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This study used a qualitative approach to explore family physicians' beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians' attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician-patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones "own spiritual place." The residents' voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs dier from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed.

This paper examines mindfulness as a popular and paradigmatic alternative healing practice within the context of contemporary medicalization trends. In recognition of the increasingly influential role popular media play in shaping ideas about illness and healing, what follows is a discursive analysis of bestselling mindfulness meditation self-help books and audio recordings by Jon Kabat-Zinn. The central and contradictory elements of this do-it-yourself healing practice as presented in these materials are best understood as aligned with medicalization trends for three principal reasons. First, mindfulness represents a significant expansion in the definition of disease beyond that advanced by mainstream medicine. Second, its etiological model intensifies the need for therapeutic surveillance and intervention. Third, by defining healing as a never-ending process, it permanently locates individuals within a disease-therapy cycle. In sum, the definition, cause, and treatment of disease as articulated by popular mindfulness resources expands the terrain of experiences and problems that are mediated by medical concepts. The case of mindfulness is a potent illustration of the changing character of medicalization itself.
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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.

<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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The beneficial clinical effects of mindfulness practices are receiving increasing support from empirical studies. However, the functional neural mechanisms underlying these benefits have not been thoroughly investigated. Some authors suggest that mindfulness should be described as a ‘top–down’ emotion regulation strategy, while others suggest that mindfulness should be described as a ‘bottom–up’ emotion regulation strategy. Current discrepancies might derive from the many different descriptions and applications of mindfulness. The present review aims to discuss current descriptions of mindfulness and the relationship existing between mindfulness practice and most commonly investigated emotion regulation strategies. Recent results from functional neuro-imaging studies investigating mindfulness training within the context of emotion regulation are presented. We suggest that mindfulness training is associated with ‘top–down’ emotion regulation in short-term practitioners and with ‘bottom–up’ emotion regulation in long-term practitioners. Limitations of current evidence and suggestions for future research on this topic are discussed.

This pilot study tested the efficacy of a brief intervention using motivational interviewing (MI) plus mindfulness meditation (MM) to reduce marijuana use among young adult females. Thirty-four female marijuana users between the ages of 18 and 29 were randomized to either the intervention group (n = 22), consisting of two sessions of MI-MM, or an assessment-only control group (n = 12). The participants' marijuana use was assessed at baseline and at 1, 2, and 3 months posttreatment. Fixed-effects regression modeling was used to analyze treatment effects. Participants randomized to the intervention group were found to use marijuana on 6.15 (z = -2.42, p = .015), 7.81 (z = -2.78, p = .005), and 6.83 (z = -2.23, p = .026) fewer days at Months 1, 2, and 3, respectively, than controls. Findings from this pilot study provide preliminary evidence for the feasibility and effectiveness of a brief MI-MM for young adult female marijuana users.
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In 2 daily experience studies and a laboratory study, the authors test predictions from approach-avoidance motivational theory to understand how dating couples can maintain feelings of relationship satisfaction in their daily lives and over the course of time. Approach goals were associated with increased relationship satisfaction on a daily basis and over time, particularly when both partners were high in approach goals. Avoidance goals were associated with decreases in relationship satisfaction over time, and people were particularly dissatisfied when they were involved with a partner with high avoidance goals. People high in approach goals and their partners were rated as relatively more satisfied and responsive to a partner's needs by outside observers in the lab, whereas people with high avoidance goals and their partners were rated as less satisfied and responsive. Positive emotions mediated the link between approach goals and daily satisfaction in both studies, and responsiveness to the partner's needs was an additional behavioral mechanism in Study 2. Implications of these findings for approach-avoidance motivational theory and for the maintenance of satisfying relationships over time are discussed.
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After years of meditating, are you still saddled with many of the same personal conflicts and interpersonal inhibitions that plagued you before you began? Rubin explores the hidden flaws in the meditative method itself. He explores Buddhism's ambivalent relationship to emotional life, and the negative consequences of "letting go" of experience. Detaching from experience may result in renouncing vital aspects of ourselves, such as constructive passion. The author argues that real meditation is transformative not tranquilizing, fostering a dynamic way of living.

Most research on the impact of mind-body training does not ask about participants' baseline experience, expectations, or preferences for training. To better plan participant-centered mind-body intervention trials for nurses to reduce occupational stress, such descriptive information would be valuable.

The aim of this article is to investigate how a contemplative orientation to teaching may facilitate wholeness for teachers and students through a portrait of Diana, a kindergarten teacher working in a contemplative elementary school. The portrait, one of three portraits from a larger study, illustrates three central features of contemplative teaching: compassion, integrity, and mindful awareness. These three central features develop internally within individual teachers and are animated and influenced externally through their role as teachers. The context of their teaching, relationships with students, parents, and colleagues, and pedagogical choices, in turn influence the three central features. The emphasis on wholeness, unity, and integration of a contemplative orientation to teaching moves us toward a view of teachers and students as beings with not only minds and heads but also hearts and bodies. Contemplative teaching offers educational communities a path toward transformational, holistic, and integrative learning and teaching.

The effectiveness of meditation as a tool to recover from stress has already been widely established. However, less is known about the potential psychological mediating and moderating mechanisms affecting its effectiveness. The present study aimed to advance insight in this respect by examining the mediating role of the recovery experiences "relaxation", "mastery", and "detachment", and by studying the moderating role of intrinsic motivation. To this purpose, after completion of a stress-inducing speech preparation task, 100 participants were randomly assigned to either a 15-minute guided imagery meditation exercise or to a 15-minute radio interview on meditation. Subjectively experienced stress and serenity were included as measures of (recovery from) stress. These measures were completed after the speech preparation task and after the meditation exercise/radio interview. Results showed that participants who meditated reported a larger increase in serenity and decrease in subjectively experienced stress than those who listened to the radio fragment. Furthermore, it turned out that this superior effect of meditation could be partly explained by the mediating effects of "relaxation" and "mastery" (but not "detachment"). The recovery effects of meditation were also stronger for participants who were highly intrinsically motivated for this activity. Altogether, results of this study provide insight into the underlying mediating and moderating mechanisms that explain the effectiveness of meditation as a recovery activity.
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The theme of this edition of the "Journal of Experimental Education" is "new perspectives" on motivation. As understood in this article, new perspectives means synthesis and new understanding of old ideas about motivation rather than outright abandonment of accepted thinking. This article has both a theoretical and an empirical objective: First, and theoretically, a new conceptual model of self-regulation, reflective intentionality, in which motivation to act is based heavily on one's conception of self and on higher order processes--specifically reflective self-awareness, emotion, and volition--is described. Second, findings are presented from a study that represents the seminal stages of a program of research to validate the proposed model. The findings tentatively suggest the value of a process-content view of motivation. According to this view, motivation can be understood as being a self-determining process emanating out of the ongoing self-regulatory interaction among self as process (i.e., levels of consciousness, emotion, and volition), the self as content (i.e., self-conception), and the environment. When this ongoing self-regulatory interaction involves higher order consciousness, one's motivation is reflectively intentional.

<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>

Depression has been associated with dysfunctional executive functions and abnormal activity within the anterior cingulate cortex (ACC), a region critically involved in action regulation. Prior research invites the possibility that executive deficits in depression may arise from abnormal responses to negative feedback or errors, but the underlying neural substrates remain unknown. We hypothesized that abnormal reactions to error would be associated with dysfunctional rostral ACC activity, a region previously implicated in error detection and evaluation of the emotional significance of events. To test this hypothesis, subjects with low and high Beck Depression Inventory (BDI) scores performed an Eriksen Flanker task. To assess whether tonic activity within the rostral ACC predicted post-error adjustments, 128-channel resting EEG data were collected before the task and analyzed with low-resolution electromagnetic tomography (LORETA) using a region-of-interest approach. High BDI subjects were uniquely characterized by significantly lower accuracy after incorrect than correct trials. Mirroring the behavioral findings, high BDI subjects had significantly reduced pretask gamma (36.5-44 Hz) current density within the affective (rostral; BA24, BA25, BA32) but not cognitive (dorsal; BA24', BA32') ACC subdivision. For low, but not high, BDI subjects pretask gamma within the affective ACC subdivision predicted post-error adjustments even after controlling for activity within the cognitive ACC subdivision. Abnormal responses to errors may thus arise due to lower activity within regions subserving affective and/or motivational responses to salient cues. Because rostral ACC regions have been implicated in treatment response in depression, our findings provide initial insight into putative mechanisms fostering treatment response.
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Emotions seem to play a critical role in moral judgment. However, the way in which emotions exert their influence on moral judgments is still poorly understood. This study proposes a novel theoretical approach suggesting that emotions influence moral judgments based on their motivational dimension. We tested the effects of two types of induced emotions with equal valence but with different motivational implications (anger and disgust), and four types of moral scenarios (disgust-related, impersonal, personal, and beliefs) on moral judgments. We hypothesized and found that approach motivation associated with anger would make moral judgments more permissible, while disgust, associated with withdrawal motivation, would make them less permissible. Moreover, these effects varied as a function of the type of scenario: the induced emotions only affected moral judgments concerning impersonal and personal scenarios, while we observed no effects for the other scenarios. These findings suggest that emotions can play an important role in moral judgment, but that their specific effects depend upon the type of emotion induced. Furthermore, induced emotion effects were more prevalent for moral decisions in personal and impersonal scenarios, possibly because these require the performance of an action rather than making an abstract judgment. We conclude that the effects of induced emotions on moral judgments can be predicted by taking their motivational dimension into account. This finding has important implications for moral psychology, as it points toward a previously overlooked mechanism linking emotions to moral judgments.
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<p>Human beings can be proactive and engaged or, alternatively, passive and alienated, largely as a function of the social conditions in which they develop and function. Accordingly, research guided by self-determination theory has focused on the social–contextual conditions that facilitate versus forestall the natural processes of self-motivation and healthy psychological development. Specifically, factors have been examined that enhance versus undermine intrinsic motivation, self-regulation, and well-being. The findings have led to the postulate of three innate psychological needs—competence, autonomy, and relatedness—which when satisfied yield enhanced self-motivation and mental health and when thwarted lead to diminished motivation and well-being. Also considered is the significance of these psychological needs and processes within domains such as health care, education, work, sport, religion, and psychotherapy.</p>

<p>Previous research has reported that individuals high in the need for Power, high in inhibition, and high in power stress (the HHH group) are more likely than other individuals to report more severe illnesses. The present study investigates the possibility that the mechanism underlying this relationship is greater sympathetic activation in the HHH group which has an immunosuppressive effect. College males with the HHH syndrome reported more frequent and more severe illnesses than other individuals, as in previous studies. More of the HHH than other subjects also showed above average epinephrine excretion rates in urine and below average concentrations of immunoglobulin A in saliva (S-IgA). Furthermore, higher rates of epinephrine excretion were significantly associated with lower S-IgA concentrations, and lower S-IgA concentrations were significantly associated with reports of more frequent illnesses. The findings are interpreted as consistent with the hypothesis that a strong need for Power, if it is inhibited and stressed, leads to chronic sympathetic overactivity which has an immunosuppressive effect making individuals characterized by this syndrome more susceptible to illness.</p>
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Laughter facilitates the adaptive response to stress by increasing the psychological distance from distress and by enhancing social relations. To test these hypotheses, the authors related measures of bereaved adults' laughter and smiling 6 months postloss to measures of their (a) subjective emotion and dissociation from distress, (b) social relations, and (c) responses they evoked in others. Duchenne laughter, which involves orbicularis oculi muscle action, related to self-reports of reduced anger and increased enjoyment, the dissociation of distress, better social relations, and positive responses from strangers, whereas non-Duchenne laughter did not. Lending credence to speculations in the ethological literature, Duchenne laughter correlated with different intrapersonal and interpersonal responses than Duchenne smiles. Discussion focuses on the relevance of these findings to theories of positive emotion.
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A humanistic and transpersonal approach to personal growth necessitates careful inquiry into the often pathological world of egoistic functioning—where the psyche is engaged in a continual, defensive, and ruminative effort to assert the uniqueness, power, and positivity of an independent symbolic self. This article describes narrative research, conducted at the beginning of several undergraduate courses in personality theory, in which students (n = 229) were encouraged to introspect into the process of objectifying and evaluating the self. After undergoing brief mindfulness training, individuals spent 1 week journaling about salient upward and downward social comparisons, with particular attention to those experiences that triggered strong feelings of inferiority and superiority. Prototypic journal passages are quoted to illustrate central findings. Participants expressed a remarkably intense array of self-evaluative episodes, particularly along the dimensions of physical appearance and intellect. Discussion focuses on the very high frequency of social comparisons reported, the cyclical nature of self-evaluation and its implications for persistent suffering, and the spontaneous experiences of insight into ego transcendence and deeper levels of self-awareness. This work advances the humanistic project by detailing a novel mechanism for facilitating self-realization in an educational context.

Reputation systems promote cooperation and deter antisocial behavior in groups. Little is known, however, about how and why people share reputational information. Here, we seek to establish the existence and dynamics of prosocial gossip, the sharing of negative evaluative information about a target in a way that protects others from antisocial or exploitative behavior. We present a model of prosocial gossip and the results of 4 studies testing the model's claims. Results of Studies 1 through 3 demonstrate that (a) individuals who observe an antisocial act experience negative affect and are compelled to share information about the antisocial actor with a potentially vulnerable person, (b) sharing such information reduces negative affect created by observing the antisocial behavior, and (c) individuals possessing more prosocial orientations are the most motivated to engage in such gossip, even at a personal cost, and exhibit the greatest reduction in negative affect as a result. Study 4 demonstrates that prosocial gossip can effectively deter selfishness and promote cooperation. Taken together these results highlight the roles of prosocial motivations and negative affective reactions to injustice in maintaining reputational information sharing in groups. We conclude by discussing implications for reputational theories of the maintenance of cooperation in human groups.
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