How do mindfulness-based interventions promote coping and self-efficacy in patients with cancer: A systematic review of qualitative and quantitative data

OBJECTIVE

The purpose of this study was to review the existing quantitative and qualitative evidence regarding how mindfulness-based interventions (MBIs) help cope with cancer-related challenges and increase affected patients' perceived self-efficacy.

METHODS

A systematic literature search was conducted on PubMed, PsycInfo, PubPsych, and CINAHL. Quantitative, qualitative, and mixed methods studies were included if they (1) evaluated MBIs (2) for patients with cancer or cancer survivors (3) regarding their impact on coping with cancer and perceived self-efficacy. The reports were screened by two independent reviewers and conflicts were resolved by a third reviewer. The review was pre-registered on PROSPERO (CRD42022368765).

RESULTS

Findings from 28 reports of 19 quantitative studies, six qualitative studies, and three mixed-methods studies (total N = 1722) were extracted and integrated. The synthesis of quantitative data showed considerable heterogeneity in outcomes and measurement instruments. Most often reported were significant positive impacts of mindfulness on general coping skills, self-regulation, and perceived efficacy in coping with cancer. Qualitative interviews with patients supported those results. The three meta-themes identified were that MBI (1) provided patients with tools to use in stressful situations, (2) promoted a general change of mindset and (3) created a feeling of social connectedness.

CONCLUSIONS

The reviewed studies suggest that MBI can promote coping and enhance the perceived self-efficacy of patients with cancer. In the future, more research investigating the different aspects of coping and the potentially moderating role of self-efficacy could provide further insights with respect to how coping and self-efficacy related to MBI.

The mechanism and effectiveness of mindfulness-based intervention for reducing the psychological distress of parents of children with autism spectrum disorder: A protocol of randomized control trial of ecological momentary intervention and assessment

BACKGROUND

Existing studies have unequivocally demonstrated that parents of children with autism spectrum disorder (ASD) experience various stressful daily life events and suffer from psychological distress. Mindfulness level is found to be an effective buffer between parents' appraisal of stress life events and psychological distress. However, the mechanism behind the function of mindfulness is unclear, and traditional mindfulness-based intervention (MBI) in experimental settings is not tailored to personal real-life needs. This study proposes to conduct a randomized controlled trial (RCT) to examine the effectiveness of MBI delivered by ecological momentary intervention (EMI) and assessed by ecological momentary assessment (EMA) in changing participants' cognitive appraisal of stressful life events and thus reducing the psychological distress of parents of children with ASD.

METHOD

The proposed study will recruit 670 parents of children with ASD and randomly assign them to the intervention and control groups (335 in each group). Participants in the intervention group will install the EMI/A app on their smartphones. In the app, participants can receive practice prompts daily, browse and practice different mindfulness exercises in the intervention library at any time, talk to a virtual counselor (chatbot) when feeling stressed, complete EMA on the cognitive appraisal of life events, and receive the log of change of psychological status daily. Participants in the control group will only receive audio-based standardized mindfulness practice instructions three times per week. The effects of MBI will be assessed based on the EMA data, right after the intervention and at the 2-month follow-up. The primary outcome will be participants' psychological distress measured by the depression anxiety stress scale. The secondary outcomes will include participants' subjective well-being, measured by the satisfaction with life scale, and level of resilience, measured by the psychological empowerment scale. Multilevel structural equational modelling will be applied to examine the pathways of the relationship between daily life events, cognitive appraisal, and psychological distress.

DISCUSSION

The potential benefit of the proposed study is to increase the psychological well-being of parents of children with ASD, and the method may extend to participants suffering from other psychological issues in the future. Trial registration: This trial has been registered on clinicaltrials.gov with the ID of NCT05746468.

The association between posttraumatic stress symptoms and suicidal ideations among Palestinians: The mediating role of spirituality, social support and mindfulness

The current study aimed to test whether social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideation among Palestinians. The study sample consisted of 520 Palestinian adults selected using online tools. The findings of the study revealed that posttraumatic stress symptoms positively correlated with suicidal ideations (r = .32, p < .01), and negatively correlated with social support (r = -.34, p < .01), spirituality (r = -.16, p < .05) and mindfulness (r = -.72, p < .01), whereas suicidal ideations negatively correlated with social support (r = -.46, p < .01), spirituality(r = -.27, p < .01) and mindfulness (r = -.72, p < .01). Results of the path analysis showed that social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideations. Developing intervention programs to enhance social support, mindfulness and spirituality to mitigate the effect of ongoing traumatic experiences among Palestinians is crucial to reducing suicidal ideations. Further studies are also recommended to investigate the role of potentially protective factors that may reduce suicidal ideations and appropriate techniques to deal effectively with traumatic and stressful events.

Relationship between mindfulness, meaning in life and post-traumatic growth among Nigerian cancer patients

Understanding the psychosocial factors that predict recovery and promote growth from trauma is critical to effective management of oncology patients. Although previous studies have shown that mindfulness and meaning in life could be predictors of post-traumatic growth (PTG), no study to date has explored the combined role of mindfulness and meaning in life in the development of PTG among cancer patients. Using a cross-sectional design, data were collected from 957 cancer patients (46.8% male, 53.2% female) who completed relevant self-report measures. Results showed that the presence of meaning in life mediated the relationship between mindfulness and PTG. However, the mediation effect of search for meaning in life was not significant. These findings indicate that the presence of meaning in life is an essential mechanism of mindfulness in facilitating PTG. Therefore, psychosocial interventions geared towards promoting PTG should consider mindfulness as a potential effective component in improving cancer patients' ability to find meaning in life and possibly promote recovery.

Measuring Mindfulness in Business School Students: A Comparative Analysis of Mindful Attention Awareness Scale and Langer's Scale

Research studies have established that mindfulness helps in psychological well-being, stress reduction, chronic pain management, behavioral therapy, and other areas including organizational development. Mindfulness often refers to a state of consciousness, but mindfulness can also be understood as a personality trait. State mindfulness is referred as the individual's capacity to cultivate a particular state of mind during meditative practice. Traits are more permanent facets of personality characteristics that are difficult to change and likely have some basis in genetics. Few scholars have criticized meditative mindfulness as a trend and cautioned that organizations should carefully consider their goals before introducing meditative mindfulness training. This dichotomy has prompted us to review the literature and carry out a comparative analysis of two divergent measurement scales of mindfulness: the Mindful Attention Awareness Scale (MAAS) and Langer's mindfulness/mindlessness scale. The MAAS is the most widely used mindfulness scale to measure mindfulness, and Langer's scale measures mindfulness/mindlessness. We developed hypotheses relating Langer's scale and the MAAS. Further, we studied whether there is any difference in mindfulness/mindlessness among business school students with an undergraduate background in engineering and nonengineering streams. Using a self-administered questionnaire, we measured the mindfulness levels of 221 MBA first- and second-year graduates and tested the hypothesis using partial least squares structural equations modeling (PLS-SEM). We found that Langer's mindfulness/mindlessness scale was negatively associated with the MAAS. We did not find any effect of gender, education, and professional specializations on mindfulness.

An Open Trial on the Feasibility and Efficacy of a Mindfulness-Based Intervention with Psychoeducational Elements on Atopic Eczema and Chronic Itch

(1) Background: Mindfulness-based interventions (MBI) are psychological group interventions conducted over several weeks. Their effects on reducing stress and improving physical and psychological health have been proven in various clinical populations. Growing evidence suggests that MBIs might be beneficial for dermatology patients. This article reports on a novel Mindfulness-based Training for chronic Skin Conditions (MBTSC) with psychoeducational elements that was developed with the goal of improving self-regulation including stress management and emotion regulation in patients and to help in coping with disease symptoms such as itch and scratching. The intervention was tested in a pilot efficacy trial in order to examine feasibility and to collect preliminary data on the effectiveness of the intervention on disease severity including itch perception and on psychological distress in an atopic dermatitis (AD) sample. (2) Methods: Following an uncontrolled pre-test-post-test design based on standardized self-report measures, nine adult AD patients were recruited from a dermatology clinic. Data were collected at baseline, post-treatment and 3 month follow-up. Patients completed questionnaires assessing disease severity, itch perception, stress, anxiety and depression, mindfulness and intervention acceptability. The 7 week intervention included seven weekly sessions and a daily home-practice requirement, supported by guided audio-meditations and reading material. (3) Results: Quantitative data showed improvements in disease severity, itch perception and stress levels with small to medium effect sizes. Psychological distress increased at post-treatment—significantly in the case of depression. Qualitative data highlighted the mixed effects of MBTSC on symptoms. Treatment acceptability was high and 100% of the participants completed the intervention; (4) Conclusions: These data indicate that MBTSC is feasible and that it might be a useful tool as adjunct therapy for AD. Further studies with larger samples and control groups are needed.

Mindfulness Practice Is Associated With Subjective Wellbeing Homeostasis Resilience in People With Crohn's Disease but Not Ulcerative Colitis

OBJECTIVES

People with Crohn's disease and ulcerative colitis (inflammatory bowel disease: IBD), commonly experience high levels of depressive symptoms and stress and low levels of subjective wellbeing (SWB). Mindfulness is increasingly considered an adjuvant IBD treatment. The relationships between depression, disease symptoms and mindfulness have not previously been considered within the theory of SWB homeostasis. This theory states that SWB is normally maintained by a homeostatic system around a setpoint range but can fail when psychological challenges dominate consciousness. This study explored the relationship among SWB and patient-reported psychological and IBD symptoms and investigated whether mindfulness practice is independently associated with SWB homeostatic resilience.

DESIGN

This cross-sectional study recruited participants through online IBD support groups.

METHODS

Participants (n = 739; 62% Crohn's disease) detailed symptoms of depression and stress, patient-reported disease symptoms, and regularity of mindfulness practice.

RESULTS

The sample had significantly lower SWB (hedges g = -0.98) than normative data. A logistic regression found mindfulness practice doubled the Crohn's disease participants' odds of reporting SWB within the normal homeostatic range, after controlling for psychological, physical, and demographic variables (OR 2.15, 95% CI: 1.27, 3.66). A one-point increase of patient-reported bowel symptoms reduced the participant's odds of reporting SWB in the normal homeostatic range by about a third (OR 0.66, 95% CI: 0.50, 0.85). However, the influence of mindfulness or disease symptoms on SWB was not observed for people with ulcerative colitis.

CONCLUSION

These findings provide initial evidence for an association between mindfulness and SWB homeostatic resilience in a clinical population.

The Effectiveness of Mindfulness-Based-Stress-Reduction for Military Cadets on Perceived Stress

This study aimed to develop a program of mindfulness-based stress reduction for military cadets (MBSR-MC). On the basis of a pretest-posttest design, participants were assigned to either a control or an experimental group to examine the effectiveness of MBSR-MC. First, 60 volunteering cadets of National Defense University were randomly assigned to the MBSR-MC group (n = 30) and the control group (n = 30). In the pretest, all participants were required to complete the Taiwanese version of the Five Facet Mindfulness Questionnaire (T-FFMQ) and a perceived stress scale (PSS). Subsequently, the MBSR-MC group participated in the 8-week MBSR-MC program, whereas the control group did not receive any experimental treatment. One week following the completion of the program, a posttest consisted of the same questions as the pretest was conducted. Statistical analysis showed that (1) Comparing with the control group, the MBSR-MC group showed superior performance in three subscales of T-FFMQ, namely Acting with awareness, Non-judgment, and Non-reactivity. However, no significant difference was found in the remaining two facets: Observing and Describing. (2) The perceived stress score of the MBSR-MC group was significantly lower than that of the control group. Furthermore, an analysis of mediating effect showed that Acting with awareness, Non-judgment, and Non-reactivity were mediating variables of the relationship between MBSR-MC and perceived stress. The aforementioned results indicated that MBSR-MC training significantly increased military cadets' Acting with awareness, Non-judgment, and Non-reactivity, thereby significantly reducing their perceived stress. Therefore, this study supported the effectiveness of the MBSR-MC program on perceived stress.

Adapting Mindfulness Training for Military Service Members With Chronic Pain

INTRODUCTION

Rates of chronic pain in military personnel are disproportionately high. Chronic pain is often associated with mental health and substance use disorders as comorbid conditions, making treatment of chronic pain complex. Mindfulness-based interventions (MBIs) are a promising behavioral approach to managing chronic pain and psychosocial sequelae. The unique nature of the military context may require adaptations to original MBIs for successful delivery in active-duty military populations. This study adapted the mindfulness-based stress reduction (MBSR) program to create a mindfulness training program that was relevant to active-duty Army personnel experiencing chronic pain. This article delineates the adaptation process employed to modify the MBSR program to the military context and discusses the resulting training program.

MATERIALS AND METHODS

The adaptation process consisted of three iterative stages: 1) Drafting the preliminary intervention protocol with recommendations from stakeholders, including military healthcare providers; 2) Refining the preliminary protocol after pretesting the sessions with research team members and a military Veteran advisory committee; and 3) Delivering the preliminary protocol to one cohort of active-duty Soldiers with chronic pain, collecting feedback, and further refining the intervention protocol.

RESULTS

Military-related adaptations to MBSR addressed three areas: military culture, language and terminology, and practical and logistical factors relevant to implementation in the military setting. This adaptation process resulted in a live, online program with six, weekly, sessions. Feedback from a military Veteran advisory committee resulted in modifications, including increasing military-relevant examples; preliminary testing with the target population resulted in additional modifications, including shortening the sessions to 75 min and structuring discussions more efficiently.

CONCLUSIONS

The adaptation process was successful in generating an engaging mindfulness training program that was highly relevant to the military context. Obtaining input from stakeholders, such as military healthcare providers and active-duty soldiers, and iterative feedback and modification, were key to the process. Moreover, the program was designed to maintain the integrity and core elements of MBIs while adapting to military culture. A future randomized controlled trial design will be used to evaluate the effectiveness of the intervention in improving chronic pain in military personnel. This program is responsive to the military's call for nonpharmacologic treatments for chronic pain that are easily accessible. If effective, the mindfulness program has the potential for widespread dissemination to complement standard care for Service Members experiencing chronic pain.

The dynamic relationship between state mindfulness and negative emotions

The current study examines the dynamic influence of state mindfulness on negative emotions in daily life, and we developed two models to investigate their dynamic relationship after controlling the role of perceived stress. One hundred participants recruited from a Chinese university reported their daily and momentary emotions and their levels of state mindfulness five times per day for an entire week. Participants provided 3,177 valid responses, accounting for 90.77% of all required responses. Using a multilevel model, we found that (a) state mindfulness at Time t + 1 mediated the association between negative emotions at t and at t + 2, and the negative emotions encompasses three aspects (anxiety, depression, and sadness), and (b) negative emotion at t + 1 significantly mediated the association between state mindfulness at t and at t + 2. The current study showed that state mindfulness and negative emotions could reciprocally weaken each other, meaning that they demonstrate a counterproductive relationship.

Psychometric properties of the transaddiction craving triggers questionnaire in alcohol use disorder

OBJECTIVES

We aimed to develop the transaddiction craving triggers questionnaire (TCTQ), which assesses the propensity of specific situations and contexts to trigger craving and to test its psychometric properties in alcohol use disorder (AUD).

METHODS

This study included a sample of 111 AUD outpatients. We performed exploratory factor analysis (EFA) and calculated item-dimension correlations. Internal consistency was measured with Cronbach's alpha coefficient. Construct validity was assessed through Spearman correlations with craving, emotional symptoms, impulsivity, mindfulness, and drinking characteristics.

RESULTS

The EFA suggested a 3-factor solution: unpleasant affect, pleasant affect, and cues and related thoughts. Cronbach's coefficient alpha ranged from .80 to .95 for the three factors and the total score. Weak positive correlations were identified between the TCTQ and drinking outcomes, and moderate correlation were found between the TCTQ and craving strength, impulsivity, anxiety, depression, and impact of alcohol on quality of life.

CONCLUSIONS

The 3-factor structure is congruent with the well-established propensity of emotions and cues to trigger craving. Construct validity is supported by close relations between the TCTQ and psychological well-being rather than between the TCTQ and drinking behaviors. Longitudinal validation is warranted to assess sensitivity to change of the TCTQ and to explore its psychometric properties in other addictive disorders.

A Tripartite Function of Mindfulness in Adjustment to Aging: Acceptance, Integration, and Transcendence

Mindfulness has been gradually incorporated into clinical intervention and personal growth. Considerable research demonstrates that mindfulness is associated with positive health and well-being outcomes. Researchers have begun to inquire into the mechanisms of mindfulness. Building on empirical and theoretical insights and Buddhist philosophy, this article argues that mindfulness can serve a tripartite function of acceptance, integration, and transcendence in adjustment to aging. More specifically, mindfulness would help older adults (a) to accept phenomenal impermanence, emotional experience, and what they are, (b) to integrate life and death and integrate the ego, and (c) to transcend the ego and develop into the self. This article concludes by highlighting the acceptance-integration-transcendence framework as a heuristic framework for practice and suggesting directions for future research on mindfulness and aging.

Trait Mindfulness Is Associated With the Self-Similarity of Heart Rate Variability

Previous studies have linked trait mindfulness with better self-regulation and adaptation. Heart rate variability (HRV) is a good physiological indicator of the capacity for self-regulation and adaptation. The present study explored the relationship between trait mindfulness and HRV from the viewpoint of crosstalking between different HRV parameter pairs, which would reflect the dynamic interactions between each pair of HRV parameters in different processes. We measured the trait mindfulness of seventy-four undergraduate students and recorded nine HRV parameters during the following four consecutive experimental phases: (1) calming phase, (2) mental arithmetic task phase, (3) recovery phase, and (4) mindfulness practice phase. The relationship between trait mindfulness and HRV was explored at the following three levels: (1) the absolute level, i.e., HRV parameters in four different states, (2) the difference-change level, i.e., differences in HRV parameters between different states, and (3) the crosstalking level, i.e., self-similarity of crosstalking HRV parameter pairs. The results supported the following hypothesis: trait mindfulness, as measured by the Mindful Attention Awareness Scale (MAAS), was significantly and positively correlated with the self-similarity of crosstalking HRV parameter pairs but was not significantly correlated with the HRV parameters at the difference-change and absolute levels. These findings indicate that as trait mindfulness increases, the ability to maintain ANS function homeostasis improves. HIGHLIGHTS -Trait mindfulness is associated with better self-regulation and adaptation.-Heart rate variability (HRV) is a good physiological indicator of the capacity for self-regulation and adaptation.-Trait mindfulness is significantly correlated with self-similarity of crosstalking HRV parameter pairs but not with the HRV parameters at the difference-change or absolute levels.

Perceived stress mediates the relationship between mindfulness and negative affect variability: A randomized controlled trial among middle-aged to older adults

Despite the interest in mindfulness over the past 20 years, studies have only recently begun to examine mindfulness in older adults. The primary aim of this study was to evaluate pretreatment to post-treatment change in negative affect variability (NAV) following a mindfulness training among 134 mildly stressed, middle-aged to older adults. The secondary aim was to assess if the effects of mindfulness training on NAV would be partially explained by pretreatment to post-treatment reductions in perceived stress, a trend that would be congruent with several stress models. In this randomized control trial, participants were assigned to either a 6-week mindfulness meditation training programme or to a wait list control. Ecological momentary assessment, a data capturing technique that queries about present moment experiences in real time, captured NAV. Mixed-model ANOVAs and a path analysis were conducted. Participants in the mindfulness meditation training significantly reduced NAV when compared with wait list control participants. Further, there was a significant indirect group effect on reductions in NAV through change in perceived stress. Few studies have tested mechanisms of action, which connect changes that occur during mindfulness training with psychological outcomes in older adults. Understanding the mechanisms by which mindfulness enhances well-being may optimize interventions.

Positive psychological states in the arc from mindfulness to self-transcendence: extensions of the Mindfulness-to-Meaning Theory and applications to addiction and chronic pain treatment

The Mindfulness-to-Meaning Theory (MMT) is a temporally dynamic process model of mindful positive emotion regulation that elucidates downstream cognitive-affective mechanisms by which mindfulness promotes health and resilience. Here we review and extend the MMT to explicate how mindfulness fosters self-transcendence by evoking upward spirals of decentering, attentional broadening, reappraisal, and savoring. Savoring is highlighted as a key, potential means of inducing absorptive experiences of oneness between subject and object, amplifying the salience of the object while imbuing the sensory-perceptual field with affective meaning. Finally, this article provides new evidence that inducing self-transcendent positive emotions and nondual states of awareness through mindfulness-based interventions may restructure reward processing and thereby produce therapeutic effects on addictive behavior (e.g. opioid misuse) and chronic pain syndromes.

Centeredness Theory: Understanding and Measuring Well-Being Across Core Life Domains

Background: Centeredness Theory (CT) is proposed as a new mental health paradigm that focuses on well-being at a systems-level, across the core life domains of the self, the family unit, relationships, community, and work. The current studies aimed to validate the psychometric properties of a new scale that measures CT against existing well-being and mental health measures. Methods: Study 1 included 488 anonymous online respondents (46% females, 28% males, 25% unknown with median age between 31 and 35 years) across 38 countries who completed the CT scale. Study 2 included 49 first-year psychology students (90% females, mean age of 19 years) from Sydney Australia that completed the CT scale and other well-being and mental health questionnaires at baseline and 2-weeks follow-up. Results: Exploratory and confirmatory factor analyses resulted in a refined 60-item CT scale with five domains, each with four sub-domains. The CT scale demonstrated good internal consistency reliability and test-retest reliability, and showed evidence of convergent validity against other well-being measures (e.g., COMPAS-W Wellbeing Scale, SWLS scale, and Ryff's Psychological Well-being scale). Conclusions: The CT scale appears to be a reliable measure of well-being at a systems-level. Future studies need to confirm these findings in larger heterogeneous samples.

Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective

Mindfulness-based interventions have been heralded as promising means of alleviating chronic stress. While meta-analyses indicate that mindfulness-based interventions significantly reduce global measures of stress, how mindfulness-based interventions modulate the specific mechanisms underpinning chronic stress as operationalized by the National Institute of Mental Health research domain criteria (RDoC) of sustained threat has not yet been detailed in the literature. To address this knowledge gap, this article aims to (1) review evidence that mindfulness-based interventions ameliorate each of the 10 elements of behavioral dysregulation characterizing sustained threat via an array of mindful counter-regulatory strategies; (2) review evidence that mindfulness-based interventions modify biological domains implicated in sustained threat, such as the hypothalamic–pituitary–adrenal axis, as well as brain circuits involved in attentional function, limbic reactivity, habit behavior, and the default mode network; and (3) integrate these findings into a novel conceptual framework of mindful self-regulation in the face of stress—the Mindfulness-to-Meaning Theory. Taken together, the extant body of scientific evidence suggests that the practice of mindfulness enhances a range biobehavioral factors implicated in adaptive stress coping and induces self-referential plasticity, leading to the ability to find meaning in adversity. These mechanistic findings can inform the treatment development process to optimize the next generation of mindfulness-based interventions for greater therapeutic efficacy.

Psychological Distress in Jordanian Parents of Children with Autism Spectrum Disorder: The Role of Positive Reappraisal Coping

BACKGROUND

Parents of children with autism spectrum disorder (ASD) frequently report poor psychological well-being. Positive reappraisal coping (PRC) is a coping strategy which offers a protective effect from anxiety and depression. However, the association between PRC and the psychological distress in parents of children with ASD has yet to be established.

AIM

This study examines the association between PRC and the psychological distress in parents of children with ASD.

METHOD

In this descriptive correlational study, 104 parents of children with ASD completed measures of psychological distress and PRC. Hierarchical multiple regression analysis was used to examine the association between PRC and the psychological distress in parents after controlling the influence of parental age and gender.

RESULTS

The PRC was associated with the psychological distress in parents above and beyond the variance accounted for by parental age and gender. After controlling for parental age and gender, PRC had significant negative correlation with the levels of anxiety, stress, and depression in parents (Anxiety: β=-0.36, p<0.001; Stress: β=-0.21, p=0.03; Depression: β=- 0.37, p<0.001).

CONCLUSION

Using positive reappraisal coping strategy may help to reduce psychological distress in parents of children with ASD.

Effectiveness of mindfulness-based interventions on quality of life and positive reappraisal coping among parents of children with autism spectrum disorder

BACKGROUND

Previous research has supported mindfulness-based interventions (MBIs) to enhance quality of life (QOL) in different populations, but no studies have been found to examine the effectiveness of MBIs on QOL among parents of children with ASD.

AIM

The purpose of the current study was to examine the effectiveness of brief MBI on perceived QOL and positive stress reappraisal (PSR) among parents of children with ASD.

METHODS

A quasi-experimental, with nonequivalent control group design was used. One hundred and four parents of children with ASD were equally assigned to the intervention and control groups. The study groups were matched on measures of their gender and age, and level of severity of ASD in children. The intervention group participated in MBI program for 5 weeks, while the control group had not attended the program.

RESULTS

After the intervention program, results of paired samples t-test indicated that parents in the intervention group demonstrated significant improvements in measures of psychological health domain of QOL, social health domain of QOL, mindfulness, and positive stress reappraisal with medium to large effect size (P<0.01). The control group demonstrated improvement in measures of the dependent variables with small effect size.

CONCLUSION

MBI is culturally adaptable, acceptable, and effective method to improve QOL and PSR in parents of children with ASD.

Restructuring reward processing with Mindfulness-Oriented Recovery Enhancement: novel therapeutic mechanisms to remediate hedonic dysregulation in addiction, stress, and pain

Though valuation processes are fundamental to survival of the human species, hedonic dysregulation is at the root of an array of maladies, including addiction, stress, and chronic pain, as evidenced by the allostatic shift in the relative salience of natural reward to drug reward observed among persons with severe substance use disorders. To address this crucial problem, novel interventions are needed to restore hedonic regulatory processes gone awry in persons exhibiting addictive behaviors. This article describes a theoretical rationale and empirical evidence for the effects of one such new intervention, Mindfulness-Oriented Recovery Enhancement (MORE), on top-down and bottom-up mechanisms implicated in cognitive control and hedonic regulation. MORE is innovative and distinct from extant mindfulness-based interventions in that it unites traditional mindfulness meditation with reappraisal and savoring strategies designed to reverse the downward shift in salience of natural reward relative to drug reward, representing a crucial tipping point to disrupt the progression of addiction-a mechanistic target that no other behavioral intervention has been designed to address. Though additional studies are needed, clinical and biobehavioral data from several completed and ongoing trials suggest that MORE may exert salutary effects on addictive behaviors and the neurobiological processes that underpin them.

The Applied Mindfulness Process Scale (AMPS): A process measure for evaluating mindfulness-based interventions

OBJECTIVE

Mindfulness-based interventions (MBIs) include the application of meditation and mind-body practices used to promote mindful awareness in daily life. Operationalizing the construct of mindfulness is important in order to determine mechanisms of therapeutic change elicited by mindfulness practice. In addition to existing state and trait measures of mindfulness, process measures are needed to assess the ways in which individuals apply mindfulness in the context of their practice.

METHOD

This report details three independent studies (qualitative interview, N = 8; scale validation, N = 134; and replication study, N = 180) and the mixed qualitative-quantitative methodology used to develop and validate the Applied Mindfulness Process Scale (AMPS), a 15-item process measure designed to quantify how mindfulness practitioners actively use mindfulness to remediate psychological suffering in their daily lives.

RESULTS

In Study 1, cognitive interviewing yielded a readily comprehensible and accessible scale of 15 items. In Study 2, exploratory factor analysis derived a potential three-factor solution: decentering, positive emotion regulation, and negative emotion regulation. In Study 3, confirmatory factor analysis verified better model fit with the three-factor structure over the one-factor structure.

CONCLUSIONS

AMPS functions as a measure to quantify the application of mindfulness and processes of change in the context of MBIs and general mindfulness practice.

Mindfulness Broadens Awareness and Builds Eudaimonic Meaning: A Process Model of Mindful Positive Emotion Regulation

Contemporary scholarship on mindfulness casts it as a form of purely non-evaluative engagement with experience. Yet, traditionally mindfulness was not intended to operate in a vacuum of dispassionate observation, but was seen as facilitative of eudaimonic mental states. In spite of this historical context, modern psychological research has neglected to ask the question of how the practice of mindfulness affects downstream emotion regulatory processes to impact the sense of meaning in life. To fill this lacuna, here we describe the Mindfulness-to-Meaning Theory, from which we derive a novel process model of mindful positive emotion regulation informed by affective science, in which mindfulness is proposed to introduce flexibility in the generation of cognitive appraisals by enhancing interoceptive attention, thereby expanding the scope of cognition to facilitate reappraisal of adversity and savoring of positive experience. This process is proposed to culminate in a deepened capacity for meaning-making and greater engagement with life.

Understanding individual resilience in the workplace: the international collaboration of workforce resilience model

When not managed effectively, high levels of workplace stress can lead to several negative personal and performance outcomes. Some professional groups work in highly stressful settings and are therefore particularly at risk of conditions such as anxiety, depression, secondary traumatic stress, and burnout. However, some individuals are less affected by workplace stress and the associated negative outcomes. Such individuals have been described as “resilient.” A number of studies have found relationships between levels of individual resilience and specific negative outcomes such as burnout and compassion fatigue. However, because psychological resilience is a multi-dimensional construct it is necessary to more clearly delineate it from other related and overlapping constructs. The creation of a testable theoretical model of individual workforce resilience, which includes both stable traits (e.g., neuroticism) as well as more malleable intrapersonal factors (e.g., coping style), enables information to be derived that can eventually inform interventions aimed at enhancing individual resilience in the workplace. The purpose of this paper is to introduce a new theoretical model of individual workforce resilience that includes several intrapersonal constructs known to be central in the appraisal of and response to stressors and that also overlap with the construct of psychological resilience. We propose a model in which psychological resilience is hypothesized to mediate the relationship between neuroticism, mindfulness, self-efficacy, coping, and psychological adjustment.

Mindfulness training promotes upward spirals of positive affect and cognition: multilevel and autoregressive latent trajectory modeling analyses

Recent theory suggests that positive psychological processes integral to health may be energized through the self-reinforcing dynamics of an upward spiral to counter emotion dysregulation. The present study examined positive emotion-cognition interactions among individuals in partial remission from depression who had been randomly assigned to treatment with mindfulness-based cognitive therapy (MBCT; n = 64) or a waitlist control condition (n = 66). We hypothesized that MBCT stimulates upward spirals by increasing positive affect and positive cognition. Experience sampling assessed changes in affect and cognition during 6 days before and after treatment, which were analyzed with a series of multilevel and autoregressive latent trajectory models. Findings suggest that MBCT was associated with significant increases in trait positive affect and momentary positive cognition, which were preserved through autoregressive and cross-lagged effects driven by global emotional tone. Findings suggest that daily positive affect and cognition are maintained by an upward spiral that might be promoted by mindfulness training.

Dispositional Mindfulness Co-varies with Self-Reported Positive Reappraisal

Emerging research suggests that mindfulness is associated with positive reappraisal and that mindfulness practice may be a means of encouraging positive reappraisal capacities. These findings, linking mindfulness with the promotion of cognitive coping strategies, challenge traditional Western conceptualizations of mindfulness as non-discursive. This study explored the relationship between dispositional mindfulness and self-reported positive reappraisal across five distinct samples: a general sample of American adults, contemplative practitioners, college students chronic pain outpatients, and alcohol dependent inpatient. Results indicate that dispositional mindfulness is positively related with self-reported positive reappraisal in all five studies as well as in an aggregated analysis combining all five studies. Furthermore, a second set of analyses statistically controlling for factors previously associated with positive reappraisal (i.e., psychological well-being, positive affect, and positive refocusing), provided evidence that mindfulness is uniquely associated with self-reported positive reappraisal. While more research is needed to refine our understanding of the relationship between mindfulness and positive reappraisal, the present investigation contributes to the growing evidence base supporting the hypothesized link between dispositional mindfulness and self-reported reappraisal by demonstrating a significant association between these constructs across a variety of samples and in the largest combined dataset on this phenomenon collected to date (N=819).

Cognitive and affective mechanisms linking trait mindfulness to craving among individuals in addiction recovery

The present study aimed to identify affective, cognitive, and conative mediators of the relation between trait mindfulness and craving in data culled from an urban sample of 165 persons (in abstinence verified by urinalysis) entering into residential treatment for substance use disorders between 2010 and 2012. Multivariate path analysis adjusting for age, gender, education level, employment status, and substance use frequency indicated that the association between the total trait mindfulness score on the Five Facet Mindfulness Questionnaire and alcohol/drug craving was statistically mediated by negative affect (measured by the PANAS, beta = -.13) and cognitive reappraisal (measured by the CERQ, beta = -.08), but not by readiness to change (measured by the URICA, beta = -.001). Implications for mindfulness-oriented treatment of persons with substance use disorders are discussed. The study's limitations are noted.

Mindfulness-oriented recovery enhancement reduces pain attentional bias in chronic pain patients

BACKGROUND

Chronic pain involves hypervigilance for pain-related stimuli. Selective attention to pain-related stimuli, known as pain attentional bias (AB), can exacerbate chronic pain, prolong suffering, and undermine quality of life. The aim of this study was to determine if a multimodal mindfulness-oriented intervention could significantly reduce pain AB among chronic pain patients receiving opioid analgesics.

METHODS

A total of 67 chronic pain patients were randomized to an 8-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention or a social support group intervention and began treatment. A dot probe task was used to measure pain AB. Primary outcomes were pain AB scores for cues presented for 2,000 and 200 ms.

RESULTS

Prior to intervention, participants exhibited a significant bias towards pain-related cues presented for 2,000 ms, but no bias for cues presented for 200 ms. A statistically significant time × intervention condition interaction was observed for 2,000 ms pain AB, such that participants in MORE evidenced significantly reduced posttreatment pain AB relative to pretreatment levels, whereas no significant pre-post treatment changes in pain AB were observed for support group participants. Decreases in pain AB were associated with increased perceived control over pain and attenuated reactivity to distressing thoughts and emotions.

CONCLUSION

Study findings provide the first indication that a mindfulness-oriented intervention may reduce pain AB among adults suffering from chronic pain. Given the magnitude of chronic pain in postindustrial societies, coupled with the dramatic escalation in prescription opioid misuse, future studies should evaluate MORE as a nonpharmacological means of addressing factors linked with chronic pain.

Complementary and Alternative Medicine in the Treatment of Chronic Pelvic Pain in Women: What Is the Evidence?

Chronic pelvic pain (CPP) is defined as pain of at least 6 months' duration that occurs in the lower abdomen or below the umbilicus and has resulted in functional or psychological disability or required intervention and treatment. Therapeutic interventions center around the treatment of CPP as a diagnosis in and of itself, and treatment of specific disorders that may be related to CPP. A multidisciplinary approach for diagnosis and treatment seems to be most effective for symptomatic relief. This paper reviews the evidence for such interventions as psychological treatments including the use of complementary and alternative medicine techniques for CPP in women. Unfortunately, finding the best evidence in this setting is difficult as only very few randomized controlled trials are available. A combination of treatments is usually required over time for the treatment of refractory CPP. The multifactorial nature of CPP needs to be discussed with the patient and a good rapport as well as a partnership needs to be developed to plan a management program with regular followup. Promotion of a multidisciplinary approach which includes complementary and alternative medicine techniques in managing CPP in women seems to yield the best results.

State Mindfulness During Meditation Predicts Enhanced Cognitive Reappraisal

Putatively, mindfulness meditation involves generation of a state of "nonappraisal", yet, little is known about how mindfulness may influence appraisal processes. We investigated whether the state and practice of mindfulness could enhance cognitive reappraisal. Participants (N = 44; M age = 24.44, SD = 4.00, range 19 - 38, 82.2% female) were randomized to either 1) mindfulness, 2) suppression, or 3) mind-wandering induction training conditions. Cognitive reappraisal was assessed with the Emotion Regulation Questionnaire (ERQ) prior to experimental induction, and state mindfulness was assessed immediately following induction using the Toronto Mindfulness Scale (TMS). Participants practiced their assigned strategy for one week and then were reassessed with the ERQ reappraisal subscale. Participants receiving mindfulness training reported significantly higher levels of state mindfulness than participants in the thought suppression and mind wandering conditions. Although brief mindfulness training did not lead to significantly greater increases in reappraisal than the other two conditions, state mindfulness during mindfulness meditation was prospectively associated with increases in reappraisal. Path analysis revealed that the indirect effect between mindfulness training and reappraisal was significant through state mindfulness. Degree of state mindfulness achieved during the act of mindfulness meditation significantly predicted increases in reappraisal over time, suggesting that mindfulness may promote emotion regulation by enhancing cognitive reappraisal.

Yoga meditation practitioners exhibit greater gray matter volume and fewer reported cognitive failures: results of a preliminary voxel-based morphometric analysis

Hatha yoga techniques, including physical postures (asanas), breathing exercises (pranayama), and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent neuroplastic changes. Though prior studies have identified differences in gray matter volume (GMV) between long-term mindfulness practitioners and controls, no studies to date have reported on whether yoga meditation is associated with GMV differences. The present study investigated GMV differences between yoga meditation practitioners (YMP) and a matched control group (CG). The YMP group exhibited greater GM volume in frontal, limbic, temporal, occipital, and cerebellar regions; whereas the CG had no greater regional greater GMV. In addition, the YMP group reported significantly fewer cognitive failures on the Cognitive Failures Questionnaire (CFQ), the magnitude of which was positively correlated with GMV in numerous regions identified in the primary analysis. Lastly, GMV was positively correlated with the duration of yoga practice. Results from this preliminary study suggest that hatha yoga practice may be associated with the promotion of neuroplastic changes in executive brain systems, which may confer therapeutic benefits that accrue with repeated practice.

Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations

Irritable bowel syndrome (IBS) is a prevalent functional disorder characterized by abdominal pain and hypervigilance to gastrointestinal sensations. We hypothesized that mindfulness training (MT), which promotes nonreactive awareness of emotional and sensory experience, may target underlying mechanisms of IBS including affective pain processing and catastrophic appraisals of gastrointestinal sensations. Seventy five female IBS patients were randomly assigned to participate in either 8 weeks of MT or a social support group. A theoretically grounded, multivariate path model tested therapeutic mediators of the effect of MT on IBS severity and quality of life. Results suggest that MT exerts significant therapeutic effects on IBS symptoms by promoting nonreactivity to gut-focused anxiety and catastrophic appraisals of the significance of abdominal sensations coupled with a refocusing of attention onto interoceptive data with less emotional interference. Hence, MT appears to target and ameliorate the underlying pathogenic mechanisms of IBS.

The Biology of Caring

Caring, a core tenet of nursing practice, grew out of a holistic approach. Nurse theorists often note the establishment of a therapeutic relationship as the beginning point of caring, with subsequent nursing interventions reliant upon this relationship for effectiveness. Relational exchange serves as a source of either stress or healing between participants, and rarely is its impact neutral. Relational stress, in fact, has become a primary contributor to many disease processes in terms of promotion and progression and perhaps even initiation. Patient–provider relationships have a long history in medical and nursing literature as critical to providing effective interventions, but our understanding of relational dynamics between patients and providers remains fairly superficial. This theoretical article adapts a previously described biobehavioral model to illustrate the nature and centrality of caring relationships in nursing practice. The dynamic process of face-to-face engagement is deconstructed from a psychobiological standpoint in order to understand the physiological, emotional, cognitive, and behavioral impacts of relational interaction. This understanding is then applied to the patient–provider relationship. Finally, the utility of biomarkers of stress, positive emotion and resonance, and of disease is discussed relative to the patient-provider relationship. Methodological and interpretive challenges inherent in this line of research, along with suggestions to address such challenges, are also presented.

Mindfulness-Oriented Recovery Enhancement for Alcohol Dependence: Therapeutic Mechanisms and Intervention Acceptability

Mindfulness-based interventions may decrease addictive behaviors while promoting non-reactivity to stressors. This study employed qualitative methods to enhance understanding of mindfulness-related treatment effects. Study participants were eighteen alcohol dependent adults residing in a therapeutic community who had participated in a Mindfulness-Oriented Recovery Enhancement (MORE) intervention. Interviews were conducted to elicit participant narratives. Responses to open-ended questions were analyzed using a grounded theory approach and the method of constant comparison. Narrative accounts suggested that MORE enhanced self-awareness while helping clients to cope more effectively with emotional distress and addictive impulses. MORE appears to be acceptable to participants and feasible to implement within a residential treatment setting. Mindfulness training may assist marginalized persons recover from addiction.

History of Mindfulness-Based Cognitive Therapy Is Associated with Increased Cognitive Reappraisal Ability

Mindfulness-based cognitive therapy (MBCT) has been shown to be an effective treatment for mood and anxiety disorders. Little is known, however, about the specific psychological skills that may improve with MBCT. The present study investigated the relationship between history of MBCT and emotion regulation ability. Specifically, we examined cognitive reappraisal ability (CRA) in a sample of individuals with a history of MBCT compared with two control groups: a group without a history of any type of therapy and a group with a history of cognitive behavioral therapy (CBT). Groups were matched on key variables including age, sex, education, working memory, emotional reactivity, and life stress. CRA was measured using a standardized laboratory challenge. Results indicated that participants with a history of MBCT demonstrated higher CRA than both the no-therapy control group and the CBT control group. These results suggest that, by guiding people to accept thoughts and feelings without judgment and to focus on the present moment, MBCT may lay the foundation for increased CRA.

Meditation-State Functional Connectivity (msFC): Strengthening of the Dorsal Attention Network and Beyond

Meditation practice alters intrinsic resting-state functional connectivity (rsFC) in the default mode network (DMN). However, little is known regarding the effects of meditation on other resting-state networks. The aim of current study was to investigate the effects of meditation experience and meditation-state functional connectivity (msFC) on multiple resting-state networks (RSNs). Meditation practitioners (MPs) performed two 5-minute scans, one during rest, one while meditating. A meditation naïve control group (CG) underwent one resting-state scan. Exploratory regression analyses of the relations between years of meditation practice and rsFC and msFC were conducted. During resting-state, MP as compared to CG exhibited greater rsFC within the Dorsal Attention Network (DAN). Among MP, meditation, as compared to rest, strengthened FC between the DAN and DMN and Salience network whereas it decreased FC between the DAN, dorsal medial PFC, and insula. Regression analyses revealed positive correlations between the number of years of meditation experience and msFC between DAN, thalamus, and anterior parietal sulcus, whereas negative correlations between DAN, lateral and superior parietal, and insula. These findings suggest that the practice of meditation strengthens FC within the DAN as well as strengthens the coupling between distributed networks that are involved in attention, self-referential processes, and affective response.

Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial

OBJECTIVES

This prospective, randomized controlled trial explored the feasibility and efficacy of a group program of mindfulness training, a cognitive-behavioral technique, for women with irritable bowel syndrome (IBS). The technique involves training in intentionally attending to present-moment experience and non-judgmental awareness of body sensations and emotions.

METHODS

Seventy-five female IBS patients were randomly assigned to eight weekly and one half-day intensive sessions of either mindfulness group (MG) training or a support group (SG). Participants completed the IBS severity scale (primary outcome), IBS-quality of life, brief symptom inventory-18, visceral sensitivity index, treatment credibility scale, and five-facet mindfulness questionnaire before and after treatment and at 3-month follow-up.

RESULTS

Women in the MG showed greater reductions in IBS symptom severity immediately after training (26.4% vs. 6.2% reduction; P=0.006) and at 3-month follow-up (38.2% vs. 11.8%; P=0.001) relative to SG. Changes in quality of life, psychological distress, and visceral anxiety were not significantly different between groups immediately after treatment, but evidenced significantly greater improvements in the MG than in the SG at the 3-month follow-up. Mindfulness scores increased significantly more in the MG after treatment, confirming effective learning of mindfulness skills. Participants' ratings of the credibility of their assigned interventions, measured after the first group session, were not different between groups.

CONCLUSIONS

This randomized controlled trial demonstrated that mindfulness training has a substantial therapeutic effect on bowel symptom severity, improves health-related quality of life, and reduces distress. The beneficial effects persist for at least 3 months after group training.

Mindfulness is Inversely Associated with Alcohol Attentional Bias Among Recovering Alcohol-Dependent Adults

Although mindfulness has been linked with salutary clinical outcomes, less is known about its relation to cognitive mechanisms implicated in the onset and maintenance of alcohol dependence. Because trait mindfulness is associated with attentional control and emotion regulation, we hypothesized that trait mindfulness would be inversely associated with attentional bias towards visual alcohol cues. We tested this hypothesis in a sample of alcohol-dependent adults residing in a treatment facility, who completed questionnaires on trait mindfulness, craving, and stress, as well as a spatial cueing task designed to assess alcohol attentional bias. Recovering alcohol-dependent individuals high in trait mindfulness exhibited less alcohol attentional bias (AB), stress, and craving, and greater alcohol-related self-efficacy, than their counterparts low in trait mindfulness. Multiple linear regression analyses indicated that trait mindfulness was more predictive of alcohol AB than stress, craving, alcohol-related self-efficacy, time in treatment, or pre-treatment level of alcohol consumption. Identification of malleable traits that can offset automatic cognitive mechanisms implicated in addiction may prove to be crucial to treatment development efforts.

Targeting cognitive-affective risk mechanisms in stress-precipitated alcohol dependence: an integrated, biopsychosocial model of automaticity, allostasis, and addiction

This paper proposes a novel hypothetical model integrating formerly discrete theories of stress appraisal, neurobiological allostasis, automatic cognitive processing, and addictive behavior to elucidate how alcohol misuse and dependence are maintained and re-activated by stress. We outline a risk chain in which psychosocial stress initiates physiological arousal, perseverative cognition, and negative affect that, in turn, triggers automatized schema to compel alcohol consumption. This implicit cognitive process then leads to attentional biases toward alcohol, subjective experiences of craving, paradoxical increases in arousal and alcohol-related cognitions due to urge suppression, and palliative coping through drinking. When palliative coping relieves distress, it results in negative reinforcement conditioning that perpetuates the cycle by further sensitizing the system to future stressful encounters. This model has implications for development and implementation of innovative behavioral interventions (such as mindfulness training) that disrupt cognitive-affective mechanisms underpinning stress-precipitated dependence on alcohol.

Trait Mindfulness Predicts Attentional and Autonomic Regulation of Alcohol Cue-Reactivity

BACKGROUND

The trait of mindfulness varies among meditation-naïve individuals and is associated with attentional and autonomic regulation, two neurocognitive functions that become impaired in addiction. It was hypothesized that alcohol dependent inpatients with comparatively high levels of trait mindfulness would exhibit significant autonomic recovery from stress-primed alcohol cues mediated by greater attentional disengagement from such cues.

METHODS

58 alcohol dependent inpatients participated in affect-modulated psychophysiological cue-reactivity protocol and a spatial cueing task designed to assess alcohol attentional bias (AB). Associations between trait mindfulness, alcohol AB, and an index of autonomic activity, high-frequency heart rate variability (HFHRV), were examined via multivariate path analysis.

RESULTS

Higher trait mindfulness was significantly associated with less difficulty resisting the urge to drink and greater HFHRV recovery from stress-primed alcohol cues. After statistically controlling for the correlation of mindfulness and perceived difficulty resisting drinking urges, the association between mindfulness and HFHRV recovery was partially mediated by attentional disengagement from alcohol cues (model R² = .30).

DISCUSSION

Alcohol dependent inpatients higher in mindfulness are better able to disengage attention from alcohol cues, which in turn predicts the degree of HFHRV recovery from such cues. Trait mindfulness may index cognitive control over appetitive responses reflected in superior attentional and autonomic regulation of stress-primed alcohol cue-reactivity.

Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology

This review integrates Fredrickson's broaden-and-build theory of positive emotions with advances in affective neuroscience regarding plasticity in the neural circuitry of emotions to inform the treatment of emotion deficits within psychopathology. We first present a body of research showing that positive emotions broaden cognition and behavioral repertoires, and in so doing, build durable biopsychosocial resources that support coping and flourishing mental health. Next, by explicating the processes through which momentary experiences of emotions may accrue into self-perpetuating emotional systems, the current review proposes an underlying architecture of state-trait interactions that engenders lasting affective dispositions. This theoretical framework is then used to elucidate the cognitive-emotional mechanisms underpinning three disorders of affect regulation: depression, anxiety, and schizophrenia. In turn, two mind training interventions, mindfulness and loving-kindness meditation, are highlighted as means of generating positive emotions that may counter the negative affective processes implicated in these disorders. We conclude with the proposition that positive emotions may exert a countervailing force on the dysphoric, fearful, or anhedonic states characteristic of psychopathologies typified by emotional dysfunctions.

Mindfulness training modifies cognitive, affective, and physiological mechanisms implicated in alcohol dependence: results of a randomized controlled pilot trial

Mindfulness training may disrupt the risk chain of stress-precipitated alcohol relapse. In 2008, 53 alcohol-dependent adults (mean age = 40.3) recruited from a therapeutic community located in the urban southeastern U.S. were randomized to mindfulness training or a support group. Most participants were male (79.2%), African American (60.4%), and earned less than $20,000 annually (52.8%). Self-report measures, psychophysiological cue-reactivity, and alcohol attentional bias were analyzed via repeated measures ANOVA. Thirty-seven participants completed the interventions. Mindfulness training significantly reduced stress and thought suppression, increased physiological recovery from alcohol cues, and modulated alcohol attentional bias. Hence, mindfulness training appears to target key mechanisms implicated in alcohol dependence, and therefore may hold promise as an alternative treatment for stress-precipitated relapse among vulnerable members of society.

The role of mindfulness in positive reappraisal

Mindfulness meditation is increasingly well known for therapeutic efficacy in a variety of illnesses and conditions, but its mechanism of action is still under debate in scientific circles. In this paper, we propose a hypothetical causal model that argues for the role of mindfulness in positive reappraisal coping. Positive reappraisal is a critical component of meaning-based coping that enables individuals to adapt successfully to stressful life events. Mindfulness, as a metacognitive form of awareness, involves the process of decentering, a shifting of cognitive sets that enables alternate appraisals of life events. We review the concept of positive reappraisal in transactional stress and coping theory, then describe research and traditional literature related to mindfulness and positive reappraisal, and detail the central role of mindfulness in the reappraisal process. With this understanding, we present a causal model explicating the proposed mechanism. The discussion has implications for clinical practice, suggesting how mindfulness-based integrative medicine interventions can be designed to support adaptive coping processes.

Mindfulness Research Update: 2008

OBJECTIVE: To briefly review the effects of mindfulness on the mind, the brain, the body, and behavior. METHODS: Selective review of MEDLINE, PsycINFO, and Google Scholar databases (2003-2008) using the terms "mindfulness", "meditation", "mental health", "physical health", "quality of life", and "stress reduction." A total of 52 exemplars of empirical and theoretical work were selected for review. RESULTS: Both basic and clinical research indicate that cultivating a more mindful way of being is associated with less emotional distress, more positive states of mind, and better quality of life. In addition, mindfulness practice can influence the brain, the autonomic nervous system, stress hormones, the immune system, and health behaviors, including eating, sleeping and substance use, in salutary ways. CONCLUSION: The application of cutting-edge technology toward understanding mindfulness - an "inner technology" - is elucidating new ways in which attention, awareness, acceptance, and compassion may promote optimal health - in mind, body, relationships, and spirit.