The Frequent Stressor and Mental Health Monitoring-Paradigm: A Proposal for the Operationalization and Measurement of Resilience and the Identification of Resilience Processes in Longitudinal Observational Studies.

Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time windows of inter-individually comparable stressor exposure relative to which the maintenance or recovery of mental health can be determined. To address this pertinent issue, we propose to frequently and regularly monitor stressor exposure (E) and mental health problems (P) throughout a study's observation period [Frequent Stressor and Mental Health Monitoring (FRESHMO)-paradigm]. On this basis, a subject's deviation at any single monitoring time point from the study sample's normative E-P relationship (the regression residual) can be used to calculate that subject's current mental health reactivity to stressor exposure ("stressor reactivity," SR). The SR score takes into account the individual extent of experienced adversity and is comparable between and within subjects. Individual SR time courses across monitoring time points reflect intra-individual temporal variability in SR, where periods of under-reactivity (negative SR score) are associated with accumulation of fewer mental health problems than is normal for the sample. If FRESHMO is accompanied by regular measurement of potential resilience factors, temporal changes in resilience factors can be used to predict SR time courses. An increase in a resilience factor measurement explaining a lagged decrease in SR can then be considered to index a process of adaptation to stressor exposure that promotes a resilient outcome (an allostatic resilience process). This design principle allows resilience research to move beyond merely determining baseline predictors of resilience outcomes, which cannot inform about how individuals successfully adjust and adapt when confronted with adversity. Hence, FRESHMO plus regular resilience factor monitoring incorporates a dynamic-systems perspective into resilience research.

Decreased emotional reactivity after 3-month socio-affective but not attention- or meta-cognitive-based mental training: A randomized, controlled, longitudinal fMRI study.

Meditation-based mental training interventions show physical and mental health benefits. However, it remains unclear how different types of mental practice affect emotion processing at both the neuronal and the behavioural level. In the context of the ReSource project, 332 participants underwent an fMRI scan while performing an emotion anticipation task before and after three 3-month training modules cultivating 1) attention and interoceptive awareness (Presence); 2) socio-affective skills, such as compassion (Affect); 3) socio-cognitive skills, such as theory of mind (Perspective). Only the Affect module led to a significant reduction of experienced negative affect when processing images depicting human suffering. In addition, after the Affect module, participants showed significant increased activation in the right supramarginal gyrus when confronted with negative stimuli. We conclude that socio-affective, but not attention- or meta-cognitive based mental training is specifically effective to improve emotion regulation capabilities when facing adversity.

Endogenous emotion generation ability is associated with the capacity to form multimodal internal representations.

Training the capacity to self-generate emotions can be a potent "vaccine" against negative stressors and be an effective intervention for affective psychopathology. However, due to a lack of knowledge about sources of individual differences in generation abilities, it is unclear how to optimally design such interventions. We investigated one potential source of variation, namely preference for using different information modalities (Visual Imagery, Auditory Imagery, Bodily Interoception, and Semantic Analysis). A representative sample of 293 participants self-induced positive and negative emotional states, freely choosing to use these modalities singly or in combination. No evidence was found for modality usage being associated with differential efficacy at generating of positive or negative emotion. Rather, usage of all modalities (except Auditory Imagery) predicted success at generation of both positive and negative emotional states. Increasing age predicted capacity to generate, especially negative, emotions. While no specific combinations of modalities were superior, the overall degree to which participants adopted multimodal implementations did predict generation efficacy. These findings inform interventions aimed at improving emotional self-generation, suggesting these must be mindful of individual differences in generation abilities and implementation tendencies, and that they should focus on enhancing the capacity to use multiple modalities.

Structural changes in socio-affective networks: Multi-modal MRI findings in long-term meditation practitioners.

Our goal was to assess the effects of long-term mental training in socio-affective skills on structural brain networks. We studied a group of long-term meditation practitioners (LTMs) who have focused on cultivating socio-affective skills using loving-kindness and compassion meditation for an average of 40k h, comparing these to meditation-naïve controls. To maximize homogeneity of prior practice, LTMs were included only if they had undergone extensive full-time meditation retreats in the same center. MRI-based cortical thickness analysis revealed increased thickness in the LTM cohort relative to meditation-native controls in fronto-insular cortices. To identify functional networks relevant for the generation of socio-affective states, structural imaging analysis were complemented by fMRI analysis in LTMs, showing amplitude increases during a loving-kindness meditation session relative to non-meditative rest in multiple prefrontal and insular regions bilaterally. Importantly, functional findings partially overlapped with regions of cortical thickness increases in the left ventrolateral prefrontal cortex and anterior insula, suggesting that these regions may play a central role in the generation of emotional states relevant for the meditative practice. Our multi-modal MRI approach revealed structural changes in LTMs who have cultivated loving-kindness and compassion for a significant period of their life in functional networks activated by these practices. These preliminary cross-sectional findings motivate future longitudinal work studying brain plasticity following the regular practice of skills aiming at enhancing human altruism and prosocial motivation.

Compassion-based emotion regulation up-regulates experienced positive affect and associated neural networks.

Emotion regulation research has primarily focused on techniques that attenuate or modulate the impact of emotional stimuli. Recent evidence suggests that this mode regulation can be problematic in the context of regulation of emotion elicited by the suffering of others, resulting in reduced emotional connectedness. Here, we investigated the effects of an alternative emotion regulation technique based on the up-regulation of positive affect via Compassion-meditation on experiential and neural affective responses to depictions of individuals in distress, and compared these with the established emotion regulation strategy of Reappraisal. Using fMRI, we scanned 15 expert practitioners of Compassion-meditation either passively viewing, or using Compassion-meditation or Reappraisal to modulate their emotional reactions to film clips depicting people in distress. Both strategies effectively, but differentially regulated experienced affect, with Compassion primarily increasing positive and Reappraisal primarily decreasing negative affect. Imaging results showed that Compassion, relative to both passive-viewing and Reappraisal increased activation in regions involved in affiliation, positive affect and reward processing including ventral striatum and medial orbitfrontal cortex. This network was shown to be active prior to stimulus presentation, suggesting that the regulatory mechanism of Compassion is the stimulus-independent endogenous generation of positive affect.