Vago DR, Gupta RS, Lazar SW.
Measuring Cognitive Outcomes in Mindfulness-based Intervention Research: A Reflection on Confounding Factors and Methodological Limitations. Current Opinion in Psychology. 2018;28 :143-150.
AbstractOne potential pathway by which mindfulness-based meditation improves
health outcomes is through changes in
cognitive functioning. Here, we summarize and comment upon three
systematic reviews conducted over the last seven years that have had the goal of identifying the impact of
mindfulness on cognitive outcomes. In our analysis, we identified a number of methodological limitations and potential confounding factors that interfere with and limit our ability to interpret the results. In order to gain a granular view of the relationship between mindfulness training and cognition, we report on the following: 1) What do we know? How does mindfulness affect cognition? 2)
variable criteria that define an MBI; 2) limitations of assays used to measure cognition; and 3) methodological quality of an MBI trial and reporting of findings. Finally, we offer constructive means for interpretation and recommendations for moving the field of mindfulness research forward regarding effects on cognition.
Greenberg J, Braun TD, Schneider ML, Finkelstein-Fox L, Conboy LA, Schifano ED, Park C, Lazar SW.
Is less more? A randomized comparison of home practice in a mind-body program. Behaviour research and therapy. 2018;111 :52-56.
Publisher's VersionAbstractHome practice is a major component of mind-body programs, yet little is known about how to optimize the amount of prescribed home practice in order to achieve an effective “dose” of practice while minimizing participant burden. This study tested how varying the amount of home practice in a mind-body
program impacts compliance and
stress reduction, and whether prescribing a flexible home practice schedule increases compliance. Eighty-four stressed participants undergoing a 12-week
yoga program were randomized to low, medium, and high home practice conditions. The medium condition allowed participants the
flexibility to choose one of two amounts of practice each day. The low practice group exhibited the highest compliance (91%) compared to the medium and low practice groups (∼60%), but exhibited the lowest total practice time, and did not significantly reduce
stress. The high practice group was the only group to achieve significant stress-reduction, which was maintained 12 weeks post program. Prescribing a flexible home practice schedule did not increase compliance. Results suggest that prescribing higher practice doses may maximize practice time and
symptom reduction despite lower compliance.
Greenberg J, Datta T, Shapero BG, Sevinc G, Mischoulon D, Lazar SW.
Compassionate hearts protect against wandering minds: Self-compassion moderates the effect of mind-wandering on depression. Spirituality in Clinical Practice. 2018;5 (3) :155-169.
Publisher's VersionAbstractDepression is associated with high levels of mind-wandering and low levels of self-compassion. However, little is known about whether and how these two factors interact with one another to influence depressive symptoms. The current study examined the interaction between mind-wandering, self-compassion, and depressive symptoms in a depressed sample and tested the effects of an 8-week mindfulness-based cognitive therapy (MBCT) program on these constructs. At baseline, mind-wandering was associated with higher depressive symptoms only among individuals with low self-compassion. Self-compassion additionally predicted depressive improvement. As expected, MBCT increased self-compassion and reduced mind-wandering compared with a treatment-as-usual control group. Overall, longitudinal changes in self-compassion produced a moderation effect similar to the one at baseline so that increases in mind-wandering were associated with increases in depressive symptoms only among those who decreased in self-compassion. Results provide the first evidence that self-compassion can protect against the deleterious effects of mind-wandering among depressed participants, both at baseline and longitudinally. Findings also suggest that self-compassion is an effective predictor of depressive improvement. Finally, MBCT is effective not only at reducing depressive symptoms, but also at targeting protective and risk factors associated with depression.
Sevinc G, Hölzel BK, Hashmi J, Greenberg J, McCallister A, Treadway M, Schneider ML, Dusek JA, Carmody J, Lazar SW.
Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs. Psychosomatic Medicine. 2018;80 (5) :439-451.
PubMed VersionAbstractObjective: We investigated common and dissociable neural and psychological correlates of two widely used meditation-based stress reduction programs.
Methods: Participants were randomized to the Relaxation Response (RR; n = 18; 56% female) or the Mindfulness-Based Stress Reduction (MBSR; n = 16; 56% female) programs. Both programs use a “bodyscan” meditation; however, the RR program explicitly emphasizes physical relaxation during this practice, whereas the MBSR program emphasizes mindful awareness with no explicit relaxation instructions. After the programs, neural activity during the respective meditation was investigated using functional magnetic resonance imaging.
Results: Both programs were associated with reduced stress (for RR, from 14.1 ± 6.6 to 11.3 ± 5.5 [Cohen's d = 0.50; for MBSR, from 17.7 ± 5.7 to 11.9 ± 5.0 [Cohen's d = 1.02]). Conjunction analyses revealed functional coupling between ventromedial prefrontal regions and supplementary motor areas (p < .001). The disjunction analysis indicated that the RR bodyscan was associated with stronger functional connectivity of the right inferior frontal gyrus—an important hub of intentional inhibition and control—with supplementary motor areas (p < .001, family-wise error [FWE] rate corrected). The MBSR program was uniquely associated with improvements in self-compassion and rumination, and the within-group analysis of MBSR bodyscan revealed significant functional connectivity of the right anterior insula—an important hub of sensory awareness and salience—with pregenual anterior cingulate during bodyscan meditation compared with rest (p = .03, FWE corrected).
Conclusions: The bodyscan exercises in each program were associated with both overlapping and differential functional coupling patterns, which were consistent with each program's theoretical foundation. These results may have implications for the differential effects of these programs for the treatment of diverse conditions.
Shapero BG, Greenberg J, Mischoulon D, Pedrelli P, Meade K, Lazar SW.
Mindfulness-Based Cognitive Therapy Improves Cognitive Functioning and Flexibility Among Individuals with Elevated Depressive Symptoms. Mindfulness. 2018 :1-13.
Publisher's VersionAbstractMajor depressive disorder is a prevalent psychiatric condition that affects cognitive functioning. Cognitive impairments associated with depression impact the treatment course and effectiveness, creating a need to target this aspect of depression directly. Mindfulness-based cognitive therapy (MBCT) has been shown to be effective at preventing depressive relapse and reducing depressive symptoms, yet very little is known about its effects on cognitive impairments associated with depression. Therefore, the current study aimed to assess the effectiveness of MBCT on cognitive impairment in individuals with elevated symptoms of depression. Participants were assigned to an MBCT program (N = 22) or waitlist (N = 18). Participants completed diagnostic interviewing and self-report measures of depressive symptoms, overall cognitive functioning, and cognitive flexibility before and after the program. Participants who received MBCT had significantly improved cognitive flexibility and reduced cognitive deficits compared to those on the waitlist. In addition, improvement in cognitive deficits was significantly associated with depressive symptom improvement. These findings provide preliminary evidence that MBCT may be effective at improving cognitive impairment associated with elevated depressive symptoms.
Dam NTV, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Kerr CE, Gorchov J, et al. Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on Psychological Science. 2018.
Publisher's VersionAbstractDuring the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and “key to building more resilient soldiers.” Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.
Dam NTV, van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Gorchov J, Fox KCR, et al. Reiterated Concerns and Further Challenges for Mindfulness and Meditation Research: A Reply to Davidson and Dahl. Perspectives on Psychological Science. 2018.
Publisher's VersionAbstractIn response to our article, Davidson and Dahl offer commentary and advice regarding additional topics crucial to a comprehensive prescriptive agenda for future research on mindfulness and meditation. Their commentary raises further challenges and provides an important complement to our article. More consideration of these issues is especially welcome because limited space precluded us from addressing all relevant topics. While we agree with many of Davidson and Dahl’s suggestions, the present reply (a) highlights reasons why the concerns we expressed are still especially germane to mindfulness and meditation research (even though those concerns may not be entirely unique) and (b) gives more context to other issues posed by them. We discuss special characteristics of individuals who participate in mindfulness and meditation research and focus on the vulnerability of this field inherent in its relative youthfulness compared to other more mature scientific disciplines. Moreover, our reply highlights the serious consequences of adverse experiences suffered by a significant subset of individuals during mindfulness and other contemplative practices. We also scrutinize common contemporary applications of mindfulness and meditation to illness, and some caveats are introduced regarding mobile technologies for guidance of contemplative practices.