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<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>

Mindfulness is a relatively new construct in counseling that is rapidly gaining interest as it is applied to people struggling with a myriad of problems. Research has consistently demonstrated that counseling interventions using mindfulness improve well-being and reduce psychopathology. This article provides a detailed definition of mindfulness, including a discussion of the mechanisms underlying mindfulness practice; explores the implementation of mindfulness as a counseling intervention; and examines literature supporting its effectiveness.
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Using a randomized wait-list controlled design, this study evaluated the effects of a novel intervention, mindfulness-based relationship enhancement, designed to enrich the relationships of relatively happy, nondistressed couples. Results suggested the intervention was efficacious in (a) favorably impacting couples' levels of relationship satisfaction, autonomy, relatedness, closeness, acceptance of one another, and relationship distress; (b) beneficially affecting individuals' optimism, spirituality, relaxation, and psychological distress; and (c) maintaining benefits at 3-month follow-up. Those who practiced mindfulness more had better outcomes, and within-person analyses of diary measures showed greater mindfulness practice on a given day was associated on several consecutive days with improved levels of relationship happiness, relationship stress, stress coping efficacy, and overall stress.

<p>Objective This study compared changes in bodily pain, health-related quality of life (HRQoL), and psychological symptoms during an 8-week mindfulness-based stress reduction (MBSR) program among groups of participants with different chronic pain conditions. Methods From 1997-2003, a longitudinal investigation of chronic pain patients ( n=133) was nested within a larger prospective cohort study of heterogeneous patients participating in MBSR at a university-based Integrative Medicine center. Measures included the Short-Form 36 Health Survey and Symptom Checklist-90-Revised. Paired t tests were used to compare pre–post changes on outcome measures. Differences in treatment effect sizes were compared as a function of chronic pain condition. Correlations were examined between outcome parameters and home meditation practice. Results Outcomes differed in significance and magnitude across common chronic pain conditions. Diagnostic subgroups of patients with arthritis, back/neck pain, or two or more comorbid pain conditions demonstrated a significant change in pain intensity and functional limitations due to pain following MBSR. Participants with arthritis showed the largest treatment effects for HRQoL and psychological distress. Patients with chronic headache/migraine experienced the smallest improvement in pain and HRQoL. Patients with fibromyalgia had the smallest improvement in psychological distress. Greater home meditation practice was associated with improvement on several outcome measures, including overall psychological distress, somatization symptoms, and self-rated health, but not pain and other quality of life scales. Conclusion MBSR treatment effects on pain, HRQoL and psychological well-being vary as a function of chronic pain condition and compliance with home meditation practice.</p>
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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>This position paper advocates for early childhood teachers and parents to regularly use of mindfulness practices themselves and with very young children. An understanding of 'mindfulness' is important because it can provide ways to support children during their sensitive years and sow seeds of kindness, tolerance and peace in our fast paced, competitive, consumerist culture. In addition, in times of trauma, mindfulness techniques offer teachers and parents ways to calm themselves and the children close to them. The value of using mindfulness techniques with children and for demonstrating mindfulness as adults is well supported by research (McCown, Reibel and Micozzi, 2010; Saltzman and Goldin, 2008).</p>

<p>In this interpretive study, the authors explore the experience of mindfulness among hospice caregivers who regularly practice mindfulness meditation at a Zen hospice. They explore meditative awareness constituted within themes of meditation-in-action, abiding in liminal spaces, seeing differently, and resting in groundlessness. By opening into nonconceptual, paradoxical, and uncertain dimensions of experience, hospice caregivers cultivate internal and external environments in which direct experience is increasingly held without judgment. This inquiry points to in-between spaces of human experience wherein mindfulness fosters openness and supports letting go, and creating spaces for whatever is happening in attending the living-and-dying process.</p>
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Twenty-seven adult survivors of childhood sexual abuse participated in a pilot study comprising an 8-week mindfulness meditation-based stress reduction (MBSR) program and daily home practice of mindfulness skills. Three refresher classes were provided through final follow-up at 24 weeks. Assessments of depressive symptoms, post-traumatic stress disorder (PTSD), anxiety, and mindfulness, were conducted at baseline, 4, 8, and 24 weeks. At 8 weeks, depressive symptoms were reduced by 65%. Statistically significant improvements were observed in all outcomes post-MBSR, with effect sizes above 1.0. Improvements were largely sustained until 24 weeks. Of three PTSD symptom criteria, symptoms of avoidance/numbing were most greatly reduced. Compliance to class attendance and home practice was high, with the intervention proving safe and acceptable to participants. These results warrant further investigation of the MBSR approach in a randomized, controlled trial in this patient population. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 1–18, 2010.

In theory, mindfulness has a role to play in resolving intercultural conflicts. This suggestion rests upon the relatively untested presumption that mindfulness operates similarly across cultures. In a test of this presumption, university students from two countries that are often in conflict at the governmental level, Iran (N=723) and the United States (N=900), responded to the Mindful Attention Awareness Scale (Brown and Ryan Journal of Personality and Social Psychology 84(4):822-848, 2003), along with an array of other psychological measures. This Mindfulness Scale displayed structural complexities in both societies, but a measurement invariant subscale was nevertheless identified. Similar cross-cultural evidence of concurrent validity was obtained in relationships with wide-ranging measures of adjustment. Nonsignificant linkages with Public Self-Consciousness and Self-Monitoring demonstrated discriminant validity in both societies. These data identified mindfulness as a cross-culturally similar psychological process that could plausibly have a role in resolving intercultural conflicts.
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<p>Despite the availability of various substance abuse treatments, alcohol and drug misuse and related negative consequences remain prevalent. Vipassana meditation (VM), a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. In this study, the authors evaluated the effectiveness of a VM course on substance use and psychosocial outcomes in an incarcerated population. Results indicate that after release from jail, participants in the VM course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. VM participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes. The utility of mindfulness-based treatments for substance use is discussed.</p>

Students with learning disabilities (LD; defined by compromised academic performance) often have higher levels of anxiety, school-related stress, and less optimal social skills compared with their typically developing peers. Previous health research indicates that meditation and relaxation training may be effective in reducing anxiety and promoting social skills. This pilot study used a pre—post no-control design to examine feasibility of, attitudes toward, and outcomes of a 5-week mindfulness meditation intervention administered to 34 adolescents diagnosed with LD. Postintervention survey responses overwhelmingly expressed positive attitudes toward the program. All outcome measures showed significant improvement, with participants who completed the program demonstrating decreased state and trait anxiety, enhanced social skills, and improved academic performance. Although not directly assessed, the outcomes are consistent with a cognitive-interference model of learning disability and suggest that mindfulness meditation decreases anxiety and detrimental self-focus of attention, which, in turn, promotes social skills and academic outcomes.

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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<p>Mindfulness refers to a set of practices as well as the psychological state and trait produced by such practices. The state, trait, and practice of mindfulness may be broadly characterized by a present-oriented, nonjudgmental awareness of cognitions, emotions, sensations, and perceptions without fixation on thoughts of past or future. Research on mindfulness has proliferated over the past decade. Given the explosion of scientific interest in this topic, mindfulness-based therapies are attracting the attention of clinical social workers, who seek to implement these interventions in numerous practice settings. Concomitantly, research on mindfulness is now falling within the scope and purview of social work scholars. In response to the growing interest in mindfulness within academic social work, the present article outlines six conceptual and methodological recommendations for the conduct of future empirical studies on mindfulness. These recommendations have practical importance for advancing mindfulness research within and beyond social work.</p>
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Children with ADHD are often non-compliant with parental instructions. Various methods have been used to reduce problem behaviors in these children, with medication and manipulation of behavioral contingencies being the most prevalent. An objection often raised by parents is that these management strategies require them to impose external control on the children which not only results in the children not learning self-control strategies, but also does not enhance positive interactions between them and their parents. Studies have shown that providing mindfulness training to parents, without a focus on reducing problem behaviors, can enhance positive interactions with their children and increase their satisfaction with parenting. We were interested to see what effects giving mindfulness training to two mothers, and subsequently to their children, would have on compliance by the children. Using a multiple baseline across mothers and children design, we found that giving a mother mindfulness training enhanced compliance by her child. When the children were subsequently given similar training, compliance increased even more markedly, and was maintained during follow-up. The mothers reported associated increases in satisfaction with the interactions with their children and happiness with parenting. We suspect that the mindfulness training produces personal transformations, both in parents and children, rather than teaching strategies for changing behavior.

Research shows that after training in the philosophy and practice of mindfulness, parents can mindfully attend to the challenging behaviors of their children with autism. Parents also report an increased satisfaction with their parenting skills and social interactions with their children. These findings were replicated and extended with 4 parents of children who had developmental disabilities, exhibited aggressive behavior, and had limited social skills. After mindfulness training, the parents were able to decrease aggressive behavior and increase their children's social skills. They also reported a greater practice of mindfulness, increased satisfaction with their parenting, more social interactions with their children, and lower parenting stress. Furthermore, the children showed increased positive and decreased negative social interactions with their siblings. We speculate that mindfulness produces transformational change in the parents that is reflected in enhanced positive behavioral transactions with their children.

This paper introduces a model of “mindful parenting” as a framework whereby parents intentionally bring moment-to-moment awareness to the parent–child relationship. This is done by developing the qualities of listening with full attention when interacting with their children, cultivating emotional awareness and self-regulation in parenting, and bringing compassion and nonjudgmental acceptance to their parenting interactions. First, we briefly outline the theoretical and empirical literature on mindfulness and mindfulness-based interventions. Next, we present an operational definition of mindful parenting as an extension of mindfulness to the social context of parent–child relationships. We discuss the implications of mindful parenting for the quality of parent–child relationships, particularly across the transition to adolescence, and we review the literature on the application of mindfulness in parenting interventions. We close with a synopsis of our own efforts to integrate mindfulness-based intervention techniques and mindful parenting into a well-established, evidence-based family prevention program and our recommendations for future research on mindful parenting interventions.

<p>In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.</p>
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In light of a growing interest in contemplative practices such as meditation, the emerging field of contemplative science has been challenged to describe and objectively measure how these practices affect health and well-being. While “mindfulness” itself has been proposed as a measurable outcome of contemplative practices, this concept encompasses multiple components, some of which, as we review here, may be better characterized as equanimity. Equanimity can be defined as an even-minded mental state or dispositional tendency toward all experiences or objects, regardless of their origin or their affective valence (pleasant, unpleasant, or neutral). In this article, we propose that equanimity be used as an outcome measure in contemplative research. We first define and discuss the inter-relationship between mindfulness and equanimity from the perspectives of both classical Buddhism and modern psychology and present existing meditation techniques for cultivating equanimity. We then review psychological, physiological, and neuroimaging methods that have been used to assess equanimity either directly or indirectly. In conclusion, we propose that equanimity captures potentially the most important psychological element in the improvement of well-being, and therefore should be a focus in future research studies.
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<p>Recent studies have shown that the presence of a caring relational partner can attenuate neural responses to threat. Here we report reanalyzed data from Coan, Schaefer, and Davidson ( 2006 ), investigating the role of relational mutuality in the neural response to threat. Mutuality reflects the degree to which couple members show mutual interest in the sharing of internal feelings, thoughts, aspirations, and joys - a vital form of responsiveness in attachment relationships. We predicted that wives who were high (versus low) in perceived mutuality, and who attended the study session with their husbands, would show reduced neural threat reactivity in response to mild electric shocks. We also explored whether this effect would depend on physical contact (hand-holding). As predicted, we observed that higher mutuality scores corresponded with decreased neural threat responding in the right dorsolateral prefrontal cortex and supplementary motor cortex. These effects were independent of hand-holding condition. These findings suggest that higher perceived mutuality corresponds with decreased self-regulatory effort and attenuated preparatory motor activity in response to threat cues, even in the absence of direct physical contact with social resources.</p>
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<p>Empathy—the ability to share the feelings of others—is fundamental to our emotional and social lives. Previous human imaging studies focusing on empathy for others' pain have consistently shown activations in regions also involved in the direct pain experience, particularly anterior insula and anterior and midcingulate cortex. These findings suggest that empathy is, in part, based on shared representations for firsthand and vicarious experiences of affective states. Empathic responses are not static but can be modulated by person characteristics, such as degree of alexithymia. It has also been shown that contextual appraisal, including perceived fairness or group membership of others, may modulate empathic neuronal activations. Empathy often involves coactivations in further networks associated with social cognition, depending on the specific situation and information available in the environment. Empathy-related insular and cingulate activity may reflect domain-general computations representing and predicting feeling states in self and others, likely guiding adaptive homeostatic responses and goal-directed behavior in dynamic social contexts.</p>
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<p>Social neuro-science has recently started to investigate the neuronal mechanisms underlying our ability to understand the mental and emotional states of others. In this review, imaging research conducted on theory of mind (ToM or mentalizing) and empathy is selectively reviewed. It is proposed that even though these abilities are often used as synonyms in the literature these capacities represent different abilities that rely on different neuronal circuitry. ToM refers to our ability to understand mental states such as intentions, goals and beliefs, and relies on structures of the temporal lobe and the pre-frontal cortex. In contrast, empathy refers to our ability to share the feelings (emotions and sensations) of others and relies on sensorimotor cortices as well as limbic and para-limbic structures. It is further argued that the concept of empathy as used in lay terms refers to a multi-level construct extending from simple forms of emotion contagion to complex forms of cognitive perspective taking. Future research should investigate the relative contribution of empathizing and mentalizing abilities in the understanding of other people's states. Finally, it is suggested that the abilities to understand other people's thoughts and to share their affects display different ontogenetic trajectories reflecting the different developmental paths of their underlying neural structures. In particular, empathy develops much earlier than mentalizing abilities, because the former relys on limbic structures which develop early in ontogeny, whereas the latter rely on lateral temporal lobe and pre-frontal structures which are among the last to fully mature.</p>
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In this article, the authors elaborate on 3 ideas advanced in P. Rozin and A. B. Cohen's (2003) innovative study of facial expression. Taking a cue from their discovery of new expressive behaviors (e.g., the narrowed eyebrows), the authors review recent studies showing that emotions are conveyed in more channels than usually studied, including posture, gaze patterns, voice, and touch. Building on their claim that confusion has a distinct display, the authors review evidence showing distinct displays for 3 self-conscious emotions (embarrassment, shame, and pride), 5 positive emotions (amusement, desire, happiness, love, interest), and sympathy and compassion. Finally, the authors offer a functional definition of emotion to integrate these findings on "new" displays and emotions.
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