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<p>Past research has shown that rumination exacerbates dysphoric mood whereas distraction attenuates it. This research examined whether the practice of mindfulness meditation could reduce dysphoric mood even more effectively than distraction. A dysphoric mood was induced in 139 female and 38 male participants who were then randomly assigned to a rumination, distraction, or meditation condition. As predicted, participants instructed to meditate reported significantly lower levels of negative mood than those in either of the two other conditions. Distraction was associated with a lessening of dysphoric mood when compared to rumination but was not as effective as mindfulness meditation. The implications of these findings are discussed.</p>

Abstract Interest into the rehabilitative utility of Buddhist-derived interventions (BDIs) for incarcerated populations has been growing. The present paper systematically reviews the evidence for BDIs in correctional settings. Five databases were systematically searched. Controlled intervention studies of BDIs that utilized incarcerated samples were included. Jadad scoring was used to evaluate methodological quality. PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines were followed. The initial search yielded 85 papers, but only eight studies met the inclusion criteria. The eight eligible studies comprised two mindfulness studies, four vipassana meditation studies, and two studies utilizing other BDIs. Intervention participants demonstrated significant improvements across five key criminogenic variables: (i) negative affect, (ii) substance use (and related attitudes), (iii) anger and hostility, (iv) relaxation capacity, and (v) self-esteem and optimism. There were a number of major quality issues. It is concluded that BDIs may be feasible and effective rehabilitative interventions for incarcerated populations. However, if the potential suitability and efficacy of BDIs for prisoner populations is to be evaluated in earnest, it is essential that methodological rigor is substantially improved. Studies that can overcome the ethical issues relating to randomization in correctional settings and employ robust randomized controlled trial designs are favored.

Responding to growing interest among psychotherapists of all theoretical orientations, this practical book provides a comprehensive introduction to mindfulness and its clinical applications. The authors, who have been practicing both mindfulness and psychotherapy for decades, present a range of clear-cut procedures for implementing mindfulness techniques and teaching them to patients experiencing depression, anxiety, chronic pain, and other problems. Also addressed are ways that mindfulness practices can increase acceptance and empathy in the therapeutic relationship. The book reviews the philosophical underpinnings of mindfulness and presents compelling empirical findings. User-friendly features include illustrative case examples, practice exercises, and resource listings.

<p>A number of books have explored the ways psychotherapy clients can benefit from learning and practicing mindfulness. This is the first volume to focus specifically on how mindfulness can deepen the therapeutic relationship. Grounded in research, chapters demonstrate how therapists' own mindfulness practice can help them to listen more attentively and be more fully present. Leading proponents of different treatment approaches—including behavioral, psychodynamic, and family systems perspectives—illustrate a variety of ways that mindfulness principles can complement standard techniques and improve outcomes by strengthening the connection between therapist and client. Also presented are practical strategies for integrating mindfulness into clinical training.</p>

<p>Mindfulness-based approaches are increasingly employed as interventions for treating a variety of psychological, psychiatric and physical problems. Such approaches include ancient Buddhist mindfulness meditations such as Vipassana and Zen meditations, modern group-based standardized meditations, such as mindfulness-based stress reduction and mindfulness-based cognitive therapy, and further psychological interventions, such as dialectical behavioral therapy and acceptance and commitment therapy. We review commonalities and differences of these interventions regarding philosophical background, main techniques, aims, outcomes, neurobiology and psychological mechanisms. In sum, the currently applied mindfulness-based interventions show large differences in the way mindfulness is conceptualized and practiced. The decision to consider such practices as unitary or as distinct phenomena will probably influence the direction of future research. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1-21, 2011.</p>

Interest in applications of mindfulness-based approaches with adults has grown rapidly in recent times, and there is an expanding research base that suggests these are efficacious approaches to promoting psychological health and well-being. Interest has spread to applications of mindfulness-based approaches with children and adolescents, yet the research is still in its infancy. I aim to provide a preliminary review of the current research base of mindfulness-based approaches with children and adolescents, focusing on MBSR/MBCT models, which place the regular practice of mindfulness meditation at the core of the intervention. Overall, the current research base provides support for the feasibility of mindfulness-based interventions with children and adolescents, however there is no generalized empirical evidence of the efficacy of these interventions. For the field to advance, I suggest that research needs to shift away from feasibility studies towards large, well-designed studies with robust methodologies, and adopt standardized formats for interventions, allowing for replication and comparison studies, to develop a firm research evidence base.

The purpose of this study was to evaluate the feasibility, acceptability, and helpfulness of Mindfulness-Based Cognitive Therapy for Children (MBCT-C) for the treatment of internalizing and externalizing symptoms in a sample of nonreferred children. Twenty-five children, ages 9 to 12, participated in the 12-week intervention. Assessments were conducted at baseline and posttreatment. Open trial analyses found preliminary support for MBCT-C as helpful in reducing internalizing and externalizing symptoms within subjects on the parent report measure. The high attendance rate (Intent-to-Treat sample, 78%; Completer sample, 94%), high retention rate (68%), and positive ratings on program evaluations supported treatment feasibility and acceptability. Overall, this pilot study offers feasibility and acceptability data for MBCT-C as a potential treatment for internalizing and externalizing symptoms in children. Further research is needed to test the efficacy of the intervention with a larger sample of children who meet diagnostic criteria for clinical disorders.
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BACKGROUND: Many antidepressant medications (ADM) are associated with disruptions in sleep continuity that can compromise medication adherence and impede successful treatment. The present study investigated whether mindfulness meditation (MM) training could improve self-reported and objectively measured polysomnographic (PSG) sleep profiles in depressed individuals who had achieved at least partial remission with ADM, but still had residual sleep complaints. METHODS: Twenty-three ADM users with sleep complaints were randomized into an 8-week Mindfulness-Based Cognitive Therapy (MBCT) course or a waitlist control condition. Pre-post measurements included PSG sleep studies and subjectively reported sleep, residual depression symptoms. RESULTS: Compared to controls, the MBCT participants improved on both PSG and subjective measures of sleep. They showed a pattern of decreased wake time and increased sleep efficiency. Sleep depth, as measured by stage 1 and slow-wave sleep, did not change as a result of mindfulness training. CONCLUSIONS: MM is associated with increases in both objectively and subjectively measured sleep continuity in ADM users. MM training may serve as more desirable and cost-effective alternative to discontinuation or supplementation with hypnotics, and may contribute to a more sustainable recovery from depression.

<p>BACKGROUND: Many antidepressant medications (ADM) are associated with disruptions in sleep continuity that can compromise medication adherence and impede successful treatment. The present study investigated whether mindfulness meditation (MM) training could improve self-reported and objectively measured polysomnographic (PSG) sleep profiles in depressed individuals who had achieved at least partial remission with ADM, but still had residual sleep complaints. METHODS: Twenty-three ADM users with sleep complaints were randomized into an 8-week Mindfulness-Based Cognitive Therapy (MBCT) course or a waitlist control condition. Pre-post measurements included PSG sleep studies and subjectively reported sleep, residual depression symptoms. RESULTS: Compared to controls, the MBCT participants improved on both PSG and subjective measures of sleep. They showed a pattern of decreased wake time and increased sleep efficiency. Sleep depth, as measured by stage 1 and slow-wave sleep, did not change as a result of mindfulness training. CONCLUSIONS: MM is associated with increases in both objectively and subjectively measured sleep continuity in ADM users. MM training may serve as more desirable and cost-effective alternative to discontinuation or supplementation with hypnotics, and may contribute to a more sustainable recovery from depression.</p>
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Mindfulness-based cognitive therapy (MBCT), a meditation-based maintenance therapy, reduces the relapse risk in individuals suffering from major depressive disorder (MDD). However, only a few studies investigated the psychophysiological mechanisms underlying this protective effect. We examined effects of MBCT on trait rumination and mindfulness, as indicators of global cognitive style, as well as on residual depressive symptoms in a group of recurrently depressed patients (n = 78) in remission. Additionally, alpha asymmetry in resting-state electroencephalogram (EEG) was assessed. Alpha asymmetry has been found to be predictive of affective style and a pattern indicative of stronger relative right-hemispheric anterior cortical activity may represent a trait marker for the vulnerability to develop MDD. In line with previous findings, residual depressive symptoms and trait rumination decreased, whereas trait mindfulness increased following MBCT, while no such changes took place in a wait-list control group. Mean values of alpha asymmetry, on the other hand, remained unaffected by training, and shifted systematically toward a pattern indicative of stronger relative right-hemispheric anterior cortical activity in the whole sample. These findings provide further support for the protective effect of MBCT. In the examined patients who were at an extremely high risk for relapse, however, this effect did not manifest itself on a neurophysiological level in terms of alpha asymmetry, where a shift, putatively indicative of increased vulnerability, was observed.

<p>Baer's review (2003; this issue) suggests that mindf ulness-based interventions are clinically efficacious, but that better designed studies are now needed to substantiate the field and place it on a firm foundation for future growth. Her review, coupled with other lines of evidence, suggests that interest in incorporating mindfulness into clinical interventions in medicine and psychology is growing. It is thus important that professionals coming to this field understand some of the unique factors associated with the delivery of mindfulness-based interventions and the potential conceptual and practical pitfalls of not recognizing the features of this broadly unfamiliar landscape. This commentary highlights and contextualizes (1) what exactly mindfulness is, (2) where it came from, (3) how it came to be introduced into medicine and health care, (4) issues of cross-cultural sensitivity and understanding in the study of meditative practices stemming from other cultures and in applications of them in novel settings, (5) why it is important for people who are teaching mind-fulness to practice themselves, (6) results from 3 recent studies from the Center for Mindfulness in Medicine, Health Care, and Society not reviewed by Baer but which raise a number of key questions about clinical applicability, study design, and mechanism of action, and (7) current opportunities for professional training and development in mindfulness and its clinical applications.</p>

<p>Cognitive-behavioral approaches to alcohol and drug use disorders have received considerable empirical support over the past 20 years. One cognitive-behavioral treatment, relapse prevention, was initially designed as an adjunct to existing treatments. It has also been extensively used as a stand-alone treatment and serves as the basis for several other cognitive and behavioral treatments. After a brief review of relapse prevention, as well as the hypothesized mechanisms of change in cognitive and behavioral treatments, we will describe a "new" approach to alcohol and drug problems called mindfulness-based relapse prevention. Preliminary data in support of mindfulness-meditation as a treatment for addictive behavior are provided and directions for future research are discussed.</p>

Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a mindfulness-based procedure, Meditation on the Soles of the Feet, in helping three adolescents to manage their physical aggression. This procedure required the adolescents to rapidly shift the focus of their attention from the aggression-triggering event to a neutral place on their body, the soles of their feet. Incidents of aggression across the three adolescents ranged from a mean of 14–20 per week during baseline, 4–6 per week during mindfulness training, including zero rates during the last 4 weeks of intervention. Aggression occurred a rate of about 1 per year during a 3-year follow-up. Our results suggest adolescents with autism can learn, and effectively use, a mindfulness-based procedure to self-manage their physical aggression over several years.
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OBJECTIVE: To determine whether completing a mindfulness-based stress reduction (MBSR) program would affect the general health, health-related quality of life, sleep quality, and family harmony of Spanish- and English-speaking medical patients at an inner-city health center. MATERIALS AND METHODS: An intervention group of 68 patients (48 Spanish-speaking and 20 English-speaking) completed the SF-36 Health Survey and two additional questions about sleep quality and family harmony before and after completing the 8-week MBSR program. A comparison group of 18 Spanish-speaking patients who received no intervention completed the same questionnaire at the same intervals. RESULTS: Sixty-six percent of the total intervention group completed the 8-week MBSR program. There was significant comorbidity of medical and mental health diagnoses among the intervention and comparison groups, with no differences in the mean number of diagnoses of the total intervention group, the comparison group, or the Spanish- or English-speaking intervention subgroups. Compared with the comparison group, the intervention group showed statistically significant improvement on five of the eight SF-36 measures, and no improvement on the sleep quality or family harmony items. CONCLUSIONS: MBSR may be an effective behavioral medicine program for Spanish- and English-speaking inner-city medical patients. Suggestions are given for future research to help clarify the program’s effectiveness for this population.

This study examined the effects of mindfulness-based stress reduction (MBSR) on health-related quality of life and physical and psychological symptomatology in a heterogeneous patient population. Patients (n=136) participated in an 8-week MBSR program and were required to practice 20 min of meditation daily. Pre- and post-intervention data were collected by using the Short-Form Health Survey (SF-36), Medical Symptom Checklist (MSCL) and Symptom Checklist-90 Revised (SCL-90-R). Health-related quality of life was enhanced as demonstrated by improvement on all indices of the SF-36, including vitality, bodily pain, role limitations caused by physical health, and social functioning (all P&lt;.01). Alleviation of physical symptoms was revealed by a 28% reduction on the MSCL (P&lt;.0001). Decreased psychological distress was indicated on the SCL-90-R by a 38% reduction on the Global Severity Index, a 44% reduction on the anxiety subscale, and a 34% reduction on the depression subscale (all P&lt;.0001). One-year follow-up revealed maintenance of initial improvements on several outcome parameters. We conclude that a group mindfulness meditation training program can enhance functional status and well-being and reduce physical symptoms and psychological distress in a heterogeneous patient population and that the intervention may have long-term beneficial effects.

<p>The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stress reduction (MBSR), on health care professionals. Results from this prospective randomized controlled pilot study suggest that an 8-week MBSR intervention may be effective for reducing stress and increasing quality of life and self-compassion in health care professionals. Implications for future research and practice are discussed.</p>

OBJECTIVES: The objectives of this study were to assess the general acceptability and to assess domains of potential effect of a mindfulness-based stress reduction (MBSR) program for human immunodeficiency virus (HIV)-infected and at-risk urban youth. METHODS: Thirteen-to twenty-one-year-old youth were recruited from the pediatric primary care clinic of an urban tertiary care hospital to participate in 4 MBSR groups. Each MBSR group consisted of nine weekly sessions of MBSR instruction. This mixed-methods evaluation consisted of quantitative data--attendance, psychologic symptoms (Symptom Checklist 90-Revised), and quality of life (Child Health and Illness Profile-Adolescent Edition)--and qualitative data--in-depth individual interviews conducted in a convenience sample of participants until interview themes were saturated. Analysis involved comparison of pre- and postintervention surveys and content analysis of interviews. RESULTS: Thirty-three (33) youth attended at least one MBSR session. Of the 33 who attended any sessions, 26 youth (79%) attended the majority of the MBSR sessions and were considered "program completers." Among program completers, 11 were HIV-infected, 77% were female, all were African American, and the average age was 16.8 years. Quantitative data show that following the MBSR program, participants had a significant reduction in hostility (p = 0.02), general discomfort (p = 0.01), and emotional discomfort (p = 0.02). Qualitative data (n = 10) show perceived improvements in interpersonal relationships (including less conflict), school achievement, physical health, and reduced stress. CONCLUSIONS: The data suggest that MBSR instruction for urban youth may have a positive effect in domains related to hostility, interpersonal relationships, school achievement, and physical health. However, because of the small sample size and lack of control group, it cannot be distinguished whether the changes observed are due to MBSR or to nonspecific group effects. Further controlled trials should include assessment of the MBSR program's efficacy in these domains.

Stress within the teaching profession has a negative impact on the health and well-being of individual teachers and on retention and recruitment for the profession as a whole. There is increasing literature to suggest that Mindfulness is a useful intervention to address a variety of psychological problems, and that Mindfulness-Based Stress Reduction (MBSR) is a particularly helpful intervention for stress. We investigated the effects of teaching a MBSR course to primary school teachers to reduce stress. The MBSR course was taught to a group of primary school teachers and evaluated to establish its effects on levels of anxiety, depression, and stress, as well as movement towards a stated goal and changes in awareness. The results showed improvement for most participants for anxiety, depression, and stress, some of which were statistically significant. There were also significant improvements on two of the four dimensions of a mindfulness skills inventory. These results suggest that this approach could be a potentially cost-effective method to combat teacher stress and burnout.

<p>Mindfulness-Based Stress Reduction (MBSR) is a potential candidate for learning to cope with stress in a high-stress professional environment. In a pilot study the authors evaluated the potential of MBSR for stress management. Workers participated in an MBSR training for stress-related problems (treatment, n = 12) or waited for such a course (control, n = 11). The authors conducted interviews and measured coping and well-being. Qualitative interviews indicated that subjects had attained more awareness of work-related problems contributing to stress and had grown more critical toward their work environment. In the treatment group, positive strategies of coping with stress increased and negative strategies of coping decreased (significant difference at post treatment: p = .039 compared to control). Eighty-two percent of the participants reported having reached their personal goal.</p>

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