In situ fNIRS measurements during cognitive behavioral emotion regulation training in rumination-focused therapy: A randomized-controlled trial.

Repetitive negative thinking (RNT), including rumination, plays a key role in various psychopathologies. Although several psychotherapeutic treatments have been developed to reduce RNT, the neural correlates of those specific treatments and of psychotherapy in general are largely unknown. Functional near-infrared spectroscopy (fNIRS) offers the potential to investigate the neural correlates of psychotherapeutic techniques in situ. Therefore, in this study we investigated the efficacy and neural correlates of a fNIRS adapted Mindfulness-based Emotion Regulation Training (MBERT) for the treatment of depressive rumination in 42 subjects with major depressive disorder (MDD) in a cross-over designed randomized controlled trial. Using psychometric measures, subjective ratings and fNIRS, we analyzed in situ changes in depressive symptom severity, ruminative thoughts and cortical activity in the Cognitive Control Network (CCN). Our results show that MBERT is effective in treating depressive symptoms and rumination. On a neural level, we found consistently higher cortical activation during emotion regulation training compared to control trials in the bilateral inferior frontal gyrus (IFG) and dorsolateral prefrontal cortex (DLPFC). Furthermore, cortical oxygenation decreased from session to session in the bilateral DLPFC. The relevance of the results for the psychotherapeutic treatment of MDD as well as further necessary investigations are discussed.

Real-Time fMRI Functional Connectivity Neurofeedback Reducing Repetitive Negative Thinking in Depression: A Double-Blind, Randomized, Sham-Controlled Proof-of-Concept Trial.

INTRODUCTION: Repetitive negative thinking (RNT) is a cognitive process focusing on self-relevant and negative experiences, leading to a poor prognosis of major depressive disorder (MDD). We previously identified that connectivity between the precuneus/posterior cingulate cortex (PCC) and right temporoparietal junction (rTPJ) was positively correlated with levels of RNT. OBJECTIVE: In this double-blind, randomized, sham-controlled, proof-of-concept trial, we employed real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) to delineate the neural processes that may be causally linked to RNT and could potentially become treatment targets for MDD. METHODS: MDD-affected individuals were assigned to either active (n = 20) or sham feedback group (n = 19). RNT was measured by the Ruminative Response Scale-brooding subscale (RRS-B) before and 1 week after the intervention. RESULTS: Individuals in the active but not in the sham group showed a significant reduction in the RRS-B; however, a greater reduction in the PCC-rTPJ connectivity was unrelated to a greater reduction in the RRS-B. Exploratory analyses revealed that a greater reduction in the retrosplenial cortex (RSC)-rTPJ connectivity yielded a more pronounced reduction in the RRS-B in the active but not in the sham group. CONCLUSIONS: RtfMRI-nf was effective in reducing RNT. Considering the underlying mechanism of rtfMIR-nf, the RSC and rTPJ could be part of a network (i.e., default mode network) that might collectively affect the intensity of RNT. Understanding the relationship between the functional organization of targeted neural changes and clinical metrics, such as RNT, has the potential to guide the development of mechanism-based treatment of MDD.

Orientação a pais por chamadas de áudio durante a pandemia de covid-19 / Support for parents via audio calls during the covid-19 pandemic / Orientación de los padres mediante llamadas de audio durante la pandemia de covid-19

O distanciamento social ocasionado pela pandemia de Covid-19 levou a profundas mudanças na rotina das famílias com crianças pequenas, aumentando o estresse no ambiente doméstico. Este estudo analisou a experiência de planejamento e implementação de um projeto de extensão universitária que ofereceu orientação a pais com filhos de 0 a 11 anos por meio de chamadas de áudio durante a pandemia. O protocolo de atendimento foi desenvolvido para atender às necessidades de famílias de baixa renda e listava problemas específicos relacionados ao confinamento em casa e ao fechamento das escolas seguidos por uma variedade de estratégias de enfrentamento. A análise de 223 queixas relatadas pelos usuários em 130 ligações revelou que 94% dos problemas referidos pelos pais foram contemplados pelo protocolo de atendimento e estavam relacionados aos problemas externalizantes (39%) ou internalizantes (26%) das crianças ou ao declínio do bem-estar subjetivo dos pais (29%). Serviços de apoio devem orientar os pais quanto ao uso de práticas responsivas e assertivas que promovam o bem-estar emocional da criança e estabeleçam expectativas comportamentais em contextos estressantes. A diminuição dos conflitos entre pais e filhos resultante do uso dessas estratégias tende a reduzir o sofrimento dos pais, aumentando sua sensação de bem-estar subjetivo. Recomenda-se ampla divulgação dessas iniciativas e seguimento dos casos.(AU)

The social distancing the COVID-19 pandemic entailed has led to profound changes in the routine of families with young children, increasing stress in the home environment. This study analyzed the experience of planning and implementing a university extension program that offered support to parents with children from 0 to 11 years old via audio calls during the COVID-19 pandemic. The service protocol was developed to meet the needs of low-income families and listed specific problems related to home confinement and school closure followed by a variety of coping strategies. The analysis of 223 complaints reported by users in 130 calls revealed that 94% of the problems reported by parents were addressed by the protocol and were related to children's externalizing (39%) or internalizing (26%) problems or to the decline in parents' subjective well-being (29%). Support services should guide parents on the use of responsive and assertive practices that promote the child's emotional well-being and set behavioral expectations in stressful contexts. The reduction in conflicts between parents and children resulting from the use of these strategies tends to reduce parents' suffering, increasing their sense of subjective well-being. Wide dissemination of these initiatives and case follow-up are recommended.(AU)

La distancia social causada por la pandemia de COVID-19 condujo a cambios profundos en la rutina de las familias con niños pequeños, aumentando el estrés en el entorno del hogar. Este estudio analizó la experiencia de planificar e implementar un proyecto de extensión universitaria que ofreció orientación a los padres con niños de cero a 11 años a través de llamadas de audio durante la pandemia COVID-19. El protocolo de atención se desarrolló para satisfacer las necesidades de las familias de bajos ingresos y enumeró problemas específicos relacionados con el confinamiento en el hogar y el cierre de la escuela, seguido de una variedad de estrategias de afrontamiento. El análisis de 223 quejas informadas por los usuarios en 130 llamadas reveló que el 94% de los problemas informados por los padres fueron abordados por el protocolo de atención y estaban relacionados con los problemas de externalización (39%) o internalización (26%) de los niños o la disminución del bienestar subjetivo de los padres (29%). Los servicios de apoyo deberían aconsejar a los padres sobre el uso de prácticas receptivas y asertivas que promuevan el bienestar emocional del niño y establezcan expectativas de comportamiento en contextos estresantes. La reducción de los conflictos entre padres e hijos como resultado del uso de estas estrategias tiende a reducir el sufrimiento de los padres, aumentando su sensación de bienestar subjetivo. Se recomienda una amplia difusión de estas iniciativas y seguimiento de casos.(AU)

Evaluation of a stand-alone mobile mindfulness app in people experiencing infertility: the protocol for an exploratory randomised controlled trial (MoMiFer-RCT).

INTRODUCTION: Infertility and its treatment bring a considerable emotional burden. Increasing evidence demonstrates the effectiveness of smartphone-delivered mindfulness apps for reducing symptoms of emotional distress in both clinical and non-clinical populations. Evidence on this topic in women, men and couples experiencing infertility is currently under-represented. The aim of the MoMiFer study is, therefore, to investigate the efficacy of a stand-alone mobile mindfulness app on symptoms of emotional distress and fertility-related quality of life in people experiencing infertility. METHODS AND ANALYSIS: This study is an exploratory randomised controlled trial (RCT) with open enrollment. The primary outcomes are symptoms of emotional distress and fertility-related quality of life. Secondary outcomes are mindfulness skills, repetitive negative thinking, self-compassion, user-rated quality of the stand-alone mobile mindfulness app and use of the app. Experience sampling method and standardised self-report questionnaires are combined within a repeated measures design to measure the effects of the stand-alone mobile mindfulness app on the primary and secondary outcomes, apart from the use of the app. The latter will be evaluated through app tracking. People, including women, men and couples, experiencing infertility (n=60) will be randomised to an intervention group receiving the stand-alone mobile mindfulness app for 3 months or a wait-list control group. The app follows the format and content of Mindfulness-Based Stress Reduction. Data will be collected at baseline, at 1.5 months and 3 months after randomisation. Analysis will be according to intention to treat and based on general linear modelling and multilevel mixed-effects modelling. ETHICS AND DISSEMINATION: This study received approval from the Medical Ethical Committee of the Leuven University Hospital (Belgium). The findings of this exploratory RCT will be disseminated through presentations at public lectures, scientific institutions and meetings, and through peer-reviewed scientific articles. TRIAL REGISTRATION NUMBER: NCT04143828.

Depressed mood and repetitive negative thinking in Delayed Sleep-Wake Phase Disorder: Treatment effects and a comparison with good sleepers.

Circadian dysregulation and depressed mood commonly co-occur in young people, yet mechanisms linking Delayed Sleep-Wake Phase disorder (DSWPD) with depression are poorly understood. The present study aimed to examine the role of repetitive negative thinking (RNT), by comparing sleep, RNT and depressive symptomology between 40 'good' sleeping young people and 63 with DSWPD, with (n = 30) and without (n = 33) self-reported doctor-diagnosed depression. Secondary analysis from a randomised controlled trial was also undertaken to observe changes in depressive symptoms and RNT as a result of treatment for DSWPD. The 60 young people with DSWPD (mean [SD] age of 15.9 [2.2] years, 63% female) received either short (green) or long (red) wavelength bright light therapy (BLT) over 3 weeks. Cross-sectional baseline comparisons revealed an escalating pattern of worse sleep, more RNT and higher depressed mood scores in the DSWPD young people compared to good sleepers. Across all participants, RNT accounted for the associations between sleep-onset difficulties and depressed mood at baseline. Symptoms of depression, RNT and sleep onset difficulties in DSWPD individuals significantly improved after treatment (d = 0.47-0.65) and at the 1- (d = 0.43-1.00) and 3-month follow-up (d = 0.39-1.38), yet there were no differences between short- and long-wavelength BLT. Results provide preliminary evidence that RNT may link delayed sleep phase with depression. BLT conferred sleep benefits, but also improvements in depressed mood and RNT, and thus represents a potentially cost-effective strategy for young people experiencing delayed sleep phase and low mood.

Biology of Perseverative Negative Thinking: The Role of Timing and Folate Intake.

Past-oriented rumination and future-oriented worry are two aspects of perseverative negative thinking related to the neuroticism endophenotype and associated with depression and anxiety. Our present aim was to investigate the genomic background of these two aspects of perseverative negative thinking within separate groups of individuals with suboptimal versus optimal folate intake. We conducted a genome-wide association study in the UK Biobank database (n = 72,621) on the "rumination" and "worry" items of the Eysenck Personality Inventory Neuroticism scale in these separate groups. Optimal folate intake was related to lower worry, but unrelated to rumination. In contrast, genetic associations for worry did not implicate specific biological processes, while past-oriented rumination had a more specific genetic background, emphasizing its endophenotypic nature. Furthermore, biological pathways leading to rumination appeared to differ according to folate intake: purinergic signaling and circadian regulator gene ARNTL emerged in the whole sample, blastocyst development, DNA replication, and C-C chemokines in the suboptimal folate group, and prostaglandin response and K+ channel subunit gene KCNH3 in the optimal folate group. Our results point to possible benefits of folate in anxiety disorders, and to the importance of simultaneously taking into account genetic and environmental factors to determine personalized intervention in polygenic and multifactorial disorders.

Acceptability and Preliminary Effects of a Mindfulness Mobile Application for Ruminative Adolescents.

Rumination is a transdiagnostic risk factor that appears to be reduced through mindfulness interventions. However, mindfulness mobile apps have not been tested for their effects on rumination, especially among adolescents. Thus, we aimed to test the acceptability and effects of a mindfulness mobile intervention among ruminative adolescents using a within-subjects pretest/posttest design. Participants were 80 adolescents ages 12-15, selected for moderate-to-high rumination (M age = 14.01, SD = .99; 46.2% girls; 86.25% White; 3.75% Hispanic). We asked adolescents to use our mindfulness app 3 times per day for 3 weeks. Participants and parents completed questionnaires at baseline, post-intervention, and 6 and 12 weeks later. Acceptability was assessed by tracking app use and asking adolescents and parents to report on their experiences post-intervention. We assessed repetitive negative thinking (i.e., rumination and worry) and internalizing symptoms via self- and parent-report. The intervention demonstrated acceptability, and there were significant reductions in rumination, worry, anxiety and parent-reported internalizing symptoms post-intervention. Effects on rumination, anxiety and internalizing symptoms persisted throughout the 12-week follow-up with large effect sizes using an intention-to-treat approach. Thus, a brief mindfulness mobile app intervention appeared to be both engaging and helpful in reducing negative repetitive thinking and internalizing symptoms among ruminative adolescents. It will be important to test this intervention in a randomized controlled trial to control for effects of time and attention.

Longitudinal changes in spiritual well-being and associations with emotional distress, pain, and optimism-pessimism: a prospective observational study of terminal cancer patients admitted to a palliative care unit.

PURPOSE: Although spiritual well-being (SWB) is gaining increasing attention within the international palliative care (PC) guidelines, a lack of insight exists into the correlates and course of SWB among cancer patients. We therefore conducted a prospective observational study to capture trend of SWB and to identify their predictors in Chinese inpatients with terminal cancer receiving short-term PC. METHODS: A prospective observational study was conducted of terminal cancer inpatients in the hospice ward, Shengjing Hospital of China Medical University. A total of 108 patients completed self-report questionnaires on Functional Assessment of Chronic Illness Therapy-Spiritual Well-being, Hospital Anxiety and Depression Scale, Numerical Rating Scales, and Life Orientation Scale-Revised anonymously at baseline; SWB, depression, anxiety, and pain were subsequently assessed at 1-week interval. Multilevel regression was used to analyze the temporal course and predictors of SWB. RESULTS: Patients' existential well-being (B = - 0.99, p = 0.008; 95%CI = - 1.72 to - 0.26) and meaning dimension (B = - 0.87, p < 0.001; 95% CI = - 1.29 to - 0.43) significantly decreased after admission to the PC unit, but peace and faith did not change over time. Increases in depression and pain were related to lower existential well-being, particularly in the meaning dimension. Optimism-pessimism moderated the linear trend of existential well-being and meaning domain, such that those with higher optimism and lower pessimism paired with a decrease in outcomes. CONCLUSIONS: Terminal cancer patients experienced worsening existential well-being, particularly in the meaning facet while hospitalized, indicating that PC should include content that targets the existential concerns of spirituality in China. These findings also supported the need for an integrated PC to address personality traits and emotional and physical distress in this population.

Differential effects of mindfulness meditation conditions on repetitive negative thinking and subjective time perspective: a randomized active-controlled study.

ObjectivePreliminary findings suggest that different kinds of meditation could work on diverse cognitive and psychological processes. The present study aimed at disentangling the effects of three mindfulness techniques on mental rumination and subjective time perspective. Design: 75 young healthy participants were randomly assigned to one of four conditions: mindful breathing, body scan, observing-thoughts meditation and an active control condition. The meditation groups practiced mindfulness daily and attended weekly group meetings for 8 weeks, while the control group was involved in reading and discussing a book about mindfulness. Main outcome measures: Self-report measures of mindfulness skills, ruminative thinking, attitude towards time, anxiety, depression and personality traits. Results: In all meditation conditions, analysis of covariance showed a significant improvement in mindfulness skills compared to the control group. We found a specific effect of mindful breathing in reducing participants' tendency to brooding and in increasing their positive vision of the future, compared to all other conditions. Conclusions: As expected, we found some differential effects: breathing meditation helped practitioners to train more effectively their ability to disengage from maladaptive ruminative thoughts, which could be reflected in a more optimistic attitude toward the future. These results provide useful information to structure better mindfulness-based interventions.

Effects of modifying interpretation bias on transdiagnostic repetitive negative thinking.

OBJECTIVE: Repetitive negative thinking (RNT; e.g., worry and rumination) is common across emotional disorders, as is the tendency to generate negative interpretations (interpretation bias). Ameliorating negative interpretations via cognitive bias modification of interpretations (CBM-I) reduces worry/rumination, and improves mood in people diagnosed with generalized anxiety disorder (GAD) or depression. We investigated whether these findings generalize to high worry or rumination populations, irrespective of diagnosis, and whether effects are increased by enhancing emotional engagement with training with active generation of positive resolutions of ambiguity and imagery. METHOD: Community volunteers with excessive worry and/or rumination, who were above clinical cut-off on anxiety and/or depression measures, were allocated to an active control condition (n = 54), interpretation training condition with prior activation of RNT (CBM_RNT; n = 54), or training condition augmented with positive outcome generation and imagery (CBM_ENH; n = 53). Interpretation bias, RNT, and mood were assessed before and following 10 Internet-based sessions completed within a 1-month period. RNT and mood questionnaires were also completed at 1-month follow-up. RESULTS: After training, both forms of CBM-I (vs. control) facilitated more positive interpretations and reduced negative intrusions during a worry task. At 1-month follow-up, anxiety, depression, RNT, and worry in the past week were lower in the CBM-I than control conditions, but not rumination or trait worry. Compared with standard CBM-I, the augmented form facilitated more positive interpretations, reduced negative intrusions after training, and reduced trait rumination at 1-month follow-up, but it did not augment effects on trait worry, anxiety or depression. CONCLUSIONS: Interpretation bias maintains transdiagnostic RNT and Internet-based CBM-I can reduce longer-term RNT. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations.

So far, the large and expanding body of research on meditation has mostly focussed on the putative benefits of meditation on health and well-being. However, a growing number of reports indicate that psychologically unpleasant experiences can occur in the context of meditation practice. Very little is known about the prevalence and potential causes of these experiences. The aim of this study was to report the prevalence of particularly unpleasant meditation-related experiences in a large international sample of regular meditators, and to explore the association of these experiences with demographic characteristics, meditation practice, repetitive negative thinking, mindfulness, and self-compassion. Using a cross-sectional online survey, 1,232 regular meditators with at least two months of meditation experience (mean age = 44.8 years ± 13.8, 53.6% female) responded to one question about particularly unpleasant meditation-related experiences. A total of 315 participants (25.6%, 95% CI: 23.1 to 28.0) reported having had particularly unpleasant meditation-related experiences, which they thought may have been caused by their meditation practice. Logistic regression models indicated that unpleasant meditation-related experiences were less likely to occur in female participants and religious participants. Participants with higher levels of repetitive negative thinking, those who only engaged in deconstructive types of meditation (e.g., vipassana/insight meditation), and those who had attended a meditation retreat at any point in their life were more likely to report unpleasant meditation-related experiences. The high prevalence of particularly unpleasant meditation-related experiences reported here points to the importance of expanding the scientific conception of meditation beyond that of a (mental) health-promoting and self-regulating technique. We propose that understanding when these experiences are constitutive elements of meditative practice rather than merely negative effects could advance the field and, to that end, we conclude with an overview of methodological and conceptual considerations that could be used to inform future research.

Cognitive "insomnia" processes in delayed sleep-wake phase disorder: Do they exist and are they responsive to chronobiological treatment?

OBJECTIVE: To systematically investigate whether cognitive "insomnia" processes are implicated in adolescent Delayed Sleep-Wake Phase Disorder (DSWPD) and to examine whether these processes are responsive to chronobiological treatment. METHOD: Sixty-three adolescents (M = 15.8 ± 2.2 years, 63.5% f) diagnosed with DSWPD and 40 good sleeping adolescents (M = 15.9 ± 2.4 years, 75% f) completed baseline measures of sleep, daytime functioning and cognitive "insomnia" processes (i.e., repetitive negative thinking, physiological hyperarousal, distress, sleep-related attention and monitoring, sleep misperception). Sixty DSWPD adolescents (M = 15.9 ± 2.2 y, 63% f) entered a treatment trial and received 3 weeks of light therapy. Sleep, daytime functioning, and insomnia were measured again post-treatment and at 3-month follow-up. RESULTS: Adolescents with DSWPD had significantly later sleep timing (d = 0.99-1.50), longer sleep latency (d = 1.14), and shorter total sleep time (d = 0.85) on school nights, compared with the good sleeping adolescents. There was evidence of cognitive "insomnia" symptoms, with the DSWPD group reporting more repetitive negative thinking (d = 0.70-1.02), trait hyperarousal (d = 0.55), distress (d = 2.19), sleep associated monitoring (d = 0.76), and sleep onset misperception (d = 1.29). Across treatment and follow-up, adolescents with DSWPD reported advanced sleep timing (d = 0.54-0.62), reduced sleep latency (d = 0.53), increased total sleep time (d = 0.49), and improved daytime functioning (d = 0.46-1.00). Repetitive negative thinking (d = 0.64-0.96), physiological arousal (d = 0.69), distress (d = 0.87), and sleep onset misperception (d = 0.37) also showed improvement. CONCLUSIONS: Cognitive "insomnia" processes may be implicated in the development and maintenance of DSWPD in adolescents. Many of these processes are amendable to chronobiological treatment; however, residual symptoms may place adolescents at risk of poor treatment outcome or relapse. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Does the future look bright? Processing style determines the impact of valence weighting biases and self-beliefs on expectations.

People regularly form expectations about their future, and whether those expectations are positive or negative can have important consequences. So, what determines the valence of people's expectations? Research seeking to answer this question by using an individual-differences approach has established that trait biases in optimistic/pessimistic self-beliefs and, more recently, trait biases in behavioral tendencies to weight one's past positive versus negative experiences more heavily each predict the valence of people's typical expectations. However, these two biases do not correlate, suggesting limits on a purely individual-differences approach to predicting people's expectations. We hypothesize that, because these two biases appear to operate via distinct processes (with self-beliefs operating top-down and valence weighting bias operating bottom-up), to predict a person's expectations on a given occasion, it is also critical to consider situational factors influencing processing style. To test this hypothesis, we investigated how an integral part of future thinking that influences processing style-mental imagery-determines each bias's influence. Two experiments measured valence weighting biases and optimistic/pessimistic self-beliefs, then manipulated whether participants formed expectations using their own first-person visual perspective (which facilitates bottom-up processes) or an external third-person visual perspective (which facilitates top-down processes). Expectations corresponded more with valence weighting biases from the first-person (vs. third-person) but more with self-beliefs from the third-person (vs. first-person). Two additional experiments manipulated valence weighting bias, demonstrating its causal role in shaping expectations (and behaviors) with first-person, but not third-person, imagery. These results suggest the two biases operate via distinct processes, holding implications for interventions to increase optimism. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The vividness of imagining emotional feelings in positive situations is attenuated in non-clinical dysphoria and predicts the experience of positive emotional feelings.

OBJECTIVE: The vividness of imagining emotional feelings in positive situations (EFP) in non-clinically dysphoric and non-dysphoric individuals and its relation to dysphoric and positive feelings was examined. METHOD: Participants were university students in Study 1 (N = 106, 84 women; 18-45 years), in Study 2 (N = 43, 39 women; 20-47 years), in Study 3 (N = 109, 92 women; 18-50 years) who filled out a set of questionnaires assessing depressive symptoms, cognition measures, and then completed an affective imagery task, using a cross-sectional design. RESULTS: Non-clinically dysphoric participants imagined less vividly EFP than non-dysphoric participants. The vividness of imagining EFP accounted for group differences in positive feelings beyond positive and negative cognition and negative mood. CONCLUSIONS: In addition to deficits in the general imagery of positive events, the attenuation of vividness of EFP in non-clinical dysphoric individuals warrants attention as a separate pathway by which non-clinically dysphoric individuals develop deficiencies of conscious positive feelings.

The role of negative affect, rumination, cognitive fusion and mindfulness on depressive symptoms in depressed outpatients and normative individuals

This study examined the mediating effect of rumination, cognitive fusion and mindfulness, in the relationship between negative affect (NA) and depressive symptoms, and the differences between depressed outpatients and normative individuals. A cross-sectional design, employing validated questionnaires was used to measure NA, depressive symptoms, rumination, cognitive fusion and mindfulness in 140 participants (70 with Major Depressive Disorder, 57 female; 70 normative individuals, 44 female). Our tested model showed that cognitive fusion was the only significant mediator of the relationship between NA and depressive symptoms. Furthermore, our results showed that both rumination and mindfulness have a mediation effect in the relationship between NA and cognitive fusion. A partial metric invariance was indicated, allowing the identification of specific parameters that may be acting differently in the two samples. Our study showed that individuals high in NA, who repeatedly think about negative aspects of the self/situations, may become easily attached to literal content of thoughts and less sensitive to the contingencies of direct experience, which may increases their depressive symptoms. However, adopting a non-evaluative perspective of unwanted private experiences, seems to be central to achieve a psychological distance from their negative thoughts/feelings, and possibly a consequential decrease of depressive symptoms. As rumination, cognitive fusion, and mindfulness operate differently across depressed outpatients and normative individuals, a deeply understanding of their unique relations allow us to plane more effective interventions

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Positive visual reframing: A randomised controlled trial using drawn visual imagery to defuse the intensity of negative experiences and regulate emotions in healthy adults / Reformulación Visual Positiva: Un ensayo controlado aleatorizado utilizando imágenes visuales para disminuir la intensidad de experiencias negativas y regular emociones en adultos sanos

This research explores the outcome of positive visual reframing (PVR), a single session intervention where drawn images of negative experiences and open memories were redrawn and visually reframed to form new positive narratives. The study hypothesised that PVR would lead to improvements to positive and negative affect, self-efficacy and the perceived intensity and perceived resolution of a selected negative experience. Healthy adults (n = 62) were randomly assigned to the PVR or control condition. For the experimental group, statistical significance was identified for positive affect and the perceived intensity and resolution of the negative experience immediately following the PVR activity. Self-efficacy was marginally significant. The findings highlight the potential of positive visual reframing to enhance emotional regulation when negative emotions are triggered. At two weeks' post-intervention, improvements were identified in both conditions. This suggests that over time, the visual and sensory exposure created by drawing a negative memory may also lead to positive gains. The study emphasises the potential of PVR to regulate emotions and defuse the intensity of negative or open memories by visually transforming a moment of peak perceptual intensity. Future studies exploring the effectiveness of positive visual reframing to shift negative emotions in clinical and non-clinical populations are recommended

Se exploran los resultados de la reformulación visual positiva (RVP), una intervención en la que imágenes de memorias abiertas y experiencias negativas son reformuladas visualmente para formar nuevas narrativas positivas. El estudio plantea la hipótesis de que la RVP conduciría a mejoras en el afecto positivo y negativo, autoeficacia e intensidad y resolución percibidas de experiencias negativas. 62 adultos sanos fueron aleatorizados a condiciones de RVP o control. Se hallaron mejoras para el grupo experimental en niveles de afecto positivo, así como intensidad percibida y resolución de la experiencia negativa inmediatamente después de completar la actividad de RVP. Estos hallazgos ponen de relieve el potencial de la RVP para mejorar la regulación emocional cuando se activan emociones negativas. A las dos semanas se identificaron mejoras en ambas condiciones. Esto sugiere que, con el tiempo, la exposición viso-sensorial creada al extraer un recuerdo negativo también puede conducir a mejoría. El estudio hace hincapié en el potencial de la RVP para regular emociones y difuminar la intensidad de un recuerdo abierto mediante la transformación visual de un momento de máxima intensidad perceptual. Se recomiendan estudios que exploren la efectividad de la RVP para cambiar percepciones negativas en poblaciones clínicas y no clínicas

The effects of cognitive-behavior therapy for depression on repetitive negative thinking: A meta-analysis.

It is not clear if treatments for depression targeting repetitive negative thinking (RNT: rumination, worry and content-independent perseverative thinking) have a specific effect on RNT resulting in better outcomes than treatments that do not specifically target rumination. We conducted a systematic search of PsycINFO, PubMed, Embase and the Cochrane library for randomized trials in adolescents, adults and older adults comparing CBT treatments for (previous) depression with control groups or with other treatments and reporting outcomes on RNT. Inclusion criteria were met by 36 studies with a total of 3307 participants. At post-test we found a medium-sized effect of any treatment compared to control groups on RNT (g = 0.48; 95% CI: 0.37-0.59). Rumination-focused CBT: g = 0.76, <0.01; Cognitive Control Training: g = 0.62, p < .01; CBT: g = 0.57, p < .01; Concreteness training: g = 0.53, p < .05; and Mindfulness-based Cognitive Therapy: g = 0.42, p < .05 had medium sized and significantly larger effect sizes than other types of treatment (i.e., anti-depressant medication, light therapy, engagement counseling, life review, expressive writing, yoga) (g = 0.14) compared to control groups. Effects on RNT at post-test were strongly associated with the effects on depression severity and this association was only significant in RNT-focused CBT. Our results suggest that in particular RNT-focused CBT may have a more pronounced effect on RNT than other types of interventions. Further mediation and mechanistic studies to test the predictive value of reductions in RNT following RNT-focused CBT for subsequent depression outcomes are called for.

Effects of a Mindfulness Intervention on Sports-Anxiety, Pessimism, and Flow in Competitive Cyclists.

BACKGROUND: This study investigated whether mindfulness training increases athletes' mindfulness and flow experience and decreases sport-specific anxiety and sport-specific pessimism. METHODS: Cyclists were assigned to an eight-week mindfulness intervention, which incorporated a mindful spin-bike training component, or a wait-list control condition. Participants completed baseline and post-test measures of mindfulness, flow, sport-anxiety, and sport-related pessimistic attributions. RESULTS: Analyses of covariance showed significant positive effects on mindfulness, flow, and pessimism for the 27 cyclists in the mindfulness intervention condition compared with the 20 cyclists in the control condition. Changes in mindfulness experienced by the intervention participants were positively associated with changes in flow. CONCLUSIONS: Results suggest that mindfulness-based interventions tailored to specific athletic pursuits can be effective in facilitating flow experiences.

The Mediating Role of Optimism and Pessimism on the Relationship between Spirituality and Depression among Elderly Cancer Patients

BACKGROUND: Numerous studies have demonstrated that spirituality has protective effects on depression. However, there are only few studies on the theoretical mechanism showing how spirituality effects on depression. Thus, to find mediating variables explaining the relationship between the spirituality and depression may help to develop appropriate program for reducing depression in elderly cancer patients. In this study, we examined the effect of optimism and pessimism as their mediating effects on depression. METHODS: This study is to verify the relationships between spirituality and depression along with the mediating effects of optimism and pessimism among 600 South Korean elderly cancer patients who participated in a community-based study about their mental health. RESULTS: Optimism and pessimism are linked with spirituality and depression. Higher spirituality levels were associated with increased optimistic thinking, and then optimistic thinking is associated with low possibility of depression, whereas lower spirituality levels were associated with more pessimistic thinking, and in turn pessimistic thinking is associated with high depression scores. CONCLUSIONS: Understanding optimism and pessimism affecting depression level is critical for developing spirituality-based programs to reduce depression in elderly cancer patients.