Amit Bernstein’s research while affiliated with University of Haifa and other places

Despite increased public interest and research on intensive high-dose mental health interventions, much remains unknown about the mental health effects and safety of multi-day intensive high-dose mindfulness meditation training. Accordingly, we aimed to study its salutary and adverse effects on mental health. We conducted a preregistered prospective intervention study among 89 adults who registered for 6-day insight mindfulness meditation retreats and 46 matched controls (Mage(SDage) = 33.75(9.50), 56.3% female). Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and matched to retreat participants on age and lifetime meditation experience. Retreat participants demonstrated significant improvements in well-being, negative affect, perseverative thinking, brooding rumination, and depression symptoms at 2-week follow-up compared to matched controls (η² range = .04–.08, ps < .05). Importantly, the % of participants exhibiting statistically reliable deterioration in mental health outcomes at 2-week follow-up were equal or lower among retreat participants than among matched controls in the entire sample, as well as in a sub-sample with clinically elevated depression and/or anxiety (ORs < 1). These findings suggest that a 6-day mindfulness meditation retreat can produce rapid improvements in mental health, comparable to effect sizes of much longer 8-week mindfulness-based programs. These findings also challenge concerns about adverse effects of intensive high-dose meditation training and suggest that it may be a safe and effective intervention modality, even for clinically vulnerable adults struggling with depression or anxiety.

Objective: Despite growing popularity and scientific interest in meditation retreats, their effects on mental health and their safety remain poorly understood. Accordingly, we aimed to study their salutary and adverse effects on mental health. Method: We conducted a preregistered prospective intervention study among 89 adults who registered for 6-day insight mindfulness meditation retreats and 46 matched controls (Mage(SDage) = 33.75(9.50), 56.3% female). Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and matched to retreat participants on age and lifetime meditation experience. Participants completed measures of well-being (WHO-5), affect (I-PANAS-SF), emotion regulation (DERS-16), repetitive negative thinking (PTQ), brooding rumination (RRS-B), depression (PHQ-9), and anxiety (OASIS) at baseline and at 2-week follow-up. Results: Retreat participants demonstrated significant improvements in well-being, negative affect, perseverative thinking, brooding rumination, and depression symptoms at follow-up compared to matched controls (η² range = .04–.08, ps < .05). Importantly, the % of participants exhibiting statistically reliable deterioration in mental health outcomes were equal or lower among retreat participants than among matched controls in the entire sample, as well as in a sub-sample with clinically elevated depression and/or anxiety (ORs < 1). Conclusions: A 6-day mindfulness meditation retreat can produce mental health benefits on par with effect sizes of longer 8-week mindfulness-based programs. Findings challenge concerns about adverse effects of intensive high-dose meditation training and suggest that it may be a safe and effective intervention modality, even for clinically vulnerable adults struggling with depression and anxiety.

Attention is theorized to have a definitive role in mindfulness and its salutary effects. Yet, extant findings from more than two decades of research testing this central theoretical premise have been surprisingly mixed. To account for this paradoxical disparity between theory and findings, we propose the Mindfulness Internal Attention (MIA) framework. We theorize and review initial findings suggesting that mindfulness training primarily targets internal attention processes which operate on internally generated or stored representations and experiences. Additionally, we theorize and review findings suggesting that mindfulness training affects executive functions and working memory processes shared between internal attention and late-stage external attention. In contrast, we theorize and review findings suggesting that mindfulness training does not affect early-stage external attention processes, which do not share cognitive resources with internal attention. Finally, we propose methodological innovations and outstanding questions for future research to advance understanding of the attentional mechanisms of mindfulness training.

Attention is theorized to have a definitive role in mindfulness and its salutary effects. Yet, extant findings from more than two decades of research testing this central theoretical premise have been surprisingly mixed. To account for this paradoxical disparity between theory and findings, we propose the Mindfulness Internal Attention (MIA) framework. We theorize and review initial findings suggesting that mindfulness training primarily targets internal attention processes which operate on internally generated or stored representations and experiences. Additionally, we theorize and review findings suggesting that mindfulness training affects executive functions and working memory processes shared between internal attention and late-stage external attention. In contrast, we theorize and review findings suggesting that mindfulness training does not affect early-stage external attention processes, which do not share cognitive resources with internal attention. Finally, we propose methodological innovations and outstanding questions for future research to advance understanding of the attentional mechanisms of mindfulness training.

Rationale To examine the acute effects of ayahuasca use and their relationship to sub-acute changes in affect and mindfulness in a non-clinical sample, addressing the need for a better understanding of ayahuasca’s immediate and short-term impacts as interest in its use grows. Objectives Using prospective ecological assessment, this study investigates how ayahuasca used at a 4-day retreat affects positive/negative affect and mindfulness skills in daily living compared to pre-retreat. Additionally, we explore acute psychedelic experiences during the ayahuasca retreat, assessed retrospectively 1–2 days post-retreat, as potential mechanisms for theorized effects in daily living post-retreat. Methods Thirty-six participants reported positive/negative affect and mindfulness skills three times daily for 5 days before and after the retreat. Baseline assessments included lifetime psychedelic experience, and post-retreat assessments covered acute ayahuasca experiences. Mixed-effect linear models were used to analyze the data. Results Post-retreat, we observed reduced negative affect, increased positive affect, and enhanced mindfulness skills in daily living. Ayahuasca-induced acute experiences, such as time/space transcendence, emotional breakthrough and challenging experiences predicted greater subacute positive affect. Notably, none of these experiences were linked to subacute improvements in negative affect or mindfulness. No participants showed clinically significant adverse responses post-retreat, and only 5.5% exhibited some degree of potentially clinically significant deterioration in affect. Conclusions Ayahuasca use may lead to improvement in mood and mindfulness skills, and key acute psychedelic experiences induced by ayahuasca may be important to some of these salutary effects, positive affect in particular.

Background There has been rapid growth of neuroelectrophysiological studies that aspire to uncover the “black box” of mindfulness and meditation. Reliance on traditional data analysis methods hinders understanding of the complex, nonlinear, multidimensional, and systemic nature of the functional neuroelectrophysiology of meditation states. Methods Thus, to reveal the complex systemic neuroelectrophysiology of meditation, we applied a machine learning extreme gradient boosting classification algorithm and 4 complementary feature importance methods to extract systemic electroencephalography features characterizing mindful states from electroencephalography recorded during a focused attention meditation and a control mind-wandering state among 26 experienced meditators. Results The algorithm classified meditation versus mind-wandering states with 83% accuracy, with an area under the receiver operating characteristic curve of 79% and F1 score of 74%. Feature importance techniques identified 10 electroencephalography features associated with increased power and coherence of high-frequency oscillations during focused attention meditation relative to an instructed mind-wandering state. Conclusions The findings help delineate the complex systemic oscillatory activity that characterizes meditation.

Objective: Among forcibly displaced people, maternal trauma and stress have been implicated in poor child socioemotional outcomes via intergenerational trauma transmission. This study explored the role of maternal postmigration living difficulties (PMLD) in the pathway linking maternal trauma, trauma-related psychopathology, and child socioemotional outcomes among mother–child dyads seeking asylum in a high-risk urban setting. Method: Participants were East African (Eritrean) mothers (N = 127) of preschool-aged children seeking asylum in Israel. Using moderated mediation analysis, we tested whether and how PMLD may moderate the mediating role of current maternal International Classification of Diseases, 11th revision (ICD-11) posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder disturbances in self-organization (DSO) symptoms between past maternal trauma exposure and current postdisplacement child internalizing and externalizing difficulties. Children’s direct exposure to adverse life experiences was controlled for. Results: Maternal PTSD symptoms mediated the association between past maternal trauma exposure and child internalizing difficulties, but not externalizing difficulties, across all levels of current maternal PMLD. However, maternal DSO symptoms mediated internalizing and externalizing child outcomes, but only among mothers reporting high levels of current PMLD. Conclusion: This study provides novel evidence that PMLD may amplify the toxicity of past maternal trauma exposure for poor child socioemotional outcomes via ICD-11 DSO symptoms. The intergenerational transmission pathway via the narrower fear-based ICD-11 PTSD, however, is independent of the degree of maternal PMLD. Findings suggest that policies designed to buffer intergenerational trauma transmission among forcibly displaced people may need to consider the toxicity of PMLD as well as enable mothers to heal from PTSD.

Objective: We sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary or intense subjective experiences during meditation-based interventions. To do so, we empirically characterized such peak experiences during an intensive meditation intervention and their impact postintervention. Method: We conducted a preregistered prospective intervention study among 96 adults who registered for 6-day insight (Vipassana) mindfulness meditation retreats and 47 matched controls. Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and systematically matched to retreat participants on age and lifetime meditation experience. Measures included the novel Peak Meditative Experience Scale and the Impact of PMES. Results: Seventeen peak experiences that were primarily pleasant (e.g., deep and unusual peace, aha! Moment) occurred more frequently among retreat participants than among matched controls in daily living (ps < .05; mean ϕ = .33). In contrast, 14 peak experiences that were mostly unpleasant (e.g., flashbacks, overwhelming sadness) occurred at similar rates in both groups (ps > .05). At 2-week follow-up, the perceived impact of all pleasant and most unpleasant peak experiences was more salutary than adverse (ps ≤ .015; M Cohen’s d = 1.61). Conclusions: Peak experiences that resulted from meditation retreats were primarily pleasant and had a large salutary impact postretreat. Inconsistent with conclusions from uncontrolled retrospective studies, findings document that intensive insight mindfulness meditation training in retreats may not contribute to unpleasant peak experiences and even when they occurred their impact was typically more salutary than adverse.

Background: Traumatic stress among forcibly displaced people has a variety of adverse consequences beyond individual mental health, including implications for poor socioemotional developmental outcomes for their children post-displacement. Objective: This study explored the intergenerational transmission of maternal ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) and depression among asylum-seeking mothers for their children’s internalizing and externalizing difficulties. Method: Participants were 127 trauma-affected Eritrean mothers of preschool-aged children in Israel. The severity of child difficulties was compared between mothers with probable ICD-11 CPTSD (94.5% comorbid depression), ICD-11 PTSD (48.5% comorbid depression), unimorbid depression, and healthy mothers, using multivariate analyses of variance, while controlling for children’s direct exposure to adverse life experiences. Results: Probable ICD-11 CPTSD and PTSD were present in 23.6% and 26.0% of mothers, respectively. Relative to maternal PTSD, CPTSD was significantly and strongly associated with elevated child internalizing symptoms (d = 2.44) and marginally significantly, although strongly, associated with child externalizing symptoms (d = 1.30). Post-hoc exploratory analyses documented that, relative to maternal PTSD and depression, CPTSD and depression comorbidity was marginally significantly but strongly associated with child internalizing (SMD = .67), but not externalizing symptoms (SMD = .35). Conclusions: Findings implicate maternal CPTSD and comorbid depression in child socio-emotional development and inform clinical assessment, prevention, and intervention to attenuate poor development among children in unstable post-displacement settings.