The neuroscience of mindfulness meditation

The effectiveness of three mobile-based psychological interventions in reducing psychological distress and preventing stress-related changes in the psycho-neuro-endocrine-immune network in breast cancer survivors: Study protocol for a randomised controlled trial

Background

A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study.

Methods

A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N = 440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions - Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) - or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach.

Discussion

This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health.

Complementary and Integrative Treatments for Attention-Deficit/Hyperactivity Disorder in Youth

First-line psychopharmacologic and psychosocial treatments for attention-deficit/hyperactivity disorder in children are effective but limited by tolerability and accessibility problems. Many complementary and integrative strategies have been investigated as alternative or adjunctive treatments for the disorder, and the literature has progressed to meta-analyses for several. Although heterogeneity of study methods and risk of bias pervades the literature, we conclude that Omega-3 supplementation, dietary restriction of artificial food colorings, and physical activity can be considered evidence-based. Additionally, meditation, yoga, and sleep hygiene are safe, partially effective, cost effective and sensible adjunctive treatment strategies.

Long-Term and Meditation-Specific Modulations of Brain Connectivity Revealed Through Multivariate Pattern Analysis

Neuroimaging studies have provided evidence that extensive meditation practice modifies the functional and structural properties of the human brain, such as large-scale brain region interplay. However, it remains unclear how different meditation styles are involved in the modulation of these large-scale brain networks. Here, using machine learning and fMRI functional connectivity, we investigated how focused attention and open monitoring meditation styles impact large-scale brain networks. Specifically, we trained a classifier to predict the meditation style in two groups of subjects: expert Theravada Buddhist monks and novice meditators. We showed that the classifier was able to discriminate the meditation style only in the expert group. Additionally, by inspecting the trained classifier, we observed that the Anterior Salience and the Default Mode networks were relevant for the classification, in line with their theorized involvement in emotion and self-related regulation in meditation. Interestingly, results also highlighted the role of specific couplings between areas crucial for regulating attention and self-awareness as well as areas related to processing and integrating somatosensory information. Finally, we observed a larger involvement of left inter-hemispheric connections in the classification. In conclusion, our work supports the evidence that extensive meditation practice modulates large-scale brain networks, and that the different meditation styles differentially affect connections that subserve style-specific functions.

Effects of Brief Mindfulness Meditation and Compassion Meditation on Parochial Empathy and Prosocial Behavior Toward Ethnic Out-Group Members

Objectives

Relative to the tendency to empathize with and help sociocultural in-group members, there are often social and psychological barriers to responding prosocially toward out-group members. This experiment examined the roles of mindfulness instruction and compassion instruction in fostering prosocial behavior toward an ethnic out-group (non-U.S. Arabs) relative to an ethnic in-group (U.S. residents). The study also examined whether contemplative practices would predict less parochial empathy and whether parochial empathy would mediate the relations between mindfulness/compassion and prosocial behavior toward the out-group.

Method

A national sample of n = 450 U.S. residents was recruited online via the Prolific platform using the standard sample function, which distributed the study to available participants on Prolific. Participants were randomly assigned to one of three brief, structurally equivalent audio-recorded instruction conditions: mindfulness meditation, compassion meditation, or a relaxation control, and then completed a series of tasks to assess prosociality toward in- and out-group members.

Results

The compassion training was most effective in reducing parochial empathy when controlling for all covariates. The mindfulness training reduced parochial empathy when controlling for in-group empathy, and it led to greater out-group altruism and support for out-group immigration. Parochial empathy predicted out-group altruism; however, it was not a better predictor of support for Arab immigration than trait empathic concern. Training conditions did not differ on support for out-group cause. Exploratory moderation analyses found that those with higher trait empathic concern and intergroup contact quality were more likely to show compassion training and mindfulness training effects, respectively, on support for out-group immigration.

Conclusions

Brief compassion training had the strongest effect on parochial empathy, but mindfulness training showed stronger effects on out-group altruism and support for out-group immigration. Predisposing social psychological characteristics may enhance intergroup prosociality among those receiving compassion or mindfulness instruction.

Preregistration

This study is preregistered at https://osf.io/rnc97.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-023-02100-z.

The influence of childhood maltreatment on trait depression in patients with major depressive disorder: A moderated mediation model of rumination and mindful attention awareness

Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders. Individuals who were exposed to childhood maltreatment might be an especially vulnerable group and were more likely to meet the diagnostic criteria for depression than those who were not. Trait depression refers to a personality trait predisposition to depression, expressed as the frequency of symptoms rather than a transient depressive mood state. Clarifying the relationship between childhood maltreatment and trait depression in patients with MDD has therefore become an important field of research. Childhood Trauma Questionnaire-Short Form (CTQ-SF), Ruminative Responses Scale (RRS), State-Trait Depression Scale (ST-DEP), and Mindful Attention Awareness Scale (MAAS) were used as research instruments. SPSS 23.0 statistical software was used for statistical analysis and examined the moderated mediation models. A total of 288 patients with MDD were included in this study. After standardization of the variables, the model revealed childhood maltreatment was positively associated with trait depression (β = 0.215, p < 0.001) and that rumination partially mediated the effect between childhood trauma and trait depression. Mindfulness moderated the association between rumination and trait depression in depressed patients (β = 0.171, p < 0.001). Simple slope tests showed that rumination significantly predicted trait depression in patients with high levels of mindfulness (bsimple = 0.460, p < 0.001, 95%CI = [0.339, 0.581]), while this predictive effect was not significant in patients with low levels (bsimple = 0.119, p = 0.097, 95%CI = [-0.022, 0.261]). After adding mediating variables, we found that the negative impact of childhood maltreatment on trait depression was both directly and indirectly through the patients' own ruminative levels. However, mindfulness performed a critical moderating role in the overall mediating model, aggravating the negative impact of childhood maltreatment on trait depression. There are several limitations in this study: the history of childhood maltreatment was reviewed and reported; the MAAS was a single-dimensional questionnaire that fails to measure the content of other mindfulness factors; cross-sectional data could not be used to infer the causal relationship between variables.

Dyadic inter-brain EEG coherence induced by interoceptive hyperscanning

Previous single-brain studies suggested interoception plays a role in interpersonal synchronization. The aim of the present study was to assess the electrophysiological intersubject coherence through electrophysiological (EEG) hyperscanning recording during simple dyadic synchronization tasks when the participants focused on their breath. To this aim, the neural activity of 15 dyads of participants was collected during the execution of a cognitive and motor synchronization task in two distinct IA conditions: focus and no focus on the breath condition. Individuals' EEG frequency bands were recorded through EEG hyperscanning and coherence analysis was performed. Results showed greater EEG coherence was observed for the alpha band in frontopolar brain regions (Fp1, Fp2) and also in central brain regions (C3, C4) within the dyads, during the focus on the breath condition for the motor compared to the cognitive synchronization task; during the same experimental condition, delta and theta band showed augmented inter-individual coherence in the frontal region (Fz) and central areas (C3, C4). To conclude, the current hyperscanning study highlights how the manipulation of the interoceptive focus (obtained through the focus on the breath) strengthens the manifestation of the EEG markers of interpersonal tuning during a motor synchronization task in specific brain areas.

Effectiveness of spiritual interventions on psychological outcomes and quality of life among paediatric patients with cancer: a study protocol for a systematic review

INTRODUCTION

Cancer and its treatment affect children's physical, psychological and social well-being throughout the disease trajectory. Spiritual well-being is a fundamental dimension of people's overall health and is considered a source of strength to motivate patients to cope with and adapt to their disease. Appropriate spiritual interventions are important to mitigate the psychological impact of cancer on children, with an ultimate goal of improving their quality of life (QoL) throughout the treatment course. However, the overall effectiveness of spiritual interventions for paediatric patients with cancer remains unclear. This paper describes a protocol to systematically summarise the characteristics of studies related to existing spiritual interventions and synthesise their effectiveness on psychological outcomes and QoL among children with cancer.

METHODS AND ANALYSIS

Ten databases will be searched to identify appropriate literature: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PsycINFO, LILACS, OpenSIGLE, the Chinese Biomedical Literature Database, the Chinese Medical Current Contents and the Chinese National Knowledge Infrastructure. All randomised controlled trials that meet our inclusion criteria will be included. The primary outcome will be QoL as evaluated by self-reported measures. The secondary outcomes will be self-reported or objectively measured psychological outcomes, including anxiety and depression. Review Manager V.5.3 will be used to synthesise the data, calculate treatment effects, perform any subgroup analyses and assess the risk of bias in included studies.

ETHICAL AND DISSEMINATION

The results will be presented at international conferences and published in peer-reviewed journals. As no individual data will be involved in this review, ethical approval is not required.

On the road to resilience: Epigenetic effects of meditation

Many environmental and lifestyle related factors may influence the physiology of the brain and body by acting on fundamental molecular pathways, such as the hypothalamus-pituitary-adrenal axis (HPA) and the immune system. For example, stressful conditions created by adverse early-life events, unhealthy habits and low socio-economic status may favor the onset of diseases linked to neuroendocrine dysregulation, inflammation and neuroinflammation. Beside pharmacological treatments used in clinical settings, much attention has been given to complementary treatments such as mind-body techniques involving meditation that rely on the activation of inner resources to regain health. At the molecular level, the effects of both stress and meditation are elicited epigenetically through a set of mechanisms that regulate gene expression as well as the circulating neuroendocrine and immune effectors. Epigenetic mechanisms constantly reshape genome activities in response to external stimuli, representing a molecular interface between organism and environment. In the present work, we aimed to review the current knowledge on the correlation between epigenetics, gene expression, stress and its possible antidote, meditation. After introducing the relationship between brain, physiology, and epigenetics, we will proceed to describe three basic epigenetic mechanisms: chromatin covalent modifications, DNA methylation and non-coding RNAs. Subsequently, we will give an overview of the physiological and molecular aspects related to stress. Finally, we will address the epigenetic effects of meditation on gene expression. The results of the studies reported in this review demonstrate that mindful practices modulate the epigenetic landscape, leading to increased resilience. Therefore, these practices can be considered valuable tools that complement pharmacological treatments when coping with pathologies related to stress.

Resting state dynamics in people with varying degrees of anxiety and mindfulness: A nonlinear and nonstationary perspective

Anxiety and mindfulness are two inversely linked traits shown to be involved in various physiological domains. The current study used resting state electroencephalography (EEG) to explore differences between people with low mindfulness-high anxiety (LMHA) (n = 29) and high mindfulness-low anxiety (HMLA) (n = 27). The resting EEG was collected for a total of 6 min, with a randomized sequence of eyes closed and eyes opened conditions. Two advanced EEG analysis methods, Holo-Hilbert Spectral Analysis and Holo-Hilbert cross-frequency phase clustering (HHCFPC) were employed to estimate the power-based amplitude modulation of carrier frequencies, and cross-frequency coupling between low and high frequencies, respectively. The presence of higher oscillation power across the delta and theta frequencies in the LMHA group than the HMLA group might have been due to the similarity between the resting state and situations of uncertainty, which reportedly triggers motivational and emotional arousal. Although these two groups were formed based on their trait anxiety and trait mindfulness scores, it was anxiety that was found to be significant predictor of the EEG power, not mindfulness. It led us to conclude that it might be anxiety, not mindfulness, which might have contributed to higher electrophysiological arousal. Additionally, a higher δ-β and δ-γ CFC in LMHA suggested greater local-global neural integration, consequently a greater functional association between cortex and limbic system than in the HMLA group. The present cross-sectional study may guide future longitudinal studies on anxiety aiming with interventions such as mindfulness to characterize the individuals based on their resting state physiology.

Inflammatory Milieu Induces Mitochondrial Alterations and Neuronal Activations in Hypothalamic POMC Neurons in a Time-Dependent Manner

Inflammation has been associated with numerous neurological disorders. Inflammatory environments trigger a series of cellular and physiological alterations in the brain. However, how inflammatory milieu affects neuronal physiology and how neuronal alterations progress in the inflammatory environments are not fully understood. In this study, we examined the effects of pro-inflammatory milieu on mitochondrial functions and neuronal activities in the hypothalamic POMC neurons. Treating mHypoA-POMC/GFP1 with the conditioned medium collected from LPS activated macrophage were employed to mimic the inflammatory milieu during hypothalamic inflammation. After a 24-h treatment, intracellular ROS/RNS levels were elevated, and the antioxidant enzymes were reduced. Mitochondrial respiration and mitochondrial functions, including basal respiratory rate, spared respiration capacity, and maximal respiration, were all significantly compromised by inflammatory milieu. Moreover, pro-inflammatory cytokines altered mitochondrial dynamics in a time-dependent manner, resulting in the elongation of mitochondria in POMC neurons after a 24-h treatment. Additionally, the increase of C-Fos and Pomc genes expression indicated that the neurons were activated upon the stimulation of inflammatory environment. This neuronal activation of were confirmed on the LPS-challenged mice. Collectively, a short-term to midterm exposure to inflammatory milieu stimulated metabolic switch and neuronal activation, whereas chronic exposure triggered the elevation of oxidative stress, the decrease of the mitochondrial respiration, and the alterations of mitochondrial dynamics.

Brain activity during meditation in first-time meditators

AIM OF THE STUDY

The electrophysiological correlates of meditation states in both short and long-term meditators have been increasingly documented; however, little is known about the brain activity associated with first-time meditation experiences. The goal of this study was to investigate the electrophysiological correlates of a single guided mindfulness meditation session in subjects with no previous meditation experience.

MATERIALS AND METHODS

We analyzed electroencephalogram (EEG) changes in signal power, hemispheric asymmetry, and information flow between EEG channels, in 16 healthy subjects who were new to meditation practice.

RESULTS

Our results show that information flow decreases in the theta (4-8 Hz) and alpha ranges (8-13 Hz) during mindfulness meditation exercise as compared to control: a passive listening condition. These changes are accompanied by a general trend in the decrease of alpha power over the whole scalp. One possible interpretation of these results is that there is an increased level of alertness/vigilance associated with the meditation task rather than reaching the target state.

CONCLUSIONS

Our study expands on the existing body of knowledge concerning neural oscillations during breathing meditation practice by showing that in participants with no previous meditation training, EEG correlates are different from the electrophysiological signatures of mindfulness meditation found in studies of more advanced practitioners.

Effects of mindfulness meditation and Acceptance and commitment therapy in patients with obstructive sleep apnea with residual excessive sleepiness: A randomized controlled pilot study

OBJECTIVE

Assessing the effects of Mindfulness-Based Stress Reduction (MBSR) on symptoms of OSA, especially on the primary outcome, excessive daytime sleepiness (EDS).

METHODS

Parallel randomized controlled trial. 16 OSA patients with residual EDS (rEDS) were randomized and assigned to either a standardized 8-week MBSR program or a time-matched program on Acceptance and Commitment Therapy (ACT). Both programs were conducted online. Participants answered questionnaires online at baseline (pre), post-intervention (post), three months after the intervention (follow-up) and were blinded to whether their group was the treatment or active control group but not to group allocation (partial blinding). Three participants dropped out early. Most analyses are based on the remaining 13 patients.

RESULTS

There was a significant difference between the MBSR (n = 7) and ACT group (n = 6) in changes of EDS between pre and post (Cohen's d = 1.24, CI [0.01, 2.42]) and a significant reduction of EDS for patients in the ACT group at post (Cohen's d = 1.18 and [0.08, 2.22]). This EDS reduction averaging 2.17 points on the Epworth Sleepiness Scale reached the prespecified bar for clinical significance of two points on that scale. Insomnia symptoms, a secondary outcome, reduced significantly following ACT (Cohen's d = 1.43 [0.23, 2.58]). In MBSR, both participants and the MBSR-trainer judged movement-based exercises to be most efficacious.

CONCLUSION

ACT shows potential as adjunctive therapy for OSA with rEDS, although further studies are needed. It seems promising to develop therapeutic approaches for OSA with rEDS using ACT, especially if they are tailored to the needs specific to this patient group.

TRIAL REGISTRATION

https://www.drks.de; Identifier: DRKS00026812.

Exploring impaired self-awareness of motor symptoms in Parkinson's disease: Resting-state fMRI correlates and the connection to mindfulness

OBJECTIVE

To further explore the phenomenon of impaired self-awareness of motor symptoms in patients with Parkinson's Disease by using an evaluated measurement approach applied in previous studies, while also examining its connection with dispositional mindfulness and possible correlates of functional connectivity.

BACKGROUND

Recently, the phenomenon of impaired self-awareness has been studied more intensively by applying different measurement and imaging methods. Existing literature also points towards a possible connection with mindfulness, which has not been examined in a cross-sectional study. There is no data available concerning correlates of functional connectivity.

METHODS

Non-demented patients with idiopathic Parkinson's Disease without severe depression were tested for impaired self-awareness for motor symptoms following a psychometrically evaluated approach. Mindfulness was measured by applying the German version of the Five Facet Mindfulness Questionnaire. A subset of eligible patients underwent functional MRI scanning. Spearman correlation analyses were performed to examine clinical data. Whole-brain voxelwise regressions between seed-based connectivity and behavioral measures were calculated to identify functional connectivity correlates of impaired self-awareness scores.

RESULTS

A total of 41 patients with Parkinson's Disease were included. 15 patients successfully underwent resting-state fMRI scanning. Up to 88% of patients showed signs of impaired self-awareness. Awareness for hypokinetic movements correlated with total mindfulness values and three facets, while awareness for dyskinetic movements did not. Three significant clusters between scores of impaired self-awareness in general and for dyskinetic movements were identified linking behavioral measures with the functional connectivity of the inferior frontal gyrus, the right insular cortex, the supplementary motor area, and the precentral gyrus among others. Impaired self-awareness for hypokinetic movements did not have any neural correlate.

CONCLUSIONS

Clinical data is comparable with results from previous studies applying the same structured approach to measure impaired self-awareness in Parkinson's Disease. Functional connectivity analyses were conducted for the first time to evaluate neural correlates thereof. This data does not support a connection between impaired self-awareness of motor symptoms and dispositional mindfulness.

Dispositional Mindfulness in Heterosexual and Lesbian/Bisexual Women: Associations with Sexual Prejudice and Internalized Sexual Stigma

This research investigated the effect of dispositional mindfulness on the reduction of sexual prejudice and internalized sexual stigma in heterosexual and lesbian/bisexual women, who still represent a population that is under-represented in the scientific literature. Participants were 203 Italian women, both heterosexual (N = 104, 51.2%) and lesbian/bisexual (N= 99, 48.8%), ranging between 18 and 68 years old. They responded to a questionnaire containing demographic information and measures of dispositional mindfulness, need for cognitive closure, and adherence to traditional gender roles. Dominance analyses were run to test the predictive power of mindfulness' dimensions on internalized sexual stigma and on sexual prejudice over and above the other predictors. Results showed that having a mindful nonjudging attitude toward one's inner experience is associated with less internalized sexual stigma in lesbian and bisexual women. On the contrary, dispositional mindfulness was not associated with heterosexual women's sexual prejudice against gay and lesbian individuals.

Making "Joy Pie" to Stay Joyful: Self-Care Interventions Alleviate College Students' Mental Health Challenges

As more college students are facing mental health challenges, it is imperative to explore innovative ways of improving their mental health, including developing self-care interventions that help mitigate their stressors. Based on the Response Styles Theory and self-care conceptions, this study creates the "Joy Pie" project that consists of five self-care strategies, aiming to regulate negative emotions and increase self-care efficacy. Using an experimental design and two-wave data collected from a representative sample of Beijing college students (n₁ = 316, n₂ = 127), this study assesses the effects of the five proposed interventions on the students' self-care efficacy and mental health management. The results show that self-care efficacy helped improve mental health through emotion regulation, which is mediated by age, gender, and family income. The promising results support the effectiveness of the "Joy Pie" interventions in strengthening self-care efficacy and improving mental health. This study offers insights into building back better mental health security among college students at this critical time when the world is recovering from the COVID-19 pandemic.

The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic

This quantitative, before-after study was developed to evaluate the usefulness of an online mindfulness practices program to help nursing professionals deal with stress in the challenging context of the COVID-19 pandemic through the assessment of perceived stress, anxiety and depression, levels of mindfulness, and participants' satisfaction with the program. Eligible participants were assessed at baseline to receive the online mindfulness training program for eight weeks and were appraised again at the end of the program. Standardized measures of perceived stress, depression, anxiety, and one-dimensional and multidimensional mindfulness were performed. Participant satisfaction was also studied. Adherence to treatment was 70.12%. The perceived stress, depression, and anxiety scores were significantly lower after the intervention. The mindfulness measure increased significantly, as well as the sense of well-being and satisfaction with life, study, and/or work. The participants showed high satisfaction with the program and would recommend it to other professionals. Our results indicate that mindfulness-based interventions represent an effective strategy for nurses in the face of the need for self-care with mental health and mechanisms that guarantee the sustainability of their capacities to continue exercising health care.

Depression and Internet Gaming Disorder among Chinese Adolescents: A Longitudinal Moderated Mediation Model

Internet gaming disorder (IGD) is significantly associated with depression across previous studies, and significantly affects the development of mental health among Chinese adolescents. In this two-wave longitudinal research, we tested the mediating role of maladaptive cognition and the moderating role of mindfulness in the linkage between depression and IGD among Chinese adolescents (N = 580, 355 females, average age = 15.76 years, SD = 1.31) who completed questionnaires. Results of regression-based analyses showed that depression was positively related to IGD. Maladaptive cognition significantly mediated the link between depression and IGD. Moreover, mindfulness moderated the second part of the mediation process. Specifically, as the level of mindfulness increased, the influence of depression on the future IGD through maladaptive cognition was weakened. The present study demonstrates the key roles of maladaptive cognition and mindfulness in the link between depression and IGD, and further supports the cognitive-behavioral model of pathological Internet use.

Change in Time Perception Following the Place of Pre-Existence Technique

Time perception is closely related to spatial and bodily perception, yet little is known about how this interrelationship is impacted by meditation and biological sex. To examine this, we studied the effects of a stepwise application of three meditation techniques, from focused attention, to open monitoring to non-dual meditation, encompassed in the Place of Pre-Existence technique (PPEt) on the subjective perception of time, space and body using a pre-post research design. A total of 280 participants (mean age = 47.09 years; SD = 10.13; 127:153 males to females) completed the Subjective Time, Self, Space inventory before and after PPEt. Following PPEt, participants perceived time passing as slowing down, while time intensity, relaxation, 'awareness of space' and 'awareness of body' increased, suggesting heightened mindfulness to these constructs following the training. Awareness of space revealed to be modulated by biological sex and meditation expertise, with males showing a decrease of spatial awareness as a function of meditation expertise while females showed an opposite pattern. The speed and intensity of the experience of time both correlated with body and space awareness. In line with previous studies demonstrating a connection between relaxation and perception of time, a significant correlation was found between relaxation and the subjective experience of the intensity of time. The current results are discussed in the context of the embodied experience of time, and the Sphere Model of Consciousness.

Neuroscience-based psychotherapy: A position paper

In the recent years, discoveries in neuroscience have greatly impacted upon the need to modify therapeutic practice starting from the evidence showing some cerebral mechanisms capable of coping with mental health crisis and traumatic events of the individual's life history by redesigning the narrative plot and the person's sense of the Self. The emerging dialogue between neuroscience and psychotherapy is increasingly intense and modern psychotherapy cannot ignore the heritage deriving from studies about neuropsychological modification of memory traces, neurobiology of attachment theory, cognitive mechanisms involved in psychopathology, neurophysiology of human empathy, neuroimaging evidence about psychotherapeutic treatment, and somatoform disorders connecting the brain and the body. In the present article, we critically examined sectorial literature and claimed that psychotherapy has to referred to a neuroscience-based approach in order to adopt the most tailored interventions for specific groups of patients or therapy settings. We also provided recommendations for care implementation in clinical practice and illustrated challenges of future research.

Electrophysiological correlates of dispositional mindfulness: A quantitative and complexity EEG study

While growing evidence supports that dispositional mindfulness relates to psychological health and cognitive enhancement, to date there have been only a few attempts to characterize its neural underpinnings. In the present study, we aimed at exploring the electrophysiological (EEG) signature of dispositional mindfulness using quantitative and complexity measures of EEG during resting state and while performing a learning task. Hundred twenty participants were assessed with the Five Facet Mindfulness Questionnaire and underwent 5 min eyes-closed resting state and 5 min at task EEG recording. We hypothesized that high mindfulness individuals would show patterns of brain activity related to (a) lower involvement of the default mode network (DMN) at rest (reduced frontal gamma power) and (b) a state of 'task readiness' reflected in a more similar pattern from rest to task (reduced overall q-EEG power at rest but not at task), as compared to their low mindfulness counterparts. Dispositional mindfulness was significantly linked to reduced frontal gamma power at rest and lower overall power during rest but not at task. In addition, we found a trend towards higher entropy during task performance in mindful individuals, which has recently been reported during mindfulness meditation. Altogether, our results add to those from expert meditators to show that high (dispositional) mindfulness seems to have a specific electrophysiological pattern characteristic of less involvement of the DMN and mind-wandering processes.

Mindful mindfulness reporting: Media portrayals of scientific evidence for meditation mobile apps

Promoting mental health is a major global challenge. As mindfulness meditation apps can help maintain and restore good mental health, it is important to understand how their efficacy and safety are portrayed in the media. This study systematically evaluates whether evidence from academic research is used to communicate the health effects of two popular mindfulness apps, Calm and Smiling Mind. A scoping review mapped research findings from 16 relevant articles, and a media analysis examined the types of evidence used in news reporting. Analysing 105 news articles revealed that 98% did not use evidence from academic research on app-based meditation to support health claims. Only 28.5% of articles included advice from a health expert, and 9.5% mentioned potential risks and alternative treatments. Stronger evidence-based reporting on the health effects of mindfulness apps is needed to enable people to make more informed decisions for their health and wellbeing.

Neural correlates of a mindfulness-based intervention in anorexia nervosa

We examined the neural underpinnings of the effects of mindfulness on anxiety in anorexia nervosa using functional magnetic resonance imaging in 21 anorexia patients. We used a functional magnetic resonance imaging task designed to induce weight-related anxiety and asked participants to regulate their anxiety either using or not using an acceptance strategy. Our results showed reduced activity in the amygdala, anterior cingulate cortex, putamen, caudate, orbital gyrus, middle frontal gyrus, posterior cingulate cortex and precuneus following a mindfulness-based intervention. The present study provides new insight regarding the neural mechanisms underlying the effect of mindfulness-based intervention in ameliorating anorexia nervosa.

Graded functional organisation in the left inferior frontal gyrus: evidence from task-free and task-based functional connectivity

The left inferior frontal gyrus (LIFG) has been ascribed key roles in numerous cognitive domains, including language, executive function and social cognition. However, its functional organisation, and how the specific areas implicated in these cognitive domains relate to each other, is unclear. Possibilities include that the LIFG underpins a domain-general function or, alternatively, that it is characterized by functional differentiation, which might occur in either a discrete or a graded pattern. The aim of the present study was to explore the topographical organisation of the LIFG using a bimodal data-driven approach. To this end, we extracted functional connectivity (FC) gradients from 1) the resting-state fMRI time-series of 150 participants (77 female), and 2) patterns of co-activation derived meta-analytically from task data across a diverse set of cognitive domains. We then sought to characterize the FC differences driving these gradients with seed-based resting-state FC and meta-analytic co-activation modelling analyses. Both analytic approaches converged on an FC profile that shifted in a graded fashion along two main organisational axes. An anterior-posterior gradient shifted from being preferentially associated with high-level control networks (anterior LIFG) to being more tightly coupled with perceptually-driven networks (posterior). A second dorsal-ventral axis was characterized by higher connectivity with domain-general control networks on one hand (dorsal LIFG), and with the semantic network, on the other (ventral). These results provide novel insights into a graded functional organisation of the LIFG underpinning both task-free and task-constrained mental states, and suggest that the LIFG is an interface between distinct large-scale functional networks.

The Western origins of mindfulness therapy in ancient Rome

Stoic philosophy has multiple parallels with cognitive behavioural therapy interventions. In their ancient texts, the Roman Stoics present a set of theoretical principles and behavioural strategies that are directly relevant to the clinical care of patients with a wide range of neuropsychiatric conditions. Mindfulness is a key component of the 'third wave' of modern psychotherapy that closely resembles the ancient Stoic practice of attention or 'concentration on the present moment'. Stoic mindfulness draws attention to one of the main principles driving both Stoicism and modern psychotherapy: the assumption that cognitive activity (reasoning) mediates emotions and behaviours. This principle can be traced back to Epictetus' Enchiridion, where he recognises that 'men are disturbed not by things, but by the views which they take of things'. It has been shown that cognitive behavioural therapies and mindfulness-based interventions directed at patients with neuropsychiatric disorders were originally developed as Stoic-inspired treatment interventions. Both Albert Ellis and Aaron Beck (the founders of rational emotive behaviour therapy and cognitive behavioural therapy, respectively) explicitly acknowledged the role of Stoicism as the philosophical precursor of their treatment approaches. The effective implementation of evidence-based guidelines would benefit from an increased awareness of the influence of the Stoic tradition of philosophical therapy on the treatment approaches currently in use in neuropsychiatry.

Enhanced declarative memory in long-term mindfulness practitioners

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Mindfulness Training Changes Brain Dynamics During Depressive Rumination: A Randomized Controlled Trial

BACKGROUND

Depression is a leading cause of disability worldwide and its prevalence is on the rise. One of the most debilitating aspects of depression is the dominance and persistence of depressive rumination, a state of mind that is linked to onset and recurrence of depression. Mindfulness meditation trains adaptive attention regulation and present-moment embodied awareness, skills that may be particularly useful during depressive mind states characterized by negative ruminative thoughts.

METHODS

In a randomized controlled functional magnetic resonance imaging study (N = 80), we looked at the neurocognitive mechanisms behind mindfulness-based cognitive therapy (n = 50) for recurrent depression compared with treatment as usual (n = 30) across experimentally induced states of rest, mindfulness practice and rumination, and the relationship with dispositional psychological processes.

RESULTS

Mindfulness-based cognitive therapy compared with treatment as usual led to decreased salience network connectivity to the lingual gyrus during a ruminative state, and this change in salience network connectivity mediated improvements in the ability to sustain and control attention to body sensations.

CONCLUSIONS

These findings showed that a clinically effective mindfulness intervention modulates neurocognitive functioning during depressive rumination and the ability to sustain attention to the body.

Yoga for COVID-19: An ancient practice for a new condition - A literature review

A substantial proportion of people with acute COVID-19 develop post-COVID-19 condition (previously known as long-COVID) characterized by symptoms that persist for months after the initial infection, including neuropsychological sequelae. Post-COVID-19 condition frequency varies greatly according to different studies, with values ranging from 4 to 80% of the COVID-19 patients. Yoga is a psycho-somatic approach that increases physical, mental, emotional and spiritual strength, and connection. Yoga practice enhances innate immunity and mental health, so it can be used as complementary therapy in the COVID-19 treatment, namely the post-COVID-19 condition. In this article, we conducted a literature review on yoga and COVID-19, finding that an intervention comprising asana, pranayama, and meditation may be a strategy of choice for these patients' recovery. However, further studies are needed to show its effectiveness in this, still unknown, context.

The Value of Mind-Body Connection in Physical Activity for Older People

Exercise that targets balance and strength is proven to prevent falls in older age. The Successful AGEing yoga trial is the first large randomized controlled trial to assess the impact of yoga on falls in people aged ≥60 years. We conducted a realist process evaluation to explain the strong participant engagement observed using interviews (21 participants and three yoga instructors) and focus groups (12 participants and four yoga instructors). Results showed that relaxation, breathing, and yoga's mind-body connection created a satisfying internal focus on bodily sensation which was valued by participants. The mechanisms of mindfulness and embodiment appeared to facilitate this. Mindfulness and embodiment are also linked to, and enhance engagement with, other forms of physical activity. By focusing creatively on these mechanisms, we can develop a range of programs that target improvements in physical and mental health (including reducing falls and fear of falls) and appeal to older people.

Relationship between early-life stress and trait mindfulness in adulthood: a correlational study

BACKGROUND

To investigate the relationship between early-life stress (ELS) and the trait mindfulness level in workers.

METHOD

This study is quantitative cross-sectional and correlational research with a sample of 929 workers from a Brazilian public university. ELS and mindfulness assessment was performed using the Childhood Trauma Questionnaire (CTQ) and the Five-Facet Mindfulness Questionnaire-BR (FFMQ-BR), respectively. The data were submitted to correlation tests adopting a significance level of .05 and a multivariate linear regression analysis.

RESULTS

50.0% of the participants obtained a score indicative of ELS exposure in at least one subtype among the five proposed by the CTQ, with emotional neglect predominating (63.0%). The group not exposed to emotional abuse had higher scores in the "describe-positive formulation" and "non-reactivity to inner experience" facets. Those that scored for physical abuse had higher values in "acting with awareness-autopilot". However, the group exposed to sexual abuse obtained the highest score in the "acting with awareness-autopilot" and "acting with awareness-distraction" facets. The correlation between FFMQ-BR and CTQ overall scores showed a weak correlation with statistical significance. The multiple linear revealed that the facets of mindfulness were significantly associated by at least one type of early stress; however, no significant association was found between CTQ and FFMQ-BR overall results.

CONCLUSION

The results showed that emotional regulation might have effectively occurred in this specific population, even with the presence of some childhood trauma.

The effects of mindfulness-based interventions on anxiety, depression, stress, and mindfulness in menopausal women: A systematic review and meta-analysis

Background

Mindfulness-based interventions (MBIs) are psychological interventions widely used in menopausal women. Currently, there is no evidence summary on the effectiveness of MBIs on anxiety, depression, stress, and mindfulness in menopausal women. This meta-analysis examines the effectiveness of MBIs in improving anxiety, depression, stress, and mindfulness scores in menopausal women.

Methods

A systematic search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang, using relevant terms such as MBIs as keywords and covering all studies published before March 13, 2022. The outcomes were anxiety, depression, stress, and mindfulness. The screening and extraction of data were conducted by two independent reviewers.

Results

A total of 1,138 menopausal women participated in 13 studies. Meta-analysis results showed that MBIs significantly reduced stress in menopausal women (SMD = -0.84, 95% CI: -1.64 to -0.05, p = 0.04), but no statistical differences were found in reducing anxiety (SMD = -0.40, 95% CI: -0.81 to 0.01, p = 0.06) and depression (SMD = -0.19, 95% CI: -0.45 to 0.07, p = 0.16) and in raising the scores of mindfulness (SMD = 0.37, 95% CI: -0.06 to 0.81, p = 0.09) in menopausal women.

Conclusion

MBIs may reduce stress in menopausal women, but their effect on improving anxiety, depression, and mindfulness needs further validation.

Systematic review registration

https://www.crd.york.ac.uk/prospero/#recordDetails.

Effectiveness Evaluation of Repetitive Transcranial Magnetic Stimulation Therapy Combined with Mindfulness-Based Stress Reduction for People with Post-Stroke Depression: A Randomized Controlled Trial

Background: Post-stroke depression (PSD) is most prevalent during the rehabilitative period following a stroke. Recent studies verified the effects of repetitive transcranial magnetic stimulation therapy (rTMS) and mindfulness-based stress reduction (MBSR) in patients with depression. However, the effectiveness and prospect of application in PSD patients remain unclear. This study sought to evaluate the effectiveness of a combined intervention based on rTMS and MBSR for the physical and mental state of PSD patients. Methods: A randomized, double-blind, sham-controlled study design was employed. Participants were recruited from the Rehabilitation Medicine Centre and randomly assigned to receive either MBSR combined with active or sham rTMS or sham rTMS combined with general psychological care. We used a 17-item Hamilton Depression Rating Scale (HAMD-17), a mini-mental state examination (MMSE), the Modified Barthel Index (MBI), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate depressed symptoms, cognitive function, activities of daily living (ADL), and sleep quality at baseline, post-intervention, and the 8-week follow-up. A two-factor analysis of variance was used to compare differences between groups, and Pearson’s linear correlation was used to analyze the possible relationship between variables and potential predictors of depression improvement. Results: Seventy-two participants were randomized to rTMS−MBSR (n = 24), sham rTMS−MBSR (n = 24), or sham rTMS−general psychological care (n = 24). A total of 71 patients completed the questionnaire, a 99% response rate. There were significant time and group interaction effects in HAMD-17, MMSE, MBI, and PSQI scores (p < 0.001). The repeated-measure ANOVA showed a significant improvement of all variables in rTMS−MBSR compared to sham rTMS−MBSR and sham rTMS combined with general psychological care (p < 0.05). Additional results demonstrated that cognitive function, sleep quality, and activities of daily living are associated with depressive symptoms, and cognitive function is a potential variable for improved depression. Conclusion: Depressive symptoms can be identified early by assessing cognitive function, and rTMS−MBSR might be considered a potentially helpful treatment for PSD.

Pavlovian-based neurofeedback enhances meta-awareness of mind-wandering

Absorption in mind-wandering (MW) may worsen our mood and can cause psychological disorders. Researchers indicate the possibility that meta-awareness of MW prevents these mal-effects and enhances favorable consequences of MW, such as boosting creativity; thus, meta-awareness has attracted psychological and clinical attention. However, few studies have investigated the nature of meta-awareness of MW, because there has been no method to isolate and operate this ability. Therefore, we propose a new approach to manipulate the ability of meta-awareness. We used Pavlovian conditioning, tying to it an occurrence of MW and a neutral tone sound inducing the meta-awareness of MW. To perform paired presentations of the unconditioned stimulus (neutral tone) and the conditioned stimulus (perception accompanying MW), we detected participants' natural occurrence of MW via electroencephalogram and a machine-learning estimation method. The double-blinded randomized controlled trial with 37 participants found that a single 20-min conditioning session significantly increased the meta-awareness of MW as assessed by behavioral and neuroscientific measures. The core protocol of the proposed method is real-time feedback on participants' neural information, and in that sense, we can refer to it as neurofeedback. However, there are some differences from typical neurofeedback protocols, and we discuss them in this paper. Our novel classical conditioning is expected to contribute to future research on the modulation effect of meta-awareness on MW.

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

Background

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

Methods

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

Results

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

Conclusions

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

Using Buddhist Meditation-informed Hypnotic Techniques to Manage Rumination: Two Case Illustrations

Rumination is a clinical phenomenon that causes significant distress in clients who suffer from various psychological and physical disorders. It also has a deleterious impact on both therapeutic process and outcome. One approach that holds promise to manage rumination is mindfulness meditation in combination with clinical hypnosis. This article: (1) reviews the concept of and techniques to manage rumination in the Buddhist psychological framework, (2) introduces 2 simple mindfulness-based techniques to deal with rumination, i.e., mindful thought detachment and mindful dereflection, and (3) describes 2 case studies in which these strategies were applied successfully. Hypnosis-informed clinicians are encouraged to integrate these approaches in their practices.

The role of mindfulness and dysexecutive functioning in the association between depression and COVID-19-related stress: cross-sectional and longitudinal analyses

Background: Since the COVID-19 outbreak, the severity of college student's mental health has increased, with depression being the most prominent. This study's primary purpose was to explore (1) whether the perceived stress of COVID-19 was associated with depression through sequential mediation of mindfulness and dysexecutive function and also (2) the temporal association among mindfulness, dysexecutive function and depression.Methods: We performed two studies to evaluate dysexecutive function as a mechanism through which mindfulness impacts depression under the stress of the COVID-19 pandemic. Study 1 used a sequential mediation model to test the mediating role of mindfulness and dysexecutive function between the perceived stress of COVID-19 and depression based on 1,665 emerging adults. Study 2 used a random-effect, cross-lagged panel model (RE-CLPM) to test the directionality among mindfulness, dysexecutive function, and depression based on 370 emerging adults.Results: The cross-sectional study showed that perceived stress of COVID-19 was positively associated with depression through the sequential mediation of mindfulness and dysexecutive function (effect: 0.08, 95%CI = [0.07, 0.10]), also through the mediation of mindfulness (effect: 0.05, 95%CI = [0.03, 0.06]) and dysexecutive function (effect: 0.08, 95%CI = [0.06, 0.10]) separately. The RE-CLPM study indicated that dysexecutive function mediates the reciprocal relation between mindfulness and depression at the within-person level.Conclusion: These results suggest that dysexecutive function is an intermediate psychological mechanism that exacerbates depression under pandemic-related stress. Mindfulness can predict dysexecutive function and subsequently improve depression. As depression under pandemic-related stress can weaken the mindful state, long-term mindfulness practices are needed to maintain mental health during COVID-19.

Consciousness, embodied Quantum Entanglement

We have systematically misconstrued the nature of consciousness by overlooking our own physiology as that awareness. The following is a way to rectify this error through a deep understanding of what life 'means' in order to further advance our knowledge of who and what we are. The evolution of consciousness from the cell membrane to physiology is revealed by the effect of microgravity on phenotypic identity, revealing the two levels of consciousness experimentally. As does the classic Double-Slit experiment, exposing the dual way in which consciousness functions as both the day-to-day of the cell membrane and the transcendent property of our physiology.

Healthcare Workers' Well-Being: A Systematic Review of Positive Psychology Interventions

Given persistent occupational stressors and multiple challenges in the delivery of healthcare, there is an increased focus on the well-being of healthcare workers. Responding to these challenges will require a multipronged approach, focusing on system level, organization, and individual actions. Positive psychology interventions (PPIs) represent a promising area for individual action. This systematic review indicates that PPI, delivered via many methods, holds promise for improving the well-being of healthcare workers, although there is a clear need for additional randomized controlled trials utilizing defined and standardized outcome measures. In this review, the most commonly evaluated PPIs were mindfulness-based or gratitude-based interventions. These were delivered via different methods, with many administered in the workplace and commonly in the form of courses ranging from two days to eight weeks. Researchers documented measurable improvements in multiple studied outcomes, noting reductions in symptoms of depression, anxiety, burnout, and stress. Some interventions increased well-being, job and life satisfaction, self-compassion, relaxation, and resilience. Most studies emphasized that these are simple, accessible, low-cost interventions. Limitations included some nonrandomized or quasi-experimental designs, alongside generally small sample sizes and varying methods of intervention delivery. Another concern is the lack of standardized outcome assessments and long-term follow-up data. As almost all studies included were performed before the pandemic, further research will be required post-pandemic. Overall, however, PPI shows promise as one arm of a multipronged approach to improving the well-being of healthcare workers.

Exploring the Influence of a Mindfulness Intervention on the Experiences of Mothers with Infants in Neonatal Intensive Care Units

Objectives

Mothers with infants in the neonatal intensive care unit (NICU) are at increased risk of psychological distress, which can have lasting negative impacts on both mother and infant. However, few interventions are available to promote these mothers' mental health and wellbeing. In the context of a pilot randomized controlled trial testing a mindfulness intervention for mothers with infants in the NICU, we explore the experiences of the mothers participating in the mindfulness-based intervention, with mothers in the control group as comparison, and the ways they felt it influenced their time in the NICU.

Method

Twenty-six participants (15 participants in the intervention arm and 11 participants in the control arm) recruited from two NICUs in an urban center in Eastern United States completed semi-structured interviews. Interviews explored the mothers' NICU experience as well as experience with the mindfulness and health education (control) programs. Data was analyzed using an iterative, thematic constant comparison process informed by grounded theory.

Results

Mothers reported that participation in the mindfulness intervention helped them to calm the chaos through recentering and fostering connections, find comfort through non-judgmental acceptance, gain perspective on the situation, and facilitate self-care. These were experienced only among the mothers in the intervention arm. These themes did not vary based on demographics of the mothers in the mindfulness study arm or their pre-study awareness of mindfulness.

Conclusions

Mindfulness interventions may foster new practices and perspectives for mothers with infants in the NICU, potentially leading to improved mental health wellbeing.

'My words become my hands': Yoga instructors' experiences of adapting teleyoga in the SAGE fall prevention trial-A qualitative analysis

Objective

This research identifies practical lessons regarding the delivery of teleyoga. Our objectives are to (1) describe challenges and opportunities experienced by yoga instructors when moving the Successful AGEing (SAGE) yoga programme online, and (2) describe how yoga instructors adapted to manage the challenges and leverage opportunities presented by teleyoga.

Methods

This study is a secondary analysis of the data from a previous realist process evaluation of the SAGE yoga trial. The SAGE yoga trial is testing the effect of a yoga-based exercise programme on falls among 700 community-dwelling people aged 60+ years. We draw on focus groups and interviews with four SAGE yoga instructors which we analysed using previously developed programme theories combined with inductive coding and an analytical workshop.

Results

The concerns of the yoga instructors about teleyoga can be characterised into four broad issues: threats to safety, altered interpersonal dynamics, facilitating mind-body connection and difficulties with technology. The SAGE instructors identified eight modifications they used to manage these challenges: a 1:1 participant interview prior to programme commencement, more descriptive verbal instructions, increased focus on interoception, increased attention and support, slower more structured class flow, simplifying poses, adapting the studio environment and IT support.

Conclusions

We have created a typology of strategies for addressing challenges in the delivery of teleyoga for older people. As well as maximising engagement with teleyoga, these manageable strategies could be applied by other instructors to a wide range of telehealth classes, improving the uptake and adherence of beneficial online programmes and services.

Psychological maltreatment and aggression in preadolescence: Roles of temperamental effortful control and maladaptive cognitive emotion regulation strategies

BACKGROUND

Aggression is a type of externalization problem, which is common in preadolescence. The cause of preadolescents' aggression can be traced to their adverse family experiences, such as childhood psychological maltreatment. Therefore, exploring the cause and mechanism underlying aggressive behavior in preadolescents who have experienced psychological maltreatment is critical to preadolescents' healthy development.

OBJECTIVE

The purpose of this study is to explore the mediating effects of effortful control and maladaptive cognitive emotion regulation strategies in the relationship between psychological maltreatment and aggressive behavior among preadolescents.

PARTICIPANTS AND SETTING

A total sample of 940 preadolescents (50.53 % males and 49.47 % females, M_age = 9.75 years, SD = 1.17) were selected from two primary schools in Liaoning province, China. All preadolescents were in grades 3-5.

METHODS

The participants completed questionnaires regarding psychological maltreatment, effortful control, cognitive emotion regulation strategies, and aggression.

RESULTS

The results revealed that: (a) psychological maltreatment was positively associated with aggressive behavior; and (b) effortful control and maladaptive cognitive emotion regulation mediated the link between psychological maltreatment and aggression in a sequential pattern.

CONCLUSIONS

The present study provides further understanding of the relations between psychological maltreatment and aggression, and it also provides prevention and intervention suggestions concerning how to reduce the effect of psychological maltreatment on aggressive behavior among preadolescents.

Single-lead ECG based autonomic nervous system assessment for meditation monitoring

We propose a single-lead ECG-based heart rate variability (HRV) analysis algorithm to quantify autonomic nervous system activity during meditation. Respiratory sinus arrhythmia (RSA) induced by breathing is a dominant component of HRV, but its frequency depends on an individual's breathing speed. To address this RSA issue, we designed a novel HRV tachogram decomposition algorithm and new HRV indices. The proposed method was validated by using a simulation, and applied to our experimental (mindfulness meditation) data and the WESAD open-source data. During meditation, our proposed HRV indices related to vagal and sympathetic tones were significantly increased (p < 0.000005) and decreased (p < 0.000005), respectively. These results were consistent with self-reports and experimental protocols, and identified parasympathetic activation and sympathetic inhibition during meditation. In conclusion, the proposed method successfully assessed autonomic nervous system activity during meditation when respiration influences disrupted classical HRV. The proposed method can be considered a reliable approach to quantify autonomic nervous system activity.

The Effect of Mindfulness Training on the Self-Regulation of Socio-Moral Thoughts

The change in moral attitude due to discrimination of the degree of reality of thought is an unexplored potential effect of mindfulness training. In this article we examine whether the mindfulness training of novices reduces the defensive reaction to normative transgressions when the threatening thought is salient, that is, a thought that stands out regardless of the objective reality that threatens self-survival. To test the study hypotheses, we used a bifactorial design mindfulness training (pre vs. post) x threatened thought salience (low vs high) in a sample of 115 participants. The dependent variable (punishment of social norm transgression) was measured on two different occasions: (1) pre-training (T1), (2) after training (T2). One group receives training in mindfulness in the threatened thought salience low condition (N = 47), and a second group receives the same training in the threatened thought salience high condition (N = 38). A third group did not receive training in threatening thought salience high condition (N = 30). The results show that training mindfulness reduces moral punishment with high threatening thought salience and reduces moral judgment with low threatening thought salience. The shift in reactivity (punishment) is more representative of a MT effect than the shift in moral judgment (seriousness). Implications of the results and limitations of the study are also explored.

Association of Emotion Regulation and Dispositional Mindfulness in an Adolescent Sample: The Mediational Role of Time Perspective

This study relates emotional regulation strategies with dispositional mindfulness and the mediating role of time perspective. It is based on the fact that one of the mechanisms of mindfulness consists in providing protective emotional regulation strategies. At the same time, a direct relationship between dispositional mindfulness and time perspective has been observed. To do this, a representative sample of 320 Chilean adolescents from the city of Talcahuano, whose age ranged between 14 and 17 years old, and who were attending high school, was evaluated. The Zimbardo Time Perspective Inventory, the Difficulties in Emotion Regulation Scale, and the Five Facet Mindfulness Questionnaire were applied. Regression analysis results verified the close relationship between emotional regulation and dispositional mindfulness (R² = 0.54), as well as with the factors of time perspective (R² = 0.41), explaining, between both of them, 60% of the variance of difficulties in emotional regulation. The possible mediational role of time perspective between dispositional mindfulness and emotional regulation is established.

Internet delivered, non-inferiority, two-arm, assessor-blinded intervention comparing mindfulness-based stress reduction and cognitive-behavioral treatment for insomnia: a protocol study for a randomized controlled trial for nursing staff with insomnia

BACKGROUND

Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study.

METHODS

This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction.

CONCLUSION

It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments.

TRIAL REGISTRATION

Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.