Emily K. Lindsay

Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress

OBJECTIVE To test whether a brief mindfulness meditation training intervention buffers self-reported psychological and neuroendocrine responses to the Trier Social Stress Test (TSST) in young adult volunteers. A second objective evaluates whether pre-existing levels of dispositional mindfulness moderate the effects of brief mindfulness meditation training on stress reactivity. METHODS Sixty-six (N=66) participants were randomly assigned to either a brief 3-day (25-min per day) mindfulness meditation training or an analytic cognitive training control program. All participants completed a standardized laboratory social-evaluative stress challenge task (the TSST) following the third mindfulness meditation or cognitive training session. Measures of psychological (stress perceptions) and biological (salivary cortisol, blood pressure) stress reactivity were collected during the social evaluative stress-challenge session. RESULTS Brief mindfulness meditation training reduced self-reported psychological stress reactivity but increased salivary cortisol reactivity to the TSST, relative to the cognitive training comparison program. Participants who were low in pre-existing levels of dispositional mindfulness and then received mindfulness meditation training had the greatest cortisol reactivity to the TSST. No significant main or interactive effects were observed for systolic or diastolic blood pressure reactivity to the TSST. CONCLUSIONS The present study provides an initial indication that brief mindfulness meditation training buffers self-reported psychological stress reactivity, but also increases cortisol reactivity to social evaluative stress. This pattern may indicate that initially brief mindfulness meditation training fosters greater active coping efforts, resulting in reduced psychological stress appraisals and greater cortisol reactivity during social evaluative stressors.

How Does Mindfulness Training Affect Health? A Mindfulness Stress Buffering Account:

Initial well-controlled studies have suggested that mindfulness training interventions can improve a broad range of mental and physical health outcomes (e.g., HIV pathogenesis, depression relapse, inflammation, drug abuse), yet the underlying pathways linking mindfulness and health are poorly understood. In this article, we offer a mindfulness stress buffering account to explain these health outcomes, which posits that mindfulness-based health effects are mostly likely to be observed in high-stress populations for which stress is known to affect the onset or exacerbation of disease pathogenic processes. We then offer an evidence-based biological model of mindfulness, stress buffering, and health.

Alterations in Resting-State Functional Connectivity Link Mindfulness Meditation With Reduced Interleukin-6: A Randomized Controlled Trial

BACKGROUND Mindfulness meditation training interventions have been shown to improve markers of health, but the underlying neurobiological mechanisms are not known. Building on initial cross-sectional research showing that mindfulness meditation may increase default mode network (DMN) resting-state functional connectivity (rsFC) with regions important in top-down executive control (dorsolateral prefrontal cortex [dlPFC]), here we test whether mindfulness meditation training increases DMN-dlPFC rsFC and whether these rsFC alterations prospectively explain improvements in interleukin (IL)-6 in a randomized controlled trial. METHODS Stressed job-seeking unemployed community adults (n = 35) were randomized to either a 3-day intensive residential mindfulness meditation or relaxation training program. Participants completed a 5-minute resting-state scan before and after the intervention program. Participants also provided blood samples at preintervention and at 4-month follow-up, which were assayed for circulating IL-6, a biomarker of systemic inflammation. RESULTS We tested for alterations in DMN rsFC using a posterior cingulate cortex seed-based analysis and found that mindfulness meditation training, and not relaxation training, increased posterior cingulate cortex rsFC with left dlPFC (p < .05, corrected). These pretraining to posttraining alterations in posterior cingulate cortex-dlPFC rsFC statistically mediated mindfulness meditation training improvements in IL-6 at 4-month follow-up. Specifically, these alterations in rsFC statistically explained 30% of the overall mindfulness meditation training effects on IL-6 at follow-up. CONCLUSIONS These findings provide the first evidence that mindfulness meditation training functionally couples the DMN with a region known to be important in top-down executive control at rest (left dlPFC), which, in turn, is associated with improvements in a marker of inflammatory disease risk.

Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: a randomized controlled trial

Recent studies indicate that mindfulness meditation training interventions reduce stress and improve stress-related health outcomes, but the neural pathways for these effects are unknown. The present research evaluates whether mindfulness meditation training alters resting state functional connectivity (rsFC) of the amygdala, a region known to coordinate stress processing and physiological stress responses. We show in an initial discovery study that higher perceived stress over the past month is associated with greater bilateral amygdala-subgenual anterior cingulate cortex (sgACC) rsFC in a sample of community adults (n = 130). A follow-up, single-blind randomized controlled trial shows that a 3-day intensive mindfulness meditation training intervention (relative to a well-matched 3-day relaxation training intervention without a mindfulness component) reduced right amygdala-sgACC rsFC in a sample of stressed unemployed community adults (n = 35). Although stress may increase amygdala-sgACC rsFC, brief training in mindfulness meditation could reverse these effects. This work provides an initial indication that mindfulness meditation training promotes functional neuroplastic changes, suggesting an amygdala-sgACC pathway for stress reduction effects.

Helping the self help others: self-affirmation increases self-compassion and pro-social behaviors

Reflecting on an important personal value in a self-affirmation activity has been shown to improve psychological functioning in a broad range of studies, but the underlying mechanisms for these self-affirmation effects are unknown. Here we provide an initial test of a novel self-compassion account of self-affirmation in two experimental studies. Study 1 shows that an experimental manipulation of self-affirmation (3-min of writing about an important personal value vs. writing about an unimportant value) increases feelings of self-compassion, and these feelings in turn mobilize more pro-social behaviors to a laboratory shelf-collapse incident. Study 2 tests and extends these effects by evaluating whether self-affirmation increases feelings of compassion toward the self (consistent with the self-compassion account) or increases feelings of compassion toward others (an alternative other-directed compassion account), using a validated storytelling behavioral task. Consistent with a self-compassion account, Study 2 demonstrates the predicted self-affirmation by video condition interaction, indicating that self-affirmation participants had greater feelings of self-compassion in response to watching their own storytelling performance (self-compassion) compared to watching a peer’s storytelling performance (other-directed compassion). Further, pre-existing levels of trait self-compassion moderated this effect, such that self-affirmation increased self-compassionate responses the most in participants low in trait self-compassion. This work suggests that self-compassion may be a promising mechanism for self-affirmation effects, and that self-compassionate feelings can mobilize pro-social behaviors.

Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT)

Despite evidence linking trait mindfulness and mindfulness training with a broad range of effects, still little is known about its underlying active mechanisms. Mindfulness is commonly defined as (1) the ongoing monitoring of present-moment experience (2) with an orientation of acceptance. Building on conceptual, clinical, and empirical work, we describe a testable theoretical account to help explain mindfulness effects on cognition, affect, stress, and health outcomes. Specifically, Monitor and Acceptance Theory (MAT) posits that (1), by enhancing awareness of ones experiences, the skill of attention monitoring explains how mindfulness improves cognitive functioning outcomes, yet this same skill can increase affective reactivity. Second (2), by modifying ones relation to monitored experience, acceptance is necessary for reducing affective reactivity, such that attention monitoring and acceptance skills together explain how mindfulness improves negative affectivity, stress, and stress-related health outcomes. We discuss how MAT contributes to mindfulness science, suggest plausible alternatives to the account, and offer specific predictions for future research.

Brief Mindfulness Meditation Training Reduces Mind Wandering: The Critical Role of Acceptance.

Mindfulness meditation programs, which train individuals to monitor their present-moment experience in an open or accepting way, have been shown to reduce mind wandering on standardized tasks in several studies. Here we test 2 competing accounts for how mindfulness training reduces mind wandering, evaluating whether the attention-monitoring component of mindfulness training alone reduces mind wandering or whether the acceptance training component is necessary for reducing mind wandering. Healthy young adults (N = 147) were randomized to either a 3-day brief mindfulness training condition incorporating instruction in both attention monitoring and acceptance, a mindfulness training condition incorporating attention monitoring instruction only, a relaxation training condition, or an active reading-control condition. Participants completed measures of dispositional mindfulness and treatment expectancies before the training session on Day 1 and then completed a 6-min Sustained Attention to Response Task (SART) measuring mind wandering after the training session on Day 3. Acceptance training was important for reducing mind wandering, such that the attention-monitoring plus acceptance mindfulness training condition had the lowest mind wandering relative to the other conditions, including significantly lower mind wandering than the attention-monitoring only mindfulness training condition. In one of the first experimental mindfulness training dismantling studies to-date, we show that training in acceptance is a critical driver of mindfulness-training reductions in mind wandering. This effect suggests that acceptance skills may facilitate emotion regulation on boring and frustrating sustained attention tasks that foster mind wandering, such as the SART.

Back to the Basics: How Attention Monitoring and Acceptance Stimulate Positive Growth

Mindfulness-to-meaning theory moves beyond asking how mindfulness reduces negative affective states (a dominant theme in the mindfulness literature) to a focus on how mindfulness might foster positive psychological processes and outcomes. Specifically, how might mindfulness cultivate personal growth and flourishing? Mindfulness is a practice of monitoring present-moment experiences with an orientation of acceptance, regardless of the content or affective tone of those experiences. But when we return to our daily lives, where the content of our thoughts and feelings does have self-relevant meaning and implications, how does mindfulness integrate with these evaluative processes to initiate a chain of positive growth? The target article by Garland, Farb, Goldin, and Fredrickson (this issue) addresses these questions by describing how mindfulness engenders positive reappraisal and savoring, and through multiple iterations of decentering and metacognitive awareness, a cascade of positive growth and meaning making is posited. Despite a tremendous surge of empirical work on mindfulness and mindfulness training interventions over the last 15 years (Brown, Ryan, & Creswell, 2007; Creswell & Lindsay, 2014), there have been few organizing conceptual or theoretical models offered in the mindfulness literature (Brown, Creswell, & Ryan, 2015). Mindfulness-to-meaning theory offers a new conceptual lens that attempts to bridge mindfulness research with theoretical perspectives in positive psychology and affective science, and we welcome this important contribution to the literature. In our commentary, we first offer some questions raised by the mindfulness-to-meaning theoretical account and then turn to some considerations of what specific mechanisms of mindfulness may be important for triggering and propagating positive growth and meaning-making processes.

Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial

OBJECTIVE Mindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects. METHOD In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor+Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age=32years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test. RESULTS As predicted, Monitor+Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress. CONCLUSIONS This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.

Mindfulness Meditation Training and Executive Control Network Resting State Functional Connectivity: A Randomized Controlled Trial

Objective Mindfulness meditation training has been previously shown to enhance behavioral measures of executive control (e.g., attention, working memory, cognitive control), but the neural mechanisms underlying these improvements are largely unknown. Here, we test whether mindfulness training interventions foster executive control by strengthening functional connections between dorsolateral prefrontal cortex (dlPFC)—a hub of the executive control network—and frontoparietal regions that coordinate executive function. Methods Thirty-five adults with elevated levels of psychological distress participated in a 3-day randomized controlled trial of intensive mindfulness meditation or relaxation training. Participants completed a resting state functional magnetic resonance imaging scan before and after the intervention. We tested whether mindfulness meditation training increased resting state functional connectivity (rsFC) between dlPFC and frontoparietal control network regions. Results Left dlPFC showed increased connectivity to the right inferior frontal gyrus (T = 3.74), right middle frontal gyrus (MFG) (T = 3.98), right supplementary eye field (T = 4.29), right parietal cortex (T = 4.44), and left middle temporal gyrus (T = 3.97, all p < .05) after mindfulness training relative to the relaxation control. Right dlPFC showed increased connectivity to right MFG (T = 4.97, p < .05). Conclusions We report that mindfulness training increases rsFC between dlPFC and dorsal network (superior parietal lobule, supplementary eye field, MFG) and ventral network (right IFG, middle temporal/angular gyrus) regions. These findings extend previous work showing increased functional connectivity among brain regions associated with executive function during active meditation by identifying specific neural circuits in which rsFC is enhanced by a mindfulness intervention in individuals with high levels of psychological distress. Clinical Trial Registration Clinicaltrials.gov, NCT01628809.