Mindfulness training and neural integration: differentiation of distinct streams of awareness and the cultivation of well-being1

Enhancing outcomes in IVF laboratories: navigating the human element through leadership and emotional intelligence

PURPOSE

We analyze the psychological and interpersonal aspects of in vitro fertilization (IVF) laboratory operations, highlighting how human factors such as leadership style, emotional intelligence (EI), and team dynamics influence the effectiveness of IVF treatments. We also examine the role of personality dynamics in team functioning and the adverse effects of toxic behaviors on laboratory performance and morale.

METHODS

The manuscript comprehensively reviews contemporary literature about leadership styles, EI, and team dynamics. It also includes a detailed analysis of the ramifications of their operations within IVF laboratories. The primary emphasis resides in determining how these human factors contribute to the overall efficacy of IVF treatments and following patient outcomes.

RESULTS

The findings suggest that staff well-being is not just a concern, but a critical factor in enhancing successful IVF outcomes. Leadership styles that promote emotional intelligence and healthy team dynamics significantly improve laboratory performance. On the other hand, a toxic workplace negatively impacts staff well-being and patient outcomes. The study highlights the need for management development and EI training as vital components of successful IVF laboratory operations, reassuring the audience that these measures can lead to improved outcomes.

CONCLUSION

This manuscript presents the case for an equitable operational framework that recognizes the value of soft skills and technical expertise in IVF laboratories. It underscores the significance of emphasizing the human element in reproductive medicine, proposing that by prioritizing empathy and delineating the contributions of the human factor, the field can achieve its maximum potential and enhance outcomes for staff members and patients. The pivotal role of future research in empirically substantiating the influence of these human factors in realizing successful IVF laboratories cannot be overstated, and we urge the academic community to participate actively in this crucial area of research.

Mexican American Intergenerational Research: Transformative Model of Occupational Therapy

Thirty-seven interviews of Mexican American women who crossed the border into the United States during the era of the Mexican Revolution of 1910 were analyzed using constructivist grounded theory methods. The intent is to expand the occupational therapy profession's occupational consciousness and cultivate cultural humility. Four themes emerged from the data: suffering, work, yearning for an education, and compassion for others. The findings suggest that environmental barriers such as hierarchy (patriarchy and discrimination) and physical barriers (limited access to built environments, lack of nonexploitative work opportunities, and hostile educational institutions) prevented occupational participation. Small acts of resistance through everyday living (finding joy, playing, self-sufficiency, and community organizing) were identified as facilitators of occupational participation. The research findings challenge proposed assumptions found within the occupational therapy literature: (1) humans and occupations exist as separate from their environments, and (2) work, productivity, and leisure contribute positively to health. The Transformative Model of Occupational Therapy is introduced as a decolonized framework that inextricably links individual health to community and global health. The model centers play, social participation, work, and education as occupations that contribute to the common good. These occupations are kept in equilibrium within the Four Pillars of Culture (self-determination, compassion, sustainability, and language) or the cultural values identified and derived from the stories.

Enhancing specialization of attention-related EEG power and phase synchronism brain patterns by meditation

Meditation, mental training that aims to improve one's ability to regulate their cognition, has been widely applied in clinical medicine. However, the mechanism by which meditation affects brain activity is still unclear. To explore this question, electroencephalogram data were recorded in 20 long-term meditators and 20 nonmeditators during 2 high-level cognitive tasks (meditation and mental calculation) and a relaxed resting state (control). Then, the power spectral density and phase synchronization of the electroencephalogram were extracted and compared between these 2 groups. In addition, machine learning was used to discriminate the states within each group. We found that the meditation group showed significantly higher classification accuracy and calculation efficiency than the control group. Then, during the calculation task, both the power and global phase synchronism of the gamma response decreased in meditators compared to their relaxation state; yet, no such change was observed in the control group. A potential explanation for our observations is that meditation improved the flexibility of the brain through neural plastic mechanism. In conclusion, we provided robust evidence that long-term meditation experience could produce detectable neurophysiological changes in brain activity, which possibly enhance the functional segregation and/or specialization in the brain.

Virtual Mindfulness-Based Therapy for the Management of Endometriosis Chronic Pelvic Pain: A Novel Delivery Platform to Increase Access to Care

OBJECTIVES

This study assessed the effectiveness of a virtual mindfulness-based stress reduction (MBSR) program to improve quality of life and pain in people with endometriosis.

METHODS

This was a multiple-method, before and after study design. Fifteen patients with a clinical or surgical diagnosis of endometriosis were recruited from a Canadian outpatient gynaecology clinic. Participants completed the Endometriosis Health Profile, a validated survey tool, and a pain medication use questionnaire before and after a virtual 8-week MBSR program run by an experienced social worker. A focus group was held upon completion of the program to assess participants' experiences using mindfulness for management of endometriosis symptoms. Quantitative data was analyzed with paired-samples t tests. Qualitative data was thematically analyzed.

RESULTS

A total of 67% of people enrolled completed the MBSR course (10/15). Following the MBSR program, participants had a statistically significant decrease in 4 components of the Endometriosis Health Profile: control and powerlessness (P = 0.012), emotional well-being (P = 0.048), social support (P = 0.030), and self-image (P = 0.014). There was no change in pain scores or medication use. Participants felt the program's benefits came from a sense of community, education about their condition, and application of mindfulness tools when approaching pain. Participants felt more comfortable with the virtual format over in-person sessions.

CONCLUSIONS

A virtual MBSR course can improve quality of life domains in people with endometriosis. The virtual format was effective and preferred by participants. Virtual MBSR programs may increase access to this type of care.

[Les effets de la méditation de pleine conscience sur les symptômes cognitivo- émotionnels dans le trouble cognitif léger et la maladie d'Alzheimer : une revue de littérature narrative]

La maladie d'Alzheimer se manifeste par des troubles de la mémoire et un déclin cognitif plus général, le plus souvent associés à des troubles de l'humeur et du comportement. Les traitements médicamenteux ayant une efficacité assez modeste, il apparaît nécessaire de leur associer une prise en charge non pharmacologique. La méditation de pleine conscience, qui a des effets bénéfiques sur le fonctionnement cognitif et sur l'état émotionnel, semble être une piste intéressante. Cette revue de littérature narrative se propose de recenser les études ayant testé l'efficacité d'une intervention basée sur la pleine conscience auprès de personnes souffrant de la maladie d'Alzheimer ou à risque de développer cette maladie. Il apparaît que ces interventions présentent un intérêt pour réduire les symptômes cognitifs (troubles attentionnels et mnésiques notamment) et émotionnels (affects dépressifs et anxiété en particulier). Cependant, elles nécessitent un certain nombre de modifications pour être adaptées à ce public.

Mindfulness-based interventions to support wellbeing of adults in low socio-economic settings: a realist review

BACKGROUND

Mindfulness as a modality involves training the innate human capacity for present-moment awareness with a view to cultivating a more harmonious and integrated life experience, especially in the face of hardship. Over the past four decades, the field of mindfulness has grown rapidly. Despite a substantial body of literature outlining the many benefits of mindfulness practice within a range of contexts and populations, the authors noticed that studies addressing the adaptation, application and value of mindfulness-based interventions (MBIs) for adults within socio-economically challenged setting were scant. To address this gap, we conducted a realist review of studies pertaining to MBIs within low socio-economic settings, to determine the extend and nature of research in this sector and culminating in a program theory which may be useful for the design of interventions going forward.

METHODS

We selected realist review as the methodology as it is well suited to investigating the complex nature of social interventions. The value of realist review is that the exploration of the causal relationships between the mechanisms (M) within a specific context (C) towards particular outcomes (O) offers a deeper understanding of the intervention which may assist in more effective delivery going forward. The review follows the guidelines presented by the Realist and Meta-narrative Evidence Synthesis - Evolving Standards project.

RESULTS

Of the 112 documents identified, 12 articles met the inclusion criteria. Of these 12 studies, 10 were conducted in the United States, with little representation across the rest of the globe. The interventions described in these articles were varied. We identified mechanisms that offered beneficial outcomes for participants across a range of contexts, with indications of how interventions might be adapted towards greater accessibility, acceptability, and feasibility within communities.

CONCLUSION

By reviewing the various programs in their respective contexts, we developed a program theory for implementing socio-culturally adapted MBIs in low socio-economic settings. In the future, this program theory could be tested as a means to create a sense of wellbeing for people living in low socio-economic settings.

Mindfulness attenuates the impact of worry on late-life cognitive function

Objectives: Worry has been shown to have a negative impact on many aspects of neurocognitive performance. Interestingly, research indicates mindfulness both improves aspects of cognitive ability and reduces worry symptoms. Yet, the impact of mindfulness on the relationship between worry and cognition has yet to be explored. Based on research discussed herein, we hypothesize that those with higher levels of dispositional mindfulness will have better cognitive performance than those with lower levels of dispositional mindfulness, regardless of worry level. The present study investigated the potential moderating influence of mindfulness on the relationship between worry and cognitive performance.Methods: The sample included 113 older veterans who were screened at the VA Palo Alto Health Care System in Palo Alto, CA. Cognitive domains of interest included learning and memory, processing speed, attention, working memory, and executive function. Mindfulness was assessed with the Five Facet Mindfulness Questionnaire (FFMQ), and worry symptoms were assessed using the Penn State Worry Questionnaire (PSWQ). Hypotheses were tested with multiple regression analyses using the Hayes (2003) PROCESS macro.Results: Contrary to what was hypothesized, only mindful awareness significantly moderated the relationship between worry and processing speed.Conclusion: This finding has important implications for introducing mindfulness techniques into older adults' routines to decrease worry and mitigate its negative effects on processing speed.

Mindfulness Initiatives for Students, Teachers, and Parents: a Review of Literature and Implications for Practice During COVID-19 and Beyond

The use of mindfulness in schools has greatly expanded over the past 10 years. Research has demonstrated positive psychological effects of mindfulness for students as well as teachers (Emerson et al., Mindfulness 8:1136-1149, 2017; Semple et al., Psychology in the Schools 54:29-52, 2017). Similarly, studies focusing on mindfulness interventions for parents of children with disabilities and/or psychosocial difficulties have also yielded a variety of positive outcomes, including reduced parenting stress, increases in quality of life, and improved parent-child interactions (Bögels et al., 2016; Rayan and Ahmad, Research in Developmental Disabilities 55:185-196, 2016). Although there has been a proliferation of mindfulness research, and mindfulness has become a buzzword in popular culture, it has not been systematically examined or applied as an approach to improving psychosocial functioning in children, school personnel, and families during COVID-19 and in online settings. This article provides a preliminary framework for this examination by reviewing relevant research and providing practical strategies and resources for school psychologists.

Science catching up: Experiential family therapy and neuroscience

Experiential family therapy, pioneered by Virginia Satir and Carl Whitaker, centered the experience of the "here and now," human authenticity and congruent communication in the work of psychotherapy. Their approach-often considered atypical and atheoretical-was popular for a while, then relegated as behavioral and cognitive theories developed. However, with the proliferation of modern neuroscience, particularly the field of Interpersonal Neurobiology, therapists can see neuroscience research providing hard data and respective frameworks delineating the underlying architecture for understanding the connections between the mind, emotions, behavior, and relationships. This article highlights the neurobiological mechanisms that explain why classic experiential family therapy was so powerful. The main tenets of both Carl Whitaker's symbolic experiential family therapy as well as Virginia Satir's model for peoplemaking are illuminated through the postulates and scientific findings of interpersonal neurobiology.

Implementing Mindfulness in General Life and Organizations. Validation of the Time Flow Mindfulness Questionnaire for Effective Health Management

The primary purpose of the current research was to examine the psychometric properties of the Time Flow Mindfulness Questionnaire (TFMQ), a new self-report scale designed to measure cognitive, emotional, bodily, context-related, and action-related distracting inputs experienced by the mind during three different time windows of mindfulness practice (preliminary moments, during-the-practice, after-the-practice). The 42-item scale assesses the following second-order and first-order factors: Practice (preliminary, during), Benefits (short-term, long-term) and Benefits at work. Three studies were conducted. The first study assessed the factor structure and internal consistency on a sample of 141 mindfulness practitioners. Using a two-wave lagged design on a different sample of 46 trainees attending mindfulness based stress reduction (MBSR) courses, the second study examined concurrent validity by performing correlations between the TFMQ and Five Facets Mindfulness Questionnaire (FFMQ). The third study (same sample as Study 1) examined criterion validity by testing a structural equation model wherein mindfulness practice predicts job burnout, both directly and indirectly through mindfulness benefits at work. All studies relied on anonymous surveys. Our findings suggest that the TFMQ: (a) has a factor structure consistent with the hypothesized conceptual dimensions; (b) has good concurrent validity as demonstrated by significant correlations with the FFMQ dimensions; and (c) consists of mindfulness dimensions that predict job burnout in organizations (i.e., criterion validity). The TFMQ is a valid and reliable mindfulness measure that may help (a) practitioners gain awareness of different types of inputs that potentially distract the mind and mindfulness beneficial consequences, and (b) organizations implement mindfulness in work-settings.

Randomized Trial on the Effects of a Mindfulness Intervention on Temperament, Anxiety, and Depression: A Multi-Arm Psychometric Study

Mindfulness is a mental state that can be achieved through meditation. So far, studies have shown that practicing mindfulness on a consistent and regular basis can improve attentional functions and emotional well-being. Mindfulness has recently begun to be used in the field of child development. The goal of this study is to assess if a mindfulness program may help primary school students in reducing anxiety and depression while also improving their temperamental characteristics. This multi-arm pre-post study included 41 subjects recruited in the fifth year of two primary school classes. Participants were randomly assigned to the experimental and control groups. The experimental group, but not the control group, underwent an eight-week mindfulness training. Every week, the program included 60-min group sessions. QUIT (Italian Questionnaires of Temperament) and TAD (Test for Anxiety and Depression in Childhood and Adolescence) were used to assess temperament, and anxiety and depression, respectively. Both groups were administered both instruments before and after mindfulness intervention. The mindfulness program lowered anxiety levels and was effective in changing temperament dimensions: there was an increase in social orientation (SO), positive emotionality (PE), and attention (AT), as well as a decrease in inhibition to novelty (IN) and negative emotionality. Path analysis revealed that AT may promote the improvement of both SO and IN. Similarly, PE may be promoted by the decrease of IN. Clinical implications are discussed.

The implications of parent mental health and wellbeing for parent-child attachment: A systematic review

BACKGROUND

Parent mental health and wellbeing may have implications for understanding attachment transmission. In this systematic review, we synthesise the published literature to determine the nature of the relationship between parent mental health and wellbeing and the intergenerational transmission of attachment and to provide recommendations for future research, clinical practice and intervention.

METHOD

Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, five electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on adult attachment, child attachment, and a domain of parent mental health/wellbeing. No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42020157247).

RESULTS

Eleven studies examining the impact on parent mental health and wellbeing on the intergenerational transmission of attachment were identified for inclusion in this review. Our review found preliminary evidence that parent mental health and wellbeing play a role in the intergenerational transmission of attachment. Other key findings from the review were: evidence quality is mixed due to variable measurement of attachment and mental health; studies have mostly included correlational analysis or do not utilise contemporary methodological approaches to testing mediating or moderating relationships; and literature is largely focused on psychopathology and negative factors of mental health.

CONCLUSIONS

The limited scope of parent mental health and wellbeing constructs examined in the literature, the sparse use of robust statistical analyses, and the lack of literature in general makes it difficult to draw conclusions on how and why parent mental health impacts attachment transmission. Addressing these limitations will further progress attachment-related literature and may have particular implications for attachment-informed interventions with clinical populations.

Reflecting Before, During, and After the Heat of the Moment: A Review of Four Approaches for Supporting Health Staff to Manage Stressful Events

Being a healthcare professional in both paediatric and adult hospitals will mean being exposed to human tragedies and stressful events involving conflict, misunderstanding, and moral distress. There are a number of different structured approaches to reflection and discussion designed to support healthcare professionals process and make sense of their feelings and experiences and to mitigate against direct and vicarious trauma. In this paper, we draw from our experience in a large children's hospital and more broadly from the literature to identify and analyse four established approaches to facilitated reflective discussions. Each of the four approaches seeks to acknowledge the stressful nature of health professional work and to support clinicians from all healthcare professions to develop sustainable skills so they continue to grow and thrive as health professionals. Each approach also has the potential to open up feelings of uncertainty, frustration, sorrow, anguish, and moral distress for participants. We argue, therefore, that in order to avoid unintentionally causing harm, a facilitator should have specific skills required to safely lead the discussion and be able to explain the nature, scope, safe application, and limits of each approach. With reference to a hypothetical but realistic clinical case scenario, we discuss the application and key features of each approach, including the goals, underpinning theory, and methods of facilitation.

Mindfulness and Embodiment in Family Therapy: Overview, Nuances, and Clinical Applications in Poststructural Practices

This paper discusses the inclusion of ideas from mindfulness, embodiment, and associated brain research in poststructural family therapies. Connecting research and practice across diverse fields is presented as enriching therapeutic work, increasing clinical effectiveness, and broadening options for families seeking our assistance. Ways of incorporating mindfulness and embodiment are described and offer distinctively novel practices not typically used in traditional forms of poststructural therapies. These innovative practices are illustrated by clinical work with a mother and her five-year- daughter who survived a dangerous health crisis and an extremely painful hospitalization. Therapeutic work with this family exemplifies how traumatic experiences are not always accessible through linguistic means alone. Working with interpersonal mind-body practices can uniquely contribute to relaxing the sympathetic nervous system and activating the social engagement branch of the parasympathetic nervous system. The inclusion of such practices can provide valuable opportunities to facilitate the emergence of preferred experiences of self for all family members.

Re-inhabiting one's body: A pilot study on the effects of dance movement therapy on body image and alexithymia in eating disorders

BACKGROUND

Body image disturbance and alexithymia are two core aspects of Eating Disorders (EDs). However, standard treatments for EDs do not include specific techniques to approach these issues on a bodily level. This pilot study evaluated the effects of a Dance Movement Therapy (DMT) intervention on body image and alexithymia in patients with EDs, and also explored their experience of the therapeutic process.

METHOD

14 patients with EDs were recruited from a private clinic. Seven were assigned via quasi-randomization to the DMT group and the others (n = 5) continued their treatment as usual. The length of the intervention was 14 weeks. All participants completed the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the Toronto Alexithymia Scale (TAS-20) at the beginning and at the end of the intervention. Additionally, the DMT group wrote reflective diaries about their experience at the end of each session, which were analyzed using qualitative methods.

RESULTS

Between the pre- and post-intervention, the participants of the DMT group significantly improved in Body Areas Satisfaction (effect size: 0.95) and Appearance Evaluation (effect size: 1.10), and they decreased significantly in Appearance Orientation (effect size: 1.30). A decrease in Overweight Preoccupation was observed (effect size: 0.75), however this was not statistically significant. The control group did not show significant changes in any of the MBSRQ subscales. Neither the DMT group nor the control group improved significantly in the alexithymia scores. The qualitative analysis revealed valuable insights into the participants' processes throughout the sessions. In general, participants received the DMT intervention positively. They reported improvements in their mood states and an increase in their self-awareness. They also appreciated the relationship with the group and the therapist.

CONCLUSION

These results indicate that DMT might be a complementary treatment option for EDs, as it may be able to address body image issues more effectively than verbal therapies. More studies with larger samples are needed to confirm these promising preliminary results.

The mediating role of thriving: Mindfulness and contextual performance among Turkish nurses

AIMS

To examine the role of thriving in the relationship between mindfulness and contextual performance.

BACKGROUND

Thriving has been known as one of the most important components in the professional development of nurses. Previous studies have also shown that mindfulness and contextual performance have an effective role in workplace. Yet, we still know relatively little about the underlying mechanisms that explain the relationship among mindfulness, thriving and contextual performance in a nursing context.

METHODS

Data were collected from nurses from various hospitals in Turkey (N = 398). We used the structural equation model to test the mediation model.

RESULTS

Empirical results indicate that thriving mediates the link between employee mindfulness and contextual performance.

CONCLUSIONS

This study contributes to the existing literature on thriving by explaining the mediating mechanisms through which mindfulness affects contextual performance and provides implications for practitioners by showing that employees with higher levels of mindfulness engage in more extra-role behaviours when their thriving is high.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers should pay attention to finding ways to improve mindfulness and thriving in organisations in order to increase nurses' contextual performance.

Picture This! Bringing joy into Focus and Developing Healthy Habits of Mind: Rationale, design, and implementation of a randomized control trial for young adults

Research shows that daily experiences of awe, curiosity, gratitude, joy, and love can put the average person on a trajectory of growth, success, and positive social connection, and can also prevent those who are suffering from following a downward spiral. Nonetheless, data show that most people are not functioning at optimal capacity. In fact, just 20% of people may be categorized as "flourishing," with the vast majority of people merely "languishing," at risk for mental health issues, or with clinical levels of mental health concerns. Despite the success of the Positive Psychology movement and the proliferation of Positive Psychology Interventions, the field remains in need of high quality studies that test potential mechanisms of change. The Picture This! intervention, informed by Positive Psychology principles, was designed to improve well-being and decrease depressive symptoms in young adults. This paper details the rationale, design, and implementation of a 4-group randomized control trial (RCT) to test the effectiveness of Picture This!. Specific indices of mental health and well-being (e.g., depressive symptoms, gratitude) were measured at baseline and at the conclusion of the intervention along with potential mechanisms of change (i.e., attentional bias, cognitive style), while positive emotion and general well-being were assessed daily over the 21-day intervention period. If successful, this intervention may provide critical behavioral, cognitive, and attentional tools that, once internalized, can be drawn upon for years to come.

Exploring common changes after acute mental stress and acute tryptophan depletion: Resting-state fMRI studies

Stress and low serotonin levels are important biological factors in depression and anxiety etiologies. Although studies indicate that low serotonin levels, stress, and other factors may interact in depression/anxiety psychopathology, few studies have investigated the potentially shared neural substrates. We conducted resting-state fMRI scans pre- and post-stress task, and under control and tryptophan depletion condition, to explore the common changes induced by acute mental stress (AMS) and acute tryptophan depletion (ATD). The present study targeted regions within core brain networks - default mode network, salience network, executive control network, and emotion network - reported altered in AMS and ATD, and used regional homogeneity (ReHo) and functional connectivity (FC) analyses to explore their overlapped effects. We additionally examined the relationships among core neural networks - operationalized as an index of resource allocation bias that quantifies the shift from internal to external modes of processing. We found both manipulations induced increased ReHo of the amygdala and decreased ReHo of the posterior cingulate cortex (PCC). The PCC-amygdala FC was negatively correlated with the change of negative affect, whereas the right dorsolateral prefrontal cortex and right anterior insula FC was positively associated with anxiety level. In addition, we found that a greater shift to an external mode was correlated with higher anxiety level under both conditions. Common changes induced by acute mental stress and acute tryptophan depletion confirmed our hypothesis that AMS and ATD induce changes in common neural pathways, which in turn might mark vulnerability to depression and anxiety.

Exploring the Role of Meditation and Dispositional Mindfulness on Social Cognition Domains: A Controlled Study

Research suggests that mindfulness can induce changes in the social domain, such as enhancing emotional connection to others, prosocial behavior, and empathy. However, despite growing interest in mindfulness in social psychology, very little is known about the effects of mindfulness on social cognition. Consequently, the aim of this study was to explore the relationship between mindfulness and social cognition by comparing meditators with non-meditators on several social cognition measures. A total of 60 participants (meditators, n = 30; non-meditators, n = 30) were matched on sex, age, and ethnic group, and then asked to complete the following assessment measures: Mindful Awareness Attention Scale (MAAS), Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF), Interpersonal Reactivity Index (IRI), Revised Eyes Test, Hinting Task, Ambiguous Intentions and Hostility Questionnaire (AIHQ), Hospital Anxiety and Depression Scale (HADS), and Screening for Cognitive Impairment in Psychiatry (SCIP). The results showed that meditators reported higher empathy (except for the personal distress subscale), higher emotional recognition, higher theory of mind (ToM), and lower hostile attributional style/bias. The findings also demonstrated that dispositional mindfulness (both total score assessed with MAAS and mindfulness facets using the FFMQ) was associated with social cognition, although it was not equally correlated with all social cognition outcomes, and correlation patterns differ when analyses were conducted separately for meditators and non-meditators. In addition, results showed potential predictors for each social cognition variable, highlighting non-reactivity to inner experience as a key component of mindfulness in order to explain social cognition performance. In summary, the findings indicated that the meditator sample performed better on certain qualities (i.e., empathy, emotional recognition, ToM, hostile attributional style/bias) in comparison to non-meditators and, furthermore, support the notion that mindfulness is related to social cognition, which may have implications for the design of mindfulness-based approaches for use in clinical and non-clinical settings.

How does mindfulness training improve moral cognition: a theoretical and experimental framework for the study of embodied ethics

Mindfulness meditation has been primarily studied within the context of individual's psychological well being and/or in relation to it's potential to enhance cognitive skills such as attention and working memory. However, in Buddhism, mindfulness is used as a tool to cultivate wholesome actions, and as a means to promote virtuous, prosocial qualities. In this article, we postulate that heightened awareness of physiological and mental phenomena following mindfulness training may contribute to altered processing of morally relevant information and promote moral action. We will first briefly summarize neuroscientific investigations into moral cognition, and then provide a theoretical and an experimental framework for the investigation of the relationship between mindfulness and ethical behavior.

A Cross-Sectional Study of Perceived Stress, Mindfulness, Emotional Self-Regulation, and Self-Care Habits in Registered Nurses at a Tertiary Care Medical Center

Introduction

Workplace stress and burnout may influence nurses’ physical and emotional well-being, which can impact the quality of care patients receive and their overall satisfaction with their hospitalization.

Objectives

The objectives of the study were to evaluate whether there are significant statistical relationships between nurses’ perceived stress, frequency of stressors, mindfulness, emotional self-regulation, self-care habits, and patient satisfaction scores.

Methods

The study took place over the course of 4 weeks. In this study, 340 nurse participants were surveyed using cross-sectional voluntary sampling design. The survey included previously developed and validated instruments. SAS v. 9.4 was used for statistical analysis.

Results

Significant differences were noted in average patient satisfaction scores by perceived stress; major nursing units in the Death and Dying, Conflict with Physicians, Lack of Support, and Work Load subscales of the Nursing Stress Scale; and major nursing units and dispositional mindfulness.

Conclusions

Hospital administrators can use this information in their organizations and set priorities and tailor mindfulness-based stress-reduction interventions for nursing professionals.

A Cross-Sectional Study of Stress and the Perceived Style of Decision-Making in Clinicians and Patients With Cancer

BACKGROUND AND AIMS

Perceived stress and mindfulness can impact medical decision-making in both patients and clinicians. The aim of this study was to conduct a cross-sectional evaluation of the relationships between stress, mindfulness, self-regulation, perceptions of treatment conversations, and decision-making preferences among clinicians. Also, perceptions of treatment conversations and decision-making preferences among patients with cancer were evaluated.

METHODOLOGY

Survey instruments were developed for clinicians and patients incorporating previously published questions and validated instruments. Institutional review board approval was obtained. Patients, physicians, and advanced practice providers from a tertiary referral center were asked to complete surveys. Continuous variables were evaluated for normality and then bivariate relationships between variables were evaluated using χ2, Fisher's exact test, Cochran-Mantel-Haenszel (CMH) row mean scores differ statistic, or Kruskal-Wallis tests, where appropriate. Significance was defined at P < .05. All tests were conducted using SAS v.9.4.

RESULTS

77 patients and 86 clinicians (60.1% and 43% response rates, respectively) participated in the surveys. More clinicians who reported feeling "great/good" said they always/sometimes had enough time to spend with patients (66.1%) compared to those that hardly ever/never had enough time (26.3%), χ2(1, N = 75) = 6.62, P = .0101; CMH row mean scores differ statistic). Interestingly, 40.3% of patients preferred a paternalistic style of decision-making compared to 6.3% of clinicians, χ2(2, N = 146) = 27.46, P < .0001; χ2 test. Higher levels of dispositional mindfulness (Mindful Attention Awareness Scale) were found among clinicians who reported they felt "great/good" (median = 4.5) as compared to those who reported that they were "definitely stressed/stressed out" (3.3), χ2(2, N = 80) = 10.32, P = .0057; Kruskal-Wallis test. Higher levels of emotional self-regulation (Emotional Regulation Questionnaire-Cognitive Reappraisal facet) were found among clinicians who reported they felt "great/good" (median = 31.0) compared to those who reported that they were "definitely stressed/stressed out" (20.0), χ2(2, N = 79) = 8.88, P = .0118; Kruskal-Wallis test.

CONCLUSION

In order to have meaningful conversations about treatment planning, an understanding of mental well-being and its relationship to decision-making preferences is crucial for both oncology patients and clinicians. Our results show that for clinicians, lower perceived stress was associated with higher levels of mindfulness (experiencing the present moment), emotional self-regulation, and spending more time with patients. Larger prospective studies are needed to validate these findings.

The embodied nurse: Interdisciplinary knowledge exchange between compassionate nursing and recent developments in embodied leadership studies

AIMS

To report a potential knowledge exchange between nursing studies and the results obtained from a study conducted into the attributes of embodied leadership.

BACKGROUND

Leadership theories have been applied to evaluate, improve, and train nursing practitioners in several previous studies. However, leadership research has entered a new phase where the focus is to produce sustainable leaders through authenticity and compassion, the same two characteristics identified as being of most success in emergent nursing practice. There are few studies that have indicated a knowledge exchange between the latest developments in leadership studies and nursing.

DESIGN

An exploratory and qualitative study.

METHODS

Between February 2012 - July 2012, a focused sample of 14 medical care professionals was interviewed across a chain of hospitals. The aim was to evaluate embodied leadership characteristics and understand the factors that contribute to the manifestation of these characteristics. The transcribed interviews were analysed using thematic analysis.

FINDINGS

Several factors that contribute to the characteristics of embodied leadership have been identified in the interviews and in subsequent literature searches on the characteristics and contributing factors found to be associated with nursing research. These could prompt a knowledge exchange.

CONCLUSION

The results suggest common ground between nursing and contemporary leadership research in the exposition of behaviours; namely, being non-judgmental, listening actively, reflective practice and embracing uncertainty. Several implications can therefore be expected through the exchange of knowledge resulting from collaboration between researchers in the two disciplines.

Regulatory role of NGFs in neurocognitive functions

Nerve growth factors (NGFs), especially the prototype NGF and brain-derived neurotrophic factor (BDNF), have a diverse array of functions in the central nervous system through their peculiar set of receptors and intricate signaling. They are implicated not only in the development of the nervous system but also in regulation of neurocognitive functions like learning, memory, synaptic transmission, and plasticity. Evidence even suggests their role in continued neurogenesis and experience-dependent neural network remodeling in adult brain. They have also been associated extensively with brain disorders characterized by neurocognitive dysfunction. In the present article, we aimed to make an exhaustive review of literature to get a comprehensive view on the role of NGFs in neurocognitive functions in health and disease. Starting with historical perspective, distribution in adult brain, implied molecular mechanisms, and developmental basis, this article further provides a detailed account of NGFs’ role in specified neurocognitive functions. Furthermore, it discusses plausible NGF-based homeostatic and adaptation mechanisms operating in the pathogenesis of neurocognitive disorders and has presents a survey of such disorders. Finally, it elaborates on current evidence and future possibilities in therapeutic applications of NGFs with an emphasis on recent research updates in drug delivery mechanisms. Conclusive remarks of the article make a strong case for plausible role of NGFs in comprehensive regulation of the neurocognitive functions and pathogenesis of related disorders and advocate that future research should be directed to explore use of NGF-based mechanisms in the prevention of implicated diseases as well as to target these molecules pharmacologically.

Effects of a Mindful Rational Living Intervention on the Experience of Destructive Emotions

The objective of this study was to measure the effects of a 90-day mindful rational living (MRL) program on the experience of destructive emotions-anger, anxiety, depression, guilt-among a normal population in a pilot trial. The MRL program combines mindfulness meditation techniques with rational emotive behavior therapy (REBT) strategies. Participants were 17 adults who completed the MRL program. Participants completed pre- and post-intervention assessments, which included scales measuring anger, anxiety, depression, guilt, rumination, shame, and subjective happiness. As hypothesized, participants showed significant decreases in anger, rumination, anxiety, depression, and shame after participating in the MRL program. There were no significant increases in subjective happiness. Findings from this pilot study provide preliminary support for the potential utility of interventions that combine mindfulness meditation with REBT strategies and can be used as the basis of future studies.

Recollections of Being in Child Expressive Arts Group Therapy: A Qualitative Study of Adult Former Clients' Conceptions of Their Therapy as Children

The current study aims to explore, through the eyes of adult former clients, the experience of being in expressive arts group therapy (EAGT) as a child. By focusing on the memories of adults, the study allowed the exploration of former clients' understanding of what the therapy was about and its effects on their lives. Semi-structured open-ended interviews were conducted with 20 adult former clients who, as children, had participated for at least one year in EAGT. Findings point toward the background of the empathic, attuned, safety, together with the fostering of the capacity to enter into spontaneous creative states, as central themes in participant' recollections of the therapeutic process. Further findings relate to the implicit and long-term quality of the therapeutic effect.

State and Training Effects of Mindfulness Meditation on Brain Networks Reflect Neuronal Mechanisms of Its Antidepressant Effect

The topic of investigating how mindfulness meditation training can have antidepressant effects via plastic changes in both resting state and meditation state brain activity is important in the rapidly emerging field of neuroplasticity. In the present study, we used a longitudinal design investigating resting state fMRI both before and after 40 days of meditation training in 13 novices. After training, we compared differences in network connectivity between rest and meditation using common resting state functional connectivity methods. Interregional methods were paired with local measures such as Regional Homogeneity. As expected, significant differences in functional connectivity both between states (rest versus meditation) and between time points (before versus after training) were observed. During meditation, the internal consistency in the precuneus and the temporoparietal junction increased, while the internal consistency of frontal brain regions decreased. A follow-up analysis of regional connectivity of the dorsal anterior cingulate cortex further revealed reduced connectivity with anterior insula during meditation. After meditation training, reduced resting state functional connectivity between the pregenual anterior cingulate and dorsal medical prefrontal cortex was observed. Most importantly, significantly reduced depression/anxiety scores were observed after training. Hence, these findings suggest that mindfulness meditation might be of therapeutic use by inducing plasticity related network changes altering the neuronal basis of affective disorders such as depression.

Dialectical behavior therapy with American Indian/Alaska Native adolescents diagnosed with substance use disorders: combining an evidence based treatment with cultural, traditional, and spiritual beliefs

This pilot study examined pre to post-change of patients in a substance use residential treatment center that incorporated Dialectical Behavior Therapy with specific cultural, traditional and spiritual practices for American Indian/Alaska Native adolescents. Specifically, the incorporation of cultural, spiritual and traditional practices was done while still maintaining fidelity to the evidence based treatment (DBT). 229 adolescents participated in the study and were given the Youth Outcome Questionnaire-Self-Report version at pre-treatment and post-treatment and the total scores were compared. The results of the research study showed that 96% of adolescents were either "recovered" or "improved" using clinical significant change criteria. Additionally, differences between the group's pre-test scores and post-test scores were statistically significant using a matched standard T-test comparison. Finally, the effect size that was calculated using Cohen's criteria was found to be large. The results are discussed in terms of the implication for integrating western and traditional based methods of care in addressing substance use disorders and other mental health disorders with American Indian/Alaska Native adolescents.

Mindfulness, Self-Compassion, Posttraumatic Stress Disorder Symptoms, and Functional Disability in U.S. Iraq and Afghanistan War Veterans

Mindfulness and self-compassion are overlapping, but distinct constructs that characterize how people relate to emotional distress. Both are associated with posttraumatic stress disorder (PTSD) and may be related to functional disability. Although self-compassion includes mindful awareness of emotional distress, it is a broader construct that also includes being kind and supportive to oneself and viewing suffering as part of the shared human experience--a potentially powerful way of dealing with distressing situations. We examined the association of mindfulness and self-compassion with PTSD symptom severity and functional disability in 115 trauma-exposed U.S. Iraq/Afghanistan war veterans. Mindfulness and self-compassion were each uniquely, negatively associated with PTSD symptom severity. After accounting for mindfulness, self-compassion accounted for unique variance in PTSD symptom severity (f(2) = .25; medium ES). After accounting for PTSD symptom severity, mindfulness and self-compassion were each uniquely negatively associated with functional disability. The combined association of mindfulness and self-compassion with disability over and above PTSD was large (f(2) = .41). After accounting for mindfulness, self-compassion accounted for unique variance in disability (f(2) = .13; small ES). These findings suggest that interventions aimed at increasing mindfulness and self-compassion could potentially decrease functional disability in returning veterans with PTSD symptoms.

The New ABCs: A Practitioner's Guide to Neuroscience-Informed Cognitive-Behavior Therapy

Cognitive-behavioral therapy models are evolving to take into account the impact of physiological responses on client distress and the secondary role of conscious cognitions and beliefs in perpetuating distress and dysfunction. This article presents an accessible and practical description of a neuroscience-informed cognitive-behavior therapy model, in the hope that readers will learn how to apply this model in practice.

Brief mindfulness meditation improves mental state attribution and empathizing

The ability to infer and understand the mental states of others (i.e., Theory of Mind) is a cornerstone of human interaction. While considerable efforts have focused on explicating when, why and for whom this fundamental psychological ability can go awry, considerably less is known about factors that may enhance theory of mind. Accordingly, the current study explored the possibility that mindfulness-based meditation may improve people’s mindreading skills. Following a 5-minute mindfulness induction, participants with no prior meditation experience completed tests that assessed mindreading and empathic understanding. The results revealed that brief mindfulness meditation enhanced both mental state attribution and empathic concern, compared to participants in the control group. These findings suggest that mindfulness may be a powerful technique for facilitating core aspects of social-cognitive functioning.

Metacognitive model of mindfulness

Mindfulness training has proven to be an efficacious therapeutic tool for a variety of clinical and nonclinical health problems and a booster of well-being. In this paper we propose a multi-level metacognitive model of mindfulness. We postulate and discuss following hypothesis: (1) mindfulness is related to the highest level of metacognition; (2) mindfulness depends on dynamic cooperation of three main components of the metacognition (metacognitive knowledge, metacognitive experiences and metacognitive skills); (3) a mindful meta-level is always conscious while the other meta-cognitive processes can occur implicitly; (4) intentionally practiced mindfulness decreases dissociations between awareness and meta-awareness; (5) components of mindful meta-level develop and change during continuous practice. The current model is discussed in the light of empirical data and other theoretical approaches to mindfulness concept. We believe that presented model provides some helpful avenues for future research and theoretical investigations into mindfulness and the mechanisms of its actions.