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Recent research: six studies on mindfulness, values & meaning

Here are half a dozen recent research studies on mindfulness, values & meaning - fuller details, links and abstracts for all studies are listed further down this page.  Hofmann and colleagues' meta-analysis on "The effect of mindfulness-based therapy on anxiety and depression" found encouraging effect sizes for mindfulness training and concluded "These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations".  Meanwhile Barnhofer & Chittka underlined the toxicity of ruminative brooding with their demonstration that the well-demonstrated link between neurotic temperament and depression is mediated by "Tendencies to respond to mild low mood with ruminative thinking".  They conclude that "The results suggest that neuroticism predisposes individuals to depression by generally increasing the likelihood of ruminative responses to low mood".  And, of course, reduction in rumination is a major target of mindfulness-based cognitive therapy interventions.

As a child of the sixties, brought up on the exhortation to "Lose your head and come to your senses", I particularly enjoyed Farb et al's paper "Minding one's emotions: mindfulness training alters the neural expression of sadness."  Using functional MRI brain scanning they demonstrated that sadness provocation in people on a waiting list to start mindfulness training " ... resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline" - presumably picking up triggered ruminative brooding.  In contrast, people who had completed an eight week mindfulness course " ... demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks-supporting conceptual and body based representations of emotion-could be one path through which mindfulness reduces vulnerability to dysphoric reactivity".

Hayes and colleagues provide a bridge between mindfulness and values in their paper "Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder."  An acceptance-based behaviour therapy has previously been developed and shown to be effective for generalized anxiety disorder (GAD).  This study assessed "session-by-session changes in two proposed mechanisms of change: acceptance of internal experiences and engagement in meaningful activities."  They found that "Change in both acceptance and engagement in meaningful activities was related to responder status at post-treatment and change in these two proposed mechanisms predicted outcome above and beyond change in worry."

And staying now with values and meaning, Holder et al report on "Spirituality, Religiousness, and Happiness in Children Aged 8-12 Years" finding that "Children's spirituality, but not their religious practices (e.g., attending church, praying, and meditating), was strongly linked to their happiness ... Temperament was also a predictor of happiness, but spirituality remained a significant predictor of happiness even after removing the variance associated with temperament. The personal (i.e., meaning and value in one's own life) and communal (quality and depth of inter-personal relationships) domains of spirituality were particularly good predictors of children's happiness."  And in a study focusing on the other end of life - "Effect of a Purpose in Life on Risk of Incident Alzheimer Disease and Mild Cognitive Impairment in Community-Dwelling Older Persons"  - Boyle et al found " ... a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was approximately 2.4 times more likely to remain free of AD (Alzheimer Disease) than was a person with a low score (score = 3.0, 10th percentile). This association did not vary along demographic lines and persisted after the addition of terms for depressive symptoms, neuroticism, social network size, and number of chronic medical conditions. In subsequent models, purpose in life also was associated with a reduced risk of MCI (Mild  Cognitive Impairment) (hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .02) and a slower rate of cognitive decline (mean [SE] global cognition estimate, 0.03 [0.01], P < .01). Conclusion Greater purpose in life is associated with a reduced risk of AD and MCI in community-dwelling older persons."

Hofmann, S. G., A. T. Sawyer, et al. (2010). "The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review." J Consult Clin Psychol 78(2): 169-183.  [PubMed] 
OBJECTIVE: Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. METHOD: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions. RESULTS: Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges's g = 0.63) and mood symptoms (Hedges's g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges's g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up. CONCLUSIONS: These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.

Barnhofer, T. and T. Chittka (2010). "Cognitive reactivity mediates the relationship between neuroticism and depression." Behaviour Research and Therapy 48(4): 275-281.  [Abstract/Full Text] 
Although neuroticism has long been established as an important risk factor for depression, the mechanisms through which this temperamental predisposition translates into the occurrence of symptoms are still relatively unclear. This study investigated cognitive reactivity, i.e. the ease with which particular patterns of negative thinking are reactivated in response to mild low mood, as a potential mediator. Individuals with (N = 98) and without a previous history of depression (N = 83) who had provided neuroticism scores six years previously were assessed for cognitive reactivity and current symptoms of depression using self-report questionnaires. Tendencies to respond to mild low mood with ruminative thinking mediated the relation between neuroticism and current symptoms of depression in both groups. Reactivation of hopelessness and suicidal thinking occurred as an additional mediator only in those with a history of previous depression. The results suggest that neuroticism predisposes individuals to depression by generally increasing the likelihood of ruminative responses to low mood. In those with a history of depression in the past, neuroticism additionally increases risk of recurrence by facilitating reactivation of previously associated patterns such as suicidal thinking and hopelessness. These findings suggest potential targets for interventions to help preventing the occurrence, or recurrence of depression in those who due to their temperamental predisposition are at an increased risk.

Farb, N. A., A. K. Anderson, et al. (2010). "Minding one's emotions: mindfulness training alters the neural expression of sadness." Emotion 10(1): 25-33.     [PubMed]    
Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted controls. Sadness resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline. Despite equivalent self-reported sadness, MT participants demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks-supporting conceptual and body based representations of emotion-could be one path through which mindfulness reduces vulnerability to dysphoric reactivity.

Hayes, S. A., S. M. Orsillo, et al. (2010). "Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder."  Behaviour Research and Therapy 48(3): 238-245.   [Abstract/Full Text]  
Based on the theory that generalized anxiety disorder (GAD) is maintained through a reactive and fused relationship with one's internal experiences and a tendency towards experiential avoidance and behavioral restriction, an acceptance-based behavior therapy (ABBT) was developed to specifically target these elements. Since ABBT has been shown to be an efficacious treatment in previous studies, the current study focuses on proposed mechanisms of change over the course of therapy. Specifically, the current study focuses on session-by-session changes in two proposed mechanisms of change: acceptance of internal experiences and engagement in meaningful activities. Overall, clients receiving ABBT reported an increase in the amount of time spent accepting internal experiences and engaging in valued activities. Change in both acceptance and engagement in meaningful activities was related to responder status at post-treatment and change in these two proposed mechanisms predicted outcome above and beyond change in worry. In addition, change in acceptance was related to reported quality of life at post-treatment.

Holder, M., B. Coleman, et al. (2010). "Spirituality, Religiousness, and Happiness in Children Aged 8-12 Years." Journal of Happiness Studies 11(2): 131-150.    [Abstract/Full Text]   
The relation between spirituality and happiness was assessed in 320 children aged 8-12 from public and private (i.e., faith-based) schools. Children rated their own spirituality using the Spiritual Well-Being Questionnaire and 11 items selected and modified from the Brief Multidimensional Measurement of Religiousness/Spirituality which reflected the children's practices and beliefs. Children's happiness was assessed using self-reports based on the Oxford Happiness Scale short form, the Subjective Happiness Scale, and a single-item measure. Parents also rated their children's happiness. Children and parents rated the children's temperament using the emotionality, activity, and sociability temperament survey. Children's spirituality, but not their religious practices (e.g., attending church, praying, and meditating), was strongly linked to their happiness. Children who were more spiritual were happier. Spirituality accounted for between 3 and 26% of the unique variance in children's happiness depending on the measures. Temperament was also a predictor of happiness, but spirituality remained a significant predictor of happiness even after removing the variance associated with temperament. The personal (i.e., meaning and value in one's own life) and communal (quality and depth of inter-personal relationships) domains of spirituality were particularly good predictors of children's happiness. These results parallel studies of adult happiness and suggest strategies to enhance happiness in children.

Boyle, P. A., A. S. Buchman, et al. (2010). "Effect of a Purpose in Life on Risk of Incident Alzheimer Disease and Mild Cognitive Impairment in Community-Dwelling Older Persons." Arch Gen Psychiatry 67(3): 304-310.   [Abstract/Full Text] 
Context: Emerging data suggest that psychological and experiential factors are associated with risk of Alzheimer disease (AD), but the association of purpose in life with incident AD is unknown. Objective: To test the hypothesis that greater purpose in life is associated with a reduced risk of AD. Design: Prospective, longitudinal epidemiologic study of aging. Setting Senior housing facilities and residences across the greater Chicago metropolitan area. Participants More than 900 community-dwelling older persons without dementia from the Rush Memory and Aging Project. Main Outcome Measures: Participants underwent baseline evaluations of purpose in life and up to 7 years of detailed annual follow-up clinical evaluations to document incident AD. In subsequent analyses, we examined the association of purpose in life with the precursor to AD, mild cognitive impairment (MCI), and the rate of change in cognitive function. Results: During up to 7 years of follow-up (mean, 4.0 years), 155 of 951 persons (16.3%) developed AD. In a proportional hazards model adjusted for age, sex, and education, greater purpose in life was associated with a substantially reduced risk of AD (hazard ratio, 0.48; 95% confidence interval, 0.33-0.69; P < .001). Thus, a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was approximately 2.4 times more likely to remain free of AD than was a person with a low score (score = 3.0, 10th percentile). This association did not vary along demographic lines and persisted after the addition of terms for depressive symptoms, neuroticism, social network size, and number of chronic medical conditions. In subsequent models, purpose in life also was associated with a reduced risk of MCI (hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .02) and a slower rate of cognitive decline (mean [SE] global cognition estimate, 0.03 [0.01], P < .01). Conclusion: Greater purpose in life is associated with a reduced risk of AD and MCI in community-dwelling older persons.

 

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