The Effect of Mindfulness Training on Proactive and Reactive Cognitive Control

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).

Cognitive Training in Obsessive-Compulsive Disorder: A Systematic Review

Background

Cognitive training (CT) for illness-linked neuropsychological deficits has been attempted in psychiatric disorders and, more recently, in obsessive-compulsive disorder (OCD). However, studies are few and far between, with a limited understanding of factors contributing to efficacy. This article aims to provide a comprehensive critical review of studies employing CT in OCD.

Methods

This systematic review follows the Preferred Reporting of Items for Systematic Review and Meta-Analyses Protocols. Empirical studies that used any form of CT/remediation in individuals with OCD were included.

Results

Eight articles met the criteria for inclusion, of which five were randomized controlled trials, two were case series, and one was an open-label trial. The studies have predominantly demonstrated improved trained cognitive functions, with only two showing generalization to untrained domains like clinical symptoms and socio-occupational functioning.

Conclusion

There are few controlled trials of CT in OCD, which limits conclusions of efficacy. Given the sparse research in the area, the review summarizes the current status of research and examines important methodological considerations that may inform future studies.

The Impact of Team Mindfulness on Project Team Performance: The Moderating Role of Effective Team Leadership

The current study aims to investigate the consequences of team mindfulness in project-based organizations by proposing team cohesion as an underlying mechanism and effective team leadership as a boundary condition through which team mindfulness promotes project team performance. Data were collected through a time-lagged survey from Pakistani employees (N = 379). The data supported the proposed model revealing that team mindfulness enhances team cohesion among employees, which increases project team performance and effective team leadership moderates this relationship. This study has identified the team-level factors that can be used by project managers to increase project team performance.

The potential mediating role of anxiety sensitivity in the impact of mindfulness training on anxiety and depression severity and impairment: A randomized controlled trial

The benefits of mindfulness-based interventions to alleviate anxiety and depression have been supported by many studies. Given the effectiveness of mindfulness-based interventions on anxiety and depression, the underlying mechanisms need to be explored. Using a randomized waitlist-controlled design, this study investigated whether anxiety sensitivity was a potential mechanism for the impact of mindfulness training on anxiety and depression. Participants with high psychological distress were randomly assigned to an eight-week mindfulness intervention (N = 35) or a wait-list control group (N = 34). Before and after the intervention or corresponding waitlist period, participants completed measures of anxiety and depression severity and impairment and anxiety sensitivity. Separate mixed ANOVA demonstrated significant group (intervention vs. control group) × time (pre- vs. post-test) interactions for anxiety sensitivity and overall anxiety severity and impairment and marginally significant interaction for overall depression severity and impairment. Moreover, simple mediation models showed that reductions of anxiety sensitivity from pre- to post-test mediated the impact of mindfulness training on changes in anxiety and depression severity and impairment. The findings suggest that anxiety sensitivity is a potential mechanism underlying the effect of mindfulness training on anxiety and depression, which provides a new perspective for the study of processes of change of mindfulness-based interventions.

Development of Proactive Control and Anxiety Among Behaviorally Inhibited Adolescents

OBJECTIVE

Behavioral inhibition (BI) is an infant temperament characterized by heightened reactivity and negative affect in response to novel people and situations. BI is among the earliest and strongest predictors of future anxiety problems. However, not all children with a history of BI will manifest anxiety problems. A growing body of evidence suggests that proactive control skills may help buffer youth with BI from future anxiety difficulties; yet, it remains unclear how temperament may interact with the development of cognitive control to influence anxiety risk. The present study tested whether enhancements in proactive control occurring during adolescence may reduce risk for anxiety among youth with a history of BI.

METHOD

Participants included 185 adolescents (56% female) whose temperament was assessed during toddlerhood. In adolescence, participants completed anxiety assessments and an AX Continuous Performance Test (AX-CPT) to assess cognitive control strategy. Both assessments were administered at age 13 years and again at 15 years.

RESULTS

Latent change score modeling revealed that, on average, participants increasingly used proactive control strategies and experienced worsening anxiety from age 13-15 years. Early BI was associated with a smaller anxiety increase from 13-15 years, but only among participants whose proactive control skills improved at mean or greater rates.

CONCLUSION

The present findings suggest that greater proactive control development during adolescence protects youth with high BI from age-related increases in anxiety. Results support a framework that highlights cognitive control as a key moderator of anxiety risk among children with a history of high BI.

PE augmented mindfulness: A neurocognitive framework for research and future healthcare

Various well-controlled studies have suggested that practitioners in mindfulness can be prone to patient drop-out (e.g., due to chronic stress, pathology, cognitive reactivity), despite researchers having identified the underlying mechanisms that link mindfulness to mental health. In this article, a framework for physical exercise (PE) augmented mindfulness is proposed, which posits that consistently practiced PE before meditation can support (early-stage) mindfulness. Neurocognitive research shows PE (aerobic exercises or yoga) and mindfulness to impact similar pathways of stress regulation that involve cognitive control and stress regulation, thereby supporting the proposed synergistic potential of PE augmented mindfulness. Research focused on the psychophysiological impact of PE, showed its practice to promote short-term neurocognitive changes that can promote both cognitive control and the attainment of mindful awareness (MA). In order to chart dose responses required for protocol development, further research will be presented. Together these findings are discussed in light of future research on this multidisciplinary topic, protocol development, mindful walking, and further application in healthcare and beyond.

Experimental Manipulation of Guided Attention to the Shoulder Movement Task in Clinical Dohsa-hou Induces Shifts in the Reactive Mode and Indicates Flexible Cognitive Control Performance

The empirical basis for self-control in Dohsa-hou as it relates to effects on cognitive processes has been explored in a few studies of the Japanese psychotherapy, but not under standardized conditions with a strong predictive theory of control. This study reports on a series of experiments with the Dual Mechanisms of Control framework to clarify the possible regulatory mechanism of Dohsa-hou by focusing on shoulder movement, a key body movement task used by practitioners across applied settings. Cognitive control was operationalized with the AX version of Continuous Performance Test (AX-CPT) paradigm for proactive control and a modified Stroop task paradigm for reactive control in a 3-arm parallel group trial study design. Healthy Japanese university students were assigned to a Dohsa-hou group that performed a shoulder movement task for few minutes, an active control group that performed a similar task, or a passive control group comprised of a resting condition. A total of 55 participants performed the AX-CPT and 57 participants performed the modified Stroop task before and after the group manipulation. In the AX-CPT, an increase in the error rate of AY (true cue-false probe) trial from pre- to post-test was observed in the passive control group only, and found to be marginally higher in the passive control group relative to Dohsa-hou group at post-test. This indicated that Dohsa-hou moderated the activation of proactive control by repeated AX-CPT performance. The error rate of the Proactive Behavioral Index did not differ from zero at post-test only in the Dohsa-hou group, indicating flexible cognitive control. In the modified Stroop task, there was no difference between congruent and incongruent trials at post-test for the Dohsa-hou group only, indicating the facilitation of reactive control. The evidence for a balancing effect for the Dohsa-hou-based shoulder movement task indicates that clients experience a form of continuous self-monitoring, which might reduce mind-wandering from their focus on movement execution combined with iterative verbal feedback from the therapist. Overall, the results of the present study suggest that the self-regulatory mechanism promoted in clinical Dohsa-hou emphasizes guided shifts in attention to the reactive mode toward a balance of cognitive control.

Effects of Mindfulness Meditation on Doctors' Mindfulness, Patient Safety Culture, Patient Safety Competency and Adverse Event

Objective: This study investigated the effects of mindfulness meditation on doctors’ mindfulness, patient safety culture, patient safety competency, and adverse events. Methods: We recruited 91 doctors from a hospital in China and randomized them to mindfulness meditation group (n = 46) and a waiting control group (n = 45). The mindfulness meditation group underwent an 8-week mindfulness meditation intervention, while the control group underwent no intervention. We measured four main variables (mindfulness, patient safety culture, patient safety competency, and adverse event) before and after the mindfulness meditation intervention. Results: In the experimental group, mindfulness, patient safety culture and patient safety competency were significantly higher compared with those of the control group. In the control group, there were no significant differences in any of the three variables between the pre-test and post-test. Adverse events in the experimental group were significantly lower than in the control group. Conclusions: The intervention of mindfulness meditation significantly improved the level of mindfulness, patient safety culture and patient safety competency. During the mindfulness meditation intervention, the rate of adverse events in the meditation group was also significantly lower than in the control group. As a simple and effective intervention, mindfulness meditation plays a positive role in improving patient safety and has certain promotional value.

Employee mindfulness and proactive coping for technostress in the COVID-19 outbreak: The roles of regulatory foci, technostress, and job insecurity

The transition to digital platforms during the COVID-19 pandemic has created technostress to several workers. Our study aims to investigate whether employee mindfulness contributes to their proactive coping for technostress. We built the dataset from 714 employees from service industries during the pandemic. The findings lent credence to the role of prevention focus in mediating the positive link between dispositional mindfulness and proactive coping for technostress as well as the role of promotion focus in mediating the positive relationship between interpersonal mindfulness and proactive coping for technostress. Technostress was found to strengthen the negative association between prevention focus and proactive coping for technostress while job insecurity represented an attenuating effect on such a link. The results further confirmed the attenuating effect of job insecurity on the positive link between promotion focus and proactive coping for technostress. This study adds dispositional and interpersonal mindfulness as crucial personal antecedents to proactive coping for technostress as well as offers insights into mechanisms underlying such relationships.

Investigating mindfulness influences on cognitive function: On the promise and potential of converging research strategies

Research investigating the effects and underlying mechanisms of mindfulness on cognitive functioning has accelerated exponentially over the past two decades. Despite the rapid growth of the literature and its influential role in garnering public interest in mindfulness, inconsistent methods in defining and measuring mindfulness have yielded variable findings, which contribute to the overall dearth of clear generalizable conclusions. The focus of this article is to address the lack of cohesion in the collective methodologies used in this domain by providing a new perspective grounded in classic cognitive and experimental psychology principles. We leverage the concept of converging operations to demonstrate how seemingly disparate research strategies can be integrated towards a more unified and systematic approach. An organizing taxonomic framework is described to provide useful structure in how mindfulness can be operationalized, measured, and investigated. We illustrate the rationale and core organizing principles of the framework through a selective review of studies on mindfulness and cognitive control. We then demonstrate the utility of the approach by showing how it can be applied to synthesize extant methodologies and guide the development of future research. Specific suggestions and examples pertaining to experimental design and statistical analysis are provided.

Behavioral inhibition and dual mechanisms of anxiety risk: Disentangling neural correlates of proactive and reactive control

Background:

Behavioral inhibition (BI) is a temperament style characterized by heightened reactivity and negative affect in response to novel people and situations, and it predicts anxiety problems later in life. However, not all BI children develop anxiety problems, and mounting evidence suggests that how one manages their cognitive resources (cognitive control) influences anxiety risk. The present study tests whether more (proactive control) or less (reactive control) planful cognitive strategies moderate relations between early BI and later anxiety.

Methods:

Participants included 112 adolescents (55% female; M_age = 15.4 years) whose temperament was assessed during toddlerhood. In adolescence, participants completed an AX Continuous Performance Test while electroencephalography was recorded to disentangle neural activity related to proactive (cue-locked P3b) and reactive (probe-locked N2) control.

Results:

Greater BI was associated with greater total anxiety scores only among adolescents with smaller ΔP3bs and larger ΔN2s—a pattern consistent with decreased reliance on proactive strategies and increased reliance on reactive strategies. Additionally, a larger ΔP3b was associated with greater total anxiety scores; however, this effect was largely explained by the fact that females tended to have larger ΔP3bs and greater anxiety than males.

Conclusions:

Early BI relates to risk for later anxiety specifically among adolescents who rely less on proactive strategies and more on reactive control strategies. Thus, cognitive control strategy moderates the association between developmental context (i.e., temperament) and later anxiety. The present study is the first to characterize how proactive and reactive control uniquely relate to pathways toward anxiety risk.

Mindfulness Is Associated With Lower Stress and Higher Work Engagement in a Large Sample of MOOC Participants

Objective: This study aimed to understand the associations between mindfulness, perceived stress, and work engagement in a very large sample of English-speaking adults, from 130 different countries. It also aimed to assess participants' self-reported changes following a 6-week mindfulness massive open online course (MOOC). Methods: Participants in the 6-week MOOC were invited to complete pre-post online surveys. Cross-sectional associations were assessed using univariate linear models, followed by structural equation models to test mediation pathways in baseline data (N = 16,697). Self-reported changes in mindfulness, stress and engagement following training were assessed using paired t-tests (n = 2,105). Results: Each standard deviation unit increase in mindfulness was associated with a 0.52 standard deviation unit decrease in perceived stress, and with 0.06 standard deviation unit increment in work engagement. 73% of the influence of mindfulness on engagement was direct. Following the mindfulness MOOC, participants reported higher mindfulness (d = 1.16), reduced perceived stress (d = 1.00) and a small improvement in work engagement (d = 0.29). Conclusions: Mindfulness was associated with lower perceived stress and higher work engagement in both cross-sectional and longitudinal analyses. These findings support mindfulness as a potentially protective and modifiable personal resource. The MOOC format offers a low cost, highly accessible means for extending the reach and potential benefits of mindfulness training to large numbers of people.

Do group-based mindfulness meditation programs enhance executive functioning? A systematic review and meta-analysis of the evidence

Research examining the effects of group-based mindfulness interventions on executive functioning have yielded inconsistent findings, with some reports of enhanced performance and other reports of null findings. Inconsistencies in the literature may be due to methodological differences across studies, including the type of control group employed and sample characteristics (e.g., clinical vs. non-clinical samples). The current systematic review and meta-analysis examined the effect of group-based mindfulness programs on executive functioning in persons 18+ years of age. Following the standards for systematic review, a total of 29 studies were included in the meta-analysis, of which 21 comparisons contributed to the analysis of inhibition; nine to working memory; nine to attention shifting; and four to the analysis of verbal fluency. After removing outliers, random effects models suggested a small but significant synthesized effect of group-mindfulness training on overall executive functioning (95% CI = 0.256, 0.725). Examination of executive subdomains after removing outliers suggested a small, statistically significant effect for inhibition (95% CI = 0.055, 0.387), working memory (95% CI = 0.010, 0.437), and verbal fluency (95% CI = 0.071, 1.931). No significant pooled effects were found for attention shifting. A priori subgroup analysis by randomization, type of control group, and sample cohort revealed inconsistent results. Overall, the current review suggests that the effect of group-based mindfulness training on executive functioning is not robust.

The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis

Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].

Repeat Traffic Offenders Improve Their Performance in Risky Driving Situations and Have Fewer Accidents Following a Mindfulness-Based Intervention

Risky decision-making is highly influenced by emotions and can lead to fatal consequences. Attempts to reduce risk-taking include the use of mindfulness-based interventions (MBI), which have shown promising results for both emotion regulation (ER) and risk-taking. However, it is still unclear whether improved emotion regulation is the mechanism responsible for reduced risk-taking. In the present study, we explore the effect of a 5-week MBI on risky driving in a group of repeat traffic offenders by comparing them with non-repeat offenders and repeat offenders without training. We evaluated the driving behavior of the participants through a driving simulation, and self-reported emotion regulation, both before and after the intervention. At baseline, poor emotion regulation was related to a more unstable driving behavior, and speeding. The group that received mindfulness training showed improved performance during risky driving situations and had fewer accidents, although their overall driving behavior remained largely unchanged. The observed trend toward improved emotion regulation was not significant. We discuss whether other effects of MBI – such as self-regulation of attention – could underlie the observed reduction in risky driving in the initial stages. Nonetheless, our findings still confirm the close relationship between emotion regulation skills and risky driving.

Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

There is an urgent need for mental health promotion in nonclinical settings. Mindfulness-based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions.

METHODS AND FINDINGS

Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in-person, expert-defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk-of-Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well-being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta-regression and sensitivity analyses were prespecified. Pairwise random-effects multivariate meta-analyses and prediction intervals (PIs) were calculated. A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = -0.56; 95% confidence interval (CI) -0.80 to -0.33; p-value < 0.001; 95% PI -1.19 to 0.06), depression (14 trials; SMD = -0.53; 95% CI -0.72 to -0.34; p-value < 0.001; 95% PI -1.14 to 0.07), distress (27 trials; SMD = -0.45; 95% CI -0.58 to -0.31; p-value < 0.001; 95% PI -1.04 to 0.14), and well-being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p-value = 0.003; 95% PI -0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = -0.46; 95% CI -0.81 to -0.10; p-value = 0.012, 95% PI -1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well-being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs' superiority. Only effects on distress remained when higher-risk trials were excluded. USA-based trials reported smaller effects. MBPs targeted at higher-risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials.

CONCLUSIONS

Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.

Proactive and reactive control mechanisms in navigational search

Reactive and proactive cognitive control are fundamental for guiding complex human behaviour. In two experiments, we evaluated the role of both types of cognitive control in navigational search. Participants searched for a single hidden target in a floor array where the salience at the search locations varied (flashing or static lights). An a-priori rule of the probable location of the target (either under a static or a flashing light) was provided at the start of each experiment. Both experiments demonstrated a bias towards rule-adherent locations. Search errors, measured as revisits, were more likely to occur under the flashing rule for searching flashing locations, regardless of the salience of target location in Experiment 1 and at rule-congruent (flashing) locations in Experiment 2. Consistent with dual mechanisms of control, rule-adherent search was explained by engaging proactive control to guide goal-maintained search behaviour and by engaging reactive control to avoid revisits to salient (flashing) locations. Experiment 2 provided direct evidence for dual mechanisms of control using a Dot Pattern Expectancy task to distinguish the dominant control mode for a participant. Participants with a reactive control mode generated more revisits to salient (flashing) locations. These data point to complementary roles for proactive and reactive control in guiding navigational search and propose a novel framework for interpreting navigational search.

Dual mechanisms of cognitive control in mindful individuals

Not much research has adopted a multicomponent approach to examine the relationship between mindfulness and cognitive control. Studies addressing this issue have produced mixed results that may be due to the incorporation of different questionnaires to assess mindfulness and to the assessment of different stages and types of mindfulness itself. In the present study, we aimed to investigate to which extent dispositional mindfulness relates to a dynamic use of control modes as understood from the dual mechanisms of control theory. Further, we aimed to test this hypothesis by including two different frequently used mindfulness questionnaires in order to explore their confluence. Hundred thirty young adults completed two well-established assessment tools of mindfulness (Mindful Attention Awareness Scale and Five Facets Mindfulness Questionnaire) and two well-validated experimental tasks measuring proactive/reactive control modes (AX-Continuous Performance Task and Cued Task-Switching Paradigm). The data analyses were performed considering the continuous values in multiple regression analyses, as it is thought to better capture individual differences. The results replicate the previous findings suggesting that mindful individuals tend to use proactive and reactive control in a balanced manner in comparison to low mindfulness individuals, who tend to rely more on proactive control. Moreover, mindful individuals showed greater flexibility when the two processing modes were available. Hence, the major effects were found by using the two questionnaires. Altogether our findings indicate that mindful individuals, who have been characterized by an enhanced focus on the present moment without judgment, are less attached to the previous contextual information, which allows them to exhibit a more flexible performance.

The Mediating Role of Non-reactivity to Mindfulness Training and Cognitive Flexibility: A Randomized Controlled Trial

Mindfulness training has been shown to have a beneficial effect on cognitive flexibility. However, little is known about the mediators that produce this effect. Cross-sectional studies show that there might be a link between Non-judgment, Non-reactivity and cognitive flexibility. Longitudinal studies examining whether Non-judgment or Non-reactivity mediate the effectiveness of mindfulness training on improving cognitive flexibility are lacking. The present study aims to test the effect of mindfulness training on increasing cognitive flexibility and to test whether this effect is mediated by Non-judgment or Non-reactivity. We conducted a single-blind randomized controlled trial in 54 nonclinical high-stress participants between October 2018 and January 2019. Participants were randomly assigned to a Mindfulness Based Stress Reduction (MBSR) group or a waitlist control group. The experimenters were blind to the group assignment of participants. The MBSR group received 8-weekly sessions (2.5-h per week) and a one-day retreat (6-h), and was required to accomplish a 45-min daily formal practice during the intervention. The waitlist control group did not receive any intervention during the waiting period and received a 2-day (6-h per day) mindfulness training after the post-intervention. The primary outcome was self-report cognitive flexibility and perceived stress administered before and after MBSR. The secondary outcome was self-report mindfulness skills (including Non-reactivity and Non-judgment) measured at pre-treatment, Week 3, Week 6, and post-intervention. For cognitive flexibility, mixed-model repeated-measure ANOVA results showed that there were significant main effects of Time, Group and a significant interaction of Time by Group. Follow-up ANOVA indicated that the MBSR group was associated with greater improvements in cognitive flexibility than the waitlist. Path analysis results showed that the effect of the treatment on cognitive flexibility at post-treatment was fully mediated by Non-reactivity at Week 6. The mediation effects of Non-reactivity at Week 3, and Non-judgment at Week 3 and Week 6 were not significant. Our findings support the efficacy of MBSR on improving cognitive flexibility. Non-reactivity is an important element of the effectiveness of MBSR training on cognitive flexibility.

Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review

Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.