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Gasión V, Barceló-Soler A, Beltrán-Ruiz M, Hijar-Aguinaga R, Camarero-Grados L, López-Del-Hoyo Y, García-Campayo J, Montero-Marin J. Effectiveness of an amygdala and insula retraining program combined with mindfulness training to improve the quality of life in patients with long COVID: a randomized controlled trial protocol. BMC Complement Med Ther 2023; 23:403. [PMID: 37946190 PMCID: PMC10634181 DOI: 10.1186/s12906-023-04240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND There has been growing clinical awareness in recent years of the long-term physical and psychological consequences of the SARS-CoV-2 virus, known as Long COVID. The prevalence of Long COVID is approximately 10% of those infected by the virus. Long COVID is associated with physical and neuropsychological symptoms, including those related to mental health, psychological wellbeing, and cognition. However, research on psychological interventions is still in its early stages, in which means that available results are still limited. The main objective of this study is to evaluate the effects of a program based on amygdala and insula retraining (AIR) combined with mindfulness training (AIR + Mindfulness) on the improvement of quality of life, psychological well-being, and cognition in patients with Long COVID. METHODS This study protocol presents a single-blind randomized controlled trial (RCT) that encompasses baseline, post-treatment, and six-month follow-up assessment time points. A total of 100 patients diagnosed with Long COVID by the Spanish National Health Service will be randomly assigned to either AIR + Mindfulness (n = 50) or relaxation intervention (n = 50), the latter as a control group. The primary outcome will be quality of life assessed using the Short Form-36 Health Survey (SF-36). Additional outcomes such as fatigue, pain, anxiety, memory, and sleep quality will also be evaluated. Mixed effects regression models will be used to estimate the effectiveness of the program, and effect size calculations will be made. DISCUSSION Long COVID syndrome is a clinical condition characterized by the persistence of symptoms for at least 12 weeks after the onset of COVID-19 that significantly affects people's quality of life. This will be the first RCT conducted in Spain to apply a psychotherapy program for the management of symptoms derived from Long COVID. Positive results from this RCT may have a significant impact on the clinical context by confirming the beneficial effect of the intervention program being evaluated on improving the symptoms of Long COVID syndrome and aiding the development of better action strategies for these patients. TRIAL REGISTRATION Clinical Trials.gov NCT05956405. Registered on July 20, 2023.
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Affiliation(s)
- Virginia Gasión
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
| | - Alberto Barceló-Soler
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain.
- Research Network on Chronicity, Primary Care and Health Promotion, RICAPPS, Zaragoza, RD21/0016/0005, Spain.
- University of Zaragoza, Huesca, Spain.
| | - María Beltrán-Ruiz
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion, RICAPPS, Zaragoza, RD21/0016/0005, Spain
| | | | | | - Yolanda López-Del-Hoyo
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion, RICAPPS, Zaragoza, RD21/0016/0005, Spain
| | - Javier García-Campayo
- Aragon Institute for Health Research, IIS Aragon, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion, RICAPPS, Zaragoza, RD21/0016/0005, Spain
| | - Jesus Montero-Marin
- Department of Psychiatry, University of Oxford, Oxford, UK
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
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Kou H, Luo W, Liu X, Ke M, Xie Q, Li X, Bi T. Mindfulness training modifies attentional bias to facial emotion and emotional symptoms. J Psychiatr Res 2023; 167:139-148. [PMID: 37871515 DOI: 10.1016/j.jpsychires.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/21/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Mindfulness training has been shown to improve emotional symptoms such as anxiety and depressive symptoms. However, its cognitive-behavioral mechanism is still unclear. The present study aimed to investigate the effect of mindfulness training on attention to emotional faces and its role in the improvement in emotional symptoms. METHODS Eighty participants were recruited and randomly divided into a training group (n = 40) that received eight weeks of mindfulness training and a control group (n = 40) that attended a mindfulness lecture. Before training (T1), immediately after training (T2), and three months after training (T3), all participants were asked to complete the Self-Rating Depression Scale (SDS) and the Self-Rating Anxiety Scale (SAS) to assess their emotional symptoms and a modified dot-probe task to measure their attention to emotional faces. RESULTS Mindfulness training significantly reduced anxiety and depressive symptoms at both T2 and T3. After training, the attentional bias toward happy faces increased, while the attentional bias toward sad faces decreased in the training group compared with the control group. Mediation analysis showed that the improvement in attentional bias toward sad faces partially mediated the effect of mindfulness training on depression at T2. LIMITATIONS Our participants were not a clinical sample (i.e., were not diagnosed with emotional disorders), and the time course of attention components was difficult to examine in the present study. CONCLUSIONS Mindfulness training can stably reduce anxious and depressive symptoms. However, it may have a temporary effect on attentional bias toward facial emotions, which plays a limited role in improving emotional symptoms.
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Affiliation(s)
- Hui Kou
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Wei Luo
- The Institute of Ethnology and Anthropology, Chinese Academy of Social Sciences, Beijing, China
| | - Xinnan Liu
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Mingyang Ke
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Qinhong Xie
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Xue Li
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Taiyong Bi
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China.
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Alan A, Ennabe M, Joshi N, Weinand M. Emotional intelligence in neurosurgery: Mitigating burnout and enhancing performance. Surg Neurol Int 2023; 14:326. [PMID: 37810292 PMCID: PMC10559373 DOI: 10.25259/sni_624_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 10/10/2023] Open
Abstract
Background This study underscores the high burnout rates among physicians, particularly surgical residents, attributing it to the demanding health-care ecosystem. It highlights the negative impacts of burnout, such as medical errors and increased health-care costs, while exploring the potential mitigating role of emotional intelligence (EI) and mindfulness. The research aimed to analyze the existing literature on EI in neurosurgery, focusing on its relationship with physician burnout and its potential role in healthcare leadership and residency training programs. Methods A comprehensive literature review was conducted using multiple databases, including PubMed, OVID Embase, and OVID Medline, using the keywords "Emotional Intelligence" and "neurosurgery." The search duration spanned from each database's inception to June 2023. Results The review highlighted various studies emphasizing the importance of integrating EI and mindfulness training into medical education and leadership, suggesting that a balance between technical competencies and interpersonal skills are critical. It identified personal integrity, effective communication, professional ethics, pursuit of excellence, relationship building, and critical thinking as key competencies for health-care leadership. Conclusion EI and a growth mindset play a critical role in managing burnout, enhancing job satisfaction and performance, and promoting effective healthcare leadership. The review, however, acknowledges certain limitations such as small sample sizes, single-institution experiences, potential biases, and inconsistencies in burnout parameters and EI measurement tools. Despite these, it points toward potential areas for future investigation and highlights the importance of standardized EI measurement tools and robust quantitative assessment methods.
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Affiliation(s)
- Albert Alan
- Department of Neurosurgery, University of Arizona, Tucson, United States
- College of Medicine, The University of Arizona College of Medicine - Tucson, United States
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, United States
- Global Neurosurgical Alliance, Tucson, Arizona, United States
| | - Michelle Ennabe
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, United States
- Global Neurosurgical Alliance, Tucson, Arizona, United States
- College of Medicine, The University of Arizona College of Medicine - Phoenix, Arizona, United States
| | - Neil Joshi
- Department of Neurosurgery, University of Arizona, Tucson, United States
| | - Martin Weinand
- Department of Neurosurgery, University of Arizona, Tucson, United States
- College of Medicine, The University of Arizona College of Medicine - Tucson, United States
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Yagi SR, Napa W, Awirutworakul T, Ittasakul P, Yagi N, Hartelius G. Effects of a brief interpersonal mindfulness program embedded in a psychiatric nursing practicum: A controlled pilot study. J Prof Nurs 2023; 47:46-55. [PMID: 37295912 DOI: 10.1016/j.profnurs.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Nursing school is a stressful environment that demands high performance both professionally and academically. Interpersonal mindfulness training has shown promise for its stress-reducing capacity in other contexts; however, few descriptions or tests of this method in nursing training settings exist in the literature. PURPOSE This pilot study examined effects of a brief interpersonal mindfulness program embedded in a 4-week psychiatric nursing practicum in Thailand. METHODS Mixed methods were used with 31 fourth-year nursing students to measure changes in mindfulness and assess their experiences of the program's impact. The control and experimental groups received the same clinical training, but the experimental group was also trained to practice interpersonal mindfulness throughout the course. FINDINGS The experimental group reported statistically significantly greater increases in Observing, Describing, and Non-reacting subscale scores, and in scores for the overall Five-Facet Mindfulness questionnaire, Thai version, than the control group (p < .05, Cohen's d = 0.83-0.95, large effect sizes). Group interviews revealed themes: initial challenges to mindfulness practice, experiences of becoming more mindful, intrapersonal benefits, and consequences of mindfulness on interpersonal skills. CONCLUSION Overall, an interpersonal mindfulness program embedded in a psychiatric nursing practicum was effective. Further studies are required to address limitations of the present study.
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Affiliation(s)
- Sudaros Rongmuang Yagi
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand.
| | - Wilai Napa
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Tantawan Awirutworakul
- Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Pichai Ittasakul
- Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | | | - Glenn Hartelius
- School of Consciousness and Transformation, California Institute of Integral Studies, 1453 Mission St, San Francisco, CA 94103, United States
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Dong M, Li Y, Zhang Y. The effect of mindfulness training on executive function in youth with depression. Acta Psychol (Amst) 2023; 235:103888. [PMID: 36934696 DOI: 10.1016/j.actpsy.2023.103888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023] Open
Abstract
Youth depression is often associated with impairments in cognitive function, especially in executive function. This study examines the effect of an 8-session-long mindfulness training that can improve executive function in youth with depression. Sixty youths (age range 15-27 years) with depression were selected as participants and were randomized into a mindfulness training group (MTG) and a waitlist-control group (WCG). The MTG received an 8-week mindfulness training while the WCG received no intervention. Both groups performed the Stroop, N-back, and More-odd shifting tasks at baseline and after eight weeks to examine inhibitory control, working memory, and cognitive flexibility of executive function, respectively. The results showed that mindfulness training significantly reduced the Stroop effect size for MTG (p < 0.001), but the effect on the switching cost was not statistically significant (p = 0.975). There was an age effect of mindfulness training on working memory. For young adults, mindfulness training improved accuracy on the N-back task (p < 0.01) and shortened reaction time, although this effect slightly exceeded the significance level (p = 0.075). However, mindfulness training failed to improve the working memory of adolescents with depression. In conclusion, mindfulness training improved inhibitory control in youth with depression. It also improved working memory in young adults with depression, but future studies with large samples are needed to validate the improvement in working memory.
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Affiliation(s)
- Mingchao Dong
- Department of Psychology, Renmin University of China, Beijing, China
| | - Yingwu Li
- Department of Psychology, Renmin University of China, Beijing, China; The Laboratory of Department of Psychology, Renmin University of China, Beijing, China.
| | - Yan Zhang
- Department of Psychology, Renmin University of China, Beijing, China
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Lee SY, Gathright EC, Wu WC, Salmoirago-Blotcher E. Mindfulness-Based Interventions for Patients with Cardiovascular Disease: A Focused Review for Practicing Clinicians. Curr Cardiol Rep 2023; 25:185-191. [PMID: 36862351 DOI: 10.1007/s11886-023-01846-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE OF REVIEW With growing scientific and public interest in the health benefits of mindfulness, clinicians increasingly face questions and solicitations for advice from patients about the efficacy of mindfulness-based interventions (MBIs) for cardiovascular disease (CVD). In this clinician-focused review, we aim to revisit empirical studies on MBIs for CVD with the purpose of informing clinicians' decisions on how to provide recommendations consistent with updated scientific findings to patients interested in MBIs. RECENT FINDINGS We start by defining MBIs and identifying the possible physiological, psychological, behavioral, and cognitive mechanisms underlying the potentially positive effects of MBIs for CVD. Potential mechanisms include the reduction of sympathetic nervous system activity, improved vagal control, and biological markers (physiological); psychological distress and cardiovascular health behaviors (psychological and behavioral); and executive function, memory, and attention (cognitive). Then, we summarize the extant evidence to identify gaps and limitations in MBI research for the purpose of informing future directions for cardiovascular and behavioral medicine researchers. We conclude with practical recommendations for clinicians communicating with patients with CVD who are interested in MBIs.
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Affiliation(s)
- Sharon Y Lee
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Emily C Gathright
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Wen-Chih Wu
- Alpert Medical School, Brown University, Providence, RI, USA.,Lifespan Cardiovascular Institute Wellness and Prevention Center, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Alpert Medical School, Brown University, Providence, RI, USA. .,Lifespan Cardiovascular Institute, The Miriam Hospital, One Hoppin Street, Providence, RI, 02903, USA.
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Keirns NG, Ouaddi S, Dunsiger S, Locatelli G, Gathright EC, Black E, Tripolone J, Breault C, Riegel B, Cohen R, Salmoirago-Blotcher E. Mind Your Heart-II: Protocol for a behavioral randomized controlled trial of mindfulness training to promote self-care in patients with comorbid heart failure and cognitive impairment. Contemp Clin Trials 2023; 126:107094. [PMID: 36682491 PMCID: PMC10026453 DOI: 10.1016/j.cct.2023.107094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Heart failure (HF) self-care is a robust predictor of prognosis in HF patients. Cognitive impairment is a common comorbidity in HF patients and constitutes a major challenge to HF self-care. Mindfulness training (MT) has been shown to improve cognitive function and interoception, two components essential to promoting effective HF self-care. OBJECTIVES The aims of the Mind Your Heart-II (MYH-II) study are to investigate the effects of MT on HF self-care via changes in cognitive function and interoception in patients with comorbid HF and cognitive impairment, and to study the process by which MT can improve cognitive function via vagal control. We hypothesize that MT will improve cognitive function, interoception, and vagal control, resulting in enhanced HF self-care, compared to control participants. METHODS MYH-II is a mechanistic parallel phase II behavioral randomized controlled trial. We will enroll 176 English or Spanish-speaking patients with comorbid chronic HF and mild cognitive impairment. Participants will be randomized to either: (1) 8-week phone-delivered MT + Enhanced Usual Care (EUC), or (2) EUC alone. Participants will complete baseline, end-of-treatment (3 months), and follow-up (9 months) assessments. The primary outcome is cognitive function (NIH Toolbox Fluid Cognition Composite Score). Additional key outcomes include: interoception (heartbeat tracking task, Multidimensional Assessment of Interoceptive Awareness), HF self-care (Self-Care of Heart Failure Index v7.2), and vagal control (high-frequency heart rate variability). IMPLICATIONS If study hypotheses are confirmed, phone-based MT may be a key tool for improving HF self-care, and possibly clinical outcomes, in HF patients with comorbid cognitive impairment.
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Affiliation(s)
- Natalie G Keirns
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA; Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
| | - Sara Ouaddi
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Shira Dunsiger
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, RI, USA
| | - Giulia Locatelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Emily C Gathright
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Emma Black
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Janice Tripolone
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Christopher Breault
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Barbara Riegel
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; Australian Catholic University, Mary MacKillop Institute for Health Research, Melbourne, Australia; Center for Home Care Policy & Research at VNS Health, New York, NY, USA
| | - Ronald Cohen
- Cognitive Aging and Memory Program, McKnight Institute on Aging, University of Florida, Gainesville, FL, USA
| | - Elena Salmoirago-Blotcher
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA; Lifespan Cardiovascular Institute, The Miriam Hospital, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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Xie T, Zhao X, Jiang T, Zhong M, Ma N. Mindfulness training selectively reduces altruistic behaviour in low-cost situations. Int J Psychol 2023; 58:272-281. [PMID: 36698244 DOI: 10.1002/ijop.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/22/2022] [Indexed: 01/27/2023]
Abstract
There have been rich debates about whether and how mindfulness alters prosocial behaviour. Nevertheless, few empirical studies have touched on how mindfulness training (MT) influences altruistic behaviour under high- and low-cost situations in a real-life scenario. The present study aimed to examine the effect of mindfulness training on altruistic willingness at different cost levels. A total of 41 females participated in our study and were randomly assigned to the MT and control groups. They completed the empathy-altruism task and Five-Facet Mindfulness Questionnaire (FFMQ) before and after an 8-week experimental intervention, during which the MT group attended the Mindfulness-Based Cognitive Therapy (MBCT) programme, while the control group remained as usual. The MT group presented a significant increase in overall FFMQ scores after the 8 weeks of MBCT. However, their willingness to help declined in the low-cost situation at post-test. Further analysis revealed a positive correlation between the increase in the scores of the observing facet and willingness to help in the high-cost situation in the MT group. The changes in describing facet were a negative predictor of the change in empathy in the low-cost situation. Taken together, 8-week MBCT enhanced the level of mindfulness but reduced people's willingness to help in the low-cost situation.
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Affiliation(s)
- Tian Xie
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education; Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health & Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Xinmei Zhao
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education; Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health & Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Tianxiang Jiang
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education; Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health & Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Mingtian Zhong
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education; Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health & Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Ning Ma
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education; Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health & Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
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Sucich JT, Lehrer J, Breitbart V, Julliard KN. Mindfulness training for community-based psychotherapists: a feasibility study. Pilot Feasibility Stud 2022; 8:250. [PMID: 36494854 PMCID: PMC9733050 DOI: 10.1186/s40814-022-01205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND While mindfulness training's feasibility has been assessed in many health care settings, the feasibility of teaching mindfulness to psychotherapists of various orientations for both self- and patient-care has not been explored. The objectives of this feasibility assessment were to determine the degree to which clinic psychotherapists were willing to complete a skills-based mindfulness training program; evaluate the acceptability of integrating mindfulness interventions into an urban community mental health clinic; examine the training's influence on both personal mindfulness practice and integration into patient care; and explore the impact of a support group following the training. METHODS Data on six aspects of feasibility were gathered through quantitative surveys, semi-structured qualitative interviews, and group observation and feedback, analyzed using grounded theory. RESULTS Sixteen therapists and one administrator attended at least one session of this voluntary program and responded to the associated surveys. At 1-year post-training, 7 participants had attended one or more group support sessions, and 4 more than 50% of sessions. The following factors were identified as contributing to the training's success: significant interest on the part of clinic staff to receive the training; diversity of the teaching staff, buy-in from clinic administration, provision of meditation scripts, role-play exercises, the variety of practices taught, and case presentations. Therapists indicated that the training helped them create a personal mindfulness practice, and several proceeded to integrate mindfulness into client sessions. A bi-weekly support group organized after the training encompassed group practice, discussion, case presentations, and information about trauma-sensitive mindfulness. Clinicians identified the following challenges to integrating mindfulness into sessions: lack of scripts in client languages other than English, the unacceptability of mindfulness to some clients' religious beliefs, the lack of appropriateness for clients facing ongoing psychosocial crises, the lack of interest on the part of some clients, and the time constraints posed by brief therapy sessions. CONCLUSIONS These findings indicate that such training may be feasible in community mental health settings given support from leadership and the presence of qualified facilitators within the organization. Adaptations to the training based on participant feedback can inform a larger scale trial that compares our protocol with another intervention in the treatment of a psychological disorder or condition identified by the participants as having responded favorably to the program.
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Affiliation(s)
- James T. Sucich
- grid.137628.90000 0004 1936 8753Family Health Centers at NYU Langone, 514 49th Street, Brooklyn, NY 11220 USA
| | - Jeremy Lehrer
- grid.21729.3f0000000419368729Columbia University, New York City, USA
| | - Vicki Breitbart
- grid.137628.90000 0004 1936 8753Silver School of Social Work, New York University, New York City, USA
| | - Kell N. Julliard
- grid.137628.90000 0004 1936 8753Family Health Centers at NYU Langone, 514 49th Street, Brooklyn, NY 11220 USA
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Yuan Y. Mindfulness training on the resilience of adolescents under the COVID-19 epidemic: A latent growth curve analysis. Pers Individ Dif 2021; 172:110560. [PMID: 33518868 PMCID: PMC7831962 DOI: 10.1016/j.paid.2020.110560] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/15/2020] [Accepted: 11/25/2020] [Indexed: 11/11/2022]
Abstract
As a preventive measure during the COVID-19 epidemic, we have had to stay at home for a long time. The lifestyle of adolescents has undergone severe changes. Almost every school started online education for the first time. Some adolescents have shown low resilience when faced with these changes. Most previous research has focused on mindfulness training and resilience by using cross-sectional or two-point tracking designs. However, little is known about the developmental trajectories of the impact of mindfulness training on resilience, particularly during this epidemic. Therefore, this study aims to explore how the developmental trajectories of resilience are impacted by mindfulness training. After administering the CD-RISC, we recruited 90 students with low levels of resilience in intervention group. Finally, 84 adolescents provided data at each assessment. At the same time, we selected 90 students in the control group. Paired sample t-test was used to compare every factor defined above by time. The result showed that mindfulness training increased students' resilience and emotional intelligence in experiment group. Then in the experiment group, latent growth modeling was used to (1) examine initial levels and changes in resilience over time and (2) predict initial levels and growth in resilience based on emotional intelligence. The findings of this study are as follows: during a mindfulness training intervention, (1) individual resilience tends to increase, and rate of increase grows gradually; there are also significant individual differences in the initial level and development speed; (2) individual emotional intelligence can promote the growth of resilience. With the worldwide outbreak of COVID-19, more and more attention is paid to the mental health of students. The research in this article shows that mindfulness training program should be given increasing consideration in the future.
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Affiliation(s)
- Yue Yuan
- Renming University of China, China
- The Second Middle School of Jimsar, China
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Chan EY. Mindfulness and smoking frequency: An investigation with Australian students. Addict Behav Rep 2021; 13:100342. [PMID: 33786361 PMCID: PMC7988491 DOI: 10.1016/j.abrep.2021.100342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/24/2022] Open
Abstract
Mindfulness training helps smokers reduce smoking frequency. However, mindfulness training techniques free of mentions about smoking are absent. Also, it is unclear how mindfulness training might have such an effect. We manipulated mindfulness or mind-wandering in 91 Australian students using no mentions of smoking. Outcome arises via both acceptance of urges and ability to resist smoking impulses.
Mindfulness training has been shown to be effective in reducing smoking frequency. However, mindfulness training instructions that are free of mentions about smoking are rare, which makes it difficult to ascertain if it is the temporary state of being mindful or demand effects that reduce smoking frequency. It has also been posited that mindfulness training lowers smoking frequency by helping smokers surf the urge, but this remains untested. Thus, we conducted an experiment to test the likely process. We used a 6-minute audio clip to induce a brief mindfulness state or a mind-wandering state in 91 Australian students; the brief mindfulness exercise was free of any mentions about smoking. We found that exposure to the mindfulness-inducing audio clip helped smokers surf their urge when they were later exposed to cigarette cues and they smoked less over the subsequent 7 days. The current work offers empirical evidence for why mindfulness training can be effective in smoking cessation.
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Affiliation(s)
- Eugene Y Chan
- College of Health and Human Sciences, Purdue University, United States
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12
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Li L, Li M. Effects of Mindfulness Training on Psychological Capital, Depression, and Procrastination of the Youth Demographic. Iran J Public Health 2021; 49:1692-1700. [PMID: 33643944 PMCID: PMC7898108 DOI: 10.18502/ijph.v49i9.4086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The incidence rate of depression in youth demographic increases year by year. High-level psychological capital is conducive to relieving depression, and mindfulness training is an effective psychotherapy. We aimed to investigate the influences of mindfulness training on psychological capital, depression, and procrastination, thereby providing a direction for psychotherapy in the youth demographic. Method: A questionnaire survey on the youths in four resident communities in the cities of Wuhan and Tai’an in China was carried out in 2020 by sending a self-rating depression scale (SDS). A total of 240 youth with SDS standard scores >53 were filtered out, as the research objects to be assessed by using SDS, positive psychological capital questionnaire (PPQ), five-facet mindfulness questionnaire (FFMQ), and pure procrastination scale (PPS). Results: Two groups showed no statistically significant differences in SDS, PPQ, FFMQ, and PPS scores before intervention. Self-efficacy, toughness, hope, optimism, and PPQ scores of the experimental group were improved significantly after intervention compared with those before the intervention, and they were significantly higher than those of the control group (P<0.05). SDS, PPQ, FFMQ, and PPS scores showed statistically significant differences before and after intervention. SDS and PPS scores of the experimental group after intervention were far lower than those of the control group, while FFMQ score was significantly higher than that of the control group (P<0.05). Conclusion: Mindfulness training can improve psychological capital of the youth demographic effectively and relieve their depression, thereby improving their procrastination.
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Affiliation(s)
- Li Li
- School of Law, Humanities and Sociology, Wuhan University of Technology, Wuhan, China
| | - Mu Li
- School of Law, Humanities and Sociology, Wuhan University of Technology, Wuhan, China
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Weng X, Luk TT, Lau OS, Suen YN, Lee JJ, Li WH, Kwok JYY, Lam TH, Wang MP. Brief mindfulness training for smoking cessation in Chinese women in workplaces: A pilot randomized controlled trial. Addict Behav 2021; 113:106677. [PMID: 33069106 DOI: 10.1016/j.addbeh.2020.106677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Mindfulness training (MT) has shown preliminary efficacy as a behavioral treatment for smoking cessation. We examined the effect of a brief-MT intervention on smoking cessation for Chinese women in workplaces in Hong Kong, China. METHODS In this pilot randomized controlled trial, 213 daily smokers were recruited from workplaces and computer-randomized into the intervention (n = 114) or control (n = 99) groups. Participants in both groups received a self-help booklet. Participants in the intervention group additionally attended 2 sessions of a brief-MT workshop. The primary outcome was self-reported 7-day point-prevalence abstinence (PPA) at 6 months. Secondary outcomes were biochemically validated abstinence (exhaled CO < 4 ppm and salivary cotinine < 10 ng/mL) and smoking reduction at 6 months. Analyses were done by intention to treat. We conducted a post-trial qualitative evaluation on participants in the intervention group (n = 14). Data were analyzed thematically. RESULTS At 6-month follow-up, self-reported 7-day PPA were similar between the intervention and control groups (18.4% vs. 21.2%; P = 0.61). Very few participated in biochemical validation (n = 17), and validated abstinence and smoking reduction rates showed no significant difference (5.3% vs. 11.1%, P = 0.12 and 20.2% vs. 20.2%, P = 1.00, respectively). A posteriori analysis showed that brief-MT participants who were psychologically engaged with the intervention had greater 6-month PPA. Qualitative evaluation showed brief-MT reduced stress but its effectiveness was restrained by the insufficient home practice. CONCLUSIONS This pilot trial on a brief-MT intervention for smoking cessation on Chinese women in workplaces showed feasibility, but improving compliance is needed to maximize the efficacy in future fully powered trials.
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Sousa GMD, Lima-Araújo GLD, Araújo DBD, Sousa MBCD. Brief mindfulness-based training and mindfulness trait attenuate psychological stress in university students: a randomized controlled trial. BMC Psychol 2021; 9:21. [PMID: 33526085 PMCID: PMC7852130 DOI: 10.1186/s40359-021-00520-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/15/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Psychological distress in University settings has grown and became a public health concern. In this context, contemplative practices such as mindfulness have been proposed as a strategy to help students on stress management. METHODS Forty university students (20 female), aged between 18 to 30 years (mean = 24.15; SD = 3.56), with no previous experience with meditation or yoga were recruited at the Federal University of Rio Grande do Norte and randomized to a mindfulness training (MT) or active control (AC) groups. We analyzed measures of anxiety, affect, stress, as well as state and trait mindfulness in order to evaluate the effects of trait mindfulness and a brief mindfulness intervention in forty healthy young students. Participants were classified as Low (n = 27, females = 13) or High (n = 13, females = 7) Trait Mindfulness by k-means clustering and compared between them using Wilcoxon sum rank test. Furthermore, the sample was randomly allocated to an AC (n = 20, females = 10) or a MT (n = 20, females = 10) group, and mixed analysis of variance was performed to analyze the effect of interventions. The mechanisms and role of trait mindfulness in the intervention was assessed by a moderated mediation analysis. RESULTS We found that High Trait individuals have lower anxiety trait, anxiety state and perceived stress levels. Only the MT group reduced their anxiety state and perceived stress after the intervention and increased their state mindfulness. Both groups reduced negative affect and cortisol, and no change was found in positive affect. Moderated mediation analysis showed that the training-induced change in state mindfulness mediated the increase in positive affect and the decrease in perceived stress and cortisol, regardless of trait mindfulness. For anxiety state the decrease only occurred in individuals with High Trait Mindfulness. CONCLUSIONS Together, these results suggest that higher trait mindfulness is associated with low levels of psychological distress and that a brief mindfulness-based intervention seems to be useful to reduce distress measures in university students. TRIAL REGISTRATION ReBEC, U1111-1194-8661. Registered 28 March 2017-Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-7b8yh8.
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Affiliation(s)
- Geovan Menezes de Sousa
- Brain Institute, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 3000 - Lagoa Nova, Natal, RN, 59078 970, Brazil
| | - Geissy Lainny de Lima-Araújo
- Brain Institute, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 3000 - Lagoa Nova, Natal, RN, 59078 970, Brazil
| | - Dráulio Barros de Araújo
- Brain Institute, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 3000 - Lagoa Nova, Natal, RN, 59078 970, Brazil
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Kaufmann M, Rosing K, Baumann N. Being mindful does not always benefit everyone: mindfulness-based practices may promote alienation among psychologically vulnerable people. Cogn Emot 2020; 35:241-255. [PMID: 32993426 DOI: 10.1080/02699931.2020.1825337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A growing number of interventions have sought to cultivate mindfulness, an accepting awareness of body and mind experiences. A great deal of prior research has shown mostly beneficial effects of mindfulness interventions. However, cultivating mindfulness may not always be beneficial for everyone. Two studies examined whether mindfulness may have alienating effects among people high in state orientation (i.e. low self-regulatory abilities). Participants were randomly assigned to either a 90-minute mindfulness training plus 5-minute retreatment or a waiting list control group (Study 1 N = 54, Study 2 N = 155). Alienation was operationalised as false self-ascriptions (FSA rate) of extrinsic goals that were allegedly recommended by experts. Participants high (versus low) in state orientation had significantly higher FSA rates in the mindfulness (versus control) condition. These results suggest that mindfulness training may alienate psychologically vulnerable populations (e.g. state-oriented people) from their intrinsic emotional preferences.
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Affiliation(s)
| | - Kathrin Rosing
- Department of Psychology, University of Kassel, Kassel, Germany
| | - Nicola Baumann
- Department of Psychology, University of Trier, Trier, Germany
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Lingaiah A, Mohanty D, Marchbank J, Jacob AE, Castellanos RL, Holiday V, Espay AJ, LaFaver K. Improving anxiety in Parkinson's disease: A cautionary tale about mobile health technologies. Parkinsonism Relat Disord 2020; 73:50-1. [PMID: 32248050 DOI: 10.1016/j.parkreldis.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/05/2020] [Accepted: 03/15/2020] [Indexed: 11/22/2022]
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Pbert L, Druker S, Crawford S, Frisard C, Trivedi M, Osganian SK, Brewer J. Feasibility of a Smartphone App with Mindfulness Training for Adolescent Smoking Cessation: Craving to Quit (C2Q)-Teen. Mindfulness (N Y) 2020; 11:720-33. [PMID: 33343761 DOI: 10.1007/s12671-019-01273-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objectives The use of mobile technology for smoking cessation holds promise for adolescents, who do not typically access traditional treatments, but most are not grounded in theory or mechanism. Operant conditioning theory suggests an addictive smoking loop is formed between nicotine use and affective states, leading to habitual cue-induced craving and automatic behavior; mindfulness training may bring automated smoking behavior into awareness, so smokers may work mindfully with cravings. Mindfulness training delivered via smartphone technology therefore has potential to help adolescent smokers break this addictive loop and quit smoking. This pair-matched cluster-randomized controlled school-based pilot study evaluated program feasibility and preliminary smoking outcomes in relation to intervention engagement. Methods Six high schools were pair matched and randomly assigned to one of three interventions: (1) mindfulness training delivered via mobile smoking cessation application (Craving to Quit, C2Q), (2) NCI's QuitSTART smoking cessation application (NCI), and (3) written cessation materials (Materials). Adolescents (n = 146) smoking 5 or more cigarettes per day were recruited. Interventions were implemented over four weeks and study assessments were collected at baseline and 3- and 6- month follow-up, including self-reported 7-day point prevalence abstinence, program usage, smoking-related measures, and psychosocial factors. Results Overall cotinine-validated abstinence at 6 months was 15.8% and was similar between conditions. Odds of abstinence increased with each quartile increase in app/materials use with no significant differences between conditions (OR=1.60 (C2Q), 1.66 (Materials), and 2.69 (NCI)). Of participants still smoking at 6 months, for each quartile increase in engagement the number of cigarettes smoked in the previous 7 days showed a significantly greater decline in the C2Q condition (-5.71) compared to the Materials (-0.95) and NCI (+7.73) condition (p=0.02 for differences between conditions). Conclusions Cotinine-validated abstinence was similar between intervention conditions and tended to increase with greater engagement in each condition. Greater C2Q app engagement among continuing smokers was associated with a significantly greater decline in number of cigarettes smoked compared to the other conditions. The Craving to Quit (C2Q) mobile smoking cessation application with mindfulness training was feasible to use and has promise in assisting adolescents to quit or decrease cigarette smoking. Clinical Trial Registration Developing a Smartphone App with Mindfulness Training for Teen Smoking Cessation: ClinicalTrials.gov Identifier: NCT02218281.
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Sheydaei H, Ghasemzadeh A, Lashkari A, Kajani PG. The effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Electron Physician 2017; 9:4753-4758. [PMID: 28894531 PMCID: PMC5586989 DOI: 10.19082/4753] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 03/08/2017] [Indexed: 01/17/2023] Open
Abstract
Background and Aim Postpartum depression is one of the prevalent disorders among new mothers. The present research aimed to examine the effectiveness of mindfulness training on reducing the symptoms of postpartum depression. Method The present quasi-experimental research was conducted on 410 new mothers in Shahid Chamran Hospital, Tehran in 2014. Using the Beck Depression Inventory (BDI), Structured Clinical Interview and Psychological Clinical Diagnosis, 67 mothers were selected and then randomly divided into experimental and control groups, each of which with 32 applicants. Afterwards, the experimental group received mindfulness training for 8 sessions, each lasting for two hours while the control group received no training. The data were analyzed through descriptive statistics and Analysis of Covariance (ANCOVA) in SPSS, version 20. Results Results showed that based on Beck Inventory, the scores for the experimental group in post-test were significant (p<0.001), compared to those for the control group. Also, it was revealed that pre- and posttest mean scores for postpartum depression in the control group were 25.81 and 25.12 respectively while the scores for the experimental group were 24.75 and 18.5 respectively. Since the posttest mean score in the experimental group was lower than that in the pretest, it can be said that the treatment, i.e., mindfulness training, was effective in reducing depression symptoms in mothers. Conclusion Findings proved that mindfulness training was effective in reducing the symptoms of postpartum depression in new mothers.
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Affiliation(s)
- Hajieh Sheydaei
- MA Graduate in Clinical Psychology, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Azizreza Ghasemzadeh
- Lecturer in Rehabilitation Science, Sun Face Medical Aesthetic Center, Dubai, UAE
| | - Amir Lashkari
- MA Graduate in Clinical Psychology, Azad Islamic University of Roudehen, Roudehen, Iran
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Kirk U, Gu X, Harvey AH, Fonagy P, Montague PR. Mindfulness training modulates value signals in ventromedial prefrontal cortex through input from insular cortex. Neuroimage 2014; 100:254-62. [PMID: 24956066 DOI: 10.1016/j.neuroimage.2014.06.035] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 06/11/2014] [Accepted: 06/13/2014] [Indexed: 10/25/2022] Open
Abstract
Neuroimaging research has demonstrated that ventromedial prefrontal cortex (vmPFC) encodes value signals that can be modulated by top-down cognitive input such as semantic knowledge, price incentives, and monetary favors suggesting that such biases may have an identified biological basis. It has been hypothesized that mindfulness training (MT) provides one path for gaining control over such top-down influences; yet, there have been no direct tests of this hypothesis. Here, we probe the behavioral and neural effects of MT on value signals in vmPFC in a randomized longitudinal design of 8 weeks of MT on an initially naïve subject cohort. The impact of this within-subject training was assessed using two paradigms: one that employed primary rewards (fruit juice) in a simple conditioning task and another that used a well-validated art-viewing paradigm to test bias of monetary favors on preference. We show that MT behaviorally censors the top-down bias of monetary favors through a measurable influence on value signals in vmPFC. MT also modulates value signals in vmPFC to primary reward delivery. Using a separate cohort of subjects we show that 8 weeks of active control training (ACT) generates the same behavioral impact also through an effect on signals in the vmPFC. Importantly, functional connectivity analyses show that value signals in vmPFC are coupled with bilateral posterior insula in the MT groups in both paradigms, but not in the ACT groups. These results suggest that MT integrates interoceptive input from insular cortex in the context of value computations of both primary and secondary rewards.
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Affiliation(s)
- Ulrich Kirk
- Institute of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| | - Xiaosi Gu
- Wellcome Trust Centre for Neuroimaging, University College London, London WC1N 3BG, United Kingdom; Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute, Roanoke, VA 24016, United States
| | - Ann H Harvey
- Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute, Roanoke, VA 24016, United States
| | - Peter Fonagy
- Research Department of Clinical, Educational, and Health Psychology, University College London, London WC1E 6BT, United Kingdom; Anna Freud Centre, London NW3 5SD, United Kingdom
| | - P Read Montague
- Wellcome Trust Centre for Neuroimaging, University College London, London WC1N 3BG, United Kingdom; Human Neuroimaging Laboratory, Virginia Tech Carilion Research Institute, Roanoke, VA 24016, United States.
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