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<p>Abstract The performance of concentrative and mindfulness meditators on a test of sustained attention (Wilkins' counting test) was compared with controls. Both groups of meditators demonstrated superior performance on the test of sustained attention in comparison with controls, and long-term meditators were superior to short-term meditators. Mindfulness meditators showed superior performance in comparison with concentrative meditators when the stimulus was unexpected but there was no difference between the two types of meditators when the stimulus was expected. The results are discussed in relation to the attentional mechanisms involved in the two types of meditation and implications drawn for mental health.</p>
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Many philosophical and contemplative traditions teach that “living in the moment” increases happiness. However, the default mode of humans appears to be that of mind-wandering, which correlates with unhappiness, and with activation in a network of brain areas associated with self-referential processing. We investigated brain activity in experienced meditators and matched meditation-naive controls as they performed several different meditations (Concentration, Loving-Kindness, Choiceless Awareness). We found that the main nodes of the default-mode network (medial prefrontal and posterior cingulate cortices) were relatively deactivated in experienced meditators across all meditation types. Furthermore, functional connectivity analysis revealed stronger coupling in experienced meditators between the posterior cingulate, dorsal anterior cingulate, and dorsolateral prefrontal cortices (regions previously implicated in self-monitoring and cognitive control), both at baseline and during meditation. Our findings demonstrate differences in the default-mode network that are consistent with decreased mind-wandering. As such, these provide a unique understanding of possible neural mechanisms of meditation.
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The present study was designed to examine mindfulness and stress levels in beginner and advanced practitioners of Hatha Yoga. Participants (N = 52) were recruited through Hatha Yoga schools local to western Massachusetts. Beginner practitioners (n = 24) were designated as those with under 5 years (M = 3.33) experience and advanced practitioners (n = 28) as those with over 5 years (M = 14.53) experience in Hatha Yoga. The participants completed the Mindful Attention Awareness Scale (MAAS; Brown and Ryan 2003) and the Perceived Stress Scale (PSS; Cohen et al. 1983) directly preceding a regularly scheduled Hatha Yoga class. Based on two independent-samples t-tests, advanced participants scored significantly higher in mindfulness levels (P < .05) and significantly lower in stress levels (P < .05) when compared to beginner participants. Additionally, a significant negative correlation (r = —. 45, P = .00) was found between mindfulness and stress levels. No significant correlations were found between experience levels and mindfulness and stress levels. Hatha Yoga may be an effective technique for enhancing mindfulness and decreasing stress levels in practitioners.
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Mindfulness-based interventions have been shown to alleviate symptoms of a wide range of physical and mental health conditions. Regular between-session practice of mindfulness meditation is among the key factors proposed to produce the therapeutic benefits of mindfulness-based programs. This article reviews the mindfulness intervention literature with a focus on the status of home practice research and the relationship of practice to mindfulness program outcomes. Of 98 studies reviewed, nearly one-quarter (N = 24) evaluated the associations between home practice and measures of clinical functioning, with just over half (N = 13) demonstrating at least partial support for the benefits of practice. These findings indicate a substantial disparity between what is espoused clinically and what is known empirically about the benefits of mindfulness practice. Improved methodologies for tracking and evaluating the effects of home practice are recommended.
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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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Mindfulness practice is an ancient tradition in Eastern philosophy that forms the basis for meditation, and it is increasingly making its way into Western approaches to health care. Although it has been applied to the treatment of many different mental health disorders, it has not been discussed in the context of therapy for sexual problems. In a previous qualitative study of female meditation practitioners who did not have sexual concerns, mindfulness practice was found to be associated with greater sexual response and higher levels of sexual satisfaction. We have recently developed a psychoeducational program for women with sexual arousal disorder subsequent to gynecologic cancer and have included a component of mindfulness training in the intervention. In this paper, we will attempt to provide a rationale for the use of mindfulness in the treatment of women with sexual problems, and will include transcript excerpts from women who participated in our research trial that illustrate how mindfulness was effective in improving their sexuality and quality of life. Although these findings are preliminary, they suggest that mindfulness may have a place in the treatment of sexual concerns.
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Classical Tibetan meditation texts are used to specify the most important variables in meditation that can be subjected to empirical test. There are 3 kinds of variables: (a) nonspecific variables, common to all meditation systems; (b) specific variables, limited to spec & types of meditation practice; and (c) timedependent variables, changing over the course of meditation practice. The latter, time-dependent variables, comprise the majority of meditation variables. One set of time-dependent variables for classical concentrative meditation is explored. Using the semantic-field method of translating, technical terms most important in each level of the entire phenomenology of concentrative meditation are discussed. These terms are translated into hypotheses, which are worded in terms of traditional constructs from cognitive psychology. Supporting empirical research is presented and suggestions for further research are made. Certain similarities are noted between the Yogic texts and the constructivist theories of perception, information-processing, and affect. The overall direction of change in concentrative meditation follows an invariant sequence of levels of consciousness.
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Objective To explore participants’ experience in placebo-controlled randomized clinical trials (RCTs) specifically in relationship to their expectations. Background Aspects of being in RCTs, such as informed consent, perception of benefit and understanding of randomization, have been examined. In contrast, little is known concerning the formation of patient expectations before and during trials. Methods Qualitative methods using in-depth interviews with a semi-structured interview guide of nine patients from four different RCTs. Data analysis was conducted using a codebook format arranging participant responses under broad analytical headings. The interviewer used a semi-structured interview guide to direct the conversation from one broad topic to the next within the context of the ongoing conversation. A checklist of topics encouraged participants to describe their experiences in RCTs. Narratives concerning expectation, blinding and placebo were compared to identify common themes. Results Patient anticipatory processes were influenced and modified both before and during the trial from multiple inputs. Such factors as past experiences in RCTs, past experiences of ineffective treatment, stress of being off regular medications, fear of being a ‘placebo responder’, input of non-study doctors or other health professionals, the experience of other participants, measurements of health parameters made during the trial and the presence or absence of side-effects all affected patient expectation. Conclusion Expectations in RCTs are not fixed and instead may be viewed as continuously shaped by multiple inputs that include experience and information received both before and during the trial. Variability in placebo response observed in previous studies may be related to the fluid nature of expectations. Trying to control and equalize expectations in RCTs may be more difficult than previously assumed.
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Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin’s surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations (including warmth, tingling or flowing sensations) suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients’ unprompted descriptions of any enhanced touch sensations (e.g., warmth, tingling) and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including “warmth” and “tingling” with treatment efficacy. The conclusion offers a “neurophenomenological” account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture.
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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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Abstract 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 fulfilment 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.
The experience of pain arises from both physiological and psychological factors, including one's beliefs and expectations. Thus, placebo treatments that have no intrinsic pharmacological effects may produce analgesia by altering expectations. However, controversy exists regarding whether placebos alter sensory pain transmission, pain affect, or simply produce compliance with the suggestions of investigators. In two functional magnetic resonance imaging (fMRI) experiments, we found that placebo analgesia was related to decreased brain activity in pain-sensitive brain regions, including the thalamus, insula, and anterior cingulate cortex, and was associated with increased activity during anticipation of pain in the prefrontal cortex, providing evidence that placebos alter the experience of pain.
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Studies of homework effects in psychotherapy outcome have produced inconsistent results. Although these findings may reflect the comparability of psychotherapy with and without homework assignments, many of these studies may not have been sensitive enough to detect the effects sizes (ESs) likely to be found when examining homework effects. The present study evaluated the power of homework research and showed that, on average, current power levels are relatively weak in controlled studies ranging from 0.58 for large ESs to 0.09 for small ESs. Thus, inconsistent findings between studies may very well be due to low statistical power.
<p>In this meta-analysis, we give a comprehensive overview of the effects of meditation on psychological variables that can be extracted from empirical studies, concentrating on the effects of meditation on nonclinical groups of adult meditators. Mostly because of methodological problems, almost ¾ of an initially identified 595 studies had to be excluded. Most studies appear to have been conducted without sufficient theoretical background. To put the results into perspective, we briefly summarize the major theoretical approaches from both East and West. The 163 studies that allowed the calculation of effect sizes exhibited medium average effects ( = .28 for all studies and = .27 for the n = 125 studies from reviewed journals), which cannot be explained by mere relaxation or cognitive restructuring effects. In general, results were strongest (medium to large) for changes in emotionality and relationship issues, less strong (about medium) for measures of attention, and weakest (small to medium) for more cognitive measures. However, specific findings varied across different approaches to meditation (transcendental meditation, mindfulness meditation, and other meditation techniques). Surprisingly, meditation experience only partially covaried with long-term impact on the variables examined. In general, the dependent variables used cover only some of the content areas about which predictions can be made from already existing theories about meditation; still, such predictions lack precision at present. We conclude that to arrive at a comprehensive understanding of why and how meditation works, emphasis should be placed on the development of more precise theories and measurement devices.</p>
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<p>Psychotherapeutic interventions containing training in mindfulness meditation have been shown to help participants with a variety of somatic and psychological conditions. Mindfulness-based cognitive therapy (MBCT) is a meditation-based psychotherapeutic intervention designed to help reduce the risk of relapse of recurrent depression. There is encouraging early evidence from multi-centre randomized controlled trials. However, little is known of the process by which MBCT may bring therapeutic benefits. This study set out to explore participants' accounts of MBCT in the mental-health context. Seven participants were interviewed in two phases. Interview data from four participants were obtained in the weeks following MBCT. Grounded theory techniques were used to identify several categories that combine to describe the ways in which mental-health difficulties arose as well as their experiences of MBCT. Three further participants who have continued to practise MBCT were interviewed so as to further validate, elucidate and extend these categories. The theory suggested that the preconceptions and expectations of therapy are important influences on later experiences of MBCT. Important areas of therapeutic change ('coming to terms') were identified, including the development of mindfulness skills, an attitude of acceptance and 'living in the moment'. The development of mindfulness skills was seen to hold a key role in the development of change. Generalization of these skills to everyday life was seen as important, and several ways in which this happened, including the use of breathing spaces, were discussed. The study emphasized the role of continued skills practice for participants' therapeutic gains. In addition, several of the concepts and categories offered support to cognitive accounts of mood disorder and the role of MBCT in reducing relapse.</p>
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<p>This exploratory study examined differences in normal narcissism between mindfulness meditation practitioners (n = 76), comprised of men (30%) and women (70%) between the ages of 18 and 79, and a control group (n = 36) of nonmeditators with spiritual interests, comprised of men (19%) and women (81%) between the ages of 31 and 78. Normal narcissism was defined as a concentration of psychological interest upon the representational self (i.e., ego-identity). Quantitative analysis was conducted using the Kruskal-Wallis ANOVA and Fisher's Least Significant Differences (LSD) test. The study's measures included (a) the Narcissistic Personality Inventory (NPI) measuring normal, overt narcissism and (b) the Transpersonally Oriented Narcissism Questionnaire (TONQ)--a piloted measure of normal narcissism designed to assess overt, covert, and transformative aspects of 4 core narcissistic features: (a) self-centeredness, (b) grandiosity, (c) need-for-mirroring/admiration, and (d) emptiness. Quantitative results are informed by qualitative analysis utilizing heuristic, hermeneutical, and phenomenological principles. Results indicate no differences in NPI scores among the various meditator variables: (a) years of practice, (b) amount of meditation per week, (c) duration of meditation per sitting, and (d) retreat experience or between meditators ( n = 76) and control (n = 36). Differences exist among all 4 meditator variables (a) - (d) and control group regarding (a) overall transformation of narcissism, (b) emptiness as the ultimate potential (e.g., sunnata), and (c) self-centeredness, with controls having higher means than meditators on overall narcissism-transformation and narcissistic emptiness, and lower means on self-centeredness subscales. Differences exist between 3 meditator variables and control regarding narcissistic emptiness, with controls having higher means than meditators. Differences exist between 2 meditator variables and control regarding transforming grandiosity, where controls report higher means than meditators. This exploratory research demonstrates that the transpersonal study of narcissism is possible despite the many methodological complications and numerous theoretical questions it raises.</p>
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- Contexts of Contemplation Project,
- Classical Buddhist Contemplation Practices,
- Buddhist Contemplation by Applied Subject,
- Contemplation by Applied Subject,
- Contemplation by Tradition,
- Four Foundations of Mindfulness (Satipatthana),
- Psychology and Buddhist Contemplation,
- Science and Buddhist Contemplation,
- Practices of Buddhist Contemplation,
- Insight (vipashyana, lhaktong),
- Psychology and Contemplation,
- Science and Contemplation,
- Buddhist Contemplation
Patient–physician interactions significantly contribute to placebo effects and clinical outcomes. While the neural correlates of placebo responses have been studied in patients, the neurobiology of the clinician during treatment is unknown. This study investigated physicians’ brain activations during patient–physician interaction while the patient was experiencing pain, including a ‘treatment‘, ‘no-treatment’ and ‘control’ condition. Here, we demonstrate that physicians activated brain regions previously implicated in expectancy for pain–relief and increased attention during treatment of patients, including the right ventrolateral and dorsolateral prefrontal cortices. The physician’s ability to take the patients’ perspective correlated with increased brain activations in the rostral anterior cingulate cortex, a region that has been associated with processing of reward and subjective value. We suggest that physician treatment involves neural representations of treatment expectation, reward processing and empathy, paired with increased activation in attention-related structures. Our findings further the understanding of the neural representations associated with reciprocal interactions between clinicians and patients; a hallmark for successful treatment outcomes.
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