This study, based on a sample of 172 children, examined the relation between average afternoon salivary cortisol levels measured at home at age 4.5 years and socioemotional adjustment a year and a half later, as reported by mothers, fathers, and teachers. Cortisol levels were hypothesized to be positively associated with withdrawal-type behaviors (e.g., internalizing, social wariness) and inversely related to approach-type behaviors, both negative and positive (e.g., externalizing, school engagement). Higher cortisol levels at age 4.5 predicted more internalizing behavior and social wariness as reported by teachers and mothers, although child gender moderated the relation between cortisol and mother report measures. An inverse relation was found between boys' cortisol levels and father report of externalizing behavior. A marginal inverse relation was found between child cortisol levels and teacher report of school engagement. Behavior assessed concurrently with cortisol collection did not account for the prospective relations observed,suggesting that cortisol adds uniquely to an understanding of behavioral development.
Our objective was to conduct the first randomized controlled trial of the efficacy of a group mindfulness program aimed at reducing and preventing depression in an adolescent school-based population. For each of 12 pairs of parallel classes with students (age range 13–20) from five schools (N = 408), one class was randomly assigned to the mindfulness condition and one class to the control condition. Students in the mindfulness group completed depression assessments (the Depression Anxiety Stress Scales) prior to and immediately following the intervention and 6 months after the intervention. Control students completed the questionnaire at the same times as those in the mindfulness group. Hierarchical linear modeling showed that the mindfulness intervention showed significantly greater reductions (and greater clinically significant change) in depression compared with the control group at the 6-month follow-up. Cohen's d was medium sized (>.30) for both the pre-to-post and pre-to-follow-up effect for depressive symptoms in the mindfulness condition. The findings suggest that school-based mindfulness programs can help to reduce and prevent depression in adolescents.
<p>Human beings can be proactive and engaged or, alternatively, passive and alienated, largely as a function of the social conditions in which they develop and function. Accordingly, research guided by self-determination theory has focused on the social–contextual conditions that facilitate versus forestall the natural processes of self-motivation and healthy psychological development. Specifically, factors have been examined that enhance versus undermine intrinsic motivation, self-regulation, and well-being. The findings have led to the postulate of three innate psychological needs—competence, autonomy, and relatedness—which when satisfied yield enhanced self-motivation and mental health and when thwarted lead to diminished motivation and well-being. Also considered is the significance of these psychological needs and processes within domains such as health care, education, work, sport, religion, and psychotherapy.</p>
<p>Recent literature has described how the capacity for concurrent self-assessment—ongoing moment-to-moment self-monitoring—is an important component of the professional competence of physicians. Self-monitoring refers to the ability to notice our own actions, curiosity to examine the effects of those actions, and willingness to use those observations to improve behavior and thinking in the future. Self-monitoring allows for the early recognition of cognitive biases, technical errors, and emotional reactions and may facilitate self-correction and development of therapeutic relationships. Cognitive neuroscience has begun to explore the brain functions associated with self-monitoring, and the structural and functional changes that occur during mental training to improve attentiveness, curiosity, and presence. This training involves cultivating habits of mind such as experiencing information as novel, thinking of “facts” as conditional, seeing situations from multiple perspectives, suspending categorization and judgment, and engaging in self-questioning. The resulting awareness is referred to as mindfulness and the associated moment-to-moment self-monitoring as mindful practice—in contrast to being on “automatic pilot” or “mindless” in one's behavior. This article is a preliminary exploration into the intersection of educational assessment, cognitive neuroscience, and mindful practice, with the hope of promoting ways of improving clinicians' capacity to self-monitor during clinical practice, and, by extension, improve the quality of care that they deliver.</p>
<p>Background : Recent research suggests that the Mindfulness-Based Stress Reduction program has positive effects on health, but little is known about the immediate physiological effects of different components of the program. Purpose : To examine the short-term autonomic and cardiovascular effects of one of the techniques employed in mindfulness meditation training, a basic body scan meditation. Methods : In Study 1, 32 healthy young adults (23 women, 9 men) were assigned randomly to either a meditation, progressive muscular relaxation or wait-list control group. Each participated in two laboratory sessions 4 weeks apart in which they practiced their assigned technique. In Study 2, using a within-subjects design, 30 healthy young adults (15 women, 15 men) participated in two laboratory sessions in which they practiced meditation or listened to an audiotape of a popular novel in counterbalanced order. Heart rate, cardiac respiratory sinus arrhythmia (RSA), and blood pressure were measured in both studies. Additional measures derived from impedance cardiography were obtained in Study 2. Results : In both studies, participants displayed significantly greater increases in RSA while meditating than while engaging in other relaxing activities. A significant decrease in cardiac pre-ejection period was observed while participants meditated in Study 2. This suggests that simultaneous increases in cardiac parasympathetic and sympathetic activity may explain the lack of an effect on heart rate. Female participants in Study 2 exhibited a significantly larger decrease in diastolic blood pressure during meditation than the novel, whereas men had greater increases in cardiac output during meditation compared to the novel. Conclusions : The results indicate both similarities and differences in the physiological responses to body scan meditation and other relaxing activities.</p>
OBJECTIVE: Although the efficacy of meditation interventions has been examined among adult samples, meditation treatment effects among youth are relatively unknown. We systematically reviewed empirical studies for the health-related effects of sitting-meditative practices implemented among youth aged 6 to 18 years in school, clinic, and community settings. METHODS: A systematic review of electronic databases (PubMed, Ovid, Web of Science, Cochrane Reviews Database, Google Scholar) was conducted from 1982 to 2008, obtaining a sample of 16 empirical studies related to sitting-meditation interventions among youth. RESULTS: Meditation modalities included mindfulness meditation, transcendental meditation, mindfulness-based stress reduction, and mindfulness-based cognitive therapy. Study samples primarily consisted of youth with preexisting conditions such as high-normal blood pressure, attention-deficit/hyperactivity disorder, and learning disabilities. Studies that examined physiologic outcomes were composed almost entirely of African American/black participants. Median effect sizes were slightly smaller than those obtained from adult samples and ranged from 0.16 to 0.29 for physiologic outcomes and 0.27 to 0.70 for psychosocial/behavioral outcomes. CONCLUSIONS: Sitting meditation seems to be an effective intervention in the treatment of physiologic, psychosocial, and behavioral conditions among youth. Because of current limitations, carefully constructed research is needed to advance our understanding of sitting meditation and its future use as an effective treatment modality among younger populations.
- Practices of Hindu Contemplation,
- Contemplation by Applied Subject,
- Contemplation by Tradition,
- Scientific Studies of Transcendental Meditation,
- Transcendental Meditation (TM),
- Psychiatry and Contemplation,
- Medical Research on Contemplative Practice,
- Mindfulness-Based Stress Reduction / Cognitive Therapy,
- Psychotherapy and Contemplation,
- K-12 Education and Contemplation,
- Health Care and Contemplation,
- Education and Contemplation,
- Hindu Contemplation
OBJECTIVE: To test the hypothesis that socioeconomic status (SES) would be associated with sleep quality measured objectively, even after controlling for related covariates (health status, psychosocial characteristics). Epidemiological studies linking SES and sleep quality have traditionally relied on self-reported assessments of sleep. METHODS: Ninety-four women, 61 to 90 years of age, participated in this study. SES was determined by pretax household income and years of education. Objective and subjective assessments of sleep quality were obtained using the NightCap sleep system and the Pittsburgh Sleep Quality Index (PSQI), respectively. Health status was determined by subjective health ratings and objective measures of recent and chronic illnesses. Depressive symptoms and neuroticism were quantified using the Center for Epidemiological Studies Depression Scale and the Neuroticism subscale of the NEO Personality Inventory, respectively. RESULTS: Household income significantly predicted sleep latency and sleep efficiency even after adjusting for demographic factors, health status, and psychosocial characteristics. Income also predicted PSQI scores, although this association was significantly attenuated by inclusion of neuroticism in multivariate analyses. Education predicted both sleep latency and sleep efficiency, but the latter association was partially reduced after health status and psychosocial measures were included in analyses. Education predicted PSQI sleep efficiency component scores, but not global scores. CONCLUSIONS: These results suggest that SES is robustly linked to both subjective and objective sleep quality, and that health status and psychosocial characteristics partially explain these associations.
Mindfulness, or being fully present and attentive to the moment, not only improves the way doctors engage with patients but also mitigates the stresses of clinical practice.
<p>Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.</p>
BACKGROUND: EEG alpha power has been demonstrated to be inversely related to mental activity and has subsequently been used as an indirect measure of brain activation. The hypothesis that the thalamus serves as a neuronal oscillator of alpha rhythms has been supported by studies in animals, but only minimally by studies in humans. METHODS: In the current study, PET-derived measures of regional glucose metabolism, EEG, and structural MRI were obtained from each participant to assess the relation between thalamic metabolic activity and alpha power in depressed patients and healthy controls. The thalamus was identified and drawn on each subject's MRI. The MRI was then co-registered to the corresponding PET scan and metabolic activity from the thalamus extracted. Thalamic activity was then correlated with a 30-min aggregated average of alpha EEG power. RESULTS: Robust inverse correlations were observed in the control data, indicating that greater thalamic metabolism is correlated with decreased alpha power. No relation was found in the depressed patient data. CONCLUSIONS: The results are discussed in the context of a possible abnormality in thalamocortical circuitry associated with depression.
Several randomised controlled trials suggest that mindfulness-based approaches are helpful in preventing depressive relapse and recurrence, and the UK Government’s National Institute for Health and Clinical Excellence has recommended these interventions for use in the National Health Service. There are good grounds to suggest that mindfulness-based approaches are also helpful with anxiety disorders and a range of chronic physical health problems, and there is much clinical and research interest in applying mindfulness approaches to other populations and problems such as people with personality disorders, substance abuse, and eating disorders. We review the UK context for developments in mindfulness-based approaches and set out criteria for mindfulness teacher competence and training steps, as well as some of the challenges and future directions that can be anticipated in ensuring that evidence-based mindfulness approaches are available in health care and other settings.
This study explores two conflictingmodels of how patients experience mind-bodytherapies; these models frame the design of aclinical trial examining the effects of qigong (a traditional Chinese movementtherapy) on the immune systems of former cancerpatients. Data consist of ethnographic researchand in-depth interviews conducted at the Bostonteaching hospital where the trial is to takeplace. These interviews, with biomedicalresearchers who designed the trial and with theqigong master responsible for the qigong arm of the trial, reveal twofundamentally different understandings of howqigong is experienced and how thatexperience may be beneficial. The biomedicalteam sees qigong as a non-specifictherapy which combines relaxation and exercise. The qigong master, on the other hand,sees qigong as using specific movementsand visualizations to direct mental attentionto specific areas of the body. Thus while thebiomedical team frames qigong as a“mind-body” practice, the qigong masterframes it as a “mind-in-body” practice. This research suggests that the biomedicalnotion that mind-body therapies work byeliciting mental relaxation is only one way ofthinking about how patients experiencemodalities like qigong: indeed,characterizations of mind-body therapies whichemphasize a mental sense of relaxation may bespecific to biomedicine and the cultures whichsurround it. More broadly, the paper arguesthat gaps in understanding between researchersand practitioners may be hindering scientificefforts to assess therapies like qigong.It concludes by proposing that clinical trialsof traditional and alternative therapies buildethnographic inquiry about practitionerexperience into the design process.
This preliminary study examined whether the practice of mind–body techniques decreases symptoms of posttraumatic stress in adolescents. Posttraumatic Stress Reaction Index questionnaires were collected from 139 high school students in Kosovo who participated in a 6-week program that included meditation, biofeedback, drawings, autogenic training, guided imagery, genograms, movement, and breathing techniques. Three separate programs were held approximately 2 months apart. There was no control group. Posttraumatic stress scores significantly decreased after participation in the programs. These scores remained decreased in the 2 groups that participated in the follow-up study when compared to pretest measures. These data indicate that mind–body skills groups were effective in reducing posttraumatic stress symptoms in war-traumatized high school students.
OBJECTIVES: Affective neuroscience research that investigates core symptoms of pediatric bipolar disorder (PBD) may be effective in differentiating PBD phenotypes. The current study used affect-modulated startle to examine potential differences in reactivity to emotional stimuli (reward and punishment) in narrow and broad phenotype PBD and controls. METHODS: Thirty children meeting DSM-IV bipolar disorder criteria (i.e. narrow phenotype PBD with defined manic episodes with elevated/expansive mood), 19 children meeting criteria for severe mood dysregulation (i.e. broad phenotype with chronic irritability, hyper-reactivity, and hyperarousal), and 19 controls completed a lottery startle paradigm involving reward (money) and punishment (loud noise). Startle probes were presented during anticipation of the emotional stimulus, immediately following the presentation of the stimulus, or during return to baseline following the stimulus. RESULTS: By self-report, patients and controls found the putative punishment to be preferable to the neutral condition. In the reward condition, patient samples reported greater arousal than did controls, but no between-group differences were found on the magnitude of startle response during the reward, punishment, or neutral conditions. CONCLUSIONS: The failure to find differences in affect-modulated startle between control children and those with narrow or broad PBD phenotypes speaks to the methodological challenges associated with studying reward mechanisms in PBD. Alternative paradigms that focus on different aspects of reward mechanisms are discussed.
The authors examine the facet structure of mindfulness using five recently developed mindfulness questionnaires. Two large samples of undergraduate students completed mindfulness questionnaires and measures of other constructs. Psychometric properties of the mindfulness questionnaires were examined, including internal consistency and convergent and discriminant relationships with other variables. Factor analyses of the combined pool of items from the mindfulness questionnaires suggested that collectively they contain five clear, interpretable facets of mindfulness. Hierarchical confirmatory factor analyses suggested that at least four of the identified factors are components of an overall mindfulness construct and that the factor structure of mindfulness may vary with meditation experience. Mindfulness facets were shown to be differentially correlated in expected ways with several other constructs and to have incremental validity in the prediction of psychological symptoms. Findings suggest that conceptualizing mindfulness as a multifaceted construct is helpful in understanding its components and its relationships with other variables.
Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η(2) = .18). There were significant improvements over time for general distress (η(2) = .09), anxiety (η(2) = .08), hostility (η(2) = .07), and medical symptoms (η(2) = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.
<p>This article opens by noting that positive emotions do not fit existing models of emotions. Consequently, a new model is advanced to describe the form and function of a subset of positive emotions, including joy, interest, contentment, and love. This new model posits that these positive emotions serve to broaden an individual's momentary thought-action repertoire, which in turn has the effect of building that individual's physical, intellectual, and social resources. Empirical evidence to support this broaden-and-build model of positive emotions is reviewed, and implications for emotion regulation and health promotion are discussed.</p>
We have developed a low dose Mindfulness-Based Intervention (MBI-ld) that reduces the time committed to meetings and formal mindfulness practice, while conducting the sessions during the workday. This reduced the barriers commonly mentioned for non-participation in mindfulness programs. In a controlled randomized trial we studied university faculty and staff (n=186) who were found to have an elevated CRP level,>3.0 mg/ml, and who either had, or were at risk for cardiovascular disease. This study was designed to evaluate if MBI-ld could produce a greater decrease in CRP, IL-6 and cortisol than an active control group receiving a lifestyle education program when measured at the end of the 2 month interventions. We found that MBI-ld significantly enhanced mindfulness by 2-months and it was maintained for up to a year when compared to the education control. No significant changes were noted between interventions in cortisol, IL-6 levels or self-reported measures of perceived stress, depression and sleep quality at 2-months. Although not statistically significant (p=.08), the CRP level at 2-months was one mg/ml lower in the MBI-ld group than in the education control group, a change which may have clinical significance (Ridker et al., 2000; Wassel et al., 2010). A larger MBI-ld effect on CRP (as compared to control) occurred among participants who had a baseline BMI <30 (-2.67 mg/ml) than for those with BMI >30 (-0.18 mg/ml). We conclude that MBI-ld should be more fully investigated as a low-cost self-directed complementary strategy for decreasing inflammation, and it seems most promising for non-obese subjects.