Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model.

Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (Mage = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.

Visualization, Self-Efficacy, and Locus of Control in a Virtual Reality Biofeedback Video Game for Anxiety Regulation.

The current study aimed to identify specific feedback mechanics and psychological processes that may contribute to positive outcomes in biofeedback applications for anxiety regulation. Specifically, using a dismantling study design, the unique impact of visualizations that directly mirror users' breathing was examined in relation to anxiety regulation as well as locus of control and self-efficacy. Following an anxiety induction, participants (N = 67) were randomly assigned to play one of two variations of a biofeedback video game. In both versions, players' in-game movement was contingent on their breathing; however, the experimental condition additionally included visualizations that directly mirrored players' breathing. Changes in self-reported state anxiety and physiological arousal were measured as well as the level of internal control and self-efficacy participants experienced while playing the game. Results showed that all participants were able to effectively reduce their anxiety and arousal, but no condition differences were found. Implementing mirroring visualizations did not contribute to individuals' ability to self-regulate nor their self-efficacy or locus of control above and beyond receiving feedback based on their in-game movement. Overall, individuals who experienced higher self-efficacy and a stronger internal locus of control were better able to regulate their anxiety, but no clear links were found with changes in self-reported physiological arousal. In light of these results, we recommend the continued exploration of the role of specific design choices and intervention components as well as underlying mechanisms of change in biofeedback interventions, especially pertaining to how individuals perceive themselves and their ability to change.

Effect of the labour roadmap on anxiety, labour pain, sense of control, and gestational outcomes in primiparas.

BACKGROUND AND PURPOSE: The pain and uncertainty of the labour process can lead to anxiety. Birth ball exercises are one of the pain relief methods for the labour process. This study aimed to explore the outcomes of the use of the labour roadmap with birth balls in primiparas. MATERIALS AND METHODS: This randomized controlled trial involved Chinese women between the gestational ages of 37-42 weeks who were randomly assigned to the experimental or control group. The outcomes of labour pain, anxiety, and self-control were collected using the Short-Form McGill Pain Questionnaire, visual analogue scale-anxiety, and Labor Agentry Scale, respectively. RESULTS: The study found improvements in anxiety, pain, and self-control (P < 0.05), as well as the duration of the first stage of labour (P < 0.05) in the intervention group, but there were no significant differences in the duration of the second and third stages of labour, volume of bleeding, or the 1-min Apgar score between the two groups (P = 0.09, 0.07, 0.06, 0.63, respectively). CONCLUSION: The labour roadmap was effective for improving self-control, reducing pain and anxiety during labour, and accelerating the first stage of labour.

Demographics, health literacy and health locus of control beliefs of Australian women who take complementary medicine products during pregnancy and breastfeeding: A cross-sectional, online, national survey.

BACKGROUND: Pregnant and breastfeeding women's use of complementary medicine products (CMPs) is common, and possibly associated with autonomous health care behaviours. However, the health literacy levels and health locus of control (HLOC) beliefs of women who use CMPs in pregnancy and lactation have not been previously assessed in a large Australian sample. AIM: The aim of this study is to determine the health literacy levels and HLOC beliefs of women who use CMPs in pregnancy and lactation and determine the types of CMPs used. METHODS: A cross-sectional, national, online survey of Australian pregnant or breastfeeding women aged 18 years and older, and currently using CMPs was conducted. RESULTS: A total of 810 completed surveys (354 pregnant and 456 breastfeeding women) were analysed. Most had adequate functional health literacy levels (93.3%). Health care practitioners (HCPs) HLOC mean scores were the highest for the sample, followed by Internal HLOC beliefs mean scores. Almost all (n = 809) took at least one dietary supplement, the most popular being pregnancy and breastfeeding multivitamins, iron supplements and probiotics. Use was generally in line with clinical recommendations, except for low rates of iodine supplementation. Herbal medicine use was lower for the total sample (57.3%, n = 464), but significantly higher (p < .0001) for the breastfeeding cohort, with consumers taking one to four herbal medicines each. The most popular herbs were raspberry leaf, ginger, peppermint and chamomile (pregnant respondents) and chamomile, ginger and fenugreek (breastfeeding respondents). CONCLUSIONS: Respondents were health literate, with high scores for Internal and HCP HLOC scales, suggesting that they are likely to demonstrate self-efficacy, positive health behaviours and work well in partnership with HCPs. HCPs can facilitate discussions with pregnant and breastfeeding women using CMPs, while considering women's health literacy levels, health beliefs and goals.

Illusion of control affects ERP amplitude reductions for auditory outcomes of self-generated actions.

The reduction of neural responses to self-generated stimuli compared to external stimuli is thought to result from the matching of motor-based sensory predictions and sensory reafferences and to serve the identification of changes in the environment as caused by oneself. The amplitude of the auditory event-related potential (ERP) component N1 seems to closely reflect this matching process, while the later positive component (P2/ P3a) has been associated with judgments of agency, which are also sensitive to contextual top-down information. In this study, we examined the effect of perceived control over sound production on the processing of self-generated and external stimuli, as reflected in these components. We used a new version of a classic two-button choice task to induce different degrees of the illusion of control (IoC) and recorded ERPs for the processing of self-generated and external sounds in a subsequent task. N1 amplitudes were reduced for self-generated compared to external sounds, but not significantly affected by IoC. P2/3a amplitudes were affected by IoC: We found reduced P2/3a amplitudes after a high compared to a low IoC induction training, but only for self-generated, not for external sounds. These findings suggest that prior contextual belief information induced by an IoC affects later processing as reflected in the P2/P3a, possibly for the formation of agency judgments, while early processing reflecting motor-based predictions is not affected.

Exploring the experiences related to postpartum changes: perspectives of mothers and healthcare providers in Iran.

BACKGROUND: Numerous changes occur in different aspects of women's lives in the postpartum period. Women's adjusting with problems and taking advantage of this opportunity can develop their personality. In this regard, accurate knowledge of their experiences and feelings is necessary to help them to benefit from this period. Therefore, the present study aimed to explore the experiences related to postpartum changes in women. METHODS: In the present qualitative study, 23 participants, including women of childbearing age who gave birth and healthcare providers (midwives and obstetricians) in Isfahan, Iran were selected using purposive sampling with a maximum variation strategy. Data were collected through in-depth semi structured interviews, field notes, and daily notes, and simultaneously analyzed using the conventional qualitative content analysis. RESULTS: The data analysis results led to the extraction of three main categories including "feeling of decreased female attractiveness" (with two sub-categories of " feeling of decreased beauty" and "feeling of decreased sexual function"), "feeling of insolvency and helplessness" (with two sub-categories of "physical burnout", and "mental preoccupations") and "beginning a new period in life" (with three sub-categories of "changing the meaning of life", "feeling of maturity" and "deepening the communication"). CONCLUSIONS: Findings of this study can provide a good context for designing interventions to improve the women's quality of life by explaining and highlighting their experiences in the postpartum period. In this regard, providing sufficient empathy, social and psychological support from family members (especially husband), performing appropriate educational interventions and also regular assessment of women's psychological state by healthcare providers in postpartum period can reduce their concerns and help to improve their health.

Seeking Divine Intervention to Manage the Advanced Stages of Breast Cancer in Southwestern Nigeria.

BACKGROUND: The World Health Organization records indicate that breast cancer is the most common cancer in women both in developed and developing regions of the world. In developed countries, breast cancer is the second cause of cancer-related deaths, whereas in developing countries, breast cancer is the leading cause of cancer-related mortality in women. The empirical literature on Nigeria indicates that women present with advanced stages of the illness. OBJECTIVES: To explore the health-seeking behaviors of Southwestern Nigerian women with advanced breast cancer from the time they noticed a breast abnormality to their eventual presentation at the hospital for the management of the illness. METHODS: Thirty women with advanced stages of breast cancer in a large tertiary, referral, teaching, and university-affiliated Southwestern Nigeria Hospital were purposively selected for study participation. Participants completed a demographic information form and an in-depth face-to-face, one-on-one, semistructured interview guided by open-ended questions. Data analysis was inductive. RESULTS: Findings revealed that women sought divine interventions for the management of breast cancer. Prayer and spirituality were associated with high levels of optimism among the study participants. CONCLUSION: Nurses should provide information and counseling to women and the general public on the etiology and appropriate management of breast abnormalities and include the importance of a spiritual dimension of care. IMPLICATIONS FOR PRACTICE: Findings indicate the need to introduce a spiritual dimension to the care of women with advanced breast cancer. Findings also indicate the need for a comprehensive population-based breast health education.

The Co-occurrence of Pediatric Obesity and ADHD: an Understanding of Shared Pathophysiology and Implications for Collaborative Management.

PURPOSE OF REVIEW: To describe what is known about the association between obesity and attention-deficit hyperactivity disorder (ADHD) in children along with the co-occurring conditions of sleep dysfunction, loss of control/binge eating disorder (LOC-ED/BED), and anxiety. RECENT FINDINGS: Obesity and ADHD share common brain pathways (hypothalamic, executive, and reward centers) with pathophysiology in these areas manifesting in partial or complete expression of these diseases. Sleep dysfunction, LOC-ED/BED, and anxiety share similar pathways and are associated with this disease dyad. The association of obesity and ADHD with sleep dysfunction, LOC-ED/BED, and anxiety is discussed. An algorithm outlining decision pathways for patients with obesity and with and without ADHD is presented. Future research exploring the complex pathophysiology of both obesity and ADHD as well as co-occurring conditions is needed to develop clinical guidelines and ultimately assist in providing the best evidence-based care.

Pre-trauma Growth under Terror Threat: Suggestive Communication Method in Anticipatory Trauma.

Counterterror measures put communities in a state of alertness for several years. Jewish schools in Europe respond with higher security measures, going through transformations in their daily routines and environments, marked by security rituals. Anticipating the trauma creates extreme situations that polarizes the sense of agency and alters the state of consciousness, having a collective impact. Analyzing the anticipatory trauma within the framework of the altered state of consciousness opens the possibility for intervening with suggestive communication methods that aim to increase the sense of agency. The positive effect of teachers learning the suggestive communication methods on the sense of agency was measured with the Sense of Agency Scale. The altered state of consciousness in anticipatory trauma opens the mind for the sense of agency changing in a signature pattern, in a way that is typical for a group, allowing cultural reproduction.

Chronic Constipation in the United States: Results From a Population-Based Survey Assessing Healthcare Seeking and Use of Pharmacotherapy.

OBJECTIVES: Chronic idiopathic constipation (CIC) is characterized by unsatisfactory defecation and difficult or infrequent stools. CIC affects 9%-20% of adults in the United States, and although prevalent, gaps in knowledge remain regarding CIC healthcare seeking and medication use in the community. We recruited a population-based sample to determine the prevalence and predictors of (i) individuals having discussed their constipation symptoms with a healthcare provider and (ii) the use of constipation therapies. METHODS: We recruited a representative sample of Americans aged 18 years or older who had experienced constipation. Those who met the Rome IV criteria for irritable bowel syndrome and opioid-induced constipation were excluded. The survey included questions on constipation severity, healthcare seeking, and the use of constipation medications. We used multivariable regression methods to adjust for confounders. RESULTS: Overall, 4,702 participants had experienced constipation (24.0% met the Rome IV CIC criteria). Among all respondents with previous constipation, 37.6% discussed their symptoms with a clinician (primary care provider 87.6%, gastroenterologist 26.0%, and urgent care/emergency room physician 7.7%). Age, sex, race/ethnicity, marital status, employment status, having a source of usual care, insurance status, comorbidities, locus of control, and constipation severity were associated with seeking care (P < 0.05). Overall, 47.8% of respondents were taking medication to manage their constipation: over-the-counter medication(s) only, 93.5%; prescription medication(s) only, 1.3%; and both over-the-counter medication(s) and prescription medication(s), 5.2%. DISCUSSION: We found that 3 of 5 Americans with constipation have never discussed their symptoms with a healthcare provider. Furthermore, the use of prescription medications for managing constipation symptoms is low because individuals mainly rely on over-the-counter therapies.

Mindfulness facets predict quality of life and sleep disturbance via physical and emotional distresses in Chinese cancer patients: A moderated mediation analysis.

OBJECTIVE: Colorectal cancer survivors are at risk of symptom burden and emotional distress. Dispositional mindfulness has been linked with better sleep quality and quality of life (QoL) in these patients. This longitudinal study aimed to examine the associations among mindfulness facets, symptom burden, emotional distress, and functional outcomes. METHODS: Study sample of this three-wave, 2-month survey was 127 Chinese colorectal cancer survivors. The participants completed the Five Facet Mindfulness Questionnaire, Memorial Symptom Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and SF-12 health survey. Moderated mediation analyses examined the direct and indirect effects of mindfulness facets on QoLs and sleep quality via symptom burden and emotional distress, using acting with awareness as a moderator. RESULTS: The mindfulness facets had no significant direct effects on functional outcomes 2 months later. Awareness and nonreacting showed significant and positive indirect effects on physical and mental QoL via symptom burden and emotional distress 1 month later, respectively. Awareness, nonjudging, and nonreacting significantly predicted better sleep quality indirectly via emotional distress. Nonreacting showed stronger indirect effects on the functional outcomes among patients with greater awareness. CONCLUSIONS: This study demonstrates longitudinal linkages between dispositional mindfulness and functioning in cancer survivors via symptom burden and emotional distress. Acting with awareness and nonreacting are the two facets that displayed clinical relevance in predicting better sleep quality and QoL.

Childhood Interpersonal Trauma and Sexual Satisfaction in Patients Seeing Sex Therapy: Examining Mindfulness and Psychological Distress as Mediators.

Mindful attention and awareness may promote sexual satisfaction. However, experiencing cumulative childhood interpersonal trauma (CCT; sexual abuse, neglect, etc.) is associated with distress, which might interfere with dispositional mindfulness and lead to lower sexual satisfaction. Although the concept of mindfulness emerged as an interesting variable to understand sexual difficulties, little empirical data are available on this topic. This study tested an integrative mediation model of the relation between CCT, psychological distress, dispositional mindfulness, and sexual satisfaction within a clinical sample of 410 adult patients consulting in sex therapy. Patients completed questionnaires assessing CCT, psychological distress, dispositional mindfulness, and sexual satisfaction. Results showed that the majority of patients reported experiences of childhood interpersonal trauma. Path analyses highlighted three distinct significant paths from CCT to sexual satisfaction. First, dispositional mindfulness mediated the relationship between CCT and sexual satisfaction. Second, psychological distress also mediated the relationship between CCT and sexual satisfaction. Third, the effect of CCT on sexual satisfaction was sequentially mediated through greater levels of psychological distress and lower levels of dispositional mindfulness. The model explained 19% of the variance in sexual satisfaction. Findings suggest that dispositional mindfulness and psychological distress are key processes explaining sexual satisfaction in CCT survivors.

Soothe ourselves in times of need: A qualitative exploration of how the feeling of 'soothe' is understood and experienced in everyday life.

OBJECTIVES: Evidence suggests that self-compassion is linked to psychological benefits. Compassion-focused therapy emphasizes the importance of developing abilities to self-soothe in alleviating psychological distress. However, little is known about how the feeling of soothe is understood, experienced, and achieved in everyday life. This study addressed two research questions: (1) How is the feeling of soothe understood? (2) How is the feeling of soothe experienced in everyday life? DESIGN: This is part of our ongoing research Project Soothe (www.projectsoothe.com), which collects soothing images from the public with the goal to develop a bank of soothing images for psychotherapeutic and research use. We also set up an online survey to explore how individuals understand and experience the feeling of soothe in everyday lives. The current study was based on the qualitative narratives obtained in this survey. METHODS: A total of 176 participants were recruited. Data were analysed using thematic analysis. RESULTS: Three themes emerged in response to the first research question: (1) a complex interconnected state of feelings, (2) self-soothe and being soothed, and (3) involvement of physical sensations. Five themes emerged regarding the second research question: (1) venturing out in nature, (2) being in a familiar surrounding, (3) being solitary, (4) being affiliated, and (5) being physically and mentally relaxed. CONCLUSIONS: Our study illustrated the importance of affiliations, physical sensations, mindfulness, connection with nature, and solitude on the cultivation of soothe. Results may help develop therapeutic techniques in enhancing self-soothe by tapping into individuals' understanding and subjective experience in everyday contexts. PRACTITIONER POINTS: Compassion-focused therapy and related third wave therapies emphasize the role of cultivating self-compassion and feelings of self-soothe in reducing psychological distress and improving mental well-being. This study sheds light on how individuals understand and achieve self-soothe in everyday life contexts. Individuals' subjective narratives suggested that both being in solitude and affiliated with others were associated with feelings of self-soothe, in addition to feeling connected with the nature, being in familiar environments and experiencing physical sensations. These findings will help practitioners develop different ways to enhance individuals' self-compassion by tapping into their understanding and experience of self-soothe in everyday life.

Spiritual health locus of control and life satisfaction among African American breast cancer survivors.

Purpose: To examine the relationships between spiritual health locus of control (SHLOC) and satisfaction with life in African American (AA) breast cancer survivors (BCS).Methods: A total of 118 AABCS completed a mailed survey. Logistic regression models were used to examine relationships among variables of interest.Results: Annual income and SHLOC were significantly associated with life satisfaction. In unadjusted analyses, high overall SHLOC increased the odds (odds ratio [OR] = 2.8) of being satisfied with life. The adjusted relationships between SHLOC and life satisfaction differed by income level. Among survivors with lower incomes, high spiritual life/faith and God's grace subscale scores increased the odds of life satisfaction, when compared to those with higher incomes.Conclusions: Our data indicated that high overall SHLOC was significantly related to higher odds of life satisfaction. Further, SHLOC may serve as a resource to bolster life satisfaction, especially in low-income AA BCS.

Mentalization-based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial.

BACKGROUND: Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence-based psychotherapeutic programs, including mentalization-based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT-G) for adolescent BPD. METHOD: A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM-5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1-year MBT-G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS-C); secondary outcomes included self-harm, depression, externalizing and internalizing symptoms (all self-report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326. RESULTS: At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT-G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS-C units in favor of MBT-G, 95% confidence interval -6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group. CONCLUSIONS: There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed.

Unfolding Relations among Mindful Parenting, Recurrent Conflict, and Adolescents' Externalizing and Internalizing Problems.

The current study examined unfolding relations among mothers' mindful parenting, parent-adolescent recurrent conflict, and adolescents' externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2-3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent-adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.

Having pity on our victims to save ourselves: Compassion reduces self-critical emotions and self-blame about past harmful behavior among those who highly identify with their past self.

Previous research has shown that people often separate the present self from past selves. Applying knowledge gained from intergroup research to the interpersonal domain, we argue that the degree to which people identify with their past self (self-identification) influences their reaction when recalling a past event during which they harmed another person. Because they feel close to their past self, we expected this to be threatening for high self-identifiers, and expected them to be motivated to avoid self-critical emotions and blame. Using four meta-analyses, conducted on a set of seven experimental studies, we investigated four ways in which high self-identifiers can distance themselves from the event: by feeling compassion, by taking a third-person rather than first-person perspective, by emphasizing ways in which their present self is different to their past self, and by disidentifying with the past self altogether. We found the strongest interaction effects for compassion: whereas a compassion manipulation increased self-critical emotions and self-blame about the past event for low self-identifiers, it decreased them for high self-identifiers. We argue that this occurs because the other-focused nature of compassion allows high self-identifiers subtly to shift the focus away from their harmful behavior. Our concept of past self-identification had stronger effects than a measure of self-continuity beliefs. It also correlated only moderately with the latter, suggesting they are distinct concepts. Our findings suggest that, ironically, the most effective way to protect the self against reminders of an undesirable past, may be to have compassion for our victims.

Unmet needs of people with Parkinson's disease: A cross-sectional study.

AIMS: To identify the type and extent of unmet needs in people with Parkinson's disease and to examine the impact of health locus of control and family support on these needs. DESIGN: A cross-sectional study. METHODS: This study was conducted from October 2015 - February 2016 in Korea. Data were collected through questionnaires focusing on unmet needs, health locus of control, family support and clinical features. RESULTS: Therapeutic needs represented the highest percentage of unmet needs in people with Parkinson's disease (85.05%), followed by social/spiritual/emotional needs (82.72%). Physical needs were the lowest reported score (75.01%). Unmet needs were more frequent in those with more severe non-motor symptoms. Also, higher family support, internal locus of control and doctor locus of control were correlated with more unmet needs. CONCLUSION: Understanding factors that determine the type and degree of unmet needs in people with PD is important to provide appropriate nursing care. The findings of this study can be used for providing nursing interventions reflecting unmet needs and reducing their unmet needs to improve the overall well-being of people with PD. IMPACT: This study addressed unmet needs unmet needs specific to Parkinson's disease with respect to their nursing needs. Therapeutic needs were the highest unmet needs in people with PD, followed by social/spiritual/emotional needs, need for certainty and physical needs. The findings may be useful for nurses to identify the unmet needs of people with PD which need to be addressed. By reflecting on unmet needs, nurses can give personally tailored nursing care.

Dispositional mindfulness, self-compassion, and compassion from others as moderators between stress and depression in caregivers of patients with lung cancer.

OBJECTIVE: The present study aimed to identify the most important protective factors predicting caregivers' depressive symptoms among factors of caregivers' dispositional mindfulness, self-compassion, compassion from others, and patients' dispositional mindfulness and their moderator effects on the relationship between caregiving stress and depressive symptoms. METHODS: A total of 72 lung cancer outpatients and their family caregivers participated in this study. Family caregivers completed the Kingston Caregiver Stress Scale, Beck Depression Inventory-II (BDI-II), Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale, and Compassion from Others Scale. Patients completed the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), BDI-II, and FFMQ. RESULTS: After controlling for patients' factors (treatment status, symptom distress, and depressive symptoms) and caregivers' health status, caregivers' stress and dispositional mindfulness, the domain of mindful awareness, and self-compassionate action were significantly associated with their depressive symptoms. Further analysis indicated that mindful awareness or self-compassionate action could buffer the effect of caregiving stress on depressive symptoms. When the two moderators, mindful awareness and self-compassionate action, were tested simultaneously, only self-compassionate action remained as a significant moderating effect. CONCLUSIONS: Caregivers' mindful awareness and self-compassionate action were protective factors, which mitigate the impact of caregiving stress on their depressive symptoms. Therefore, the future supportive program aims at training the competencies of self-compassionate action with mindful awareness, which may enhance caregivers' coping resources.

Meditation focused on self-observation of the body impairs metacognitive efficiency.

In the last decade of research on metacognition, the literature has been focused on understanding its mechanism, function and scope; however, little is known about whether metacognitive capacity can be trained. The specificity of the potential training procedure is in particular still largely unknown. In this study, we evaluate whether metacognition is trainable through generic meditation training, and if so, which component of meditation would be instrumental in this improvement. To this end, we evaluated participants' metacognitive efficiency before and after two types of meditation training protocols: the first focused on mental cues (Mental Monitoring [MM] training), whereas the second focused on body cues (Self-observation of the Body [SoB] training). Results indicated that while metacognitive efficiency was stable in MM training group, it was significantly reduced in the SoB group after training. This suggests that metacognition should not be conceived as a stable capacity but rather as a malleable skill.