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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.

Mindfulness, originally a construct used in Eastern spiritual and philosophical traditions, has found new utility in psychotherapy practice. Mindfulness practice has been recently applied to treatments of several psychological and health related problems, and research is showing successful outcomes in psychological interventions incorporating mindfulness practices. Several schools of psychotherapy have theorized why mindfulness may be an effective intervention. One population which would theoretically be benefited by mindfulness practice in treatment consists of those individuals who have experienced traumatic events and are exhibiting post-traumatic stress disorder and/or related correlates of past trauma. The present paper gives a general review of the application of mindfulness to clinical psychology interventions. Additionally, we explain how mindfulness is applicable to our integrative behavioral approach to treating trauma and its sequelae. Specifically, this paper will (a) give a general overview of the conceptions and applications of mindfulness to psychology and psychotherapy and provide a brief account of the concepts origins in eastern traditions; (b) discuss the theoretical conceptualization of clinical problems that may relate to the long-term correlates of trauma; (c) describe how mindfulness, acceptance and the therapeutic relationship can address trauma symptoms and discuss a modified treatment approach for trauma survivors that incorporates mindfulness and acceptance practices into traditional exposure treatment.

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.

<p>Mindfulness-based approaches are among the most innovative and interesting new approaches to mental health treatment. Mindfulness refers to patients developing an "awareness of present experience with acceptance." Interest in them is widespread, with presentations and workshops drawing large audiences all over the US and many other countries. This book provides a comprehensive introduction to the best-researched mindfulness-based treatments. It emphasizes detailed clinical illustration providing a close-up view of how these treatments are conducted, the skills required of therapists, and how they work. The book also has a solid foundation in theory and research and shows clearly how these treatments can be understood using accepted psychological principles and concepts. The evidence base for these treatments is concisely reviewed.* Comprehensive introduction to the best-researched mindfulness-based treatments* Covers wide range of problems &amp; disorders (anxiety, depression, eating, psychosis, personality disorders, stress, pain, relationship problems, etc)* Discusses a wide range of populations (children, adolescents, older adults, couples)* Includes wide range of settings (outpatient, inpatient, medical, mental health, workplace)* Clinically rich, illustrative case study in every chapter* International perspectives represented (authors from US, Canada, Britain, Sweden)</p>

Drawing from theories regarding the role of awareness in behavioral self-regulation, this research was designed to examine the role of mindfulness as a moderator between implicit motivation and the motivation for day-to-day behavior. We hypothesized that dispositional mindfulness (Brown and Ryan, J Pers Soc Psychol, 84, 822–848, 2003) would act to modify the expression of implicit autonomy orientation in daily behavioral motivation. Using the Implicit Association Test (Greenwald et al. J Pers Soc Psychol, 74, 1464–1480, 1998), Study 1 provided evidence for the reliability and validity of a new measure of implicit autonomy orientation. Using an experience-sampling strategy, Study 2 showed the hypothesized moderating effect, such that implicit autonomy orientation predicted day-to-day motivation only for those lower in dispositional mindfulness. Those higher in mindfulness showed more autonomously motivated behavior regardless of implicit orientation toward autonomy or heteronomy. It also showed that this moderating effect of awareness was specific to mindfulness and was primarily manifest in spontaneous behavior. Discussion focuses on the implications of these findings for dual process theory and research.

Mindfulness training has had salutary effects with adult populations and it is seen as a potentially helpful to children’s development. How to implement mindfulness practices with young children is not yet clear; some meditation practices, like sitting still for long periods with internally-self-regulated focused attention, seem developmentally inappropriate. Montessori schooling is a 100-year-old system that naturally incorporates practices that align with mindfulness and are suited to very young children. Here I describe how several aspects of Montessori education, including privileging concentrated attention, attending to sensory experience, and engaging in practical work, parallel mindfulness practices. These aspects might be responsible for some of the socio-emotional and executive function benefits that have been associated with Montessori education, and they could be adapted to conventional classroom methods.
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OBJECTIVE: Positron emission tomography was used to investigate the neural substrates of normal human emotional and their dependence on the types of emotional stimulus. METHOD: Twelve healthy female subjects underwent 12 measurements of regional brain activity following the intravenous bolus administration of [15O]H2O as they alternated between emotion-generating and control film and recall tasks. Automated image analysis techniques were used to characterize and compare the increases in regional brain activity associated with the emotional response to complex visual (film) and cognitive (recall) stimuli. RESULTS: Film- and recall-generated emotion were each associated with significantly increased activity in the vicinity of the medial prefrontal cortex and thalamus, suggesting that these regions participate in aspects of emotion that do not depend on the nature of the emotional stimulus. Film-generated emotion was associated with significantly greater increases in activity bilaterally in the occipitotemporparietal cortex, lateral cerebellum, hypothalamus, and a region that includes the anterior temporal cortex, amygdala, and hippocampal formation, suggesting that these regions participate in the emotional response to certain exteroceptive sensory stimuli. Recall-generated sadness was associated with significantly greater increases in activity in the vicinity of the anterior insular cortex, suggesting that this region participates in the emotional response to potentially distressing cognitive or interoceptive sensory stimuli. CONCLUSIONS: While this study should be considered preliminary, it identified brain regions that participate in externally and internally generated human emotion.
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OBJECTIVE: Happiness, sadness, and disgust are three emotions that differ in their valence (positive or negative) and associated action tendencies (approach or withdrawal). This study was designed to investigate the neuroanatomical correlates of these discrete emotions. METHOD: Twelve healthy female subjects were studied. Positron emission tomography and [15O]H2O were used to measure regional brain activity. There were 12 conditions per subject: happiness, sadness, and disgust and three control conditions, each induced by film and recall. Emotion and control tasks were alternated throughout. Condition order was pseudo-randomized and counterbalanced across subjects. Analyses focused on brain activity patterns for each emotion when combining film and recall data. RESULTS: Happiness, sadness, and disgust were each associated with increases in activity in the thalamus and medial prefrontal cortex (Brodmann's area 9). These three emotions were also associated with activation of anterior and posterior temporal structures, primarily when induced by film. Recalled sadness was associated with increased activation in the anterior insula. Happiness was distinguished from sadness by greater activity in the vicinity of ventral mesial frontal cortex. CONCLUSIONS: While this study should be considered preliminary, it identifies regions of the brain that participate in happiness, sadness, and disgust, regions that distinguish between positive and negative emotions, and regions that depend on both the elicitor and valence of emotion or their interaction.
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<p>Ironically, in spite of the label "affective disorders", research on affective disorders has little to say about just what is disordered about emotion in these illnesses. One major purpose of this Special Issue is to begin to raise this question as a legitimate domain of inquiry in studies of emotion and psychopathology. Historically, the literature on emotion in normal subjects has proceeded almost entirely independently of studies of emotion-related psychopathology. And, studies on psychopathology make virtually no reference to basic research on emotion in normals. Major advances have occurred in our understanding of the neural substrates of these affective processes. Their application to the study of disordered emotion in affective and anxiety disorders is comparatively recent. A goal of this Special Issue is to foster increased integration between research on the neural mechanisms underlying normal emotion and disordered emotion in depression and anxiety-related illnesses. It features exemplars of the best research at many levels, from animal studies of the detailed circuitry subserving fear and anxiety, to human studies of cognitive abnormalities in subjects with affective and anxiety disorders. It also highlights a myriad array of methods for making inferences about affective processes, ranging from the biological to the behavioral, and from the molecular to the molar. A central concept that figures prominently in this collection of articles is the importance of individual differences in different components of affective processes. The study of the brain circuitry that underlies such differences in affective style offers great promise in providing a biologically plausible way of parsing the affect domain and developing a theoretically compelling taxonomy of mechanisms that give rise to vulnerability to affective and anxiety disorders.</p>
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Parenting preschoolers can be a challenging endeavor. Yet anecdotal observations indicate that parents who are more mindful may have greater ease in contending with the emotional demands of parenting than parents who are less mindful. Therefore, we hypothesized that parenting effort, defined as the energy involved in deciding on the most effective way to respond to a preschooler, would be negatively associated with mothers’ mindfulness. In this study, a new parenting effort scale and an established mindfulness scale were distributed to 50 mothers of preschoolers. Using exploratory factor analysis, the factor structure of the new parenting effort scale was examined and the scale was refined. Bivariate correlations were then conducted on this new Parenting Effort—Preschool scale and the established mindfulness scale. Results confirmed the hypothesis that a negative correlation exists between these two variables. Implications are that mindfulness practices may have the potential to alleviate some of the challenges of parenting preschoolers.

The purpose of this study was to examine pathways in a model which proposed associations among parent mindfulness, parent depressive symptoms, two types of parenting, and child problem behavior. Participants' data were from the baseline assessment of a NIMH-sponsored family-group cognitive-behavioral intervention program for the prevention of child and adolescent depression (Compas et al., 2009). Participants consisted of 145 mothers and 17 fathers (mean age = 41.89 yrs, SD = 7.73) with a history of depression and 211 children (106 males) (mean age = 11.49 yrs, SD = 2.00). Analyses showed that (a) positive parenting appears to play a significant role in helping explain how parent depressive symptoms relate to child externalizing problems and (b) mindfulness is related to child internalizing and externalizing problems; however, the intervening constructs examined did not appear to help explain the mindfulness-child problem behavior associations. Suggestions for future research on parent mindfulness and child problem outcome are described.

Several authors have argued that because mindfulness training involves repeated practice of the self-regulation of attention, it should lead to measurable improvements in attentional skills and related memory processes. Although a few studies have shown relationships between mindfulness training and performance-based tests of attention and memory, findings are mixed. In the present study, a sample of 33 adults with a long-term mindfulness meditation practice (average duration of 6 years) was compared with a demographically matched sample of nonmeditators on several widely used tests of attention and memory functioning, including sustained attention, attention switching, inhibition of elaborative processing, working memory, and short- and long-term memory. Group differences were nonsignificant for all of the attentional tasks. The only significant group differences were in short-term memory (both free and cued recall) and long-term memory (free recall only). Results suggest that the nature of the attentional and memory processing that is cultivated by mindfulness training requires clarification.

Objective To investigate the effect of mindfulness training on pain tolerance, psychological well-being, physiological activity, and the acquisition of mindfulness skills. Methods Forty-two asymptomatic University students participated in a randomized, single-blind, active control pilot study. Participants in the experimental condition were offered six (1-h) mindfulness sessions; control participants were offered two (1-h) Guided Visual Imagery sessions. Both groups were provided with practice CDs and encouraged to practice daily. Pre–post pain tolerance (cold pressor test), mood, blood pressure, pulse, and mindfulness skills were obtained. Results Pain tolerance significantly increased in the mindfulness condition only. There was a strong trend indicating that mindfulness skills increased in the mindfulness condition, but this was not related to improved pain tolerance. Diastolic blood pressure significantly decreased in both conditions. Conclusion Mindfulness training did increase pain tolerance, but this was not related to the acquisition of mindfulness skills.

BACKGROUND: Despite the apparent high placebo response rate in randomized placebo-controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response. OBJECTIVES: To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response. METHODS: We performed a meta-analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run-in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied. FINDINGS: Forty-five placebo-controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population-weighted average of 40.2%, 95% CI (35.9-44.4). Significant associations with lower placebo response rates were fulfillment of the Rome criteria for study entry (P=0.049) and an increased number of office visits (P=0.026). CONCLUSIONS: Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.
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Publisher's description: This book teaches us how to fully connect with the visual richness of our ordinary, daily experience. Photography is not just a mechanical process; it requires learning how to see. As you develop your ability to look and see, you will open, more and more, to the natural inspiration of your surroundings. Filled with practical exercises, photographic assignments, and techniques for working with texture, light, and color, this book offers a system of training that draws on both Buddhist mindfulness practice and the insights of master photographers such as Alfred Stieglitz, Edward Weston, and Henri Cartier-Bresson.

<p>Background : Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. Purpose : This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age=25; 16 men and 67 women) reporting distress. Method : Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. Results : Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p&lt;.05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen’s d=1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen’s d=.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p&lt;.04 in all cases; Cohen’s d=.57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation’s effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. Conclusions : The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.</p>

Relationships were investigated between home practice of mindfulness meditation exercises and levels of mindfulness, medical and psychological symptoms, perceived stress, and psychological well-being in a sample of 174 adults in a clinical Mindfulness-Based Stress Reduction (MBSR) program. This is an 8- session group program for individuals dealing with stress-related problems, illness, anxiety, and chronic pain. Participants completed measures of mindfulness, perceived stress, symptoms, and well-being at pre- and post-MBSR, and monitored their home practice time throughout the intervention. Results showed increases in mindfulness and well-being, and decreases in stress and symptoms, from pre- to post-MBSR. Time spent engaging in home practice of formal meditation exercises (body scan, yoga, sitting meditation) was significantly related to extent of improvement in most facets of mindfulness and several measures of symptoms and well-being. Increases in mindfulness were found to mediate the relationships between formal mindfulness practice and improvements in psychological functioning, suggesting that the practice of mindfulness meditation leads to increases in mindfulness, which in turn leads to symptom reduction and improved well-being

This article assessed whether resting electroencephalographic (EEG) asymmetry in anterior regions of the brain can predict affective responses to emotion elicitors. Baseline EEG was recorded from 32 female adults, after which Ss viewed film clips preselected to elicit positive or negative affect. Resting alpha power asymmetry in the frontal region significantly predicted self-reported global negative affect in response to clips and predicted the difference between global positive and negative affect. Analyses of discrete emotions revealed a strong relation between frontal asymmetry and fear responses to films. Effects were independent of Ss mood ratings at the time at which baseline EEG was measured. Resting anterior asymmetry may be a state-independent index of the individual's predisposition to respond affectively.
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Our objective was to conduct the first randomized controlled trial of the efficacy of a group mindfulness program aimed at reducing and preventing depression in an adolescent school-based population. For each of 12 pairs of parallel classes with students (age range 13–20) from five schools (N = 408), one class was randomly assigned to the mindfulness condition and one class to the control condition. Students in the mindfulness group completed depression assessments (the Depression Anxiety Stress Scales) prior to and immediately following the intervention and 6 months after the intervention. Control students completed the questionnaire at the same times as those in the mindfulness group. Hierarchical linear modeling showed that the mindfulness intervention showed significantly greater reductions (and greater clinically significant change) in depression compared with the control group at the 6-month follow-up. Cohen's d was medium sized (>.30) for both the pre-to-post and pre-to-follow-up effect for depressive symptoms in the mindfulness condition. The findings suggest that school-based mindfulness programs can help to reduce and prevent depression in adolescents.
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The current study investigated the effects of an 8-week mindfulness-based meditation training (MMT) intervention on attentional bias, engagement and disengagement of pain-related threat in fibromyalgia patients as compared to an age-matched control group. A well validated dot-probe task was used to explore early versus later stages of attentional processing through the use of two stimulus exposure durations (100, 500 ms) of pain-related threat words. The enduring effects of MMT were assessed 6-months after completion of MMT. Preliminary results suggest that MMT reduces avoidance of pain-related threat at early levels of processing, and facilitates disengagement from threat at later stages of processing. Furthermore, it appears that effects of MMT on early attentional threat processing do not remain stable after long-term follow-up.

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