Judson A Brewer

Judson A Brewer
Brown University · School of Public Health

MD PhD

About

108
Publications
61,548
Reads
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7,683
Citations
Introduction
I am interested in habit formation and behavior change science. I bring together theory, basic and translational neuroscience with the development of consumer and clinical training tools to improve health. I use EEG, fMRI, and app-based mindfulness training to study underlying mechanisms and ways to implement behavior change theory in the real world.
Additional affiliations
July 2008 - December 2013
Yale University
Position
  • Research Assistant
August 1996 - May 2004
Washington University in St. Louis
Description
  • MD PhD thesis work
Education
August 1996 - May 2004
Washington University in St. Louis
Field of study
  • Medicine and Immunology
August 1992 - June 1996
Princeton University
Field of study
  • Chemistry and music

Publications

Publications (108)
Article
Background: Smoking is the leading cause of preventable death in the US, while abstinence rates remain modest. Smoking has been shown to be perpetuated by operant conditioning, notably negative reinforcement (e.g., smoking to relieve negative affective states). Mindfulness training (MT) shows promise for smoking cessation, by potentially altering...
Article
Full-text available
Many philosophical and contemplative traditions teach that "living in the moment" increases happiness. However, the default mode of humans appears to be that of mind-wandering, which correlates with unhappiness, and with activation in a network of brain areas associated with self-referential processing. We investigated brain activity in experienced...
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Mindfulness training (MT) has been shown to influence smoking behavior, yet the involvement of reinforcement learning processes as underlying mechanisms remains unclear. This naturalistic, single-arm study aimed to examine slope trajectories of smoking behavior across uses of our app-based MT craving tool for smoking cessation, and whether this rel...
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Objectives Summarize existing literature on cognitive outcomes of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) for individuals with depression. Methods Following PRISMA (2021) guidance, we conducted a systematic review. We searched databases for studies published from 2000 to 2020 which examined cognitiv...
Article
Objective: Sleep disturbance is experienced by nearly 20% of Americans and is highly comorbid with anxiety. Sleep disturbances may predict development of anxiety disorders. Mindfulness training (MT) has shown efficacy for anxiety yet remains limited by in-person based delivery. Digitally delivered MT may target habitual worry processes, yet its ef...
Article
Cue reactivity is one of the most frequently used paradigms in functional magnetic resonance imaging (fMRI) studies of substance use disorders (SUDs). Although there have been promising results elucidating the neurocognitive mechanisms of SUDs and SUD treatments, the interpretability and reproducibility of these studies is limited by incomplete rep...
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This paper provides a framework for understanding why, when, and how to adapt mindfulness-based programs (MBPs) to specific populations and contexts, based on research that developed and adapted multiple MBPs. In doing so, we hope to support teachers, researchers and innovators who are considering adapting an MBP to ensure that changes made are nec...
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Objectives When experiencing negative mood, people often eat to improve their mood. A learned association between mood and eating may cultivate frequent food cravings, detracting from health goals. Training in mindful eating may target this cycle of emotion-craving-eating by teaching individuals to manage urges when experiencing negative mood. We e...
Article
Objective: Mindfulness has received attention in smoking cessation research, yet the mechanisms by which mindfulness may promote smoking cessation are not well understood. Mindfulness training may help individuals increase awareness and respond skillfully to processes that contribute to smoking, such as affective states and craving. This study use...
Preprint
BACKGROUND Smoking is the leading cause of preventable death in the US. Smoking cessation interventions delivered by smartphone apps are a promising tool for helping smokers quit. However, currently available smartphone apps for smoking cessation have not exploited their unique potential advantages to aid quitting. Notably, few to no available apps...
Article
Background Smoking is the leading cause of preventable death in the United States. Smoking cessation interventions delivered by smartphone apps are a promising tool for helping smokers quit. However, currently available smartphone apps for smoking cessation have not exploited their unique potential advantages to aid quitting. Notably, few to no ava...
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Background and aims Maladaptive eating habits are a major cause of obesity and weight-related illness. The development of empirically-based approaches, such as mindfulness training (MT) that target accurate mechanisms of action to address these behaviors is therefore critical. Two studies were conducted to examine the impact of MT on maladaptive ea...
Article
Objective In the United States, people of color (POC) are disproportionately affected by various sources of stress and prevalent mental and physical health issues that may benefit from Mindfulness-based Interventions (MBIs). However, effects of MBIs for POC are unclear. This meta-analysis examines the efficacy of MBIs through randomized controlled...
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This randomized controlled trial evaluated the effect of a mindfulness-based mobile health (mHealth) intervention, tailored to the pandemic context, among young adult students (N = 114) with elevated anxiety and/or depressive symptoms during quarantine in China, compared to a time- and attention-matched social support-based mHealth control. At base...
Article
Anxiety disorders make up the most prevalent class of mental illnesses. Given the growing prevalence of anxiety in the United States and beyond, there is an urgent clinical need to develop nonpharmacologic treatments that effectively treat and reduce its core symptoms (eg, worry). A leading theory posits that although worrying may be unpleasant, th...
Preprint
BACKGROUND Current treatments for Generalized Anxiety Disorder (GAD) yield suboptimal outcomes, partly because of insufficient targeting of underlying psychological mechanisms (e.g. avoidance reinforcement learning). Mindfulness training (MT), has shown efficacy for anxiety, yet widespread adoption has been limited, in part due to difficulty in sca...
Article
Background Current treatments for generalized anxiety disorder (GAD) often yield suboptimal outcomes, partly because of insufficient targeting of underlying psychological mechanisms (eg, avoidance reinforcement learning). Mindfulness training (MT) has shown efficacy for anxiety; yet, widespread adoption has been limited, partly because of the diffi...
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Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning...
Preprint
Full-text available
Background Cue reactivity is one of the most frequently used paradigms in functional magnetic resonance imaging (fMRI) studies of substance use disorders (SUDs). Although there have been many promising results elucidating the neurocognitive mechanisms of SUDs and SUD treatments, heterogeneities in participant characteristics, task design, craving a...
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Full-text available
Purpose of Review Food overconsumption is a major public health issue worldwide where obesity-related conditions are a leading cause of preventable death. The purpose of this study is to rate the quality of mobile apps aimed at improving eating behavior by targeting food and stress-related eating using the Mobile Application Rating Scale. Recent F...
Article
Objective: Anxiety is associated with sleep disturbance and insomnia. Mindfulness-based interventions, such as mindfulness-based stress reduction, have shown consistent anxiety reduction. Mindfulness training has been theorized to affect reinforcement learning, affecting habitual behaviors such as smoking and overeating, but a direct mechanistic l...
Article
To reach longer-term goals and live aligned with their values, people typically must regulate their behavior. Effortful self-control is one way to achieve this and is usually framed as a forceful struggle between lower-level impulses and higher-level cognitive control processes. For example, people may restrain themselves from eating cake in order...
Article
Objectives: Mindfulness-based interventions (MBIs) have been shown to reduce engagement in disordered eating behaviors, although how these interventions engender change remains unclear. The objective of this exploratory qualitative study was to describe the experiences and perceived attitudinal and behavioral changes of women participating in a min...
Article
Objectives There are several definitions of mindfulness throughout the literature, many of which suggest an attitude of non-judgmental awareness. However, the concept of “non-judgment” itself has not previously been systematically operationally defined. Our purpose was to use an expert panel to generate an operational definition of non-judgment of...
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Full-text available
Objectives The use of mobile technology for smoking cessation holds promise for adolescents, who do not typically access traditional treatments, but most are not grounded in theory or mechanism. Operant conditioning theory suggests an addictive smoking loop is formed between nicotine use and affective states, leading to habitual cue-induced craving...
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Full-text available
Objectives Mindfulness training for smoking cessation may work by lessening the association between craving and smoking. However, no studies have tested whether baseline craving may be an indicator of individual smokers who might benefit more from receiving mindfulness training. Methods This study evaluated baseline craving strength and frequency...
Article
Addiction is an age-old problem with desire pitted against self-control and will-power. In modern day substances (including food) and experiences (e.g. social media, internet gaming) are being increasingly engineered to get individuals ‘hooked’. Current cognitive control and reason-based paradigms may be losing a battle with urges, cravings and tri...
Article
Background: Physician burnout is on the rise, yet little is known about its relationship to anxiety. Mindfulness-based stress reduction has demonstrated decreases in anxiety, yet physicians have reported reluctance to engage in it due to significant time commitments. Objective: The aims of this study are to assess whether app-based mindfulness t...
Preprint
BACKGROUND Physician burnout is on the rise, yet little is known about its relationship to anxiety. Mindfulness-based stress reduction has demonstrated decreases in anxiety, yet physicians have reported reluctance to engage in it due to significant time commitments. OBJECTIVE The aims of this study are to assess whether app-based mindfulness train...
Article
Social anxiety disorder (SAD) is a common and impairing condition that emerges in early adolescence, confers significant interpersonal disability and often persists into adulthood. Prevailing interventions for socially anxious youth are largely based on cognitive-behavioral models originally developed in adult samples, but produce only modest rates...
Article
Current treatments for smoking yield suboptimal outcomes, partly because of an inability to reduce cue-induced smoking. Mindfulness training (MT) has shown preliminary efficacy for smoking cessation, yet its neurobiological target remains unknown. Our prior work with nonsmokers indicates that MT reduces posterior cingulate cortex (PCC) activity. In...
Article
Objective: To accurately deliver a source ­estimated neuro-feedback (NF) signal developed on a 128­ sensors EEG system on a reduced 32­sensors EEG system. Methods:A linearly constrained minimum variance beam-former algorithm was used to select the 64 sensors which contributed most highly to the source signal. Monte-Carlo ­based sampling was then us...
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Introduction “Lean” is a set of management principles which focus on increasing value and efficiency by reducing or avoiding waste (e.g., overproduction, defects, inventory, transportation, waiting, motion, over processing). It has been applied to manufacturing, education, and health care, leading to optimized process flow, increased efficiency and...
Data
Materials and methods section for randomized clinical neuroimaging trial. (DOCX)
Preprint
Addiction is an age-old problem with desire pitted against self-control and will-power. In modern day substances (including food) and experiences (e.g. social media, internet gaming) are being increasingly engineered to get individuals “hooked.” Current cognitive control and reason-based paradigms may be losing a battle with urges, cravings and tri...
Article
Full-text available
Emotional and other maladaptive eating behaviors develop in response to a diversity of triggers, from psychological stress to the endless external cues in our modern food environment. While the standard approach to food- and weight-related concerns has been weight-loss through dietary restriction, these interventions have produced little long-term...
Article
Introduction: Mindfulness training may reduce smoking rates and lessen the association between craving and smoking. This trial tested the efficacy of mindfulness training via smartphone app to reduce smoking. Experience sampling was used to measure real time craving, smoking and mindfulness. Methods: A researcher-blind, parallel randomized contr...
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Full-text available
Theoretically driven smartphone-delivered behavioral interventions that target mechanisms underlying eating behavior are lacking. In this study, we administered a 28-day self-paced smartphone-delivered intervention rooted in an operant conditioning theoretical framework that targets craving-related eating using mindful eating practices. At pre-inte...
Article
The human brain has evolved to support our species survival through simple neural mechanisms that help us remember where to find calorie-dense sources of food, while at the same time avoid danger. How do these survival mechanisms function in (Western) modern day, where food is plentiful, and danger exists primarily as theoretical threat? Now add in...
Article
Specific mental training cultivates diminished self-reference, encompassing non-duality, emptiness, awakened-awareness, and compassionate experiences. We aimed to elucidate the neural substrates of four distinct, interdependent Essence-of-Mind states: (1) timelessness, (2) non-preference, non-duality, non-conceptualization, (3) the view of luminosi...
Preprint
Recent advances in brain imaging have improved the measure of neural processes related to perceptual, cognitive and affective functions, yet the relation between brain activity and subjective experience remains poorly characterized. In part, it is a challenge to obtain reliable accounts of participant’s experience in such studies. Here we addressed...
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Introduction: This study aims to identify novel quantitative EEG measures associated with mindfulness meditation. As there is some evidence that meditation is associated with higher integration of brain networks, we focused on EEG measures of network integration. Methods: Sixteen novice meditators and sixteen experienced meditators participated...
Article
Though based in meditation practices that are centuries old, little is known about the neurobiological underpinnings of mindfulness. This article outlines possible psychological and related brain mechanisms of mindfulness, including links to modern-day processes such as operant conditioning (positive and negative reinforcement) and brain regions su...
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Full-text available
There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainabl...
Article
Emotional eating is an important predictor of weight loss and weight regain after weight loss. This two part study's primary aim was to explore changes in emotional eating in a general population of individuals taking the Mindfulness Based Stress Reduction (MBSR) program, with a secondary aim to explore whether changes in mindfulness predicted chan...
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Introduction Obesity is a growing epidemic fuelled by unhealthy behaviours and associated with significant comorbidities and financial costs. While behavioural interventions produce clinically meaningful weight loss, weight loss maintenance is challenging. This may partially be due to failure to target stress and emotional reactivity. Mindfulness-b...
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Purpose of review Increased understanding of “how” and “for whom” treatment works at the level of the brain has potential to transform addiction treatment through the development of innovative neuroscience-informed interventions. The 2015 Science of Change meeting bridged the fields of neuroscience and psychotherapy research to identify brain mecha...
Article
Stress and negative affect are known contributors to drug use and relapse, and several known treatments for addictions include strategies for managing them. In the current study, we administered a well-established stress provocation during functional magnetic resonance imaging (fMRI) to 23 participants who completed either mindfulness training (MT;...
Article
Increased understanding of "how" and "for whom" treatment works at the level of the brain has potential to transform addictions treatment through the development of innovative neuroscience-informed interventions. The 2015 Science of Change meeting bridged the fields of neuroscience and psychotherapy research to identify brain mechanisms of behavior...
Article
Full-text available
Mindfulness research activity is surging within organizational science. Emerging evidence across multiple fields suggests that mindfulness is fundamentally connected to many aspects of workplace functioning, but this knowledge base has not been systematically integrated to date. This review coalesces the burgeoning body of mindfulness scholarship i...
Chapter
Few conditions cause as much suffering on a personal and societal level as addictions. There have been considerable advances in elucidating the psychological and neurobiological mechanisms underlying addiction, but these insights have not translated into treatment innovations. Mindfulness training, a method of self-observation based on ancient Budd...
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Full-text available
At a fundamental level, taxonomy of behavior and behavioral tendencies can be described in terms of approach, avoid, or equivocate (i.e., neither approach nor avoid). While there are numerous theories of personality, temperament, and character, few seem to take advantage of parsimonious taxonomy. The present study sought to implement this taxonomy...
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Meditation has several beneficial effects. However, learning how to meditate is not easy, as there are no clearly visible outward signs of performance, making it difficult for teachers to provide feedback. Neurofeedback from the posterior cingulate cortex (PCC), a brain region that is associated with both meditation and mind wandering, may provide...
Article
Purpose: To evaluate whether dispositional mindfulness (defined as the ability to attend nonjudgmentally to one's own physical and mental processes) is associated with obesity and central adiposity. Methods: Study participants (n = 394) were from the New England Family Study, a prospective birth cohort, with median age 47 years. Dispositional mi...
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The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible i...
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Obesity affects more than one third of US adults and is a major cause of preventable morbidity and mortality, primarily from cardiovascular disease. Traditional behavioral interventions for weight loss typically focus on diet and exercise habits and often give little attention to the role of stress and emotions in the initiation and maintenance of...
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While the music psychology and education literatures have devoted considerable attention to how musical instrumentalists practice their instruments, less formal scholarly attention has been given in consideration of what it means to maintain a musical "practice" over time and across context. In this paper, the practice of mindfulness meditation is...
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Meditation has been associated with relatively reduced activity in the default mode network, a brain network implicated in self-related thinking and mind wandering. However, previous imaging studies have typically compared meditation to rest, despite other studies having reported differences in brain activation patterns between meditators and contr...
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Tobacco use is responsible for the death of about 1 in 10 individuals worldwide. Mindfulness training has shown preliminary efficacy as a behavioral treatment for smoking cessation. Recent advances in mobile health suggest advantages to smartphone-based smoking cessation treatment including smartphone-based mindfulness training. This study evaluate...
Chapter
Few conditions cause as much suffering on a personal and societal level as addictions. Though efforts have helped to delineate the neurobiological mechanisms of the addictive process, treatment strategies have lagged behind. Mindfulness training, which is based on ancient Buddhist psychological models of human suffering, has recently shown promise...
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Social dysfunction is a prominent and disabling aspect of borderline personality disorder. We reconsider traditional explanations for this problem, especially early disruption in the way an infant feels physical care from its mother, in terms of recent developments in computational psychiatry. In particular, social learning may depend on reinforcem...
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While reducing the burden of brain disorders remains a top priority of organizations like the World Health Organization and National Institutes of Health, the development of novel, safe and effective treatments for brain disorders has been slow. In this paper, we describe the state of the science for an emerging technology, real time functional mag...
Article
As part of the mini-symposium entitled "Can Simply Paying Attention Change Behavior? Emotion and Behavior Regulation through Meditation," Dr. Brewer briefly presents studies that used conventional and real-time fMRI to investigate the neurobiological mechanisms of mindfulness comparing novice and experienced meditators.
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Loving kindness is a form of meditation involving directed well-wishing, typically supported by the silent repetition of phrases such as “may all beings be happy,” to foster a feeling of selfless love. Here we used functional magnetic resonance imaging to assess the neural substrate of loving kindness meditation in experienced meditators and novice...
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Mindfulness training (MT) is an emerging therapeutic modality for addictive disorders. Nonjudgment of inner experience, a component of mindfulness, may influence addiction treatment response. To test whether this component influences smoking cessation, tobacco smokers (n = 85) in a randomized control trial of MT vs. Freedom from Smoking (FFS), a st...
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Full-text available
In the past decade, neuroimaging research has begun to identify key brain regions involved in self-referential processing, most consistently midline structures such as the posterior cingulate cortex (PCC). The majority of studies have employed cognitive tasks such as judgment about trait adjectives or mind wandering, that have been associated with...
Article
There has been an increased interest in mindfulness and meditation training over the past decade. As evidenced by exponential growth in the number of publications since the beginning of the 21st century, progressively more is becoming known about both the clinical efficacy and underlying neurobiological mechanisms of mindfulness training. This pape...