Using Mindfulness- and Acceptance-Based Treatments With Clients From Nondominant Cultural and/or Marginalized Backgrounds: Clinical Considerations,Meta-Analysis Findings,and Introduction to the Special Series: Clinical Considerations in using Acceptance- and Mindfulness-based Treatments With Diverse Populations

A growing body of research suggests that mindfulness- and acceptance-based principles can increase efforts aimed at reducing human suffering and increasing quality of life. A critical step in the development and evaluation of these new approaches to treatment is to determine the acceptability and efficacy of these treatments for clients from nondominant cultural and/or marginalized backgrounds. This special series brings together the wisdom of clinicians and researchers who are currently engaged in clinical practice and treatment research with populations who are historically underrepresented in the treatment literature. As an introduction to the series, this paper presents a theoretical background and research context for the papers in the series, highlights the elements of mindfulness- and acceptance-based treatments that may be congruent with culturally responsive treatment, and briefly outlines the general principles of cultural competence and responsive treatment. Additionally, the results of a meta-analysis of mindfulness- and acceptance-based treatments with clients from nondominant cultural and/or marginalized backgrounds are presented. Our search yielded 32 studies totaling 2,198 clients. Results suggest small (Hedges' g = .38, 95% CI = .11 – .64) to large (Hedges' g = 1.32, 95% CI = .61 – 2.02) effect sizes for mindfulness- and acceptance-based treatments, which varied by study design.     

CD4 Count and Physical Symptoms Among Urban African American Mothers with HIV: An Examination of the Role of Optimism and Depressive Symptoms

The current study examined the link between immune functioning (CD4 count) and physical symptoms, as well as the moderating role of optimism and depressive symptoms, in a sample of 99 low income, inner city African American women with HIV. Although there was no main effect of CD4 count on physical symptoms, depressive symptoms moderated the association between CD4 count and physical symptoms. More compromised immune functioning (lower CD4 count) was associated with more physical symptoms under conditions of higher levels of depressive symptoms, but not lower levels of depressive symptoms. This finding was observed using both a self-report measure and a clinician-rating of women’s depressive symptoms. There were no main or interactive effects for optimism. Clinical implications and future research directions are presented.     

Emotional content of true and false memories

Many people believe that emotional memories (including those that arise in therapy) are particularly likely to represent true events because of their emotional content. But is emotional content a reliable indicator of memory accuracy? The current research assessed the emotional content of participants' pre-existing (true) and manipulated (false) memories for childhood events. False memories for one of three emotional childhood events were planted using a suggestive manipulation and then compared, along several subjective dimensions, with other participants' true memories. On most emotional dimensions (e.g., how emotional was this event for you?), true and false memories were indistinguishable. On a few measures (e.g., intensity of feelings at the time of the event), true memories were more emotional than false memories in the aggregate, yet true and false memories were equally likely to be rated as uniformly emotional. These results suggest that even substantial emotional content may not reliably indicate memory accuracy.     

The persistence of false beliefs

Do false beliefs last? To explore this question, this study planted false beliefs or memories of a childhood experience with asparagus. We found that these false beliefs had consequences for subjects, when assessed directly after the suggestive manipulation. Moreover, subjects were brought back two weeks later to see if their false beliefs persisted. After two weeks, subjects' confidence in their new memories, and the consequences of those memories were diminished, but not extinguished. These false beliefs were found to be somewhat weaker than other subjects' true beliefs for the same events. Another novel finding was that the manipulation was sufficiently powerful to affect actual food choices.     

Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a Pure depression group, an Internalizing group (depression and co-occurring internalizing disorders), or an Externalizing group (depression and co-occurring externalizing disorders). Item response theory (IRT) and differential item functioning (DIF) were used to assess whether the depressed adolescents from the different comorbidity groups presented with different depressive symptoms. Results indicated that the comorbidity groups were meaningfully distinct in terms of psychosocial correlates as well as showed differences in depressive symptom profiles as informed by DIF analyses. In particular, the comorbidity groups differed in terms of presentation of psychomotor changes and cognitive impairments. Implications for assessment are discussed.

The Red Herring technique: a methodological response to the problem of demand characteristics

In past research, we planted false memories for food related childhood events using a simple false feedback procedure. Some critics have worried that our findings may be due to demand characteristics. In the present studies, we developed a novel procedure designed to reduce the influence of demand characteristics by providing an alternate magnet for subjects' natural suspicions. We used two separate levels of deception. In addition to giving subjects a typical untrue rationale for the study (i.e., normal deceptive cover story), we built in strong indicators (the "Red Herring") that the study actually had another purpose. Later, we told subjects that we had deceived them, and asked what they believed the "real purpose" of the study was. We also interviewed a subset of subjects in depth in order to analyze their subjective experiences of the procedure and any relevant demand. Our Red Herring successfully tricked subjects, and left little worry that our false memory results were due to demand. This "double cross" technique may have widespread uses in psychological research that hopes to conceal its real hypotheses from experimental subjects.     

Thematically‐induced arousal in naturally‐occurring emotional memories

A number of studies have examined participants' recollection of previously‐experienced emotional events. In these studies, emotion has generally been evoked by means of a specific attention‐grabbing visual stimulus (the sight of a bloody face or a weapon, views of surgery, and the like). We argue, however, that emotion outside of the laboratory is typically induced not by a particular visual stimulus, but by involvement and empathy with an unfolding event. We refer to this as ‘thematically‐induced arousal,’ as opposed to the ‘visually‐induced’ reactions involved in previous studies. In the present paper, we discuss the potential importance of this distinction, and report two studies that analysed sets of memories for emotional events that occurred outside the laboratory. The data make it clear that naturally‐occurring emotional events tend to be thematically‐arousing, not visually‐arousing, and provide an initial characterization of how these two types of arousal might shape memory. We discuss the implications of this finding, but we also emphasize the need for further data in this largely‐unexplored domain. Copyright © 2003 John Wiley & Sons, Ltd.