Mindful Acceptance Research Articles

Coping with the Stress in the Cardiac Intensive Care Unit: Can Mindfulness Be the Answer?

BackgroundMothers of infants with complex congenital heart disease are exposed to increased stress which has been associated with numerous adverse health outcomes. The coping mechanisms these mothers use critically effect the familial illness adaptation and most likely infant outcomes. Currently no data-based strategies have been developed for mothers to facilitate their coping, and proactively promote their adaptation in the critical care settings. A potential strategy is mindfulness which is currently used in other clinical settings with stress-reduction effects. Purpose(1) To investigate coping mechanisms of mothers whose infant with complex CHD is admitted in the CICU, and (2) to explore the acceptability and feasibility of mindfulness as a potential stress-reduction intervention for these mothers. Design and MethodsA descriptive qualitative study obtained perspectives from 14 mothers during three focus groups. A qualitative conventional content analysis was performed using ATLAS.ti. ResultsIn congruence with the Stress and Coping framework, themes identified mostly emotion-regulatory coping mechanisms including both active and passive strategies such as positive thinking, denial, distraction, relying on support systems, and focusing on baby. Mindfulness was an acceptable and feasible approach for most participants, however, practice unfamiliarity, time and space concerns, and personal preferences were identified as potential barriers for future dissemination. ConclusionsMindfulness can potentially promote illness adaptation by utilization of active coping mechanisms. Early interventions can provide immediate, and potentially long-term stress relief. Intervention settings, format, and time-frame should be flexibly tailored to the trajectory of parental distress and familial adjustment.

Preliminary Development and Validation of the Mindful Student Questionnaire

Research validating mindfulness-based interventions with youths and in schools is growing, yet research validating measures of youths’ mindfulness in schools has received far less empirical attention. The present study makes the case for and reports on the preliminary development and validation of a new, 15-item, multidimensional, self-report measure of youths’ mindfulness that is closely connected with theory and specifically targeted to school settings: the Mindful Student Questionnaire (MSQ). The MSQ was piloted with a target sample of 278 adolescents in Grades 6 to 8 and subjected to a series of structural and convergent validity analyses. Findings indicated that responses to the MSQ were characterized by a theoretically coherent three-factor latent structure—representing mindful attention, mindful acceptance, and approach and persistence behavior—and that resulting scale scores were characterized by robust internal consistency and positive concurrent associations with criterion indicators of student subjective wellbeing and academic achievement. Implications for future research and practice are discussed.

Realizing Improved Mindfulness/Flow/Mental Health Through Understanding Three Spiritual Principles

ABSTRACTA new spiritual understanding commonly known as the Three Principles proposes that mindfulness/flow/mental health is people’s most natural state and can be realized and sustained by everyone via insights gained through understanding three spiritual principles—Universal Mind, Consciousness, and Thought. We test this proposition for people exposed to the intervention grounded in these principles. The results appear to support our prediction that insight regarding “thought recognition” and/or “innate health via a clear mind” gained through understanding these spiritual principles will show a significant positive relationship with mindful attention, mindful acceptance, flow experience, and mental health.

Mindfulness and Coping with Stress: Do Levels of Perceived Stress Matter?

Few studies have explored whether mindfulness facilitates more adaptive coping with stress, and the evidence for this is mixed. It may be that mindfulness influences coping responses only among relatively stressed individuals, but this has not been tested. Two randomized controlled experiments (Study 1, N = 204; Study 2, N = 202) tested whether a brief mindfulness induction enhances coping among adults and whether perceived stress moderates these effects. In Study 1, we found that a mindfulness induction produced less self-reported avoidance coping but only among relatively stressed individuals. In Study 2, a mindful acceptance induction produced more approach and less avoidance coping than relaxation and self-affirmation controls, and these effects were strongest among individuals reporting high levels of perceived stress. These findings suggest that perceived stress is an important moderator of the influence of mindfulness upon coping responses.

Web-Based Acceptance and Commitment Therapy for Mental Health Problems in College Students: A Randomized Controlled Trial.

There are significant challenges in addressing the mental health needs of college students. The current study tested an acceptance and commitment therapy (ACT), web-based self-help program to treat a broad range of psychological problems students struggle with. A sample of 79 college students was randomized to web-based ACT or a waitlist condition, with assessments at baseline and posttreatment. Results indicated adequate acceptability and program engagement for the ACT website. Relative to waitlist, participants receiving ACT improved on overall distress, general anxiety, social anxiety, depression, academic concerns, and positive mental health. There were no between-group effects on eating concerns, alcohol use, or hostility, or on some key ACT process of change measures. ACT participants improved more on mindful acceptance and obstruction to valued living, both of which mediated treatment outcomes. Results are discussed in the context of lessons learned with the website prototype, and areas for further research are presented.

When College Students Look after Themselves: Self-Care Practices and Well-Being

Research has shown that psychological well-being is positively associated with student engagement, persistence, and performance. To learn more about the behaviors that underlie well-being, 206 (predominantly female) university students completed measures of well-being and six self-care practices. Four such practices (mindful acceptance, seeking social support, sleep hygiene, and food habits) uniquely predicted well-being, but physical exercise did not. Findings can aid the development and implementation of interventions to increase self-care and well-being in student populations.

Mindfulness as a treatment for gambling disorder: Current directions and issues

Mindfulness is a form of meditation that derives from Buddhist practice and is one of the fastest growing areas of psychological research. Studies investigating the role of mindfulness in the treatment of behavioral addictions have, to date, primarily focused on gambling disorder. Recent pilot studies and clinical case studies have demonstrated that weekly mindfulness therapy sessions can lead to clinically significant change among individuals with gambling problems. This purpose of this paper is to appraise current directions in gambling disorder research as they relates to mindfulness approaches, and discuss issues that are likely to hinder the wider acceptance of mindfulness as a treatment for gambling disorder. It is concluded that although preliminary findings indicate that there are applications for mindfulness approaches in the treatment of gambling disorder, further empirical and clinical research utilizing larger-sample controlled study designs is clearly needed.

Effects of brief mindful acceptance induction on implicit dysfunctional attitudes and concordance between implicit and explicit dysfunctional attitudes

Mindfulness-based interventions have been shown to be effective in alleviating depressive symptoms. While much work has examined the effects of mindfulness training on subjective symptoms and experiences, and less is known regarding whether mindfulness training may alter relatively uncontrollable cognitive processes associated with depressed mood, particularly implicit dysfunctional attitudes. The present study examined the effects of a brief mindful acceptance induction on implicit dysfunctional attitudes and degree of concordance between implicit and explicit dysfunctional attitudes in the context of sad mood. A total of 79 adult participants with elevated depressive symptoms underwent an autobiographical mood induction procedure before being randomly assigned to mindful acceptance or thought wandering inductions. Results showed that the effect of mindful acceptance on implicit dysfunctional attitude was significantly moderated by trait mindfulness. Participants high on trait mindfulness demonstrated significant improvements in implicit dysfunctional attitudes following the mindful acceptance induction. Those low on trait mindfulness demonstrated significantly worse implicit dysfunctional attitudes following the induction. Significantly greater levels of concordance between implicit and explicit dysfunctional attitudes were observed in the mindful acceptance condition versus the thought wandering condition. The findings highlight changes in implicit dysfunctional attitudes and improvements in self-concordance as two potential mechanisms underlying the effects of mindfulness-based interventions.

Mindfulness-based stress reduction (MBSR) enhances distress tolerance and resilience through changes in mindfulness

Distress tolerance (DT) is associated with psychological health and has been shown to be predicted by mindfulness. Resilience, another protective capacity in the face of stress, is related to positive psychological outcomes, such as preventing development of PTSD. The current longitudinal online-study investigated whether Mindfulness-Based Stress Reduction (MBSR) can lead to an increase in DT and resilience, and whether these effects are mediated by facets of mindfulness. Forty nine participants were assessed, N=20 of these were studied before and after MBSR training, and compared to a matched control group of N=29. Changes in mindfulness were assessed using the Comprehensive Inventory of Mindfulness Experience (CHIME). In line with hypotheses, MBSR enhanced self-reported mindfulness, DT, and resilience. Results are consistent with assuming a mediation of these effects by the acceptance, decentering, and relativity facets of mindfulness.. Results indicate that MBSR might not only ameliorate existing psychopathologies, but may also serve as a preventative method to allow a more adaptive response to future stress.

Effects of Mindful Acceptance and Reappraisal Training on Maladaptive Beliefs About Rumination

The present study examined the relative effects of mindful acceptance and reappraisal on metacognitive attitudes and beliefs in relation to rumination and negative experiences. A small but growing literature has compared the effects of these strategies on immediate emotional experience, but little work has examined the broader, metacognitive impact of these strategies, such as maladaptive beliefs about rumination. One hundred and twenty-nine participants who reported elevated symptoms of depression were randomly assigned to receive brief training in mindful acceptance, reappraisal, or no training prior to undergoing an autobiographical sad mood induction. Participants rated their beliefs in relation to rumination and negative experiences before and after instructions to engage in mood regulation. Results showed that relative to reappraisal or no training, training in mindful acceptance resulted in greater decreases in maladaptive beliefs about rumination. The study suggests that training in mindful acceptance promotes beneficial changes in metacognitive attitudes and beliefs relevant to depression, and contributes to a greater understanding of the mechanisms through which mindfulness-based interventions lead to positive outcomes.

The Relationships Between Psychological Flexibility, Self-Compassion, and Emotional Well-Being.

Despite theoretical overlap between self-compassion and psychological flexibility, empirical links between these constructs is limited. This study examined the relationships between psychological flexibility, self-compassion, and emotional well-being to add to the literature on understanding the importance of self-compassion as a possible contributor to mental health, adding support to continuing development of compassion-based therapies. Relationships among these constructs were explored using survey data from a sample of 144 university psychology students (110 females and 34 males, aged 17-60 years). Self-compassion was significantly correlated with psychological flexibility processes, including mindful acceptance, defusion, and emotional well-being. Regression analyses indicated that self-compassion predicts significant unique variance above and beyond psychological flexibility across various indices of emotional well-being. These findings support the association between psychological flexibility, self-compassion, and emotional well-being, with implications for 3rd-wave models of therapy, including acceptance and commitment therapy (ACT) and compassion-based approaches. Therapies incorporating compassion processes may potentially lead to improved treatment outcomes.

Reactions to an Acceptance-Based Behavior Therapy for GAD: Giving Voice to the Experiences of Clients From Marginalized Backgrounds

There is emerging evidence supporting the acceptability of mindfulness and acceptance-based therapies with individuals from marginalized backgrounds. The current phenomenological study aimed to understand the extent to which clients from marginalized backgrounds who had completed an acceptance-based behavioral therapy (ABBT) for GAD felt that their identities affected their experience of the treatment and the therapist. Purposeful sampling methods were used to identify seven clients from a larger RCT who identified with one or more marginalized identities. Nine themes related to the treatment components, treatment focus and/or delivery, and the therapist emerged. Themes reflected aspects of treatment that clients were satisfied with and areas where they experienced some discord with treatment. Clinical implications for working with marginalized individuals include the importance of inviting conversations about barriers to valued actions, balancing the need to maintain treatment fidelity with the need to be responsive to clients’ concerns, the utility of assessing responses to mindfulness exercises as they are presented, and making client-centered adjustments to either the content or delivery of mindfulness practice to help make connections between exercises and clients’ lives.

The Effects of Acceptance of Thoughts, Mindful Awareness of Breathing, and Spontaneous Coping on an Experimentally Induced Pain Task

The current study examined the effects of acceptance of thoughts, mindful awareness of breathing, and spontaneous coping on both pain tolerance and pain threshold during a cold pressor task. Eligible participants (N = 58), 16 males and 42 females (M age = 29.31, SD = 11.21), were randomized into three groups and completed two cold pressor trials. The first cold pressor trial formed a baseline for all three groups. The acceptance of thoughts and mindfulness of breathing groups listened to recorded instructions and then completed a second administration of the cold pressor task. The spontaneous coping group completed the cold pressor task twice with instructions to select their own coping style. Multilevel linear modeling showed significant group differences in pain tolerance. The acceptance of thoughts and mindfulness of breathing conditions resulted in significantly higher pain tolerance in post hoc analysis than spontaneous coping. Results were interpreted to be consistent with Acceptance and Commitment Therapy. Further examination of the effects of ACT processes on experimentally induced pain tolerance is needed.

Mindful acceptance dampens neuroaffective reactions to external and rewarding performance feedback.

Previous research on mindfulness has suggested that individuals high in trait mindfulness show heightened sensitivity to visceral and internally generated stimuli. However, when mindful individuals are exposed to external stimuli-such as pictures or faces-their emotional responses are typically attenuated. In the current study, we tested how trait mindfulness relates to reactivity in response to a different type of external stimulus, namely, performance feedback. Using electroencephalography, we recorded participants' neuroaffective reactions to rewarding, aversive, and neutral feedback, as indexed by the feedback-related negativity (FRN). The FRN is a brain response that peaks approximately 250 ms after feedback presentation, and it is thought to differentiate feedback indicating favorable versus unfavorable outcomes. Our findings suggest trait mindfulness predicts less differentiation of rewarding from neutral feedback, but does not predict brain differentiation of aversive from neutral feedback. This was the case particularly for individuals who scored highly on the "acceptance" facet of mindfulness, a facet that assesses the nonjudgmental acceptance of thoughts and emotions. We discuss the implications of these findings for current theory on mindfulness and emotion regulation.

The influence of mindfulness on upper extremity illness.

Previous studies suggest a benefit of mindfulness-based interventions on pain conditions. This study addresses the null hypothesis that mindfulness is not correlated with pain intensity or magnitude of disability in orthopedic upper extremity conditions. In a prospective cohort, the correlation of the two separate aspects of mindfulness-acceptance and awareness-with disability and pain intensity was tested in patients with nonacute upper extremity conditions. Regression analyses were performed to determine factors associated with arm-specific disability and pain intensity. Awareness and acceptance both correlated with arm-specific disability, but only awareness was retained as a predictor in the best multivariable model. Neither awareness nor acceptance correlated with pain intensity. Pain interference and symptoms of depression accounted for more of the variation in disability and pain intensity. Improved mood and decreased pain interference (a greater sense that one can accomplish one's goals in spite of pain) may be more fruitful than increased mindfulness for patients with nonacute conditions of the upper extremity.

Validation of a Spanish version of the psychological inflexibility in pain scale (PIPS) and an evaluation of its relation with acceptance of pain and mindfulness in sample of persons with fibromyalgia

BackgroundPsychological flexibility has been suggested as a fundamental process in health. The Psychological Inflexibility in Pain Scale (PIPS) is one of the scales employed for assessing psychological inflexibility in pain patients. The aim of this study was to validate the Spanish version of the PIPS and secondly, to compare it to two other psychological constructs, the acceptance of pain and mindfulness scales.MethodsThe PIPS was translated into Spanish by two bilingual linguistic experts, and then, back-translated into English to assess for equivalence. The final Spanish version was administered along with the Pain Visual Analogue Scale, Fibromyalgia Impact Questionnaire, Hospital Anxiety Depression Scale, Pain Catastrophizing Scale, Chronic Pain Acceptance Questionnaire and the Mindful Attention Awareness Scale, to 250 Spanish patients with fibromyalgia. Face validity, construct validity, reliability (internal consistency and test-retest) and convergent validity were tested. Also a multiple regression analysis was carried out.The usual guidelines have been followed for cross-cultural adaptations.ResultsData were very similar to the ones obtained in the original PIPS version. The construct validity confirmed the original two-components solution which explained 61.6% of the variance. The Spanish PIPS had good test-retest reliability (intraclass correlation coefficient 0.97) and internal consistency reliability (Cronbach’s alpha: 0.90). The Spanish PIPS’ score correlated significantly with worse global functioning (r = 0.55), anxiety (r = 0.54), depression (r = 0.66), pain catastrophizing (r = 0.62), pain acceptance (r = −0.72) and mindfulness (r = −0.47), as well as correlating modestly with pain intensity (r = 0.12). The multiple regression analyses showed that psychological inflexibility, acceptance and mindfulness are not overlapped.ConclusionsThe Spanish PIPS scale appears to be a valid and reliable instrument for the evaluation of psychological inflexibility among a sample of fibromyalgia patients. These results ensure the use of this scale in research as well as in clinical practice. Psychological inflexibility measures processes different from other related components such as acceptance and mindfulness.

Clinical Considerations in Using Mindfulness- and Acceptance-Based Approaches With Diverse Populations: Addressing Challenges in Service Delivery in Diverse Community Settings

Mindfulness- and acceptance-based strategies effectively alter clients' relationships with their internal experiences, which may have been previously restricted, avoided, or even beyond clients' awareness. Even though the scientific exploration of the psychological benefits of mindfulness in the treatment literature continues to be in its infancy, it is important to uphold best practices by exploring the applications of these therapeutic approaches in diverse community populations. In this article, we discuss recommendations for addressing challenges that have arisen while delivering mindfulness- and acceptance-based behavioral therapies to consumers of mental health services from underserved and underrepresented backgrounds (e.g., marginalized racial, religious, and socioeconomic groups). Specific case examples illustrate the challenges of promoting acceptance in the face of adversity, the acceptability of mindfulness, attending to differences in the therapist and client perspectives, and promoting the pursuit of values in the face of adversity. Clinical recommendations and suggestions for dissemination of these approaches to clinicians working with racially and ethnically diverse, underserved populations are discussed.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A discussion of cognitive behavioural therapy, mindfulness, and mindfulness based cognitive therapy

Content and FocusThis article explores the acceptability and usefulness of cognitive behavioural therapy, mindfulness, and mindfulness-based cognitive therapy for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Issues specific to researching this particular group are discussed also. Both peer reviewed literature and surveys from support groups are considered.ConclusionsThe article argues that mindfulness and mindfulness-based cognitive therapy – an integration of mindfulness and cognitive therapy – may be acceptable and beneficial to people with ME/CFS. Particular advantages lie in a flexible and cost-efficient application. The author concludes that further research into mindfulness and mindfulness-based cognitive therapy is warranted in this population. The article also highlights that a representative sample of people with ME/CFS is difficult to generate, and that findings can be hard to generalise.

Buffering low self-esteem: The effect of mindful acceptance on the relationship between self-esteem and depression

During the past decade, theoretical approaches have emerged that call into question the presumption that self-esteem is an absolute prerequisite for healthy functioning. The present study addressed the question of whether a non-judgmental accepting stance towards experience moderates the relationship between self-esteem and depression. In a sample of 216 undergraduate students, self-esteem was assessed with the Rosenberg Self-Esteem Scale ( Rosenberg, 1965), acceptance with the ‘accept without judgment’ subscale of the Kentucky Inventory of Mindfulness Skills ( Baer, Smith, & Allen, 2004), and depressive symptoms with the Beck Depression Inventory ( Beck & Steer, 1987). Results showed that non-judgmental acceptance moderates the relationship between self-esteem and depression. In persons with low mindful acceptance, self-esteem was much more closely associated with depression than in persons with high mindful acceptance. These findings suggest that an accepting, allowing, and non-judgmental stance towards present-moment experience might buffer the detrimental effects of low self-esteem on depression.

Feasibility and Preliminary Outcomes of a School-Based Mindfulness Intervention for Urban Youth

Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper reports findings from a pilot randomized controlled trial assessing the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention. Four urban public schools were randomized to an intervention or wait-list control condition (n=97 fourth and fifth graders, 60.8% female). It was hypothesized that the 12-week intervention would reduce involuntary stress responses and improve mental health outcomes and social adjustment. Stress responses, depressive symptoms, and peer relations were assessed at baseline and post-intervention. Findings suggest the intervention was attractive to students, teachers, and school administrators and that it had a positive impact on problematic responses to stress including rumination, intrusive thoughts, and emotional arousal.