Both dialectical behavior therapy (DBT) and mindfulness-based cognitive therapy (MBCT) include training in mindfulness skills and address the synthesis of acceptance and change. DBT is a comprehensive treatment for borderline personality disorder (BPD). MBCT was developed for prevention of relapse in individuals with a history of depressive episodes. Both have considerable empirical support for their efficacy. Many individuals with BPD also suffer from depressive episodes, which can interfere with motivation to participate in DBT. In such cases, it may be helpful to integrate strategies designed to prevent recurrence of depressive episodes. This case study describes integration of MBCT into ongoing DBT in the treatment of an individual with BPD and a history of depressive episodes. Findings suggest that MBCT can be successfully integrated into ongoing DBT in cases in which prevention of depressive episodes is an important goal. Findings also suggest that mindfulness skills may be very helpful in enhancing the efficacy of traditional cognitive-behavioral treatment approaches. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
This article presents 4 studies (N = 1,413) describing the development and validation of the Child and Adolescent Mindfulness Measure (CAMM). In Study 1 (n = 428), the authors determined procedures for item development and examined comprehensibility of the initial 25 items. In Study 2 (n = 334), they reduced the initial item pool from 25 to 10 items through exploratory factor analysis. Study 3 (n = 332) evaluated the final 10-item measure in a cross-validation sample, and Study 4 (n = 319) determined validity coefficients for the CAMM using bivariate and partial correlations with relevant variables. Results suggest that the CAMM is a developmentally appropriate measure with adequate internal consistency. As expected, CAMM scores were positively correlated with quality of life, academic competence, and social skills and negatively correlated with somatic complaints, internalizing symptoms, and externalizing behavior problems. Correlations were reduced but generally still significant after controlling for the effects of 2 overlapping processes (thought suppression and psychological inflexibility). Overall, results suggest that the CAMM may be a useful measure of mindfulness skills for school-aged children and adolescents.
The first meta-analytic review of the mindfulness-based treatment outcome literature (Baer, 2003) said nothing about the assessment of mindfulness. None of the 21 studies included in the review had attempted to measure mindfulness, presumably because no instruments for this purpose were available. Although the review concluded that mindfulness training appeared to be helpful in reducing a variety of psychological symptoms, the extent to which participants learned the mindfulness skills taught in the interventions was not investigated. The studies also shed no light on whether documented improvements in psychological functioning could be attributed to the acquisition of mindfulness skills.
Objective: Pro-inflammatory cytokines have been implicated in the pathophysiology and maintenance of depression. This study investigated the effects of a brief mindfulness intervention on salivary pro-inflammatory correlates of depression (IL-6, TNF-α) and self-reported symptoms of depression in college women. Methods: Sixty-four females with a cut score of ≥16 on the Center for Epidemiological Studies for Depression Scale (CES-D) were assigned to a 4-week mindfulness-based intervention (MBI; N = 31) or a contact-control group (N = 33). For both groups, salivary cytokines and depressive symptoms were assessed at baseline and posttreatment. For the mindfulness group only, salivary cytokines were also assessed at a 3-month follow-up. Results: Both groups showed similar reductions in depression. However, MBI (vs. control) predicted greater reductions in IL-6 and TNF-α; changes in IL-6 were sustained at 3-month follow-up. Higher baseline depressive symptoms predicted greater reductions in inflammation in the mindfulness group. Conclusion: MBIs may reduce inflammatory immune markers commonly implicated in depression. Individuals with greater depressive symptoms may benefit more from mindfulness training. Although reductions in salivary cytokines in the mindfulness condition were not attributable to changes in depressive symptoms, future work should examine the possibility that such reductions are protective against the development of future depressive episodes.
Previous research on assessment of mindfulness by self-report suggests that it may include five component skills: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. These elements of mindfulness can be measured with the Five Facet Mindfulness Questionnaire (FFMQ). The authors investigated several aspects of the construct validity of the FFMQ in experienced meditators and nonmeditating comparison groups. Consistent with predictions, most mindfulness facets were significantly related to meditation experience and to psychological symptoms and well-being. As expected, relationships between the observing facet and psychological adjustment varied with meditation experience. Regression and mediation analyses showed that several of the facets contributed independently to the prediction of well-being and significantly mediated the relationship between meditation experience and well-being. Findings support the construct validity of the FFMQ in a combination of samples not previously investigated.
Previous research on assessment of mindfulness by self-report suggests that it may include five component skills: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. These elements of mindfulness can be measured with the Five Facet Mindfulness Questionnaire (FFMQ). The authors investigated several aspects of the construct validity of the FFMQ in experienced meditators and nonmeditating comparison groups. Consistent with predictions, most mindfulness facets were significantly related to meditation experience and to psychological symptoms and well-being. As expected, relationships between the observing facet and psychological adjustment varied with meditation experience. Regression and mediation analyses showed that several of the facets contributed independently to the prediction of well-being and significantly mediated the relationship between meditation experience and well-being. Findings support the construct validity of the FFMQ in a combination of samples not previously investigated.
Interventions based on the practice of mindfulness meditation and related skills are increasingly popular and empirical support for their efficacy continues to grow. The present volume focuses on mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982, Kabat-Zinn, 1990, Kabat-Zinn, 2013), mindfulness-based cognitive therapy (MBCT; Segal et al., 2002, Segal et al., 2013), and closely related interventions. This introductory chapter provides a general overview of MBSR and MBCT in their standard forms, with emphasis on their mindfulness and acceptance-based skills, practices, and exercises. Mechanisms through which mindfulness training leads to beneficial outcomes are briefly discussed and important questions remaining for future research are considered. Building on the foundation provided by this introductory chapter, the remaining chapters describe adaptations and new interventions for specific populations. Each chapter includes theoretical foundations, a summary of empirical support, and a case study illustrating a typical course of treatment and practical issues that arise in implementing it.
BACKGROUND:Extending previous research, we applied latent profile analysis in a sample of adults with a history of recurrent depression to identify subgroups with distinct response profiles on the Five Facet Mindfulness Questionnaire and understand how these relate to psychological functioning.
METHOD:
The sample was randomly divided into two subsamples to first examine the optimal number of latent profiles (test sample; n = 343) and then validate the identified solution (validation sample; n = 340).
RESULTS:
In both test and validation samples, a four-profile solution was revealed where two profiles mapped broadly onto those previously identified in nonclinical samples: "high mindfulness" and "nonjudgmentally aware." Two additional subgroups, "moderate mindfulness" and "very low mindfulness," were observed. "High mindfulness" was associated with the most adaptive psychological functioning and "very low mindfulness" with the least adaptive.
CONCLUSIONS:
In most people with recurrent depression, mindfulness skills are expressed evenly across different domains. However, in a small minority a meaningful and replicable uneven profile indicating nonjudgmental awareness is observable. Current findings require replication and future research should examine the extent to which profiles change from periods of wellness to illness in people with recurrent depression and how profiles are influenced by exposure to mindfulness-based intervention.
BACKGROUND:Extending previous research, we applied latent profile analysis in a sample of adults with a history of recurrent depression to identify subgroups with distinct response profiles on the Five Facet Mindfulness Questionnaire and understand how these relate to psychological functioning.
METHOD:
The sample was randomly divided into two subsamples to first examine the optimal number of latent profiles (test sample; n = 343) and then validate the identified solution (validation sample; n = 340).
RESULTS:
In both test and validation samples, a four-profile solution was revealed where two profiles mapped broadly onto those previously identified in nonclinical samples: "high mindfulness" and "nonjudgmentally aware." Two additional subgroups, "moderate mindfulness" and "very low mindfulness," were observed. "High mindfulness" was associated with the most adaptive psychological functioning and "very low mindfulness" with the least adaptive.
CONCLUSIONS:
In most people with recurrent depression, mindfulness skills are expressed evenly across different domains. However, in a small minority a meaningful and replicable uneven profile indicating nonjudgmental awareness is observable. Current findings require replication and future research should examine the extent to which profiles change from periods of wellness to illness in people with recurrent depression and how profiles are influenced by exposure to mindfulness-based intervention.
Harrington and Pickles (this issue) raise interesting and important questions about the nature of mindfulness and its relationships to scientific clinical psychology and cognitive behavioral theory and treatment. In this commentary, we address two primary questions. First, is mindfulness a meaningful concept within scientific clinical psychology or is it religious or mystical? Second, is mindfulness compatible with cognitive behavioral therapy? We argue that mindfulness can be conceptualized as a nonreligious construct suitable for scientific study and that it can be integrated with cognitive behavioral therapy in interesting and fruitful ways.
Interventions based on training in mindfulness skills are becoming increasingly popular. Mindfulness involves intentionally bringing one's attention to the internal and external experiences occurring in the present moment, and is often taught through a variety of meditation exercises. This review summarizes conceptual approaches to mind-fulness and empirical research on the utility of mindfulness-based interventions. Meta-analytic techniques were incorporated to facilitate quantification of findings and comparison across studies. Although the current empirical literature includes many methodological flaws, findings suggest that mindfulness-based interventions may be helpful in the treatment of several disorders. Methodologically sound investigations are recommended in order to clarify the utility of these interventions.
The symptoms of borderline personality disorder (BPD) have been characterized as deficits in mindfulness. Mindfulness can be defined as nonjudgmental, present-centered awareness. The present study investigates the theory that, consistent with this conceptualization, the extent to which acting with awareness predicts reduced BPD features and related dysfunction depends upon levels of nonjudgment. In a sample of 223 undergraduates, we calculated the interaction between awareness-based and nonjudging-based mindfulness skills using subscales of the Five Facet Mindfulness Questionnaire. Regression analyses demonstrated a significant effect of the interaction on several difficulties that are common in BPD: problems with relationships, emotion-related impulsivity, and anger rumination. For acting with awareness to benefit individuals with these difficulties, a less judgmental stance toward internal experiences may be necessary. These findings have significant treatment implications and demonstrate the importance of assessing mindfulness as a multifaceted, synergistic construct.
Although mindfulness meditation traditionally is viewed as a lifelong practice, much current knowledge about its effects is based on short-term practitioners who have participated in mindfulness-based treatment. In the current study, long-term meditators and demographi- cally similar nonmeditators completed self-report measures of constructs expected to be related to the practice of mindfulness meditation. Extent of meditation experience was cor- related in the expected directions with levels of mindfulness and with many other variables. Mean differences between meditators and nonmeditators were significant in most cases. Medi- ation analyses were consistent with the hypothesis that practicing meditation is associated with increased mindfulness in daily life, which is related to decreased rumination, decreased fear of emotion, and increased behavioral self-regulation. These mechanisms appear partially responsible for the relationships between mindfulness skills and psychological adjustment. Overall, the current study suggests that the long-term practice of mindfulness meditation may cultivate mindfulness skills and promote adaptive functioning.
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
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.
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
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
The purpose of this study was to investigate whether dispositional mindfulness (the tendency to be mindful in general daily life) accounts for variance in psychological symptoms and wellbeing after accounting for the influence of dispositional self-control (the tendency to be self-disciplined, reliable, hardworking, etc.). A large sample of undergraduate students (N=280) completed self-report measures of mindfulness, self control, psychological wellbeing, and general psychological distress (depression and anxiety, and stress). As expected, both mindfulness and self-control were positively correlated with wellbeing and negatively correlated with general distress. Mindfulness was found to account for significant variance in psychological wellbeing and general distress after accounting for self-control. In addition, mindfulness was a significant moderator of the relationship between self-control and psychological symptoms. Results show that although self-control predicts significant variance in psychological health, mindfulness predicts incremental variance, suggesting that a mindful approach to ongoing experience can contribute to mental health in persons who are highly self-disciplined and hardworking.
The authors examined the relationships between change-based and acceptance-based strategies for responding to negative internal experience (thoughts and emotions) and levels of psychological symptoms and well-being. A large sample of undergraduate students completed measures of their general frequency of experiencing negative affect and intrusive thoughts, their typical ways of responding when these experiences occur, and their levels of psychological symptoms and well-being. Correlational analyses showed that most of the identified ways of responding to negative internal experiences were significantly related to psychological symptoms and well-being, even after accounting for the general frequency of experiencing unwanted thoughts and emotions. Regression analyses suggested that change-based ways of responding add little or no incremental variance over acceptance-based strategies in accounting for lower symptom levels and greater well-being.
Self-compassion is natural, trainable and multi-faceted human capacity. To date there has been little research into the role of culture in influencing the conceptual structure of the underlying construct, the relative importance of different facets of self-compassion, nor its relationships to cultural values. This study employed a cross-cultural design, with 4,124 participants from 11 purposively sampled datasets drawn from different countries. We aimed to assess the relevance of positive and negative items when building the self-compassion construct, the convergence among the self-compassion components, and the possible influence of cultural values. Each dataset comprised undergraduate students who completed the "Self-Compassion Scale" (SCS). We used a confirmatory factor analysis (CFA) approach to the multitrait-multimethod (MTMM) model, separating the variability into self-compassion components (self-kindness, common humanity, mindfulness), method (positive and negative valence), and error (uniqueness). The normative scores of the Values Survey Module (VSM) in each country, according to the cultural dimensions of individualism, masculinity, power distance, long-term orientation, uncertainty avoidance, and indulgence, were considered. We used Spearman coefficients (rs) to assess the degree of association between the cultural values and the variance coming from the positive and negative items to explain self-compassion traits, as well as the variance shared among the self-compassion traits, after removing the method effects produced by the item valence. The CFA applied to the MTMM model provided acceptable fit in all the samples. Positive items made a greater contribution to capturing the traits comprising self-compassion when the long-term orientation cultural value was higher (rs = 0.62; p = 0.042). Negative items did not make significant contributions to building the construct when the individualism cultural value was higher, but moderate effects were found (rs = 0.40; p = 0.228). The level of common variance among the self-compassion trait factors was inversely related to the indulgence cultural value (rs = -0.65; p = 0.030). The extent to which the positive and negative items contribute to explain self-compassion, and that different self-compassion facets might be regarded as reflecting a broader construct, might differ across cultural backgrounds.
The empirical literature provides increasing support for the efficacy of mindfulness training in the treatment of numerous problems and disorders. However, fewer studies have examined the mechanisms through which these beneficial outcomes are obtained. This article summarizes recent research examining three primary questions related to the mechanisms underlying mindfulness-based treatments: do people who practice mindfulness learn to be more mindful of the experiences of daily life? Is an increased general tendency to be mindful related to reduced symptoms and increased well-being? If so, then what psychological processes account for the beneficial effects of increased mindfulness? Recent studies suggest that the practice of mindfulness develops the ability to observe and describe present-moment experiences nonjudgmentally and nonreactively and to participate with awareness in ongoing activity. Increased mindfulness, in turn, appears to mediate improvement in psychological functioning, probably by cultivating an adaptive form of self-focused attention that reduces rumination and emotional avoidance and improves behavioral self-regulation.
The authors examine the facet structure of mindfulness using five recently developed mindfulness questionnaires. Two large samples of undergraduate students completed mindfulness questionnaires and measures of other constructs. Psychometric properties of the mindfulness questionnaires were examined, including internal consistency and convergent and discriminant relationships with other variables. Factor analyses of the combined pool of items from the mindfulness questionnaires suggested that collectively they contain five clear, interpretable facets of mindfulness. Hierarchical confirmatory factor analyses suggested that at least four of the identified factors are components of an overall mindfulness construct and that the factor structure of mindfulness may vary with meditation experience. Mindfulness facets were shown to be differentially correlated in expected ways with several other constructs and to have incremental validity in the prediction of psychological symptoms. Findings suggest that conceptualizing mindfulness as a multifaceted construct is helpful in understanding its components and its relationships with other variables.
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