When Mindfulness Is Therapy Harrington, Anne; Dunne, John D
The American psychologist,
10/2015, Volume:
70, Issue:
7
Journal Article
Peer reviewed
Open access
In the past 20 years, mindfulness therapeutic programs have moved firmly into the mainstream of clinical practice and beyond. As they have, we have also seen the development of an increasingly vocal ...critique. At issue is often less whether or not these mindfulness practices "work," and more whether there is a danger in dissociating them from the ethical frameworks for which they were originally developed. Mindfulness, the argument goes, was never supposed to be about weight loss, better sex, helping children perform better in school, helping employees be more productive in the workplace, or even improving the functioning of anxious, depressed people. It was never supposed to be a merchandized commodity to be bought and sold. The larger clinical and religious community, however, has not always been troubled by the idea that meditation might sometimes be used as a highly pragmatic remedy for various ailments. Why, then, are people troubled now? This essay is an effort to recapture a bigger historical perspective on current ethical qualms: to move beyond criticism and instead to try to understand the anatomy of our discontent.
Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) ...the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of one's experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying one's relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research.
•Mindfulness and mindfulness training are associated with a broad range of outcomes.•MAT describes mechanisms of mindfulness for cognition, affect, stress, and health.•Attention monitoring improves cognitive outcomes and increases affect reactivity.•Monitoring and acceptance interact to improve stress, affect, and health outcomes.•MAT is a testable account that seeks to stimulate mechanistic mindfulness research.
Background: Sugar sweetened beverage (SSB) intake in young adults is a major concern due to its association with multiple chronic conditions (e.g., obesity and type II diabetes). Mindful eating has ...been associated with positive changes in dietary behaviors and weight loss. The purpose of this study was to examine the relationship between SSB frequency and mindful eating. Methods: This convenience sample was recruited via targeted emails to university groups and Facebook. The target population was women 18-29 years old, who live within the U.S. The sample (n=175) was diverse (61% White; 21% Asian; 10% Hispanic; 5% African American/ Black). Participants completed on-line questionnaires Background Information and Mindful Eating Scale (MES)and self-report of weekly frequency of SSB intake. Results: The average SSB intake was 5/week (SD=4.08), ranging from 0 to 21. Weekly SSB intake was significantly, negatively correlated with several subscales of the MES, including the non-reactivity subscale (r= -0.221, p=.003), distractibility subscale (r= -0.286, p<.001), and routine subscale (r= -0.154, p=.042). Conclusions: Participants with higher emotional reaction to food (non-reactivity), ate without awareness (distractibility), and lacked a routine dietary pattern (routine) were more likely to have a higher SSB intake. Although mindful eating is associated with lower SSB intake, further research is needed to determine if mindful eating is a useful strategy for reducing SSB intake.
Objectives
Negative emotional eating and binge eating are positively related, occur in diverse populations, and may be driven by similar mechanisms. Mindfulness facets such as acting with awareness, ...describe, non‐judgement, non‐reactive, and observe may moderate the relationship between these maladaptive eating phenotypes.
Method
A cross‐sectional study assessed emotional eating‐depression (Emotional Eating Scale‐Revised, depression subscale), trait mindfulness facets (Five Facet Mindfulness Questionnaire‐Short Form), and binge eating severity (Binge Eating Scale) in adults (N = 258).
Results
Emotional eating‐depression was less strongly associated with binge eating severity in participants with higher acting with awareness mindfulness. Emotional eating‐depression was more strongly associated with binge eating severity in participants with higher non‐reactive mindfulness.
Conclusions
Acting with awareness and non‐reactive mindfulness may be important treatment targets in concurrent presentations of emotional eating‐depression and binge eating.
It is important to be able to differentiate mindfulness-based programs in terms of their model, therapeutic elements, and supporting evidence. This article compares mindfulness-based cognitive ...therapy (MBCT), developed for relapse prevention in depression, and mindfulness-integrated cognitive behavior therapy (MiCBT), developed for transdiagnostic applications, on: (1) origins, context and theoretical rationale (
), (2) program structure, practice and, professional training (
), and (3) evidence (
). While both approaches incorporate behavior change methods, MBCT encourages behavioral activation, whereas MiCBT includes various exposure procedures to reduce avoidance, including a protocol to practice equanimity during problematic interpersonal interactions, and a compassion training to prevent relapse. MBCT has a substantial research base, including multiple systematic reviews and meta-analyses. It is an endorsed preventative treatment for depressive relapse in several clinical guidelines, but its single disorder approach might be regarded as a limitation in many health service settings. MiCBT has a promising evidence base and potential to make a valuable contribution to psychological treatment through its transdiagnostic applicability but has not yet been considered in clinical guidelines. While greater attention to later stage dissemination and implementation research is recommended for MBCT, more high quality RCTs and systematic reviews are needed to develop the evidence base for MiCBT.
Abstract High rates of relapse following substance misuse treatment highlight an urgent need for effective therapies. Although the number of empirical studies investigating effects of mindfulness ...treatment for substance misuse has increased dramatically in recent years, few reviews have examined findings of mindfulness studies. Thus, this systematic review examined methodological characteristics and substantive findings of studies evaluating mindfulness treatments for substance misuse published by 2015. The review also includes the first meta-analysis of randomized controlled trials of mindfulness treatments for substance misuse. Comprehensive bibliographic searches in PubMed , PsycInfo , and Web of Science , identified 42 pertinent studies. Meta-analytic results revealed significant small-to-large effects of mindfulness treatments in reducing the frequency and severity of substance misuse, intensity of craving for psychoactive substances, and severity of stress. Mindfulness treatments were also effective in increasing rates of posttreatment abstinence from cigarette smoking compared to alternative treatments. Mindfulness treatment for substance misuse is a promising intervention for substance misuse, although more research is needed examining the mechanisms by which mindfulness interventions exert their effects and the effectiveness of mindfulness treatments in diverse treatment settings.
A number of studies have investigated the impact of mindfulness-based interventions on symptoms of post-traumatic stress (PTSD) compared to control conditions. The current meta-analysis consolidated ...findings from 18 studies reporting results for 21 samples of participants. Across studies, mindfulness-based treatments compared to control conditions were effective in ameliorating symptoms of PTSD, with Hedges' g=−0.44. Hedges' g was −0.59 for comparison of mindfulness-based interventions to waitlist control conditions. Changes in mindfulness may underpin the effect of mindfulness-based interventions on PTSD symptoms and thus the meta-analysis examined findings regarding increases in mindfulness. The 12 studies that assessed mindfulness found that the interventions significantly increased mindfulness, Hedges' g=0.52. Moderator analyses indicated that interventions with longer mindfulness training were more efficacious in reducing symptoms of PTSD. Across studies, gender, age, veteran status, or length of time between the intervention and assessment of PTSD symptoms did not moderate the impact of mindfulness-based interventions. The results provide a foundation for future research directions and have implications for work with those impacted by trauma.
•Mindfulness-based treatments are effective in ameliorating symptoms of PTSD.•Mindfulness-based treatments for PTSD increase mindfulness.•Longer mindfulness interventions are more efficacious.
Considering mindfulness as a multidimensional disposition domain-specific skill and state, this study aimed to explore the effect of the dimensions of mindfulness on the trajectories of ...biopsychosocial stress-recovery balance and on HRV over 10 days of a pre-competitive cycle. 24 young BMX riders completed mindfulness disposition and domain-specific skill scales. Monitoring of the recovery-stress states was based on biopsychosocial measurements (daily and biweekly). RMSSD was used to assess the organism ability to cope with the training program stimulus. After each training session, riders self-rated their state of mindfulness. Multilevel growth curve analyses examined the linear and/or quadratic trajectories of the athletes’ recovery-stress states and the effect of mindfulness on these trajectories. Mindfulness states results showed that the refocusing state had a significant negative quadratic effect over time on daily recovery and sport-specific recovery, and the awareness state on general recovery and total recovery. Concerning the dispositions of mindfulness, the observing component had a significant positive quadratic effect over time on daily stress. Nonreactivity had a significant positive quadratic effect over time on daily recovery and sport-specific recovery, and a significant positive effect on RMSSD. Acting with awareness had a significant positive effect on daily recovery and a significant negative effect on RMSSD. The study offered a better understanding of the effect of mindfulness (dispositions, domain-specific skills, and states) and its different components on the stress-recovery balance. The results suggest that mindfulness could be considered a promising effective psychological recovery strategy.
•Understanding the effect of mindfulness on the stress-recovery trajectories.•Mindfulness is considered as a multidimensional disposition, skill and state.•Monitoring the recovery-stress states was based on biopsychosocial measurements.•Mindfulness is a promising effective psychological recovery strategy.
Objective: Over the last 10 years, there has been a dramatic increase in published randomized controlled trials (RCTs) of brief mindfulness training (from single-session inductions to multisession ...interventions lasting up to 2 weeks), with some preliminary indications that these training programs may improve mental health outcomes, such as negative affectivity. This meta-analysis aimed to evaluate whether brief mindfulness training reliably reduces negative affectivity. Method: PubMed, PsycINFO, and the Mindfulness Research Monthly Newsletter were systematically searched for brief mindfulness intervention RCTs assessing negative affectivity outcomes (e.g., depression, rumination, anxiety, stress). Sixty-five RCTs, including 5,489 participants predominantly without experience in meditation (64.64% female, mean age = 24.62), qualified for the meta-analytic review. Results: The meta-analysis revealed a small but significant effect of brief mindfulness training on reducing negative affectivity compared to control programs (g = .21, p < .001). The overall effect size was significantly moderated by participant characteristics: community samples (g = .41, p < .001) produced larger training effects compared to student samples (g = .14, p = .001; Qbetween p = .03). No significant effect size differences were found between clinical and nonclinical samples. However, when accounting for publication bias, the overall effect size of brief mindfulness training programs on negative affectivity was significantly reduced (g = .04). Conclusions: Brief mindfulness training programs are increasingly popular approaches for reducing negative affectivity. This meta-analysis indicates that brief mindfulness training modestly reduces negative affectivity. Quantitative analyses indicated the presence of publication bias (i.e., unpublished null effect studies), highlighting the need to continue rigorous evaluation of brief mindfulness interventions.
What is the public health significance of this article?
This meta-analysis shows that brief mindfulness interventions lasting up to 2 weeks are potentially effective for reducing negative affectivity among people with no prior meditation experience. The presence of publication bias in this literature indicates that more published studies are needed to evaluate whether this effect is reliable and robust.
Abstract Some studies have indicated that a relaxation and/or meditation session could affect inhibitory control, while other studies have not found such an effect. Method: A total of 60 students ...aged between 16-18 years participated in the study, randomly distributed into two groups, according to the experimental (relaxation session) and the control (listening to neutral material) condition. Results: No significant improvements were found in the experimental group compared to the control group in Resistance to Interference. Conclusions: These results suggest that some prior relaxation practice might be necessary for a short relaxation session to have immediate benefits in inhibitory control or/and that the relaxation session should last longer.
PDF
