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Sohail A, Zhang L. Informing the treatment of social anxiety disorder with computational and neuroimaging data. PSYCHORADIOLOGY 2024; 4:kkae010. [PMID: 38841558 PMCID: PMC11152174 DOI: 10.1093/psyrad/kkae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Aamir Sohail
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Lei Zhang
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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2
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Song L, Luo Q, Liu C, Zhou Y, Huang D, Ju C, Chen H, Wong TKS, Chen J, Tan W, Miao C, Ma Y, Chen J. Quality of life and its association with predictors in lung transplant recipients: a latent profile analysis. Front Public Health 2024; 12:1355179. [PMID: 38741913 PMCID: PMC11089158 DOI: 10.3389/fpubh.2024.1355179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Backgrounds Improving quality of life (QOL) is one of the main aims of lung transplantation (LTx). There is a need to identify those who have poor quality of life early. However, research addressing inter individual quality of life variability among them is lacking. This study aims to identify group patterns in quality of life among lung transplant recipients and examine the predictors associated with quality of life subgroups. Methods In total, 173 lung transplant recipients were recruited from one hospital in Guangdong Province between September 2022 and August 2023. They were assessed using the Lung Transplant Quality of Life scale (LT-QOL), Mindful Attention Awareness Scale (MAAS), Life Orientation Test-Revised scale (LOT-R), and Positive and Negative Affect Scale (PANAS). Latent profile analysis was used to identify QOL subtypes, and logistic regression analysis was used to examine the associations between latent profiles and sociodemographic and psychosocial characteristics. Results Two distinct QOL profiles were identified: "low HRQOL" profile [N = 53 (30.94%)] and "high HRQOL" profile [N = 120 (69.06%)]. Single lung transplant recipients, and patients who reported post-transplant infection, high levels of negative emotion or low levels of mindfulness and optimism were significantly correlated with the low QOL subgroup. Conclusion Using the domains of the LT-QOL scale, two profiles were identified among the lung transplant recipients. Our findings highlighted that targeted intervention should be developed based on the characteristics of each latent class, and timely attention must be paid to patients who have undergone single lung transplantation, have had a hospital readmission due to infection, exhibit low levels of optimism, low levels of mindfulness or high negative emotions.
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Affiliation(s)
- Liqin Song
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Qing Luo
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Chunqin Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Danxia Huang
- Department of Nursing, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunrong Ju
- Department of Nursing, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huifang Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | | | - Jiani Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Wenying Tan
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Chuyuan Miao
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Yu Ma
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - JingWen Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, China
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Liang MZ, Tang Y, Chen P, Tang XN, Knobf MT, Hu GY, Sun Z, Liu ML, Yu YL, Ye ZJ. Brain connectomics improve prediction of 1-year decreased quality of life in breast cancer: A multi-voxel pattern analysis. Eur J Oncol Nurs 2024; 68:102499. [PMID: 38199087 DOI: 10.1016/j.ejon.2023.102499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Whether brain connectomics can predict 1-year decreased Quality of Life (QoL) in patients with breast cancer are unclear. A longitudinal study was utilized to explore their prediction abilities with a multi-center sample. METHODS 232 breast cancer patients were consecutively enrolled and 214 completed the 1-year QoL assessment (92.2%). Resting state functional magnetic resonance imaging was collected before the treatment and a multivoxel pattern analysis (MVPA) was performed to differentiate whole-brain resting-state connectivity patterns. Net Reclassification Improvement (NRI) as well as Integrated Discrimination Improvement (IDI) were calculated to estimate the incremental value of brain connectomics over conventional risk factors. RESULTS Paracingulate Gyrus, Superior Frontal Gyrus and Frontal Pole were three significant brain areas. Brain connectomics yielded 7.8-17.2% of AUC improvement in predicting 1-year decreased QoL. The NRI and IDI ranged from 20.27 to 54.05%, 13.21-33.34% respectively. CONCLUSION Brain connectomics contribute to a more accurate prediction of 1-year decreased QoL in breast cancer. Significant brain areas in the prefrontal lobe could be used as potential intervention targets (i.e., Cognitive Behavioral Group Therapy) to improve long-term QoL outcomes in breast cancer.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xiao Na Tang
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mei Ling Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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4
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Fan Y, Cui Y, Tang R, Sarkar A, Mehta P, Tang YY. Salivary testosterone and cortisol response in acute stress modulated by seven sessions of mindfulness meditation in young males. Stress 2024; 27:2316041. [PMID: 38377148 DOI: 10.1080/10253890.2024.2316041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/03/2024] [Indexed: 02/22/2024] Open
Abstract
Stress is an established risk factor for negative health outcomes. Salivary cortisol and testosterone concentrations increase in response to acute psychosocial stress. It's crucial to reduce stress for health and well-being through evidence-based interventions. Body-mind interventions such as meditation and Tai Chi have shown reduced cortisol levels but mixed results in testosterone concentration after stress. To address this research gap, we conducted a pilot randomized controlled trial to examine the modulating effects of a short-term (seven 20-minute sessions) mindfulness meditation on testosterone and cortisol in response to acute stress. Using one form of mindfulness meditation - Integrative Body-Mind Training (IBMT) and an active control-relaxation training (RT), we assessed salivary cortisol and testosterone concentrations at three stages of stress intervention - rest, stress, and an additional 20-min IBMT or RT practice. We found increased cortisol and testosterone concentrations after acute stress in both groups, but testosterone rise was not associated with cortisol rise. Moreover, an additional practice immediately after stress produced higher testosterone concentrations in the IBMT group than the RT group, whereas cortisol concentration increased in the RT group than in the IBMT group at the same time point. These findings indicate that brief mindfulness intervention modulates a dual-hormone profile of testosterone and cortisol in response to acute stress presumably via the co-regulation of hypothalamus-pituitary-adrenal and hypothalamus-pituitary-testicular axes.
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Affiliation(s)
- Yaxin Fan
- Dalian Blood Center, Dalian, Liaoning, China
| | - Yifen Cui
- Central Lab, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Rongxiang Tang
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Amar Sarkar
- Department of Human Evolutionary Biology, Harvard University, Boston, MA, USA
| | - Pranjal Mehta
- Department of Experimental Psychology, University College London, London, UK
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Zhang JX, Dixon ML, Goldin PR, Spiegel D, Gross JJ. The Neural Separability of Emotion Reactivity and Regulation. AFFECTIVE SCIENCE 2023; 4:617-629. [PMID: 38156247 PMCID: PMC10751283 DOI: 10.1007/s42761-023-00227-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/03/2023] [Indexed: 12/30/2023]
Abstract
One foundational distinction in affective science is between emotion reactivity and regulation. This conceptual distinction has long been assumed to be instantiated in spatially separable brain systems (a typical example: amygdala/insula for reactivity and frontoparietal areas for regulation). In this research, we begin by reviewing previous findings that support and contradict the neural separability hypothesis concerning emotional reactivity and regulation. Further, we conduct a direct test of this hypothesis with empirical data. In five studies involving healthy and clinical samples (total n = 336), we assessed neural responses using fMRI while participants were asked to either react naturally or regulate their emotions (using reappraisal) while viewing emotionally evocative stimuli. Across five studies, we failed to find support for the neural separability hypothesis. In univariate analyses, both presumptive "reactivity" and "regulation" brain regions demonstrated equal or greater activation for the reactivity contrast than for the regulation contrast. In multivariate pattern analyses (MVPA), classifiers decoded reactivity (vs. neutral) trials more accurately than regulation (vs. reactivity) trials using multivoxel data in both presumptive "reactivity" and "regulation" regions. These findings suggest that emotion reactivity and regulation-as measured via fMRI-may not be as spatially separable in the brain as previously assumed. Our secondary whole-brain analyses revealed largely consistent results. We discuss the two theoretical possibilities regarding the neural separability hypothesis and offer thoughts for future research. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-023-00227-9.
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Affiliation(s)
- Jin-Xiao Zhang
- Department of Psychology, Stanford University, Stanford, CA USA
| | - Matt L. Dixon
- Department of Psychology, Stanford University, Stanford, CA USA
| | - Philippe R. Goldin
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA USA
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA USA
| | - James J. Gross
- Department of Psychology, Stanford University, Stanford, CA USA
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Segal O, Sher H, Aderka IM, Weinbach N. Does acceptance lead to change? Training in radical acceptance improves implementation of cognitive reappraisal. Behav Res Ther 2023; 164:104303. [PMID: 37030244 DOI: 10.1016/j.brat.2023.104303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/26/2023] [Accepted: 03/18/2023] [Indexed: 04/09/2023]
Abstract
Third-wave cognitive behavioral treatments such as dialectical behavioral therapy (DBT) theorize that emotional acceptance facilitates cognitive change. However, empirical evidence to support this notion is scarce. This study assessed how a two-week online training in using acceptance or cognitive change DBT skills influences the implementation of these strategies in an emotion regulation task. During six training sessions, 120 healthy individuals recorded personal negative events. In a Radical Acceptance group, participants implemented a DBT skill aimed to promote acceptance of the negative events they described. In a Check the Facts group, participants reappraised their interpretations of the described events. A Control group described negative events but did not use any DBT skill. Results supported our preregistered hypotheses showing that following the training, participants who practiced Radical Acceptance improved in their ability to implement both emotional acceptance and cognitive reappraisal (cognitive change) in an emotion regulation task. In contrast, the Check the Facts group improved only in the ability to use cognitive reappraisal, but not emotional acceptance. The control group did not improve in either strategy. The findings provide empirical evidence to support the notion that cultivating acceptance can subsequently improve the ability to reinterpret reality for coping adaptively with negative events.
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Pagni BA, Hill E, Walsh MJM, Delaney S, Ogbeama D, Monahan L, Cook JR, Guerithault N, Dixon MV, Ballard L, Braden BB. Distinct and shared therapeutic neural mechanisms of mindfulness-based and social support stress reduction groups in adults with autism spectrum disorder. J Psychiatry Neurosci 2023; 48:E102-E114. [PMID: 36990468 PMCID: PMC10065804 DOI: 10.1503/jpn.220159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/16/2022] [Accepted: 12/09/2022] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) alleviates depression and anxiety in adults with autism spectrum disorder (ASD); however, underlying therapeutic neural mechanisms and mindfulness-specific effects have yet to be elucidated. METHODS We randomly assigned adults with ASD to MBSR or social support/education (SE). They completed questionnaires that assessed depression, anxiety, mindfulness traits, autistic traits and executive functioning abilities as well as a self-reflection functional MRI task. We used repeated-measures analysis of covariance (ANCOVA) to evaluate behavioural changes. To identify task-specific connectivity changes, we performed a generalized psychophysiological interactions (gPPI) functional connectivity (FC) analysis on regions of interest (ROIs; insula, amygdala, cingulum and prefrontal cortex [PFC]). We used Pearson correlations to explore brain-behaviour relationships. RESULTS Our final sample included 78 adults with ASD - 39 who received MBSR and 39 who received SE. Mindfulness-based stress reduction uniquely improved executive functioning abilities and increased mindfulness traits, whereas both MBSR and SE groups showed reductions in depression, anxiety and autistic traits. Decreases specific to MBSR in insula-thalamus FC were associated with anxiety reduction and increased mindfulness traits, including the trait "nonjudgment;" MBSR-specific decreases in PFC-posterior cingulate connectivity correlated with improved working memory. Both groups showed decreased amygdala-sensorimotor and medial-lateral PFC connectivity, which corresponded with reduced depression. LIMITATIONS Larger sample sizes and neuropsychological evaluations are needed to replicate and extend these findings. CONCLUSION Together, our findings suggest that MBSR and SE are similarly efficacious for depression, anxiety and autistic traits, whereas MBSR produced additional salutary effects related to executive functioning and mindfulness traits. Findings from gPPI identified shared and distinct therapeutic neural mechanisms, implicating the default mode and salience networks. Our results mark an early step toward the development of personalized medicine for psychiatric symptoms in ASD and offer novel neural targets for future neurostimulation research. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT04017793.
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Affiliation(s)
- Broc A Pagni
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Ethan Hill
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Melissa J M Walsh
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Shanna Delaney
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Destiny Ogbeama
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Leanna Monahan
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - James R Cook
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | | | - Maria V Dixon
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Lisa Ballard
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - B Blair Braden
- From Arizona State University, College of Health Solutions, Phoenix, AZ
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Lee HJ, Stein MB. Update on treatments for anxiety-related disorders. Curr Opin Psychiatry 2023; 36:140-145. [PMID: 36480651 DOI: 10.1097/yco.0000000000000841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW This review examines recent evidence that informs the treatment of anxiety-related disorders. RECENT FINDINGS In addition to selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines, agomelatine has demonstrated efficacy in treating generalized anxiety disorder (GAD). Other novel products, such as ketamine, psilocybin and cannabidiol, are in the process of gathering evidence in support of the treatment of anxiety disorders. In psychological therapy, various psychological treatments for anxiety disorders, such as mindfulness-based intervention, acceptance and commitment therapy, psychodynamic therapy, emotion-focused therapy and dialectical behavioural therapy, have been tried. Still, most therapies have not proven superior to cognitive behavioural therapy (CBT). In very preliminary findings: Repetitive transcranial magnetic stimulation (rTMS) was effective in GAD; transcranial direct current stimulation (tDCS) was effective for social anxiety disorder (SAD) and GAD and augmented exposure therapy for specific fears. Internet and mobile-based interventions have comparable efficacy to face-to-face therapy. SUMMARY Pharmacotherapy of anxiety disorders is expanding to novel products. Despite trying other psychological therapies for anxiety disorders, most therapies were comparable to but not superior to CBT. rTMS and tDCS were also used and show early promise for GAD, but further studies are needed. Most internet or mobile app based psychological therapies were based on CBT, and some can be considered as alternatives to in-person face-to-face therapy.
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Affiliation(s)
- Hyun Jeong Lee
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, South Korea
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
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Khosravi P, Zugman A, Amelio P, Winkler AM, Pine DS. Translating Big Data to Clinical Outcomes in Anxiety: Potential for Multimodal Integration. Curr Psychiatry Rep 2022; 24:841-851. [PMID: 36469202 PMCID: PMC9931491 DOI: 10.1007/s11920-022-01385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE OF THE REVIEW This review describes approaches to research on anxiety that attempt to link neural correlates to treatment response and novel therapies. The review emphasizes pediatric anxiety disorders since most anxiety disorders begin before adulthood. RECENT FINDINGS Recent literature illustrates how current treatments for anxiety manifest diverse relations with a range of neural markers. While some studies demonstrate post-treatment normalization of markers in anxious individuals, others find persistence of group differences. For other markers, which show no pretreatment association with anxiety, the markers nevertheless distinguish treatment-responders from non-responders. Heightened error related negativity represents the risk marker discussed in the most depth; however, limitations in measures related to error responding necessitate multimodal and big-data approaches. Single risk markers show limits as correlates of treatment response. Large-scale, multimodal data analyzed with predictive models may illuminate additional risk markers related to anxiety disorder treatment outcomes. Such work may identify novel targets and eventually guide improvements in treatment response/outcomes.
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Affiliation(s)
- Parmis Khosravi
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA.
| | - André Zugman
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
| | - Paia Amelio
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
| | - Anderson M Winkler
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, MD, Bethesda, USA
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Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials. Mindfulness (N Y) 2022; 13:2396-2412. [PMID: 36124231 PMCID: PMC9476401 DOI: 10.1007/s12671-022-01964-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 10/31/2022]
Abstract
Objectives Methods Results Conclusions Meta-analysis Pre-registration: PROSPERO #CRD42022319006 Supplementary Information
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Roberts RL, Ledermann K, Garland EL. Mindfulness-oriented recovery enhancement improves negative emotion regulation among opioid-treated chronic pain patients by increasing interoceptive awareness. J Psychosom Res 2021; 152:110677. [PMID: 34801814 DOI: 10.1016/j.jpsychores.2021.110677] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Long-term opioid therapy presents health risks for people with chronic pain. Some chronic pain patients escalate their opioid dose to regulate negative emotions. Therefore, emotion regulatory strategies like reappraisal are key treatment targets for this population. Mindfulness has been shown to enhance reappraisal, but the mechanisms of action are unknown. This study was a secondary analysis of data from a randomized, controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE) to test a specific postulate of the Mindfulness-to-Meaning Theory: that mindfulness-based interventions promote reappraisal, via interoceptive self-regulation, as a means of decreasing emotional distress. METHODS Ninety-five patients with opioid-treated chronic pain (age = 56.8 ± 11.7, 66% female) were randomized to 8 weeks of MORE or Support Group (SG) psychotherapy. An interoceptive awareness latent variable was constructed from the Multidimensional Assessment of Interoceptive Awareness (MAIA). Next, interoceptive self-regulation was assessed as a mediator of the effect of MORE on post-treatment reappraisal, and then reappraisal was examined as a mediator of change in distress through 3-month follow-up. RESULTS MORE participants had greater improvements in interoceptive awareness than the SG as measured by the interoceptive awareness latent variable (β = 0.310, p = 0.008) and by the self-regulation MAIA subscale (β = 0.335, p = 0.001). The effect of MORE on treatment-induced increases in reappraisal was mediated by increased interoceptive self-regulation (indirect effect: β = 0.110, p = 0.030). In turn, decreases in distress through 3-month follow-up were mediated by increases in reappraisal (indirect: β = -0.136, p = 0.031). CONCLUSION MORE facilitated reappraisal of distress by enhancing interoceptive self-regulation, supporting a central mechanistic causal pathway specified by the Mindfulness-to-Meaning Theory.
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Affiliation(s)
- R Lynae Roberts
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, 395 S. 1500 East, Salt Lake City, UT 84108, USA; College of Social Work, University of Utah, Goodwill Humanitarian Building, 395 S.1500 East, Salt Lake City, UT 84108, USA
| | - Katharina Ledermann
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstrasse 8, Zurich 8091, Switzerland; Department of Clinical and Health Psychology, University of Fribourg, Rue P-A Faucigny 2, Fribourg 1700, Switzerland
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), University of Utah, 395 S. 1500 East, Salt Lake City, UT 84108, USA; College of Social Work, University of Utah, Goodwill Humanitarian Building, 395 S.1500 East, Salt Lake City, UT 84108, USA; Veterans Health Care Administration VISN 19 Whole Health Flagship, VA Salt Lake City Health Care System, USA.
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