Relative Impact of Mindfulness, Self-Compassion, and Psychological Resilience on Mental Health Outcomes in Racially Minoritized Adults.

Racially minoritized adults lack equal representation in research and experience disparities in healthcare. Little is known about which trait-level factors may help mitigate negative and promote positive psychological health among adults from these communities. The aim of this study was to assess the differential impact of dispositional mindfulness, self-compassion, and resilience in predicting depression, anxiety, stress, and life satisfaction in a sample of racially minoritized adults. This study is a cross-sectional analysis of 169 participants (37.3% female and 62.7% male) between the ages of 18 and 64 (M = 37.05; SD = 11.94). Separate hierarchical multiple regression models examined the relative influence of mindfulness facets (acting with awareness (AA); nonjudging of inner experience (NJ), and nonreactivity of inner experience (NR)), self-compassion, and resilience in predicting depression, anxiety, stress, and life satisfaction. Self-compassion, resilience, AA, and NR predicted depression; self-compassion, resilience, and NR predicted anxiety; self-compassion, resilience, and NR predicted stress; and self-compassion predicted satisfaction with life. Self-compassion, resilience, AA, NJ, and NR differentially predicted depression, anxiety, stress, and life satisfaction; however, only self-compassion consistently predicted all outcomes. Future research may incorporate an intersectional methodology and account for differences among different racially minoritized groups.

Insights about levels and source appointment of petroleum hydrocarbons in Brazilian semi-arid coastal: baseline status assessment for ocean decade targets.

The Ocean decade (2021-2030) for sustainable development proclaimed in 2017 by the UN, seeks to promote and conserve the sustainable use of oceans, seas, and marine resources. For this, the distribution of n-alkanes, polycyclic aromatic hydrocarbons (PAHs), and biomarkers, in sediments from the Fortaleza coastal zone (Mucuripe harbor (MH) and Inner Continental shelf (ICS)) were used to assess the impacts of anthropogenic activities in the area. The concentrations of total n-alkanes (Σ16 n-alkanes) in MH and ICS sediments varied from 35.9 to 94.9 and 17.9 to 197.3 µg g-1, respectively, while the isoprenoids phytane and pristane in MH and ICS sediments ranged from 0.1 to 1.69 ug g-1 and from 0.14 and 1.20 µg g-1, respectively. Most of the sediment samples presented carbon preference index (CPI) values close to unity, indicating that the area is submitted to petroleum-related sources. The concentrations of Σ16 PAHs in MH and ICS sediments varied from 87.0 to 562.0 and 98 to 288.0 ng g-1. This work presents the first investigation of the petroleum biomarkers hopanes and steranes in the Fortaleza coastal zone, in which ΣBiomarkers varied from 0.10 to 1.79 and 0.02 to 0.24 ug g-1 in MH and ICS sediments, respectively. The presence at stations of biomarkers also indicates petrogenic input. The diagnosis of the distribution of pollutants in the investigated zones of the Fortaleza coast suggests contamination from urban areas and oil spills and vessel traffic.

Immediate surgery compared with short-course neoadjuvant gemcitabine plus capecitabine, FOLFIRINOX, or chemoradiotherapy in patients with borderline resectable pancreatic cancer (ESPAC5): a four-arm, multicentre, randomised, phase 2 trial.

BACKGROUND: Patients with borderline resectable pancreatic ductal adenocarcinoma have relatively low resection rates and poor survival despite the use of adjuvant chemotherapy. The aim of our study was to establish the feasibility and efficacy of three different types of short-course neoadjuvant therapy compared with immediate surgery. METHODS: ESPAC5 (formerly known as ESPAC-5f) was a multicentre, open label, randomised controlled trial done in 16 pancreatic centres in two countries (UK and Germany). Eligible patients were aged 18 years or older, with a WHO performance status of 0 or 1, biopsy proven pancreatic ductal adenocarcinoma in the pancreatic head, and were staged as having a borderline resectable tumour by contrast-enhanced CT criteria following central review. Participants were randomly assigned by means of minimisation to one of four groups: immediate surgery; neoadjuvant gemcitabine and capecitabine (gemcitabine 1000 mg/m2 on days 1, 8, and 15, and oral capecitabine 830 mg/m2 twice a day on days 1-21 of a 28-day cycle for two cycles); neoadjuvant FOLFIRINOX (oxaliplatin 85 mg/m2, irinotecan 180 mg/m2, folinic acid given according to local practice, and fluorouracil 400 mg/m2 bolus injection on days 1 and 15 followed by 2400 mg/m2 46 h intravenous infusion given on days 1 and 15, repeated every 2 weeks for four cycles); or neoadjuvant capecitabine-based chemoradiation (total dose 50·4 Gy in 28 daily fractions over 5·5 weeks [1·8 Gy per fraction, Monday to Friday] with capecitabine 830 mg/m2 twice daily [Monday to Friday] throughout radiotherapy). Patients underwent restaging contrast-enhanced CT at 4-6 weeks after neoadjuvant therapy and underwent surgical exploration if the tumour was still at least borderline resectable. All patients who had their tumour resected received adjuvant therapy at the oncologist's discretion. Primary endpoints were recruitment rate and resection rate. Analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN, 89500674, and is complete. FINDINGS: Between Sept 3, 2014, and Dec 20, 2018, from 478 patients screened, 90 were randomly assigned to a group (33 to immediate surgery, 20 to gemcitabine plus capecitabine, 20 to FOLFIRINOX, and 17 to capecitabine-based chemoradiation); four patients were excluded from the intention-to-treat analysis (one in the capecitabine-based chemoradiotherapy withdrew consent before starting therapy and three [two in the immediate surgery group and one in the gemcitabine plus capecitabine group] were found to be ineligible after randomisation). 44 (80%) of 55 patients completed neoadjuvant therapy. The recruitment rate was 25·92 patients per year from 16 sites; 21 (68%) of 31 patients in the immediate surgery and 30 (55%) of 55 patients in the combined neoadjuvant therapy groups underwent resection (p=0·33). R0 resection was achieved in three (14%) of 21 patients in the immediate surgery group and seven (23%) of 30 in the neoadjuvant therapy groups combined (p=0·49). Surgical complications were observed in 29 (43%) of 68 patients who underwent surgery; no patients died within 30 days. 46 (84%) of 55 patients receiving neoadjuvant therapy were available for restaging. Six (13%) of 46 had a partial response. Median follow-up time was 12·2 months (95% CI 12·0-12·4). 1-year overall survival was 39% (95% CI 24-61) for immediate surgery, 78% (60-100) for gemcitabine plus capecitabine, 84% (70-100) for FOLFIRINOX, and 60% (37-97) for capecitabine-based chemoradiotherapy (p=0·0028). 1-year disease-free survival from surgery was 33% (95% CI 19-58) for immediate surgery and 59% (46-74) for the combined neoadjuvant therapies (hazard ratio 0·53 [95% CI 0·28-0·98], p=0·016). Three patients reported local disease recurrence (two in the immediate surgery group and one in the FOLFIRINOX group). 78 (91%) patients were included in the safety set and assessed for toxicity events. 19 (24%) of 78 patients reported a grade 3 or worse adverse event (two [7%] of 28 patients in the immediate surgery group and 17 [34%] of 50 patients in the neoadjuvant therapy groups combined), the most common of which were neutropenia, infection, and hyperglycaemia. INTERPRETATION: Recruitment was challenging. There was no significant difference in resection rates between patients who underwent immediate surgery and those who underwent neoadjuvant therapy. Short-course (8 week) neoadjuvant therapy had a significant survival benefit compared with immediate surgery. Neoadjuvant chemotherapy with either gemcitabine plus capecitabine or FOLFIRINOX had the best survival compared with immediate surgery. These findings support the use of short-course neoadjuvant chemotherapy in patients with borderline resectable pancreatic ductal adenocarcinoma. FUNDING: Cancer Research UK.

The Relationships Between Reduced Alcohol Use and Decreased Burnout Following Mindfulness-Based Resilience Training in Law Enforcement Officers.

Objective: This study is a secondary analysis of data collected in an earlier clinical trial of mindfulness-based resilience training (MBRT) (ClinicalTrials.gov registration number 02521454), where the MBRT condition demonstrated a significant reduction in self-reported burnout and trend-level reductions in alcohol use in law enforcement officers (LEOs). Given that MBRT is not designed to be a substance use intervention and does not contain explicit substance-related content, this study sought to clarify these findings by exploring whether improved burnout mediates reduced alcohol use. Method: Participants (n = 61) were sworn LEOs (89% male, 85% White, 8% Hispanic/Latinx) recruited from departments in a large urban metro area of the northwestern United States, and were randomized to either MBRT (n = 31) or no intervention control group (n = 30) during the trial. Results: MBRT group assignment predicted reduced burnout (b = 0.43, standard error [SE] = 0.14, p = 0.004), which subsequently predicted reduced alcohol use (b = 1.69, SE = 0.81, p = 0.045). Results suggest that reduced alcohol use was indirectly related to a reduction in burnout post-MBRT. Conclusion: Given that MBRT does not explicitly address substance use, these findings were interpreted to suggest that officers in the training acquired a new set of coping skills to deal with the operational and organizational stressors of police work.

Mindful Nonreactivity Moderates the Relationship between Chronic Stress and Pain Interference in Law Enforcement Officers.

INTRODUCTION: With high levels of both chronic stress and chronic pain, law enforcement provides a unique population in which to study the potential mitigating impact of cognitive and affective reactivity on the stress-pain link. The primary aim of the present study was to examine the moderating role of mindful nonreactivity in the relationship between chronic stress and pain interference in law enforcement officers (n = 60). METHODS: A regression analysis was conducted to determine if chronic stress predicted pain interference, and subsequently, to compute an estimate of the interaction effect of the chronic stress and mindful nonreactivity on pain interference. RESULTS: Results demonstrated the overall model was significant, F (3,55) = 5.29, p =.003, R2 = .47. When controlling for mindful nonreactivity, chronic stress significantly predicted pain interference, b = .76, t (55) = 3.40, p = .001, such that every one unit increase in chronic stress was associated with a .76 unit increase in pain interference. Results also demonstrated a significant interaction effect of mindful nonreactivity and chronic stress on pain interference, b = -.04, t (55) = -2.86, p = .006. The Johnson-Neyman technique was conducted and revealed among individuals with low levels of mindful nonreactivity, chronic stress significantly predicted pain interference. However, for individuals with greater levels of mindful nonreactivity, chronic stress no longer predicted pain interference. CONCLUSIONS: Findings contribute to a growing understanding of how mindfulness can mitigate harmful effects of stress.

Relative Impact of Mindfulness, Self-Compassion, and Psychological Flexibility on Alcohol Use and Burnout Among Law Enforcement Officers.

Objectives: In the present study, we investigated the relative impact of improvements in mindfulness, self-compassion, and psychological flexibility in predicting decreased burnout and alcohol use in a sample of law enforcement officers (LEOs) participating in a mindfulness-based intervention (MBI). Design: This study is a secondary analysis of pre/post data collected as part of a larger randomized controlled trial of mindfulness-based resilience training (MBRT). Subjects: This secondary analysis comprises pre/post data from 28 LEOs recruited from a metropolitan area and its outlying regions in the Pacific Northwest. Intervention: MBRT is a MBI tailored specifically to the culture and needs of LEOs and other first responders. Outcome measures: All included data were obtained through self-report measures. Mindfulness was assessed by the Five Facet Mindfulness Questionnaire-Short Form, self-compassion was assessed by the Self-Compassion Scale-Short Form, psychological flexibility was assessed by the Acceptance and Action Questionnaire-II, alcohol use was measured by the PROMIS® (v1.0) Alcohol Use-Short Form, and burnout was assessed by the Oldenburg Burnout Inventory. Results: In the first regression, only increases in mindfulness significantly predicted decreased postintervention problematic alcohol use. In the second regression, only increases in self-compassion significantly predicted decreased postintervention burnout. Conclusions: This study builds upon a growing body of literature on the relative impact of mindfulness, self-compassion, and psychological flexibility in predicting outcomes among high-stress cohorts. Results suggest that different components of MBIs may be emphasized to achieve unique benefits. The Clinical Trial Registration number for the parent study is NCT02521454.

Mindfulness-based resilience training for aggression, stress and health in law enforcement officers: study protocol for a multisite, randomized, single-blind clinical feasibility trial.

BACKGROUND: Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. Mindfulness training is a promising approach with high-stress populations that has been shown effective for increasing resilience and improving negative mental health outcomes common among LEOs. METHOD: Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multisite trial assessing effects of mindfulness-based resilience training versus an attention control (stress management education) and a no-intervention control on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, the current study is designed to: enhance efficiency of recruitment, engagement, and retention; optimize laboratory, assessment, and data management procedures; optimize intervention training and ensure fidelity to intervention protocols; and assess participant experience and optimize outcome measures across two sites. Herein, we describe the protocol and methodology of this multisite, randomized, single-blind clinical feasibility trial. DISCUSSION: The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience and mental health among LEOs, as well as yield significant benefits for the communities and residents they serve. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03784846. Registered on 24 December 2018.

Differential impact of mindfulness practices on aggression among law enforcement officers.

OBJECTIVES: Home-based mindfulness practice is a common component of formal mindfulness training (MT) protocols. Obtaining objective data from home-based mindfulness practice is challenging. Interpreting associations between home-based mindfulness practice and clinically impactful outcomes is complicated given the variability in recommendations in length, frequency, and type of practice. In this exploratory study, adherence to home-based practices of Mindfulness-Based Resilience Training (MBRT) was studied in order to evaluate associations with clinical outcomes. METHODS: Home practices from 24 (92% male, non-Hispanic white, aged M = 43.20 years) law enforcement officers (LEOs) from the urban Pacific Northwest enrolled in a feasibility and efficacy trial of MBRT were studied using an objective tracking device and self-report data. Outcomes included adherence to home-based mindfulness practices and self-reported aggression. RESULTS: Participants completed 59.12% of the frequency amount of practice assigned in the MBRT curriculum. Frequency of practice was associated with decreased aggression, adjusted R 2 = .41, F(3,23) = 6.14, p = .004. Duration of practice also predicted decreased aggression, adjusted R 2 = .33, F(3,23) = 4.76, p = .011. CONCLUSIONS: Home-based MBRT practices for LEOs, even at low rates of adherence, may reduce aggression. MTs may show beneficial effects for other populations presented with challenges to engage in regular MT practices.

Mindfulness Training, Implicit Bias, and Force Response Decision-making.

OBJECTIVE: The goal of this study was to assess the preliminary efficacy of a Mindfulness-Based Training (Mindfulness-based Resilience Training; MBRT) in improving weapon identification among Law Enforcement Officers (LEOs). METHODS: Participants (N = 61) were randomly assigned to either MBRT or a no-intervention control group (NIC). A self-report questionnaire assessing mindfulness and a computerized measure assessing implicit stereotype reliance were administered at baseline, post-training, and three months following intervention completion. We also collected information about meditation practice outside of the training for LEOs in the MBRT group. RESULTS: Inferential analyses yielded improvements in mindfulness in the MBRT group compared to NIC. Analyses did not provide evidence for implicit stereotype reliance at baseline and therefore did not yield a significant impact of MBRT versus NIC on implicit stereotype reliance, ps > .05; however, participants across both conditions exerted more control when responding to Black male targets compared to White male targets, F(1,74) = 3.98, p = .05, 95% CI [-.05, -.01], d = .36. CONCLUSIONS: Our results do not provide evidence for the impact of MBRT on weapon identification, but do suggest that LEOs exerted more effort when responding to images of Black males compared to White males. We discuss recommendations for future clinical trials assessing implicit stereotype reliance, viz., that researchers utilize measures more sensitive to a wider range of LEO samples and with higher ecological validity, and we discuss potential reasons why our results do not align with past research.

Mindfulness-based Wellness and Resilience intervention among interdisciplinary primary care teams: a mixed-methods feasibility and acceptability trial.

AIMS: The primary objective of this study was to evaluate feasibility and acceptability of Mindfulness-based Wellness and Resilience (MBWR): a brief mindfulness-based intervention designed to enhance resilience and is delivered to interdisciplinary primary care teams. BACKGROUND: Burnout is a pervasive, international problem affecting the healthcare workforce, characterized by emotional exhaustion, depersonalization, and decreased professional effectiveness. Delivery models of mindfulness-based resilience interventions that enhance feasibility for onsite delivery, consider cultural considerations specific to primary care, and utilize team processes that are integral to primary care are now needed. METHODS: We conducted a mixed-methods feasibility and acceptability trial of MBWR. Primary feasibility and acceptability outcomes were assessed by number of participants recruited, percent of MBWR treatment completer, and attrition rate during the 8-week intervention, and four items on a Likert-type scale. Secondary outcomes of perceived effects were measured by focus groups, an online survey, and self-reported questionnaires, including the Brief Resilience Scale, the Five Facet Mindfulness Questionnaire-Short Form, and the Self-Compassion Scale-Short Form. Participants included 31 healthcare providers on interdisciplinary primary care teams employed a safety-net medical center. In the MBWR group, 68% identified as Latinx, compared to 64% in the control group. FINDINGS: All criteria for feasibility were met and participants endorsed high levels of satisfaction and acceptability. The results of this study suggest that MBWR provides multiple perceived benefits to the individual healthcare provider, cohesion of the healthcare team, and enhanced patient care. MBWR may be a feasible and acceptable method to integrate mindfulness, resilience, and teamwork training into the primary care setting.

A Brief Mindfulness-Based Intervention for Primary Care Physicians: A Pilot Randomized Controlled Trial.

Primary care physicians experience high rates of burnout, which results in diminished quality of life, poorer quality of care, and workforce attrition. In this randomized controlled trial, our primary aim was to examine the impact of a brief mindfulness-based intervention (MBI) on burnout, stress, mindfulness, compassion, and resilience among physicians. A total of 33 physicians completed the baseline assessment and were randomized to the Mindful Medicine Curriculum (MMC; n = 17) or waitlist control group (n = 16). Participants completed self-report measures at baseline, post-MBI, and 3-month follow-up. We also analyzed satisfaction with doctor communication (DCC) and overall doctor rating (ODR) data from patients of the physicians in our sample. Participants in the MMC group reported significant improvements in stress (P < .001), mindfulness (P = .05), emotional exhaustion (P = .004), and depersonalization (P = .01) whereas in the control group, there were no improvements on these outcomes. Although the MMC had no impact on patient-reported DCC or ODR, among the entire sample at baseline, DCC and ODR were significantly correlated with several physician outcomes, including resilience and personal achievement. Overall, these findings suggest that a brief MBI can have a positive impact on physician well-being and potentially enhance patient care.

Ganglion Cyst of the Temporomandibular Joint Mimicking Auriculotemporal Neuralgia.

Ganglion cysts within the temporomandibular joint (TMJ), although uncommon, typically present with swelling, pain, trismus, and difficulty with mastication. The authors report an unusual case of a ganglion cyst in the TMJ of a 52-year-old man who presented with chief complaints of severe headaches and dizziness that had not subsided following treatment with medication, trigger point injections, or sphenopalatine ganglion blocks. The cyst appeared as a nonenhancing, T2 hyperdensity adjacent to the left TMJ condyle on magnetic resonance imaging, supported by the presence of chronic erosion and remodeling of the anterior aspect of the left condylar head on computed tomography. The cyst was surgically removed, and the patient reported that the migraines and accompanying dizziness had ceased 6 months postoperatively. The patient's presentation and improvement following surgery suggest that the location of the cyst in the TMJ and its proximity to the course of the auriculotemporal nerve may have caused auriculotemporal neuralgia, mimicking the symptoms of migraine.

Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: the POLICE study.

BACKGROUND: Police officers experience a high degree of chronic stress. Policing ranks among the highest professions in terms of disease and accident rates. Mental health is particularly impacted, evidenced by elevated rates of burnout, anxiety and depression, and poorer quality of life than the general public. Mindfulness training has been shown to reduce stress, anxiety, burnout and promote quality of life in a variety of settings, although its efficacy in this context has yet to be systematically evaluated. Therefore, this trial will investigate the efficacy of a mindfulness-based intervention versus a waitlist control in improving quality of life and reducing negative mental health symptoms in police officers. METHODS: This multicenter randomized controlled trial has three assessment points: baseline, post-intervention, and six-month follow-up. Active police officers (n = 160) will be randomized to Mindfulness-Based Health Promotion (MBHP) or waitlist control group at two Brazilian major cities: Porto Alegre and São Paulo. The primary outcomes are burnout symptoms and quality of life. Consistent with the MBHP conceptual model, assessed secondary outcomes include perceived stress, anxiety and depression symptoms, and the potential mechanisms of resilience, mindfulness, decentering, self-compassion, spirituality, and religiosity. DISCUSSION: Findings from this study will inform and guide future research, practice, and policy regarding police offer health and quality of life in Brazil and globally. TRIAL REGISTRATION: ClinicalTrials.gov NCT03114605 . Retrospectively registered on March 21, 2017.

The efficacy of elastic therapeutic tape variations on measures of ankle function and performance.

OBJECTIVES: To investigate the effects of different variations of elastic therapeutic taping (ETT) on tests used to screen for ankle injury risk and function. DESIGN: Randomized crossover. SETTING: Laboratory. PARTICIPANTS: Twelve professional male soccer players completed three experimental trials: No tape (NT), RockTape™ (RT), and Kinesio™ Tape (KT) applied to the ankle complex. OUTCOME MEASURES: Clinical and functional ankle screening tests were used to assess the effects of ETT on measures of joint position sense, postural stability and ground reaction forces. RESULTS: KT (P = 0.04) and RT (P = 0.01) demonstrated significant improvements in end range joint position sense. When compared to NT, RT significantly (P = 0.02) improved mid-range joint position sense at 15°, and time to complete a drop landing task. No significant differences were observed for measures of postural stability (P ≥ 0.12) nor ground reaction force variables (P ≥ 0.33). CONCLUSIONS: Results advocate the use of ETT for proprioceptive and functional tasks when applied to the ankles of healthy male soccer players. However, a greater number of practical and significant differences were observed when RT only was applied, indicating that practitioners may potentially advocate the use of RT for tasks requiring proprioception and functional performance.

Mindfulness-based resilience training to reduce health risk, stress reactivity, and aggression among law enforcement officers: A feasibility and preliminary efficacy trial.

The primary objective of this study was to assess feasibility and gather preliminary outcome data on Mindfulness-Based Resilience Training (MBRT) for law enforcement officers. Participants (n = 61) were randomized to either an 8-week MBRT course or a no intervention control group. Self-report and physiological data were collected at baseline, post-training, and three months following intervention completion. Attendance, adherence, post-training participant feedback, and interventionist fidelity to protocol all demonstrated feasibility of MBRT for law enforcement officers. Compared to no intervention controls, MBRT participants experienced greater reductions in salivary cortisol, self-reported aggression, organizational stress, burnout, sleep disturbance, and reported increases in psychological flexibility and non-reactivity at post-training; however, group differences were not maintained at three-month follow-up. This initial randomized trial suggests MBRT is a feasible intervention. Outcome data suggest MBRT targets key physiological, psychological, and health risk factors in law enforcement officers, consistent with the potential to improve officer health and public safety. However, follow-up training or "booster" sessions may be needed to maintain training gains. A fully powered longitudinal randomized trial is warranted.

DISPOSITIONAL MINDFULNESS MODERATES THE RELATIONSHIP BETWEEN OCCUPATIONAL STRESSORS AND PERCEIVED STRESS AMONG LAW ENFORCEMENT PERSONNEL.

Law enforcement personnel (LEPs) experience occupational stressors that can result in poor health outcomes and have a negative impact on the communities they serve. Dispositional mindfulness, or receptive awareness and attention to present moment experience, has been shown to negatively predict perceived stress and to moderate the relationship between stressors and negative stress-related outcomes. The current study is an investigation of the moderating role of specific facets of dispositional mindfulness (i.e., nonreactivity, nonjudging, and acting with awareness) in the relationship between occupational stressors and perceived stress in a sample of LEPs. As hypothesized, nonreactivity significantly moderated the relationship between operational stressors and perceived stress, such that LEPs low in nonreactivity exhibited a significant relationship between stressors and perceived stress, whereas those high in nonreactivity did not. Nonjudging also moderated the relationship between organizational stressors and perceived stress; however, unexpectedly, LEPs high in nonjudging evidenced a significant relationship between stressors and perceived stress, whereas those low in nonjudging did not. Potential implications of these findings for LEP stress reduction interventions are discussed.

ROLE OF RESILIENCE IN MINDFULNESS TRAINING FOR FIRST RESPONDERS.

First responders are exposed to critical incidents and chronic stressors that contribute to a higher prevalence of negative health outcomes compared to other occupations. Psychological resilience, a learnable process of positive adaptation to stress, has been identified as a protective factor against the negative impact of burnout. Mindfulness-Based Resilience Training (MBRT) is a preventive intervention tailored for first responders to reduce negative health outcomes, such as burnout. This study is a secondary analysis of law enforcement and firefighters samples to examine the mechanistic role of psychological resilience on burnout. Results indicated that changes in resilience partially mediated the relationship between mindfulness and burnout, and that increased mindfulness was related to increased resilience (b = .41, SE = .11, p < .01), which in turn was related to decreased burnout (b = -.25, SE = .12, p = .03). The bootstrapped confidence interval of the indirect effect did not contain zero [95% CI; -.27, -.01], providing evidence for mediation. Limitations and implications are discussed.

A Qualitative Study of Mindfulness Among Veterans With Posttraumatic Stress Disorder: Practices Differentially Affect Symptoms, Aspects of Well-Being, and Potential Mechanisms of Action.

This qualitative study explored and compared the subjective experiences of 102 veterans with posttraumatic stress disorder (PTSD) who were randomly assigned to 1 of 4 arms: ( a) body scan, ( b) mindful breathing, ( c) slow breathing, or ( d) sitting quietly. Qualitative data were obtained via semistructured interviews following the intervention and analyzed using conventional content analysis. The percentage of participants within each intervention who endorsed a specific theme was calculated. Two-proportion z tests were then calculated to determine if the differences among themes endorsed in specific groups were statistically significant. Six core themes emerged from analysis of participant responses across the 4 groups: ( a) enhanced present moment awareness, ( b) increased nonreactivity, ( c) increased nonjudgmental acceptance, ( d) decreased physiological arousal and stress reactivity, ( e) increased active coping skills, and ( f) greater relaxation. More participants in the mindfulness intervention groups reported improvement in PTSD symptoms when compared to participants in non-mindfulness groups. Different types of intervention targeted different symptoms and aspects of well-being. Furthermore, type of intervention may have also differentially targeted potential mechanisms of action. This article highlights the importance of employing both quantitative and qualitative research methods when investigating the dynamic process of mindfulness and may inform how practices can be tailored to the needs of the veteran with PTSD.

The Body Scan and Mindful Breathing Among Veterans with PTSD: Type of Intervention Moderates the Relationship Between Changes in Mindfulness and Post-treatment Depression.

Mindfulness-based stress reduction (MBSR) is a promising intervention for veterans with post-traumatic stress disorder (PTSD) and depression; however, a more detailed examination of the different elements of MBSR and various facets of mindfulness to determine what works best for whom is warranted. One hundred and two veterans with PTSD were randomly assigned to one of four arms: (a) body scan (BS; n= 27), (b) mindful breathing (MB; n=25), (c) slow breathing (SB; n=25), or (d) sitting quietly (SQ; n=25). The purpose of this study was to (a) examine two separate components of MBSR (i.e., body scan and mindful breathing) among veterans with PTSD when compared to a nonmindfulness intervention (SB) and a control group (SQ), (b) assess if changes in specific mindfulness facets were predictive of post-treatment PTSD and depression for individuals who participated in a mindfulness intervention (BS vs. MB), and (c) investigate if type of mindfulness intervention received would moderate the relationship between pre- to post-treatment changes in mindfulness facets and post-treatment outcomes in PTSD and depression. Participants in the mindfulness groups experienced significant decreases in PTSD and depression symptom severity and increases in mindfulness, whereas the nonmindfulness groups did not. Among veterans who participated in a mindfulness group, change in the five facets of mindfulness accounted for 23 % of unique variance in the prediction of post-treatment depression scores. Simple slope analyses revealed that type of mindfulness intervention moderated the relationship among changes in facets of mindfulness and post-treatment depression.