History of Mindfulness-Based Cognitive Therapy Is Associated with Increased Cognitive Reappraisal Ability

Is decreasing problematic mobile phone use a pathway for alleviating adolescent depression and sleep disorders? A randomized controlled trial testing the effectiveness of an eight-session mindfulness-based intervention

Objective

The present study aimed to evaluate the efficacy of a mindfulness-based cognitive therapy (MBCT) intervention in reducing problematic mobile phone use, depression, and sleep disorders among adolescents. Additionally, it sought to investigate whether the decrease in problematic mobile phone use acted as a mediator in the relationship between the MBCT intervention and adolescent depression and sleep disorders.

Methods

In a randomized controlled trial, a total of 104 adolescents were randomly assigned to the mindfulness group (n = 52) or the wait-list control group (n = 52). The mindfulness group students completed eight 45-min sessions of mindfulness training in four weeks. The outcomes were measured at baseline, postintervention, and at the 2-month follow-up.

Results

Compared with the control group, the mindfulness group had significantly greater levels of mindfulness and lower levels of problematic mobile phone use, depression, and sleep disorders postintervention. The intervention effects were maintained at the 2-month follow-up. In addition, decreased problematic mobile phone use significantly mediated the association between the MBCT intervention and decreased depression and decreased sleep disorders.

Conclusion

The findings suggest that MBCT could improve adolescent depression and sleep disorders and that decreasing problematic mobile phone use is an effective pathway accounting for the MBCT intervention effect on adolescent depression and sleep disorders.

Integrating mindfulness into the extended process model of emotion regulation: The dual-mode model of mindful emotion regulation

Extensive research has been conducted regarding how people manage their emotions. Within this research, there has been growing attention toward the role of mindfulness in emotion regulation. While prior reviews have discussed mindfulness in the context of emotion regulation, they have not provided a thorough integration using the prevailing models of emotion regulation or mindfulness. The present review discusses the Extended Process Model of Emotion Regulation and Monitoring and Acceptance Theory of mindfulness in order to propose a novel integrated framework, the Dual-mode Model of Mindful Emotion Regulation (D-MER). This model proposes two "modes" of mindfulness: Implementation and facilitation. Implementation posits that mindfulness skills can be used as emotion regulation strategies through attentional deployment and cognitive change. Facilitation posits that mindfulness as a state or trait affects emotion generation and regulation through effects on cognitive processes and positive or negative valence systems. Further, the D-MER posits that mindfulness experience can improve the efficiency of mindfulness-based emotion regulation strategies (implementation) while effects of mindfulness on emotion regulation processes become increasingly trait-like and automatic over time (facilitation). Empirical and theoretical support for this model are discussed, specific hypotheses to guide further research are provided, and clinical implications are presented. Use of this model may identify mechanisms underlying the interaction between mindfulness and emotion regulation which can be used in ongoing affective and clinical research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Managing emotions in the age of political polarization: A randomized controlled trial comparing mindfulness to cognitive reappraisal

Emotional appraisals of political stimuli (e.g., videos) have been shown to drive shared neural encoding, which correspond to shared, yet divisive, interpretations of such stimuli. However, mindfulness practice may entrain a form of emotion regulation that de-automatizes social biases, possibly through alteration of such neural mechanisms. The present study combined a naturalistic neuroimaging paradigm and a randomized controlled trial to examine the effects of short-term mindfulness training (MT) (n = 35) vs structurally equivalent Cognitive Reappraisal training (CT) (n = 37) on politically-situated emotions while evaluating the mechanistic role of prefrontal cortical neural synchrony. Participants underwent functional near-infrared spectroscopy (fNIRS) recording while viewing inflammatory partisan news clips and continuously rating their momentary discrete emotions. MT participants were more likely to respond with extreme levels of anger (odds ratio = 0.12, p < .001) and disgust (odds ratio = 0.08, p < .001) relative to CT participants. Neural synchrony-based analyses suggested that participants with extreme emotion reactions exhibited greater prefrontal cortical neural synchrony, but that this pattern was less prominent in participants receiving MT relative to CT (CT > MT; channel 1 ISC = .040, p = .030).

Understanding the pathways linking patient-centered communication to cancer survivors' emotional health: examining the mediating roles of self-efficacy and cognitive reappraisal

PURPOSE

Many cancer survivors commonly face psychological health issues upon cancer diagnosis, both during and after treatment. Patient-centered communication can play an important role in improving health outcomes among cancer survivors across the cancer continuum. The current study examined the influence of patient-centered communication on self-efficacy in managing health, cognitive reappraisal, and emotional distress among cancer survivors.

METHODS

The analysis was conducted on a subsample of 809 cancer survivors acquired from a nationally representative 2019 Health Information National Trends Survey 5 (Cycle 3). Multivariate regression analysis was conducted to explore the pathways through which patient-centered communication can be associated with cancer survivors' emotional distress, mediated by self-efficacy and cognitive reappraisal.

RESULTS

The results indicated that effective patient-centered provider communication led to higher self-efficacy in managing health, greater involvement in cognitive reappraisal, and decreased emotional distress among cancer survivors. Additionally, the results revealed that the effect of patient-centered communication that led to decreased emotional distress was fully mediated through self-efficacy and cognitive reappraisal.

CONCLUSIONS

Although patient-centered communication positively relates to various emotional health outcomes among cancer survivors, it does not affect their emotional health directly. Self-efficacy and cognitive reappraisal play a crucial role in explaining the underlying mechanisms of such effects.

IMPLICATIONS FOR CANCER SURVIVORS

Future interventions to promote patient-centered communication in cancer care should give more emphasis to managing patients' emotions. Providers should not only recognize, elicit, and respond to patient's emotions, but also develop emotional regulation skills among patients, and improve their ability to cope with emotional distress.

Does acceptance lead to change? Training in radical acceptance improves implementation of cognitive reappraisal

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.

The cognitive control mechanism of improving emotion regulation: A high-definition tDCS and ERP study

BACKGROUND

Cognitive reappraisal as a commonly used emotion regulation strategy includes reinterpretation and detachment and is associated with the activity of the dorsolateral prefrontal cortex (DLPFC). However, the neuroenhancement mechanisms of transcranial direct current stimulation (tDCS) over DLPFC that modulate cognitive reappraisal are not yet fully understood. This work aims to verify the causal role of DLPFC in different tactics of cognitive reappraisal and further explore the cognitive control mechanisms of emotion regulation.

METHODS

A single-blind, within-subjects, sham-controlled design was adopted. Twenty-nine healthy subjects underwent two sessions of offline high-definition tDCS (HD-tDCS) that were targeted at the right DLPFC. Participants completed the cognitive control (Flanker) and cognitive reappraisal task in each session. We quantified the efficacy of cognitive control using N2 and P3 of the evoked brain responses and cognitive reappraisal using the late positivity potential (LPP).

RESULTS

Anodal HD-tDCS resulted in the decrease of LPP for reinterpretation and detachment. The cognitive control increased after stimulation, indicated by the increase of P3 and decrease of N2 amplitude. The increased cognitive control mediated the effect of HD-tDCS on modulating reinterpretation, but not for detachment.

LIMITATIONS

The single-blind design, absence of the lasting-effects measure, and the intrinsically limited focality of tDCS are limitations of this study.

CONCLUSIONS

Increasing the activity of DLPFC would facilitate emotion regulation and increase cognitive control. Cognitive control may be a significant potential mechanism for reinterpretation. Both tDCS and cognitive control interventions may be possible approaches to enhance emotion regulation.

Associations between early-life stress exposure and internalizing symptomatology during the COVID-19 pandemic: Assessing the role of neurobehavioral mediators

Background

The ongoing COVID-19 pandemic is a major stressor that has been associated with increased risk for psychiatric illness in the general population. Recent work has highlighted that experiences of early-life stress (ELS) may impact individuals' psychological functioning and vulnerability for developing internalizing psychopathology in response to pandemic-related stress. However, little is known about the neurobehavioral factors that may mediate the association between ELS exposure and COVID-related internalizing symptomatology. The current study sought to examine the mediating roles of pre-pandemic resting-state frontoamygdala connectivity and concurrent emotion regulation (ER) in the association between ELS and pandemic-related internalizing symptomatology.

Methods

Retrospective life-stress histories, concurrent self-reported ER strategies (i.e., reappraisal and suppression), concurrent self-reported internalizing symptomatology (i.e., depression- and anxiety-related symptomatology), and resting-state functional connectivity data from a sample of adults (N = 64, M age = 22.12, female = 68.75%) were utilized.

Results

There were no significant direct associations between ELS and COVID-related internalizing symptomatology. Neither frontoamygdala functional connectivity nor ER strategy use mediated an association between ELS and COVID-related internalizing symptomatology (ps > 0.05). Exploratory analyses identified a significant moderating effect of reappraisal use on the association between ELS and internalizing symptomatology (β = -0.818, p = 0.047), such that increased reappraisal use buffered the impact of ELS on psychopathology.

Conclusions

While frontoamygdala connectivity and ER do not appear to mediate the association between ELS and COVID-related internalizing symptomatology, our findings suggest that the use of reappraisal may buffer against the effect of ELS on mental health during the pandemic.

Are We Sailing in the Right Direction for Deeper Insights Into Acceptance? Evidence From a Systematic Review of Research in Laboratory Settings

This systematic review aims to review and update the current state of research on the acceptance strategy for a healthy population in a laboratory setting. Using a previously defined search strategy, the PsycInfo, PubMed, and Web of Science databases were searched from 1961 to May 2020 for articles on this topic. Twenty-five high-quality articles, involving a total of 2265 participants, met inclusion criteria. According to these results, acceptance is a strategy with promising outcomes for handling pain in healthy populations, although its superiority over other strategies to reduce negative affect, anger, and other pain variables is unclear. The instructions and outcome variables vary widely between studies, and few studies compare acceptance with mindfulness. We discuss these findings and provide information to guide future researchers for designing fine-grained investigations that can address the gaps in this area.

Gender differences in pleasure: the mediating roles of cognitive flexibility and emotional expressivity

BACKGROUND

Gender differences have been found to be associated with individuals' pleasure. Cognitive flexibility and emotional expressivity might play an important role between gender differences and pleasure. This current study is to explore the mediating role of cognitive flexibility and emotional expressivity in the relationship between gender differences and pleasure.

METHOD

In this cross-sectional study, a sample of 1107 full-time university students from five colleges in Tianjin, Chinese mainland was investigated by questionnaire. All participants completed the Temporal Experience of Pleasure Scale (TEPs), the Cognitive Flexibility Inventory (CFI), and the Berkeley Expressivity Questionnaire (BEQ).

RESULTS

The results of independent T-test suggested that females reported better emotional expressivity, anticipatory pleasure and consummatory pleasure than males, whereas males had better cognitive flexibility than females. Using bootstrapping approach revealed that the partially mediation effects of cognitive flexibility on gender differences in anticipatory and consummatory pleasure, and that of emotional expressivity on gender differences in anticipatory and consummatory pleasure. Results of this present study stated that cognitive flexibility and emotional expressivity play a partial mediating role in explaining gender differences in anticipatory and consummatory pleasure.

CONCLUSION

Females had higher anticipatory and consummatory pleasure because they tend to use emotional regulation strategy to express their emotion.

A Cross-Cultural Examination of the Role of Youth Emotion Regulation in Mentoring Relationships

Youth mentoring programs have grown in popularity, both within the United States (U.S.) and abroad, as an intervention to support youth with common behavioral and emotional difficulties. However, it is unclear whether certain dimensions of youth risk may diminish the positive impact of formalized mentoring relationships. The current study therefore examined whether youth emotion regulation, a transdiagnostic risk factor for both externalizing and internalizing behavioral difficulties, predicted mentoring relationship quality and the likelihood of early match closure. Participants included 1,298 randomized mentor-youth dyads from two nationwide mentoring programs, one with chapters across the U.S. (youth: 56% female; 37% White), and another with chapters across Mexico (youth: 49% female; 100% non-Indigenous). At baseline, youth completed the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA). At program completion, youth and mentors completed measures of mentoring relationship quality. Multigroup structural equation models of youth outcomes revealed that greater youth use of cognitive reappraisal predicted better mentoring relationship quality in both countries when co-varying for sex, and that this relationship was stronger for mentor-youth pairs in the U.S. compared to those in Mexico. These findings have important implications for understanding the ways in which youth characteristics might shape the quality and impact of mentoring relationships across different cultural settings.

The Effects of Mindfulness-Based Stress Reduction on the Association Between Autonomic Interoceptive Signals and Emotion Regulation Selection

OBJECTIVE

The ability to select the most adaptive regulatory strategy as a function of the emotional context plays a pivotal role in psychological health. Recently, we showed that mindfulness-based interventions (MBIs) can improve the sensitivity of regulatory strategy selection to emotional intensity. However, the mechanisms underlying this improvement are unclear. In this study, we tested the hypothesis that MBIs support adaptive regulatory selection by increasing sensitivity to interoceptive signals associated with the emotional stimuli.

METHODS

Participants (n = 84, mean [standard deviation {SD}] age = 30.9 [8.3] years; 54% women) were randomized to either a mindfulness-based stress reduction (MBSR) program or a wait-list control condition. Before and after the MBSR program, physiological measures for autonomic nervous system activity were obtained, and participants performed a task examining emotion regulation selections (reappraisal versus distraction) when confronted with low or high negative intensity images. They also completed a battery of mindfulness, interoception, and well-being self-report measures. A cross-classified model was used for the main analyses.

RESULTS

The participants assigned to the MBSR were overall more likely to choose reappraisal than distraction (b = 0.26, posterior SD = 0.13, 95confidence interval = 0.02-0.52) after the program. Interoceptive signals in response to negative images were associated with subsequent regulatory selections (b = 0.02, posterior SD = 0.01, 95% confidence interval = 0.01-0.03) in the MBSR group. Specifically, lower cardiac reactivity was associated with the choice to reappraise, whereas higher cardiac reactivity was related to the choice to distract. Greater differences in cardiac reactivity between states that prompt reappraisal and states that prompt distraction were associated with higher well-being (Satisfaction With Life Scale, Pearson r (29) = 0.527, p = .003).

CONCLUSIONS

Mindfulness seems to increase the sensitivity of regulatory selections to interoceptive signals, and this is associated with subjective well-being. This may be a central pathway through which MBIs exert their positive effects on mental health and resilience.

Postpartum Stress and Neural Regulation of Emotion among First-Time Mothers

Early parenting relies on emotion regulation capabilities, as mothers are responsible for regulating both their own emotional state and that of their infant during a time of new parenting-related neural plasticity and potentially increased stress. Previous research highlights the importance of frontal cortical regions in facilitating effective emotion regulation, but few studies have investigated the neural regulation of emotion among postpartum women. The current study employed a functional neuroimaging (fMRI) approach to explore the association between perceived stress, depressive symptoms, and the neural regulation of emotion in first-time mothers. Among 59 postpartum mothers, higher perceived stress during the postpartum period was associated with less self-reported use of cognitive reappraisal in everyday life, and greater use of emotion suppression. While viewing standardized aversive images during the Emotion Regulation Task (ERT), mothers were instructed to experience their natural emotional state (Maintain) or to decrease the intensity of their negative emotion by using cognitive reappraisal (Reappraise). Whole-brain analysis revealed a two-way interaction of perceived stress x condition in the right dorsolateral prefrontal cortex (DLPFC) at p < .05 cluster-wise corrected, controlling for postpartum months and scanner type. Higher levels of perceived stress were associated with heightened right DLPFC activity while engaging in cognitive reappraisal versus naturally responding to negative stimuli. Higher right DLPFC activity during Reappraise versus Maintain was further associated with elevated parenting stress. Findings suggest that stress and everyday reappraisal use is reflected in mothers' neural regulation of emotion and may have important implications for their adaptation to parenthood.

Nurses' experiences of the effects of mindfulness training: A narrative review and qualitative meta-synthesis

OBJECTIVE

To explore nurses' experiences of the effects of undertaking mindfulness training.

DESIGN

Qualitative meta-synthesis.

DATA SOURCES

Qualitative literature from seven scientific databases: Pubmed, Cochran Library, Science Direct, EBSCO, Web of Science, Scopus and PsycINFO were searched.

REVIEW METHODS

The PRISMA flow diagram was used to report the phases of the literature search. The Critical Appraisal Skills Program (CASP) qualitative research checklist, and the Mixed-Methods Appraisal Tool (MMAT) for mixed method studies were used as appraisal framework. Data synthesis was conducted using Thematic synthesis. The review steps were guided by Adams, Chamberlain, & Giles, 2019 and Whittemore & Knafl, 2005.

RESULTS

4 qualitative studies and 3 mixed-methods studies were included in the review. Four interpretive themes were generated to show how nurses experience of the effects of mindfulness training: 1. Stress conceptualisation and management; 2. Nurses' valued aspects of mindfulness training strategies; 3. Self-care awareness and strategies; 4. Challenges of mindfulness training.

CONCLUSION

Conducting mindfulness-based interventions among nursing professionals helps to reduce work-related stress and has positive effects on work and life.

The Effects of Aerobic Exercise on Psychological Functioning in Family Caregivers: Secondary Analyses of a Randomized Controlled Trial

BACKGROUND

The responsibility and stress of being a family caregiver are associated with reduced physical and mental health.

PURPOSE

To examine whether a 24-week aerobic exercise program improves multiple aspects of psychological functioning in family caregivers.

METHODS

Family caregivers of patients with Alzheimer's disease and other dementias (n = 68) were recruited and randomized into either an aerobic exercise group (n = 34) or a waitlist control group (n = 34). The exercise group was assigned a 24-week aerobic training program that incrementally increased the intensity, duration, and frequency of the exercise program until 150 min of moderate to vigorous activity were completed per week by the ninth week. Twelve measures of psychological functioning were administered at baseline and compared with responses completed following the intervention.

RESULTS

Multilevel modeling revealed significant decreases in caregiver burden (β = -4.60, 95% confidence interval [CI] = [-8.82, -0.38], RLMM2 = 0.11) and depression (β = -2.59, 95% CI = [-4.79, -0.38], RLMM2 = 0.13), as well as increases in mastery (β = 1.78, 95% CI = [0.09, 3.46], RLMM2 = .04) in the exercise intervention group compared to the control group.

CONCLUSION

Family caregivers report high levels of depression and caregiver burden. Engagement in a 24-week exercise intervention can ameliorate the perceived burden of caregiving, symptoms of depression, and their sense of mastery.

Regulating Road Rage

Road rage has been a problem since the advent of cars. Given the ubiquity of road rage, and its potentially devastating consequences, understanding road rage and developing interventions to curb it are important priorities. Emerging theoretical and empirical advances in the study of emotion and emotion regulation have provided new insights into why people develop road rage and how it can be prevented and treated. In the current article, we suggest an integrative conceptual framework for understanding road rage, based upon a psychological analysis of emotion and emotion regulation. We begin by defining road rage and other key constructs. We then consider the interplay between road rage generation and road rage regulation. Using an emotion regulation framework, we describe key points at which emotion-regulation difficulties can lead to road rage, followed by strategies that may alleviate these difficulties. We suggest that this framework usefully organizes existing research on road rage, while exposing key directions for future research.

Mindfulness-based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness

Bereavement, the experience of losing a loved one, is one of the most catastrophic but inevitable events in life. It causes grief and intense depression‐like sadness. Recent studies have revealed the effectiveness and proficiency of mindfulness‐based cognitive therapy (MBCT) in emotional regulation among bereavement populations. MBCT improves the well‐being of the bereaved by enhancing cognitive performances. Regarding the neural correlates of bereavement grief, previous studies focused on the alleviation of emotion–cognition interferences at specific brain regions. Here, we hypothesized that the bereavement grief fundamentally triggers global alterations in the resting‐state brain networks and part of the internetwork connectivity could be reformed after MBCT intervention. We recruited 19 bereaved individuals who participated the 8‐week MBCT program. We evaluated (a) the large‐scale changes in brain connectivity affected by the MBCT program; as well as (b) the association between connectivity changes and self‐rated questionnaire. First, after MBCT, the bereaved individuals showed the reduction of the internetwork connectivity in the salience, default‐mode and fronto‐parietal networks in the resting state but not under emotional arousal, implying the alleviated attention to spontaneous mind wandering after MBCT. Second, the alterations of functional connectivity between subcortical (e.g., caudate) and cortical networks (e.g., cingulo‐opercular/sensorimotor) were associated with the changes of the mindfulness scale, the anxiety and the emotion regulation ability. In summary, MBCT could enhance spontaneous emotion regulation among the bereaved individuals through the internetwork reorganizations in the resting state.

Lay Theories of the Wandering Mind: Control-Related Beliefs Predict Mind Wandering Rates in- and outside the Lab

People often fail to keep their mind from wandering. Here, we examine how the tendency to mind wander is affected by people's beliefs, or lay theories. Building on research on lay theories and self-regulation, we test whether differences in people's beliefs about the extent to which mind wandering is controllable affect thought control strategies and mind-wandering rates in daily life and the laboratory. We develop a new scale to assess control-related beliefs about mind wandering. Scores on the scale predict mind wandering (Study 1) and intrusive thoughts (Study 2) in everyday life, thought control strategies and dysfunctional responses to unwanted thoughts (Study 2), and mind wandering during reading in the laboratory (Studies 3-6). Moreover, experimentally induced lay theories affect mind-wandering rates during reading (Studies 4 and 5). Finally, the effectiveness of strategies people can use to reduce their mind wandering depends on their lay theories (Studies 2 and 6).

A feasibility investigation of mindfulness-based cognitive therapy for people with Huntington's disease

BACKGROUND

Huntington's disease (HD) is an inherited neurodegenerative condition which affects movement, coordination and cognitive functioning. Psychological difficulties are commonly experienced; however, psychological interventions have been little researched with this population. We investigated the feasibility of conducting a randomised controlled trial (RCT) of mindfulness-based cognitive therapy (MBCT) with people with the HD genetic mutation, either pre-manifest (before onset of movement symptoms) or at an early disease stage. Specifically, we evaluated the willingness of participants to be recruited into and complete the intervention; the acceptability of the study measures in relation to completion; the feasibility of offering the standard MBCT course to people with HD; the acceptability of the intervention and the estimated effect sizes.

METHODS

Participants were recruited from two UK HD centres and took part in an 8-week course of MBCT, with three reunions throughout the following year. Stress, depression, anxiety, and mindfulness were measured pre-, mid-, and post-course, at 3 months and at 1 year. Sleep, quality of life, positive affect and coping were measured pre- and post-course, at 3 months and at 1 year. Descriptive data and approximate effect sizes were calculated. Interviews were conducted post-course and at 1 year and data pertaining to the acceptability of the course were extracted.

RESULTS

Twelve participants took part in two groups; all were pre-manifest. Levels of depression and anxiety were low pre-course leaving little room for improvement. Changes in stress and in some aspects of mindfulness were medium to large. The qualitative data suggested participants rated the course highly and found it helpful and no changes to the standard course were needed. Recruitment levels were below those anticipated. Most measures were found to be acceptable.

CONCLUSIONS

Although the course was acceptable to those who took part, given the difficulties in recruiting and the rarity of HD, conducting an RCT of MBCT teaching groups in person does not seem feasible. However, alternative modes of course delivery (e.g. online) would allow the recruitment of people from a greater geographical area and may make an RCT feasible; this revised focus would be suitable for future feasibility studies.

TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT02464293, registered 8 June 2015.

Know Yourself: An Adaptive Causal Network Model for Therapeutic Intervention for Regaining Cognitive Control

Long term stress often causes depression and neuronal atrophies that in turn can lead to a variety of health problems. As a result of these cellular changes, also molecular changes occur. These changes, that include increase of glucocorticoids and decrease of the brain-derived neurotrophic factor, have the unfortunate effect that they decrease the cognitive abilities needed for the individual to solve the stressful situation. Such cognitive abilities like reappraisal and their adaptation mechanisms turn out to be substantially impaired while they are needed for regulation of the negative emotions. However, antidepressant treatments and some other therapies have proved to be quite effective for the strengthening of such cognitive abilities. This study introduces an adaptive causal network model for this phenomenon where a subject loses his or her cognitive abilities (negative metaplasticity) due to long-term stress and re-improve these cognitive abilities (positive metaplasticity) through mindfulness-based cognitive therapy (MBCT). Simulation results have been reported for demonstration of the phenomenon.

Hard to look on the bright side: neural correlates of impaired emotion regulation in depressed youth

The cognitive regulation of emotion is impaired in major depressive disorder and has been linked to an imbalance of pre-frontal–subcortical brain activity. Despite suggestions that this relationship represents a neurodevelopmental marker of depression, few studies have examined the neural correlates of emotion regulation in depressed youth. We combined a ‘cognitive reappraisal’ paradigm with functional magnetic resonance imaging to study the neural correlates of emotional regulation in a large sample of non-medicated depressed adolescents and young adults (n = 53) and healthy controls (n = 64). As compared with healthy controls, young people with depression were less able to reduce negative affect during reappraisal, which corresponded to blunted modulation of amygdala activity. While in healthy individuals amygdala activation was modulated by age, no such relationship was observed in depressed individuals. Heightened activation of the ventromedial pre-frontal cortex (vmPFC) and reduced activation of the dorsal midline cortex was also found for the depressed group. Overall, these findings suggest that brain systems that support cognitive reappraisal are functionally altered in youth depression. We argue that excessive engagement of the vmPFC in particular, may be central to understanding how the process of putting a ‘positive spin’ on negative emotional material may be altered in depressed youth.

The capacity for generating cognitive reappraisals is reflected in asymmetric activation of frontal brain regions

Encouraging patients to use cognitive reappraisal constitutes the core of modern psychotherapeutic approaches. However, evidence for specific neural correlates of the capacity for cognitive reappraisal, which is a necessary prerequisite for the effective implementation of cognitive reappraisal in everyday life, has been sparse to date. In the present study, the capacity for cognitive reappraisal was studied in terms of the participants’ inventiveness in generating alternative appraisals of anger-evoking events, and was correlated with frontal EEG alpha asymmetry recorded while the participants were generating reappraisals as well as during a common creative idea generation task. During cognitive reappraisal efforts, individuals higher on the capacity for generating cognitive reappraisals showed more left-lateralized activity in lateral prefrontal cortex, specifically in ventrolateral prefrontal cortex extending toward the frontal pole. This effect was observed independently from the activation during novel idea generation without emotional component, indicating that specific demands are implicated in the generation of reappraisals of emotional events. Taken together, the results indicate that individuals higher on the capacity for cognitive reappraisal are more capable or more prone to recruit appropriate brain regions when the situation demands coming up with alternative appraisals of stressful events. The findings may stimulate the development of more individually targeted interventions.

Exploring daily affective changes in university students with a mindful positive reappraisal intervention: A daily diary randomized controlled trial

Brief and cost-effective interventions focused on emotion regulation techniques can buffer against stress and foster positive functioning. Mindfulness and positive reappraisal are two techniques that can mutually enhance one another to promote well-being. However, research testing the effectiveness of interventions combining mindfulness and reappraisal is lacking. The current pilot examined the effect of a combined mindful-reappraisal intervention on daily affect in a 5-day diary study with 106 university students. Participants were randomized to a mindful-reappraisal intervention (n = 36), a reappraisal-only intervention (n = 34), or an active control activity (n = 36). All participants described a negative event each day but only reappraised the event in the intervention conditions. Using multilevel growth modelling, results indicated that negative affect in both interventions declined over 5 days compared to the control; however, there were no differences in the growth of positive affect. Compared to reappraisal-only, the mindful-reappraisal group reported overall lower daily negative affect and marginally higher daily positive affect over the 5-day intervention. These findings suggest that brief daily practice combining mindfulness and positive reappraisal can be trained as a self-regulatory resource to promote positive affect and buffer negative affect above and beyond reappraisal practice alone.

Improving Treatment Response for Paediatric Anxiety Disorders: An Information-Processing Perspective

Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying psychopathology of paediatric anxiety disorders indicate possibilities for improving treatment response. Using a critical review of recent theoretical, empirical and academic literature, the paper examines the role of information-processing biases in paediatric anxiety disorders, the extent to which CBT targets information-processing biases, and possibilities for improving treatment response. The literature reviewed indicates a role for attentional and interpretational biases in anxious psychopathology. While there is theoretical grounding and limited empirical evidence to indicate that CBT ameliorates interpretational biases, evidence regarding the effects of CBT on attentional biases is mixed. Novel treatment methods including attention bias modification training, attention feedback awareness and control training, and mindfulness-based therapy may hold potential in targeting attentional biases, and thereby in improving treatment response. The integration of novel interventions into an existing evidence-based protocol is a complex issue and faces important challenges with regard to determining the optimal treatment package. Novel interventions targeting information-processing biases may hold potential in improving response to CBT for paediatric anxiety disorders. Many important questions remain to be answered.

Cognitive reappraisal and acceptance: Effects on emotion, physiology, and perceived cognitive costs

Two emotion regulation strategies-cognitive reappraisal and acceptance-are both associated with beneficial psychological health outcomes over time. However, it remains unclear whether these 2 strategies are associated with differential consequences for emotion, physiology, or perceived cognitive costs in the short-term. The present study used a within-subjects design to examine the effects of reappraisal (reframing one's thoughts) and acceptance (accepting feelings without trying to control or judge them) on the subjective experience of negative emotions, positive emotions, and physiological responses during and following recovery from sad film clips shown in the laboratory. Participants also reported on perceived regulatory effort, difficulty, and success after deploying each emotion regulation strategy. In 2 samples of participants (N = 142), reappraisal (vs. acceptance) was associated with larger decreases in negative and larger increases in positive emotions, both during the film clips and recovery period. However, acceptance was perceived as less difficult to deploy than reappraisal, and was associated with a smaller dampening of skin conductance level (indicating more successful regulation) during the film clips in 1 sample. These results suggest that reappraisal and acceptance may exert differential short-term effects: Whereas reappraisal is more effective for changing subjective experiences in the short term, acceptance may be less difficult to deploy and be more effective at changing one's physiological response. Thus, these 2 strategies may both be considered "effective" for different reasons. (PsycINFO Database Record

The psychological health benefits of accepting negative emotions and thoughts: Laboratory, diary, and longitudinal evidence

Individuals differ in the degree to which they tend to habitually accept their emotions and thoughts without judging them-a process here referred to as habitual acceptance. Acceptance has been linked with greater psychological health, which we propose may be due to the role acceptance plays in negative emotional responses to stressors: acceptance helps keep individuals from reacting to-and thus exacerbating-their negative mental experiences. Over time, experiencing lower negative emotion should promote psychological health. To test these hypotheses, Study 1 (N = 1,003) verified that habitually accepting mental experiences broadly predicted psychological health (psychological well-being, life satisfaction, and depressive and anxiety symptoms), even when controlling for potentially related constructs (reappraisal, rumination, and other mindfulness facets including observing, describing, acting with awareness, and nonreactivity). Next, in a laboratory study (Study 2, N = 156), habitual acceptance predicted lower negative (but not positive) emotional responses to a standardized stressor. Finally, in a longitudinal design (Study 3, N = 222), acceptance predicted lower negative (but not positive) emotion experienced during daily stressors that, in turn, accounted for the link between acceptance and psychological health 6 months later. This link between acceptance and psychological health was unique to accepting mental experiences and was not observed for accepting situations. Additionally, we ruled out potential confounding effects of gender, ethnicity, socioeconomic status, and life stress severity. Overall, these results suggest that individuals who accept rather than judge their mental experiences may attain better psychological health, in part because acceptance helps them experience less negative emotion in response to stressors. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective

Mindfulness-based interventions have been heralded as promising means of alleviating chronic stress. While meta-analyses indicate that mindfulness-based interventions significantly reduce global measures of stress, how mindfulness-based interventions modulate the specific mechanisms underpinning chronic stress as operationalized by the National Institute of Mental Health research domain criteria (RDoC) of sustained threat has not yet been detailed in the literature. To address this knowledge gap, this article aims to (1) review evidence that mindfulness-based interventions ameliorate each of the 10 elements of behavioral dysregulation characterizing sustained threat via an array of mindful counter-regulatory strategies; (2) review evidence that mindfulness-based interventions modify biological domains implicated in sustained threat, such as the hypothalamic–pituitary–adrenal axis, as well as brain circuits involved in attentional function, limbic reactivity, habit behavior, and the default mode network; and (3) integrate these findings into a novel conceptual framework of mindful self-regulation in the face of stress—the Mindfulness-to-Meaning Theory. Taken together, the extant body of scientific evidence suggests that the practice of mindfulness enhances a range biobehavioral factors implicated in adaptive stress coping and induces self-referential plasticity, leading to the ability to find meaning in adversity. These mechanistic findings can inform the treatment development process to optimize the next generation of mindfulness-based interventions for greater therapeutic efficacy.

Circuit dysregulation and circuit-based treatments in posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that develops in some individuals in the aftermath of exposure to traumatic events, such as actual or threatened death, serious injury or sexual assault. It has been hypothesized that dysregulations in a number of specific neurocircuits, characterized by heightened responsivity of amygdala, dACC and insula, diminished responsivity of mPFC, impaired hippocampal function and deficits in cortical regions, underlie the development and expression of key PTSD symptoms. Here, we concisely describe three functional neural circuits implicated in PTSD pathophysiology and briefly review selected treatment strategies in the context of these neural circuits. We start with the commonly implicated neurocircuit model, namely, the fear learning and threat detection circuits, and then discuss the context processing circuitry, which plays an important role among others, in fear regulation. We then discuss the emotion regulation circuitry, which can further contribute to PTSD pathophysiology, and conclude with a discussion of the therapeutic approaches that might be targeting dysregulation in these circuits in PTSD patients. Specifically, we discuss how exposure-based treatments might be targeting fear learning circuits, and the pharmacological and brain-stimulation interventions aimed to augment these therapies. Finally, we discuss other pharmacological and cognitive therapeutic approaches that can augment or restore the function of the context processing and emotional regulation circuits.

The Applied Mindfulness Process Scale (AMPS): A process measure for evaluating mindfulness-based interventions

OBJECTIVE

Mindfulness-based interventions (MBIs) include the application of meditation and mind-body practices used to promote mindful awareness in daily life. Operationalizing the construct of mindfulness is important in order to determine mechanisms of therapeutic change elicited by mindfulness practice. In addition to existing state and trait measures of mindfulness, process measures are needed to assess the ways in which individuals apply mindfulness in the context of their practice.

METHOD

This report details three independent studies (qualitative interview, N = 8; scale validation, N = 134; and replication study, N = 180) and the mixed qualitative-quantitative methodology used to develop and validate the Applied Mindfulness Process Scale (AMPS), a 15-item process measure designed to quantify how mindfulness practitioners actively use mindfulness to remediate psychological suffering in their daily lives.

RESULTS

In Study 1, cognitive interviewing yielded a readily comprehensible and accessible scale of 15 items. In Study 2, exploratory factor analysis derived a potential three-factor solution: decentering, positive emotion regulation, and negative emotion regulation. In Study 3, confirmatory factor analysis verified better model fit with the three-factor structure over the one-factor structure.

CONCLUSIONS

AMPS functions as a measure to quantify the application of mindfulness and processes of change in the context of MBIs and general mindfulness practice.

Exploring the relationship of decentering to health related concepts and cognitive and metacognitive processes in a student sample

Background

Decentering, a central change strategy of Mindfulness-Based Cognitive Therapy, is a process of stepping outside of one’s own mental events leading to an objective and non-judging stance towards the self. The study aimed at investigating associated mechanisms of decentering.

Method

The present study investigated the relation of decentering, operationalized by means of the German Version of the Experiences Questionnaire, to severity of depressive symptoms, assessed by the adaptive Rasch-based depression screening, and self-focussed attention, assessed by the Questionnaire of Dysfunctional and Functional Self-Consciousness. Furthermore, the relationship between decentering and a) the ability to shift and allocate attention by means of the Stroop test, and b) metacognitive monitoring, i.e. the absolute difference between judged and real task performance, was investigated. These relationships were examined in 55 healthy students using Pearson’s correlations.

Results

In line with our assumptions, higher decentering scores were significantly associated with lower scores on severity of depressive symptoms, with higher functional- and lower dysfunctional self-focussed attention. Contrary to our expectations, results neither indicated a relationship between decentering and attention ability, nor between decentering and metacognitive monitoring.

Conclusions

The present results suggest that decentering is associated with concepts of mental health (i.e. less severity of depressive symptoms and higher functional self-focussed attention). Overall, the concept decentering seems to be mainly composed of self-focussed aspects when investigated in a healthy sample without intervention. Further investigations of associated concepts of decentering should consider aspects of self-relevance and emotional valence.

Mindfulness Broadens Awareness and Builds Eudaimonic Meaning: A Process Model of Mindful Positive Emotion Regulation

Contemporary scholarship on mindfulness casts it as a form of purely non-evaluative engagement with experience. Yet, traditionally mindfulness was not intended to operate in a vacuum of dispassionate observation, but was seen as facilitative of eudaimonic mental states. In spite of this historical context, modern psychological research has neglected to ask the question of how the practice of mindfulness affects downstream emotion regulatory processes to impact the sense of meaning in life. To fill this lacuna, here we describe the Mindfulness-to-Meaning Theory, from which we derive a novel process model of mindful positive emotion regulation informed by affective science, in which mindfulness is proposed to introduce flexibility in the generation of cognitive appraisals by enhancing interoceptive attention, thereby expanding the scope of cognition to facilitate reappraisal of adversity and savoring of positive experience. This process is proposed to culminate in a deepened capacity for meaning-making and greater engagement with life.

Prospects for a clinical science of mindfulness-based intervention

Mindfulness-based interventions (MBIs) are at a pivotal point in their future development. Spurred on by an ever-increasing number of studies and breadth of clinical application, the value of such approaches may appear self-evident. We contend, however, that the public health impact of MBIs can be enhanced significantly by situating this work in a broader framework of clinical psychological science. Utilizing the National Institutes of Health stage model (Onken, Carroll, Shoham, Cuthbert, & Riddle, 2014), we map the evidence base for mindfulness-based cognitive therapy and mindfulness-based stress reduction as exemplars of MBIs. From this perspective, we suggest that important gaps in the current evidence base become apparent and, furthermore, that generating more of the same types of studies without addressing such gaps will limit the relevance and reach of these interventions. We offer a set of 7 recommendations that promote an integrated approach to core research questions, enhanced methodological quality of individual studies, and increased logical links among stages of clinical translation in order to increase the potential of MBIs to impact positively the mental health needs of individuals and communities.

Mindfulness training promotes upward spirals of positive affect and cognition: multilevel and autoregressive latent trajectory modeling analyses

Recent theory suggests that positive psychological processes integral to health may be energized through the self-reinforcing dynamics of an upward spiral to counter emotion dysregulation. The present study examined positive emotion-cognition interactions among individuals in partial remission from depression who had been randomly assigned to treatment with mindfulness-based cognitive therapy (MBCT; n = 64) or a waitlist control condition (n = 66). We hypothesized that MBCT stimulates upward spirals by increasing positive affect and positive cognition. Experience sampling assessed changes in affect and cognition during 6 days before and after treatment, which were analyzed with a series of multilevel and autoregressive latent trajectory models. Findings suggest that MBCT was associated with significant increases in trait positive affect and momentary positive cognition, which were preserved through autoregressive and cross-lagged effects driven by global emotional tone. Findings suggest that daily positive affect and cognition are maintained by an upward spiral that might be promoted by mindfulness training.

Valuing happiness is associated with bipolar disorder

Although people who experience happiness tend to have better psychological health, people who value happiness to an extreme tend to have worse psychological health, including more depression. We propose that the extreme valuing of happiness may be a general risk factor for mood disturbances, both depressive and manic. To test this hypothesis, we examined the relationship between the extreme valuing of happiness and risk for, diagnosis of, and illness course for bipolar disorder (BD). Supporting our hypothesis, the extreme valuing of happiness was associated with a measure of increased risk for developing BD (Studies 1 and 2), increased likelihood of past diagnosis of BD (Studies 2 and 3), and worse prospective illness course in BD (Study 3), even when controlling for current mood symptoms (Studies 1-3). These findings indicate that the extreme valuing of happiness is associated with and even predicts BD. Taken together with previous evidence, these findings suggest that the extreme valuing of happiness is a general risk factor for mood disturbances. More broadly, what emotions people strive to feel may play a critical role in psychological health.

Depressive rumination and cognitive processes associated with depression in breast cancer patients and their spouses

Depression is common among patients with breast cancer (BC) and their spouses. The diagnosis of BC often results in negative cognitive processes, such as appraisals of harm/loss, intrusive thoughts, and depressive rumination, all of which contribute to the occurrence of depression in both the patient and spouse. The present research is a cross-sectional exploration of the mediating role of depressive rumination in the relationships of intrusive thoughts and appraisal of harm/loss with depression, in a sample of 56 BC patients and their partners. We hypothesized that depressive rumination would mediate the relationships between cognitive processes and depression in both BC patient and their partners. Participants completed self-report measures of depressive symptoms, depressive rumination, cognitive appraisals, and intrusive thoughts. Path analyses using hierarchical linear regression were conducted to assess the relationships among variables. Results indicated that for BC patients, harm/loss appraisals and intrusive thoughts had direct effects on depression; only harm/loss appraisals had indirect effects through depressive rumination. For partners, both harm/loss appraisal and intrusive thoughts had direct effects on depression, and both had indirect effects through depressive rumination. Dyadic analysis showed no relation of partner cognitive variables with patient depression or patient cognitive variables with partner depression. Findings show that the perseverative practice of dwelling on these negative thoughts of loss and harm relates to depressive symptoms. Rumination may act as 1 possible mechanism by which intrusive thoughts and harm/loss appraisals lead to depressive symptoms.

Knowing when to seek anger: Psychological health and context-sensitive emotional preferences

According to hedonic approaches to psychological health, healthy individuals should pursue pleasant and avoid unpleasant emotions. According to instrumental approaches, however, healthy individuals should pursue useful and avoid harmful emotions, whether pleasant or unpleasant. We sought to reconcile these approaches by distinguishing between preferences for emotions that are aggregated across contexts and preferences for emotions within specific contexts. Across five days, we assessed daily confrontational and collaborative demands and daily preferences for anger and happiness. Somewhat consistent with hedonic approaches, when averaging across contexts, psychologically healthier individuals wanted to feel less anger, but not more happiness. Somewhat consistent with instrumental approaches, when examined within contexts, psychologically healthier individuals wanted to feel angrier in more confrontational contexts, and some wanted to feel happier in more collaborative contexts. Thus, although healthier individuals are motivated to avoid unpleasant emotions over time, they are more motivated to experience them when they are potentially useful.

Emotional reactivity and emotion regulation among adults with a history of self-harm: laboratory self-report and functional MRI evidence

Intentionally hurting one's body (deliberate self-harm; DSH) is theorized to be associated with high negative emotional reactivity and poor emotion regulation ability. However, little research has assessed the relationship between these potential risk factors and DSH using laboratory measures. Therefore, we conducted 2 studies using laboratory measures of negative emotional reactivity and emotion regulation ability. Study 1 assessed self-reported negative emotions during a sad film clip (reactivity) and during a sad film clip for which participants were instructed to use reappraisal (regulation). Those with a history of DSH were compared with 2 control groups without a history of DSH matched on key demographics: 1 healthy group low in depression and anxiety symptoms and 1 group matched to the DSH group on depression and anxiety symptoms. Study 2 extended Study 1 by assessing neural responding to negative images (reactivity) and negative images for which participants were instructed to use reappraisal (regulation). Those with a history of DSH were compared with a control group matched to the DSH group on demographics, depression, and anxiety symptoms. Compared with control groups, participants with a history of DSH did not exhibit greater negative emotional reactivity but did exhibit lower ability to regulate emotion with reappraisal (greater self-reported negative emotions in Study 1 and greater amygdala activation in Study 2 during regulation). These results suggest that poor emotion regulation ability, but not necessarily greater negative emotional reactivity, is a correlate of and may be a risk factor for DSH, even when controlling for mood disorder symptoms.

State Mindfulness During Meditation Predicts Enhanced Cognitive Reappraisal

Putatively, mindfulness meditation involves generation of a state of "nonappraisal", yet, little is known about how mindfulness may influence appraisal processes. We investigated whether the state and practice of mindfulness could enhance cognitive reappraisal. Participants (N = 44; M age = 24.44, SD = 4.00, range 19 - 38, 82.2% female) were randomized to either 1) mindfulness, 2) suppression, or 3) mind-wandering induction training conditions. Cognitive reappraisal was assessed with the Emotion Regulation Questionnaire (ERQ) prior to experimental induction, and state mindfulness was assessed immediately following induction using the Toronto Mindfulness Scale (TMS). Participants practiced their assigned strategy for one week and then were reassessed with the ERQ reappraisal subscale. Participants receiving mindfulness training reported significantly higher levels of state mindfulness than participants in the thought suppression and mind wandering conditions. Although brief mindfulness training did not lead to significantly greater increases in reappraisal than the other two conditions, state mindfulness during mindfulness meditation was prospectively associated with increases in reappraisal. Path analysis revealed that the indirect effect between mindfulness training and reappraisal was significant through state mindfulness. Degree of state mindfulness achieved during the act of mindfulness meditation significantly predicted increases in reappraisal over time, suggesting that mindfulness may promote emotion regulation by enhancing cognitive reappraisal.

Use of mindful reappraisal coping among meditation practitioners

OBJECTIVE

By enhancing positive affect and cognitive flexibility, mindfulness practice may promote reappraisal of stressors. We hypothesized that coping through mindful reappraisal would be common among mindfulness practitioners from an array of traditions.

METHOD

A sample of 118 meditation practitioners completed an online survey comprising assessments of the prevalence and frequency of mindful reappraisal, as well as measures of well-being and distress.

RESULTS

Regular use of mindful reappraisal was reported by over half of the sample and was significantly correlated with years of meditation practice (r = .31, p = .01), meditation practice days per month (r = .30, p = .001), and meditation hours per week (r = .30, p = .001). Controlling for frequency of meditation practice and trait mindfulness, mindful reappraisal frequency explained significant portions of variance in well-being (P <.001) and distress (P <.001).

CONCLUSIONS

Meditation practitioners commonly employ mindful reappraisal coping as a positive emotion regulatory strategy in stressful contexts.