Changes in positive affect and mindfulness predict changes in cortisol response and psychiatric symptoms: a latent change score modelling approach

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.

Associations between mindfulness and mental health after collective trauma: results from a longitudinal, representative, probability-based survey

BACKGROUND/OBJECTIVES

Trait mindfulness (TM) may protect against post-trauma mental health ailments and related impairment. Few studies have evaluated this association in the context of collective traumas using representative samples or longitudinal designs.

DESIGN/METHOD

We explored relationships between TM and collective trauma-related outcomes in a prospective, representative, probability-based sample of 1846 U.S. Gulf Coast residents repeatedly exposed to catastrophic hurricanes, assessed twice during the COVID-19 outbreak (Wave 1: 5/14/20-5/27/20; Wave 2: 12/21/21-1/11/22). Generalized estimating equations examined longitudinal relationships between TM, COVID-19-related fear/worry, hurricane-related fear/worry, global distress, and functional impairment; ordinary least squares regression analyses examined the cross-sectional association between TM and COVID-19-related posttraumatic stress symptoms (PTSS) at Wave 1. Event-related stressor exposure was explored as a moderator.

RESULTS

In covariate-adjusted models including pre-event mental health ailments and demographics, TM was negatively associated with COVID-19-related fear/worry, hurricane-related fear/worry, global distress, and functional impairment over time; in cross-sectional analyses, TM was negatively associated with COVID-19-related PTSS. TM moderated the relationship between COVID-19 secondary stressor exposure (e.g., lost job/wages) and both global distress and functional impairment over time.

CONCLUSIONS

Results suggest TM may buffer adverse psychosocial outcomes following collective trauma, with some evidence TM may protect against negative effects of secondary stressor exposure.

The human physiology of well-being: A systematic review on the association between neurotransmitters, hormones, inflammatory markers, the microbiome and well-being

To understand the pathways through which well-being contributes to health, we performed a systematic review according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines on the association between well-being and physiological markers in four categories, neurotransmitters, hormones, inflammatory markers, and microbiome. We identified 91 studies. Neurotransmitter studies (k_{number of studies}=9) reported only a possible positive association between serotonin and well-being. For the hormone studies (k = 48), a lower momentary cortisol level was related to higher well-being (meta-analytic r = -0.06), and a steeper diurnal slope of cortisol levels. Inflammatory marker studies (k = 36) reported negative or non-significant relations with well-being, with meta-analytic estimates of respectively r = -0.07 and r = -0.05 for C-reactive protein and interleukin-6. Microbiome studies (k = 4) reported inconsistent associations between different bacteria abundance and well-being. The results indicate possible but small roles of serotonin, cortisol, and inflammatory markers in explaining differences in well-being. The inconsistent and limited results for other markers and microbiome require further research. Future directions for a complete picture of the physiological factors underlying well-being are proposed.

Effects of mindfulness-based stress reduction on psychological distress in health workers: A three-arm parallel randomized controlled trial

Mindfulness-based Stress Reduction (MBSR) has shown good efficacy for improving wellbeing in employees experiencing occupational stress. However, comparisons with other interventions, longer-term follow-up, and data from varying sociocultural contexts are lacking. This three-arm, parallel randomised controlled trial (RCT) examined the effects of MBSR on psychological distress in non-physician health workers in direct contact with patients. 105 participants were randomly allocated to either: (1) MBSR (N = 35), (2) Stress Management Course (SMC; N = 34) or (3) wait-list (N = 36). Participants and those assessing outcomes were blinded to group assignment. Participants completed questionnaires pre- and post-intervention and four months after the intervention. Psychological distress was measured using the General Health Questionnaire (GHQ-12) and Outcome Questionnaire (OQ-45). Secondary outcomes included perceived stress, job satisfaction, mindfulness skills and changes in salivary cortisol. 77 participants completed measures post-intervention and 52 at 4-month follow-up. MBSR showed a post-intervention effect in reducing GHQ-12 (ß = -0.80 [SE = 1.58] p < 0.01) and OQ-45 (ß = -0.72, [SE = 5.87] p < 0.05) psychological distress, compared to SMC and in reducing GHQ-12 (ß = -1.30 [SE = 1.38] p < 0.001) and OQ-45 (ß = -0.71, [SE = 5.58] p < 0.01) psychological distress compared to wait-list condition. In our secondary outcome, only MBSR was associated with a decrease in the cortisol awaking response by 23% (p < 0.05). At follow-up, only effects of MBSR on the psychological distress 'social role' subscale (ß = -0.76 [SE = 1.31] p < 0.05) remained significant, compared to SMC. In conclusion, MBSR appears useful in reducing short-term psychological distress in healthcare workers, but these effects were not maintained at follow-up. Trial registration: ISRCTN12039804.

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.

Dispositional mindfulness and mental health in Chinese emerging adults: A multilevel model with emotion dysregulation as a mediator

Using a multilevel model, this study examined emotion dysregulation as a mediator between dispositional mindfulness and mental health among Chinese emerging adults. Participants were 191 Chinese emerging adults (female = 172) between 18 and 27 years old (M = 21.06 years, SD = 2.01 years), who completed a questionnaire that assessed their dispositional mindfulness, emotion dysregulation, and mental health outcomes for three times over 12 months, with a three-month lag between each time point. Within-person analysis revealed that emotion dysregulation mediated between dispositional mindfulness and mental health outcomes, including subjective well-being and symptoms of depression and anxiety. Time was positively associated with emotion dysregulation and negatively associated with symptoms of depression and anxiety. Between-person analysis revealed that emotion dysregulation negatively mediated between dispositional mindfulness and symptoms of depression and anxiety, but not subjective well-being. These findings call attention to within-person versus between-person effects of emotion dysregulation as a mediator between dispositional mindfulness and psychological outcomes, particularly of symptoms of depression and anxiety. Attesting to the relations established in western societies, the relations are also applicable to emerging adults in the Chinese context. Evidence was thus advanced to inform translational research efforts that promote mindfulness and emotion regulation as assets of mental health.

Resilience-building module for undergraduate nursing students: A mixed-methods evaluation

In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.

Application of Mindfulness-Based Psychological Interventions in Infertility

Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.

Do I really feel better? Effectiveness of emotion regulation strategies depends on the measure and social anxiety

BACKGROUND

Effective emotion regulation (ER) is important to long-term healthy functioning, but little is known about what constitutes effective ER in the moment or how social anxiety symptoms and different strategies influence short-term effectiveness outcomes.

METHODS

Intensive ecological momentary data from N = 124 college students illustrate how different ways of operationalizing ER effectiveness leads to different conclusions about the short-term effectiveness of different strategies in daily life.

RESULTS

When effectiveness is operationalized as the degree to which participants judged that their ER attempts made them feel better, social anxiety severity was negatively associated with effectiveness, and avoidance-oriented strategies were judged to be less effective than engagement-oriented strategies. In contrast, when effectiveness is operationalized as the degree of change in self-reported affect following ER attempts, social anxiety severity was not related to effectiveness, and avoidance-oriented strategies were more effective than engagement-oriented strategies. Social anxiety and ER strategy type did not interact in either model, regardless of how effectiveness was measured.

CONCLUSIONS

The study highlights discrepancies when examining two common but distinct ways of measuring the same overarching effectiveness construct, and raises intriguing questions about how forms of psychopathology that are intimately tied to emotion dysregulation, like social anxiety, moderate different ways of measuring the effectiveness of ER attempts.

Cortisol profiles differentiated in adolescents and young adult males with fragile X syndrome versus autism spectrum disorder

BACKGROUND

Fragile X syndrome (FXS) and non-syndromic autism spectrum disorder (ASD) are distinct disorders with overlapping behavioral features. Both disorders are also highly associated with anxiety with abnormal physiological regulation implied mechanistically. Some reports suggest atypical hypothalamus-pituitary-adrenal (HPA) axis function, indexed via aberrant cortisol reactivity, in both FXS and non-syndromic ASD. However, no study has compared cortisol reactivity across these two disorders, or its relationship to ASD symptom severity.

METHODS

Cortisol reactivity (prior to and following a day of assessments) was measured in 54 adolescent/young adult males with FXS contrasted to 15 males with non-syndromic ASD who had low cognitive abilities.

RESULTS

Greater ASD symptom severity was related to increased cortisol reactivity and higher levels at the end of the day, but only in the non-syndromic ASD group. Elevated anxiety was associated with increased HPA activation in the group with FXS alone.

CONCLUSIONS

Taken together, findings suggest a unique neuroendocrine profile that distinguishes adolescent/young adult males with FXS from those with non-syndromic ASD. Severity of ASD symptoms appears to be related to cortisol reactivity in the non-syndromic ASD sample, but not in FXS; while anxiety symptoms are associated with HPA activation in the FXS sample, but not in ASD despite a high prevalence of ASD, anxiety and physiological dysregulation characteristic in both populations.

Dispositional Mindfulness and Psychological Health: a Systematic Review

Interest in the influence of dispositional mindfulness (DM) on psychological health has been gathering pace over recent years. Despite this, a systematic review of this topic has not been conducted. A systematic review can benefit the field by identifying the terminology and measures used by researchers and by highlighting methodological weaknesses and empirical gaps. We systematically reviewed non-interventional, quantitative papers on DM and psychological health in non-clinical samples published in English up to June 2016, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A literature search was conducted using PsycINFO, PubMED, Medline and Embase, and 93 papers met the inclusion criteria. Within these, three main themes emerged, depicting the relationship between DM and psychological health: (1) DM appears to be inversely related to psychopathological symptoms such as depressive symptoms, (2) DM is positively linked to adaptive cognitive processes such as less rumination and pain catastrophizing and (3) DM appears to be associated with better emotional processing and regulation. These themes informed the creation of a taxonomy. We conclude that research has consistently shown a positive relationship between DM and psychological health. Suggestions for future research and conceptual and methodological limitations within the field are discussed.

Test Anxiety and Salivary Cortisol Levels in Nursing Students

Stress, in the form of test anxiety, inhibits examination performance essential to nursing success. Salivary cortisol, a biomarker of stress, was obtained before 3 examinations and 1 nursing didactic class from a sample of baccalaureate nursing students in a midwestern US university. Significant differences were found between cortisol sampling events and by junior or senior status. These findings suggest that diverse examinations and program level yield differences in stress for students.

Threat to democracy: Physical and mental health impact of democracy movement in Hong Kong

BACKGROUND

This study examined the prevalence and critical predictors of anxiety and depressive symptoms and self-rated health, following the Umbrella Movement in Hong Kong.

METHODS

Random digit dialing recruited a population-representative sample of 1208 Chinese Hong Kong citizens (mean age=46.89 years; 63% female) in the first two weeks of February 2015. Respondents gave their informed consent and reported personal, social, and economic resource loss since the Umbrella Movement (Conservation of Resources-Evaluation), current anxiety symptoms (State-Trait Anxiety Inventory) and depressive symptoms (Patient Health Questionnaire-9), and self-rated health (1=very good, 4=very bad).

RESULTS

A total of 47.35% (95% CI=44.55, 50.17) respondents reported moderate/severe anxiety symptoms and 14.4% (95% CI=12.54, 16.50) reported moderate/severe depressive symptoms; 9.11% (95% CI=7.61, 10.86) reported "poor" or "very poor" health. Multivariable regressions revealed that personal and social resource loss was associated with higher anxiety and depressive symptoms and greater odds of "very poor" health (adjusted odds ratios/incidence rate ratios=5-102%), independent of lower education level and income and being unmarried.

LIMITATIONS

This study was cross-sectional in nature and thus could not determine causality from the associations between resource loss and outcome variables. Second, the telephone survey relied on self-reports; response bias and social desirability could influence respondents' answers and discount data validity. Third, potential confounders such as preexisting mental and physical health issues and concurrent predictors like exposure to the Umbrella Movement were not assessed.

CONCLUSIONS

This is one of the first studies following any recent political movement (e.g., The Arab Spring) to quantify distress and the associated correlates of distress among affected citizens. Perceived psychosocial resource losses were critical predictors of poor outcomes.