Design and Implementation of a Brief Digital Mindfulness and Compassion Training App for Health Care Professionals: Cluster Randomized Controlled Trial.

BACKGROUND: Several studies show that intense work schedules make health care professionals particularly vulnerable to emotional exhaustion and burnout. OBJECTIVE: In this scenario, promoting self-compassion and mindfulness may be beneficial for well-being. Notably, scalable, digital app-based methods may have the potential to enhance self-compassion and mindfulness in health care professionals. METHODS: In this study, we designed and implemented a scalable, digital app-based, brief mindfulness and compassion training program called "WellMind" for health care professionals. A total of 22 adult participants completed up to 60 sessions of WellMind training, 5-10 minutes in duration each, over 3 months. Participants completed behavioral assessments measuring self-compassion and mindfulness at baseline (preintervention), 3 months (postintervention), and 6 months (follow-up). In order to control for practice effects on the repeat assessments and calculate effect sizes, we also studied a no-contact control group of 21 health care professionals who only completed the repeated assessments but were not provided any training. Additionally, we evaluated pre- and postintervention neural activity in core brain networks using electroencephalography source imaging as an objective neurophysiological training outcome. RESULTS: Findings showed a post- versus preintervention increase in self-compassion (Cohen d=0.57; P=.007) and state-mindfulness (d=0.52; P=.02) only in the WellMind training group, with improvements in self-compassion sustained at follow-up (d=0.8; P=.01). Additionally, WellMind training durations correlated with the magnitude of improvement in self-compassion across human participants (ρ=0.52; P=.01). Training-related neurophysiological results revealed plasticity specific to the default mode network (DMN) that is implicated in mind-wandering and rumination, with DMN network suppression selectively observed at the postintervention time point in the WellMind group (d=-0.87; P=.03). We also found that improvement in self-compassion was directly related to the extent of DMN suppression (ρ=-0.368; P=.04). CONCLUSIONS: Overall, promising behavioral and neurophysiological findings from this first study demonstrate the benefits of brief digital mindfulness and compassion training for health care professionals and compel the scale-up of the digital intervention. TRIAL REGISTRATION: Trial Registration: International Standard Randomized Controlled Trial Number Registry ISRCTN94766568, https://www.isrctn.com/ISRCTN94766568.

Resting State Dynamics in People with Varying Degrees of Anxiety and Mindfulness: A Nonlinear and Nonstationary Perspective.

Anxiety and mindfulness are two inversely linked traits shown to be involved in various physiological domains. The current study used resting state electroencephalography (EEG) to explore differences between people with low mindfulness-high anxiety (LMHA) (n = 29) and high mindfulness-low anxiety (HMLA) (n = 27). The resting EEG was collected for a total of 6 min, with a randomized sequence of eyes closed and eyes opened conditions. Two advanced EEG analysis methods, Holo-Hilbert Spectral Analysis and Holo-Hilbert cross-frequency phase clustering (HHCFPC) were employed to estimate the power-based amplitude modulation of carrier frequencies, and cross-frequency coupling between low and high frequencies, respectively. The presence of higher oscillation power across the delta and theta frequencies in the LMHA group than the HMLA group might have been due to the similarity between the resting state and situations of uncertainty, which reportedly triggers motivational and emotional arousal. Although these two groups were formed based on their trait anxiety and trait mindfulness scores, it was anxiety that was found to be significant predictor of the EEG power, not mindfulness. It led us to conclude that it might be anxiety, not mindfulness, which might have contributed to higher electrophysiological arousal. Additionally, a higher δ-ß and δ-γ CFC in LMHA suggested greater local-global neural integration, consequently a greater functional association between cortex and limbic system than in the HMLA group. The present cross-sectional study may guide future longitudinal studies on anxiety aiming with interventions such as mindfulness to characterize the individuals based on their resting state physiology.

Low delta and high alpha power are associated with better conflict control and working memory in high mindfulness, low anxiety individuals.

Working memory capacity (WMC) can predict conflict control ability. Measures of both abilities are impaired by anxiety, which is often inversely linked with mindfulness. It has been shown that a combination of high mindfulness and low anxiety is associated with better conflict control and WMC. The current study explored the electrophysiology related to such behavioral differences. Two experimental groups, one with high mindfulness and low anxiety (HMLA) and one with low mindfulness and high anxiety (LMHA), performed a color Stroop task and a change detection task, both with simultaneous electroencephalogram (EEG) recording. An advanced EEG analytical approach, Hilbert-Huang transform (HHT) analysis, was employed. This is regarded as a robust method to analyze non-linear and non-stationary signals. Lower delta activity at posterior temporal and occipital regions was seen in the HMLA group for the Stroop conflict conditions and might be generally associated with higher accuracy in this group and indicative of higher attentiveness. Higher accuracy rates and WMC were seen in the HMLA group and might be specifically associated with the higher alpha activity observed in prefrontal cortex, fronto-central and centro-parietal regions in this group. Future studies should explore how mindfulness and anxiety can independently affect these cognitive functions and their associated neurophysiology.

Indices of association between anxiety and mindfulness: a guide for future mindfulness studies.

Mindfulness and anxiety are often linked as inversely related traits and there have been several theoretical and mediational models proposed suggesting such a relationship between these two traits. The current review report offers an account of self-report measures, behavioral, electrophysiological, hemodynamic, and biological studies, which provide converging evidence for an inverse relationship between mindfulness and anxiety. To our knowledge, there are no comprehensive accounts of empirical evidence that investigate this relationship. After reviewing several empirical studies, we propose a schematic model, where a stressor can trigger the activation of amygdala which activates the hypothalamic-pituitary-adrenal (HPA) pathway. This hyperactive HPA axis leads to a cascade of psychological, behavioral, electrophysiological, immunological, endocrine, and genetic reactions in the body, primarily mediated by a sympathetic pathway. Conversely, mindfulness protects from deleterious effects of these triggered reactions by downregulating the HPA axis activity via a parasympathetic pathway. Finally, we propose a model suggesting a comprehensive scheme through which mindfulness and anxiety may interact through emotion regulation. It is recommended that future mindfulness intervention studies should examine a broad spectrum of measurement indices where possible, keeping logistic feasibility in mind and look at mindfulness in conjunction with anxiety rather than independently.

Corrigendum: Better Cognitive Performance Is Associated With the Combination of High Trait Mindfulness and Low Trait Anxiety.

[This corrects the article on p. 627 in vol. 9, PMID: 29780338.].

Meditation Effects on the Control of Involuntary Contingent Reorienting Revealed With Electroencephalographic and Behavioral Evidence.

Prior studies have reported that meditation may improve cognitive functions and those related to attention in particular. Here, the dynamic process of attentional control, which allows subjects to focus attention on their current interests, was investigated. Concentrative meditation aims to cultivate the abilities of continuous focus and redirecting attention from distractions to the object of focus during meditation. However, it remains unclear how meditation may influence attentional reorientation, which involves interaction between both top-down and bottom-up processes. We aimed to investigate the modulating effect of meditation on the mechanisms of contingent reorienting by employing a rapid serial visual presentation (RSVP) task in conjunction with electrophysiological recording. We recruited 26 meditators who had an average of 2.9 years of meditation experience and a control group comprising 26 individuals without any prior experience of meditation. All subjects performed a 30-min meditation and a rest condition with data collected pre- and post-intervention, with each intervention given on different days. The state effect of meditation improved overall accuracy for all subjects irrespective of their group. A group difference was observed across interventions, showing that meditators were more accurate and more efficient at attentional suppression, represented by a larger Pd (distractor positive) amplitude of event related modes (ERMs), for target-like distractors than the control group. The findings suggested that better attentional control with respect to distractors might be facilitated by acquiring experience of and skills related to meditation training.

Better Cognitive Performance Is Associated With the Combination of High Trait Mindfulness and Low Trait Anxiety.

There are several ways in which cognitive and neurophysiological parameters have been consistently used to explain the variability in cognitive ability between people. However, little has been done to explore how such cognitive abilities are influenced by differences in personality traits. Dispositional mindfulness and anxiety are two inversely linked traits that have been independently attributed to a range of cognitive functions. The current study investigated these two traits in combination along with measures of the attentional network, cognitive inhibition, and visual working memory (VWM) capacity. A total of 392 prospective participants were screened to select two experimental groups each of 30 healthy young adults, with one having high mindfulness and low anxiety (HMLA) and the second having low mindfulness and high anxiety (LMHA). The groups performed an attentional network task, a color Stroop task, and a change detection test of VWM capacity. Results showed that the HMLA group was more accurate than the LMHA group on the Stroop and change detection tasks. Additionally, the HMLA group was more sensitive in detecting changes and had a higher WMC than the LMHA group. This research adds to the literature that has investigated mindfulness and anxiety independently with a comprehensive investigation of the effects of these two traits in conjunction on executive function.

3ß-Hydroxy-urs-12-en-28-oic acid confers protection against ZnONPs induced adversity in Caenorhabditis elegans.

Despite their well reported potent risk towards human health and environment Zinc oxide nanoparticles (ZnONPs) find an extensive commercial usage due to their antimicrobial properties. Here, we evaluated the efficacy of a natural triterpene ursolic acid (3ß-hydroxy-urs-12-en-28-oic acid; UA) for overcoming the cytotoxic challenges of ZnONPs employing Ceanorhabditis elegans. The 24h LC50 of Zn-ONPs (<50nm TEM) was deduced as 4.75mgL-1. UA (25µM) was observed to defend against this toxicity by attenuating Reactive Oxygen Species (ROS) resulting into better survival at 2mgL-1 in a time dependent behavior. However, reproductive health remains compromised. Our study identifies UA as a natural inducer of metallothionein proteins along with antioxidant potential. We demonstrate that UA induces upregulation of predominantly antioxidant genes, including the superoxide dismutases (sod-1, sod-5 and sod-3), glutathione S-transferase 7 (gst-7), heat shock protein (hsp-16.2) along with the metal exposure responsive metallothionein (mtl-1 and mtl-2). Moreover, UA also restores elevated transcript levels of gst-4 during ZnONPs stress conditions to normal by directly scavenging ROS owing to its own antioxidant potential. Altogether, the toxic aspects of NPs that can be avoided compensated or postponed by supplementation of phytochemical(s) in biological system underscore their potential implications in near future.