The role of dispositional mindfulness in the fear-avoidance model of pain.

OBJECTIVE: The fear-avoidance model of pain posits that a painful stimulus is interpreted through pain catastrophizing, which leads to negative downstream cognitions, emotions, and behaviors that shape the experience of pain. As dispositional mindfulness is associated with less catastrophizing and pain, some researchers have suggested incorporating mindfulness into the fear-avoidance model. Across two studies, we empirically tested dispositional mindfulness as a stand-alone component within the fear-avoidance model of pain. METHODS: Two independent, online cross-sectional surveys (Ns = 362 and 580 U.S. adults) were conducted. Participants completed validated assessments of mindfulness, pain catastrophizing, fear of pain, pain vigilance, depression, pain intensity, and pain sensitivity. Using structural equation modeling, we tested the inclusion of dispositional mindfulness in the fear-avoidance model of pain. We proposed that greater mindfulness would be associated with less pain catastrophizing, which in turn would be associated with less fear of pain, leading to less depression, and then ultimately less pain intensity and pain sensitivity. RESULTS: Across both studies, the fear-avoidance model of pain did not fit the data well, with or without mindfulness included. We found that a simplified model fit the data best (Study 1: χ2/df = 1.83; CFI = .981; RMSEA = .049, 90% CI [0.019, 0.076]; SRMR = 0.031; Study 2: χ2/df = 2.23; CFI = .976; RMSEA = .046, 90% CI [0.026, 0.067]; SRMR = .031), such that greater mindfulness was significantly associated with less pain catastrophizing and, in turn, lower levels of pain intensity and pain sensitivity. CONCLUSION: Our findings suggest that a simplified model, compared to the traditional fear-avoidance model, may partly explain the experience of pain among individuals without chronic pain. Future work should examine the temporal associations among these variables to inform the employment of future empirically supported interventions for pain management.

Perceptions and Expectations of School-Based Professionals Surrounding School-Based Mindfulness Training in Appalachia During the COVID-19 Pandemic: A Qualitative Study.

Background: School-based professionals often report high burnout, particularly in geographic areas like Appalachia, where school-aged children are exposed to high levels of adverse childhood experiences, which may be exacerbated by the COVID-19 pandemic. While school-based mindfulness trainings can reduce burnout, their efficacy is influenced by the expectations of intervention personnel ahead of implementation. The present study assessed expectations and perceptions of a school-based mindfulness training among school personnel in 21 Appalachian schools during the COVID-19 pandemic. Methods: Upon enrollment in the training, staff (N = 191) responded to open ended survey questions regarding perceived impacts of COVID-19 on students, expected benefits and barriers to school-based mindfulness, and perceived community acceptance of mindfulness. Results: School personnel identified social isolation and lack of structure as negative impacts of COVID-19 on students. Expected benefits of classroom mindfulness included improved coping skills, focus, and emotion regulation, whereas barriers included lack of time and student ability level (e.g., age, attention). While most respondents indicated that their community was accepting of mindfulness practices, some noted resistance to and misperceptions of mindfulness, which may illustrate the influence of local cultural norms and values on the acceptability of mental health interventions. Conclusions: Overall, these findings suggest positive expectations and relative perceived support for mindfulness practices within these Appalachian communities, including in response to negative impacts of the COVID-19 pandemic on students. Adapting practices and language to accommodate barriers such as time, student ability, and cultural misconceptions of mindfulness may increase the feasibility and efficacy of these interventions.

A Mixed-Method Assessment of a 10-Day Mobile Mindfulness Intervention.

Mobile mindfulness interventions represent a promising alternative to traditional in-person interventions that are resource demanding and have limited accessibility, preventing use by many populations. Despite greater accessibility and popularity of mobile mindfulness applications (apps), research is needed testing the effectiveness of brief interventions delivered via these platforms. The present study assessed the efficacy of a brief mobile mindfulness intervention compared to an active control for increasing state and trait mindfulness and improving mood, as well as the acceptability of the app, in a sample of undergraduate students. Participants (N=139; M age=19.43years, 80.6% female, 83.5% White) were randomly assigned to either a 10-day mobile mindfulness (Headspace) or cognitive training (Peak) condition. Trait mindfulness was measured pre- and post-intervention. During the 10-day intervention, participants completed 10-min daily exercises on the assigned app, responded to daily questionnaires of state mindfulness and mood, and completed a daily written log of their reactions to the app exercises. Attrition was low (90% completion rate) and did not differ by condition. Participants in the mindfulness condition spent an average of 88.15min (SD=24.75) meditating out of the full 100min prescribed by the intervention. State mindfulness significantly increased across the 10-day intervention for participants in the mindfulness, but not the cognitive training, condition beginning around days 5 and 6. Some aspects of trait mindfulness increased and mood improved from pre- to post-intervention, but these changes were observed in both conditions (i.e., no significant differences were observed by condition). Qualitative analysis of open-ended reactions to the mindfulness app indicated that participants reported more likes than dislikes. Common themes for likes were that participants experienced feelings of calm and focus following the daily mindfulness exercises. Dislikes included discomfort and anxiety associated with increased awareness of thoughts and physical sensations. These findings suggest that while a brief mobile mindfulness intervention is acceptable to undergraduate college students and effective at increasing state mindfulness, a longer intervention may be needed in order to elicit corresponding changes in trait-level mindfulness or mood.

Mind your gaze: Examining the relation between trait mindfulness and visual attention to valenced images.

Trait mindfulness pertains to one's ability to non-judgmentally attend to experiences. While attention regulation represents a core component of mindfulness, the relation between trait mindfulness and visual attention is unclear. Further, despite established associations between mindfulness and emotion regulation, few studies have examined whether trait mindfulness may be related to attention to emotionally valenced content. Thus, the present study used an eye-tracking paradigm to assess relations between trait mindfulness, emotion regulation and selective visual attention to valenced stimuli. Participants (N = 123; 75.6 % female; 87 % Caucasian; Mage = 19.14 years) completed measures of trait mindfulness, emotion regulation, and engaged in an eye-tracking paradigm in which they viewed sad, threatening, neutral, and happy images simultaneously. Dwell times on images (all categories combined), black space on screen, and each image category were calculated. Bivariate correlations were assessed to determine the relations among mindfulness, emotion regulation, and visual attention, controlling for mood. Trait mindfulness was associated with longer dwell time on images overall, but specifically longer dwell time on threatening and happy images. Although trait mindfulness and emotion regulation were positively associated, emotion regulation was not significantly associated with visual attention. These results suggest that trait mindfulness is associated with visual attention to valenced stimuli, particularly happy and threatening images, and emotion regulation does not account for these relations. These findings add to our understanding of the cognitive mechanisms underlying trait mindfulness.

Mindfulness and engagement in COVID-19 preventive behavior.

The novel coronavirus disease 2019 (COVID-19) pandemic represents a significant risk to population health. Health organizations worldwide have recommended numerous preventive health behaviors to slow the spread of COVID-19. Yet, considerable variability exists in individual-level adherence to these recommendations. Mindfulness has been associated with greater engagement in health promotive behavior (e.g., physical activity, healthy eating), and may serve as an individual difference factor that encourages adherence. However, no study to date has examined the extent to which mindfulness is associated with preventive health behaviors during a global pandemic. The purpose of the present study was to assess the relations between mindfulness and recommended preventive health behaviors for COVID-19. A national U.S. sample (N = 353; M age = 41.47 years, range: 19-84; 50.2% female) completed an online survey via Amazon's Mechanical Turk from April 3rd to 15th, 2020, including measures of mindfulness and frequency of avoiding touching one's face, handwashing, disinfecting/cleaning frequently used surfaces, social distancing, and self-quarantining. Personality, health risk, and demographic factors were also assessed to test the unique association between mindfulness and preventive health behaviors. Mindfulness was significantly correlated with greater engagement in all of the COVID-19 preventive health behaviors. However, when accounting for demographics, health risk, and personality, mindfulness was only uniquely associated with engagement in social distancing. This research highlights mindfulness as an individual-level characteristic associated with engagement in COVID-19 preventive health behavior and may inform future prevention efforts aimed at improving adherence to recommendations for curbing the spread of infectious disease.