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Mindful attention to breath regulates emotions via increased amygdala-prefrontal cortex connectivity
Abstract
Mindfulness practice is beneficial for emotion regulation; however, the neural mechanisms underlying this effect are poorly understood. The current study focuses on effects of attention-to-breath (ATB) as a basic mindfulness practice on aversive emotions at behavioral and brain levels. A key finding across different emotion regulation-strategies is the modulation of amygdala and prefrontal activity. It is unclear how ATB relevant brain areas in the prefrontal cortex integrate with amygdala activation during emotional stimulation. We proposed that, during emotional stimulation, ATB down-regulates activation in the amygdala and increases its integration with prefrontal regions. To address this hypothesis, 26 healthy controls were trained in mindfulness-based attention-to-breath meditation for two weeks and then stimulated with aversive pictures during both attention-to-breath and passive viewing while undergoing fMRI. Data were controlled for breathing frequency. Results indicate that (1) ATB was effective in regulating aversive emotions. (2) Left dorso-medial prefrontal cortex was associated with ATB in general. (3) A fronto-parietal network was additionally recruited during emotional stimulation. (4) ATB down regulated amygdala activation and increased amygdala-prefrontal integration, with such increased integration being associated with mindfulness ability. Results suggest amygdala-dorsal prefrontal cortex integration as a potential neural pathway of emotion regulation by mindfulness practice.
... However, this evidence is not based on quantitative synthesis. In the last five years, numerous functional MRI studies have examined the functional brain processes specifically underpinning focused attention meditation (Bauer et al., 2019;Doll et al., 2016;Escrichs et al., 2019;Guidotti et al., 2021;Hiroyasu and Hiwa, 2017;Kim et al., 2019;Martínez et al., 2021;May et al., 2016;Miyoshi et al., 2019;Mooneyham et al., 2017;Scheibner et al., 2017;Tomasino and Fabbro, 2016;Weng et al., 2020a;Weng et al., 2020b). This rapid proliferation of work has generated new and complex data on the core neurobiological mechanisms of focused attention meditation. ...
... We performed meta-analyses of 10 eligible studies (Brefczynski-Lewis et al., 2007;Dickenson et al., 2013;Doll et al., 2016;Farb et al., 2013;Hasenkamp et al., 2012;Hölzel et al., 2007;Manna et al., 2010;May et al., 2016;Scheibner et al., 2017;Tomasino and Fabbro, 2016) comprising a total of 228 participants to identify convergent brain clusters that were consistently activated and deactivated during focused attention meditation compared to control conditions. This included 62 participants more than the latest comparable meta-analysis examining focused attention meditation (166 participants) . ...
... This included 62 participants more than the latest comparable meta-analysis examining focused attention meditation (166 participants) . Since the ALE algorithm requires brain coordinates of activation or deactivation as inputs, we only included studies that reported group coordinates which were statistically significant after correction for multiple comparisons, including one null finding (Doll et al., 2016). To mitigate biases (Tahmasian et al., 2019), we excluded experiments for which analyses were constrained to specific brain lobes or regions. ...
Meditation trains the mind to focus attention towards an object or experience. Among different meditation techniques, focused attention meditation is considered foundational for more advanced practices. Despite renewed interest in its functional neural correlates, there is no unified neurocognitive model of focused attention meditation developed via quantitative synthesis of contemporary literature. Hence, we performed a quantitative systematic review and meta-analysis of all functional MRI studies examining focussed attention meditation. Following PRISMA guidelines, 28 studies were included in this review, of which 10 studies (200 participants) were amenable to activation likelihood estimation meta-analysis. We found that regions comprising three key functional brain networks i.e., Default-mode, Salience, and Executive Control, were consistently implicated in focused attention meditation. Furthermore, meditation expertise, mindfulness levels and attentional skills were found to significantly influence the magnitude, but not regional extent, of activation and functional connectivity in these networks. Aggregating all evidence, we present a unified neurocognitive brain-network model of focused attention meditation.
... La première étude de ce projet visait à valider une échelle rapide de bien-être, the Arizona Integrative Outcome Scale (AIOS ;Bell et al., 2004) La santé mentale et le bien-être individuel influencent la structure et la fonction du cerveau tout au long de la vie, ce qui à son tour affecte les niveaux de bien-être. Cependant, notre compréhension des dynamiques entre le bien-être et la fonction cérébrale est encore incomplète à ce jour (e.g., Dolcos, Moore and Katsumi, 2018). Le cerveau humain est un système complexe. ...
... All these factors mediate not only well-being but also shape the structure and function of our brains throughout the lifespan, which in turn, can mediate well-being levels. While progress has been made recently regarding our understanding of the direct relationships between well-being and the brain, much is still unknown (Dolcos, Moore and Katsumi, 2018). By identifying brain correlates of well-being, wearable neurotechnologies will improve the detection, prediction, and treatment of poor mental health and low well-being, in an affordable manner. ...
... To conclude this section on well-being and the brain, by identifying the neural correlates and predictors of well-being, as well as finding measures to capture changes in well-being, we will better understand the mechanisms that underlie higher levels of well-being, and in turn, develop promising interventions aiming at helping people live happier and more fulfilling lives (Dolcos, Moore and Katsumi, 2018). Attentional and inhibitory impairments are thought to be crucially associated with an increased vulnerability to depressive episodes and cognitive vulnerability (De Raedt and Koster, 2010). ...
Over the last 30 years we have observed dramatic declines in mental health worldwide, with nearly 450 million people currently suffering from a mental or behavioral disorder. Globally, there is less than 1 mental health professional for every 10,000 people, with 76-85% of the population in low and middle-income countries without access to treatment. The overarching aim of this thesis is the identification of novel and cost-effective methods for measuring, detecting, and assessing well-being. In the first study of this research project, we validated the ability of a quick global scale to capture multidimensional well-being on 1,615 participants that participated in an online survey, identified some predictors of well-being, and observed improvements from online interventions. Mental health and individual well-being also influences the structure and function of our brains across the lifespan, which in turn, mediate well-being levels. While progress has been made regarding our understanding of the interacting relationships between well-being and brain function, much is still unknown. Recent technological advances have led to the development of affordable, light-weight, wearable, and wireless electroencephalography (EEG) technologies that offer fast preparation time, high mobility, and that facilitate the collection of EEG data over large and diversified populations by increasing access to populations that were previously difficult to study with conventional systems. The analysis of large datasets with robust statistical methods or advanced machine-learning algorithms can ease the identification of trends, the mediator role of covariables, and the classification of mental states. While low-cost, low-density EEG systems have presented significant challenges for conducting EEG research, here we validated a wearable system for recording spectral measures relevant to the study of well-being, by comparison with a state-of-the-art system (study 2). In study 3, we used the tools validated in studies 1 and 2 to examine the relation between EEG and multidimensional well-being in a large sample (N = 353). We found a potential EEG marker of well-being, consistent with some literature on anxiety and depression, with age as a mediator. We discuss interpretations and limitations related to the studies and the broader field, as well as future directions (e.g., real-world EEG monitoring, dyadic or multimodal applications, brain-computer interfaces, neurofeedback training) and ethical implications for the field. The broader applications of this line of research will hopefully help to reduce the prevalence of mental health disparities worldwide (e.g., chronic stress, anxiety disorder, depression, psychiatric conditions), and will also help to predict and prevent mental illness in the broader population.
... The main characteristics of the 20 reviewed studies are presented in supplemental Table 3. All studies were conducted using quantitative methods, 15 included EEG measures (Andreu et al., 2017(Andreu et al., , 2019Bing-Canar et al., 2016;Eichel & Stahl, 2020;Incagli et al., 2020;Kakumanu et al., 2019;Lakey et al., 2011;Larson et al., 2013;Lin et al., 2019;Moore et al., 2012;Payne et al., 2020;Pozuelos et al., 2019;Saunders et al., 2016), while 5 papers involved fMRI technique (Doll et al., 2016;Haase et al., 2015Haase et al., , 2016Lebares et al., 2019;Lee et al., 2012). Andreu et al. (2017Andreu et al. ( , 2019 presented identical sample size and design in two articles. ...
... On the other hand, novices showed stronger right inferior frontal gyrus activity during meditation compared to baseline. Doll et al. (2016) evaluated the link between attention-to-breath mindfulness practice and emotion regulation using visual-emotional stimulation. Analyses focusing on the amygdala's integration with prefrontal cortices during meditation revealed increased emotion-related functional connectivity between the right amygdala and left prefrontal and cingulate areas. ...
... The authors speculated that mindfulness may improve attentional resource allocation during stressful experiences leading to a better attentional control and increased coping abilities. On the other hand, in the Doll et al.'s (2016) study a significantly shorter focused attention mindfulness training showed two possible components of the regulatory activation of mindfulness practice during emotional stimulation: (1) extended network of lateral and medial parietal, superior temporal and medial, and ACC; (2) a prefrontal-temporal network centred in the superior and middle frontal gyrus, highly involved in attentional and cognitive control. ...
The effects of mindfulness-based interventions on performance
have recently been investigated, with several studies assessing
changes in brain activity. The aim of the current systematic
review was to identify the neural correlates of mindfulness
practice that enhance performance. We completed searches on
Scopus, PubMed, EBSCO, and Web of Science in February 2020.
Peer-reviewed studies that implemented mindfulness-based
interventions or compared groups of mindfulness meditators with
non-practitioners and measured the neural activity underpinning
performance were eligible. The quality of the studies and
evidence was assessed with the Cochrane risk of bias tool and
the GRADE system. Of the 1836 records identified, 20 published
articles (925 participants) were found, including 8 experimental, 5
quasi-experimental, and 7 cross-sectional studies. None of the
studies were rated as having a low risk of bias. The quality of
evidence was graded to be low and very low. The main finding
that emerged was the potential enhancing effect of mindfulness
practice on performance monitoring abilities, which are highly
important to detect and adjust to errors. Overall findings did not
provide a robust evidence for neural correlates of mindfulness
practice aimed to enhance performance, highlighting the need
for future research. This study is registered on PROSPERO,
number CRD42020185471.
... Furthermore, the use of adaptive ERSs, such as mindfulness, was linked to reduced amygdala activation in association with increased activity of DLPFC, MFG, anterior cingulate cortex (ACC) parahyppocampal gyrus, hippocampus, and insula. 50,51 The involvement of this extended brain network was also replicated for several maladaptive ERSs including suppression (i.e., greater activation of IFG/VLPFC), 49 rumination (i.e., decreased activation in the left amygdala, hippocampus, ACC, and orbitofrontal cortex), 52 worry (i.e., increased activity of MFG, IFG, and anterior insula) (for a metaanalysis see reference 53), and experiential avoidance (i.e., reduced activation in the left MFG and bilateral amygdala). 54 Figure 2 graphically summarizes brain regions involved in ER processes. ...
... First, using a well-established ER network of interest (i.e. SFG, MFG, IFG, cingulate cortex, insula, parahippocampal gyrus, hippocampus, and amygdala, extracted by [49][50][51][52][53][54], we aimed at exploring: ...
Aim:
Departing from existing neurobiological models of dissociation, the current study aims at conducting a quantitative meta-analytic review of neural responses to emotional stimuli among individuals ascribed to the dissociative spectrum (DS). Accordingly, the study explored common and specific brain mechanisms across borderline personality disorder, conversion/somatoform disorders, post-traumatic stress disorder [PTSD], PTSD related to repeated interpersonal traumatic experiences, dissociative disorders.
Methods:
The meta-analysis included studies that administered emotional stimuli during fMRI acquisition among individuals included in the DS. There were conducted 2 meta-analytic procedures: i) a Bayesian network meta-analysis for a region-of-interest (ROI)-based approach; ii) robust voxel-based approach.
Results:
Forty-four independent studies were included for a total of 1384 individuals (DS = 741 subjects). The network meta-analysis showed specific patterns of neural activity considering an extended brain network involved in emotion regulation for each condition ascribed to the DS. The voxel-based meta-analysis highlighted an increased activity of dorsal anterior cingulate cortex as a common neurological signature of the DS.
Conclusion:
The common neural feature of the DS captures an implicit appraisals of emotion-eliciting stimuli as threatening and/or noxious for mental and physical integrity of the individual together with painful subjective experiences associated to physiological emotional reactions. Specific brain responses across the DS suggested that the engagement in different mechanisms to address emotional stimuli - implicit avoidance reactions and attempts to over-control of affective states together with a disruption of integrative processes of emotional mind-body features. This article is protected by copyright. All rights reserved.
... Furthermore, they found that emotional and functional connectivity between the amygdala and the left dmPFC was increased during mindfulness-on-breath meditation. [24] Laneri D results show increased activations of the anterior insula and cingulate gyrus as well as the dmPFC and temporal pole after long-term mindfulness training. [25] The result of Farb et al. showed the decreased recruitment of the dmPFC during interactive attention in mindfulness meditation. ...
... Reading the mind in the eyes task Enhanced empathic accuracy-related brain activity Increased neural activity in the inferior frontal gyrus and dorsomedial PFC Doll [24] Pre-post design without control ...
Meditation is a practice of concentration and relaxation. In philosophical terms, it is a process of gaining self-consciousness. Although there is diversity in meditation (Mindfulness, compassion, transcendental, and focused attention meditation), interventions show that meditation practices improve prefrontal cortex (PFC) functions like cognition, self-awareness, attention, and memory and reduce psychological symptoms. These results are thought to be due to meditation increasing functional connections of different brain regions. We reviewed to show the functional connectivity of the prefrontal cortex in various meditation practices. We were viewed various neuroimaging interventions of functional connectivity associated with the prefrontal cortex and different brain areas during meditation techniques on healthy meditators compared with non-meditators. fMRI findings show that meditation practices are associated with increased neural function and processing, default mode network, gray matter volume, and functional coupling in the brain area related to different parts of PFC. PFC's functional connectivity is associated with increased attention, working memory, cognitive control, executive control, emotion regulation, counteracting adverse effects, self-perception, and self-compassion. Furthermore, PFC's functional connectivity decreases anxiety, depression, perceived stress, negative emotion, and hyperarousal symptoms. In this review, we outlined the published effect of meditation on the function and structure of the different parts of the prefrontal cortex. We suggest a positive theoretical correlation between meditation and the functional connectivity of the prefrontal cortex. Altered prefrontal connectivity is seen in some neurological and psychosocial disorders. Therefore meditation can also play an influential role in treating these disorders.
... Bij de zo gewenste verlaging van ons arousal-niveau speelt de ademhaling een cruciale rol. Diepe en langzame ademhaling heeft niet alleen positieve cardiovasculaire gevolgen, maar vermindert ook het arousal-niveau van amygdala en hippocampus bij een toename van prefrontalecortexactivatie (Cysarz et al. 2005;Doll 2016; Melony 2018; Amarasekera 2019). Dit maakt de op diepe ademhaling gebaseerde vormen van meditatie zo belangrijk. ...
... Deze erkennende vorm van communicatie schept vertrouwen, genereert veiligheid en creëert rust. Rust en veiligheid op hun beurt intensiveren de bloedtoevoer naar de prefrontale cortex (Doll 2016). Zo ontstaat er een positieve spiraal die zichzelf versterkt. ...
Evolutionair bepaalde neurofysiologische programma’s, actief vanuit hersengebieden als de amygdala en hippocampus, leiden tot inadequate reacties bij conflictmanagement. In dit artikel wordt een strategie voor effectief conflictmanagement aangereikt. Hoge niveaus van emotionele ‘arousal’ dienen allereerst te worden afgebouwd, ten gunste van een helder en kalm bewustzijn. In tegenstelling tot een mindset zoals die gefundeerd is in Abrahamitische religies en Westerse filosofieën, wordt een klassiek daoïstisch, non-binair, dynamisch en geünificeerd wereldbeeld voorgesteld. Hieruit wordt de strategie van wuwei, de kunst van het niet-handelen, afgeleid. Het leggen van een verbinding, als essentiële schakel bij conflictmanagement, is exemplarisch voor erkenning, appreciatie en respect. Focus bij conflictoplossing is niet het probleem, maar de achterliggende behoefte.
... ATB is a simple exercise in mindfulness meditation where the practitioner focuses on taking slow deep breaths. Research has shown that ATB can help practitioners stabilize and regulate their emotions [24,30,111]. ...
... It can be difficult to get into the right mindset during an intense emotional experience, where a person can initiate cognitive reappraisal. The breathing exercise in mindfulness meditation has the potential to help people get into a state of mind for cognitive reappraisal [13,24,29]. According to Jon Kabat-Zinn, one of the founders of secular mindfulness meditation, paying attention to the present moment non-judgmentally can be practiced through paying attention to the act of breathing [54][55][56]. ...
The cognitive complexities of emotions and individualized coping strategies make it a difficult space for design. Collecting first-person data can provide nuanced understanding of the lived experience of emotional life, to better inform the design of wearable technologies for emotional self-regulation. We present a preliminary study of our first-person phenomenological approach to autobiographical design. The methodology is unique for the intertwining of emotional activities and mindfulness exercises, as a strategy for controlling emotional repercussions. Self-observation and documentation included journaling and sketching using the Inside-Out Probe workbook, followed by material prototyping and testing in-the-wild. The Breathing Scarf prototype embodies the design considerations. In designing for one to support personalized self-regulation strategies, key considerations include designing for personal comfort, ownership, and individual-over-social meaning-making. Of equal importance in the design research process are the well-being of the designer/researcher, the ability to self-regulate emotions, and the ethics of care and emotion work.
... In mindfulness meditation, instructions direct participants to nonjudgmentally attend to breathing sensations, without instructions to alter their breathing. Nevertheless, RR slows during meditation practice in novices [21][22][23] and experts 24,25 . Moreover, short-term meditation training shows similar benefits to mental health and emotional reactivity as interventions that directly manipulate breath 26,27 . ...
Mind–body interventions such as mindfulness-based stress reduction (MBSR) may improve well-being by increasing awareness and regulation of physiological and cognitive states. However, it is unclear how practice may alter long-term, baseline physiological processes, and whether these changes reflect improved well-being. Using respiration rate (RR), which can be sensitive to effects of meditation, and 3 aspects of self-reported well-being (psychological well-being [PWB], distress, and medical symptoms), we tested pre-registered hypotheses that: (1) Lower baseline RR (in a resting, non-meditative state) would be a physiological marker associated with well-being, (2) MBSR would decrease RR, and (3) Training-related decreases in RR would be associated with improved well-being. We recruited 245 adults (age range = 18–65, M = 42.4): experienced meditators (n = 42), and meditation-naïve participants randomized to MBSR (n = 72), active control (n = 41), or waitlist control (n = 66). Data were collected at pre-randomization, post-intervention (or waiting), and long-term follow-up. Lower baseline RR was associated with lower psychological distress among long-term meditators (p* = 0.03, b = 0.02, 95% CI [0.01, 0.03]), though not in non-meditators prior to training. MBSR decreased RR compared to waitlist (p = 0.02, Cohen’s d = − 0.41, 95% CI [− 0.78, − 0.06]), but not the active control. Decreased RR related to decreased medical symptoms, across all participants (p* = 0.02, b = 0.57, 95% CI [0.15, 0.98]). Post-training, lower RR was associated with higher PWB across training groups compared to waitlist (p* = 0.01, b = 0.06, 95% CI [0.02, 0.10]), though there were no significant differences in change in PWB between groups. This physiological marker may indicate higher physical and/or psychological well-being in those who engage in wellness practices.
... Similarly, fMRI activity within brain networks such as default-mode and executive control may additionally be influenced by other nonphysiological sources, such as inter-individual variability in dispositional mindfulness (Dickenson et al., 2013;Doll et al., 2016;Mooneyham et al., 2017;Scheibner et al., 2017), and arousal and effort during meditation tasks among beginners (Britton et al., 2014). Dispositional mindfulness can also mediate attentional capacity and stability (Cásedas et al., 2022;Di Francesco et al., 2017), which may in turn influence an individual's ability to sustain focus on breathing sensations in the MRI scanner. ...
... Also of interest is the amygdala, a brain area strongly associated with fight/flight stress reactivity and mental health problems generally. A study by Doll et al. (2016) found concentration meditation to increase connectivity between the prefrontal cortex and amygdala, resulting in decreased amygdala overactivity and concomitantly improved mental health outcomes. Psychedelic-assisted psychotherapy has been shown to decrease overactivity in both default mode network activity (Palhano-Fontes et al., 2015) and amygdala connectivity (Mertens et al., 2020). ...
Objectives
The mindfulness-informed intervention that has so far received the most attention as an adjunct to psychedelic-assisted psychotherapy is Acceptance and Commitment Therapy (ACT), but little remains known about potential synergies between psychedelic-assisted psychotherapy and mindfulness-based interventions such as Mindfulness-Based Cognitive Therapy (MBCT). This paper examines and evaluates the therapeutic compatibility of MBCT with psychedelic-assisted psychotherapy, and their potential synergies.
Methods
This study represents a narrative review of the current literature on psychedelic-assisted psychotherapy and MBCT.
Results
We demonstrate how MBCT targets core processes including acceptance, being present, concentration, decentering and embracing difficulties — and outline why strengthening these capacities with systematic meditation training may prove invaluable during the preparation, dosing and integration phases of psychedelic-assisted psychotherapy.
Conclusions
MBCT’s emphasis on systematic training in mindfulness meditation and fostering nonjudgmental presence aligns well with the states of consciousness induced by psychedelics, highlighting its potential to enhance various stages of both the psychedelic experience and subsequent integration. By equipping individuals with effective mindfulness and cognitive restructuring techniques, MBCT may offer advantages beyond those provided by ACT, such as the ability to skillfully navigate and manage challenging experiences that can emerge during different phases of the psychedelic experience and integration. This suggests that MBCT’s unique approach may complement psychedelic-assisted psychotherapy in ways that ACT may not fully address, particularly in the context of handling challenging experiences.
... During mindful breathing, one needs to make deliberate attempts to redirect the mind's attention from fragmentary thoughts to the inhalation and exhalation of the breath, which always happens at the present moment. An fMRI study by Doll et al. (2016) found that healthy adults who were trained to pay attention to their breath when viewing aversive images showed less negative responses, suggesting that mindful breathing can reduce activations in the amygdala while also increases neural connectivity between the amygdala and the prefrontal cortex. In terms of academic anxiety, Cho et al. (2016) reported that practicing mindful breathing in just one week could produce positive effects on college students' automatic thoughts and test anxiety. ...
Considering the heightened needs for an internet-based approach to alleviating psychological symptoms during global health crises, we conducted a series of experiments to investigate the effects of online mindfulness-based programs on Covid-related stress, mental well-being, and general anxiety in college students. In Study 1, thirty college students participated in either a wait-list control (n = 14) or an experimental group (n = 16) practicing a weekly mindfulness-based stress reduction program delivered via video-conferencing in 4 weeks. Outcomes variables were measured with the Covid-19 Stress Scale and the WHO-5 Well-Being Index. A significant difference in the stress level of the experimental group as compared to the control group was found, but not for the well-being level. To test whether a shorter and more compact course of intervention including only the practice of
mindful breathing could still produce positive results on more general anxiety and not Covid-related, Study 2 recruited a larger sample (N = 65) and conducted the experiment in 7 consecutive days. The results showed that this online daily practice of standalone mindful breathing significantly reduced self-reported state and trait anxiety. We discuss the possibilities and limitations of short-term online mindfulness-based interventions for young adults in global emergency contexts.
... Our study also provides preliminary evidence that mindfulness meditation training may reduce hyperresponsivity to unpredictable threat as measured by the APS. As the response to unpredictable threat is thought to involve the amygdala (for review see (5)), our finding is consistent with prior work showing changes to amygdala activity and functional connectivity following mindfulness meditation training (30)(31)(32). In particular, patients with generalized anxiety disorder who completed MBSR exhibited decreased amygdala responsivity to neutral (ambiguous) faces during an affect labeling task, and also increased functional connectivity between the amygdala and areas in the prefrontal cortex (33). ...
Background:
Biological markers for anxiety disorders may further understanding of disorder pathophysiology and suggest potential targeted treatments. The fear-potentiated startle (FPS, a measure of startle to predictable threat) and anxiety-potentiated startle (APS, startle to unpredictable threat) laboratory paradigm has been used to detect physiological differences in anxiety disorders compared to non-anxious controls, and in pharmacological challenge studies in healthy adults. However, little is known about how startle may change with treatment for anxiety disorders, and no data are available regarding alterations due to mindfulness meditation training.
Methods:
Ninety-three individuals with anxiety disorders and 66 healthy individuals completed two sessions of the neutral, predictable, and unpredictable (NPU) threat task, which employs a startle probe and the threat of shock to assess moment-by-moment fear and anxiety. Between the two testing sessions, patients received randomized 8-week treatment with either escitalopram or Mindfulness-Based Stress Reduction (MBSR).
Results:
APS, but not FPS, was higher in participants with anxiety compared to healthy controls at baseline. Further, there was a significantly greater decrease in APS for both treatment groups compared to controls, with the patient groups showing reductions bringing them into the range of controls at the end of the treatment.
Conclusions:
Both anxiety treatments (escitalopram and MBSR) reduced startle potentiation during unpredictable (APS) but not predictable (FPS) threat. These findings further validate APS as a biological correlate of pathological anxiety and provide physiological evidence for the impact of MBSR on anxiety disorders, suggesting that there may be comparable effects of the two treatments on anxiety neurocircuitry.
... BCLC may want to review whether a wider range of counselling opportunities can be provided to VSE clients, such as debt counselling or marital or relationship counselling, as these issues appear to be concurrent with problem gambling. Furthermore, as many of the participants struggled with emotional regulation, mindfulness programming may be a useful area to explore as a treatment option, as research has supported its use in reducing feelings of trauma, distress, depression, and addiction (Arch & Ayers, 2013;Chopko & Schwartz, 2012;Doll et al., 2016;Keng et al., 2011;Williams et al., 2010;Zgierska et al., 2009). Mindfulness may be a strategy that VSE clients can use successfully when experiencing urges to gamble or preoccupation with gambling. ...
Results of the third longitudinal study of the British Columbia Lottery Corporation's Voluntary Self-Exclusion program.
https://cjr.ufv.ca/a-review-of-bclcs-voluntary-self-exclusion-program-client-behaviours-experiences-and-perceptions/
... Therefore, lack of physiological artifact removal or correction during fMRI analysis can impact conclusions about the neurobiological underpinnings of meditation, including focused attention meditation. Similarly, fMRI activity in some brain areas within networks such as Default-mode and Executive Control may additionally be influenced by other nonphysiological sources, such as inter-individual variability in dispositional mindfulness (Dickenson et al., 2013;Doll et al., 2016;Mooneyham et al., 2017;Scheibner et al., 2017), and level of arousal and effort during meditation tasks among beginners (Britton et al., 2014). Therefore, controlling for these measures that are entrenched with brain responses to meditation can potentially enable separating the neurobiological underpinnings of meditation from other attributes that may influence meditation performance. ...
Objectives
Mapping the neurobiology of meditation using 3 Tesla functional MRI (fMRI) has burgeoned recently. However, limitations in signal quality and neuroanatomical resolution have impacted reliability and precision of extant findings. Although ultra-high strength 7 Tesla MRI overcomes these limitations, investigation of meditation using 7 Tesla fMRI is still in its infancy.
Methods
In this feasibility study, we scanned 10 individuals who were beginner meditators using 7 Tesla fMRI while they performed focused attention meditation and non-focused rest. We also measured and adjusted the fMRI signal for key physiological differences between meditation and rest. Finally, we explored the 2-week impact of the single fMRI meditation session on mindfulness, anxiety and focused attention attributes.
Results
Group-level task fMRI analyses revealed significant reductions in activity during meditation relative to rest in Default-mode network hubs, i.e., antero-medial prefrontal and posterior cingulate cortices, precuneus, as well as visual and thalamic regions. These findings survived stringent statistical corrections for fluctuations in physiological responses which demonstrated significant differences (p < 0.05/n, Bonferroni controlled) between meditation and rest. Compared to baseline, State Mindfulness Scale (SMS) scores were significantly elevated (F = 8.16, p<0.05/n, Bonferroni controlled) following the fMRI meditation session, and were closely maintained at 2-week follow up.
Conclusions
This pilot study establishes the feasibility and utility of investigating focused attention meditation using ultra-high strength (7 Tesla) fMRI, by supporting widespread evidence that focused attention meditation attenuates Default-mode activity responsible for self-referential processing. Future functional neuroimaging studies of meditation should control for physiological confounds and include behavioural assessments.
... Prior work suggests that this nonreactive mental stance is related to psychological distancing through "defusion" or "decentering" from one's emotional experience, ultimately supporting emotion regulation (28,29). For example, mindfully attending to interfering sources of anxiety and craving may help one down-regulate those affective states (44,(69)(70)(71). Taken together, these regional (de)activations and their functions suggest a putative neural process. ...
Mindful attention is characterized by acknowledging the present experience as a transient mental event. Early stages of mindfulness practice may require greater neural effort for later efficiency. Early effort may self-regulate behavior and focalize the present, but this understanding lacks a computational explanation. Here we used network control theory as a model of how external control inputs-operationalizing effort-distribute changes in neural activity evoked during mindful attention across the white matter network. We hypothesized that individuals with greater network controllability, thereby efficiently distributing control inputs, effectively self-regulate behavior. We further hypothesized that brain regions that utilize greater control input exhibit shorter intrinsic timescales of neural activity. Shorter timescales characterize quickly discontinuing past processing to focalize the present. We tested these hypotheses in a randomized controlled study that primed participants to either mindfully respond or naturally react to alcohol cues during fMRI and administered text reminders and measurements of alcohol consumption during 4 wk postscan. We found that participants with greater network controllability moderated alcohol consumption. Mindful regulation of alcohol cues, compared to one's own natural reactions, reduced craving, but craving did not differ from the baseline group. Mindful regulation of alcohol cues, compared to the natural reactions of the baseline group, involved more-effortful control of neural dynamics across cognitive control and attention subnetworks. This effort persisted in the natural reactions of the mindful group compared to the baseline group. More-effortful neural states had shorter timescales than less effortful states, offering an explanation for how mindful attention promotes being present.
... For example, respiration is shown to modulate visual perceptual sensitivity, mediated by alpha power (Kluger et al., 2021). Respiration is also the key component in mindfulness meditation, which has been repeatedly shown to have modulatory effects on brain function (Doll et al., 2016). Furthermore, the coupling between neural activity and respiration may facilitate our understanding of brain disease. ...
Respiration can induce motion and CO 2 fluctuation during resting-state fMRI (rsfMRI) scans, which will lead to non-neural artifacts in the rsfMRI signal. In the meantime, as a crucial physiologic process, respiration that can directly drive neural activity change in the brain, and may thereby modulate the rsfMRI signal. Nonetheless, this potential neural component in the respiration-fMRI relationship is largely unexplored. To elucidate this issue, here we simultaneously recorded the electrophysiology, rsfMRI and respiration signals in rats. Our data show that respiration is indeed associated with neural activity changes, evidenced by a phase-locking relationship between slow respiration variations and the gamma-band power of the electrophysiologic signal recorded in the anterior cingulate cortex. Intriguingly, slow respiration variations are also linked to a characteristic rsfMRI network, which is mediated by gamma-band neural activity. In addition, this respiration-related brain network disappears when brain-wide neural activity is silenced at an iso-electrical state, while the respiration is maintained, further confirming the necessary role of neural activity in this network. Taken together, this study identifies a respiration-related brain network underpinned by neural activity, which represents a novel component in the respiration-rsfMRI relationship that is distinct from respiration-related rsfMRI artifacts. It opens a new avenue for investigating the interactions between respiration, neural activity and resting-state brain networks in both healthy and diseased conditions.
... Tai Chi highly values coordination of the body, mind, and breath. The "Qichen Dantian," which means deep breathing to the belly, is an essential requirement of Tai Chi and is related to the subconscious control of the PFC [39]. ...
Tai Chi is an effective strategy for slowing cognitive decline, although the underlying mechanism remains unclear. We designed a cross-sectional study to examine brain functional connectivity in middle-aged Hong Chuan Tai Chi practitioners. Eighteen middle-aged Hong Chuan Tai Chi practitioners and 22 age-matched Tai Chi-naïve controls completed functional near-infrared spectroscopy (fNIRS) tests to evaluate oxyhemoglobin changes in the prefrontal cortex (PFC), motor cortex (MC), and occipital cortex (OC) in five frequency intervals (I, 0.6-2 Hz; II, 0.145-0.6 Hz; III, 0.052-0.145 Hz; IV, 0.021-0.052 Hz; V, 0.0095-0.021 Hz). Wavelet phase coherence was used to analyze the match between the instantaneous phases of the two signals to accurately measure brain functional connectivity. Global cognition was measured using the Montreal Cognitive Assessment scale. Compared with the control group, Hong Chuan Tai Chi practitioners had better global cognition (p < 0.01) and showed higher functional connectivity of the PFC, MC, and OC in intervals I, III, VI, and V in the resting state within the same brain hemispheres or between the left and right hemispheres. Our findings revealed that middle-aged Hong Chuan Tai Chi practitioners had higher functional connectivity of the PFC, MC, and OC across both brain hemispheres in cardiac activity, myogenic activity, sympathetic nervous system, and endothelial cell metabolic activities which may contribute to higher global cognition.
... With breathing techniques, a person consciously and voluntarily changes one or more respiration parameters (e.g., breath pace, breathing depth, or inspiration/expiration ratio). This is different from other relaxation techniques, such as mindfulness or meditation, where a person merely directs his attention to the act of breathing without actually changing it (i.e., breath awareness) (31). Different breathing techniques already exist today. ...
Sleep problems, like insomnia, are a prevalent condition associated with major health risks. Prevention and treatment of sleep problems are thus essential to preserve physical and mental health. Previous work supports the effectiveness of breathing guidance for sleep problems and recommends breathing exercises as an effective intervention for insomnia. While new technologies can support breathing guidance, such novel devices should be assessed for effectiveness and usability to facilitate implementation and continued use. The current pilot study investigates the acceptability and usability of a mobile tactile breathing device and explores its potential impact on subjective sleep quality. In this mixed-method pilot study, 39 participants tested the breathing device for one month in naturalistic circumstances. We collected their experiences, subjective sleep quality, and feedback regarding the usability of the device and the accompanying app through a survey in a pre-post design. The results show that the breathing device is an acceptable solution for sleep problems and participants particularly appreciate the standalone function and design. Nevertheless, important points of attention, such as the size of the device, were also identified. Explorative analyses suggest that subjective sleep quality improved after using the device and accompanying app. The current study supports the usability and acceptability of a tactile breath pacer and provides preliminary evidence supporting a positive impact of the technology on the sleep quality of participants. Recommendations for developers of breathing technologies and eHealth are devised based on the findings.
... Particularly, two experiments in the emotion regulation category involved interoceptive processing (e.g. attention to breath), implying a close relationship between interoception and emotion regulation ( Doll et al., 2016 ;Murakami et al., 2015 ). We did not find any experiments in the decision-making domain involved interoceptionrelated processing in our dataset. ...
Prominent theories propose that interoception modulates our behavioral and emotional responses involving decision-making and emotion regulation. Are the regions implicated in interoception also spatially related to and possibly nested within the networks of decision making and emotion regulation? Addressing this question, we performed three meta-analyses of functional magnetic resonance imaging studies to identify the regions that are commonly activated by the three domains using activation likelihood estimation (ALE). Additionally, we assessed the coactivation pattern of identified common regions using meta-analytic connectivity modeling (MACM). The results showed major overlaps of interoception with both decision making and emotion regulation in specifically the right dorsal anterior insula. The pairwise contrast analyses confirmed this finding and revealed conjunction-based activities in decision making and emotion regulation in the dorsal anterior cingulate cortex (dACC). MACM based on the identified insula revealed a widespread convergent coactivation pattern with the left anterior insula, dACC, and bilateral thalamus which, together, constitute the salience network. Among these co-activated regions, bilateral insula and the dACC were shared among all three domains. These results suggest that the regions mediating interoception including intero-exteroceptive integration and salience attribution are contained and thus spatially nested within the more extensive networks recruited during decision making and emotion regulation.
... There is a strong historic background on the value of conscious breathing, a vast amount of research and an international body of knowledge that shows the health benefits of breathing-related protocols in terms of exercise and therapy. In 2016, Anselm Doll and his colleagues showed that this attention focus eases stress and negative emotions, in particular by activating the dorsomedial prefrontal cortex, a regulatory area of the brain, and by reducing activity in the amygdala (Doll et al., 2016). Doria et al. (2015) offered 10 training sessions of two hours each, spread across two weeks, to 69 patients with anxiety or depressive disorders. ...
The impact of the global tourist lockdown due to the pandemic dimensions of covid-19 in 2020 and the beginning of 2021 has shaken the industry to its core. The industry of mass tourism has certainly suffered a great knockout, a kind of acute respiratory constriction, a functional collapse that on an organic level would appear as coughing, wheezing, shortness of breath, tiredness, a life-threatening difficulty in breathing. In this paper, we used the concept of hyperventilation as understood by medicine to seek an organic understanding of the crisis that has hit tourist services. The study used a qualitative research technique, namely the single case study of a healthy man at the age of 51, who was going through a health-enhancing breathing protocol. The conclusions were derived based on inductive reasoning. The pattern and results of expected organic changes due to the breathing protocol were transferred by analogy to the institutionalized level of tourism. Since we focused on changes and patterns to be reflected organically, the detailed symptoms or initial disbalance of the individual in the case study were irrelevant for our conclusions. Physiologically, hyperventilation in humans results in tissue hypoxia, meaning that less oxygen is delivered to cells. Similar logic can be transferred to hyperinflated mass tourism booming in recent years, negatively impacting the indigenous social and natural environment. The results of the expert-based and scientifically justified 5-week breathing interventions are presented via a case study. The improvement of major factors and qualitative interpretation from the subject itself has provided us with sufficient outcomes that can be used (1) in designing preventive and postcovidh ealth regenerative retreats as tourist products and (2) as amodel to support the tourism industry with an understanding of sustainable niche-market solutions.
... In adults, MT increases the recruitment of medial prefrontal cortex (PFC) to down-regulate amygdala activation in responding to emotional stimuli (Doll et al., 2016;Kral et al., 2018). However, extensive mindfulness practices can lead to reduced activation of medial PFC while increasing activation in dorsolateral PFC, insular and somatosensory cortices (Chiesa et al., 2013). ...
The neurocognitive mechanisms associated with mindfulness training in children are not well understood. This randomised controlled study with active and passive control groups examined the impact of an 18‐week mindfulness curriculum delivered by schoolteachers on emotion processing in Vietnamese 7‐to‐11‐year‐olds. Event‐related potential markers indexed emotion processing while children were completing emotional Go/No‐Go tasks before and after mindfulness training, and at 6‐month follow‐up. In an oddball Go/No‐Go task with Caucasian faces no changes in P3b and LPP components were detected, but in a Go/No‐Go task with Caucasian and Japanese faces changes were observed in P3b latencies and LPP mean amplitudes. Specifically, the P3b in response to angry non‐targets for Japanese faces peaked later in the mindfulness training group (TG) at 6‐months follow‐up in comparison to the non‐intervention control group (NCG). The LPP mean amplitudes for averaged Caucasian and Japanese angry non‐targets were also attenuated in the TG at 6‐month follow‐up. In contrast, no changes in the LPP mean amplitudes were observed for the NCG over time. Together, these findings may indicate that mindfulness training in pre‐adolescents enhances emotional non‐reactivity to negative distractors. A fluctuating pattern of LPP mean amplitude modulations for angry targets was observed in the active control group (ACG) receiving social‐emotional learning (SEL) training. Overall, findings from this study suggest that mindfulness training in pre‐adolescents enhances emotional non‐reactivity to negative distractors and some of the effects are culturally sensitive. This article is protected by copyright. All rights reserved
... The development of different types of physical and mental exercises, such as relaxation, guided breathing (Doll et al., 2016), mental imagery (Cebolla et al., 2017), and meditation , has acquired a paramount position in the Western world because of the increasing popular research of a singular serenity sustained by wellness practice (Cahn and Polich, 2006;Ryznar and Levine, 2021). ...
The search for the best wellness practice has promoted the development of devices integrating different technologies and guided meditation. However, the final effects on the electrical activity of the brain remain relatively sparse. Here, we have analyzed of the alpha and theta electroencephalographic oscillations during the realization of the arrest reaction (AR; eyes close/eyes open transition) when a chromotherapy session performed in a dedicated room [ Rebalance ( RB ) device], with an ergonomic bed integrating pulsed-wave light (PWL) stimulation, guided breathing, and body scan exercises. We demonstrated that the PWL induced an evoked-related potential characterized by the N2-P3 components maximally recorded on the fronto-central areas and accompanied by an event-related synchronization (ERS) of the delta–theta–alpha oscillations. The power of the alpha and theta oscillations was analyzed during repeated ARs testing realized along with the whole RB session. We showed that the power of the alpha and theta oscillations was significantly increased during the session in comparison to their values recorded before. Of the 14 participants, 11 and 6 showed a significant power increase of the alpha and theta oscillations, respectively. These increased powers were not observed in two different control groups ( n = 28) who stayed passively outside or inside the RB room but without any type of stimulation. These preliminary results suggest that PWL chromotherapy and guided relaxation induce measurable electrical brain changes that could be beneficial under neuropsychiatric perspectives.
... Reviews on meditation-related therapies have implied that such therapies could ameliorate chronic pain intensity and pain-related disability and improve QOL [49][50][51]. Research has also provided increasing evidence for the efficacy of meditation from an anatomic perspective; specifically, studies have demonstrated a change in the hippocampal subiculum structure [52] and an increase in amygdala-dorsal prefrontal cortex integration [53,54] after meditative practices. These findings support the functional role of meditation-based therapies in extinction learning and emotion regulation [55] and provide a theoretical basis for the mechanisms through which meditation reduces pain intensity and pain-related disability and improves QOL (Figures 3-5). ...
Background
Chronic low back pain (CLBP) is among the most common types of pain in adults. Currently, injections and analgesic and nonsteroidal anti-inflammatory drugs are often provided for patients with CLBP. However, their effectiveness remains questionable, and the safest approach to CLBP remains debated. Meditation-based therapies constitute an alternative treatment with high potential for widespread availability. We evaluated the applicability of meditation-based therapies for CLBP management.
Materials and Methods
We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of meditation-based therapies for CLBP management. The primary outcomes were pain intensity, quality of life, and pain-related disability; the secondary outcomes were the experienced distress or anxiety and pain bothersomeness in the patients. The PubMed, Embase, and Cochrane databases were searched for studies published from their inception until July 2021, without language restrictions.
Results
We reviewed 12 randomized controlled trials with 1153 patients. In 10 trials, meditation-based therapies significantly reduced the CLBP pain intensity compared with nonmeditation therapies (standardized mean difference [SMD] −0.27, 95% CI = −0.43 to − 0.12, P = 0.0006). In 7 trials, meditation-based therapies also significantly reduced CLBP bothersomeness compared with nonmeditation therapies (SMD −0.21, 95% CI = −0.34 to − 0.08, P = 0.002). In 3 trials, meditation-based therapies significantly improved patient quality of life compared with nonmeditation therapies (SMD 0.27, 95% CI = 0.17 to 0.37, P < 0.00001)
Conclusions
In conclusion, meditation-based therapies constitute a safe and effective alternative approach for CLBP management.
... A previous study showed that meditation altered brain structure and neuronal plasticity (53). Cortical thickness and the activity of several specific brain regions increased during meditation, such as the hippocampus, whereas a decrease in activity was found in the amygdala (54)(55)(56)(57). Stronger functional connectivity was found between the posterior cingulate, dorsal anterior cingulate, and prefrontal cortices was observed in experienced meditators (58,59). ...
Late-life depression (LLD) is an important public health problem among the aging population. Recent studies found that mindfulness-based cognitive therapy (MBCT) can effectively alleviate depressive symptoms in major depressive disorder. The present study explored the clinical effect and potential neuroimaging mechanism of MBCT in the treatment of LLD. We enrolled 60 participants with LLD in an 8-week, randomized, controlled trial (ChiCTR1800017725). Patients were randomized to the treatment-as-usual (TAU) group or a MBCT+TAU group. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluate symptoms. Magnetic resonance imaging (MRI) was used to measure changes in resting-state functional connectivity and structural connectivity. We also measured the relationship between changes in brain connectivity and improvements in clinical symptoms. HAMD total scores in the MBCT+TAU group were significantly lower than in the TAU group after 8 weeks of treatment ( p < 0.001) and at the end of the 3-month follow-up ( p < 0.001). The increase in functional connections between the amygdala and middle frontal gyrus (MFG) correlated with decreases in HAMA and HAMD scores in the MBCT+TAU group. Diffusion tensor imaging analyses showed that fractional anisotropy of the MFG-amygdala significantly increased in the MBCT+TAU group after 8-week treatment compared with the TAU group. Our study suggested that MBCT improves depression and anxiety symptoms that are associated with LLD. MBCT strengthened functional and structural connections between the amygdala and MFG, and this increase in communication correlated with improvements in clinical symptoms.
Randomized Controlled Trial; Follow-Up Study; fMRI; Brain Connectivity
... A third study corroborates the finding of DMN deactivation during mindful states, even in novice meditators with only brief exposure to MT (Doll et al., 2016). Researchers recruited novice meditators for a 2-week attention-to-breath mindfulness training. ...
Mindfulness training (MT) represents a family of contemplative practices aimed at promoting well-being. Despite growing evidence for the clinical efficacy of MT interventions across a range of mental health disorders, mechanistic theories of MT remain difficult to validate through self-report techniques alone. Neuroimaging investigations of MT complement self-report approaches by characterizing changes in information processing associated with MT. Such approaches may be used to analyze mindfulness at three levels: as a transient state, as the product of longitudinal MT, and as trait-like differences in the tendency to be mindful. This chapter synthesizes neuroimaging research at all three of these levels to propose a neural network model of mindfulness, relating MT to the interactions between three commonly characterized brain networks. Current contemplative neuroscience studies converge around findings that MT often involves a reconfiguration of mental habits supported by the default mode network (DMN), most commonly increasing DMN connectivity to both sensory representation areas and the brain’s central executive network (CEN). This DMN’s “dorsal shift” to the CEN from more ventral, affectively laden connections to the brain’s salience network (SLN) may reflect an increased ability to reflect upon events without lapsing into habitual ways of judging or responding. Together, this pattern of increased sensory access to the prefrontal cortex, coupled with a dorsal shift in prefrontal connectivity to regions associated with cognitive control, is suggestive of an emerging neurophenotype of capacity to access and sustain mindful states.KeywordsMindfulnessDefault mode network (DMN)Central executive network (CEN)Salience network (SLN)Mindfulness-based stress reduction (MBSR)Mindfulness-based cognitive therapy (MBCT)Dispositional or trait mindfulnessMindful Attention Awareness ScaleFive Facet Mindfulness Scale (FFMQ)DecenteringPainRewardEnhanced sensory processingEmotion regulation/emotion processingResting-state imagingAttention regulationSelf-regulation
... In contrast, when reading on smartphones, intense cognitive load may have inhibited sigh generation, causing overactivity in the prefrontal cortex. Attention and breathing functions share a common center in the locus coeruleus within the brain 25,26 . Sighing is also associated with increased workload, and breathing variability is restored to a healthy regularity by sighing 27,28 . ...
Electronic devices have become an indispensable part of our daily lives, while their negative aspects have been reported. One disadvantage is that reading comprehension is reduced when reading from an electronic device; the cause of this deficit in performance is unclear. In this study, we investigated the cause for comprehension decline when reading on a smartphone by simultaneously measuring respiration and brain activity during reading in 34 healthy individuals. We found that, compared to reading on a paper medium, reading on a smartphone elicits fewer sighs, promotes brain overactivity in the prefrontal cortex, and results in reduced comprehension. Furthermore, reading on a smartphone affected sigh frequency but not normal breathing, suggesting that normal breathing and sigh generation are mediated by pathways differentially influenced by the visual environment. A path analysis suggests that the interactive relationship between sigh inhibition and overactivity in the prefrontal cortex causes comprehension decline. These findings provide new insight into the respiration-mediated mechanisms of cognitive function.
... This task reduces EEG artifacts occurring naturally with eye movements. Most importantly, this task can later be implemented into practical translational and therapeutical applications aimed at increasing well-being levels through the modulation of alpha asymmetry and the underlying brain processes (Angelakis et al., 2007;Sessa, 2007;Moynihan et al., 2013;Doll et al., 2016;Schmalzl et al., 2018;Prpa et al., 2020). Electroencephalography data were with a sampling rate of 256 Hz and 12-bits of data resolution. ...
Electroencephalography (EEG) alpha asymmetry is thought to reflect crucial brain processes underlying executive control, motivation, and affect. It has been widely used in psychopathology and, more recently, in novel neuromodulation studies. However, inconsistencies remain in the field due to the lack of consensus in methodological approaches employed and the recurrent use of small samples. Wearable technologies ease the collection of large and diversified EEG datasets that better reflect the general population, allow longitudinal monitoring of individuals, and facilitate real-world experience sampling. We tested the feasibility of using a low-cost wearable headset to collect a relatively large EEG database (N = 230, 22–80 years old, 64.3% female), and an open-source automatic method to preprocess it. We then examined associations between well-being levels and the alpha center of gravity (CoG) as well as trait EEG asymmetries, in the frontal and temporoparietal (TP) areas. Robust linear regression models did not reveal an association between well-being and alpha (8–13 Hz) asymmetry in the frontal regions, nor with the CoG. However, well-being was associated with alpha asymmetry in the TP areas (i.e., corresponding to relatively less left than right TP cortical activity as well-being levels increased). This effect was driven by oscillatory activity in lower alpha frequencies (8–10.5 Hz), reinforcing the importance of dissociating sub-components of the alpha band when investigating alpha asymmetries. Age was correlated with both well-being and alpha asymmetry scores, but gender was not. Finally, EEG asymmetries in the other frequency bands were not associated with well-being, supporting the specific role of alpha asymmetries with the brain mechanisms underlying well-being levels. Interpretations, limitations, and recommendations for future studies are discussed. This paper presents novel methodological, experimental, and theoretical findings that help advance human neurophysiological monitoring techniques using wearable neurotechnologies and increase the feasibility of their implementation into real-world applications.
... This is akin to the adage, "before treating the patient, take your own pulse." 20,65 These techniques have a robust functional neuroscientific base 20 and are easy to adopt over time when practiced deliberately. Although much of obstetric and anesthesiology training may not regularly incorporate these techniques, a growing interest in them signals potential wider adoption. ...
Obstetric anesthesiologists provide care under unique conditions, where frequently unscheduled cases demand flexibility in thinking and acting. And although most obstetric patients may be healthy, they can quickly deteriorate, necessitating rapid team diagnostic and treatment interventions. Examining decision making is a critical step in improving care to these patients. This article reviews evidence-based models of decision making both with individuals and with teams, and presents strategies to improve decision making under any circumstance.
... Rosenszweig (2007) expressed changes in glycemic control, weight loss, blood pressure, and psychological-stress symptoms in Type 1 DM patients by providing MBSR intervention carried out for 4 weeks. While Anselm, et al (2016) states that focusing breathing when mindfulness is effective in emotional regulatory settings, decreased activation of Anigdala da enhances prefrontal integration Mindfulness is a condition in which a person accepts the conditions that occur today. Mindfulness based on Benson relaxation exercises part of Mindfulness Based Stress Reduction (MBSR) which is the basic technique for a person achieving a conscious state of existence. ...
Patients with diabetes mellitus have a high-stress level, this is because the treatment isundertaken such as diet, blood sugar control, drug consumption, and exercise. In addition, the risk of diseasecomplications that can be experienced by patients will also increase stress. Spiritual mindfulness based on bensonrelaxation affects the formation of positive cognitive (perception) responses in the brain. A good stress perceptionwill stimulate the hypothalamus to release a series of hormones that cause modulation of the physiological barrierof the immune response by decreasing the activation of the HPA axis and increasing activation of theparasympathetic nerve through the vagal stimulation. The purpose of this study was to prove the influence of spiritualmindfulness based on Benson relaxation in reducing stress levels of type 2 diabetes mellitus. This study was aquasi-experimental study using the pretest-posttest with control group design method. Respondents in this studywere 60 type 2 DM sufferers and were taken by simple random sampling technique and divided into two groupsnamely the intervention group and the control group. Stress level data is obtained using a questionnairemeasurement tool. The intervention group was given spiritual mindfulness based on Benson relaxation for fourweeks. The results of data analysis using t-Test with a significance of p <0.05. The stress level test results showeda significant difference between the intervention group and the control group with p-value = 0,000. Mindfulnessspiritual intervention based on Benson relaxation is effective against stress levels of people with type 2 diabetes.
Introduction
Patients with chronic dizziness often have an unremarkable laboratory vestibular examination and have medical clearance from other specialties. However, functional impairments are still significant and affect patients' quality of life. Recent diagnostic criteria and identification of persistent postural perceptual dizziness (PPPD) have helped us to better understand the psychological-somatic manifestations of organic disorders. As the literature suggests good efficacy using a combination of cognitive behavior therapy (CBT) and vestibular rehabilitation, we compared the efficacy of a hybrid protocol using dizziness handicap inventory (DHI) as an outcome measure amongst the different sub-types of chronic dizziness.
Methods
This was an observational study with 35 participants allocated to three different groups: those who strictly fulfilled the PPPD criteria, those with spontaneous episodic vestibular syndrome, and participants with non-specific dizziness. We compared the DHI total and sub-domain scores at baseline and 6 months post-intervention for differences. All participants undertook three sessions in 6 months.
Results
The total DHI scores were reduced in all three groups. However, the DHI total on average was 11 points higher in the episodic vestibular syndrome group. The emotional sub-domain scores were also reduced in all three groups, but the functional and physical scores were significantly higher in the episodic vestibular group.
Conclusion
A hybrid protocol worked best for typical PPPD patients who strictly fulfilled the criteria followed by participants in the non-specific dizziness group. When symptoms were episodic in spontaneous vestibular syndrome, only emotional handicap was reduced at 6 months, but functional and physical handicap scores remained high. Regardless, the DHI total scores in all groups were significantly reduced, possibly due to CBT reducing the anxiety that results from a lack of understanding of the clinical diagnoses.
Conventional Buddhist texts illustrate meditation as a condition of relaxed alertness that must fend against extreme hypoarousal (sleep, drowsiness) and extreme hyperarousal (restlessness). Theoretical, neurophysiological, and neuroimaging investigations of meditation have highlighted the relaxing effects and hypoarousing without emphasizing the alertness-promoting effects. Here we performed a systematic review supported by an activation-likelihood estimate (ALE) meta-analysis in an effort to counterbalance the surfeit of scholarship emphasizing the hypoarousing and relaxing effects of different forms of Buddhist meditation. Specifically, the current systematic review-cum-meta-analytical review seeks to highlight more support for meditation’s wake-promoting effects by drawing from neuroimaging research during wakefulness and meditation. In this systematic review and meta-analysis of 22 fMRI studies, we aim to highlight support for Buddhist meditation’s wake-promoting or arousing effects by identifying brain regions associated with alertness during meditation. The most significant peaks were localized medial frontal gyrus (MFG) and precuneus. We failed to determine areas ostensibly common to alertness-related meditation such as the medial prefrontal cortex (mPFC), superior parietal lobule, basal ganglia, thalamus, most likely due to the relatively fewer fMRI investigations that used wakefulness-promoting meditation techniques. Also, we argue that forthcoming research on meditation, related to alertness or wakefulness, continues to adopt a multi-modal method to investigate the correlation between actual behaviors and neural networks connected to Buddhist meditation. Moreover, we recommend the implementation of fMRI paradigms on Buddhist meditation with clinically diagnosed participants to complement recent trends in psychotherapy such as mindfulness-based cognitive therapy (MBCT).
Background:
Childhood maltreatment is one of the most important preventable risk factors for a wide variety of psychiatric disorders. Further, when psychiatric disorders emerge in maltreated individuals they typically do so at younger ages, with greater severity, more psychiatric comorbid conditions, and poorer response to established treatments, resulting in a more pernicious course with an increased risk for suicide. Practitioners treating children, adolescents, and young adults with psychiatric disorders will likely encounter the highest prevalence of clients with early-onset maltreatment-associated psychiatric disorders. These may be some of their most challenging cases.
Method:
In this report, we explore key validated alterations in brain structure, function, and connectivity associated with exposure to childhood maltreatment as potential mechanisms behind their patients' clinical presentations.
Results:
We then summarize key behavioral presentations likely associated with neurobiological alterations and propose a toolkit of established trauma and skills-based strategies that may help diminish symptoms and foster recovery. We also discuss how some of these alterations may serve as latent vulnerability factors for the possible development of future psychopathology.
Conclusions:
Research on the neurobiological consequences of childhood adversity provides a vastly enriched biopsychosocial understanding of the developmental origins of health and pathology that will hopefully lead to fundamental advances in clinical psychology and psychiatry.
It is well-established that the brainstem is responsible for the automatic control of breathing, however, cortical areas control perception and conscious breathing. This study investigated activity in the prefrontal cortex (PFC) during breathing difficulty using functional near-infrared spectroscopy (fNIRS). It was hypothesized that extrinsic inspiratory loads will elicit regional changes in PFC activity and increased perception ratings, as a function of load magnitude and type. Participants were exposed to varying magnitudes of resistive (R) and pressure threshold (PT) inspiratory loads to increase breathing effort. Perception ratings of breathing effort and load magnitude were positively correlated (p < 0.05). PT loads were rated more effortful than R loads (p < 0.05). Differences in perceived effort were a function of inspiratory pressure-time-product (PTP) and inspiratory work of breathing (WoB). PFC activity increased with the largest PT load (p < 0.01), suggesting that the PFC is involved in processing respiratory stimuli. The results support the hypothesis that the PFC is an element of the neural network mediating effortful breathing perception.
Introduction:
In trauma-focused Cognitive Behavioral Therapy (TF-CBT), stabilization techniques are used before confrontation ones to increase stress/affect tolerance and thus effectiveness of CBT. This study investigated the effects of pranayama, meditative yoga breathing and breath holding techniques, as a complimentary stabilization technique in patients with post-traumatic stress disorder (PTSD).
Methods:
Seventy-four PTSD-patients (84% female, 44.2 ± 13 years) were randomized to receive either pranayama at the beginning of each TF-CBT session or TF-CBT alone. The primary outcome was self-reported PTSD severity after 10 sessions of TF-CBT. Secondary outcomes included quality of life, social participation, anxiety, depression, distress tolerance, emotion regulation, body awareness, breath-holding duration, acute emotional reaction to stress, and adverse events (AEs). Intention-to-treat (ITT) and exploratory per-protocol (PP) analyses of covariance with 95% confidence intervals (CI) were performed.
Results:
ITT analyses revealed no significant differences on primary or secondary outcomes, except for breath-holding duration in favor of pranayama-assisted TF-CBT (20.81 s, 95%CI = 13.05|28.60). PP analyses of 31 patients without AEs during pranayama revealed significantly lower PTSD severity (-5.41, 95%CI = -10.17|-0.64) and higher mental quality of life (4.89, 95%CI = 1.38|8.41) than controls. In contrast, patients with AEs during pranayama breath holding reported significantly higher PTSD severity (12.39, 95%CI = 5.08|19.71) than controls. Concurrent somatoform disorders were found to be a significant moderator of change in PTSD severity (p = 0.029).
Conclusion:
In PTSD patients without concurrent somatoform disorders, the integration of pranayama into TF-CBT might reduce post-traumatic symptoms and increase mental quality of life more efficiently than TF-CBT alone. The results remain preliminary until they can be replicated by ITT analyses.
Clinical trial registration:
ClinicalTrials.gov, identifier NCT03748121.
Auch wenn es für uns alle einfach erscheint, lernbereit zu sein, erfordert es doch den Mut, sich vielen und teilweise unbequemen Lernerfahrungen auszusetzen. Wichtig ist zu verstehen, dass das meiste lernbar ist, dass Fehler eine große Hilfe sein können und dass es grundsätzlich auf den eigenen Mindset ankommt. Gewisse Übungen helfen dabei, das eigene Gehirn fürs Lernen zu öffnen und den Fokus darauf zu legen, eine Kultur des Lernens im eigenen Team oder im Unternehmen zu schaffen.
Recent research has begun to identify the neural mechanisms underlying the beneficial impact of mindfulness meditation training (MMT) on health and cognition. However, little is known about the effects of MMT on the global interplay of large-scale networks (LSNs) in the brain. In the present study, healthy, meditation-naïve adults (N = 46) underwent resting state fMRI prior to and upon completing 31 days of MMT or an active control intervention. Independent component analysis, sliding time window, and seed-based correlation analyses were performed to assess training-related changes in functional connectivity (FC) within and between networks with relevance to mindfulness meditation. Across sliding time window analyses and seed-based correlation analyses, we found increased FC between nodes of the default mode network (DMN) and nodes of the salience network (SN) in participants of the MMT. Seed-based correlation analyses revealed further connectivity increases between the SN and key regions of the central executive network (CEN). These results indicate, that, among multiple LSNs, one month of mindfulness meditation effectively increases interconnectivity between networks of the triple network model (DMN, SN, CEN), hereby introducing a potential mechanistic concept underlying the beneficial impact of MMT.
Clinical trial registration: This study is listed as a clinical trial on the ISRCTN registry with trial ID ISRCTN95197731 (date of first registration: 15/02/2022).
Background
Current first-line treatment for social anxiety disorder (SAD), one of the most prevalent anxiety disorders, is limited in its efficacy. Hence, novel treatment approaches are urgently needed. The current review suggests a combination of meditation-based interventions and the administration of a psychedelic as a future alternative treatment approach. While both separate treatments show promise in the treatment of (other) clinical conditions, their combination has not yet been investigated in the treatment of psychopathologies.
Aim
With a systematic literature review, we aim to identify the potential mechanisms by which combined psilocybin and mindfulness treatment could adjust anomalous neural activity underlying SAD and exert therapeutic effects.
Results
Thirty experimental studies investigating the neural effects of meditation or psilocybin treatment in healthy and patient samples were included. Findings suggest that psilocybin-assisted meditation interventions might change cognitive processes like biased attention to threat linked to SAD by modulating connectivity of the salience network, balancing the activity and connectivity of cortical-midline structures, and increasing frontoparietal control over amygdala reactivity.
Conclusions
Future studies should investigate whether psilocybin-assisted mindfulness-based intervention can provide therapeutic benefits to SAD patients who are do not remit following conventional therapy.
Bodily signals influence high-order cognitive and emotional processes, including social decision making. Here, we examined whether individual differences in the capacity to read signals from inside (interoception) and outside the body (exteroception) predicted participants' (dis)honesty. Deceptive behavior was measured in a card game where participants were tempted to lie to another person for financial gain in two conditions, i.e., under high vs. low risk of being seen by the other player (reputation risk). Participants completed the Heartbeat Counting Task (cardiac interoception) and a variation of the Body-Scaled Action Task (visual exteroception). Overall, when participants believed their reputation was at risk (i.e., the other player knew they lied) they told significantly less egoistic lies compared to when their choices were secret. This effect was significantly moderated by cardiac interoception. While low interoceptive participants told less egoistic lies when their reputation was at risk, high cardiac interoceptive participants did not change their behavior depending on the reputation risk conditions. We also found that cardiac interoception and visual exteroception did not correlate. Together our findings suggest that although integrated, interoception and exteroception constitute distinct facets of corporal awareness, and that high cardiac interoception shapes moral behavior by making people less concerned about their social reputation during spontaneous lies.
Résumé
Introduction
Les thérapies actives du mouvement corps-esprit sont pratiquées dans le but d’engager la personne à prendre soin de sa santé. Elles sont représentées par le qi gong, le tai-chi et le yoga. Elles comprennent toutes des postures, des exercices de respiration et de méditation. Utilisées conjointement avec la médecine traditionnelle, elles permettent une vision plus globale du patient, afin d’améliorer la qualité de vie.
État des connaissances
Ces thérapies ont été étudiées dans la bronchopneumopathie chronique obstructive, en comparaison de soins courants ou d’une activité physique de type marche, mais très peu dans le cadre de la réadaptation respiratoire. Les effets sont cliniquement significatifs sur la qualité de vie et la capacité fonctionnelle, et certaines des comorbidités peuvent également être impactées.
Perspectives
L’application de ces thérapies doit être étendue aux patients GOLD grade 1 et 4 tout en étudiant les effets sur la survenue des exacerbations bronchiques. Il reste à confirmer l’intérêt de les pratiquer en substitution d’une réadaptation respiratoire et à les évaluer en association de cette dernière.
Conclusion
Ces thérapies peuvent être utilisées pour faciliter le changement de comportement dans une optique thérapeutique et préventive, permettant de diminuer l’impact de facteurs aggravants de la maladie respiratoire.
Very rapid and transforming changes are happening in all fields, thanks to the digital revolution in technology. This has created worldwide challenges as well as opportunities. However, in addition to technical knowledge and efficiency, psychological qualities like well-being, interpersonal skills, self-confidence, remain critically important. This empirical study attempts to measure the effect on employees’ behavior, personality and psychological well-being by using Vipassana meditation as an intervention. For this purpose, 240 meditator and non-meditator employees were administered an instrument comprising of a psychological well-being scale and a specially designed behavior measure scale to study how mindfulness intervention affects personality and behavior. The data was analyzed using SPSS Ver. 20.0. The results indicated higher values for meditator employees on nine measures of behavior, personality and well-being. These scores indicated that they enjoyed higher self-confidence, interpersonal skills, equanimity, empathy, engagement and growth leading to better work ethic, teamwork and growth. It was not possible to adopt a “Before and After” study design due to the limitation of time available for completion of the study. The behavioral and personality changes that take place due to VM practice are subjective. In the future, it will be interesting to study these subjective changes in meditators by using a long-term study spanning over a few years.KeywordsBehaviorEmployeesPersonalityPsychological well-beingVipassana meditation
Early life adversities (ELA) are prevalent and have a profound and adverse impact across the lifespan, including on age-related health outcomes, yet interventions to remediate its adverse impact are scarce. This paper presents evidence for mindfulness training to reduce the elevated mental and physical health risks linked to ELA among adults by targeting biological mechanisms of ELA leading to these adverse health outcomes. We first provide a brief overview of ELA, its adverse health impacts, and mechanisms that might be responsible. Next, we review converging evidence that demonstrates that mindfulness training influences key biological pathways involved in ELA-linked negative health consequences, including (a) brain networks involved in self-regulation, (b) immunity and inflammation, (c) telomere biology, and (d) epigenetic modifications. Further, we review preliminary evidence from mindfulness-based trials that focused on populations impacted by ELA. We discuss limitations of this review and provide recommendations for future research. If effective, a mindfulness-based approach could be an important public health strategy for remediating the adverse mental and physical health consequences of ELA.
INTRODUCCIÓN El aprendizaje en la Universidad, puede ser una experiencia novedosa, estimulante, pero a la vez puede resultar frustrante o desalentadora. Los estudiantes se enfrentan a nuevas exigencias académicas, nuevos horarios, vivir fuera del entorno familiar, además de hacer frente a distintas emociones y circunstancias personales. En los últimos años, varios estudios recogen el alto nivel de estrés y ansiedad que sufre el alumnado universitario, y más concretamente los estudiantes de ciencias de la salud. Chernomas y Shapiro (2013), identificaron niveles de estrés moderados a muy severos en el 24% de los estudiantes de enfermería y niveles de ansiedad de moderados a muy severos en 31% de los estudiantes. Estos niveles de distrés psicológico son superiores a los de la población general (Mitchell, 2018), pero, además, los estudiantes de enfermería presentan barreras a la hora de pedir ayuda, como el miedo a que se cuestiones su idoneidad para ser enfermeros. El estrés en sí mismo no es perjudicial, puede generar la motivación para alcanzar un logro. Bajos niveles de ansiedad o estrés son considerados adaptativos, sin embargo niveles moderados, severos o muy severos son problemáticos. Distintos estudios asocian el estrés a una disminución del bienestar psicológico, sentimientos negativos, que pueden interferir en el aprendizaje y el rendimiento de los estudiantes. Altos niveles de estrés reducen el campo de percepción, disminuyen la retención del material aprendido y aumentan el fracaso de los estudiantes. Estos sentimientos afloran sobre todo en época de exámenes y se traducen en irritabilidad, agotamiento, dolor de cabeza, alteraciones del sueño, disminución de la concentración y retención de información, aislamiento entre otras manifestaciones (Manocchi, 2017; McCarthy et al., 2018; Sun et al., 2016). Principales estresores Los estudiantes de enfermería han de aprender a proporcionar cuidados individualizados, empleando el razonamiento clínico en situaciones complejas, respondiendo de manera adecuada y segura. Las principales fuentes de estrés identificadas por los estudiantes de enfermería se encuentran tanto en el ámbito académico, como en la formación práctico-clínica.
Lęk przed wystąpieniami publicznymi jest odczuwany przez większość ludzi. Dla znacznej części osób lęk ten ma tak dużą intensywność, że nie tylko czyni przemawianie nieprzyjemnym dla nich doświadczeniem, ale także może utrudniać i ograniczać ich funkcjonowanie w trakcie zajęć edukacyjnych, w miejscu pracy czy w życiu społecznym. Naukowcy od ponad 50 lat testują skuteczność różnych metod redukujących ten typ lęku. Brakuje jednak w języku polskim pozycji, które przedstawiałyby podsumowanie efektów ich starań. Dlatego celem tego opracowania jest omówienie metod redukcji lęku przed wystąpieniami publicznymi o potwierdzonej empirycznie skuteczności. W pracy opisano podstawowe mechanizmy działania lęku przed wystąpieniami publicznymi i przedstawiono kategoryzację metod redukujących lęk przed wystąpieniami publicznymi z podziałem na metody ekspozycyjne, terapie poznawcze i inne formy terapii. Praca adresowana jest do naukowców, praktyków (terapeutów, trenerów) oraz do osób chcących obniżyć swój lęk przed wystąpieniami publicznymi. Starano się na tyle szczegółowo opisać metodologię najważniejszych badań testujących skuteczność metod redukujących lęk przed wystąpieniami publicznymi, by z jednej strony pomóc naukowcom w projektowaniu własnych tego typu badań, a z drugiej strony by możliwe było zastosowanie części z opisanych metod przez praktyków lub samodzielnie przez osoby zmagające się z wysokim lękiem przed wystąpieniami publicznymi. We wnioskach z opracowania wskazano kierunki przyszłych badań, omówiono ograniczenia w łączeniu poszczególnych metod oraz wskazano możliwości samodzielnego zastosowania (przy zachowaniu należytej ostrożności) metod opisanych w tej pracy w ramach działań samopomocowych.
Dealing with one's emotions is a core skill in everyday life. Effective cognitive control strategies have been shown to be neurobiologically represented in prefrontal structures regulating limbic regions. In addition to cognitive strategies, mindfulness-associated methods are increasingly applied in psychotherapy. We compared the neurobiological mechanisms of these two strategies, i.e., cognitive reappraisal and mindfulness, during both the cued expectation and perception of negative and potentially negative
emotional pictures. Fifty-three healthy participants were examined with functional magnetic resonance imaging (47 participants included in analysis). Twenty-four subjects applied mindfulness, 23 used cognitive reappraisal. On the neurofunctional level, both strategies were associated with comparable activity of the medial prefrontal cortex and the amygdala. When expecting negative versus neutral stimuli, the
mindfulness group showed stronger activations in ventro- and dorsolateral prefrontal cortex, supramarginal gyrus as well as in the left insula. During the perception of negative versus neutral stimuli, the two groups only differed in an increased activity in the caudate in the cognitive group. Altogether, both strategies recruited overlapping brain regions known to be involved in emotion regulation. This result suggests that common neural circuits are involved in the emotion regulation by mindfulness-based and cognitive reappraisal strategies. Identifying differential activations being associated with the two strategies in this study might be one step towards a better understanding of differential mechanisms of change underlying frequently used psychotherapeutic interventions.
Social anxiety disorder (SAD) is thought to involve deficits in emotion regulation, and more specifically, deficits in cognitive reappraisal. However, evidence for such deficits is mixed.
Using functional magnetic resonance imaging (fMRI) of blood oxygen-level dependent (BOLD) signal, we examined reappraisal-related behavioral and neural responses in 27 participants with generalized SAD and 27 healthy controls (HC) during three socio-emotional tasks: (1) looming harsh faces (Faces); (2) videotaped actors delivering social criticism (Criticism); and (3) written autobiographical negative self-beliefs (Beliefs).
Behaviorally, compared to HC, participants with SAD had lesser reappraisal-related reduction in negative emotion in the Beliefs task. Neurally, compared to HC, participants with SAD had lesser BOLD responses in reappraisal-related brain regions when reappraising faces, in visual and attention related regions when reappraising criticism, and in the left superior temporal gyrus when reappraising beliefs. Examination of the temporal dynamics of BOLD responses revealed late reappraisal-related increased responses in HC, compared to SAD. In addition, the dorsomedial prefrontal cortex (DMPFC), which showed reappraisal-related increased activity in both groups, had similar temporal dynamics in SAD and HC during the Faces and Criticism tasks, but greater late response increases in HC, compared to SAD, during the Beliefs task. Reappraisal-related greater late DMPFC responses were associated with greater percent reduction in negative emotion ratings in SAD patients.
These results suggest a dysfunction of cognitive reappraisal in SAD patients, with overall reduced late brain responses in prefrontal regions, particularly when reappraising faces. Decreased late activity in the DMPFC might be associated with deficient reappraisal and greater negative reactivity.
ClinicalTrials.gov identifier: NCT00380731.
Mindfulness training aims to impact emotion regulation. Generalized anxiety disorder (GAD) symptoms can be successfully addressed through mindfulness-based interventions. This preliminary study is the first to investigate neural mechanisms of symptom improvements in GAD following mindfulness training. Furthermore, we compared brain activation between GAD patients and healthy participants at baseline. 26 patients with a current DSM-IV GAD diagnosis were randomized to an 8-week Mindfulness Based Stress Reduction (MBSR, N = 15) or a stress management education (SME, N = 11) active control program. 26 healthy participants were included for baseline comparisons. BOLD response was assessed with fMRI during affect labeling of angry and neutral facial expressions. At baseline, GAD patients showed higher amygdala activation than healthy participants in response to neutral, but not angry faces, suggesting that ambiguous stimuli reveal stronger reactivity in GAD patients. In patients, amygdala activation in response to neutral faces decreased following both interventions. BOLD response in ventrolateral prefrontal regions (VLPFC) showed greater increase in MBSR than SME participants. Functional connectivity between amygdala and PFC regions increased significantly pre- to post-intervention within the MBSR, but not SME group. Both, change in VLPFC activation and amygdala-prefrontal connectivity were correlated with change in Beck Anxiety Inventory (BAI) scores, suggesting clinical relevance of these changes. Amygdala-prefrontal connectivity turned from negative coupling (typically seen in down-regulation of emotions), to positive coupling; potentially suggesting a unique mechanism of mindfulness. Findings suggest that in GAD, mindfulness training leads to changes in fronto-limbic areas crucial for the regulation of emotion; these changes correspond with reported symptom improvements.
Anxiety is the cognitive state related to the inability to control emotional responses to perceived threats. Anxiety is inversely related to brain activity associated with the cognitive regulation of emotions. Mindfulness meditation has been found to regulate anxiety. However, the brain mechanisms involved in meditation-related anxiety relief are largely unknown. We employed pulsed arterial spin labeling MRI to compare the effects of distraction in the form of attending to the breath (ATB; before meditation training) to mindfulness meditation (after meditation training) on state anxiety across the same subjects. Fifteen healthy subjects, with no prior meditation experience, participated in 4 d of mindfulness meditation training. ATB did not reduce state anxiety, but state anxiety was significantly reduced in every session that subjects meditated. Meditation-related anxiety relief was associated with activation of the anterior cingulate cortex, ventromedial prefrontal cortex and anterior insula. Meditation-related activation in these regions exhibited a strong relationship to anxiety relief when compared to ATB. During meditation, those who exhibited greater default-related activity (i.e. posterior cingulate cortex) reported greater anxiety, possibly reflecting an inability to control self-referential thoughts. These findings provide evidence that mindfulness meditation attenuates anxiety through mechanisms involved in the regulation of self-referential thought processes.
Importance
Cognitive behavioral therapy (CBT) for social anxiety disorder (SAD) is thought to enhance cognitive reappraisal in patients with SAD. Such improvements should be evident in cognitive reappraisal–related prefrontal cortex responses.Objective
To determine whether CBT for SAD modifies cognitive reappraisal–related prefrontal cortex neural signal magnitude and timing when implementing cognitive reappraisal with negative self-beliefs.Design
Randomized clinical trial of CBT for SAD vs wait-list control group during a study that enrolled patients from 2007 to 2010.Setting
University psychology department.Participants
Seventy-five patients with generalized SAD randomly assigned to CBT or wait list.Intervention
Sixteen sessions of individual CBT for SAD.Main Outcome Measures
Negative emotion ratings and functional magnetic resonance imaging blood oxygen–level dependent signal when reacting to and cognitively reappraising negative self-beliefs embedded in autobiographical social anxiety situations.Results
During reactivity trials, compared with wait list, CBT produced (1) greater reduction in negative emotion ratings and (2) greater blood oxygen–level dependent signal magnitude in the medial prefrontal cortex. During cognitive reappraisal trials, compared with wait list, CBT produced (3) greater reduction in negative emotion ratings, (4) greater blood oxygen level–dependent signal magnitude in the dorsolateral and dorsomedial prefrontal cortex, (5) earlier temporal onset of dorsomedial prefrontal cortex activity, and (6) greater dorsomedial prefrontal cortex–amygdala inverse functional connectivity.Conclusions and Relevance
Modulation of cognitive reappraisal–related brain responses, timing, and functional connectivity may be important brain changes that contribute to the effectiveness of CBT for social anxiety. This study demonstrates that clinically applied neuroscience investigations can elucidate neurobiological mechanisms of change in psychiatric conditions.Trial Registration
clinicaltrials.gov Identifier: NCT00380731.
Mindfulness - an attentive, non-judgmental focus on present experiences - is increasingly incorporated in psychotherapeutic treatments as a skill fostering emotion regulation. Neurobiological mechanisms of actively induced emotion regulation are associated with prefrontally mediated down-regulation of, for instance, the amygdala. We were interested in neurobiological correlates of a short mindfulness instruction during emotional arousal. Using functional magnetic resonance imaging, we investigated effects of a short mindfulness intervention during the cued expectation and perception of negative and potentially negative pictures (50% probability) in 24 healthy individuals compared to 22 controls.The mindfulness intervention was associated with increased activations in prefrontal regions during the expectation of negative and potentially negative pictures compared to controls. During the perception of negative stimuli, reduced activation was identified in regions involved in emotion processing (amygdala, parahippocampal gyrus). Prefrontal and right insular activations when expecting negative pictures correlated negatively with trait mindfulness, suggesting that more mindful individuals required less regulatory resources to attenuate emotional arousal.Our findings suggest emotion regulatory effects of a short mindfulness intervention on a neurobiological level.
The brain network governing meditation has been studied using a variety of meditation practices and techniques practices eliciting different cognitive processes (e.g., silence, attention to own body, sense of joy, mantras, etc.). It is very possible that different practices of meditation are subserved by largely, if not entirely, disparate brain networks. This assumption was tested by conducting an activation likelihood estimation (ALE) meta-analysis of meditation neuroimaging studies, which assessed 150 activation foci from 24 experiments. Different ALE meta-analyses were carried out. One involved the subsets of studies involving meditation induced through exercising focused attention (FA). The network included clusters bilaterally in the medial gyrus, the left superior parietal lobe, the left insula and the right supramarginal gyrus (SMG). A second analysis addressed the studies involving meditation states induced by chanting or by repetition of words or phrases, known as "mantra." This type of practice elicited a cluster of activity in the right SMG, the SMA bilaterally and the left postcentral gyrus. Furthermore, the last analyses addressed the effect of meditation experience (i.e., short- vs. long-term meditators). We found that frontal activation was present for short-term, as compared with long-term experience meditators, confirming that experts are better enabled to sustain attentional focus, rather recruiting the right SMG and concentrating on aspects involving disembodiment.
Interventions based on training in mindfulness skills are becoming increasingly popular. Mindfulness involves intentionally bringing one's attention to the internal and external experiences occurring in the present moment, and is often taught through a variety of meditation exercises. This review summarizes conceptual approaches to mind-fulness and empirical research on the utility of mindfulness-based interventions. Meta-analytic techniques were incorporated to facilitate quantification of findings and comparison across studies. Although the current empirical literature includes many methodological flaws, findings suggest that mindfulness-based interventions may be helpful in the treatment of several disorders. Methodologically sound investigations are recommended in order to clarify the utility of these interventions.
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.
Bishop et al. (this issue) propose an operational definition of mindfulness developed by a recent consensus panel. The group provides a solid empirical framework from which to develop measures of mindfulness, and they propose an exciting research agenda. We describe measurement development work from our research group that provides initial support for the proposed consensus definition and that examines mindfulness in relation to emotion regulation variables. We extend the discussion by describing how mindfulness can enhance the stabilizing and destabilizing aspects of therapeutic change, and we illustrate this in the context of our treatment program for depression.
To evaluate the impact of an intensive period of mindfulness meditation training on cognitive and affective function, a non-clinical
group of 20 novice meditators were tested before and after participation in a 10-day intensive mindfulness meditation retreat.
They were evaluated with self-report scales measuring mindfulness, rumination and affect, as well as performance tasks assessing
working memory, sustained attention, and attention switching. Results indicated that those completing the mindfulness training
demonstrated significant improvements in self-reported mindfulness, depressive symptoms, rumination, and performance measures
of working memory and sustained attention, relative to a comparison group who did not undergo any meditation training. This
study suggests future directions for the elucidation of the critical processes that underlie the therapeutic benefits of mindfulness-based
interventions.
One component of mindfulness training (MT) is the development of interoceptive attention (IA) to visceral bodily sensations, facilitated through daily practices such as breath monitoring. Using functional magnetic resonance imaging (fMRI), we examined experience-dependent functional plasticity in accessing interoceptive representations by comparing graduates of a Mindfulness-Based Stress Reduction course to a waitlisted control group. IA to respiratory sensations was contrasted against two visual tasks, controlling for attentional requirements non-specific to IA such as maintaining sensation and suppressing distraction. In anatomically partitioned analyses of insula activity, MT predicted greater IA-related activity in anterior dysgranular insula regions, consistent with greater integration of interoceptive sensation with external context. MT also predicted decreased recruitment of the dorsomedial prefrontal cortex (DMPFC) during IA, and altered functional connectivity between the DMPFC and the posterior insula, putative primary interoceptive cortex. Furthermore, meditation practice compliance predicted greater posterior insula and reduced visual pathway recruitment during IA. These findings suggest that interoceptive training modulates task-specific cortical recruitment, analogous to training-related plasticity observed in the external senses. Further, DMPFC modulation of IA networks may be an important mechanism by which MT alters information processing in the brain, increasing the contribution of interoception to perceptual experience.
Objective:
To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms.
Method:
A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57% Caucasian) with a principal diagnosis of generalized SAD were randomly assigned to 16 sessions of I-CBT (n = 38) or a wait-list control (WL) group (n = 37). All patients completed self-report inventories measuring CR-SE and social anxiety symptoms at baseline and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year posttreatment.
Results:
Compared with WL, I-CBT resulted in greater increases in CR-SE and greater decreases in social anxiety. Increases in CR-SE during I-CBT mediated the effect of I-CBT on social anxiety. Gains achieved by patients receiving I-CBT were maintained 1-year posttreatment, and I-CBT-related increases in CR-SE were also associated with reduction in social anxiety at the 1-year follow-up.
Conclusions:
Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.
Mindfulness meditation—the practice of attending to present moment experience and allowing emotions and thoughts to pass without
judgment—has shown to be beneficial in clinical populations across diverse outcomes. However, the basic neural mechanisms
by which mindfulness operates and relates to everyday outcomes in novices remain unexplored. Focused attention is a common
mindfulness induction where practitioners focus on specific physical sensations, typically the breath. The present study explores
the neural mechanisms of this common mindfulness induction among novice practitioners. Healthy novice participants completed
a brief task with both mindful attention [focused breathing (FB)] and control (unfocused attention) conditions during functional
magnetic resonance imaging (fMRI). Relative to the control condition, FB recruited an attention network including parietal
and prefrontal structures and trait-level mindfulness during this comparison also correlated with parietal activation. Results
suggest that the neural mechanisms of a brief mindfulness induction are related to attention processes in novices and that
trait mindfulness positively moderates this activation.
This study sought to examine the effect of meditation experience on brain networks underlying cognitive actions employed during contemplative practice. In a previous study, we proposed a basic model of naturalistic cognitive fluctuations that occur during the practice of focused attention meditation. This model specifies four intervals in a cognitive cycle: mind wandering (MW), awareness of MW, shifting of attention, and sustained attention. Using subjective input from experienced practitioners during meditation, we identified activity in salience network regions during awareness of MW and executive network regions during shifting and sustained attention. Brain regions associated with the default mode were active during MW. In the present study, we reasoned that repeated activation of attentional brain networks over years of practice may induce lasting functional connectivity changes within relevant circuits. To investigate this possibility, we created seeds representing the networks that were active during the four phases of the earlier study, and examined functional connectivity during the resting state in the same participants. Connectivity maps were then contrasted between participants with high vs. low meditation experience. Participants with more meditation experience exhibited increased connectivity within attentional networks, as well as between attentional regions and medial frontal regions. These neural relationships may be involved in the development of cognitive skills, such as maintaining attention and disengaging from distraction, that are often reported with meditation practice. Furthermore, because altered connectivity of brain regions in experienced meditators was observed in a non-meditative (resting) state, this may represent a transference of cognitive abilities "off the cushion" into daily life.
The subjective experience of one's environment is constructed by interactions among sensory, cognitive, and affective processes. For centuries, meditation has been thought to influence such processes by enabling a nonevaluative representation of sensory events. To better understand how meditation influences the sensory experience, we used arterial spin labeling functional magnetic resonance imaging to assess the neural mechanisms by which mindfulness meditation influences pain in healthy human participants. After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest. A two-factor repeated-measures ANOVA was used to identify interactions between meditation and pain-related brain activation. Meditation reduced pain-related activation of the contralateral primary somatosensory cortex. Multiple regression analysis was used to identify brain regions associated with individual differences in the magnitude of meditation-related pain reductions. Meditation-induced reductions in pain intensity ratings were associated with increased activity in the anterior cingulate cortex and anterior insula, areas involved in the cognitive regulation of nociceptive processing. Reductions in pain unpleasantness ratings were associated with orbitofrontal cortex activation, an area implicated in reframing the contextual evaluation of sensory events. Moreover, reductions in pain unpleasantness also were associated with thalamic deactivation, which may reflect a limbic gating mechanism involved in modifying interactions between afferent input and executive-order brain areas. Together, these data indicate that meditation engages multiple brain mechanisms that alter the construction of the subjectively available pain experience from afferent information.
Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples.
We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions.
Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges's g = 0.63) and mood symptoms (Hedges's g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges's g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up.
These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.
Meditation refers to a family of complex emotional and attentional regulatory practices, which can be classified into two main styles - focused attention (FA) and open monitoring (OM) - involving different attentional, cognitive monitoring and awareness processes. In a functional magnetic resonance study we originally characterized and contrasted FA and OM meditation forms within the same experiment, by an integrated FA-OM design. Theravada Buddhist monks, expert in both FA and OM meditation forms, and lay novices with 10 days of meditation practice, participated in the experiment. Our evidence suggests that expert meditators control cognitive engagement in conscious processing of sensory-related, thought and emotion contents, by massive self-regulation of fronto-parietal and insular areas in the left hemisphere, in a meditation state-dependent fashion. We also found that anterior cingulate and dorsolateral prefrontal cortices play antagonist roles in the executive control of the attention setting in meditation tasks. Our findings resolve the controversy between the hypothesis that meditative states are associated to transient hypofrontality or deactivation of executive brain areas, and evidence about the activation of executive brain areas in meditation. Finally, our study suggests that a functional reorganization of brain activity patterns for focused attention and cognitive monitoring takes place with mental practice, and that meditation-related neuroplasticity is crucially associated to a functional reorganization of activity patterns in prefrontal cortex and in the insula.
The regulation of negative emotion through reappraisal has been shown to induce increased prefrontal activity and decreased amygdala activity. Individual differences in dispositional mindfulness reflect differences in typical recognition, detachment and regulation of current experience, thought to also operate as top-down control mechanism. We sought to investigate whether such individual differences would be associated with brain activity elicited during reappraisal of negative emotion. Eighteen healthy participants completed a functional magnetic resonance imaging task that involved attending to or reappraising negative stimuli, and provided emotion experience ratings after each trial. Dispositional mindfulness was assessed with a self-report questionnaire. Reappraisal induced activity in a brain network involving predominantly dorsal portions of the prefrontal cortex, replicating previous studies. A voxelwise regression analysis showed that individual differences in the tendency to be mindful predicted activity in neural regions underlying reappraisal, with dorsomedial prefrontal cortex activation increasing with more mindfulness traits. Notably, this prefrontal activation was inversely correlated with the amygdala response to negative scenes, further supporting its role in down-regulating emotion-generation regions. These findings suggest that individual differences in dispositional mindfulness, which reflect the tendency to recognize and regulate current states, may modulate activity in neural systems involved in the effective cognitive control of negative emotion.
Mindfulness-based stress reduction (MBSR) is an established program shown to reduce symptoms of stress, anxiety, and depression. MBSR is believed to alter emotional responding by modifying cognitive-affective processes. Given that social anxiety disorder (SAD) is characterized by emotional and attentional biases as well as distorted negative self-beliefs, we examined MBSR-related changes in the brain-behavior indices of emotional reactivity and regulation of negative self-beliefs in patients with SAD. Sixteen patients underwent functional MRI while reacting to negative self-beliefs and while regulating negative emotions using 2 types of attention deployment emotion regulation-breath-focused attention and distraction-focused attention. Post-MBSR, 14 patients completed neuroimaging assessments. Compared with baseline, MBSR completers showed improvement in anxiety and depression symptoms and self-esteem. During the breath-focused attention task (but not the distraction-focused attention task), they also showed (a) decreased negative emotion experience, (b) reduced amygdala activity, and (c) increased activity in brain regions implicated in attentional deployment. MBSR training in patients with SAD may reduce emotional reactivity while enhancing emotion regulation. These changes might facilitate reduction in SAD-related avoidance behaviors, clinical symptoms, and automatic emotional reactivity to negative self-beliefs in adults with SAD.
To better understand the relationship between mindfulness and depression, we studied normal young adults (n = 27) who completed measures of dispositional mindfulness and depressive symptomatology, which were then correlated with (a) rest: resting neural activity during passive viewing of a fixation cross, relative to a simple goal-directed task (shape-matching); and (b) reactivity: neural reactivity during viewing of negative emotional faces, relative to the same shape-matching task. Dispositional mindfulness was negatively correlated with resting activity in self-referential processing areas, whereas depressive symptomatology was positively correlated with resting activity in similar areas. In addition, dispositional mindfulness was negatively correlated with resting activity in the amygdala, bilaterally, whereas depressive symptomatology was positively correlated with activity in the right amygdala. Similarly, when viewing emotional faces, amygdala reactivity was positively correlated with depressive symptomatology and negatively correlated with dispositional mindfulness, an effect that was largely attributable to differences in resting activity. These findings indicate that mindfulness is associated with intrinsic neural activity and that changes in resting amygdala activity could be a potential mechanism by which mindfulness-based depression treatments elicit therapeutic improvement.
Anhedonia, the loss of pleasure or interest in previously rewarding stimuli, is a core feature of major depression. While theorists have argued that anhedonia reflects a reduced capacity to experience pleasure, evidence is mixed as to whether anhedonia is caused by a reduction in hedonic capacity. An alternative explanation is that anhedonia is due to the inability to sustain positive affect across time. Using positive images, we used an emotion regulation task to test whether individuals with depression are unable to sustain activation in neural circuits underlying positive affect and reward. While up-regulating positive affect, depressed individuals failed to sustain nucleus accumbens activity over time compared with controls. This decreased capacity was related to individual differences in self-reported positive affect. Connectivity analyses further implicated the fronto-striatal network in anhedonia. These findings support the hypothesis that anhedonia in depressed patients reflects the inability to sustain engagement of structures involved in positive affect and reward.
It has long been theorised that there are two temporally distinct forms of self-reference: extended self-reference linking experiences across time, and momentary self-reference centred on the present. To characterise these two aspects of awareness, we used functional magnetic resonance imaging (fMRI) to examine monitoring of enduring traits ('narrative' focus, NF) or momentary experience ('experiential' focus, EF) in both novice participants and those having attended an 8 week course in mindfulness meditation, a program that trains individuals to develop focused attention on the present. In novices, EF yielded focal reductions in self-referential cortical midline regions (medial prefrontal cortex, mPFC) associated with NF. In trained participants, EF resulted in more marked and pervasive reductions in the mPFC, and increased engagement of a right lateralised network, comprising the lateral PFC and viscerosomatic areas such as the insula, secondary somatosensory cortex and inferior parietal lobule. Functional connectivity analyses further demonstrated a strong coupling between the right insula and the mPFC in novices that was uncoupled in the mindfulness group. These results suggest a fundamental neural dissociation between two distinct forms of self-awareness that are habitually integrated but can be dissociated through attentional training: the self across time and in the present moment.
Background:
Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions.
Purpose:
This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress.
Method:
Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability.
Results:
Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience.
Conclusions:
The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.
Although depressed mood is a normal occurrence in response to adversity in all individuals, what distinguishes those who are vulnerable to major depressive disorder (MDD) is their inability to effectively regulate negative mood when it arises. Investigating the neural underpinnings of adaptive emotion regulation and the extent to which such processes are compromised in MDD may be helpful in understanding the pathophysiology of depression. We report results from a functional magnetic resonance imaging study demonstrating left-lateralized activation in the prefrontal cortex (PFC) when downregulating negative affect in nondepressed individuals, whereas depressed individuals showed bilateral PFC activation. Furthermore, during an effortful affective reappraisal task, nondepressed individuals showed an inverse relationship between activation in left ventrolateral PFC and the amygdala that is mediated by the ventromedial PFC (VMPFC). No such relationship was found for depressed individuals, who instead show a positive association between VMPFC and amygdala. Pupil dilation data suggest that those depressed patients who expend more effort to reappraise negative stimuli are characterized by accentuated activation in the amygdala, insula, and thalamus, whereas nondepressed individuals exhibit the opposite pattern. These findings indicate that a key feature underlying the pathophysiology of major depression is the counterproductive engagement of right prefrontal cortex and the lack of engagement of left lateral-ventromedial prefrontal circuitry important for the downregulation of amygdala responses to negative stimuli.
The ability to regulate emotions is an important part of adaptive functioning in society. Advances in cognitive and affective neuroscience and biological psychiatry have facilitated examination of neural systems that may be important for emotion regulation. In this critical review we first develop a neural model of emotion regulation that includes neural systems implicated in different voluntary and automatic emotion regulatory subprocesses. We then use this model as a theoretical framework to examine functional neural abnormalities in these neural systems that may predispose to the development of a major psychiatric disorder characterized by severe emotion dysregulation, bipolar disorder.
