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Introduction The efficacy of interventions based on mindfulness and compassion has been demonstrated in both clinical and general population, and in different social contexts. These interventions include so-called attentional and constructive meditation practices, respectively. However, there is a third group, known as deconstructive meditation practices, which has not been scientifically studied. Deconstructive practices aim to undo maladaptive cognitive patterns and generate knowledge about internal models of oneself, others and the world. Although there are theoretical and philosophical studies on the origin of addiction to the self or on the mechanisms of action associated with the deconstruction of the self, there are no randomized controlled trials evaluating these techniques in either a healthy population or clinical samples. This study aims to evaluate the effect of three deconstructive techniques by comparing them to mindfulness in the general population. Methods and analysis A randomized controlled clinical trial will be conducted with about 240 participants allocated to four groups: (a) mindful breathing, (b) prostrations, according to Tibetan Buddhist tradition; (c) the Koan Mu, according to Zen Buddhist tradition; and (d) the mirror exercise, according to Toltec tradition. The primary outcome will be the qualities of the non-dual experience and spiritual awakening, measured by the Nondual Embodiment Thematic Inventory, assessed at pre- and post-treatment and at 3- and 6-month follow-ups. Other outcomes will be mindfulness, happiness, compassion, affectivity and altered state of consciousness. Quantitative data will be compared using mixed-effects linear regression models, and qualitative data will be analysed through thematic analysis and using the constant comparative method from grounded theory. Ethics and dissemination Approval was obtained from the Research Ethics Committee of Aragon, Spain. The results will be submitted to peer-reviewed specialized journals, and brief reports will be sent to participants on request. Trial registration ClinicalTrials.gov NCT05317754. Registered on August 2,2022.

Ajuts: Financial support was obtained through Gobierno de Aragón's funding of regional excellence research groups (B17-20R). This study was supported by the Chair of Contemplative Sciences and Master of Mindfulness degree program of University of Zaragoza, Spain. The funders did not have any influence on the results. Fibromyalgia patients often experience anxiety and depressive symptoms; however, validated interventions show only limited efficacy. This pilot study analyzed the effects of a 16-session version of attachment-based compassion therapy (ABCT-16) for improving anxiety and depressive symptomatology, as well as self-compassion and decentering, in 11 fibromyalgia patients. Scales were assessed at four time points: baseline, after sessions 8 and 16, and 3.5 months after the completion of the program. Significant improvements were found in all outcomes after the program, and most remained significant in the follow-up assessment. Our preliminary results suggest that ABCT-16 can be effective for improving anxiety and depressive symptomatology in fibromyalgia patients. Nonetheless, further studies with larger samples and control groups are necessary to confirm these results.

Objectives: In this study, we analyzed the validation and effects of a brief intervention of Attachment-Based Compassion Therapy (ABCT). Specifically, the aim of this study was to assess the efficacy of this brief protocol in improving compassion and other related variables. Method: The intervention consists of two five-hour sessions, in a controlled trial with one intervention group (ABCT) and one control group. Before and after the intervention, a short questionnaire was administered, focused on compassion and other related variables (i.e. transcendence beliefs, happiness, endo-group solidarity, and global identity). Participants in the experimental group were 17 healthy adults (i.e., students and university teachers) attending a compassion intervention based on ABCT. The control group was composed of 44 participants who did not attend the intervention. Results: Results showed that, compared to the control group, the brief ABCT intervention significantly improved compassion, which was the main aim of the intervention, and further analysis showed that it also significantly increased transcendence beliefs and endo-group solidarity. Moreover, the ABCT intervention were empirically validated. Conclusions: These results confirm and validate the potential of a brief ABCT intervention. Objetivos: Este estudio pretende analizar la validación y los efectos de una intervención breve centrada en la Terapia de compasión basada en los estilos de apego (ABCT). Específicamente, se trata de evaluar la eficacia de este breve protocolo para mejorar la compasión y otras variables relacionadas. Método: La intervención consta de dos sesiones de cinco horas, en un ensayo controlado con un grupo de intervención (ABCT) y un grupo control. Antes y después de la intervención, se administró un cuestionario, centrado en la compasión y otras variables relacionadas (creencias de trascendencia, felicidad, solidaridad endogrupal e identidad global). Los participantes en el grupo experimental fueron 17 adultos sanos (estudiantes y profesores universitarios) que asistieron a una intervención de compasión basada en ABCT. El grupo de control estuvo compuesto por 44 participantes que no asistieron a la intervención. Resultados: Los resultados mostraron que en comparación con el grupo control, la intervención breve ABCT mejoró significativamente la compasión, que era el objetivo principal de la intervención, y un análisis posterior mostró que también aumentaron significativamente las creencias de trascendencia y la solidaridad endogrupal. Además, la intervención ABCT fue validada empíricamente. Conclusiones: Estos resultados confirman y validan el potencial de una intervención breve en ABCT.

El ejercicio físico está demostrando en los últimos años ser una buena estrategia antidepresiva complementaria para muchos pacientes. La asociación entre el grado de actividad física y las características clínicas y sociodemográficas en la Depresión aún no se ha estudiado suficientemente en muestras amplias y representativas de pacientes. Hacerlo es importante para obtener información que posibilite mejorar el diseño de programas destinados a promover el ejercicio físico en estos pacientes. Se reclutaron 3374 pacientes con Depresión Mayor en tratamiento, que acudieron a consulta psiquiátrica por primera vez en Centros de Salud Mental distribuidos por toda España. Fueron clasificados en tres grupos de acuerdo con el nivel de actividad física semanal que declararon. En este estudio comparamos el grupo que comunicó mayor actividad física (n = 1033; 30.6%) con el que menos (n = 858; 25.4%). Los pacientes más activos tenían menor gravedad clínica de acuerdo con la puntuación en la escala Montgomery-Asberg Depression Rating Scale (MADRS). Además eran más jóvenes, con mejor nivel educativo y de empleo, menor aislamiento social y menor consumo de tabaco. Sin embargo, cuando todas estas variables fueron controladas, la diferencia en la puntuación en la MADRS seguía siendo estadísticamente significativa. De lo anterior deducimos que los pacientes depresivos con más edad o dificultades socioeconómicas tienden a hacer menos ejercicio espontáneamente, por lo que probablemente necesiten un apoyo especial al recomendárselo. Physical activity is showing in recent years to be a good antidepressant complementary strategy for many patients. The association between the degree of physical activity and clinical and sociodemographic characteristics in depression has still not been studied sufficiently in large and representative patient samples. Doing so is important to improve the design of programs that promote physical activity in depressive patients. 3374 patients with Major Depression who first came to psychiatric consultation in mental health centres in Spain were recruited. They were classified into three groups according to the level of weekly physical activity declared. In this study we compared the most physical activity declared group (n = 1033; 30.6%) with less physical activity declared group (n = 858; 25.4%). Most physically active patients had lower clinical depression severity according to the Montgomery-Asberg Depression Rating Scale (MADRS) scale. They were also younger, with higher education level and employment status; do not tend to live alone and less tobacco use. However, when all these variables were controlled, differences in MADRS Scores between groups remain statistically significant. Older and with socioeconomic difficulties depressive patients tend to do less physical activity, for this reason, it is probably that they need a particular support to recommend do exercise. A atividade física mostra nos últimos anos uma boa estratégia de antidepressivos complementares para muitos pacientes. A associação entre o grau de atividade física e as características clínicas e sociodemográcas na Depressão ainda não foi sucientemente estudada em amostras grandes e representativas de pacientes. Fazer isso é importante para obter informa- ções que permitam melhorar o design de programas destinados a promover a atividade física nesses pacientes. Registramos 3374 pacientes com maior depressão no tratamento, que participaram de consultas psiquiátricas pela primeira vez em centros de saúde mental distribuídos em toda a Espanha. Eles foram classicados em três grupos de acordo com o nível de atividade física semanal que relataram. Neste estudo, comparamos o grupo que relatou a maior atividade física (n = 1033, 30,6%) com o mínimo (n = 858, 25,4%). Os pacientes mais ativos tiveram menor gravidade clínica de acordo com a pontuação na Escala de Avaliação de Depressão de Montgomery-Asberg (MADRS). Eles também eram mais jovens, com melhores níveis educacionais e de emprego, menos isolamento social e menor consumo de tabaco. No entanto, quando todas essas variáveis foram controladas, a diferença no índice MADRS permaneceu estatisticamente signicante. A partir do acima, deduzimos que os pacientes deprimidos mais velhos ou as diculdades socioeconômicas tendem a uma atividade física espontaneamente menor, então eles provavelmente precisam de apoio especial ao recomendá-lo.

Additional file 1. SPIRIT 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents.

SPIRIT checklist. (DOC 137 kb)

Despite the long-term use and evidence-based efficacy of meditation and mindfulness-based interventions, there is still a lack of data about the possible unwanted effects (UEs) of these practices. The aim of this study was to evaluate the occurrence of UEs among meditation practitioners, considering moderating factors such as the type, frequency, and lifetime duration of the meditation practices.An online survey was developed and disseminated through several websites, such as Spanish-, English- and Portuguese-language scientific research portals related to mindfulness and meditation. After excluding people who did not answer the survey correctly or completely and those who had less than two months of meditation experience, a total of 342 people participated in the study. However, only 87 reported information about UEs.The majority of the practitioners were women from Spain who were married and had a University education level. Practices were more frequently informal, performed on a daily basis, and followed by focused attention (FA). Among the participants, 25.4% reported UEs, showing that severity varies considerably. The information requested indicated that most of the UEs were transitory and did not lead to discontinuing meditation practice or the need for medical assistance. They were more frequently reported in relation to individual practice, during focused attention meditation, and when practising for more than 20 minutes and alone. The practice of body awareness was associated with UEs to a lesser extent, whereas focused attention was associated more with UEs.This is the first large-scale, multi-cultural study on the UEs of meditation. Despite its limitations, this study suggests that UEs are prevalent and transitory and should be further studied. We recommend the use of standardized questionnaires to assess the UEs of meditation practices.

Background. The practice of meditation has been shown to improve pain-related quality of life and also to alter brain activity. To assess brain volumetry in fibromyalgia ( FM) patients, healthy meditators and healthy non-meditator control groups, and to elucidate the possible association between brain changes in meditators and years of meditation practice. Methods. Twelve patients diagnosed with FM, eleven long-term Zen meditators and ten healthy control subjects closely matched for sex and age were recruited. A high resolution T1-3D sequence was acquired and a high-dimensional DARTEL normalization strategy was applied. Questionnaires on anxiety, depression and cognitive impairment were administered. Results. There was a statistically significant increase in grey matter volume in the Brodmann area 20 (right and left inferior temporal gyri) in patients with fibromyalgia and a significant decrease in the meditator group as compared to controls. On the other hand, there was a significant increase in grey matter volume in fibromyalgia patients as compared to controls and meditators, to the right temporal gyrus (p=0.03, t=6.85) and left temporal gyrus (p=0.04, t=6.31). The number of months of meditation did not correlate with significant grey matter volume changes in the meditator group. Conclusions. FM and meditation appears to be reliably associated with altered anatomical structure in the Brodmann area 20 (in both inferior temporal gyri), and these changes are associated with anxiety and depression levels. In addition, exploratory morphometric analyses for fibromyalgia patients and meditators may reveal relevant brain regions showing structural diminution in meditation practitioners. Morphologic changes might predispose toward vulnerability to develop a chronic pain state. Such structural diminutions could potentially indicate functional benefits.

Background: Economic crises have a negative effect on mental health. Little evidence has been published on the impact of economic downturns on male and female. The aim of the study was to analyze gender differences in specific mental disorders in primary care during the current economic recession in Spain. Method: A total of 7, 914 patients in 2006 and 5, 876 patients in 2010 were recruited to collect sociodemographic data and the Primary Care Evaluation of Mental Disorders. Results: Between 2006 and 2010 the prevalence of Major Depressive Disorder increased 155.7% in men and 104.9% in women; Generalized Anxiety Disorder increased 98.3% in men and 71.3% in women; and Multisomatoform Disorder increased 100.05% in men and 37% in women. The effect of the Employment confounder was significant across all comparisons: Major Depressive Disorder Generalized Odds Ratio=2.557 for Men (p

Background Primary health care professionals (PHPs) usually report high levels of distress and burnout symptoms related to job strain. Mindfulness, defined as non-judgmental-present-moment awareness, seems to be a moderator in the causal association between life stressors and well-being. This study aimed to verify correlations among self-reported mindfulness, perceived stress (PS), and subjective well-being (SW) in Brazilian PHPs. Methods We performed a correlational cross-sectional study in a purposive sample of Brazilian PHPs (physicians, nurses, nursing assistants, and community health workers), working in community-oriented primary care programs (known locally as “Family Health Programs”). We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), and the Subjective Well-being Scale (SWS). We performed a multivariate analysis of variance (MANOVA), through regression coefficients (beta) in relation to the professional category (nursing assistant), in addition to the length of time in the same job (under than 6 months) that had indicated the lowest level of PS. Results Participants (n = 450) comprised community health workers (65.8 %), nursing assistants (18 %), registered nurses (10.0 %), and doctors (family physicians) (6.0 %); 94 % were female and 83.1 % had worked in the same position for more than one year. MANOVA regression analysis showed differences across professional categories and length of time in the same job position in relation to mindfulness, PS, and SW. Nurses demonstrated lower levels of mindfulness, higher PS, and SW negative affect, as well as lower SW positive affect. Being at work for 1 year or longer showed a clear association with higher PS and lower SW positive affect, and no significance with mindfulness levels. Pearson’s coefficient values indicated strong negative correlations between mindfulness and PS, and medium correlations between mindfulness and SW. Conclusion In this study, there were clear correlations between mindfulness, PS, and SW across different primary care professional categories and time in the same job position, suggesting specific vulnerabilities that should be addressed through the development of staff awareness, stress prevention, and well-being interventions. We are grateful to Dr. Luiz B Leonelli for all support during data collection and to the CAPES - Brazilian Coordination for the Improvement of Higher Education Personnel - for a master fellowship supporting the first author (ACMA). Federal University of Sao Paulo (UNIFESP) Funding Agency and the Postgraduate Program on Public Health of the UNIFESP.

Objective To investigate the psychometric and structural properties of the Five Facets Mindfulness Questionnaire (FFMQ) among meditators, to develop a short form, and to examine associations of mindfulness with mental health and the mechanisms of mindfulness. Methods Two independent samples were used, a German (n = 891) and a Spanish (n = 393) meditator sample, practicing various meditation styles. Structural and psychometric properties of the FFMQ were investigated with multigroup confirmatory factor analysis and exploratory structural equation modeling. Associations with mental health and mechanisms of mindfulness were examined with path analysis. Results The derived short form broadly matched a previous item selection in samples of non-meditators. Self-regulated Attention and Orientation to Experience governed the facets of mindfulness on a higher-order level. Higher-order factors of mindfulness and meditation experience were negatively associated with symptoms of depression and anxiety, and perceived stress. Decentering and nonattachment were the most salient mechanisms of mindfulness. Aspects of emotion regulation, bodily awareness, and nonattachment explained the effects of mindfulness on depression and anxiety. Conclusions A two-component conceptualization for the FFMQ, and for the study of mindfulness as a psychological construct, is recommended for future research. Mechanisms of mindfulness need to be examined in intervention studies.

BACKGROUND: To assess the psychometric properties and the factor structure of the Spanish version of the Scale of Body Connection (SBC) in a community population of meditators and non-meditators and to investigate the relationships among mindfulness, body awareness and body dissociation. METHODS: Design. Validation study. Sampling. An internet-based commercial system was used to recruit the sample. Instruments. In addition to the SBC, the Five Facet Mindfulness Questionnaire (FFMQ) and the Depression, Anxiety, and Stress Scale (DASS-21) were administered. RESULTS: A sample of 578 subjects responded to all of the items in the protocol. A total of 55.2% of respondents had some previous experience with meditation. A Scree plot showed a two-factor solution involving the Body Awareness (BA) and Body Dissociation (BD) subscales. This study differed from the original validation study in the lack of independence of the subscales; they were correlated in the present study (r=-.11). Internal consistency for BA was α: .86, and for BD, the α was .62. Test-retest reliability was assessed in a subsample (N=67) and was r=.679 for BA and r=.765 for BD. Hierarchical multiple regression analyses showed that mindfulness practice and the FFMQ factors of Observing and Describing were positive predictors of BA. Describing, Acting with awareness and Non-judging negatively predicted BD, and Observing positively predicted BD. CONCLUSION: The study confirms the adequacy of the psychometric properties of the Spanish version of the SBC for use in community samples. The relationship between SBC and mindfulness is discussed in light of previous research.

Interest of the study: mindfulness is a concept describing the focus on the present moment, intentionally and without judgement. This approach has only recently been applied to sport psychology. Objectives: the aim of the current review is to investigate which indicators and questionnaires are used in mindfulness research in sport, being specifically interested in mindfulness assessment. Methods: PRISMA guidelines for systematic reviews and the recommendations of the Cochrane Collaboration were used. Literature searches were conducted in Psychinfo, PubMed, EMBASE and the Cochrane Library. Results: From 2,203 records initially retrieved, 17 articles were included. The results show that mindfulness, anxiety and acceptance are the most commonly studied psychological indicators. The Five Facet Mindfulness Questionnaire is the most frequently used mindfulness scale. We also discuss the possibility of using physiological indicators as complementary assessment. Conclusions: It is recommended to specifically adapt some questionnaires, such is already done with the Sport Anxiety Scale or the Mindfulness Inventory for Sport, for their use in sport psychology.