A neurobehavioral account for decentering as the salve for the distressed mind

Cultivating Self-Transcendence Through Meditation Practice: A Test of the Role of Meta-Awareness, (Dis)identification and Non-Reactivity

In this paper, we present a study comprising two distinct stages to examine the extent to which metacognitive processes of decentering facilitate the emergence of self-transcendence experiences in everyday life (i.e., the frequency of self-transcendent emotions, flow proneness, and adopting an interconnected identity). In the course of conducting this research, the first stage (N = 374) focused on assessing the structure and validity of the French version of the Metacognitive Processes of Decentering Scale (MPoD-t). Building on this, the second stage (N = 294) examined the potential relationship between meditative practices and psychological decentering processes (i.e., meta-awareness, (dis)identification with internal experiences, and (non)reactivity to thought content) and explored whether these mechanisms explain the association between meditative practices and the experience of self-transcendent states. Overall, the results demonstrated satisfactory psychometric properties of the French version of the MPoD and provided enhanced insights into the distinct mediating roles played by various decentering components in the manifestation of self-transcendence experiences in daily life. Indeed, the findings revealed that the relationship between practice and the occurrence of self-transcendent emotions or flow was mediated by the meta-awareness component, while the association between practice and the development of an interconnected identity was explained by the (dis)identification with internal experiences component. The implications of these findings are discussed.

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).

The Psychedelic Future of Post-Traumatic Stress Disorder Treatment

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur following exposure to a traumatic experience. An estimated 12 million U.S. adults are presently affected by this disorder. Current treatments include psychological therapies (e.g., exposure-based interventions) and pharmacological treatments (e.g., selective serotonin reuptake inhibitors (SSRIs)). However, a significant proportion of patients receiving standard-of-care therapies for PTSD remain symptomatic, and new approaches for this and other trauma-related mental health conditions are greatly needed. Psychedelic compounds that alter cognition, perception, and mood are currently being examined for their efficacy in treating PTSD despite their current status as Drug Enforcement Administration (DEA)- scheduled substances. Initial clinical trials have demonstrated the potential value of psychedelicassisted therapy to treat PTSD and other psychiatric disorders. In this comprehensive review, we summarize the state of the science of PTSD clinical care, including current treatments and their shortcomings. We review clinical studies of psychedelic interventions to treat PTSD, trauma-related disorders, and common comorbidities. The classic psychedelics psilocybin, lysergic acid diethylamide (LSD), and N,N-dimethyltryptamine (DMT) and DMT-containing ayahuasca, as well as the entactogen 3,4-methylenedioxymethamphetamine (MDMA) and the dissociative anesthetic ketamine, are reviewed. For each drug, we present the history of use, psychological and somatic effects, pharmacology, and safety profile. The rationale and proposed mechanisms for use in treating PTSD and traumarelated disorders are discussed. This review concludes with an in-depth consideration of future directions for the psychiatric applications of psychedelics to maximize therapeutic benefit and minimize risk in individuals and communities impacted by trauma-related conditions.

Validation of the factor structure of the Experiences Questionnaire using Exploratory Graph Analysis

Introduction

Decentering describes the ability to shift the focus away from one's subjective experience onto the experience itself. The Experiences Questionnaire (EQ) is a self-report measure that was developed to systematically assess changes in Decentering ability. Although several studies show the validity of the questionnaire, there are discrepancies between the factorial structure of the Decentering scale of the EQ (EQ-D) found in the initial study (one factor) and other studies (two factors). Therefore, the current study aimed to assess the dimensionality of the EQ-D using Exploratory Graph Analysis (EGA).

Methods

In total, 1,100 participants were recruited online (790 female, 307 male, 3 non-binary; age 18 to 65 years). Participants completed the EQ and the Rosenberg Self-esteem scale (RSES).

Results

The bootstrapped EGA results revealed a two-dimensional structure of the EQ-D (Factor 1: Distanced Perspective, DP; Factor 2: Accepting Self-perception, AS) with high structural and item stability (all items > 0.70). The two dimensions of the EQ-D showed a high internal consistency (DP: ω = 0.74; AS: ω = 0.86) and discriminant validity with the rumination items of the EQ. Furthermore, a high convergent validity of the EQ was established, as the AS factor exhibited a significantly stronger correlation with self-esteem than the DP factor (z = 7.98, p < 0.001), which aligns with theoretical considerations suggesting that the AS factor encompasses aspects of self-compassion alongside decentering. We also found measurement invariance of the DP and AS factor across age, gender and country but not for education.

Discussion

These results support the EQ's validity, demonstrated in a larger sample with a new methodology, aligning with existing two-factor decentering models literature.

Construct Validity of Inherited Retinal Disease-Specific Patient-Reported Outcome Measures

PURPOSE

To evaluate aspects of construct validity of the Michigan Retinal Degeneration Questionnaire (MRDQ) and the Michigan Vision-related Anxiety Questionnaire (MVAQ).

METHODS

Subjects with a clinical diagnosis of an inherited retinal disease (IRD) were recruited prospectively and 3 tests were used to assess construct validity: the ability to distinguish different IRD phenotypes; test a priori hypothesis of an association between vision-related anxiety and vision-related disabilities; and correlate MRDQ and MVAQ with the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) and the Impact of Vision Impairment (IVI). One-way analysis of variance (ANOVA) was used to compare different phenotypes for mean domain scores for MRDQ/MVAQ. Pearson correlations were performed between; Cone-Function Anxiety and Central Vision controlling for better eye visual acuity, Rod-Function Anxiety and Scotopic Function controlling for visual field area (III4e and IV4e), and scores of MRDQ/MVAQ, NEI VFQ-25, and IVI.

RESULTS

The study sample consisted of 146 patients evenly divided between males and females, and mean age was 50 years. The 1-way ANOVA test was significant for distinguishing IRD phenotypes in 6 domains of MRDQ/MVAQ. Cone-Function Anxiety correlated with Central Vision controlling for visual acuity, Rod-Function Anxiety correlated with Scotopic Function controlling for visual field area, and all domains in MRDQ/MVAQ had significant correlations with NEI VFQ-25 and IVI composite scores.

CONCLUSION

MRDQ and MVAQ domenstrate aspects of construct-validity set forth by the US Food and Drug Administration. The study futher supports the use of both patient-reported outcome measures in IRD clinical trials and natural history studies.NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity

This meta-analysis sought to expand upon neurobiological models of mindfulness through investigation of inherent brain network connectivity outcomes, indexed via resting state functional connectivity (rsFC). We conducted a systematic review and meta-analysis of rsFC as an outcome of mindfulness training (MT) relative to control, with the hypothesis that MT would increase cross-network connectivity between nodes of the Default Mode Network (DMN), Salience Network (SN), and Frontoparietal Control Network (FPCN) as a mechanism of internally-oriented attentional control. Texts were identified from the databases: MEDLINE/PubMed, ERIC, PSYCINFO, ProQuest, Scopus, and Web of Sciences; and were screened for inclusion based on experimental/quasi-experimental trial design and use of mindfulness-based training interventions. RsFC effects were extracted from twelve studies (mindfulness n = 226; control n = 204). Voxel-based meta-analysis revealed significantly greater rsFC (MT > control) between the left middle cingulate (Hedge's g = .234, p = 0.0288, I2 = 15.87), located within the SN, and the posterior cingulate cortex, a focal hub of the DMN. Egger's test for publication bias was nonsignificant, bias = 2.17, p = 0.162. In support of our hypothesis, results suggest that MT targets internetwork (SN-DMN) connectivity implicated in the flexible control of internally-oriented attention.

Decentering predicts attenuated perseverative thought and internalizing symptoms following stress exposure: A multi-level, multi-wave study

While research identifies a growing list of risk factors for anxiety and depression, it is equally important to identify potential protective factors that may prevent or reduce vulnerability to developing internalizing psychopathology. We hypothesized that forms of perseverative thinking, such as rumination and worry, act as mechanisms linking negative life experiences and prospective symptoms of anxiety and depression. More specifically, we investigated whether decentering, the meta-cognitive capacity to adopt a distanced perspective toward one's thoughts and feelings, serves as a protective factor at various points along this mediational pathway. A sample of 181 undergraduate students were recruited and assessed at five time points over a 12-week period. Multilevel modeling indicated that decentering was associated with an attenuated impact of (1) negative events on prospective depressive symptoms; (2) negative events on prospective brooding, and (3) brooding, pondering and worry on prospective internalizing symptoms. Multilevel moderated mediation analyses provided partial support for the hypothesis that perseverative thinking would mediate the longitudinal associations between negative life events and internalizing symptoms, with decentering attenuating risk at several connections of the indirect pathways. The strongest support was provided for moderated mediation models in which decentering was associated with attenuated relationships between negative events, brooding, and symptoms of depression. This study is the first to elucidate the role of decentering as a protective factor against anxiety and depressive symptoms at different points in the path from stress to perseverative thought to internalizing symptoms. Decentering therefore may be a critical target for clinical intervention to promote resilience against anxiety and depression.

Mindfulness and Acceptance-Based Interventions in Physical Therapist Practice: The Time Is Now

One in 5 adults in the United States lives with a mental illness, and many more struggle with stress-related chronic illnesses. Physical therapists often see the physical effects that stress has on the body, but there is an underutilization of evidence-based stress management strategies with patients and clients. Mindfulness and acceptance-based interventions (MABIs) constitute a family of methods that emphasize present-moment awareness, nonjudgment, and values-based living. They operate by teaching patients to cope with stressful thoughts, emotions, and physical sensations. MABIs are associated with improved health outcomes in areas commonly seen in physical therapist practice, including health promotion, physical function, injury prevention, pain management, immune function, and noncommunicable diseases. The purpose of this Perspective article is to (1) describe MABIs; (2) discuss the relevance of MABIs to physical therapist practice; (3) discuss the positive impact of MABIs for pain, sports, immune function, physical and mental health promotion, and wellness; and (4) identify MABI outcome measures related to health behavior change. It is time.

IMPACT

Contemporary practice requires that physical therapists manage patient care by addressing both the mind and body. Given the existing research on MABIs, it is time to translate the evidence into minimum accreditable standards for health promotion and prevention of chronic, noncommunicable disease. This approach would have far-reaching benefits for individuals, family units, communities, and society as a whole.

LAY SUMMARY

Mindfulness instruction delivered by a physical therapist can help improve physical and mental well-being.

Imbalance between default mode and sensorimotor connectivity is associated with perseverative thinking in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is highly heterogeneous. Although perseverative negative thinking (PT) is a feature of OCD, little is known about its neural mechanisms or relationship to clinical heterogeneity in the disorder. In a sample of 85 OCD patients, we investigated the relationships between self-reported PT, clinical symptom subtypes, and resting-state functional connectivity measures of local and global connectivity. Results indicated that PT scores were highly variable within the OCD sample, with greater PT relating to higher severity of the "unacceptable thoughts" symptom dimension. PT was positively related to local connectivity in subgenual anterior cingulate cortex (ACC), pregenual ACC, and the temporal poles-areas that are part of, or closely linked to, the default mode network (DMN)-and negatively related to local connectivity in sensorimotor cortex. While the majority of patients showed higher local connectivity strengths in sensorimotor compared to DMN regions, OCD patients with higher PT scores had less of an imbalance between sensorimotor and DMN connectivity than those with lower PT scores, with healthy controls exhibiting an intermediate pattern. Clinically, this imbalance was related to both the "unacceptable thoughts" and "symmetry/not-just-right-experiences" symptom dimensions, but in opposite directions. These effects remained significant after accounting for variance related to psychiatric comorbidity and medication use in the OCD sample, and no significant relationships were found between PT and global connectivity. These data indicate that PT is related to symptom and neural variability in OCD. Future work may wish to target this circuity when developing personalized interventions for patients with these symptoms.

Applying the S-ART Framework to Yoga: Exploring the Self-Regulatory Action of Yoga Practice in Two Culturally Diverse Samples

Mindfulness practices form the core of numerous therapeutic programs and interventions for stress reduction and the treatment of different health conditions related to stress and life habits. Ways and means to regulate oneself effectively also form the foundation of the path of yoga in the accomplishment of holistic health and well-being. The self-awareness, self-regulation, and self-transcendence (S-ART) model can be considered as an overarching neurobiological framework to explain the self-regulatory mechanisms of well-being present in mindfulness-based practices. The current study, by connecting and applying the S-ART framework to the self-regulatory mechanisms in yoga and generating related hypotheses, provides a theory-led explanation of the action of yoga practices, which is sparse in the literature. Testing the S-ART model in yoga in two culturally diverse samples, assessing the model-mapped psychological mechanisms of action, and exploring the influence of perseverance in yoga practice are the original contributions of this study. The study sample comprised 362 yoga practitioners and non-practitioners (197 Indian and 165 Spanish), who completed four tests of psychological variables indicative of the aforementioned three S-ART abilities. These tests were Multidimensional Assessment of Interoceptive Awareness (MAIA), Experiences Questionnaire-Decentering (EQ-D) subscale, Difficulties in Emotion Regulation Scale (DERS), and Relational Compassion Scale (RCS). The results indicated significantly better self-awareness and self-regulatory abilities in yoga practitioners (Indian and Spanish in a combination) than non-practitioners, reflected in higher levels of interoceptive awareness and decentering abilities. Moreover, perseverance in yoga practice acted as a significant predictor of self-awareness and self-regulation in practitioners. An analysis of each cultural sample revealed some differences. Yoga practice and perseverance in it acted as a significant predictor of interoceptive awareness and decentering in Indian practitioners having more than 1 year of sustained yoga practice, but for the Spanish participants, physical exercise and frequency of yoga practice acted as better predictors of interoceptive awareness and decentering in comparison to yoga practice and perseverance in it. The obtained results suggested that the S-ART model provided preliminary but promising evidence for the self-regulatory mechanisms of action in yoga practice within a culturally diverse sample of yoga practitioners. This study also widens the scope of generating further hypotheses using the S-ART theoretical framework for testing the self-regulatory mechanisms of action in yoga practice.

Punishment on Pause: Preliminary Evidence That Mindfulness Training Modifies Neural Responses in a Reactive Aggression Task

Reactive aggression, a hostile retaliatory response to perceived threat, has been attributed to failures in emotion regulation. Interventions for reactive aggression have largely focused on cognitive control training, which target top-down emotion regulation mechanisms to inhibit aggressive impulses. Recent theory suggests that mindfulness training (MT) improves emotion regulation via both top-down and bottom-up neural mechanisms and has thus been proposed as an alternative treatment for aggression. Using this framework, the current pilot study examined how MT impacts functional brain physiology in the regulation of reactive aggression. Participants were randomly assigned to 2 weeks of MT (n = 11) or structurally equivalent active coping training (CT) that emphasizes cognitive control (n = 12). Following training, participants underwent functional magnetic resonance imaging (fMRI) during a retaliatory aggression task, a 16-trial game in which participants could respond to provocation by choosing whether or not to retaliate in the next round. Training groups did not differ in levels of aggression displayed. However, participants assigned to MT exhibited enhanced ventromedial prefrontal cortex (vmPFC) recruitment during punishment events (i.e., the aversive consequence of losing) relative to those receiving active CT. Conversely, the active coping group demonstrated greater dorsomedial prefrontal cortex (dmPFC) activation when deciding how much to retaliate, in line with a bolstered top-down behavior monitoring function. The findings suggest that mindfulness and cognitive control training may regulate aggression via different neural circuits and at different temporal stages of the provocation-aggression cycle. Trial Registration: identification no. NCT03485807.

Spontaneous brain state oscillation is associated with self-reported anxiety in a non-clinical sample

The anti-correlation relationship between the default-mode network (DMN) and task-positive network (TPN) may provide valuable information on cognitive functions and mental disorders. Moreover, maintaining a specific brain state and efficaciously switching between different states are considered important for self-regulation and adaptation to changing environments. However, it is currently unclear whether competitions between the DMN and TPN are associated with negative affect (here, anxiety and depression) in non-clinical samples. We measured the average dwell time of DMN dominance over the TPN (i.e., the average state duration before transition to another state, indicating persistent DMN dominance) with a sample of 302 non-clinical young adults. Subsequently, we explored individual differences in this persistent DMN dominance by examining its correlations with subjective depression and anxiety feelings. Moreover, we linked state transition between DMN/TPN dominance with right fronto-insular cortex (RFIC) blood oxygen-level dependent signal variability. We found that the average dwell time of DMN dominance was positively associated with self-reported anxiety. Furthermore, state transition between DMN or TPN dominance was positively linked to RFIC activity. These findings highlight the importance of investigating the complex and dynamic reciprocal inhibition patterns of the DMN and TPN and the important role of the RFIC in the association between these networks.

Intrinsic Connectivity Networks in the Self- and Other-Referential Processing

Neuroimaging studies have revealed a multitude of brain regions associated with self- and other-referential processing, but the question how the distinction between self, close other, and distant other is processed in the brain still remains unanswered. The default mode network (DMN) is the primary network associated with the processing of self, whereas task-positive networks (TPN) are indispensable for the processing of external objects. We hypothesize that self- and close-other-processing would engage DMN more than TPN, whereas distant-other-processing would engage TPN to a greater extent. To test this hypothesis, we used functional magnetic resonance imaging (fMRI) functional connectivity data obtained in the course of a trait adjective judgment task while subjects evaluated themselves, the best friend, a neutral stranger, and an unpleasant person. A positive association between the degree of self-relatedness and the degree of DMN dominance was revealed in cortical midline structures (CMS) and the left lateral prefrontal cortex. Relative to TPN, DMN showed greater connectivity in me than in friend, in friend than in stranger, and in stranger than in unpleasant conditions. These results show that the less the evaluated person is perceived as self-related, the more the balance of activity in the brain shifts from the DMN to the TPN.

The Metacognitive Processes of Decentering Scale: Development and initial validation of trait and state versions

The ability to decenter from internal experiences is important for mental health. Consequently, improving decentering is a common therapeutic target, particularly for mindfulness-based interventions. However, extant decentering measures are limited as they fail to directly assess all 3 metacognitive processes recently theorized to subserve decentering. We thus conducted 4 studies to develop and test the Metacognitive Processes of Decentering-Trait (MPoD-t) and State (MPoD-s) scales. Consistent with the metacognitive processes model, exploratory factor analysis (N = 355) and then bifactor exploratory structural equation modeling (N = 275) indicated the MPoD-t was composed of three independent yet interrelated lower-order factors, metaawareness, (dis)identification with internal experience, and (non)reactivity to internal experience, which subserved an emergent, higher-order, decentering factor. We next found evidence of the MPoD-t's convergent validity; as well as known-groups criterion validity, wherein mindfulness practitioners reported higher MPoD-t scores than nonpractitioners. Item response theory analyses were then used to identify a subset of 3 MPoD-t items for the MPoD-s. Finally, we found evidence that the MPoD-s was sensitive to changes in state decentering following a brief mindfulness induction relative to an active control condition; and that MPoD-s changes mediated the effect of mindfulness on levels of pain and related outcomes among a sample of preoperative surgery patients (N = 82). These studies indicate the trait and state versions of the MPoD may prove useful for the study of decentering and its constituent metacognitive processes. As such, the MPoD may help advance our understanding of how the metacognitive processes of decentering support mental health and well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Emotion Regulation Therapy and Its Potential Role in the Treatment of Chronic Stress-Related Pathology Across Disorders

Although stress is an inevitable part of everyday life, its chronicity, severity, and perceived burden can result in enduring distress, which may manifest as heightened emotionality, contributing to a number of self-regulatory failures. Specifically, distress disorders are characterized, in part, by heightened sensitivity to underlying motivational systems related to threat/safety, reward/loss, or both. Further, individuals suffering from these conditions typically engage in perseverate negative thinking (e.g., worry, rumination, self-criticism) in an effort to manage motivationally relevant distress and often utilize these processes at the detriment of engaging in new contextual learning. Distress disorders are often brought on by enduring chronic stress, coupled with these maladaptive emotional, cognitive, and behavioral responses and ensuing impairment which contribute to and in turn worsen the deficits from these purported mechanisms. Emotion regulation therapy is a theoretically derived treatment that is based upon affective science to offer a blueprint for improving intervention by focusing on targeting the motivational responses and corresponding regulatory failures of individuals with distress disorders. Open and randomized controlled trials have demonstrated considerable preliminary evidence for the utility of emotion regulation therapy and its proposed mechanisms in treating the distress conditions.

Towards an Explanatory Model of Suicidal Ideation: The Effects of Cognitive Emotional Regulation Strategies, Affectivity and Hopelessness

Suicide constitutes a public health problem that has a significant economic, social and psychological impact on a global scale. Recently, the American Psychological Association has indicated that suicide prevention should be a public health priority. Suicidal ideation appears as a key variable in suicide prevention. The objective of this research was to verify the adjustment of an explanatory model for suicidal ideation, which considers the effects of cognitive emotion regulation strategies, affectivity and hopelessness. An open mode on-line sample of 2,166 Argentine participants was used and a path analysis was carried out. The results make it possible to conclude that the model presents an optimal fit (χ2 = .10, p = .75, CFI = .99, RMSEA = .01) and predicts 42% of suicidal thoughts. The model proves to be invariant based on age and gender. In conclusion, there is an importance of reducing the use of automatic strategies, such as repetitive negative thoughts of ruminative type, and increasing the use of more controlled strategies, such as reinterpretation or planning.

A comparison of decentering across demographic groups and meditation experience: Support for the measurement invariance of the Experiences Questionnaire

Theory and prior research suggests that decentering-an objective, distanced perspective on one's internal experiences-may vary based upon characteristics such as age, gender, race/ethnicity, and meditation experience. However, little is known about whether decentering measures are comparable in their meaning and interpretation when administered to individuals with different group membership (e.g., men or women; younger or older adults, etc.). The current study examined the measurement invariance of the Experiences Questionnaire (Fresco et al., 2007), a commonly used measure of decentering, evaluating age, gender, race/ethnicity, and meditation experience in three samples (students, community members, and clinical participants). Each sample was tested separately to assess the generalizability of results. The Experiences Questionnaire demonstrated full or partial measurement invariance in all cases, suggesting that scores are not biased based upon group membership and may be compared across individuals who vary in age, race/ethnicity, gender, and meditation experience. The current study also examined mean differences in decentering by groups, finding some evidence that decentering scores are higher for men, racial/ethnic minorities, older adults, and individuals with more meditation experiences. Implications are discussed for assessing decentering in diverse samples. (PsycINFO Database Record (c) 2020 APA, all rights reserved).