The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders.
Hsiao Yu-Yu,Tofighi Davood,Kruger Eric S,Lee Van Horn M,MacKinnon David P,Witkiewitz Katie
The development and evaluation of mindfulness-based interventions for a variety of psychological and medical disorders has grown exponentially over the past 20 years. Yet, calls for increasing the rigor of mindfulness research and recognition of the difficulties of conducting research on the topic of mindfulness have also increased. One of the major difficulties is the measurement of mindfulness, with varying definitions across studies and ambiguity with respect to the meaning of mindfulness. There is also concern about the reproducibility of findings given few attempts at replication. The current secondary analysis addressed the issue of reproducibility and robustness of the construct of self-reported mindfulness across two separate randomized clinical trials of mindfulness-based relapse prevention (MBRP), as an aftercare treatment for substance use disorder. Specifically, we tested the robustness of our previously published findings, which identified a latent construct of mindfulness as a significant mediator of the effect of MBRP on reducing craving following treatment. First, we attempted to replicate the findings in a separate randomized clinical trial of MBRP. Second, we conducted sensitivity analyses to test the assumption of the no-omitted confounder bias in a mediation model. The effect of MBRP on self-reported mindfulness and overall mediation effect failed to replicate in a new sample. The effect of self-reported mindfulness in predicting craving following treatment did replicate and was robust to the no-omitted confounder bias. The results of this work shine a light on the difficulties in the measurement of mindfulness and the importance of examining the robustness of findings.
Can mindfulness mechanistically target worry to improve sleep disturbances? Theory and study protocol for app-based anxiety program.
Brewer Judson A,Roy Alexandra,Deluty Alana,Liu Tao,Hoge Elizabeth A
Health psychology : official journal of the Division of Health Psychology, American Psychological Association
OBJECTIVE:Anxiety is associated with sleep disturbance and insomnia. Mindfulness-based interventions, such as mindfulness-based stress reduction, have shown consistent anxiety reduction. Mindfulness training has been theorized to affect reinforcement learning, affecting habitual behaviors such as smoking and overeating, but a direct mechanistic link between the use of mindfulness training for anxiety reduction and improvement in sleep has not been studied. Moreover, the mechanisms by which mindfulness might affect worry and subsequent sleep disturbances have not been elucidated. This study protocol evaluates the impact an app-based mindfulness training program for anxiety might have on decreasing worry and improvement in sleep. METHOD:A randomized controlled study will be conducted in approximately 80 adults with worry that interferes with their sleep. Participants will be randomly allocated (1:1) to two groups: treatment-as-usual (TAU) or TAU + App-Based Mindfulness Training (Unwinding Anxiety app). The primary outcomes will be the non-reactivity subscale of the Five Facet Mindfulness Questionnaire and Patient-Reported Outcomes Measurement Information System sleep quality measures (Baer et al., 2008; Yu et al., 2011). Secondary outcomes will include the Penn State Worry Questionnaire, Generalized Anxiety Disorder-7, and Multidimensional Assessment of Interoceptive Awareness Scale (Mehling et al., 2012; Meyer, Miller, Metzger, & Borkovec, 1990; Spitzer, Kroenke, Williams, & Löwe, 2006). DISCUSSION:This study will be the first to test the mechanism of app-based mindfulness training on worry and sleep disturbance. Testing the mechanistic effects of mindfulness training using the science of behavior change framework will help move the field forward both in further elucidation of potential mechanisms of mindfulness (e.g., targeting reinforcement learning) and determining whether such a platform might be a viable method for delivering high-fidelity treatment at scale and for a low cost. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Which are the best questionnaires to longitudinally evaluate mindfulness skills in personality disorders?
Caletti Elisabetta,Pagliari Chiara,Vai Benedetta,Delvecchio Giuseppe,Brambilla Paolo
Journal of affective disorders
BACKGROUND:Personality disorders (PDs) are severe mental illnesses, characterized by inflexible and enduring response patterns in a broad range of personal and social situations. With the aim of identifying effective and evidence-based interventions, in the last decades we observed a flourishing of the so-called "thirdwave" cognitive-behavioural therapies, where mindfulness appears as relevant factor in promoting individual well-being and treatment response. In this regard, several authors tried to develop new instruments that enable to measure mindfulness skills, such as the Kentucky Inventory of Mindfulness Skills (KIMS), the Five Facet Mindfulness Questionnaire (FFMQ) and the Philadelphia Mindfulness Scale (PHLMS). The aim of this review is to provide new insights about the mindfulness questionnaires currently used in longitudinal studies in PDs by providing a benchmark for future studies evaluating mindfulness changes associated to therapeutic interventions. METHODS:In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search in PubMed was performed. Three reviewers conducted the data extraction. Longitudinal studies on PDs evaluating mindfulness skills through a validated questionnaire were selected. Ten studies met the selection criteria. RESULTS:The majority of the studies reviewed (N=7) detected an increase in mindfulness skills (4 rated with FFMQ, 2 KIMS, and 1 Philadelphia Mindfulness Scale). Finally, from the selected studies mindfulness changes were also associated with clinical amelioration. LIMITATIONS:Few studies evaluate male patients and PDs other than borderline personality disorder. CONCLUSION:Although mindfulness is a complex construct to operationalize, the considered questionnaires emerged as useful instruments for clinicians to detect changes in mindfulness abilities. In particular, currently the FFMQ appears as the most suitable measure.
Cardiovascular effects of brief mindfulness meditation among perfectionists experiencing failure.
Koerten Hannah R,Watford Tanya S,Dubow Eric F,O'Brien William H
Research links perfectionism, the tendency to hold and pursue unrealistically high standards, to negative mental health outcomes such as eating disorders, anxiety, and depression. Previous research used high frequency heart rate variability (HF-HRV) to measure recovery from stress during a mindfulness meditation in perfectionistic university students and found that only nonperfectionists demonstrated HF-HRV recovery from stress, suggesting that mindfulness was not effective for perfectionists. However, the mindfulness meditation did not incorporate a nonjudgment element, which may be a key component for perfectionists. In the current study, we examined whether mindfulness with a focus on nonjudgment helps university student perfectionists (n = 120) recover from failure (measured by heart rate (HR), HF-HRV, pNN50). Students were randomly assigned to one of four meditation groups: nonjudgment mindfulness, general mindfulness (i.e., attentional awareness without a nonjudgment component), progressive muscle relaxation, and nothing. Cardiac data were recorded during a 5-min baseline, failure task, and 10-min meditation session. HR results suggest that both mindfulness conditions and "nothing" encouraged cardiovascular recovery, but that the mindfulness conditions showed even further recovery during the last five minutes of the meditations. HF-HRV results indicated that participants in the nonjudgment mindfulness condition had marginally higher HF-HRV during the last five minutes of the meditation than at baseline, while participants in the other conditions did not. Therefore, mindfulness with a focus on nonjudgment of emotions may be especially important to help perfectionists improve HF-HRV after failure.
The relationship between trait mindfulness and affective symptoms: A meta-analysis of the Five Facet Mindfulness Questionnaire (FFMQ).
Carpenter Joseph K,Conroy Kristina,Gomez Angelina F,Curren Laura C,Hofmann Stefan G
Clinical psychology review
Trait mindfulness appears to be related to lower levels of negative affective symptoms, but it remains uncertain which facets of mindfulness are most important in this relationship. Accordingly, the present meta-analysis examined studies reporting correlations between affective symptoms and trait mindfulness as assessed by the Five Facet Mindfulness Questionnaire. A comprehensive search yielded 148 eligible studies, comprising 157 distinct samples and 44,075 participants. The weighted mean correlation for affective symptoms and overall trait mindfulness was r = -0.53. Among mindfulness facets, Nonjudge (r = -0.48) and Act with Awareness (r = -0.47) demonstrated the largest correlations, followed by Nonreact (r = -0.33) and Describe (r = -0.29). Observe was not significantly correlated with affective symptoms. No significant differences in the strength of correlations were found between anxiety, depression and posttraumatic stress disorder (PTSD) symptoms, though symptoms of generalized anxiety disorder exhibited a weaker negative relationship with the Describe facet compared to PTSD symptoms. Describe also showed a stronger relationship with affective symptoms in Eastern samples compared to Western samples, whereas Western samples had a stronger relationship with Nonjudge. These results provide insight into the nature of the association between trait mindfulness and negative affect.
Mindful Emotion Regulation: Exploring the Neurocognitive Mechanisms behind Mindfulness.
Grecucci Alessandro,Pappaianni Edoardo,Siugzdaite Roma,Theuninck Anthony,Job Remo
BioMed research international
The purpose of this paper is to review some of the psychological and neural mechanisms behind mindfulness practice in order to explore the unique factors that account for its positive impact on emotional regulation and health. After reviewing the mechanisms of mindfulness and its effects on clinical populations we will consider how the practice of mindfulness contributes to the regulation of emotions. We argue that mindfulness has achieved effective outcomes in the treatment of anxiety, depression, and other psychopathologies through the contribution of mindfulness to emotional regulation. We consider the unique factors that mindfulness meditation brings to the process of emotion regulation that may account for its effectiveness. We review experimental evidence that points towards the unique effects of mindfulness specifically operating over and above the regulatory effects of cognitive reappraisal mechanisms. A neuroanatomical circuit that leads to mindful emotion regulation is also suggested. This paper thereby aims to contribute to proposed models of mindfulness for research and theory building by proposing a specific model for the unique psychological and neural processes involved in mindful detachment that account for the effects of mindfulness over and above the effects accounted for by other well-established emotional regulation processes such as cognitive reappraisal.
A Moment of Mindfulness: Computer-Mediated Mindfulness Practice Increases State Mindfulness.
Mahmood Lynsey,Hopthrow Tim,Randsley de Moura Georgina
Three studies investigated the use of a 5-minute, computer-mediated mindfulness practice in increasing levels of state mindfulness. In Study 1, 54 high school students completed the computer-mediated mindfulness practice in a lab setting and Toronto Mindfulness Scale (TMS) scores were measured before and after the practice. In Study 2 (N = 90) and Study 3 (N = 61), the mindfulness practice was tested with an entirely online sample to test the delivery of the 5-minute mindfulness practice via the internet. In Study 2 and 3, we found a significant increase in TMS scores in the mindful condition, but not in the control condition. These findings highlight the impact of a brief, mindfulness practice for single-session, computer-mediated use to increase mindfulness as a state.
Mediating effect of mindfulness cognition on the development of empathy in a university context.
De la Fuente-Anuncibay Raquel,González-Barbadillo Ángela,González-Bernal Jerónimo,Cubo Esther,PizarroRuiz Juan P
Numerous interventions propose mindfulness training as a means of improving empathy. Our aim is to analyse the relationship between mindfulness practice and empathy through the mediating process of trait mindfulness. This sample comprised 264 undergraduate students ([Formula: see text], SD = 11,39). The instruments used were Five Facet Mindfulness Questionnaire and Toronto Empathy Questionnaire. The indirect effect was calculated using 10.000 bootstrap samples for the bootstrap confidence intervals corrected for bias. Empathy improvement is mediated by changes in the cognitions derived from mindfulness (B = .346, p<.01). The direct effect of mindfulness practice on empathy disappears in presence of this mediator (B = .133, p>.05). Mindfulness interventions that aim to improve empathy should focus on three of its components; observing, describing and nonreactivity to inner experience. Given the significance of the results, the research must be extended to larger samples.