Healthy Minds Index: A brief measure of the core dimensions of well-being.

We developed a self-report measure of psychological well-being for teens and adults, the Healthy Minds Index, based on a novel theory that four trainable pillars underlie well-being: awareness, connection, insight, and purpose. Ninety-seven items were developed and revised by experts and guided by qualitative testing with teens (n = 32; average age = 16.0 years). After assessing the internal validity and factor structure in teens (n = 1607; average age = 16.7 years) and adults (n = 420; average age = 45.6 years), we reduced the survey to 17 items. We then validated the factor structure, internal and convergent and divergent validity, and retest reliability of the 17-item Healthy Minds Index in two new teen samples (study 1: n = 1492, average age = 15.7 years; study 2: n = 295, average age = 16.1 years), and one adult sample (n = 285; average age = 45.3 years). The Healthy Minds Index demonstrated adequate validity and provided a comprehensive measure of a novel theory of psychological well-being that includes two domains not found in other conceptualizations of this construct-awareness and insight. This measure will be invaluable for primary research on well-being and as a translational tool to assess the impact and efficacy of widely used behavioral training programs on these core dimensions of wellbeing.

Is informal practice associated with outcomes in loving-kindness and compassion training? Evidence from pre-post and daily diary assessments.

We investigated whether informal meditation practice (i.e., self-reported application of meditative techniques outside a period of formal meditation) was associated with outcomes in smartphone-based loving-kindness and compassion training. Meditation-naïve participants (n = 351) with clinically elevated symptoms completed measures of psychological distress, loneliness, empathy, and prosociality at baseline and following a two-week intervention. Informal practice, psychological distress, and loneliness were also assessed daily. Steeper increases in informal practice had small associations with pre-post improvements in distress (r = -.18, p = .008) and loneliness (r = -.19, p = .009) but not empathy or prosociality. Using a currently recommended approach for establishing cross-lagged effects in longitudinal data (latent curve model with structured residuals), higher current-day informal practice was associated with decreased next-day distress with a very small effect size (ßs = -.06 to -.04, p = .018) but not decreased next-day loneliness. No cross-lagged associations emerged from distress or loneliness to informal practice. Findings suggest that further investigation into a potential causal role of informal practice is warranted. Future studies experimentally manipulating informal practice are needed.

Revealing subgroup-specific mechanisms of change via moderated mediation: A meditation intervention example.

OBJECTIVE: Effective psychosocial interventions exist for numerous mental health conditions. However, despite decades of research, limited progress has been made in clarifying the mechanisms that account for their beneficial effects. We know that many treatments work, but we know relatively little about why they work. Mechanisms of change may be obscured due to prior research collapsing across heterogeneous subgroups of patients with differing underlying mechanisms of response. Studies identifying baseline individual characteristics that predict differential response (i.e., moderation) may inform research on why (i.e., mediation) a particular subgroup has better outcomes to an intervention via tests of moderated mediation. METHOD: In a recent randomized controlled trial comparing a 4-week meditation app with a control condition in school system employees (N = 662), we previously developed a "Personalized Advantage Index" (PAI) using baseline characteristics, which identified a subgroup of individuals who derived relatively greater benefit from meditation training. Here, we tested whether the effect of mindfulness acquisition in mediating group differences in outcome was moderated by PAI scores. RESULTS: A significant index of moderated mediation (IMM = 1.22, 95% CI [0.30, 2.33]) revealed that the effect of mindfulness acquisition in mediating group differences in outcome was only significant among those individuals with PAI scores predicting relatively greater benefit from the meditation app. CONCLUSIONS: Subgroups of individuals may differ meaningfully in the mechanisms that mediate their response to an intervention. Considering subgroup-specific mediators may accelerate progress on clarifying mechanisms of change underlying psychosocial interventions and may help inform which specific interventions are most beneficial for whom. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations of childhood adversity with emotional well-being and educational achievement: A review and meta-analysis.

BACKGROUND: Profound negative implications of adverse childhood experiences (ACEs) have raised public health concern worldwide. METHOD: This systematic review and meta-analysis examined associations of three types of ACEs (abuse, neglect, and household dysfunctions) with experiential (emotional quality of momentary and everyday experiences) and reflective (judgments about life satisfaction, sense of meaning, and ability to pursue goals that can include and extend beyond the self) facets of emotional well-being (EWB) and educational achievement. The systematic review yielded 100 studies with 176 effect sizes that met criteria for inclusion in the meta-analysis. RESULTS: ACEs were related particularly strongly to lower EWB, r = -0.32, p < .001; [95 % CI: -0.44 to 0.01], but also to lower educational achievement, r = -0.18, p < .001; [95 % CI: -0.21 to -0.05]. Associations were stronger for abuse and composite indicators of ACEs than for household dysfunctions. Associations of ACEs with EWB and educational achievement were stronger in childhood and adolescence than in emerging or later adulthood. Associations did not differ for males and females or for Eastern versus Western cultural groups. Analyses provided evidence for the causal role of ACEs in the development of lower EWB and academic achievement as well as their reciprocal associations. LIMITATIONS: There is no standard conceptualization of well-being and studies are not always clear about the types of ACEs examined, with limited research on educational achievement. CONCLUSION: Findings have important implications for mental health professionals, policy makers and social service agencies in developing resources and intervention services that target ACEs to protect individuals and promote well-being and academic achievement.

Educators Are Not Alright: Mental Health During COVID-19.

Educator mental health sits at the intersection of multiple pressing educational issues. We are among the first to provide estimates of school system employee (SSE) stress, anxiety, and depression during the COVID-19 pandemic. Most participants reported clinically meaningful anxiety and depressive symptoms (77.96% and 53.65%, respectively). Being in the lowest strata of family income was associated with higher stress, a greater likelihood of clinically significant depressive symptoms, and reduced intentions to continue in the same job, portending the current staffing shortages affecting schools. Supporting SSE mental health should become a policy priority.

Examining Equity in Access and Utilization of a Freely Available Meditation App.

Digital interventions have the potential to alleviate mental health disparities for marginalized and minoritized communities. The current study examined whether disparities in access and utilization of meditation in the United States (US) were reduced for a freely available meditation app. We analyzed demographic and usage data from US-based users of the Healthy Minds Program (HMP; N = 66,482) between October 2019 and July 2022. College education was associated with a greater likelihood of accessing (65.0% of users vs. 32.9% of the US population) and continuing to utilize the app (ß = .11-.17). Conversely, identifying as African American was associated lower likelihood of accessing (5.3% vs. 13.4% of US population) and continuing to utilize the app (ß = -.02-.03). African Americans were more likely to access content from an African American meditation teacher, but this did not appear to increase utilization. Additional efforts are warranted to identify factors which might reduce disparities.

COVID-19 pandemic effects on college student mental health: A cross-sectional cohort comparison study.

OBJECTIVE: Evaluate COVID-19 pandemic impacts on college student mental health. PARTICIPANTS: Three cohorts of college students (2018 n = 466; 2019 n = 459; 2020, n = 563; N = 1488) from three American universities. Participants were 71.4% female, 67.5% White, and 85.9% first-year students. METHODS: Multivariable regression models and bivariate correlations were used to compare anxiety, depression, well-being, and search for meaning before and during the pandemic, and the relationships between pandemic health-compliance behaviors and mental health. RESULTS: Anxiety, depression, and well-being did not significantly worsen during compared to before (2019) the pandemic (ps = .329-.837). During the pandemic, more frequent in-person social interactions were correlated with lower anxiety (r = -0.17, p < .001) and depressive symptoms (r=-0.12, p = .008), and higher well-being (r = 0.16, p < .001), but also less handwashing (r = -0.11, p = .016) and face mask-wearing (r = -0.12, p = .008). CONCLUSIONS: We observed little evidence for pandemic impacts on college student mental health. Lower compliance with pandemic health guidelines was associated with better mental health.

Does variability across three universities in the implementation of a college course on human flourishing affect student outcomes?

OBJECTIVE: This study explores whether variability in the implementation of an undergraduate course on human flourishing is differentially associated with student outcomes. PARTICIPANTS: 101 students in the "Art and Science of Human Flourishing" course across three large, public, R1 universities in Fall 2018 participated in the study. METHODS: Formative course data included researcher observations of weekly class pedagogy, students' weekly meditation practice logs and end-of-course assessments, and pre/post surveys measuring changes in participating students' outcomes related to flourishing (e.g., attentional skills, social-emotional skills, perspectives on flourishing, mental and physical health). RESULTS: Although course pedagogy and student engagement varied across the three universities, students' outcomes were nonetheless similar. CONCLUSIONS: Variability in course implementation did not appear to differentially affect students' outcomes. We tentatively conclude that other institutions interested in offering the flourishing course may make limited adaptations to fit their pedagogical preferences without concern for altering its impact on students.

Can the Academic and Experiential Study of Flourishing Improve Flourishing in College Students? A Multi-University Study.

Objectives: Significant concerns have been raised about the "mental health crisis" on college campuses, with attention turning to what colleges can do beyond counseling services to address students' mental health and well-being. We examined whether primarily first-year (89.1%) undergraduate students (n=651) who enrolled in the Art and Science of Human Flourishing (ASHF), a novel academic and experiential for-credit elective course on human flourishing, would demonstrate improved mental health and strengthen skills, perspectives, and behaviors associated with flourishing relative to students who did not enroll in this course. Methods: In a two-wave, multi-site, propensity-score matched controlled trial (ASHF n=217, Control n=434; N=651), we used hierarchal linear models and false discovery rate corrected doubly robust estimates to evaluate the impact of the ASHF on attention and social-emotional skill development, flourishing perspectives, mental health, health, and risk behavior outcomes. Results: ASHF participants reported significantly improved mental health (i.e., reduced depression) and flourishing, improvements on multiple attention and social-emotional skills (e.g., attention function, self-compassion), and increases in prosocial attitudes (empathic concern, shared humanity; Cohen's ds= 0.18-0.46) compared to controls. There was no evidence for ASHF course impacts on health or risk behaviors, raising the possibility that these outcomes take more time to change. Conclusions: This research provides initial evidence that the ASHF course may be a promising curricular approach to reduce and potentially prevent poor mental health while promoting flourishing in college students. Continued research is needed to confirm these conclusions.

A Randomized Controlled Trial of a Smartphone-Based Well-Being Training in Public School System Employees During the COVID-19 Pandemic.

While the extraordinary pressures of the COVID-19 pandemic on student mental health have received considerable attention, less attention has been placed on educator well-being. School system employees play a vital role in society, and teacher levels of well-being are associated with the educational outcomes of young people. We extend extant research on the prevalence and correlates of educator distress during the pandemic by reporting on a pragmatic randomized wait-list controlled trial (N=662; 64% teachers) of an innovative mental health promotion strategy implemented during the pandemic; a free four-week smartphone-based meditation app designed to train key constituents of well-being (Healthy Minds Program; HMP). Following our preregistered analysis plan and consistent with hypotheses, assignment to the HMP predicted significantly larger reductions in psychological distress, our primary outcome, at post-intervention (Cohen's d=-0.52, 95% confidence interval [-0.68, -0.37], p<.001) and at the three-month follow-up (d=-0.33 [-0.48, -0.18], p<.001). Also consistent with hypotheses, we observed similar indications of immediate and sustained benefit following the HMP on all six preregistered secondary outcomes selected to tap skills targeted in the app (e.g., perseverative thinking, social connection, well-being; absolute ds=0.19-0.42, all ps<.031 corrected except mindful action at follow-up). We found no evidence for elevated adverse events and the HMP was equally effective among participants with elevated baseline anxiety and depressive symptoms. These data suggest that the HMP may be an effective and scalable approach to supporting the mental health and well-being of teachers and other school system employees, with implications for employee retention and performance, and student outcomes.

Personalized Prediction of Response to Smartphone-Delivered Meditation Training: Randomized Controlled Trial.

BACKGROUND: Meditation apps have surged in popularity in recent years, with an increasing number of individuals turning to these apps to cope with stress, including during the COVID-19 pandemic. Meditation apps are the most commonly used mental health apps for depression and anxiety. However, little is known about who is well suited to these apps. OBJECTIVE: This study aimed to develop and test a data-driven algorithm to predict which individuals are most likely to benefit from app-based meditation training. METHODS: Using randomized controlled trial data comparing a 4-week meditation app (Healthy Minds Program [HMP]) with an assessment-only control condition in school system employees (n=662), we developed an algorithm to predict who is most likely to benefit from HMP. Baseline clinical and demographic characteristics were submitted to a machine learning model to develop a "Personalized Advantage Index" (PAI) reflecting an individual's expected reduction in distress (primary outcome) from HMP versus control. RESULTS: A significant group × PAI interaction emerged (t658=3.30; P=.001), indicating that PAI scores moderated group differences in outcomes. A regression model that included repetitive negative thinking as the sole baseline predictor performed comparably well. Finally, we demonstrate the translation of a predictive model into personalized recommendations of expected benefit. CONCLUSIONS: Overall, the results revealed the potential of a data-driven algorithm to inform which individuals are most likely to benefit from a meditation app. Such an algorithm could be used to objectively communicate expected benefits to individuals, allowing them to make more informed decisions about whether a meditation app is appropriate for them. TRIAL REGISTRATION: ClinicalTrials.gov NCT04426318; https://clinicaltrials.gov/ct2/show/NCT04426318.

Absence of structural brain changes from mindfulness-based stress reduction: Two combined randomized controlled trials.

Studies purporting to show changes in brain structure following the popular, 8-week mindfulness-based stress reduction (MBSR) course are widely referenced despite major methodological limitations. Here, we present findings from a large, combined dataset of two, three-arm randomized controlled trials with active and waitlist (WL) control groups. Meditation-naïve participants (n = 218) completed structural magnetic resonance imaging scans during two visits: baseline and postintervention period. After baseline, participants were randomly assigned to WL (n = 70), an 8-week MBSR program (n = 75), or a validated, matched active control (n = 73). We assessed changes in gray matter volume, gray matter density, and cortical thickness. In the largest and most rigorously controlled study to date, we failed to replicate prior findings and found no evidence that MBSR produced neuroplastic changes compared to either control group, either at the whole-brain level or in regions of interest drawn from prior MBSR studies.

Integrating mindfulness and connection practices into preservice teacher education results in durable automatic race bias reductions.

Automatic race bias, which is the tendency to associate positive attributes more quickly with White as compared to Black faces, reflects enculturation processes linked to inequitable teaching behaviors. In sample of undergraduate preservice teachers (N = 88), we examined whether a novel mindfulness and connection practice intervention without anti-bias content incorporated into undergraduate teacher education would result in reduced automatic race bias favoring White faces. Random assignment to the intervention predicted significantly reduced race preference for White child faces immediately after the intervention. These significant reductions persisted at the 6-month follow-up, which are the most durable reductions in automatic race bias reported to date in adults. Data from semi-structured interviews indicated that the intervention enhanced self-awareness and self-regulation while reducing automatic responding among preservice teachers. These qualities are instrumental to adaptive teaching and putative mechanisms for reducing automatic race bias. The potential value of integrating mindfulness and connection practices into undergraduate preservice teacher education is discussed.

Prevalence of harm in mindfulness-based stress reduction.

BACKGROUND: Mindfulness meditation has become a common method for reducing stress, stress-related psychopathology and some physical symptoms. As mindfulness programs become ubiquitous, concerns have been raised about their unknown potential for harm. We estimate multiple indices of harm following Mindfulness-Based Stress Reduction (MBSR) on two primary outcomes: global psychological and physical symptoms. In secondary analyses, we estimate multiple indices of harm on anxiety and depressive symptoms, discomfort in interpersonal relations, paranoid ideation and psychoticism. METHODS: Intent-to-treat analyses with multiple imputations for missing data were used on pre- and post-test data from a large, observational dataset (n = 2155) of community health clinic MBSR classes and from MBSR (n = 156) and waitlist control (n = 118) participants from three randomized controlled trials conducted contemporaneous to community classes in the same city by the same health clinic MBSR teachers. We estimate the change in symptoms, proportion of participants with increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms, and for global psychological symptoms, clinically significant harm. RESULTS: We find no evidence that MBSR leads to higher rates of harm relative to waitlist control on any primary or secondary outcome. On many indices of harm across multiple outcomes, community MBSR was significantly preventative of harm. CONCLUSIONS: Engagement in MBSR is not predictive of increased rates of harm relative to no treatment. Rather, MBSR may be protective against multiple indices of harm. Research characterizing the relatively small proportion of MBSR participants that experience harm remains important.

Alliance With an Unguided Smartphone App: Validation of the Digital Working Alliance Inventory.

The working alliance may be relevant in unguided smartphone-based interventions, but no validated measure exists. We evaluated the psychometric properties of the six-item Digital Working Alliance Inventory (DWAI) using a cross-sectional survey of meditation app users (n = 290) and the intervention arm of a randomized trial testing a smartphone-based meditation app (n = 314). Exploratory factor analysis suggested a single-factor solution which was replicated using longitudinal confirmatory factor analysis. The DWAI showed adequate internal consistency and test-retest reliability. Discriminant validity was supported by a lack of association with social desirability, psychological distress, and preference for a waitlist condition. Convergent validity was supported by positive associations with perceived app effectiveness and preference for an app condition. Supporting predictive validity, DWAI scores positively predicted self-reported and objective app utilization. When assessed at Weeks 3 or 4 of the intervention, but not earlier, DWAI scores predicted pre-post reductions in psychological distress.

Brief breath awareness training yields poorer working memory performance in the context of acute stress.

Mindfulness-based interventions that span multiple sessions over time appear to confer psychological benefits. However, the effects of brief periods of mindfulness meditation training are less clear, particularly on measures of cognitive functioning. This study assessed whether brief mindfulness practice (breath awareness) or training in two other contemplative practices - loving-kindness and gratitude - differentially impact working memory performance following acute physiological stress relative to an attentional control. Participants (n = 162) were randomly assigned to one of four training groups and completed the automated Operation Span (OSPAN) task pre-training and again after undergoing the cold pressor task. Three of the four groups improved in OSPAN performance, with loving-kindness, gratitude, and attentional control conditions showing increases in OSPAN relative to breath awareness. Changes in OSPAN were not correlated with changes in positive or negative affect. It appears that brief breath awareness training may not effectively buffer against acute stress in this predominantly meditation naïve sample and may in fact impair subsequent cognitive performance relative to a control or other contemplative practices. A granular approach is warranted to understand potentially distinct and contextually variable effects of different contemplative practices. Implications are discussed in light of the stress buffering hypothesis and Monitor and Acceptance Theory.Trial registration: ClinicalTrials.gov identifier: NCT02214264.

Emotional Style Questionnaire: A multidimensional measure of healthy emotionality.

In four studies, we document the development and validation of the Emotional Style Questionnaire (ESQ)-a 24-item self-report measure that captures how people vary across 6 dimensions that make up a healthy emotional life. These 6 dimensions (Outlook, Resilience, Social Intuition, Self-Awareness, Sensitivity to Context, and Attention) are based on a theoretical framework drawn from neuroscientific studies of emotion. Study 1 reports the development of the ESQ and provides initial support for the proposed factorial structure of the scale. Study 2 confirms the adequacy of the factorial structure in a second sample and establishes the construct validity of each of the 6 subscales. In Study 3, we test the relationship between the ESQ as a measure of healthy emotionality and various indicators of psychological and physical well-being. Finally, Study 4 investigates the test-retest reliability of the scale and reveals very good reliability across an interval of 4 weeks. We conclude that the ESQ is a psychometrically solid and easily implementable instrument that can be used to gauge healthy emotionality and its components in both clinical and research settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Divergent effects of brief contemplative practices in response to an acute stressor: A randomized controlled trial of brief breath awareness, loving-kindness, gratitude or an attention control practice.

Mindfulness practices are increasingly being utilized as a method for cultivating well-being. The term mindfulness is often used as an umbrella for a variety of different practices and many mindfulness-based interventions (MBIs) contain multiple styles of practice. Despite the diversity of practices within MBIs, few studies have investigated whether constituent practices produce specific effects. We randomized 156 undergraduates to one of four brief practices: breath awareness, loving-kindness, gratitude, or to an attention control condition. We assessed practice effects on affect following brief training, and effects on affect and behavior after provocation with a stressor (i.e., Cold pressor test). Results indicate that gratitude training significantly improved positive affect compared to breath awareness (d = 0.58) and loving-kindness led to significantly greater reductions in implicit negative affect compared to the control condition (d = 0.59) immediately after brief practice. In spite of gains in positive affect, the gratitude group demonstrated increased reactivity to the stressor, reporting the CPT as significantly more aversive than the control condition (d = 0.46) and showing significantly greater increases in negative affect compared to the breath awareness, loving-kindness, and control groups (ds = 0.55, 0.60, 0.65, respectively). Greater gains in implicit positive affect following gratitude training predicted decreased post-stressor likability ratings of novel neutral faces compared to breath awareness, loving-kindness, and control groups (ds = - 0.39, -0.40, -0.33, respectively) as well. Moreover, the gratitude group was significantly less likely to donate time than the loving-kindness group in an ecologically valid opportunity to provide unrewarded support. These data suggest that different styles of contemplative practice may produce different effects in the context of brief, introductory practice and these differences may be heightened by stress. Implications for the study of contemplative practices are discussed.

Getting a Grip on the Handgrip Task: Handgrip Duration Correlates with Neuroticism But Not Conscientiousness.

Questions regarding the replicability of key findings in the self-regulation literature (e.g., ego-depletion effect) have led some to call for a more thorough evaluation of commonly used measures of self-control. The isometric handgrip task is one such measure. The current study examined correlates of handgrip persistence using data drawn from a larger randomized controlled trial. Handgrip persistence was measured both at baseline and following a physical stressor (cold pressor test). Correlations were examined between handgrip performance and personality traits theoretically closely linked with self-regulation: conscientiousness and neuroticism. Baseline handgrip performance was correlated with several measures drawn from the nomological network of self-regulation including measures of trait neuroticism, mindfulness, anxiety sensitivity, perceived stress, and positive affect, although not with trait conscientiousness. Baseline handgrip predicted aversiveness experienced during the physical stressor, while changes in handgrip performance tracked changes in implicit and explicit negative affect (i.e., affective reactivity). These associations were largely maintained when controlling for variables highly correlated with overall grip strength (i.e., gender, height, and weight), although correlations separated by gender suggest associations were primarily driven by female participants. Results support future research using the handgrip task.