Doing no harm in mindfulness-based programs (review)

Baer, R., et al. (2019). Doing no harm in mindfulness-based programs: conceptual issues and empirical findings. Clinical psychology review. Full text. In Press.

Abstract. The benefits of empirically supported mindfulness-based programs (MBPs) are well documented, but the potential for harm has not been comprehensively studied. The available literature, although too small for a systematic review, suggests that the question of harm in MBPs needs careful attention. We argue that greater conceptual clarity will facilitate more systematic research and enable interpretation of existing findings.

After summarizing how mindfulness, mindfulness practices, and MBPs are defined in the evidence-based context, we examine how harm is understood and studied in related approaches to physical or psychological health and wellbeing, including psychotherapy, pharmacotherapy, and physical exercise.

We also review research on harmful effects of meditation in contemplative traditions. These bodies of literature provide helpful parallels for understanding potential harm in MBPs and suggest three interrelated types of factors that may contribute to harm and require further study: program-related factors, participant-related factors, and clinician- or teacher-related factors. We discuss conceptual issues and empirical findings related to these factors and end with recommendations for future research and for protecting participants in MBPs from harm.

Distress coping, empathy, and compassionate behavior

Laneri, D., et al. (2017). Mindfulness meditation regulates anterior insula activity during empathy for social pain. Human brain mapping38(8), 4034-4046. Abstract.

Mindfulness has been shown to reduce stress, promote health, and well‐being, as well as to increase compassionate behavior toward others. It reduces distress to one’s own painful experiences, going along with altered neural responses, by enhancing self‐regulatory processes and decreasing emotional reactivity.

In order to investigate if mindfulness similarly reduces distress and neural activations associated with empathy for others’ socially painful experiences, which might in the following more strongly motivate prosocial behavior, the present study compared trait, and state effects of long‐term mindfulness meditation (LTM) practice. To do so we acquired behavioral data and neural activity measures using functional magnetic resonance imaging (fMRI) during an empathy for social pain task while manipulating the meditation state between two groups of LTM practitioners that were matched with a control group.

The results show increased activations of the anterior insula (AI) and anterior cingulate cortex (ACC) as well as the medial prefrontal cortex and temporal pole when sharing others’ social suffering, both in LTM practitioners and controls. However, in LTM practitioners, who practiced mindfulness meditation just prior to observing others’ social pain, left AI activation was lower and the strength of AI activation following the mindfulness meditation was negatively associated with trait compassion in LTM practitioners.

The findings suggest that current mindfulness meditation could provide an adaptive mechanism in coping with distress due to the empathic sharing of others’ suffering, thereby possibly enabling compassionate behavior.

Mind-wandering and negative mood

Poerio, G. L., Totterdell, P., & Miles, E. (2013). Mind-wandering and negative mood: Does one thing really lead to another?. Consciousness and cognition22(4), 1412-1421. Full text.

Abstract. Mind-wandering is closely connected with negative mood. Whether negative mood is a cause or consequence of mind-wandering remains an important, unresolved, issue. We sought to clarify the direction of this relationship by measuring mood before and after mind-wandering.

We also measured the affective content, time-orientation and relevance of mind-wandering to current concerns to explore whether the link between mind-wandering and negative mood might be explained by these characteristics. A novel experience-sampling technique with smartphone application prompted participants to answer questions about mind-wandering and mood across 7 days.

While sadness tended to precede mind-wandering, mind-wandering itself was not associated with later mood and only predicted feeling worse if its content was negative. We also found prior sadness predicted retrospective mind-wandering, and prior negative mood predicted mind-wandering to current concerns.

Our findings provide new insight into how mood and mind-wandering relate but suggest mind-wandering is not inherently detrimental to well-being.

Mindfulness-based interventions for depressive rumination: Review and meta-analysis

Perestelo-Perez, L., et al. (2017). Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis. International Journal of Clinical and Health Psychology17(3), 282-295.

Background/Objective: This systematic review aims to evaluate the effect of interventions based on the mindfulness and/or acceptance process on ruminative thoughts, in patients with depression.

Results: A meta-analysis of the effect of the intervention compared to usual care showed a significant and moderate reduction of ruminative thoughts. Furthermore, findings suggest that mindfulness/acceptance processes might mediate changes in rumination, and that they in turn mediate in the clinical effects of interventions.

A meta-analysis of three studies that compared the intervention to other active treatments (medication, behavioral activation and cognitive-behavioral therapy, respectively) showed no significant differences.

Prevalence, patterns, and predictors of meditation use among US children

Wang, C., et al.  (2019). Prevalence, patterns, and predictors of meditation use among US children: Results from the National Health Interview Survey. Complementary Therapies in Medicine. In Press. https://doi.org/10.1016/j.ctim.2019.02.004.

Highlights

•  Overall meditation use has increased substantially from 1.6% in 2012 to 7.4% in 2017 among children in the US.

• In particular, the rates of mantra and mindfulness meditation use have quadrupled. The prevalence of spiritual meditation use has increased sevenfold in 2017.

• Given the rapidly increasing use of spiritual meditation among pediatric population in the past few years, future studies aimed to explore the benefits of spiritual meditation are warranted.

• Mantra meditation use had an inverse relation with regularly taking prescription medication.

• Children who have difficulties affording mental health care are more likely to use mindfulness meditation points towards the feasibility and affordability of mindfulness meditation as a complementary health approach for maintaining psychological health in pediatric population.

Efficacy of a lovingkindness meditation intervention

Wren, A. A., et al. (2019). Preliminary efficacy of a lovingkindness meditation intervention for patients undergoing biopsy and breast cancer surgery: A randomized controlled pilot study. Supportive Care in Cancer, pp. 1-10. From Abstract.

Purpose: Despite more women undergoing treatment for breast cancer and increased survival rates, many women suffer from anxiety and physical symptoms (e.g., pain, fatigue) surrounding diagnosis and surgery. Research investigating the efficacy of psychosocial interventions for breast cancer patients during this period is limited. This randomized controlled pilot study examined the effect of a brief lovingkindness meditation intervention on these key outcomes.

Results: Multilevel modeling analyses demonstrated that lovingkindness meditation significantly improved pain, self-compassion, and heart rate over time compared to control conditions. There was a trend for anxiety. Music significantly improved pain compared to usual care.

Women benefit more than men

Rojiani, R., et al. (2017). Women benefit more than men in response to college-based meditation training. Frontiers in psychology8, 551, https://doi.org/10.3389/fpsyg.2017.00551, full text.

Objectives: While recent literature has shown that mindfulness training has positive effects on treating anxiety and depression, there has been virtually no research investigating whether effects differ across genders—despite the fact that men and women differ in clinically significant ways. The current study investigated whether college-based meditation training had different effects on negative affect for men and women.

Methods: Seventy-seven university students (36 women) participated in 12-week courses with meditation training components. They completed self-report questionnaires of affect, mindfulness, and self-compassion before and after the course.

Results: Compared to men, women showed greater decreases in negative affect and greater increases on scales measuring mindfulness and self-compassion. Women’s improvements in negative affect were correlated to improvements in measures of both mindfulness skills and self-compassion. In contrast, men showed non-significant increases in negative affect, and changes in affect were only correlated with ability to describe emotions, not any measures of experiential or self-acceptance.

Conclusion: These findings suggest that women may have more favorable responses than men to school-based mindfulness training, and that the effectiveness of mindfulness-based interventions may be maximized by gender-specific modifications.