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Irwin A, Igudesman D, Crandell J, Kichler JC, Kahkoska AR, Burger K, Zaharieva DP, Addala A, Mayer-Davis EJ. Mindfulness, disordered eating, and impulsivity in relation to glycemia among adolescents with type 1 diabetes and suboptimal glycemia from the Flexible Lifestyles Empowering Change (FLEX) intervention trial. Pediatr Diabetes 2022; 23:516-526. [PMID: 35297136 PMCID: PMC9268578 DOI: 10.1111/pedi.13334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the relationship between mindfulness and glycemia among adolescents with type 1 diabetes (T1D) with suboptimal glycemia, and evaluate the potential mediation by ingestive behaviors, including disordered eating, and impulsivity. RESEARCH DESIGN AND METHODS We used linear mixed models for hemoglobin A1c (HbA1c) and linear regression for continuous glucose monitoring (CGM) to study the relationship of mindfulness [Child and Adolescent Mindfulness Measure (CAMM)] and glycemia in adolescents with T1D from the 18-month Flexible Lifestyles Empowering Change (FLEX) trial. We tested for mediation of the mindfulness-glycemia relationship by ingestive behaviors, including disordered eating (Diabetes Eating Problem Survey-Revised), restrained eating, and emotional eating (Dutch Eating Behavior Questionnaire); and impulsivity (total, attentional, and motor, Barrett Impulsiveness Scale). RESULTS At baseline, participants (n = 152) had a mean age of 14.9 ± 1.1 years and HbA1c of 9.4 ± 1.2% [79 ± 13 mmol/mol]. The majority of adolescents were non-Hispanic white (83.6%), 50.7% were female, and 73.0% used insulin pumps. From adjusted mixed models, a 5-point increase in mindfulness scores was associated with a -0.19% (95%CI -0.29, -0.08, p = 0.0006) reduction in HbA1c. We did not find statistically significant associations between mindfulness and CGM metrics. Mediation of the relationship between mindfulness and HbA1c by ingestive behaviors and impulsivity was not found to be statistically significant. CONCLUSIONS Among adolescents with T1D and suboptimal glycemia, increased mindfulness was associated with lower HbA1c levels. Future studies may consider mindfulness-based interventions as a component of treatment for improving glycemia among adolescents with T1D, though more data are needed to assess feasibility and efficacy.
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Affiliation(s)
- Ashley Irwin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daria Igudesman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jamie Crandell
- Department of Biostatistics and School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessica C Kichler
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Anna R Kahkoska
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kyle Burger
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dessi P Zaharieva
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, California, USA
| | - Ananta Addala
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, California, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Kral TRA, Davis K, Korponay C, Hirshberg MJ, Hoel R, Tello LY, Goldman RI, Rosenkranz MA, Lutz A, Davidson RJ. Absence of structural brain changes from mindfulness-based stress reduction: Two combined randomized controlled trials. SCIENCE ADVANCES 2022; 8:eabk3316. [PMID: 35594344 PMCID: PMC9122316 DOI: 10.1126/sciadv.abk3316] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Studies purporting to show changes in brain structure following the popular, 8-week mindfulness-based stress reduction (MBSR) course are widely referenced despite major methodological limitations. Here, we present findings from a large, combined dataset of two, three-arm randomized controlled trials with active and waitlist (WL) control groups. Meditation-naïve participants (n = 218) completed structural magnetic resonance imaging scans during two visits: baseline and postintervention period. After baseline, participants were randomly assigned to WL (n = 70), an 8-week MBSR program (n = 75), or a validated, matched active control (n = 73). We assessed changes in gray matter volume, gray matter density, and cortical thickness. In the largest and most rigorously controlled study to date, we failed to replicate prior findings and found no evidence that MBSR produced neuroplastic changes compared to either control group, either at the whole-brain level or in regions of interest drawn from prior MBSR studies.
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Affiliation(s)
- Tammi R. A. Kral
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin–Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin–Madison, Madison, WI, USA
- Healthy Minds Innovations, Madison, WI, USA
| | - Kaley Davis
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
| | - Cole Korponay
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Rachel Hoel
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
| | - Lawrence Y. Tello
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
| | - Robin I. Goldman
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin–Madison, Madison, WI, USA
| | - Melissa A. Rosenkranz
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin–Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin–Madison, Madison, WI, USA
| | - Antoine Lutz
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin–Madison, Madison, WI, USA
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon 1 University, Lyon, France
| | - Richard J. Davidson
- Center for Healthy Minds, University of Wisconsin–Madison, Madison, WI, USA
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, USA
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin–Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin–Madison, Madison, WI, USA
- Healthy Minds Innovations, Madison, WI, USA
- Corresponding author.
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Angioletti L, Balconi M. The Increasing Effect of Interoception on Brain Frontal Responsiveness During a Socially Framed Motor Synchronization Task. Front Hum Neurosci 2022; 16:834619. [PMID: 35669205 PMCID: PMC9163315 DOI: 10.3389/fnhum.2022.834619] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
This research explored the effect of explicit Interoceptive Attentiveness (IA) manipulation on hemodynamic brain correlates during a task involving interpersonal motor coordination framed with a social goal. Participants performed a task requiring interpersonal movement synchrony with and without a social framing in both explicit IA and control conditions. Functional Near-Infrared Spectroscopy (fNIRS) was used to record oxygenated (O2Hb) and deoxygenated hemoglobin (HHb) changes during the tasks. According to the results, the prefrontal cortex (PFC), which is involved in high-order social cognition and interpersonal relations processing, was more responsive when inducing the explicit focus (IA) on the breath during the socially framed motor task requiring synchronization, as indicated by increased O2Hb. In the absence of a broader social frame, this effect was not significant for the motor task. Overall, the present study suggests that when a joint task is performed and the individual focuses on his/her physiological body reactions, the brain hemodynamic correlates are “boosted” in neuroanatomical regions that support sustained attention, reorientation of attention, social responsiveness, and synchronization. Furthermore, the PFC responds significantly more as the person consciously focuses on physiological interoceptive correlates and performs a motor task requiring synchronization, particularly when the task is socially framed.
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Affiliation(s)
- Laura Angioletti
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- *Correspondence: Laura Angioletti,
| | - Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Sönmez MB, Meriç IA, Sübay B, Görgülü Y. Relationship of Interoceptive Accuracy With Risky Decision-Making and Treatment Outcomes in Male Patients With Alcohol Use Disorder. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Lower levels of interoceptive awareness (IA) may be present in individuals with substance use disorder (SUD), and damage to related brain regions caused by substance use may disrupt IA. Disturbance in the bodily feedback system may fail to engage in effective decision-making. This study focused on the premise that interoceptive accuracy (IAc), as the primary construct of IA, is implicated in SUD and that poor IAc is linked to risky decision-making and adversely affects treatment outcomes. Eighty-five patients with alcohol use disorder (AUD) (current severity: moderate or severe) and 87 healthy control subjects were enrolled in the present study. All participants performed the heart rate tracking task and a computerized version of the Iowa gambling task (IGT). Characteristics of patients’ addiction profiles were assessed with the Addiction Profile Index (API) Clinical Form. IAc and IGT scores of patients with AUD were lower than healthy controls. IGT scores of patients with low IAc were lower than those of patients with high IAc and decreased IAc is predictive of decreased IGT scores. No significant differences were determined in treatment outcomes at 3, 6, and 12 months after hospitalization between the low-IAc and high-IAc patient groups. Our results suggest that IAc is implicated in AUD and that poor IAc is predictive of increased risky decision-making. Risky decision-making that results in substance use may be partly related to a deficit in the interoceptive ability to guide behavior. Focus on IAc without reference to complex clinical case presentations in AUD makes it difficult to draw any definitive conclusions about the role of IAc in clinical outcomes.
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Affiliation(s)
| | - Işıl Avcu Meriç
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
- Department of Psychiatry, Tekirdağ Dr. İsmail Fehmi Cumalioğlu City Hospital, Tekirdağ, Turkey
| | - Büşra Sübay
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
- Department of Psychiatry, Acıbadem Etiler Outpatient Clinic, Istanbul, Turkey
| | - Yasemin Görgülü
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
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Simon E, Zsidó AN, Birkás B, Csathó Á. Pain catastrophizing, pain sensitivity and fear of pain are associated with early life environmental unpredictability: a path model approach. BMC Psychol 2022; 10:97. [PMID: 35399087 PMCID: PMC8996610 DOI: 10.1186/s40359-022-00800-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Socioeconomic disadvantages in the childhood environment might strongly influence beliefs and behavior characterizing the adult years. When children experience unpredictable and adverse situations, they develop an unpredictability schema with the core belief that situations are unpredictable. METHODS In two studies, we examined the association of childhood socioeconomic disadvantages with self-reported pain sensitivity, pain catastrophizing, and pain-related fear. Multidimensional survey measures were used to assess environmental conditions experienced in childhood. In addition, participants completed the Pain Catastrophizing Scale, Pain Sensitivity Questionnaire, Body Awareness Questionnaire, Unpredictability Schema Questionnaire, and Fear of Pain Questionnaire. In Study 1 (N = 252), in separate models, we examined pain sensitivity and pain catastrophizing of a community sample of pain-free young individuals in association with their childhood experiences. In Study 2 (N = 293), in a new sample, but with a wider age range, we examined the association of early life socioeconomic disadvantages with pain-related fear. In both studies, the predictions were tested with Structural Equation Modeling. Our models constituted a path from childhood socioeconomic status and household unpredictability to pain variables via the factors of family resources, unpredictability schemas, and body awareness. RESULTS AND CONCLUSIONS The findings converged on the conclusion that individuals experiencing disadvantageous early life conditions tended to have an elevated level of pain catastrophizing, higher perceived sensitivity to pain, and higher level of pain-related fear. These associations were mediated by an unpredictability schema and body awareness.
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Affiliation(s)
- Eszter Simon
- Department of Behavioral Sciences, Medical School, University of Pécs, Szigeti str. 12, 7624, Pécs, Hungary
| | - András N Zsidó
- Institute of Psychology, University of Pécs, Pécs, Ifjúság str. 6, 7624, Pécs, Hungary
| | - Béla Birkás
- Department of Behavioral Sciences, Medical School, University of Pécs, Szigeti str. 12, 7624, Pécs, Hungary
| | - Árpád Csathó
- Department of Behavioral Sciences, Medical School, University of Pécs, Szigeti str. 12, 7624, Pécs, Hungary.
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Interoceptive influences on the production of self-serving lies in reputation risk conditions. Int J Psychophysiol 2022; 177:34-42. [DOI: 10.1016/j.ijpsycho.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/22/2022]
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Angioletti L, Tormen F, Balconi M. Judgment and Embodied Cognition of Lawyers. Moral Decision-Making and Interoceptive Physiology in the Legal Field. Front Psychol 2022; 13:853342. [PMID: 35401313 PMCID: PMC8987697 DOI: 10.3389/fpsyg.2022.853342] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/08/2022] [Indexed: 01/07/2023] Open
Abstract
Past research showed that the ability to focus on one’s internal states (e.g., interoceptive ability) positively correlates with the self-regulation of behavior in situations that are accompanied by somatic and/or physiological changes, such as emotions, physical workload, and decision-making. The analysis of moral oriented decision-making can be the first step for better understanding the legal reasoning carried on by the main players in the field, as lawyers are. For this reason, this study investigated the influence of the decision context and interoceptive manipulation on the moral decision-making process in the legal field gathering the responses of two groups of lawyers. A total of 20 lawyers were randomly divided into an experimental group (EXP), which was explicitly required to focus the attention on its interoceptive correlates, and a control group (CON), which only received the general instruction to perform the task. Both groups underwent a modified version of the Ultimatum Game (UG), where are presented three different moral conditions (professional, company, and social) and three different offers (fair, unfair, and equal). Results highlighted a significant increase of Acceptance Rate (AR) in those offers that should be considered more equal than fair or unfair ones, associated with a general increase of Reaction Times (RTs) in the equal offers. Furthermore, the interoceptive manipulation oriented the Lawyers toward a more self-centered decision. This study shows how individual, situational, contextual, and interoceptive factors may influence the moral decision-making of lawyers. Future research in the so-called Neurolaw field is needed to replicate and expand current findings.
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Affiliation(s)
- Laura Angioletti
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- *Correspondence: Laura Angioletti,
| | - Federico Tormen
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Yu X, Cohen ZP, Tsuchiyagaito A, Cochran G, Aupperle RL, Stewart JL, Singh MK, Misaki M, Bodurka J, Paulus MP, Kirlic N. Neurofeedback-Augmented Mindfulness Training Elicits Distinct Responses in the Subregions of the Insular Cortex in Healthy Adolescents. Brain Sci 2022; 12:brainsci12030363. [PMID: 35326319 PMCID: PMC8946655 DOI: 10.3390/brainsci12030363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 02/05/2023] Open
Abstract
Mindfulness training (MT) reduces self-referential processing and promotes interoception, the perception of sensations from inside the body, by increasing one’s awareness of and regulating responses to them. The posterior cingulate cortex (PCC) and the insular cortex (INS) are considered hubs for self-referential processing and interoception, respectively. Although MT has been consistently found to decrease PCC, little is known about how MT relates to INS activity. Understanding links between mindfulness and interoception may be particularly important for informing mental health in adolescence, when neuroplasticity and emergence of psychopathology are heightened. We examined INS activity during real-time functional magnetic resonance imaging neurofeedback-augmented mindfulness training (NAMT) targeting the PCC. Healthy adolescents (N = 37; 16 female) completed the NAMT task, including Focus-on-Breath (MT), Describe (self-referential processing), and Rest conditions, across three neurofeedback runs and two non-neurofeedback runs (Observe, Transfer). Regression coefficients estimated from the generalized linear model were extracted from three INS subregions: anterior (aINS), mid (mINS), and posterior (pINS). Mixed model analyses revealed the main effect of run for Focus-on-Breath vs. Describe contrast in aINS [R2 = 0.39] and pINS [R2 = 0.33], but not mINS [R2 = 0.34]. Post hoc analyses revealed greater aINS activity and reduced pINS activity during neurofeedback runs, and such activities were related to lower self-reported life satisfaction and less pain behavior, respectively. These findings revealed the specific involvement of insula subregions in rtfMRI-nf MT.
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Affiliation(s)
- Xiaoqian Yu
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
| | - Zsofia P. Cohen
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
| | - Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
| | - Gabriella Cochran
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
- Department of Community Medicine, University of Tulsa, Tulsa, OK 74104, USA
| | - Jennifer L. Stewart
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
- Department of Community Medicine, University of Tulsa, Tulsa, OK 74104, USA
| | - Manpreet K. Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA;
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA;
| | - Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (X.Y.); (Z.P.C.); (A.T.); (G.C.); (R.L.A.); (J.L.S.); (M.M.); (M.P.P.)
- Correspondence: ; Tel.: +1-918-502-5747
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Gan Q, Ding N, Bi G, Liu R, Zhao X, Zhong J, Wu S, Zeng Y, Cui L, Wu K, Fu Y, Chen Z. Enhanced Resting-State Functional Connectivity With Decreased Amplitude of Low-Frequency Fluctuations of the Salience Network in Mindfulness Novices. Front Hum Neurosci 2022; 16:838123. [PMID: 35308619 PMCID: PMC8927720 DOI: 10.3389/fnhum.2022.838123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Mindfulness and accordant interventions are often used as complementary treatments to psychological or psychosomatic problems. This has also been gradually integrated into daily lives for the promotion of psychological well-being in non-clinical populations. The experience of mindful acceptance in a non-judgmental way brought about the state, which was less interfered by a negative effect. Mindfulness practice often begins with focused attention (FA) meditation restricted to an inner experience. We postulate that the brain areas related to an interoceptive function would demonstrate an intrinsic functional change after mindfulness training for the mindful novices along with paying more attention to internal processes. To further explore the influence of mindfulness on the organization of the brain regions, both functional connectivity (FC) in the voxel and the region of interest (ROI) level were calculated. In the current study, 32 healthy volunteers, without any meditation experiences, were enrolled and randomly assigned to a mindfulness-based stress reduction group (MBSR) or control group (CON). Participants in the MBSR group completed 8 weeks of mindfulness-based stress reduction (MBSR) and rated their mindfulness skills before and after MBSR. All subjects were evaluated via resting-state functional MRI (rs-fMRI) in both baselines and after 8 weeks. They also completed a self-report measure of their state and trait anxiety as well as a positive and negative affect. Pre- and post-MBSR assessments revealed a decreased amplitude of low-frequency fluctuations (ALFF) in the right anterior cingulate gyrus (ACC.R), left anterior and posterior insula (aIC.L, pIC.L), as well as left superior medial frontal gyrus (SFGmed.L) in MBSR practitioners. Strengthened FC between right anterior cingulate cortex (ACC.R) and aIC.R was observed. The mean ALFF values of those regions were inversely and positively linked to newly acquired mindful abilities. Along with a decreased negative affect score, our results suggest that the brain regions related to attention and interoceptive function were involved at the beginning of mindfulness. This study provides new clues in elucidating the time of evaluating the brain mechanisms of mindfulness novices.
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Affiliation(s)
- Quan Gan
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Ning Ding
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Guoli Bi
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Department of Magnetic Resonance Imaging, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Ruixiang Liu
- Department of Clinical Psychology, The Second People’s Hospital of Yunnan Province, Kunming, China
| | - Xingrong Zhao
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingmei Zhong
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Shaoyuan Wu
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yong Zeng
- Department of Clinical Psychology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Liqian Cui
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kunhua Wu
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Department of Magnetic Resonance Imaging, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yunfa Fu
- School of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, China
| | - Zhuangfei Chen
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- *Correspondence: Zhuangfei Chen,
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Tatta J, Willgens AM, Palombaro KM. Mindfulness and Acceptance-Based Interventions in Physical Therapist Practice: The Time Is Now. Phys Ther 2022; 102:6481182. [PMID: 35079796 DOI: 10.1093/ptj/pzab293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/03/2021] [Accepted: 11/04/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED One in 5 adults in the United States lives with a mental illness, and many more struggle with stress-related chronic illnesses. Physical therapists often see the physical effects that stress has on the body, but there is an underutilization of evidence-based stress management strategies with patients and clients. Mindfulness and acceptance-based interventions (MABIs) constitute a family of methods that emphasize present-moment awareness, nonjudgment, and values-based living. They operate by teaching patients to cope with stressful thoughts, emotions, and physical sensations. MABIs are associated with improved health outcomes in areas commonly seen in physical therapist practice, including health promotion, physical function, injury prevention, pain management, immune function, and noncommunicable diseases. The purpose of this Perspective article is to (1) describe MABIs; (2) discuss the relevance of MABIs to physical therapist practice; (3) discuss the positive impact of MABIs for pain, sports, immune function, physical and mental health promotion, and wellness; and (4) identify MABI outcome measures related to health behavior change. It is time. IMPACT Contemporary practice requires that physical therapists manage patient care by addressing both the mind and body. Given the existing research on MABIs, it is time to translate the evidence into minimum accreditable standards for health promotion and prevention of chronic, noncommunicable disease. This approach would have far-reaching benefits for individuals, family units, communities, and society as a whole. LAY SUMMARY Mindfulness instruction delivered by a physical therapist can help improve physical and mental well-being.
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Affiliation(s)
- Joe Tatta
- Integrative Pain Science Institute, New York, New York, USA
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Interoceptive Attentiveness Induces Significantly More PFC Activation during a Synchronized Linguistic Task Compared to a Motor Task as Revealed by Functional Near-Infrared Spectroscopy. Brain Sci 2022; 12:brainsci12030301. [PMID: 35326258 PMCID: PMC8946073 DOI: 10.3390/brainsci12030301] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/04/2022] Open
Abstract
Currently, there is little understanding of how interoceptive attentiveness (IA) affects brain responses during synchronized cognitive or motor tasks. This pilot study explored the effect of explicit IA manipulation on hemodynamic correlates of simple cognitive tasks implying linguistic or motor synchronization. Eighteen healthy participants completed two linguistic and motor synchronization tasks during explicit IA and control conditions while oxygenated (O2Hb) and deoxygenated (HHb) hemoglobin variations were recorded by functional Near-Infrared Spectroscopy (fNIRS). The findings suggested that the brain regions associated with sustained attention, such as the right prefrontal cortex (PFC), were more involved when an explicit focus on the breath was induced during the cognitive linguistic task requiring synchronization with a partner, as indicated by increased O2Hb. Interestingly, this effect was not significant for the motor task. In conclusion, for the first time, this pilot research found increased activity in neuroanatomical regions that promote sustained attention, attention reorientation, and synchronization when a joint task is carried out and the person is focusing on their physiological body reactions. Moreover, the results suggested that the benefits of conscious concentration on physiological interoceptive correlates while executing a task demanding synchronization, particularly verbal alignment, may be related to the right PFC.
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A Pilot Feasibility Study of Reconnecting to Internal Sensations and Experiences (RISE), a Mindfulness-Informed Intervention to Reduce Interoceptive Dysfunction and Suicidal Ideation, among University Students in India. Brain Sci 2022; 12:brainsci12020237. [PMID: 35204000 PMCID: PMC8870213 DOI: 10.3390/brainsci12020237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023] Open
Abstract
Although 20% of the world’s suicides occur in India, suicide prevention efforts in India are lagging (Vijayakumar et al., 2021). Identification of risk factors for suicide in India, as well as the development of accessible interventions to treat these risk factors, could help reduce suicide in India. Interoceptive dysfunction—or an inability to recognize internal sensations in the body—has emerged as a robust correlate of suicidality among studies conducted in the United States. Additionally, a mindfulness-informed intervention designed to reduce interoceptive dysfunction, and thereby suicidality, has yielded promising initial effects in pilot testing (Smith et al., 2021). The current studies sought to replicate these findings in an Indian context. Study 1 (n = 276) found that specific aspects of interoceptive dysfunction were related to current, past, and future likelihood of suicidal ideation. Study 2 (n = 40) was a small, uncontrolled pre-post online pilot of the intervention, Reconnecting to Internal Sensations and Experiences (RISE). The intervention was rated as highly acceptable and demonstrated good retention. Additionally, the intervention was associated with improvements in certain aspects of interoceptive dysfunction and reductions in suicidal ideation and eating pathology. These preliminary results suggest further testing of the intervention among Indian samples is warranted.
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Benefits of Interoceptive Awareness: A Correlational Study of the Distinct Sport Education Program among Slovak University Students. SUSTAINABILITY 2022. [DOI: 10.3390/su14031607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study aims to determine the formation of cognitive abilities and self-assessment among students of the special physical training in security forces program. A total of 96 students aged 18 to 24 years completed 12 close-ended questions, i.e., 6 knowledge awareness (KA) and 6 ideomotor awareness questions (IA). The 13th question was aimed at self-assessment of their own answers. Based on the Dunning–Kruger effect, comparing all positive answers to KA and IA questions with the self-assessment answer showed that 51% of first-year students provided positive answers with a 50% self-assessment rate, indicating a balanced self-assessment. The percentage of positive answers for the second-year students totaled 51%, with a 70% self-assessment rate, indicating overassessment. The percentage of positive answers totaled 82% for the third-year students, with a 62% self-assessment rate, indicating underassessment. To help students to become proficient requires balancing theory and experience, classroom and practice, where they incorporate a “student-as-instructor” modality to the entire curriculum, not only to the limited selected courses of the special forces training. Using the active learning technique helps students to gain exposure to a stimulating and interactive environment. We stress a teaching modality that includes learning by doing and having the student act as a teacher. In this role, participants maximize their learning through interoceptive awareness, feeling, and applying course material in a more comprehensively factual setting.
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Food Consciousness Intervention Improves Interoceptive Sensitivity and Expression of Exteroception in Women. Nutrients 2022; 14:nu14030450. [PMID: 35276809 PMCID: PMC8837977 DOI: 10.3390/nu14030450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 02/05/2023] Open
Abstract
The perception of the body’s internal state (interoception) and the perception and processing of environmental sensory stimuli (exteroception) act together to modulate adaptive behaviour, including eating behaviour, and are related to bodyweight control. This study evaluated the impact of the Food and Nutrition Education Program with Sensory and Cognitive Exercises on interoceptive sensitivity and on the expression of exteroceptive perception in women who experienced difficulty in controlling their body weight. Thirty-seven women were randomized into two groups and evaluated at two moments: before and after the intervention or before and after a 3- to 4-week waiting period. A heartbeat tracking task was used for interoception evaluation. Participants were asked to write a text describing three foods after tasting them for exteroception evaluation. After the intervention, the participants showed an increase in interoceptive sensitivity, and an increase in the expression of exteroceptive stimuli perception through a semantic assessment of their writing related to the tasting experience. In addition, the results point to a possible connection between the mechanisms governing interoception and exteroception. This work brings important contributions to the search for strategies capable of promoting the perception and integration of physiological and environmental stimuli in food consumption.
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Wu Q, Mao X, Luo W, Fan J, Liu X, Wu Y. Enhanced interoceptive attention mediates the relationship between mindfulness training and the reduction of negative mood. Psychophysiology 2021; 59:e13991. [PMID: 34932832 DOI: 10.1111/psyp.13991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022]
Abstract
Although accumulating evidence has revealed the effect of mindfulness training on the reduction of general stress and the improvement of mental well-being, the underlying mechanism remains unclear. In this study, we investigated whether interoceptive attention to respiratory signals plays a role. Healthy adults were randomly assigned to either receive an 8-week mindfulness training (n = 29) or inactive control (n = 28). The pre- and post-training self-reported states of negative mood were assessed together with an objective measure of interoceptive attention to respiration. Compared to the control group, mindfulness training led to a decrease in the level of negative mood and an increase in interoceptive sensitivity. Mediation analysis further showed that the effect of mindfulness training on the reduction of negative mood was fully mediated by increased interoceptive sensitivity. These results suggest that mindfulness training effectively alleviates negative mood by enhancing interoceptive attention to respiratory signals.
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Affiliation(s)
- Qiong Wu
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Xinrui Mao
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Wei Luo
- Chinese Academy of Social Sciences, Beijing, China
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, New York, New York, USA
| | - Xinghua Liu
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.,Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yanhong Wu
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.,Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
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66
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Angioletti L, Balconi M. Interoceptive attentiveness and autonomic reactivity in pain observation. Somatosens Mot Res 2021; 39:81-89. [PMID: 34847833 DOI: 10.1080/08990220.2021.2005016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aim: This study explores interoceptive attentiveness (IA) influence on autonomic reactivity related to pain and self-regulation during situations evoking physiological mirroring for pain.Methods: 20 participants observed face/hand, painful/non-painful stimuli in an individual versus social condition while the autonomic response was measured [Electrodermal activity, Pulse Volume Amplitude (PVA), and Heart Rate (HR)] was measured. The sample was divided into experimental (EXP) subjects, required to focus on their interoceptive correlates while observing the stimuli, and the control (CNT) group. HR inter-beat interval (IBI), and HR Variability (HRV) were calculated.Results: Results showed high accuracy to painful and non-painful stimuli recognition. Regarding autonomic indices, higher PVA values were detected for hand painful versus non-painful stimuli, whereas for the EXP group a significant activation of IBI was found for face painful vs non-painful stimuli.Conclusion: In the context of observation of pain in others, PVA and IBI could be respectively markers of mirroring mechanisms and autonomic self-regulation mediated by IA.
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Affiliation(s)
- Laura Angioletti
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Using Actigraphy and Heart Rate Variability (HRV) to Assess Sleep Quality and Sleep Arousal of Three App-Based Interventions: Sleep Music, Sleepcasts, and Guided Mindfulness. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-021-00233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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68
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Fazia T, Bubbico F, Berzuini G, Tezza LD, Cortellini C, Bruno S, Bernardinelli L. Mindfulness meditation training in an occupational setting: Effects of a 12-weeks mindfulness-based intervention on wellbeing. Work 2021; 70:1089-1099. [PMID: 34842215 PMCID: PMC8764590 DOI: 10.3233/wor-210510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) are known for their beneficial effects on positive and negative psychological factors. When applied in an occupational context, MBIs might help workers to cope with stress, increase their professional outcomes and wellbeing. OBJECTIVE In this two-groups pre-post experimental design we tested the effect of our MBI, called Integral Meditation (IM), among the employers of an Italian service company by measuring positive and negative aspects of psychological wellbeing related to mindfulness and workplace functioning through eight self-report questionnaires (CORE-OM, FFMQ, WEMWBS, MAIA, PSS, PANAS, STAI-X1, SCS). METHOD Forty-two voluntary non-clinical employers of the company, randomly assigned to the experimental or the control group, were analyzed. The experimental group underwent our IM program, which consists of 12 weekly meditation classes given after the afternoon shift, while the control group did not receive any intervention. Data was analyzed via linear mixed models. RESULTS Statistically significant results were obtained for FFMQ observing subscale (β= 0.49, p = 0.014), WEMWBS (β= 5.31, p = 0.02), PSS (β= -3.31, p = 0.03), the whole scale of SCS (β= 0.47, p = 0.01) and self-judgment (β= 0.68, p = 0.003) and isolation (β= -0.66, p = 0.01) SCS subscales. Statistically significant results were also found in four out of eight subscales of MAIA: emotional awareness (β= 1.26, p < 0.001), self-regulation (β= 1.28, p < 0.001), body listening (β= 1.08, p < 0.001) and trusting (β= 1.1, p < 0.001). CONCLUSION Our intervention has demonstrated to bring beneficial effects in a mindfulness subdomain, in perceived stress, self-compassion, interoception and psychological wellbeing. Based on our results, we conclude that our intervention was effective in increasing the positive aspects of wellbeing and in reducing stress.
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Affiliation(s)
- Teresa Fazia
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesco Bubbico
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Giovanni Berzuini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Laura Dalla Tezza
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | | | - Luisa Bernardinelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Effects of a Single Yoga Session on Cardiac Interoceptive Accuracy and Emotional Experience. Brain Sci 2021; 11:brainsci11121572. [PMID: 34942874 PMCID: PMC8699040 DOI: 10.3390/brainsci11121572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is an increasing body of research supporting the idea that cardiac interoceptive accuracy (IAc) can be improved by training. Findings concerning the effects of a single yoga session on IAc and the related construct emotional experience are sparse. The aim of this study was to examine if a single yoga session increases IAc and improves emotional experience. METHODS 137 students were randomly assigned to a 20-min yoga session (n = 47), an endurance session (n = 46), or an inactive control condition (n = 44). IAc and emotional experience were assessed before and after the sessions. RESULTS There were no significant changes in IAc, or positive and negative affect. IAc at baseline and the change in positive effect were found as predictors for IAc after the yoga session. CONCLUSION A 20-min yoga session seems to be not applicable to improve IAc and emotional experience. Future studies should investigate long-term interventions and diverse healthy and clinical populations.
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Sanilevici M, Reuveni O, Lev-Ari S, Golland Y, Levit-Binnun N. Mindfulness-Based Stress Reduction Increases Mental Wellbeing and Emotion Regulation During the First Wave of the COVID-19 Pandemic: A Synchronous Online Intervention Study. Front Psychol 2021; 12:720965. [PMID: 34858260 PMCID: PMC8631924 DOI: 10.3389/fpsyg.2021.720965] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic imposed extreme living conditions of social distancing, which triggered negative mental health problems and created challenges in seeking mental health support. Mindfulness-based interventions (MBIs) have been found to enhance wellbeing and mental health by reducing stress and anxiety and improving emotion regulation. Preliminary evidence suggests that online, synchronous MBIs may produce beneficial effects similar to face-to-face programs. However, the effectiveness of such online-MBIs to support mental health in highly stressful times, such as a global pandemic, requires further study. To this end, we investigated the effect of an online 8-week Mindfulness-Based Stress Reduction (MBSR) program on aspects of mental health during the first wave of the COVID-19 pandemic. Participants (N=92) who expressed interest in discounted online-MBSR programs were recruited for the study. The division into experimental and control groups was based on actual enrollment to the courses. Those who enrolled in a program were assigned to the experimental condition and those who decided not to enroll served as controls. Participants were assessed pre-intervention, post-intervention, and 1-month post-intervention for levels of mindfulness, perceived stress, anxiety, emotion regulation, and intolerance of uncertainty. Differences between the groups were tested using the general linear mixed effects model (GLMM) and Individual Growth Curve Models (IGCM) in intent to treat analysis. The findings indicated that, relative to the control group, MBSR improved mindfulness abilities (p <0.001), decreased anxiety (p <0.001), and stress (p <0.001) and increased emotion regulation (p <0.001). These effects were found to persist 1 month after the end of the program, despite the increased governmental public-health restrictions due to COVID-19 at that time. The ability to tolerate uncertainty, a central characteristic of the pandemic, was not found to be affected by the program. A mediation analysis revealed that the effect of the intervention on mental health improvement was partially mediated by the improvement in emotion regulation. Overall, the findings provide positive evidence for the feasibility of an online-MBSR program to support the mental health of individuals from the general population through the mediation of emotion regulation in challenging times, such as a global pandemic.
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Affiliation(s)
- Maya Sanilevici
- Sagol Center for Brain and Mind, Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya (IDC), Herzliya, Israel
| | - Omer Reuveni
- Sagol Center for Brain and Mind, Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya (IDC), Herzliya, Israel
| | - Shahar Lev-Ari
- Department of Health Promotion, Faculty of Medicine, School of Public Health, Tel-Aviv University, Tel-Aviv, Israel
| | - Yulia Golland
- Sagol Center for Brain and Mind, Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya (IDC), Herzliya, Israel
| | - Nava Levit-Binnun
- Sagol Center for Brain and Mind, Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya (IDC), Herzliya, Israel
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71
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Gu Y, Zhu Y, Brown KW. Mindfulness and Attention Deficit Hyperactivity Disorder: A Neuropsychological Perspective. J Nerv Ment Dis 2021; 209:796-801. [PMID: 34292276 DOI: 10.1097/nmd.0000000000001388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
ABSTRACT Understanding the underlying mechanisms of mindfulness has been a hot topic in recent years, not only in clinical fields but also in neuroscience. Most neuroimaging findings demonstrate that critical brain regions involved in mindfulness are responsible for cognitive functions and mental states. However, the brain is a complex system operating via multiple circuits and networks, rather than isolated brain regions solely responsible for specific functions. Mindfulness-based treatments for attention deficit hyperactivity disorder (ADHD) have emerged as promising adjunctive or alternative intervention approaches. We focus on four key brain circuits associated with mindfulness practices and effects on symptoms of ADHD and its cognitive dysfunction, including executive attention circuit, sustained attention circuit, impulsivity circuit, and hyperactivity circuit. We also expand our discussion to identify three key brain networks associated with mindfulness practices, including central executive network, default mode network, and salience network. We conclude by suggesting that more research efforts need to be devoted into identifying putative neuropsychological mechanisms of mindfulness on how it alleviates ADHD symptoms.
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Affiliation(s)
- Yingqi Gu
- Department of Psychology, Zhejiang Sci-Tech University, Hangzhou
| | | | - Kirk Warren Brown
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
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Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and Behavior Change. Harv Rev Psychiatry 2021; 28:371-394. [PMID: 33156156 PMCID: PMC7647439 DOI: 10.1097/hrp.0000000000000277] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
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74
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Colgan DD, Eddy A, Green K, Oken B. Adaptive body awareness predicts fewer central sensitization-related symptoms and explains relationship between central sensitization-related symptoms and pain intensity: A cross-sectional study among individuals with chronic pain. Pain Pract 2021; 22:222-232. [PMID: 34651401 DOI: 10.1111/papr.13083] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Central sensitization (CS), defined as the amplification of neural signaling within the CNS that elicits pain hypersensitivity, is thought be a characteristic of several chronic pain conditions. Maladaptive body awareness is thought to contribute and maintain CS. Less is known about the relationship between CS and adaptive body awareness. PURPOSE This cross-sectional study investigated relationships among self-reported adaptive body awareness (Multidimensional Interoceptive Awareness Scale-2; MAIA-2), CS-related symptoms (Central Sensitization Inventory; CSI), and pain intensity and further delineate potential direct and indirect links among these constructs. METHODS Online surveys were administered to 280 individuals with chronic pain reporting elevated CSI scores. Strategic sampling targeted respondents to reflect the 2010 census. Pearson's correlations characterized overall relationship between variables. Multiple regression analyses investigated potential direct links. A path analysis assessed mediational effects of CS-related symptoms on the relationship between adaptive body awareness and pain intensity. RESULTS CSI demonstrated strong, inverse correlations with some MAIA-2 subscales, but positive correlations with others. Higher CSI scores predicted greater pain intensity (b = 0.049, p ≤ 0.001). Two MAIA-2 subscales, Not-Distracting (b = -0.56, p ≤ 0.001) and Not-Worrying (b = -1.17, p ≤ 0.001) were unique predictors of lower CSI. Not-Distracting (b = -0.05, p = 0.003) and Not-Worrying (b = -0.06, p = 0.007) uniquely predicted lower pain intensity. CSI completely mediated the relationship between adaptive body awareness and pain intensity [point estimate = -0.04; 95% bootstrap confident intervals (CI) = -0.05 to -0.02]. CONCLUSIONS Findings also support future research to explore causal relationships of variables. Findings suggest that frequency of attention to bodily sensations is distinct from cognitive-affective appraisal of bodily sensation, and the two distinct higher order processes may have divergent influences on perceived pain and CS-related symptoms. Results also support future research to explore causal relationships of variables.
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Affiliation(s)
| | - Ashley Eddy
- School of Graduate Psychology, Pacific University, Forest Grove, Oregon, USA
| | - Kaylie Green
- School of Graduate Psychology, Pacific University, Forest Grove, Oregon, USA
| | - Barry Oken
- Neurology Department, Oregon Health and Science University, Portland, Oregon, USA
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Ardi Z, Golland Y, Shafir R, Sheppes G, Levit-Binnun N. The Effects of Mindfulness-Based Stress Reduction on the Association Between Autonomic Interoceptive Signals and Emotion Regulation Selection. Psychosom Med 2021; 83:852-862. [PMID: 34387225 DOI: 10.1097/psy.0000000000000994] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The ability to select the most adaptive regulatory strategy as a function of the emotional context plays a pivotal role in psychological health. Recently, we showed that mindfulness-based interventions (MBIs) can improve the sensitivity of regulatory strategy selection to emotional intensity. However, the mechanisms underlying this improvement are unclear. In this study, we tested the hypothesis that MBIs support adaptive regulatory selection by increasing sensitivity to interoceptive signals associated with the emotional stimuli. METHODS Participants (n = 84, mean [standard deviation {SD}] age = 30.9 [8.3] years; 54% women) were randomized to either a mindfulness-based stress reduction (MBSR) program or a wait-list control condition. Before and after the MBSR program, physiological measures for autonomic nervous system activity were obtained, and participants performed a task examining emotion regulation selections (reappraisal versus distraction) when confronted with low or high negative intensity images. They also completed a battery of mindfulness, interoception, and well-being self-report measures. A cross-classified model was used for the main analyses. RESULTS The participants assigned to the MBSR were overall more likely to choose reappraisal than distraction (b = 0.26, posterior SD = 0.13, 95confidence interval = 0.02-0.52) after the program. Interoceptive signals in response to negative images were associated with subsequent regulatory selections (b = 0.02, posterior SD = 0.01, 95% confidence interval = 0.01-0.03) in the MBSR group. Specifically, lower cardiac reactivity was associated with the choice to reappraise, whereas higher cardiac reactivity was related to the choice to distract. Greater differences in cardiac reactivity between states that prompt reappraisal and states that prompt distraction were associated with higher well-being (Satisfaction With Life Scale, Pearson r (29) = 0.527, p = .003). CONCLUSIONS Mindfulness seems to increase the sensitivity of regulatory selections to interoceptive signals, and this is associated with subjective well-being. This may be a central pathway through which MBIs exert their positive effects on mental health and resilience.
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Affiliation(s)
- Ziv Ardi
- From the Sagol Center for Brain and Mind, Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya (Ardi, Golland, Levit-Binnun), Herzliya; Department of Behavioral Sciences (Ardi), Kinneret Academic College, Sea of Galilee; and The School of Psychological Sciences and Sagol School of Neuroscience (Shafir, Sheppes), Tel Aviv University, Tel Aviv, Israel
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Price CJ, Weng HY. Facilitating Adaptive Emotion Processing and Somatic Reappraisal via Sustained Mindful Interoceptive Attention. Front Psychol 2021; 12:578827. [PMID: 34566738 PMCID: PMC8457046 DOI: 10.3389/fpsyg.2021.578827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/26/2021] [Indexed: 12/03/2022] Open
Abstract
Emotions are by nature embodied, as the brain has evolved to quickly assess the emotional significance of stimuli and output signals to the body's viscera and periphery to aid adaptive responses. Emotions involve both implicit bodily and explicit narrative processes, and patients may experience transdiagnostic distress when bodily signals are not attended to and holistically integrated with explicit narratives about experience. Similarly, therapists may be trained in more implicit body-based approaches (i.e., massage/bodywork, physical and occupational therapy, and nursing/medicine) or more explicit narrative-based approaches (i.e., psychotherapy), and may lack training in skills that integrate both levels of emotion processing to aid healing and growth. To address these gaps, we propose a framework where the bridge between implicit bodily sensations and explicit narratives lies in cultivating mindful awareness of bodily sensations associated with emotions. This process brings subjective awareness to notice inner body experience (or interoceptive awareness) that is often outside of conscious awareness, so that it may be understood and re-integrated in more adaptive ways, which we call somatic reappraisal. Using clinical theory and example vignettes, we present mindful interoceptive awareness for adaptive emotion processing as a framework to cultivate and enhance somatic reappraisal. Mindful interoceptive awareness brings more focused and sustained attention to inner body experience; likewise, internal sensations associated with emotions become more granular, vivid, and can shift in ways that facilitate somatic reappraisal. Learning to sustain interoceptive awareness when engaged with mindfulness qualities of nonjudgment and compassion promotes an experience where new associations between emotions, meanings, and memories can be made that generate insights that are holistic and integrative. A clinical vignette is used in this paper to provide examples of this approach in psychotherapy. An example script for use in mindfulness groups is included, and resources are suggested for clinicians to gain more experience. Mindful interoceptive awareness for adaptive emotion processing is a clinical process that can be learned and applied by a range of clinicians to treat mental and physical health conditions that may benefit greater embodied awareness.
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Affiliation(s)
- Cynthia J. Price
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, United States
| | - Helen Y. Weng
- Osher Center for Integrative Medicine, Neuroscape Center, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States
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Guidotti R, Del Gratta C, Perrucci MG, Romani GL, Raffone A. Neuroplasticity within and between Functional Brain Networks in Mental Training Based on Long-Term Meditation. Brain Sci 2021; 11:brainsci11081086. [PMID: 34439705 PMCID: PMC8393942 DOI: 10.3390/brainsci11081086] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/31/2021] [Accepted: 08/15/2021] [Indexed: 11/16/2022] Open
Abstract
(1) The effects of intensive mental training based on meditation on the functional and structural organization of the human brain have been addressed by several neuroscientific studies. However, how large-scale connectivity patterns are affected by long-term practice of the main forms of meditation, Focused Attention (FA) and Open Monitoring (OM), as well as by aging, has not yet been elucidated. (2) Using functional Magnetic Resonance Imaging (fMRI) and multivariate pattern analysis, we investigated the impact of meditation expertise and age on functional connectivity patterns in large-scale brain networks during different meditation styles in long-term meditators. (3) The results show that fMRI connectivity patterns in multiple key brain networks can differentially predict the meditation expertise and age of long-term meditators. Expertise-predictive patterns are differently affected by FA and OM, while age-predictive patterns are not influenced by the meditation form. The FA meditation connectivity pattern modulated by expertise included nodes and connections implicated in focusing, sustaining and monitoring attention, while OM patterns included nodes associated with cognitive control and emotion regulation. (4) The study highlights a long-term effect of meditation practice on multivariate patterns of functional brain connectivity and suggests that meditation expertise is associated with specific neuroplastic changes in connectivity patterns within and between multiple brain networks.
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Affiliation(s)
- Roberto Guidotti
- Department of Neuroscience, Imaging and Clinical Sciences, “Gabriele D’Annunzio” University Chieti-Pescara, 66100 Chieti, Italy; (C.D.G.); (M.G.P.)
- Correspondence:
| | - Cosimo Del Gratta
- Department of Neuroscience, Imaging and Clinical Sciences, “Gabriele D’Annunzio” University Chieti-Pescara, 66100 Chieti, Italy; (C.D.G.); (M.G.P.)
- Institute for Advanced Biomedical Technologies, “Gabriele D’Annunzio” University Chieti-Pescara, 66100 Chieti, Italy;
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, “Gabriele D’Annunzio” University Chieti-Pescara, 66100 Chieti, Italy; (C.D.G.); (M.G.P.)
- Institute for Advanced Biomedical Technologies, “Gabriele D’Annunzio” University Chieti-Pescara, 66100 Chieti, Italy;
| | - Gian Luca Romani
- Institute for Advanced Biomedical Technologies, “Gabriele D’Annunzio” University Chieti-Pescara, 66100 Chieti, Italy;
| | - Antonino Raffone
- Department of Psychology, “La Sapienza” University Rome, 00185 Rome, Italy;
- School of Buddhist Studies, Philosophy and Comparative Religions, Nalanda University, Rajgir 803116, India
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78
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Srivastava AB, Sanchez-Peña J, Levin FR, Mariani JJ, Patel GH, Naqvi NH. Drinking reduction during cognitive behavioral therapy for alcohol use disorder is associated with a reduction in anterior insula-bed nucleus of the stria terminalis resting-state functional connectivity. Alcohol Clin Exp Res 2021; 45:1596-1606. [PMID: 34342012 DOI: 10.1111/acer.14661] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/26/2021] [Accepted: 06/22/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Connectivity between the anterior insula (AI) and the bed nucleus of the stria terminalis (BNST) may play a role in negative emotions that drive compulsive drinking in patients with alcohol use disorder (AUD). We hypothesized that reductions in drinking during cognitive behavioral therapy (CBT), an effective treatment that teaches regulation (coping) skills for managing negative emotions during abstinence, would be associated with reductions in resting-state functional connectivity (RSFC) between the AI and the BNST. METHODS We included 18 patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of AUD who were (1) seeking treatment and (2) drinking heavily at baseline. We measured RSFC as Pearson's correlation between the BNST and multiple regions of interest in the insula at baseline and after completion of 12 weeks of a single-arm clinical trial of outpatient CBT. We also assessed the number of heavy drinking days over the previous 28 days (NHDD) at both time points. We used 1-sample t-tests to evaluate AI-BNST RSFC at baseline, paired t-tests to evaluate changes in AI-BNST RSFC from pre-CBT to post-CBT, and linear regression to evaluate the relationship between changes in AI-BNST RSFC and NHDD. RESULTS We found a significant positive RSFC between the AI and the BNST at baseline (p = 0.0015). While there were no significant changes in AI-BNST RSFC from pre- to post-CBT at the group level (p = 0.42), we found that individual differences in reductions in AI-BNST RSFC from pre- to post-CBT were directly related to reductions in NHDD from pre- to post-CBT (r = 0.73, p = 0.0008). CONCLUSIONS These findings provide preliminary evidence that reduced AI-BNST RSFC may be a mechanism of drinking reduction in AUD and that AI-BNST RSFC may be a target for CBT and possibly other treatments.
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Affiliation(s)
- A Benjamin Srivastava
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - Juan Sanchez-Peña
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - Frances R Levin
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - John J Mariani
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - Gaurav H Patel
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA
| | - Nasir H Naqvi
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA
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79
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Ooishi Y, Fujino M, Inoue V, Nomura M, Kitagawa N. Differential Effects of Focused Attention and Open Monitoring Meditation on Autonomic Cardiac Modulation and Cortisol Secretion. Front Physiol 2021; 12:675899. [PMID: 34335292 PMCID: PMC8320390 DOI: 10.3389/fphys.2021.675899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022] Open
Abstract
Mindfulness-based interventions (MBIs) have been used widely as a useful tool for the alleviation of various stress-related symptoms. However, the effects of MBIs on stress-related physiological activity have not yet been ascertained. MBIs primarily consist of focused-attention (FA) and open-monitoring (OM) meditation. Since differing effects of FA and OM meditation on brain activities and cognitive tasks have been mentioned, we hypothesized that FA and OM meditation have also differing effects on stress-related physiological activity. In this study, we examined the effects of FA and OM meditation on autonomic cardiac modulation and cortisol secretion. Forty-one healthy adults (aged 20-46 years) who were meditation novices experienced 30-min FA and OM meditation tasks by listening to instructions. During resting- and meditation-states, electrocardiogram transducers were attached to participants to measure the R-R interval, which were used to evaluate heart rate (HR) and perform heart rate variability (HRV) analyses. Saliva samples were obtained from participants pre- and post-meditation to measure salivary cortisol levels. Results showed that FA meditation induced a decrease in HR and an increase in the root mean square of successive differences (rMSDD). In contrast, OM meditation induced an increase in the standard deviation of the normal-to-normal interval (SDNN) to rMSSD ratio (SDNN/rMSSD) and a decrease in salivary cortisol levels. These results suggest that FA meditation elevates physiological relaxation, whereas OM meditation elevates physiological arousal and reduces stress.
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Affiliation(s)
- Yuuki Ooishi
- NTT Communication Science Laboratories, NTT Corporation, Atsugi, Japan
| | - Masahiro Fujino
- Open Innovation Institute, Kyoto University, Kyoto, Japan.,Division of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan
| | - Vimala Inoue
- Faculty of Health Science, Health Science University, Fujikawaguchiko, Japan
| | - Michio Nomura
- Division of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan
| | - Norimichi Kitagawa
- NTT Communication Science Laboratories, NTT Corporation, Atsugi, Japan.,BKC Research Organization of Social Sciences, Ritsumeikan University, Kusatsu, Japan.,Yoshika Institute of Psychology, Kanoashi, Japan
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80
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Boyadzhieva A, Kayhan E. Keeping the Breath in Mind: Respiration, Neural Oscillations, and the Free Energy Principle. Front Neurosci 2021; 15:647579. [PMID: 34267621 PMCID: PMC8275985 DOI: 10.3389/fnins.2021.647579] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/27/2021] [Indexed: 11/22/2022] Open
Abstract
Scientific interest in the brain and body interactions has been surging in recent years. One fundamental yet underexplored aspect of brain and body interactions is the link between the respiratory and the nervous systems. In this article, we give an overview of the emerging literature on how respiration modulates neural, cognitive and emotional processes. Moreover, we present a perspective linking respiration to the free-energy principle. We frame volitional modulation of the breath as an active inference mechanism in which sensory evidence is recontextualized to alter interoceptive models. We further propose that respiration-entrained gamma oscillations may reflect the propagation of prediction errors from the sensory level up to cortical regions in order to alter higher level predictions. Accordingly, controlled breathing emerges as an easily accessible tool for emotional, cognitive, and physiological regulation.
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Affiliation(s)
| | - Ezgi Kayhan
- Department of Developmental Psychology, University of Potsdam, Potsdam, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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81
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Strohacker K, Keegan R, Beaumont CT, Zakrajsek RA. Applying P-Technique Factor Analysis to Explore Person-Specific Models of Readiness-to-Exercise. Front Sports Act Living 2021; 3:685813. [PMID: 34250469 PMCID: PMC8267010 DOI: 10.3389/fspor.2021.685813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Recent research in exercise prescription and periodization has emphasized the importance of subjective experience, both in medium- and long-term monitoring, but also in the acute experience. Emerging evidence also highlights an important role of subjective readiness (pre-exercise mental and physical states) in determining how exercise is experienced, and in acutely modifying the prescribed exercise intensity. The concept of "readiness-to-exercise" shows promise in enabling and informing this acute decision-making to optimize the experiences and outcomes of exercise. While subjective experiences can be effectively assessed using psychometric scales and instruments, these are often developed and deployed using cross-sectional samples, with resulting structures that reflect a normative pattern (nomothetic). These patterns may fail to reflect individual differences in sensitivity, experience and saliency (idiographic). We conducted this research with the primary aim of comparing the nomothetical and idiographic approaches to modeling the relatively novel concept of readiness-to-exercise. Study 1 (nomothetic) therefore analyzed data collected from 572 participants who completed a one-time survey using R-technique factor analysis. Results indicated a four-factor structure that explained 60% of the variance: "health and fitness;" "fatigue;" "vitality" and "physical discomfort." Study 2 (idiographic) included a sample of 29 participants who completed the scale multiple times, between 42 and 56 times: permitting intra-individual analysis using separate P-technique factor analyses. Our analyses suggested that many individuals displayed personal signature, or "profiles" of readiness-to-exercise that differed in structure from the nomothetic form: only two participants' personal signatures contained four structures as modeled in Study 1, whereas the majority demonstrated either two or three factors. These findings raise important questions about how experiential data should be collected and modeled, for use in research (conceptual development and measurement) and applied practice (prescribing, monitoring)-as well as in more applied research (implementation, effectiveness).
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Affiliation(s)
- Kelley Strohacker
- Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Richard Keegan
- Research Institute for Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Cory T Beaumont
- Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Rebecca A Zakrajsek
- Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, United States
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83
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Thomas EM, Freeman TP, Poplutz P, Howden K, Hindocha C, Bloomfield M, Kamboj SK. Stimulating meditation: a pre-registered randomised controlled experiment combining a single dose of the cognitive enhancer, modafinil, with brief mindfulness training. J Psychopharmacol 2021; 35:621-630. [PMID: 33645313 PMCID: PMC8278547 DOI: 10.1177/0269881121991835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mindfulness-meditation has a variety of benefits on well-being. However, individuals with primary attentional impairments (e.g. attention deficit disorder) or attentional symptoms secondary to anxiety, depression or addiction, may be less likely to benefit, and require additional mindfulness-augmenting strategies. AIMS To determine whether a single dose of the cognitive enhancer, modafinil, acutely increases subjective and behavioural indices of mindfulness, and augments brief mindfulness training. METHODS A randomised, double-blind, placebo-controlled, 2 (drug: placebo, modafinil) × 2 (strategy: mindfulness, relaxation control) experiment was conducted. Seventy-nine meditation-naïve participants were assigned to: placebo-relaxation, placebo-mindfulness, modafinil-relaxation or modafinil-mindfulness. Pre-drug, post-drug and post-strategy state mindfulness, affect and autonomic activity, along with post-strategy sustained attention and mind-wandering were assessed within a single lab session. After the session, participants were instructed to practice their assigned behavioural strategy daily for one week, with no further drug administration, after which, follow-up measures were taken. RESULTS As predicted, modafinil acutely increased state mindfulness and improved sustained attention. Differential acute strategy effects were found following mindfulness on autonomic activity but not state mindfulness. There were no strategy or drug effects on mind-wandering. However, exploratory analyses indicated that participants receiving modafinil engaged in more strategy practice across strategy conditions during follow-up. CONCLUSIONS Modafinil acutely mimicked the effects of brief mindfulness training on state mindfulness but did not enhance the effects of this training. Limitations of the current study, and recommendations for future research examining modafinil as an adjunct to mindfulness- (or relaxation-) based treatments are discussed.
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Affiliation(s)
- Emily M Thomas
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK,Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Patrick Poplutz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Kane Howden
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK,Translational Psychiatry Research Group, University College London, London, UK
| | - Michael Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, UK,Translational Psychiatry Research Group, University College London, London, UK
| | - Sunjeev K Kamboj
- Clinical Psychopharmacology Unit, University College London, London, UK,Sunjeev K Kamboj, Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower St, London, WC1E 6BT, UK.
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84
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Dickenson JA, Diamond L, King JB, Jenson K, Anderson JS. Understanding heterosexual women's erotic flexibility: the role of attention in sexual evaluations and neural responses to sexual stimuli. Soc Cogn Affect Neurosci 2021; 15:447-465. [PMID: 32415978 PMCID: PMC7308660 DOI: 10.1093/scan/nsaa058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/10/2020] [Accepted: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
Many women experience desires, arousal and behavior that run counter to their sexual orientation (orientation inconsistent, 'OI'). Are such OI sexual experiences cognitively and neurobiologically distinct from those that are consistent with one's sexual orientation (orientation consistent, 'OC')? To address this question, we employed a mindful attention intervention-aimed at reducing judgment and enhancing somatosensory attention-to examine the underlying attentional and neurobiological processes of OC and OI sexual stimuli among predominantly heterosexual women. Women exhibited greater neural activity in response to OC, compared to OI, sexual stimuli in regions associated with implicit visual processing, volitional appraisal and attention. In contrast, women exhibited greater neural activity to OI, relative to OC, sexual stimuli in regions associated with complex visual processing and attentional shifting. Mindfully attending to OC sexual stimuli reduced distraction, amplified women's evaluations of OC stimuli as sexually arousing and deactivated the superior cerebellum. In contrast, mindfully attending to OI sexual stimuli amplified distraction, decreased women's evaluations of OI stimuli as sexually arousing and augmented parietal and temporo-occipital activity. Results of the current study constrain hypotheses of female erotic flexibility, suggesting that sexual orientation may be maintained by differences in attentional processing that cannot be voluntarily altered.
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Affiliation(s)
- Janna A Dickenson
- Human Sexuality, California Institute of Integral Studies, San Francisco, CA 94103, USA.,Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Lisa Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.,Program in Neuroscience, University of Utah, Salt Lake City, UT 84108, USA
| | - Kay Jenson
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Jeffrey S Anderson
- Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.,Program in Neuroscience, University of Utah, Salt Lake City, UT 84108, USA.,Department of Bioengineering, University of Utah, Salt Lake City, UT 84108, USA
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85
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Lai ST, Lim KS, Tang V, Low WY. Mindfulness-based intervention to promote psychological wellbeing in people with epilepsy: A randomized controlled trial. Epilepsy Behav 2021; 118:107916. [PMID: 33743343 DOI: 10.1016/j.yebeh.2021.107916] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND We investigated the efficacy of mindfulness-based intervention (MBI) in promoting psychological wellbeing in people with epilepsy (PWE) using an assessor-blinded randomized controlled design. METHODS A total of 28 PWE were randomly assigned to either intervention (n = 14 cases) or control group (n = 14 controls). The intervention group received a six 2.5-hour weekly MBI, while the control group did not receive any intervention. They were assessed at three timepoints (T0: before intervention, T1: immediately after intervention, and T2: 6 weeks after intervention). Repeated measures of analyses of variance (RM-ANOVAs) were used for inter-group comparisons to determine intervention effect from baseline -to T1 and -to T2 for all outcome measures. The individual changes were calculated using the reliable change index (RCI). Key outcomes included depression (BDI-II), anxiety (BAI), epilepsy-related quality of life (QOLIE-31), satisfaction with life (SWLS), and level of mindfulness (MAAS). RESULTS Participants who participated in the MBI showed significant reduction in BDI-II (p = 0.001), significant increases in MAAS (p = 0.027) and QOLIE-31 (p = 0.001) at T1 when compared with the control group. However, BAI and SWLS were not significant. The trend was similar at 6-week follow-up, all outcome measures of MBI remained significant (p < 0.05) except for BAI and SWLS. Beyond the 6-week intervention, RCI analysis showed a significant improvement in levels of mindfulness (45.45% vs. 21.43%, p = 0.009), depression (45.45% vs. 0.00%, p = 0.016), quality of life (45.45% vs. 14.29%, p = 0.017) with MBI, as compared to the no-intervention phase. CONCLUSION Mindfulness-based intervention is effective in reducing psychological distress and improving the quality of life in PWE.
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Affiliation(s)
- Siew-Tim Lai
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kheng-Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Venus Tang
- Department of Clinical Psychology, Prince of Wales Hospital, Hospital Authority, Hong Kong; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wah-Yun Low
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
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86
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Palascha A, van Kleef E, de Vet E, van Trijp HCM. The effect of a brief mindfulness intervention on perception of bodily signals of satiation and hunger. Appetite 2021; 164:105280. [PMID: 33940054 DOI: 10.1016/j.appet.2021.105280] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/23/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
An increasing number of studies investigate the effects of mindfulness on food intake and weight outcomes, while the underlying mechanisms by which mindfulness exerts its effects have received less attention. We conducted two pre-registered studies to shed light on the frequently proposed yet largely understudied hypothesis that mindfulness improves awareness of bodily signals of satiation and hunger. We assessed the ability to perceive the onset of bodily signals of satiation with the two-step water load test (Study 1) and the ability to perceive the onset of bodily signals of hunger with the preload test (Study 2). A brief mindfulness exercise (body scan) did not impact the perception of satiation but improved the ability to perceive bodily signals of hunger. After the consumption of a standardized preload, participants in the two experimental conditions felt equally satiated; nevertheless, those in the mindfulness condition perceived the onset of hunger 18min earlier than those in the control condition and this effect persisted also in the presence of control variables. These findings together suggest that even a single and short mindfulness exercise can improve perception of hunger signals substantially, while more intensive mindfulness training may be needed to impact perception of satiation signals.
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Affiliation(s)
- Aikaterini Palascha
- Marketing and Consumer Behaviour Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, the Netherlands.
| | - Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, the Netherlands
| | - Emely de Vet
- Consumption and Healthy Lifestyles Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, the Netherlands
| | - Hans C M van Trijp
- Marketing and Consumer Behaviour Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, the Netherlands
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87
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Balconi M, Angioletti L. One's Interoception Affects the Representation of Seeing Others' Pain: A Randomized Controlled qEEG Study. Pain Res Manag 2021; 2021:5585060. [PMID: 33884043 PMCID: PMC8041555 DOI: 10.1155/2021/5585060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 12/30/2022]
Abstract
Objective This research demonstrates that interoceptive attentiveness (IA) can modulate cortical oscillations related to the emotional and cognitive representations of observing pain in others. Methods Twenty participants were required to observe painful/nonpainful stimuli in an individual versus the interactive condition during the recording of the electroencephalogram. The sample was divided into experimental (EXP) and control (CTR) groups, and the EXP group was explicitly required to direct the attention on its interoceptive correlates while observing the stimuli. Results Mixed repeated measures, analyses of variance, were applied to each EEG frequency band. Significant findings were obtained mainly for theta and beta bands for the two groups. A hemispheric lateralisation effect was found, with right lateralisation of the theta band for the EXP group when observing painful stimuli and enhanced left activation of theta and beta bands for the CTR group when observing nonpainful stimuli. For both groups, frontal cortical regions were significantly sensitive to social scenarios, while posterior parietal activation was found for stimuli depicting the individual condition. Conclusions The results suggest that IA might enhance the emotional representation of painful stimuli, highlighting their negative and unpleasant features in the EXP group, while the attention of the CTR group was mainly drawn to nonpainful stimuli in social and individual conditions, with a positive valence. The role of frontal regions in the processing of social stimuli through social cognition, inducing emotional mirroring and requiring deeper analysis of the social context, was underlined. We propose that IA could be trained for promoting emotion regulation and empathic response.
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Affiliation(s)
- Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Laura Angioletti
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Baltruschat S, Cándido A, Maldonado A, Verdejo-Lucas C, Catena-Verdejo E, Catena A. There Is More to Mindfulness Than Emotion Regulation: A Study on Brain Structural Networks. Front Psychol 2021; 12:659403. [PMID: 33868133 PMCID: PMC8046916 DOI: 10.3389/fpsyg.2021.659403] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/11/2021] [Indexed: 01/10/2023] Open
Abstract
Dispositional mindfulness and emotion regulation are two psychological constructs closely interrelated, and both appear to improve with the long-term practice of mindfulness meditation. These constructs appear to be related to subcortical, prefrontal, and posterior brain areas involved in emotional processing, cognitive control, self-awareness, and mind wandering. However, no studies have yet discerned the neural basis of dispositional mindfulness that are minimally associated with emotion regulation. In the present study, we use a novel brain structural network analysis approach to study the relationship between structural networks and dispositional mindfulness, measured with two different and widely used instruments [Mindfulness Attention Awareness Scale (MAAS) and Five Facet Mindfulness Questionnaire (FFMQ)], taking into account the effect of emotion regulation difficulties. We observed a number of different brain regions associated with the different scales and dimensions. The total score of FFMQ and MAAS overlap with the bilateral parahippocampal and fusiform gyri. Additionally, MAAS scores were related to the bilateral hippocampus and the FFMQ total score to the right insula and bilateral amygdala. These results indicate that, depending on the instrument used, the characteristics measured could differ and could also involve different brain systems. However, it seems that brain areas related to emotional reactivity and semantic processing are generally related to Dispositional or trait mindfulness (DM), regardless of the instrument used.
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Affiliation(s)
- Sabina Baltruschat
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Antonio Cándido
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Antonio Maldonado
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | | | | | - Andrés Catena
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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89
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Carvalho GB, Damasio A. Interoception and the origin of feelings: A new synthesis. Bioessays 2021; 43:e2000261. [PMID: 33763881 DOI: 10.1002/bies.202000261] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023]
Abstract
Feelings are conscious mental events that represent body states as they undergo homeostatic regulation. Feelings depend on the interoceptive nervous system (INS), a collection of peripheral and central pathways, nuclei and cortical regions which continuously sense chemical and anatomical changes in the organism. How such humoral and neural signals come to generate conscious mental states has been a major scientific question. The answer proposed here invokes (1) several distinctive and poorly known physiological features of the INS; and (2) a unique interaction between the body (the 'object' of interoception) and the central nervous system (which generates the 'subject' of interoception). The atypical traits of the INS and the direct interactions between neural and non-neural physiological compartments of the organism, neither of which is present in exteroceptive systems, plausibly explain the qualitative and subjective aspects of feelings, thus accounting for their conscious nature.
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Affiliation(s)
- Gil B Carvalho
- Brain and Creativity Institute, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California, USA
| | - Antonio Damasio
- Brain and Creativity Institute, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California, USA
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90
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Santarnecchi E, Egiziano E, D'Arista S, Gardi C, Romanella SM, Mencarelli L, Rossi S, Reda M, Rossi A. Mindfulness-based stress reduction training modulates striatal and cerebellar connectivity. J Neurosci Res 2021; 99:1236-1252. [PMID: 33634892 DOI: 10.1002/jnr.24798] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 01/05/2023]
Abstract
Mindfulness is a meditation practice frequently associated with changes in subjective evaluation of cognitive and sensorial experience, as well as with modifications of brain activity and morphometry. Aside from the anatomical localization of functional changes induced by mindfulness practice, little is known about changes in functional and effective functional magnetic resonance imaging (fMRI) connectivity. Here we performed a connectivity fMRI analysis in a group of healthy individuals participating in an 8-week mindfulness-based stress reduction (MBSR) training program. Data from both a "mind-wandering" and a "meditation" state were acquired before and after the MBSR course. Results highlighted decreased local connectivity after training in the right anterior putamen and insula during spontaneous mind-wandering and the right cerebellum during the meditative state. A further effective connectivity analysis revealed (a) decreased modulation by the anterior cingulate cortex over the anterior portion of the putamen, and (b) a change in left and right posterior putamen excitatory input and inhibitory output with the cerebellum, respectively. Results suggest a rearrangement of dorsal striatum functional and effective connectivity in response to mindfulness practice, with changes in cortico-subcortical-cerebellar modulatory dynamics. Findings might be relevant for the understanding of widely documented mindfulness behavioral effects, especially those related to pain perception.
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Affiliation(s)
- Emiliano Santarnecchi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Eutizio Egiziano
- Department of Neurological, Neurosurgical and Behavioral Sciences, University of Siena, Siena, Italy
| | - Sicilia D'Arista
- Department of Neurological, Neurosurgical and Behavioral Sciences, University of Siena, Siena, Italy
| | - Concetta Gardi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Sara M Romanella
- Siena Brain Investigation and Neuromodulation Laboratory (SiBIN-Lab), Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
| | - Lucia Mencarelli
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Siena Brain Investigation and Neuromodulation Laboratory (SiBIN-Lab), Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
| | - Simone Rossi
- Department of Neurological, Neurosurgical and Behavioral Sciences, University of Siena, Siena, Italy.,Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,Siena Brain Investigation and Neuromodulation Laboratory (SiBIN-Lab), Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy.,Department of Medicine, Surgery and Neuroscience, Human Physiology Section, Siena Medical School, Siena, Italy
| | - Mario Reda
- Department of Neurological, Neurosurgical and Behavioral Sciences, University of Siena, Siena, Italy
| | - Alessandro Rossi
- Siena Brain Investigation and Neuromodulation Laboratory (SiBIN-Lab), Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
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91
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Schultchen D, Schneider C, Berberich G, Zaudig M, Erle TM, Pollatos O. On the Relationship of Interoceptive Accuracy and Attention: A Controlled Study With Depressed Inpatients and a Healthy Cohort. Front Psychol 2021; 11:597488. [PMID: 33597903 PMCID: PMC7882488 DOI: 10.3389/fpsyg.2020.597488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Previous research has shown reduced interoceptive accuracy (IAcc) in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention. Methods Thirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention. Results Depressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable. Discussion The results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression.
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Affiliation(s)
- Dana Schultchen
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Carolin Schneider
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Götz Berberich
- Psychosomatic Clinic Windach am Ammersee, Windach, Germany
| | - Michael Zaudig
- Psychotherapeutisches Gesundheitszentrum und Medizinisches Versorgungszentrum am Goetheplatz, Munich, Germany
| | - Thorsten M Erle
- Department of Social Psychology, School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Olga Pollatos
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Turpyn CC, Chaplin TM, Fischer S, Thompson JC, Fedota JR, Baer RA, Martelli AM. Affective Neural Mechanisms of a Parenting-Focused Mindfulness Intervention. Mindfulness (N Y) 2021; 12:392-404. [PMID: 33737986 PMCID: PMC7962669 DOI: 10.1007/s12671-019-01118-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Behavioral evidence suggests that parenting-focused mindfulness interventions can improve parenting practices and enhance family wellbeing, potentially operating through altered emotional processing in parents. However, the mechanisms through which parent mindfulness interventions achieve their positive benefits have not yet been empirically tested, knowledge which is key to refine and maximize intervention effects. Thus, as part of a randomized controlled trial, the present study examined the affective mechanisms of an 8-week parenting-focused mindfulness intervention, the Parenting Mindfully (PM) intervention, versus a minimal-intervention parent education control. METHODS Twenty highly stressed mothers of adolescents completed pre- and post-intervention behavioral and fMRI sessions, in which mothers completed a parent-adolescent conflict interaction, fMRI emotion task, and fMRI resting state scan. Mothers reported on their mindful parenting, and maternal emotional reactivity to the parent-adolescent conflict task was assessed via observed emotion expression, self-reported negative emotion, and salivary cortisol reactivity. RESULTS Results indicated that the PM intervention increased brain responsivity in left posterior insula in response to negative affective stimuli, and altered resting state functional connectivity in regions involved in self-reference, behavioral regulation, and social-emotional processing. Changes in mothers' brain function and connectivity were associated with increased mindful parenting and decreased emotional reactivity to the parent-adolescent conflict task. CONCLUSIONS Findings suggest that mindfulness-based changes in maternal emotional awareness at the neurobiological level are associated with decreased emotional reactivity in parenting interactions, illuminating potential neurobiological targets for future parent-focused intervention.
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Affiliation(s)
- Caitlin C Turpyn
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Tara M Chaplin
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Sarah Fischer
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - James C Thompson
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - John R Fedota
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Ruth A Baer
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Alexandra M Martelli
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
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93
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Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:295-310. [PMID: 33834406 DOI: 10.1007/978-981-33-6044-0_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Recently, the importance of cognitive behavioral therapy (CBT) in the treatment of depression is gradually emerging. Particularly, mindfulness meditation has various approaches related to dialectical behavioral therapy (DBT), acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), and evidence has been provided that they alleviate depressive symptoms. In particular, as MBCT increases the level of evidence in the treatment of repetitive depressive disorders, guidelines are being recommended to prevent recurrence. Mindfulness may also contribute to improving the patient's symptoms as well as improving the therapeutic relationship with the therapist. For both mindful patients and therapists, positive awareness of internal experiences can be a good way to enrich the mind and overcome depressive disorders.
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94
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Weng HY, Feldman JL, Leggio L, Napadow V, Park J, Price CJ. Interventions and Manipulations of Interoception. Trends Neurosci 2021; 44:52-62. [PMID: 33378657 PMCID: PMC7805576 DOI: 10.1016/j.tins.2020.09.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 08/22/2020] [Accepted: 09/27/2020] [Indexed: 12/15/2022]
Abstract
Interoceptive pathways may be manipulated at various levels to develop interventions to improve symptoms in a range of disorders. Primarily through the lens of the respiratory system, we outline various pathways that can be manipulated at neural, behavioral, and psychological levels to change the representation of and attention to interoceptive signals, which can alter interconnected physiological systems and improve functioning and adaptive behavior. Interventions can alter interoception via neuromodulation of the vagus nerve, slow breathing to change respiratory rate and depth, or awareness processes such as mindfulness-based interventions. Aspects of this framework may be applied to other physiological systems and future research may integrate interventions across multiple levels of manipulation or bodily systems.
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Affiliation(s)
- Helen Y Weng
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Jack L Feldman
- Department of Neurobiology, David Geffen School of Medicine, Center for Health Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA; Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Vitaly Napadow
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jeanie Park
- Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Research Service Line, Department of Veterans Affairs Medical Center, Decatur, GA, USA
| | - Cynthia J Price
- School of Nursing, University of Washington, Seattle, WA, USA; Osher Center for Integrative Medicine, University of Washington, Seattle, WA, USA
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Sübay B, Sönmez MB. Interoceptive Awareness, Decision-Making and Impulsiveness in Male Patients with Alcohol or Opioid Use Disorder. Subst Use Misuse 2021; 56:1275-1283. [PMID: 33985408 DOI: 10.1080/10826084.2021.1914108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The present study was prepared on the assumption that interoceptive awareness (IA) and decision-making processes are implicated in addiction, and that somatic feedback plays an important role in decision-making. METHODS The study participants included 80 abstinent male inpatients with alcohol use disorder (n = 40) or opioid use disorder (n = 40) according to DSM-5 criteria (current severity: moderate or severe), along with 40 healthy male volunteers. All participants performed the heart rate tracking task as an objective physiological performance measure of IA and a computerized version of the Iowa gambling task (IGT) as a validated measure of decision-making. Impulsiveness was assessed using the Barratt Impulsiveness Scale 11 (BIS-11). Craving was evaluated with the Penn Alcohol Craving Scale (PACS) or Substance Craving Scale (SCS). RESULTS (1) Heartbeat perception (HBP) and IGT scores were similar between the patients with alcohol or opioid addiction, being significantly lower than those in the control group, and the difference remained significant even when controlling for the factors that were significant in bivariate analyses; (2) HBP scores of patients correlated significantly with IGT scores, even when controlling the effect of the related variables; (3) BIS-11 scores of patients negatively correlated significantly with HBP scores and did not correlate significantly with IGT scores; and (4) PACS/SCS scores did not correlate significantly with HBP and IGT scores. CONCLUSIONS Our findings support the hypothesis that IA and decision-making processes are implicated in addiction and that decreased IA is associated with impaired decision-making.
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Affiliation(s)
- Büşra Sübay
- School of Medicine, Department of Psychiatry, Trakya University, Edirne, Turkey
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96
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Eleftheriou ME, Thomas E. Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy. Front Psychiatry 2021; 12:707057. [PMID: 34456763 PMCID: PMC8386240 DOI: 10.3389/fpsyt.2021.707057] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/12/2021] [Indexed: 12/20/2022] Open
Abstract
Mindfulness-based interventions and psychedelic-assisted therapy have been experimentally utilised in recent years as alternative treatments for various psychopathologies with moderate to great success. Both have also demonstrated significant post-acute and long-term decreases in clinical symptoms and enhancements in well-being in healthy participants. These two therapeutic interventions share various postulated salutogenic mechanisms, such as the ability to alter present-moment awareness and anti-depressive action, via corresponding neuromodulatory effects. Recent preliminary evidence has also demonstrated that psychedelic administration can enhance mindfulness capacities which has already been demonstrated robustly as a result of mindfulness-based interventions. These shared mechanisms between mindfulness-based interventions and psychedelic therapy have led to scientists theorising, and recently demonstrating, synergistic effects when both are used in combination, in the form of potentiated therapeutic benefit. These synergistic results hold great promise but require replication in bigger sample groups and better controlled methodologies, to fully delineate the effect of set and setting, before they can be extended onto clinical populations.
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Affiliation(s)
- Maria Eleni Eleftheriou
- Department of Clinical Psychopharmacology, University College London, London, United Kingdom
| | - Emily Thomas
- Department of Clinical Psychopharmacology, University College London, London, United Kingdom
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Kirk U, Axelsen JL. Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention. PLoS One 2020; 15:e0243488. [PMID: 33332403 PMCID: PMC7746169 DOI: 10.1371/journal.pone.0243488] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/23/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The goal of the present study was to probe the effects of mindfulness practice in a naturalistic setting as opposed to a lab-based environment in the presence of continuous heart rate variability (HRV) measurements. The specific experimental goals were to examine the effects of a brief 10-day online-based mindfulness intervention on both chronic and acute HRV responses. METHOD We conducted a fully randomized 10-day longitudinal trial of mindfulness practice, explicitly controlling for practice effects with an active-control group (music listening) and a non-intervention control group. To assess chronic cardiovascular effects, we asked participants in the 3 groups to complete 2-day HRV pre- and post-intervention measurement sessions. Using this experimental setup enabled us to address training effects arising from mindfulness practice to assess physiological impact on daytime as well as nighttime (i.e. assessing sleep quality) on the underlying HRV response. To assess acute cardiovascular effects, we measured HRV in the 2 active intervention groups during each of the 10 daily mindfulness or music sessions. This allowed us to track the development of purported training effects arising from mindfulness practice relative to the active-control intervention in terms of changes in the HRV slope over the 10-day time-course. RESULTS Firstly, for the acute phase we found increased HRV during the daily practice sessions in both the mindfulness and active-control group indicating that both interventions were effective in decreasing acute physiological stress. Secondly, for the chronic phase we found increased HRV in both the day- and nighttime indicating increased sleep quality, specifically in the mindfulness group. CONCLUSION These results suggest causal effects in both chronic and acute phases of mindfulness practice in formerly naïve subjects and provides support for the argument that brief online-based mindfulness interventions exert positive impact on HRV.
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Affiliation(s)
- Ulrich Kirk
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Johanne L. Axelsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Nicholson AA, Ros T, Densmore M, Frewen PA, Neufeld RWJ, Théberge J, Jetly R, Lanius RA. A randomized, controlled trial of alpha-rhythm EEG neurofeedback in posttraumatic stress disorder: A preliminary investigation showing evidence of decreased PTSD symptoms and restored default mode and salience network connectivity using fMRI. Neuroimage Clin 2020; 28:102490. [PMID: 33395981 PMCID: PMC7708928 DOI: 10.1016/j.nicl.2020.102490] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The default-mode network (DMN) and salience network (SN) have been shown to display altered connectivity in posttraumatic stress disorder (PTSD). Restoring aberrant connectivity within these networks with electroencephalogram neurofeedback (EEG-NFB) has been shown previously to be associated with acute decreases in symptoms. Here, we conducted a double-blind, sham-controlled randomized trial of alpha-rhythm EEG-NFB in participants with PTSD (n = 36) over 20-weeks. Our aim was to provide mechanistic evidence underlying clinical improvements by examining changes in network connectivity via fMRI. METHODS We randomly assigned participants with a primary diagnosis of PTSD to either the experimental group (n = 18) or sham-control group (n = 18). We collected resting-state fMRI scans pre- and post-NFB intervention, for both the experimental and sham-control PTSD groups. We further compared baseline brain connectivity measures pre-NFB to age-matched healthy controls (n = 36). RESULTS With regard to the primary outcome measure of PTSD severity, we found a significant main effect of time in the absence of a group × time interaction. Nevertheless, we found significantly decreased PTSD severity scores in the experimental NFB group only, when comparing post-NFB (dz = 0.71) and 3-month follow-up scores (dz = 0.77) to baseline measures. Interestingly, we found evidence to suggest a shift towards normalization of DMN and SN connectivity post-NFB in the experimental group only. Both decreases in PTSD severity and NFB performance were correlated to DMN and SN connectivity post-NFB in the experimental group. Critically, remission rates of PTSD were significant higher in the experimental group (61.1%) as compared to the sham-control group (33.3%). CONCLUSION The current study shows mechanistic evidence for therapeutic changes in DMN and SN connectivity that are known to be associated with PTSD psychopathology with no patient dropouts. This preliminary investigation merits further research to demonstrate fully the clinical efficacy of EEG-NFB as an adjunctive therapy for PTSD.
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Affiliation(s)
- Andrew A Nicholson
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Austria
| | - Tomas Ros
- Departments of Neuroscience and Psychiatry, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Maria Densmore
- Departments of Neuroscience, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Paul A Frewen
- Departments of Neuroscience, Western University, London, ON, Canada; Departments of Psychology, Western University, London, ON, Canada
| | - Richard W J Neufeld
- Departments of Neuroscience, Western University, London, ON, Canada; Departments of Psychiatry, Western University, London, ON, Canada; Departments of Psychology, Western University, London, ON, Canada
| | - Jean Théberge
- Departments of Psychiatry, Western University, London, ON, Canada; Departments of Psychology, Western University, London, ON, Canada; Departments of Medical Imaging, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Departments of Neuroscience, Western University, London, ON, Canada; Departments of Psychiatry, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada.
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Addington EL, Javandel S, De Gruttola V, Paul R, Milanini B, Ances BM, Moskowitz JT, Valcour V. Mindfulness-based stress reduction for HIV-associated neurocognitive disorder: Rationale and protocol for a randomized controlled trial in older adults. Contemp Clin Trials 2020; 98:106150. [PMID: 32942053 PMCID: PMC7686285 DOI: 10.1016/j.cct.2020.106150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022]
Abstract
The symptom burden of HIV-associated neurocognitive disorder (HAND) is high among older individuals, and treatment options are limited. Mindfulness-based stress reduction (MBSR) has potential to improve neurocognitive performance, psychosocial wellbeing, and quality of life, but empirical studies in this growing vulnerable population are lacking. In this trial, participants (N = 180) age 55 and older who are living with HIV infection, are on combination antiretroviral therapy with suppressed viral loads, and yet continue to experience behavioral and cognitive symptoms of HAND, are randomized to MBSR or to a waitlist control arm that receives MBSR following a 16-week period of standard care. Primary outcomes (attention, executive function, stress, anxiety, depression, everyday functioning, quality of life) and potential mediators (affect, mindfulness) and moderators (social support, loneliness) are assessed at baseline and weeks 8, 16, and 48 in both groups, with an additional assessment at week 24 (post-MBSR) in the crossover control group. Assessments include self-report and objective measures (e.g., neuropsychological assessment, neurological exam, clinical labs). In addition, a subset of participants (n = 30 per group) are randomly selected to undergo fMRI to evaluate changes in functional connectivity networks and their relationship to changes in neuropsychological outcomes. Forthcoming findings from this randomized controlled trial have the potential to contribute to a growing public health need as the number of older adults with HAND is expected to rise.
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Affiliation(s)
- Elizabeth L Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA.
| | - Shireen Javandel
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Victor De Gruttola
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
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Smith JL, Allen JW, Haack C, Wehrmeyer K, Alden K, Lund MB, Mascaro JS. The Impact of App-Delivered Mindfulness Meditation on Functional Connectivity and Self-Reported Mindfulness Among Health Profession Trainees. Mindfulness (N Y) 2020; 12:92-106. [PMID: 33052251 PMCID: PMC7543678 DOI: 10.1007/s12671-020-01502-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/30/2022]
Abstract
Objectives Previous research indicates that mindfulness meditation reduces anxiety and depression and enhances well-being. We examined the impact of app-delivered mindfulness meditation on resting state functional MRI (fMRI) connectivity among physician assistant (PA) students and surgery residents. Methods PA students and residents were randomized to receive a popular meditation app or to wait-list control group. Before and after the 8-week meditation period, we acquired fMRI scans of participants’ resting state, and participants completed a self-report measure of mindfulness. We used a 2 × 2, within- and between-group factorial design and leveraged a whole-brain connectome approach to examine changes in within- and between-network connectivity across the entire brain, and to examine whether changes in connectivity were associated with app use or to changes in self-reported mindfulness. Results Meditation practitioners exhibited significantly stronger connectivity between the frontoparietal network and the left and right nucleus accumbens and between the default mode (DMN) and salience networks, among other regions. Mindfulness practice time was correlated with increased connectivity between the lateral parietal cortex and the supramarginal gyrus, which were also positively correlated with increased scores on the “Describing” subscale of the Five Facet Mindfulness Questionnaire between baseline and post-meditation. These findings are consistent with previous research indicating that mindfulness-based interventions alter functional connectivity within the DMN and between the DMN and other networks both during meditation and at rest, as well as increased connectivity in systems important for emotion and reward. Conclusions Recent commentaries call for healthcare provider and trainee wellness programs that are sustainable and preventive in nature rather than reactive; these data indicate that even brief sessions of app-delivered mindfulness practice are associated with functional connectivity changes in a dose-dependent manner. Electronic supplementary material The online version of this article (10.1007/s12671-020-01502-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA USA
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA USA.,Department of Neurology, Emory University, Atlanta, GA USA
| | - Carla Haack
- Department of Surgery, Emory University, Atlanta, GA USA
| | - Kathryn Wehrmeyer
- Department of Family and Preventive Medicine, Emory University, 1841 Clifton Road NE, Suite 507, Atlanta, GA 30329 USA
| | - Kayley Alden
- Department of Family and Preventive Medicine, Emory University, 1841 Clifton Road NE, Suite 507, Atlanta, GA 30329 USA
| | - Maha B Lund
- Department of Family and Preventive Medicine, Physician Assistant Program, Emory University, Atlanta, GA USA
| | - Jennifer S Mascaro
- Department of Family and Preventive Medicine, Emory University, 1841 Clifton Road NE, Suite 507, Atlanta, GA 30329 USA
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