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Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Zen Meditation for Depression, Anxiety, Pain, and Psychological Distress
Abstract
Mindfulness has been described as a practice of learning to focus attention on moment-bymoment experience with an attitude of curiosity, openness, and acceptance. Mindfulness practices have become increasingly popular as complementary therapeutic strategies for a variety of medical and psychiatric conditions. This paper provides an overview of three mindfulness interventions that have demonstrated effectiveness for psychiatric symptoms and/or pain. The goal of this review is to provide a synopsis that practicing clinicians can use as a clinical reference concerning Zen meditation, mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT). All three approaches originated from Buddhist spiritual practices, but only Zen is an actual Buddhist tradition. MBSR and MBCT are secular, clinically based methods that employ manuals and standardized techniques. Studies indicate that MBSR and MBCT have broad-spectrum antidepressant and antianxiety effects and decrease general psychological distress. MBCT is strongly recommended as an adjunctive treatment for unipolar depression. The evidence suggests that both MBSR and MBCT have efficacy as adjunctive interventions for anxiety symptoms. MBSR is beneficial for general psychological health and stress management in those with medical and psychiatric illness as well as in healthy individuals. Finally, MBSR and Zen meditation have a role in pain management.
... By focusing on moment-to-moment awareness and responding to emotions consciously rather than reactively, mindfulness can help regulate emotional responses by engaging the higher cognitive functions of the brain (3). Studies have indicated that individuals with higher levels of mindfulness tend to experience fewer negative automatic thoughts and feel more empowered to break free from them (2,4,5). Research has also shown that people seek to enhance their performance in various tasks by incorporating techniques that target psycho-social factors (3,4). ...
... Studies have indicated that individuals with higher levels of mindfulness tend to experience fewer negative automatic thoughts and feel more empowered to break free from them (2,4,5). Research has also shown that people seek to enhance their performance in various tasks by incorporating techniques that target psycho-social factors (3,4). Given the strong connection between mindfulness and awareness, reflecting on our current state of awareness can shed light on the complexity of defining consciousness (6)(7)(8). ...
... Whether positive or negative, thoughts are simply thoughts and not a reflection of reality. While one cannot completely control their thoughts, they can choose to observe them from a distance (4,8,13). This sense of detachment can lead to a greater sense of self-control. ...
... Other dissociators-music therapy (Herbert, 2013) and hypnosis (Cleveland et al., 2015)-are intense and direct. Often, these methods are used in tandem with one another (Bryant et al., 2005;Hilliard, 2006;Marchand, 2012). ...
... Underneath the acute and enduring experiential and behavioral differences common to NSCs, default mode network (DMN) activity is altered. DMN activity is relatively attenuated during attentive mindfulness meditation (Marchand, 2012;Boccia et al., 2015). For psychedelics, functional connectivity, activation, spectral power, and entropy-related measures are altered in the DMN, relative to baseline (Carhart-Harris and Friston, 2019). ...
... In terms of externally observable behavior, skilled meditators are able to reflexively separate pain signals from painful experience (Marchand, 2012). In examining the neural mechanisms of mindfulness-based pain relief, Zeidan et al. (2019) contrast the differences between novitiate (<10 practice hours) and expert (>1000 practice hours) meditators. ...
Common mental health pathologies such as depression, anxiety, addiction, and PTSD have recently seen treatment inroads. These issues share a phenomenological core—a dissociative quality that involves the disintegration of self and other. Interestingly, some of the most effective treatments of these pathologies are themselvesacutely dissociative. For example, psychedelic therapy has been effective at treating these pathologies and involves highly dissociative altered states. This pattern holds across other dissociative methods such as hypnosis, CBT, and meditation, leading some to hypothesize that there is a common pathway from acutely altered states to long-term treatment of conditions that involve pathological dissociation. Among the proposed mechanisms are pivotal mental states, the entropic brain, REBUS, and pattern breaking. In this paper, I highlight the methods and mechanisms behind the observed clinical efficacy in treating pathologically dissociative mental health issues. I also propose a simplified underlying structure and an experimental approach that could result in effective treatment without complicated pharmacological interventions.
... MBSR combines mindfulness meditation, body scans, and yoga, while MBCT integrates elements of cognitive behavioral therapy (CBT) with mindfulness practices to prevent depressive relapse. Both methods have shown effectiveness in reducing anxiety and depression and improving general psychological health [114,331]. ...
... Participants in these programs often report reductions in perceived stress and improvements in psychological well-being. However, the evidence suggests that the benefits might vary depending on individual readiness and demographic factors such as age and psychological symptom severity [222,308,331]. ...
The connection between chronic psychological stress and the onset of various diseases, including diabetes, HIV, cancer, and cardiovascular conditions, is well documented. This review synthesizes current research on the neurological, immune, hormonal, and genetic pathways through which stress influences disease progression, affecting multiple body systems: nervous, immune, cardiovascular, respiratory, reproductive, musculoskeletal, and integumentary. Central to this review is an evaluation of 16 Behavioral Stress Reduction Programs (BSRPs) across over 200 studies, assessing their effectiveness in mitigating stress-related health outcomes. While our findings suggest that BSRPs have the potential to enhance the effectiveness of medical therapies and reverse disease progression, the variability in study designs, sample sizes, and methodologies raises questions about the generalizability and robustness of these results. Future research should focus on long-term, large-scale studies with rigorous methodologies to validate the effectiveness of BSRPs.
... As one of the first Western MBPs, Kabat-Zinn and colleagues developed Mindfulness-Based Stress Reduction (MBSR) and intended to bring the practice of mindfulness into mainstream secular settings (non-religious) to relieve debilitating anxiety and chronic pain (Marchand, 2012;Wielgosz et al., 2019). Another widely supported standardized MBP within Western contexts used to improve psychological wellbeing is Mindfulness-Based Cognitive Therapy (MBCT; Gotink et al., 2016;Hofmann & Gómez, 2017). ...
... Another widely supported standardized MBP within Western contexts used to improve psychological wellbeing is Mindfulness-Based Cognitive Therapy (MBCT; Gotink et al., 2016;Hofmann & Gómez, 2017). Following decades of practice and research, both MBSR and MBCT are widely accepted as effective MBPs for the treatment of anxiety and depression, as well as general stress management (Gotink et al., 2016;Hofmann & Gómez, 2017;Marchand, 2012). ...
Objectives
this scoping review aimed to explore the diversity of existing nature-based mindfulness (NBM) interventions. The specific objectives of this review were to (1) describe the practices and methods that are used in NBM interventions, and to (2) determine the environmental conditions that are typically associated with NBM interventions.
Method
Thirty peer-reviewed scientific studies were identified via a systematic PRISMA search protocol and then thematically analysed and categorically organised.
Results
In relation to the first research objective, a typological scheme for classifying NBM interventions was proposed in which four main categorizations of NBM interventions were identified, including (1) conventional practices combined with nature, (2) activity-based practices using nature, (3) NBM therapy practices, and (4) emerging practices. These themes demonstrate the diversity of existing NBM interventions and provide a more integrated understanding of the applicability of these interventions across different clinical and non-clinical contexts. In relation to the second research objective, existing NBM interventions were found to be conducted in (1) naturally occurring, (2) curated natural, and (3) simulated natural environments. Within these categories, a diverse range of restorative environments were identified as suitable contexts for NBM interventions, with forest-based interventions being the most commonly used environment.
Conclusions
Overall, this study contributes to a more integrated understanding of the practices, methods, and environmental conditions typical of existing NBM interventions, proposes a classification scheme for NBM interventions, and identifies a number of new developments within the field as well as promising avenues for future research and practice.
Preregistration
This study has not been preregistered.
... The potential of meditation as a complementary approach to pain management has been highlighted by Teixeira (2008) (76) and Marchand (2012) (77). The latter specifically recommends mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) as effective interventions. ...
... The potential of meditation as a complementary approach to pain management has been highlighted by Teixeira (2008) (76) and Marchand (2012) (77). The latter specifically recommends mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) as effective interventions. ...
Introduction: The latest researches concerning the effect of the meditation on the well-being show the increased number of meditation proponents due to its benefits to the mental resilience, stress management and also general health. Meditation is increasingly recognized globally for promoting overall well-being. Purpose: This study investigates impact of meditation on mental and physical well-being. It aims at understanding the mechanisms behind the improvements of health, giving special emphasis on its use as a treatment tool and a prevention measure. State of Knowledge: Meditation is validated in terms of the amount of data proving its positive effects on psychological and physical health. Ranging from stress reduction to immune system modulation, cognitive enhancements, and cardiovascular benefits, meditation turns out to be a wide applicability tool. Mediation perception factors such as cultural and social aspects are contrasted, stressing the important of research on its original Buddhist context. Meditation, due to cultural differences, still is a controversial in many areas, especially in social work. Summary: Meditation is a diverse tool for the promotion of the whole person well-being including stress reduction, immunity modulation, enhancement in cognition and cardiovascular health. It is crucial for building resilience, an important part of preventive and clinical psychology, and the medically oriented stress management. Noticing the role of culture, meditation is a significant aid to the improvement of personal, educator, and healthcare provider well-being. Meditation is a versatile tool that can be integrated into various practices, enhancing the overall well-being and life-coping skills of individuals and professionals alike.
... Practices such as mindfulness meditation and yoga can help reduce stress and enhance emotional regulation, leading to improved WR [61]. (2) Resilience Training: Programs designed to build resilience skills can help medical staff cope with stressors and recover more effectively from work-related fatigue [62]. ...
Background
Heavy work requirements can lead to significant increases in depression anxiety and stress among hospital staff. However, there is limited research considering the role of work recovery (WR) and rumination in this relationship, particularly how poor WR can create a vicious cycle of negative psychological outcomes for medical staff.
Objective
In this cross-sectional observational study, the aim is to explore high-risk WR classes among hospital staff. By constructing chain mediation models according to the WR classes, the study seeks to identify which class of medical staff is most affected by work requirements in terms of mental distress, and to examine the chain mediation effects of rumination and WR classes.
Methods
The cross-sectional observational study utilized Latent Profile Analysis (LPA) and Structural Equation Modeling (SEM) to investigate the relationships among various constructs. It employed the Work Requirements Scale (WRS), the Recovery - Stress Questionnaire (RESTQ), the Depression Anxiety Stress Scales (DASS), and the Revised Emotion Control Questionnaire (RECQ) to survey a sample of 889 hospital staff at a tertiary hospital.
Results
The findings revealed three distinct WR classes among hospital staff. Significant associations were found between work requirements and mental distress among medical staff in the low and moderate WR classes. Additionally, in these two classes, there were significant relationships in which rumination and WR classes had a chain-mediated nature about work requirements and mental distress. This suggests that future intervention studies should focus on these two classes and develop psychological health interventions for hospital staff according to different WR classes.
... Yoga and meditation practices, physical activities, and exercises have been reported to improve gastrointestinal disorders and mental health [30,[56][57][58][59][60]. Arhatic Yoga is a global non-sectarian spiritual practice which cultivates holistic development of the physical, emotional, and mental aspects [39,43]. ...
Background
The human microbiome plays a vital role in human health, mediated by the gut–brain axis, with a large diversity of functions and physiological benefits. The dynamics and mechanisms of meditations on oral and gut microbiome modulations are not well understood. This study investigates the short-term modulations of the gut and oral microbiome during an Arhatic Yoga meditation retreat as well as on the role of microbiome in improving well-being through a possible gut-brain axis.
Methods
A single-arm pilot clinical trial was conducted in a controlled environment during a 9-day intensive retreat of Arhatic Yoga meditation practices with vegetarian diet. Oral and fecal samples of 24 practitioners were collected at the start (Day0: T1), middle (Day3: T2), and end (Day9:T3) of the retreat. Targeted 16S rRNA gene amplicon sequencing was performed for both oral and gut samples. Functional pathway predictions was identified using phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt2). DESeq2 was used to identify the differential abundant taxa. Various statistical analyses were performed to assess the significant changes in the data.
Results
Our findings revealed that Arhatic Yoga meditation together with a vegetarian diet led to changes in the oral and gut microbiome profiles within the 9-day retreat. Oral microbiome profile showed a significant (p < 0.05) difference in the species richness and evenness at the end of study, while non-metric multidimensional scaling (NMDS) confirmed the shift in the gut microbiome profile of the practitioners by T2 timepoint, which was further supported by PERMANOVA analysis (p < 0.05). Health-benefiting microbes known to improve the gastrointestinal and gut-barrier functions, immune modulation, and gut-brain axis were enriched. Gut microbiome of both beginner and advanced Arhatic Yoga practitioners showed similar trends of convergence by the end of study. This implies a strong selection pressure by Arhatic Yoga meditation together with a vegetarian diet on the beneficial gut microbiome.
Conclusion
This pilot study demonstrates that Arhatic Yoga meditation practices combined with a vegetarian diet during a short intensive retreat resulted in enrichment of known health-promoting microbes. Such microbial consortia may be developed for potential health benefits and used as probiotics to improve the gastrointestinal and immune systems, as well as functions mediated by the gut-brain axis.
Trial registration
Study was submitted in https://clinicaltrials.gov/on28-02-2024. Retrospective registered.
... The dACC plays a key role in cognitive monitoring (Bush et al., 2000). Consequently, continuous monitoring of experiences during OM is associated with increased activation in the dACC Marchand, 2012;Tang, 2017). The network monitors and coordinates attention to both inward and outward channels of information (Dixon et al., 2014). ...
Open monitoring meditation is generally defined as the nonreactive, meta-aware observation of moment-by-moment phenomenal experiences associated with mental contents without focusing on predetermined mental or physical objects. However, in the current literature, neither general definitions nor more technical ones specify any particular mental state as the content of the meditator’s meta-awareness. In this article, we argue at both cognitive and neural levels that the object of the meditator’s meta-awareness consists solely of the phenomenal experiences associated with mind wandering contents, characterized as unguided, spontaneous thoughts. We demonstrate that out of the various definitions of mind wandering, only the one outlined in the dynamic framework aligns with our proposition, which defines open monitoring as the nonreactive meta-awareness of mind wandering.
... In the context of health, mindfulness has been adopted as a methodology to assist individuals in managing stress, anxiety, and various health conditions. Research indicates that mindfulness can enhance mental and physical health and positively in luence quality of life [1]. The prevalence of autoimmune diseases continues to increase in Indonesia. ...
Mindfulness therapy, a psychological approach emphasizing awareness of the present experience without judgment, has gained attention as a potential intervention for improving the quality of life of patients with autoimmune diseases in Indonesia. With the increasing prevalence of autoimmune diseases and their associated physical and psychological symptoms, mindfulness therapy is highly relevant. This review explored the mechanisms of action, case studies, challenges, and recommendations for implementing mindfulness therapy in Indonesia. Mindfulness has been shown to modulate brain activity associated with emotional processing, reduce inflammation, improve pain management, enhance social relationships, and improve sleep quality. Case studies in Indonesia have demonstrated the effectiveness of mindfulness therapy in patients with rheumatoid arthritis and lupus, with participants reporting significant improvements in their physical and mental symptoms. However, challenges such as insufficient understanding among medical personnel, societal stigma, limited availability of programs, cultural factors, and lack of comprehensive research need to be addressed. Recommendations include enhanced education and training for medical personnel, public awareness initiatives, the development of culturally appropriate programs, improved accessibility, and further research on the effectiveness of mindfulness therapy in Indonesia. By addressing these challenges and implementing recommendations, mindfulness therapy can be effectively integrated into the Indonesian healthcare system to improve patient's quality of life with autoimmune diseases.
... Audio-based meditation apps have been found to reduce Figure 1: (a) Participants engaging in Zen meditation with VR (b) VR Environment used for the study anxiety in children during dental procedures [12]. Mindfulness practices, including Zen meditation, have shown broad-spectrum antidepressant and anxiolytic effects as well as benefits for pain management [13]. ...
... research suggests that mindfulness has anti-depressive and antianxiety effects. Interventions are effective in significantly alleviating overall psychological distress, particularly symptoms related to anxiety (Marchand, 2012). Moreover, Tang et al. (2022), focusing on recovering athletes, found that mindfulness can reduce anxiety and fatigue when facing pressure, showing a significant negative correlation between them, particularly in athletes recovering from injuries. ...
Introduction
Penalty shootouts are a pivotal factor influencing outcomes in soccer matches. Soccer players face the challenge of overcoming physical fatigue and psychological pressure when taking penalty kicks. Instances of low confidence and competitive state anxiety during matches exacerbate the detrimental impact on attention control, particularly in non-target defined features, leading to suboptimal performance during penalty kicks.
Methods
This cross-sectional survey investigates the relationship between mindfulness and attention control. Convenient sampling was employed to gather a sample of 266 soccer players from sports teams and training bases in Central and South China who had participated in city-level or higher-level competitions. A structural equation model, created using AMOS 26, was employed for hypotheses validation.
Results
Findings reveal a positive correlation between mindfulness and confidence, and a negative correlation between mindfulness and competitive state anxiety. Additionally, confidence positively associates with attention control, while competitive state anxiety shows a negative relationship with attention control. Confidence and competitive state anxiety also function as mediators in the correlation between mindfulness and attention control. To elaborate, soccer penalty kickers with heightened mindfulness demonstrate increased confidence levels, reduced competitive state anxiety, and improved attention control.
Discussion
Mindfulness training positively influences attention control during penalty kicks for soccer players. To boost players’ confidence, alleviate competitive state anxiety, and enhance their performance during penalty shootouts, it is recommended that governments increase investment in mindfulness training and talent development. Coaches should enhance their understanding of mindfulness training mechanisms, and athletes themselves should prioritize mindfulness training.
... The results of combining questionnaire tasks and ERP indicators suggest that the effective integration of mindfulness meditation and calm music significantly promotes attention processing of conflict control (Ziegler et al., 2019) and cognitive function in young adults with ID (Ding et al., 2024;Liu et al., 2021c;Loo et al., 2020). Based on our questionnaire results and existing research findings (Marchand, 2012;Zhao et al., 2021), MBML reduced levels of cognitive and somatic arousal in individuals with ID. In the emotional-face sub-task, the Stroop effect on accuracy and response time was significant. ...
Introduction
Insomnia Disorder (ID) has become the second most prevalent mental disorder, with significant negative effects on daytime cognitive functions. Previous studies suggested that mindfulness-based music listening (MBML) can effectively improve conflict control and attentional processing in healthy adults. However, the behavioral and neurophysiological characteristics of MBML in young adults with ID remain unclear.
Methods
To explore the behavioral and neurophysiological characteristics of MBML in regulating negative emotions among young Chinese adults with ID, 60 young adults with ID were asked to complete an emotion-word Stroop task under three mood states while recording event-related potentials (ERPs).
Results
Task and questionnaire results showed that (1) negative emotion induced by the negative simulated video significantly suppressed the attentional processing of emotional faces and words in the conflict control task among young people with ID, (2) MBML reduced cognitive and physical arousal levels, enhanced positive mood, and improved attentional control abilities in young adults with ID. The ERP results showed that a greater N3 effect and the smaller P3 and late positive component (LPC) effects reflected that MBML effectively regulated negative emotions induced by the negative simulated video and attentional processing abilities for conflict control in young adults with ID.
Discussion
Maintaining mindfulness while listening to music may enhance positive emotional experiences and improve cognitive ability, and exhibit larger N3 effects and smaller P3 and LPC effects in the electrophysiology mechanism, with a reduction in the hyperarousal level in young adults with insomnia disorders.
... As for the usefulness of individual mindfulness, highlighted is its contribution to developing wisdom (Petchsawang and McLean, 2017), reducing negative functioning and increasing positive results in physical and mental health (Gajda, 2018), namely, in clinical psychology in treating and curing mental and behavioural disturbances (Keng et al., 2011;Lau et al., 2006;Teasdale and Chaskalson, 2013), as a therapy of clinical symptoms, dependence on alcohol and other substances, anxiety, depression and in treating chronic pain (Evans et al., 2008;Kabat-Zinn et al., 1987;Marchand, 2012;Zgierska et al., 2021). A changed perspective of experience (Levinthal and Rerup, 2006), objectivity and decisionmaking in stressful situations (Hülsheger et al., 2013), maintaining positive mental health, and greater sensitivity to others' perspectives (Chandwani et al., 2016) are also mentioned. ...
Purpose: The study of mindfulness is still shown to be of interest in different aspects of organizations and/or businesses. Therefore, this study aims to present an integrative, multi-level model of mindfulness based on a holistic approach that can contribute to better governance practices and lead to competitive advantages.
Design/methodology/approach: To fulfil this aim, an extensive integrative review of the literature, from the main articles about this topic, was made.
Findings: This study shows that the concept of mindfulness, a conscious presence or full attention and its relation with organisations or firms’ personal, behavioural and social characteristics, in the current context of great adversity, uncertainty and unpredictability, is of interest at the individual, organisational and social level.
Practical implications: This conceptual study has important implications for both practice and theory. It demonstrates that mindfulness significantly impacts the manager/business person’s ecosystem at the individual, organizational and social levels, particularly in relation to sustainable development goals (SDGs).
Originality/value: This study introduces a comprehensive theoretical model that explains this relationship and organizes information from a multi-level perspective. This approach can contribute to the advancement of theory by clarifying and discussing the role of mindfulness at the individual, organizational, and societal levels. It also identifies opportunities and outlines future research directions, aiming to promote more sustainable development.
... The most commonly studied form of mindfulness training in the USA is the mindfulness-based stress reduction (MBSR) program developed at the University of Massachusetts Medical Center in the 1970s by Jon Kabat-Zinn [14]. MBSR is the practice of focusing on the present moment with openness and nonjudgmental acceptance and investigation of the present experience to reduce suffering or distress [15]. MBSR incorporates components of meditation and yoga. ...
Introduction and Hypothesis
Urodynamics (UDS) assesses voiding dysfunction using intravesical, vaginal, or rectal catheters, which can be distressing. This study was aimed at utilizing mindfulness to reduce anxiety and pain in patients undergoing UDS.
Methods
A single-institution randomized controlled trial was conducted on 60 patients who underwent UDS. Patients were assigned to a mindfulness group ( n = 30) or a control group ( n = 30). Before UDS testing, all patients completed validated questionnaires assessing lower urinary tract symptoms (Urogenital Distress Inventory 6, UDI-6), anxiety (State-Trait Anxiety Inventory 6, STAI-6), and pain (Visual Analog Scale, VAS). The mindfulness group listened to a mindfulness audio prompt before UDS. All patients received standardized UDS education before UDS testing in a calm environment. After UDS testing, all patients completed validated UDS-perception questionnaires, STAI-6, Likert scale, and VAS surveys. Statistical analysis was performed using paired t tests, independent t tests, Wilcoxon, and Chi-squared tests.
Results
Both groups had similar demographics, history of prior UDS, anxiety, and baseline UDI-6 and STAI-6. Post-UDS, anxiety scores decreased in both groups, with the mindfulness group reporting significant improvement in “calmness” (mean 1.7, SD = 0.84) compared with the control group (mean 2.3, SD = 1.0, p < 0.05). The mindfulness group reported increased relaxation whereas the control group reported decreased relaxation post-UDS. Patients in both groups without a history of UDS had a significant improvement in total anxiety compared with those with a history of UDS.
Conclusion
Mindfulness meditation may improve calmness and relaxation for patients undergoing UDS.
... The interaction of Buddhist meditation with mindful awareness of sensations, thoughts, and emotions fosters greater self-awareness (Allen et al., 2021). The integration of MBCT with Indian mindfulness practices provides individuals with a versatile toolkit to manage stress, anxiety, and depression (Evans et al., 2008;Marchand, 2012;Rizwana, 2020). By combining cognitive restructuring techniques with mindfulness, individuals can cultivate a more balanced and adaptive approach to their thoughts and emotions. ...
The article outlines specific risks posed by GPT-4, such as reinforcing biases, spreading misinformation, or influencing users' mental states negatively through inappropriate responses. It discusses how prolonged interaction with GPT-4 could impact users' behaviour, mental well-being, or decision-making processes, especially if the model outputs misleading or harmful information. Various strategies for reducing these risks were proposed, including developing more transparent AI systems, enhancing human oversight, and introducing ethical guidelines for AI deployment in sensitive areas like healthcare or education. Further, the findings suggests regulatory frameworks should control the deployment of AI systems, focusing on accountability, user safety, and continuous monitoring of AI performance in behavioural contexts.
... The act of meditation holds consciously creating a space for this alertness, embracing a variety of different practices (Matko & Sedlmeier, 2019). These practices have been investigated for decades and are incorporated into therapies for many mental disorders, demonstrating their positive impact on overall health and well-being (Marchand et al., 2012). Amongst the variety of benefits that mindfulness practice can provide, it is shown to positively impact individuals' stress regulation, reward processing and self-regulation (Garland, 2016;Redwine et al., 2022;Nigg, 2017). ...
This paper provides a computational analysis of the behavioural effects of ADHD and its underlying decision making and epigenetic factors including the DNA methylation in relation to the ST3GAL3 gene, which has been found to play an important role in ADHD. It includes a systematic literature review combined with an adaptive dynamical system modelling approach to model and simulate the adaptive mental and behavioural dynamics in an integrative manner. As individuals with ADHD are prone to consuming digital media in an unhealthy manner, the behavioural effects of ADHD are considered in the context of digital media use. This is examined in relation to the associated neurological impairments in self-regulation as well as reward processing underlying decision-making. To illustrate this interplay, it is modelled by a higher-order adaptive dynamical system modelling approach. In addition, this paper discusses both traditional (pharmacological) and non-traditional (mindfulness) interventions to improve quality of life and reduce impairments associated with ADHD and applied in the context of problematic digital media use.
... Thinking plays an important role in stress management and mental health [12]. Psychological interventions are effective on depression and improve the mental health of people in the community Psychiatria 2024, tom 21, nr [2][3][4] and reduce the risk of mental disorders and related problems [8,9]. Critical thinking has been the focus of researchers in psychological interventions [10,11]. ...
INTRODUCTION: Considering the importance of reducing psychological problems in society, the aim of this study was to evaluate the effectiveness of thinking skills training on mental health and stress management in women. MATERIAL AND METHODS: this is a quasi-experimental and interventional study conducted on 30 women aged 20 to 50 years in Alborz Province. They were selected using a simple sampling method and randomly divided into control (n = 15) and experimental (n = 15) groups. The experimental group was trained on critical thinking program in twelve sessions once a week. Mental health and stress were measured using the Symptom Checklist-90-Revised (SCL-90-R) and Stress Management Questionnaires. Data were analyzed using Kolmogorov–Smirnov and multivariate analysis of covariance tests. RESULTS: The results showed that the value of the Wilks Lambda and Pillai indices were 0.12 and 0.88, respectively. Therefore, the implementation of critical thinking training has a significant effect on all subscales of mental health (except Phobia) and also on stress management (p < 0.01). CONCLUSIONS: Critical thinking training could be beneficial for women by improving and upgrading the subscales of mental health and stress management.
... Mindfulness-based stress reduction (MBSR) benefits many mental health issues and mental wellbeing generally, as well as physical problems (Grossman et al., 2004;Marchand, 2012). Mindfulness practice is effective in reducing stress and decreasing burnout amongst healthcare professionals including nursing staff (Cohen-Katz et al., 2004); and enhances job satisfaction (Choi and Koh, 2015). ...
Design and intervention: Before-and-after evaluation of web-based mindfulness trainingfor staff caring for people living with dementia in care homes. Stepped-wedge clusterrandomised design.Setting and participants: Random sample of 31 care homes for people living with dementia.Homes started mindfulness training at a random time over 35 weeks. From thesehomes 172 staff volunteered, 151 (88%) started training, and 111 (67%) completedquestionnaires after 20 weeks.Methods: Questionnaires completed at baseline, 8 and 20 weeks included job stress (WSI)and health and well-being (SF-12).Results: There were significant reductions in job stress of 0.07 (95% confidence interval[CI]: 0.02, 0.13) at 8 weeks and 0.06 (95% CI: 0.01, 0.11) at 20 weeks; and improvementsof 2.49 points (95% CI: 0.81, 4.17) in the SF-12 Mental Component Score at 8 weeksand 3.41 (95% CI: 1.88, 4.94) at 20 weeks.Conclusions: Web-based mindfulness training improved the psychological well-beingof care home staff and reduced their stress with small to moderate effects in both shortand medium term
... The different practices of meditation (e.g., attentional, open monitoring, loving kindness) have a variety of positive effects, including present-moment awareness and observation of experience with openness, acceptance, and nonattachment (Dahl, Lutz, & Davidson, 2015;Kabat-Zinn, 2003;Lutz, Slagter, Dunne, & Davidson, 2009;Ricard, Lutz, & Davidson, 2014). They can also promote stress reduction, well-being, social connectedness, selfawareness, and attention and emotional regulation (Basso, McHale, Ende, Oberlin, & Suzuki, 2019;Champion, Economides, & Chandler, 2018;Guendelman, Medeiros, & Rampes, 2017;Ludwig & Kabat-Zinn, 2008;Marchand, 2012;Pascoe, Thompson, Jenkins, & Ski, 2017;Tang, Hölzel, & Posner, 2015;Valentine & Sweet, 1999). ...
Contemplative neuroscience has increasingly explored meditation using neuroimaging. However, the brain mechanisms underlying meditation remain elusive. Here, we implemented a mechanistic framework to explore the spatiotemporal dynamics of expert meditators during meditation and rest, and controls during rest. We first applied a model-free approach by defining a probabilistic metastable substate (PMS) space for each condition, consisting of different probabilities of occurrence from a repertoire of dynamic patterns. Moreover, we implemented a model-based approach by adjusting the PMS of each condition to a whole-brain model, which enabled us to explore in silico perturbations to transition from resting-state to meditation and vice versa. Consequently, we assessed the sensitivity of different brain areas regarding their perturbability and their mechanistic local-global effects. Overall, our work reveals distinct whole-brain dynamics in meditation compared to rest, and how transitions can be induced with localized artificial perturbations. It motivates future work regarding meditation as a practice in health and as a potential therapy for brain disorders.
... The primary goal of mindfulness meditation is to attain a state of awareness, so primary achievement is heightened awareness. Besides, physical and psychological benefits are also achieved as byproducts of mindfulness which may include: greater well-being (Nyklíček & Kuijpers, 2008) (Lomas et al., 2017), the ability to concentrate better, release of stress (Keng et al., 2011), improvement in quality of sleep (Smith et al., 2021) and reduction in symptoms of anxiety (Hölzel et al., 2013), depression and psychological distress (Marchand, 2012;Eberth J, 2012). ...
Meditation, an inward journey to explore profound levels of consciousness, has a rich history especially in Buddhist practice which focuses on mindfulness of oneself and surrounding. Rooted in non-judgmental awareness of the present moment, this way of life has recently drawn the attention of neuroscientist as studies have found significant positive effects on various health conditions. Researches have unveiled a number of physical and psychological benefits associated with mindfulness meditation, including enhanced well-being, improved concentration, emotional stability, and positive cognitive shifts. Neuroimaging studies have revealed its significant impact on brain regions including structural changes involving anterior cingulate cortex, temporal lobe, insula, hippocampus, amygdala, thalamus and other areas. This indexes the widespread impact of mindfulness on brain. Four fundamental mechanisms summarize the mindfulness meditation: attention regulation, body awareness, emotion regulation, and a transformed self-perspective. Despite notable progress in meditation research, a substantial gap remains in the scientific understanding of this practice. This narrative review aims to consolidate past two decades of research on the effects of Buddhist mindfulness meditation on neurophysiology. By synthesizing and analysing relevant studies, we seek to shed light on the potential mechanisms underlying the impact of mindfulness meditation on brain function and structure. The research provides the foundation for a deeper 1 understanding of the potential benefits of mindfulness meditation in promoting mental well-being on an individual and societal level.
... A lab assistant called the participants once a week to remind them to access the weekly modules on the iPad and to answer any questions or concerns they might have had. [22][23][24] Samadhi Meditation, also known as Sahaj Sahaj Samadhi Meditation (SSM), is a standardized and manualized meditation program that is taught in public spaces by trained non-clinical meditation instructors. The programs are run by and the teacher certification is supervised by Art of Living (AOL), a worldwide nonprofit charitable organization active in 150 nations. ...
Background: Pain medication with meditation has been practiced for a long time. Multiple meta-analyses have shown whether meditation is ineffective for treating pain, but there does not appear to be enough information for researchers to draw firm conclusions. At the same time, the trend of just using meditation as a pain therapy is still apparent in the search results for documents related to this subject. Method: We collected the Scopus database of meditation as a pain therapy and then performed a quantitative analysis using Biblioshiny and VOSviewer software. Results: The quantitative analysis's findings show the use of meditation as a pain therapy technique. Researchers continue to trust in the clinical benefits of mindfulness meditation in pain management, despite several studies showing the limited effect of meditation as a pain therapy. Many methods have been utilized to modify mindfulness meditation in recent studies. Conclusion: Due to mounting clinical evidence supporting its efficacy, researchers are increasingly turning to mindfulness meditation as a kind of pain management.
... Subjective experiences induced by psychedelics appear to share similarities with those associated with meditation (Millière et al., 2018;Simonsson and Goldberg, 2023). Specifically, both practices are associated with improved emotional regulation (Orłowski et al., 2022;Tang et al., 2016); also, both have therapeutic potential for mood disorders (Marchand, 2012;Pascoe et al., 2021;Vollenweider and Kometer, 2010) and have similar effects on neuronal activity, such as reduction of activity in the default mode network (Gattuso et al., 2023;Jerath et al., 2012;Taylor et al., 2013). In our study, we attempted to control for confounding variables such as lifetime meditation practice, but despite collecting data from around 5000 responders we were not able to create subgroups of psychedelics users and non-users that did not differ in terms of meditation practice (Table 1). ...
Background
Previous research has suggested that controlled administration of psychedelic substances can modulate emotional reactivity, enhancing positive and diminishing negative emotions. However, it is unclear whether similar effects are associated with using psychedelics in less-controlled naturalistic environments.
Aims
This cross-sectional study investigated the neural markers associated with the perception of emotional stimuli in individuals with extensive experience of naturalistic psychedelic use (15 or more lifetime experiences), comparing them to non-users.
Methods
Electroencephalography (EEG) signals were recorded from two groups: experienced psychedelics users ( N = 56) and non-users ( N = 55). Participants were presented with facial images depicting neutral or emotional expressions (anger, sadness, and happiness). Event-related potential (ERP) components were analyzed as indices of emotional reactivity.
Results
Psychedelic users were characterized by significantly lower amplitudes of the N200 component in response to fearful faces, in comparison to non-users. In addition, interaction effects between Group and Emotional expression were observed on N170 and N200 amplitudes, indicating group differences in the processing of fearful faces. However, no significant between-group differences emerged in the analysis of later ERP components associated with attention and cognitive processes (P200 and P300).
Conclusions
The results suggest that naturalistic use of psychedelics may be linked to reduced reactivity to emotionally negative stimuli at the early and automatic processing stages. Our study contributes to a better understanding of the effects related to using psychedelics in naturalistic contexts.
... One complementary mind/body approach that offers the potential to enhance the effectiveness of EAET is mindfulness, which has been used widely to treat chronic pain for over three decades (Kabat-Zinn, 1994). While research indicates that mindfulness shows only moderate effects in alleviating chronic physical pain, the approach is highly effective in improving associated psychological symptoms and physical limitations associated with the pain (Marchand, 2012). These promising findings led Schubiner and Betzold (2016) to suggest that integrating mindfulness with an emotionfocused approach like EAET could help clients more effectively tolerate their physical pain, while also allowing them a greater psychological capacity to experience deep-rooted emotions. ...
Public Health Significance Statement
Chronic pain has become an epidemic in the United States that affects over 20% of the population. It is also a disease that is not effectively treated by current medical interventions such as medication and surgery. However, recent breakthroughs in pain research indicate the potential for mind/body interventions to cure many forms of chronic pain. In this qualitative study, the authors examined the perspectives of 11 chronic pain clients who participated in a small group psychotherapy intervention that integrated emotion-focused therapy and mindfulness to understand their experiences. Results provide a first step in understanding how and under what conditions clients can be healed using these powerful mind/body approaches.
... 6 Studies show that mind body therapies (MBT) demonstrate similar effectiveness to traditional psychotherapy models. [7][8][9][10] MBTs, which include yoga, meditation, progressive relaxation, guided imagery, hypnosis, biofeedback, and others, are non-invasive techniques designed to use the body to influence the mind. Cognitive behavioral therapy (CBT), although recognized as a traditional model of psychotherapy, is also considered to be under the umbrella of MBTs. ...
... It is well known that athletes experience pre-competition anxiety, and the impact of anxiety on their performance is widely recognized [23]. In particular, athletes who have recovered from an injury often exhibit higher levels of competitive state anxiety due to their fear of re-injury and failure compared to uninjured athletes [24]. Mindfulness is an effective approach for reducing competitive state anxiety [25]. ...
Injured athletes often face performance challenges upon returning to the field, influenced by external factors and negative emotions. This study investigates how mindfulness is associated with perfectionism, exercise self-efficacy, and competitive state anxiety in athletes recovering from injuries. Using snowball sampling and convenience sampling methods with a cross-sectional dataset of 359 participants from southern China (collected between October and November 2022), we employed structural equation modelling to analyse the relationship between mindfulness and competitive state anxiety in returning athletes. The results reveal that mindfulness interventions enhance exercise self-efficacy, boost task-related confidence, reshape perfectionism towards a positive outlook, and decrease competitive state anxiety. This study establishes positive correlations between perfectionism and competitive state anxiety, and a negative correlation between exercise self-efficacy and competitive state anxiety. Moreover, exercise self-efficacy and perfectionism partially mediate mindfulness’s positive impact on competitive state anxiety. In conclusion, this research highlights mindfulness’s potential to alleviate perfectionism and competitive state anxiety while enhancing exercise self-efficacy among athletes on the road to recovery.
... The study's findings concluded that cognitive language therapy was found to be an effective method in improving anxiety, stress, and depression levels. Various studies (Marchand, 2012;Novaco, 1977;Li et al., 2020) has also confirmed that cognitive therapy has been found effective in reducing depression, stress, and anxiety level. In the present study, DASS 21 questionnaire mean value (both pre-questionnaire and postquestionnaire data) significantly varies in the three categories (stress, anxiety, and Depression) after the intervention of cognitive language therapy. ...
The psychosomatic condition affects the hippocampus, temporal role, and parietal lobes of the brain. People with Psychosomatic condition displays poor language skills, higher level of cognitive dysfunction, Memory disorders, Anxiety level, Depression, and stress level. Cognitive language therapy aids learners towards the improvement of anxiety, depression, and stress levels. The sampling method employed in the study is the purposive sampling method. DASS 21 was used to analyze the stress, anxiety, and depression levels before and after the intervention. Cognitive language therapy activities like chunking, embroidery, and identifying errors were given to the learners to reduce the impact of stress, anxiety, and depression among individuals with the psychosomatic condition. The paired t-test in SPSS was performed and from the study findings, it is concluded that the participants displayed a low to medium range of depression after the intervention of cognitive language therapy. Through paired samples test, the significance value for all three pairs (Depression, anxiety, and stress) is 0.000, which is lesser than 0.05. Hence, there is a considerable improvement in depression, anxiety, and stress levels among the participants with the psychosomatic condition as a result of cognitive language therapy intervention.
... 31 This therapy consists of courses of 2.5 h/week, 8 weeks with a 1-day retreat. 32 Participants received training in formal mindfulness meditation techniques involving simple stretching and postures 33 Infertile women are more susceptible to mental anxiety disorders than fertile women. 6 Anxiety is manifested by disturbances in mood, as well as thought, behavior, and physiological activity. ...
Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study’s purpose was to analyze mindfulness’s effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.
... In addition, differences in findings between studies reinforce the assertion that cohort studies are required to identify the precise risk factors and the degree to which each of these factors contributes to stress in a particular community. The intervention outcomes in the present study are comparable to those reported in many previous studies in terms of the significant mental health improvement measured 25,26,[37][38][39][40] . However, the reduction in stress score as measured by the PSS-10 scale in previous intervention studies is inconsistent [40][41][42][43] . ...
Intervention de réduction du stress pour les étu-diants en médecine préventive au Vietnam dans un contexte de ressources limitées Introduction. La mise en place d'approches de réduc-tion du stress pour les étudiants à haut risque peut réduire les effets négatifs sur les performances acadé-miques, les relations sociales et la santé. La plupart des recherches existantes sur les interventions ont montré l'efficacité de la réduction du stress basée sur la pleine conscience (MBSR) avec des conceptions d'étude strictes, mais n'ont pas examiné l'impact dans un en-vironnement réel. ABSTRACT Introduction. Implementing stress reduction approaches for high-risk students may reduce the negative effects on academic performance, social relationships, and health. Most existing research on intervention showed the effectiveness of mindfulness-based stress reduction (MBSR) with strict study designs but has not examined the impact in a real-life setting. The objective of the study was to identify the factors associated with stress level and the effectiveness of intervention using MBSR. Material and methods. A mixed-methods study consisting of a cross-sectional study in 362 students (Phase 1) and intervention in 115 students with moderate and
... The different practices of meditation (e.g., attentional, open monitoring, loving kindness) have a variety of positive effects, including presentmoment awareness and observation of experience with openness, acceptance, and non-attachment (Dahl et al., 2015;Ricard et al., 2014;Lutz et al., 2009;Kabat-Zinn, 2003). They can also promote stress reduction, well-being, social connectedness, self-awareness, and attention and emotional regulation (Basso et al., 2019;Champion et al., 2018;Pascoe et al., 2017;Guendelman et al., 2017;Tang et al., 2015;Marchand, 2012;Ludwig and Kabat-Zinn, 2008;Valentine and Sweet, 2007). ...
Contemplative neuroscience has increasingly explored meditation using neuroimaging. However, the brain mechanisms underlying meditation remain elusive. Here, we implemented a causal mechanistic framework to explore the spatiotemporal dynamics of expert meditators during meditation and rest. We first applied a model-free approach by defining a probabilistic metastable substate (PMS) space for each state, consisting of different probabilities of occurrence from a repertoire of dynamic patterns. Different brain signatures were mainly found in the triple-network model (i.e., the executive control, salience, and default-mode networks). Moreover, we implemented a model-based approach by adjusting the PMS of the resting state to a whole-brain model, which enabled us to explore in silico perturbations to transition to the meditation state. Consequently, we assessed the sensitivity of different brain areas regarding their perturbability and their mechanistic local-global effects. Using a synchronous protocol, we successfully transitioned from the resting state to the meditative state by shifting areas mainly from the somatomotor and dorsal attention networks. Overall, our work reveals distinct whole-brain dynamics in meditation compared to rest, and how the meditation state can be induced with localized artificial perturbations. It motivates future work regarding meditation as a practice in health and as a potential therapy for brain disorders.
... In addition, differences in findings between studies reinforce the assertion that cohort studies are required to identify the precise risk factors and the degree to which each of these factors contributes to stress in a particular community. The intervention outcomes in the present study are comparable to those reported in many previous studies in terms of the significant mental health improvement measured 25,26,[37][38][39][40] . However, the reduction in stress score as measured by the PSS-10 scale in previous intervention studies is inconsistent [40][41][42][43] . ...
Background: Implementing stress reduction approaches for high-risk students may reduce negative effects on academic performance, social relationships, and health. Most existing research on intervention showed the effectiveness of mindfulness-based stress reduction (MBSR) with strict study designs but has not examined the impact in a real-life setting.
Objective: This study aimed to identify factors associated with stress level and the effectiveness of intervention using MBSR.
Methods: A mixed-methods study consisting of a cross-sectional study in 362 students (Phase 1) and intervention in 115 students with moderate and severe stress levels (Phase 2). The 10-item Perceived Stress Scale (PSS-10) was used to assess participants’ stress levels and evaluate the outcome of the intervention.
Results: The online MBSR effectively reduced stress in students with moderate and severe stress levels after two months of intervention. MBSR was associated with a statistically significant reduction in stress, with 63.48% of cases showing reduced stress levels, and a group reduction in stress score of 5.97 with a 95% confidence interval (CI): 4.96 to 6.96, (p=0.008); The logistic regression model showed that being a woman, disagreeing with parents, having a loved one with a severe illness, ending a relationship, and financial trouble were factors associated with moderate and severe stress.
Conclusion: Delivering MBSR was associated with an improvement in stress status with a significant reduction in stress scores among students. These findings provide evidence that future research is necessary to design tailored strategies for coping with stress in academic environments.
Keywwords: stress, MBSR, student.
... Some CBT techniques aim at decentering the pain through education and information, learning coping strategies and reassurance, stress management, relaxation, mindfulness meditation, hypnosis, etc. [51]. Their effectiveness is documented in the literature and they are the subject of numerous international recommendations for improving physical and psychological well-being [52]. The "Understanding my pain" quiz is therefore based on the therapeutic education recommended in pain management in order to understand the underlying mechanisms and the difference between pain and suffering. ...
... In recent years, mindfulness practice has become increasingly common as a mind-body intervention for various medical and psychiatric conditions, complementing traditional medical intervention (Jain et al., 2007;Marchand, 2012;Travis et al., 2018). Furthermore, mindfulness is widely accepted and practiced among the healthy population as an effective counter-stress method. ...
Mindfulness is an intervention that was used in many psychiatry treatments. In this study, the subject experienced two different states: (1) attention (i.e., listening to a podcast) and (2) mindfulness (i.e., meditation). Twenty-two students were included in a Mindfulness-Based Stress Reduction (MBSR) course with EEG recording sessions on week four and week six. Brain dynamics were investigated to elucidate the complexity and connectivity of the brain. The alpha PSD increased in all brain areas during mindfulness in both weeks. For complexity, Fractal Dimension (FD) increased significantly during meditation in the week six recording. When comparing the FD in the mindfulness state of week four and week six, we also witnessed a significant increase in the following week. The coherence of the interhemispheric frontal and temporal regions increased significantly in both weeks. In conclusion, the subject successfully transferred from attention to mindfulness, demonstrated by the alpha changes when going from podcast to meditating. An enhancement in brain complexity was found, suggesting an augmentation in cognitive function. Finally, the coherence exhibits strengthened connections in the frontal area.
... Mindfulness is the practice of purposefully, nonjudgmentally, and continually cultivating active attention to the present moment (Kabat-Zinn, 1990, 2003. There is robust support that face-to-face mindfulness-based interventions improve anxiety (Arch et al., 2013;Evans et al., 2008;Fjorback et al., 2011;Hofmann et al., 2010;Kimbrough et al., 2010;Marchand, 2012) and worry (Arch et al., 2013;Hoge et al., 2015) among participants with anxiety disorders. Results from a meta-analysis (Vøllestad et al., 2012) showed that face-to-face mindfulness-and acceptance-based interventions delivered to clinically anxious participants produce large effect sizes for anxiety reduction from pre-to post-intervention (Hedges' g = 1.08), as well as for betweengroup differences between intervention and control groups within randomized controlled trials (Hedges' g = 0.83). ...
Objectives: the availability of smartphone-based mindfulness training applications (apps) may circumvent many barriers to receiving in-person help, but little controlled research has been conducted on them. This study sought to evaluate the effectiveness of a widely used mindfulness training app, Headspace, at reducing anxiety and worry. Methods: this study used a randomized-controlled design to examine the app using a 3 (Time; baseline, 4 weeks, 8 weeks) × 2 (Access; immediate, delayed for 4 weeks) design. Participants who reported moderate to high anxiety or worry were randomly assigned to receive either immediate access or delayed access to the app. For null hypothesis significance testing (NHST), analyses of variance were used to test the hypotheses that app access for 4 and 8 weeks would reduce anxiety and worry as compared to waitlist or baseline and that app access for 8 weeks would reduce anxiety and worry as compared to 4 weeks. Bayes estimates were used to determine the level of evidence for the hypothesis that app access reduces anxiety and worry. Results: four weeks of app access significantly reduced anxiety symptoms, as did 8 weeks, but NHST indicated there were no significant difference between 4 and 8 weeks of access. We failed to reject the null for the analysis of variance on worry, but Bayesian estimates indicated substantial evidence for the hypothesis that the mindfulness training app reduces worry. Conclusions: this research shows that using Headspace can reduce anxiety and worry, but that there does not appear to be a consistent dose relation.
... A mindfulness-alapú stresszcsökkentés (Mindfulness-Based Stress Reduction) a buddhista mindfulness koncepció társulása a nyugati pszichológiával, melyet John Kabat-Zinn dolgozott ki, és mely olyan technikákat ölel fel, mint az ülő meditáció, a testpásztázás, és a hatha jóga. Ezenfelül stresszedukációra, coping stratégiák elsajátítására és az asszertivitás fejlesztésére törekszik a módszer (Marchand, 2012). Összességében az MBSR számos specifi kus populációban, így fokozott szuicid kockázatnak kitett páciensek esetében is hatékonyan alkalmazható, ugyanakkor csupán kevés számú, és sok esetben igen kis mintával készült tanulmány áll rendelkezésre. ...
There are several approached to suicide prevention based on various psychotherapeutic interventions, which are effective, especially when these are matched to the given psychiatric patient population, environment and context. In this paper the possibilities of psychotherapeutic methods of suicide prevention and intervention are described along with their indications. The following interventions are discussed: Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP), Cognitive Therapy for Suicide Prevention (CT-SP), Brief Cognitive-Behavioral Therapy for Suicide Prevention (BCBT), Problem Solving Therapy (PST), Problem Adaptation Therapy (PATH), Dialectial Behavior Therapy (DBT), SchemaFocused Therapy (SFT), Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Mentalization-Based Treatment (MBT), Interpersonal Psychotherapy (IPT), Transference-Focused Psychotherapy (TFP), Collaborative Assessment and Management of Suicidality (CAMS), Teachable Moment Brief Intervention (TMBI), Motivational Interviewing (MI), Attempted Suicide Short Intervention Program (ASSIP) and other Interned-Based Interventions (IBI). The effectiveness of the above methods may vary, however, they focus on the psychological processes playing a role in the emergence of suicidal behaviours including cognitive processes, as well as difficulties of problem solving and emotion regulation. As the efficacy of these interventions are supported by clinical trials, their use is recommended in case of this vulnerable patient population. The importance of using such methods in the clinical work with suicidal patients should be prioritized in our effort to provide a complex treatment for suicidal behaviour based on the most optimal and appropriate intervention considering the given patient.
Zusammenfassung: Schmerzen zu reduzieren, ist eine unzweifelhafte ethische Forderung, der Bedarf an Schmerzbehandlung ist zwingend. Zeitgemässe Schmerztherapie sollte in einem interdisziplinären Kontext erfolgen, um die Vorteile der Kombination von somatischen und psychologischen Therapien nutzen zu können. Ziel ist es, Patientinnen und Patienten zu unterstützen, ihre Selbstwirksamkeit zu stärken und Strategien zur Akzeptanz von (in Teilen verbleibenden) chronischen Schmerzen zu entwickeln. Die interventionelle Schmerztherapie ist gegenüber langfristiger Analgetikagabe zu favorisieren. Zur Stärkung von Selbstwirksamkeit und Akzeptanz sollten sowohl psychotherapeu-tische wie auch körpertherapeutische Techniken zur Anwendung kommen. Schmerztherapeutische Erfolge aus der Zusammenarbeit der verschiedenen Disziplinen schaffen die Voraussetzungen dafür, dass Patientinnen und Patienten wieder selbst aktiv werden und versuchen können, dem noch verbleibenden Schmerz den ihm gebührenden Raum im Leben zu geben. Schlüsselwörter: Phänomenologie des Schmerzes, interdisziplinäre Schmerztherapie, minimal-invasive Schmerzmedizin, Achtsamkeits-basierte Techniken, Selbstwirksamkeit Pain Therapy Follows Function: Interventional Pain Therapy in an Interdisciplinary Setting Abstract: Reducing pain is an indubitable ethical requirement; the need for pain treatment is compelling. Modern pain therapy should take place in an interdisciplinary context in order to use the advantages of combined somatic and psychological therapies. The aim is to support patients in strengthening their self-efficacy and developing strategies for accepting (some residual) chronic pain. Interventional pain therapy should be favored over administering analgesics on a long-term basis. Both psychotherapeutic and body therapy techniques should be used to strengthen self-efficacy and acceptance. Successes in pain therapy from a cooperation between the various disciplines create the conditions for patients to become active again themselves and to try to give any remaining pain the space it deserves in their lives.
Two ancient religions with deep roots in India, Jainism and Buddhism, resonate with many of us through their shared teachings and practices. Both arose at pivotal moments in history, responding to the socioeconomic and spiritual challenges of their times. This book invites you to explore the rich tapestry of their histories, doctrines, customs, and the many parallels they offer, while also appreciating the unique distinctions that set them apart. By understanding their similarities and differences, we can gain greater insight into our beliefs and values. This book provides an invaluable resource for exploring these two ancient religions and their profound impact on the modern world. By delving into these compelling narratives, you’ll uncover the profound influence these religions have had not only on Indian culture but also on the world at large. Buddhism blossomed in ancient India around the fifth century BCE through the enlightening journey of Siddhartha Gautama, known to many as the Buddha, or "the Enlightened One." Similarly, Jainism took root in the sixth century BCE, not long after Mahavira, who is celebrated as the final and most important of the 24 Tirthankaras, or spiritual teachers. In their emergence, both Jainism and Buddhism courageously challenged the prevailing religious norms of Brahmanism, offering new pathways to spiritual freedom. They turned away from the Vedas, the sacred texts of Brahmanism, and presented teachings that emphasized compassion, morality, and ethical living as means to achieve liberation. The enduring legacies of these faiths continue to shape thoughts and practices, leaving a significant mark on the hearts and minds of countless individuals seeking understanding and meaning in their lives. These faiths continue to serve as a source of spiritual nourishment and inspiration for people of all backgrounds. They are a reminder of the power of love and the importance of treating others with respect and understanding.
Chapter 4 documented the normal stress response mechanisms, yet prolonged stress forms a key ingredient in explanations for how social circumstances adversely affect health. Stress arises from an imbalance between the demands placed on a person and their resources for handling those demands. This chapter outlines the challenges of defining stress and measuring stress reactions; it gives a historical overview of evolving conceptual models of stress. Life events research is then summarized to illustrate stimulus models; a description of response models reviews the contributions of Wolff, Selye, and Antonovsky. Interactional or dynamic models of stress are then described. In explaining the stress response, these consider complex interactions among the person’s environmental context, their perception of the event, their learning from previous experiences, and their resiliency. Factors that determine a person’s vulnerability or resiliency are described, and connections between socioeconomic status and stress responses are summarized. The chapter concludes with a review of the design and effectiveness of stress management programs.
mindfulness and behavioural therapy learning resource manual
Background
Many cancer patients require long-term self-care, both during and after treatment, and need to have self-care competence. Mindfulness and emotional regulation can enhance self-care competence among cancer patients.
Objective
To examine the effect of mindfulness and emotional regulation on self-care competence among cancer patients undergoing chemotherapy.
Methods
The data were completed by 106 cancer patients who were hospitalized at 3 long-term nursing hospitals. The instruments were the Mindfulness Scale, Korean Version of the Difficulties in Emotion Regulation Scale, and Self-As-Care Inventory Scale.
Result
Self-care competence was significantly correlated with mindfulness among cancer patients undergoing chemotherapy. Also, the relationship between mindfulness and emotional regulation was significant. However, emotional regulation did not significantly affect self-care competence.
Conclusions
It is important for cancer patients to focus on the present moment and maintain a balanced approach that keeps a distance from excessive worry. Development and application of interventions aimed at enhancing self-care competence among cancer patients should focus on a high level of mindfulness.
Implications for Practice
It is necessary to support cancer patients in taking time out for mindfulness practice through meditation programs and to help them seamlessly incorporate this habit into their daily lives. Nurses can effectively assist cancer patients by being well-versed in mindfulness techniques and providing adept guidance. Offering personalized mindfulness guidance based on the patient’s condition and needs is also beneficial. By developing programs that incorporate feedback from both patients and healthcare providers, nurses can help patients continuously apply mindfulness practices.
The topic of the impact of online language learning on psychological well-being is gaining increasing attention due to the shift towards digital learning platforms. Online language learning offers convenience, flexibility, and a wide range of resources, which can positively influence individuals' self-confidence, cultural understanding, and sense of achievement. This study examines the influence of online language learning platforms on psychological aspects. The study was conducted through a google form survey consisting of 10 questions in Almaty, Kazakhstan. Research shows that using online language learning platforms can make people feel happier and less stressed. Learning a new language online reduces loneliness and provides confidence. These platforms can also help improve communication skills and understanding of different cultures. Setting goals, tracking progress, and receiving rewards on these platforms can help keep people motivated and interested in the learning process. The results, presented through tables and detailed analysis, indicate the positive impact of online language learning on reducing feelings of isolation, enhancing stress levels, and improving communication skills. The findings shed light on the potential benefits of online platforms in promoting psychological well-being through accessible learning opportunities.
Previous research indicates that psychedelic substances taken in well-controlled laboratory or therapeutic settings have the potential to decrease negative and increase positive emotional reactivity. However, it is unclear whether similar effects are associated with using psychedelics in less-controlled naturalistic environments. Therefore, in the present study we compared neural markers of emotional stimuli perception between groups of experienced users of psychedelics (N = 56) and non-users (N = 55). EEG signals were collected while participants were presented with pictures of faces showing neutral or emotional expressions (anger, sadness, happiness). Subsequently, we analyzed event-related potential (ERP) components that are established markers of emotional reactivity. Compared to non-users, psychedelics users exhibited weaker neural responses to negative emotional stimuli, as indicated by significantly lower amplitude of the N200 component when processing fearful faces. Furthermore, the analysis revealed significant interaction effects between Group and Emotion on N170 and N200 amplitudes, thus indicating between-group differences in processing of fearful faces. However, analysis of later ERP components associated with attention and cognitive processes (P200, P300) did not reveal significant between-group differences. Therefore, our results indicate that naturalistic use of psychedelics may be related to reduced reactivity to emotionally negative stimuli at the early and automatic processing stages.
Objective: Framed in Reinforcement Sensitivity Theory, this study examined the moderating effects of mindfulness and moderate-to-vigorous physical activity (MVPA) on the relationship between behavioral inhibition system (BIS) sensitivity and psychological distress in college students. Participants: Undergraduate students (n = 183) at a large public university in the United States were included in the study. Methods: Self-reported BIS sensitivity, mindfulness, MVPA, and psychological distress were examined in November 2021. Results: Findings revealed a positive relationship between BIS sensitivity and psychological distress, however, this relationship was conditional on levels of mindfulness and MVPA. Specifically, increased reports of mindfulness and MVPA related to lower psychological distress for participants with higher than average BIS sensitivity. Conclusions: Mindfulness and MVPA are buffers for university students prone to psychological distress. Identifying diverse strategies that effectively lower psychological vulnerabilities in college students can be used to develop targeted interventions that reduce psychopathology and promote mental health.
Background
Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses’ stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive.
Objective
To systematically evaluate the impact of mindfulness training on nurse’s performance and increase the certainty of existing evidence.
Methods
This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software.
Results
This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = −0.81; 95% confidence interval (CI) = −1.11 to −0.52], with no significant effect on anxiety (SMD = −0.30; 95% CI = −0.72 to 0.13) or depression (SMD = −0.24; 95% CI = −0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = −4.27; 95% CI = −5.94 to −2.59) and depersonalization (SMD = −2.89; 95% CI = −4.24 to −1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects.
Conclusion
Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout.
Systematic review registration
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.
Rumination was examined as a potential common mechanism linking risk factors with depression. Initially nondepressed individuals (N = 137) were assessed for presence of a ruminative response style and 4 other hypothesized risk factors for depression. They were followed for 2.5 years. Negative cognitive styles, self-criticism, dependency, neediness, and history of past depression were all significantly associated with rumination. Rumination mediated the predictive relationships of all risk factors except dependency with the number of prospective Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) major depressive episodes (MDEs; definite and subthreshold) during the follow-up period. In contrast, private self-consciousness did not mediate any relationships between risk factors and subsequent MDEs. Thus, rumination, as a special kind of self-focus, may act as a general proximal mechanism through which other vulnerability factors affect depression.
Working largely independently, numerous investigators have explored the role of self-focused attention in various clinical disorders. This article reviews research examining increased self-focused attention in these disorders. Using information processing constructs, a model of self-focused attention is proposed, and it is suggested that certain deviations in this process constitute a psychopathological kind of attention. A meta-construct model of descriptive psychopathology is then outlined to examine how certain aspects of attention can be considered specific to certain disorders and others common to different disorders
This is a pilot study about the effects of a Zen meditation retreat.
There has been substantial interest in mindfulness as an approach to reduce cognitive vulnerability to stress and emotional distress in recent years. However, thus far mindfulness has not been defined operationally. This paper describes the results of recent meetings held to establish a consensus on mindfulness and to develop conjointly a testable operational definition. We propose a two-component model of mindfulness and specify each component in terms of specific behaviors, experiential manifestations, and implicated psychological processes. We then address issues regarding temporal stability and situational specificity and speculate on the conceptual and operational distinctiveness of mindfulness. We conclude this paper by discussing implications for instrument development and briefly describing our own approach to measurement.
Considerable research has disclosed how cognitive reappraisals and the modulation of emotional responses promote successful emotion regulation. Less research has examined how the early processing of emotion-relevant stimuli may create divergent emotional response consequences. Mindfulness-a receptive, non-evaluative form of attention-is theorized to foster emotion regulation, and the present study examined whether individual differences in mindfulness would modulate neural responses associated with the early processing of affective stimuli. Focus was on the late positive potential (LPP) of the event-related brain potential to visual stimuli varying in emotional valence and arousal. This study first found, replicating past research, that high arousal images, particularly of an unpleasant type, elicited larger LPP responses. Second, the study found that more mindful individuals showed lower LPP responses to high arousal unpleasant images, even after controlling for trait attentional control. Conversely, two traits contrasting with mindfulness-neuroticism and negative affectivity-were associated with higher LPP responses to high arousal unpleasant images. Finally, mindfulness was also associated with lower LPP responses to motivationally salient pleasant images (erotica). These findings suggest that mindfulness modulates neural responses in an early phase of affective processing, and contribute to understanding how this quality of attention may promote healthy emotional functioning.
This randomised trial compared the effects of Brain Wave Vibration (BWV) training, which involves rhythmic yoga-like meditative exercises, with Iyengar yoga and Mindfulness. Iyengar provided a contrast for the physical components and mindfulness for the "mental" components of BWV. 35 healthy adults completed 10 75-minute classes of BWV, Iyengar, or Mindfulness over five weeks. Participants were assessed at pre- and postintervention for mood, sleep, mindfulness, absorption, health, memory, and salivary cortisol. Better overall mood and vitality followed both BWV and Iyengar training, while the BWV group alone had improved depression and sleep latency. Mindfulness produced a comparatively greater increase in absorption. All interventions improved stress and mindfulness, while no changes occurred in health, memory, or salivary cortisol. In conclusion, increased well-being followed training in all three practices, increased absorption was specific to Mindfulness, while BWV was unique in its benefits to depression and sleep latency, warranting further research.
Research on the effectiveness and mechanisms of mindfulness training applied in psychotherapy is still in its infancy (Erisman & Roemer, 2010). For instance, little is known about the extent and processes through which mindfulness practice improves emotion regulation. This experience sampling study assessed the relationship between mindfulness, emotion differentiation, emotion lability, and emotional difficulties. Young adult participants reported their current emotional experiences 6 times per day during 1 week on a PalmPilot device. Based on these reports of emotions, indices of emotional differentiation and emotion lability were composed for negative and positive emotions. Mindfulness was associated with greater emotion differentiation and less emotional difficulties (i.e., emotion lability and self-reported emotion dysregulation). Mediational models indicated that the relationship between mindfulness and emotion lability was mediated by emotion differentiation. Furthermore, emotion regulation mediated the relationship between mindfulness and both negative emotion lability and positive emotion differentiation. This experience sampling study indicates that self-reported levels of mindfulness are related to higher levels of differentiation of one's discrete emotional experiences in a manner reflective of effective emotion regulation.
Contemplative practices are believed to alleviate psychological problems, cultivate prosocial behavior and promote self-awareness. In addition, psychological science has developed tools and models for understanding the mind and promoting well-being. Additional effort is needed to combine frameworks and techniques from these traditions to improve emotional experience and socioemotional behavior. An 8-week intensive (42 hr) meditation/emotion regulation training intervention was designed by experts in contemplative traditions and emotion science to reduce "destructive enactment of emotions" and enhance prosocial responses. Participants were 82 healthy female schoolteachers who were randomly assigned to a training group or a wait-list control group, and assessed preassessment, postassessment, and 5 months after training completion. Assessments included self-reports and experimental tasks to capture changes in emotional behavior. The training group reported reduced trait negative affect, rumination, depression, and anxiety, and increased trait positive affect and mindfulness compared to the control group. On a series of behavioral tasks, the training increased recognition of emotions in others (Micro-Expression Training Tool), protected trainees from some of the psychophysiological effects of an experimental threat to self (Trier Social Stress Test; TSST), appeared to activate cognitive networks associated with compassion (lexical decision procedure), and affected hostile behavior in the Marital Interaction Task. Most effects at postassessment that were examined at follow-up were maintained (excluding positive affect, TSST rumination, and respiratory sinus arrhythmia recovery). Findings suggest that increased awareness of mental processes can influence emotional behavior, and they support the benefit of integrating contemplative theories/practices with psychological models and methods of emotion regulation.
Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η(2) = .18). There were significant improvements over time for general distress (η(2) = .09), anxiety (η(2) = .08), hostility (η(2) = .07), and medical symptoms (η(2) = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.
There is a growing scientific interest in mindfulness meditation (MM), yet its underlying neurophysiological mechanism is still uncertain. We investigated whether MM affects self-referential processing, associated with default mode network (DMN), either as short (state) - or long-term (trait) effects.
Three levels of MM expertise were compared with controls (n=12 each) by electroencephalography (EEG).
DMN deactivation was identified during the transition from resting state to a time production task, as lower gamma (25-45 Hz) power over frontal and midline regions. MM practitioners exhibited a trait lower frontal gamma activity, related to narrative self-reference and DMN activity, as well as producing longer durations, these being negatively correlated with frontal gamma activity. Additionally, we found state increases in posterior gamma power, suggesting increased attention and sensory awareness. MM proficiency did not affect the results.
Gamma power over frontal midline areas reflects DMN activity. MM practitioners exhibit lower trait frontal gamma activity, as well as a state and trait increases in posterior gamma power, irrespective of practice proficiency.
First, the DMN can be studied non-invasively by EEG. Second, MM induces from the early stages of practice neuroplasticity in self-referential and attentional networks.
Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and chronically disabling psychiatric disorder that usually emerges during childhood or adolescence. This paper aims to review the literature on functional neuroimaging in OCD, analysing the reported dysfunctional connectivity in the corticostriatothalamocortical circuitry.
This study included papers published in peer-reviewed journals dealing with functional imaging in OCD.
Striatal dysfunction, mainly of the caudate nucleus, leads to inefficient thalamic gating, resulting in hyperactivity within the orbitofrontal cortex (intrusive thoughts) and the anterior cingulate cortex (non-specific anxiety). Compulsions consist of ritualistic behaviours performed to recruit the inefficient striatum and neutralise unwanted thoughts and anxiety. Functional neuroimaging findings are discussed against the background of specific cognitive impairments, mainly regarding visuospatial processing, executive functioning and motor speed. Cognitive deficits are partial and specific, matching imaging data.
Several studies have targeted brain regions hypothesised to be involved in the pathogenesis of OCD, showing the existence of dysfunctional connectivity in the corticostriatothalamocortical circuitry. Improvements in spatial resolution of neuroimaging techniques may contribute to a better understanding of the neurocircuitry of OCD and other anxiety disorders.
The present study is a waitlist-controlled investigation of the impact of a Mindfulness-Based Stress Reduction (MBSR) program on mindful attentiveness, rumination and blood pressure (BP) in women with cancer. Female post-treatment cancer patients were recruited from the MBSR program waitlist. Participants completed self-report measures of mindfulness and rumination and measured casual BP at home before and after the 8-week MBSR program or waiting period. MBSR group participants demonstrated higher levels of mindful attentiveness and decreased ruminative thinking following the intervention but no difference in BP, when compared to controls. In the MBSR group, decreases in rumination correlated with decreases in SBP and increases in mindful attention. When participants were assigned to "Higher BP" and "Lower BP" conditions based on mean BP values at week 1, "Higher BP" participants in the MBSR group (n=19) had lower SBP at week 8 relative to the control group (n=16). A MBSR program may be efficacious in increasing mindful attention and decreasing rumination in women with cancer. Randomized controlled trials are needed to evaluate an impact on clinically elevated BP.
Anterior cingulate cortex (ACC) is a part of the brain's limbic system. Classically, this region has been related to affect, on the basis of lesion studies in humans and in animals. In the late 1980s, neuroimaging research indicated that ACC was active in many studies of cognition. The findings from EEG studies of a focal area of negativity in scalp electrodes following an error response led to the idea that ACC might be the brain's error detection and correction device. In this article, these various findings are reviewed in relation to the idea that ACC is a part of a circuit involved in a form of attention that serves to regulate both cognitive and emotional processing. Neuroimaging studies showing that separate areas of ACC are involved in cognition and emotion are discussed and related to results showing that the error negativity is influenced by affect and motivation. In addition, the development of the emotional and cognitive roles of ACC are discussed, and how the success of this regulation in controlling responses might be correlated with cingulate size. Finally, some theories are considered about how the different subdivisions of ACC might interact with other cortical structures as a part of the circuits involved in the regulation of mental and emotional activity.
A growing number of psychosocial interventions are being offered to cancer patients during and after their medical treatment. Here, we examined whether Mindfulness-Based Stress Reduction (MBSR), a stress management course, helps women to cope better with stress and illness once their breast cancer treatment is completed. Our aim was to understand how MBSR may benefit those who participate in the course. Methods Our cohort study enrolled 59 women in an 8-week MBSR program. They completed "before and after" questionnaires pertaining to outcomes (stress, depression, medical symptoms) and process variables (mindfulness, coping with illness, sense of coherence). Paired t-tests examined changes from before to after the MBSR course. Changes in mindfulness were correlated with changes in post-MBSR variables, and a regression analysis examined which variables contributed to a reduction in stress after program participation. Results Adherence to the program was 91%. Participants reported significant reductions in stress (p < 0.0001), depression (p < 0.0001), and medical symptoms (p < 0.0001), and significant improvements in mindfulness (p < 0.0001), coping with illness (p < 0.0001), and sense of coherence (p < 0.0001). Changes in mindfulness were significantly related to changes in depression, stress, emotional coping, and sense of coherence. Increases in mindfulness and sense of coherence predicted reductions in stress. Conclusions It appears that learning how to be mindful is beneficial for women after their treatment for breast cancer.
Die Zeit antagonistischer Wissenschaftskulturen scheint vorüber: Begriffe, Modelle und Objekte wandern zwischen den Geistes-, Sozial- und Technowissenschaften. Dabei entstehen neue und intensive Verflechtungen. So werden ehemals kritische Konzepte des vermeintlich Nicht-Technischen in den Technowissenschaften aufgegriffen, während biokybernetische Denkfiguren auch die Geisteswissenschaften durchziehen. Dieser Band verfolgt solche Übersetzungsversuche und fragt, ob sich eine kreative interdisziplinäre Wissenskultur oder eine restriktive, formale Kultur der ›Interdisziplinierung‹ auf der Grundlage einer neuen Technorationalität herausbildet.
An ACT Approach Chapter 1. What is Acceptance and Commitment Therapy? Steven C. Hayes, Kirk D. Strosahl, Kara Bunting, Michael Twohig, and Kelly G. Wilson Chapter 2. An ACT Primer: Core Therapy Processes, Intervention Strategies, and Therapist Competencies. Kirk D. Strosahl, Steven C. Hayes, Kelly G. Wilson and Elizabeth V. Gifford Chapter 3. ACT Case Formulation. Steven C. Hayes, Kirk D. Strosahl, Jayson Luoma, Alethea A. Smith, and Kelly G. Wilson ACT with Behavior Problems Chapter 4. ACT with Affective Disorders. Robert D. Zettle Chapter 5. ACT with Anxiety Disorders. Susan M. Orsillo, Lizabeth Roemer, Jennifer Block-Lerner, Chad LeJeune, and James D. Herbert Chapter 6. ACT with Posttraumatic Stress Disorder. Alethea A. Smith and Victoria M. Follette Chapter 7. ACT for Substance Abuse and Dependence. Kelly G. Wilson and Michelle R. Byrd Chapter 8. ACT with the Seriously Mentally Ill. Patricia Bach Chapter 9. ACT with the Multi-Problem Patient. Kirk D. Strosahl ACT with Special Populations, Settings, and Methods Chapter 10. ACT with Children, Adolescents, and their Parents. Amy R. Murrell, Lisa W. Coyne, & Kelly G. Wilson Chapter 11. ACT for Stress. Frank Bond. Chapter 12. ACT in Medical Settings. Patricia Robinson, Jennifer Gregg, JoAnne Dahl, & Tobias Lundgren Chapter 13. ACT with Chronic Pain Patients. Patricia Robinson, Rikard K. Wicksell, Gunnar L. Olsson Chapter 14. ACT in Group Format. Robyn D. Walser and Jacqueline Pistorello
Objective:
To systematically review fully randomised patient preference trials and to explore the impact of preferences on attrition and outcome by meta-analysis of patient level data.
Data sources:
Citation search using Science Citation Index and Google Scholar and search of the main electronic databases (Medline, CINAHL, Embase, and AMED) with a combination of key words.
Study selection:
Fully randomised patient preference trials that compared treatments for any clinical condition were included. Other types of preference trials and crossover trials were excluded. Other inclusion criteria: participants aged 16 years and over; primary, self-reported outcomes measured on a continuous numerical scale. From 167 studies identified and screened, 17 were identified as fully randomised patient preference trials.
Data synthesis:
Of the 17 trials identified, 11 authors provided raw data for the meta-analysis. Data collected were baseline and follow-up data for the main outcome, randomised allocation data, preference data, and demographic data. Baseline and first post-intervention follow-up data for the main outcome were standardised. To improve homogeneity, data for only the eight musculoskeletal trials (n=1594) were combined. To estimate the effects of preferences on outcomes and attrition, three groups were compared: patients who had a preference and were randomly allocated to their preferred treatment; patients who had a preference and were randomly allocated to the treatment they did not prefer; and patients who had no preference.
Results:
Patients who were randomised to their preferred treatment had a standardised effect size greater than that of those who were indifferent to the treatment assignment (effect size 0.162, 95% confidence interval 0.011 to 0.314; P=0.04). Participants who received their preferred treatment also did better than participants who did not receive their preferred treatment (effect size 0.152, -0.035 to 0.339), although this was not statistically significant (P=0.11). Participants allocated to their undesired treatment had outcomes that were no different from those who were indifferent. Participants who were allocated to their undesired treatment were less likely to be lost to first follow-up compared with indifferent participants (odds ratio 1.70, 1.076 to 2.693; P=0.02). No difference was found in attrition between patients allocated to their preference and those who were indifferent.
Conclusions:
Preferences among patients in musculoskeletal trials are associated with treatment effects. In open randomised trials, preferences should be ascertained before randomisation.
Objective
Mindfulness based Cognitive Therapy (MBCT) is a standardized meditation program which has been proposed as a therapeutic option for the prevention of relapses in patients suffering from major depression (MD). The aim of the present review and meta-analysis is to provide an estimate of the efficacy of MBCT for MD patients.
Methods
A literature search was undertaken using MEDLINE, ISI web of knowledge, the Cochrane database, Google scholar and references of retrieved articles. Controlled studies investigating the efficacy of MBCT for MD were entered in the Cochrane Collaboration Review Manager Software (RevMan version 5.0).
Results
Reviewed data showed that MBCT in adjunct to usual care was significantly better than usual care alone for reducing MD relpases in patients with 3 or more past episodes of MD. MBCT plus gradual discontinuation of maintenance antidepressants was similar to continuation of antidepressants alone with respect to relapse prevention. The augmentation of MBCT could be useful for patients with current residual symptoms of depression as well.
Conclusions
Current studies showed preliminary evidence about the efficacy of MBCT for patients with 3 or more past episodes of depression and for currently depressed patients with residual symptoms. However, methodological shortcomings of reviewed studies including small sample size, frequent lack of replications and the absence of studies comparing MBCT to control groups designed to distinguish specific from non specific effects of meditation imply the necessity for further research.
Tested 5 hypotheses related to the goals, religious orientation, and cognitions of long-term meditation with 27 students (mean age 35.6 yrs) of meditation who had signed up for a 2-wk or 3-mo meditation retreat. Ss completed the Motivation, Expectation, Adherence instrument (D. H. Shapiro, 1980) at baseline and 1 and 6 mo after the retreat. Results show that reasons for continuing meditation shifted overall along a continuum of self-regulation, self-exploration, and self-liberation as a function of time; that effects equaled or exceeded goals for the majority of Ss; and that the effects meditators received from the practice were significantly related to what they wanted. Length of practice was associated with religious orientation and with the nature of cognitions when the S did not practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In mindfulness-based cognitive therapy (MBCT), it is proposed that training in mindfulness should reduce the tendency of formerly depressed patients to enter into ruminative thinking, thus reducing their risk of depressive relapse. However, data showing that rumination is associated with depressive relapse are lacking.
In an uncontrolled study with 24 formerly depressed patients, rumination was assessed with the Ruminative Response Scale. To assess the occurrence of relapse or recurrence, the Structured Clinical Interview for DSM-IV was administered 12 months after the end of the MBCT.
Rumination significantly decreased during the MBCT course. Post-treatment levels of rumination predicted the risk of relapse of major depressive disorder in the 12-month follow-up period even after controlling for numbers of previous episodes and residual depressive symptoms.
The results provide preliminary evidence that rumination is important in the process of depressive relapse.
Once considered to be a disorder associated with minimal impairment, the link between generalized anxiety disorder (GAD) and impairment across a broad constellation of domains is now well established. However, less is known about how comorbidity affects these relationships or how GAD impacts one's perceived life satisfaction or quality of life. To investigate these questions, data from 52 treatment-seeking individuals with GAD (33 with comorbid Axis I diagnoses) were compared to data from 55 nonanxious controls. Individuals with GAD reported more impairment at work and in their social functioning than they did with home and family responsibilities. They also reported lower quality of life than nonanxious controls, particularly in regard to self-esteem, goals and values, money, work, play, learning, creativity, friends, and relatives. Trait worry was positively correlated with impairment and inversely related to life satisfaction within the clinical sample. Individuals with GAD, with and without comorbid Axis I diagnoses, showed few differences on measures of impairment (differing only on impairment in social functioning). However, individuals with GAD and comorbid disorders perceived their lives as less satisfying than did individuals with GAD without comorbid diagnoses. Depression and Anxiety 24:342–349, 2007. © 2006 Wiley-Liss, Inc.
The self is a complex concept that has long been investigated in philosophy and most recently in neuroscience. The present
paper discusses some conceptual issues revolving around the self and how that match with the current empirical data. It becomes
clear that we need to abandon the traditional Cartesian-based concept of the self as entity or substance and replace it by
more process-based concept of the self in which medial cortical regions seem to play a central role.
KeywordsCortical Midline Structures-Entity versus Processes-Self
The practice of mindfulness is increasingly being integrated into contemporary clinical psychology. Based in Buddhist philosophy and subsequently integrated into Western health care in the contexts of psychotherapy and stress management, mindfulness meditation is evolving as a systematic clinical intervention. This article describes stress-reduction applications of mindfulness meditation predominantly in medical settings, as originally conceived and developed by Kabat-Zinn and colleagues. It describes process factors associated with the time-limited, group-based formal favored by this model, and presents in tabular form results of both early and more recent outcome studies.
Mindfulness-based stress reduction (MBSR) has been found to reduce psychological distress and improve psychological adjustment in medical, psychiatric, and nonclinical samples. We examined its effects on several processes, attitudes, and behavior patterns related to emotion regulation.
Fifty-six adults were randomly assigned to MBSR or to a waiting list (WL).
Compared with WL completers (n = 21), MBSR completers (n = 20) reported significantly greater increases in trait mindfulness and decreases in absent-mindedness, greater increases in self-compassion, and decreases in fear of emotions, suppression of anger, aggressive anger expression, worry, and difficulties regulating emotions. The WL group subsequently received MBSR, and the two groups combined showed significant changes on all of these variables from pre-MBSR to post-MBSR, and on all except the 2 anger variables from pre-test to 2-month follow-up, as well as significant reductions in rumination.
An 8-week mindfulness training program might increase mindful awareness in daily life and have beneficial impact on clinically relevant emotion regulation processes.
Bipolar disorder is associated with impairments in cognition, including difficulties in executive functioning, even when patients are euthymic (neither depressed nor manic). The purpose of this study was to assess changes in self-reported cognitive functioning in patients with bipolar disorder who participated in an open pilot trial of mindfulness-based cognitive therapy (MBCT). Following MBCT, patients reported significant improvements in executive functioning, memory, and ability to initiate and complete tasks, as measured by the Behavior Rating Inventory of Executive Function (BRIEF) and the Frontal Systems Behavior Scale (FrSBe). Changes in cognitive functioning were correlated with increases in mindful, nonjudgmental observance and awareness of thoughts, feelings, and sensations, and were not associated with decreases in depression. Improvements tended to diminish after termination of treatment, but some improvements, particularly those in executive functioning, persisted after 3 months. These results provide preliminary evidence that MBCT may be a treatment option that can be used as an adjunct to medication to improve cognitive functioning in bipolar disorder.
In major depression, the neural mechanisms underlying suicide related thoughts and behaviors as well as the expression of other depressive symptoms are incompletely characterized. Evidence indicates that both the striatum and cortical midline structures (CMS) may be involved with both suicide and emotional dysregulation in unipolar illness. The aim of this study was to identify striatal-CMS circuits associated with current depression severity and suicidal ideation (SI) as well as a history of self-harm.
Twenty-two male subjects with recurrent unipolar depression were studied using functional MRI. All subjects were unmedicated and without current psychiatric comorbidity. Correlational analyses were used to determine whether striatal-CMS functional connectivity was associated with any of the three clinical variables.
A network involving the bilateral striatum and anterior CMS was found to be associated with depressive symptom severity. Current SI was associated with a similar but less extensive circuit in the left hemisphere. A distinct striatal motor/sensory network was associated with self-harm behaviors, but not current SI or depression severity.
The striatal-anterior CMS circuit likely plays a significant role in the expression of depressive symptoms and SI. In contrast, a striatum-motor/sensory cortex network may be a trait marker of suicide-related behaviors. If replicated, this result might eventually lead to the development of a biomarker that would be useful for studies of pharmacologic and/or psychotherapeutic suicide prevention interventions.
Bipolar disorder is characterized by recurrent episodes of depression and/or mania along with interepisodic mood symptoms that interfere with psychosocial functioning. Despite periods of symptomatic recovery, many individuals with bipolar disorder continue to experience substantial residual mood symptoms that often lead to the recurrence of mood episodes.
This study explored whether a new mindfulness-based cognitive therapy (MBCT) for bipolar disorder would increase mindfulness, reduce residual mood symptoms, and increase emotion-regulation abilities, psychological well-being, positive affect, and psychosocial functioning. Following a baseline clinical assessment, 12 individuals with DSM-IV bipolar disorder were treated with 12 group sessions of MBCT.
At the end of treatment, as well as at the 3 months follow-up, participants showed increased mindfulness, lower residual depressive mood symptoms, less attentional difficulties, and increased emotion-regulation abilities, psychological well-being, positive affect, and psychosocial functioning.
These findings suggest that treating residual mood symptoms with MBCT may be another avenue to improving mood, emotion regulation, well-being, and functioning in individuals with bipolar disorder.
The aim of this study is to examine the efficacy of mindfulness-based cognitive therapy (MBCT) in addition to treatment as usual (TAU) for recurrent depressive patients with and without a current depressive episode.
A randomized, controlled trial comparing MBCT+TAU (n=102) with TAU alone (n=103). The study population consisted of patients with three or more previous depressive episodes. Primary outcome measure was post-treatment depressive symptoms according to the Hamilton Rating Scale for Depression. Secondary outcome measures included the Beck Depression Inventory, rumination, worry and mindfulness skills. Group comparisons were carried out with linear mixed modelling, controlling for intra-group correlations. Additional mediation analyses were performed. Comparisons were made between patients with and without a current depressive episode.
Patients in the MBCT+TAU group reported less depressive symptoms, worry and rumination and increased levels of mindfulness skills compared with patients receiving TAU alone. MBCT resulted in a comparable reduction of depressive symptoms for patients with and without a current depressive episode. Additional analyses suggest that the reduction of depressive symptoms was mediated by decreased levels of rumination and worry.
The study findings suggest that MBCT is as effective for patients with recurrent depression who are currently depressed as for patients who are in remission. Directions towards a better understanding of the mechanisms of action of MBCT are given, although future research is needed to support these hypotheses.
Objective. Severe health anxiety (hypochondriasis) is a common and disabling condition for which existing psychological treatments have limited effects (Thomson & Page, 2007). Hence, it is a priority to examine both the efficacy and acceptability of new psychological treatments for health anxiety. The aim of this study was to explore the experiences of participants with severe health anxiety who received Mindfulness-based Cognitive Therapy (MBCT) as part of a randomized controlled trial.
Design. Semi-structured interviews were carried out 3 months after participants completed MBCT in order to explore their experiences of the course and subsequent self-managed practice.
Methods. Interpretative Phenomenological Analysis (Smith, 1996) was used to analyze interview transcripts from nine participants who had received MBCT.
Results. Two main themes emerged from the analysis: (1) My awareness of barriers to experiencing change through MBCT, and (2) Cultivation of a new approach to health anxiety and my life in general.
Conclusions. The majority of participants considered MBCT to be an acceptable and beneficial treatment for health anxiety. Participants reported beneficial impacts of MBCT both on their health anxiety and on their broader functioning. Importantly, the focusing of attention upon bodily sensations required in MBCT practice did not exacerbate participants’ health anxiety.
Unlabelled:
Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS; sometimes known as myalgic encephalomyelitis). However, only a minority of patients fully recover after CBT; thus, methods for improving treatment outcomes are required. This pilot study concerned a mindfulness-based cognitive therapy (MBCT) intervention adapted for people with CFS who were still experiencing excessive fatigue after CBT. The study aimed to investigate the acceptability of this new intervention and the feasibility of conducting a larger-scale randomized trial in the future. Preliminary efficacy analyses were also undertaken. Participants were randomly allocated to MBCT or waiting list. Sixteen MBCT participants and 19 waiting-list participants completed the study, with the intervention being delivered in two separate groups. Acceptability, engagement and participant-rated helpfulness of the intervention were high. Analysis of covariance controlling for pre-treatment scores indicated that, at post-treatment, MBCT participants reported lower levels of fatigue (the primary clinical outcome) than the waiting-list group. Similarly, there were significant group differences in fatigue at 2-month follow-up, and when the MBCT group was followed up to 6 months post-treatment, these improvements were maintained. The MBCT group also had superior outcomes on measures of impairment, depressed mood, catastrophic thinking about fatigue, all-or-nothing behavioural responses, unhelpful beliefs about emotions, mindfulness and self-compassion. In conclusion, MBCT is a promising and acceptable additional intervention for people still experiencing excessive fatigue after CBT for CFS, which should be investigated in a larger randomized controlled trial.
Key practitioner message:
Only about 30% of people with chronic fatigue syndrome (CFS) recover after cognitive behaviour therapy (CBT); thus, methods for improving treatment outcomes are needed. This is the first pilot randomized study to demonstrate that a mindfulness-based intervention was associated with reduced fatigue and other benefits for people with CFS who were still experiencing excessive fatigue after a course of CBT. Levels of acceptability, engagement in the intervention and rated helpfulness were high. A larger-scale randomized controlled trial is required.
Few studies have examined changes of diurnal cortisol profiles prospectively, in relation to non-pharmacological interventions such as mindfulness-based cognitive therapy (MBCT). Fifty-six patients remitted from recurrent depression (≥3 episodes) were included in an 8-week randomized controlled trial comparing MBCT plus treatment as usual (TAU) with TAU for depression relapse prophylaxis. Saliva samples (0, 15, 30, 45, 60 min post-awakening, 3 PM, 8 PM) were collected on six occasions (pre- and post-intervention, 3-, 6-, 9-, 12-month follow-up). Cortisol awakening response (CAR), average day exposure (AUCday) and diurnal slope were analyzed with mixed effects models (248 profiles, 1-6 per patient). MBCT (n = 28) and TAU groups (n = 28) did not significantly differ with respect to baseline variables. Intra-individual variability exceeded inter-individual variability for the CAR (62.2% vs. 32.5%), AUC(day) (30.9% vs. 23.6%) and diurnal slope (51.0% vs. 34.2%). No time, group and time by group effect was observed for the CAR and diurnal slope. A significant time effect (p = 0.003) was detected for AUCday, which was explained by seasonal variations (p = 0.012). Later wake-up was associated with lower CAR (-11.7% per 1-hour later awakening, p < 0.001) and lower AUCday (-4.5%, p = 0.014). Longer depression history was associated with dampened CAR (-15.2% per 10-year longer illness, p = 0.003) and lower AUCday (-8.8%, p = 0.011). Unchanged cortisol secretion patterns following participation in MBCT should be interpreted with regard to large unexplained variability, similar relapse rates in both groups and study limitations. Further research is needed to address the scar hypothesis of diminished HPA activity with a longer, chronic course of depression.
Individuals with high anxiety show heightened neural activation in affective processing regions, including the amygdala and insula. Activations have been shown to be correlated with anxiety severity, but although anxiety is a heterogeneous state, prior studies have not systematically disentangled whether neural activity in affective processing circuitry is uniquely related to specific domains of anxiety. Forty-five young adults were tested on an emotional face processing task during functional magnetic resonance imaging. Participants completed the Social Interactional Anxiety Scale, Anxiety Sensitivity Index, and Spielberger Trait Anxiety Inventory. Using a robust multiple regression approach, we examined the effects of social anxiety, anxiety sensitivity, and trait anxiety (which overlapped with depressive symptoms, and can therefore be considered a measure of negative affectivity) on activation in insula, amygdala, and medial prefrontal cortex, in response to emotional faces. Adjusting for negative affectivity and anxiety sensitivity, social anxiety was associated with activity in left amygdala, right insula, and subgenual anterior cingulate across all emotional faces. When comparing negative and positive faces directly, greater negative affectivity was uniquely associated with less activity to positive faces in left amygdala, left anterior insula, and dorsal anterior cingulate. The current findings support the hypothesis that hyperactivity in brain areas during general emotional face processing is predominantly a function of social anxiety. In comparison, hypoactivity to positively valenced faces was predominantly associated with negative affectivity. Implications for the understanding of emotion processing in anxiety are discussed.
Mindfulness-based cognitive therapy (MBCT) is a group-based clinical intervention program designed to reduce relapse or recurrence of major depressive disorder (MDD) by means of systematic training in mindfulness meditation combined with cognitive-behavioral methods.
By means of a meta-analysis to evaluate the effect of MBCT for prevention of relapse or recurrence among patients with recurrent MDD in remission.
Electronic databases were searched and researchers were contacted for further relevant studies. Studies were coded for quality. Meta-analyses were performed by means of the Cochrane Collaboration Review Manager 5.1.
Six randomized controlled trials with a total of 593 participants were included in the meta-analysis. MBCT significantly reduced the risk of relapse/recurrence with a risk ratio of 0.66 for MBCT compared to treatment as usual or placebo controls, corresponding to a relative risk reduction of 34%. In a pre-planned subgroup analysis the relative risk reduction was 43% for participants with three or more previous episodes, while no risk reduction was found for participants with only two episodes. In two studies, MBCT was at least as effective as maintenance antidepressant medication.
Results of this meta-analysis indicate that MBCT is an effective intervention for relapse prevention in patients with recurrent MDD in remission, at least in case of three or more previous MDD episodes.
Research suggests that an 8-week Mindfulness-Based Stress Reduction (MBSR) program (a structured form of meditation) might be effective in the treatment of various health problems including chronic pain. Our objective was to compare the clinical effectiveness of the MBSR program with a multidisciplinary pain intervention (MPI) program in terms of pain intensity, pain-related distress, quality of life, and mood in patients with chronic pain.
A randomized, comparative clinical trial was conducted, including 6-month posttreatment follow-up. Ninety-nine participants, aged 24 to 64 years, with pain for a minimum of 3 months, were recruited from community-based clinics, hospitals, and community service centers. Participants were randomly allocated to either the MBSR program (51 participants) or a MPI program (48 participants). The study used validated Chinese versions of self-reported questionnaires measuring pain, mood symptoms, and health-related quality of life.
Thirty-nine participants (77%) completed the MBSR program and 44 (90%) completed the MPI program. Patients in both the groups were comparable with regard to demographical characteristics, pain intensity, mood symptoms, and health-related quality-of-life measures before intervention. In both the groups, patients who completed the trial demonstrated statistically significant improvements in pain intensity and pain-related distress. However, no statistically significant differences were observed in overall results between the MBSR and MPI groups.
This randomized, clinical trial showed that both MBSR and MPI programs reduced pain intensity and pain-related distress although no statistically significant differences were observed between the 2 groups and the improvements were small.
Even when euthymic bipolar disorder patients can have persistent deficits in working memory, but the neural basis of this deficit remains unclear. We undertook an functional magnetic resonance imaging investigation of euthymic bipolar disorder patients performing two working memory paradigms; the two-back and Sternberg tasks, selected to examine the central executive and the phonological loop respectively. We hypothesized that neuronal dysfunction would be specific to the network underlying the executive rather than the phonological loop component of working memory.
Twelve right-handed euthymic bipolar I males receiving lithium carbonate monotherapy were matched with 12 controls. The two-back task comprised a single working memory load contrasted with baseline vigilance condition. The Sternberg paradigm used a parametric design incorporating variable working memory load with fixed delay between presentation of an array of items to be remembered and a target item. Functional activation data were acquired during performance of the tasks and were analysed to produce brain activation maps representing significant group differences in activation (ANOVA). Load-response curves were derived from the Sternberg task data set.
There were no significant between-group differences (t-test) in performance of the two-back task, or in 2 x 5 group by memory load ANOVA for the performance data from Sternberg task. In the two-back task, compared with controls bipolar disorder patients showed reductions in bilateral frontal, temporal and parietal activation, and increased activations with the left precentral, right medial frontal and left supramarginal gyri. No between-group differences were observed in the Sternberg task at any working memory load.
Our findings support the notion that, in euthymic bipolar disorder, failure to engage fronto-executive function underpins the core neuropsychological deficits.
Several lines of evidence suggest that deficits in cognition persist in bipolar patients during periods of euthymia. Working memory impairment has been observed in euthymic bipolar patients and noted to be a significant source of functional deficits in psychiatric disorders. Functional changes associated with these cognitive deficits however, remain poorly understood. We hypothesized that patients with bipolar disorder would demonstrate changes in neuronal activation in specific regions forming part of the working memory network.
Fifteen euthymic bipolar patients and fifteen age- and gender-matched healthy controls were recruited. Subjects participated in fMRI scans during which a two-back working memory task alternated with a zero-back control/attention task using a block-design paradigm. Groups were analyzed separately, and intergroup comparisons were made using an exploratory, voxel-by-voxel analysis.
Bipolar patients performed more poorly on the cognitive tasks than did healthy controls (F = 3.77, p = 0.04). After covarying for task performance and reaction time, bipolar patients demonstrated significantly greater activation than healthy subjects in several regions including the fronto-polar prefrontal cortex, temporal cortex, basal ganglia, thalamus, and posterior parietal cortex. No areas showed a significant decrease in activation, compared with healthy controls.
Our findings suggest that decreased working memory performance in bipolar patients reflects specific neurofunctional deficits. These deficits may represent primary areas of neuropathology or be secondary to neuropathology elsewhere in the working memory network. Continued research utilizing other imaging modalities may further clarify the underlying neuropathology involved in these cognitive deficits.
A complex brain network, centered on the hippocampus, supports episodic memories throughout their lifetimes. Classically, upon memory encoding during active behavior, hippocampal activity is dominated by theta oscillations (6-10Hz). During inactivity, hippocampal neurons burst synchronously, constituting sharp waves, which can propagate to other structures, theoretically supporting memory consolidation. This 'two-stage' model has been updated by new data from high-density electrophysiological recordings in animals that shed light on how information is encoded and exchanged between hippocampus, neocortex and subcortical structures such as the striatum. Cell assemblies (tightly related groups of cells) discharge together and synchronize across brain structures orchestrated by theta, sharp waves and slow oscillations, to encode information. This evolving dynamical schema is key to extending our understanding of memory processes.
Bipolar II depression is a serious and disabling illness associated with significant impairment and high rates of suicide attempts. However, mechanisms underlying emotional dysregulation in this condition are poorly characterized. The goal of this work was to investigate one component of emotional processing in this disorder, brain activation associated with exposure to emotional faces. Functional MRI was used to study 16 unmedicated male subjects with bipolar II depression and 19 healthy male controls. The activation paradigm exposed subjects to happy, fearful and neutral faces. The two key findings of this study were as follows. First, bipolar subjects demonstrated significantly decreased activation in response to happy facial expression in the left posterior cortical midline structures (CMS) and frontal cortex. Second, depression severity was positively correlated with activation of the posterior CMS and other regions. Our results suggest that mechanisms involving CMS dysfunction may play a role in the neurobiology of bipolar II depression as has been demonstrated for unipolar illness. Further investigations of CMS function in bipolar spectrum disorders are warranted.
Considerable evidence implicates dysfunction of striatal and cortical midline structure (CMS) circuitry in mood disorders. Whether such aberrations exist in bipolar II depression is unknown.
Sixteen unmedicated subjects with bipolar II depression and 19 healthy controls were studied using functional MRI and a motor activation paradigm. Analyses of both activation and functional connectivity were conducted.
A history of suicidal ideation (SI) was negatively correlated with activation of the left putamen while depression severity was positively correlated with activation of the left thalamus. The superior bilateral putamen was simultaneously correlated with depression severity and anti-correlated with SI. Striatal functional connectivity was altered with the bilateral CMS and right inferior parietal lobule. Depression severity was correlated with strength of connectivity between the bilateral striatum and the right lingual gyrus and left cerebellum.
Only males experiencing an episode of major depression were studied.
Striatal and CMS circuit abnormalities likely contribute to the neurobiology of bipolar II depression. Altered connectivity of the striatum may directly impact depression severity. Further, dissociable components of activation associated with depression severity and suicidal ideation may exist. Finally, the motor activation paradigm used in this study appears to be a useful probe of some neural processes underlying bipolar II depression.