Mindfulness Deficits Research Articles

What aspects of mindfulness and emotion regulation underpin self-harm in individuals with borderline personality disorder?

Background Self-harm presents significant risk for individuals with borderline personality disorder (BPD). Both self-harm and BPD are associated with deficits in mindfulness and emotion dysregulation. Previous research suggests that thought suppression and emotional inexpressivity may underpin self-harm in people with BPD, suggesting potential links to self-harm functions common for those with BPD. More research is needed to strengthen our understanding of this relationship. Aims This study examines how BPD symptoms, mindfulness, emotion dysregulation and self-harm functions are related. Methods Australian community outpatients diagnosed with BPD (N = 110) completed measures of mindfulness, emotion dysregulation and self-harm functions. Serial mediation analyses were conducted to examine relationships between variables. Results BPD symptoms, chronic emptiness, mindfulness skills, describing and non-reacting, emotion dysregulation areas of emotion regulation strategies and poor emotional clarity were associated with recent self-harm. Various combinations of describing, strategies and clarity mediated the path between emptiness and self-harm functions more likely to be endorsed by individuals with a diagnosis of BPD. Describing was associated with all but anti-suicide function, while strategies was associated with all but anti-dissociation. Conclusion The study highlights how individuals with BPD experiencing chronic emptiness may benefit from treatment targeting describing skills and adaptive emotion regulation strategies.

Facets of Mindfulness Mediate the Relationship Between Attachment Orientation and Emotion Regulation in University Students.

Whilst both mindfulness and adult attachment have been linked to wellbeing, little is known about how these constructs relate to emotion regulation that can underpin wellbeing. The present study examined the association between adult attachment orientation and emotion regulation (strategies and difficulties) and the mediating role of facets of dispositional mindfulness. A sample of 301 university students (Mage = 23.08, SD = 8.08; 74.75% female) completed measures of adult attachment, emotion regulation, difficulties in emotion regulation, and dispositional mindfulness. Parallel multiple mediation analyses indicated that the act with awareness and non-judging facets of mindfulness repeatedly emerged as significant mediators in the positive associations between the dimensions of attachment insecurity (anxiety, avoidance, and disorganized) and maladaptive emotion regulation strategies and difficulties in emotion regulation. Those individuals exhibiting greater attachment insecurity employ maladaptive emotion regulation strategies and display difficulties in emotion regulation via mindfulness deficits. The present findings extend our current understanding of the role of dispositional mindfulness in the associations between adult attachment orientation and varying aspects of the emotion regulation process.

Mindfulness and Early Maladaptive Schemas Among Men in Treatment for Substance Use Disorder

Early maladaptive schema (EMS), the dysfunctional life views regarding oneself or others, is relatively more prevalent in clinical populations and is related to avoidant behaviors (e.g., substance use). Avoidance is inconsistent with the acceptance of present-moment experiences characterized by mindfulness. As such, dispositional mindfulness negatively related to EMS in samples recruited from the community and substance use disorder (SUD) treatment facilities. However, past research used small or non-clinical samples with limited measures of mindfulness and analyses that preclude the possibility of tailoring future treatments to specific mindfulness deficits within a clinical sample. The current study extended prior research by examining the relations between the five EMS domains and five different facets of dispositional mindfulness in a sample of men in a residential SUD treatment program (N = 752). We hypothesized that the EMS domains of impaired autonomy and performance, impaired limits, other-directedness, and disconnection and rejection would be negatively related to the mindfulness facet acting with awareness. Additionally, as an exploratory aim, it was hypothesized that the EMS domains would be negatively associated with most of the remaining mindfulness facets. Path analyses revealed that the EMS domains of disconnection and rejection and overvigilance and inhibition negatively associated with acting with awareness, controlling for substance use. Additionally, impaired limits negatively related to the other four mindfulness facets and disconnection and rejection related to describing experience and observing experience. Results suggest therapeutic interventions may need to be tailored to specific EMS domains and mindfulness facets within individuals in treatment for SUDs.

To Better Understand the Link between Psychopathy and Antisocial Behavior: Moderation by Dispositional Mindfulness

Background: Dispositional mindfulness deficits and psychopathic personality traits have been shown to be closely associated and independent predictors of antisocial behaviors (AB) in young adults. However, the interaction effects of these 2 factors have not yet been explored. The aim of this study was to examine the contribution of dispositional mindfulness and psychopathic traits to ABs in a college student sample. Methods: Participants were 1,572 students from different French universities who completed self-report questionnaires. Regression analyses were conducted in order to test a moderation model between psychopathic traits and AB. Results: Moderation analyses revealed that dispositional mindfulness interacted with psychopathic personality traits in predicting AB. In males with high levels of dispositional mindfulness, as psychopathic traits increased, AB increased less than in males with low levels of dispositional mindfulness. Conclusions: The present study suggests possible implications for prevention and treatment of AB among non-clinical young adults with relatively high psychopathic traits.

Inpatient Treatment of Complex PTSD Following Childhood Abuse: Effectiveness and Predictors of Treatment Outcome

There is a lack of studies investigating the effectiveness of inpatient trauma-focused psychotherapy of complex post-traumatic stress disorder. The first aim of this retrospective investigation was to analyze the course of PTSD. Second, possible predictors of treatment response were investigated. 150 inpatients of Clinic St. Irmingard with complex PTSD following childhood physical and childhood sexual abuse were assessed regarding childhood abuse, PTSD symptomatology, mindfulness, dissociation and general psychopathology. Differences in pre and post scores were analyzed using regression analyses. A classification tree was used to identify predictors of response. The significant reduction of PTSD symptoms corresponded to a large effect (d=1.8) and a reponse rate of 52% according to the reliable change index (p<0.05). Effect sizes for other symptoms were medium to large (0.5<d<1.1) and both drop-outs (7%) and worsenings (4%) were scarce. Somatoform symptoms, complex dissociative disorders and mindfulness deficits were identified as negative predictors of reliable change. Trauma-focused inpatient treatment is safe and effective for patients with complex PTSD under naturalistic conditions. Yet, despite significant improvements there is a high rate of nonresponse. Future studies should further investigate the negative predictors of treatment outcome we identified. Possible ways to reduce nonresponse are discussed.

Mindfulness and pathological dissociation fully mediate the association of childhood abuse and PTSD symptomatology

IntroductionThe role of dissociation and mindfulness deficits in posttraumatic stress disorder (PTSD) is not yet fully clear. ObjectiveWe examined how mindfulness deficits and pathological dissociation might explain the association of childhood sexual and childhood physical abuse and PTSD. MethodUsing data from 218 severely traumatized inpatients with PTSD, we fit a multiple mediation model in a structural equation-modeling (SEM) framework. ResultsWe found significant indirect effects of childhood physical and childhood sexual abuse on PTSD symptomatology via pathological dissociation and mindfulness. After accounting for these indirect effects, the direct effect of childhood abuse on PTSD symptoms disappeared, indicating full mediation. ConclusionOur results suggest that pathological dissociation and mindfulness deficits may be important mechanisms underlying the association of childhood abuse and chronic PTSD. We discuss implications of this finding for the effective treatment of survivors of childhood abuse with PTSD, highlighting the importance of focusing on dissociative symptoms and mindfulness deficits.

Efectos y Particularidades del Uso del Mindfulness en el Trastorno Límite de la Personalidad

Distintos estudios muestran que los sujetos con trastorno límite de la personalidad (TLP) presentan –respecto a controles sanos– una menor capacidad de mindfulness, entendida como la habilidad para prestar atención al momento presente de forma no-evaluativa y no-reactiva. Parecería ser que estos déficits en la capacidad de mindfulness se relacionan con algunas de las características del trastorno como la disregulación emocional, la impulsividad o las dificultades en el área interpersonal, y que, el hecho de haber sufrido abuso sexual en la infancia también contribuiría a una menor capacidad de mindfulness. Estudios en los que se han evaluado los efectos del entrenamiento en mindfulness en pacientes con TLP sugieren que éste se relaciona con mejorías en algunos parámetros atencionales (i.e., capacidad de inhibir respuestas) y de impulsividad (i.e., habilidad para tolerar recompensas, percepción temporal). Además, la práctica de mindfulness se asocia con un aumento de la capacidad de descentramiento, describir, no-juzgar y no reaccionar, y con una disminución de la sintomatología límite. En conjunto, la literatura actual sugiere que el mindfulness es eficaz para el tratamiento del TLP, y que intervenciones de este tipo deberían hacer especial énfasis en trabajar aspectos actitudinales del mindfulness, como la capacidad de no-juzgar.

Mindfulness skills deficits in pathological skin picking behaviours

IntroductionPathological Skin Picking (SP) is a psychiatric condition with a 2–5%-prevalence in the community and consists of repetitive picking behaviours associated to marked distress, which can cause significant skin damage. Research has evidenced a Focused SP subtype, typically occurring in response to negative emotions, an Automatic subtype, occurring without awareness during activities not related to the picking behavior, and a Mixed one. Mindfulness skills have been studied as a protective factor involved in the treatment of several psychiatric disorders. Studying Mindfulness deficits in SP might help to identify interventions tailored for specific subtypes of SP behaviours.ObjectivesThe current study examined the relationship between Mindfulness skills and pathological SP behaviours.AimsThe study aimed to investigate whether Mindfulness skills deficits uniquely predicted SP subtypes behaviours after controlling for general distress in a community sample.MethodsNinety-seven community individuals (mean age = 39.71, SD = 16.37, 59% females) completed measures of SP, Mindfulness skills and general distress (anxiety and depression).ResultsLower Mindfulness skills of Describing Internal Experiences (B = −0.12, P &lt; 0.05) and higher anxiety (B = 0.08, P &lt; 0.05) predicted more severe Automatic SP. Lower Mindfulness skills of Non-judging Inner Experiences (B = −0.12, P &lt; 0.05), higher anxiety (B = −0.12, P &lt; 0.05) and higher depression (B = −0.12, P &lt; 0.05) predicted more severe Mixed SP. Focused SP was not associated to Mindfulness skills and general distress.ConclusionsMindfulness skills deficits could be associated to Automatic and Mixed but not Focused SP. Future studies should investigate whether Mindfulness programs are effective for individuals reporting Automatic or Mixed SP behaviours.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Making the most of mindfulness: Which specific mindfulness deficits might be targeted to optimize addiction treatment?

Patterns in non-medical prescription opioid (NMPO) and heroin use have recently shifted, with evidence that NMPO-only users transition to NMPO and heroin co-use. Co-use is associated with increased risk of morbidity and overdose, highlighting the need for further investigation. This study aims to quantify, describe, and explore trends in co-use.Using data from the 2003–2014 National Surveys on Drug Use and Health, we compared co-use to NMPO- and heroin-only use across demographic, substance use and mental health characteristics with chi-squared tests. Logistic regression models assessed trends in opioid use overall, and among co-users.From 2003 to 2014, the prevalence of all opioid use (NMPO-only, heroin-only, and co-use) and NMPO-only use decreased 6.08% (p < 0.01) and 4.65% (p < 0.001), respectively, while prevalence of heroin-only use increased 21.32% (non-significant). Co-use increased 248.17% (p < 0.001) overall, and did so in all demographic, substance use, and mental health groups. Demographic, substance use, and mental health characteristics of co-users were more similar to the heroin-only group than to NMPO-only. The highest co-use prevalence was among those: without health insurance (8.72%), aged 26–34 (9.76%), reporting unemployment (12.08%), and with a major depressive episode, psychological distress, and who illicitly use or abuse drugs other than opioids or marijuana in the past year (9.33%, 10.75%, 11.87%, and 16.81%, respectively).The increased prevalence of co-use and differences across demographic, substance use, and mental health characteristics highlight the need for targeted prevention and response interventions for this emerging, high-risk group.

Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women.

Borderline personality disorder (BPD) features have been linked to deficits in mindfulness, or nonjudgmental attention to present-moment stimuli. However, no previous work has examined the role of fluctuations in mindfulness over time in predicting BPD features. The present study examines the impact of both between-person differences and within-person changes in mindfulness. 40 women recruited to achieve a flat distribution of BPD features completed 4 weekly assessments of mindfulness (Five Facet Mindfulness Questionnaire; FFMQ) and BPD features. Multilevel models predicted each outcome from both 1) a person's average levels of each facet and 2) weekly deviations from a person's average for each facet. Average acting with awareness, nonjudging, and nonreactivity predicted lower BPD features at the between-person level, and weekly deviations above one's average (i.e., higher-than-usual) nonjudging predicted lower BPD feature expression at the within-person level. Within-person fluctuations in the nonjudging facet of mindfulness may be relevant to the daily expression of BPD features over and above dispositional mindfulness.

Teasing apart low mindfulness: Differentiating deficits in mindfulness and in psychological flexibility in predicting symptoms of generalized anxiety disorder and depression

BackgroundThis research investigated the differential ability of three components of low mindfulness to uniquely predict symptoms of generalized anxiety disorder (GAD) and depression, while controlling for psychological inflexibility, a construct conceptually related to low mindfulness. Also examined was the meditational role of several mindfulness facets in the relationship between psychological inflexibility and symptoms of each disorder. MethodsUsing a clinical sample (n=153) containing mostly patients with GAD or depression diagnoses, we conducted hierarchical multiple regression analyses and mediation analyses to determine unique relationships. ResultsWhereas deficits in adopting a non-reactive perspective exhibited incremental validity beyond psychological inflexibility in predicting symptoms of GAD, deficits in acting with awareness did so in predicting symptoms of depression. Results of mediation analyses corroborated this pattern, as the relationships psychological inflexibility exhibited with symptoms of GAD and of depression were mediated by non-reactivity and acting with awareness, respectively. LimitationsThe cross-sectional design of this study precludes causal interpretations of the mediation models. ConclusionFindings corroborate the following conclusions: (i) the lack of present oriented awareness experienced by individuals with symptoms of depression is not completely accounted for by psychological inflexibility nor by symptoms of GAD; (ii) the reactive approach to automatic thoughts adopted by those with symptoms of GAD is not completely accounted for by psychological inflexibility nor by symptoms of depression. These conclusions suggest that it would be profitable for mindfulness-based therapies to concentrate on these specific mindfulness deficits to ameliorate the severity of GAD and depression.

Mindfulness deficits in a sample of substance abuse treatment seeking adults: a descriptive investigation

Mindfulness is increasingly being recognized as an important correlate of mental health, and is inversely corelated with substance use. To date, preliminary research suggests that mindfulness-based interventions may be effective for the treatment of substance use disorders. However, there is a notable lack of research on deficits in mindfulness among individuals who seek residential substance abuse treatment, including whether they report lower levels of mindfulness relative to healthy controls. Thus, the current study examined differences in mindfulness between a sample of adult substance abusers who sought residential treatment (N = 107) and normative data on mindfulness from healthy adults. Results demonstrated that the substance abusers reported less mindfulness relative to the normative data, including lower levels of mindful curiosity and decentering, with effect sizes differences between groups falling into the large range. No differences were evident in mindfulness between men and women patients or between individuals with an alcohol or drug diagnosis. These results provide evidence that substance abusers seeking treatment may have lower levels of mindfulness relative to healthy adults, supporting the use of mindfulness-based interventions with this population.

Borderline Personality Features and Harmful Dysregulated Behavior: The Mediational Effect of Mindfulness

The current preliminary study investigated whether deficits in mindfulness (awareness, attentiveness, and acceptance of the present experience) may underlie the relationship of borderline personality disorder (BPD) features to self-injury and overall acts of harmful dysregulated behavior. Nonparametric bootstrapping procedures were used to examine theoretical relationships among variables in a psychiatric sample of adults (N = 70). Participants were asked to imagine themselves in distress-inducing situations and then write what they would actually do to decrease distress in such situations. As hypothesized, mindfulness statistically mediated the relationship of BPD features to reported acts of (a) self-injury and (b) overall harmful dysregulated behaviors. Difficulties in the ability to be aware, attentive, and accepting of ongoing experience may play a role in the relationship of BPD features to harmful dysregulated behaviors. Future research should clarify potential reciprocal effects between BPD features and mindfulness with prospective, multioccasion designs.

Nonjudgment as a moderator of the relationship between present-centered awareness and borderline features: Synergistic interactions in mindfulness assessment

The symptoms of borderline personality disorder (BPD) have been characterized as deficits in mindfulness. Mindfulness can be defined as nonjudgmental, present-centered awareness. The present study investigates the theory that, consistent with this conceptualization, the extent to which acting with awareness predicts reduced BPD features and related dysfunction depends upon levels of nonjudgment. In a sample of 223 undergraduates, we calculated the interaction between awareness-based and nonjudging-based mindfulness skills using subscales of the Five Facet Mindfulness Questionnaire. Regression analyses demonstrated a significant effect of the interaction on several difficulties that are common in BPD: problems with relationships, emotion-related impulsivity, and anger rumination. For acting with awareness to benefit individuals with these difficulties, a less judgmental stance toward internal experiences may be necessary. These findings have significant treatment implications and demonstrate the importance of assessing mindfulness as a multifaceted, synergistic construct.

Mind reading and mindfulness deficits in patients with major depression disorder

Theory of Mind is a social cognitive ability of brain, and Mindfulness is comprised of the abilities to self-regulate and guide attention to task. In order to compare mindfulness and mind reading abilities in major depressed and healthy matched subjects, 45 major depressed patients were compared with 50 healthy subjects. Participants completed Baron-Cohen's Reading the Mind in the Eyes Test and Mindful Attention Awareness Scale. Findings show that mind reading and mindfulness in depressed individuals are significantly lower than in healthy individuals. The results demonstrate that mindfulness and mind reading can be regarded as predictors of social cognitive function in individuals with depression.

Mindfulness and modification therapy for behavioral dysregulation: results from a pilot study targeting alcohol use and aggression in women

Increasing evidence suggests that deficits in mindfulness (awareness, attentiveness, and acceptance of the present moment) play a role in a range of disorders involving behavioral dysregulation. This paper adds to that literature by describing a transdiagnostic psychotherapy (Mindfulness & Modification Therapy; MMT) developed to target behavioral dysregulation. An open-treatment pilot-trial investigated the feasibility, acceptability, and pre-post effects of MMT targeting women (N = 14) court-referred for alcohol abuse/dependence and aggression. Pre-post comparisons revealed significant decreases in alcohol use, drug use, and aggression. In addition, the retention rate was 93%. Preliminary evidence suggests that MMT is a feasible and acceptable treatment that decreases dysregulated behaviors such as substance use and aggression, while also potentially increasing retention.

Mindfulness impairments in individuals seeking treatment for substance use disorders

Background: Mindfulness training may be an effective treatment for substance use disorders (SUDs). Little research has been done, however, on baseline levels of mindfulness in the substance using population. Objectives/Methods: We investigated mindfulness levels using the Mindful Attention Awareness Scale (MAAS) in individuals presenting for substance use treatment, and compared polydrug vs. monodrug users, as well as investigated for differences between groups based on substance used, predicting that group means would fall below the mean obtained from a large national adult sample, that the different drug groups would have comparable scores, and that the polydrug users would have a significantly lower score than do monodrug users. Results: We found that the means of most drug groups were below the national mean, and that the polydrug users had a lower score on the MAAS than did monodrug users (4 vs. 3.6, p = 0.04). We were also surprised to find that opiate users had a significantly higher score (4.31) than did users of other substances (p = 0.02). Conclusion/Significance: These results suggest that mindfulness deficits may be common in the substance using population, that there may be sub-groups in which these deficits are more pronounced, and that they may be a suitable focus of SUD treatment. These findings lend support to the ongoing development of mindfulness-based treatments for SUDs, and suggest that particular sub-groups may benefit more than others. Future research can aim at clarifying these deficits, and at elucidating their clinical relevance.

The Role of Mindfulness in Borderline Personality Disorder Features

This study investigated whether deficits in mindfulness (attention, awareness, and acceptance of the present moment) underlie variability in borderline personality disorder (BPD) features and related impairments in interpersonal functioning, impulsivity, and emotion regulation. A path analytic approach was used to examine the relationships of trait mindfulness with BPD features, interpersonal effectiveness, impulsive and passive emotion-regulation, and neuroticism in a psychiatric sample of adults (N = 70). As hypothesized, mindfulness was associated inversely with BPD features and core areas of dysfunction, and these associations continued when controlling for neuroticism. Furthermore, mindfulness deficits continued to predict BPD features even when interpersonal effectiveness, passive and impulsive emotion-regulation, and neuroticism were controlled. These findings suggest that mindfulness may be a unique predictor for the expression of BPD pathology. An emphasis on mindfulness may thus be crucial in enhancing the formulation and treatment of BPD.

Sexual body esteem and mindfulness in college women

Literature suggests that many young women hold negative perceptions of their sexual bodies and facial features. This may be related to deficits in mindfulness, manifested by rigid and automatic thoughts, feelings, and behavior about one's sexual body. The present study examined the relationships between the five factors of mindfulness measured by the Five Factor Mindfulness Questionnaire (FFMQ) and sexual body esteem, measured by the Sexual Attractiveness subscale of the Body Esteem Scale (BES) in 79 college women. A multiple regression was performed to examine the relationship between sexual body esteem and the factors of mindfulness. The Observing and Describing subscales were significantly and positively predictive of sexual body esteem while Non-reactivity to Inner Experience was significantly and negatively predictive of sexual body esteem. This relationship may have implications for future research and clinical practice.

Do Deficits in Mindfulness Underlie Borderline Personality Features and Core Difficulties?

The current study investigated whether deficits in mindfulness (the awareness, attention, and acceptance of the present moment) can account for variability in borderline personality (BPD) features and characteristic difficulties in emotion regulation, interpersonal effectiveness, and impulsivity. Structural equation modeling and hierarchical regressions were utilized to examine the associations of trait mindfulness with BPD features, interpersonal problem-solving, impulsive and passive emotion-regulation strategies, and neuroticism in a sample of young adults (N = 342). As hypothesized, mindfulness was related inversely to BPD features and core areas of difficulty, and these associations continued even when controlling for neuroticism. Additionally, mindfulness deficits continued to predict borderline features even when interpersonal effectiveness, passive and impulsive emotion-regulation, and neuroticism were controlled. It is concluded that deficits in mindfulness may be integral to BPD features. Difficulties with attention, awareness, and acceptance of internal and external experience appear to explain borderline pathology even when controlling for problems with negative affectivity, behavioral dyscontrol, and emotional and interpersonal dysfunction--which have been described as definitional of this disorder. Thus, attention to mindfulness deficits may enhance clinical formulation of BPD symptomatology, as well as provide a vital component of effective BPD treatment.