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Based on promising results with adults, Acceptance and Commitment Therapy (ACT) presents as a treatment opportunity for depressed adolescents. We present a pilot study that compares ACT with treatment as usual (TAU), using random allocation of participants who were clinically referred to a psychiatric outpatient service. Participants were 30 adolescents, aged M = 14.9 (SD = 2.55), with 73.6% in the clinical range for depression. At posttreatment on measures of depression participants in the ACT condition showed significantly greater improvement statistically (d = 0.38), and 58% showed clinically reliable change with a response ratio of 1.59 in favor of ACT. Outcomes from 3-month follow-up data are tentative due to small numbers but suggest that improvement increased in magnitude. Measures of global functioning showed statistically significant improvement for both conditions, although clinical change measures favored only the ACT condition. The results support conducting a larger trial of ACT for the treatment of adolescent depression.
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Children and adolescents with Asperger syndrome occasionally exhibit aggressive behavior against peers and parents. In a multiple baseline design across subjects, three adolescents with Asperger syndrome were taught to use a mindfulness-based procedure called Meditation on the Soles of the Feet to control their physical aggression in the family home and during outings in the community. They were taught to shift the focus of their attention from the negative emotions that triggered their aggressive behavior to a neutral stimulus, the soles of their feet. Prior to training in the mindfulness-based procedure the adolescents had moderate rates of aggression. During mindfulness practice, which lasted between 17 and 24 weeks, their mean rates of aggression per week decreased from 2.7, 2.5 and 3.2 to 0.9, 1.1, and 0.9, respectively, with no instances observed during the last 3 weeks of mindfulness practice. No episodes of physical aggression occurred during a 4-year follow-up. This study suggests that adolescents with Asperger syndrome may successfully use a mindfulness-based procedure to control their aggressive behavior.
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OBJECTIVE: The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored. We performed a randomized, controlled study on the effects on brain and immune function of a well-known and widely used 8-week clinical training program in mindfulness meditation applied in a work environment with healthy employees. METHODS: We measured brain electrical activity before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N = 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine. RESULTS: We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine. CONCLUSIONS: These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function. These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research.

The primary taste cortex consists of the insula and operculum. Previous work has indicated that neurons in the primary taste cortex respond solely to sensory input from taste receptors and lingual somatosensory receptors. Using functional magnetic resonance imaging, we show here that expectancy modulates these neural responses in humans. When subjects were led to believe that a highly aversive bitter taste would be less distasteful than it actually was, they reported it to be less aversive than when they had accurate information about the taste and, moreover, the primary taste cortex was less strongly activated. In addition, the activation of the right insula and operculum tracked online ratings of the aversiveness for each taste. Such expectancy-driven modulation of primary sensory cortex may affect perceptions of external events.
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On the basis of a review of the extant literature describing emotion-cognition interactions, the authors propose 4 methodological desiderata for studying how task-irrelevant affect modulates cognition and present data from an experiment satisfying them. Consistent with accounts of the hemispheric asymmetries characterizing withdrawal-related negative affect and visuospatial working memory (WM) in prefrontal and parietal cortices, threat-induced anxiety selectively disrupted accuracy of spatial but not verbal WM performance. Furthermore, individual differences in physiological measures of anxiety statistically mediated the degree of disruption. A second experiment revealed that individuals characterized by high levels of behavioral inhibition exhibited more intense anxiety and relatively worse spatial WM performance in the absence of threat, solidifying the authors' inference that anxiety causally mediates disruption. These observations suggest a revision of extant models of how anxiety sculpts cognition and underscore the utility of the desiderata.
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Interest in mindfulness-based interventions for children and adolescents is burgeoning, bringing with it the need for validated instruments to assess mindfulness in youths. The present studies were designed to validate among adolescents a measure of mindfulness previously validated for adults (e.g., Brown & Ryan, 2003), which we herein call the Mindful Attention Awareness Scale—Adolescent (MAAS–A). In 2 large samples of healthy 14- to 18-year-olds (N = 595), Study 1 supported a single-factor MAAS–A structure, along with acceptably high internal consistency, test–retest reliability, and both concurrent and incremental validity. In Study 2, with a sample of 102 psychiatric outpatient adolescents age 14–18 years, participants randomized to a mindfulness-based stress reduction intervention showed significant increases in MAAS–A scores from baseline to 3-month follow-up, relative to nonsignificant score changes among treatment-as-usual participants. Increases in MAAS–A scores among mindfulness-based stress reduction participants were significantly related to beneficial changes in numerous mental health indicators. The findings support the reliability and validity of the MAAS–A in normative and mixed psychiatric adolescent populations and suggest that the MAAS–A has utility in mindfulness intervention research.
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"Informed by the maxim that you can't study what you can't see, Baer's book provedes the necessary psychometric underpinning to further our understanding of core change processes in mindfulness-based interventions."---Zindel V. Segal, Ph.D., author of The Mindful Way Through Depression"This kind of attention to the reasons why mindfulness-based intervention may be beneficial will help stimulate informative research in the area and also help clinicians provide therapy that enhances these important skills."---Lizabeth Roemer, Ph.D., coauthor of Mindfulness-and Acceptance-Based Behavioral Therapies in Practice"An excellent resource not only for mindfulness researchers and practitioners, but for amyone interested in what leads to mental health and emotional balance."---Cassandra Vieten, Ph.D., director of research at the Institute of Noetic Sciences and author of Mindful Motherhood"A fascinating journey to the heart of what actually changes in mindfulness and acceptance-based treatment...Highly recommneded for psychotherapists, health care professionals, and anyone seeking the very latest scientific understanding of psychological change."---Christopher K. Germer, Ph.D., author of The Mindful Path to Self-CompassionHow does mindfulness work? Thousands of therapists utilize mindfulness-based treatments and have witnesed firsthand the effectiveness of these approaches on clients suffering from anxiety, depression, and other common mental health issues. But for many clinicians, the psychological processes and brain functions that explain these changes remain a mystery, and effective methodologies for measuring each client's progress are elusive.In Assessing Mindfulness and Acceptance Processes in Clients, Ruth Baer presents a collection of articles by some of the most respected mindfulness researchers and therapists practicing today. Each contribution assesses the variables that represent potential processes of change, such as mindfulness.acceptance, self-compassion, spirituality, and focus on values, and determines the importance of each of these processes to enhanced psychological functioning and quality of life. Clinicians learn to accurately measure each process in individual clients, an invaluable skill for any practicing therapist. A seminal contribution to the existing professional literature on mindfulnessbased treatments, this book is also an essential resource for any mental health professional seeking to illuminate the processes at work behind any mindfulness and acceptance-based therapy.

This article presents 4 studies (N = 1,413) describing the development and validation of the Child and Adolescent Mindfulness Measure (CAMM). In Study 1 (n = 428), the authors determined procedures for item development and examined comprehensibility of the initial 25 items. In Study 2 (n = 334), they reduced the initial item pool from 25 to 10 items through exploratory factor analysis. Study 3 (n = 332) evaluated the final 10-item measure in a cross-validation sample, and Study 4 (n = 319) determined validity coefficients for the CAMM using bivariate and partial correlations with relevant variables. Results suggest that the CAMM is a developmentally appropriate measure with adequate internal consistency. As expected, CAMM scores were positively correlated with quality of life, academic competence, and social skills and negatively correlated with somatic complaints, internalizing symptoms, and externalizing behavior problems. Correlations were reduced but generally still significant after controlling for the effects of 2 overlapping processes (thought suppression and psychological inflexibility). Overall, results suggest that the CAMM may be a useful measure of mindfulness skills for school-aged children and adolescents.

Context  Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce.Objective  To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients.Design, Setting, and Participants  Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo).Main Outcome Measures  Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months.Results  Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Δ], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Δ = −6.8; 95% CI, −4.8 to −8.8; depersonalization, 8.4 to 5.9; Δ = −2.5; 95% CI, −1.4 to −3.6; and personal accomplishment, 40.2 to 42.6; Δ = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Δ = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Δ = −4.1; 95% CI, −1.8 to −6.4); total mood disturbance (33.2 to 16.1; Δ = −17.1; 95% CI, −11 to −23.2), and personality (conscientiousness, 6.5 to 6.8; Δ = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Δ = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = −0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = −0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001).Conclusions  Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

Thirty-two participants were tested for both resting electroencephalography (EEG) and neuropsychological function. Eight one-minute trials of resting EEG were recorded from 14 channels referenced to linked ears, which was rederived to an average reference. Neuropsychological tasks included Verbal Fluency, the Tower of London, and Corsi's Recurring Blocks. Asymmetries in EEG alpha activity were correlated with performance on these tasks. Similar patterns were obtained for delta and theta bands. Factor analyses of resting EEG asymmetries over particular regions suggested that asymmetries over anterior scalp regions may be partly independent from those over posterior scalp regions. These results support the notions that resting EEG asymmetries are specified by multiple mechanisms along the rostral/caudal plane, and that these asymmetries predict task performance in a manner consistent with lesion and neuroimaging studies.
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Drawing its main source of inspiration from a naturalized interpretation of Husserlian phenomenology, On Becoming Aware: A Pragmatics of Experiencing attempts to examine closely the nature of experience and how we may become aware of our own mental life. The authors also focus on how this project fits into the larger context of cognitive science, psychology, neurosciences, and philosophy. Additional partners in the effort to better understand experience are the contemplative systems of the world's spiritual or wisdom traditions, including particularly that of Buddhism. The book includes three separate glossaries of technical terms in phenomenology, the cognitive sciences, and Tibetan Buddhism. The book On Becoming Aware seeks a disciplined and practical approach to exploring human experience. While much of the book draws its inspiration from the phenomenological theories of Husserl, other approaches to the direct study of experience are also explored in depth. One of these approaches is embodied by the world's spiritual or wisdom or contemplative traditions such as Sufism, Buddhism, the Philokalia tradition, and others. Collectively, these traditions have come upon a variety of their own insights and methods for understanding experience, or, to use words from the phenomenological tradition, has developed its own ways of phenomenological reduction Amongst the various wisdom traditions, the authors focus mainly on Buddhism. The authors give an introduction to Buddhist theory and history, followed by an in-depth discussion of the Buddhist contemplative practices of mindfulness, śamatha, vipaśyanā, tonglen (gtong len), lojong (blo sbyong), dzokchen (rdzogs chen), and mahāmudrā. The authors then relate this discussion to themes from philosophy and phenomenology explored earlier in the book, paricularly Husserl's concept of épochè. (Zach Rowinski 2005-01-17) Publisher's description: This book searches for the sources and means for a disciplined practical approach to exploring human experience. The spirit of this book is pragmatic and relies on a Husserlian phenomenology primarily understood as a method of exploring our experience. The authors do not aim at a neo-Kantian a priori ‘new theory’ of experience but instead they describe a concrete activity: how we examine what we live through, how we become aware of our own mental life. The range of experiences of which we can become aware is vast: all the normal dimensions of human life (perception, motion, memory, imagination, speech, everyday social interactions), cognitive events that can be precisely defined as tasks in laboratory experiments (e.g., a protocol for visual attention), but also manifestations of mental life more fraught with meaning (dreaming, intense emotions, social tensions, altered states of consciousness). The central assertion in this work is that this immanent ability is habitually ignored or at best practiced unsystematically, that is to say, blindly. Exploring human experience amounts to developing and cultivating this basic ability through specific training. Only a hands-on, non-dogmatic approach can lead to progress, and that is what animates this book.

Many of us go through our daily lives on autopilot, not fully aware of our conscious experiences. In a discussion moderated by Steve Paulson, executive producer and host of To the Best of Our Knowledge, neuroscientists Richard Davidson and Amishi Jha and clinical mindfulness expert Jon Kabat-Zinn explore the role of consciousness in mental and physical health, how we can train our minds to be more flexible and adaptable, and cutting-edge neuroscience findings about the transformation of consciousness through mindfulness and contemplative practice. The following is an edited transcript of the discussion that occurred February 6, 2013, 7:00-8:15 PM, at the New York Academy of Sciences in New York City.

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