Autonomic indices of negative emotion regulation predict treatment response in opioid-treated chronic low back pain.

Mindfulness-based interventions (MBIs) have shown promising effects across diverse areas of psychiatry, yet their specific role in bereavement remains insufficiently synthesized. Bereavement is a universal but heterogeneous process, with a minority of individuals at risk of developing prolonged grief disorder (PGD). Understanding the potential benefits of MBIs in this context is crucial for informing clinical practice. Following the methodological framework of systematized narrative reviews, a comprehensive literature search was conducted across major databases. Eligible studies included empirical investigations of MBIs applied to bereavement, without restrictions on type of loss, population, or intervention format. Data were narratively synthesized and summarized in tables; no meta-analysis was performed. Seventeen studies met inclusion criteria. The strongest evidence was found for Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), which demonstrated improvements in grief-related distress, depressive symptoms, and psychological well-being. Across interventions, MBIs were associated with reductions in rumination and experiential avoidance, increased self-compassion, and enhanced emotion regulation. However, most studies were limited by small sample sizes, heterogeneous outcome measures, and a lack of long-term follow-up. MBIs show promise as adjunctive interventions in bereavement care, targeting mechanisms central to grief adaptation, including acceptance, decentering, and self-compassion. Nevertheless, the evidence remains preliminary and methodologically constrained. Future high-quality randomized controlled trials are needed to establish efficacy, clarify mechanisms of action, and define the role of MBIs alongside established grief therapies.

ABSTRACT Background Chronic ischemic stroke survivors experience cognitive, emotional, and participation-related limitations that affect reintegration into the community and life satisfaction. Mindfulness-Based Stress Reduction (MBSR) and Cognitive Rehabilitation Therapy (CRT) may aid in the recovery process of stroke survivors. These rehabilitation programs may act through different mechanisms. However, little is known about the domain-specific responsiveness of stroke survivors to these rehabilitation programs. Objectives The objectives of this study were to investigate the domain-specific functional responsiveness of stroke survivors with chronic ischemic stroke to both mindfulness-based and cognitive rehabilitation programs, especially in terms of participation, communication, and cognitive outcomes. Methods This controlled longitudinal study consisted of 36 stroke survivors with chronic ischemic stroke who were randomly assigned to one of the three groups: MBSR, cognitive rehabilitation based on Powell’s protocol, or a control group. Participants underwent the Stroke Impact Scale (SIS) assessment. Changes in SIS domain scores from baseline to post-intervention and two-month follow-up were evaluated using repeated measures analysis of variance. Results The results revealed that the patterns of domain-specific responsiveness varied between the interventions. It was noted that the mindfulness-based intervention showed better recovery in cognitive-affective domains, especially memory, thinking, and participation/role function. Conversely, cognitive rehabilitation showed better recovery in communication-related outcomes. No significant recovery was noted in the control group for any of the domains. Conclusions The study suggests that both mindfulness-based and cognitive rehabilitation interventions facilitate recovery through unique pathways in chronic ischemic stroke survivors. Domain-specific responsiveness may be a valuable tool for providing clinically relevant information for tailoring rehabilitation approaches according to individual patient characteristics.

Psychological distress, including depression, anxiety, and stress, is highly prevalent among adults with cancer. Mindfulness-based interventions (MBIs), such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), are increasingly used to address these symptoms. However, no prior review has comprehensively stratified MBI effects across intervention types, symptom domains, cancer populations, and geographic regions. To evaluate the effectiveness of MBIs, including standard and adapted formats, on depression, anxiety, and stress in adults with cancer. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in accordance with PRISMA guidelines. Six databases were searched from January 2010 to July 2025. Eligible studies included RCTs comparing MBIs to control conditions in adults with cancer, reporting validated outcomes for depression, anxiety, or stress. Random-effects meta-analyses were performed using Hedges' g, with subgroup analyses by intervention type, duration, geographic region, and cancer type. Across 84 effect sizes from 45 RCTs (N=7395), mindfulness-based interventions were evaluated. MBIs significantly reduced depression (g=-0.92), anxiety (g=-1.06), and stress (g=-1.50). Modified MBIs MBIs demonstrated the largest effects (g=-1.57), followed by MBSR (g=-0.72) and MBCT (g=-0.68). The strongest effects were observed in breast cancer populations (g=-1.48) and in studies conducted in North America (g=-1.21) and Asia (g=-1.07). Mindfulness-based interventions (MBIs) were associated with reduced depression, anxiety, and stress in adults with cancer, though heterogeneity was high and evidence was largely from breast cancer trials. MBIs appear scalable, particularly for women with breast cancer, but broader conclusions remain limited. Findings support their inclusion in tailored psychosocial care, with a need for more diverse and rigorously controlled research.

Background/Objectives: Mindfulness-Based Cognitive Therapy (MBCT) is a well-documented treatment option for chronic pain. However, few studies have examined the emotional state experienced by participants with chronic pain during the sessions. This study aimed to assess the trajectory of mood experiences in an MBCT program and evaluate the effect on temporal mood state. Methods: The Temporary Mood Scale (TMS) was used to assess vigor, fatigue, anger-hostility, depression-dejection, tension-anxiety, and confusion before and after each MBCT session from July 2018 to May 2019. A total of 33 patients with chronic pain who attended the MBCT program were included in the study. A mixed-effect model was used to identify single-session and overall effects on each mood state. Pearson's correlation analysis was used to examine the associations between changes in the six mood states and baseline conditions, including pain-related factors. Results: The mixed-effect model identified significant improvements in single-session effects on all mood states (p < 0.001). Significant overall effects were identified on vigor (p < 0.01), depression-dejection (p < 0.01), tension-anxiety (p < 0.001), and confusion (p < 0.05) states throughout the sessions. Moreover, participants with higher tension-anxiety at baseline showed significantly greater improvements in anger-hostility (p < 0.05), depression-dejection (p < 0.01), tension-anxiety (p < 0.05), and confusion (p < 0.01). Conclusions: Individual sessions and the overall MBCT program significantly improved the mood states of patients with chronic pain. Patients with higher tension-anxiety are likely to be effective treatment targets for MBCT programs.

Objective: To analyze the improvement effect of anxiety state in breast cancer patients with malignant tumor after psychological intervention based on systematic review and network Meta-analysis. Methods: Randomized controlled trials (RCTS) on the effect of psychological intervention on anxiety of breast cancer patients were collected from CNKI, Wanfang database, VIP database and foreign Pubmed database, and the retrieval period was from the establishment of the database to 30 November 2025. The quality of the included studies was evaluated by Cochrane bias risk assessment tool. python software was used for network Meta-analysis. Results: A total of 11 studies involving 828 patients were included in this study, with 427 patients in the observation group and 401 patients in the control group. A total of 7 interventions were involved, including usual care, computerized cognitive behavioral therapy, Internet cognitive behavioral therapy, mindfulness-based cognitive therapy, positive psychological intervention based on PERMA model, acceptance and commitment therapy, and cognitive behavioral group therapy. Among them, the evaluation of anxiety improvement involved 12 studies, depression improvement involved 12 studies, and quality of life improvement involved 6 studies. The results of network Meta-analysis showed that mindfulness-based cognitive therapy was the best psychological intervention to improve anxiety, depression and quality of life in breast cancer patients, and the SUCRA probability was 100.00%. Conclusion: Mindfulness-based cognitive therapy has the best effect on improving anxiety, depression and quality of life in breast cancer patients, which can be prioritized for application.

Mindfulness in virtual reality or mindfulness-based cognitive therapy? Unraveling a more effective way to improve college students’ sleep quality

Quieting the night mind: A randomized controlled pilot study of mindfulness-based cognitive therapy for sleep quality in college students

Abstract Background College students with social anxiety often exhibit negative self-evaluation, social avoidance, and excessive self-focus, which significantly impair their social functioning and academic performance in classroom presentations, interviews, and interpersonal interactions. Although cognitive behavioral interventions and group counseling are widely used, some individuals still experience residual tension, persistent rumination, and heightened sensitivity to physiological arousal, indicating the need to explore more effective intervention approaches that improve emotional processing patterns and reduce self-focused biases. Mindfulness-based cognitive therapy (MBCT), through mindfulness practices and cognitive decentering training, may reduce reactivity to internal experiences and enhance emotional regulation flexibility. However, randomized controlled trials and follow-up evidence for MBCT in college students with social anxiety remain insufficient, and key psychological mechanisms lack longitudinal validation. To address this, the study employs randomized grouping and multi-timewide measurements to compare intervention effects and examine the predictive value of mechanism indicators on symptom trajectories, aiming to evaluate the sustained intervention value of MBCT for college students with social anxiety. Methods The study enrolled 318 college students for baseline assessment, with 240 participants meeting social anxiety screening criteria randomized into intervention groups. A control group of 78 low-anxiety students served as baseline reference. Participants were randomly assigned to one of three 8-week interventions: (1) Mindfulness-Cognitive Therapy (n = 80), (2) Group Cognitive Behavioral Intervention (n = 78), or (3) Waiting List Control (n = 82). Key outcomes included Social Anxiety Symptom Scale scores, negative self-focus and rumination levels, emotion regulation strategies, and mindfulness awareness. Results Experimental results demonstrated that compared to the traditional cognitive behavioral intervention group and waiting control group, the mindfulness cognitive therapy group showed significant reduction in social anxiety symptoms at the end of intervention (p&amp;lt;.001, d = 0.52), with the improvement remaining stable during follow-up (p=.004). In terms of psychological mechanism indicators, the mindfulness awareness level in the mindfulness cognitive therapy group increased significantly (p=.002, d = 0.48), while negative self-focus decreased markedly (p=.009, d = 0.41), and emotional reactivity also showed a significant downward trend. Physiological indicators revealed that the heart rate variability in the mindfulness cognitive therapy group during social situational tasks increased significantly (p=.01, d = 0.39), indicating improved autonomic nervous system regulation. Further analysis showed that both the elevated mindfulness awareness (p=.02) and reduced negative self-focus (p=.03) could predict lower social anxiety symptom levels during follow-up, and were associated with reduced risk of symptom relapse. Discussion The findings demonstrate that mindfulness-based cognitive therapy (MBCT) significantly alleviates social anxiety in college students, with sustained improvements observed during follow-up periods. Its efficacy matches or surpasses that of group cognitive behavioral interventions. The core psychological and physiological mechanisms underlying its effects may include enhanced mindfulness awareness, reduced rumination and negative self-focus, and diminished arousal responses in stressful situations. This study suggests MBCT serves as an effective group intervention for social anxiety in higher education, providing a scalable alternative to conventional psychological services. Future research should compare different training intensities and digital implementation approaches, while identifying subgroups more responsive to mindfulness interventions to enhance targeted effectiveness.

Abstract Background The treatment of bipolar disorder (BD) in adolescents currently faces two major challenges: high relapse rates and impaired social functioning. Therefore, there is an urgent need to develop adjunctive interventions that can both stabilize mood and improve social functioning. As a team activity integrating physical exertion, collaboration, and structured rules, basketball offers unique characteristics—its structure, rhythm, and social interaction—that provide a distinct vehicle for emotional regulation and social functional rehabilitation. Group psychological counseling programs based on basketball can organically integrate physical activity with psychological techniques such as cognitive-behavioral therapy and social skills training. However, empirical research examining the impact of structured group sports like basketball on core symptoms and social functioning in adolescents with BD remains limited. Consequently, the study designed a standardized basketball group psychological counseling program, aiming to evaluate the intervention effect of basketball group psychological counseling on the emotional stability, social function and quality of life of adolescent BD patients. Methods The study first integrated exercise therapy with mindfulness-based cognitive therapy and teamwork principles to develop a standardized 12-week basketball group counseling program, conducted twice weekly. The program encompassed fundamental skills, team tactics, emotion awareness games, and post-game reflection discussions. The study recruited 64 adolescents diagnosed with bipolar disorder, randomly assigned to an intervention group (n = 32) and a control group (n = 32). The intervention group received standard medication combined with basketball-based group therapy, while the control group maintained standard medication and general health education. Mood symptoms were assessed using the Young Mania Rating Scale (YMRS) and Hamilton Depression Scale (HAMD) at baseline, post-intervention, and 3 months post-intervention. Social functioning was evaluated using the Global Assessment of Function (GAF) and Social Disability Screening Schedule (SDSS). Results Following the intervention, the experimental group demonstrated significant and sustained improvements in both emotional stability and social functioning. Regarding emotional symptoms, the experimental group's post-intervention YMRS total score (5.2 ± 3.1) and HAMD total score (9.8 ± 4.0) were significantly lower than those of the control group (8.7 ± 4.5; 15.3 ± 5.2) (p&amp;lt;.01). Regarding social functioning, the experimental group's GAF score (68.4 ± 6.7) was significantly higher than that of the control group (58.9 ± 8.1) (p&amp;lt;.01), while the experimental group's SDSS score (4.5 ± 2.3) was significantly lower than that of the control group (7.8 ± 3.0) (p&amp;lt;.01). Discussion Research indicates that a structured intervention combining basketball activities with group psychological counseling effectively complements pharmacological treatment, significantly improving emotional stability, social functioning, and quality of life in adolescents with bipolar disorder (BD). This approach demonstrates sustained long-term effects, offering a novel embodied and socialized non-pharmacological intervention strategy for adolescent BD rehabilitation. Future research should validate its efficacy in larger samples and across different disease stages (e.g., acute phase). Utilizing neuroimaging and physiological indicators to explore its underlying neurobiological and social psychological mechanisms will provide stronger evidence for developing personalized intervention strategies.

Purpose Mindfulness-based cognitive therapy (MBCT) is a flagship intervention addressing depressive disorders that are distressing for the self and socially impairing. While psychological processes such as self-regulation, meta-awareness and self-transcendence account for its efficacy, these are often examined in isolation, and the social aspects of the self remain under-researched. Moreover, theoretical paradoxes in mindfulness – simultaneous strengthening and deconstruction of the self – call for more holistic and qualitative approaches. The purpose of this paper is to explore how MBCTs are experienced by individuals to inform selfrelated and social mechanisms. Design/methodology/approach This study explored these dynamics through ten post-interventional semi-structured interviews focusing on changes in psychological, physical and social dimensions of the self. Two independent coders used thematic analysis methods to blindly assess the verbatim transcriptions and extract themes. Thematic analysis revealed four main themes: 1) evolution of awareness, 2) evolution of the sense of self, 3) evolution of the connection to others, and 4) negative aspects, with the sense of self predominating. Participants reported that social connectedness evolved alongside differentiation, suggesting that MBCT strengthens intrapersonal self-regulation more readily than social identity processes, which are particularly impaired in depression. Findings A thematic content analysis revealed four main themes associated with changes involved in the MBCT: 1) evolution of awareness, 2) evolution of the sense of self, 3) evolution of the connection to others, and 4) negative aspects. Theme 2 was significantly predominant. A focus on theme 3 reflected participants’ common discourses of differentiation that coexisted with social connectedness, and a lesser importance of this theme compared to the first two. Research limitations/implications The findings contribute to theory development by showing that, despite mindfulness being associated with empathy and prosocial behaviors in the literature, the social dimension of the self remained subtle and ambivalent – torn between processes of differentiation and social identification – highlighting a theoretical blind spot and the need to explicitly address social identity in mindfulness-based interventions. These insights illuminate the complex interplay between individual and social dimensions of the self in MBCT and suggest avenues for enhancing both therapeutic and social outcomes. Practical implications The findings suggest that MBCT protocols could benefit from explicitly integrating social dimensions of the self which are often overlooked. Clinically this means adding modules or exercises that target social belonging and connection to others enhancing social support for depressed patients. Recognizing the limitations of MBCT for certain personality profiles calls for more personalized interventions. Addressing individual and social needs more effectively could improve treatment adherence and optimize overall therapeutic outcomes. Social implications This research highlights the crucial but underexplored role of the social self in mental health within mindfulness practices. It reveals a paradox of increased self-awareness coupled with limited social connection among depressed patients. Beyond clinical settings, these findings encourage rethinking group interventions to foster belonging and social identity recognition. Promoting the “social cure” through mindfulness could reduce social isolation, strengthen support networks and ultimately help prevent depressive relapse, producing significant societal benefits. Originality/value This study offers an original qualitative exploration of the social self-experience in MBCT an area rarely investigated. It challenges classical models by showing that an enhanced sense of self does not necessarily coincide with improved social connectedness. The holistic change-focused approach reveals a fundamental theoretical paradox and suggests integrating social identity processes more explicitly in interventions. This perspective advances the psychosocial understanding of mindfulness mechanisms and proposes innovative directions to enhance therapeutic protocols.

ABSTRACT Objectives Substance use disorders (SUDs), especially stimulant-related, represent a significant global public health burden, where maladaptive coping mechanisms commonly impede recovery and increase relapse likelihood. This study compared Schema Therapy (ST) and Mindfulness-Based Cognitive Therapy (MBCT) in promoting adaptive coping strategies among individuals with stimulant SUD. Methods Conducted in 2024 at residential treatment centers in Ahvaz, Iran, the quasi-experimental investigation employed pretest, posttest, and three-month follow-up assessments. From an initial pool of 165 patients, 66 meeting DSM-5 criteria for stimulant use disorder were selected via convenience sampling and randomly allocated to three groups (n = 22 each): a 12-week ST condition, an 8-week MBCT condition, and a control group receiving only standard residential care without additional structured psychotherapy. Coping strategies were measured using the Ways of Coping Questionnaire and analyzed via repeated-measures ANOVA. Results Both interventions yielded significant improvements in adaptive coping (time×group interactions: p < 0.001, η2 = 0.58–0.62). ST produced larger immediate gains in problem-focused coping, whereas both therapies substantially reduced maladaptive emotion-focused coping (lower scores denoting improvement), with MBCT showing particularly strong effects at follow-up. Conclusion These distinct profiles underscore the complementary strengths of schema-focused and mindfulness-based approaches and support tailored treatment selection based on patients’ predominant maladaptive coping patterns to enhance long-term recovery from stimulant SUD.

Major depressive disorder (MDD) is a chronic condition with high relapse rates affecting patients and health systems. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are strategies for relapse prevention, but their comparative long-term cost-effectiveness remains unclear. We developed a cohort-based Markov model with three health states, depressive episode, remission, and death, to compare MBCT and CBT in adults with MDD. The model used a lifetime horizon, six-month cycles, with healthcare payer and societal perspectives. Costs included direct medical and productivity losses discounted at 1.5%. Health-state utilities were drawn from published sources. Incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB) were estimated at willingness-to-pay (WTP) thresholds of $50,000 and $100,000 per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses, plus scenario analyses with alternative horizons and discount rates, assessed uncertainty. In the base case, MBCT was associated with 14.71 QALYs at a cost of $543,861, while CBT yielded 15.07 QALYs at $549,487. CBT provided an incremental 0.37 QALYs at $5625 higher cost, producing an ICER of $15,266 per QALY gained, well below both thresholds. NMB favored CBT ($204,242 vs. $191,443 at $50,000; $957,971 vs. $926,746 at $100,000). Sensitivity analyses highlighted remission- and depression-related costs as main drivers. Probabilistic analyses showed CBT optimal in 56% of simulations at $50,000 and 61% at $100,000, with MBCT preferred at lower thresholds. CBT may be more cost-effective relative to MBCT for relapse prevention in MDD, though differences are modest. MBCT remains a competitive alternative where CBT access is limited.

BackgroundMindfulness-based interventions have been applied across various chronic illnesses, but no tailored program exists for individuals with pulmonary hypertension (PH).ObjectiveThis study aimed to develop and evaluate the feasibility of a mindfulness-based self-management program for patients with PH, delivered online to accommodate their limited mobility.MethodsA single-arm pre-post study was conducted using an 8-session, weekly videoconference program incorporating PH self-management education and elements of mindfulness-based cognitive therapy. A mobile app linked to an Apple Watch was used to support symptom monitoring and mindfulness awareness. Outcomes included PH-related symptoms, quality of life (emPHasis-10), depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]), resilience (Connor-Davidson Resilience Scale [CD-RISC]), and loneliness (UCLA Loneliness Scale–short version). Assessments occurred at baseline, week 4, and program completion. Exit interviews explored perceived changes and experiences.ResultsTwelve participants (mean age 41.8, SD 10.5 years; range 26‐56 years) were enrolled, and 9 completed the program (75% retention). Participants valued the online format and Apple Watch integration, while noting a need for optional on-demand sessions. Qualitative analysis identified themes such as increased self-awareness, use of meditation for pain management, and enhanced self-compassion. Quantitative analysis showed significant changes across 3 time points (baseline, week 4, and week 8) for emPHasis-10 (χ²₂=9.74; P=.008) and CD-RISC (χ²₂=7.27; P=.03). Trends toward change were observed for PHQ-9 (χ²₂=4.75; P=.09) and GAD-7 (χ²₂=5.07; P=.08), but week 12 data were limited (n=5). No significant changes in loneliness were observed.ConclusionsThe program appeared to support patients with PH in managing symptoms and emotions and suggested potential improvements in quality of life. These preliminary findings warrant evaluation in a future randomized controlled trial.

Post-mastectomy pain syndrome (PMPS) is a frequent and burdensome complication of breast cancer surgery, manifesting as persistent pain following mastectomy, typically with neuropathic characteristics. This review synthesizes current knowledge on the epidemiology, prevention, and treatment of PMPS, and highlight knowledge gaps to inform future research. PMPS occurs in 28-52% of patients. It is associated with impairment in quality of life, and reductions in physical and psychosocial functioning. Consistently identified risk factors include younger age, extensive axillary surgery, total mastectomy, and preexisting chronic pain. Perioperative preventive strategies, such as topical EMLA cream, pregabalin, PECS II block, i.v. dexmedetomidine and flurbiprofen axetil, show potentially promising effects in reducing the incidence or severity of PMPS. Treatment options for established PMPS with potentially promising effects include topical capsaicin, amitriptyline, venlafaxine, multimodal pharmacological therapy, thermal radiofrequency of the stellate ganglion, and mindfulness-based cognitive therapy. For both preventive and therapeutic strategies, heterogeneity in study design, dosing regimens, and outcome frameworks, as well as the small sample size of most studies, limit the strength of evidence. Large knowledge gaps exist in the understanding of the molecular mechanisms associated with PMPS. Future research focusing on the molecular mechanisms promoting PMPS can facilitate the development of novel effective preventive and therapeutic strategies. Large-scale well-powered clinical trials on interventions aiming to prevent and treat PMPS are highly needed to inform evidence-based clinical practice. Future clinical studies should also aim to identify biomarkers that predict the efficacy of interventions in individual patients, thereby supporting personalized medicine.

Diabetes and mental health.

Background: A significant worldwide health concern that raises morbidity and death, particularly in older persons, is hypertension. Psychological stress can worsen blood pressure, making non-pharmacological approaches such as Mindfulness-Based Cognitive Therapy (MBCT) valuable. This study applies MBCT using the Neuman Systems Model while integrating ontological, epistemological, and axiological principles of nursing. Objective: To assess how well MBCT reduces stress in people with hypertension and to identify the integration of nursing philosophical values in the intervention. Methods: The intervention was carried out over three days at Puskesmas Simpang Tiga, Pekanbaru. Activities included education on stressors, guided mindfulness meditation, and reflective stress-management sessions. Stress and mindfulness levels were assessed before and after the intervention using the Perceived Stress Scale (PSS-10) and the Mindful Attention Awareness Scale (MAAS). Results: Most participants showed reduced blood pressure and decreased stress scores after the intervention. Mindfulness levels also increased. Ontological values were reflected in viewing patients as holistic beings; epistemological values through evidence-based practice; and axiological values through empathy and ethical nursing care. Conclusion: When used as a non-pharmacological treatment, MBCT helps individuals with hypertension feel less stressed. The intervention strengthens holistic nursing practice grounded in ontological, epistemological, and axiological principles.

The Development and Effects of a Nursing Program with Mindfulness-Based Cognitive Therapy for Psychological Care After Post-Stroke Patients

Background/Objectives: Anxiety disorders (ADs) affect up to 20% of mothers in the postpartum period, characterized by psychological symptoms (e.g., emotion dysregulation; ER) and physical symptoms (e.g., disrupted bodily awareness). Although Cognitive Behavioural Therapy effectively reduces anxiety and mood symptoms, it shows limited efficacy in addressing ER difficulties and rarely targets interoceptive dysfunction-both common in postpartum ADs. This study evaluates the effectiveness of a brief mindfulness-based intervention in improving anxiety, ER, and interoception in mothers with postpartum ADs. A secondary aim is to examine changes in brain connectivity associated with these domains. Methods: This protocol describes a proof-of-concept randomized controlled trial involving 50 postpartum mothers with ADs. Participants will be randomized to receive either a 4-week mindfulness intervention plus treatment-as-usual (TAU) or TAU alone. Participants in the mindfulness + TAU group will complete a virtual 4-week group intervention adapted from Mindfulness-Based Cognitive Therapy. The TAU group will receive usual care for 4 weeks and then be offered the mindfulness intervention. Self-report measures of anxiety, ER, and interoception will be collected at baseline, post-intervention, and at a 3-month follow-up. Resting-state functional MRI will be conducted at baseline and post-intervention to assess functional connectivity changes. This trial has been registered on ClinicalTrials.gov (NCT07262801). Results: Improvements in anxiety, ER, and interoception are anticipated, along with decreased default mode network, and increased salience network connectivity post-intervention is hypothesized. Conclusions: This study will be the first to examine the combined psychological and neural effects of mindfulness in postpartum ADs, offering a potentially scalable mind-body treatment.

Cognitive-Behavioural Therapy vs. Mindfulness-Based Cognitive Therapy for Obsessive-Compulsive Disorder: Effectiveness and Treatment Mechanisms