Individual differences in attachment and eating pathology: The mediating role of mindfulness

Family Socioeconomic Status and Adolescent Mental Health Problems during the COVID-19 Pandemic: The Mediating Roles of Trait Mindfulness and Perceived Stress

The present study was conducted twice over one year during the COVID-19 pandemic with Chinese adolescents (n = 1582) to investigate the relationships among family socioeconomic status (SES), adolescent mental health problems, trait mindfulness, and perceived stress using self-reported measures. We administered the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PPS), the Self-rating Anxiety Scale (SAS), the Epidemiologic Studies Depression Scale (CES-D), and Conduct Problem Tendency Inventory (CPTDI) to a sample of Chinese adolescents. The results prove that (1) there were significant correlations among socioeconomic status, trait mindfulness, perceived stress, and adolescent mental health problems, and the (2) serial mediation analysis indicated that trait mindfulness and perceived stress performed as mediators on the path from SES to anxiety, depression, and externalizing problems. Our findings provide a contribution by showing the connection between socioeconomic position and adolescent mental health problems and by offering a reference for the treatment of psychological issues affecting adolescents.

The Mediating Effect of Empathy between Mindfulness and Self-Leadership in Female University Students: A Cross-Sectional Study

(1) Background: Acknowledging scant research on integrating mindfulness, empathy, and self-leadership among female university students, this study aimed to investigate the relationships among these three variables, as well as the mediating effect of empathy. (2) Methods: A cross-sectional design was employed with 127 female sophomores in a mindfulness-based liberal arts class at K Women's University in South Korea. Participants completed a self-reported questionnaire measuring levels of mindfulness, empathy, and self-leadership. Data were analyzed with descriptive statistics and correlations between the variables using the SPSS 28 program. The Jamovi 2.2.5 program was used to analyze the mediating effect of empathy. (3) Results: The levels of mindfulness, empathy, and self-leadership were higher than in previous studies. Mindfulness was positively related to empathy (r = 0.407, p < 0.001) and self-leadership (r = 0.635, p < 0.001); empathy was also positively associated with self-leadership (r = 0.635, p < 0.001). Furthermore, empathy mediated the relationship between mindfulness and self-leadership (β = 0.187, p < 0.001). (4) Conclusions: The findings indicate that mindfulness is helpful in improving university students' self-leadership by reinforcing their empathy, and that an integrated training program of mindfulness and empathy could produce positive effects on promoting self-leadership. The findings can be utilized as a basis for developing programs to improve mindfulness and empathy, eventually improving students' self-leadership.

Mediating effects of emotion regulation between socio-cognitive mindfulness and empathy in nurses: a cross-sectional study

Background

Acknowledging the under-examined research of socio-cognitive mindfulness and Gross’s emotion regulation strategies in nursing, this study investigated the relationships between socio-cognitive mindfulness, emotion regulation (i.e., reappraisal and suppression), and empathy among nurses. It also explored the mediating effects of emotion regulation.

Methods

A cross-sectional quantitative study was conducted in a sample of 245 nurses from two university hospitals in South Korea. Convenience sampling was used to collect data between August 3 and September 29, 2020. Participants completed the questionnaire measuring their socio-cognitive mindfulness, emotion regulation, and empathy. Structural equation modeling and path analysis were conducted for data analysis.

Results

Socio-cognitive mindfulness positively influenced emotion regulation of reappraisal (β = 0.404, p < 0.01) and empathy (β = 0.402, p < 0.01), but negatively influenced emotion regulation of suppression (β = −0.149, p < 0.05). Reappraisal positively influenced empathy (β = 0.341, p < 0.01), whereas suppression negatively influenced empathy (β = −0.127, p < 0.05). Importantly, emotion regulation of reappraisal mediated the association between socio-cognitive mindfulness and empathy (a X b = 0.107, p < 0.01).

Conclusion

The findings indicate that socio-cognitive mindfulness is effective in improving empathy among nurses by enhancing reappraisal. This study can provide a foundation for developing socio-cognitive mindfulness or emotion regulation programs to improve empathy among nurses, which would ultimately lead to better nursing performance by increasing patient satisfaction.

Mindfulness mediates the relationship between positive parenting and aggression, depression, and suicidal ideation: A longitudinal study in middle school students

Previous research has indicated that parenting factors affect the risk of maladaptive psychological outcomes (e.g., aggression, depression, or suicidal ideation), and that positive parenting is a prospective risk factor for maladaptive psychological outcomes. However, the mechanisms underlying the relationships between positive parenting, mindfulness, and maladaptive psychological outcomes remain unknown, as do the processes that mediate the effect of positive parenting on maladaptive psychological outcomes in adolescents. The objective of the present study was to investigate the longitudinal relationship between positive parenting, mindfulness, and maladaptive psychological outcomes in middle school students, as well as the mediating effect of mindfulness in the relationships between positive parenting and depression, aggression, and suicidal ideation. In this study, 386 middle school children (aged 12–16) were tested three times over a period of 6 months. Positive parenting was assessed at Time 1, mindfulness at Time 2, and depression, aggression, and suicidal ideation at Time 3. Using structural equation modeling, positive parenting was revealed to be longitudinally associated with mindfulness and negatively associated with maladaptive psychological outcomes. More crucially, mindfulness mediated the relationship between positive parenting and maladaptive psychological outcomes. This research provides important insights into how to effectively decrease adolescent maladaptive psychological outcomes and highlights the importance of teaching mindfulness to youths.

Nursing Students' Grit, Socio-Cognitive Mindfulness, and Achievement Emotions: Mediating Effects of Socio-Cognitive Mindfulness

Background: Recognizing the under-examined socio-cognitive mindfulness and achievement emotions in nursing, this study aimed to examine the relationships between grit, socio-cognitive mindfulness, and achievement emotions among nursing students, as well as the mediating effects of socio-cognitive mindfulness. Methods: This study utilized a cross-sectional design. A total of 220 nursing students in Korea completed the questionnaire measuring the levels of grit, socio-cognitive mindfulness, and achievement emotions. To analyze data, structural equation modeling and path analysis were performed. Results: Grit was positively related to socio-cognitive mindfulness and positive achievement emotions but negatively related to negative emotions. Socio-cognitive mindfulness was positively related to positive emotions but negatively related to negative emotions. In addition, the mediating effects of socio-cognitive mindfulness were found in the association between grit and achievement emotions in nursing students. Conclusions: Grittier students tend to have higher socio-cognitive mindfulness and positive emotions but lower negative emotions in learning environments. Mediating effects highlight the benefits of socio-cognitive mindfulness in the context of nursing education, providing the basis for developing practical mindfulness programs to cultivate nursing students’ socio-cognitive mindfulness.

The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach

Background

Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between adaptive and maladaptive emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology.

Methodology

A total of 104 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted. We ran a Bayesian random effects network meta-analysis and the initial network was well-connected with each emotion regulation strategy being linked to at least one other strategy. We also conducted a network meta-regression to explore whether between-study differences in body mass index (BMI), age, and whether the sample consisted of solely female participants explained any possible network inconsistency.

Results

The network meta-analysis revealed that ruminations and non-acceptance of emotions were most closely associated with ED psychopathology. There was no significant network inconsistency but two comparisons approached significance and thus meta-regressions were conducted. The meta-regressions revealed a significant effect of BMI such that the associations between different emotion regulation strategies and ED symptomatology were weaker among those with low BMI.

Discussion

The present findings build on previous work and highlight the role of rumination and difficulties with accepting emotions as key emotion regulation difficulties in EDs. Additionally, the finding that the associations were weaker among ED patients with low BMI may point toward a complex relationship between ED behaviors and emotion regulation. Taken together, our findings call for interventions that target emotion regulation, specifically rumination and difficulties accepting emotions, in the treatment of EDs.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249996, PROSPERO, identifier: CRD42021249996.

Dispositional Mindfulness is Cross-Sectionally Predicted by Interactions between Interparental Conflict and Parent-Child Relationships

Theory emphasizes the importance of the family environment for the development of dispositional mindfulness, but past research has focused exclusively on parent-child attachment relationships as family-level predictors of mindfulness. Our goal was to examine unique and joint associations of both interparental conflict and parent-child relationship quality with dispositional mindfulness. Participants were 150 youth (14-21 yrs) who reported the warmth and support in their relationships with mothers and fathers separately, as well as their appraisals of the properties of their parents' conflict, how threatening that conflict is, and how responsible for it they feel, in addition to dispositional mindfulness. Results indicated consistent interactions between conflict properties and mother-child relationship quality in relation to dispositional mindfulness. Dispositional mindfulness was lowest for youth who reported low levels of frequent/intense interparental conflict and poor-quality relationships with mothers. In contrast, either self-blame/threat or poor-quality relationships with mothers predicted lower levels of dispositional mindfulness. Implications for theory and practice are discussed.

How food brings us together: The ties between attachment and food behaviors

Interpersonal food behaviors, such as food sharing and food offering, are associated with closeness between people and thought to facilitate the formation and strengthening of social bonds. Despite the importance of food and food-related behavior in general and for social bonding specifically, there is relatively little research about the psychological underpinnings of food-related behavior within relationship science. To fill this gap, we conducted three studies focusing on food behaviors and attachment style. In Study 1, we found attachment avoidance to be negatively associated with engagement in food sharing behaviors, and with a lower likelihood of dating a potential partner due to the partner's food preferences. In Study 2, we found that enhancing attachment security increased the tendency to offer one's food to a fellow participant. In Study 3, we found that the tendency to accept food from a fellow participant was positively associated with attachment anxiety, but security priming did not affect this tendency. Implications for attachment, close relationships, and food sciences are discussed.

Care vs Food as an Emotional Regulation Strategy in Elementary School Children: The Role of the Attachment Style

According to attachment theory, potentially threatening stimuli tend to activate the attachment system for the search of the protective figure. In secure attachments, the experience of responsive relationships increases the probability of resorting to available figures as a strategy for regulating emotions in stressful situations. The aim of the research was to verify whether, in conditions of mild threat, children's attachment styles affect the choice between caring relationships and food as a form of emotion regulation. We used a mixed experimental design to perform this research. Here, we presented children (N = 65; M_age= 9.4) with threatening and neutral images and, afterwards, asked them to select from images of caring relationship or images of food. The results indicate that securely and ambivalently attached but not avoidantly attached children under both the neutral and threatening image conditions chose the care pictures over the food pictures. Second, only the securely attached increased their choice of care over food images in the threatening condition, and third, this difference was significant when compared with the avoidant children. In conclusion, the results show that although in general the choice of care is primary with respect to food, children with insecure attachments differ from secure children between the two options of emotional regulation.

Mindfulness and eating disorder psychopathology: A meta-analysis

OBJECTIVE

Mindfulness is implicated in eating disorder (ED) psychopathology. However, this literature has not been synthesized to date. The current meta-analysis examined the associations between mindfulness and ED psychopathology.

METHODS

A total of 74 independent samples (effects = 576) were included. We used a multilevel random-effects model to estimate summary study-level effect sizes, and multilevel mixed-effects models to examine moderator effects.

RESULTS

Mindfulness was negatively associated with ED psychopathology (r = -.25, p < .001), both concurrently (r = -.25, p < .001) and prospectively (rs = -.22 to -.24, ps < .001). Associations were strongest for binge eating, emotional/external eating, and body dissatisfaction as well as the acting with awareness and nonjudging facets.

DISCUSSION

Mindfulness may be an important process in ED psychopathology. Future research should prospectively and experimentally examine the relation between mindfulness and ED psychopathology.

Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis

In the last two decades, the number of studies focused on the mediators connecting insecure attachment with Eating Disorders (EDs), at both clinical and sub-clinical level, has considerably increased. However, there has not been a systematic synthesis of this literature to date. To fill this gap, the current meta-analytic review aimed at identifying and quantifying the extent to which mediators contribute to the explanation of this relationship. The present study was registered with PROSPERO (CRD42017076807). A comprehensive search process in seven different electronic databases retrieved 24 studies that examined how insecure attachment leads to ED symptoms through mediation analysis. Standardized regression coefficients of the indirect and total paths of 21 mediation models were pooled. Studies were coded and ranked for quality. We found evidence to show that maladaptive emotion regulation and depressive symptoms had the highest effect size for mediation (mediation ratio [P_M] = 0.71). Further, body dissatisfaction, neuroticism, perfectionism, mindfulness and social comparison had significant, but moderate to low mediating effects (P_M = 0.21–0.58). The methodological quality of these studies was mostly low to moderate and potential areas for development were highlighted. Our findings support the direct targeting of these psychological constructs in prevention programs and treatment of EDs. Future investigations addressing the time sequence between the variables will provide valuable clues to untangle the prospective contribution of each variable on the development and maintenance of eating pathology.

Individual Differences in the Relationship Between Attachment and Nomophobia Among College Students: The Mediating Role of Mindfulness

Background

There is a growing interest in nomophobia, which is defined as the fear of being out of cellular phone contact, or "feelings of discomfort or anxiety experienced by individuals when they are unable to use their mobile phones or utilize the affordances these devices provide”. However, only limited research can be found in terms of its determinants at present. Contemporary literature suggests that the relationships among attachment styles, mindfulness, and nomophobia have not been investigated.

Objective

This study aims to investigate the mediating effect of mindfulness on the relationship between attachment and nomophobia. In addition, the study also focuses on gender differences in attachment, mindfulness, and nomophobia. A theory-based structural model was tested to understand the essentials of the associations between the constructs.

Methods

The Experiences in Close Relationships Scale, Nomophobia Questionnaire, and Mindful Attention Awareness Scale were used to collect data from undergraduate students (N=450; 70.9% women [319/450]; mean age=21.94 years [SD 3.61]). Two measurement models (ie, attachment and mindfulness) and a structural model were specified, estimated, and evaluated.

Results

The structural equation model shows that the positive direct effects of avoidant (.13, P=.03) and anxious attachment (.48, P<.001) on nomophobia were significant. The negative direct effects of avoidant (−.18, P=.01) and anxious attachment (−.33, P<.001) on mindfulness were also significant. Moreover, mindfulness has a significant negative effect on nomophobia for women only (−.13, P=.03). Finally, the Sobel test showed that the indirect effects of avoidant and anxious attachment on nomophobia via mindfulness were significant (P<.001). The direct and indirect effects of anxious attachment, avoidant attachment, and mindfulness altogether accounted for 33% of the total variance in nomophobia. Gender comparison results show that there is a significant difference in attachment based on gender (F_2,447=6.97, P=.01, Wilk λ=.97, partial η²=.03). Women (mean 68.46 [SD 16.96]) scored significantly higher than men (mean 63.59 [SD 15.97]) in anxious attachment (F₁=7.93, P=.01, partial η²=.02). Gender differences in mindfulness were not significant (F_4,448=3.45, P=.69). On the other hand, results do show significant gender differences in nomophobia (F_4,445=2.71, P=.03, Wilk λ=.98, partial η²=.02) where women scored significantly higher than men.

Conclusions

In general, individuals who are emotionally more dependent and crave more closeness and attention in the relationship tend to display higher levels of fear or discomfort when they have no access to their mobile phones. However, gender has a differential impact on the relationship between avoidant attachment and nomophobia. This study establishes the impact of mindfulness on nomophobia for women; therefore, future studies should test the effectiveness of mindfulness-based therapy approaches and confirm whether they are effective and efficient. On the basis of significant gender difference in nomophobia and attachment, we conclude that gender should be taken into account in mindfulness-based treatments dealing with nomophobia.

The Relationship Between Adult Attachment Orientation and Mindfulness: a Systematic Review and Meta-analysis

Mindfulness can be measured as an individual trait, which varies between individuals. In recent years, research has investigated the overlap between trait mindfulness and attachment. The aim of the present review and meta-analysis was to investigate the current evidence linking adult attachment dimensions to trait mindfulness dimensions, and to quantitatively synthesize these findings using meta-analyses. A systematic literature search was conducted using five scientific databases of which, upon review, 33 articles met inclusion criteria. Inclusion criteria were peer-reviewed journals and dissertations published in English that relied on quantitative methods using reliable and validated self-report measures where study participants were aged 16 years and older. Random-effects model meta-analytic procedures were used to investigate the relationship between both constructs. Cross-sectional studies found significant negative correlations between adult attachment insecurity, on either dimension (anxiety or avoidance) and both total mindfulness score and all five sub-dimensions of mindfulness (act with awareness, observe, describe, non-reacting, and non-judging), with the exception of a non-significant positive correlation between attachment anxiety and observe. The effect size of the relationships ranged from small to medium. The overall mean effect sizes were moderate (anxiety, r+ = .34; avoidance, r+ = -.28), with both attachment dimensions associated with lower levels of total mindfulness. Results are discussed in relation to theory and research. Implications for future research include the need to utilize longitudinal design to address causality and mechanisms of the relationship between these constructs.

Eating disorders in adolescence: attachment issues from a developmental perspective

In the present article we review findings from an emerging body of research on attachment issues in adolescents with eating disorders from a developmental perspective. Articles for inclusion in this review were identified from PsychINFO (1966-2013), Sciencedirect (1970-2013), Psychindex (1980-2013), and Pubmed (1980-2013). First, we will outline the crucial developmental changes in the attachment system and discuss how they might be related to the early onset of the disease. Then we will report on the major results from attachment studies using self-report and narrative instruments in that age group. Studies with a developmental approach on attachment will be analyzed in more detail. The high incidence of the unresolved attachment pattern in eating disorder samples is striking, especially for patients with anorexia nervosa. Interestingly, this predominance of the unresolved category was also found in their mothers. To date, these transgenerational aspects are still poorly understood and therefore represent an exciting research frontier. Future studies that include larger adolescent samples and provide a more detailed description including symptom severity and comorbidity would contribute to a better understanding of this complex and painful condition.