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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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<p>Humans often judge others egocentrically, assuming that they feel or think similarly to themselves. Emotional egocentricity bias (EEB) occurs in situations when others feel differently to oneself. Using a novel paradigm, we investigated the neurocognitive mechanisms underlying the developmental capacity to overcome such EEB in children compared with adults. We showed that children display a stronger EEB than adults and that this correlates with reduced activation in right supramarginal gyrus (rSMG) as well as reduced coupling between rSMG and left dorsolateral prefrontal cortex (lDLPFC) in children compared with adults. Crucially, functional recruitment of rSMG was associated with age-related differences in cortical thickness of this region. Although in adults the mere presence of emotional conflict occurs between self and other recruited rSMG, rSMG-lDLPFC coupling was only observed when implementing empathic judgements. Finally, resting state analyses comparing connectivity patterns of rSMG with that of right temporoparietal junction suggested a unique role of rSMG for self-other distinction in the emotional domain for adults as well as for children. Thus, children’s difficulties in overcoming EEB may be due to late maturation of regions distinguishing between conflicting socio-affective information and relaying this information to regions necessary for implementing accurate judgments.</p>
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BACKGROUND: Autism is a syndrome of unknown cause, marked by abnormal development of social behavior. Attempts to link pathological features of the amygdala, which plays a key role in emotional processing, to autism have shown little consensus. OBJECTIVE: To evaluate amygdala volume in individuals with autism spectrum disorders and its relationship to laboratory measures of social behavior to examine whether variations in amygdala structure relate to symptom severity. DESIGN: We conducted 2 cross-sectional studies of amygdala volume, measured blind to diagnosis on high-resolution, anatomical magnetic resonance images. Participants were 54 males aged 8 to 25 years, including 23 with autism and 5 with Asperger syndrome or pervasive developmental disorder not otherwise specified, recruited and evaluated at an academic center for developmental disabilities and 26 age- and sex-matched community volunteers. The Autism Diagnostic Interview-Revised was used to confirm diagnoses and to validate relationships with laboratory measures of social function. MAIN OUTCOME MEASURES: Amygdala volume, judgment of facial expressions, and eye tracking. RESULTS: In study 1, individuals with autism who had small amygdalae were slowest to distinguish emotional from neutral expressions (P=.02) and showed least fixation of eye regions (P=.04). These same individuals were most socially impaired in early childhood, as reported on the Autism Diagnostic Interview-Revised (P<.04). Study 2 showed smaller amygdalae in individuals with autism than in control subjects (P=.03) and group differences in the relation between amygdala volume and age. Study 2 also replicated findings of more gaze avoidance and childhood impairment in participants with autism with the smallest amygdalae. Across the combined sample, severity of social deficits interacted with age to predict different patterns of amygdala development in autism (P=.047). CONCLUSIONS: These findings best support a model of amygdala hyperactivity that could explain most volumetric findings in autism. Further psychophysiological and histopathological studies are indicated to confirm these findings.
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This article presents an overview of the author's recent electrophysiological studies of anterior cerebral asymmetries related to emotion and affective style. A theoretical account is provided of the role of the two hemispheres in emotional processing. This account assigns a major role in approach- and withdrawal-related behavior to the left and right frontal and anterior temporal regions of two hemispheres, respectively. Individual differences in approach- and withdrawal-related emotional reactivity and temperament are associated with stable differences in baseline measures of activation asymmetry in these anterior regions. Phasic state changes in emotion result in shifts in anterior activation asymmetry which are superimposed upon these stable baseline differences. Future directions for research in this area are discussed.
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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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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.

Background Early life stress (ELS) can compromise development, with higher amounts of adversity linked to behavioral problems. To understand this linkage, a growing body of research has examined two brain regions involved with socioemotional functioning—amygdala and hippocampus. Yet empirical studies have reported increases, decreases, and no differences within human and nonhuman animal samples exposed to different forms of ELS. This divergence in findings may stem from methodological factors, nonlinear effects of ELS, or both. Methods We completed rigorous hand-tracing of the amygdala and hippocampus in three samples of children who experienced different forms of ELS (i.e., physical abuse, early neglect, or low socioeconomic status). Interviews were also conducted with children and their parents or guardians to collect data about cumulative life stress. The same data were also collected in a fourth sample of comparison children who had not experienced any of these forms of ELS. Results Smaller amygdala volumes were found for children exposed to these different forms of ELS. Smaller hippocampal volumes were also noted for children who were physically abused or from low socioeconomic status households. Smaller amygdala and hippocampal volumes were also associated with greater cumulative stress exposure and behavioral problems. Hippocampal volumes partially mediated the relationship between ELS and greater behavioral problems. Conclusions This study suggests ELS may shape the development of brain areas involved with emotion processing and regulation in similar ways. Differences in the amygdala and hippocampus may be a shared diathesis for later negative outcomes related to ELS.
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Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.

We propose that cognition is more than a collection of independent processes operating in a modular cognitive system. Instead, we propose that cognition emerges from dependencies between all of the basic systems in the brain, including goal management, perception, action, memory, reward, affect, and learning. Furthermore, human cognition reflects its social evolution and context, as well as contributions from a developmental process. After presenting these themes, we illustrate their application to the process of anticipation. Specifically, we propose that anticipations occur extensively across domains (i.e., goal management, perception, action, reward, affect, and learning) in coordinated manners. We also propose that anticipation is central to situated action and to social interaction, and that many of its key features reflect the process of development.
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This article examines the lay meditation movement occurring in contemporary Buddhism in Sri Lanka. The lay meditation movement represents a different perspective from the nationalistic Sinhala Buddhism that has dominated the discourse in the wake of the intractable ethnic conflict in the country. The lay meditation movement reflects the contemporary ferment in Buddhist discourse among the laity. One of the key themes in this movement is the privileging of experience because it gives the lay groups authority to challenge contemporary orthodoxy and it has empowered a new class of spiritual leaders, the lay gurus. Paraphrasing Stirrat, we can say that these lay gurus are leading the lay meditation movement towards ‘a series of different interpretations of what it means’ to be a Buddhist today. In its overall effect the lay meditation movement not only reconstructs what it means to be a Buddhist today but also points in the direction of establishing new forms of sectarianism that could be considered to be ‘new religious movements’ under the umbrella of Buddhism.

Background: Mindfulness is the development of a nonjudgmental accepting awareness of moment-by-moment experience. Intentionally attending to one’s ongoing stream of sensations, thoughts, and emotions as they arise has a number of benefits, including the ability to react with greater flexibility to events and sustain attention. Thus the teaching of mindfulness-based skills to children and their carers is a potential means of improving family relationships and helping children achieve more positive developmental outcomes through increased ability to sustain attention and manage emotions. We provide a review of recent studies evaluating mindfulness-based interventions targeting children, adolescents, and families in educational and clinical settings.Method: Searches were conducted of several databases (including Medline, PsychINFO and Cochrane Reviews) to identify studies that have evaluated mindfulness-based interventions targeting children, adolescents or families published since 2009.Results: Twenty-four studies were identified. We conclude that mindfulness-based interventions are an important addition to the repertoire of existing therapeutic techniques. However, large-scale, methodologically rigorous studies are lacking. The interventions used in treatment evaluations vary in both content and dose, the outcomes targeted have varied, and no studies have employed methodology to investigate mechanisms of change.Conclusions: There is increasing evidence that mindfulness-based therapeutic techniques can have a positive impact on a range of outcome variables. A greater understanding of the mechanisms of change is an important future direction of research. We argue that locating mindfulness-based therapies targeting children and families within the broader child and family field has greater promise in improving child and family functioning than viewing mindful parenting as an independent endeavor.
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Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.

Between June 2004 and April 2005, the Garrison Institute… mapped the current status of programs utilizing contemplative techniques with mainstream student populations in K-12 educational settings. The Mapping Project sought to identify similarities and differences in program pedagogy and methodology…

Raised in the tumult of Japan's industrial powerhouse, the eleven men and women profiled in this book have all made the transition to sustainable, fulfilling lives. They are today artists, philosophers, and farmers who reside deep in the mountains of rural Japan. Their lives may be simple, yet they are surrounded by the luxuries of nature, art, contemplation, delicious food, and an abundance of time. For example: Atsuko Watanabe is an environmentalist and home-schooler who explores Christian mysticism while raising her two daughters in an old farmhouseAkira Ito is an ex-petroleum engineer who has become a painter and children's book illustrator and explores the role of "chi" (life energy) in the universe through art and musicKogan Murata grows rice and crafts elegant bamboo flutes that he plays for alms in the surrounding villagesJinko Kaneko is a fine artist and fabric dyer who runs a Himalayan-style curry restaurant in the Japan AlpsBy presenting the journeys of these ordinary--yet exceptional--people, Andy Couturier shows how we too can travel a meaningful path of living simply, with respect for our communities and our natural resources. When we leave behind the tremendous burdens of wage labor, debt, stress, and daily busyness, we grow rich in a whole new way. These Japanese are pioneers in a sense; drawing on traditional Eastern spiritual wisdom, they have forged a new style of modernity, and in their success is a lesson for us all: live a life that matters.Andy Couturier is an essayist, poet, and writing teacher. He lived in Japan for four years where he taught, was a journalist, and worked on environmental causes. He lives in the San Francisco Bay Area.

We report the results of a quasi-experimental study evaluating the effectiveness of the Mindfulness Education (ME) program. ME is a theoretically derived, teacher-taught universal preventive intervention that focuses on facilitating the development of social and emotional competence and positive emotions, and has as its cornerstone daily lessons in which students engage in mindful attention training (three times a day). Pre- and early adolescent students in the 4th to 7th grades (N = 246) drawn from six ME program classrooms and six comparison classrooms (wait-list controls) completed pretest and posttest self-report measures assessing optimism, general and school self-concept, and positive and negative affect. Teachers rated pre- and early adolescents on dimensions of classroom social and emotional competence. Results revealed that pre- and early adolescents who participated in the ME program, compared to those who did not, showed significant increases in optimism from pretest to posttest. Similarly, improvements on dimensions of teacher-rated classroom social competent behaviors were found favoring ME program students. Program effects also were found for self-concept, although the ME program demonstrated more positive benefits for preadolescents than for early adolescents. Teacher reports of implementation fidelity and dosage for the mindfulness activities were high and teachers reported that they were easily able to integrate the mindful attention exercises within their classrooms. Theoretical issues linking mindful attention awareness to social and emotional competence and implications for the development of school-based interventions are discussed.
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Mindfulness-based Stress Reduction, a stress-reduction program, has increasing empirical support as a patient-care intervention. Its emphasis on self-care, compassion, and healing makes it relevant as an intervention for helping nurses manage stress and reduce burnout. This article describes the implementation of Mindfulness-based Stress Reduction in a hospital system as a way to lower burnout and improve well-being among nurses, using both quantitative and qualitative data.

This article is the second in a series reporting on research exploring the effects of Mindfulness-based Stress Reduction on nurses and describes the quantitative data. The third article describes qualitative data. Treatment group participants reduced scores on 2 of 3 subscales of the Maslach Burn...

Part III of the study on mindfulness-based stress reduction (MBSR) describes qualitative data and discusses the implications of the findings. Study analysis revealed that nurses found MBSR helpful. Greater relaxation and self-care and improvement in work and family relationships were among reported benefits. Challenges included restlessness, physical pain, and dealing with difficult emotions.

Social comparison can elicit emotions such as envy, which can affect social interactions. The emergence and development of such social emotions through ontogeny, and their influence on social interaction, are unknown. We tested 182 children from 7 to 13 years of age with a novel monetary reward-and-punishment task measuring envy and Schadenfreude (i.e., gloating or taking delight in someone else’s misfortune). Children were either rewarded or punished in a trial-by-trial evaluation of their performance on a speeded reaction time task. In a social condition, feedback of their own and a competitor’s performance was given for each trial. Afterward, children rated how they felt about the outcome. The ratings suggest that when children won, they felt better if the competitor lost instead of winning (i.e., Schadenfreude). Conversely, when children lost, they felt worse if the competitor won instead of losing (i.e., envy). Crucially, levels of envy and Schadenfreude decreased with age. We also studied how these emotions relate to social decisions made separately during three resource allocation paradigms. In each, children chose between two options that differed in the distribution of valuable tokens between themselves and an anonymous other. The combination of choices allowed the measurement of inequity aversion (i.e., equality for all) and spite (i.e., self-profit to maximal disadvantage of the other). We found an age-related increase in inequity aversion and decrease in spite. Crucially, age-related changes in both envy and Schadenfreude predicted the developmental change in equity-related decisions. These findings shed light on the development of social emotions and demonstrate their importance in the development of prosocial behavior in children.
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