Facing the dreaded: does mindfulness facilitate coping with distressing experiences? A moderator analysis

Increasing evidence shows that mindfulness is positively related to mental health; however, the nature of this relationship is not fully understood. The current study used structural equation modeling to investigate the hypothesis that mindfulness moderates the association between the occurrence of unavoidable distressing experiences (UDE) and mental health. Participants from a community sample (N = 376) completed the Freiburg Mindfulness Inventory, the Positive and Negative Affect Scale, the Brief Symptom Inventory, the Inventory of Approach and Avoidance Motivation, and the Incongruence Scale. Results indicated that mindfulness moderated the association between unavoidable distressing events and psychopathological symptoms/negative affect. Thus, mindfulness may contribute to enhance the ability to cope with UDE and thus mitigate the detrimental effects of these experiences on mental health.

The assessment of mindfulness with self-report measures: existing scales and open issues

During recent years, mindfulness-based approaches have been gaining relevance for treatment in clinical populations. Correspondingly, the empirical study of mindfulness has steadily grown; thus, the availability of valid measures of the construct is critically important. This paper gives an overview of the current status in the field of self-report assessment of mindfulness. All eight currently available and validated mindfulness scales (for adults) are evaluated, with a particular focus on their virtues and limitations and on differences among them. It will be argued that none of these scales may be a fully adequate measure of mindfulness, as each of them offers unique advantages but also disadvantages. In particular, none of them seems to provide a comprehensive assessment of all aspects of mindfulness in samples from the general population. Moreover, some scales may be particularly indicated in investigations focusing on specific populations such as clinical samples (Cognitive and Affective Mindfulness Scale, Southampton Mindfulness Questionnaire) or meditators (Freiburg Mindfulness Inventory). Three main open issues are discussed: (1) the coverage of aspects of mindfulness in questionnaires; (2) the nature of the relationships between these aspects; and (3) the validity of self-report measures of mindfulness. These issues should be considered in future developments in the self-report assessment of mindfulness.

The potential of a mindfulness-enhanced, integrative neuropsychotherapy program for treating fatigue following stroke: A preliminary Study

Fatigue is a frequently reported symptom after a stroke. Although the phenomenology of poststroke fatigue is well known, clear definitions as well as diagnostic and therapeutic guidelines are missing. Poststroke fatigue can be regarded as a multidimensional phenomenon that might be influenced by neurological, physical, psychological, and cognitive factors. It can range from mild to severe and can affect every area of the activities of daily life. The objective of our preliminary study was to outline aspects of a specific treatment program for the management of poststroke fatigue. Eight patients were recruited for a mindfulness-enhanced, integrative neuropsychotherapy program. The treatment was a combination of neuropsychological interventions, psychoeducation, cognitive-behavioral therapy, and mindfulness techniques. The main treatment foci were (a) to facilitate an increased awareness of fatigue symptoms, (b) to help the patient detect and manage triggers of fatigue, and (c) to equip the patient with multiple self-help tools. Measures were assessed at the beginning, during, and at the end of treatment using self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries. Significant pre- to post-assessment differences were observed. These findings suggest that patients may benefit from a specific treatment program in order to better adapt to poststroke fatigue. These findings encourage further investigation of this integrative treatment in larger samples that include adequate control treatments.

Zazen meditation and no-task resting EEG compared with LORETA intracortical source localization

Meditation is a self-induced and willfully initiated practice that alters the state of consciousness. The meditation practice of Zazen, like many other meditation practices, aims at disregarding intrusive thoughts while controlling body posture. It is an open monitoring meditation characterized by detached moment-to-moment awareness and reduced conceptual thinking and self-reference. Which brain areas differ in electric activity during Zazen compared to task-free resting? Since scalp electroencephalography (EEG) waveforms are reference-dependent, conclusions about the localization of active brain areas are ambiguous. Computing intracerebral source models from the scalp EEG data solves this problem. In the present study, we applied source modeling using low resolution brain electromagnetic tomography (LORETA) to 58-channel scalp EEG data recorded from 15 experienced Zen meditators during Zazen and no-task resting. Zazen compared to no-task resting showed increased alpha-1 and alpha-2 frequency activity in an exclusively right-lateralized cluster extending from prefrontal areas including the insula to parts of the somatosensory and motor cortices and temporal areas. Zazen also showed decreased alpha and beta-2 activity in the left angular gyrus and decreased beta-1 and beta-2 activity in a large bilateral posterior cluster comprising the visual cortex, the posterior cingulate cortex and the parietal cortex. The results include parts of the default mode network and suggest enhanced automatic memory and emotion processing, reduced conceptual thinking and self-reference on a less judgmental, i.e., more detached moment-to-moment basis during Zazen compared to no-task resting.

Brain sources of EEG gamma frequency during volitionally meditation-induced, altered states of consciousness, and experience of the self.

Multichannel EEG of an advanced meditator was recorded during four different, repeated meditations. Locations of intracerebral source gravity centers as well as Low Resolution Electromagnetic Tomography (LORETA) functional images of the EEG 'gamma' (35-44 Hz) frequency band activity differed significantly between meditations. Thus, during volitionally self-initiated, altered states of consciousness that were associated with different subjective meditation states, different brain neuronal populations were active. The brain areas predominantly involved during the self-induced meditation states aiming at visualization (right posterior) and verbalization (left central) agreed with known brain functional neuroanatomy. The brain areas involved in the self-induced, meditational dissolution and reconstitution of the experience of the self (right fronto-temporal) are discussed in the context of neural substrates implicated in normal self-representation and reality testing, as well as in depersonalization disorders and detachment from self after brain lesions.

Die umfassende Erfassung von Achtsamkeit zur Erforschung achtsamkeitsbasierter Interventionen bei psychischen Störungen – Das Comprehensive Inventory of Mindfulness Experiences (CHIME)

Einleitung: Achtsamkeitsbasierte psychotherapeutische Interventionen haben sich in den letzten Jahren als wirksame Methoden bei der Behandlung unterschiedlichen psychischen Störungen etabliert. So konnte z.B. die Achtsamkeitsbasierte Kognitive Therapie der Depression (Mindfulness Based Cognitive Therapy, MBCT) in kontrollierten Studien eine Halbierung der Rückfallraten bei rezidivierenden Depressionen erreichen. Auch die Mindfulness Based Stress Reduction (MBSR) erwies sich in einem weiteren Bereich von Störungen als wirksam. Zur Evaluation und weiteren Entwicklung achtsamkeitsbasierter Interventionen ist eine umfassende und differenzierte Erfassung der Trait-Achtsamkeit und ihrer Veränderung im Rahmen der Behandlung von vorrangiger Bedeutung. Die bisher vorliegenden Instrumente konnte diese Anforderungen nur teilwiese erfüllen. Methode: Im vorliegenden Beitrag werden Entwicklung und Validierung eines Fragebogens zur umfassenden Erfassung der Achtsamkeit, des Comprehensive Inventory of Mindfulness Experiences (CHIME, Bergomi, Tschacher & Kupper, 2014), beschrieben. An einer Allgemeinbevölkerungs-Stichprobe (N=298) und einer Stichprobe von TeilnehmerInnen an MBSR-Gruppen (N=161) wurde die Faktorenstruktur des CHIME ermittelt und seine Reliabilität und Validität geprüft. Ergebnisse: Faktorenanalytische Verfahren ergaben eine achtfaktorielle Struktur. Der Fragebogen sowie seine Unterskalen weisen gute Reliabilitätswerte auf (interne Konsistenz und Retest-Reliabilität). Analysen zur Messinvarianz der einzelnen Items über Gruppen, die sich bezüglich Meditationserfahrung, Alter, Geschlecht und Symptombelastung unterschieden, zeigten keine systematischen Unterschiede im Verständnis der Items. Die Kennwerte zur Konstrukt-, Kriterium-, und inkrementellen Validität sowie zurVeränderungssensitivität waren alle mindestens zufriedenstellend. Mit dem CHIME steht somit ein Fragebogen mit guten psychometrischen Eigenschaften zur Selbsteinschätzung der Achtsamkeit zur Verfügung. Der CHIME basiert auf alle in den aktuellen Instrumenten enthaltenen Aspekte des Achtsamkeitskonstrukts und kann die Evaluation und weitere Entwicklung von achtsamkeitsbasierten Interventionen bei psychischen Störungen unterstützen. Referenz: Bergomi, C., Tschacher, W. & Kupper, Z. (2014). Konstruktion und erste Validierung eines Fragebogens zur umfassenden Erfassung von Achtsamkeit: Das Comprehensive Inventory of Mindfulness Experiences. Diagnostica. 60 (3) 111-125.

Mindfulness-based cognitive therapie for depression (MBCT) in clinical practice - baseline patient characteristics, process and outcome

Introduction: Mindfulness based cognitive therapy for depression (MBCT) has shown to be effective for the reduction of depressive relapse. However, additional information regarding baseline patient characteristics and process features related to positive response could be helpful both for the provision of MBCT in clinical practice, as well as for its further development. Method: Baseline characteristics, process data, and immediate outcome (symptom change, change in attitudes and trait mindfulness) of 108 patients receiving MBCT in routine care were recorded. A newly developed self-report measure (Daily Mindfulness Scale, DMS) was applied daily during the MBCT program. Additionally, patients filed daily reports on their mindfulness practice. There was no control group available. Results: Patients with more severe initial symptoms indicated greater amounts of symptom improvement, but did not show great rates of dropout from the MBCT intervention. Younger age was related to higher rates of dropout. Contradictory to some previous data, patients with lower levels of initial trait mindfulness showed greater improvement in symptoms, even after controlling for initial levels of symptoms. Adherence to daily mindfulness practice was high. Consistent with this result, the duration of daily mindfulness practice was not related to immediate outcome. Process studies using multivariate time series analysis revealed a specific role of daily mindfulness in reducing subsequent negative mood. Conclusions: Within the range of patient present in this study and the given study design, results support the use of MBCT in more heterogeneous groups. This demanding intervention was well tolerated by patients with higher levels of symptoms, and resulted in significant improvements regarding residual symptoms. Process-outcome analyses of initial trait mindfulness and daily mindfulness both support the crucial role of changes in mindfulness for the effects of MBCT.