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

College students' daily mind wandering is related to lower social well-being

Objective: This study sought to examine how daily mind wandering is related to loneliness, felt connection to others, and school belonging among college students. Participants: Three samples (n = 209, n = 173, and n = 266) from two US campuses were recruited. Methods: Data were collected via ecological momentary assessment over the course of two academic quarters in one sample and an academic semester in two samples. Results: Social well-being declined throughout the academic term in all samples. Lower day-to-day mind wandering predicted lower loneliness at the next time point and was concurrently related to a higher felt connection to others and higher school belonging. Thoughts about the past and future were associated with lower social well-being than present-focused thoughts. Conclusions: This study supports the proposition that promoting present-centered attention can benefit college students' social well-being and alleviate their feelings of loneliness and isolation that they often experience.

Integrating mindfulness into the extended process model of emotion regulation: The dual-mode model of mindful emotion regulation

Extensive research has been conducted regarding how people manage their emotions. Within this research, there has been growing attention toward the role of mindfulness in emotion regulation. While prior reviews have discussed mindfulness in the context of emotion regulation, they have not provided a thorough integration using the prevailing models of emotion regulation or mindfulness. The present review discusses the Extended Process Model of Emotion Regulation and Monitoring and Acceptance Theory of mindfulness in order to propose a novel integrated framework, the Dual-mode Model of Mindful Emotion Regulation (D-MER). This model proposes two "modes" of mindfulness: Implementation and facilitation. Implementation posits that mindfulness skills can be used as emotion regulation strategies through attentional deployment and cognitive change. Facilitation posits that mindfulness as a state or trait affects emotion generation and regulation through effects on cognitive processes and positive or negative valence systems. Further, the D-MER posits that mindfulness experience can improve the efficiency of mindfulness-based emotion regulation strategies (implementation) while effects of mindfulness on emotion regulation processes become increasingly trait-like and automatic over time (facilitation). Empirical and theoretical support for this model are discussed, specific hypotheses to guide further research are provided, and clinical implications are presented. Use of this model may identify mechanisms underlying the interaction between mindfulness and emotion regulation which can be used in ongoing affective and clinical research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mind-Body Training: A Plausible Strategy against Osteomuscular Chronic Pain-A Systematic Review with Meta-Analysis

(1) Background: Chronic pain, which affects more than one in five adults worldwide, has a negative impact on the quality of life, limiting daily activities and generating absences from work. The aim of the present review is to analyze the efficacy of mind-body therapies as therapeutic strategies for patients with chronic pain. (2) Methods: A systematic review with a meta-analysis was carried out, searching PubMed, Scopus, and Web of Science databases using specific keywords. We selected studies that included mind-body therapies as the primary intervention for older adults with chronic pain. The methodological quality of the articles was assessed using the PEDro scale. (3) Results: Of the 861 studies identified, 11 were included in this review, all of which employed different mind-body therapies as an intervention. The selected studies measured chronic pain as the main variable. (4) Conclusions: This review highlights the value of mind-body exercises in reducing chronic pain in older adults, suggesting their integration as a non-pharmacological therapeutic alternative that improves the quality of life, promoting a holistic approach to pain management.

Mindfulness and loneliness in retired older adults in China: mediation effects of positive and negative affect

Objectives: Drawing from the mindfulness framework and the broaden-and-build theory, this study investigates the extent to which mindfulness influences loneliness and whether the relation is mediated by positive and negative affect.Method: Data were collected from 748 retired older adults aged 60 and above in Chengdu, China in 2022. Loneliness and mindfulness were measured by the UCLA loneliness scale and by the short-form version of the Five Facet Mindfulness Questionnaire, while the positive and negative affect was assessed by the International Positive and Negative Affect Schedule.Results: The results of this study show that mindfulness was positively associated with positive affect (β = 0.37, p<.001), negatively related to negative affect (β=-0.21, p<.001) and loneliness (β=-0.13, p<.001), and had an indirect effect on loneliness via positive and negative affect (β=-0.20, p<.001).Conclusion: The findings suggest that mindfulness could be a positive resource for improving mental health and reducing loneliness among retired older adults in China.

Inside the mindful moment: The effects of brief mindfulness practice on large-scale network organization and intimate partner aggression

Mindfulness can produce neuroplastic changes that support adaptive cognitive and emotional functioning. Recently interest in single-exercise mindfulness instruction has grown considerably because of the advent of mobile health technology. Accordingly, the current study sought to extend neural models of mindfulness by investigating transient states of mindfulness during single-dose exposure to focused attention meditation. Specifically, we examined the ability of a brief mindfulness induction to attenuate intimate partner aggression via adaptive changes to intrinsic functional brain networks. We employed a dual-regression approach to examine a large-scale functional network organization in 50 intimate partner dyads (total n = 100) while they received either mindfulness (n = 50) or relaxation (n = 50) instruction. Mindfulness instruction reduced coherence within the Default Mode Network and increased functional connectivity within the Frontoparietal Control and Salience Networks. Additionally, mindfulness decoupled primary visual and attention-linked networks. Yet, this induction was unable to elicit changes in subsequent intimate partner aggression, and such aggression was broadly unassociated with any of our network indices. These findings suggest that minimal doses of focused attention-based mindfulness can promote transient changes in large-scale brain networks that have uncertain implications for aggressive behavior.

Effect of a Mindfulness-Based Intervention on Self-Compassionate Behaviors: A Randomized Controlled Trial

Self-compassion is regarded as a mediating or moderating variable in mindfulness-based interventions (MBI). However, few studies have investigated the role of self-compassion on MBI. Therefore, we conducted a randomized controlled trial to examine whether (1) MBI decreases depression and trait anxiety, while increasing trait mindfulness, trait self-compassion, self-compassionate behaviors (SC behaviors), mindful behaviors, and mood after behaviors; and (2) SC behaviors moderate the effect of mindful behaviors on mood in daily life. Participants were patients with depression and/or anxiety (N=19) in Japan. Of the 27 participants recruited, 19 participated in the study. Using stratified randomization, we allocated 10 participants to the intervention group, with an 8-week standard MBI, and nine to the waitlist control group. Depression, trait anxiety, trait mindfulness, and trait self-compassion were assessed using questionnaires, while SC behaviors, mindful behaviors, and mood were measured using an ecological momentary assessment-a method used to repeatedly record events and behaviors in daily life. The results revealed that depression, trait anxiety, trait mindfulness, and trait self-compassion did not significantly change. However, SC behaviors, mindful behaviors, and mood significantly improved with MBI. Moreover, the interaction between SC behaviors and mindful behaviors was significantly shown in the pre-intervention, suggesting that SC behaviors moderate the effect of mindful behaviors on mood in daily life.

Cognitive-affective changes mediate the mindfulness-based intervention effect on endometriosis-related pain and mental health: A path analysis approach

BACKGROUND

There is poor knowledge about the therapeutic mechanisms of the conservative interventions for endometriosis. We hypothesized that the effects of a brief mindfulness-based intervention (bMBI) on pelvic pain intensity (PPI), pain unpleasantness (PU) and quality of life mental health (QoL-MH) are mediated by direct and indirect paths of changes in pain catastrophizing (PC), positive affect (PA) and negative affect (NA).

METHODS

A secondary analysis of a pilot randomized controlled trial of women with endometriosis, assigned to standard medical treatment (n = 32) and standard medical treatment plus bMBI (n = 31). We tested a series of parallel and serial mediators (PC, PA and NA) of the relationship between bMBI and outcomes (PPI, PU and QoL-MH).

RESULTS

The bMBI group demonstrated improvement in PA (Cohen's f2  = 0.12 [0.01, 0.36]), decreases in NA (Cohen's f2  = 0.06 [0.00, 0.24]) and PC (Cohen's f2  = 0.16 [0.02, 0.42]). The PC reduction mediated the effect of the bMBI on PPI and PU directly; however, the PC effect through PA increase mediated the PU marginally but not PPI changes. bMBI effect on Qol-MH was mediated directly by PA and NA. The PC improved Qol-MH through PA increase and Pain decrease but not via NA.

CONCLUSIONS

Our findings showed that bMBI impacts pain through changes in pain-related cognitive-affective factors. bMBI can improve QoL-MH by multiple pathways, including but not limited to pain reduction, highlighting the independent potential of improvement in affect to restore mental health in endometriosis.

SIGNIFICANCE

Brief mindfulness-based intervention improves endometriosis pain through pain-related cognitive-affective factors and quality of life mental health via pain and affect changes unrelated to pain.

Problematic Internet Use in Early Adolescents: Gender and Loneliness Differences in a Latent Growth Model

Purpose

Based on the Cognitive-Behavioral model and the Interaction of Person-Affect-Cognition-Execution model, this study examined the developmental trajectory of problematic Internet use (PIU) in early adolescents and explored whether there were gender differences in the onset level and rate of development of this developmental trajectory, and tested whether developmental changes in loneliness could have an impact on the developmental trajectory of problematic Internet use.

Participants and Methods

This longitudinal study collected data on PIU and loneliness from 296 early adolescents (Mage=11.65, SD=0.58) in four waves. The development of PIU in adolescents and the effects of gender and loneliness development on PIU development were examined using a latent growth model.

Results

The results revealed that individuals' PIU development showed a nonlinear latent growth model, with PIU significantly higher than 0 in grade 6 and its growth rate slowing down as PIU increased. Individuals' PIU at low starting levels developed more rapidly later. Boys had higher initial levels of PIU but their PIU developed and increased at the same rate as girls'. Both the initial value and slope of loneliness had a significant effect on the initial value and slope of boys' and girls' PIU.

Conclusion

Interventions for PIU in early adolescents also need to consider loneliness at the same time, and intervention groups can focus on individuals with low initial levels of PIU, boys, and individuals with high levels of loneliness.

The Effect of Digital Mindfulness Interventions on Depressive, Anxiety, and Stress Symptoms in Pregnant Women: A Systematic Review and Meta-Analysis

Introduction. Pregnancy is a unique time in a woman's life that can be both exciting and challenging. It is also a period that can be associated with significant stress, anxiety, and depression, which can have negative consequences for both the mother and the baby. Mindfulness interventions are known to be a well-suited treatment and prevention method for psychiatric symptoms in pregnancy, and web-based applications have been explored. We here present an up-to-date systematic review and meta-analysis of randomized-controlled trials to investigate the effect of digital-based mindfulness interventions on depressive, anxiety, and stress symptoms during pregnancy. Methods. The systematic literature search and data extraction was performed by two independent raters. It resulted in 13 eligible studies overall comprising 1373 participants. We conducted random-effects meta-analyses for depressive, anxiety, and stress symptoms after completion of a digital mindfulness intervention (compared to a control group). Results. Digital mindfulness intervention methods were significantly able to reduce depression (g = -0.47, 95% CI [-0.9; -0.09]) and anxiety symptoms (g = -0.41, 95% CI [-0.77; -0.05]), but not stress symptoms. These effects were moderated by the attrition rate (βDepression = 0.025, pDepression < 0.01; βAnxiety = 0.022, pAnxiety < 0.01; βStress = 0.022, pStress < 0.01). Primiparity also had a significant influence on the intervention effect regarding depression symptoms (β = 0.033, p = 0.024). Conclusions. Digital mindfulness interventions are a promising method to reduce mental health symptoms in pregnant women. We identified certain parameters moderating this effect, for example, primiparity and the attrition rate.

The Role of Anger Expression in Unmet Expectations and Depressive Symptoms

Background and Objectives. Depression is associated with unmet relational expectations, but little is known about how both partners experience meeting expectations and how this relates to anger expression and depressive symptoms. The aim of study 1 was to explore the role of anger expression in explaining the link between relational expectations and depression using the actor-partner interdependence mediation model. Additionally, social expectations beyond romantic relationships are associated with societal demands. Study 2 is aimed at investigating the role of anger expression in the relationship between internalized social demands (i.e., outer self-awareness) and depressive symptoms. Design and Methods. Online self-report data were collected from N = 194 romantic partners (97 dyads) in study 1 and N = 407 individuals in study 2. Results. In study 1, unmet expectations were associated with both actor and partner effects on depressive symptoms and anger expression. In particular, inwardly directed anger was linked to depressive symptoms in the case of the individual experiencing unmet expectations, whereas outwardly directed anger predicted such symptoms in the case of the partner's unmet expectations. In study 2, there was a positive association between outer self-awareness and directing anger inwards and outwards, which was linked to higher depressive symptoms. Furthermore, while directing anger inwards seemed to be a universal mechanism underlying the association, the interpersonal mechanism (i.e., directing anger outwards) was found to be dependent on gender.

Effects and mechanisms of an online short-term audio-based mindfulness program on positive affect: A randomized controlled trial including exploratory moderator analyses

This study investigated the effects and mechanisms of an online short-term audio-based mindfulness (SAM) intervention program on positive affect and explored how well-being and negative affect influenced these effects and mechanisms. Participants (N = 100) were randomized into an intervention group (n = 50) and a control group (n = 50). Those in the mindfulness group underwent 3 weeks of an online SAM program and completed the online measures four times, while those in the control group completed the measures twice. Participants completed measures including the World Health Organization Well-Being Index, the Freiburg Mindfulness Inventory, and the Positive and Negative Affect Schedule. The effects of measures in both groups were compared. Parallel process latent growth curve modeling analysis was used to explore the longitudinal moderated mediation effects. The results showed that SAM was effective at improving positive affect, mindfulness, well-being, and reducing negative affect. Mindfulness growth speed during the intervention period mediated the relationship between SAM and positive affect improvement speed. The moderation effects of baseline well-being and negative effect on mediation effects were found to be significant. The SAM program was effective for the general public and was more beneficial for those with medium/high well-being and low/medium negative affect.

How relative deprivation affects the sleep quality of Chinese college students: testing an integrated model of social anxiety and trait mindfulness

Although previous studies have confirmed the association between relative deprivation and individual health, the relationship between and underlying mechanisms of relative deprivation and sleep quality have rarely been explored. Therefore, the present study investigated how relative deprivation affected sleep quality by testing an integrated model and examining the roles of social anxiety and trait mindfulness. We surveyed 568 college students using the Relative Deprivation Scale, Interaction Anxiousness Scale, Mindful Attention Awareness Scale, and Pittsburg Sleep Quality Index. Data were analyzed using SPSS 24.0 and PROCESS macro for SPSS. We found that a high relative deprivation score predicted poor sleep quality, and social anxiety partially mediated this relationship. Our model also indicated that the relationship between relative deprivation and sleep quality via social anxiety was moderated by mindfulness. Specifically, increasing trait mindfulness may decrease the indirect effect of relative deprivation on sleep quality through social anxiety. The current study expands our understanding of the underlying mechanisms, paths, and conditions of the effects of relative deprivation on sleep quality. Furthermore, we provide additional evidence that trait mindfulness can mitigate the adverse effects of negative events. College students should consciously use trait mindfulness techniques to consider problems, reduce anxiety, and improve their sleep quality.

The Mental Imagery for Suicidality in Students Trial (MISST): study protocol for a feasibility randomised controlled trial of broad-minded affective coping (BMAC) plus risk assessment and signposting versus risk assessment and signposting alone

BACKGROUND

Going to university is an important milestone in many people's lives. It can also be a time of significant challenge and stress. There are growing concerns about mental health amongst student populations including suicide risk. Student mental health and counselling services have the potential to prevent suicide, but evidence-based therapies are required that fit these service contexts. The Broad-Minded Affective Coping intervention (BMAC) is a brief (6 sessions), positive imagery-based intervention that aims to enhance students access to past positive experiences and associated emotions and cognitions. Pilot data provides preliminary support for the BMAC for students struggling with suicidal thoughts and behaviours, but this intervention has not yet been evaluated in the context of a randomised controlled trial (RCT). The Mental Imagery for Suicidality in Students Trial (MISST) is a feasibility RCT that aims to determine the acceptability and feasibility of evaluating the BMAC as an intervention for university students at risk of suicide within a larger efficacy trial. Key feasibility uncertainties have been identified relating to recruitment, retention, and missing data. Intervention acceptability and safety will also be evaluated.

METHOD

MISST is a feasibility randomised controlled trial design, with 1:1 allocation to risk assessment and signposting plus BMAC or risk assessment and signposting alone. Participants will be university students who self-report experiences of suicidal ideation or behaviour in the past 3 months. Assessments take place at baseline, 8, 16, and 24 weeks. The target sample size is 66 participants. A subset of up to 20 participants will be invited to take part in semi-structured qualitative interviews to obtain further data concerning the acceptability of the intervention.

DISCUSSION

The BMAC intervention may provide an effective, brief talking therapy to help university students struggling with suicidal thoughts that could be readily implemented into university student counselling services. Depending on the results of MISST, the next step would be to undertake a larger-scale efficacy trial.

TRIAL REGISTRATION

The trial was preregistered (17 December 2021) on ISRCTN (ISRCTN13621293) and ClinicalTrials.gov (NCT05296538).

Reciprocal Prospective Effects of Momentary Cognitions and Affect in Daily Life and Mood Reactivity Toward Daily Events in Remitted Recurrent Depression

Major depressive disorder is a recurrent condition. Potential risk factors for future episodes are maladaptive cognitions, such as rumination and unfavorable reactivity toward negative daily events. Positive thoughts and positive daily events, in contrast, could act as a buffer against mood deterioration. The aim of the present study is to (a) examine differences in daily affect and cognitions in remitted depressed patients with a history of recurrent episodes (rMDD) and healthy controls, (b) analyze reciprocal prospective effects of momentary cognitions and affect, and (c) investigate effects of daily events on affect and cognitions in both groups. A sample of N = 102 participants underwent an ecological momentary assessment (EMA) phase of 5 consecutive days, where rMDD patients (n = 51) and healthy controls (n = 51) indicated their momentary rumination, positive thoughts, affect, and the occurrence of daily events 10 times per day. Via multilevel lag models, we found higher rumination to predict a decrease of positive affect (PA) in the rMDD group, but no effect of rumination on subsequent negative affect (NA) in either group. Higher positive thoughts predicted an increase in PA and a decrease in NA, similarly strong in both groups. Regarding daily events, rMDD patients reported a stronger increase in NA and rumination following negative daily events compared to controls, whereas an observed subsequent decrease of PA and positive thoughts was not moderated by group. Following positive daily events, rMDD patients showed a stronger increase in PA and positive thoughts and a stronger decrease in NA and rumination than controls. For interventions targeting relapse prevention, our results indicate the implementation of strategies fostering the responsiveness to positive events and the up-regulation of positive affect.

Enhanced electroencephalography effective connectivity in frontal low-gamma band correlates of emotional regulation after mindfulness training

Practicing mindfulness, focusing attention on the internal and external experiences occurring in the present moment with open and nonjudgement stance, can lead to the development of emotional regulation skills. Yet, the effective connectivity of brain regions during mindfulness has been largely unexplored. Studies have shown that mindfulness practice promotes functional connectivity in practitioners, potentially due to improved emotional regulation abilities and increased connectivity in the lateral prefrontal areas. To examine the changes in effective connectivity due to mindfulness training, we analyzed electroencephalogram (EEG) signals taken before and after mindfulness training, focusing on training-related effective connectivity changes in the frontal area. The mindfulness training group participated in an 8-week mindfulness-based stress reduction (MBSR) program. The control group did not take part. Regardless of the specific mindfulness practice used, low-gamma band effective connectivity increased globally after the mindfulness training. High-beta band effective connectivity increased globally only during Breathing. Moreover, relatively higher outgoing effective connectivity strength was seen during Resting and Breathing and Body-scan. By analyzing the changes in outgoing and incoming connectivity edges, both F7 and F8 exhibited strong parietal connectivity during Resting and Breathing. Multiple regression analysis revealed that the changes in effective connectivity of the right lateral prefrontal area predicted mindfulness and emotional regulation abilities. These results partially support the theory that the lateral prefrontal areas have top-down modulatory control, as these areas have high outflow effective connectivity, implying that mindfulness training cultivates better emotional regulation.

Predictors of Mental Health Help-Seeking During COVID-19: Social Support, Emotion Regulation, and Mental Health Symptoms

Little is known about factors that contribute to mental health help-seeking during disasters beyond attitudes toward counseling. The COVID-19 (SARS-CoV-2) global pandemic dramatically impacted individuals, families, and communities worldwide. The pandemic led to significant disruptions to family routines, and evidence suggests an increase in instances of mental health symptoms, like depression and anxiety, and poor utilization of mental health services. To better understand psychological factors associated with help-seeking during the COVID-19 pandemic, researchers surveyed respondents (n = 1,533 at time 1) about their mental health and help-seeking using Amazon's MTurk platform. The results indicated that individuals with higher levels of anxiety rate their likelihood of help-seeking as higher and those who do seek psychological help report higher levels of depression. Further, those who began new treatment for behavioral health difficulties during the COVID-19 pandemic reported lower social support and less clarity about how they felt (specifically, emotional clarity when upset). Implications for clinical researchers and public health are discussed.

Effectiveness of an online short-term audio-based mindfulness program on negative emotions during the COVID-19 pandemic: Latent growth curve analyses of anxiety and moderated mediation effects of anxiety between mindfulness and negative affect

This pilot study aims to explore the effects and mechanisms of a mindfulness-based intervention on negative emotions in community settings during the COVID-19 pandemic. Participants (N = 100) were randomized into an intervention group (n = 50) and a waitlist control group (n = 50). Participants in the mindfulness group underwent 3 weeks (21 sessions) of an online audio-based mindfulness-based intervention program and completed the online measures four times whereas those in the waitlist control group needed to complete the measures twice. Participants completed measures of the Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule. The results of the measures of the two groups were compared. Moderated mediation analysis was used to analyze intervention outcomes on negative affect through anxiety. Unconditional quadratic latent growth analysis was used to test the growth trajectories of anxiety. The results showed that this intervention program was effective at improving positive affect and at reducing depression, anxiety, and negative affect. The baseline anxiety moderator was found to be significant, and indirect effects of anxiety post-intervention were found between the mindfulness-based intervention and negative affect. Anxiety levels of participants were not at the same starting point and had similar but non-quadratic growth trajectories. The mindfulness-based intervention program was effective at promoting mental wellbeing and reducing mental problems in community settings in China. Mindfulness practices were beneficial to people with different anxiety levels but had more obvious benefits on anxiety and a negative affect for participants with low anxiety levels. Clinical trial registration: ISRCTN16205138 on 26/02/2021.

Effects of a Mindfulness-Based Weight Loss Intervention on Long-Term Psychological Well-Being Among Adults with Obesity: Secondary Analyses from the Supporting Health by Integrating Nutrition and Exercise (SHINE) Trial

Objective

This study tested whether a mindfulness-based intervention for obesity that included components aimed at emotion regulation and mindful eating improved psychological outcomes including stress, anxiety, positive emotion, and depression, during the intervention period and at longer-term follow-up.

Methods

Adults with obesity (N=194) were randomized to a 5.5-month diet-exercise weight loss intervention with or without mindfulness training focused on emotion regulation and mindful eating. Participants completed self-report measures of mindfulness and psychological well-being, which were planned secondary outcomes, at baseline, mid-intervention (3 months), and at 6-, 12-, and 18-months post-baseline (maintenance period). Mixed effects models and linear regression were used to test between- and within-group changes in psychological well-being. Finally, this study explored whether changes in mindfulness (from baseline to each 6- and 18-months post-baseline) mediated the effects of intervention arm on changes in psychological outcomes during those respective time periods. This study explored whether changes in mindfulness from baseline to 6 months mediated the effects of intervention arm on changes in psychological outcomes from baseline to 18 months.

Results

Participants randomized to the mindfulness arm had significant increases in positive emotions at all follow-up times compared to controls. There were statistically significant increases in mindfulness, psychological flexibility, and reflection, as well as decreases in anxiety and depressive symptoms at 12 months compared to control participants. These changes remained significant for psychological flexibility and reflection at 18 months. There were no significant differences in perceived stress. Among mindfulness participants, greater increases in mindfulness from 6-18 months was associated with greater positive emotions and psychological flexibility as well as lower perceived stress, anxiety, depressive symptoms, and rumination at 18 months, adjusting for 6-month values. Mediation analyses indicated that randomization to the mindfulness intervention arm was associated with 6-month increases in mindfulness, and these increases were in turn associated with improved psychological outcomes at 6 months and 18 months. Changes from baseline to 18 months did not mediate 18-month changes in psychological outcomes.

Conclusions

Mindfulness training in emotion regulation and mindful eating may provide greater longer-term psychological well-being benefits in non-clinical populations with obesity compared to conventional diet-exercise interventions.

Exploring the past, present, and future of the mindfulness field: A multitechnique bibliometric review

This paper provides an overview of the mindfulness literature up until the end of 2020 by (a) uncovering its underlying intellectual structure, (b) identifying the most influential and popular themes, and (c) presenting new directions for future research on mindfulness. To this end, a systematic quantitative review based on bibliometric methods was conducted, which is perhaps less prone to researcher bias and can complement existing meta-analyses and qualitative (narrative) structured reviews as an objective approach. Three bibliometric techniques—document co-citation analysis, co-word (co-occurrence and content) analysis, and bibliographic coupling—were applied to explore the past, present, and future of mindfulness research. The co-citation analysis showed that measurement, mechanisms, mindfulness-based interventions, and examinations of the efficacy of mindfulness interventions are among the key theoretical knowledge bases from which the field of mindfulness is derived. The content analysis demonstrated the beneficial effects of mindfulness meditation for physical and mental health conditions. The bibliographic coupling revealed novel directions in cognitive behavioral therapy, emotion regulation, the application of mindfulness practice to children and adolescents, mindfulness at work, and the role of mindfulness in positive psychology. The large sample of articles that was analyzed allowed us to provide a broader and more objective overview than possible with other forms of literature reviews. The combination of the three bibliometric techniques granted deeper insights into the complex multidisciplinary field of mindfulness, along with specific suggestions for future research.

When Mindfulness Becomes a Mental Health Risk: The Relevance of Emotion Regulation Difficulties and Need Frustration

Although a great deal of research has shown the positive effects of mindfulness on mental health, some studies have provided evidence that mindfulness can have negative consequences. However, not much is known about the conditions that can account for such negative effects. We examined the moderating roles of difficulties in emotion regulation and basic psychological need frustration in the relationship between mindfulness and psychological ill-being. Longitudinal data were collected at three points in time during a 6-month period from two adult samples in Turkey and Germany. Self-report measures were used to measure ill-being, mindfulness, emotion regulation difficulties, and need frustration. In the German sample, difficulties in emotion regulation and need frustration were related to ill-being, but there were no significant interactions. In the Turkish sample, need frustration predicted ill-being, and the interaction between mindfulness and difficulties in emotion regulation also predicted ill-being. Mindfulness was a protective factor among people with no major difficulties in emotion regulation, whereas it was a risk factor among those with emotion regulation difficulties. The findings suggest that the relationship between mindfulness and ill-being may be more complex than previously thought.

Comparing impacts of meditation training in focused attention, open monitoring, and mindfulness-based cognitive therapy on emotion reactivity and regulation: Neural and subjective evidence from a dismantling study

Commonly conducted mindfulness‐based trainings such as Mindfulness‐based Stress Reduction (MBSR) and Mindfulness‐based Cognitive Therapy (MBCT) highlight training in two key forms of meditation: focused attention (FA) and open monitoring (OM). Largely unknown is what each of these mindfulness practices contributes to emotional and other important training outcomes. This dismantling trial compared the effects of structurally equivalent trainings in MBCT, FA, and OM on neural and subjective markers of emotional reactivity and regulation among community adults, with the aim to better understand which forms of training represent active ingredients in mindfulness trainings. Participants with varying levels of depressive symptoms were randomized to one of the three trainings. Before and after each 8‐week training, N = 89 participants completed a modified version of the Emotional Reactivity and Regulation Task while electroencephalographic (EEG) and self‐reported emotional responses to negative, positive, and neutral photographic images were collected. Examination of EEG‐based frontal alpha band asymmetry during passive viewing (reactivity) and active regulation phases of the task showed that FA and MBCT trainings produced significant leftward hemispheric shifts in frontal alpha asymmetry, commonly associated with a shift toward approach‐based positive affect. Self‐reported emotional responses to negative images corroborated these results, suggesting salutary changes in both emotional reactivity and regulation. OM training had limited beneficial effects, restricted to the subjective outcomes. The findings suggest that MBCT may derive its greatest benefit from training in FA rather than OM. Discussion highlights the potential value of FA training for emotional health.

In the first report comparing emotion‐relevant impacts of focused attention meditation (FA), open awareness meditation (OM), and Mindfulness‐based Cognitive Therapy (MBCT) among those with depressive symptoms, we show that FA and MBCT produced leftward hemispheric shifts in frontal alpha asymmetry, consistent with approach‐based positive affect, during an emotion reactivity and regulation task. Self‐reported emotional responses to negative images corroborated these results. The findings highlight the potential value of FA and MBCT training for emotional health.

A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents

BACKGROUND

Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health, but its effectiveness is still unclear.

METHODS

MindChamp is a pre-registered randomised controlled trial comparing an 8-week family MBI (called 'MYmind') in addition to care-as-usual (CAU) (n = 55) with CAU-only (n = 48). Children aged 8-16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post-treatment parent-rated child self-control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher-rated Conners' and SWAN; teacher-rated BRIEF), other psychological symptoms (parent/teacher-rated), well-being (parent-rated) and mindfulness (self-rated). Secondary parent outcomes included self-ratings of ADHD symptoms, other psychological symptoms, well-being, self-compassion and mindful parenting. Assessments were conducted at post-treatment, 2- and 6-month follow-up.

RESULTS

Relative to CAU-only, MBI+CAU resulted in a small, statistically non-significant post-treatment improvement on the BRIEF (intention-to-treat: d = 0.27, p = .18; per protocol: d = 0.33, p = .11). Significantly more children showed reliable post-treatment improvement following MBI+CAU versus CAU-only (32% versus 11%, p < .05, Number-Needed-to-Treat = 4.7). ADHD symptoms significantly reduced post-treatment according to parent (Conners' and SWAN) and teacher ratings (BRIEF) per protocol. Only parent-rated hyperactivity impulsivity (SWAN) remained significantly reduced at 6-month follow-up. Post-treatment group differences on other secondary child outcomes were consistently favour of MBI+CAU, but mostly non-significant; no significant differences were found at follow-ups. Regarding parent outcomes, significant post-treatment improvements were found for their own ADHD symptoms, well-being and mindful parenting. At follow-ups, some significant effects remained (ADHD symptoms, mindful parenting), some additional significant effects appeared (other psychological symptoms, self-compassion) and others disappeared/remained non-significant.

CONCLUSIONS

Family MBI+CAU did not outperform CAU-only in reducing child self-control deficits on a group level but more children reliably improved. Effects on parents were larger and more durable. When CAU for ADHD is insufficient, family MBI could be a valuable addition.

The Effect of Mindfulness-Based Cognitive-Behavioral Sex Therapy on Improving Sexual Desire Disorder, Sexual Distress, Sexual Self-Disclosure and Sexual Function in Women: A Randomized Controlled Clinical Trial

Sexual desire disorder is the most common form of sexual dysfunction among women and is associated with problems like sexual distress and reduced sexual self-disclosure. As a result, this RCT study was conducted with 70 reproductive-age women in the form of 4 weekly group educational sessions. Compared to the control group, the mindfulness-based cognitive-behavioral sex therapy (MBCST) intervention significantly improved sexual -desire, -distress, self-disclosure and -function immediately, 4 and 12 weeks after the educational sessions were completed in the intervention group (p < 0.001). Overall, our findings underscore the significance of the MBCST intervention on improving sexual dysfunction among women.Trial registration number: Iranian registry of clinical trials. IRCT Id: IRCT20160808029255N4.Trial registration date: 17th September 2018.Date of first patient's enrollment: 19th September 2018.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.2008075.

Mindfulness Training Associated With Resting-State Electroencephalograms Dynamics in Novice Practitioners via Mindful Breathing and Body-Scan

Objectives: Mindfulness-based stress reduction has been proven to improve mental health and quality of life. This study examined how mindfulness training and various types of mindfulness practices altered brain activity. Methods: Specifically, the spectral powers of scalp electroencephalography of the mindfulness-based stress reduction (MBSR) group (n=17) who underwent an 8-week MBSR training-including mindful breathing and body-scan-were evaluated and compared with those of the waitlist controls (n=14). Results: Empirical results indicated that the post-intervention effect of MBSR significantly elevated the resting-state beta powers and reduced resting-state delta powers in both practices; such changes were not observed in the waitlist control. Compared with mindful breathing, body-scanning resulted in an overall decline in electroencephalograms (EEG) spectral powers at both delta and low-gamma bands among trained participants. Conclusion: Together with our preliminary data of expert mediators, the aforementioned spectral changes were salient after intervention, but mitigated along with expertise. Additionally, after receiving training, the MBSR group's mindfulness and emotion regulation levels improved significantly, which were correlated with the EEG spectral changes in the theta, alpha, and low-beta bands. The results supported that MBSR might function as a unique internal processing tool that involves increased vigilant capability and induces alterations similar to other cognitive training.

A Longitudinal Study of Exercise Addiction and Passion in New Sport Activities: the Impact of Motivational Factors

Recent research suggests that the risk of exercise addiction (REA) is primarily predicted by passion. However, this relationship stems from cross-sectional studies. The objective of this 12-week longitudinal investigation was to examine and compare the temporal changes in REA and passion among women and men (N = 149) who just started a new sport activity. To further test their similarities and distinctiveness, we also examined how exercise motivations predict REA and passion. Latent growth modeling showed that REA and passion were high at baseline and showed a slight increase over the 12 weeks. Passion was predicted by several motivational factors, whereas REA was predicted by being female, team sport participation, higher exercise intensity, and identified motivation. These findings suggest that the development of passion and REA over time, both being associated with sport motivations, manifest independent patterns. Consequently, despite the reported strong relationship between the two, they appear to be independent constructs.

A Mixed-Method Assessment of a 10-Day Mobile Mindfulness Intervention

Mobile mindfulness interventions represent a promising alternative to traditional in-person interventions that are resource demanding and have limited accessibility, preventing use by many populations. Despite greater accessibility and popularity of mobile mindfulness applications (apps), research is needed testing the effectiveness of brief interventions delivered via these platforms. The present study assessed the efficacy of a brief mobile mindfulness intervention compared to an active control for increasing state and trait mindfulness and improving mood, as well as the acceptability of the app, in a sample of undergraduate students. Participants (N=139; M_age=19.43years, 80.6% female, 83.5% White) were randomly assigned to either a 10-day mobile mindfulness (Headspace) or cognitive training (Peak) condition. Trait mindfulness was measured pre- and post-intervention. During the 10-day intervention, participants completed 10-min daily exercises on the assigned app, responded to daily questionnaires of state mindfulness and mood, and completed a daily written log of their reactions to the app exercises. Attrition was low (90% completion rate) and did not differ by condition. Participants in the mindfulness condition spent an average of 88.15min (SD=24.75) meditating out of the full 100min prescribed by the intervention. State mindfulness significantly increased across the 10-day intervention for participants in the mindfulness, but not the cognitive training, condition beginning around days 5 and 6. Some aspects of trait mindfulness increased and mood improved from pre- to post-intervention, but these changes were observed in both conditions (i.e., no significant differences were observed by condition). Qualitative analysis of open-ended reactions to the mindfulness app indicated that participants reported more likes than dislikes. Common themes for likes were that participants experienced feelings of calm and focus following the daily mindfulness exercises. Dislikes included discomfort and anxiety associated with increased awareness of thoughts and physical sensations. These findings suggest that while a brief mobile mindfulness intervention is acceptable to undergraduate college students and effective at increasing state mindfulness, a longer intervention may be needed in order to elicit corresponding changes in trait-level mindfulness or mood.

Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial

Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.

Daily mindfulness training reduces negative impact of COVID-19 news exposure on affective well-being

COVID-19 has led to mental health adversities worldwide. The current study examined whether daily practice of brief mindfulness training has a beneficial impact on affective well-being, and mitigates the negative impact of exposure to COVID-19 news during the pandemic. Participants were randomly assigned into a mindfulness training (MT) group or a waitlist control (WC) group. Participants in the MT group practiced guided mindfulness meditation for a minimum of 10 min each day for 10 days. Both groups completed questionnaires assessing well-being at baseline and after the 10-day period. We also included four ecological momentary assessments (EMA) interspersed throughout the day to measure fine-grained affective states and recent exposure to COVID-19-related news, which has been linked to negative affect. We observed an increase in positive affect in the MT group compared to the WC group in the post-training assessment. However, no group differences emerged in the other three post-training affective measures of negative affect, anxiety and depression. EMA revealed that the MT group also showed more positive affective valence than the WC group across the 10 days. Notably, the WC group reported more negative affective valence following COVID-19 news exposure, whereas the MT group was not impacted. Taken together, our study indicates brief sessions of guided mindfulness meditation during COVID-19 may boost positive affect and serve as a protective buffer against the negative impact of exposure to COVID-19-related news on affective well-being. These findings highlight the utility of mindfulness meditation as an accessible and cost-effective technique to elevate positive affect amidst the COVID-19 pandemic.

The Horyzons project: a randomized controlled trial of a novel online social therapy to maintain treatment effects from specialist first-episode psychosis services

This study aimed to determine whether, following two years of specialized support for first-episode psychosis, the addition of a new digital intervention (Horyzons) to treatment as usual (TAU) for 18 months was more effective than 18 months of TAU alone. We conducted a single-blind randomized controlled trial. Participants were people with first-episode psychosis (N=170), aged 16-27 years, in clinical remission and nearing discharge from a specialized service. They were randomly assigned (1:1) to receive Horyzons plus TAU (N=86) or TAU alone (N=84) between October 2013 and January 2017. Horyzons is a novel, comprehensive digital platform merging: peer-to-peer social networking; theory-driven and evidence-informed therapeutic interventions targeting social functioning, vocational recovery and relapse prevention; expert clinician and vocational support; and peer support and moderation. TAU involved transfer to primary or tertiary community mental health services. The primary outcome was social functioning at 18 months as measured by the Personal and Social Performance Scale (PSP). Forty-seven participants (55.5%) in the Horyzons plus TAU group logged on for at least 6 months, and 40 (47.0%) for at least 9 months. Social functioning remained high and stable in both groups from baseline to 18-month follow-up, with no evidence of significant between-group differences (PSP mean difference: -0.29, 95% CI: -4.20 to 3.63, p=0.77). Participants in the Horyzons group had a 5.5 times greater increase in their odds to find employment or enroll in education compared with those in TAU (odds ratio, OR=5.55, 95% CI: 1.09-28.23, p=0.04), with evidence of a dose-response effect. Moreover, participants in TAU were twice as likely to visit emergency services compared to those in the Horyzons group (39% vs. 19%; OR=0.31, 95% CI: 0.11-0.86, p=0.03, number needed to treat, NNT=5). There was a non-significant trend for lower hospitalizations due to psychosis in the Horyzons group vs. TAU (13% vs. 27%; OR=0.36, 95% CI: 0.11-1.08, p=0.07, NNT=7). So, although we did not find a significant effect of Horyzons on social functioning compared with TAU, the intervention was effective in improving vocational or educational attainment, a core component of social recovery, and in reducing usage of hospital emergency services, a key aim of specialized first-episode psychosis services. Horyzons holds significant promise as an engaging and sustainable intervention to provide effective vocational and relapse prevention support for young people with first-episode psychosis beyond specialist services.

A mindfulness-based, stress and coping model of craving in methamphetamine users

There is increasing interest in the role of mindfulness and mindfulness-based interventions to optimize recovery from a substance use disorder (SUD). However, relatively little is known about the theory-based psychological and social pathways whereby mindfulness could have beneficial effects for managing a chronic, relapsing SUD. Informed by Revised Stress and Coping Theory, the present cross-sectional study examined affective, cognitive, and social pathways whereby mindfulness is associated with lower methamphetamine craving. A total of 161 HIV-positive, methamphetamine-using sexual minority men completed a screening visit for a randomized controlled trial. Using a hybrid structural equation model, we examined pathways whereby mindfulness is associated with lower methamphetamine craving. We found that greater mindfulness was directly associated with lower negative affect and higher positive affect as well as indirectly associated with less methamphetamine craving. Interestingly, the indirect association between mindfulness and methamphetamine craving appeared to be uniquely attributable to positive affect. Only positive affect was indirectly associated with lower methamphetamine craving via higher positive re-appraisal coping and greater self-efficacy for managing triggers for methamphetamine use. Methamphetamine craving was supported by moderate associations with greater substance use severity and more frequent methamphetamine use. These findings support the role of mindfulness in cultivating positive affect, which could be crucial to build the capacity of individuals to manage methamphetamine craving as a chronic stressor that threatens recovery from SUD.

The long shadow of childhood trauma for depression in midlife: examining daily psychological stress processes as a persistent risk pathway

BACKGROUND

Childhood trauma (CT) increases the risk of adult depression. Buffering effects require an understanding of the underlying persistent risk pathways. This study examined whether daily psychological stress processes - how an individual interprets and affectively responds to minor everyday events - mediate the effect of CT on adult depressive symptoms.

METHODS

Middle-aged women (N = 183) reported CT at baseline and completed daily diaries of threat appraisals and negative evening affect for 7 days at baseline, 9, and 18 months. Depressive symptoms were measured across the 1.5-year period. Mediation was examined using multilevel structural equation modeling.

RESULTS

Reported CT predicted greater depressive symptoms over the 1.5-year time period (estimate = 0.27, s.e. = 0.07, 95% CI 0.15-0.38, p < 0.001). Daily threat appraisals and negative affect mediated the effect of reported CT on depressive symptoms (estimate = 0.34, s.e. = 0.08, 95% CI 0.22-0.46, p < 0.001). Daily threat appraisals explained more than half of this effect (estimate = 0.19, s.e. = 0.07, 95% CI 0.08-0.30, p = 0.004). Post hoc analyses in individuals who reported at least moderate severity of CT showed that lower threat appraisals buffered depressive symptoms. A similar pattern was found in individuals who reported no/low severity of CT.

CONCLUSIONS

A reported history of CT acts as a latent vulnerability, exaggerating threat appraisals of everyday events, which trigger greater negative evening affect - processes that have important mental health consequences and may provide malleable intervention targets.

Persistent Low Positive Affect and Sleep Disturbance across Adolescence Moderate Link between Stress and Depressive Symptoms in Early Adulthood

The purpose of this study was to characterize the association between recent major life events and depressive symptoms during early adulthood, and to determine whether adolescents with chronically low positive affect or persistent sleep disturbance were more vulnerable to the link between stress and depressive symptoms. Adolescents (n = 147; 63.9% female; 33.7% non-Hispanic white) were recruited in 10th-11th grade and re-assessed 2 and 4 years later. At each assessment, adolescents completed measures of positive affect and sleep disturbances. At the final assessment, participants reported on their exposure to major life events in the past 12 months. Exposure to more major life events in the past year was associated with greater depressive symptoms in early adulthood. Chronically low positive affect and persistent sleep disturbances throughout adolescence each independently moderated this relationship. Specifically, only participants reporting low positive affect across the three assessments showed a positive and significant association between major life events and depressive symptoms. Further, only participants reporting sleep disturbances at all three assessments showed a positive and significant association between major life events and depressive symptoms. Chronically low positive affect and persistent sleep disturbances during adolescence may be useful indicators of risk for depression during early adulthood. Further, interventions targeting adolescent sleep disturbances and improving positive affect may be useful in reducing the risk for depression following life stress during this high risk developmental phase.

The Art of Happiness: An Explorative Study of a Contemplative Program for Subjective Well-Being

In recent decades, psychological research on the effects of mindfulness-based interventions has greatly developed and demonstrated a range of beneficial outcomes in a variety of populations and contexts. Yet, the question of how to foster subjective well-being and happiness remains open. Here, we assessed the effectiveness of an integrated mental training program The Art of Happiness on psychological well-being in a general population. The mental training program was designed to help practitioners develop new ways to nurture their own happiness. This was achieved by seven modules aimed at cultivating positive cognition strategies and behaviors using both formal (i.e., lectures, meditations) and informal practices (i.e., open discussions). The program was conducted over a period of 9 months, also comprising two retreats, one in the middle and one at the end of the course. By using a set of established psychometric tools, we assessed the effects of such a mental training program on several psychological well-being dimensions, taking into account both the longitudinal effects of the course and the short-term effects arising from the intensive retreat experiences. The results showed that several psychological well-being measures gradually increased within participants from the beginning to the end of the course. This was especially true for life satisfaction, self-awareness, and emotional regulation, highlighting both short-term and longitudinal effects of the program. In conclusion, these findings suggest the potential of the mental training program, such as The Art of Happiness, for psychological well-being.

Neural responses to threat and reward and changes in inflammation following a mindfulness intervention

OBJECTIVE

Mindfulness meditation has been shown to reduce distress and increase well-being among individuals with chronic disease, including breast cancer survivors. However, the neural correlates of these changes and their links with inflammatory biology are not yet known. The present study examined whether a mindfulness meditation intervention was associated with changes in neural responses to threat and reward from pre- to post-intervention, and whether those neural changes were associated with changes in markers of inflammation in breast cancer survivors.

METHODS

This was a single-arm trial of a standardized, validated 6-week mindfulness meditation intervention. Participants were 20 women who had been diagnosed and treated for early-stage breast cancer. Participants provided peripheral blood samples and underwent a 90-minute neuroimaging scan before and after the intervention, with a focus on tasks known to elicit activity in threat- and reward-related neural regions.

RESULTS

There were significant changes in neural responses to the two tasks of interest from pre to post-intervention (ps < 0.042). Participants showed significant reductions in amygdala activity in response to threatening images and significant increases in ventral striatum activity to rewarding images from pre- to post-intervention. Although changes in amygdala activity were not correlated with inflammatory markers, increases in ventral striatum activity were correlated with decreases in circulating concentrations of the proinflammatory cytokine IL-6 and the inflammatory marker CRP.

CONCLUSIONS

These results, while preliminary, suggest that while a mindfulness meditation intervention can alter neural responses to both threat and nonsocial reward-related stimuli, changes in neural reward activity may be more closely linked to changes in circulating levels of inflammation.

Development of a mindfulness-based treatment for smoking cessation and the modification of alcohol use: A protocol for a randomized controlled trial and pilot study findings

The combined use of cigarettes and alcohol is associated with an increased risk of morbidity and mortality. Yet, efficacious interventions that address both behaviors concurrently are lacking. Smoking cessation and alcohol modification not only garner health benefits, but there is also value in addressing alcohol use in the context of smoking cessation to reduce the risk for smoking relapse. In this paper we describe the development of mindfulness-based relapse prevention for smoking cessation and alcohol modification (MBRP-SA) and pilot study findings (Phase 1). Next, details regarding the methods and design of an ongoing, randomized controlled trial, Project RISE (Phase 2), are described. MBRP-SA is a group-based intervention that consists of eight weekly treatment sessions. Results from the Phase 1 pilot study (N = 21 enrolled) indicated that participants planned to use the skills learned in their everyday activities and to address their smoking and alcohol goals. Based on the progression of Phase 1 cohorts, modifications were made to the inclusion/exclusion criteria and recruitment methods that will be implemented in Phase 2. Phase 2 will assess the feasibility and acceptability of MBRP-SA, delivered via live online groups, as a primary treatment option for smoking cessation and alcohol use modification.

Daily change patterns in mindfulness and psychological health: A pilot intervention

OBJECTIVE

This study examined the differences in first-year college students' daily change trajectories in subjective happiness, depression, anxiety, stress, and state mindfulness.

METHOD

A 5-day, online mindfulness-based intervention (MI) condition and stress management (SM) condition were employed in 247 first-year college students.

RESULTS

Students in both the MI and SM conditions displayed similar significant linear declines in anxiety and stress, but there were significant differences between the two conditions, including: (1) the MI condition showing a significant linear increase in subjective happiness compared with no change in the SM condition and (2) the SM condition showed a significant linear decrease in depression compared to no significant change in the MI condition.

CONCLUSION

Brief online interventions-whether MI or SM-can promote better mental health and reduce psychological distress. The results also lend support for MI's differential influence on first-year college students' happiness and SM's differential influence on their depression.

Approach coping and substance use outcomes following mindfulness-based relapse prevention among individuals with negative affect symptomatology

Objectives

Mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs) appears to be particularly effective among individuals with high levels of co-occurring affective symptoms. We sought to understand whether changes in approach and avoidance coping may explain the effects of MBRP among this subpopulation.

Method

The sample included 286 individuals with SUDs randomized to MBRP, relapse prevention (RP), or treatment-as-usual (TAU) as an aftercare treatment. We conducted conditional indirect effect models with treatment condition as the predictor, baseline affective symptoms as the moderator, changes in approach and avoidance coping over time from baseline through 6-months post-treatment as mediators, and substance use and substance-related problems at 12-months post-treatment as the outcome. Affective symptomatology at baseline was modeled as a latent factor indicated by depression, anxiety, and PTSD symptoms. Change in approach and avoidance coping was modeled using latent growth curve analyses.

Results

We found significant conditional indirect effects of MBRP, such that the interaction of MBRP vs. TAU by affective symptoms predicted increases in approach coping, which in turn predicted fewer heavy drinking days and substance-related problems at month 12. Follow-up analyses showed that increases in approach coping mediated the therapeutic effect of MBRP on these outcomes among those with high, but not low or moderate, affective symptoms. We did not find indirect or conditional indirect effects when comparing RP to TAU, or when avoidance coping was the mediator.

Conclusions

The pronounced therapeutic effects of MBRP among individuals with SUD and relatively higher negative affective symptoms may be due to increases in approach coping over time.

A complex systems approach to the study of change in psychotherapy

BACKGROUND

A growing body of research highlights the limitations of traditional methods for studying the process of change in psychotherapy. The science of complex systems offers a useful paradigm for studying patterns of psychopathology and the development of more functional patterns in psychotherapy. Some basic principles of change are presented from subdisciplines of complexity science that are particularly relevant to psychotherapy: dynamical systems theory, synergetics, and network theory. Two early warning signs of system transition that have been identified across sciences (critical fluctuations and critical slowing) are also described. The network destabilization and transition (NDT) model of therapeutic change is presented as a conceptual framework to import these principles to psychotherapy research and to suggest future research directions.

DISCUSSION

A complex systems approach has a number of implications for psychotherapy research. We describe important design considerations, targets for research, and analytic tools that can be used to conduct this type of research.

CONCLUSIONS

A complex systems approach to psychotherapy research is both viable and necessary to more fully capture the dynamics of human change processes. Research to date suggests that the process of change in psychotherapy can be nonlinear and that periods of increased variability and critical slowing might be early warning signals of transition in psychotherapy, as they are in other systems in nature. Psychotherapy research has been limited by small samples and infrequent assessment, but ambulatory and electronic methods now allow researchers to more fully realize the potential of concepts and methods from complexity science.

Reciprocal effects between cognitive and affective states in women with Premenstrual Dysphoric Disorder: An Ecological Momentary Assessment study

Premenstrual Dysphoric Disorder (PMDD) is characterized by cyclical mood changes resulting in clinically significant distress and functional impairment. Studies on momentary cognitive and affective states and their interplay during daily life over the menstrual cycle in affected women are still lacking. Using Ecological Momentary Assessment with electronic diaries, 61 women with current PMDD and 61 healthy control women reported their current mood, rumination, and self-acceptance eight times a day over two consecutive days per cycle phase (menstrual, follicular, ovulatory, and late luteal phase). Results revealed that women with PMDD showed significant increases in negative affect and rumination and decreases in positive affect and self-acceptance toward the end of the cycle. Lagged analyses demonstrated stronger within-person reciprocal effects of cognitions and mood in PMDD women compared to controls with the effect of rumination on subsequent negative affect being limited to the late luteal phase. Identified stronger prospective associations between cognitive processes and mood deteriorations in women with PMDD suggest that affected women are more sensitive to detrimental effects of either dimension. Hence, therapeutic strategies aiming at reducing ruminative thoughts and improving self-acceptance such as mindfulness-based interventions could be promising for reducing the burden of PMDD.

Does mindfulness practice promote psychological functioning or is it the other way around? A daily diary study

Mindfulness-based interventions are commonly used to reduce psychological symptoms and enhance positive qualities of human functioning. However, the influence of mindfulness practice dosage remains poorly understood, limiting dissemination and implementation efforts. The current study examined the association between practice dosage and several constructs related to psychological functioning (positive and negative affect, state mindfulness) over the course of a standardized mindfulness-based intervention (Mindfulness-Oriented Recovery Enhancement). Twenty-five participants completed daily diary assessments for 12 weeks. Two-part gamma regression models examined the dichotomous (did practice occur?) and continuous (how much practice?) components of practice minutes. Practice time and outcomes showed same-day relationships in the expected directions. Lagged models, however, showed no evidence that current day practice time predicts subsequent day outcomes. In contrast, higher current day negative affect predicted less subsequent day practice time, and higher current day mindfulness predicted more subsequent day practice time. In a post hoc analysis, practice time moderated the link between day-to-day affect, strengthening the link for positive affect and weakening the link for negative affect. Collectively, these findings suggest that the causal direction linking practice time and outcome may flow from outcome to practice time, rather than the reverse-with potential recursive relationships between these factors. Further examination of lagged relationships between practice time and outcome as well as random assignment of participants to varying practice dosages (e.g., in within-person microrandomized trials) may help clarify the influence of this central treatment ingredient within mindfulness-based interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Changes in the daily life experience of patients with obsessive-compulsive disorder following mindfulness-based cognitive therapy: Looking beyond symptom reduction using ecological momentary assessment

The current study examines changes in daily life experiences following mindfulness-based cognitive therapy (MBCT) in a sample of 38 patients with obsessive-compulsive disorder (OCD) and residual symptoms following cognitive behavioral therapy (CBT). Participants were randomized to either an MBCT group (n = 17), or to a psychoeducational group (OCD-EP; n = 21) as an active control condition. Both groups underwent ecological momentary assessment (EMA) six times a day for a period of six consecutive days pre- and posttreatment. Contrary to hypotheses, MBCT participation did not, when compared to OCD-EP, result in significant changes of positive affect, negative affect, acceptance of momentary emotions, or distress associated with obsessive-compulsive (OC) symptoms. In fact, insight into the unreasonableness of OC symptoms improved significantly more in the OCD-EP group compared to MBCT. However, in the MBCT group, the presence of momentary OC symptoms at post assessment predicted increased insight, which indicates an improved ability to detach from OC symptoms in the moments in which they occur. All in all, however, results do not indicate favorable changes in everyday life experiences of OCD patients following MBCT. Owing to the modest sample size, results must be considered preliminary. Implications and directions for future research are discussed.

More Purpose in Life and Less Novelty Seeking Predict Improvements in Self-Compassion During a Mindfulness-Based Intervention: The EXMIND Study

OBJECTIVES

Recently, a 4-week mindfulness-based intervention followed by a 4-week existential approach was found to be as effective for increasing self-compassion as an 8-week mindfulness-based intervention. The purpose of the present study was to identify the factors that predicted change in self-compassion during the 8-week mindfulness-based intervention.

METHODS

Fifty-seven of the 61 completers of the 8-week mindfulness-based intervention provided baseline, 4-week, and 8-week self-compassion scale scores. The mean age of the 47 females and 10 males was 49.6 years. Pearson's correlation coefficients were generated on the associations between the change of total self-compassion scale scores from baseline to 8 weeks with age; gender; and the baseline scores on the Temperament Evaluation of Memphis, Pisa and San Diego Auto-questionnaire, Temperament and Character Inventory (TCI), Mini-Mental State Examination, Japanese Adult Reading Test, Young Mania Rating Scale, Hamilton Rating Scale for Depression, Parental Bonding Instrument, and purpose in life (PIL). Multiple regression analysis was performed to identify the predictors of the change in total self-compassion scale scores.

RESULTS

Novelty seeking (TCI) was significantly and negatively associated with the change in total self-compassion scale scores, whereas the PIL scores were significantly and positively associated with the change in total self-compassion scale scores. Novelty seeking was not significantly associated with baseline, 4-week, or 8-week total self-compassion scale scores, whereas the PIL scores were significantly and positively associated with baseline, 4-week, and 8-week total self-compassion scale scores. The limitation of the present study was a relatively small number of subjects which deterred a more sophisticated analysis of the pathways involved.

CONCLUSIONS

The present findings suggest that more PIL and less novelty seeking predict improvements in self-compassion during mindfulness-based interventions, although novelty seeking might substantially predict the improvement but self-compassion scale and PIL might somewhat conceptually overlap.

Using a Mindfulness-Based Intervention to Promote Subjective Well-Being, Trait Emotional Intelligence, Mental Health, and Resilience in Women With Fibromyalgia

The objective of the present study was to experimentally assess the effects of a mindfulness-based intervention (MBI) for the improvement of subjective well-being, trait emotional intelligence (TEI), mental health, and resilience in a sample of women with fibromyalgia (FM). The sample consisted of 104 women, between 29 and 77 years old (M = 47.59; SD = 5.93). The measures used were as follows: Satisfaction with Life Scale (SWLS), Positive and Negative Affection Scale (PANAS), Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF), Mental Health Questionnaire (MH-5), and Resilience Scale (ER-14). A quasi-experimental design of repeated measures with a control group (CG) was used: before and after the application of the treatment and a follow-up assessment 6 months after the completion of the intervention. In order to assess the effect of the program, the participants were randomly assigned to the experimental and control conditions. In the pretest evaluation, a multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA) were carried out. In the post-test evaluation, a multivariate analysis of covariance (MANCOVA) of the study variables as a whole was performed. Then, descriptive analyses and analysis of covariance (ANCOVA) of the post-test scores (covariate pretest score) were performed. In the follow-up evaluation, a MANCOVA of the study variables as a whole was performed. Then, descriptive and ANCOVA analyses of the follow-up scores (covariate pretest score) were performed. In addition, the effect size was calculated using partial eta-squared (μ2). The post-test results confirmed statistically significant differences in satisfaction with life (SWL), positive affect (PA), mental health, and resilience. The follow-up results showed statistically significant differences in SWL, PA, TEI, mental health, and resilience. The study provides an effective intervention tool that has been validated experimentally. The general results allow the emphasis of the importance of the implementation of MBIs framed in non-pharmacological treatments in FM.

Mindfulness-Based stress reduction in early palliative care for people with metastatic cancer: A mixed-method study

OBJECTIVES

To explore the impact of a Mindfulness-Based Stress Reduction (MBSR) intervention for people with metastatic cancer integrated in Early Palliative Care (EPC).

DESIGN

Mixed-method study.

SETTINGS/LOCATION

EPC Service integrated with Oncology Unit, Carpi General Hospital, Italy from January to October 2017. The MBSR intervention took place inside the hospital.

SUBJECTS

Study participation was offered to 25 consecutive people referred to the EPC service.

INCLUSION CRITERIA

people with metastatic cancer between 18 and 75 years old; informed consent.

EXCLUSION CRITERIA

Performance Status <60% according to Karnofsky scale; active psychiatric disorder. 20 patients were included in the study.

INTERVENTION

The adapted program consists of 8 meetings for 2.5 h once a week, a 4.5 h session between the 6th and 7th weeks and 0.5 h home practice daily. The following mindfulness practices were included during the training: formal sitting meditation, body scan, light yoga, walking meditation, and Aikido exercises. Participants were provided with materials for home practice. A qualified MBSR instructor conducted the program. Sessions were attended by a clinical psychologist and a physician trained in meditation, together with the palliative nurse as facilitators.

OUTCOME MEASURES

Feasibility and acceptability were assessed on 16 participants. In addition, pre-post measures of cancer pain and mood state were collected. Semi-structured, in-depth interviews were conducted on a subset of 8 participants at the end of the study and analysed using the Interpretative-Phenomenological approach.

RESULTS

MBSR attendance to meetings and adherence to home practice were 75%. MBSR intervention helped participants to develop an accepting attitude in respect to metastatic cancer disease helping them to face anxiety and cancer pain. MBSR improves self-regulation of mood state engendering feelings of compassion MBSR program supports participants in questioning and reconnecting with their values and spiritual beliefs.

CONCLUSIONS

A Mindfulness intervention integrated into EPC setting is feasible, well accepted and could help metastatic cancer patients to control cancer pain together with an opportunity of emotional and spiritual relief.

Using Intensive Longitudinal Data to Study Treatment Effects in Patients with Major Depression: A Systematic Review

Depression is a disabling condition, causing suffering worldwide. The purpose of this paper is to review studies that have used Intensive Longitudinal Data (ILD) in research on depression treatment. Intensive longitudinal data in the form of daily diaries, experience sampling method (ESM), and ecological momentary assessment (EMA) are increasingly used in psychotherapy research to gather individualized data. A systematic search was conducted in the research databases PsycINFO, PubMed and Scopus on depression treatment assessed with ILD methods. Seven studies met inclusion criteria; two focused on the effects of cognitive therapy/cognitive behavioral therapy (CBT)/Self-System Therapy (SST); one focused on the effects of physical exercise; and four examined ESM as an add-on intervention to pharmacological treatment. ILD is useful when studying changes in complex patterns of patients’ functioning, such as daily affective reactivity, empowerment, daily dose-response effects of physical activity on PA, and associations between activity and depressive symptoms. Results also showed that ESM registration in itself can help patients with major depression (MDD) to engage more in physical and social activities and to spend less time alone or resting.