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Yu Y, Cui X, Du J, Wilson A, Xu S, Wang Y. Linear and curvilinear association of pain tolerance and social anxiety symptoms among youth with different subgroups of childhood trauma. J Affect Disord 2024; 354:491-499. [PMID: 38508458 DOI: 10.1016/j.jad.2024.03.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Social anxiety is a common symptom that occurs after exposure to childhood trauma (CT), and pain tolerance is a protective factor against social anxiety in generic populations with CT. However, few studies have investigated whether and how this association varies across different CT subgroups. Thus, this study aimed to investigate (1) the effects of pain tolerance on social anxiety symptoms among youth with different subgroups of CT; (2) the nonlinear relationship between pain tolerance and social anxiety symptoms among different CT categories. METHODS In this study, 15,682 college or university students with experiences of CT were identified in a large sample and divided into five CT subgroups. Linear and quadratic regression models were conducted to explore the association between pain tolerance and social anxiety symptoms among youth with different CT subgroups. RESULTS The results of model revealed a linear relationship between pain tolerance and social anxiety symptoms among youth with most CT subgroups. Notably, an inverted U-shaped curve was found between pain tolerance and social anxiety symptoms in youth with emotional abuse. Social anxiety symptoms increased gradually with pain tolerance scores between 0 and 16, and then sharply decreased when scores reached above 16. LIMITATIONS Limited by self-report measurements, the results of this study focused only on perceived pain tolerance and ignored behavioral pain tolerance. CONCLUSION These findings highlight the importance of assessing pain tolerance thresholds in youth with emotional abuse and improving pain tolerance to prevent social anxiety symptoms in youth with different subgroups of CT.
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Affiliation(s)
- Yi Yu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xin Cui
- Department of Psychology, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jinmei Du
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Li Y, He M, Wang Z, Hofmann SG, Liu X. Distress tolerance as a mediator of mindfulness-based intervention for anxiety and depression: Evidence from two randomized controlled trials. Int J Clin Health Psychol 2024; 24:100445. [PMID: 38333547 PMCID: PMC10847027 DOI: 10.1016/j.ijchp.2024.100445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024] Open
Abstract
Objective We aimed to investigate whether distress tolerance mediated the effects of mindfulness-based intervention (MBI) on anxiety and depression with two randomized controlled studies. Method In Study 1, 374 participants with at least moderate emotional distress were randomized to an intervention group (N = 174) and a waitlist control group (N = 173). Mindfulness, distress tolerance, anxiety, and depression were measured at the pre-test, week 3, week 5, and post-test. In Study 2, 170 participants with emotional disorders were randomized to an intervention group (N = 86) and a control group (N = 84). The same variables were assessed at pre-test, weekly during the intervention, and post-test. Results In both studies, linear mixed effect models showed that compared to the control group, mindfulness, distress tolerance, anxiety, and depression significantly improved in the intervention group. Parallel process latent growth curve models showed that changes in distress tolerance mediated the effects of the MBI on changes in anxiety and depression. Random-intercept cross-lagged panel models found that distress tolerance temporally preceded depression, but not anxiety. Conclusions Distress tolerance is a potential mechanism underlying MBIs. Interventions targeting distress tolerance could be embedded in MBIs to enhance the intervention effects for emotional distress.
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Affiliation(s)
- Yanjuan Li
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Mengyao He
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Zhenzhen Wang
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Stefan G. Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Germany
| | - Xinghua Liu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
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Laure T, Engels RCME, Remmerswaal D, Spruijt-Metz D, Konigorski S, Boffo M. Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial. JMIR Res Protoc 2023; 12:e46603. [PMID: 37889525 PMCID: PMC10638637 DOI: 10.2196/46603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/20/2023] [Accepted: 08/22/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Many university students experience mental health problems such as anxiety and depression. To support their mental health, a transdiagnostic mobile app intervention has been developed. The intervention provides short exercises rooted in various approaches (eg, positive psychology, mindfulness, self-compassion, and acceptance and commitment therapy) that aim to facilitate adaptive emotion regulation (ER) to help students cope with the various stressors they encounter during their time at university. OBJECTIVE The goals of this study are to investigate whether the intervention and its components function as intended and how participants engage with them. In addition, this study aims to monitor changes in distress symptoms and ER skills and identify relevant contextual factors that may moderate the intervention's impact. METHODS A sequential explanatory mixed methods design combining a microrandomized trial and semistructured interviews will be used. During the microrandomized trial, students (N=200) will be prompted via the mobile app twice a day for 3 weeks to evaluate their emotional states and complete a randomly assigned intervention (ie, an exercise supporting ER) or a control intervention (ie, a health information snippet). A subsample of participants (21/200, 10.5%) will participate in interviews exploring their user experience with the app and the completed exercises. The primary outcomes will be changes in emotional states and engagement with the intervention (ie, objective and subjective engagement). Objective engagement will be evaluated through log data (eg, exercise completion time). Subjective engagement will be evaluated through exercise likability and helpfulness ratings as well as user experience interviews. The secondary outcomes will include the distal outcomes of the intervention (ie, ER skills and distress symptoms). Finally, the contextual moderators of intervention effectiveness will be explored (eg, the time of day and momentary emotional states). RESULTS The study commenced on February 9, 2023, and the data collection was concluded on June 13, 2023. Of the 172 eligible participants, 161 (93.6%) decided to participate. Of these 161 participants, 137 (85.1%) completed the first phase of the study. A subsample of participants (18/172, 10.5%) participated in the user experience interviews. Currently, the data processing and analyses are being conducted. CONCLUSIONS This study will provide insight into the functioning of the intervention and identify areas for improvement. Furthermore, the findings will shed light on potential changes in the distal outcomes of the intervention (ie, ER skills and distress symptoms), which will be considered when designing a follow-up randomized controlled trial evaluating the full-scale effectiveness of this intervention. Finally, the results and data gathered will be used to design and train a recommendation algorithm that will be integrated into the app linking students to relevant content. TRIAL REGISTRATION ClinicalTrials.gov NCT05576883; https://www.clinicaltrials.gov/study/NCT05576883. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46603.
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Affiliation(s)
- Tajda Laure
- Department of Psychology, Education, and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University of Rotterdam, Rotterdam, Netherlands
| | - Rutger C M E Engels
- Department of Psychology, Education, and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University of Rotterdam, Rotterdam, Netherlands
| | - Danielle Remmerswaal
- Department of Psychology, Education, and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University of Rotterdam, Rotterdam, Netherlands
| | - Donna Spruijt-Metz
- Dornsife Center for Economic & Social Research, University of Southern California, Los Angeles, CA, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Stefan Konigorski
- Department of Statistics, Harvard University, Boston, MA, United States
- Digital Health Center, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany
- Icahn School of Medicine at Mount Sinai, Hasso Plattner Institute for Digital Health at Mount Sinai, New York, NY, United States
| | - Marilisa Boffo
- Department of Psychology, Education, and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University of Rotterdam, Rotterdam, Netherlands
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Li Y, Ju R, Hofmann SG, Chiu W, Guan Y, Leng Y, Liu X. Distress tolerance as a mechanism of mindfulness for depression and anxiety: Cross-sectional and diary evidence. Int J Clin Health Psychol 2023; 23:100392. [PMID: 37456917 PMCID: PMC10345371 DOI: 10.1016/j.ijchp.2023.100392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
Background Both trait and state mindfulness are associated with less depression and anxiety, but the mechanisms remain unknown. Distress tolerance, an important transdiagnostic factor of emotional disorders, may mediate the relationship between mindfulness and depression/anxiety. Method Study 1 examined the mediation model at the between-person level in a large cross-sectional sample (n = 905). In Study 2, a daily diary study (n = 110) was conducted to examine within-person changes. Participants were invited to complete daily diaries measuring daily mindfulness, distress tolerance, depression and anxiety for 14 consecutive days. Results In Study 1, results of simple mediation analyses indicated that distress tolerance mediated the relationship between mindfulness and depression/anxiety at the between-person level. In Study 2, results of multilevel mediation analyses indicated that, in both the concurrent model and time-lagged model, daily distress tolerance mediated the effects of daily mindfulness on daily depression/anxiety at both the within- and between-person level. Conclusions Distress tolerance is a mechanism underlying the relationship between mindfulness and depression/anxiety. Individuals with high or fluctuating depression and anxiety may benefit from short-term or long-term mindfulness training to increase distress tolerance.
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Affiliation(s)
- Yanjuan Li
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Ruilin Ju
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Stefan G. Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Germany
| | - Wingsze Chiu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Ye Guan
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Yu Leng
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Xinghua Liu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
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LaRowe LR, Bohlen LC, Gaudiano BA, Abrantes AM, Butryn ML, Dunsiger SI, Griffin E, Loucks EB, Uebelacker LA, Williams DM. Testing the Feasibility and Acceptability of an Acceptance and Commitment Therapy Intervention to Increase Physical Activity among Individuals with Depression: A Protocol Paper. Ment Health Phys Act 2022; 23:100475. [PMID: 37649877 PMCID: PMC10465112 DOI: 10.1016/j.mhpa.2022.100475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Engaging in regular physical activity (PA) is particularly important among individuals with depression, who are at heightened risk for a host of negative health outcomes. However, people with depression are 50% less likely to meet national guidelines for PA and face unique barriers to PA adherence, including lower distress tolerance and motivation for exercise. Acceptance and Commitment Therapy (ACT) may offer promise for increasing PA among adults with depressive symptoms due to its effects on distress tolerance and motivation. Therefore, we developed ACTivity, an ACT-based intervention designed to promote PA among low-active adults with elevated depressive symptoms. Prior to testing the efficacy of ACTivity in an RCT, an important first step is to conduct a preliminary trial to establish feasibility of study procedures for the ACTivity and comparison intervention programs, as well as to establish the credibility/acceptability of the intervention. The purpose of this paper is to describe the ACTivity intervention and the design of this feasibility trial. Method/Design We will conduct a feasibility RCT with two parallel groups and a 1:1 allocation ratio comparing ACTivity to a comparison intervention (relaxation training + PA promotion) among 60 low-active adults with elevated depressive symptoms. All study procedures will be conducted remotely. Discussion Results of this feasibility study will inform a subsequent RCT designed to test the efficacy of ACTivity. If shown to be efficacious, ACTivity will provide a treatment that can be widely disseminated to increase PA among adults with depressive symptoms and thereby decrease their risk for chronic disease.
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Affiliation(s)
- Lisa R. LaRowe
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Lauren Connell Bohlen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Brandon A. Gaudiano
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- Butler Hospital, Providence, RI, 02906, USA
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- Butler Hospital, Providence, RI, 02906, USA
| | - Meghan L. Butryn
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, 19104, USA
| | - Shira I. Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Elizabeth Griffin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Eric B. Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Lisa A. Uebelacker
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
- Butler Hospital, Providence, RI, 02906, USA
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA
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Neate SL, Reece JC, Hassed C, Chambers R, Connaughton S, Nag N. A qualitative analysis of free text comments of participants from a massive open online mindfulness course. Front Public Health 2022; 10:947898. [PMID: 36033817 PMCID: PMC9413085 DOI: 10.3389/fpubh.2022.947898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/26/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction Mindfulness-based interventions are associated with improved health and wellbeing. Online mindfulness interventions offer potential scalability and cost advantages over face-to-face interventions. However, little is known about the experiences of learners, what they identify as being helpful to developing a practice of mindfulness and what outcomes they experience from undertaking an online mindfulness program. Methods The Mindfulness for Wellbeing and Peak Performance Massive Open Online Course is a 4-week mindfulness program which includes psychoeducation, mindfulness meditation, applications and moderated discussion forums. Of the 3,335 participants who completed the March 2020 course, 527 (16%) responded to the final forum which invited participants to describe the highlights of the course. In order to enhance understanding of participant experiences and perceived outcomes of undertaking the course, a qualitative analysis of these free text comments was conducted using reflexive thematic analysis. Results Two overarching themes were identified: (1) internal mechanisms of developing mindfulness (subthemes: paying attention to the present moment, learning to let go and find acceptance, cultivating an attitude of gentleness, and learning through a sense of belonging) and (2) the translation of mindfulness into daily living (subthemes: mindfulness being a support to mental wellbeing, learning to deal with uncertainty and adversity, living a more conscious life, a greater connection with self and others and channeling attention into productivity). Discussion The themes and subthemes provided insights into the mechanisms learners used to develop mindfulness and how they translated mindfulness into their lives in a variety of beneficial ways. This understanding of learners' experiences could inform delivery of future online mindfulness interventions.
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Affiliation(s)
- Sandra L. Neate
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia,*Correspondence: Sandra L. Neate
| | - Jeanette C. Reece
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Craig Hassed
- Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, VIC, Australia
| | - Richard Chambers
- Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, VIC, Australia
| | - Sherelle Connaughton
- Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, VIC, Australia
| | - Nupur Nag
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Woolverton GA, Marks AK. An Integrative Model for the Development of Anti-Racist Behavior in White Adolescents. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221091492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We propose an integrative model for the development of anti-racism in white adolescents that unpacks and combines critical consciousness, color consciousness, anti-racism, and Critical Race Theory frameworks. Black and Brown youth in the U.S. face increasing rates of peer-directed racism, which contribute to long-term negative physical, psychological, academic, and behavioral outcomes. Despite increased focus on how critical consciousness and anti-racism develop uniquely in adolescence, there are no existing theories that provide an integrated, comprehensive model of anti-racist development in white adolescents. Our model unpacks and reorganizes the core features of four prominent theories into cognitive, psychological, and behavioral components of anti-racism development in white adolescents based on existing research to support a next-generation of hypotheses for future research. In doing so, we aim to provide a contemporary theoretical foundation for research that will elucidate anti-racism development among white youth, and help to dismantle structural racism against Black and Brown people in the U.S.
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Pilatti A, Michelini Y, Bravo AJ, Pautassi RM. The Association between Distress Tolerance and Alcohol Outcomes via Internal Drinking Motives. Subst Use Misuse 2022; 57:230-238. [PMID: 34789052 DOI: 10.1080/10826084.2021.2002900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous work suggests that college students who perceive themselves as less able to tolerate negative affect are more motivated to use alcohol to alleviate psychological distress. Recent findings also indicate that distress tolerance influences alcohol outcomes via a positive reinforcement pathway. However, results concerning the association between distress tolerance and alcohol outcomes remain inconsistent. Aim: The present study examined the association between distinctive features of distress tolerance and alcohol outcomes via internal drinking motives (i.e., coping and enhancement) in Argentinean college students. Method: From April to November 2019, a sample of 387 college students with last-month alcohol use (Mean age = 21.09 ± 4.98) completed an online survey assessing alcohol outcomes (past-month frequency of binge drinking and negative alcohol-related consequences), internal drinking motives, and four components of distress tolerance (i.e., tolerance, appraisal, absorption, and regulation). Results: The associations between specific facets of distress tolerance and drinking outcomes were atemporally mediated by coping and enhancement motives. Coping motives significantly mediated the effect of absorption and appraisal on alcohol-related problems (i.e., lower absorption and lower appraisal were associated with more problems via higher coping motives). Enhancement motives significantly mediated the effect of absorption (lower absorption was associated with greater enhancement motives) on binge drinking frequency and alcohol-related problems. Conclusions: Distress tolerance was associated with alcohol outcomes via coping and enhancement motives in this sample of Argentinean undergraduates. The ability to withstand negative affect could be a focal point of interventions to prevent the development of maladaptive patterns of drinking.
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Affiliation(s)
- Angelina Pilatti
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,IIPsi-CONICET-UNC, Instituto de Investigaciones Psicológicas, Córdoba, Argentina
| | - Yanina Michelini
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,IIPsi-CONICET-UNC, Instituto de Investigaciones Psicológicas, Córdoba, Argentina
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, USA
| | - Ricardo Marcos Pautassi
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,INIMEC-CONICET-UNC, Instituto de Investigación Médica M. y M. Ferreyra, Córdoba, Argentina
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9
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The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness During COVID-19. Mindfulness (N Y) 2021; 12:1999-2008. [PMID: 34093889 PMCID: PMC8171361 DOI: 10.1007/s12671-021-01657-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 01/15/2023]
Abstract
Objectives The COVID-19 pandemic is associated with mental health difficulties, especially during pregnancy and early postpartum. Intolerance of uncertainty (IU) and reduced capacity for mindfulness-a protective factor for child-bearers-may be particularly relevant factors driving mental health problems given the unpredictable nature of the pandemic. The current study aims to shed light on modifiable paths to perinatal psychological distress by testing whether there is an indirect effect of IU on psychological symptoms through a perceived reduction in mindfulness during the pandemic. Methods Pregnant individuals (67%, n = 133) and new mothers within 6 months postpartum (33%, n = 66) participated in a cross-sectional online survey assessing IU, current and retrospective pre-pandemic mindfulness (FFMQ), and psychological symptoms (anxiety, depression, somatization; BSI). Perceived change in mindfulness was captured by including retrospective mindfulness as a covariate in the PROCESS macro used for analyses. Results Tests of the direct association between mindfulness, IU, and psychological symptoms showed significant effects of IU (b = 0.46, SE = 0.064; p < .001) and perceived decrease in mindfulness during the pandemic (b = - 0.72, SE = 0.08, p < .001) on psychological symptoms (R 2 = .21-.34; F[2, 197] = 51.13-52.81, p < .001). The indirect effect of IU on symptoms via perceived decrease in mindfulness during the pandemic (b = 0.13, SE = 0.043, 95%CI [.060, .226]) was significant (R 2 = .41, F[3, 195] = 45.08, p < .001). Conclusions Results suggest that mothers who are less able to tolerate uncertainty experience more psychological symptoms, in part due to perceived reduction in mindfulness during the pandemic. Future research should examine whether IU is a screening risk marker and target for mindfulness-based interventions to improve maternal well-being and family outcomes.
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10
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Anxiety Sensitivity and Distress Tolerance Predict Changes in Internalizing Symptoms in Individuals Exposed to Interpersonal Trauma. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Luberto CM, Crute S, Wang A, Yeh GY, Celano CM, Huffman JC, Park ER. Lower distress tolerance is associated with greater anxiety and depression symptoms among patients after acute coronary syndrome. Gen Hosp Psychiatry 2021; 70:143-144. [PMID: 33551181 PMCID: PMC8320852 DOI: 10.1016/j.genhosppsych.2021.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Christina M Luberto
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA.
| | - Sydney Crute
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Amy Wang
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Gloria Y Yeh
- Department of Medicine, Division of General Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Christopher M Celano
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Benson-Henry Institute for Mind-Body Medicine, Boston, MA, USA
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12
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Reynolds GO, Willment K, Gale SA. Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood. Am J Med 2021; 134:444-455. [PMID: 33385339 DOI: 10.1016/j.amjmed.2020.10.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
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Affiliation(s)
| | - Kim Willment
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Seth A Gale
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
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13
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Kraemer KM, Luberto CM, Hall DL, Ngo LH, Yeh GY. A systematic review and meta-analysis of mindfulness- and acceptance-based interventions for affect intolerance/sensitivity. Behav Res Ther 2020; 135:103746. [PMID: 33011486 PMCID: PMC7943058 DOI: 10.1016/j.brat.2020.103746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 12/18/2022]
Abstract
Affect intolerance/sensitivity, defined as one's sensitivity to, or inability to tolerate, affective states, is a transdiagnostic process implicated in the development and maintenance of numerous forms of psychopathology. Mindfulness and acceptance interventions are posited to improve affect intolerance/sensitivity; however, there has been no quantitative synthesis of this research to date. Seven electronic databases were searched up until November 2018. Hedges' g values, 95% confidence intervals, p-values, and Q-values were calculated for a series of random-effects models. Twenty-five studies (pooled N = 1778) met eligibility criteria and were included in the qualitative synthesis (n = 22 included in the meta-analysis). There was a small, significant effect of mindfulness and acceptance interventions on improving affect intolerance/sensitivity from pre-to post-intervention (Hedges' g = -0.37, 95% CI = -0.52 to -0.23, p < .001), with effects maintained up to 6-months (Hedges' g = -0.35, 95% CI = -0.61 to -0.09, p < .01). There was a significantly larger effect for studies with inactive compared to active controls. No significant effect size differences were found for intervention length (<8 vs. ≥ 8 sessions), intervention type (mindfulness vs. acceptance) or sample type (clinical vs. non-clinical). Mindfulness and acceptance interventions modestly improve affect intolerance/sensitivity.
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Affiliation(s)
- Kristen M Kraemer
- Division of General Medicine, Harvard Medical School/Beth Israel Deaconess Medical Center, 330 Brookline Avenue, CO-1309, 2nd Floor, Boston, MA, 02215, USA.
| | - Christina M Luberto
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, 100 Cambridge St, 16th Floor, Boston, MA, 02108, USA.
| | - Daniel L Hall
- Division of General Medicine, Harvard Medical School/Beth Israel Deaconess Medical Center, 330 Brookline Avenue, CO-1309, 2nd Floor, Boston, MA, 02215, USA; Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, 100 Cambridge St, 16th Floor, Boston, MA, 02108, USA.
| | - Long H Ngo
- Division of General Medicine, Harvard Medical School/Beth Israel Deaconess Medical Center, 330 Brookline Avenue, CO-1309, 2nd Floor, Boston, MA, 02215, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Gloria Y Yeh
- Division of General Medicine, Harvard Medical School/Beth Israel Deaconess Medical Center, 330 Brookline Avenue, CO-1309, 2nd Floor, Boston, MA, 02215, USA.
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Galla BM, Esposito MV, Fiore HM. Mindfulness predicts academic diligence in the face of boredom. LEARNING AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.lindif.2020.101864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Luberto CM, Hall DL, Park ER, Haramati A, Cotton S. A Perspective on the Similarities and Differences Between Mindfulness and Relaxation. Glob Adv Health Med 2020; 9:2164956120905597. [PMID: 32076580 PMCID: PMC7003166 DOI: 10.1177/2164956120905597] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 10/31/2019] [Accepted: 01/13/2020] [Indexed: 11/17/2022] Open
Abstract
Mind-body medicine is an evidence-based approach to health and healing that focuses on interactions between the mind, body, and behavior. It encompasses a wide range of interventions that are similar yet different in meaningful ways. Mindfulness and relaxation practices are 2 mind-body techniques that have similarities and differences; however, these techniques are often used or discussed interchangeably, such that the differences between them become obscured. A greater understanding of the unique facets of mindfulness and relaxation is needed for researchers and clinicians to make informed decisions when selecting an approach. The purpose of the current article is to offer an evidence-informed perspective on similarities and differences between mindfulness and relaxation. Specifically, mindfulness and relaxation practices are compared and contrasted in terms of theoretical foundation, intention, and psychological and physiological effects and mechanisms. Implications for clinical practice and suggestions for future research are discussed.
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Affiliation(s)
- Christina M Luberto
- Benson-Henry Institute for Mind-Body Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Daniel L Hall
- Benson-Henry Institute for Mind-Body Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Elyse R Park
- Benson-Henry Institute for Mind-Body Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Aviad Haramati
- Department of Biochemistry, Molecular and Cellular Biology, Georgetown University School of Medicine, Washington, District of Columbia
| | - Sian Cotton
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Colgary CD, Dong S, Fisher PH. One-Session Mindfulness versus Concentrative Meditation: The Effects of Stress Anticipation. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1712668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Evanovich EK, Marshall AJ, David SJ, Mumma GH. A network conceptualization of the multiple facets of distress tolerance. ANXIETY STRESS AND COPING 2019; 32:654-669. [PMID: 31294629 DOI: 10.1080/10615806.2019.1641799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Using a network analysis (NA) approach, the current study examined the relations among different facets of Distress Tolerance (DT). The NA approach quantifies and displays relations among variables in a visual network consisting of nodes (symptoms) and edges (partial correlations between symptoms). DESIGN An exploratory NA approach evaluated how manifestations of DT uniquely and systematically relate to one another. METHODS Undergraduate students (N = 288) completed 10 commonly used measures of DT including cognitive, behavioral, and self-report measures. RESULTS Results indicated all relations in the network were positive apart from social sensitivity and suppression. Further, individual DT facets did not form distinct community structures (nodes that cluster together and thus have stronger relations with each other than other nodes in the network). CONCLUSIONS The lack of community structures suggests that DT is a general ability to tolerate distress that is comprised of many different facets rather than the idea that DT is hierarchical and comprised of distinct domains; a current debate within the literature. The self-reported ability to tolerate life demands and tasks was the most influential facet in the overall network suggesting the Frustration Discomfort Scale may be the best global measure of DT.
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Affiliation(s)
- Emma K Evanovich
- Department of Psychological Sciences, Texas Tech University , Lubbock , TX , USA
| | - Andrew J Marshall
- Department of Psychological Sciences, Texas Tech University , Lubbock , TX , USA
| | - Sarah Jo David
- Department of Psychological Sciences, Texas Tech University , Lubbock , TX , USA
| | - Gregory H Mumma
- Department of Psychological Sciences, Texas Tech University , Lubbock , TX , USA
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Carpenter JK, Sanford J, Hofmann SG. The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity. Behav Ther 2019; 50:630-645. [PMID: 31030879 PMCID: PMC6494113 DOI: 10.1016/j.beth.2018.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022]
Abstract
Poor distress tolerance (DT) is considered an underlying facet of anxiety, depression, and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance or nonjudgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the nonjudge and nonreact facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.
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Affiliation(s)
- Joseph K. Carpenter
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon St, 6th floor, Boston, MA, 02215;
| | - Jenny Sanford
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon St, 6th floor, Boston, MA, 02215; ,Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114;
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon St, 6th floor, Boston, MA, 02215; ,Denotes corresponding author
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19
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O’Bryan EM, Luberto CM, Kraemer KM, McLeish AC. An examination of mindfulness skills in terms of affect tolerance among individuals with elevated levels of health anxiety. ANXIETY, STRESS, AND COPING 2018; 31:702-713. [PMID: 30205718 PMCID: PMC6540987 DOI: 10.1080/10615806.2018.1521515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Affect tolerance factors, including anxiety sensitivity, intolerance of uncertainty, and emotional distress tolerance, have been implicated in the exacerbation of health anxiety. Therefore, identifying methods to improve affect tolerance in health anxious populations is imperative. Despite the link between mindfulness and greater affect tolerance in non-clinical populations, no work has examined the role of mindfulness skills in terms of affect tolerance among individuals with elevated health anxiety. The aim of the current study was to examine the unique contribution of mindfulness skills in terms of distress tolerance, anxiety sensitivity, and intolerance of uncertainty. METHODS Participants were 218 undergraduates with clinically elevated levels of health anxiety (75.7% female; Mage = 19.53, SD = 3.16, Range = 18-45) who completed self-report measures for course credit. RESULTS Findings indicated that, after controlling for theoretically relevant covariates, greater acting with awareness, non-judgment, and non-reactivity were uniquely associated with greater distress tolerance, and greater non-reactivity was associated with lower levels of intolerance of uncertainty. Though none of the mindfulness skills emerged as specific individual predictors of anxiety sensitivity, these skills collectively accounted for unique variance in anxiety sensitivity. CONCLUSIONS These findings suggest that mindfulness skills may be helpful in targeting affect tolerance factors among individuals with elevated health anxiety.
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Affiliation(s)
| | | | - Kristen M. Kraemer
- University of Cincinnati
- Beth Israel Deaconess Medical Center /Harvard Medical School
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20
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Overstreet C, Brown E, Berenz EC, Brown RC, Hawn S, McDonald S, Pickett T, Danielson CK, Thomas S, Amstadter A. Anxiety Sensitivity and Distress Tolerance Typologies and Relations to Posttraumatic Stress Disorder: A Cluster Analytic Approach. MILITARY PSYCHOLOGY 2018; 30:547-556. [PMID: 30886457 DOI: 10.1080/08995605.2018.1521682] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A growing literature suggests a relationship between a high anxiety sensitivity (AS; the fear of anxiety and its related consequences)/low distress tolerance (DT; the capacity tolerate internal negative states) profile and posttraumatic stress disorder (PTSD) symptoms. However, specific profiles have not been identified or examined specifically in veteran samples. Thus, the aims of the present study were to establish empirically derived profiles created from response patterns on the Anxiety Sensitivity Index and Distress Tolerance Scale and to examine associations with PTSD symptom clusters among a sample of combat-exposed veterans (N = 250). A cluster analytic approach was utilized to identify AS/DT profiles, and a series of MANOVAs with post hoc analyses was conducted to examine the relationship between each AS/DT profile and each PTSD symptom cluster. Results indicated a three-cluster solution including a high AS/low DT "at risk" profile, a low AS/high DT "resilient" profile, and an average AS/DT "intermediate" profile. The at-risk profile was associated with significantly greater symptoms in each PTSD cluster (i.e., hyperarousal, avoidance, re-experiencing) when compared to the other two profiles. The at-risk profile was also associated with greater depressive symptoms and lower self-reported resilience. These findings extend the previous literature by identifying a high AS/low DT "at risk" profile and its associations with PTSD symptoms, underscoring the potential utility in targeting these affect-regulation constructs for clinical intervention.
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Affiliation(s)
- Cassie Overstreet
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Emily Brown
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Erin C Berenz
- Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.,Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ruth C Brown
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Sage Hawn
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Suzanne Thomas
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ananda Amstadter
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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21
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Luberto CM, Shinday N, Song R, Philpotts LL, Park ER, Fricchione GL, Yeh GY. A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion, and Prosocial Behaviors. Mindfulness (N Y) 2018; 9:708-724. [PMID: 30100929 PMCID: PMC6081743 DOI: 10.1007/s12671-017-0841-8] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Increased attention has focused on methods to increase empathy, compassion, and pro-social behavior. Meditation practices have traditionally been used to cultivate pro-social outcomes, and recently investigations have sought to evaluate their efficacy for these outcomes. We conducted a systematic review and meta-analysis of meditation for pro-social emotions and behavior. A literature search was conducted in PubMed, MEDLINE, PsycINFO, CINAHL, Embase, and Cochrane databases (inception-April 2016) using the search terms: mindfulness, meditation, mind-body therapies, tai chi, yoga, MBSR, MBCT, empathy, compassion, love, altruism, sympathy, or kindness. Randomized controlled trials in any population were included (26 studies with 1,714 subjects). Most were conducted among healthy adults (n=11) using compassion or loving kindness meditation (n=18) over 8-12weeks (n=12) in a group format (n=17). Most control groups were wait-list or no-treatment (n=15). Outcome measures included self-reported emotions (e.g., composite scores, validated measures) and observed behavioral outcomes (e.g., helping behavior in real-world and simulated settings). Many studies showed a low risk of bias. Results demonstrated small to medium effects of meditation on self-reported (SMD = .40, p < .001) and observable outcomes (SMD = .45, p < .001) and suggest psychosocial and neurophysiological mechanisms of action. Subgroup analyses also supported small to medium effects of meditation even when compared to active control groups. Clinicians and meditation teachers should be aware that meditation can improve positive pro-social emotions and behaviors.
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Affiliation(s)
- Christina M. Luberto
- Harvard Medical School/Massachusetts General Hospital, Department of
Psychiatry, 15 Parkman Street, Boston, MA, USA, 02114
- Benson-Henry Institute for Mind-Body Medicine, Massachusetts General
Hospital, 151 Merrimac St, Boston, MA, USA, 02114
| | - Nina Shinday
- Harvard Medical School/Beth Israel Deaconess Medical Center,
Division of General Medicine and Primary Care, 1309 Brookline Avenue, Boston MA,
USA, 02445
| | - Rhayun Song
- Chungnam National University, Daejeon, Korea, 6 Munwha 1-Dong,
Jung-Gu, Dae Jeon, 301-747
| | - Lisa L. Philpotts
- Treadwell Library, Massachusetts General Hospital, 125 Nashua
Street, Boston, MA, USA, 02114
| | - Elyse R. Park
- Harvard Medical School/Massachusetts General Hospital, Department of
Psychiatry, 15 Parkman Street, Boston, MA, USA, 02114
- Benson-Henry Institute for Mind-Body Medicine, Massachusetts General
Hospital, 151 Merrimac St, Boston, MA, USA, 02114
| | - Gregory L. Fricchione
- Harvard Medical School/Massachusetts General Hospital, Department of
Psychiatry, 15 Parkman Street, Boston, MA, USA, 02114
- Benson-Henry Institute for Mind-Body Medicine, Massachusetts General
Hospital, 151 Merrimac St, Boston, MA, USA, 02114
| | - Gloria Y. Yeh
- Harvard Medical School/Beth Israel Deaconess Medical Center,
Division of General Medicine and Primary Care, 1309 Brookline Avenue, Boston MA,
USA, 02445
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22
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Luberto CM, McLeish AC. The effects of a brief mindfulness exercise on state mindfulness and affective outcomes among adult daily smokers. Addict Behav 2018; 77:73-80. [PMID: 28965070 DOI: 10.1016/j.addbeh.2017.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/19/2017] [Accepted: 09/22/2017] [Indexed: 11/18/2022]
Abstract
Brief, single session mindfulness training has been shown to reduce emotional distress, craving, and withdrawal symptoms among smokers when they are nicotine-deprived. However, no research has examined the efficacy of brief mindfulness training for non-nicotine-deprived smokers, or explored its effects on smokers' ability to tolerate emotional distress. Smokers progress differently through various stages as they attempt to change their smoking behavior and evidence-based strategies are needed for smokers at all levels of nicotine deprivation. Therefore, the purpose of the current study was to examine the effects of a brief mindfulness exercise on state mindfulness, distress, distress tolerance, and smoking urges following a distressing laboratory task among 86 non-nicotine-deprived adult daily smokers (Mage=46years, 55% male, 74% African-American) who completed behavioral tasks and self-report measures before and after randomization to a 10-min mindfulness or control exercise. As hypothesized, the mindfulness exercise significantly increased state mindfulness [F=14.24, p=0.00, η2partial=0.15] and demonstrated a non-significant small to medium effect on decreased distress levels [F=3.22, p=0.08, η2partial=0.04]. Contrary to prediction, it was not associated with improvements in self-reported [F=2.68, p=0.11, η2partial=0.03] or behavioral distress tolerance [F(1)=0.75, p=0.39, η2partial=0.01], or smoking urges following a stressor [F=0.22, p=0.64, η2partial=0.00.] These findings suggest that brief mindfulness exercises successfully induce states of mindfulness in non-nicotine-deprived smokers. These exercises might also improve current moment levels of distress, but they do not appear to improve self-report or behavioral indices of distress tolerance.
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Affiliation(s)
- Christina M Luberto
- University of Cincinnati, United States; Massachusetts General Hospital, Harvard Medical School, United States.
| | - Alison C McLeish
- University of Cincinnati, United States; University of Louisville, United States
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Kamboj SK, Irez D, Serfaty S, Thomas E, Das RK, Freeman TP. Ultra-Brief Mindfulness Training Reduces Alcohol Consumption in At-Risk Drinkers: A Randomized Double-Blind Active-Controlled Experiment. Int J Neuropsychopharmacol 2017; 20:936-947. [PMID: 29016995 PMCID: PMC5737497 DOI: 10.1093/ijnp/pyx064] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/18/2017] [Accepted: 07/28/2017] [Indexed: 02/04/2023] Open
Abstract
Background Like other complex psychosocial interventions, mindfulness-based treatments comprise various modality-specific components as well as nonspecific therapeutic ingredients that collectively contribute to efficacy. Consequently, the isolated effects of mindfulness strategies per se remain unclear. Methods Using a randomized double-blind design, we compared the isolated effects of 11-minutes of "supervised" mindfulness instruction against a closely matched active control (relaxation) on subjective, physiological, and behavioral indices of maladaptive alcohol responding in drinkers at risk of harm from alcohol use (n = 68). Simple follow-up instructions on strategy use were provided, but practice was unsupervised and not formally monitored. Results Both groups showed acute reductions in craving after training, although a trend group x time interaction (P = .056) suggested that this reduction was greater in the relaxation group (d = 0.722 P < .001) compared with the mindfulness group (d = 0.317, P = .004). Furthermore, upregulation of parasympathetic activity was found after relaxation (d = 0.562; P < .001) but not mindfulness instructions (d = 0.08; P > .1; group x time interaction: P = .009). By contrast, only the mindfulness group showed a reduction in past-week alcohol consumption at 7-day follow-up (-9.31 units, d = 0.593, P < .001), whereas no significant reduction was seen in the relaxation group (-3.00 units, d = 0.268, P > .1; group x time interaction: P = .026). Conclusion Very brief mindfulness practice can significantly reduce alcohol consumption among at-risk drinkers, even with minimal encouragement to use this strategy outside of the experimental context. The effects on consumption may therefore represent a lower bound of efficacy of "ultra-brief" mindfulness instructions in hazardous drinkers, at least at short follow-up intervals.
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Affiliation(s)
- Sunjeev K Kamboj
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Damla Irez
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Shirley Serfaty
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Emily Thomas
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Ravi K Das
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
| | - Tom P Freeman
- Clinical Psychopharmacology Unit (Dr Kamboj, Ms Thomas, and Drs Das and Freeman); Research Department of Clinical, Educational and Health Psychology (Drs Kamboj, Irez, and Serfaty, Ms Thomas, and Drs Das and Freeman), University College London, United Kingdom
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Felton JW, Banducci AN, Shadur JM, Stadnik R, MacPherson L, Lejuez CW. The developmental trajectory of perceived stress mediates the relations between distress tolerance and internalizing symptoms among youth. Dev Psychopathol 2017; 29:1391-1401. [PMID: 28318473 PMCID: PMC6360527 DOI: 10.1017/s0954579417000335] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study examines the relation between distress tolerance, perceived stress, and internalizing symptoms across adolescence. Participants included 331 youth, ages 10 to 14 at the first wave of the study, assessed annually over 5 years. A latent growth curve approach was used to test three research questions, including whether perceived stress would increase across adolescence, whether distress tolerance (as measured by a behavioral task) would predict changes in perceived stress, and whether changes in perceived stress would mediate the relation between distress tolerance and internalizing symptoms. Results suggest that, consistent with previous findings, rates of perceived stress do increase across adolescence. Further, findings indicate that distress intolerance at baseline predicted increases in perceived stress, which in turn drove increases in internalizing symptoms. These findings point to the critical role of distress tolerance in bringing about changes in depression and anxiety symptoms and suggest support for utilizing a negative reinforcement framework to understand the emergence of internalizing symptomology.
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25
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Paz R, Zvielli A, Goldstein P, Bernstein A. Brief mindfulness training de-couples the anxiogenic effects of distress intolerance on reactivity to and recovery from stress among deprived smokers. Behav Res Ther 2017. [DOI: 10.1016/j.brat.2017.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kraemer KM, O'Bryan EM, Johnson AL, McLeish AC. The role of mindfulness skills in terms of anxiety-related cognitive risk factors among college students with problematic alcohol use. Subst Abus 2017; 38:337-343. [PMID: 28594607 DOI: 10.1080/08897077.2017.1340394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of the current study was to examine the associations between the specific mindfulness skills of observing, describing, awareness, nonjudgment, and nonreactivity in terms of anxiety sensitivity (AS), distress tolerance (DT), and intolerance of uncertainty (IU) among college students with problematic alcohol use. METHODS Participants were 202 (69.3% male; Mage = 18.96, SD = 2.24, range = 18-45 years) undergraduate college students with problematic alcohol use who completed self-report measures for course credit. RESULTS Results indicated that after controlling for the effects of gender, smoking status, marijuana use status, and negative affectivity, greater use of the mindfulness skill of observing was associated with higher AS, greater describing was associated with lower AS and higher DT, greater nonjudgment was associated with lower AS and IU and higher DT, and greater nonreactivity was associated with increased DT. Awareness did not significantly predict any of the examined risk factors. CONCLUSIONS These results suggest that specific mindfulness skills are associated with a greater tolerance of physiological, emotional, and uncertain states. An important next step will be to examine whether mindfulness skills are associated with decreased problematic alcohol use due to improvements in these anxiety-related risk factors.
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Affiliation(s)
- Kristen M Kraemer
- a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA
| | - Emily M O'Bryan
- a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA
| | - Adrienne L Johnson
- a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA
| | - Alison C McLeish
- a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA
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Kraemer KM, Luberto CM, O'Bryan EM, Mysinger E, Cotton S. Mind-Body Skills Training to Improve Distress Tolerance in Medical Students: A Pilot Study. TEACHING AND LEARNING IN MEDICINE 2016; 28:219-228. [PMID: 27064724 DOI: 10.1080/10401334.2016.1146605] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PROBLEM Medical students face rigorous and stressful work environments, resulting in high rates of psychological distress. However, there has been a dearth of empirical work aimed at modifying risk factors for psychopathology among this at-risk group. Distress tolerance, defined as the ability to withstand emotional distress, is one factor that may be important in promoting psychological well-being in medical students. Thus, the aim of the current mixed-methods study was (a) to describe changes in facets of distress tolerance (i.e., emotional tolerance, absorption, appraisal, regulation) for medical students who completed a mind-body skills training group, and a no-intervention control group of students; (b) to examine the relationship between changes in psychological variables and changes in distress tolerance; and (c) to report students' perceptions of the mind-body group, with an emphasis on how the group may have affected personal and professional functioning due to improvements in distress tolerance. INTERVENTION The mind-body program was an 11-week, 2-hour skills training group that focused on introducing, practicing, and processing mind-body skills such as biofeedback, guided imagery, relaxation, several forms of meditation (e.g., mindfulness), breathing exercises, and autogenic training. CONTEXT Participants were 52 first- and second-year medical students (62.7% female, Mage = 23.45, SD = 1.51) who participated in a mind-body group or a no-intervention control group and completed self-report measures before and after the 11-week period. OUTCOME Students in the mind-body group showed a modest improvement in all distress tolerance subscales over time (ΔM = .42-.53, p = .01-.03, d = .44-.53), whereas the control group showed less consistent changes across most subscales (ΔM = .11-.42, p = .10-.65, d = .01-.42). Students in the mind-body group qualitatively reported an improved ability to tolerate affective distress. Overall, improvements in psychological symptoms were associated with improvements in distress tolerance in the mind-body group but not in the control group. LESSONS LEARNED These preliminary findings provide support for the notion that improving distress tolerance through mind-body skills training might serve to protect medical students from becoming functionally impaired by psychological distress. Thus, implementing mind-body skills training into medical school education may help to improve the psychological well-being of medical students. Future studies utilizing more methodologically rigorous designs are warranted.
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Affiliation(s)
- Kristen M Kraemer
- a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA
| | - Christina M Luberto
- b Department of Psychiatry , Massachusetts General Hospital/Harvard Medical School , Boston , Massachusetts , USA
| | - Emily M O'Bryan
- a Department of Psychology , University of Cincinnati , Cincinnati , Ohio , USA
| | - Erica Mysinger
- c Department of Family and Community Medicine , University of Cincinnati , Cincinnati , Ohio , USA
| | - Sian Cotton
- c Department of Family and Community Medicine , University of Cincinnati , Cincinnati , Ohio , USA
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Norr AM, Allan NP, Macatee RJ, Keough ME, Schmidt NB. The effects of an anxiety sensitivity intervention on anxiety, depression, and worry: mediation through affect tolerances. Behav Res Ther 2014; 59:12-9. [PMID: 24949907 PMCID: PMC4151115 DOI: 10.1016/j.brat.2014.05.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/24/2014] [Accepted: 05/28/2014] [Indexed: 11/29/2022]
Abstract
Recently there has been increased interest in emotional and physical tolerance risk factors for mood and anxiety disorders. Three tolerance risk factors that have been shown to be related are anxiety sensitivity (AS), distress tolerance (DT), and discomfort intolerance (DI). Although previous research has demonstrated these constructs are malleable, no research has investigated the effects of an AS intervention on DT or DI. Further, no studies have investigated whether changes in DT or DI play a role in mood and anxiety symptom amelioration due to an AS intervention. Participants (N = 104), who were selected for elevated levels of AS, completed a single-session computer-assisted AS intervention or a control intervention and follow-up assessments at 1-week and 1-month post intervention. Results revealed that the intervention reduced AS and increased DT, but did not affect DI at the 1-week follow-up. Mediation analyses revealed that changes in AS and DT both mediated changes in symptoms (depression, anxiety, worry) due to the intervention at 1-month follow-up, however, when AS and DT were considered in the same model only the effect via AS remained significant. These results have important implications for the nature of the relationships between AS, DT, and DI as well as the specific mechanistic pathways through which an AS intervention ameliorates symptoms.
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Affiliation(s)
- Aaron M Norr
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
| | - Nicholas P Allan
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
| | - Richard J Macatee
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
| | - Meghan E Keough
- University of Washington, Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, 325 Ninth Ave, PS-5035, Box 359911, Seattle, WA 98104, USA.
| | - Norman B Schmidt
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
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