practice, thus bringing the intrinsic functional configuration in participants' brains closer to a state required for mindful awareness.

A systematic review and activation likelihood estimation meta-analysis of fMRI studies on arousing or wake-promoting effects in Buddhist meditation

Conventional Buddhist texts illustrate meditation as a condition of relaxed alertness that must fend against extreme hypoarousal (sleep, drowsiness) and extreme hyperarousal (restlessness). Theoretical, neurophysiological, and neuroimaging investigations of meditation have highlighted the relaxing effects and hypoarousing without emphasizing the alertness-promoting effects. Here we performed a systematic review supported by an activation-likelihood estimate (ALE) meta-analysis in an effort to counterbalance the surfeit of scholarship emphasizing the hypoarousing and relaxing effects of different forms of Buddhist meditation. Specifically, the current systematic review-cum-meta-analytical review seeks to highlight more support for meditation's wake-promoting effects by drawing from neuroimaging research during wakefulness and meditation. In this systematic review and meta-analysis of 22 fMRI studies, we aim to highlight support for Buddhist meditation's wake-promoting or arousing effects by identifying brain regions associated with alertness during meditation. The most significant peaks were localized medial frontal gyrus (MFG) and precuneus. We failed to determine areas ostensibly common to alertness-related meditation such as the medial prefrontal cortex (mPFC), superior parietal lobule, basal ganglia, thalamus, most likely due to the relatively fewer fMRI investigations that used wakefulness-promoting meditation techniques. Also, we argue that forthcoming research on meditation, related to alertness or wakefulness, continues to adopt a multi-modal method to investigate the correlation between actual behaviors and neural networks connected to Buddhist meditation. Moreover, we recommend the implementation of fMRI paradigms on Buddhist meditation with clinically diagnosed participants to complement recent trends in psychotherapy such as mindfulness-based cognitive therapy (MBCT).

Prefrontal cortical hemodynamics and functional network organization during Tai Chi standing meditation: an fNIRS study

Introduction

Tai Chi standing meditation (Zhan Zhuang, also called pile standing) is characterized by meditation, deep breathing, and mental focus based on theories of traditional Chinese medicine. The purpose of the present study was to explore prefrontal cortical hemodynamics and the functional network organization associated with Tai Chi standing meditation by using functional near-infrared spectroscopy (fNIRS).

Methods

Twenty-four channel fNIRS signals were recorded from 24 male Tai Chi Quan practitioners (54.71 ± 8.04 years) while standing at rest and standing during Tai Chi meditation. The general linear model and the SPM method were used to analyze the fNIRS signals. Pearson correlation was calculated to determine the functional connectivity between the prefrontal cortical sub-regions. The small world properties of the FC networks were then further analyzed based on graph theory.

Results

During Tai Chi standing meditation, significantly higher concentrations of oxygenated hemoglobin were observed in bilateral dorsolateral prefrontal cortex (DLPFC), ventrolateral prefrontal cortex (VLPFC), frontal eye field (FEF), and pre-motor cortex (PMC) compared with the values measured during standing rest (p < 0.05). Simultaneously, significant decreases in deoxygenated hemoglobin concentration were observed in left VLPFC, right PMC and DLPFC during Tai Chi standing meditation than during standing rest (p < 0.05). Functional connectivity between the left and right PFC was also significantly stronger during the Tai Chi standing meditation (p < 0.05). The functional brain networks exhibited small-world architecture, and more network hubs located in DLPFC and VLPFC were identified during Tai Chi standing meditation than during standing rest.

Discussion

These findings suggest that Tai Chi standing meditation introduces significant changes in the cortical blood flow and the brain functional network organization.

The (In)flexible self: Psychopathology, mindfulness, and neuroscience

Clinical and neuroscientific evidence indicates that transdiagnostic processes contribute to the generation and maintenance of psychopathological symptoms and disorders. Rigidity (inflexibility) appears a core feature of most transdiagnostic pathological processes. Decreasing rigidity may prove important to restore and maintain mental health. One of the primary domains in which rigidity and flexibility plays a role concerns the self. We adopt the pattern theory of self (PTS) for a working definition of self. This incorporates the pluralist view on self as constituted by multiple aspects or processes, understood to constitute a self-pattern, i.e. processes organized in non-linear dynamical relations across a number of time scales. The use of mindfulness meditation in the format of Mindfulness Based Interventions (MBIs) has been developed over four decades in Clinical Psychology. MBIs are promising as evidence-based treatments, shown to be equivalent to gold-standard treatments and superior to specific active controls in several randomized controlled trials. Notably, MBIs have been shown to target transdiagnostic symptoms. Given the hypothesized central role of rigid, habitual self-patterns in psychopathology, PTS offers a useful frame to understand how mindfulness may be beneficial in decreasing inflexibility. We discuss the evidence that mindfulness can alter the psychological and behavioral expression of individual aspects of the self-pattern, as well as favour change in the self-pattern as a whole gestalt. We discuss neuroscientific research on how the phenomenology of the self (pattern) is reflected in associated cortical networks and meditation-related alterations in cortical networks. Creating a synergy between these two aspects can increase understanding of psychopathological processes and improve diagnostic and therapeutic options.

Within-Person Modulation of Neural Networks following Interoceptive Awareness Training through Mindful Awareness in Body-Oriented Therapy (MABT): A Pilot Study

Interoception, the representation of the body's internal state, is increasingly recognized for informing subjective wellbeing and promoting regulatory behavior. However, few empirical reports characterize interoceptive neural networks, and fewer demonstrate changes to these networks in response to an efficacious intervention. Using a two-group randomized controlled trial, this pilot study explored within-participant neural plasticity in interoceptive networks following Mindful Awareness in Body-oriented Therapy (MABT). Participants (N = 22) were assigned to either 8 weeks of MABT or to a no-treatment control and completed baseline and post-intervention assessments that included subjective interoceptive awareness (MAIA) and neuroimaging of an interoceptive awareness task. MABT was uniquely associated with insula deactivation, increased functional connectivity between the dorsal attention network and the somatomotor cortex, and connectivity changes correlated positively with changes in subjective interoception. Within the MABT group, changes in subjective interoception interacted with changes in a predefined anterior cingulate seed region to predict changes in right middle insula activity, a putative primary interoceptive representation region. While the small sample size requires the replication of findings, results suggest that interoceptive training enhances sensory-prefrontal connectivity, and that such changes are commensurate with enhanced interoceptive awareness.

Insular dysfunction of interoception in major depressive disorder: from the perspective of neuroimaging

Interoception plays a crucial role in maintaining bodily homeostasis and promoting survival, and is considered the basis of human emotion, cognition, and self-formation. A malfunction of interoception is increasingly suggested to be a fundamental component of different mental health conditions, and depressive disorders have been especially closely associated. Interoceptive signaling and processing depends on a system called the "interoceptive pathway," with the insula, located in the deep part of the lateral fissure, being the most important brain structure in this pathway. Neuroimaging studies have revealed alterations in the structure and function of the insula in a large number of individuals with depression, yet the precise relationship between these alterations and interoceptive dysfunction remains unclear. The goal of this review is to examine the evidence that exists for dysfunction of interoception in people with Major Depressive Disorder (MDD), and to determine the associated specific alterations in the structure and function of the insula revealed by neuroimaging. Overall, three aspects of the potential relationship between interoceptive dysfunction and alterations in insular function in people with depression have been assessed, namely clinical symptoms, quantitative measures of interoceptive function and ability, and interoceptive modulation. To conclude, several specific limitations of the published studies and important lines of enquiry for future research are offered.

Altered Brain Connectivity and Network Topological Organization in a Non-ordinary State of Consciousness Induced by Hypnosis

Hypnosis has been shown to be of clinical utility; however, its underlying neural mechanisms remain unclear. This study aims to investigate altered brain dynamics during the non-ordinary state of consciousness induced by hypnosis. We studied high-density EEG in 9 healthy participants during eyes-closed wakefulness and during hypnosis, induced by a muscle relaxation and eyes fixation procedure. Using hypotheses based on internal and external awareness brain networks, we assessed region-wise brain connectivity between six ROIs (right and left frontal, right and left parietal, upper and lower midline regions) at the scalp level and compared across conditions. Data-driven, graph-theory analyses were also carried out to characterize brain network topology in terms of brain network segregation and integration. During hypnosis, we observed (1) increased delta connectivity between left and right frontal, as well as between right frontal and parietal regions; (2) decreased connectivity for alpha (between right frontal and parietal and between upper and lower midline regions) and beta-2 bands (between upper midline and right frontal, frontal and parietal, also between upper and lower midline regions); and (3) increased network segregation (short-range connections) in delta and alpha bands, and increased integration (long-range connections) in beta-2 band. This higher network integration and segregation was measured bilaterally in frontal and right parietal electrodes, which were identified as central hub regions during hypnosis. This modified connectivity and increased network integration-segregation properties suggest a modification of the internal and external awareness brain networks that may reflect efficient cognitive-processing and lower incidences of mind-wandering during hypnosis.

The Missing Ingredient: How Misogyny and the Patriarchy Sabotage our Clinical Practice and Research

Discussing massive, unrelenting trauma, especially during a global pandemic, when the threat is not only personally affecting you, but also everyone else, is not an easy thing to do. We can see the consequences of two years of being locked inside. People's trauma responses literally came flooding out. It seems that the pandemic tipped us over an abyss that is hard to comprehend. In so many countries there are protests, laws rolling back basic human rights, the threat of fascism, and actual war. There seems to be widespread governmental corruption that cannot stop the favouritism of those who have wealth, and perpetually admonish those who do not. Our world seems very unstable. Change is deeply desired. Yet, this instability is predictable. It is predictable because the systems that created the structures that "run and rule" us are fundamentally destructive and violent. In never-ending ways, the only way that change happens is by utilizing violence as the only way to achieve change. This is the legacy of patriarchy. A system that not only is ruled by one group of people but also tends to be controlled by a very specific type of person. It is a system that cultivates human cruelty, selfishness, and violence. It is a system that is managed by those who do the "best" in violence. Most of us do not work this way but are forced to live this way because of the belief that humans are innately violent, selfish, and self-serving; a myth based on the traumatic reaction of fight. It is a dissociated, relational injury that is a direct result of not having our mothers and fathers able to be mothers and fathers. It is formed in misogyny. There are ways to heal, if one can comprehend what misogyny does to human beings, and what we would be like in its absence.

Touching and being touched: where knowing and feeling meet

Philosophers maintain that touch confers a sense of reality or grounding to perceptual experience. In touching oneself, one is simultaneously both subject and object of touch, a template for experiencing oneself as subject and object of intentions, feelings, and motivations, or intersubjectivity. Here, I explore a form of self-touch carefully documented by Winnicott in observing how the infant engages the transitional object. I compare the processes of self-loss in transitional states, including absorption in art, empathic immersion, drug-induced ego dissolution, and depersonalization. I use examples drawn from Rodin, Dante, and the Beatles; research correlating neurophysiological findings with aspects of self-representation; predictive processing-based models; Hohwy's concepts of minimal and narrative self; Clark's notion of the extended mind; and phenomenological perspectives on touch, to postulate a role for self-touch in the pre-reflective sense of mine-ness, or grounding, in transitional states.

A machine learning approach towards the differentiation between interoceptive and exteroceptive attention

Interoception, the representation of the body's internal state, plays a central role in emotion, motivation and wellbeing. Interoceptive sensibility, the ability to engage in sustained interoceptive awareness, is particularly relevant for mental health but is exclusively measured via self-report, without methods for objective measurement. We used machine learning to classify interoceptive sensibility by contrasting using data from a randomized control trial of interoceptive training, with functional magnetic resonance imaging assessment before and after an 8-week intervention (N = 44 scans). The neuroimaging paradigm manipulated attention targets (breath vs. visual stimuli) and reporting demands (active reporting vs. passive monitoring). Machine learning achieved high accuracy in distinguishing between interoceptive and exteroceptive attention, both for within-session classification (~80% accuracy) and out-of-sample classification (~70% accuracy), revealing the reliability of the predictions. We then explored the classifier potential for 'reading out' mental states in a 3-min sustained interoceptive attention task. Participants were classified as actively engaged about half of the time, during which interoceptive training enhanced their ability to sustain interoceptive attention. These findings demonstrate that interoceptive and exteroceptive attention is distinguishable at the neural level; these classifiers may help to demarcate periods of interoceptive focus, with implications for developing an objective marker for interoceptive sensibility in mental health research.

Altered self-reported resting state mediates the effects of Mindfulness-Based Stress Reduction on mental health: a longitudinal path model analysis within a community-based randomized trial with 6-months follow-up

Background

A large body of randomized controlled trials (RCTs) has shown that mindfulness-based interventions are effective for improving mental health, but research is lacking in regards to the mechanisms of change. We aimed to investigate the mediating effects of self-reported altered resting state of Mindfulness-Based Stress Reduction (MBSR) on mental health, when provided as a universal intervention in a real-life context.

Methods

Autoregressive path models with three time points of measurement, and contemporaneous and constant b paths were used in an RCT. The RCT took place in all five geographical regions of Denmark and included 110 schools and 191 schoolteachers. The schools were randomized 1:1 in each geographical region to intervention or a wait-list control group. The intervention was the standardized MBSR. Data were collected at baseline and after 3 and 6  months. The outcomes were perceived stress, measured by Cohen's Perceived Stress Scale (PSS), symptoms of anxiety and depression, measured by Hopkins Symptom Check List-5 (SCL-5), and well-being measured by WHO-5 Well-being Index (WHO-5). The mediator was resting state measured by the Amsterdam Resting State Questionnaire (ARSQ).

Results

Statistically significant mediated effects of altered ARSQ-subscales scores for Discontinuity of Mind, Planning, and Comfort were found for the MBSR effect on all outcomes; PSS, SCL-5 and WHO-5. Furthermore, statistically significant mediated effects of altered sleepiness subscale score of the effects on PSS and SCL-5 of MBSR were found. No statistically significant mediating effects of the subscales Theory of Mind, Self and Somatic Awareness for the MBSR intervention effect were found.

Conclusion

The results support that the MBSR program can alter self-reported resting state, towards less mind wandering and more comfort, measured by the ARSQ, and that this may explain some of the mechanisms regarding the effectiveness of MBSR on mental health at 6 months, when provided as a universal intervention. The study provides insight into an active ingredient of how MBSR may improve mental health and well-being. It supports the suggestions that mindfulness meditation may be a sustainable way of training the mental health.Clinical trial registration:ClinicalTrials.gov, identifier NCT03886363.

Increased relaxation, less boredom, and a faster passage of time during a period of silence in the forest

INTRODUCTION

There is growing evidence of the beneficial effects of exposure to nature on health and well-being. Time spent in nature can decrease stress, anxiety, depression, and improve mood. In the present study, we compared the experience of a short period of silence in the natural environment of a forest with the same amount of silence in a seminar room.

METHODS

We applied an intra-subject design with two 6:30-min sessions of silence in two different environments (forest, seminar room). The participants (n=41) were assigned to four groups. Two groups started with the indoor condition and two groups with the outdoor condition. After 1 week, the two groups were exposed to the other condition. Participants filled out personality-trait scales on meaning in life and belief in oneness with the world, as well as state scales assessing emotional reactions, relaxation, boredom, and the subjective sense of self, time, and space.

RESULTS

Participants felt significantly more relaxed and less bored in the forest compared to indoors. They experienced time less intensely, judging it to pass faster and to last shorter in the forest. Regarding trait variables, the higher the search for meaning, the higher oneness beliefs in participants. The higher oneness beliefs, the more positive participants felt during silence in the forest.

DISCUSSION

Interest in nature-assisted therapy is increasing in the healthcare sector. Exposure to silence in the natural setting of a forest could prove to be an effective complement to interventions applied in nature-assisted therapy, such as forest therapy.

The Effects of Concentrative Meditation on the Electroencephalogram in Novice Meditators

Following investigations into the benefits of meditation on psychological health and well-being, research is now seeking to understand the mechanisms underlying these outcomes. This study aimed to identify natural alpha and theta frequency components during eyes-closed resting and concentrative meditation states and examined their differences within and between two testing sessions. Novice meditators had their EEG recorded during eyes-closed resting and concentrative meditation conditions, before and after engaging in a brief daily concentrative meditation practice for approximately one-month. Separate frequency Principal Components Analyses (f-PCA) yielded four spectral components of interest, congruent between both conditions and sessions: Delta-Theta-Alpha, Low Alpha, High Alpha, and Alpha-Beta. While all four components showed some increase in the meditation condition at the second session, only Low Alpha (∼9.5-10.0 Hz) showed similar increases while resting. These findings support the use of f-PCA as a novel method of data analysis in the investigation of psychophysiological states in meditation.

Enhanced declarative memory in long-term mindfulness practitioners

OBJECTIVES

Mindfulness meditation (MM) practice is considered to benefit physical and mental health. In particular, several studies have shown a beneficial effect of MM practice on memory performance. However, it is still not clear how long-term training affects long-term declarative memory. In this study we aimed to examine whether long-term MM training impacts declarative memory formation for diverse memoranda types, as well as the role of trait mindfulness, and the possible mediating role of anxiety.

METHODS

We examined long-term memory performance in 23 experienced MM practitioners and 22 meditation-naïve age-matched individuals, by administering a variety of declarative memory tests, ranging from item recognition to narrative and autobiographical memory recollection and future projection. The participants also filled the Five Facet Mindfulness Questionnaire (FFMQ) and State-Trait Anxiety Inventory (STAI).

RESULTS

Compared to the control group, long-term MM practitioners exhibited heightened memory performance for the picture recognition test and experienced enhanced vividness during autobiographic memory retrieval and future simulations. We also report a significant trait mindfulness and memory performance correlation, stemming exclusively from the Mm group.

CONCLUSIONS

Our findings extend previous reports of the beneficial effect of a short-term MM training on memory performance, by showing the beneficial effect of long-term training on declarative memory. We also provide initial evidence that trait mindfulness is positively correlated with declarative memory performance, as a function of MM practice, and discuss these findings in light of the role of self-mode and cognitive diffusion, as well as attention and emotion.

Disentangling self from pain: mindfulness meditation-induced pain relief is driven by thalamic-default mode network decoupling

ABSTRACT

For millenniums, mindfulness was believed to diminish pain by reducing the influence of self-appraisals of noxious sensations. Today, mindfulness meditation is a highly popular and effective pain therapy that is believed to engage multiple, nonplacebo-related mechanisms to attenuate pain. Recent evidence suggests that mindfulness meditation-induced pain relief is associated with the engagement of unique cortico-thalamo-cortical nociceptive filtering mechanisms. However, the functional neural connections supporting mindfulness meditation-based analgesia remain unknown. This mechanistically focused clinical trial combined functional magnetic resonance imaging with psychophysical pain testing (49°C stimulation and pain visual analogue scales) to identify the neural connectivity supporting the direct modulation of pain-related behavioral and neural responses by mindfulness meditation. We hypothesized that mindfulness meditation-based pain relief would be reflected by greater decoupling between brain mechanisms supporting appraisal (prefrontal) and nociceptive processing (thalamus). After baseline pain testing, 40 participants were randomized to a well-validated, 4-session mindfulness meditation or book-listening regimen. Functional magnetic resonance imaging and noxious heat (49°C; right calf) were combined during meditation to test study hypotheses. Mindfulness meditation significantly reduced behavioral and neural pain responses when compared to the controls. Preregistered (NCT03414138) whole-brain analyses revealed that mindfulness meditation-induced analgesia was moderated by greater thalamus-precuneus decoupling and ventromedial prefrontal deactivation, respectively, signifying a pain modulatory role across functionally distinct neural mechanisms supporting self-referential processing. Two separate preregistered seed-to-seed analyses found that mindfulness meditation-based pain relief was also associated with weaker contralateral thalamic connectivity with the prefrontal and primary somatosensory cortex, respectively. Thus, we propose that mindfulness meditation is associated with a novel self-referential nociceptive gating mechanism to reduce pain.

Knock yourself out: Brief mindfulness-based meditation eliminates self-prioritization

Recent research has asserted that self-prioritization is an inescapable facet of mental life, but is this viewpoint correct? Acknowledging the flexibility of social-cognitive functioning, here we considered the extent to which mindfulness-based meditation-an intervention known to reduce egocentric responding-attenuates self-bias. Across two experiments (Expt. 1, N = 160; Expt. 2, N = 160), using an object-classification task, participants reported the ownership of previously assigned items (i.e., owned-by-self vs. owned-by-friend) following a 5-minute period of mindfulness-based meditation compared with control meditation (Expt. 1) or no meditation (Expt. 2). The results revealed that mindfulness meditation abolished the emergence of the self-ownership effect during decision-making. An additional computational (i.e., drift diffusion model) analysis indicated that mindfulness meditation eliminated a prestimulus bias toward self-relevant (vs. friend-relevant) responses, increased response caution, and facilitated the rate at which evidence was accumulated from friend-related (vs. self-related) objects. Collectively, these findings elucidate the stimulus and response-related operations through which brief mindfulness-based meditation tempers self-prioritization.

A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics

No contemporary unifying framework has been provided for the study of non-ordinary states of consciousness (NSCs) despite increased interest in hypnosis, meditation, and psychedelics. NSCs induce shifts in experiential contents (what appears to the experiencer) and/or structure (how it appears). This can allow the investigation of the plastic and dynamic nature of experience from a multiscale perspective that includes mind, brain, body, and context. We propose a neurophenomenological (NP) approach to the study of NSCs which highlights their role as catalysts of transformation in clinical practice by refining our understanding of the relationships between experiential (subjective) and neural dynamics. We outline the ethical implications of the NP approach for standard conceptions of health and pathology as well as the crucial role of experience-based know-how in NSC-related research and application.

The effectiveness of mindfulness-based interventions for ruminative thinking: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To systematically evaluate the effectiveness of mindfulness-based interventions for ruminative thinking.

METHODS

Cochrane Library, Web of Science, Embase, EBSCO, PubMed and Science Direct databases were searched to include randomized controlled trials of mindfulness-based interventions for rumination that met the criteria. The Rumination scale was used as the primary outcome indicator, and the secondary outcome indicator included the Mindfulness scale. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. Stata 16.0 software was used to perform meta-analysis, subgroup analysis, sensitivity analysis, meta-regression analysis and publication bias detection of the extracted data.

RESULTS

A total of 61 studies with 4229 patients were included. Meta-analysis results revealed a significant intervention effect on ruminative thinking (SMD = -0.534, 95 % CI = [-0.675, -0.394], z = -7.449, P < 0.001). However, there was no significant difference between mindfulness-based interventions and CBT (SMD = 0.009, 95%CI = [-0.239, 0.258], z = 0.073, P = 0.941). Meta-analysis showed that mindfulness-based interventions significantly enhanced the level of mindfulness (SMD = 0.495, 95 % CI = [0.343, 0.647], z = 6.388, P < 0.001), while it was not significant compared to CBT (SMD = 0.158, 95%CI = [-0.087, 0.403], z = 1.266, P = 0.205). The two subgroups with >65 % (SMD = -0.534, 95%CI = [-0.681, -0.386], z = -7.081, P < 0.001) and 80 % (SMD = -0.462, 95%CI = [-0.590, -0.334], z = -7.071, P < 0.001) of females showed significant improvement in ruminative thinking. There were significant intervention effects for depression, students, cancer, healthy adults, and clinical patients. Significant intervention effects were demonstrated for various participant ages and intervention periods.

CONCLUSION

This study confirmed the feasibility of mindfulness-based interventions in improving ruminative thinking and enhancing the level of mindfulness. However, the effectiveness of mindfulness-based interventions was not significant compared to CBT. The two subgroups with a higher proportion of females showed a more significant improvement in ruminative thinking, whereas there were no significant differences in participant characteristics, age, and the duration of intervention.

Web-based training for post-secondary student well-being during the pandemic: a randomized trial

Background: The COVID-19 pandemic has been a highly stressful period where post-secondary education moved to online formats. Coping skills like decentering and reappraisal appear to promote stress resilience, but limited research exists on cultivating these skills in online learning contexts.Methods: In a three-arm randomized trial design, we evaluated three-week, web-based interventions to gauge how to best cultivate mindfulness and stress-reappraisal skills and whether the proposed interventions led to improved mental health. Undergraduate participants (N = 183) were randomly assigned to stress mindset, mindfulness meditation, or mindfulness with choice conditions.Results: At the study level (baseline vs. post-intervention), decentering improved across all conditions. Mindfulness with choice significantly decreased negative affect and rumination compared to stress mindset, while stress mindset significantly enhanced stress mindset skills compared to both mindfulness groups. At the daily level (three sessions per week), stress mindset significantly increased positive affect compared to mindfulness meditation.Conclusions: Results suggest that student mental health can be remotely supported through brief web-based interventions. Mindfulness practices seem to be effective in improving students' negative mood and coping strategies, while stress mindset training can help students to adopt a stress-is-enhancing mindset. Additional work on refining and better matching students to appropriate interventions is needed.

Nonlinear brain correlates of trait self-boundarylessness

Alterations of the sense of self induced by meditation include an increased sense of boundarylessness. In this study, we investigated behavioural and functional magnetic resonance imaging correlates of trait self-boundarylessness during resting state and the performance of two experimental tasks. We found that boundarylessness correlated with greater self-endorsement of words related to fluidity and with longer response times in a math task. Boundarylessness also correlated negatively with brain activity in the posterior cingulate cortex/precuneus during mind-wandering compared to a task targeting a minimal sense of self. Interestingly, boundarylessness showed quadratic relations to several measures. Participants reporting low or high boundarylessness, as compared to those in between, showed higher functional connectivity within the default mode network during rest, less brain activity in the medial prefrontal cortex during self-referential word processing, and less self-endorsement of words related to constancy. We relate these results to our previous findings of a quadratic relation between boundarylessness and the sense of perspectival ownership of experience. Additionally, an instruction to direct attention to the centre of experience elicited brain activation similar to that of meditation onset, including increases in anterior precentral gyrus and anterior insula and decreases in default mode network areas, for both non-meditators and experienced meditators.

Effectiveness of CBT and its modifications for prevention of relapse/recurrence in depression: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

CBT and its modifications are effective for depression, but its efficacy for preventing depressive relapse/recurrence remains unclear.

METHODS

A systematic review and meta-analysis was conducted scrutinizing the efficacy of CBT and its modifications for preventing depressive relapse/recurrence in randomized controlled trials. The retrieval database included PubMed, Web of Science, MEDLINE, and three major Chinese databases (CNKI, VIP, Wanfang), and the retrieval period was from January 1, 2009, to July 1, 2022. Data were analyzed by RevMan 5.4 and Stata 16.

RESULTS

A total of 28 randomized controlled trials with 3938 participants were included. The relapse/recurrence rates in CBT and its modifications and the control group were 31.6 % and 41.3 %, respectively; CBT and its modifications significantly reduced the risk of developing a new depressive episode (RR, 0.73, 95%CI, 0.64-0.83). Stratified by follow-up time, both CBT and its modifications significantly reduced the relapse/recurrence of depression at ≤12 months (RR, 0.61, 95%CI, 0.47-0.79) and > 12 months (RR, 0.74, 95%CI, 0.59-0.93) compared with other active treatments. The beneficial effects of CBT and its modifications alone in reducing depressive relapse/recurrence were equivalent to those of antidepressant medication alone (RR, 1.01, 95 % CI, 0.79-1.28). Meta-regression results showed that the intervention method (P = 0.005) was one of the sources of heterogeneity.

LIMITATIONS

Further subgroup analysis is limited by the literature.

CONCLUSION

CBT and its modifications are reliable interventions for preventing relapse/recurrence in patients with depression. Further research is needed to determine the specific conditions for CBT and its applications in clinical practice.

Is Mindfulness Associated With Lower Pain Reactivity and Connectivity of the Default Mode Network? A Replication and Extension Study in Healthy and Episodic Migraine Participants

Formal training in mindfulness-based practices promotes reduced experimental and clinical pain, which may be driven by reduced emotional pain reactivity and undergirded by alterations in the default mode network, implicated in mind-wandering and self-referential processing. Recent results published in this journal suggest that mindfulness, defined here as the day-to-day tendency to maintain a non-reactive mental state in the absence of training, associates with lower pain reactivity, greater heat-pain thresholds, and resting-state default mode network functional connectivity in healthy adults in a similar manner to trained mindfulness. The extent to which these findings extend to chronic pain samples and replicate in healthy samples is unknown. Using data from healthy adults (n = 36) and episodic migraine patients (n = 98) and replicating previously published methods, we observed no significant association between mindfulness and heat-pain threshold, pain intensity or unpleasantness, or pain catastrophizing in healthy controls, or between mindfulness and headache frequency, severity, impactor pain catastrophizing in patients. There was no association between default mode network connectivity and mindfulness in either sample when probed via seed-based functional connectivity analyses. In post-hoc whole brain exploratory analyses, a meta-analytically derived default mode network node (ie, posterior cingulate cortex) showed connectivity with regions unassociated with pain processing as a function of mindfulness, such that healthy adults higher in mindfulness showed greater functional connectivity between the posterior cingulate cortex-and cerebellum. Collectively, these findings suggest that the relationship between mindfulness and default mode network functional connectivity may be nuanced or non-robust, and encourage further investigation of how mindfulness relates to pain. PERSPECTIVE: This study found few significant associations between dispositional mindfulness and pain, pain reactivity and default mode connectivity in healthy adults and migraine patients. The relationship between mindfulness and default mode network connectivity may be nuanced or non-robust.

Effects of a randomised trial of 5-week heart rate variability biofeedback intervention on mind wandering and associated brain function

Previous research suggests that excessive negative self-related thought during mind wandering involves the default mode network (DMN) core subsystem and the orbitofrontal cortex (OFC). Heart rate variability (HRV) biofeedback, which involves slow paced breathing to increase HRV, is known to promote emotional well-being. However, it remains unclear whether it has positive effects on mind wandering and associated brain function. We conducted a study where young adults were randomly assigned to one of two 5-week interventions involving daily biofeedback that either increased heart rate oscillations via slow paced breathing (Osc+ condition) or had little effect on heart rate oscillations (active control or Osc- condition). The two intervention conditions did not differentially affect mind wandering and DMN core-OFC functional connectivity. However, the magnitude of participants' heart rate oscillations during daily biofeedback practice was associated with pre-to-post decreases in mind wandering and in DMN core-OFC functional connectivity. Furthermore, the reduction in the DMN core-OFC connectivity was associated with a decrease in mind wandering. Our results suggested that daily sessions involving high amplitude heart rate oscillations may help reduce negative mind wandering and associated brain function.

Phenomenological support for escape theory: a qualitative study using explicitation interviews with emotional eaters

The current study explored the phenomenology of emotional eating, that is, the descriptive knowledge of what one perceives, senses, and knows in one's immediate awareness and experience during emotional eating. Eight individuals with emotional eating were interviewed twice using explicitation interviewing. Data were analyzed using thematic analysis, which resulted in nine themes describing the diachronic (or temporal) unfolding of emotional eating and several sub-themes that described various synchronic (or experiential) dimensions of this unfolding. The core findings of this study support the escape theory of emotional eating and recommend future directions to investigate the self-related shifts proposed by this theory. Namely, the findings show that individuals tend to use food to regulate their emotions by reducing the unpleasant experience of negative emotions and the associated unpleasant narrative processing or ruminations about stressors that caused the negative emotions. This then leads to an urge to eat associated with a desire for the sensory experience of eating. Eating then enables individuals to reduce thoughts about their stressors and bring themselves into the present moment through embodiment. Future quantitative research could investigate this mechanism of shifting from narrative to embodied processing to regulate emotions in emotional eating to develop treatment programs, such as mindfulness-based programs, that could encourage such a shift and emotion regulation without the use of food.

Self-transcendent experiences as promoters of ecological wellbeing? Exploration of the evidence and hypotheses to be tested

In recent years, much has been written on the role of different mental states and their potential to influence our way of thinking and, perhaps more importantly, the way we act. With the recent acceleration of environmental and mental health issues, alongside the limited effectiveness of existing interventions, an exploration of new approaches to deliver transformative change is required. We therefore explore the emerging potential of a type of mental state known as self-transcendent experiences (STEs) as a driver of ecological wellbeing. We focus on four types of STEs: those facilitated by experiences of flow, awe, and mindfulness, as well as by psychedelic-induced experiences. Some of these experiences can occur naturally, through sometimes unexpected encounters with nature or during immersion in every-day activities that one intrinsically enjoys, as well as through more intentional practices such as meditation or the administration of psychedelics in controlled, legal settings. We explore the evidence base linking each of the four types of STE to ecological wellbeing before proposing potential hypotheses to be tested to understand why STEs can have such beneficial effects. We end by looking at the factors that might need to be considered if STEs are going to be practically implemented as a means of achieving ecological wellbeing.

Impact of a mindfulness-based school curriculum on emotion processing in Vietnamese pre-adolescents: An event-related potentials study

The neurocognitive mechanisms associated with mindfulness training in children are not well understood. This randomised controlled study with active and passive control groups examined the impact of an 18-week mindfulness curriculum delivered by schoolteachers on emotion processing in Vietnamese 7- to 11-year-olds. Event-related potential markers indexed emotion processing while children were completing emotional Go/No-Go tasks before and after mindfulness training, and at 6-month follow-up. In an oddball Go/No-Go task with Caucasian faces no changes in P3b and LPP components were detected, but in a Go/No-Go task with Caucasian and Japanese faces changes were observed in P3b latencies and LPP mean amplitudes. Specifically, the P3b in response to angry non-targets for Japanese faces peaked later in the mindfulness training group (TG) at 6-months follow-up in comparison to the non-intervention control group (NCG). The LPP mean amplitudes for averaged Caucasian and Japanese angry non-targets were also attenuated in the TG at 6-month follow-up. In contrast, no changes in the LPP mean amplitudes were observed for the NCG over time. Together, these findings may indicate that mindfulness training in pre-adolescents enhances emotional non-reactivity to negative distractors. A fluctuating pattern of LPP mean amplitude modulations for angry targets was observed in the active control group (ACG) receiving social-emotional learning (SEL) training. Overall, findings from this study suggest that mindfulness training in pre-adolescents enhances emotional non-reactivity to negative distractors and some of the effects are culturally sensitive.

Mindfulness based cognitive therapy (MBCT) reduces depression-related self-referential processing in patients with bipolar disorder: an exploratory task-based study

Negative self-referential processing has fruitfully been studied in unipolar depressed patients, but remarkably less in patients with bipolar disorder (BD). This exploratory study examines the relation between task-based self-referential processing and depressive symptoms in BD and their possible importance to the working mechanism of mindfulness-based cognitive therapy (MBCT) for BD. The study population consisted of a subsample of patients with BD (n = 49) participating in an RCT of MBCT for BD, who were assigned to MBCT + TAU (n = 23) or treatment as usual (TAU) (n = 26). Patients performed the self-referential encoding task (SRET), which measures (1) positive and (2) negative attributions to oneself as well as (3) negative self-referential memory bias, before and after MBCT + TAU or TAU. At baseline, all three SRET measures were significantly related to depressive symptoms in patients with BD. Moreover, repeated measures analyses of variance revealed that negative self-referential memory bias diminished over time in the MBCT + TAU group, compared with the TAU group. Given the preliminary nature of our findings, future research should explore the possibly mediating role of reducing negative self-referential memory bias in preventing and treating depressive symptoms in BD through MBCT.

Mindfulness in the focus of the neurosciences - The contribution of neuroimaging to the understanding of mindfulness

BACKGROUND

Mindfulness affects human levels of experience by facilitating the immediate and impartial perception of phenomena, including sensory stimulation, emotions, and thoughts. Mindfulness is now a focus of neuroimaging, since technical and methodological developments in magnetic resonance imaging have made it possible to observe subjects performing mindfulness tasks.

OBJECTIVE

We set out to describe the association between mental processes and characteristics of mindfulness, including their specific cerebral patterns, as shown in structural and functional neuroimaging studies.

METHODS

We searched the MEDLINE databank of references and abstracts on life sciences and biomedical topics via PubMed using the keywords: "mindfulness," "focused attention (FA)," "open monitoring (OM)," "mind wandering," "emotional regulation," "magnetic resonance imaging (MRI)" and "default mode network (DMN)." This review extracted phenomenological experiences across populations with varying degrees of mindfulness training and correlated these experiences with structural and functional neuroimaging patterns. Our goal was to describe how mindful behavior was processed by the constituents of the default mode network during specific tasks.

RESULTS AND CONCLUSIONS

Depending on the research paradigm employed to explore mindfulness, investigations of function that used fMRI exhibited distinct activation patterns and functional connectivities. Basic to mindfulness is a long-term process of learning to use meditation techniques. Meditators progress from voluntary control of emotions and subjective preferences to emotional regulation and impartial awareness of phenomena. As their ability to monitor perception and behavior, a metacognitive skill, improves, mindfulness increases self-specifying thoughts governed by the experiential phenomenological self and reduces self-relational thoughts of the narrative self. The degree of mindfulness (ratio of self-specifying to self-relational thoughts) may affect other mental processes, e.g., awareness, working memory, mind wandering and belief formation. Mindfulness prevents habituation and the constant assumptions associated with mindlessness. Self-specifying thinking during mindfulness and self-relational thinking in the narrative self relies on the default mode network. The main constituents of this network are the dorsal and medial prefrontal cortex, and posterior cingulate cortex. These midline structures are antagonistic to self-specifying and self-relational processes, since the predominant process determines their differential involvement. Functional and brain volume changes indicate brain plasticity, mediated by mental training over the long-term.

Embracing Uncertainty: How literary writing helps us change our minds

Creative writing and cognitive neuroscience can jointly illuminate how literary writing can change our minds by enhancing our tolerance for uncertainty. From my perspective as a novelist, I will show how literary writing hijacks the mechanisms of day-to-day perception and orchestrates cognition to facilitate vividness of (imaginary) experience and insight. Drawing on examples from my novel and other research, I will discuss the role of uncertainty and literary devices such as contradiction and paradox in stymieing habitual assumptions while inviting the reader’s sensory imagination and conscious awareness, thereby creating an open space for insight. I hypothesize that literary writing promotes a form of dual cognition that involves both sensory experience and detachment, is therapeutic, and may share some of the benefits of mindfulness.

Beyond the veil of duality-topographic reorganization model of meditation

Meditation can exert a profound impact on our mental life, with proficient practitioners often reporting an experience free of boundaries between a separate self and the environment, suggesting an explicit experience of "nondual awareness." What are the neural correlates of such experiences and how do they relate to the idea of nondual awareness itself? In order to unravel the effects that meditation has on the brain's spatial topography, we review functional magnetic resonance imaging brain findings from studies specific to an array of meditation types and meditator experience levels. We also review findings from studies that directly probe the interaction between meditation and the experience of the self. The main results are (i) decreased posterior default mode network (DMN) activity, (ii) increased central executive network (CEN) activity, (iii) decreased connectivity within posterior DMN as well as between posterior and anterior DMN, (iv) increased connectivity within the anterior DMN and CEN, and (v) significantly impacted connectivity between the DMN and CEN (likely a nonlinear phenomenon). Together, these suggest a profound organizational shift of the brain's spatial topography in advanced meditators-we therefore propose a topographic reorganization model of meditation (TRoM). One core component of the TRoM is that the topographic reorganization of DMN and CEN is related to a decrease in the mental-self-processing along with a synchronization with the more nondual layers of self-processing, notably interoceptive and exteroceptive-self-processing. This reorganization of the functionality of both brain and self-processing can result in the explicit experience of nondual awareness. In conclusion, this review provides insight into the profound neural effects of advanced meditation and proposes a result-driven unifying model (TRoM) aimed at identifying the inextricably tied objective (neural) and subjective (experiential) effects of meditation.

Lasting increases in trait mindfulness after psilocybin correlate positively with the mystical-type experience in healthy individuals

Background

Psilocybin-induced mystical-type experiences are associated with lasting positive psychological outcomes. Recent studies indicate that trait mindfulness is increased 3 months after psilocybin intake, preceded by decreases in neocortical serotonin 2A receptor (5-HT_2AR) binding. However, the association between psilocybin-induced mystical-type experiences and subsequent changes in trait mindfulness remains unexplored, as does the association between pre-drug trait mindfulness and 5-HT_2AR binding in the healthy brain.

Aim

We evaluated whether psilocybin induced lasting increases in trait mindfulness in healthy volunteers, and whether the mystical-type experience was associated with this increase. We further examined the association between pre-drug trait mindfulness and 5-HT_2AR binding in neocortex and selected frontolimbic regions.

Materials and methods

Forty-six medium-high dose psilocybin sessions were conducted in 39 healthy individuals. The mystical-type experience was measured with the Mystical Experience Questionnaire (MEQ) at the end of the session. Trait mindfulness was measured using the Mindful Attention and Awareness Scale (MAAS) at baseline and 3 months after the psilocybin session. Thirty-two of the participants completed pre-drug [¹¹C]-Cimbi-36 positron emission tomography (PET) to assess 5-HT_2AR binding in neocortex and, post-hoc, in the frontolimbic regions amygdala, frontal cortex, and anterior cingulate cortex.

Results

The MAAS score was significantly increased at 3-month follow-up (p = 3.24 × 10^–6), a change positively associated with the MEQ score (p = 0.035). Although the association between pre-drug MAAS score and neocortex 5-HT_2AR binding was not significant (p = 0.24), post-hoc analyses revealed a significant negative association between MAAS and right amygdala 5-HT_2AR binding (p_FWER = 0.008).

Conclusion

We here show that lasting changes in trait mindfulness following psilocybin administration are positively associated with intensity of the mystical-type experience, suggesting that the acute phenomenology of psilocybin facilitates a shift in awareness conducive for mindful living. We furthermore show that higher pre-drug trait mindfulness is associated with reduced 5-HT_2AR binding in the right amygdala.