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Abstract Background Mindfulness skills training is a core component of Dialectical Behavior Therapy and aims to improve emotion dysregulation (ED) in people with Borderline Personality Disorder (BPD). However, the underlying mechanisms of change are not fully understood. Methods A total of 75 BPD outpatients participated in a 10-week mindfulness skills training. Multilevel models with a time-lagged approach were conducted to examine the temporal dynamics between the proposed mechanisms and ED. Decentering, nonjudgment, body awareness and attention awareness as putative mechanisms and ED as outcome were assessed on a session-by-session basis. Results Greater nonjudgment and body awareness showed within-person effects; participants who reported higher nonjudgement of inner experience and body awareness than their own personal average at a given week showed improvement in ED at the following week. Notably, decentering moderated these associations, such that increased nonjudgment and body awareness predicted improvements in ED more strongly in those participants with high decentering ability. Lastly, a bidirectional relationship between the mechanisms and ED was found; when participants were more emotionally dysregulated than their usual state, they showed less gain in the mechanisms at the following week. Conclusions Knowing how mindfulness training works is relevant to optimize treatments. Clinicians may use strategies to increase these mechanisms when the goal is to improve emotion regulation difficulties in BPD.

IntroductionAttention Deficit Hyperactivity Disorder (ADHD) has a global mean prevalence of 5%. Cognitive Training (CT) and Mindfulness-Based Interventions (MBIs) have shown promising results in managing ADHD symptoms, but they are not its Treatment-As-Usual (TAU). The NeuroMind Study aims to evaluate the preliminary effectiveness and feasibility of three interventions: Mindfulness for Health (M4H), CT using the NeuronUP® platform (CT), and a combination of both, Mindfulness Cognitive Training (MCT). There is empirical evidence supporting the effectiveness of the M4H and NeuronUP® platform; however, this study explores for the first time the effectiveness of MCT and CT, as well as the integration of M4H into TAU. The objectives of this 5-month Randomized Controlled Trial (RCT) are: (1) To analyze the preliminary effectiveness and feasibility of M4H, CT or a combination of both (MCT) added to TAU for children with ADHD; (2) To evaluate the role of psychological process variables (mindfulness and emotional regulation) as mediators of 5-month follow-up clinical outcomes; (3) To preliminarily explore whether specific sociodemographic and clinical characteristics can predict the short-and medium-term clinical response to the specific treatments.Methods and analysisParticipants will be 120 children (7 to 12 years) with ADHD recruited at Child and Adolescent Mental Health Service (CAMHS) Sant Joan de Déu Terres de Lleida (Spain) randomly allocated to one of the four study arms: TAU vs. TAU + CT vs. TAU + M4H vs. TAU + MCT. An assessment to collect ADHD symptoms, Executive Functions (EF), comorbid symptoms and global functioning will be conducted pre-intervention, post-intervention (2 months after baseline) and at the 5-month follow-up. Linear mixed models and mediational models will be computed.DiscussionIf the preliminary effectiveness and feasibility of the MCT are demonstrated, this study could be a preliminary basis to do a full RCT with a larger sample to definitively validate the intervention. The MCT could be applied in clinical practice if it is definitively validated.Clinical trial registration:ClinicalTrials.gov, identifier, NCT05937347. https://clinicaltrials.gov/study/NCT05937347?locStr=Spain&country=Spain&cond=ADHD&intr=Mindfulness&rank=1.

Abstract 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.

Abstract Background Long-term follow-up studies in patients with borderline personality disorder (BPD) consistently show persistent impairment in psychosocial adjustment, although symptoms tend to decrease over time. Consequently, it might be better to deemphasize symptom-oriented interventions and instead promote interventions that incorporate patient perspectives on recovery. In this study we aimed to examine the feasibility and acceptability of a novel intervention (dialectical behavioral therapy combined with positive psychology and contextual-based skills) in the clinical treatment of long-lasting BPD difficulties. Methods This was a qualitative study. We developed an initial 8-week group intervention for long-lasting BPD. Upon completion of the 8-week program, the participants were asked to participate in a group discussion to provide feedback. Based on that feedback, the intervention protocol was modified and then offered to a second group of patients, who also provided feedback. The protocol was revised again and administered to a third group. A total of 32 patients participated in the group interventions; of these, 20 provided feedback in the qualitative study. The main outcome measure was acceptability. Results The following overarching themes emerged from the group interviews: helpful, unhelpful and neutral practices; internal/external barriers; facilitators; and effects. Participants reported difficulties in imagining an optimal future and self-compassion. By contrast, positive skills were associated with an increase in positive emotions. The main internal barrier was facing difficult emotions. The main external barriers were language-related issues. The group format was perceived as a facilitator to success. Dropout rates, which were assessed as an additional measure of acceptability, decreased substantially in each successive group, from 60 to 40% and finally 20%. Conclusions The intervention was feasible to implement in the clinical setting and participants rated the final set of skills highly. Most of the skills were considered useful. Participant feedback was invaluable to improve the intervention, as evidenced by the large increase in the retention rate from 40 to 80%. Randomized clinical trials are needed to test the efficacy of this intervention in promoting well-being in participants with long-lasting BPD.

ObjectivesThe Toronto Mindfulness Scale (TMS) and the State Mindfulness Scale (SMS) are two relevant self-report measures of state mindfulness. The purpose of this study was to examine the internal structure and to offer evidence of the reliability and validity of the Spanish versions of the TMS and SMS.MethodsData from six distinct non-clinical samples in Spain were obtained. They responded to the TMS (n = 119), SMS (n = 223), and measures of trait mindfulness, decentering, non-attachment, depression, anxiety, stress, positive and negative affect, self-criticism, and self-reassurance. The internal structure of the TMS and SMS was analyzed through confirmatory factor analysis. Reliability, construct validity, and sensitivity to change analyses were performed.ResultsThe correlated two-factor structure (curiosity and decentering) was the best-fitting model for the TMS (CFI = 0.932; TLI = 0.913; RMSEA = 0.100 [0.077–0.123]; WRMR = 0.908). The bifactor structure (general factor, mindfulness of body, and mindfulness of mind) was the best-fitting model for the SMS (CFI = 0.961; TLI = 0.950; RMSEA = 0.096 [0.086–0.106]; WRMR = 0.993). Adequate reliability was found for both measures. The reliability of the SMS specific factors was very poor when controlling for the general factor. The patterns of correlations were mainly as expected and according to previous literature. The TMS and SMS have been able to detect state mindfulness changes after different meditation practices.ConclusionValidity evidence is provided to support the use of the TMS and SMS in Spanish populations, though the reliability of the SMS specific factors merit revision.

Severity is the main component of the ICD-11 personality disorder (PD) classification, but pertinent instruments have only recently been developed. We analyzed the psychometric properties of the ICD-11 Personality Disorder Severity scale (PDS-ICD-11) in a mixed sample of 726 community and clinical subjects. We also examined how the different components of the ICD-11 PD system —five trait domains, the borderline pattern specifier, and severity, all of them measured through self-reports— are interconnected and operate together. PDS-ICD-11 properties were adequate and similar to those of the original instrument. However, regressions and factor analyses showed a considerable overlap of severity with the five personality domains and the borderline specifier (72.6%). Bifactor modeling resulted in a general factor of PD (g-PD) that was not equivalent to severity nor improved criterion validity. The whole ICD-11 PD system, i.e., five personality domains, borderline, and severity, explained an average of 43.6% of variance of external measures of well-being, disability, and clinical problems, with severity contributing 4.8%. Suggestions to further improve the ICD-11 PD taxonomy include remodeling the present definition of severity to give more weight to the real-life consequences of traits.

Abstract Borderline personality disorder (BPD) is a severe and highly prevalent psychiatric disorder, more common in females than in males and with notable differences in presentation between genders. Recent studies have shown that epigenetic modifications such as DNA methylation may modulate gene × environment interactions and impact on neurodevelopment. We conducted an epigenome wide study (Illumina Infinium HumanMethylation450k beadchip) in a group of BPD patients with (N = 49) and without (N = 47) childhood traumas and in a control group (N = 44). Results were confirmed in a replication cohort (N = 293 BPD patients and N = 114 controls) using EpiTYPER assays. Differentially methylated CpG sites were observed in several genes and intragenic regions in the X chromosome (PQBP1, ZNF41, RPL10, cg07810091 and cg24395855) and in chromosome 6 (TAP2). BPD patients showed significantly lower methylation levels in these CpG sites than healthy controls. These differences seemed to be increased by the existence of childhood trauma. Comparisons between BPD patients with childhood trauma and patients and controls without revealed significant differences in four genes (POU5F1, GGT6, TNFRSF13C and FAM113B), none of them in the X chromosome. Gene set enrichment analyses revealed that epigenetic alterations were more frequently found in genes controlling oestrogen regulation, neurogenesis and cell differentiation. These results suggest that epigenetic alterations in the X chromosome and oestrogen-regulation genes may contribute to the development of BPD and explain the differences in presentation between genders. Furthermore, childhood trauma events may modulate the magnitude of the epigenetic alterations contributing to BPD.

Abstract Background Over the last two decades an increasing number of countries have legalized euthanasia and physician-assisted suicide (EAS) leading to considerable debate over the inherent ethical dilemmas. Increasing numbers of people with personality disorders, faced with unbearable suffering, have requested and received assistance in terminating their lives. EAS in people with personality disorders has, however, received very sparse attention from clinicians and researchers. In this paper, we examine the literature on the practice and prevalence of EAS in people with personality disorders to date and discuss the associated challenges for research and practice. Methods Narrative review of the literature combined with the authors’ collective experience and knowledge of personality disorders. Results In six of the eight countries where EAS is currently legal, mental disorders are accepted as disorders for which EAS may be granted. In four of these countries, EAS in minors with mental disorders is also accepted. Our literature search resulted in 9 papers on the subject of EAS in people with personality disorders. These studies suggest that most clinicians who grant EAS have indeed perceived their patients’ suffering as chronic, unbearable and untreatable without prospect of improvement. The majority of patients with personality disorders had tried some form of psychotherapy, but very few had received any of the relevant evidence-based treatments. The decision to grant EAS based on a perception of the patient’s illness as being untreatable with no prospect of improvement, could, thus, in many cases fail to meet the due care criteria listed in EAS laws. People with personality disorders more often wish for death for extended periods of time than people without these disorders. However, there is ample empirical data to show that suicidal tendencies and behaviour can be treated and that they fluctuate rapidly over time. Conclusions In light of our findings, we believe that the current legislation and practice of EAS for people with personality disorders is based on an inadequate understanding of underlying psychopathology and a lack of awareness about the contemporary treatment literature. Moreover, we assert that this practice neglects the individual’s potential for having a life worth living.

Among mindfulness measures the three constructs acceptance, decentering, and non-attachment are psychometrically closely related, despite their apparent semantic differences. These three facets present robust psychometric features and can be considered core themes in most “third wave” clinical models. The aim of the present study was to explore the apparently different content domains (acceptance, decentering, and non-attachment) by administering various psychometric scales in a large sample of 608 volunteers. Resilience and depression were also assessed. Exploratory and confirmatory factor analyses performed in two randomly selected subsamples showed a bifactor approximation. The explained common variance suggested a unidimensional nature for the general factor, with good psychometric properties, which we named “Delusion of Me” (DoM). This construct is also strongly correlated with resilience and depression, and appears to be a solid latent general construct closely related to the concept of “ego.” DoM emerges as a potentially transdiagnostic construct with influence on well-being and clinical indexes such as resilience and depression. Further studies should analyze the potential utility of this new construct at a therapeutic level.

Abstract Personality disorders (PD) are common and burdensome mental disorders. The treatment of individuals with PD represents one of the more challenging areas in the field of mental health and health care providers need evidence-based recommendations to best support patients with PDs. Clinical guidelines serve this purpose and are formulated by expert consensus and/or systematic reviews of the current evidence. In this review, European guidelines for the treatment of PDs are summarized and evaluated. To date, eight countries in Europe have developed and published guidelines that differ in quality with regard to recency and completeness, transparency of methods, combination of expert knowledge with empirical data, and patient/service user involvement. Five of the guidelines are about Borderline personality disorder (BPD), one is about antisocial personality disorder and three concern PD in general. After evaluating the methodological quality of the nine European guidelines from eight countries, results in the domains of diagnosis, psychotherapy and pharmacological treatment of PD are discussed. Our comparison of guidelines reveals important contradictions between recommendations in relation to diagnosis, length and setting of treatment, as well as the use of pharmacological treatment. All the guidelines recommend psychotherapy as the treatment of first choice. Future guidelines should rigorously follow internationally accepted methodology and should more systematically include the views of patients and users.

The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) was designed to measure self-criticism (SC) through Inadequate Self (IS) and Hated Self (HS) factors, as well as self-reassurance (RS). However, its long and short forms have yet to be validated in the Spanish Population. The present study examines the psychometric properties of the short form (FSCRS-SF) and its clinical usefulness in a sample of 576 adult individuals, 77 with psychiatric disorders and 499 without. Non-clinical participants were split according to their previous experience with meditation (active meditators, n = 133; non-active meditators, n = 41; and non-meditators, n = 325) and differences between these subgroups were explored. Additionally, a subsample of 20 non-clinical participants took part in a mindfulness- and compassion- based intervention (MCBI) to assess the usefulness of the scale as an outcome measure. Results confirmed the original three-factorial structure, good internal consistency, acceptable test-retest reliability, and a pattern of correlations consistent with previous literature. Regarding differences between groups, the clinical subsample showed significant higher SC and lower RS levels than non-clinical participants and active meditators had significant lower IS and higher RS levels than non-meditators. Participants who participated in the MCBI showed significant RS improvement and a decrease in IS and HS levels. Moreover, a hierarchical multiple regression showed that RS made a significant predictive contribution to distress at three months' time. In conclusion, results show that the Spanish version of the FSCRS-SF is a reliable and valid measure of SC and RS in non-clinical populations and an adequate instrument to detect changes after MCBIs.

Objective: Starting from the controversial results showed by empirical research on Linehan’s Biosocial model of Borderline Personality Disorder (BPD), this study aims to empirically evaluate Linehan’s conceptualization of emotional hypersensitivity and hyperreactivity, as well as to investigate the role of pre-existing emotional states in BPD altered physiological responsivity. Methods: We asked 24 participants (BPD = 12; Healthy Controls = 12) to complete a self-reported questionnaire (Positive and Negative Affect Schedule) in order to assess their pre-task affective state. Subsequently, 36 emotional pictures from four valence categories (i.e. erotic, negative, positive, neutral) were administered while assessing participants self-reported and electrodermal responses. Results: BPD patients showed higher levels of pre-task negative affectivity as well as an enhanced physiological response to neutral stimuli. No main BPD group effect was found for the physiological data. Moreover, pre-task negative affectivity levels were exclusively related to physiological responses among BPD subjects. Discussion: Our findings supported the hypersensitivity hypothesis operationalized as an enhanced responsiveness to non-emotional cues. Hyperreactivity assumption was not supported. Conversely, our study revealed heightened physiological responses in relation to pre-existent negative emotional states in BPD. We discussed our results in the context of the putative pathological processes underlying BPD.

The aim of this research was to contribute to the study of the doming geometry of Testudo carapace as an unstable point of equilibrium when animals are overturned. We performed this research using geometric morphometric using a sample of 64 Testudo individuals belonging to different species (T. hermannin = 30, T. graecan = 3, T. marginata n = 13 and T. horsfieldii n = 18), sexes and ages. A set of four sagittal landmarks (discrete homologous points) and 15 pairs of semi-landmarks, on the frontal doming of the carapace, were digitized on individual carapace pictures. Significative fluctuating asymmetry was detected, defined as small, completely random departures from bilateral symmetry, but much less than directional asymmetry, which appeared highly significative. Anti-symmetry did not appear. Carapace asymmetry was dominated by a clear right directionality. A possible biological speculation could be that this asymmetry more that easing the self-righting potential (“kinematic instability”, understood as the ability to self-right without effort), makes stable ventral turning difficult (“static stability”, understood as the ability to resist passively turning the body produced by destabilizing forces). This asymmetry is present among both sexes but more marked among males. An explanation for this sexually differentiated pattern could be the higher locomotion and the fight for mating in males, making them consequently more prone to losing their balance and falling on their back. These data may be useful in studying adaptative traits in Testudo species as well as establishing a seminal base for future studies. This research is the first attempt to explore a suitable method to assess doming asymmetry which could be useful in future, more extensive investigations, on a larger interspecific sample.

Reactive transport (RT) couples bio-geo-chemical reactions and transport. RT is important to understand numerous scientific questions and solve some engineering problems. RT is highly multidisciplinary, which hinders the development of a body of knowledge shared by RT modelers and developers. The goal of this paper is to review the basic conceptual issues shared by all RT problems, so as to facilitate advancement along the current frontier: biochemical reactions. To this end, we review the basic equations to indicate that chemical systems are controlled by the set of equilibrium reactions, which are easy to model, but whose rate is controlled by mixing. Since mixing is not properly represented by the standard advection-dispersion equation (ADE), we conclude that this equation is poor for RT. This leads us to review alternative transport formulations, and the methods to solve RT problems using both the ADE and alternative equations. Since equilibrium is easy, difficulties arise for kinetic reactions, which is especially true for biochemistry, where numerous challenges are open (how to represent microbial communities, impact of genomics, effect of biofilms on flow and transport, etc.). We conclude with the basic eleven conceptual issues that we consider fundamental for any conceptually sound RT effort.

Abstract People with personality disorders frequently face stigma, ignorance and pessimism regarding the treatability of their disorders. This is despite substantial progress that has been made in developing a number of effective evidence based psychotherapeutic treatments. However, expertise in how to systematically deliver these treatments in a sustainable way throughout Europe is largely lacking. To bridge the gap between evidence based treatments and their implementation in health services, the European Society for the Study of Personality Disorders is currently building a new alliance of experts to promote personality disorder scholarship, and to support the development of clinical expertise and systematic treatment implementation throughout Europe. The aim of this paper is to describe how the Society is currently using its interdisciplinary and international roster of experts to address the specific treatment and research needs of the European personality disorder field, particularly to countries in which expertise in the field is less developed.

Finding a numerical method to model solute transport in porous media with high heterogeneity is crucial, especially when chemical reactions are involved. The phase space formulation termed the multi-advective water mixing approach (MAWMA) was proposed to address this issue. The water parcel method (WP) may be obtained by discretizing MAWMA in space, time, and velocity. WP needs two transition matrices of velocity to reproduce advection (Markovian in space) and mixing (Markovian in time), separately. The matrices express the transition probability of water instead of individual solute concentration. This entails a change in concept, since the entire transport phenomenon is defined by the water phase. Concentration is reduced to a chemical attribute. The water transition matrix is obtained and is demonstrated to be constant in time. Moreover, the WP method is compared with the classic random walk method (RW) in a high heterogeneous domain. Results show that the WP adequately reproduces advection and dispersion, but overestimates mixing because mixing is a sub-velocity phase process. The WP method must, therefore, be extended to take into account incomplete mixing within velocity classes.

Abstract Background Dialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD). The aim of the study was to investigate the efficacy of an intervention that combines emotion regulation and mindfulness skills of DBT to prevent depression relapse/recurrence. Methods A total of 75 individuals (79% females; mean age, 52 years) with a diagnosis of MDD in complete or partial remission were recruited. Participants were randomly allocated either to an intervention combining emotion regulation and mindfulness skills (ER + M group, n = 37) or to a psychoeducative program (n = 38). After the 10-week treatment period, participants were followed for 1 year. Analyses were run in per-protocol (PP) and intention-to-treat (ITT) samples. The primary outcome measure was time to depression relapse/recurrence. Results ER + M training was not more effective than the control intervention in preventing depression relapse. However, PP and ITT analyses showed that participants trained in ER + M presented a significant reduction in depressive symptoms and overall psychopathology. Based on the PP and ITT analyses, neither of the interventions were related with an increase in dispositional mindfulness. Conclusions More studies are needed to confirm the efficacy of ER + M to decrease depressive symptoms and overall psychopathology. Trial registration NCT02747134 . Registered on 20 April 2016.

Although mindfulness is included in many positive psychology manuals as a “positive” technique, the implications of its use have scarcely been developed and the relationship between mindfulness and human well-being has barely been researched. Analyzing the main strengths of the two fields, the possibilities for their integration and the potential contradictions between their messages is essential in order to establish connections. Mindfulness is more than a meditation technique. It has implicit within it a set of values and ethical conditions that coincide to a great extent with the proposed assumptions from positive psychology, such as the development of kindness, compassion, and positive emotions. The aim of this paper is to present, on the one hand, the commonalities and similarities, and on the other, the differences between mindfulness and positive psychology. We also present the main studies that have investigated the role of mindfulness and contemplative practices on human well-being. Finally future research will be discussed and intervention suggested in order to bring the two proposals together.

Mindfulness-based interventions, rooted in old Buddhist practices, have been updated and adapted to the western context. In the present review, the most frequently used mindfulness interventions will be described as well as the psychological mechanisms activated by them. Afterwards, applied studies will be reviewed. First, clinical trials and meta-analytic studies focused on interventions for psychological disorders will be analyzed. Second, clinical trials and meta-analytic studies focused on interventions for health conditions will be analyzed. In the last section some important issues are addressed, such as, for instance, potential adverse effects, personality profiles that fit better with this type of interventions, and topics that need more attention, such as the analysis of efficacy compared with other well-validated interventions, are reviewed. The overall conclusion after the literature review is that mindfulness-based interventions show high versatility, being very suitable for primary health care or similar settings, and have demonstrated their best results in patients with symptoms of stress, anxiety, or depression.

There has been increased interest in the relationships between religiosity, meditation practice and well-being, but there is lack of understanding as to how specific religious components and distinct meditation practices could influence different positive and negative psychological adjustment outcomes. The aim of this study was to assess the explanatory power of religious beliefs and the practice of prayer, focused attention (FA), open monitoring (OM), and compassion meditation (CM) on psychological adjustment, taking into consideration a number of practice-related variables such as session length, frequency of practice and lifetime practice. Psychological adjustment was assessed by means of happiness, positive affect, depression, negative affect, and emotional overproduction. A cross-sectional design was used, with a final sample comprising 210 Spanish participants who completed an online assessment protocol. Hierarchical regressions were performed, including age, sex and psychotropic medication use in the first step as possible confounders, with the addition of religious beliefs and the practice of prayer, FA, OM, and CM in the second step. FA session length was related to all psychological adjustment outcomes: happiness (ΔR2 = 0.09, p = 0.002; β = 0.25, p = 0.001), positive affect (ΔR2 = 0.09, p = 0.002; β = 0.18, p = 0.014), depression (ΔR2 = 0.07, p = 0.004; β = -0.27, p < 0.001), negative affect (ΔR2 = 0.08, p = 0.007; β = -0.27, p < 0.001) and emotional overproduction (ΔR2 = 0.07, p = 0.013; β = -0.23, p = 0.001). CM session length was related to positive affect (β = 0.18, p = 0.011). CM practice frequency was associated with happiness (ΔR2 = 0.06, p = 0.038; β = 0.16, p = 0.041). Lifetime practice of FA was related to happiness (ΔR2 = 0.08, p = 0.007; β = 0.21, p = 0.030) and OM to emotional overproduction (ΔR2 = 0.08, p = 0.037; β = -0.19, p = 0.047). Religious beliefs and prayer seemed to be less relevant than meditation practices such as FA, OM, and CM in explaining psychological adjustment. The distinct meditation practices might be differentially related to distinct psychological adjustment outcomes through different practice-related variables. However, research into other forms of institutional religiosity integrating social aspects of religion is required.

At the end of the Middle Palaeolithic around 40,000 years ago, a population of archaic humans, Neanderthal men descended from the earliest settlers, lived in Europe. They were perfectly adapted to the land and its resources. They and their ancestors had survived all the climate and environmental changes that had occurred throughout the Pleistocene for hundreds of millennia, but they mysteriously disappeared upon the arrival of anatomically modern men, who originated in Africa. The latter were the humans from our own species, Homo sapiens, also called Cro-Magnon men in Europe, and they would gradually replace the archaic populations of the Old World. In Catalonia, archaeology shows how the old civilisation of the Neanderthal men, the Mousterian, which remained in place for many millennia with few changes, was swiftly replaced by another new civilisation which was very different and more dynamic, the Aurignacian, which was a civilisation of modern men. Over time, the Aurignacian evolved to give way to other civilisations of largegame hunters of the European Upper Palaeolithic. In Catalonia, the sites in Serinyà, among others, allow us to study the civilisation of the Neanderthal and Cro-Magnon men near the time of their replacement and to precisely date when this took place. They also provide us with the oldest remains of modern men found in Catalonia.

Although we have made significant progress in the development of preventive tools and especially in the efficacy of the psychological treatments, we are still far from an optimal situation. This paper focuses on two major issues which we consider fundamental challenges and urges in this area: (a) the need for improving and spreading prevention, early intervention, and the promotion of mental health and (b) the need for greater dissemination of effective psychological treatments, the development of new interventions and greater understanding of the mechanisms of action of psychological treatments. The aim is to promote discussion among all stakeholders and debate on those lines we think as priority.

Depressive and anxious symptoms have a clear impact on the functioning of people. Their appearance seems to be related to the presence of deficits in metacognitive capacities. Mindfulness interventions increase metacognitive awareness through their effect in the decentering capacity. Therefore, the aim of this study was to evaluate the relationship between mindfulness and decentering with anxious and depressive symptomatology respectively. The sample consisted of 465 participants contacted through universities and social networks. Results revealed that both mindfulness and the ability to decenter explain the presence of depressive symptoms while only mindfulness explains the presence of anxiety symptoms. These results are encouraging for intervention in mindfulness with anxious and depressive symptoms and stress the importance of metacognitive processes such as decentering in their development.

The magnitude and impact of mental disorders does not correspond to the resources devoted to research and attention. Although we have made significant progress in their understanding and the efficacy of the psychological treatments, we are still far from an optimal situation. This paper focuses on one of the major issues which we consider fundamental challenges and needs in this area, the increase in research focusing on psychopathology, especially on the mechanisms and processes that explain and maintain mental disorders, as a key point for the design and development of new psychological interventions for the prevention, treatment, and promotion of mental health. The aim is to promote discussion among all stakeholders and debate on those lines we think as a priority.

Background: Individuals with eating disorders might be characterized by lower levels of direct engagement with the eating experience. This study aims to explore similarities and differences in direct experience while eating in four different weight conditions and healthy controls (HCs): anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and obesity (OB).Methods: A total sample of 143 women were recruited. Participants were asked to eat an orange slice and write down 10 things about the experience of eating, classifying the focus of these thoughts as either experiential (“direct experience”) or analytical (“thinking about”). A direct experience index (DEI) was calculated by dividing the number of times a participant classified an experience as a “direct experience” (the numerator) by the total number of observations. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and rated their level of anxiety after the task.Results: Between-groups significant differences were found on the DEI, with individuals in the OB group scoring higher than AN and BN, and similar to HC. After the task, the AN group reported significantly higher anxiety levels than HC, and EDNOS reported more anxiety than HC and OB. Between-group significant differences were also found for all the FFMQ facets. Conclusion: AN and BN presented lower access to direct experience while eating. Individuals with OB did not respond in the same way as the other clinical groups, showing a similar performance to HC.

Background: The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic N,N-dimethyltryptamine (DMT) and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a) participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b) participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR), with the specific goal of improving these skills.Methods: Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). The MINDSENS Composite Index was also calculated, including those EQ and FFMQ items that have proven to be the most sensitive to meditation practice. Group A (n = 10) was assessed before and after the last of four closely spaced consecutive ayahuasca sessions. Group B (n = 10) was assessed before and after completion of a standard 8-week MBSR course.Results: MBSR training led to greater increases in overall mindfulness scores after the 8-week period. MBSR but not ayahuasca led to increases in the MINDSENS Composite Index. However, the ayahuasca sessions induced comparable increases in the Non-Judging subscale of the FFMQ, specifically measuring “acceptance.” Improving this capacity allows for a more detached and less judgmental stance toward potentially distressing thoughts and emotions.Results: The present findings suggest that a small number of ayahuasca sessions can be as effective at improving acceptance as more lengthy and costly interventions. Future studies should address the benefits of combining ayahuasca administration with mindfulness-based interventions. This will allow us to investigate if ayahuasca will improve the outcome of psychotherapeutic interventions.

Structural imaging studies of borderline personality disorder (BPD) have found regions of reduced cortical volume, but these have varied considerably across studies. Reduced hippocampus and amygdala volume have also been a regular finding in studies using conventional volumetric measurement. How far comorbid major depression, which is common in BPD and can also affect in brain structure, influences the findings is not clear.Seventy-six women with BPD and 76 matched controls were examined using whole-brain voxel-based morphometry (VBM). The hippocampus and amygdala were also measured, using both conventional volume measurement and VBM within a mask restricted to these two subcortical structures. Lifetime history of major depression was assessed using structured psychiatric interview.At a threshold of p = 0.05 corrected, the BPD patients showed clusters of volume reduction in the dorsolateral prefrontal cortex bilaterally and in the pregenual/subgenual medial frontal cortex. There was no evidence of volume reductions in the hippocampus or amygdala, either on conventional volumetry or using VBM masked to these regions. Instead there was evidence of right-sided enlargement of these structures. No significant structural differences were found between patients with and without lifetime major depression.According to this study, BPD is characterized by a restricted pattern of cortical volume reduction involving the dorsolateral frontal cortex and the medial frontal cortex, both areas of potential relevance for the clinical features of the disorder. Previous findings concerning reduced hippocampus and amygdala volume in the disorder are not supported. Brain structural findings in BPD do not appear to be explainable on the basis of history of associated lifetime major depression.

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. There are few studies devoted to assessing the impact of meditation-intensive retreats on the well-being, positive psychology and personality of experienced meditators. We aimed to assess whether a 1-month Vipassana retreat: a) would increase mindfulness and well-being; b) would increase prosocial personality traits; and c) whether psychological changes would be mediated and/or moderated by non-attachment.Method. A controlled, non-randomized, pre-post-intervention trial was used. The intervention group was a convenience sample (n=19) of experienced meditators who participated in a 1-month Vipassana meditation retreat. The control group (n=19) comprised matched experienced meditators who did not take part in the retreat. During the retreat, the mean duration of daily practice was 8-9 hours, the diet was vegetarian and silence was compulsory. The Experiences Questionnaire (EQ), Non-Attachment Scale (NAS), Positive and Negative Affect Schedule (PANAS), Satisfaction With Life Scale (SWLS), Temperament Character Inventory Revised (TCI-R-67), Five Facets Mindfulness Questionnaire (FFMQ), Self-Other Four Immeasurables (SOFI) and the MINDSENS Composite Index were administered. ANCOVAs and linear regression models were used to assess pre-post changes and mediation/moderation effects.Results. Compared to controls, retreatants showed increases in non-attachment, observing, MINDSENS, positive-affect, balance-affect and cooperativeness; and decreases in describing, negative-others, reward-dependence and self-directedness. Non-attachment had a mediating role in decentring, acting aware, non-reactivity, negative-affect, balance-affect and self-directedness; and a moderating role in describing and positive others, with both mediating and moderating effects on satisfaction with life.Conclusions. A 1-month Vipassana meditation retreat seems to yield improvements in mindfulness, well-being and personality, even in experienced meditators. Non-attachment might facilitate psychological improvements of meditation, making it possible to overcome possible ceiling effects ascribed to non-intensive practices.

El presente estudio pretende determinar si existe o no una mayor reactividad emocional en el Trastorno Límite de la Personalidad (TLP) en un contexto de laboratorio. Se realizó una inducción emocional negativa (presentación de imágenes estandarizadas con contenido negativo) a cincuenta participantes (35 pacientes con TLP y 15 controles sanos). Para evaluar la respuesta emocional subjetiva se utilizaron cuestionarios auto-informados; los niveles de cortisol (sCORT) y alfa-amilasa (sAA) salivares se utilizaron para medir la reactividad biológica al procedimiento. En el grupo de TLP, se observaron niveles de sCORT más bajos y niveles de sAA más elevados en comparación al grupo control. No se observaron diferencias significativas en relación a la reactividad emocional auto-informada, pero los pacientes con TLP reportaron mayor intensidad de emociones negativas a nivel basal así como también durante todo el procedimiento. Los resultados no apoyan la hipótesis de hiperreactividad emocional en el TLP. Sin embargo, los pacientes con TLP presentaron mayor intensidad de emociones negativas a nivel basal, característica que debería ser considerada como esencial en el trastorno. Futuros estudios deberán incorporar otros paradigmas de inducción emocional más específicos para TLP con el fin de confirmar las tendencias observadas en el presente estudio. © 2012 Asociación Española de Psicología Conductual. Publicado por Elsevier España, S.L. Todos los derechos reservados.