Mindfulness interventions improve momentary and trait measures of attentional control: Evidence from a randomized controlled trial.

Mindfulness interventions have been shown to improve several subcomponents of attention; however, the psychological mechanisms driving these improvements are unknown. Mindfulness interventions train individuals to monitor present moment experiences while adopting an attitude of acceptance toward these experiences. We conducted a theoretically driven randomized controlled trial to test the putative mechanisms of mindfulness training that drive improvements in attentional control. Participants were randomly assigned to 1 of 3 conditions: (a) monitor and accept (MA) training, a standard 8-week mindfulness-based stress reduction (MBSR) intervention that included cultivation of both monitoring and acceptance skills; (b) monitor only (MO) training, a well-matched modified 8-week MBSR-adapted intervention that focused on monitoring skills only; or (c) no treatment (NT) control. Momentary attentional control was measured via ecological momentary assessment for 3 days at baseline and postintervention. Trait attentional control was assessed at baseline and postintervention using traditional self-report. Participants also completed a dichotic listening task to assess sustained attention at baseline and postintervention. We found that MA and MO participants improved in momentary and trait attentional control (but not attention task performance) relative to NT participants. Analyses of indirect effects were consistent with the possibility that increased momentary attentional control partially accounts for MA/MO intervention-related increases in trait attentional control. This randomized controlled trial provides one of the first experimental tests of the mechanisms of mindfulness interventions that drive improvements in attention outcomes. These findings support the notion that present-focused monitoring skills training drives mindfulness intervention-related improvements in momentary attentional control, which in turn fosters greater trait attentional control. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Learning to BREATHE "Plus": A Multi-Modal Adaptive Supplement to an Evidence-Based Mindfulness Intervention for Adolescents.

Incorporating technological supplements into existing group mindfulness-based interventions (MBIs), particularly for use with adolescents, is an important next step in the implementation of MBIs. Yet there is little available content. Herein we present the development and content of a technological supplement for MBIs, which incorporates multiple technological elements to support (a) skill transfer from the group MBI to daily life, (b) the establishment of a formal mindfulness practice, and (c) the use of mindfulness during periods of high stress. A mixed-methods approach was used to develop this multi-method adaptive supplement. Findings about the use of this supplement will be disseminated scientifically and/or publicly as appropriate.

A faith-based mind-body intervention to improve psychosocial well-being among rural adults.

Churches are well positioned to promote better mental health outcomes in underserved populations, including rural adults. Mind-body (MB) practices improve psychological well-being yet are not widely adopted among faith-based groups due to conflicting religious or practice beliefs. Thus, "Harmony & Health" (HH) was developed as a culturally adapted MB intervention to improve psychosocial health in urban churchgoers and was adapted and implemented in a rural church. The purpose of this study was to explore the feasibility, acceptability, and efficacy of HH to reduce psychosocial distress in rural churchgoers. HH capitalized on an existing church partnership to recruit overweight or obese (body mass index [BMI] ≥25.0 kg/m2) and insufficiently active adults (≥18 years old). Eligible adults participated in an 8 week MB intervention and completed self-reported measures of perceived stress, depressive symptoms, anxiety, and positive and negative affect at baseline and postintervention. Participants (mean [M] age = 49.1 ± 14.0 years) were mostly women (84.8%), non-Hispanic white (47.8%) or African American (45.7%), high socioeconomic status (65.2% completed ≥bachelor degree and 37.2% reported an annual household income ≥$80,000), and obese (M BMI = 32.6 ± 5.8 kg/m2). Participants reported lower perceived stress (t = -2.399, p = .022), fewer depressive symptoms (t = -3.547, p = .001), and lower negative affect (t = -2.440, p = .020) at postintervention. Findings suggest that HH was feasible, acceptable, and effective at reducing psychosocial distress in rural churchgoers in the short-term. HH reflects an innovative approach to intertwining spirituality and MB practices to improve physical and psychological health in rural adults, and findings lend to our understanding of community-based approaches to improve mental health outcomes in underserved populations.

Moving 2 Mindful (M2M) study protocol: testing a mindfulness group plus ecological momentary intervention to decrease stress and anxiety in adolescents from high-conflict homes with a mixed-method longitudinal design.

INTRODUCTION: Interparental conflict exposure places adolescents at risk for problems with stress and anxiety; existing prevention/intervention strategies focus on reducing interparental conflict. Mindfulness-based programmes may be a promising treatment strategy for this population, but studies have not yet tested whether they are effective in this high-conflict context. In addition, evidence suggests that extensions to traditional treatments, such as delivering components in daily life that are tailored to moments of need, can increase treatment efficacy, particularly when combined with in-person treatments and particularly for adolescents. However, there are no such extensions to mindfulness interventions available. The Moving 2 Mindful study aims to (1) develop an ecological momentary intervention (EMI) supplement to Learning to BREATHE (L2B), an evidence-based mindfulness intervention for adolescents; (2) refine the EMI programme and determine the best delivery plan; (3) examine the feasibility and acceptability of L2B Plus (L2B plus the developed supplement) and (4) examine the potential for L2B Plus to reduce stress and anxiety for adolescents from high-conflict homes. METHODS AND ANALYSIS: The Moving 2 Mindful study proposes a mixed-methods approach to developing and refining a multimethod adaptive supplement to L2B. Feasibility, acceptability and potential effectiveness will be tested in a sample of 38 families, who will be randomly assigned to receive L2B Plus or an active health and wellness control condition and followed until 3 months postintervention. A range of psychosocial and physiological factors will be assessed at multiple time points. This study is registered with clinicaltrials.gov (ID NCT03869749; pre-results). ETHICS AND DISSEMINATION: The Institutional Review Board at Colorado State University has approved this study. Findings will be disseminated in scientific journals and conferences, whether they are positive, negative or inconclusive.

Mindfulness training and systemic low-grade inflammation in stressed community adults: Evidence from two randomized controlled trials.

Mindfulness interventions have garnered significant attention as a complementary health treatment for many physical and psychological conditions. While some research has shown that mindfulness training can decrease psychological and physiological stress responses, it remains unclear whether mindfulness training impacts inflammation-a predictor of poor health outcomes. In addition, little research has examined the active components of mindfulness that may drive health-related improvements. Here, we provide data from two 3-arm randomized controlled trials that examined the effect of mindfulness training on inflammation in stressed community adults. Specifically, we examined whether training individuals to have an accepting attitude towards present moment experiences is a key emotion regulation skill that can lead to decreases in inflammation. Both studies randomly assigned participants to one of three conditions: mindfulness training that taught both attention monitoring and acceptance skills (Monitor+Accept); mindfulness training teaching monitoring without the acceptance component (Monitor Only); or a control condition. Study 1 employed a novel 2-week smartphone-based intervention and Study 2 employed a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention. We hypothesized that Monitor+Accept training would lead to reductions in the inflammatory biomarker C-Reactive Protein (CRP) compared to Monitor Only training and control groups. Contrary to this hypothesis, we found that Monitor+Accept mindfulness training did not lead to reductions in CRP. Exploratory analyses combining study subsamples, however, suggest that both mindfulness interventions may reduce CRP in populations at risk for systemic inflammation-midlife-to-older adults and individuals with high BMI. Overall, the present studies contribute significantly to the question of whether mindfulness interventions can reduce systemic markers of low-grade inflammation.

New Avenues for Promoting Mindfulness in Adolescence using mHealth.

There is a large evidence base supporting the efficacy of mindfulness interventions in adulthood, and growing support for the efficacy of these interventions in adolescence. Historically mindfulness interventions have been delivered in person and in groups, with recommendations for home practice being a critical part of the intervention. However, compliance with these practice recommendations in adolescence is very poor. Past studies indicate that using mobile technology to promote skill transfer to real life can be an effective strategy, particularly when used as a supplement to an in-person intervention strategy. To date, however, mobile technology has largely been used to create stand-alone mindfulness interventions. The goals of the current paper are to discuss the potential opportunities and challenges with a mobile-technology-enhanced mindfulness intervention, and to present the rationale that such an approach is not only theoretical and empirically sound but also a critical next step to increase the efficacy and developmental appropriateness of mindfulness interventions for adolescents. This discussion is grounded in a specific example of a mindfulness intervention supplemented by momentary interventions we are developing.

Psychological mechanisms driving stress resilience in mindfulness training: A randomized controlled trial.

OBJECTIVE: Mindfulness interventions have been shown to reduce stress; however, the mechanisms driving stress resilience effects are not known. Mindfulness interventions aim to teach individuals how to: (a) use attention to monitor present moment experiences; with (b) an attitude of acceptance and equanimity. A randomized controlled dismantling trial (RCT) was conducted to test the prediction that the removal of acceptance skills training would eliminate stress-reduction benefits of a mindfulness intervention. METHOD: This preregistered RCT randomly assigned stressed community adults to 1 of 3 conditions: (a) Monitor and Accept (MA) mindfulness training, a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention that provided explicit instruction in developing both monitoring and acceptance skills; (b) Monitor Only (MO) mindfulness training, a well-matched 8-week MBSR intervention that taught monitoring skills only; or (c) No Treatment (NT) control. Stress and nonjudgment were measured using ecological momentary assessment (EMA) for 3 days at baseline and 3 days at postintervention. RESULTS: Consistent with predictions, MA participants increased in nonjudgment and decreased in both stress ratings and the proportion of assessments that they reported experiencing feelings of stress in daily life, relative to both MO and NT participants. CONCLUSIONS: This RCT provides one of the first experimental tests of the mechanisms linking mindfulness interventions with stress resilience. These findings suggest that acceptance skills training may be a necessary active ingredient and support the value of integrating acceptance skills training into stress-reduction interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mindfulness training reduces loneliness and increases social contact in a randomized controlled trial.

Loneliness and social isolation are a growing public health concern, yet there are few evidence-based interventions for mitigating these social risk factors. Accumulating evidence suggests that mindfulness interventions can improve social-relationship processes. However, the active ingredients of mindfulness training underlying these improvements are unclear. Developing mindfulness-specific skills-namely, (i) monitoring present-moment experiences with (ii) an orientation of acceptance-may change the way people perceive and relate toward others. We predicted that developing openness and acceptance toward present experiences is critical for reducing loneliness and increasing social contact and that removing acceptance-skills training from a mindfulness intervention would eliminate these benefits. In this dismantling trial, 153 community adults were randomly assigned to a 14-lesson smartphone-based intervention: (i) training in both monitoring and acceptance (Monitor+Accept), (ii) training in monitoring only (Monitor Only), or (iii) active control training. For 3 d before and after the intervention, ambulatory assessments were used to measure loneliness and social contact in daily life. Consistent with predictions, Monitor+Accept training reduced daily-life loneliness by 22% (d = 0.44, P = 0.0001) and increased social contact by two more interactions each day (d = 0.47, P = 0.001) and one more person each day (d = 0.39, P = 0.004), compared with both Monitor Only and control trainings. These findings describe a behavioral therapeutic target for improving social-relationship functioning; by fostering equanimity with feelings of loneliness and social disconnect, acceptance-skills training may allow loneliness to dissipate and encourage greater engagement with others in daily life.

How mindfulness training promotes positive emotions: Dismantling acceptance skills training in two randomized controlled trials.

Mindfulness meditation interventions-which train skills in monitoring present-moment experiences with a lens of acceptance-have shown promise for increasing positive emotions. Using a theory-based approach, we hypothesized that learning acceptance skills in mindfulness interventions helps people notice more positive experiences in daily life, and tested whether removing acceptance training from mindfulness interventions would eliminate intervention-related boosts in positive affect. In 2 randomized controlled trials (RCTs) of stressed community adults, mindfulness skills were dismantled into 2 structurally equivalent interventions: (a) training in both monitoring and acceptance (Monitor + Accept) and (b) training in monitoring only (Monitor Only) without acceptance training. Study 1 tested 8-week group-based Monitor + Accept and Monitor Only interventions compared with a no treatment control group. Study 2 tested 2-week smartphone-based Monitor + Accept and Monitor Only interventions compared with an active control training. In both studies, end-of-day and momentary positive affect and negative affect were measured in daily life for 3 days pre- and post-intervention using ambulatory assessments. As predicted, across 2 RCTs, Monitor + Accept training increased positive affect compared with both Monitor Only and control groups. In Study 1, this effect was observed in end-of-day positive affect. In Study 2, this effect was found in both end-of-day and momentary positive affect outcomes. In contrast, all active interventions in Studies 1 and 2 decreased negative affect. These studies provide the first experimental evidence that developing an orientation of acceptance toward present-moment experiences is a central mechanism of mindfulness interventions for boosting positive emotions in daily life. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Clarifying the Associations between Mindfulness Meditation and Emotion: Daily High- and Low-arousal Emotions and Emotional Variability.

BACKGROUND: Research examining the effects of mindfulness meditation (MM) on emotion seldom considers differences by arousal level or emotion variability. METHODS: In the present study, 115 participants (64% Female, 72% White, Mage = 19.03) were randomly assigned to a brief MM intervention condition (n = 60) or a wait-list control condition (n = 51). Participants in the MM condition were trained in MM and instructed to practice MM daily for one week. All participants provided daily diary reports of both higher- and lower-arousal positive (PE) and negative (NE) emotions. Emotions were weighted by valence and arousal. Multilevel modeling was used to examine valence, arousal, and their interaction; multivariate regression was used to examine emotional variability. RESULTS: More time spent meditating (but not the MM condition itself) was associated with increased lower arousal emotions, and exhibited a significant effect on the interaction between valence and arousal. Examination of individual emotion items suggested that more time meditating significantly predicted increased feelings of quiet and calm and marginally increased relaxation and sleepiness among participants, but did not predict any other emotions assessed in daily life. MM was not associated with emotional variability. CONCLUSION: These results may suggest that PE should be separated by arousal when examining the effects of MM interventions.

Start making sense: Art informing health psychology.

Growing evidence suggests that the arts may be useful in health care and in the training of health care professionals. Four art genres - novels, films, paintings and music - are examined for their potential contribution to enhancing patient health and/or making better health care providers. Based on a narrative literature review, we examine the effects of passive (e.g. reading, watching, viewing and listening) and active (e.g. writing, producing, painting and performing) exposure to the four art genres, by both patients and health care providers. Overall, an emerging body of empirical evidence indicates positive effects on psychological and physiological outcome measures in patients and some benefits to medical training. Expressive writing/emotional disclosure, psychoneuroimmunology, Theory of Mind and the Common Sense Model of Self-Regulation are considered as possible theoretical frameworks to help incorporate art genres as sources of inspiration for the further development of health psychology research and clinical applications.

Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial.

OBJECTIVE: Mindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects. METHOD: In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor+Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age=32years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test. RESULTS: As predicted, Monitor+Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress. CONCLUSIONS: This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.

Anger toward God: social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer.

Many people see themselves as being in a relationship with God and see this bond as comforting. Yet, perceived relationships with God also carry the potential for experiencing anger toward God, as shown here in studies with the U.S. population (Study 1), undergraduates (Studies 2 and 3), bereaved individuals (Study 4), and cancer survivors (Study 5). These studies addressed 3 fundamental issues regarding anger toward God: perceptions and attributions that predict anger toward God, its prevalence, and its associations with adjustment. Social-cognitive predictors of anger toward God paralleled predictors of interpersonal anger and included holding God responsible for severe harm, attributions of cruelty, difficulty finding meaning, and seeing oneself as a victim. Anger toward God was frequently reported in response to negative events, although positive feelings predominated. Anger and positive feelings toward God showed moderate negative associations. Religiosity and age correlated negatively with anger toward God. Reports of anger toward God were slightly lower among Protestants and African Americans in comparison with other groups (Study 1). Some atheists and agnostics reported anger involving God, particularly on measures emphasizing past experiences (Study 2) and images of a hypothetical God (Study 3). Anger toward God was associated with poorer adjustment to bereavement (Study 4) and cancer (Study 5), particularly when anger remained unresolved over a 1-year period (Study 5). Taken together, these studies suggest that anger toward God is an important dimension of religious and spiritual experience, one that is measurable, widespread, and related to adjustment across various contexts and populations.

Expressive writing and post-traumatic stress disorder: effects on trauma symptoms, mood states, and cortisol reactivity.

OBJECTIVES: This study investigates the boundary conditions (feasibility, safety, and efficacy) of an expressive writing intervention for individuals with post-traumatic stress disorder [PTSD]. DESIGN: Randomized trial with baseline and 3-month follow-up measures of PTSD severity and symptoms, mood states, post-traumatic growth, and (post-only) cortisol reactivity to trauma-related stress. METHODS: Volunteers with a verified diagnosis of PTSD (N=25) were randomly assigned to an experimental group (writing about their traumatic experience) or control group (writing about time management). RESULTS: Expressive writing was acceptable to patients with PTSD and appeared safe to utilize. No changes in PTSD diagnosis or symptoms were observed, but significant improvements in mood and post-traumatic growth were observed in the expressive writing group. Finally, expressive writing greatly attenuated neuroendocrine (cortisol) responses to trauma-related memories. CONCLUSIONS: The present study provides insight into several boundary conditions of expressive writing. Writing did not decrease PTSD-related symptom severity. Although patients continue to exhibit the core features of PTSD, their capacity to regulate those responses appears improved following expressive writing. Dysphoric mood decreased after writing and when exposed to traumatic memories, participants' physiological response is reduced and their recovery enhanced.

Beyond self-selection in video game play: an experimental examination of the consequences of massively multiplayer online role-playing game play.

There is burgeoning interest in the study of video games. Existing work is limited by the use of correlational designs and is thus unable to make causal inferences or remove self-selection biases from observed results. The recent development of online, socially integrated video games (massively multiplayer online role-playing games [MMORPGs]) has created a new experience for gamers. This randomized, longitudinal study examined the effects of being assigned to play different video game types on game usage, health, well-being, sleep, socializing, and academics. One hundred 18- to 20-year-old participants (73% male; 68% Caucasian) were randomly assigned to play arcade, console, solo computer, or MMORPG games for 1 month. The MMORPG group differed significantly from other groups after 1 month, reporting more hours spent playing, worse health, worse sleep quality, and greater interference in "real-life" socializing and academic work. In contrast, this group also reported greater enjoyment in playing, greater interest in continuing to play, and greater acquisition of new friendships. MMORPGs represent a different gaming experience with different consequences than other types of video games and appear to pose both unique risks and benefits from their use.