Experiential acceptance and trait-mindfulness as predictors of analogue post-traumatic stress

Trait Mindfulness Moderates Treatment Outcomes in a Randomized Controlled Trial of Mantram Repetition Program for Veterans with Post-Traumatic Stress Disorder

Objectives: This secondary analysis examined five facets of mindful awareness as potential moderators of clinical outcomes using data from a randomized controlled trial (RCT) that compared Mantram Repetition Program (MRP) with present-centered therapy (PCT) in veterans with post-traumatic stress disorder (PTSD). Methods: Data were examined from 173 veterans with military-related PTSD randomly assigned to receive eight sessions of MRP (n = 89) or PCT (n = 84). Clinician-administered and self-report measures of mindfulness (Five Facet Mindfulness Questionnaire [FFMQ]), PTSD severity, insomnia symptoms, and depression symptoms, and were obtained pre- and post-intervention. Hierarchical regressions were used to test for FFMQ moderation on clinical outcomes within the two treatment groups. Results: For those with greater ability to "describe their internal experience" (+1 standard deviation [SD]), MRP was associated with lower PTSD hyperarousal symptoms post-intervention than PCT (p < 0.001). For those with lower "nonreactivity to internal stimuli" (-1 SD), MRP was associated with greater reductions in PTSD avoidance and numbing symptoms and insomnia compared with PCT (all ps < 0.002). Conclusions: Pre-intervention mindfulness domains of "describe" and "nonreactivity to inner experience" differentially predicted improvements in PTSD and insomnia symptoms for MRP as compared with PCT subjects. The FFMQ may be an important tool for predicting patient preparedness for mindfulness-based interventions, such as MRP.

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.

Relationships Between Burnout, Secondary Traumatic Stress, Mindfulness, and Self-Compassion in Victim Advocates

Victim advocates experience burnout and secondary traumatic stress (STS) in response to their exposure to trauma at work. Mindful awareness may serve as a protective factor against these negative outcomes. The current study examined a sample of 133 victim advocates from across the country to better understand and predict STS and burnout. Higher mindful awareness was found to be associated with lower STS and burnout, even when controlling for other best-known predictors. Self-compassion partially mediated these relationships. These findings support further research exploring the effects of mindful awareness training for victim advocates to reduce STS and burnout.

Trait mindfulness and emotion regulation responsiveness to negative affect in daily life

Objectives

Recent conceptualizations of adaptive emotion regulation is predicated on the ability to flexibly use emotion regulation strategies to meet changing contextual demands. Although trait mindfulness has been linked to enhanced emotional well-being and use of adaptive emotion regulation strategies, there is a dearth of literature examining associations between trait mindfulness and emotion regulation flexibility. Further, despite a rich literature suggesting that emotion regulation processes change with age, no study to date has assessed whether the role of trait mindfulness on emotion regulation responsiveness to negative emotions-a component of emotion regulation flexibility-differs between young and older adults.

Methods

The current study recruited 130 young adults and 130 older adults to assess trait mindfulness, emotion regulation strategy use, and emotion regulation responsiveness of six distinct strategies in daily life.

Results

Across the full sample, trait mindfulness was related to reduced distraction (β = -0.11, t(238.09) = -3.02, p = .003) and expressive suppression (β = -0.15, t(237.70) = -4.62, p < .001) strategy use. Age moderation analyses revealed that trait mindfulness was associated with reduced expressive suppression responsiveness (β = 0.12, t(247) = 2.31, p = .022) in young adults and increased detached reappraisal responsiveness among older adults (β = 0.15, t(247) = -2.95, p = .003).

Conclusions

The current findings highlight the importance of understanding how trait mindfulness is associated with strategy use and responsiveness to negative affect changes in daily life as well as how these patterns may shift across the lifespan.

Manuscript Pre-registration

Open Science Framework, registration number: z5g8v.

Association between trait mindfulness and symptoms of post-traumatic stress: A meta-analysis

Mindfulness is characterized by skills such as heightened awareness and acceptance of internal experiences, which may be helpful for people who have experienced trauma. The consistency and strength of the relationship between trait mindfulness and PTSD symptomology, however, is unknown. Studies were included in this review if they were published in an English language peer-reviewed journal, reported on a correlational relationship between validated measures of mindfulness and PTSD, and all participants were over the age of 18. A random effects meta-analysis showed that there was a robust, pooled relationship between total mindfulness and PTSD (r₊ = -0.39, 95% CI [-0.47 to -0.30]), based on 35 datasets with 13,370 participants, with low risk of publication bias. Sixteen articles reported on facets of mindfulness and PTSD symptomology [5,206 to 5,600 participants]: the strongest associations were with Act with Awareness (r₊ = -0.37) and Non-judge (r₊ = -0.37), followed by Describe (r₊ = -0.22) and Non-react (r₊ = -0.21). Observe was not significantly associated with PTSD symptoms. Results from this analysis suggest that people who are more mindful also report fewer symptoms of PTSD ; the strength of the relationship varies across mindfulness facets. There was high heterogeneity across studies.

Mindfulness and Posttraumatic Stress Disorder Symptom Severity in Urban African-American High School Students

OBJECTIVES

The aim of the current study was to examine the relations among mindfulness, posttraumatic stress disorder (PTSD) symptom severity, and stressful life events (SLEs) in African-American urban adolescents. Another aim was to examine mindfulness as a moderator of the relation between SLEs and PTSD symptom severity in this population.

METHOD

Eighty-eight African-American high school students from a low-income urban community completed measures of demographics, PTSD symptom severity, SLEs, and mindfulness.

RESULTS

Mindfulness was significantly negatively related to PTSD symptom severity, r(86) = -.70, p < .001, 95% CI [-.58, -79], and SLEs were significantly positively related to PTSD symptom severity, r(86) = .29, p = .003, 95% CI [.09, .47]. Mindfulness was an independent predictor of PTSD symptom severity after accounting for SLEs, B = -1.16, t(84) = -9.06, p < .001, 95% CI [-1.41, -0.90], and SLEs were an independent predictor of PTSD symptom severity after accounting for mindfulness, B = 0.49, t(84) = 2.92, p = .004, 95% CI [0.16, 0.82]. Mindfulness did not moderate the relation between SLEs and PTSD symptom severity, B = -.003, t(84) = -0.15, p = .89, 95% CI [-.04, .03].

IMPLICATIONS

This study has implications for both mindfulness as a potential protective factor against PTSD symptom severity and SLEs as a potential risk factor for increased PTSD symptom severity in African-American urban adolescents.

Mindfulness as a mediator between trauma exposure and mental health outcomes: Results from the National Health and Resilience in Veterans Study

OBJECTIVE

Exposure to traumatic life events is associated with increased risk of posttraumatic stress disorder (PTSD) and other mental health problems such as suicidal ideation (SI), alcohol use disorder (AUD), and decreased quality of life (QOL). Mindfulness, which involves attending to the present moment, may help individuals cope with traumatic events by increasing acceptance of trauma-related experiences and decreasing trauma-related negative affect and avoidance of trauma reminders. The current study evaluated whether mindful attention to the present moment mediated the association between number of lifetime traumas and mental health.

METHOD

The sample consisted of 1,268 trauma-exposed U.S. veterans who participated in the National Health and Resilience in Veterans Study, a nationally representative study of U.S. veterans. On average, the sample was 60.6 years of age (SD = 15.2, range = 20-94), predominantly male (89.8%), Caucasian (75.0%), and noncombat veterans (59.2%).

RESULTS

Path analyses revealed that mindfulness partially mediated the relation between number of lifetime traumas and PTSD symptoms (β = -.55), AUD (β = -.17), and QOL (β = .38), and fully mediated the relation between number of lifetime traumas and SI (β = -.36).

CONCLUSIONS

The relationship between lifetime trauma burden and various mental health issues of relevance to U.S. veterans may be mediated by mindfulness, or the ability to pay attention to the present moment. Interventions that bolster mindfulness may help mitigate the negative impact of cumulative traumas in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Dampening of positive affect is associated with posttraumatic stress following stressful life events

Background: Treatments for posttraumatic stress (PTS) are effective for many but not all people. There is a continued need to further our understanding of psychological mechanisms involved in the development and maintenance of PTS. Research has examined dysregulation of negative affect (NA) in PTS but relatively little attention has been paid to the role of dysregulation of positive affect (PA) in PTS. Objective: The current study sought to examine the incremental role of PA dysregulation - specifically self-focused and emotion-focused rumination (strategies to upregulate PA) and dampening (a strategy downregulating PA) in explaining variance in PTS, while taking into account neuroticism, plus more often-researched processes of NA regulation (i.e. brooding and reflection) and experiential acceptance and mindfulness - broader regulatory styles involved in PTS. Method: Data were available from 473 students who completed measures about stressful life events experienced, PTS, and measures of PA dysregulation and all other variables of interest. Results: Zero order correlations showed that dampening of PA but not self-focused and emotion-focused regulation of PA were associated with PTS total scores and PTS clusters of re-experiencing, avoidance, and hyperarousal. Multiple regression analyses revealed, among other things, that dampening of PA, neuroticism, brooding, and mindfulness (but not emotion-focused and self-focused rumination about PA, reflection, and experiential acceptance) explained unique proportions of variance in PTS when taking into account the shared variance between these variables. Conclusions: Future research may continue addressing difficulties in regulating PA alongside difficulties regulating NA to improve the understanding of mechanisms maintaining PTS and to examine the usefulness of interventions improving PA regulation in the treatment of PTS.

Tendency to Worry and Fear of Mental Health during Italy's COVID-19 Lockdown

Background: We tested whether the tendency to worry could affect psychological responses to quarantine by capitalizing on the opportunity of having collected data before the COVID-19 outbreak on measures of worry, anxiety, and trait mindfulness in a group of university students. Methods: Twenty-five participants completed self-report measures assessing worry (Penn State Worry Questionnaire, PSWQ), anxiety (Anxiety Sensitivity Index, ASI-3), and trait mindfulness (Mindful Attention Awareness Scale, MAAS) at T0 (pre-lockdown, 4 November 2019–17 February 2020) and T1 (at the end of lockdown, 26 April–30 April 2020). We compared assessments at the two time points in the whole sample and in high and low worriers (defined at T0 by scores on PSWQ respectively above and below 1.5 SD from mean of the Italian normative sample). Outcomes: High worriers showed at T1 a significant increase of anxiety sensitivity and fear of mental health in comparison to low worriers. Moreover, in the whole sample, at T1 trait mindfulness was inversely related to worry and fear of mental health. Interpretation: A valuable approach to support individuals experiencing anxiety related to the COVID-19 outbreak could be represented by mindfulness-based interventions improving the ability to focus attention and awareness on the present moment.

Hippocampal Functional Connectivity Mediates the Impact of Acceptance on Posttraumatic Stress Symptom Severity

Investigation in posttraumatic stress disorder (PTSD) shows a negative association between patients' degrees of acceptance (the willingness to face unwanted private experiences while pursuing one's values and goals) and those of clinical symptom severity, suggesting that experiential acceptance is a protective factor of symptoms or an early indicator of resilience after trauma. However, neural mechanisms involved in the relationship between these two variables have yet to be elucidated. Thus, we here investigate whether there are neural mechanisms mediating such relationship using whole-brain voxel-level mediation analysis with seed-based resting-state functional connectivity (RSFC) maps generated by hippocampal subregion seeds in accident survivors (n = 33). We found that the correlation between patients' acceptance and symptom severity was mediated by the RSFC strength between left hippocampal body and left lateral occipital cortex adjacent to superior parietal cortex, the areas related to flashbacks. Our result provides novel evidence that hippocampal RSFC mediates the effect of experiential acceptance on posttraumatic stress symptom severity. If further refined and validated, the finding may aid to the identification of biomarkers to intervention and prevention programs for patients with PTSD.

The contributions of affective traits and emotion regulation to internalizing disorders: Current state of the literature and measurement challenges

Dysfunctional affective processes are central to the experience of internalizing disorders (e.g., depression, anxiety, and related disorders). Specifically, extreme positive affect and elevated negative affect each have unique and robust patterns of associations with internalizing symptoms. This article examines affect as both an individual difference and a within-person dynamic process that unfolds over time. Recent research is reviewed that clarifies the hierarchical structure of affect and facet-level associations with symptoms, affect-laden traits that confer risk for internalizing psychopathology, models of emotion regulation, and how emotion regulation abilities and strategies contribute to or detract from psychological well-being. Several measurement challenges in this literature are identified and discussed, including possible conceptual and content overlap, mood-state distortion, naturalistic assessment in daily life, and the benefits and limitations of self-reported affective experience. (PsycINFO Database Record (c) 2018 APA, all rights reserved).