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OBJECTIVES: Randomized controlled studies on the effectiveness of body-oriented methods of treatment for children with attention-deficit hyperactivity disorder (ADHD) are lacking. Our aim was to compare the effectiveness of two methods of treatment (yoga for children vs. conventional motor exercises) in a randomized controlled pilot study. METHODS: Nineteen children with a clinical diagnosis of ADHD (according to ICD-10 criteria) were included and randomly assigned to treatment conditions according to a 2x2 cross-over design. Effects of treatment were analyzed by means of an analysis of variance for repeated measurements. RESULTS: For all outcome measures (test scores on an attention task, and parent ratings of ADHD symptoms) the yoga training was superior to the conventional motor training, with effect sizes in the medium-to-high range (0.60-0.97). All children showed sizable reductions in symptoms over time, and at the end of the study, the group means for the ADHD scales did not differ significantly from those for a representative control group. Furthermore, the training was particularly effective for children undergoing pharmacotherapy (MPH). CONCLUSIONS: The findings from this pilot study demonstrate that yoga can be an effective complementary or concomitant treatment for attention-deficit hyperactivity disorder. The study advocates further research into the impact of yoga or body-oriented therapies on the prevention and treatment of ADHD.
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The effectiveness of an 8-week mindfulness training for adolescents aged 11–15 years with ADHD and parallel Mindful Parenting training for their parents was evaluated, using questionnaires as well as computerized attention tests. Adolescents (N = 10), their parents (N = 19) and tutors (N = 7) completed measurements before, immediately after, 8 weeks after and 16 weeks after training. Adolescents reported on their attention and behavioral problems and mindful awareness, and were administered two computerized sustained attention tasks. Parents as well as tutors reported on adolescents’ attention and behavioral problems and executive functioning. Parents further reported on their own parenting, parenting stress and mindful awareness. Both the mindfulness training for the adolescents and their parents was delivered in group format. First, after mindfulness training, adolescents’ attention and behavior problems reduced, while their executive functioning improved, as indicated by self-report measures as well as by father and teacher report. Second, improvements in adolescent’ actual performance on attention tests were found after mindfulness training. Moreover, fathers, but not mothers, reported reduced parenting stress. Mothers reported reduced overreactive parenting, whereas fathers reported an increase. No effect on mindful awareness of adolescents or parents was found. Effects of mindfulness training became stronger at 8-week follow-up, but waned at 16-week follow-up. Our study adds to the emerging body of evidence indicating that mindfulness training for adolescents with ADHD (and their parents) is an effective approach, but maintenance strategies need to be developed in order for this approach to be effective in the longer term.

Studies on the effects of mindfulness interventions on mental health and behavioral problems in children show promising results, but are primarily conducted with selected samples of children. The few studies investigating school-based interventions used self-selected samples, provided training outside of the classroom, and did not report longer-term effects. The immediate and longer-term effects of a class-based mindfulness intervention for elementary school children were investigated as a primary prevention program (MindfulKids) to reduce stress and stress-related mental health and behavioral problems. Children (8–12 years) from three elementary schools participated. Classes were randomized to an immediate-intervention group (N = 95) or a waitlist-control group (N = 104), which received the intervention after a waitlist period. Twelve 30-min sessions were delivered in 6 weeks. At baseline, pretest, posttest, and follow-up, variables indicative of stress and metal well-being were assessed with children, variables indicative of mental health problems were assessed with parents, and teachers reported on class climate. Multilevel analysis revealed that there were no significant changes from baseline to pretest. Some primary prevention effects on stress and well-being were found directly after training and some became more apparent at follow-up. Effects on mental health problems also became apparent at follow-up. MindfulKids seems to have a primary preventive effect on stress, well-being, and behavior in schoolchildren, as reported by children and parents. Exploratory analysis revealed that children who ruminate more are affected differently by the intervention than children who ruminate less. It is concluded that mindfulness training can be incorporated in elementary schools at the class level, letting all children benefit from the intervention.

The present investigation examined the contributions of specific attentional networks to long-term trait effects of meditation. It was hypothesized that meditation could improve the efficiency of executive processing (inhibits prepotent/incorrect responses) or orientational processing (orients to specific objects in the attentional field). Participants (50 meditators and 10 controls) were given the Stroop (measures executive attention) and Global-Local Letters (measures orientational attention) tasks. Results showed that meditation experience was associated with reduced interference on the Stroop task (p < 0.03), in contrast with a lack of effect on interference in the Global-Local Letters task. This suggests that meditation produces long-term increases in the efficiency of the executive attentional network (anterior cingulate/prefrontal cortex) but no effect on the orientation network (parietal systems). The amount of time participants spent meditating each day, rather than the total number of hours of meditative practice over their lifetime, was negatively correlated with interference on the Stroop task (r = −0.31, p < 0.005).

<p>BACKGROUND: Typical interventions for acute pain in children attempt to reduce pain by directing attention away from pain. Conversely, mindfulness involves devoting attention to one’s experience in an accepting and nonjudgmental way. However, the effect that instructing children to mindfully devote attention to acute pain has on pain outcomes is unknown. OBJECTIVES: To examine whether mindful attention can help children attend to pain without increasing pain intensity or decreasing pain tolerance; to compare the effects of mindful attention with a well-established intervention designed to take attention away from pain (guided imagery); and to test whether baseline coping style or trait mindfulness alter the effects of these interventions. METHODS: A total of 82 children (10 to 14 years of age) completed measures of coping style and trait mindfulness. Participants then received either mindful attention or guided imagery instructions designed to direct attention toward or away from pain, respectively, before participating in a cold pressor task. RESULTS: The mindful attention group reported more awareness of the physical sensations of pain and thoughts about those sensations. Overall, there were no between-group differences in measures of pain intensity or pain tolerance during the cold pressor task, and no evidence of an interaction between baseline characteristics of the child and experimental condition. CONCLUSIONS: Mindful attention was successful in helping children focus attention on experimental pain without increasing pain intensity or decreasing tolerance compared with a well-established intervention for acute pain reduction.</p>
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During selective attention, ∼7–14 Hz alpha rhythms are modulated in early sensory cortices, suggesting a mechanistic role for these dynamics in perception. Here, we investigated whether alpha modulation can be enhanced by “mindfulness” meditation (MM), a program training practitioners in sustained attention to body and breath-related sensations. We hypothesized that participants in the MM group would exhibit enhanced alpha power modulation in a localized representation in the primary somatosensory neocortex in response to a cue, as compared to participants in the control group. Healthy subjects were randomized to 8-weeks of MM training or a control group. Using magnetoencephalographic (MEG) recording of the SI finger representation, we found meditators demonstrated enhanced alpha power modulation in response to a cue. This finding is the first to show enhanced local alpha modulation following sustained attentional training, and implicates this form of enhanced dynamic neural regulation in the behavioral effects of meditative practice.
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<p>In two prior studies, we investigated the neural mechanisms of spatial attention using a combined event-related potential (ERP) and positron emission tomography (PET) approach (Heinze et al. [1994]: Nature 392:543-546; Mangun et al. [1997]: Hum Brain Mapp 5:273-279). Neural activations in extrastriate cortex were observed in the PET measures for attended stimuli, and these effects were related to attentional modulations in the ERPs at specific latencies. The present study used functional magnetic resonance imaging (fMRI) and ERPs in single subjects to investigate the intersubject variability in extrastriate spatial attention effects, and to qualitatively compare this to variations in ERP attention effects. Activations in single subjects replicated our prior group-averaged PET findings, showing attention-related increases in blood flow in the posterior fusiform and middle occipital gyri in the hemisphere contralateral to attended visual stimuli. All subjects showed attentional modulations of the occipital P1 component of the ERPs. These findings in single subjects demonstrate the consistency of extrastriate attention effects, and provide information about the feasibility of this approach for integration of electrical and functional imaging data.</p>
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<p>A number of issues important to the clinical utility of mindfulness require systematic study. These include the most parsimonious definition of mindfulness for clinical purposes, how mindfulness is best described to be most approachable to patients, and the extent to which mindfulness shares common mechanisms with other mind-body programs. The discussion includes a brief review of the transition of mindfulness from traditional into clinical settings as well as the components commonly contained within clinical descriptions of mindfulness. A model based on facility in the use of attention is proposed, and a description of mechanisms by which attentional skill may lead to the recognition of internal associational processes and account for psychological outcomes is given. Using constructs already familiar to patients, an attention-based conception may also be more accessible to patients than more elaborate descriptions and have greater utility in identifying commonalities that mindfulness training may have with other mind-body programs.</p>

Many recent behavioral and neuroscientific studies have revealed the importance of investigating meditation states and traits to achieve an increased understanding of cognitive and affective neuroplasticity, attention and self-awareness, as well as for their increasingly recognized clinical relevance. The investigation of states and traits related to meditation has especially pronounced implications for the neuroscience of attention, consciousness, self-awareness, empathy and theory of mind. In this article we present the main features of meditation-based mental training and characterize the current scientific approach to meditation states and traits with special reference to attention and consciousness, in light of the articles contributed to this issue.

Individuals differ dramatically in the quality and intensity of their response to affectively evocative stimuli. On the basis of prior theory and research, we hypothesized that these individual differences are related to variation in activation of the left and right frontal brain regions. We recorded baseline brain electrical activity from subjects on two occasions 3 weeks apart. Immediately following the second recording, subjects were exposed to brief positive and negative emotional film clips. For subjects whose frontal asymmetry was stable across the 3-week period, greater left frontal activation was associated with reports of more intense positive affect in response to the positive films, whereas greater right frontal activation was associated with more intense reports of negative affect in response to the negative film clips. The methodological and theoretical implications of these data are discussed.
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Recent studies have identified a distributed network of brain regions thought to support cognitive reappraisal processes underlying emotion regulation in response to affective images, including parieto-temporal regions and lateral/medial regions of prefrontal cortex (PFC). A number of these commonly activated regions are also known to underlie visuospatial attention and oculomotor control, which raises the possibility that people use attentional redeployment rather than, or in addition to, reappraisal as a strategy to regulate emotion. We predicted that a significant portion of the observed variance in brain activation during emotion regulation tasks would be associated with differences in how participants visually scan the images while regulating their emotions. We recorded brain activation using fMRI and quantified patterns of gaze fixation while participants increased or decreased their affective response to a set of affective images. fMRI results replicated previous findings on emotion regulation with regulation differences reflected in regions of PFC and the amygdala. In addition, our gaze fixation data revealed that when regulating, individuals changed their gaze patterns relative to a control condition. Furthermore, this variation in gaze fixation accounted for substantial amounts of variance in brain activation. These data point to the importance of controlling for gaze fixation in studies of emotion regulation that use visual stimuli.
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<p>With each eye fixation, we experience a richly detailed visual world. Yet recent work on visual integration and change direction reveals that we are surprisingly unaware of the details of our environment from one view to the next: we often do not detect large changes to objects and scenes ('change blindness'). Furthermore, without attention, we may not even perceive objects ('inattentional blindness'). Taken together, these findings suggest that we perceive and remember only those objects and details that receive focused attention. In this paper, we briefly review and discuss evidence for these cognitive forms of 'blindness'. We then present a new study that builds on classic studies of divided visual attention to examine inattentional blindness for complex objects and events in dynamic scenes. Our results suggest that the likelihood of noticing an unexpected object depends on the similarity of that object to other objects in the display and on how difficult the priming monitoring task is. Interestingly, spatial proximity of the critical unattended object to attended locations does not appear to affect detection, suggesting that observers attend to objects and events, not spatial positions. We discuss the implications of these results for visual representations and awareness of our visual environment.</p>

Many objects typically occur in particular locations, and object words encode these spatial associations. We tested whether such object words (e.g., head, foot) orient attention toward the location where the denoted object typically occurs (i.e., up, down). Because object words elicit perceptual simulations of the denoted objects (i.e., the representations acquired during actual perception are reactivated), we predicted that an object word would interfere with identification of an unrelated visual target subsequently presented in the object's typical location. Consistent with this prediction, three experiments demonstrated that words denoting objects that typically occur high in the visual field hindered identification of targets appearing at the top of the display, whereas words denoting low objects hindered target identification at the bottom of the display. Thus, object words oriented attention to and activated perceptual simulations in the objects' typical locations. These results shed new light on how language affects perception.
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Research on the anatomical bases of interhemispheric interaction, including individual differences in corpus callosum (CC) anatomy, is reviewed. These anatomical findings form the basis for the discussion of two major themes. The first considers interhemispheric transfer time (IHTT) and related issues. These include varieties of IHTT and possible directional asymmetries of IHTT. Evidence suggests that pathological variations in IHTT may have cognitive consequences. The second involves conditions under which interhemispheric interaction is necessary and beneficial. The data suggest that when both hemispheres have some competence at a difficult task, there is a benefit to interhemispheric interaction. The role of the CC in the dynamic distribution of attention may be particularly relevant to this advantage. Throughout the article reference is made to individual differences and developmental changes associated with interhemispheric interaction.
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Cultivation of mindfulness, the nonjudgmental awareness of experiences in the present moment, produces beneficial effects on well-being and ameliorates psychiatric and stress-related symptoms. Mindfulness meditation has therefore increasingly been incorporated into psychotherapeutic interventions. Although the number of publications in the field has sharply increased over the last two decades, there is a paucity of theoretical reviews that integrate the existing literature into a comprehensive theoretical framework. In this article, we explore several components through which mindfulness meditation exerts its effects: (a) attention regulation, (b) body awareness, (c) emotion regulation (including reappraisal and exposure, extinction, and reconsolidation), and (d) change in perspective on the self. Recent empirical research, including practitioners’ self-reports and experimental data, provides evidence supporting these mechanisms. Functional and structural neuroimaging studies have begun to explore the neuroscientific processes underlying these components. Evidence suggests that mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network structures. The authors suggest that the mechanisms described here work synergistically, establishing a process of enhanced self-regulation. Differentiating between these components seems useful to guide future basic research and to specifically target areas of development in the treatment of psychological disorders.
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Neurosurgical treatment of psychiatric disorders has been influenced by evolving neurobiological models of symptom generation. The advent of functional neuroimaging and advances in the neurosciences have revolutionized understanding of the functional neuroanatomy of psychiatric disorders. This article reviews neuroimaging studies of depression from the last 3 decades and describes an emerging neurocircuitry model of mood disorders, focusing on critical circuits of cognition and emotion, particularly those networks involved in the regulation of evaluative, expressive and experiential aspects of emotion. The relevance of this model for neurotherapeutics is discussed, as well as the role of functional neuroimaging of psychiatric disorders.
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Two groups of 45 children each, whose ages ranged from 9 to 13 years, were assessed on a steadiness test, at the beginning and again at the end of a 10-day period during which one group received training in yoga, while the other group did not. The steadiness test required insertion of and holding for 15 sec. a metal stylus without touching the sides of holes of decreasing sizes in a metal plate. The contacts were counted as 'errors'. During the 10-day period, one group (the 'Yoga' group) received training in special physical postures (asanas), voluntary regulation of breathing (Pranayama), maintenance of silence, as well as visual focussing exercises (tratakas) and games to improve the attention span and memory. The other group (control) carried out their usual routine. After 10 days, the 'Yoga' group showed a significant (Wilcoxon's paired signed-ranks test) decrease in errors, whereas the 'control' group showed no change.
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OBJECTIVE: In this case study, we describe the effects of a particular individual's concentration/meditation technique on autonomic nervous system activity and the innate immune response. The study participant holds several world records with regard to tolerating extreme cold and claims that he can influence his autonomic nervous system and thereby his innate immune response. METHODS: The individual's ex vivo cytokine response (stimulation of peripheral blood mononuclear cells with lipopolysaccharide [LPS]) was determined before and after an 80-minute full-body ice immersion during which the individual practiced his concentration/meditation technique. Furthermore, the individual's in vivo innate immune response was studied while practicing his concentration/mediation technique during human endotoxemia (intravenous administration of 2 ng/kg LPS). The results from the endotoxemia experiment were compared with a historical cohort of 112 individuals who participated in endotoxemia experiments in our institution. RESULTS: The ex vivo proinflammatory and anti-inflammatory cytokine response was greatly attenuated by concentration/meditation during ice immersion, accompanied by high levels of cortisol. In the endotoxemia experiment, concentration/meditation resulted in increased circulating concentrations of catecholamines, and plasma cortisol concentrations were higher than in any of the previously studied participants. The individual's in vivo cytokine response and clinical symptoms after LPS administration were remarkably low compared with previously studied participants. CONCLUSIONS: The concentration/meditation technique used by this particular individual seems to evoke a controlled stress response. This response is characterized by sympathetic nervous system activation and subsequent catecholamine/cortisol release, which seems to attenuate the innate immune response.
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The ability to focus one's attention underlies success in many everyday tasks, but voluntary attention cannot be sustained for extended periods of time. In the laboratory, sustained-attention failure is manifest as a decline in perceptual sensitivity with increasing time on task, known as the vigilance decrement. We investigated improvements in sustained attention with training (~ 5 hr/day for 3 months), which consisted of meditation practice that involved sustained selective attention on a chosen stimulus (e.g., the participant's breath). Participants were randomly assigned either to receive training first (n = 30) or to serve as waiting-list controls and receive training second (n = 30). Training produced improvements in visual discrimination that were linked to increases in perceptual sensitivity and improved vigilance during sustained visual attention. Consistent with the resource model of vigilance, these results suggest that perceptual improvements can reduce the resource demand imposed by target discrimination and thus make it easier to sustain voluntary attention.
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We investigated whether mindfulness training (MT) influences information processing in a working memory task with complex visual stimuli. Participants were tested before (T1) and after (T2) participation in an intensive one-month MT retreat, and their performance was compared with that of an age- and education-matched control group. Accuracy did not differ across groups at either time point. Response times were faster and significantly less variable in the MT versus the control group at T2. Since these results could be due to changes in mnemonic processes, speed-accuracy trade-off, or nondecisional factors (e.g., motor execution), we used a mathematical modeling approach to disentangle these factors. The EZ-diffusion model (Wagenmakers, van der Maas, & Grasman, Psychonomic Bulletin & Review 14:(1), 3-22, 2007) suggested that MT leads to improved information quality and reduced response conservativeness, with no changes in nondecisional factors. The noisy exemplar model further suggested that the increase in information quality reflected a decrease in encoding noise and not an increase in forgetting. Thus, mathematical modeling may help clarify the mechanisms by which MT produces salutary effects on performance.
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