Mindfulness improves verbal learning and memory through enhanced encoding

Mindfulness in Surgical Training (MiST): A Modified Mindfulness Curriculum for Surgical Residents

OBJECTIVES

Residents experience numerous work-related and personal stressors that make it difficult to focus in the operating room, negatively impacting learning and surgical performance. Mindfulness-based cognitive therapy decreases anxiety and improves memory and learning. This study aimed to create a feasible and desirable modified mindfulness curriculum for surgical residents.

DESIGN

This was a prospective cohort study using multiple methods design to assess a 12-week modified mindfulness curriculum tailored to busy surgical trainees involving a 30 min group session weekly and 15 minutes home practice daily. The main outcomes were program feasibility and desirability. Focus groups explored how mindfulness techniques were used in the operating room. Secondary outcomes were measured in a pre- and post- intervention design assessing surgical performance, anxiety, confidence and burnout using validated assessment scales. Outcome measures were collected at baseline, immediately following the course and at 3 months postintervention.

SETTING

Academic obstetrics and gynecology residency program.

PARTICIPANTS

Obstetrics and gynecology residents in postgraduate years 2-5 at the University of Toronto were invited to participate in Mindfulness in Surgical Training.

RESULTS

Twelve (20%) out of 61 eligible residents enrolled in the program and 8 (67%) completed the course. There was a statistically significant decrease in anxiety (p < 0.001) and increase in surgical confidence (p = 0.007) following the mindfulness curriculum using validated survey tools. There was no change in burnout or surgical performance evaluations. Thematic analysis identified that mindfulness tools were beneficial and regularly utilized by participants in the operating room with sustained use 3 months post intervention. The biggest barrier to participation in the mindfulness curriculum was time. Participants felt the residency program should support ongoing mindfulness training to promote a positive culture shift.

CONCLUSIONS

A modified mindfulness curriculum designed for surgical trainees is feasible, desirable, reduces anxiety and increases surgical confidence.

Efficacy of Cognitive Interventions in Mild Cognitive Impairment due to Alzheimer's Disease- An Open-Labelled Exploratory Analysis

BACKGROUND

Efficacy data on nonpharmacotherapy-based interventions such as cognitive retraining and mindfulness meditation on improving neuropsychological functioning in early Alzheimer's disease (AD) are sparse in Indian literature.

OBJECTIVE

The objective of the study was to quantify the effect of cognitive retraining (CR) versus mindfulness training (MT) on neuropsychological test performance in patients with early AD.

METHODS AND MATERIALS

We administered CR and MT strategies in two prospectively enrolled groups of individuals (N = 34) who met the criteria for mild cognitive impairment (MCI) due to AD. Inclusion was based on patient choice and informed consent. One group of 20 patients was imparted supervised CR, and the other group included 14 patients who opted for MT as open-labeled interventions, with group allocation based on participant choice.

RESULTS

Paired t test was performed with assessment of baseline and postintervention neuropsychological scores of CR and MT groups. The CR group revealed significant improvement on scores at 3 months (P < 0.05) for Addenbrooke's Cognitive Examination (ACE) subcomponents, particularly total score, memory, visuospatial, and language subscores as well as on Clinical Dementia Rating (CDR) scale. The MT group showed no significant differences on these tests post-intervention with a trend toward improvement on recall scores, and none of the other test scores demonstrated a declining trend.

CONCLUSIONS

This proof-of-concept study demonstrated significant benefit of CR in improving neuropsychological test performance in patients with MCI due to AD and need to be studied in long-term, multicenter, randomized controlled trials in harmonized groups of patients with MCI and early AD.

Treatment as a moderator and executive function as a mediator of the effect of a mindfulness ecological momentary intervention for generalized anxiety disorder

BACKGROUND

Theory and research indicated that executive functioning (EF) correlated with, preceded, and stemmed from worry in generalized anxiety disorder (GAD). The present secondary analysis (Zainal & Newman, 2023b) thus determined whether EF domains mediated the effect of a 14-day (5 prompts/day) mindfulness ecological momentary intervention (MEMI) against a self-monitoring control (SM) for GAD.

METHOD

Participants (N = 110) diagnosed with GAD completed self-reported (Attentional Control Scale, GAD Questionnaire, Perseverative Cognitions Questionnaire) and performance-based tests (Letter-Number Sequencing, Stroop, Trail Making Test-B, Verbal Fluency) at baseline, post-treatment, and one-month follow-up (1MFU). Causal mediation analyses determined if pre-post changes in EF domains preceded and mediated the effect of MEMI against SM on pre-1MFU changes in GAD severity and trait repetitive negative thinking (RNT).

RESULTS

MEMI was more efficacious than SM in improving pre-post inhibition (β = -2.075, 95% [-3.388, -0.762], p = .002), working memory (β = 0.512, 95% [0.012, 1.011], p = .045), and set-shifting (β = -2.916, 95% [-5.142, -0.691], p = .010) but not verbal fluency and attentional control. Within groups, MEMI but not SM produced improvements in all examined pre-post EF outcomes except attentional control. Only pre-post improvements in inhibition mediated the effect of MEMI against SM on pre-1MFU reductions in GAD severity (β = -0.605, 95% [-1.357, -0.044], p = .030; proportion mediated = 7.1%) and trait RNT (β = -0.024, 95% [-0.054, -0.001], p = .040; proportion mediated = 7.4%). These patterns remained after conducting sensitivity analyses with non-linear mediator-outcome relations.

CONCLUSIONS

Optimizing MEMI for GAD might entail specifically boosting inhibition plausibly by augmenting it with dialectical behavioral therapy, encouraging high-intensity physical exercises, and targeting negative emotional contrast avoidance.

Transdiagnostic and transtherapeutic strategies for optimising autobiographical memory

Our memories for past personally experienced autobiographical events play an important role in therapy, irrespective of presenting issue, diagnoses or therapeutic modality. Here, we summarise evidence for how autobiographical memory abilities can influence our mental health and the relevance of this for the treatment of mental health problems. We then guide the reader through principles and strategies for optimising autobiographical memory within treatment. We ground these recommendations within research for stand-alone interventions for improving autobiographical memory and from studies of how to support the formation and retrieval of therapeutic memories. Options are given for clinicians to guide clients in improving retrieval of autobiographical memories within treatment, for improving autobiographical memory for the therapeutic experience itself, and for creating improvements in autobiographical memory that endure post-treatment. We also provide worksheets for clinicians to use within treatment.

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.

Mindfulness enhances cognitive functioning: a meta-analysis of 111 randomized controlled trials

BACKGROUND

Currently no comprehensive meta-analysis of MBI efficacy on global and unique cognitive subdomains exist.

METHOD

Examined the effects of MBIs on global cognition and 15 cognitive subdomains. Inclusion criteria: meditation naïve participants; randomized controlled trial; outcome included one objective or subjective cognitive functioning measure; primary focus was teaching mindfulness skills. Exclusion criteria: inadequate data; one-session ; control condition contained any MBI component. Robust variance estimation and moderator analyses controlling for presence of treatment fidelity were conducted.

RESULTS

One-hundred-and-eleven RCTs (n = 9,538) met eligibility criteria. MBIs had small-to-moderate significant effects on global cognition, executive attention, working memory accuracy, inhibition accuracy, shifting accuracy, sustained attention, and subjective cognitive functioning (vs. waitlist/no-treatment, g = 0.257-0.643; vs. active controls, g = 0.192-0.394). MBIs did not impact executive functioning (EF) latency indices, verbal fluency, processing speed, episodic memory, and cognitive error. Treatment effects were stronger for those with elevated psychiatric symptoms vs. healthy controls, and medical samples, studies with complete-case (vs. intention-to-treat) analysis, face-to-face (vs. self-guided) delivery, and non-standard (vs. standard MBI).

CONCLUSION

MBIs consistently yielded small-to-moderate yet practically meaningful effect sizes on global cognition and six cognitive subdomains that captured accuracy vs. latency-based indices of EF and sustained accuracy.

Cognitive, psychological, and physiological effects of a web-based mindfulness intervention in older adults during the COVID-19 pandemic: an open study

BACKGROUND

The development of effective strategies to maintain good mental health of older adults is a public health priority. Mindfulness-based interventions have the potential to improve psychological well-being and cognitive functions of older adults, but little is known about the effect of such interventions when delivered through internet. During the COVID-19 pandemic we evaluated short- and long-term cognitive, psychological, and physiological effects of a mindfulness-based intervention (MBI) delivered via web-based videoconference in healthy older adults.

METHODS

Fifty older adults participated in an 8-week MBI, which comprised structured 2-h weekly group sessions. A comprehensive evaluation encompassing cognitive (verbal memory, attention and processing speed, executive functions) and psychological assessments (depression and anxiety symptoms, mindfulness, worries, emotion regulation strategies, well-being, interoceptive awareness and sleep) was conducted. Additionally, electroencephalography (EEG) data were recorded before and after the MBI and at the 6-month follow-up (T6). Data were analyzed using an intention-to-treat approach, using linear mixed models adjusted for age. The effect size for time was computed as omega squared.

RESULTS

We observed significant improvements from pre-MBI to post-MBI and at the T6 across several measures. These improvements were notable in the areas of verbal memory (California Verbal Learning Test, p ≤ .007), attention and executive functions (Trail Making Test A and BA, p < .050), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness, p = .0002 for self-regulation and p < .05 for noticing, body listening, and trusting dimensions), and rumination (Heidelberg Form for Emotion Regulation Strategies, p = .018). These changes were associated with low to medium effect size. Moreover, we observed significant changes in EEG patterns, with a decrease in alpha1 (p = .004) and an increase in alpha2 (p < .0001) from pre-MBI to T6. Notably, improvements in TMTBA and rumination were correlated with the decrease in alpha1 (p < .050), while improvements in TMTA were linked to the increase in alpha2 (p = .025).

CONCLUSIONS

The results of our study show that a web-based MBI in older adults leads to improvements in cognitive and psychological measures, with associated modulations in specific brain rhythms. While these findings are promising, further controlled studies are required to validate these preliminary results.

TRIAL REGISTRATION

The trial has been registered with the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT05941143 on July 12, 2023.

Lived Experiences of Cognitive Dysfunction in Fibromyalgia: How Patients Discuss Their Experiences and Suggestions for Patient Education

Cognitive dysfunction (CD) is a common, impairing symptom experienced by persons with fibromyalgia (FM). This study explored how individuals with FM describe their experience of CD in an online peer support environment. Posts referencing cognitive symptoms were extracted from two Facebook FM peer support groups at two timepoints. Using inductive Thematic Analysis, key discussion themes were identified and compared across groups and time. Four themes represented the way members described their cognitive experiences in FM: understanding and describing CD experiences, distrust of cognitive abilities, choosing between pain and medication side effects, and misunderstanding and judgement from others. Two themes represented the impact of CD on members' lives: impaired social interaction and loss of identity. Group members described broad impairments in daily functioning that significantly and negatively impacted their quality of life, indicating CD symptoms may play a more prominent role in the FM experience than previously understood. An infographic is included to aid patient education and help facilitate patient-provider discussions of CD symptoms.

A meta-analytical review of the impact of mindfulness on creativity: Framing current lines of research and defining moderator variables

Findings relating to the impact of mindfulness interventions on creative performance remain inconsistent, perhaps because of discrepancies between study designs, including variability in the length of mindfulness interventions, the absence of control groups or the tendencies to explore creativity as one unitary construct. To derive a clearer understanding of the impact that mindfulness interventions may exert on creative performance, two meta-analytical reviews were conducted, drawing respectively on studies using a control group design (n = 20) and studies using a pretest-posttest design (n = 17). A positive effect was identified between mindfulness and creativity, both for control group designs (d = 0.42, 95% CIs [0.29, 0.54]) and pretest-posttest designs (d = 0.59, 95% CIs [0.38, 0.81]). Subgroup analysis revealed that intervention length, creativity task (i.e., divergent vs. convergent thinking tasks) and control group type, were significant moderators for control group studies, whereas only intervention length was a significant moderator for pretest-posttest studies. Overall, the findings support the use of mindfulness as a tool to enhance creative performance, with more advantageous outcomes for convergent as opposed to divergent thinking tasks. We discuss the implications of study design and intervention length as key factors of relevance to future research aimed at advancing theoretical accounts of the relationship between mindfulness and creativity.

Psilocybin intoxication did not affect daytime or sleep-related declarative memory consolidation in a small sample exploratory analysis

Psilocybin is investigated as a fast-acting antidepressant used in conjunction with psychotherapy. Intact cognitive functions, including memory, are one of the basic conditions of effective psychedelic-assisted therapy. While cognitive and memory processing is attenuated on various domains during psilocybin intoxication, the effect of psilocybin on the consolidation of memories learned outside of acute intoxication is not known. Thus the main aim of the current study was to test the effects of psilocybin on (A) memory consolidation of previously learned material just after the psilocybin session and (B) on overnight memory consolidation the night just after the psilocybin session. 20 healthy volunteers (10 M/10F) were enrolled in a placebo-controlled, double-blind, cross-over design. Effects on declarative memory consolidation in condition (A) The Groton Maze Learning Task and Rey Auditory Verbal Learning Test were used, and for (B) the Pair Associative Learning Test was used. We did not find psilocybin to improve memory consolidation. At the same time, we did not find psilocybin to negatively affect memory consolidation in any of the tests used. This evidence adds to the safety profile for the use of psilocybin.

A new multidimensional group intervention for cognitive and psychosocial functioning for older adults: Background, content, and process evaluation

Introduction

An essential element of quality aging is the maintenance of cognitive and psychosocial functioning. The principal objective of the present paper was to present the theoretical framework, content and process evaluation of a newly developed multi-dimensional group intervention designed to strengthen/improve areas of cognitive and psychosocial functioning in adults over 65.

Methods

The intervention implements multiple methodologies aiming to facilitate contextual integration of learned concepts and strategies derived from clinical psychology and rehabilitation. It moves seamlessly on the cognition-emotion axes and consists of five active ingredients selected to address challenges associated with aging: Memory Compensatory Strategies, Problem-Solving, Emotion Regulation, Mindfulness, and Locus of Control. Thirty participants joined the intervention group aged 65-75  years (M = 69.03; SD = 3.04). All 30 participants who were included in the intervention group completed the program.

Results

Results from the Participant Satisfaction Scale indicate that the program was perceived very positively by participants, who also reported implementing their newly learned strategies in activities of daily life. Furthermore, there was high correlation between internal locus of control and the learned strategies.

Discussion

The outcomes of this analysis indicate that the intervention is feasible and well tolerated by our target group. This multidimensional intervention may offer a valuable contribution to public health care and dementia prevention for older adults.

Clinical Trial Registration

[https://clinicaltrials.gov/ct2/results?cond=NCT01481246], identifier [NCT01481246].

A Mini-Review of Work Stress and Mindfulness: A Neuropsychological Point of View

Work stress is consistently linked with the deterioration of cognitive and mental health, limitations in everyday workplace performance, and an increased risk of developing diseases. A common thread binding these consequences appears to be stress-associated alterations in neuropsychological functions and affective domains, especially those reliant on hippocampal, prefrontal, and amygdala brain area. Although research broadly supports the claim that the practice of mindfulness meditation for the reduction of the consequences of stress and the promotion of health exert positive effects on workplaces, the precise neuropsychological benefits of Mindfulness-based interventions (MBIs) in the context of organizations remain elusive. In this review, we will analyze the impairments imposed by stress on the brain areas and functions and the benefits of MBIs from a neuropsychological point of view. This is significant since there is a centrality of cognitive functions in core processes necessary for work achievements, such as emotion regulation, problem-solving, and learning. The promotion of wellbeing is a responsibility shared between workers and organizations. Developing healthy environments allows workers to exercise greater control over their work, face work challenges, work productively and develop their talent.

Lateralized Contributions of Medial Prefrontal Cortex Network to Episodic Memory Deficits in Subjects With Amnestic Mild Cognitive Impairment

Both episodic memory and executive function are impaired in amnestic mild cognitive impairment (aMCI) subjects, but it is unclear if these impairments are independent or interactive. The present study aimed to explore the relationship between episodic memory deficits and executive function deficits, and the underlying functional mechanisms in aMCI subjects. Thirty-one aMCI subjects and 27 healthy subjects underwent neuropsychological tests and multimodal magnetic resonance imaging (MRI) scans. Hippocampal networks and medial prefrontal cortex (MPFC) networks were identified based on resting-sate functional MRI (fMRI) data. AMCI subjects displayed lower episodic memory scores and executive function scores than control subjects, and the episodic memory scores were positively correlated with the executive function scores in aMCI subjects. Brain network analyses showed an interaction between the hippocampal networks and the MPFC networks, and the interaction was significantly associated with the episodic memory scores and the executive function scores. Notably, aMCI subjects displayed higher functional connectivity (FC) of the right hippocampal network with the right prefrontal cortex than did control subjects, but this difference disappeared when controlling for the MPFC networks. Furthermore, the effects of the MPFC networks on the hippocampal networks were significantly associated with the episodic memory scores in aMCI subjects. The present findings suggested that the episodic memory deficits in aMCI subjects could be partially underpinned by the modulation of the MPFC networks on the hippocampal networks.

Immediate & delayed effects of suppression and mindfulness as emotion regulation strategies

BACKGROUND & OBJECTIVES

Emotion regulation is an integral component of multiple physical and psychological functions, and problems with emotion regulation are thought to be involved with the development of psychological disorders. Most laboratory research on emotion regulation has been limited to investigating short-term impact during a single session.

DESIGN & METHODS

In the current study, we investigated the potential delayed consequences of the short-term use of two emotion regulation strategies: mindfulness and suppression. To do so, a two-session design was implemented, with 56 undergraduate participants viewing images under various regulation instructions at Time 1, returning one week later for a recognition memory test for these images at Time 2. Images were rated for valence and arousal at both time points.

RESULTS

We hypothesized that images encoded mindfully would elicit lower levels of anxiety upon re-exposure, while suppression would increase levels of anxiety. Results did not support original hypotheses: although participants reported being calmer and happier at re-exposure, this effect did not vary by strategy. High-anxiety participants reported higher arousal levels regardless of Instruction condition or Time Point.

CONCLUSIONS

These findings suggest that short-term use of emotion regulation does not impact feelings of calmness long-term, when exposed to anxiety-provoking stimuli.

Effects of mindfulness-and acceptance-based interventions on quality of life, coping, cognition, and mindfulness of people with multiple sclerosis: a systematic review and meta-analysis

This systematic review and meta-analysis of randomized controlled trials (RCTs) examined effects of mindfulness- and acceptance-based interventions (MABIs) on quality of life (QoL), coping, cognition, and mindfulness among people with multiple sclerosis (MS). Four electronic databases were searched to 3 July 2020. Data was combined in a random-effects meta-analysis model. Eighteen RCTs met the eligibility criteria. Meta-analyses at the immediate posttest found: moderate effects of MABIs on QoL, coping, and attention; and a large effect on memory. A large effect of MABIs on QoL was found at follow-up. There was no significant effect of MABIs on mindfulness. Relatively fewer studies in outcomes other than QoL were found, and the overall risk of bias across the included 18 RCTs was unclear. Future high-quality studies with follow-up evaluations are needed to support effects of MABIs on QoL, coping, cognition, and mindfulness in people with MS and examine intervention features that increase and maintain effects.

[The Effect of a Short-Term Mindfulness Program on Memory Performance in School-Aged Children]

The Effect of a Short-Term Mindfulness Program on Memory Performance in School-Aged Children A one-week mindfulness-based intervention designed to improve 8- to 10-year-old children's memory performance was investigated. Seventy-three children were quasi-randomly assigned either to one of two mindfulness-based intervention groups (breathing meditation or yoga), or to an active control group. The sessions were held on six consecutive days. Prior to intervention and after completing the intervention, children's short-term and long-term memory performance were assessed. In confirmation of prior studies, breathing meditation and yoga showed positive effects on memory performance when compared with the control group. Moreover, differences in the effectiveness of breathing meditation and yoga were found: While both interventions had comparable effects on long-term memory, only breathing meditation showed improvements in short-term memory performance. The present study provides valuable evidence on the effectiveness of meditation on cognitive functions in childhood and shows that school-aged children can already benefit from short-term meditation programs.

Recent cocaine use and memory impairment in HIV

Both Human Immunodeficiency Virus (HIV) and cocaine use have been associated with impairment in neuropsychological functioning. The high comorbidity between HIV and cocaine use highlights the importance of ascertaining whether there is a compounding effect of cocaine use in individuals with HIV. Among neuropsychological domains impacted by HIV, verbal memory deficits have received substantial attention partly because they have been associated with declines in functional status in HIV positive individuals. We collected California Verbal Learning Test-II data from HIV participants who met lifetime diagnostic criteria of cocaine abuse and/or dependence (HIV/CocDx+, N = 80 & HIV/CocDx-, N = 30, respectively) and those with and without recent cocaine use, which was confirmed by toxicology analysis (HIV/Coc+, N = 56 & HIV/Coc-, N = 57, respectively). The Item Specific Deficit Approach (ISDA) was employed to determine any additional cocaine-associated deficits in encoding, consolidation, and retrieval, which attempts to control for potential confounding factors of memory such as attention. Using conventional methods of evaluating memory profiles, we found that the HIV/Coc + group demonstrated worse learning, immediate and delayed free recall, and recognition in contrast to the HIV/Coc - group; although using the ISDA, we found that encoding was the only significant difference between HIV/Coc + and HIV/Coc-participant, with HIV/Coc - performing better. Our data suggest that for individuals with HIV, cocaine use is associated with a temporary decline in verbal memory, is characterized by greater encoding deficits, and these effects may reduce with abstinence. Clinically, our findings suggest that reduced encoding is the likely contributor to verbal memory decline in HIV/Coc + and these effects are partially reversible-at least to the level of their HIV/Coc - counterparts.