Mindfulness-based Stress Reduction Research Articles

Learning to be mindful ─ experiences of mindfulness-based stress reduction for young adults with moderate to severe mental disorders

IntroductionMental disorders among young adults are a major health challenge. Mindfulness-based stress reduction (MBSR) has in previous research shown positive effects on mental health. However, research evaluating MBSR for young adults with mental disorders is insufficient and qualitative research exploring experiences of the programme is scarce. The aim of this study was to explore experiences of MBSR as a supplementary treatment in psychiatric outpatient care among young adults with moderate to severe mental disorders, from a short- and long-term perspective. MethodEleven young adults (aged 18–27 years) who had participated in an MBSR programme were interviewed approximately three months or two years later. The analytic method was Grounded Theory. ResultsThe analysis resulted in a theoretical model including one core category and five categories. The model illustrated a learning process, explaining the participants’ short- and long-term experiences of learning to pay attention to the body, regulate emotions, a change of attitude towards oneself, and still using skills two years after the programme. DiscussionThe MBSR programme was experienced as a learning process which improved the longstanding ability to cope with emotional stress in daily life. Tailoring MBSR to individual needs may further enhance its effectiveness. ConclusionThe experienced short- and long-term health-promotion benefits of an MBSR programme among young adults with mental disorders support its implementation in psychiatric and primary health care. Future research should investigate how to optimise implementation and tailor to individual needs.

Combined mindfulness-based stress reduction and physical activity improved psychological factors and sleep quality in patients with MDD: A randomized controlled trial study

Non-pharmacological interventions are available to improve sleep quality including mindfulness-based stress reduction (MBSR) and physical activity (PA). The present study aimed to evaluate the effectiveness of the combination of MBSR and PA interventions as an augmentation to treatment as usual with sertraline to improve sleep and psychological factors among patients with MDD. Sixty-seven patients in outpatient care diagnosed with MDD for a minimum of 2 months (mean age: 35.32 ± 7.8; 65 % female) and currently on sertraline treatments were randomized into four groups including: 1) Physical activity, 2) MBSR, 3) Combination MBSR and physical activity (MBSRPA), and 4) Control. All participants completed self-reported questionnaires on sleep quality, depression, anxiety, and perceived stress from baseline to 8 weeks later at post-test and four weeks later at follow-up. Over time, sleep disturbance and psychological problems were reduced in all conditions when compared to the control. Moreover, MBSRPA had a more positive impacts on perceived stress, anxiety, depressive symptoms and sleep quality. The results of the present study confirmed the effectiveness of MBSRPA as an augmentation to standard therapy to help reduce symptoms of depression, anxiety, perceived stress, and sleep problems in patients with MDD.

The Vedic Foundations of Secular Mindfulness: A Study of Upaniṣad and Yoga Influences

This paper explores the Vedic foundations of secular mindfulness, particularly examining the influences of Advaita Vedānta, Patañjali Yoga, and Haṭha Yoga systems on the development of contemporary mindfulness practices, specifically as popularized by Jon Kabat-Zinn through his Mindfulness-Based Stress Reduction (MBSR) program. While mindfulness is often recognized for its Buddhist origins, this research highlights the underexplored connections to Vedic contemplative traditions, demonstrating that secular mindfulness may owe a significant debt to these ancient systems. The study delves into key Vedic concepts such as intrinsic wholeness, perpetual availability, and non-duality, and compares them with the philosophical underpinnings of Kabat-Zinn's mindfulness approach. Through an analysis of primary Vedic texts and Kabat-Zinn's own writings, the paper argues that his secularization of mindfulness is not only an innovative adaptation but also deeply influenced by Vedic philosophy, particularly Advaita Vedānta. The findings suggest that secular mindfulness, as practiced today, may be more closely aligned with Vedic traditions than previously acknowledged, offering a new perspective on the historical and philosophical roots of this widely adopted practice.

Chronic Pain Psychology in Neurology Practice

ABSTRACT OBJECTIVE This article reviews the latest literature regarding chronic pain epidemiology and describes pain-specific psychological factors associated with the development and maintenance of chronic pain, mental health conditions that co-occur with chronic pain, and advances in the psychobehavioral treatment of chronic pain, including established treatments (ie, cognitive behavioral therapy [CBT], acceptance and commitment therapy, and mindfulness-based stress reduction) and emerging treatments (ie, pain reprocessing therapy). LATEST DEVELOPMENTS In addition to CBT and acceptance and commitment therapy for pain, numerous other psychological treatment modalities have been integrated into chronic pain management, including mindfulness-based stress reduction, mindfulness meditation, chronic pain self-management, relaxation response, pain neuroscience education, biofeedback, hypnosis, and, more recently, integrative psychological treatment for centralized pain. This article gives an overview of these methods and contextualizes their use within the standard psychological treatment of chronic pain. ESSENTIAL POINTS Guided by the biopsychosocial treatment model, pain psychologists use numerous evidence-based psychological methods to treat patients with chronic pain conditions. Familiarity with the psychological tools available for pain management will aid neurologists and their patients in navigating the psychological aspects of living with chronic pain.

EP.15B.01 Effect of Mindfulness-Based Stress Reduction Psychological Intervention on Anxiety and Depression in Patients with Lung Cancer Radiotherapy

EP.15B.01 Effect of Mindfulness-Based Stress Reduction Psychological Intervention on Anxiety and Depression in Patients with Lung Cancer Radiotherapy

Effectiveness of mindfulness-based stress reduction therapy on sleep quality and psychological well-being of women with epilepsy

Effectiveness of mindfulness-based stress reduction therapy on sleep quality and psychological well-being of women with epilepsy

Correction to “The effects of mindfulness-based stress reduction on spiritual well-being and hope in patients with breast cancer: A randomized controlled trial” by Wang et al. (2024).

Correction to “The effects of mindfulness-based stress reduction on spiritual well-being and hope in patients with breast cancer: A randomized controlled trial” by Wang et al. (2024).

Classification of mindfulness experiences from gamma-band effective connectivity: Application of machine-learning algorithms on resting, breathing, and body scan

Background and ObjectivePracticing mindfulness is a mental process toward interoceptive awareness, achieving stress reduction and emotion regulation through brain-function alteration. Literature has shown that electroencephalography (EEG)-derived connectivity possesses the potential to differentiate brain functions between mindfulness naïve and mindfulness experienced, where such quantitative differentiation could benefit telediagnosis for mental health. However, there is no prior guidance in model selection targeting on the mindfulness-experience prediction. Here we hypothesized that the EEG effective connectivity could reach a good prediction performance in mindfulness experiences with brain interpretability. MethodsWe aimed at probing direct Directed Transfer Function (dDTF) to classify the participants’ history of mindfulness-based stress reduction (MBSR), and aimed at optimizing the prediction accuracy by comparing multiple machine learning (ML) algorithms. Targeting the gamma-band effective connectivity, we evaluated the EEG-based prediction of the mindfulness experiences across 7 machine learning (ML) algorithms and 3 sessions (i.e., resting, focus-breathing, and body-scan). ResultsThe support vector machine and naïve Bayes classifiers exhibited significant accuracies above the chance level across all three sessions, and the decision tree algorithm reached the highest prediction accuracy of 91.7 % with the resting state, compared to the classification accuracies with the other two mindful states. We further conducted the analysis on essential EEG channels to preserve the classification accuracy, revealing that preserving just four channels (F7, F8, T7, and P7) out of 19 yielded the accuracy of 83.3 %. Delving into the contribution of connectivity features, specific connectivity features predominantly located in the frontal lobe contributed more to classifier construction, which aligned well with the existing mindfulness literature. ConclusionIn the present study, we initiated a milestone of developing an EEG-based classifier to detect a person's mindfulness experience objectively. The prediction accuracy of the decision tree was optimal to differentiate the mindfulness experiences using the local resting-state EEG data. The suggested algorithm and key channels on the mindfulness-experience prediction may provide guidance for predicting mindfulness experiences using the EEG-based classification embedded in future wearable neurofeedback systems or plausible digital therapeutics.

Interpersonal and individual effects of an app-based Christian and Islamic heart meditation intervention in healthy adults: protocol of a stratified randomised controlled trial

BackgroundThe academic development and widespread adoption of meditation practices for well-being and therapy have predominantly focused on secularised adaptations of Buddhist and Hindu techniques. This study aims to expand the field by investigating Christian and Islamic meditation that emphasize the spiritual significance of the heart through elements of visualisation and recitation. It compares the effects of spiritual heart-centred meditation with mindfulness meditation and a waitlist control, focusing on dimensions of social functioning, psychophysiology, cognition, and mental health.MethodThis study employs a stratified 3-arm randomised controlled method with mixed-method repeated measures across three assessment time points: before intervention (T1), after an 8-week intervention (T2), and at a 3-month follow up (T3). The three conditions include spiritual meditation (either Christian or Islamic), mindfulness meditation (Mindfulness-Based Stress Reduction – MBSR), and a waitlist. Participants will be stratified into Christian and Muslim samples and randomly allocated to the spiritual meditation, MBSR, or waitlist control conditions. Importantly, participants assigned to the spiritual meditation condition will be matched to the spiritual meditation program corresponding to their religion. The intervention will be administered through a mobile phone app with daily 20-minute guided meditation sessions for eight weeks. Primary outcomes pertain to the domain of interpersonal functioning, focusing on prosociality, forgiveness, empathy, and perspective taking. Secondary outcomes include physiology: pain tolerance, pain intensity, stress reactivity assessed via heart rate (HR) and heart rate variability (HRV), psychophysiological reactivity associated with a forgiveness task as measured through HR and HRV, attention (alerting, orienting, and executive attention networks), and mental health (stress, depression, anxiety, subjective well-being, positive and negative affect).DiscussionThis trial aims to test the effects of an app-based Christian and Islamic meditation, compared to secular mindfulness and a waitlist, using a randomised controlled trial. If the results yield positive outcomes, this study will support the efficacy of these contemplations, offering practitioners a way to enhance their well-being within their religious framework.Trial registrationClinicalTrials.gov, NCT06136676. Registered on 18 November 2023.https://clinicaltrials.gov/study/NCT06136676.

A study on improving cancer-related fatigue and disease-related psychological variables in patients with cervical cancer based on online mindfulness-based stress reduction: a randomized controlled trial

BackgroundThe persistent destructive power of cancer-related fatigue (CRF) has been regarded as the biggest influencing factor affecting the postoperative physical and mental health of patients with cervical cancer. During this process, patients might also experience different feelings of disease-related psychological. Therefore, this study aimed to adopt mindfulness-based stress reduction (MBSR) to intervene in patients with cervical cancer, and conducted follow-up for 3 and 6 months to observe the effects of changes in CRF, uncertainty in illness, coping styles, sense of coherence (SOC), and perceived social support (PSS).MethodsA randomized controlled trial was conducted in ShengJing Hospital of China Medical University. A total of 102 patients were selected, and 78 patients completed the whole process, including 40 in the experimental group and 38 in the control group. Data were collected according to Cancer Fatigue Scale, Medical Coping Modes Questionnaire, Multidimensional Scale of Perceived Social Support, and Sense of Coherence-13. The change trend and difference of the two groups of research data were compared by repeated measurement analysis of variance. Bonferroni test was used for multiple tests between groups.ResultsThe CRF, SOC, and coping styles of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR, 3 months follow-up, and 6 months follow-up compared to the before MBSR. However, the uncertainty in illness of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR compared to the before MBSR, and it rose in 3 months follow-up and 6 months follow-up.ConclusionMBSR can effectively alleviate the fatigue of CRF after treatment, while improving their psychological environment. Medical workers can consider implementing online MBSR for patients with cervical cancer in their daily rehabilitation nursing, which is beneficial for their recovery.Trial registrationChina Clinical Trial Registration Center ChiCTR2000040122 (https//www.chictr.org.cn/). Registered on November 21, 2020.

Efficacy of Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) a Treatment for Cancer-related Cognitive Impairment (CRCI): A Randomized Controlled Trial.

Introduction: The Mindfulness-Based Stress Reduction (MBSR) Program for breast cancer survivors (BCS) is designed to enhance cognitive training through formal and informal meditational practices. This randomized clinical trial (RCT) aimed to evaluate if BCS assigned to either the MBSR(BC), Breast Cancer Education Support (BCES), or Usual Care (UC) regimens experienced greater improvements at 6, 12, and 26 weeks on objective and subjective cognitive performance. Methods: BCS (n = 212) randomized to a three-group RCT: MBSR(BC) (n = 91), BCES (n = 90), or UC (n = 31) were assessed on cognitive performance and symptoms at baseline, 6, 12, and 26 weeks. Linear mixed models were fit to evaluate the effects of the MBSR(BC) program, hypothesizing ordered effect improvements: (MBSR[BC] highest, BCES intermediate, UC lowest) along with baseline characteristics evaluated as moderators. Results: Of the BCS (mean age of 57), 73% were White, and non-Hispanic, and 77% received both chemotherapy (CT) and radiation. Cognitive performance improved in all groups. Although there were no statistically significant between-group differences in cognitive outcomes, significant symptom reductions occurred for the MBSR(BC) group (p = 0.003). Within-group effect size analysis at 26 weeks showed substantial improvements in all three groups (effect sizes >0.50) in subjective impairments and quality of life (effect size >0.50) and objective measures of cognitive performance. MBSR(BC) showed the largest within-group effect size in the reduction of fatigue (effect size = 0.81). Effect sizes occurred in the hypothesized direction for 10 of the 18 outcomes. Discussion: Although the MBSR(BC) program did not show significant differences in cognitive performance compared with BCES and UC, all groups improved and reductions in fatigue were beneficial for MBSR(BC). Results suggest that cognitive performance may improve after CT over time considering one's natural history. Furthermore, BCS enrolled in RCTs may be more motivated to improve their health status (NCT02786797).

In-person and online mixed method non-randomised studies exploring feasibility and acceptability of HEADS: UP, an adapted Mindfulness-Based Stress Reduction programme for stroke survivors experiencing symptoms of anxiety and depression

BackgroundDepression and anxiety are prevalent after stroke and associated with poor outcomes. We previously co-developed a stroke-specific self-management intervention, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). The two studies reported here aimed to test the feasibility and acceptability of the HEADS: UP course and supporting materials, and research processes ahead of a definitive trial.MethodsWe recruited community-dwelling stroke survivors (SS) ≥ 3 months post-stroke, with symptoms of mood disorder (Hospital Anxiety and Depression Scale ≥ 8). Participants could ‘enrol’ a family member/ ‘other’ to take part with them, if desired. Study 1 tested HEADS: UP delivered in-person, and informed optimisation of research processes and intervention delivery and materials. In a pragmatic response to Covid-related socialising restrictions, HEADS: UP was then adapted for online delivery, tested in Study 2. The primary outcome (both studies) was the feasibility (acceptability, fidelity) of the intervention and of research processes. Quantitative data (including patient-reported outcome measures (PROMs) assessing mood and quality of life) and qualitative data were collected pre-/post-intervention. Descriptive statistics were used to analyse quantitative data; a thematic framework approach was used to analyse qualitative data. Both studies received ethical approval prior to commencement.ResultsStudy 1Feasibility: 13 (59.1%) of 22 potentially eligible stroke survivors consented; aged 66 (median, interquartile range (IQR) 14); male (n = 9; 69%); 28 (IQR 34) months post-stroke. Of these, n = 10 (76.9%) completed PROMS pre-intervention; n = 6 (46.2%) post-intervention.Acceptability: Nine (69.2%) of the 13 participants attended ≥ 4 core intervention sessions. Aspects of screening and data collection were found to be burdensome.Study 2Feasibility: SS n = 9 (41%) of 22 potentially eligible stroke survivors consented; aged 58 years (median; IQR 12); male (n = 4; 44.4%); 23 (IQR 34) months post-stroke. Of these, n = 5 (55.6%) completed PROMS pre-intervention; n = 5 (55.6%) post-intervention.Acceptability: Five (55.6%) of the 9 participants attended ≥ 4 core sessions. They found online screening and data collection processes straightforward.

Evolution of treatment for unspecific back pain: From past to future.

Unspecific back pain (UBP) has long puzzled medical professionals. Historically, back pain (BP) was often attributed to mystical causes, treated with incantations or herbal concoctions. The Middle Ages shifted towards empirical practices, though still intertwined with superstition, using methods like leeches and bloodletting. The Renaissance introduced systematic healthcare approaches, laying the foundation for modern medicine. The 20th century saw significant advancements with diagnostic imaging, pharmacotherapy, physical therapy, and surgical interventions, though UBP remained elusive. Recent decades have seen a paradigm shift towards multidisciplinary approaches, addressing BP's multifactorial nature through holistic methods considering biomechanical, psychosocial, and lifestyle factors. This shift integrates quantitative research with hermeneutic interpretation, emphasizing evidence-based guidelines. Non-pharmacological interventions such as exercise therapy, electrotherapy, cognitive behavioral therapy, and mindfulness-based stress reduction have gained prominence, empowering individuals in their recovery. Technological innovations like virtual reality and artificial intelligence offer personalized treatment plans, optimizing outcomes. The future of BP treatment holds promise with advancements in regenerative medicine, neuromodulation, telemedicine, and remote monitoring platforms, enhancing accessibility and continuity of care, especially in underserved communities. However, challenges such as the opioid epidemic and healthcare disparities remain, necessitating judicious prescribing practices and equitable resource distribution. The evolving treatment landscape for UBP reflects the dynamic interplay between scientific progress, clinical innovation, and societal needs, aiming to alleviate the burden of back pain and improve quality of life.

Does practice make perfect? Functional connectivity of the salience network and somatosensory network predicts response to mind-body treatments for fibromyalgia.

Mind-body treatments can improve coping mechanisms to deal with pain, improve the quality of life of patients with fibromyalgia syndrome (FMS), and reduce perceived pain in some cases. However, responses to these treatments are highly variable, the mechanisms underpinning them remain unclear, and reliable predictors of treatment response are lacking. We employed resting-state blood oxygen level-dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to examine changes in brain functional connectivity (FC) following mind-body treatment that may relate to and predict pain relief. We recruited patients with FMS who underwent either mindfulness-based stress reduction (MBSR; n = 18) or a psychoeducational program (FibroQoL; n = 22) and a treatment-as-usual FMS group (TAU; n = 18). We collected rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioral changes and FC changes in the salience network (SN) and sensorimotor network (SMN) and performed regression analyses to identify predictors for treatment response. The MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. After treatment, the FC of the sensorimotor cortex with the rest of the SMN became significantly reduced in the MBSR group compared to the TAU group. The FC between the SN and the SMN at baseline was negatively correlated with pain reductions following MBSR but positively correlated with pain reductions in the FibroQoL group. These results yielded large to very large effect sizes. Following MBSR, only for those patients with lower baseline SMN-SN FC, minutes of mindfulness practice were positively associated with clinical improvement (small to medium effect size). Different mind-body treatments are underpinned by discrete brain networks. Measures of the functional interplay between SN and SMN have the potential as predictors of mind-body treatment response in patients with FMS.

Mindfulness for test anxiety and negative self-evaluation in high school

There is growing evidence that mindfulness-based interventions reduce test anxiety in university-level students, but less is known about high school students. Adolescence is a time of frequent testing, identity concerns, and increases in self-conscious emotions. We hypothesized that test anxiety would be associated with negative self-referential thinking (negative self-thinking, study 1) and that Mindfulness-based Stress Reduction (MBSR) would reduce test anxiety, negative self-thinking, and self-judgment (study 2). 455 high school students (M age = 17.1 years (SD = 1.07), 43.2% female) reported their test anxiety and negative self-thinking in a cross-sectional study (study 1) and 33 high school students (mean age = 17.5 years (SD = 1.60, 88% female) reported measures at the pre-, post, and one-year follow-up during an 8-week MBSR course (study 2). Test anxiety was positively related to negative self-thinking (study 1). Test anxiety and self-judgment were reduced after participating in MBSR and remained low one year after (study 2). Negative self-thinking was not reduced during the intervention. MBSR seems promising in reducing test anxiety and self-judgment in adolescents and might increase awareness of negative self-thinking, perhaps also reducing the impact of such thoughts by encouraging observation of the thoughts as “events in the mind” rather than facts. Mindfulness training seems promising for reducing test anxiety in high school, but results need to be replicated in larger samples with a control group.

The effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life.

This research was conducted to determine the effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life. A randomized controlled design was used. The study was conducted with a total of 146 women, including 41 acupressure, 31 laughter yoga, 37 mindfulness-based stress reduction, and 37 control group women. The women in the acupressure group were administered acupressure twice a week, which accounted for 16 sessions in total. Women in the laughter yoga and mindfulness-based stress reduction groups received a total of eight sessions of the related intervention, which was performed once a week. Study data were collected using a participant information form, the Menopause Rating Scale (MRS), and the Menopause-Specific Quality of Life Scale (MENQOL). Descriptive statistics, paired-samples t test, χ 2 test, analysis of variance test, and intention to treat analysis were used to analyze the data. Before the intention to treat analysis was performed, the multiple imputation method was employed to deal with missing data. In the study, it was found that there was a decrease in the MRS total score after the intervention in women in all three intervention groups compared to the control group ( P < 0.05). In the laughter yoga group, total MRS scores decreased by 3.16 points ( P < 0.05). In the acupressure group, total MRS scores decreased by 5.46 points ( P < 0.05). In the mindfulness-based stress reduction (MBSR) program group, total MRS scores decreased by 4.65 points ( P < 0.05). It was determined that the mean scores of women in the laughter yoga and acupressure groups on all subscales of the MENQOL decreased after the intervention compared to the control group ( P < 0.05). The comparison of the MBSR group and the control group showed that there was a decrease only in the psychosocial domain subdimension of the MENQOL ( P < 0.05). In conclusion, it was determined that laughter yoga, acupressure, and MBSR could be effective in reducing menopause symptoms and improving quality of life, although findings require further testing in a rigorously controlled study and in a study with only a single prespecified outcome.

Cancer-related cognitive impairment: updates to treatment, the need for more evidence, and impact on quality of life-a narrative review.

Due to advances in early detection and treatment options, non-central nervous system (non-CNS) cancer survivors are living longer, even those with metastatic disease. Many of these survivors will experience enduring symptoms of breast cancer, such as cancer-related cognitive impairment (CRCI). Although CRCI is bothersome and, in some cases, potentially debilitating, little research has been done to address this symptom. Thus, the overarching goal of this narrative review is to provide both an overview of the problem of CRCI and its impact and focus on the latest research aimed at addressing CRCI in non-CNS cancer survivors. A MEDLINE database (PubMed) search was conducted for terms related to non-CNS cancer, cognition, impacts of CRCI, and interventions. The English-language articles published until April 8th, 2024, were included in the search. CRCI includes self-reported cognitive complaints and/or impaired performance in multiple cognitive domains, including memory, processing speed, attention, and executive function. CRCI, in turn, can have a significant impact on everyday functioning, work ability, work engagement and productivity, and overall quality of life (QoL) of cancer survivors. While some researchers have examined pharmacological approaches, the vast majority of the interventional studies to date to address CRCI has focused on non-pharmacological approaches. Three of the most common non-pharmacological approaches are physical activity or exercise, mind-body approaches [e.g., mindfulness-based stress reduction (MBSR)], and cognitive rehabilitative approaches [e.g., cognitive training (CT) and cognitive behavioral therapy (CBT)]. Addressing the cognitive health of cancer survivors is imperative but has only recently been the focus of interventional research. More research in larger and more diverse samples of non-CNS cancer survivors is needed to identify effective ways to manage CRCI for all cancer survivors. Overall, maintaining cognitive health, especially in cancer survivors who are at increased risk for deficits, is a national health care priority that should not be ignored.

Treatment mechanism and outcome decoupling effects in cognitive therapy, mindfulness-based stress reduction, and behavior therapy for chronic pain.

Findings suggest that cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) for chronic pain produce improvements through changes in putative mechanisms. Evidence supporting this notion is largely based on findings showing significant associations between treatment mechanism variables and outcomes. An alternative view is that treatments may work by reducing or decoupling the impact of changes in mechanism variables on changes in outcomes. We examined the degree to which relationships between previous changes in potential treatment mechanisms and subsequent changes in outcomes changed as treatment progressed and vice versa. Cognitive therapy, MBSR, BT, and treatment as usual (TAU) were compared in people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of putative treatment mechanisms and outcomes. Lagged analyses revealed mechanism × session number interactions and outcome × session number interactions, such that associations between mechanism and outcome variables were strong and significant in the first third of treatment, but weakened over time and became nonsignificant by the last third of treatment. These effects were similar across treatment conditions but did not emerge among people undergoing TAU. Results suggest that during the course of CT, MBSR, and BT, the links between changes in treatment mechanism variables became decoupled from subsequent changes in outcomes and vice versa. Thus, starting by midtreatment and continuing into late treatment, participants may have learned through participation in the treatments that episodes of maladaptive pain-related thoughts and/or spikes in pain need not have detrimental consequences on their subsequent experience.

Mindfulness-Based Interventions in Schools: Assessing the Evidence Base.

Mindfulness-based interventions are increasingly being used in schools to improve students' mental, emotional, and behavioral development. Although many mindfulness programs exist, the types of programs that are effective for specific age groups remain unclear. In this systematic review, the authors used established rating criteria to describe the level of evidence for school-based mindfulness interventions. A search of major databases, gray literature, and evidence base registries was conducted to identify studies published between 2008 and 2022 that focused on mindfulness interventions within school settings. The authors rated mindfulness interventions as having high, moderate, or low levels of evidence based on the number and rigor of studies with positive outcomes. Of the 24 interventions identified across 41 studies, three interventions-Learning to BREATHE, Mindfulness in School Project, and mindfulness-based stress reduction (MBSR)-received a rating of high level of evidence. Three interventions-Gaia Program, MindUP, and a blended version of MBSR and mindfulness-based cognitive therapy-received a rating of moderate level of evidence. The interventions rated as having a high level of evidence were conducted with middle or high school students, and interventions with moderate evidence were also conducted with elementary students, demonstrating effectiveness of mindfulness across a range of age groups. Few studies examined outcomes for underserved populations. With greater use and more research, mindfulness interventions have the potential to promote student well-being and prevent mental health conditions.

Mindfulness-based stress reduction for chronic pain: Enhancing psychological well-being without altering attentional biases towards pain faces.

This study examines the effects of a Mindfulness-Based Stress Reduction (MBSR) program on psychological measures and attentional patterns to pain stimuli, using eye-tracking methods, in individuals with chronic pain. Thirty-two participants with chronic pain and no prior mindfulness experience were randomly assigned to an experimental group or a waiting list group. Both groups completed self-report measures of symptoms, well-being, and an attentional disengagement task using emotional faces as stimuli. Assessments were conducted at two points: before and after the intervention for the experimental group, with the waiting list group serving as a control. Before the MBSR program, chronic pain participants exhibited significant attentional biases towards pain-related stimuli during early attentional stages. Following the program, significant improvements were observed in depression, anxiety, stress, pain acceptance, overall well-being, and life satisfaction. However, it had a limited impact on attentional patterns, with only a significant increase in gaze duration across all stimuli. Despite the MBSR program's success in reducing symptoms associated with chronic pain, the lack of broader attentional improvements raises questions about the mechanisms responsible for psychological improvements. This study pioneers the use of eye-tracking to examine how MBSR influences attention in chronic back pain. While the program improved psychological well-being, it did not generally alter attentional patterns, except for an increased ability to maintain attention across stimuli. We discuss whether this attentional change could be associated with the increased acceptance observed in the MBSR program.