US Congressman Authors Mindfulness Book

A colleague passed on this tidbit from The Plain Dealer. Tim Ryan, an Ohio Congressman and Democrat, has authored a book an mindfulness that will hit the shelves in March. It's entitled, A Mindful Nation: How a Simple Practice Can Help Us Reduce Stress, Improve Performance, and Recapture the American Spirit.

That's all I know about it!

ACT for Zombies

The Acceptance and Commitment Therapy people try not to take each other too seriously. Each year at the main ACT conference--the Association for Behavioral Contextual Science--they hold a "Follies night" where people poke fun aat ACT and some of the key ACT people. Created by Joe Oliver and Eric Morris, this video was unveiled at the most recent conference.

WARNING: There's some graphic violence, so it's not for the faint-hearted!

Watch the wide-screen version on YouTube.

Mindfulness Journal

A posting on a professional journal reminded me of this: there's a journal called Mindfulness that's been around since March 2010. The journal is dedicated to mindfulness-based research. The reason why I mention it is that you can download all the articles for free. That's right--free!

Most scientific journals require that you pay--either by the article or through a subscription. Colleges and universities usually have subscription packages, as do some public libraries, although the public libraries tend to be more limited.

I don't know how long Mindfulness will be offered for free. My guess is that when it becomes popular enough to charge for, the publisher will start charging. In the meantime, download what you want.

You can check out Mindfulness here.

NYT Article on Marsha Linehan and Dialectical Behavior Therapy

We've written in the past in Scientific Mindfulness about Dialectical Behavior Therapy (DBT), one of the early pioneers in mindfulness-based treatments. DBT is also hugely important in providing effective treatment for extremely suicidal people who how have difficult regulating their emotions--often diagnosed as borderline personality disorder. These are the kind of clients that many therapists in Portland still shy away from.

In this New Yorker Times article, University of Washington professor and core DBT originator Dr. Marsha Linehan talks about her own struggles with suicidality. This is the first time she's publicly come out about being hospitalized for 26 months when she was a teenager. During this time she was placed in seclusion, strapped down, and given electroconvulsive therapy. Dr. Linehan eventually devoted her life to helping people with the types of problems she had struggled with. As she says, 

“I decided to get supersuicidal people, the very worst cases, because I figured these are the most miserable people in the world — they think they’re evil, that they’re bad, bad, bad — and I understood that they weren’t,” she said. “I understood their suffering because I’d been there, in hell, with no idea how to get out.”

It's a stunning, public revelation from a very important researcher, clinician, and figure in psychology. To read the full article, click here.

Mindfulness-Based Attention as a Moderator of the Relationship Between Depressive Affect and Negative Cognitions

Here’s another study in the growing body of research suggesting that mindfulness changes how we experience depression.

Researchers at Pacific University collected self-report measures of mindfulness, depression, and negative thinking from a sample of 278 undergraduates. Analyses suggest that there is a weaker relationship between negative thinking and depressive symptom for people higher in mindfulness than for people lower in mindfulness.

What might this mean?

The authors conclude that being more mindful may serve a protective function against becoming depressed when someone experiences negative thoughts. Conversely, less mindful people may be more likely to become depressed when they have negative thoughts.

The results are pretty limited. For one, this was a convenience sample of undergraduate students, not a sample of people with clinical depression. Also, because the results are correlational, we can’t draw any firm conclusions that one thing causes another. We can't tell from these results whether increasing mindfulness actually serves as a prophylactic against becoming depressed.

However, if you're interested in studies that tell us more about how mindfulness may impact how we experience depression, check out some of the past posts from Scientific Mindfulness on Mindfulness-Based Cognitive Therapy and Mindfulness-Based Relapse Prevention. Additionally, a longitudinal study showed that less mindful police officers showed greater increases in depression over time compared to their more mindful counterparts.

For the full citation:

Gilbert, B.D., & Christopher, M.S. (2010). Mindfulness-Based Attention as a Moderator of the Relationship Between Depressive Affect and Negative Cognitions. Cognitive Therapy and Research, 34, 514-521.

You might also be interested in some of these other books about mindfulness and depression: 

I’d like to thank Molly Ellis for her help with this post!

Meditation Experience Predicts Less Negative Appraisal of Pain: Electrophysiological Evidence for the Involvement of Anticipatory Neural Responses

In a recent study, researchers in the United Kingdom examined the impact of meditation experience and the anticipation of and experience of pain. The control group consisted of 15 people with no previous experience in meditation. They were compared with 12 people who came from a variety of Buddhist and non-Buddhist meditative backgrounds. It was a pretty heterogeneous sample of meditators.

The researchers encountered difficulty developing a reliable estimate of meditation experience. They eventually disregarded the amount of hours per week of practice and instead looked at the overall lifetime experience with meditation. These ranged from less than 1 year to more than 30 years experience.

The researchers used a laser to induce a painful burning sensation in the participants. Anticipation of pain was created through a visual stimulus that indicated to the participants that they would be exposed to the laser within 3 seconds.  Because of the design, the researchers suggest they may have over-estimated the impact of the anticipation of pain on the actual pain response. In addition to self-report by the participants, the researchers used an EEG (e.g., brain scan) to measure participants' anticipation to and experience of pain.

Initially, the researchers found no significant difference in perceived pain between the mediation and control groups. Once the researchers dropped participants with less than 6 years of meditation experience from the analyses, however, participants with more meditation experience showed a lower response to anticipated pain unpleasantness.  This relationship was accounted for by the age of the meditators.  However, there was no correlation in the control group between pain response and age.  Although the relationship is not entirely clear, it appears that meditation experience may impact anticipation of pain.

In looking at the EEG results, an interesting pattern emerges. The researchers suggest that those with meditation experience were more likely to process and contextutalize the experience of pain before responding to it emotionally.

In summary, the researchers suggest that the cultivation of acceptance through practicing attentional control (i.e., through regular meditation practice) may allow people to show more equanimity in both in their anticipation of pain and their actual experience of it.

There are some limitations with the pain assessment in this study. As noted, researchers admitted that they had a difficult time determining if the pain assessment was in fact influenced by the anticipation of the pain. Also, because of the design of the study, we can't completely rule out that people who take up meditation are inherently different from those who don't meditate, and that these differences--rather than the actual meditation practice--better explain the results.

To download a  copy of the article, click on the full citation is below:

Brown, C.A., & Jones, A.K.P. (2010). Mediation Experience Predicts Less Negative Appraisal of Pain: Electrophysiological Evidence for the Involvement of Anticipatory Neural Responses. Pain, 150, 428-438.

I’d like to thank Molly Ellis for her help with drafting this post!

Sesame Street: Monster in the Mirror

I discovered this Sesame Street clip after a therapist posted it on a professional listserv. As the poster noted, it's a clever illustration of the ease that can come from accepting parts of us that we experience judgment towards. I'd like to thank Jonathan Kandell for sharing it!

BOOK REVIEW: Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind

I recently finished reading Kristin Neff's new book, Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind. As I've mentioned before in Scientific Mindfulness, I've been following Dr. Neff's work on self-compassion for several years now. This new book is the first written for a lay audience.

A researcher at the University of Texas - Austin, Dr. Neff discovered self-compassion when she began attending a local Buddhist center while she was a graduate student at the University of California at Berkley. According to her book, she was really struck by the Buddhist view of compassion and devoted much of her professional career to defining and studying it. In Neff's conceptualization, self-compassion has three component: 1.) being kind to one's self, as opposed to harsh and judgmental; 2.) feeling part of the human condition, as opposed to alone and isolated; 3.) and being mindful of the present moment.

Research on self-compassion has really snowballed of late, and changes in self-compassion are being increasingly studied in mindfulness and acceptance-based research. There's also a growing body of literature suggesting that self-compassion is a more useful construct than that of self-esteem. Despite it's widespread use, our understanding of self-esteem is very problematic, as Dr. Neff discusses in her book.

Dr. Neff's book is an enjoyable mixture of theory, research, and personal anecdotes. It has elements of self-help but is not primarily a self-help book. Each chapter has exercises the reader may use to help develop self-compassion. I bookmarked several of them to use with clients. The exercises become a little weaker in the second half of the book, in my opinion--less specific, more abstract and vague--but I really liked many of them.

Dr. Neff does a great job incorporating research in a very readable and accessible style. Nothing is presented very technically, and the reader can easily find the studies cited in the "Notes" appendix in the back if he or she wants to seek out the original source material. I found myself flipping to the back frequently.

What I found most brave and unique about this book is Dr. Neff's willingness to speak candidly about her own life. In her book, she leads by example and shows a startling openness in sharing her own struggles. From an ex-husband who has never forgiven her for cheating on him to the difficulties of raising a child with autism, Dr. Neff offers incredibly personal anecdotes from her own experience and other people she knows. She doesn't present herself as an expert on self-compassion in the sense that she has it all figured out; rather, she vividly describes her own successes and struggles in incorporating self-compassion into her life.

Overall, I highly recommend the book. For people who'd like to know more about self-compassion and the research behind it, the book is a very up-to-date primer. For those interested in bringing more self-compassion into their lives, the book has a number of exercises and useful illustrations of self-compassion in action. As the book demonstrates and research increasingly shows, there is much to be gained in learning to treat ourselves more kindly.


Neff, K. (2011). Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind. New Yorker: HarperCollins.

You might also check out Dr. Neff's website at www.self-compassion.com.

Mindfulness-Based Cognitive Therapy for Bipolar Disorder: A Feasibility Trial

Mindfulness-based cognitive therapy (MBCT) studies generally focus on what’s sometimes called unipolar depression. The term “unipolar” is just a fancy way of distinguishing clinical depression from depression experienced in people with bipolar disorder. People with bipolar disorder may alternate between periods of depression and periods of elation called mania or hypomania (hypomania is less extreme than mania).

In earlier studies of MBCT, people with bipolar depression were screened out. More recently, researchers from Geneva University Hospital in Switzerland set out to determine if MBCT may be helpful for people with bipolar disorder.  They hypothesized that mindfulness may help break the vicious cycles of depression and mania.  This study is the first to pilot the use of MBCT for a sample comprised entirely of people with bipolar disorder.

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The intervention consisted of weekly, 2-hour, MBCT sessions for a total of 8 weeks. Each group met three months after the end of the 8-week program for a 2-hour refresher session. Little was changed to the program except that mania and hypomania were discussed in sessions and mentioned in handouts. Participants were assessed a month before the MBCT class, a month afterward, and at the 3-month follow-up. Of 23 participants, only 15 attended enough sessions to be included in the analyses, and only 9 were assessed at follow-up.

Overall, there were no significant improvements in mindfulness, depression, and hypomania between the beginning and end of the MBCT program. Interestingly, it didn’t look like the researchers included the 3-month follow-up in their analyses. Statistical analyses indicate no significant changes in depressive symptoms, mindfulness, and mania during the study. According to a table in the article, it even looks like depression may have increased at the follow-up! The good news is that 82% of the participants reported having benefited from the program. This point is emphasized by the authors.

A big limitation of this study is sample size: it’s hard to detect changes when working with such a small sample. That said, the study is spun a bit. The authors seem to downplay the nonsignificant changes in symptoms and mindfulness in favor of the participants’ self-report that they found the program beneficial. People says they liked the program, but there's no evidence it impacted depressive symptoms or mania, or that people improved in mindfulness.

In sum, the study suggests that people with bipolar disorder can participate in MBCT, but it provides little evidence that they benefited from it. However, because the sample size was small, it may be worth running another MBCT study for people with bipolar disorder with a larger sample.

The full citation is below:

Weber, B., Jermann, F., Gex-Fabry, M., Nallet, A., Bondolfi, G., & Aubry, J.-M. (2010). Mindfulness-Based Cognitive Therapy for Bipolar Disorder: A Feasibility Trial. European Psychiatry, 25, 334-337.

If you're interested in learning more about MBCT, the original book is one of the more readable therapist manuals out there:

Segal, Z.V., Williams, J.M.G., & Teasdale, J.D. (2001). Mindfulness-Based Cognitive Therapy for Depression: A New Aproach to Preventing Relapse. New York: Guilford.

The core MBCT originators also created a self-help book called The Mindful Way Through Depression.

I'd like to thank Molly Ellis for her help with this post.

Comparison of Motivational Interviewing with Acceptance and Commitment Therapy: A Conceptual and Clinical Review

Motivation Interviewing (MI) is not an a mindfulness and acceptance-based treatment; however, it is consistent with many of same principles and can be used in conjunction with a number of treatments. MI is a type therapy in which the primary aim is increasing motivation for change. It was originally developed for addiction but has since been adapted for all sorts of things, including health-related behaviors. Rooted in Carl Roger's person-centered approach, MI is not a stand alone therapy in itself, but a way to prepare someone for change. The therapist accepts the client where she is while helping to guide the individual towards talking about change.

Dr. Jonathan Bricker--who also piloted the telephone smoking cessation study I posted about last year--co-authored a recent article exploring the conceptual similarities and differences between MI and Acceptance and Commitment Therapy (ACT). The article highlights three ways in which both approaches overlap:

1. Both seek to increase commitment to changing behavior.

2. Both draw upon values to enhance commitment. In particular, MI and ACT therapists strive to help people contact long-term goals and life directions to increase the motivation for behavior change.

3. Both look at processes of language to help facilitate change. In MI, there's an emphasis on helping people engage in "change talk" (e.g., openly verbalizing what they want to do). By contrast, ACT seeks to undermine verbal self-rules (e.g., unhelpful ideas that keep people stuck) and help people make commitments towards valued goals and directions.

The article does a nice job summarizing both treatments. According to the Acknowledgments section, the authors received feedback on the manuscript from Drs. Bill Miller and Steve Hayes, core originators of MI and ACT, respectively. There's no new data, but the article provides a balanced view of MI and ACT and offers suggestions for how they may complement one another. Even if you've never heard of MI, the article provides a concise introduction.

The article hasn't been officially published yet but is available online. To download a copy click on the full citation below:

Bricker, J., & Tollison, S. (in press). Comparison of Motivational Interviewing with Acceptance and Commitment Therapy: A Conceptual and Clinical Review. Behavioural and Cognitive Psychotherapy.

If you'd like to read further about MI, I encourage you to check out the core MI book:

Miller, W.R., & Rollnick, S. (2002). Motivational Interview, Second Edition: Preparing People for Change. New York: Guilford Press.

For a book with chapters on an ACT approach to substance use, check out:

Hayes, S.C., & Strosahl, K. (Eds.) (2004). A Practical Guide to Acceptance and Commitment Therapy. New York: Springer.

Living with Your Fears

A friend sent me a link to the cartoon below at 9GAG. I think it's a cute illustration of mindful acceptance.

http://9gag.com/gag/99399/

Therapist and Client Perceptions of Therapeutic Presence: The Development of a Measure

This post isn't directly related to mindfulness, but the topic overlaps. Most psychotherapists would agree that the therapeutic relationship with clients is very important. There is less agreement, however, in a definition of what makes up a good therapeutic relationship and how it can be measured.

The lab of Dr. Les Greenberg, the core originator of Emotion Focused Therapy, has taken some initial steps to address this issue more empirically. The first author is Dr. Shari Geller.

These researchers from York University in Toronto have developed two measures of what the call therapeutic presence. Therapeutic presence, according to their definition, involves "bringing one’s whole self into the encounter with clients, by being completely in the moment on multiple levels:  physically, emotionally, cognitively, and spiritually."

Therapeutic presence differs from mindfulness, according to the authors, in two ways. The authors consider mindfulness a technique used to cultivate presence rather than presence itself. They also suggest that mindfulness--at least how it's presented in the research literature--is a way of engaging the internal world of one's self and another person, whereas "therapeutic presence is an internal and relational therapeutic stance that includes the therapist's present-centered sensory attention in direct relation to the client's in-the-moment experience.

I found the authors terminology a little imprecise for my tastes. There seemed to be a blurring of technical terms with vaguely defined descriptions; however, it could be that they're drawing from a research literature I'm not all that familiar with. Regardless, I believe it's clinically useful to define therapuetic presence as something separate from mindfulness.

The study went through a series of stages, beginning with creating items and, eventually, using them in an actual clinical setting with clients who met criteria for depression. The researchers developed two versions of a measure they call Therapeutic Presence Inventory. In one version (TPI-C), clients rate the presence of their therapist; in the other (TPI-T), therapists rate themselves.

The client measure predicted the therapeutic relationship and improved outcomes. The therapist version wasn't predictive of either. This supports a long line of research showing that psychotherapists aren't a very good judge of how well therapy is going. Psychotherapists tend to overestimate how much their clients like them! Consequently, the findings for the therapist measure are not too surprising.

The client version, though, is potentially really useful. It's short (only 3 items), and it can give therapists feedback about how clients perceive their relationship. Moreover, this feedback appears to be related to how clients change and improve.

In my own practice, I often give clients the option of filling out a feedback form about how well the session went. When I get the chance, I intend to revise my form to incorporate these three items.

To download the article, click on the full citation below:

Geller, S.M., Greenberg, L.S., & Watson, J.C. (2010). Therapist and Client Perceptions of Therapeutic Presence: The Development of a Measure. Psychotherapy Research, 20(5), 599-610.

Neural Correlates of Focused Attention and Cognitive Monitoring in Meditation

A former classmate from graduate school sent me a nifty neuroimaging study by a group of researchers in Italy. The article compared 8 Buddhist monks against 8 novice meditators. The monks were part of the Thai Forest Tradition founded by Ajahn Chah. They averaged 15,750 hours of meditation experience! By contrast, the novice sample were people who expressed an interest in meditation but had no prior meditative experience. They were given 10 days of meditation practice prior to the study.

Using an fMRI (e.g., functional brain scans), the researchers recorded brain patterns during an hour block involving alternating periods of focused attention (FA) and open monitoring (OM). For those familiar with Buddhist practices, FA corresponded to Samatha meditation (Pali: calm abiding) and OM was a form of Vipassana (Pali: clear seeing or insight), according the researchers. (Our garden variety mindfulness meditation is more or less based on Vipassana meditation.) Participants alternated between 6 minutes of Samatha and Vipassana with 3 minutes of non-meditative rest preceding and following these conditions.

The article is pretty technical. Since I can't really do it justice, I won't parrot back the specific results (e.g., which parts of neuroanatomy relate to which forms of attention). Overall, results suggest that meditation practice reorganizes brain activity. More simply, experienced meditators showed a different pattern of brain activity than novices on these tasks.

Reorganization of brain processes is called neuroplasticity. Previously researchers believed the brain doesn't change much after we're born. Recent research has shown that this isn't so--the brain can and does change--and regular meditation practice can re-map the way the brain processes stuff.

For the full citation:

Manna, A., Raffone, A., Perrucci, M.G., Nardo, D., Ferretti, A., et al. (2010). Neural Correlates of Focused Attention and Cognitive Monitoring in Meditation. Brain Research Bulletin, 82, 46-56.

Open, Aware, and Active: Contextual Approaches as an Emerging Trend in the Behavioral and Cognitive Therapies

In recent post, I wrote about how Dr. Steven Hayes coined the term "third wave" to describe the recent crop of mindfulness and acceptance-based treatments. In a new paper, Dr. Hayes and his colleagues at the University of Nevada-Reno explore this notion further.

The article examines the theoretical underpinnings of the current generation of mindfulness and acceptance-based psychotherapies, and at the published empirical data supporting the theory. This article provides a fantastic overview of the current state and development of many of these treatments.

Towards the end of article, Hayes and colleagues suggest abandoning the term "third wave" in favor of what they call "contextual cognitive behavioral therapy" or contextual CBT. According to the authors, contextual CBT differs from traditional CBT in several important ways:

1. Contextual CBT emphasizes changing the context and function of psychological events (e.g., thoughts, emotions, physical sensation) rather than the content, accuracy, and frequency. For example, a contextual CBT therapist is more interest in changing how someone relates to self-critical thinking than in changing the thoughts themselves.

2. Contextual CBT focuses more on what the authors call a "transdiagnostic approach to mental health." What this means is that, rather than treat specific diagnoses (e.g., generalized anxiety disorder), contextual CBT therapists focus more on processes (e.g., emotion regulation).

3. Contexutal CBT therapists are encouraged to apply these methods to themselves. For example, leaders of Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy groups are encouraged--even required--to maintain their own mindfulness practices.

4. Contextual CBT is less about throwing away techinques and interventions from other treatments than in taking what is useful and applying it in ways that are consistent with the theories underlying contextual CBT.

5. In their final distinction, the authors suggest contextual CBT is being applied to a much broader and deeper range of problems within the human conditions, such as spirituality and values. (The authors admit that this point is more of a "judgment call" than an accepted fact.)

I highly recommend this article for readers of Scientific Mindfulness. It's a great review article for much of what we write about in this blog.

To download a copy of the article, click on the full citation below:

Hayes, S.C., Villatte, M., Levin, M., & Hildebrandt, M. (2011). Open, Aware, and Active: Contextual Approaches as an Emerging Trend in the Behavioral and Cognitive Therapies. Annual Review of Clinical Psychology, 7, 141-168.

The Strange Powers of the Placebo Effect

This video isn't about mindfulness specifically, but I think it's a wonderful illustration of one of the reasons why scientific research is so important. Without controlled studies, it's hard to discern active treatments from placebo because placebo by itself can an effective treatment. It's important to assess whether treatments work for the reasons we think they work; otherwise, we can become lost in a sea of pseudoscientific cures. (If you're interested, click here for a blog post I did about pseudoscience in psychotherapy.)

In Memory of Alan Marlatt's Passing

For those of you who haven't heard, University of Washington professor and researcher Dr. G. Alan Marlatt passed away from melanoma on Monday (3/14/2011). He was 69. My understanding is that the diagnosis was unexpected, and Dr. Marlatt was told he had only days left to live. By report, he passed away in the company of his family.

I've previously talked about Dr. Marlatt's work with Mindfulness-Based Relapse Prevention here in Scientific Mindfulness. Dr. Marlatt has a 30-year history practicing mindfulness and meditation. He started by with Transcendental Meditation hoping it would help lower his blood pressure (it did), and eventually began exploring different Buddhist meditative traditions.

Even if Dr. Marlatt had never incorporated mindfulness into his research, he would be well-known for his other contributions to the study of addictions and substance abuse. He is well-known for his work on harm reduction: the notion that some people who don't want to give up alcohol entirely may learn to drink moderately. He made significant contributions towards understanding relapse.

I had a few brushes with Alan in my career. Early on in my graduate studies, I emailed him a question about problems with alcohol abuse in Buddhist teachers. Not only did he respond, but he suggested we talk about by phone! He was extremely kind and supportive during our brief chat. A year or two later, he was the discussant at a symposium I participated in. I introduced myself again but felt too shy to make an effort at engaging him, as there were others calling for his attention. Everyone I've spoken with about Alan has commented on his kindness and gentleness, an impression I shared.

Alan Marlatt will be missed. We've lost an exceptional researcher, a great contributor towards understanding mindfulness and acceptance-based treatments, and a wonderful man.

Time has a brief article on Dr. Marlatt. To check it out, click here.

For those interested in knowing more about him, Dr. Marlatt wrote a very touching portrait of his history with mindfuless that's worth tracking down:

Marlatt, G. A. (2006). Mindfulness Meditation: Reflections from a Personal Journey. Current Psychology, 25(3), 155-172.

Psychology Today: Bringing ACT to Sierra Leone

In a blog post today on the Psychology Today website, Dr. D.J. Moran, author of ACT in Practice, writes of a recent trip to war-torn Sierra Leone with two other psychologists. Together, they taught two workshops on Acceptance and Commitment Therapy (ACT) to local mental health practitioners. Dr. Moran writes:

In January 2011, my colleagues Beate Ebert and JoAnne Dahl and I set out to present two workshops in evidence-based behavior therapy and Acceptance and Commitment Therapy (ACT).  Beate is a dedicated psychologist and the founder of Commit + Act, the non-governmental agency that planned this trip.  JoAnne has extensive understanding of using ACT with the chronic pain population, but also has experience with bringing ACT to populations that have limited access to mental health care.  Our first five (5) day workshop was in Freetown, S.L. and the second three (3) day workshop was in Serabu, S.L..  Each workshop had over 30 mental health practitioners in attendance.   They were very eager to hear how they could address Post-Traumatic Stress Disorder with behavior therapy and ACT.

Dr. Moran offers a touching sketch of their efforts to bring an evidence-based mindfulness and acceptance-based treatment to therapists in a country that has witnessed unimaginable horror. I can't do it justice to through summary; to read the full post, click here.

How Does Mindfulness-Based Cognitive Therapy Work?

Mindfulness-Based Cognitive Therapy (MBCT) has demonstrated it reduces depressive relapse in those with three or more depressive episodes across several studies now. But why--what changes occur in MBCT that reduce relapse? The theory behind MBCT suggests increased mindfulness leads to reduced chance of relapse; however, treatments may be effective for reasons having little to do with why we think they're effective.

A recent article by Kuyken and colleagues examines processes of change in MBCT in order to assess the theory behind underlying it. The researchers used what are called mediational analyses. Mediational analyses look at whether changes in one factor (e.g., mindfulness) lead to changes in another (e.g. lower depression).

The authors used data from a previous study (Kuyken et al., 2008) in which 123 people with 3 or more depressive episodes who were currently prescribed antidepressant medication were randomly assigned to either 8-weeks of MBCT or were placed on a wait list. Those in the MBCT condition were weaned off their medication while those not assigned to MBCT remained on their meds. Participants were assessed every 3 months up to a 15 month follow-up. (In the original study, there was no difference in rate of relapse between MBCT and antidepressant meds; however, people in MBCT exhibited fewer depressive symptoms by the 15-month follow-up.)

Results of this study suggest increases in mindfulness and self-compassion mediated the effect of MBCT on depressive symptoms at follow-up. Researchers also looked at what they called cognitive reactivity. Cognitive reactivity was defined as changes in depressive thinking before and after a short piece of "sad" music (i.e., Prokofiev).

Curiously, people who participated in MBCT exhibited greater cognitive reactivity than those who remained on antidepressant medication. Here's the interesting part, though: whereas cognitive reactivity was associated with poorer outcome for people taking antidepressants, participation in MBCT appears to erase this relationship. Said another way, for people who participated in MBCT, cognitive reactivity no longer appeared to impact depressive symptoms. This reminds me of the Mindfulness-Based Relapse Prevention study in which the researchers found the relationship between depression and relapse appeared to disappear for those who participated in the program.

These results of the current study offer further evidence that mindfulness doesn't change patterns of thinking so much as it changes how people relate to thinking. Additionally, this is another study showing the useful in self-compassion in understanding mechanisms of change in mindfulness based treatments. (For another study indicating the importance of self-compassion, click here.)

As with any study, there are limitations. Mediational analyses don't definitively tell us that particular variables lead to change. However, the results largely supported the hypotheses of the researchers, offering additional evidence in support of the theory.

To download a copy of the article, click on the full citation below:

Kuyken, W., Watkins, E., Holden, E., White, K., Taylor, R.S. et al. (2010). How Does Mindfulness-Based Cognitive Therapy Work? Behaviour Research and Therapy, 48, 1105-1113.

The U.S. Government Lists Acceptance and Commitment Therapy as an Evidence-Based Treatment

This is exciting news within the Acceptance and Commitment Therapy (ACT) community! The Substance Abuse and Mental Health Services Administration (SAMHSA), a major department within the U.S. government, now lists ACT as an empirically supported treatment. This is part of its National Registry of Evidence-based Programs and Practices (NREPP).

ACT received high scores across a number of different dimensions, including quality of research and efforts at dissemination (e.g., getting ACT out there to professional and the public). This is a great victory for mindfulness and acceptance-based treatments, and for ACT in particular!

Read about it yourself here.

Investigating the Similarities and Differences Between Practitioners of Second- and Third-Wave Cognitive Behavioral Therapies

In 2004, Dr. Steven Hayes published an influential paper in which he coined the term "third wave." Third wave refers to the mindfulness and acceptance-based cognitive behavioral therapies we focus on in Scientific Mindfulness: Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT), among others.

In calling these third wave treatments, Dr. Hayes distinguished them from the first wave of treatments that came out of behaviorism, and from the second wave of therapies that came out of cognitive therapy. Traditional cognitive behavioral therapy (CBT), which focuses on changing maladaptive thoughts, is a second wave treatment. The mindfulness and acceptance-based treatments of the third wave differ from the second wave, according to Dr. Hayes, in their focus on changing how people relate to thinking, not the thoughts themselves. (You can download a copy of this seminal article at the bottom of this post.)

A group of researchers affiliated with Brown University took some data from a larger study to examine similarities and differences between second and third wave therapists. Out of a sample of 176 clinicians who completed an Internet survey, 55 identified as second wave and 33 identified as third wave. The terms second and third wave weren't actually used in the Internet survey: rather, therapists who identified as "cognitive or cognitive behavioral" (i.e., second wave) or "acceptance-based behavioral/cognitive" (i.e., third wave) were included in the two categories.

In general, the researchers found that second and third wavers are more similar than different. For example, both were equally likely to endorse using social skills training and homework. The main differences the authors found were related to techniques and treatment strategies. Second wavers were more likely to use traditional cognitive techniques such as cognitive restructuring and relaxation training; by contrast, third wavers were--as you might imagine--more likely to use mindfulness and acceptance techniques.

Curiously, third wavers were also more likely to report using existential/humanistic and family systems techniques. The authors offers explanations for these findings. For one, they suggest the emphasis in values clarification in ACT may explain the endorsement of existential/humanistic techniques. This is a reasonable assumption but, by no means, an clear-cut interpretation. What seems a little more far afield is the authors' suggestion that the endorsement of family systems techniques reflects a greater inclusiveness in the use of techniques by third wavers. Again, this assumption is not unreasonable, but it seems like a stretch in the absence of any additional data. That said, I don't know how to explain these findings either!

What I found most interesting is that third wavers reported greater use of exposure. Exposure is a decades old behavioral intervention that has been widely successful in treating anxiety disorders (e.g., anxiety, phobias, obsessive-compulsive disorder, and posttraumatic stress disorder). In my view, exposure is an extremely useful intervention when appropriate applied. As it's also been incorporated into traditional CBT and interpreted according to cognitive models, I find it really interesting that second wavers are significant less likely to use exposure than third wavers because it is frequently a component of empirically-supported CBT treatments for anxiety disorders.

The authors conclude both second and third wavers emphasize evidence-based practice. Where they differ is that, although third wavers use both first and second wave interventions, they are less likely to use traditional cognitive techniques (e.g., cognitive restructuring). One important potential bias the authors note is that, as they recruited from an ACT listserv, among other listservs, ACT therapists may be over-represented in their sample compared to other third wave therapies such as DBT and MBCT. Consequently, the results may be more reflective of ACT therapists than to the broader community of third wave therapists.

The full citations are below. Only members of ACBS can download the main article I covered. However, everyone can click on the second citation to download a copy of Dr. Hayes seminal 2004 article:

Brown, L.A., Gaudiano, B.A., & Miller, I.W., (2011). Investigating the Similarities and Differences Between Practitioners of Second- and Third-Wave Cognitive Behavioral Therapies. Behavior Modification, 35(2), 187-200.

Hayes, S.C. (2004). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavior Therapy. Behavior Therapy, 35, 639-665.

BehaviorTherapist.com Podcast Interview with Drs. Susan Orsillo & Lizabeth Roemer about The Mindful Way Through Anxiety

At BehaviorTherapist.com, Dr. Trent Codd interviews Drs. Susan Orsillo and Lizabeth Roemer, two psychologists in the Boston area who are well-known within the mindfulness community for their work on mindfulness-based approaches to anxiety. They have recently authored a self-help book, The Mindful Way Through Anxiety: Break Free From Chronic Worry and Claim Your Life. The book came out last month.

The BehaviorTherapist.com has a promotional code that allows you to receive a 20% discount off the book through the publisher. (Even with the discount, however, it seems to be cheaper through Amazon at the moment).

I've not read their book but have great respect for Drs. Orsillo and Roemer's work. (As graduate student, I did a research symposium with one of Dr. Roemer's students. Not only was Dr. Roemer really friendly, but she came across as incredibly engaged and expressive during the presentations.) 

We've previously featured Dr. Codd's podcast interviews with Steven Hayes, Rob Zettle, and Michael Twohig. If you've listened to any of these, you know that Dr. Codd is a thoughtful interviewer and has really great people on his podcasts. As Dr. Codd notes, this is one of his more accessible podcasts, and his interviewees offer very practical suggestions for working with anxiety.

To check out the podcast at the BehaviorTherapist.com, click here. To check out the authors' website for their book, click here.

The citation for their book is:

Orsillo, S.M., & Roemer, L. (2011). The Mindful Way Through Anxiety: Break Free From Chronic Worry and Claim Your Life. New York, NY: Guilford .

Yoga for Persistent Pain: New Findings and Directions for an Ancient Practice

Although the literature isn't nearly as large as that for mindfulness and meditation, there is a growing body of research on the use of yoga to address mental health concerns. In a recent issue of Pain, Wren and colleagues offer a brief summary of current research on the application of yoga to medical conditions.

One of the co-authors is Dr. James Carson, a former researcher at Duke who is now at the Oregon Health & Science University. Dr. Carson and his wife Kimberly developed an 8-week yoga program called Yoga of Awareness. You can download a bunch of Jim's research on mindfulness and yoga-based interventions on his Yoga of Awareness website.

The article examines 13 randomized controlled trials of yoga with pain and related medical conditions. The authors propose three potential pathways for the benefits of yoga: 1.) Physiological changes, such as decreased heart rate and improved strength, circulation, and flexibility; 2.) Behavioral changes such as increased social contact and regular physical activity; 3.) Psychological changes, such as increased awareness and mindful acceptance.

The growing literature is very encouraging. I expect we'll hear a lot more about yoga interventions in the future as the trend picks up steam. At moment, however, there's not a lot that unifies the studies other than yoga practice. They're based on a variety of yogic traditions--especially Inyengar and Hatha. What will likely be important to this literature in the future is the development of programmatic research around a specific yoga intervention (e.g., Yoga of Awareness) with more attention paid to the contributions of particular techniques and theorized mechanisms of change. It will be interesting to see if a particular yoga-based course eventually becomes as well known as specific mindfulness-based programs such as Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Acceptance and Commitment Therapy. I'm curious to see the evidence base on the use of yoga continue to move forward in a more systematic way, as I think there's great potential.

Reference:

Wren, A.A., Wright, M.A., Carson, J.W., & Keefe, F.J. (2011). Yoga for Persistent Pain: New Findings and Directions for an Ancient Practice. Pain, 152, 477-480.

Psychology Today Blog Post: "Confronting Death with an Open, Mindful Attitude"

Back in November, I posted about a study in which the researchers examined the impact of mindfulness on mortality salience ("Being Present in the Face of Existential Threat"). Today, one of the authors and George Mason University professor Dr. Todd Kashdan published a blog post about the study on the Psychology Today website

Dr. Kashdan provides a nice summary of the research and reflects upon his personal interest in the topic. He writes:

So what do mindful people do that allows them to confront death in a non-defensive manner? What we found was that when asked to deeply contemplate their death, mindful people spent more time writing (as opposed to avoiding) and used more death-related words when reflecting on the experience. This suggests that a greater openness to processing the threat of death allows compassion and fairness to reign. In this laboratory staged battle, mindfulness alters the power that death holds over us. Pretty cool.

To read Dr. Kashdan's full post, click here. To read the Scientific Mindfulness post on the original article, click here.

The Unwelcome Party Guest

This animated short by Joe Oliver illustrates a popular metaphor from the Acceptance and Commitment Therapy literature. I've heard the metaphor called "Joe the Bum" and "Aunt Edna"--here the uninvited guest is "Brian." (Also, my name!--there are any number of self-deprecatory comments I can insert here.)

The metaphor is used to illustrate the practice of acceptance or (in ACT terms) willingness.

Mindfulness-Based Treatments for Co-Occurring Depression and Substance Use Disorders: What Can We Learn from the Brain?

In a previous post, I wrote about the implications if a pilot study that Mindfulness-Based Relapse Prevention (MBRP) may help people in recovery avoid relapse during depressed moods (Witkiewitz & Bowen, 2010). A recent article in Addiction by Brewer and colleagues explores how mindfulness-based treatments may be useful in treating people with both substance use problems and depression. (The authors of the article include a few of the developers of MBRP--Drs. Alan Marlatt and Sarah Bowen.)

The article is largely theoretical and includes explorations of potential neurobiological processes that may change through mindfulness training. It's relatively brief, so feel free to check it yourself!

To download a copy of the article, click on the citation below:

Brewer, J.A., Bowen, S., Smith, J.T., Marlatt, G.A., & Potenza, M.N. (2010). Mindfulness-Based Treatments for Co-Occurring Depression and Substance Use Disorders: What Can We Learn from the Brain? Addiction, 105(10), 1698-1706.

Mindfulness Practice Leads to Increases in Regional Brain Gray Density Matter

Last week, I posted a New York Times article about a study looking at brain changes following an 8-week mindfulness program. As promised, I've since read the study on which the article was based and am posting my own summary.

Lead by Dr. Britta Hölzel, a group of researchers, mainly located at Massachusetts General Hospital, examined changes in the brain following an 8-week Mindfulness-Based Stress Reduction (MBSR) program. As I've posted about before, previous research has indicated differences in cortical thickness in areas of the brains of experience meditators compared to age-matched control groups. The weakness of the previous studies is that it doesn't rule out that people with pre-existing differences in brain structure may be more likely to gravitate towards meditation.

In the current study, the researchers conducted MRI scans of 16 people 2 weeks before and 2 weeks after an 8-week MBSR course. This scans were compared against a control sample of 17 people on wait list for the course. Researchers scanned the wait list group twice about 2 months apart. In addition the scans, participants also completed the Five-Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006), a self-report measure of mindfulness.

As the researchers predicted, MBSR participants showed significant increases in gray matter density in the left hippocampus, an area of the brain associated with arousal, responsiveness, and emotion regulation, according to the researchers. They suggest these changes may reflect improvements in regulating emotional responding. These changes were unrelated to self-reported mindfulness scores on the FFMQ and to the amount of time people practiced mindfulness outside the course. Contrary to the researchers' predictions, there was no changes in the insula, a region of the brain associated with awareness.

I'll note here that the researchers predicted changes in the hippocampus and insula prior to conducting the study. After looking at these regions, they also conducted exploratory analyses to examine whether there were changes in other parts of the brain that they did not make specific hypotheses about. What this means is that the researchers had no prior expectations about whether these other areas would change. Since they had the data, they thought, "Hey, let's take a look!" There's nothing wrong with this, but it does mean these results should be interpreted more cautiously, since there were no prior reasons to believe they would change.

These exploratory analyses found increases in density in the posterior cingulate cortex (PCC), the left temporo-parietal junction (TPJ), and in two regions of the cerebellum. In addition, there were changes in density within the brain stem. In the interests of space, I'll give a more general summary of the functions associated with these regions. According to the researchers, these regions of the brain appear to be associated with consciousness of one's self (TPJ), assessment of the self-relevance of stimuli (PCC), regulation of emotion and cognition (cerebellum).

This is a general summary of what the study found. As I'm not an expert in neuroscience, any errors in what I reported are likely mine. I encourage anyone interested to consult the original study if you want more detail.

Although this study shows greater methodological rigor in controlling for other possible influences other than meditation, as the authors note, their methodology is not completely airtight. Perhaps the biggest weakness is comparing a wait list control group against an active treatment. It's perfectly reasonable comparison, but the downside is that it doesn't control for the possibility of non-specific factors other than meditation influencing outcome. Said less technically, simply being in a group for 8 week may have caused changes independent of the actual mindfulness practices. In addition, the sample size is pretty small--which is understandable as neuroimaging research is expensive!

These caveats aside, this is a really important study in gathering further evidence that people may show actual physical changes in relevant areas brain through mindfulness practice. That significant differences were shown with only 8 weeks of mindfulness practice is pretty remarkable.

To download the article, click on the citation below:

Hölzel, B.K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S.M., et al. (2011). Mindfulness Practice Leads to Increases in Regional Brain Gray Density Matter. Psychiatry Research: Neuroimagining, 191, 36-43.

New York Times: How Meditation Changes the Brain

The New York Times published an article today on a recent study that provides further evidence that regular meditation practice  affects the brain. Compared to a control group, people who meditated 30 minutes a day for 8 weeks showed changes in brain gray-matter density. The affected regions of the brain are associated with memory, stress, empathy, and what they call "sense of self."

The research article was published in Psychiatry Research: Neuroimaging. Dr. Britta Hölzel, a psychologist at Mass General and Harvard Medical School, is first author. (Coincidentally, I printed out a copy of the article last week but haven't had a chance to look at it yet. I guess I'll move it up in my queue and will hopefully post a summary within the next few weeks.) According to the article:Times

M.R.I. brain scans taken before and after the participants’ meditation regimen found increased gray matter in the hippocampus, an area important for learning and memory. The images also showed a reduction of gray matter in the amygdala, a region connected to anxiety and stress. A control group that did not practice meditation showed no such changes.

I've written about changes in gray matter in meditators in a previous post, in which long-term meditators showed greater cortical thickness compared to non-meditators matched for age. A major difference between this study and those others is that the other studies looked at samples of experienced meditators whereas this study involved people who practed meditation for only 8 weeks! The article mentions a control group, but I wasn't clear if people were randomly assigned to either the control or meditation group. I'm really looking forward to reading the original article now! (UPDATE: I've since posted on the original article here.)

To read the Times article, click here.

In Opening Monologue, Jay Leno Refers to Dr. Twohig's Study of Acceptance and Commitment Therapy for OCD

Back in October, I posted about a study by Dr. Michael Twohig of Utah State. The study focused on the use of Acceptance and Commitment Therapy (ACT) in the treatment of obsessive-compulsive disorder.

I haven't seen it myself, but apparently Jay Leno made a joke about the study in a recent Tonight Show monologue. According to The Utah Statesman: 

A few weeks ago, Jay Leno's opening monologue mentioned a study that recently began here at USU focusing on scrupulosity. He joked that researchers are looking into people obsessed with morals and religion and the punch line was, "Yeah, we call those people parents."

While this is probably a footnote in Dr. Twohig's career, I still think it's really neat that the study is well-known enough to catch the attention of Leno or his cadre of joke writers.

The title of the article is "Leno-Featured Prof Sudies [SIC] Moral Obsessions." (That's a pretty glaring typo in the title!--I presume the writer meant "studies," not "sudies." College newspapers...)

To read the Utah Statesman article, click here.

To read my post of the actual study, click here.

A Novel Application of Acceptance and Commitment Therapy for Psychosocial Problems Associated with Multiple Sclerosis

In a previous post, I wrote about an 8-week mindfulness-based intervention for multiple sclerosis. Here's one that's even shorter: it's a one-shot 5-hour workshop.

This study is from Dr. John Forsyth's lab at the University of Albany - SUNY. His lab is also currently investigating the effectiveness of Dr. Forsyth's self-help book, from which some preliminary data looking at mindfulness and self-compassion was recently published.

Dr. Forsyth and another psychologist led a 5-hour Acceptance and Commitment Therapy (ACT) workshop for people with multiple sclerosis (MS). At the end of the workshop, participants were given a CD of various mindfulness exercises and a bunch of worksheets and exercises from the workshop. They also received daily practice logs to track what they did following the workshop. Fifteen people with MS completed a battery as part of the workshop, and 11 completed the battery again 12 weeks later.

According to the authors, MS is the most common cause of neurologic disability in the US. MS is incurable and associated with pain, fatigue, depression, and anxiety.

For a one-short 5-hour workshop, the results are very promising. Depression decreased over time, showing a large effect. (Depression went from the moderate-severe range down to the mild-moderate range.) Although the effect of pain itself did not change, the impact of pain on behavior and mood decreased at follow-up. Mindfulness did not improve, but people reported a reduced tendency to suppress thoughts, which suggests increased mindful acceptance. Lastly, overall quality of life improved at the follow-up. Participants reported practicing exercises from the workshop or listening to the mindfulness CD nearly 3 hours per week, which is pretty good.

Because of the design of the study, the findings are preliminary. With only 15 people, 4 of whom dropped out, it's difficult to know how representative the sample is; however, with such a small sample size, it's impressive the researchers found significant results at all, as the results had to be very strong to be detected. Also, without a comparison group, it's impossible to know if ACT was the active ingredient. The authors acknowledged these weaknesses and others in the paper.

Limitations aside, the results are extremely promising. If a 5-hour group could lead to some pretty strong improvements for people with a painful, incurable disease, this is well worth exploring further. According to the authors, traditional cognitive behavioral treatments have shown mixed results for people with MS, and even the positive results weren't all that impressive. By contrast, this is a short, inexpensive group intervention that may have made a real different in the lives of people with MS.

To download a pdf of the article, click on the citation below:

Sheppard, S.C., Forsyth, J.P., Hickling, E.J., & Bianchi, J.M. (2010). A Novel Application of Acceptance and Commitment Therapy for Psychosocial Problems Associated with Multiple Sclerosis: Results from a Half-Day Workshop Intervention. International Journal of MS Care, 12, 200-206.

Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhancing Psychological Flexibility

Within the past few years, I've been coming across more and more studies of time-limited, group interventions of mindfulness and acceptance-based treatments. Recently, a group of Dutch researchers designed and implemented a brief Acceptance and Commitment Therapy (ACT) intervention for people with mild to moderate distress.

From an initial pool of 140, 93 people were randomly assigned to either an ACT and mindfulness intervention (n = 49) or a wait list (n = 44). They completed measures before the intervention, immediately after the intervention, and 3 months after the intervention.

The ACT and mindfulness intervention consisted of eight 2-hour groups with about 7 people each. Facilitators taught each of the 6 core ACT processes, and mindfulness exercises were woven in each session. After the study ended, the wait list participants were allowed to take part in the intervention.

The researchers found that emotional and psychological well-being improved following the intervention. There was no change in social well-being. Psychological flexibility--defined as the ability to move towards meaningful change in the present moment--did not increase immediately after the intervention but showed improvement at the 3-month follow-up. I always find these sort of delayed effects interesting, as it suggests an active intervention beyond the basic group effects. Moreover, improvements in psychological flexibility appeared to impact improvements in mental health.

As the authors acknowledge, a wait list control group is not ideal, as it doesn't eliminate the possibility that improvements were related to the fact that people received eight session of something; that is, it's hard to tell if improvements are unique to the particular intervention. This caveat aside, the study joins a growing body of literature suggesting that comparatively brief, mindfulness-based intervention can have a significant impact on people.

Member of the Association for Contextual Behavioral Science can download the article here.

See below for the full citation:

Fledderus, M., Bohlmeijer, E.T., Smit, F., & Westerhof, G.J. (2010). Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhancing Psychological Flexibility. American Journal of Public Health, 100(12), 2372-2378.

On Being Mindful, Emotionally Aware, and More Resilient: Longitudinal Pilot Study of Police Recruits

I don't tend to read much research about the study of law enforcement. Consequently, it was with great curiosity that I came across a recent study by a group of researchers at the University of Wollongong in New South Wales, Australia.

Dr. Williams--along with Dr. Ciarrochi, who authored another study I recently wrote about on adolescent well-being--examined changes in police recruits between becoming trainees to being "probationary constables." Of the 592 recruits who completed the initial assessment through a Bachelor of Policing course, 60 completed the follow-up measures.

According to the authors, police are encouraged to not show emotions within the law enforcement culture. Research has shown that police become more emotionally detached within 18 months of service. As there's a large body of research suggesting that detachment from emotions can have detrimental consequences to emotional health, the researchers were interested in the interaction of these variables over time.

Perhaps the most striking finding of this study was that police recruits showed an increase in depression and other mental health problems after starting the job. What's really interesting, though, is that officers who were more mindful, less likely to suppress thoughts, and more able to identify feelings, showed smaller increases in depression. Moreover, of the variables measured by the researchers, low mindfulness was the strongest predictor of depression. (This indirectly supports the Mindfulness-Based Cognitive Therapy research.) Results suggest that mindfulness and the ability to identify one's feelings may have a protective factor for police recruits.

This study measured dispositional mindfulness. As the authors suggest, it would be really interesting to see if a mindfulness-based intervention may help to foster these abilities in police recruits. There could be significant long-term benefits for law enforcement agencies.

To download a copy of the study, click on the citation below:

Williams, V., Ciarrochi, J., & Deane, F.P. (2010). On Being Mindful, Emotionally Aware, and More Resilient: Longitudinal Pilot Study of Police Recruits. Australian Psychologist, 45(4), 274-282.

University of California-San Diego Center for Mindfulness

The Center for Mindfulness at UCSD has opened up a number of social networking opportunities.

For professionals interested in mindfulness-based treatments, there's a Mindfulness-Based Interventions Linked In group. (Click on the link to access.) From there, one can join subgroups, including Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Mindfulness-Based Relapse Prevention, among others.

In addition, there's a Center for Mindfulness Facebook Fan Page. (Click on the link to access.)

I just became aware of these sites today, so I haven't had a chance to fully explore them. However, the Center for Mindfulness has been an excellent resource for mindfulness-based training an resources for several years now. Their resources are well-worth checking out!

The Wall Street Journal Article on Mindfulness-Based Treatments

The 01/02/2011 issue of the The Wall Street Journal features an article by Melinda Beck on mindfulness-based treatments. The article quotes Dr. Steven Hayes, the prime originator of Acceptance and Commitment Therapy (ACT), Dr. Zindel Segal, one of the developers of Mindfulness-Based Cognitive Therapy (MBCT), and Dr. Marsha Linehan, the prime originator of Dialectical Behavior Therapy (DBT). According to the article:

This new psychology movement centers on mindfulness—the increasing popular emphasis on paying attention to the present moment. One of its key tenets is that urging people to stop thinking negative thoughts only tightens their grip—"like struggling with quicksand," Dr. Hayes says. But simply observing them like passing clouds can diffuse their emotional power, proponents say, and open up more options. ("Here's that old fat feeling again. You know, this happens every time I look at fashion magazines. I am sure judging myself harshly. Do I want to go to the gym? Or I could go to a movie. Or I could stop reading magazines.")

To read the full article, click here.

Self-Compassion is a Better Predictor Than Mindfulness of Symptom Severity and Quality of Life in Mixed Anxiety and Depression

Way back in June, I wrote about some data Dr. John Forsyth had collected about his self-help book, The Mindfulness and Acceptance Workbook for Anxiety. Dr. Forsyth's lab is still collecting data for the second part of the study; in the meantime, they've used some of it to look at the relationship between mindfulness and self-compassion to anxiety and depression. Self-compassion, which SM has posted about before, was developed by Dr. Kristin Neff and is based on Buddhist notions of compassion. The three components of self-compassion are mindfulness, kindness to one's self (as opposed to self-judgment), and feeling part of a common humanity (as opposed to isolation).

Dr. Forsyth's lab analyzed some of the data they've been collecting from 504 people to look at what processes may be most important to anxiety and depression. They used Dr. Neff's Self-Compassion Scale (SCS; Neff, 2003) and--for their measure of mindfulness--the Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003). The articles uses some very precise statistical terms that I'll try to translate for a more general audience, but please bear in mind that my descriptions below lose some of the nuance of the original.

Interestingly, self-compassion was a much better measure than mindfulness in accounting for problems with anxiety, depression, and overall quality of life. The SCS has several subscales: the most important one for anxiety and depression was the self-judgment subscale. Greater self-judgment showed a comparatively larger relationship with greater anxiety and depression. What this means is that the SCS appears to be a better than the MAAS in measuring treatment outcomes for people with anxiety and depression. It also suggests that awareness of thoughts and emotions may be less important than how one relates to them. What this means is that self-compassion may be a particularly important component in mindfulness-based treatments, and that it is a useful predictor of psychological health.

A caveat to these findings is that the MAAS is only one of several mindfulness measures. Some of the other mindfulness measures such as the Kentucky Inventory of Mindfulness Skills (KIMS) and the Five Facet Mindfulness Questionnaire (FFMQ) measure 4-5 aspects of mindfulness whereas the MAAS measures one. What is does suggest, though, is that self-compassion, as it is measured by the SCS, may be an extremely important construct in measuring treatment outcome for mindfulness-based therapies. This study contributes to a growing body of literature suggesting the importance of self-compassion as a construct.

To download a copy of the article, click on the full citation below:

Van Dam, N.T., Sheppard, S.C., Forsyth, J.P., & Earlywine, M. (2011). Self-Compassion is a Better Predictor Than Mindfulness of Symptom Severity and Quality of Life in Mixed Anxiety and Depression. Journal of Anxiety Disorders, 25, 123-130.