Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data.
PLoS One. 2017;12(12):e0187727
Authors: Garland EL, Hanley AW, Goldin PR, Gross JJ
BACKGROUND AND OBJECTIVE: The Mindfulness to Meaning Theory (MMT) provides a detailed process model of mindful positive emotion regulation.
DESIGN: We conducted a post-hoc reanalysis of longitudinal data (N = 107) derived from a RCT of mindfulness-based stress reduction (MBSR) versus cognitive-behavioral therapy (CBT) for social anxiety disorder to model the core constructs of the MMT (attentional control, decentering, broadened awareness, reappraisal, and positive affect) in a multivariate path analysis.
RESULTS: Findings indicated that increases in attentional control from baseline to post-training predicted increases in decentering by 3 months post-treatment (p<.01) that in turn predicted increases in broadened awareness of interoceptive and exteroceptive data by 6 months post-treatment (p<.001). In turn, broadened awareness predicted increases in the use of reappraisal by 9 months post-treatment (p<.01), which culminated in greater positive affect at 12 months post-treatment (p<.001). MBSR led to significantly greater increases in decentering (p<.05) and broadened awareness than CBT (p<.05). Significant indirect effects indicated that increases in decentering mediated the effect of mindfulness training on broadening awareness, which in turn mediated enhanced reappraisal efficacy.
CONCLUSION: Results suggest that the mechanisms of change identified by the MMT form an iterative chain that promotes long-term increases in positive affectivity. Though these mechanisms may reflect common therapeutic factors that cut across mindfulness-based and cognitive-behavioral interventions, MBSR specifically boosts the MMT cycle by producing significantly greater increases in decentering and broadened awareness than CBT, providing support for the foundational assumption in the MMT that mindfulness training may be a key means of stimulating downstream positive psychological processes.
PMID: 29211754 [PubMed - in process]
Effect of mindfulness meditation on short-term weight loss and eating behaviors in overweight and obese adults: A randomized controlled trial.
J Complement Integr Med. 2017 Dec 05;:
Authors: Spadaro KC, Davis KK, Sereika SM, Gibbs BB, Jakicic JM, Cohen SM
Background There is a significant health crisis with rates of obesity continuing to increase despite research and clinical standard behavioral weight loss programs (SBWP). Mindfulness meditation (MM), with demonstrated benefits on physical, psychological health, and self-regulation behaviors was explored with SBWP. Methods Forty-six adults (BMI=32.5±3.7 kg/m2; age=45.2±8.2 years, 87 % female, 21.7 % African American) were randomly assigned to a 6-month SBWP only (n=24) or SBWP+MM (n=22) at a university-based physical activity and weight management research center in a northeastern US city. Participants were instructed to decrease intake (1200-1500 kcal/day), increase physical activity (300 min/wk), and attend weekly SBWP or SBWP+MM sessions. SBWP+MM had the same SBWP lessons with addition of focused MM training. Outcome measures collected at 0, 3, and 6 months included: weight, Block Food Frequency Questionnaire, Eating Behavior Inventory, Eating Inventory and Paffenbarger Physical Activity Questionnaire. Data were analyzed using linear mixed modeling for efficacy analysis of weight (primary) and eating, exercise and mindfulness (secondary outcomes). Results Retention rate was 76.1 % (n=35). A significant group by time interaction (p=0.03) was found for weight, with weight loss favoring SBWP+MM (-6.9 kg+2.9) over SBWP (-4.1 kg+2.8). Eating behaviors (p=0.02) and dietary restraint (p=0.02) improved significantly in SBWP+MM, compared to SBWP. MM enhanced weight loss by 2.8 kg potentially through greater improvements in eating behaviors and dietary restraint. Conclusions These findings support further study into the use of MM strategies with overweight and obese adults. The use of this low-cost, portable strategy with standard behavioral interventions could improve weight management outcomes.
PMID: 29211681 [PubMed - as supplied by publisher]
New Nursing Faculty and Incivility: Applying Mindfulness-Based Strategies.
Holist Nurs Pract. 2018 Jan/Feb;32(1):4-7
Authors: Green C
Workplace incivility remains a problem within the nursing profession. As nurse leaders, we must recognize and not ignore the complexity of cultures that have adapted incivility into the work environment. Nursing education is a discipline that requires collaborative team work, independent drive, and commitment. New nursing faculty experiencing incivility can use mindfulness-based meditation approaches to cope with uncivil behaviors experienced within the workplace. Nurse educators applying the concepts of mindfulness can learn how to provide themselves self-care by reducing stress, as enhanced daily awareness of peace and calm are incorporated into their lifestyle. Mindfulness provides a realization that control can only be given to other persons when an individual allows or accepts another's negative behaviors. Awareness of the value and importance of oneself can assist the nurse educator experiencing incivility to maintain his or her emotional, physical, and spiritual health despite the volatility of the work environment.
PMID: 29210872 [PubMed - in process]
A Qualitative Study with Healthcare Staff Exploring the Facilitators and Barriers to Engaging in a Self-Help Mindfulness-Based Intervention.
Mindfulness (N Y). 2017;8(6):1653-1664
Authors: Banerjee M, Cavanagh K, Strauss C
In order to increase the cost-efficiency, availability and ease of accessing and delivering mindfulness-based interventions (MBIs), clinical and research interest in mindfulness-based self-help (MBSH) interventions has increased in recent years. Several studies have shown promising results of effectiveness of MBSH. However, like all self-help interventions, dropout rates and disengagement from MBSH are high. The current study explored the facilitators and barriers of engaging in a MBSH intervention. Semi-structured interviews with members of healthcare staff who took part in an MBSH intervention (n = 16) were conducted. A thematic analysis approach was used to derive central themes around engagement from the interviews. Analyses resulted in four overarching themes characterising facilitation and hindrance to engagement in MBSH. These are "attitude towards engagement", "intervention characteristics", "process of change" and "perceived consequences". Long practices, emerging negative thoughts and becoming self-critical were identified as the key hindrances, whilst need for stress reduction techniques, shorter practices and increased sense of agency over thoughts were identified as the key facilitators. Clinical and research implications are discussed.
PMID: 29201248 [PubMed]
Differential Effects of Attention-, Compassion-, and Socio-Cognitively Based Mental Practices on Self-Reports of Mindfulness and Compassion.
Mindfulness (N Y). 2017;8(6):1488-1512
Authors: Hildebrandt LK, McCall C, Singer T
Research on the effects of mindfulness- and compassion-based interventions is flourishing along with self-report scales to assess facets of these broad concepts. However, debates remain as to which mental practices are most appropriate to develop the attentional, cognitive, and socio-affective facets of mindfulness and compassion. One crucial question is whether present-moment, attention-focused mindfulness practices are sufficient to induce a cascade of changes across the different proposed facets of mindfulness, including nonjudgmental acceptance, as well as compassion or whether explicit socio-affective training is required. Here, we address these questions in the context of a 9-month longitudinal study (the ReSource Project) by examining the differential effects of three different 3-month mental training modules on subscales of mindfulness and compassion questionnaires. The "Presence" module, which aimed at cultivating present-moment-focused attention and body awareness, led to increases in the observing, nonreacting, and presence subscales, but not to increases in acceptance or nonjudging. These latter facets benefitted from specific cultivation through the socio-cognitive "Perspective" module and socio-affective, compassion-based "Affect" module, respectively. These modules also led to further increases in scores on the subscales affected by the Presence module. Moreover, scores on the compassion scales were uniquely influenced by the Affect module. Thus, whereas a present-moment attention-focused training, as implemented in many mindfulness-based programs, was indeed able to increase attentional facets of mindfulness, only socio-cognitive and compassion-based practices led to broad changes in ethical-motivational qualities like a nonjudgmental attitude, compassion, and self-compassion.
PMID: 29201246 [PubMed]
Design of the integrative medical group visits randomized control trial for underserved patients with chronic pain and depression.
Contemp Clin Trials. 2017 Mar;54:25-35
Authors: Gardiner P, Lestoquoy AS, Gergen-Barnett K, Penti B, White LF, Saper R, Fredman L, Stillman S, Lily Negash N, Adelstein P, Brackup I, Farrell-Riley C, Kabbara K, Laird L, Mitchell S, Bickmore T, Shamekhi A, Liebschutz JM
BACKGROUND: Given the public health crisis of opioid overprescribing for pain, there is a need for evidence-based non pharmacological treatment options that effectively reduce pain and depression. We aim to examine the effectiveness of the Integrative Medical Group Visits (IMGV) model in reducing chronic pain and depressive symptoms, as well as increasing pain self-management.
METHODS: This paper details the study design and implementation of an ongoing randomized controlled trial of the IMGV model as compared to primary care visits. The research aims to determine if the IMGV model is effective in achieving: a) a reduction in self-reported pain and depressive symptoms and 2) an improvement in the self-management of pain, through increasing pain self-efficacy and reducing use of self-reported pain medication. We intend to recruit 154 participants to be randomized in our intervention, the IMGV model (n=77) and to usual care (n=77).
CONCLUSIONS: Usual care of chronic pain through pharmacological treatment has mixed evidence of efficacy and may not improve quality of life or functional status. We aim to conduct a randomized controlled trial to evaluate the effectiveness of the IMGV model as compared to usual care in reducing self-reported pain and depressive symptoms as well as increasing pain management skills.
PMID: 27979754 [PubMed - indexed for MEDLINE]