Larissa G. Duncan

A Model of Mindful Parenting: Implications for Parent–Child Relationships and Prevention Research

This paper introduces a model of “mindful parenting” as a framework whereby parents intentionally bring moment-to-moment awareness to the parent–child relationship. This is done by developing the qualities of listening with full attention when interacting with their children, cultivating emotional awareness and self-regulation in parenting, and bringing compassion and nonjudgmental acceptance to their parenting interactions. First, we briefly outline the theoretical and empirical literature on mindfulness and mindfulness-based interventions. Next, we present an operational definition of mindful parenting as an extension of mindfulness to the social context of parent–child relationships. We discuss the implications of mindful parenting for the quality of parent–child relationships, particularly across the transition to adolescence, and we review the literature on the application of mindfulness in parenting interventions. We close with a synopsis of our own efforts to integrate mindfulness-based intervention techniques and mindful parenting into a well-established, evidence-based family prevention program and our recommendations for future research on mindful parenting interventions.

Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver–Child Relationship Quality, and Neighborhood Cohesion as Protective Factor

This short-term, longitudinal interview study used an ecological framework to explore protective factors within the child, the caregiver, the caregiver–child relationship, and the community that might moderate relations between community violence exposure and subsequent internalizing and externalizing adjustment problems and the different patterns of protection they might confer. Participants included 101 pairs of African American female caregivers and one of their children (56% male, M = 11.15 yrs, SD = 1.28) living in high-violence areas of a mid-sized southeastern city. Child emotion regulation skill, felt acceptance from caregiver, observed quality of caregiver–child interaction, and caregiver regulation of emotion each were protective, but the pattern of protection differed across level of the childs ecology and form of adjustment. Implications for prevention are discussed.

The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample

OBJECTIVES There is increasing recognition of the links between mindfulness, decreased stress, and healthier psychological functioning. However, the majority of this research has been conducted in US samples and the mechanisms through which mindfulness decreases stress and increases well-being are not well understood. The aim of this study was to examine the relations between mindfulness and psychological functioning in a general population sample in Sweden. DESIGN This cross-sectional study examined the association of mindfulness and five subscales of mindfulness with depression, anxiety, positive states of mind (PSOM), and perceived health. METHODS In the spring of 2007, a random population-based sample of N= 1,000 individuals aged 18-60 years in Sweden was contacted by mail with a request to participate in the study. RESULTS Mindfulness and some of its subscales, in particular Acting with awareness and Non-reactivity to inner experiences, were strongly related to PSOM and perceived health, and inversely related to depression and anxiety. Tests of the moderating role of mindfulness showed that the associations of perceived stress with depression and perceived health were diminished for those with higher levels of mindfulness. CONCLUSIONS Mindfulness is strongly related to well-being and perceived health. Results suggest that dispositional mindfulness might buffer against the negative influence of perceived stress on psychological well-being. These findings give additional support for the use of mindfulness training as a way of improving psychological functioning among people experiencing stress.

Patterns of Retention in a Preventive Intervention with Ethnic Minority Families

This study examined socio-demographic, child, and family-level correlates of retention patterns among parent participants of Familias Unidas/SEPI (Coatsworth, Pantin, & Szapocznik, 2002), a randomized, controlled trial of a family-focused preventive intervention. The current studys aim was to identify variables that could be used to classify ethnic minority (African American and Hispanic) caregivers (N = 143) into their known patterns of retention across 30 sessions of the intervention. Person-centered analyses identified three broad attendance pattern groups: (a) non-attenders; (b) variable-attenders; (c) consistent-high-attenders. Subgroups of the variable-attender group included: (a) dropouts; (b) variable-low-attenders; (c) variable-high-attenders. Four socio-demographic indicators were significant discriminators of the broad retention patterns. Three family-level factors were significant discriminators of the variable-attender subgroups. Additional significant mean/rate differences among retention pattern groups on correlates are reported. Implications for how retention is examined in preventive interventions and for developing intervention strategies for improving retention rates are discussed. Editors Strategic Implications: The authors address factors related to clients’ engagement and retention from multiple ecological levels. Lessons from this low income, low education, minority sample may prove useful to program developers who want to build in supports and incentives prior to program implementation.

A positive affect intervention for people experiencing health-related stress: Development and non-randomized pilot test:

In this article we present background, theoretical rationale, and pilot data on the development of an intervention designed to increase positive affect in people living with serious health-related stress. This proof-of-concept study demonstrated that a multiple-component positive affect intervention is feasible and acceptable for people newly diagnosed with HIV. Retention in the intervention and adherence to home practice were high. Participants reported significant increases in positive affect and significant decreases in negative affect. This positive affect intervention can serve as a template for programs to be developed to help people experiencing health-related and other types of life stress.

Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized Wait-List Controlled Trial

CONTEXT Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV. OBJECTIVES This study tested the efficacy of Mindfulness-Based Stress Reduction (MBSR) for reducing ART symptoms and bother/distress related to ART side effects. Secondary aims were to test the impact of MBSR on medication adherence and psychological functioning. METHODS Seventy-six people living with HIV who were actively taking ART and reported distress from ART-related side effects were randomly assigned to an MBSR program or a wait-list control (WLC) standard care condition. We measured side effects, ART adherence, perceived stress, depression, positive and negative affect, and mindfulness at three time points: baseline, three-month follow-up, and six-month follow-up. Side effects and related distress were assessed separately from other symptoms. RESULTS Compared with a WLC, participants in the MBSR condition experienced a reduction in the frequency of symptoms attributable to ARTs at three months post-intervention (mean difference=0.33; 95% confidence interval [CI]=0.01, 0.66; t(132)=2.04, P=0.044) and six months post-intervention (mean difference=0.38; 95% CI=0.05, 0.71; t(132)=2.27, P=0.025). MBSR participants also experienced a reduction in distress associated with those symptoms at three months post-intervention (mean difference=0.47; 95% CI=0.003, 0.94; t(132)=1.99, P=0.048) compared with the WLC condition. CONCLUSION MBSR is a promising approach for reducing HIV treatment-related side effects.

Functional connectivity of negative emotional processing in adolescent depression

BACKGROUND The subgenual anterior cingulate cortex (sgACC) and its connected circuitry have been heavily implicated in emotional functioning in adolescent-onset major depressive disorder (MDD). While several recent studies have examined sgACC functional connectivity (FC) in depressed youth at rest, no studies to date have investigated sgACC FC in adolescent depression during negative emotional processing. METHODS Nineteen medication-naïve adolescents with MDD and 19 matched healthy controls (HCL) performed an implicit fear facial affect recognition task during functional magnetic resonance imaging (fMRI). We defined seeds in bilateral sgACC and assessed FC using the psychophysiological interaction method. We also applied cognitive behavioral modeling to estimate group differences in perceptual sensitivity in this task. Finally, we correlated connectivity strength with clinical data and perceptual sensitivity. RESULTS Depressed adolescents showed increased sgACC-amygdala FC and decreased sgACC-fusiform gyrus, sgACC-precuneus, sgACC-insula, and sgACC-middle frontal gyrus FC compared to HCL (p<0.05, corrected). Among the MDD, sgACC-precuneus FC negatively correlated with depression severity (p<0.05, corrected). Lastly, MDD adolescents exhibited poorer perceptual sensitivity in the task than HCL, and individual differences in perceptual sensitivity significantly correlated with sgACC FC and depression scores (p<0.05, corrected). LIMITATIONS Subjects were clinically homogenous, possibly limiting generalizability of the findings. CONCLUSIONS Adolescent depression is associated with biased processing of negative stimuli that may be driven by sgACC dysregulation and may possibly lead to an imbalance among intrinsic functional brain networks. This work also establishes the use of combining neuroimaging and cognitive behavioral modeling methods to investigate cognitive and neural differences between psychiatric and healthy populations.

Integrating mindfulness with parent training: effects of the Mindfulness-Enhanced Strengthening Families Program.

There is growing support for the efficacy of mindfulness training with parents as an intervention technique to improve parenting skills and reduce risk for youth problem behaviors. The evidence, however, has been limited to small scale studies, many with methodological shortcomings. This study sought to integrate mindfulness training with parents into the Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14), an empirically-validated family-based preventive intervention. It used a randomized-controlled comparative effectiveness study design (N = 432 families, 31% racial/ethnic minority) to test the efficacy of the Mindfulness-Enhanced Strengthening Families Program (MSFP), compared to standard SFP 10-14 and a minimal-treatment home study control condition. Results indicated that, in general, MSFP was as effective as SFP 10-14 in improving multiple dimensions of parenting, including interpersonal mindfulness in parenting, parent-youth relationship quality, youth behavior management, and parent well-being, according to both parent and youth reports at both postintervention and 1-year follow-up. This study also found that in some areas MSFP boosted and better sustained the effects of SFP 10-14, especially for fathers. Although the pattern of effects was not as uniform as hypothesized, this study provides intriguing evidence for the unique contribution of mindfulness activities to standard parent training.

Retaining Ethnic Minority Parents in a Preventive Intervention: The Quality of Group Process

This study examined relations between group process variables and retention of ethnic minority (African American and Hispanic) caregivers in a family-focused preventive intervention. Data from the Familias Unidas/SEPI project (Coatsworth, Pantin, & Szapocznik, 2002), a randomized, controlled intervention trial, were used to cluster participants according to their patterns of retention over 30 intervention sessions. These person-centered analyses identified three broad patterns: (a) dropouts; (b) variable-attenders; and (c) consistent-high-attenders. Two subgroups of the variable-attender group were also identified: (a) intermittent-attenders, and (b) continual-attenders. Discriminant Function Analysis (DFA) with follow-up Analysis of Variance tested for differences among the three main retention groups on facilitator ratings of participants’ general level of participation, leadership, positive alliance with the group, and negative alliance with the group during the first half of the intervention. Leadership and positive alliance significantly discriminated the broad retention patterns. Mean level of participation was not significantly different across retention groups. Results of DFA and ANOVA analyses using leadership, alliance, and participation variables from the first and second halves of the intervention indicated only leadership and positive alliance during the second half of the intervention discriminated continual-attenders from intermittent-attenders.Editors’ Strategic Implications: The authors describe a promising approach to studying facilitators’ assessments of client involvement in a family-focused preventive intervention. The quality of the participants’ behavior during sessions, rather than their absolute levels of participation, predicted their pattern of retention in the program. Future comparisons of facilitator and parent views may prove helpful.

Pilot Study to Gauge Acceptability of a Mindfulness-Based, Family-Focused Preventive Intervention

The purpose of the present study was to conduct a test of acceptability of a new model for family-focused drug prevention programs for families of early adolescents. An existing evidence-based behavioral intervention, the Strengthening Families Program: For Parents and Youth 10–14 (SFP), was adapted to include concepts and activities related to mindfulness and mindful parenting (an extension of mindfulness to the interpersonal domain of parent–child relationships). The foundation for this innovative intervention approach stems from research on the effects of mind-body treatments involving mindfulness meditation and the function of stress and coping in relation to parenting and parent well-being. One group of families participated in a seven-week pilot of this mindfulness-enhanced version of SFP. Results of a mixed-method implementation evaluation suggest that the new intervention activities were generally feasible to deliver, acceptable to participants, and perceived to yield positive benefits for family functioning and parent psychological well-being. The next phase of this research will involve curriculum refinement based upon results of this initial study, and a larger pilot efficacy trial will be conducted.