Exploring the Effects of the Mindfulness and Countering Emotional Behaviors Modules From the Unified Protocol on Dysregulated Anger in the Context of Emotional Disorders

Dysregulated anger in the context of emotional (e.g., mood, anxiety, related) disorders is associated with treatment attrition and a lower likelihood of responding to extant treatments. Therefore, there is a need to identify the most effective skills for targeting this anger and prioritize their delivery in treatment with the hope of producing more potent interventions. The current study explored the specific effects of two treatment skills (mindfulness and countering emotional behaviors) in isolation and combination as interventions for dysregulated anger using single-case experimental design. Patients were randomized to a 2- or 4-week baseline with no intervention applied and then to the first treatment skill received. All patients subsequently completed the alternate treatment skill and 1 month of follow-up. Results suggested the first module had clinically meaningful effects for five patients and the second module produced incremental improvement for five patients. Visual inspection and effect sizes indicated mindfulness produced greater reductions in anger when delivered in isolation compared to countering emotional behaviors (d = 0.96, 0.33, for mindfulness and countering emotional behaviors, respectively). With regard to the second module, more patients (n = 4) experienced a reduction in anger in response to mindfulness than to countering emotional behaviors (n = 1); effect sizes indicated significant improvements in response to both modules (d = 0.83, 0.72, for mindfulness and countering emotional behaviors, respectively). Taken together, results suggest mindfulness may be a more efficacious intervention for anger than countering emotional behaviors. Implications of these results for addressing dysregulated anger in treatment are discussed.     

Trait Mindfulness Predicts Efficient Top‐Down Attention to and Discrimination of Facial Expressions

In social situations, skillful regulation of emotion and behavior depends on efficiently discerning others' emotions. Identifying factors that promote timely and accurate discernment of facial expressions can therefore advance understanding of social emotion regulation and behavior. The present research examined whether trait mindfulness predicts neural and behavioral markers of early top‐down attention to, and efficient discrimination of, socioemotional stimuli. Attention‐based event‐related potentials (ERPs) and behavioral responses were recorded while participants (N = 62; White; 67% female; M_age = 19.09 years, SD = 2.14 years) completed an emotional go/no‐go task involving happy, neutral, and fearful facial expressions. Mindfulness predicted larger (more negative) N100 and N200 ERP amplitudes to both go and no‐go stimuli. Mindfulness also predicted faster response time that was not attributable to a speed‐accuracy trade‐off. Significant relations held after accounting for attentional control or social anxiety. This study adds neurophysiological support for foundational accounts that mindfulness entails moment‐to‐moment attention with lower tendencies toward habitual patterns of responding. Mindfulness may enhance the quality of social behavior in socioemotional contexts by promoting efficient top‐down attention to and discrimination of others' emotions, alongside greater monitoring and inhibition of automatic response tendencies.     

Dispositional mindfulness and perceived stress: The role of emotional intelligence

The present study examined the relationships between dispositional mindfulness, emotional intelligence and perceived stress using self-report measures. We administered the Mindful Attention Awareness Scale (MAAS), the Wong Law Emotional Intelligence Scale (WLEIS), and the Perceive Stress Scale (PPS) to a non-clinical sample of Chinese adults (n = 380). The results showed that mindfulness was positively associated with four components of WLEIS, and negatively associated with perceived stress. Mediation analysis indicated that only the regulation and use of emotion components of WLEIS acted as mediators of the association between mindfulness and perceived stress. Effect contrasts showed no significant difference between the specific indirect effects through these two mediators. Implications and suggestions for future research are discussed.     

Mindfulness, body image, and drive for muscularity in men

Studies have shown that dispositional mindfulness, a construct characterized by awareness and attention to present moment experiences, is associated with body image constructs in women. However, little is known about the relationship between dispositional mindfulness and body image among men. Therefore, this study examined the unique associations between dispositional mindfulness and three body image variables in men: overall appearance evaluation, satisfaction with distinct body areas, and drive for muscularity. Undergraduate men (N=296) completed the Multidimensional Body Self-Relations Questionnaire-Appearance Scales, the Drive for Muscularity Scale, the Mindful Attention Awareness Scale, and the Positive and Negative Affect Schedule. A series of hierarchical regression analyses revealed that mindfulness was uniquely associated with all three body image variables after accounting for body mass index and negative affect. Results are discussed with regard to the potential role of dispositional mindfulness in body dissatisfaction among men.     

The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity

Poor distress tolerance (DT) is considered an underlying facet of anxiety, depression, and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance or nonjudgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the nonjudge and nonreact facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.     

Pilot Mindfulness Intervention for Children Born with Esophageal Atresia and Their Parents

A pilot mindfulness home intervention was conducted for 6 weeks among 8–12-year-old children born with esophageal atresia and their parents. Participants were randomly assigned to a waiting list control (WLC) group (n?=?8) and an experimental group (n?=?12). When all participants had completed the mindfulness-based program, data were pooled and treated for the entire sample (n?=?19). Self-assessment measures included the Mindful Attention Awareness Scale for Adolescents (MAAS-A), the Child and Adolescent Mindfulness Measure (CAMM), the modified Spielberger State-Trait Anxiety Inventory—Child (STAI-C), the Children’s Depression Inventory (CDI), and the Cognitive Emotion Regulation Questionnaire Kids version (CERQ-k). Parental assessment measures included the modified STAI-C. The results underlined the program’s feasibility and acceptability. Clinical effects of the mindfulness-based program were observed. Self-assessed data for children who had practiced mindfulness compared to the WLC group showed increased mindfulness and decreased depression. Reduced anxiety was found in all groups. Positive affect tended to improve from pre-test to post-test in children who had practiced mindfulness compared to the WLC group. Parental assessments showed significant improvement in positive affect and decreases in anxiety and negative affect in the intervention group compared to the WLC group. Cognitive emotion regulation strategies were also affected by the mindfulness-based program. Rumination scores significantly decreased from pre-test to post-test in the intervention group. This preliminary study suggests that regular mindfulness practice presents a promising approach to reducing the burden of this neonatal malformation.     

Mindfulness and Eating Disorders: A Network Analysis

Higher trait mindfulness may be protective against eating disorder (ED) pathology. However, little is understood about which specific mindfulness processes connect to specific ED symptoms. This study (N = 1,056 undergraduates) used network analysis at the symptom/process level to identify: (1) central nodes, or symptoms/processes with the greatest collective connection with all other symptoms/processes; and (2) bridge nodes, or symptoms/processes driving interconnection between mindfulness processes and ED symptoms. We conducted analyses both with and without food- and body-related mindfulness items. Central nodes included: describing how one feels in detail, expressing how one feels in words, and feeling guilty about eating due to shape/weight. Bridge nodes connecting higher mindfulness processes with lower ED symptoms included: the eating disorder symptom, being uncomfortable about others seeing one eat, and the mindfulness process, not criticizing oneself for having irrational/inappropriate emotions. Bridge nodes connecting higher mindfulness processes with higher ED symptoms included: noticing sensations of the body moving when walking and noticing how food/drinks affect thoughts, bodily sensations, and emotions. Findings suggest that future research should explore whether mindfulness-based interventions for EDs may be more effective by targeting mindfulness processes related to describing, expressing, and accepting emotions, accepting discomfort when eating with others, and reducing hyper-focus on and reactivity to food-and-body related sensations.     

Mindfulness-based psychotherapy in patients with obsessive-compulsive disorder: A meta-analytical Study

Background/ObjectiveObsessive compulsive disorder is a disorder of special relevance in mental health, however, not all patients respond adequately to traditional intervention systems. The present work aims to study the usefulness of mindfulness-based interventions in patients with obsessive compulsive disorder.MethodAn exhaustive search of the literature between 1996 and 2021 allowed us to locate 11 published articles. The effect size was the pretest-posttest standardized mean change calculated for obsession-compulsion, as well as depression symptoms and conscious coping.Resultshe results showed mean effect sizes for mindfulness in the reduction of obsessive-compulsive symptoms (d + = 0.648) and, to a lesser extent, depression (d + = 0.417) and the improvement in Mindfull coping (d + = 0.509). There was no significant decrease in effect size when mindfulness was applied in patients with residual symptoms from previous treatments.ConclusionsThese results are promising regarding the usefulness of the application of intervention programs based on mindfulness in people with obsessive compulsive disorder, both as an alternative option and as a complementary treatment to more traditional intervention formats.     

From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness

Theory suggests that heightening state mindfulness in meditation practice over time increases trait mindfulness, which benefits psychological health. We prospectively examined individual trajectories of state mindfulness in meditation during a mindfulness-based intervention in relation to changes in trait mindfulness and psychological distress. Each week during the eight-week intervention, participants reported their state mindfulness in meditation after a brief mindfulness meditation. Participants also completed pre- and post-intervention measures of trait mindfulness and psychological symptoms. Tests of combined latent growth and path models suggested that individuals varied significantly in their rates of change in state mindfulness in meditation during the intervention, and that these individual trajectories predicted pre-post intervention changes in trait mindfulness and distress. These findings support that increasing state mindfulness over repeated meditation sessions may contribute to a more mindful and less distressed disposition. However, individuals’ trajectories of change may vary and warrant further investigation.     

Sitting with it: An investigation of the relationship between trait mindfulness and sustained attention

BackgroundSustaining attention for extended periods of time is associated with negative affect and this increase in negative affect is related to poorer task performance. Trait mindfulness has been shown to be associated with better sustained attention performance. This may be because trait mindfulness is associated with better attention ability or better emotion regulation ability.AimsThe present research aims to replicate previous findings and better understand why trait mindfulness is associated with better sustained attention performance.MethodParticipants responded to self-report questionnaires assessing their trait mindfulness, attentional control, and experiential avoidance. Next, participants performed a sustained attention task, during which they also reported their subjective feelings of discomfort and boredom. Finally, participants reported their retrospective discomfort and boredom after the task.ResultsWe replicated and extended previous findings by showing that the relationship between trait mindfulness and sustained attention performance was mediated by negative affect experienced during the task. Moreover, the correlation between trait mindfulness and sustained attention disappeared when controlling for experiential avoidance, but remined when controlling for attention control.ConclusionOur results suggest that trait mindfulness is associated with sustained attention because of enhanced emotion regulation and that enhancing affective regulation would be an effective strategy for improving sustained attention performance.     

Mindfulness and Emotion Regulation Difficulties in Generalized Anxiety Disorder: Preliminary Evidence for Independent and Overlapping Contributions

Diminished levels of mindfulness (awareness and acceptance/nonjudgment) and difficulties in emotion regulation have both been proposed to play a role in symptoms of generalized anxiety disorder (GAD); the current studies investigated these relationships in nonclinical and clinical samples. In the first study, among a sample of 395 individuals at an urban commuter campus, self-reports of both emotion regulation difficulties and aspects of mindfulness accounted for unique variance in GAD symptom severity, above and beyond variance shared with depressive and anxious symptoms, as well as variance shared with one another. In the second study, individuals with GAD (n = 16) reported significantly lower levels of mindfulness and significantly higher levels of difficulties in emotion regulation than individuals in a nonanxious control group (n = 16). Results are discussed in terms of directions for future research and potential implications for treatment development.     

Laboratory stressors in clinically anxious and non-anxious individuals: The moderating role of mindfulness

Objective

Mindfulness forms the basis for multiple clinical interventions and has been induced in laboratory settings. However, few studies have examined the effects of dispositional or trait mindfulness. The purpose of this study was to investigate the relationship of trait mindfulness to laboratory stressor responding across fear-based anxiety disorder and non-anxious samples. We hypothesized that trait mindfulness would be associated with diminished stressor responding above and beyond the contribution of anxiety and depression-related variables, and to a greater extent in high anxiety than low anxiety individuals.

Methods

90 participants, including 46 with anxiety disorders and 44 non-anxious controls, were assessed on hyperventilation and relaxation stressors. The relationship of trait mindfulness to stressor-related anxiety, negative affect, and duration was investigated in a hierarchical multiple regression model.

Results

Trait mindfulness predicted stressor responding in over 80% of measured outcomes, and predicted to a greater extent among high anxiety individuals in 50% of outcomes.

Conclusions

Trait mindfulness was associated with diminished responses to laboratory stressors in clinically anxious and non-anxious samples. Implications for emotion regulation and clinical interventions are discussed.     

The Effectiveness of Mindfulness Training on Behavioral Problems and Attentional Functioning in Adolescents with ADHD

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.     

Cognition and Emotion,Volume 24, 2010, List of Contents

Effective emotion regulation is important for high-quality social functioning. Recent laboratory-based evidence suggests that mindfulness may enhance emotion regulation in socioemotional contexts; however, little is known about mindful emotion regulation during in vivo social interactions. In a study of romantic couples, we assessed each partner's mindfulness and top-down attentional efficiency (with an Emotional Go/No-Go task) prior to sampling emotions and perceived connection with others during day-to-day social interactions. Analyses revealed that mindfulness-related differences in top-down attentional efficiency on the Emotional Go/No-Go predicted positive emotion during daily social interactions. In turn, positive emotion and two additional indices of social emotion regulation each mediated the relation between actor mindfulness and perceived social connection. In corresponding analyses, neither trait reappraisal nor suppression use predicted the outcomes, and all mindfulness relations held controlling for these strategies. Findings support a framework for investigating mindfulness and higher-quality social functioning, for which mindful emotion regulation may be key.     

Why do they do it? Differences in high-intensity exercise-affect between those with higher and lower intensity preference and tolerance

Evidence suggests high-intensity exercise results in a more negative affective response when compared to moderate- or low-intensity exercise. However, a large number of individuals continue participating in high-intensity exercise, in spite of these supposed declines in affective state.PurposeDetermine whether trait differences influence variability in exercise-affect for those with higher versus lower exercise intensity preference and/or tolerance, and determine the mediating relationship between traits, exercise behavior, and affective states.MethodsUndergraduates (N = 245, 20.3 ± 1.7 yrs, BMI = 23.7 ± 3.8, 60.8% female, 82% regular exercisers) completed the Preference for and Tolerance of the Intensity of Exercise Questionnaire. They then completed a 15-min high-intensity body-weight circuit (HIC), a walk, and a reading condition, where valence (via Feeling Scale), perceived physiological activation (via Felt Arousal Scale), and ratings of perceived exertion were taken prior to, every 3-min during, and 20-min post (P20) condition, while activity enjoyment was assessed immediately post.ResultsMultivariate ANOVAs revealed significant differences (p_s < 0.05) in valence between those with high versus low intensity preferences during HIC at minutes 3 (d = 0.615), 6 (d = 0.772), 9 (d = 0.659), 12 (d = 0.625), 15 (d = 0.632), and at P20 (d = 0.554), and for enjoyment following HIC (d = 0.545), but not for walking or reading conditions.ConclusionsThese findings suggest the intensity-preference trait influences how an individual feels during high-intensity exercise, but has less influence on affect during moderate/lower intensity activities. These differences may be predictive of whether an individual will continue high-intensity exercise programming.     

Psychometric assessment of the Mindful Attention Awareness Scale (MAAS) among Chinese adolescents

The Mindful Attention Awareness Scale (MAAS) has the longest empirical track record as a valid measure of trait mindfulness. Most of what is understood about trait mindfulness comes from administering the MAAS to relatively homogenous samples of Caucasian adults. This study rigorously evaluates the psychometric properties of the MAAS among Chinese adolescents attending high school in Chengdu, China. Classrooms from 24 schools were randomly selected to participate in the study. Three waves of longitudinal data (N = 5,287 students) were analyzed. MAAS construct, nomological, and incremental validity were evaluated as well as its measurement invariance across gender using latent factor analyses. Participants' mean age was 16.2 years (SD = 0.7), and 51% were male. The 15-item MAAS had adequate fit to the one-dimensional factor structure at Wave 1, and this factor structure was replicated at Wave 2. A 6-item short scale of the MAAS fit well to the data at Wave 3. The MAAS maintained reliability (Cronbach's α = .89-.93; test-restest r = .35-.52), convergent/discriminant validity, and explained additional variance in mental health measures beyond other psychosocial constructs. Both the 15- and 6-item MAAS scales displayed at least partial factorial invariance across gender. The findings suggest that the MAAS is a sound measure of trait mindfulness among Chinese adolescents. To reduce respondent burden, the MAAS 6-item short-scale provides an option to measure trait mindfulness.     

Mindfulness and psychological well-being among black South African university students and their relatives

This study investigated the relationship between mindfulness and psychological well-being in a convenience sample of black South African students (n = 203) and their parents and other relatives (n = 204) (66.1% = female; age range 18–73). The students self-reported on their mindfulness on the Mindful Attention Awareness Scale and psychological well-being on the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, Adult Trait Hope Scale and the Meaning in Life Questionnaire. A multivariate regression model was specified and analysed via structural equation modelling in Mplus 7.3. Results revealed that mindfulness scores strongly predicted elevated levels of meaning and positive affect, and lowered levels of negative effect, and were moderately strong predictors of life satisfaction and hope. The findings imply that mindfulness likely plays an important role in relation to the psychological well-being of cross-generational African culture community members.     

Facets of mindfulness mediate behavioral inhibition systems and emotion dysregulation

Behavioral motivation is regulated through the behavioral inhibition system (BIS) and the behavioral approach system (BAS), which underlie responses to emotional stimuli and are thought to influence emotion dysregulation. Research shows that mindfulness may increase the efficacy of emotion regulation among those with psychological symptoms, but the relationships between behavioral motivation and mindfulness have been only minimally explored. This study examines relationships between behavioral motivation systems and emotion dysregulation as mediated by mindfulness facets. Mediation was tested in a sample of 246 college students (M_age = 19.28, 61.8% female, 81.3% Caucasian) using a multiple mediator bootstrapping method. Results revealed an indirect relationship between BIS sensitivity and increased emotion dysregulation through underutilization of three distinct mindfulness skills: act with awareness, non-judging, and non-reactivity. Mindfulness facets did not mediate relationships between BAS sensitivity and emotion dysregulation, though BAS Reward Responsiveness directly predicted increased emotion dysregulation while BAS Drive was marginally associated with decreased emotion dysregulation. Findings delineate specific relationships between BIS/BAS, mindfulness skills, and emotion dysregulation while suggesting mindfulness training may be useful for BIS sensitive individuals.     

Changes in Problematic Anger,Shame, and Disgust in Anxious and Depressed Adults Undergoing Treatment for Emotion Dysregulation

Emotion dysregulation, the pervasive difficulty managing negative emotions, is a core problem across mood and anxiety disorders. Anger, shame, and disgust are particularly problematic emotions, impacting both disorder severity and treatment outcome. We previously found that a 16-week dialectical behavior therapy skills training group (DBT-ST) was superior to an activities-based support group (ASG) in decreasing emotion dysregulation in 44 adults with high emotion dysregulation who met diagnostic criteria for an anxiety or depressive disorder. We presently examine these participants’ changes in anger, shame, disgust, and distress using self-reports collected over 6 months during and after treatment. Hierarchical linear modeling analyses show that DBT-ST was superior to ASG in decreasing anger suppression (d = 0.93) and distress (d = 1.04). Both conditions significantly reduced shame, disgust propensity, and disgust sensitivity, but neither was superior for these outcomes. The treatments did not significantly reduce anger expression. Mediation analyses suggest that condition indirectly influenced 4-month anger suppression, shame, and distress through its effect on 2-month emotion dysregulation. These findings suggest that DBT-ST is efficacious for certain problematic emotions and distress in depressed and anxious adults and that common factors may account for some, but not all, of its benefits.