A Randomized Controlled Trial Comparing the Attention Training Technique and Mindful Self-Compassion for Students With Symptoms of Depression and Anxiety

Relationship of autistic traits and the severity of fear of the COVID-19 pandemic in the general population

Background

The aim of the study was to investigate the level of fear of the COVID-19 pandemic and to detect a possible correlation between the autistic traits and the level of fear and to learn about other factors that may affect the level of fear.

Methods

The study utilised a questionnaire and was conducted online in the period from 16.02.2021 to 11.06.2021. The test group consisted of 214 respondents with an average age of 23.78 years (95%CI: 22.48 - 25.08; max: 61, min: 14) from the general population. The study used The Autism-Spectrum Quotient (AQ) questionnaire to assess the degree of autistic traits in the general population and The Fear of COVID-19 Scale, which was used to assess the level of fear of COVID-19.

Results

Among the respondents, 9 people scored ≥32 on the AQ test and were considered to have a high degree of autistic traits. In multiple regression (R2 = 0.1, p<0.0001), a positive relationship between the severity of fear of COVID-19 and the autistic traits (p=0.01) and age (p<0.001) was obtained. Additionally, a second multiple regression (R2 = 0.1, p<0.000001) including the subscales of AQ was performed and a positive relationship between the severity of fear of COVID-19 and the difficulties in attention switching (p=0.0004) and age (p=0.00001) was obtained.

Conclusion

People with higher autistic traits present greater fear of the COVID-19 pandemic. We suggest that it might be caused by cognitive stiffness and disorders in emotions regulation, according to the literature. The elderly also present higher levels of fear. The other variables did not affect the level of fear of the COVID-19 pandemic.

Attention training technique delivered in groups as treatment for anxiety and depression in patients with coronary heart disease: study protocol for a waiting-list randomized controlled trial

Introduction

Clinically significant symptoms of depression and anxiety in coronary heart disease (CHD) patients are common and associated with adverse outcomes. Psychological treatments have shown limited effectiveness and more effective treatments have been requested. Attention training technique (ATT), a component of metacognitive therapy, can potentially be effective as a stand-alone treatment for anxiety and depression. In an open study, ATT delivered face-to-face in a group format was feasible and potentially effective for improving depression and anxiety symptoms in CHD patients. The next progressive step is to test the effectiveness of ATT in a randomized controlled trial. This paper describes the methodology of this trial.

Methods

ATT-CHD is a randomized wait-list (WL) controlled study. Eligible CHD patients from two hospitals with Hospital Anxiety and Depression Scale (HADS)-Anxiety and/or HADS-Depression subscales scores ≥8 will be randomized into ATT (n = 32) or WL control (n = 32). After 6-8 weeks, WL patients will be allocated to ATT. Participants will be evaluated pre-, mid- and post-treatment, and at 6-months follow-up using changes in HADS as primary outcome. Secondary outcomes will be changes in psychiatric disorders, rumination, worry, type D-personality, metacognitions, insomnia, quality of life, and C-Reactive protein (CRP).

Discussion

To our knowledge, this will be the first WL-controlled randomized study testing the effectiveness of group-based ATT as treatment of symptoms of anxiety and depression in CHD patients. It will also explore correlations between changes in psychological distress and CRP. A qualitative analysis will reveal patients' experience with ATT including processes that may facilitate or serve as barriers to effectiveness. Recruitment into the study commenced in December 2022.

Ethics and dissemination

The Regional Committees for Medical and Health Research Ethics (REK), Norway has granted approval for the study (ID 52002). The trial results will be published in peer-reviewed journals. According to Norwegian legislation, the Norwegian Data Protection Authority, and the Committee of Ethics, we are not allowed to share original study data publicly.

Clinical trial registration

ClinicalTrials.gov, identifier NCT05621408 pre-inclusion. There were no significant changes of methods or outcomes after study start.

Effects of Self-Compassion Interventions on Reducing Depressive Symptoms, Anxiety, and Stress: A Meta-Analysis

Objectives

A growing body of evidence shows self-compassion can play a key role in alleviating depressive symptoms, anxiety, and stress in various populations. Interventions fostering self-compassion have recently received increased attention. This meta-analysis aimed to identify studies that measured effects of self-compassion focused interventions on reducing depressive symptoms, anxiety, and stress.

Methods

A comprehensive search was conducted within four databases to identify relevant randomized controlled trials (RCTs). The quality of the included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. Either a random-effects model or fixed-effects model was used. Subgroup analyses were conducted according to types of control groups, intervention delivery modes, and the involvement of directly targeted populations with psychological distress symptoms.

Results

Fifty-six RCTs met the eligibility criteria. Meta-analyses showed self-compassion focused interventions had small to medium effects on reducing depressive symptoms, anxiety, and stress at the immediate posttest and small effects on reducing depressive symptoms and stress at follow-up compared to control conditions. The overall risk of bias across included RCTs was high.

Conclusions

Fewer studies were conducted to compare effects of self-compassion interventions to active control conditions. Also, fewer studies involved online self-compassion interventions than in-person interventions and directly targeted people with distress symptoms. Further high-quality studies are needed to verify effects of self-compassion interventions on depressive symptoms, anxiety, and stress. As more studies are implemented, future meta-analyses of self-compassion interventions may consider conducting subgroup analyses according to intervention doses, specific self-compassion intervention techniques involved, and specific comparison or control groups.

Preregistration

This study is not preregistered.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-023-02148-x.

Body image, self-compassion, and sexual distress in individuals living with endometriosis

OBJECTIVE

Extensive psychological burden is associated with the experience of living with endometriosis, including negative changes to body image and sexual functioning. Emerging evidence suggests that potential protective factors such as body appreciation and self-compassion may help mitigate these adverse impacts of endometriosis. This study aimed to investigate the association of body image, both positive (body appreciation) and negative (body image disturbance) dimensions, with sexual distress and the potential buffering effect of self-compassion on the body image-sexual distress link.

METHODS

Data were collected via an online cross-sectional survey (N = 471) assessing body image disturbance, body appreciation, self-compassion and sexual distress in individuals with endometriosis. A series of hierarchical linear regression analyses were conducted to explore the relationship between key variables.

RESULTS

>80% of the sample reported clinically significant sexual distress and high levels of body image disturbance. Regression analyses indicated a moderate positive effect of body image disturbance with sexual distress, and a weaker inverse effect of self-compassion with sexual distress. Body appreciation was not associated with sexual distress, and no moderating effects of self-compassion were evident.

CONCLUSION

The high prevalence of sexual distress identified in this sample, along with the finding that body image disturbance was strongly associated with sexual distress, suggest that psychosocial interventions addressing body image may help ameliorate sexual distress in individuals with endometriosis.

Neural correlates of the attention training technique as used in metacognitive therapy – A randomized sham-controlled fMRI study in healthy volunteers

Introduction

The Attention Training Technique (ATT) developed as part of metacognitive therapy is a psychotherapeutic treatment method used to enhance top-down attentional flexibility and control. This study investigated potential neurocognitive changes due to ATT and its underlying neural mechanisms using pre-to-post functional magnetic resonance imaging (fMRI).

Materials and methods

Fifty-four healthy participants were subjected to a randomized, sham-controlled attention training and evaluated using a neurocognitive test battery that partly took place in an fMRI environment. Participants received two doses ATT or sham ATT daily for 1 week. On day eight, all subjects completed the neurocognitive test battery again.

Results

After the training, the ATT group showed a significant improvement in reaction times regarding attentional disengagement compared to the sham ATT group. fMRI data showed decreased levels of activation in the anterior cingulate cortex (ACC) when comparing the ATT group to the sham ATT group during attentional disengagement post intervention. No ATT &gt; sham ATT effects were found regarding selective auditory attention, working memory performance and inhibitory control.

Discussion

These findings putatively indicate that ATT facilitates faster attention allocation and increased attentional flexibility in healthy subjects. The fMRI results suggest this ATT-dependent improvement is accompanied by reduced ACC activity, indicating a more flexible attentional state.

The effects of short interventions of focused-attention vs. self-compassion mindfulness meditation on undergraduate students: Evidence from self-report, classroom performance, and ERPs

Mindfulness-based stress reduction (MBSR) training has been shown to improve cognitive processing, wellbeing, and academic performance. However, mindfulness interventions that are integrated into non-mindfulness related courses have not been well-investigated. Further, the unique effects of different aspects of MBSR training are not as well understood. This paper examines the effects that are uniquely associated with focused-attention versus self-compassion mindfulness practices utilizing a multi-method approach. Event-related potentials (ERPs) were recorded during an Emotional Flanker task, and self-report measures of wellbeing and measures of classroom performance were collected before and after training. Participants were students in two sections of the same undergraduate course and either completed 10 weeks of focused-attention practice or self-compassion practice that was built into their class sessions. Students in the focused-attention group (mean age = 22.08) had reduced interference effects on their reaction times following the training. Students in the self-compassion group (mean age = 23.91) showed altered processing of conflict on negative trials via the N2 and P3 ERP amplitudes after the training. This group also reported significant improvements in wellbeing and performed significantly better on more class tests compared to the focused-attention group. These data support the effectiveness of incorporating brief, simplified mindfulness practices in any classroom as an intervention to improve attention, wellbeing and classroom performance.

Internalized weight stigma in women with class III obesity: A randomized controlled trial of a virtual lifestyle modification intervention followed by a mindful self-compassion intervention

Background

Internalized weight stigma (Internalized-WS) is prevalent among individuals with severe obesity, particularly women, and is associated with shame, disordered eating, and weight gain. Effective, accessible interventions that address both severe (Class-III) obesity and Internalized-WS are needed. This randomized pilot trial evaluated the feasibility, acceptability, and preliminary efficacy of a fully-remote lifestyle modification intervention (LM) followed by mindful self-compassion training (MSC) or control.

Methods

Twenty-eight women with Class-III obesity (46.6 ± 3.7 kg/m2) and elevated Internalized-WS were randomized to a virtually-delivered 4-month LM followed by a 2-month MSC or cooking/dietary education (CON). Psychosocial measures/weight were assessed at baseline, 4-(post-LM), 6-(post-MSC/CON), and 9-month (follow-up).

Results

Improvements in Internalized-WS, shame, and self-compassion were observed with LM. Mean 4-month weight loss was 6.3 ± 3.7%. MSC had lower attendance and usefulness ratings versus CON. Post-MSC/CON, MSC yielded significant and/or meaningful improvements in Internalized-WS, self-compassion, and intuitive eating relative to CON. Weight loss did not differ by group at 6-month, and at 9-month trended lower in MSC versus CON.

Conclusion

Virtual LM is feasible, acceptable, and leads to significant weight loss among women with severe obesity; MSC led to further improved Internalized-WS, self-compassion, and intuitive eating. Continued work is needed to elucidate effects of self-compassion training on Internalized-WS, its mechanisms, and linkages to cardiometabolic health and long-term weight loss.

A review of attentional bias modification trainings for depression

Negative attentional bias is a basic character of depression. The attentional bias modification training (ABMT), being a highly promising and easy-to-use depression intervention technique, has attracted much attention to alleviate depressive symptoms in recent years. However, the effectiveness of ABMT programs was mixed across studies, since it remained unclear the underlying mechanisms of ABMT on alleviating depressive symptoms. We systematically analyzed the main ABMT paradigms to clarify possible mechanisms of effective training and reasons of ineffective training. Valid ABMT programs might alleviate depressive symptoms through regulating self-related rumination or two subcomponents of attentional bias: facilitated attention and impaired attentional disengagement. The reasons for the invalidity of ABMT mainly included the suboptimal design of training procedures, mixed effects of participants' personal characteristics, and the unclear relationship between attentional bias and depression. The ABMT is promising for alleviating depressive symptoms, but training procedures are required to be improved to obtain stable training effects.

Effects of the Interculturality and Mindfulness Program (PIM) on University Students: A Quasi-Experimental Study

Rates of mental health issues have been increasing among university students. This study investigates the effects of the Interculturality and Mindfulness Program (PIM) on academic students on mindfulness, emotional regulation, depression, anxiety, stress, life satisfaction, optimism, positive solitude, and loneliness. A quasi-experimental research was conducted, with pre- and post-test comparative measurements in three groups: in-person (IG), synchronous online (OG), and passive control (CG). A diverse group of students (n = 150; mean age = 25.4 ± 8.31) participated from two universities in Portugal. When compared to the CG, both active groups (IG and OG) demonstrated a beneficial interaction effect in acceptance, positive solitude, optimism, and mindfulness. The IG demonstrated a positive interaction effect in awareness and satisfaction with life, whereas the OG indicated a favorable interaction effect in impulse. When analyzing the intra-group effects, both active groups presented a significant improvement in stress, emotion regulation, mindfulness, positive solitude, and optimism. The OG demonstrated an improvement in awareness and loneliness. The main limitations of this research are that students were not randomly assigned, and groups were heterogeneous in nationality, education level, and sex. Nonetheless, PIM has indicated beneficial results in both IG and OG, and is a promising intervention for the prevention of mental health issues (e.g., stress, difficulties in emotional regulation, and loneliness), as well as for the promotion of well-being (e.g., positive solitude, mindfulness, life satisfaction, and optimism).

The Attention Training Technique Reduces Anxiety and Depression in Patients With Coronary Heart Disease: A Pilot Feasibility Study

Background and Objectives

Depression and anxiety symptoms are highly prevalent in coronary heart disease (CHD) patients and associated with poor outcome. Most psychological treatments have shown limited effectiveness on anxiety and depression in these patients. This study evaluates the feasibility of the attention training technique (ATT) in CHD patients with symptoms of anxiety and/or depression.

Methods

Five consecutive CHD patients with significant depression and anxiety symptoms with Hospital Anxiety and Depression rating scale (HADS) -anxiety or -depression subscale score > 8 received 6 weekly group-sessions of ATT in an open trial. Outcomes included feasibility and symptoms measured by HADS, at baseline, post-treatment and at 6 months follow-up. We also assessed psychiatric diagnoses, type D personality, insomnia, worry, and rumination.

Results

The sample comprised five men with a mean age of 59.9 (SD 4.4) years. Four of the patients attended all six sessions, and one patient attended all but one session. Mean HADS-A scores at baseline, post-treatment, and follow-up were 9.4 (SD 3.0), 4.2 (SD 3.0), and 4.0 (SD 2.5), and for HADS-D 8.6 (SD 3.3), 3.0 (SD 3.7), and 1.6 (SD 1.5), respectively. The results showed clinically significant changes in anxiety, depression, psychiatric disorders, insomnia, worry, and rumination. Statistically significant changes were found from pre- to post-treatment scores for HADS-A and worry, which were maintained at follow-up, and HADS-D scores significantly decreased from pre-treatment to 6-months follow-up.

Conclusions

ATT in a group format appears to be a feasible stand-alone metacognitive treatment for CHD patients. An adequately powered randomized controlled trial is warranted.

Parental Self-Compassion and Child Adjustment: The Mediating Role of Parental Depressive Symptoms

Previous research suggests that self-compassion is associated with mental health and well-being. However, little has been done to understand the role of self-compassion in the family context. Hence, the present study investigated the associations between parents’ self-compassion, parent’s depressive symptoms, and child adjustment. A total 189 Chinese parents (101 mothers) whose children were 2–8 years old were recruited to complete a questionnaire, including measures of parents’ self-compassion, depressive symptoms, and children’s prosocial behavior, internalizing problems, and externalizing problems. Findings indicated mediation effects, in that parents’ depressive symptoms mediated the association between their self-compassion and child adjustment outcomes, namely children’s internalizing and externalizing problems, after controlling for the effects of monthly family income, child gender, and parent gender. Competing hypothesis suggested that parents’ self-compassion did not moderate between parents’ depressive symptoms and child adjustment outcomes. Hence, the association between parental depressive symptoms and child adjustment was not dependent on the level of parents’ self-compassion. As an implication, researchers and practitioners should be made aware of the benefits of parents’ self-compassion on parents’ mental health and child adjustment.

Mindfulness-based interventions in undergraduate students: a systematic review

ObjectiveTo describe how mindfulness-based intervention (MBIs) are held with undergraduate students, systematize the outcomes of these interventions and indicate possible limitations. Method: Systematic searches were performed in seven databases in January 2019 with the following descriptors: ("mindfulness intervention" AND ("undergraduate" OR "college" OR "students"). Results: A total of 510 articles were found, and 19 articles fully met the inclusion criteria. The searches showed a visible growth in this field of research as articles publications increased in the past years. Regardless of intervention's length, most studies reported beneficial effects. The examination of Anxiety, Stress, and Depression constructs have shown to be predominant. Even though study designs were mostly randomized controlled trials (RCT), it was noticed a shortage use of physiological measures and follow-up assessments. Conclusions: Nonetheless, MBIs have shown to be promising interventions to promote mental health in academic settings.

The influence of stimuli valence, extraversion, and emotion regulation on visual search within real-world scenes

Affective traits, including extraversion and emotion regulation, are important considerations in clinical psychology due to their associations with the occurrence of affective disorders. Previously, emotional real-world scenes have been shown to influence visual search. However, it is currently unknown whether extraversion and emotion regulation can influence visual search towards neutral targets embedded within real-world scenes, or whether these traits can impact the effect of emotional stimuli on visual search. An opportunity sample of healthy individuals had trait levels of extraversion and emotion regulation recorded before completing a visual search task. Participants more accurately identified search targets in neutral images compared to positive images, whilst response times were slower in negative images. Importantly, individuals with higher trait levels of expressive suppression displayed faster identification of search targets regardless of the emotional valence of the stimuli. Extraversion and cognitive reappraisal did not influence visual search. These findings add to our understanding regarding the influence of extraversion, cognitive reappraisal, and expressive suppression on our ability to allocate attention during visual search when viewing real-world scenes.

Effects of Mindfulness Meditation Intervention on Depressive Symptoms in Emerging Adults: A Systematic Review and Meta-Analysis

Introduction: Depression in emerging adults (20-29 years of age), a transition from adolescence to adulthood, is a mental health problem globally. Antidepressants and psychotherapy have limited effectiveness and might not be available worldwide. Alternative and complementary treatments, such as mindfulness meditation, are growing. Objective: We examined the effects of mindfulness interventions on depression in emerging adults and explored the moderating effects of participants, methods, and intervention characteristics. Design: Systematic review and meta-analysis. Subjects: Emerging adults. Interventions: Mindfulness meditation interventions versus control groups. Outcomes measures: depressive symptoms. Results: Forty-five studies resulted in 49 comparisons, including 3479 participants (23.0-2.7 years old); 1826 participants practiced mindfulness and 1653 served as controls. Overall, mindfulness interventions showed significant reduction in depression compared with controls (g = 0.44, 95% confidence interval: 0.33-0.55). Mindfulness interventions conducted in Asian countries had a greater decrease in depression (g = 0.69) than studies conducted in North America (g = 0.44) or Europe (g = 0.23). Mindfulness interventions showed greater reductions in depression in studies with higher proportion of females (Slope = 0.010, τ² = 0.07, Q_between = 7.10, p = 0.008). Mindfulness interventions conducted in emerging adults with depressive disorders reduced depression more (g = 1.12) than in emerging adults without (g = 0.40). Providing mindfulness intervention in a group setting had a greater reduction of depression (g = 0.54) than on an individual basis (g = 0.30). More minutes of unstructured mindfulness practice per session showed a greater reduction in depressive symptoms (Slope = 0.016, Q_between = 1.34, p = 0.035). Using intention-to-treat analyses showed a lower ES (g = 0.14) than not using it (g = 0.55). Other quality indicators were not significant moderators. Primary researchers did not report the adverse effects of mindfulness interventions. Conclusion: Mindfulness interventions somewhat improved depression in emerging adults. Because primary researchers did not report the adverse effects, mindfulness interventions should be used with caution. Future researchers might study the adverse effects of mindfulness interventions as well as the long-term effects.

Social climate in university classrooms: A mindfulness-based educational intervention

There is a limited number of studies on the impact of mindfulness-based interventions on university students and their positive effect on collective experiences of shared flow. The aim of the present study was to explore the effectiveness of mindfulness training in terms of reducing stress and enhancing well-being, experiences of shared flow and classroom climate (engagement and affiliation). The intervention and control groups were matched by age and sex (n = 125; M = 20.71, SD = 4.60, 68% women). The intervention group comprised mindfulness exercises performed in the classroom over the course of 7 weeks. The principal variables were measured at pretest and posttest, and shared flow was also measured in the intervention group. In comparison with the control group, statistically significant differences were observed in the intervention group in relation to mindfulness, perceived stress, and classroom climate (affiliation). Furthermore, the perception of shared flow among students increased from the beginning to the end of the program. Mindfulness skills were found to mediate improvements in perceived well-being and stress. It is concluded that mindfulness practice can turn learning into a challenging and shared task. The study highlights the importance of fostering programs that enhance the development of competencies related to mindfulness among university students.

Promoting helpful attention and interpretation patterns to reduce anxiety and depression in young people: weaving scientific data with young peoples' lived experiences

BACKGROUND

Anxiety and depression are common, disabling and frequently start in youth, underscoring the need for effective, accessible early interventions. Empirical data and consultations with lived experience youth representatives suggest that maladaptive cognitive patterns contribute to and maintain anxiety and depression in daily life. Promoting adaptive cognitive patterns could therefore reflect "active ingredients" in the treatment and/or prevention of youth anxiety and depression. Here, we described and compared different therapeutic techniques that equipped young people with a more flexible capacity to use attention and/or promoted a tendency to positive/benign (over threatening/negative) interpretations of uncertain situations.

METHODS

We searched electronic databases (PubMed, PsycINFO, EMBASE, and PsycARTICLES) for studies containing words relating to: intervention; youth; anxiety and/or depression and attention and/or interpretation, and selected studies which sought to reduce self-reported anxiety/depression in youth by explicitly altering attention and/or interpretation patterns. Ten young people with lived experiences of anxiety and depression and from diverse backgrounds were consulted on the relevance of these strategies in managing emotions in their daily lives and also whether there were additional strategies that could be targeted to promote adaptive thinking styles.

RESULTS

Two sets of techniques, each targeting different levels of responding with different strengths and weaknesses were identified. Cognitive bias modification training (CBM) tasks were largely able to alter attention and interpretation biases but the effects of training on clinical symptoms was more mixed. In contrast, guided instructions that teach young people to regulate their attention or to evaluate alternative explanations of personally-salient events, reduced symptoms but there was little experimental data establishing the intervention mechanism. Lived experience representatives suggested that strategies such as deliberately recalling positive past experiences or positive aspects of oneself to counteract negative thinking.

DISCUSSION

CBM techniques target clear hypothesised mechanisms but require further co-design with young people to make them more engaging and augment their clinical effects. Guided instructions benefit from being embedded in clinical interventions, but lack empirical data to support their intervention mechanism, underscoring the need for more experimental work. Feedback from young people suggest that combining complimentary techniques within multi-pronged "toolboxes" to develop resilient thinking patterns in youth is empowering.

The Relationship between Self-Compassion and the Experience of Memorial Symptoms in Patients with Gastrointestinal Cancer

Background:

Patients with Gastrointestinal (GI) cancer experience a range of physical and psychological memorial symptoms after developing cancer and beginning to receive medical care. The present study was conducted to investigate the relationship between self-compassion and the experience of memorial symptoms in patients with GI cancer.

Materials and Methods:

This descriptive-correlational study was conducted in July to August 2019. The study sample included 190 patients admitted to Seyed Al-Shohada Hospital, with GI cancer who entered the study by convenience sampling. Data were collected using a patient demographic information form, Neff's Self-Compassion Scale (SCS), and the Memorial Symptoms Assessment Scale (MSAS) and then analyzed by Pearson correlation coefficient in SPSS-20.

Results:

The mean (SD) total score of self-compassion was 86.67 (16.65) out of 130, and the mean (SD) total score of memorial symptoms was 1.40 (0.64) out of 4 in patients with GI cancer. The most frequently reported physical symptom was lack of energy, with an 86.84% prevalence, and the most frequently reported psychological symptoms included worrying and feeling nervous, with 70.52% prevalence rates. The total score of self-compassion was inversely correlated with the total score of memorial symptoms, the score of psychological symptoms, and the score of physical symptoms. Furthermore, the total score of the memorial symptoms was inversely correlated with the scores of all the self-compassion components (p < 0.001).

Conclusions:

Cancer patients had memorial symptoms in both physical and psychological domains. These symptoms decrease with an increase in self-compassion, so compassion-based educational interventions by nurses can be used to reduce these symptoms.

A randomized experimental analysis of the attention training technique: Effects on worry and relevant processes in individuals with probable generalized anxiety disorder

CONTEXT

The Attention Training Technique (ATT, Wells, 1990) is an intervention guiding individuals to focus, shift, and divide their attention in response to sounds presented in an audiorecording. The ATT has long been recommended for generalized anxiety disorder (GAD); however, there is insufficient research on its effects on excessive worry and related processes.

OBJECTIVES

This experiment examined whether the ATT is more efficacious than a control intervention at reducing worry and modifying worry-related processes (e.g., attention control, negative metacognitive beliefs, attention bias, mindfulness).

PARTICIPANTS

78 adults with probable GAD.

DESIGN

Participants completed measures of worry and worry-related processes at the lab. They then monitored worry and attention daily for a week. Following this baseline, participants recompleted the lab measures and were randomly assigned to ATT or control. Participants listened to their assigned recording once/day for a week while again monitoring worry and attention daily. Participants then recompleted the lab measures.

RESULTS

The ATT did not perform better than the control condition on any measure. A variety of improvements were seen over the intervention period in both conditions.

CONCLUSIONS

ATT may not have meaningful effects on excessive worry and worry-related processes. Explanations for null findings are offered. CLINICALTRIALS.

GOV REGISTRATION

NCT03216382.

Effortful control moderates relationships between worry and symptoms of depression and anxious arousal

OBJECTIVES

Findings are inconsistent regarding the relationship between worry and anxious arousal (AA). Effortful control (EC) capacity may explain these inconsistent findings, such that only high worriers with higher EC are able to suppress autonomic arousal through worrying. The current study investigated these main and interactive effects of worry and EC on AA as well as depression.

METHODS

Participants (N = 1210, 779 females) were recruited from Amazon's Mechanical Turk website and completed self-report measures assessing worry, EC, AA, depression, and negative affect intensity.

RESULTS

Regression models revealed that EC moderated the relationship between worry and AA, with individuals lower in EC demonstrating a stronger positive relationship between worry and AA. EC also moderated the relationship between worry and depression, with individuals lower in EC demonstrating a stronger positive relationship between worry and depression. Results remained the same when controlling for age, gender, and negative affect intensity.

CONCLUSIONS

Results support the idea that low EC may help to explain a range of comorbid psychiatric symptoms.

PRACTITIONER POINTS

Individuals low in effortful control demonstrate a stronger association between worry and anxious arousal, as well as between worry and depression Those low in effortful control may be especially vulnerable to comorbid worry and depression High worriers who are high in effortful control may be motivated to continue worrying due to their ability to reduce anxious arousal during worry.

Toward a better understanding of the influence of repetitive negative thinking in alcohol use disorder: An examination of moderation effect of metacognitive beliefs and gender

Repetitive negative thinking (RNT), the most studied forms of which are depressive ruminations and anxious worry, is a unique transdiagnostic process responsible for the development and maintenance of many mental disorders. Over the past decade, studies have shown that RNT could be involved in the development and maintenance of alcohol use disorder (AUD). However, to date, little is known about the factors that can influence this relationship, even though some theoretical and empirical arguments suggest that variables such as gender or metacognitive beliefs may determine the role of RNT in the onset of symptoms. The aim of the present study was to test the moderation effect of metacognitive beliefs and gender in the relationship between RNT and AUD. Eighty-one AUD patients were administered measures of AUD severity, RNT, metacognitive beliefs about thinking and alcohol use, anxiety, and depression. Results indicated that the 'capture mental resources' factor of RNT is a significant predictor of AUD severity, independent from anxiety and depression, and that this effect is moderated by metacognitive beliefs and gender. RNT is a significant predictor of AUD severity only for people with high negative beliefs about thoughts regarding uncontrollability and danger. Furthermore, RNT was found to predict AUD severity only for men with high beliefs about the need to control thoughts and for men with high positive beliefs about emotional self-regulation. Treatments that reduce attentional impairments caused by RNT and modify dysfunctional metacognitive beliefs could be promising for some patients with AUD.

Effects of attention training technique on brain function in high- and low-cognitive-attentional syndrome individuals: Regional dynamics before, during, and after a single session of ATT

OBJECTIVE

Attention Training Technique (ATT) is a key therapeutic tool in metacognitive therapy. There are numerous studies on the behavioral effects of ATT, however the neural mechanisms at work in the training are yet to be uncovered. To date there have been no controlled fMRI studies of ATT.

METHOD

We conducted a randomized double-blind controlled study of two groups with varying levels of cognitive-attentional syndrome (CAS). Groups with high (n = 43) and low (n = 46) levels of CAS underwent a single session of ATT or a control condition (CON) in an MRI scanner. Participants underwent resting state functional MRI (rsfMRI) sessions and rumination induction sessions both pre- and post-intervention Functional connectivity analyses and inter-subject correlations analyses were computed. We also collected data on emotion and attention functioning pre- and post-intervention.

RESULTS

We did not observe any behavioral effects of ATT. However, direct comparison between ATT and CON sessions revealed greater inter-subject correlations in almost all hubs belonging to the studied functional networks. Moreover, subjects who received ATT showed diminished connectivity in the fronto-parietal network during ruminations and diminished connectivity of the precuneus with lateral occipital cortices and the intraparietal sulcus in abstract thinking and rsfMRI, respectively. Furthermore, some of the observed effects in functional connectivity and inter-subject correlations were specific to different levels of CAS.

CONCLUSIONS

Our results may support a proposed neural mechanism for ATT: disengagement of attention from CAS-type processing in either low- or high-CAS individuals. It is also possible that some neural effects of ATT are specific to individuals with different levels of CAS.

Meditation Increases the Entropy of Brain Oscillatory Activity

We address the hypothesis that the entropy of neural dynamics indexes the intensity and quality of conscious content. Previous work established that serotonergic psychedelics can have a dysregulating effect on brain activity, leading to subjective effects that present a considerable overlap with the phenomenology of certain meditative states. Here we propose that the prolonged practice of meditation results in endogenous increased entropy of brain oscillatory activity. We estimated the entropy of band-specific oscillations during the meditative state of traditions classified as 'focused attention' (Himalayan Yoga), 'open monitoring' (Vipassana), and 'open awareness' (Isha Shoonya Yoga). Among all traditions, Vipassana resulted in the highest entropy increases, predominantly in the alpha and low/high gamma bands. In agreement with previous studies, all meditation traditions increased the global coherence in the gamma band, but also stabilized gamma-range dynamics by lowering the metastability. Finally, machine learning classifiers could successfully generalize between certain pairs of meditation traditions based on the scalp distribution of gamma band entropies. Our results extend previous findings on the spectral changes observed during meditation, showing how long-term practice can lead to the capacity for achieving brain states of high entropy. This constitutes an example of an endogenous, self-induced high entropy state.

The effect of four Immeasurables meditations on depressive symptoms: A systematic review and meta-analysis

The Four Immeasurables Meditations (FIM) intervention have been shown as a promising intervention for reducing depressive symptoms. The current study is a systematic review of FIM intervention effects on depressive symptoms. Among 192 empirical research articles on FIM published before May 2019, 40 independent trials from 35 records measured depressive symptoms. The meta-analysis included 21 randomized controlled trials (RCT; n = 1468) and 16 uncontrolled trials (n = 376). The results supported overall effectiveness of FIM on depressive symptoms (d = 0.38 for RCT and d = 0.87 for uncontrolled trials). Moderator analysis indicated the effects differed across protocols, and effects were smaller in RCT using active control groups. No significant differences were observed for participant type, measures, intervention length, or intervention components. Individual studies found no direct association between meditation practice time and effects, and mindfulness and self-compassion were widely supported as mechanisms of change. Current evidence supports FIM as an effective intervention for reducing depressive symptoms, but additional studies with more rigorous designs using active control groups are needed. Further investigation should be encouraged regarding specific protocols and participants, the contribution of meditation practice, and other mechanisms such as positive emotions.