Trait mindfulness modulates neuroendocrine and affective responses to social evaluative threat

Mindfulness, teacher mental health, and well-being in early education: a correlational study

This study analyzed the relationship between mindfulness and variables considered relevant for teacher-student interactions: teacher burnout, general stress, anxiety, depression, and quality of life. We hypothesized that mindfulness would relate negatively with mental health variables and positively with quality of life. We also explored which specific aspects of mindfulness would predict burnout, depression, anxiety, stress, and quality of life. Given the results of regression analyses, mediation models were performed to explore the mechanisms through which different facets of mindfulness affect quality of life. As predicted, the correlation analysis showed that mindfulness and its dimensions were positively associated with the quality of life of the teachers and burnout dimension of personal fulfillment and negatively associated with anxiety, depression, and stress (considering FFMQ total score and most of its dimensions). Consistently, regression analysis showed that the overall level of mindfulness, after controlling for the grade level at which the teacher works, showed significant associations with the level of personal fulfillment, depression, anxiety, stress, and quality of life. The results of the mediation analyses showed that the ability not to judge ourselves was associated with fewer symptoms of depression and stress and, through these pathways, positively affected quality of life. On the other hand, the ability not to react favored quality of life by reducing anxiety and stress. Finally, acting with awareness was the only facet of mindfulness that favored quality of life, affecting one of the dimensions of burnout.

Dispositional mindfulness: Dissociable affective and cognitive processes

Mindfulness has been linked to a range of positive social-emotional and cognitive outcomes, but the underlying mechanisms are unclear. As one of the few traits or dispositions that are associated with both affective and cognitive benefits, we asked whether mindfulness is associated with affective and cognitive outcomes through a shared, unitary process or through two dissociable processes. We examined this in adolescents using behavioral measures and also reanalyzed previously reported neuroimaging findings relating mindfulness training to either affect (negative emotion, stress) or cognition (sustained attention). Using multivariate regression analyses, our findings suggest that the relationships between dispositional mindfulness and affective and cognitive processes are behaviorally dissociable and converge with neuroimaging data indicating that mindfulness modulates affect and cognition through separate neural pathways. These findings support the benefits of trait mindfulness on both affective and cognitive processes, and reveal that those benefits are at least partly dissociable in the mind and brain.

Evidence for differential associations of distinct trait mindfulness facets with acute and chronic stress

Stress and stress-associated disease are considered the health epidemic of the 21st century. Interestingly, despite experiencing similar amounts of stress than those falling ill, some individuals are protected against the "wear and tear of daily life". Based on the notion that mindfulness training strengthens stress resilience, we explored whether facets of trait mindfulness, prior to training intervention, are linked to acute psychosocial stress reactivity and chronic stress load. To assess different mindfulness facets, over 130 participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and the Freiburg Mindfulness Inventory (FMI). For acute stress induction, a standardized psychosocial stress test was conducted. Subjective stress, sympathetic and parasympathetic activity, and levels of the hypothalamic-pituitary-adrenal axis end hormone cortisol were assessed repeatedly. Additionally, levels of hair cortisol and cortisone as indices of the long-term physiological stress load were collected. We found differential associations of different facets of mindfulness with subjective stress, cortisol, and hair cortisone levels. Specifically, the trait mindfulness facets FMI "Acceptance" and the ability to put one's inner experience into words (FFMQ "Describing") were associated with lower acute subjective and cortisol stress reactivity. Contrarily, monitoring-related trait mindfulness facets (FFMQ "Acting with Awareness" and "Observing") were associated with higher acute cortisol and marginally higher long-term cortisone release. Our results suggest granularity of the mindfulness construct. In accordance with the "Monitor and Acceptance Theory", especially acceptance-related traits buffered against stress, while monitoring-related traits seemed to be maladaptive in the context of stress. The current results give valuable guidance for the conceptualization of mindfulness-based interventions geared towards stress reduction.

A brief nonattachment intervention based on the three marks of existence: development, rationale, and initial evidence

BACKGROUND

The practices described in Buddhist philosophy are essentially a suite of non-theistic cognitive and behavioral interventions designed to induce nonattachment (N-A), which can be defined in terms of the absence of a need for one's personal reality to be other than it is. Although meditative practices have received attention in multiple literatures, the cognitive analogs to these behaviorally-oriented practices have not.

DESIGN

Two experiments involving undergraduate participants (total N = 239; M age = 19.04) investigated whether the provision of wisdom related to the Three Marks of Existence (i.e., some degree of suffering is inevitable, there is impermanence, and many events are not in our control) could result in (1) higher nonattachment attitudes, (2) lower threat appraisals, (3) lower stressor reactivity, and (4) shorter emotion reaction durations.

RESULTS

With moderate to large effect sizes, the Three Marks trainings (relative to placebo or control conditions) resulted in (1) higher nonattachment attitudes, (2) lower threat appraisals, (3) no differences in negative emotional intensity, but 4) shorter emotion durations.

CONCLUSIONS

These results provide preliminary evidence that enduring cognitive trainings such as the Three Marks can be an effective tool to increase acceptance-related attitudes while attenuating negative reactivity.

Associations between capacity of cognitive control and sleep quality: a two-wave longitudinal study

This longitudinal study explored the impact of the upper limit of cognitive control on the sleep quality of high school students. We collected data in two waves to examine four main variables: capacity of cognitive control (CCC), trait mindfulness, emotional distress and sleep quality. At the first time point (T1), trait mindfulness and emotional distress were measured by rating scales, and the CCC was evaluated by revised backward masking majority function task. Sleep quality was rated 5 months later (T2). The results indicated that: (1) the CCC was negatively correlated with trait mindfulness, and trait mindfulness was negatively correlated with emotional stress; (2) there was no simple mediation of either trait mindfulness or emotional distress in the relationship between CCC and sleep quality; (3) instead, the CCC was associated with poor sleep quality in a sequential mediation through trait mindfulness and then emotional stress. The research highlights the importance of trait mindfulness and emotional distress for addressing sleep problems in adolescents.

Investigating adverse daily life effects following a psychosocial laboratory stress task, and the moderating role of Psychopathology

Laboratory stress tasks are necessary to closely investigate the stress response in a controlled environment. However, to our knowledge, no study has tested whether participating in such tasks can pose any daily life adverse effect. Fifty-three healthy participants (46 women) took part in a laboratory session where stress was induced using a typical psychosocial stressor: the repeated Montreal Imaging Stress Task (rMIST). Average levels of negative affect (NA), heart rate (HR), root mean square of successive differences (RMSSD), and skin conductance level (SCL), as well as reactivity across all these parameters as measured with the experience sampling method (ESM) in the four days prior to the laboratory session were compared with the four days following the session. We also assessed whether vulnerability to psychopathology moderated these associations. Findings showed that the task did not pose any significant adverse effect on participants. However, there was an unexpected increase in average RMSSD and a decrease in average SCL pre- to post- task. In addition, more vulnerable individuals were more likely to experience an increase in average levels of NA in the days following the task compared to the days preceding it. Our findings suggest that laboratory stress tasks may pose a significant risk to more vulnerable individuals.

A randomized controlled trial of mindfulness-based stress reduction on academic resilience and performance in college students

OBJECTIVE

The transition into college can pose barriers for student success. We examined the impact of mindfulness-based stress reduction (MBSR) compared to an active and no treatment control group, respectively, on stressor appraisals, academic persistence, and performance in unversity students.

PARTICIPANTS

Students were randomly assigned to receive MBSR (n = 29), study skills active control (n = 27), or no treatment (n = 29).

METHOD

Participants reported stressor appraisals and academic persistence pre- and post-intervention. Semester grade point average (GPA) and enrollment was also obtained.

RESULTS

Academic stressor appraisals did not vary by group. MBSR was protective against depleted academic persistence, whereas academic persistence decreased in the control groups. Enrollment rates remained unchanged in the MBSR group, but increased in the active control relative to no treatment. Finally, GPA improved in the MBSR group, but not controls.

CONCLUSIONS

Findings suggest that MBSR confers some benefits for resilience in university students.

Trait and state effects of different modes of thinking on salivary cortisol in daily life in patients with recurrent major depression and healthy individuals

Habitual modes of thinking such as repetitive negative thinking (RNT), but also momentary cognitive processes such as mindwandering could be vulnerability factors for the course of Major Depressive Disorder (MDD). On the physiological level, cortisol represents an important biological stress marker of the hypothalamic-pituitary-adrenal (HPA) axis. Being a dynamic and non-invasive measure, salivary cortisol can be assessed in daily life via Ambulatory Assessment (AA). So far, consensus exists on a dysregulation of the HPA axis in MDD. However, findings are ambiguous and AA-studies examining both trait and state level effects of cognitive processes on cortisol release in daily life in patients with recurrent major depression (rMDD) and healthy controls (HCs) are lacking. A sample of 119 (n_rMDD=57, n_HCs=62) participants underwent a baseline session, including self-rated questionnaires (RNT, mindfulness) followed by a 5-day AA, where participants indicated the occurrence of mindwandering and levels of mentalshift problems ten times per day via smartphone, and collected saliva cortisol samples five times per day. Via multilevel models, we found habitual RNT, but not mindfulness, to predict higher cortisol levels, with the effects being stronger in rMDD patients. State mindwandering and mentalshift problems predicted increased cortisol 20 min later across groups. State cognitions did not mediate the effects of habitual RNT on cortisol release. Our results suggest independent mechanisms of action for trait and state cognitions on cortisol activity in daily life and indicate a greater physiological vulnerability toward trait RNT and the tendency to experience mentalshift problems in patients with recurrent major depression.

Tri-process model of interpersonal mindfulness: theoretical framework and study protocol

According to the Center for Disease Control and Prevention, over 14% of the US population practice mindfulness meditation. The effects of mindfulness training on physical and mental health have been consistently documented, but its effects on interpersonal relationships are not yet fully understood or investigated. Interpersonal relationships play a crucial role in the wellbeing of individuals and society, and therefore, warrants further study. The aim of this paper is to present a tri-process theoretical model of interpersonal mindfulness and a study protocol to validate the proposed model. Specifically, according to the proposed model, mindfulness meditation training increases the self-awareness, self-regulation, and prosociality of those receiving the training, which ameliorates the quality of interpersonal interactions and the socioemotional support provided to other individuals. Finally, better socioemotional support increases the support receiver's ability to regulate their emotions. Using a multiphasic longitudinal design involving 640 participants randomized into 480 dyads, the proposed protocol aims to validate the tri-process model and to investigate its mechanisms of actions. The proposed study has important theoretical and social implications and will allow devising new and more effective interpersonal mindfulness programs with applications in multiple fields.

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

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

A constructivist grounded theory exploration of Mindfulness for Healthcare Professional students

BACKGROUND AND PURPOSE

To better understand the effects of an intervention, Mindfulness for Healthcare Professional (MIHP), and how it may improve healthcare professional student (HCP) functioning, a constructivist grounded theory exploration was conducted.

MATERIALS AND METHODS

Ten participants with the lowest or highest changes on quantitative measures of burnout and perceived stress at the end of MIHP were interviewed at a long-term follow-up. A theoretical framework was developed from the resultant themes to describe the mechanisms by which MIHP had effects on work-relevant functioning.

RESULTS

Three overarching themes emerged as mechanisms of change both from their presence in those participants reporting an improvement in stress and their missingness from those participants who reported no change: developing a mindfulness practice, integrating practice into daily life, and enhanced awareness. These mechanisms led to optimized work-relevant functioning: 1) emotional competencies, including nonjudgement, emotion regulation, and burnout prevention; and 2) patient-centered care, including improved listening, patience, and efficiency at work.

CONCLUSION

The resultant framework is discussed in the context of previous literature on MIHP and mindfulness theory more broadly. Implications for future disseminations of MIHP encourage the use of group interventions with emphasis on developing at-home practice and informal mindfulness integrated into daily work.

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.

Nonpartner Violence Perpetration Among Emerging Adults: Associations With Polysubstance Use and Trait Mindfulness

Objective

Violence is a leading cause of death among individuals ages 18-25, with alcohol misuse consistently linked with violence perpetration. However, the association between polysubstance use and violence perpetration is less clear, despite the frequency of use of alcohol with other drugs. Additionally, protective factors such as mindfulness that may reduce violence perpetration among emerging adults have been understudied. This cross-sectional study examined the association between substance use, trait mindfulness, and violence perpetration outside of romantic relationships, utilizing a compensatory model of resilience.

Methods

Data were drawn from a sample of 665 emerging adults ages 18-25, recruited from an urban Emergency Department (68% men). Participants self-administered a computer survey that assessed non-partner violence perpetration (NPV), alcohol use, marijuana use, prescription drug misuse, and trait mindfulness. Fifteen percent reported non-partner violence perpetration over the past six months.

Results

Multivariate logistic regression tested associations between violence perpetration, substance use, trait mindfulness, and demographic characteristics. Results showed that alcohol use alone (OR= 3.04), prescription opioid use alone (OR = 3.58), alcohol and marijuana use (OR = 3.75), and use of all three substances (OR= 7.78) were positively associated with violence perpetration. Post-hoc contrasts demonstrated the polysubstance use significantly increased risk over single substance use. Trait mindfulness (OR= 0.97) was negatively associated with violence perpetration after controlling for substance use.

Conclusions

Findings suggest that polysubstance use may increase risk for violence. Interventions that address polysubstance use, potentially including mindfulness, could reduce non-partner violence perpetration among emerging adults and requires further study.

Is daily-life stress reactivity a measure of stress recovery? An investigation of laboratory and daily-life stress

Typical measures of laboratory reactivity (i.e. difference between control and stress) and recovery (i.e. difference between stress and post-stress) were compared with a conventional measure of daily-life reactivity, best known as event-related stress. Fifty-three healthy individuals between 19 and 35 years of age took part in a laboratory session where stress was induced using the repeated Montreal Imaging Stress Task and 8 days of experience sampling method. Measures of negative affect, heart rate (HR), HR variability, and skin conductance level were collected. Findings show no strong associations between laboratory and daily life measures with the exception of laboratory affective recovery and daily life reactivity. Findings and their implications are discussed.

The biological dimensions of transcendent states: A randomized controlled trial

This study evaluated the biological dimension of meditation and self-transcendent states. A convenience sample of 513 participants was drawn from attendees at a 4-day guided meditation workshop. Half were randomly assigned to an active placebo control intervention. All were assessed on a variety of measures, both psychological [anxiety, pain, posttraumatic stress disorder (PTSD), positive emotions, and transcendent states], and physiological (physical functioning). Additional biological assessments including salivary immunoglobulin-A (SIgA), cortisol, and Quantitative Electroencephalography (qEEG) were obtained from subset of the Experimental group (N = 117). No significant difference in psychological symptoms or positive emotions was observed between Experimental and placebo groups at baseline. At post-test, significant improvements were noted in the Experimental group, including a 49.5% median increase in SIgA (p = 0.01), though cortisol remained unchanged. qEEG z-score analysis identified sustained stress reduction, including delta frequency band amplitude increases, high beta decreases, and faster acquisition of sustained alpha states (all p < 0.001). Psychological symptoms also improved on all measures. At 6-month follow-up (N = 140), PTSD and somatic symptoms significantly improved from baseline, and post-test versus 6-month follow-up results indicated significant increases in happiness and spiritual and physical oneness, along with decreases in depressive symptoms. These findings suggest that autonomic self-regulation and transcendent states may be measured in both biological and psychological dimensions and are associated with pervasive health benefits.

Within-Person variations in mindfulness mediate effects of daily stressors on psychological distress in adolescence

OBJECTIVE

We tested two competing models linking daily stress, mindfulness, and psychological distress in adolescence: 1) whether daily mindfulness moderates the impact of daily stressors on psychological distress or 2) whether mindfulness mediates the relationship between greater daily stressors and psychological distress.

METHODS

Every evening for a week, 138 adolescents completed ecological momentary assessments (EMAs). Daily diaries assessed negative events, work-school conflict, mindfulness, and perceived stress. Multilevel mediation and moderation were tested.

RESULTS

Results indicated that there were meaningful variations in adolescent mindfulness from day-to-day, and supported mediation rather than moderation; the within-person association between stressors and psychological distress was mediated by mindfulness at the daily level.

CONCLUSION

It may be too challenging for adolescents to remain in a mindful state during stress to effectively use mindfulness as a buffer. Instead, daily stressors may indirectly impact psychological distress through decreasing mindfulness.

How and when perceived COVID-19 crisis strength impacts individuals' life satisfaction and sleep quality: A moderated mediation model

The COVID-19 pandemic has caused millions of deaths, seriously hampering people's lives and their productivity. Drawing on social information processing theory, this research developed a moderated mediation model to investigate the influence of perceived COVID-19 crisis strength on individuals' well-being. The results from a sample of 441 suggest that individuals' perceived COVID-19 crisis strength indirectly affects their life satisfaction and sleep quality via their perceived risk of being infected. Moreover, both individuals' trust in local government and mindfulness trait can buffer the positive effect of perceived COVID-19 crisis strength on their perceived risk of being infected. At the same time, they also buffer the indirect impact of individuals' perceived COVID-19 crisis strength on life satisfaction and sleep quality through perceived risk of being infected. This research provides several practical implications for governments and individuals to mitigate the negative influences of the COVID-19 pandemic and help individuals boost life satisfaction and sleep quality.

The dual threat of COVID-19 to health and job security - Exploring the role of mindfulness in sustaining frontline employee-related outcomes

Navigating the increasingly uncertain business world requires organizations and employees to be highly adaptive to threats and changes. During COVID-19, the dual threats to health and job security have been especially salient for frontline employees. Drawing on the job demands-resources (JD-R) model, we investigated individual and organizational mindfulness as valuable resources, which influence employee outcomes of preventative behaviors, emotional exhaustion, and job performance both directly, and indirectly through threat appraisals. We find that individual and organizational mindfulness influence threat appraisals in a "counterbalanced manner": individual mindfulness decreases threat appraisals, while organizational mindfulness heightens the perceived threat of contracting COVID-19. The threat to health further serves as a double-edged sword, predicting both emotional exhaustion and preventative behaviors, while job insecurity impairs all employee outcomes. Based on these findings, we provide key implications for research and practice, and future research directions.

Physical Activity and Mindfulness are Associated with Lower Anxiety in Different but Complementary Ways

INTRODUCTION

Anxiety is the most prevalent mental illness worldwide. Physical activity and mindfulness both reduce anxiety. The two are highly related; however, the relative association of physical activity and mindfulness on anxiety has yet to be examined. The present study aimed to evaluate the unique variance accounted for by physical activity and mindfulness on anxiety.

METHODS

Fifty young adults from a student population (M ± SD = 19 ± 0.2 years old; 58% female) reported their physical activity, mindfulness, and anxiety symptoms at the start of the study and reported their change in state anxiety to an acute psychological stress test, Trier Social Stress Test.

RESULTS

Mindfulness explained more of the variance associated with anxiety symptoms at baseline, whereas physical activity explained more of the variance associated with change in state anxiety in response to the acute stressor. Females had higher rates of anxiety symptoms than males suggesting that females may benefit more from mindfulness. In contrast, both males and females reacted similarly to an acute stressor suggesting that both genders may benefit from physical activity.

CONCLUSIONS

Our findings suggest that physical activity and trait mindfulness may have related, but distinct impacts on anxiety levels. These results have important implications for using these lifestyle interventions to support mental health and point to personalizing interventions to help ease the burden of anxiety felt by the individual.

Nature and Mindfulness to Cope with Work-Related Stress: A Narrative Review

In recent years, work-related stress has grown exponentially and the negative impact that this condition has on people's health is considerable. The effects of work-related stress can be distinguished in those that affect workers (e.g., depression and anxiety) and those that affect the company (e.g., absenteeism and productivity). It is possible to distinguish two types of prevention interventions. Individual interventions aim at promoting coping and individual resilience strategies with the aim of modifying cognitive assessments of the potential stressor, thus reducing its negative impact on health. Mindfulness techniques have been found to be effective stress management tools that are also useful in dealing with stressful events in the workplace. Organizational interventions modify the risk factors connected to the context and content of the work. It was found that a restorative workplace (i.e., with natural elements) reduces stress and fatigue, improving work performance. Furthermore, practicing mindfulness in nature helps to improve the feeling of wellbeing and to relieve stress. In this paper, we review the role of mindfulness-based practices and of contact with nature in coping with stressful situations at work, and we propose a model of coping with work-related stress by using mindfulness in nature-based practices.

The effects of voice content on stress reactivity: A simulation paradigm of auditory verbal hallucinations

OBJECTIVES

Psychosis is associated with increased subjective and altered endocrine and autonomic nervous system stress-reactivity. Psychosis patients often experience auditory verbal hallucinations, with negative voice content being particularly associated with distress. The present study developed a voice-simulation paradigm and investigated the effect of simulated voices with neutral and negative content on psychophysiological stress-reactivity, and the effect of mindful voice-appraisals on stress-reactivity.

METHOD

Eighty-four healthy participants completed the Montreal Imaging Stress Task with simultaneous presentation of one of three randomly allocated auditory stimuli conditions: negative voices, neutral voices or non-voice ambient sounds. Subjective stress-levels and mindful voice-appraisals were assessed using questionnaire measures, and cortisol and α-amylase levels were measured using saliva samples.

RESULTS

ANOVA revealed a significant effect of condition on subjective stress-levels (p = .002), but not cortisol (p = .63) or α-amylase (p = .73). Post-hoc analyses showed that negative voices increased subjective stress-levels relative to neutral voices (p = .002) and ambient sounds (p = .01), which did not differ from each other (p = .41). Mindful voice-appraisals were associated with less distress across conditions (p = .003), although negative voices were also associated with less mindful appraisals (p < .001).

CONCLUSIONS

Negative voice content, rather than voices or auditory stimuli per se, is linked to greater subjective but not physiological stress-reactivity. Mindful appraisals may partially moderate this effect. These findings highlight the importance of voice content for the impact of voice-hearing, and highlight the potential value of mindfulness training to treat voice distress in psychosis.

Inter-relationships between changes in stress, mindfulness, and dynamic functional connectivity in response to a social stressor

We conducted a study to understand how dynamic functional brain connectivity contributes to the moderating effect of trait mindfulness on the stress response. 40 male participants provided subjective reports of stress, cortisol assays, and functional MRI before and after undergoing a social stressor. Self-reported trait mindfulness was also collected. Experiencing stress led to significant decreases in the prevalence of a connectivity state previously associated with mindfulness, but no changes in two connectivity states with prior links to arousal. Connectivity did not return to baseline 30 min after stress. Higher trait mindfulness was associated with attenuated affective and neuroendocrine stress response, and smaller decreases in the mindfulness-related connectivity state. In contrast, we found no association between affective response and functional connectivity. Taken together, these data allow us to construct a preliminary brain-behaviour model of how mindfulness dampens stress reactivity and demonstrate the utility of time-varying functional connectivity in understanding psychological state changes.

Short Mindfulness-Based Relaxation Training Has No Effects on Executive Functions but May Reduce Baseline Cortisol Levels of Boys in First Grade: A Pilot Study

(1) Background: Executive functions are important for academic performance and school readiness. Children’s executive function skills are found to be improved by mindfulness-based interventions, and these programs are also effective in stress reduction. The aim of this study was to evaluate the feasibility and the effects of a short mindfulness-based relaxation training compared to a passive control condition right before school entry on executive function skills and cortisol levels. (2) Methods: The feasibility and the effects of the intervention before school entry were tested with 61 preschoolers. The final sample consisted of 51 participants (Mage = 81.90 months, SD = 5.45; 41% male). Short-term memory, executive function skills and cortisol levels before and after the intervention were assessed. Additionally, cortisol levels were assessed one week and one month after school entry. (3) Results: There was a significant sex difference in the effects of the intervention on children’s cortisol levels (p = 0.026, η2 = 0.134). The mindfulness-based relaxation training applied before school entry prevented a rise in boys’ cortisol levels one week after starting school. (4) Conclusion: A short mindfulness-based intervention before starting school could be effective in fostering physiological stress management in boys.

Effects of Organizational Controls on Employees' Cyber-loafing

Cyber-loafing is a workplace deviant behavior that may impose perennial losses and security threats to organizations. Due to the destructive impact, organizations take controls to manage employees' cyber-loafing behavior. While previous research concerning these cyber-loafing controls has yielded inconsistent results, this research further advances this line of research through two primarily adopted organizational controls: computer monitoring and Internet usage policy. We contend that the inconsistent results of the effects of computer monitoring and Internet usage policy on cyber-loafing behavior are due to ignoring the influence of individual differences. Motivated thus, we draw on pertaining literature of trait mindfulness to propose that trait mindfulness moderates the effect of perceived computer monitoring and perceived Internet usage policy on behavioral automaticity towards cyber-loafing, which leads to employees' cyber-loafing behavior. In essence, this paper sheds new light on the relationships amid organizational controls, cyber-loafing behavior, and the moderating effects of trait mindfulness. 450 responses were collected to test these hypotheses. Our results show that trait mindfulness enhances the negative effect of perceived Internet usage policy on behavioral automaticity towards cyber-loafing. In addition, we find out that trait mindfulness has an indirect effect on employees' cyber-loafing behavior by reducing behavioral automaticity.

Mindfulness predicts less depression, anxiety, and social impairment in emergency care personnel: A longitudinal study

Medical personnel working in emergency rooms (ER) are at increased risk of mental health problems and suicidality. There is increasing evidence that mindfulness-based interventions can improve burnout and other mental health outcomes in health care providers. In contrast, few longitudinal prospective studies have examined protective functions of dispositional mindfulness in this population. The objective of this study was to examine whether mindfulness prospectively predicts anxiety, depression, and social impairment in a sample of emergency care professionals. The authors administered online surveys to ER personnel prior to work in ER, and at 3 and 6 months follow up. Participants were 190 ER personnel (73% residents, 16% medical students, 11% nurses). Linear mixed effects regression was used to model longitudinal 3-month and 6-month follow up of depression, anxiety, and social impairment. Predictors included time-varying contemporaneous work stressors, perceived social support at work and life events, and baseline dispositional mindfulness, demographics, and workplace characteristics. Mindfulness indexed when starting ER work predicted less depression, anxiety, and social impairment 6 months later. Mindfulness remained a strong predictor of mental health outcomes after controlling for time-varying stressful events in emergency care, negative life events, and social support at work. Mindfulness moderated the adverse impact of poor social support at work on depression. To our knowledge, this is the first longitudinal study to show that mindfulness prospectively and robustly predicts anxiety, depression, and social impairment. Results support the role of mindfulness as a potential resilience factor in at-risk health care providers.

Job Demands, Resources, and Burnout in Social Workers in China: Mediation Effect of Mindfulness

Internationally, human service professionals, including social workers, experience high burnout and turnover rates. Despite the recent and rapid development of contemporary social work in China, Chinese social workers similarly experience significant rates of burnout. Therefore, there is a need to investigate the factors that contribute to social work burnout. This study applied the job demands and resources (JD-R) model to examine the effects of JD-R on burnout in social workers (n = 897) from Chengdu, China, and whether these relations are mediated by state mindfulness. Structural equation modeling results supported the previously hypothesized dual process by which JD-R affect burnout, specifically in a sample of social workers in China. Job demands (JD) were positively associated with burnout, while job resources (JR) were negatively associated with burnout. These relations were partially mediated by state mindfulness. JR had a strong, positive direct effect on mindfulness (β = 0.38), and its total effect on burnout was high (β = −0.56). Meanwhile, JD had a slight negative direct effect on mindfulness (β = −0.09), and its total effect on burnout was 0.42. The results suggest that the implementation of mindfulness-based interventions for social workers can potentially mitigate the effect of JD on burnout, as well as increase the effect of JR on burnout.

Effects of a Brief Mindful Hypnosis Intervention on Stress Reactivity: A Randomized Active Control Study

A novel, audio-based brief mindful hypnosis (BMH) intervention for reducing stress-reactivity during the Trier Social Stress Test (TSST) was investigated. Fifty-five college-aged participants with elevated stress were randomized to BMH or a cognitive training (CT) active-control condition. Participants received a BMH or CT session and downloaded the audio-recorded intervention for daily home practice. Approximately 1 week later, participants received their second BMH or CT session and then completed the TSST. Results indicated BMH produced significant and medium effects in reducing stress reactivity and weekly stress and increasing mindfulness, with large increases in immediate relaxation compared to the CT active control. BMH demonstrated excellent adherence and was rated highly regarding satisfaction, ease of practice, perceived benefit, and likelihood of future use. This study provides the first empirical support that BMH is superior to an active-control intervention for reducing stress reactivity while significantly increasing mindfulness and relaxation.

Momentary and longitudinal relationships of mindfulness to stress and anxiety among Chinese elementary school students: mediations of cognitive flexibility, self-awareness, and social environment

Mindfulness could benefit elementary school students' mental health, but little is known about the mechanisms of mindfulness in the elementary school context. The current studies explored mindfulness's relationship to stress and anxiety in elementary school students and potential mediators in the connections from proximal and distal perspectives.

DESIGN

In Study 1, a daily diary approach was used to examine the mediating role of cognitive flexibility on mindfulness's dynamic association to stress and anxiety. In Study 2, we examined the longitudinal relationships between mindfulness at baseline and stress and anxiety at 6-month follow-up and the mediating roles of self-awareness (i.e., self-esteem and self-identity) and social environment (i.e., student-teacher relationship and peer relationship).

MAIN OUTCOMES

From a proximal perspective, cognitive flexibility mediated the negative relationship of state mindfulness to stress and anxiety. From a distal standpoint, self-esteem mediated the relationship between dispositional mindfulness and anxiety. Perceived peer relationship mediated the association of dispositional mindfulness to stress and anxiety.

CONCLUSION

For elementary school students, state mindfulness showed immediate effects, and dispositional mindfulness showed long-term effects on reducing anxiety and stress through different mechanisms. Limitations and implications were discussed.

Trait Mindfulness Moderates the Association Between Stressor Exposure and Perceived Stress in Law Enforcement Officers

Objectives

To test the magnitude of the relationship between self-reported stressor exposure and perceived stress in police officers using a novel measure of daily work events, and whether dispositional mindfulness and resilience moderate this relationship.

Methods

A total of 114 law enforcement officers from a mid-sized Midwestern US city completed daily logs of job stressors and associated perceived stress, as well as additional self-report measures of perceived stress, trait mindfulness and resilience, and demographics and work information. Principal component analysis (PCA) was used to cluster job stressors into a smaller number of components in a data-driven manner. Linear mixed-effects models were used to test the relationship between stressor exposure and perceived stress for each component, and the moderation of this relationship by trait mindfulness and resilience.

Results

The PCA categorized stressor exposure into three components: (1) acute or traumatic line-of-duty stressors, (2) routine daily stressors, and (3) interpersonal stressors. Results of mixed models showed robust positive relationships between self-reported stressor exposure and corresponding perceived stress across all 3 components. Dispositional mindfulness (but not resilience) moderated the association between stressor exposure and perceived stress for routine stressors, such that individuals with higher dispositional mindfulness showed a relatively attenuated relationship between exposure to routine daily stressors and resulting perceived stress.

Conclusions

Police officers high in dispositional mindfulness may experience daily routine stressors as less stressful, which can reduce the accumulation of general stress in the long term and which could help buffer against negative health outcomes associated with perceived stress.

Trial registration

Clinicaltrials.gov/ct2/show/NCT03488875

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-021-01707-4.

The Joyful Life: An Existential-Humanistic Approach to Positive Psychology in the Time of a Pandemic

In the midst of a global pandemic, psychology has a duty to identify dispositional or character traits that can be cultivated in citizens in order to create resiliency in the face of profound losses, suffering and distress. Dispositional joy holds some promise as such a trait that could be especially important for well-being during the current pandemic and its consequences. The concept of the Joyful Life may operate as bridge between positive psychology and humanistic, existential, and spiritual views of the good life, by integrating hedonic, prudential, eudaimonic and chaironic visions of the good life. Previous phenomenological research on state joy suggests that momentary states of joy may have features that overlap with happiness but go beyond mere hedonic interests, and point to the experience of a life oriented toward virtue and a sense of the transcendent or the sacred. However, qualitative research on the Joyful Life, or dispositional joy, is sorely lacking. This study utilized a dialogical phenomenological analysis to conduct a group-based analysis of 17 volunteer students, who produced 51 autobiographical narrative descriptions of the joyful life. The dialogical analyses were assisted by integration of the Imagery in Movement Method, which incorporated expressive drawing and psychodrama as an aid to explicate implicit themes in the experiences of the participants. The analyses yielded ten invariant themes found across the autobiographical narrative descriptions: Being broken, being grounded, being centered, breaking open, being uplifted, being supertemporal, being open to the mystery, being grateful, opening up and out, and being together. The descriptions of a Joyful Life were consistent with a meaning orientation to happiness, due to their emphasis on the cultivation of virtue in the service of a higher calling, the realization of which was felt to be a gift or blessing. The discussion examines implications for future research, including the current relevance of a joyful disposition during a global pandemic. Due to the joyful disposition's tendency to transform suffering and tragedy into meaning, and its theme of an orientation to prosocial motivations, the Joyful Life may occupy a central place in the study of resiliency and personal growth in response to personal and collective trauma such as COVID-19.

Regulatory Resources and Emotional States in Overcoming Difficulties of Self-organization During Lockdown

The research aimed to study the characteristics of the joint influence of conscious self-regulation and emotional states on life self-organization during a lockdown and identify the factors that contribute to overcoming emerging difficulties. It was conducted online, using the block site builder Tilda Publishing (tilda.ws) and a Google Forms survey administration application. The empirical structural model of regulatory and emotional predictors of self-organization during the lockdown shows that conscious self-regulation in conditions of imposed self-isolation acts as a universal resource for successful self-organization, managing the difficulties of reorganizing one's life, and coping with the anxiety of uncertainty. Positive and negative emotional states affect these processes differently. Optimism significantly contributes to conscious self-regulation, indirectly supporting successful self-organization of life and preventing the development of accomplishments. We identified the regulatory factor ("Cito-resource of self-regulation"), which plays a crucial role in overcoming self-organization difficulties during a lockdown. This factor is represented by the regulatory indicators of modeling significant conditions for achieving goals and reliability. The higher its development, the easier it is for a person to manage the difficulties of self-organization and cope with anxiety caused by uncertainty. Conscious self-regulation acts as a resource for the self-organization of human life in the lockdown conditions, providing a flexible adjustment of behavior to new challenges. High self-regulation and successful self-organization, acting as a resource of stress protection, increases the ability to maintain health. An optimistic attitude, in its turn, positively affects the conscious self-regulation of human activity.

Self-distancing and Avoidance Mediate the Links Between Trait Mindfulness and Responses to Emotional Challenges

Objectives

Mindfulness has been linked to better emotion regulation and more adaptive responses to stress across a number of studies, but the mechanisms underlying these links remain to be fully understood. The present study examines links between trait mindfulness (Five Facets of Mindfulness Questionnaire; FFMQ) and participants' responses to common emotional challenges, focusing specifically on the roles of reduced avoidance and more self-distanced engagement as key potential mechanisms driving the adaptive benefits of trait mindfulness.

Methods

Adults (n = 305, age range: 40-72) from the Second Generation Study of the Harvard Study of Adult Development completed two laboratory-based challenges - public speaking combined with difficult math tasks (the Trier Social Stress Test) and writing about a memory of a difficult moment. State anxiety and sadness were assessed immediately before and after the two stressors. To capture different ways of engaging, measures of self-distancing, avoidance, and persistent worry were collected during the lab session.

Results

As predicted, individuals who scored higher on the FFMQ experienced less anxiety and persistent worry in response to the social stressors. The FFMQ was also linked to less anxiety and sadness when writing about a difficult moment. The links between mindfulness and negative emotions after the writing task were independently mediated by self-distanced engagement and lower avoidance.

Conclusions

Affective benefits of trait mindfulness under stress are associated with both the degree and the nature of emotional engagement. Specifically, reduced avoidance and self-distanced engagement may facilitate reflection on negative experiences that is less affectively aversive.

Trait mindfulness is negatively associated with distress related to COVID-19

Research suggests that mindfulness is associated with psychological health including a healthier response to stressors.

Objective

This research tested associations between trait mindfulness and mental health factors related to the novel coronavirus (COVID-19).

Methods

Two studies (Study 1 N = 248 college students; Study 2 N = 300 U.S adults) assessed trait mindfulness, perceived stress and anxiety, worry about the coronavirus, and anticipated negative affect of a coronavirus diagnosis. Additionally, Study 2 assessed depressive symptoms and coping with the coronavirus.

Results

In both studies, findings indicated that individuals higher in trait mindfulness reported less stress and anxiety. Higher mindfulness in both studies was also associated with less worry about the virus and anticipating less negative affect if one gets the virus. In Study 2, trait mindfulness was negatively related to depression, and numerous associations between mindfulness and coping emerged, showing higher trait mindfulness was associated with healthier strategies in coping with coronavirus.

Conclusions

These data are consistent with research that has revealed that those who think and act more mindfully are less stressed and anxious. By revealing these associations with mindfulness in the context of a real-world, novel stressor, this research makes an important contribution to the literature.

The interactive effects of heart rate variability and mindfulness on indicators of well-being in healthcare professionals' daily working life

OBJECTIVE

Heart rate variability (HRV) and mindfulness have been described as correlates of self-regulation and well-being. The goal of the present study was to investigate their interactions from a within-person perspective in the context of work.

METHODS

Applying an ambulatory assessment approach, we studied 89 healthcare professionals across two to four work shifts. Self-reports of momentary job demands, mindfulness, and well-being (as indicated by emotional exhaustion, relaxation, and contentment) were provided three to four times a day via smartphone questionnaires. Electrocardiogram and activity sensors continuously recorded data from the beginning to the end of the shifts. Multilevel models based on 937 measurements were built for emotional exhaustion, relaxation, and contentment.

RESULTS

After controlling for covariates, including bodily movement, shift, and job demands, short-term HRV was marginally significantly related to decreased emotional exhaustion and significantly related to increased relaxation. State mindfulness was significantly related to decreased emotional exhaustion, and increased relaxation and contentment. Furthermore, HRV and mindfulness significantly interacted such that emotional exhaustion was lowest and relaxation was highest when both HRV and mindfulness were high.

CONCLUSIONS

Together, the findings provide insights into the use of HRV and mindfulness as indexes of psychophysiological regulatory resources that seemingly intensify their respective beneficial effects on the daily well-being of employees.

Does Dispositional Mindfulness Buffer the Links of Stressful Life Experiences with Adolescent Adjustment and Sleep?

According to the mindfulness stress buffering hypothesis, mindfulness protects individuals from negative effects of stress. Prior investigations focused on the potential of mindfulness for reducing internalizing symptoms for adults in the context of general stress. We provided the first test of the mindfulness stress buffering hypothesis in the context of both adolescent general stress and interparental conflict (IPC) in relation to internalizing and externalizing, as well as sleep. Participants were 150 adolescents who reported dispositional mindfulness, perceived stress, IPC, internalizing, and externalizing. Participants wore an actigraph which objectively measured sleep for a week. Results suggested a stress buffering effect of mindfulness for the effects of general stress on internalizing symptoms at trend levels. Mindfulness stress buffering was not evident in relation to externalizing or sleep, or for the effect of IPC appraisals on adjustment or sleep. Greater IPC appraisals were associated with greater sleep onset latency, but mindfulness was not associated with objective measures of sleep quality or quantity. This study indicates that mindfulness may protect adolescents from the internalizing problems that often result from general stress, but that these stress buffering effects of mindfulness may not generalize to all types of stressors or adjustment/health outcomes.

Brief mindfulness-based training and mindfulness trait attenuate psychological stress in university students: a randomized controlled trial

BACKGROUND

Psychological distress in University settings has grown and became a public health concern. In this context, contemplative practices such as mindfulness have been proposed as a strategy to help students on stress management.

METHODS

Forty university students (20 female), aged between 18 to 30 years (mean = 24.15; SD = 3.56), with no previous experience with meditation or yoga were recruited at the Federal University of Rio Grande do Norte and randomized to a mindfulness training (MT) or active control (AC) groups. We analyzed measures of anxiety, affect, stress, as well as state and trait mindfulness in order to evaluate the effects of trait mindfulness and a brief mindfulness intervention in forty healthy young students. Participants were classified as Low (n = 27, females = 13) or High (n = 13, females = 7) Trait Mindfulness by k-means clustering and compared between them using Wilcoxon sum rank test. Furthermore, the sample was randomly allocated to an AC (n = 20, females = 10) or a MT (n = 20, females = 10) group, and mixed analysis of variance was performed to analyze the effect of interventions. The mechanisms and role of trait mindfulness in the intervention was assessed by a moderated mediation analysis.

RESULTS

We found that High Trait individuals have lower anxiety trait, anxiety state and perceived stress levels. Only the MT group reduced their anxiety state and perceived stress after the intervention and increased their state mindfulness. Both groups reduced negative affect and cortisol, and no change was found in positive affect. Moderated mediation analysis showed that the training-induced change in state mindfulness mediated the increase in positive affect and the decrease in perceived stress and cortisol, regardless of trait mindfulness. For anxiety state the decrease only occurred in individuals with High Trait Mindfulness.

CONCLUSIONS

Together, these results suggest that higher trait mindfulness is associated with low levels of psychological distress and that a brief mindfulness-based intervention seems to be useful to reduce distress measures in university students.

TRIAL REGISTRATION

ReBEC, U1111-1194-8661. Registered 28 March 2017-Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-7b8yh8.

Stress and mindfulness in Parkinson's disease - a survey in 5000 patients

Many Parkinson’s disease (PD) patients notice that motor symptoms worsen during stress, and experience stress-related neuropsychiatric symptoms such as anxiety and depression. Here we investigated which personal and disease characteristics are associated with perceived stress in PD, which PD symptoms are sensitive to stress, and we assessed self-reported benefits of stress-reducing strategies such as mindfulness. We sent an online survey to the Fox Insight cohort (n = 28,385 PD patients, n = 11,413 healthy controls). The survey included specific questions about the influence of stress on PD symptoms, use of stress-reducing strategies, and several validated scales measuring perceived stress, anxiety, dispositional mindfulness, rumination, and self-compassion. We received completed surveys from 5000 PD patients and 1292 controls. Patients perceived more stress than controls. Among patients, stress was correlated with increased rumination (R = 0.65), lower quality of life (R = −0.56), lower self-compassion (R = −0.65), and lower dispositional mindfulness (R = −0.48). Furthermore, patients indicated that stress significantly worsened both motor symptoms – especially tremor – and non-motor symptoms. Physical exercise was most frequently used to reduce stress (83.1%). Mindfulness was practiced by 38.7% of PD respondents, who noticed improvement in both motor and non-motor symptoms. Among non-users, 43.4% were interested in gaining mindfulness skills. We conclude that PD patients experience greater levels of stress than controls, and that stress worsens both motor and non-motor symptoms. Mindfulness may improve PD symptom severity, with the strongest effects on anxiety and depressed mood. These findings justify further controlled studies to establish the merits of mindfulness and other stress-alleviating interventions.

Effects of a mindfulness-induction on subjective and physiological stress response in adolescents at-risk for adult obesity

BACKGROUND

Mindfulness-training may benefit stress response and stress-eating, yet few studies have experimentally tested these effects in adolescents. In this short communication, we report whether a brief mindfulness-induction affected acute stress response and stress-eating in adolescents at-risk for adult obesity. We explored disordered eating as a moderator.

METHOD

Twenty-nine adolescents (age 14 ± 2 y) at-risk for adult obesity participated in a within-subjects, randomized crossover experiment. Following a 10-minute mindfulness or neutral-induction on different days in random order, the Trier Social Stress Test adapted for adolescents was administered, followed by an ad libitum lunch meal. Physiological stress response (heart rate, blood pressure) and subjective stress response (anxiety, mindlessness) were determined with area under the curve with respect to increase. Stress-eating was measured as test meal energy consumed. Global disordered-eating and binge-eating were assessed with the Eating Disorders Examination-Questionnaire.

RESULTS

Relative to a neutral-induction, a mindfulness-induction reduced state anxiety response (p = .04). There were significant interactions of induction-type by global disordered-eating (p = .02) and binge-eating (p = .03), such that the mindfulness-induction most reduced anxiety response in adolescents with relatively lower global disordered-eating and those with no binge-eating. Induction-type also interacted with binge-eating in predicting diastolic blood pressure (p = .03). A mindfulness-induction, versus neutral-induction, most reduced diastolic blood pressure response in adolescents with binge-eating.

CONCLUSIONS

Brief mindfulness-training may alter some aspects of acute stress response, with variations by disordered-eating. Future research should test alternative mindfulness induction-types (e.g., acceptance/self-compassion) to improve our understanding of how mindfulness-training may benefit adolescents at-risk for adult obesity.

Trait mindfulness during pregnancy and perception of childbirth

Women's subjective childbirth experience is a risk factor for postpartum depression and childbirth-related posttraumatic stress symptoms. Subjective childbirth experience is influenced not only by characteristics of the childbirth itself but also by maternal characteristics. A maternal characteristic that may be associated with a more positive childbirth experience is trait mindfulness. The current study aimed to assess this association and to assess whether trait mindfulness during pregnancy had a moderating role in the possible association between non-spontaneous delivery and perception of childbirth. A subsample of 486 women, participating in a longitudinal prospective cohort study (Holistic Approach to Pregnancy and the first Postpartum Year study), completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Women completed the Childbirth Perception Scale and the Edinburgh Postnatal Depression Scale between 7 and 21 days postpartum. The mindfulness facets acting with awareness and non-reacting were significantly associated with a more positive perception of childbirth, after adjusting for covariates. Moderation analyses showed a significant interaction between acting with awareness and non-spontaneous delivery and non-judging and non-spontaneous delivery. Non-spontaneous delivery was associated with a more negative perception of childbirth for low/medium scores of acting with awareness and non-judging, but not for high scores on these mindfulness facets. Trait mindfulness during pregnancy may enhance a positive perception of childbirth. Because this is among the first studies examining the association between maternal dispositional mindfulness and perception of childbirth, future research is needed to confirm the results of the current study.

Immediate effects of meditation in college students: A pilot study examining the role of baseline attention performance and trait mindfulness

OBJECTIVE

Determine feasibility of a procedure to identify relationships between preexisting traits and immediate mindfulness meditation (MM) responses in novice college students.

PARTICIPANTS

Twenty-four novice college students participated between September 2016 and April 2017.

METHODS

We measured trait mindfulness, attention and executive function performance, and immediate MM-related changes in self-reported state mindfulness and state anxiety following a 13-min MM.

RESULTS

The procedure appeared to be feasible and acceptable to college students. Preliminary findings included increases in state mindfulness and decreases in state anxiety, which appeared to vary by level of trait mindfulness. Better attention performance correlated with greater increases in state mindfulness of body.

CONCLUSION

This pilot study demonstrated feasibility of investigating the relationship between baseline traits and college students' immediate MM responses. Using these methods, future studies can provide a unique examination of MM effects stratified by validated facets of state mindfulness of body and mind.

Effectiveness and cost-effectiveness of an electronic mindfulness-based intervention (eMBI) on maternal mental health during pregnancy: the mindmom study protocol for a randomized controlled clinical trial

Background

Mental disorders are common during the peripartum period and may have far-reaching consequences for both mother and child. Unfortunately, most antenatal care systems do not provide any structured screening for maternal mental health. As a consequence, mental illnesses are often overlooked and not treated adequately. If correctly diagnosed, cognitive behavioral therapy is currently the treatment of choice for mental illnesses. In addition, mindfulness-based interventions (MBIs) seem to represent a promising treatment option for anxiety and depression during the peripartum period. Considering the internet’s increasing omnipresence, MBIs can also be offered electronically via a (tablet) computer or smartphone (electronically based MBI = eMBI).

Objective

The current study aims to examine the clinical effectiveness and cost-effectiveness of an eMBI (the mindmom application) developed by an interdisciplinary team of gynecologists, psychologists, and midwives, teaching pregnant women how to deal with stress, pregnancy-related anxiety, and depressive symptoms. The study sample consists of pregnant women in their third trimester who screened positive for emotional distress. The mindmom study is a bicentric prospective randomized controlled trial (RCT), which is currently conducted at the University women’s hospitals of Heidelberg and Tübingen, Germany.

Methods

Within the scope of the routine prenatal care, pregnant women attending routine pregnancy care in Baden-Wuerttemberg, Germany, are invited to participate in a screening for mental distress based on the Edinburgh Postnatal Depression Scale (EPDS). Women with an EPDS screening result > 9 will be referred to one of the mindmom coordinating study centers and are offered counseling either face-to-face or via videotelephony. After an initial psychological counseling, women are invited to participate in an eMBI in their last pregnancy trimester. The study will enroll N = 280 study participants (N = 140 per group), who are randomized 1:1 into the intervention (IG) or control group (treatment as usual = TAU).

All participants are requested to complete a total of 7 digital assessments (5 visits pre- and 2 follow-up visits postpartum), involving self-report questionnaires, sociodemographic and medical data, physiological measures, and morning cortisol profiles. The primary outcome will be depressive and anxiety symptoms, measured by the Edinburgh Postnatal Depression Scale, the State Trait Anxiety Questionnaire, and the Pregnancy-Related Anxiety Questionnaire. Secondary outcomes include mindfulness, satisfaction with birth, quality of life, fetal attachment, bonding, mode of delivery, and cost-effectiveness.

Discussion

This is the first German RCT to examine the (cost-)effectiveness of an eMBI on maternal mental health during pregnancy. If successful, the mindmom app represents a low-threshold and cost-effective help for psychologically distressed women during pregnancy, thereby reducing the negative impact on perinatal health outcome.

Trial registration

Deutsches Register Klinischer Studien, German Clinical Trials Register DRKS00017210. Registered on 13 January 2020. Retrospectively registered.

Supplementary information

The online version contains supplementary material available at 10.1186/s13063-020-04873-3.

When enhanced awareness threatens: Interactive effects of domain-specific awareness and acceptance manipulations on cardiovascular indices of challenge and threat

Mindfulness includes acceptance and awareness subcomponents, and emerging theories imply that cultivating both acceptance and awareness may benefit health by diminishing stress reactivity. Yet, no prior work has examined the effects of mindful acceptance and awareness on cardiovascular markers of threat and challenge-cardiac output and total peripheral resistance-despite the unique insights these indices yield into stress-related evaluations and motivation. The current research integrates Monitor and Acceptance Theory with the Biopsychosocial Model of Challenge and Threat to elucidate how an awareness manipulation and a brief acceptance training are associated with cardiovascular stress responses underlying states of challenge and threat. Healthy young adults (N = 202) were enrolled in a 2 × 2 between-subjects experimental design manipulating both awareness (enhanced awareness vs. no enhanced awareness) and acceptance (acceptance training vs. no acceptance training) of physiological responses to a social-evaluative cold pressor test. Cardiovascular indices were recorded throughout. The combination of enhanced awareness and acceptance training led to higher cardiac output and lower total peripheral resistance (indexing greater challenge, less threat) to the cold pressor test than the combination of enhanced awareness and no acceptance training. However, the combination of no enhanced awareness and no acceptance training also led to higher cardiac output and lower total peripheral resistance than the combination of enhanced awareness and no acceptance training. These results add to a growing body of work suggesting that mindful awareness and acceptance subcomponents interact to influence stress reactivity and imply that enhanced stressor awareness without acceptance may lead to increased threat.