Conscious, Pre-Conscious and Unconscious Mechanisms in Emotional Behaviour. Some Applications to the Mindfulness Approach with Wearable Devices

Neurofeedback as neuroempowerment technique for affective regulation and interoceptive awareness in adolescence: preliminary considerations applied to a psychogenic pseudosyncope case

Revisions of classical models of acute stress response spectrum and defence cascade process might represent a valuable background for the interpretation of the link between affective reactions, traumatic experiences, and Psychogenic pseudosyncope (PPS) events in childhood and across the lifespan. Indeed, associations between subjective emotional life, early exposure to distressing and/or traumatic events, and PPS have fuelled a debate on potential causes of occurrence and recurrence of such a peculiar clinical manifestation. At the same time, such background suggests that empowering stress management and affective regulation skills could be the target for neurorehabilitation interventions aiming at reducing the severity of symptomatology and/or improving awareness and management of pseudosyncopal spells. Specifically, neuro/biofeedback-based empowerment of self-regulation skills, associated to an increased interoceptive increased awareness, could be a promising complement to classical psychological therapies. Starting from the presentation of a paediatric PPS clinical case, the present work discusses the relevance of assessing affective appraisal and autonomic reactivity in individuals suffering from PPS episodes and introduces a novel potential neuroempowerment protocol aimed at improving self-regulation and stress management skills in adolescence based on a combined neurofeedback and embodied-awareness intervention. By capitalizing available evidence of the effects of neuromodulation and embodied practices on self-awareness/regulation across the life-span, the proposed protocol is based on neurofeedback-supported affective management training, as well as both contemplative and informal awareness exercises devised to be appealing and challenging even for younger patients.

The connection between heart rate variability (HRV), neurological health, and cognition: A literature review

The heart and brain have bi-directional influences on each other, including autonomic regulation and hemodynamic connections. Heart rate variability (HRV) measures variation in beat-to-beat intervals. New findings about disorganized sinus rhythm (erratic rhythm, quantified as heart rate fragmentation, HRF) are discussed and suggest overestimation of autonomic activities in HRV changes, especially during aging or cardiovascular events. When excluding HRF, HRV is regulated via the central autonomic network (CAN). HRV acts as a proxy of autonomic activity and is associated with executive functions, decision-making, and emotional regulation in our health and wellbeing. Abnormal changes of HRV (e.g., decreased vagal functioning) are observed in various neurological conditions including mild cognitive impairments, dementia, mild traumatic brain injury, migraine, COVID-19, stroke, epilepsy, and psychological conditions (e.g., anxiety, stress, and schizophrenia). Efforts are needed to improve the dynamic and intriguing heart-brain interactions.

Heart rate variability during mindful breathing meditation

We discuss Heart Rate Variability (HRV) measured during mindful breathing meditation. We provide a pedagogical computation of two commonly used heart rate variability metrics, i.e. the root mean square of successive differences (RMSSD) and the standard deviation of RR intervals (SDRR), in terms of Fourier components. It is shown that the root mean square of successive differences preferentially weights higher frequency Fourier modes, making it unsuitable as a biosignal for mindful breathing meditation which encourages slow breathing. We propose a new metric called the autonomic balance index (ABI) which uses Respiratory Sinus Arrhythmia to quantify the fraction of heart rate variability contributed by the parasympathetic nervous system. We apply this metric to heart rate variability data collected during two different meditation techniques, and show that the autonomic balance index is significantly elevated during mindful breathing, making it a good signal for biofeedback during meditation sessions.

Advances in Materials, Sensors, and Integrated Systems for Monitoring Eye Movements

Eye movements show primary responses that reflect humans' voluntary intention and conscious selection. Because visual perception is one of the fundamental sensory interactions in the brain, eye movements contain critical information regarding physical/psychological health, perception, intention, and preference. With the advancement of wearable device technologies, the performance of monitoring eye tracking has been significantly improved. It also has led to myriad applications for assisting and augmenting human activities. Among them, electrooculograms, measured by skin-mounted electrodes, have been widely used to track eye motions accurately. In addition, eye trackers that detect reflected optical signals offer alternative ways without using wearable sensors. This paper outlines a systematic summary of the latest research on various materials, sensors, and integrated systems for monitoring eye movements and enabling human-machine interfaces. Specifically, we summarize recent developments in soft materials, biocompatible materials, manufacturing methods, sensor functions, systems' performances, and their applications in eye tracking. Finally, we discuss the remaining challenges and suggest research directions for future studies.

Mindfulness in the focus of the neurosciences - The contribution of neuroimaging to the understanding of mindfulness

BACKGROUND

Mindfulness affects human levels of experience by facilitating the immediate and impartial perception of phenomena, including sensory stimulation, emotions, and thoughts. Mindfulness is now a focus of neuroimaging, since technical and methodological developments in magnetic resonance imaging have made it possible to observe subjects performing mindfulness tasks.

OBJECTIVE

We set out to describe the association between mental processes and characteristics of mindfulness, including their specific cerebral patterns, as shown in structural and functional neuroimaging studies.

METHODS

We searched the MEDLINE databank of references and abstracts on life sciences and biomedical topics via PubMed using the keywords: "mindfulness," "focused attention (FA)," "open monitoring (OM)," "mind wandering," "emotional regulation," "magnetic resonance imaging (MRI)" and "default mode network (DMN)." This review extracted phenomenological experiences across populations with varying degrees of mindfulness training and correlated these experiences with structural and functional neuroimaging patterns. Our goal was to describe how mindful behavior was processed by the constituents of the default mode network during specific tasks.

RESULTS AND CONCLUSIONS

Depending on the research paradigm employed to explore mindfulness, investigations of function that used fMRI exhibited distinct activation patterns and functional connectivities. Basic to mindfulness is a long-term process of learning to use meditation techniques. Meditators progress from voluntary control of emotions and subjective preferences to emotional regulation and impartial awareness of phenomena. As their ability to monitor perception and behavior, a metacognitive skill, improves, mindfulness increases self-specifying thoughts governed by the experiential phenomenological self and reduces self-relational thoughts of the narrative self. The degree of mindfulness (ratio of self-specifying to self-relational thoughts) may affect other mental processes, e.g., awareness, working memory, mind wandering and belief formation. Mindfulness prevents habituation and the constant assumptions associated with mindlessness. Self-specifying thinking during mindfulness and self-relational thinking in the narrative self relies on the default mode network. The main constituents of this network are the dorsal and medial prefrontal cortex, and posterior cingulate cortex. These midline structures are antagonistic to self-specifying and self-relational processes, since the predominant process determines their differential involvement. Functional and brain volume changes indicate brain plasticity, mediated by mental training over the long-term.

Interoception: A Multi-Sensory Foundation of Participation in Daily Life

The purpose of this article is to examine evidence that broadens the clinical perspective on interoception as an imperative consideration for individuals with mental health and sensory processing challenges. The central supposition is that interoception is broader than just signals from the viscera. Rather, interoception refers to perceptions of bodily signals and bodily states that construct a subjective representation of the experience. These representations are then utilized for categorizing the sensory attributes and constructing meaning. Thus, this updated conceptualization presents interoception as a complex multidimensional system, with bidirectional features. The interplay between the brain and the body is necessary to maintain homeostasis as well as respond adaptively to the changes in one's internal and external environment. As a sensory capacity, interoceptive information must be processed and interpreted before it can be integrated into a personal experiential history. Interoception supports both body and mental functions and as such, interoceptive processes support health and wellness by establishing a felt sense of psychological and physiological safety that is foundational to meaningful participation in life. The information presented in this article is central to the pursuit of evidence-based best practices for any professional wishing to integrate consideration of interoception into their clinical practice.

The Empowering Effect of Embodied Awareness Practice on Body Structural Map and Sensorimotor Activity: The Case of Feldenkrais Method

While outcomes of embodied awareness practices in terms of improved posture and flexibility, movement efficiency, and well-being are often reported, systematic investigations of such training effects and of the actual nature, extent, and neurofunctional correlates of learning mechanisms thought to lie at the core of such practices are very limited. The present study focused on the Feldenkrais method (FM), one of the most established embodied awareness practices, and aimed at investigating the neurofunctional outcomes of the somatic learning process at the core of the method by testing the modulations induced by a standardized FM protocol on the complexity of practicers’ body structural map and on the activity of their sensorimotor network during different movement-related tasks (i.e., gestures observation, execution, and imagery). Twenty-five participants were randomly divided into an experimental group—which completed a 28-session FM protocol based on guided group practice—and a control group, and underwent pre-/post-training psychometric and electrophysiological assessment. Data analysis highlighted, at the end of the FM protocol, a significant increase of EEG markers of cortical activation (task-related mu desynchronization) in precentral regions during action observation and in central regions during action execution and imagery. Also, posterior regions of the sensorimotor network showed systematic activation during all the action-related tasks.

Perceived acceptability of wearable devices for the treatment of mental health problems

OBJECTIVE

This study examined the potential acceptability of wearable devices (e.g., smart headbands, wristbands, and watches) aimed at treating mental health disorders, relative to conventional approaches.

METHODS

A questionnaire assessed perceptions of wearable and nonwearable treatments, along with demographic and psychological information. Respondents (N = 427) were adults from a community sample (M_age  = 44.6, SD_age  = 15.3) which included current (30.2%) and former (53.9%) mental health help-seekers.

RESULTS

Perceived effectiveness of wearables was a strong predictor of interest in using them as adjuncts to talk therapies, or as an alternative to self-help options (e.g., smartphone applications). Devices were more appealing to those with negative evaluations of psychological therapy and less experience in help-seeking.

CONCLUSIONS

Interest in using wearable devices was strong, particularly when devices were seen as effective. Clients with negative attitudes to conventional therapies may be more responsive to using wearable devices as a less directive treatment approach.

Efficacy of a Neurofeedback Training on Attention and Driving Performance: Physiological and Behavioral Measures

Increased attention and lower stress levels are associated with more functional and safe driving behavior, since they contribute to reduce distractibility and risk-taking at the wheel. Previous neuroscience research highlighted that NeuroFeedback (NF) training mediated by wearable devices could be effective in terms of neurocognitive strengthening and attention regulation with a direct effect on driving attentional performance. Thus, this research aims to test the effectiveness of a NF protocol on a sample of drivers, to observe its impact on attentional skills and psychophysiological levels of stress involved in driving behavior. 50 participants were randomly assigned to the experimental and active control group. The experimental condition consisted of a 21-day mindfulness NF training with incremental duration sessions. A pre- (t0) and post-treatment (t1) assessment included behavioral, psychometric, neuropsychological, and psychophysiological autonomic measures. Specifically, the Driver Behavior Questionnaire (DBQ) and the Active Box (AB) device were used to evaluate the everyday driving behavior. Results underlined an improvement in driving behavior performance and a decrease of violations at the wheel of the experimental group (EXPg) at t1 measured, respectively by AB and DBQ. About the autonomic and neuropsychological measure, an increase in heart rate (HR) and an increased accuracy at the Stroop Task were detected: a specific increase of Stroop-related HR was found for the EXPg at t1. Also, reduced reaction times were found in the Multiple Features Target Cancellation for the EXPg at t1. Overall, the EXPg displayed a physiological, behavioral and neuropsychological increased efficiency related to attention as well as a driving-related behavioral improvement after NF training.

Neurocognitive Enhancement Effects of Combined Mindfulness-Neurofeedback Training in Sport

To foster performance across all levels of sports practice, physical training has been integrated with various mental training practices. Recently, an integrative approach to neurocognitive enhancement tried to combine the strengths of mental practices (i.e. mindfulness) and of training with neurofeedback devices. Based on previous validation studies showing the effect of a combined mindfulness-neurofeedback program on neurocognitive efficiency and stress/anxiety levels, we aimed at testing the feasibility and potential of that intensive combined program for improving psychological well-being and attention regulation in sport contexts. 50 participants (sportspeople and volunteers not regularly involved in sports) were divided into groups undergoing experimental and active control training programs. The experimental one was based on breathing-awareness practices supported by a wearable neurofeedback, while the active control one included only breathing practices. Before and after training participants underwent standardized neuropsychological and electrophysiological assessment. Data analysis highlighted a significant reduction of response times and false alarms at computerized cognitive tasks in sportspeople who completed the training, as well as a consistent improvement of the N2 event-related potential - a marker of attention regulation processes. We have also observed a general reduction of perceived stress and increased ability to keep a non-evaluative stance. Findings extend available observations on cognitive and neural effects of combined mindfulness-neurofeedback practice by showing that it is possible to observe training effects even after a limited period of practice among sportspeople. Such early training effects might mirror optimized implicit learning curves due to peculiar sensitivity to bodily signals and awareness.

Stress and neurocognitive efficiency in managerial contexts

Purpose

The purpose of this paper is to test the potential of an innovative technology-mediated mental training protocol for the empowerment of stress management and neurocognitive efficiency in highly stressful professional contexts, with people who occupy top management positions. The innovative protocol specifically combines mindfulness practice and a wearable neurofeedback system managed via smartphone.

Design/methodology/approach

The longitudinal research included pre- and post-training assessment steps in order to test training effects with respect to subjective level and physiological markers of stress, anxiety and mood profiles, cognitive abilities and markers of neurocognitive efficiency.

Findings

Results showed decreased stress, anxiety, anger and mental fatigue; increased participants’ information-processing efficiency; increased electrophysiological markers concerning the balance and reactivity of the mind-brain system; and improved physiological markers of vagal tone.

Research limitations/implications

Though further investigation and replication with larger samples would strengthen present findings, the authors suggest that observed outcomes, together with the limited duration of the overall protocol and of daily practices, make the training a potentially valuable tool especially for people whose professional position imposes time limitations and elevated job duties, thus increasing the risk of drop-out from traditional stress management programs.

Originality/value

The combination of mindfulness-based mental training with the advantages offered by a novel brain-sensing wearable technology allows for overcoming the weak points of traditional approaches (e.g. notable time expense) and optimizing training opportunities and outcomes. Furthermore, this is, to the authors’ best knowledge, the first systematic report of the application of such methodology in an organization and with top management professionals.

To Rate or Not to Rate? Autonomic Response and Psychological Well-being of Employees During Performance Review

Organizational research started including neurosciences exploring pivotal phenomena and promoting organizational well-being. Leadership was investigated by assessing psychophysiological responses during performance review characterized by narrative or quantitative assessments and their effects on employees' well-being. As is known, rating could be perceived as threatening for employees' ranking and status perception, leading to avoidant behaviors.

DESIGN AND METHODOLOGY

Here, manager-employee dyads were assigned to 2 conditions: in the nonrate scenario, managers were asked to describe the employee's performance; in the rate one, they had to provide a quantitative rating. Skin conductance level and response and heart rate indices were continuously recorded.

FINDINGS

Dyads in nonrate condition showed higher arousal-related responses (skin conductance level and skin conductance response), perhaps highlighting an increased engagement triggered by a rewarding exchange. Conversely, in rate condition, employees showed higher heart rate, usually related to negative and stressful conditions, and avoidant behaviors.

ORIGINALITY/VALUE

Results are discussed for their possible applications to employees' well-being.

Effects of technology-mediated mindfulness practice on stress: psychophysiological and self-report measures

Repeated exposure to stressors, even if mild, may alter the efficiency of optimal stress responses and hinder emotion regulation skills. Mindfulness meditation, by strengthening self-regulation and awareness, may optimize the efficiency of physiological, cognitive, and behavioral reactions to stressful events but typically requires notable commitment to practice, which often leads to disengagement. Recent research suggested that such practices may be made more accessible and that the potential for self-enhancement and stress management of meditation might be improved by supporting mental training with wearable neurofeedback devices able to inform the practicer on ongoing modulation of bodily and brain activity. This study aimed at testing the effect of such novel training approach based on the integration of mental training with brain-sensing wearable devices on physiological (heart rate and variability) and subjective markers of stress (perceived stress, anxiety, and mood states). Participants (N = 55) have been randomly divided into an active control (CONTg) and an experimental group (EXPg). Both groups completed a four-week training constituted by brief daily activities based on mindfulness practices. Experimental participants practiced with the support of dedicated brain-sensing devices. By analyzing pre- and post-training assessments, we observed relevantly decreased stress and anxiety measures in EXPg, as well as relevantly decreased mental fatigue and increased vigor. EXPg also showed improved physiological markers of vagal tone both at rest and during exposure to a cognitive stressor. Reported findings add to the limited available literature on potential effects of technology-supported mental training protocols for promoting subjective well-being and enhancing self-regulation skills.