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Interoception, the representation of the body’s internal state, plays a central role in emotion, motivation, and wellbeing. Interoceptive attention is qualitatively different from attention to the external senses and may recruit a distinct neural system, but the neural separability of interoceptive and exteroceptive attention is unclear. We used a machine learning approach to classify neural correlates of interoceptive and exteroceptive attention in a randomized control trial of interoceptive training (MABT). Participants in the training and control groups attended fMRI assessment before and after an 8-week intervention period (N = 44 scans). The imaging paradigm manipulated attention targets (breath vs. visual stimulus) and reporting demands (active reporting vs. passive monitoring). Machine learning models achieved high accuracy in distinguishing between interoceptive and exteroceptive attention using both in-sample and more stringent out-of-sample tests. We then explored the potential of these classifiers in “reading out” mental states in a sustained interoceptive attention task. Participants were classified as maintaining an active reporting state for only ∼90s of each 3-minute sustained attention period. Within this active period, interoceptive training enhanced participants’ ability to sustain interoceptive attention. These findings demonstrate that interoceptive and exteroceptive attention engage reliable and distinct neural networks; machine learning classifiers trained on this distinction show promise for assessing the stability of interoceptive attention, with implications for the future assessment of mental health and treatment response.

Social anxiety disorder (SAD) is characterized by negative self-referential processing, which triggers excessive emotional reactivity. In healthy individuals, positive self-views typically predominate and are supported by regions of the default mode network (DMN) that represent self-related information and regions of the frontoparietal control network (FPCN) that contribute to metacognitive awareness and emotion regulation. The current study used functional magnetic resonance imaging (fMRI) to examine patterns of DMN and FPCN activation during positive and negative self-referential judgments in SAD patients (N = 97) and controls (N = 34). As expected, SAD patients demonstrated a striking difference in self-beliefs compared with non-anxious healthy controls, endorsing fewer positive traits and more negative traits. However, SAD patients and controls demonstrated largely similar patterns of DMN and FPCN recruitment during self-referential judgements. No significant group differences were observed. However, equivalence testing identified numerous regions demonstrating effect sizes that were not small enough to conclude that they were practically equivalent to zero, despite the nonsignificant null hypothesis test. These regions may be key targets to investigate in future studies using larger samples.

Older adulthood presents unique challenges to mental health. We explored how a mindfulness training intervention adapted for older adults addressed these challenges, contributing to a qualitative profile of mindfulness pedagogy for older adults. Mindfulness-based stress reduction (MBSR) was adapted for a geriatric community sample with elevated depressive symptoms. Intervention effects were examined through a combination of scale-based assessment and qualitative interviews. Scales measured depressive symptoms, cognitive function, quality of life, and mindful attitudes. Interviews assessed stressors, goals, perceived obstacles, outcomes, and practice habits. A grounded-theory approach was used to identify responses in each category. Multiple regression analyses were used to identify qualitative responses that best predicted symptom reduction. The program was well-tolerated, positively endorsed, and associated with reduced depressive symptoms. Qualitatively, participants who identified family and mood as their primary stressors benefitted the most from course participation. A focus on present moment awareness was associated with decreased depressive symptoms, whereas a focus on hedonics, i.e., “feeling good,” was associated with poorer treatment outcomes. Participants maintained strong future practice intentions and preferred guided meditations to self-directed practice. The adapted MBSR program was well-tolerated and efficacious in a geriatric community sample. Efficacy may be improved by emphasizing skill development outcomes rather than achievement of positive feeling states, and by prioritizing program referrals for coping with socioemotional rather than environmental stressors. Future research could extend this mixed-methods approach to deepen our understanding of the relationship between participants’ lived experiences and clinical outcomes.

Interoception, the representation of the body’s internal state, serves as a foundation for emotion, motivation, and wellbeing. Yet despite its centrality in human experience, the neural mechanisms of interoception are poorly understood. The Interoceptive/Exteroceptive Attention Task (IEAT) is a novel neuroimaging paradigm that compares behavioral tracking of the respiratory cycle (Active Interoception) to tracking of a visual stimulus (Active Exteroception). Twenty-two healthy participants completed the IEAT during two separate scanning sessions (N = 44) as part of a randomized control trial of Mindful Awareness in Body-oriented Therapy (MABT). Compared to Exteroception, Interoception deactivated somatomotor and prefrontal regions. Greater interoceptive sensibility (MAIA scale) predicted sparing from deactivation along the anterior cingulate cortex (ACC) and left-lateralized language regions. The right insula—typically described as a primary interoceptive cortex—was only implicated by its further deactivation during an exogenously paced respiration condition (Active Matching). Psychophysiological interaction analysis characterized Active Interoception as promoting greater ACC connectivity with lateral frontal and parietal regions commonly referred to as the Dorsal Attention Network. Interoception of the breath may therefore involve reduced corticalactivitybut greaterconnectivity, with greater sensibility sparing cortical inhibition within well-characterized attentional networks. In contrast to a literature that relates detection of liminal signals such as the heartbeat to anterior insula activity, attention towards accessible body sensations such as the breath may lead to a low activity, high connectivity state in which sensory signals from the body may be better discerned.Significance StatementInteroception, the representation of the body’s internal state, is poorly understood compared to the external senses, with existing neuroimaging studies failing to match task difficulty between interoceptive and exteroceptive tasks. The present study used a novel fMRI task to compare interoceptive and exteroceptive attention, and how this distinction was moderated by self-reported interoceptive awareness. The results implicate three novel interoceptive mechanisms: interoception reduces corticalactivitywhile increasingconnectivity, wherein awareness is linked to preserved activation of the brain’s salience network and left-lateralized language regions. These findings characterize interoception as a lower activity state in which awareness depends upon the ability to notice and report on body signals typically obscured by the processing of exteroceptive information and other forms of cognition.

Science requires replicable tools to measure its intended constructs. Attention research has developed tools that have been used in mind-wandering research, but mind-wandering measures often rely on response-inhibition, which introduces speed-accuracy trade-offs that may conflate errors for mind-wandering. We sought to replicate three studies that used an improved mind-wandering measure: the Metronome Response Task (MRT). In a large (N=300) multisite sample, the primary MRT finding was replicated, showing that continuous rhythmic response time variability reliably predicted self-reported mind-wandering. Our findings also show previously undetected differences between intentional and unintentional mind-wandering. While previously reported mediators (motivation) and moderators (confidence) did not replicate, additional covariates add predictive value and additional constructs (e.g., boredom, effort) demonstrate convergent validity. The MRT is useful for inducing and measuring mind-wandering and provides an especially replicable tool. The MRT's measurement of attention could support future models of the complete cycle of sustained attention.

How can we measure the absence of awareness? Attention research has developed tools for measuring self-caught meta-awareness restoration and behavioral mind-wandering, but we lack a way to dynamically track the loss of meta-awareness. The present pre-registered study sought to bring together three extant paradigms into one tool designed to dynamically measure meta-awareness: the Metronome Counting Task (MCT). The MCT is a continuous performance task wherein participants tap along to a steady beat while counting to 20, indicating the final count by a special button press. This sample (N = 74) provides evidence that participants could self-catch their failures in the task, that a response variability metric measuring mind-wandering depth was successfully recreated in this new tool, and that dynamic performance changes may be useful for detecting meta-awareness loss before participants become internally aware of the loss or are caught by external errors. The MCT was conceived as a tool that will support neuroimaging models of dynamic fluctuations during sustained attention, providing a link between the phenomenology of meta-awareness, the behavior measured by a replicable index of task engagement, and a continuous performance task on time-scales relevant for MRI. We discuss the possibility that meta-awareness may exist on a continuum and that conceptions of mind-wandering as attention failures may plausibly be reconceived as changes in goal priority manifesting as shifting task engagement.

Objective:Children treated for brain tumors often experience social and emotional difficulties, including challenges with emotion regulation; our goal was to investigate the attention-related component processes of emotion regulation, using a novel eye-tracking measure, and to evaluate its relations with emotional functioning and white matter (WM) organization.Method:Fifty-four children participated in this study; 36 children treated for posterior fossa tumors, and 18 typically developing children. Participants completed two versions of an emotion regulation eye-tracking task, designed to differentiate between implicit (i.e., automatic) and explicit (i.e., voluntary) subprocesses. The Emotional Control scale from the Behavior Rating Inventory of Executive Function was used to evaluate emotional control in daily life, and WM organization was assessed with diffusion tensor imaging.Results:We found that emotional faces captured attention across all groups (F(1,51) = 32.18, p < .001, η2p = .39). However, unlike typically developing children, patients were unable to override the attentional capture of emotional faces when instructed to (emotional face-by-group interaction: F(2,51) = 5.58, p = .006, η2p = .18). Across all children, our eye-tracking measure of emotion regulation was modestly associated with the parent-report emotional control score (r = .29, p = .045), and in patients it was associated with WM microstructure in the body and splenium of the corpus callosum (all t > 3.03, all p < .05).Conclusions:Our findings suggest that an attention-related component process of emotion regulation is disrupted in children treated for brain tumors, and that it may relate to their emotional difficulties and WM organization. This work provides a foundation for future theoretical and mechanistic investigations of emotional difficulties in brain tumor survivors.

We would all like to make wise choices- the trouble lies in separating wisdom from folly. The target article presents a researcher-informed model for wisdom to help us better define it via two cent...

There is a limited research on the effects of self-care, specifically the importance of taking time to reflect on one’s self-care habits. Healthy undergraduate students (N = 95) were assigned to ei...

Creativity, a key component of engineering design, is not a static trait, but a skill that can be strategically enhanced. Neurostimulation methods, e.g., using electrical current to stimulate brain areas, have been reliably shown to improve creative performance. However, safety and ethical concerns present obstacles to the direct implementation of such methods in the engineering-design process. Thus, the current work explores whether creative performance can be enhanced using behavioral tasks that recruit the same brain regions targeted in neurostimulation studies. Study participants were 30 undergraduate students enrolled in an introductory psychology course. Two intervention tasks, a Stroop task and a finger-tapping pattern-matching task, each with easy and hard versions, were used in a 2 (task type) x 3 (task difficulty) within-subjects design. Relative to the pretest period, difficulty was manipulated by using versions of tasks with 1) predictable responses (easy) and 2) unpredictable responses (hard). Creativity in each experimental condition was assessed via the well-validated Alternative Uses Test (AUT). A multilevel analysis revealed a significant increase in fluency (number of alternative uses) as task difficulty increased regardless of task type. Flexibility (number of alternative-uses categories) also increased with task difficulty, but the effect was stronger for the Stroop task. These results suggest that high-difficulty versions of the selected tasks may be more effective in increasing AUT performance. Between the two tasks studied, the Stroop task has greater potential as a candidate to adapt as a behavioral intervention to improve creativity. Beyond the Stroop task, other behaviors, which activate brain regions that respond favorably to neurostimulation, may also be explored as the bases of interventions to improve creative performance in engineering design.

BackgroundObsessive-compulsive disorder (OCD) is an anxiety disorder with significant morbidity whose pathophysiology is not fully understood. Neuroimaging studies have characterized OCD in terms of elevated striatal and prefrontal reactivity to emotion provocation. This neural model may be informed by investigation of functional connectivity in OCD, identifying alterations in how sensory information is integrated into frontostriatal regions.MethodsThe current study employed functional magnetic resonance imaging (fMRI) to compare neural activity and connectivity in 31 OCD patients (12 washing and 19 checking subtypes) and 17 healthy volunteers in an emotion provocation paradigm using visual stimuli.ResultsOCD status was associated with hyper-activation of the posterior cingulate (PCg) in response to emotion provocation. Additionally, OCD patients demonstrated elevated PCg functional connectivity with the visual cortices and frontostriatal regions. Exploratory analyses suggested that stimulus-provoked activity and connectivity was elevated for checking subtypes in motor cortices, and elevated in washing subtypes in the anterior insula and orbitofrontal cortex.ConclusionsThe PCg's role in moderating connectivity between the visual cortex and frontolimbic regions is muted in OCD, consistent with the PCg's suggested role in regulating attention towards emotional stimuli. Exploratory analyses suggest distinct PCg connectivity profiles in OCD subtypes, with checking linked to motor activation, but washing linked to a network supporting emotional salience. The study was not powered to fully investigate the effects of medication, patients often endorsed secondary symptom subtypes that muddied washing/checking distinctions, and the emotion provocation paradigm was of limited intensity compared to life stressors.

Meditation has become a cultural phenomenon, and modern scientific research on the topic has exploded. Thousands of scientific articles report various benefits of meditation including clinical, physiological and well-being outcomes. Despite these benefits, drop-out rates in mindfulness-based interventions remain a problem and little work has studied the drawbacks of meditation. Reports of adverse reactions to meditation have emerged and critical voices have begun advocating caution, rather than enthusiasm, for meditation training. Furthermore, the experiences of meditators outside interventions and conventional lab studies are not well understood. Here we develop an empirical codebook of and framework for meditation benefits and drawbacks (MBDs), discussing the actionable implications for meditation training in the real world. These data reveal the major drawbacks hindering real-world meditators, including several less intuitive drawbacks. We also report the major benefits of meditation and generate a structural framework from which they can be understood in parallel with drawbacks. We investigate whether meditation styles affect MBDs and report comparisons between current and former meditators. These results bring cogent structure to the variety of meditation outcomes laypeople experience. As the number of meditators continues to increase, we need such structures to inform how meditation is taught, ensuring ethically informed consent and optimizing practice-fit. Mixed-methods research such as this study allows a greater practical understanding of how meditation is experienced in situ. This work complements the literature on the clinical benefits and neurophysiological mechanisms of meditation and this framework will inform clinicians, researchers and meditation teachers as best practices are reviewed in the coming years.

Background: Neural reactivity to dysphoric mood induction indexes the tendency for distress to promote cognitive reactivity and sensory avoidance. Linking these responses to illness prognosis following recovery from Major Depressive Disorder informs our understanding of depression vulnerability and provides engagement targets for prophylactic interventions. Objective: A prospective fMRI neuroimaging design investigated the relationship between dysphoric reactivity and relapse following prophylactic intervention. Remitted depressed outpatients (N=85) were randomized to 8 weeks of either Cognitive Therapy or Mindfulness Based Cognitive Therapy and followed for 2 years to assess future relapse status. Findings: Dysphoric mood challenge evoked prefrontal activation and sensory inhibition. Controlling for number of past episodes and concurrent symptoms, somatosensory inhibition was significantly associated with depression recurrence in a static pattern that was unaffected by prophylactic treatment (HR ·05, 95% CI 0·02–0·17; p

Neural reactivity to dysphoric mood induction indexes the tendency for distress to promote cognitive reactivity and sensory avoidance. Linking these responses to illness prognosis following recovery from Major Depressive Disorder informs our understanding of depression vulnerability and provides engagement targets for prophylactic interventions.A prospective fMRI neuroimaging design investigated the relationship between dysphoric reactivity and relapse following prophylactic intervention. Remitted depressed outpatients (N = 85) were randomized to 8 weeks of Cognitive Therapy with a Well-Being focus or Mindfulness Based Cognitive Therapy. Participants were assessed before and after therapy and followed for 2 years to assess relapse status. Neural reactivity common to both assessment points identified static biomarkers of relapse, whereas reactivity change identified dynamic biomarkers.Dysphoric mood induction evoked prefrontal activation and sensory deactivation. Controlling for past episodes, concurrent symptoms and medication status, somatosensory deactivation was associated with depression recurrence in a static pattern that was unaffected by prophylactic treatment, HR 0.04, 95% CI [0.01, 0.14], p .001. Treatment-related prophylaxis was linked to reduced activation of the left lateral prefrontal cortex (LPFC), HR 3.73, 95% CI [1.33, 10.46], p = .013. Contralaterally, the right LPFC showed dysphoria-evoked inhibitory connectivity with the right somatosensory biomarker CONCLUSIONS: These findings support a two-factor model of depression relapse vulnerability, in which: enduring patterns of dysphoria-evoked sensory deactivation contribute to episode return, but vulnerability may be mitigated by targeting prefrontal regions responsive to clinical intervention. Emotion regulation during illness remission may be enhanced by reducing prefrontal cognitive processes in favor of sensory representation and integration.

Background Cancer patients transitioning to survivorship after completing cancer treatments need psychosocial interventions to manage stressors such as anxiety, depression, and fear of cancer recurrence. Mindfulness-based interventions (MBIs) are effective for treating these symptoms; however, cancer survivors are often unable to participate in face-to-face interventions because of difficulties such as work and family commitments, treatment-related side-effects, scheduling conflicts, and geography. Smartphone app–based MBIs are an innovative way to deliver psychosocial cancer care and can overcome several such difficulties, since patients can participate at their own convenience. Objective The SEAMLESS (Smartphone App–Based Mindfulness Intervention for Cancer Survivors) study aims to evaluate the efficacy of a tailored app-based mindfulness intervention for cancer survivors (the Am Mindfulness-Based Cancer Survivorship—MBCS—Journey) for treating (1) symptoms of stress (primary outcome), as well as (2) fear of cancer recurrence, anxiety, depression, fatigue, and overall physical functioning (secondary outcomes). This is the first Canadian efficacy trial of a tailored mindfulness app intervention in cancer survivors. Methods This is a randomized waitlist-controlled trial, which will evaluate the effectiveness of Am MBCS for impacting the primary and secondary outcomes in cancer survivors who have completed all their cancer treatments. Outcomes will be assessed using web-based surveys with validated psychometric instruments at (1) baseline, (2) mid-intervention (2 weeks later), (3) immediately postintervention (4 weeks), (4) 3 months postbaseline, (5) 6 months postbaseline, and (6) 12 months postbaseline. The waitlist group will complete all assessments and will cross over to the intervention condition after the 3-month assessment. In addition, data will be obtained by the smartphone app itself, which includes users’ engagement with the app-based intervention, their emotional state (eg, angry and elated) from a user-inputted digital emotion-mapping board, and psychobiometric data using photoplethysmography technology. Results The study received ethics approval in September 2018 and recruitment commenced in January 2019. Participants are being recruited through a provincial cancer registry, and the majority of participants currently enrolled are breast (44/83, 53%) or colorectal (17/83, 20%) cancer survivors, although some survivors of other cancer are also present. Data collection for analysis of the primary outcome time-point will be complete by September 2019, and the follow-up data will be collected and analyzed by September 2020. Data will be analyzed to determine group differences using linear mixed modelling statistical techniques. Conclusions Cancer care providers are uncertain about the efficacy of app-based mindfulness interventions for patients, which are available in great supply in today’s digital world. This study will provide rigorously evaluated efficacy data for an app-based mindfulness intervention for cancer survivors, which if helpful, could be made available for psychosocial care at cancer centers worldwide. Trial Registration ClinicalTrials.gov NCT03484000; https://clinicaltrials.gov/ct2/show/NCT03484000 International Registered Report Identifier (IRRID) DERR1-10.2196/15178

Background Social anxiety disorder (SAD) is characterized by negative self-beliefs (NSBs) that are thought to maintain symptom severity—at least in part—by impairing emotion regulation. Few studies to date have investigated the neural basis of emotion regulation during NSBs in SAD. Moreover, different regulation strategies have not been directly compared, leaving open questions about the generality of emotion regulation deficits in SAD. Methods Patients with SAD (n = 113) and healthy control subjects (n = 35) underwent functional magnetic resonance imaging while reacting to NSBs or attempting to downregulate negative emotions occasioned by NSBs using either reappraisal (reinterpreting negative beliefs) or acceptance (nonjudgmentally experiencing thoughts and emotions). Ratings of negative emotion were collected after each trial. Results When cued to do so, patients with SAD were able to downregulate negative emotions using both reappraisal and acceptance and demonstrated effective recruitment of frontoparietal regulatory regions. Patients with SAD demonstrated greater activation of default mode network and somatomotor regions for the react versus accept contrast. Both groups demonstrated reductions in frontoparietal and default mode network activation during acceptance relative to reappraisal. Greater SAD symptom severity was associated with lower activation in frontoparietal regions during both regulation conditions. Conclusions There were no group differences in frontoparietal recruitment during two distinct emotion regulation strategies. However, individual differences in symptom severity within the SAD group were associated with frontoparietal regulation–related activation. Patients with SAD were differentiated from control subjects in default mode network recruitment patterns, suggesting that acceptance may be a useful task condition for revealing altered neural activity in SAD.

Background: Mindfulness training (MT) includes a variety of contemplative practices aimed at promoting intentional awareness of experience, coupled with attitudes of nonjudgment and curiosity. Following the success of 8-week, manualized group interventions, MT has been implemented in a variety of modalities, including smartphone apps that seek to replicate the success of group interventions. However, although smartphone apps are scalable and accessible to a wider swath of population, their benefits remain largely untested. Objective: This study aimed to investigate a newly developed MT app called Wildflowers, which was codeveloped with the laboratory for use in mindfulness research. It was hypothesized that 3 weeks of MT through this app would improve subjective well-being, attentional control, and interoceptive integration, albeit with weaker effects than those published in the 8 week, manualized group intervention literature. Methods: Undergraduate students completed 3 weeks of MT with Wildflowers (n=45) or 3 weeks of cognitive training with a game called 2048 (n=41). State training effects were assessed through pre- and postsession ratings of current mood, stress level, and heart rate. Trait training effects were assessed through pre- and postintervention questionnaires canvassing subjective well-being and behavioral task measures of attentional control and interoceptive integration. State and trait training data were analyzed in a multilevel model using emergent latent factors (acceptance, awareness, and openness) to summarize the trait questionnaire battery. Results: Analyses revealed both state and trait effects specific to MT; participants engaging in MT demonstrated improved mood (r=.14) and a reduction of stress (r=−.13) immediately after each training session compared with before the training session and decreased postsession stress over 3 weeks (r=−.08). In addition, MT relative to cognitive training resulted in greater improvements in attentional control (r=−.24). Interestingly, both groups demonstrated increased subjective ratings of awareness (r=.28) and acceptance (r=.23) from pre- to postintervention, with greater changes in acceptance for the MT group trending (r=.21). Conclusions: MT, using a smartphone app, may provide immediate effects on mood and stress while also providing long-term benefits for attentional control. Although further investigation is warranted, there is evidence that with continued usage, MT via a smartphone app may provide long-term benefits in changing how one relates to their inner and outer experiences. Trial Registration: ClinicalTrials.gov NCT03783793; https://clinicaltrials.gov/ct2/show/NCT03783793 (Archived by WebCite at http://www.webcitation.org/75EF2ehst), Journal of Medical Internet Research, 6 (1), ISSN:1438-8871

Many people are starting to establish contemplative practices and Mindfulness-Based Interventions have become quite popular. While Mindfulness-Based Interventions positively impact well-being, drop-out and lack of practice-maintenance plagues these interventions. Such adherence issues may reveal a lack of fit between participant partiality for attentional anchors of meditative practice and the intervention’s use of the breath as the anchor of attention. No study had yet compared partiality towards practices using anchors from different sensory modalities (e.g., auditory and visual) thus the present study examined such individual differences, sharing resources on the Open Science Framework1. Participants (N = 82) engaged 10-min practices within three modalities (somatosensory, auditory, and visual) and partiality towards these meditations was modelled. Partiality differences did exist: 49% preferred the breath, 30% the auditory-phrase, and 21% the visual-image. Pre-practice motivation and anchor-modality predicted partiality while cardiac responses were also positively associated with partiality. Preferences were updated through experience and over half of participants left the experiment partial to a different anchor than their initial meditation-naïve bias. Tangible next-steps are discussed, including integrating additional anchor modalities into existing interventions by offering brief practices with a variety of anchors. Suggestions are made for increasing post-training contact using email-automation to answer central practice-maintenance questions, including whether and which contemplative benefits are predicated on continued practice.

Interoception is the process of sensing the body’s internal state. An emerging neurobiological model supports the idea that subjective well-being is influenced by how physiological changes are detected and appraised. Contemplative interventions such as mindfulness training, which appear efficacious in reducing emotional distress, may operate by promoting curiosity and flexibility in this appraisal process. This chapter reviews evidence about the relationship between interceptive appraisal and mental health, including an account of how contemplative training modulates interoceptive networks to alter interoceptive appraisal tendencies. New measures are needed to distinguish the effects of appraisal tendencies from more implicit effects of physiological change. To support this endeavour, pilot data is introduced from a novel, respiration-focused task that experimentally manipulates interoceptive awareness, and by extension the need for interoceptive appraisal, within a given level of physiological arousal. Potential applications of this task for exploring the influence of interoceptive appraisal on affect, cognition, and behavior are discussed.

BACKGROUND To investigate whether usage of treatment-acquired regulatory skills is associated with prevention of depressive relapse/recurrence. METHOD Remitted depressed outpatients entered a 24-month clinical follow up after either 8 weekly group sessions of cognitive therapy (CT; N = 84) or mindfulness-based cognitive therapy (MBCT; N = 82). The primary outcome was symptom return meeting the criteria for major depression on Module A of the SCID. RESULTS Factor analysis identified three latent factors (53% of the variance): decentering (DC), distress tolerance (DT), and residual symptoms (RS), which were equivalent across CT and MBCT. Latent change score modeling of factor slopes over the follow up revealed positive slopes for DC (β = .177), and for DT (β = .259), but not for RS (β = -.017), indicating posttreatment growth in DC and DT, but no change in RS. Cox regression indicated that DC slope was a significant predictor of relapse/recurrence prophylaxis, Hazard Ratio (HR) = .232 90% Confidence Interval (CI) [.067, .806], controlling for past depressive episodes, treatment group, and medication. The practice of therapy-acquired regulatory skills had no direct effect on relapse/recurrence (β = .028) but predicted relapse/recurrence through an indirect path (β = -.125), such that greater practice of regulatory skills following treatment promoted increases in DC (β = .462), which, in turn, predicted a reduced risk of relapse/recurrence over 24 months (β = -.270). CONCLUSIONS Preventing major depressive disorder relapse/recurrence may depend upon developing DC in addition to managing residual symptoms. Following the acquisition of therapy skills during maintenance psychotherapies, DC is strengthened by continued skill utilization beyond treatment termination. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Meditation practices are used to cultivate internally-oriented attention to bodily sensations, which may improve health via cognitive and emotion regulation of bodily signals. However, it remains unclear how meditation impacts internal attention states due to lack of measurement tools that can objectively assess mental states during meditation practice itself, and produce time estimates of internal focus at individual or group levels. To address these measurement gaps, we tested the feasibility of applying multi-voxel pattern analysis (MVPA) to single-subject fMRI data to (1) learn and recognize internal attentional (IA) states relevant for meditation during a directed IA task, and (2) decode or estimate the presence of those IA states during an independent meditation session. Within a mixed sample of experienced meditators and novice controls (N=16), we first used MVPA to develop single-subject brain classifiers for 5 modes of attention during an IA task in which subjects were specifically instructed to engage in one of five states (i.e., meditation-related states: breath attention, mind wandering, and self-referential processing, and control states: attention to feet and sounds). Using standard cross-validation procedures, MVPA classifiers were trained in five of six IA blocks for each subject, and predictive accuracy was tested on the independent sixth block (iterated until all block volumes were tested, N=2160). Across participants, all five IA states were significantly recognized well above chance (>41% vs. 20% chance). At the individual level, IA states were recognized in most participants (87.5%), suggesting that recognition of IA neural patterns may be generalizable for most participants, particularly experienced meditators. Next, for those who showed accurate IA neural patterns, the originally trained classifiers were then applied to a separate meditation run (10-min) to make an inference about the percentage time engaged in each IA state (breath attention, mind wandering, or self-referential processing). Preliminary group-level analyses demonstrated that during meditation practice, participants spent more time attending to breath compared to mind wandering or self-referential processing. This paradigm established the feasibility of using MVPA classifiers to objectively assess mental states during meditation at the participant level, which holds promise for improved measurement of internal attention states cultivated by meditation.

Microdosing psychedelics—the regular consumption of small amounts of psychedelic substances such as LSD or psilocybin—is a growing trend in popular culture. Recent studies on full-dose psychedelic psychotherapy reveal promising benefits for mental well-being, especially for depression and end-of-life anxiety. While full-dose therapies include perception-distorting properties, microdosing mayprovide complementary clinical benefits using lower-risk, non-hallucinogenic doses. This pre-registered study aimed to investigate whether microdosing psychedelics is related to differences in personality, mental health, and creativity. In this observational study, respondents recruited from online forums self-reported their microdosing behaviors and completed questionnaires concerning dysfunctional attitudes, wisdom, negative emotionality, open-mindedness, and mood. Respondents also performed the Unusual Uses Task to assess their creativity. Current and former microdosers scored lower on measures of dysfunctional attitudes (p < 0.001, r = − 0.92) and negative emotionality (p = 0.009, r = − 0.85) and higher on wisdom (p < 0.001, r = 0.88), openmindedness(p = 0.027, r = 0.67), and creativity (p < 0.001, r = 0.15) when compared to non-microdosing controls. These findings provide promising initial evidence that warrants controlled experimental research to directly test safety and clinical efficacy. As microdoses are easier to administer than full-doses, this new paradigm has the exciting potential to shape future psychedelic research.

This study investigated the effect of an intravenous serotonin reuptake inhibitor on the neural substrates of obsessive-compulsive disorder (OCD), as intravenous agents may be more effective in treating OCD than conventional oral pharmacotherapy. Eight OCD subjects and eight control subjects received alternate infusions of citalopram and placebo during functional magnetic resonance imaging, in a randomized, symptom-provocation, crossover design. Compared with baseline, OCD subjects displayed significant changes in prefrontal neural activity after the citalopram infusion relative to placebo, and these changes correlated with reductions in subjective anxiety.

Over the past several decades, a corpus of research has emerged detailing the therapeutic outcomes and processes of mindfulness. The emergence of the field of contemplative science has given rise t...

Objective Both Mindfulness Based Cognitive Therapy (MBCT) and Cognitive Therapy (CT) enhance self-management of prodromal symptoms associated with depressive relapse, albeit through divergent therapeutic procedures. We evaluated rates of relapse in remitted depressed patients receiving MBCT and CT. Decentering and dysfunctional attitudes were assessed as treatment-specific process markers. Method Participants in remission from Major Depressive Disorder (MDD; N = 166) were randomized to 8 weeks of either MBCT (N = 82) or CT (N = 84) and were followed for 24 months, with process markers measured every 3 months. Attendance in both treatments was high (6.3/8 session) and treatment fidelity and competence were evaluated. Relapse was defined as a return of symptoms meeting the criteria for major depression on Module A of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID). Results Intention-to-treat analyses indicated no differences between MBCT and CT in either rates of relapse to MDD or time to relapse across 24 months of follow up. Both groups experienced significant increases in decentering and participants in CT reported greater reductions in dysfunctional attitudes. Within both treatments, participants who relapsed evidenced lower decentering scores than those who stayed well over the follow up. Conclusions This is the first study to directly compare relapse prophylaxis following MBCT and CT directly. The lack of group differences in time to relapse supports the view that both interventions are equally effective and that increases in decentering achieved via either treatment are associated with greater protection. These findings lend credence to Teasdale et al.'s (2002) contention that, even though they may be taught through dissimilar methods, CT and MBCT help participants develop similar metacognitive skills for the regulation of distressing thoughts and emotions. (PsycINFO Database Record

BACKGROUND Patients with suspected thiamine deficiency should receive treatment with parenteral thiamine to achieve the high serum thiamine levels necessary to reverse the effects of deficiency and to circumvent problems with absorption common in the medically ill. OBJECTIVE To quantify rates of parenteral administration of thiamine across university-affiliated hospitals and to identify factors associated with higher rates of parenteral prescribing. DESIGN Multicenter, retrospective observational study of thiamine prescriptions. METHODS Prescriptions for thiamine were captured from computerized pharmacy information systems across participating centers, providing information concerning dose, route, frequency, and duration of thiamine prescribed from January 2010 to December 2011. SETTING Fourteen university-affiliated tertiary care hospitals geographically distributed across Canada, including 48,806 prescriptions for thiamine provided to 32,213 hospitalized patients. RESULTS Parenteral thiamine accounted for a statistically significant majority of thiamine prescriptions (57.6%, P

Many new people are engaging contemplative practices and Mindfulness-Based Interventions (MBIs) have become quite popular. While MBIs positively impact well-being, drop-out and lack of practice-maintenance plagues these interventions, which use the breath to anchor attention. No study had yet compared preferences for practices using anchors from different sensory modalities (e.g. auditory, visual) thus the present study examined such individual differences, sharing resources on the OSF (osf.io/hcnz2/). Participants engaged 10-min practices within three modalities (somatosensory, auditory, visual) and post-practice preferences were modelled. Preference differences did exist: 49% preferred the breath, 30% the auditory-phrase, and 21% the visual-image. Pre-practice motivation and anchor-modality were primary predictors and cardiac responses also influenced preference. Preferences were updated through experience and over half of participants left the experiment preferring a different anchor than when entering. Tangible next-steps are discussed, including integrating additional anchor modalities into existing interventions by offering brief practices with a variety of anchors. Suggestions are made for increasing post-training contact using email-automation to answer central practice-maintenance questions, including whether and which contemplative benefits are predicated on continued practice.

Well-being is deeply rooted in the body, a continuous flow of feelings denoting comfort or distress. Interoception, the representation of the body's internal state, is a growing target of scientific research, buoyed by a growing respect for contemplative traditions relating interoceptive awareness to the cultivation of well-being. An emerging interoception literature cuts across studies of neurophysiology, somatic anthropology, contemplative practice, and mind-body medicine. Key questions include: How is body awareness cultivated? What role does interoception play for emotion and cognition across the lifespan as well as in different psychopathologies? What are the neurophysiological effects of interoceptive training in Yoga, mindfulness meditation, Tai Chi, and other embodied contemplative practices? What categories from other traditions might be useful in this investigation? How might the cultivation of interoceptive awareness improve resilience in chronic health conditions?

The term “hypo-egoic” can refer to a variety of cognitive states, ranging from internal experiences of meditation, hypnosis, or spirituality, to overt acts of forgiveness or altruism. This chapter reviews the nascent literature on the neuroscience supporting such states, aiming to provide a more unified neural account. For parsimony, research findings are framed in terms of implicated brain networks, with particular attention as to whether networks are modulated to directly inhibit of egoic processes, or to generate competing, experientially salient, hypo-egoic states. The chapter concludes that hypo-egoic processing is not purely inhibitory in its neural architecture but often incorporates generative neural representations, enhancing sensory awareness in meditation and hypnosis, the theory of another’s mind in love and forgiveness, and vicarious enjoyment in altruistic acts. These generative processes may anchor attention and attenuate prepotent tendencies toward egoic thinking, allowing for the transcendence of self-concern in favor of some greater good.

Facial emotion recognition (FER) deficits are evident and pervasive across neurodevelopmental, psychiatric, and acquired brain disorders in children, including children treated for brain tumours. Such deficits are thought to perpetuate challenges with social relationships and decrease quality of life. The present study combined eye-tracking, neuroimaging and cognitive assessments to evaluate if visual attention, brain structure, and general cognitive function contribute to FER in children treated for posterior fossa (PF) tumours (patients: n = 36) and typically developing children (controls: n = 18). To assess FER, all participants completed the Diagnostic Analysis of Nonverbal Accuracy (DANVA2), a computerized task that measures FER using photographs, while their eye-movements were recorded. Patients made more FER errors than controls (p

Putatively, mindfulness meditation involves generation of a state of “nonappraisal”, yet, little is known about how mindfulness may influence appraisal processes. We investigated whether the state and practice of mindfulness could enhance cognitive reappraisal. Participants (N = 44; M age = 24.44, SD = 4.00, range 19 – 38, 82.2% female) were randomized to either 1) mindfulness, 2) suppression, or 3) mind-wandering induction training conditions. Cognitive reappraisal was assessed with the Emotion Regulation Questionnaire (ERQ) prior to experimental induction, and state mindfulness was assessed immediately following induction using the Toronto Mindfulness Scale (TMS). Participants practiced their assigned strategy for one week and then were reassessed with the ERQ reappraisal subscale. Participants receiving mindfulness training reported significantly higher levels of state mindfulness than participants in the thought suppression and mind wandering conditions. Although brief mindfulness training did not lead to significantly greater increases in reappraisal than the other two conditions, state mindfulness during mindfulness meditation was prospectively associated with increases in reappraisal. Path analysis revealed that the indirect effect between mindfulness training and reappraisal was significant through state mindfulness. Degree of state mindfulness achieved during the act of mindfulness meditation significantly predicted increases in reappraisal over time, suggesting that mindfulness may promote emotion regulation by enhancing cognitive reappraisal.

Mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) are particularly effective treatment approaches in terms of alleviating depressive symptoms and preventing relapse once remission has been achieved. Although engaging in mindfulness practice is an essential element of both treatments; it is unclear whether informal or formal practices differentially impact on symptom alleviation. The current study utilizes a correlational design to examine data provided by thirty-two previously depressed, remitted outpatients who received either MBCT or MBSR treatment. Outpatients in the MBCT group received treatment as part of a previously published randomized efficacy trial (Segal et al. in Arch Gen Psychiatry 67:1256–1264, 2010), while those in the MBSR group received treatment as part of a separate, unpublished randomized clinical trial. Throughout treatment, clients reported on their use of formal and informal mindfulness practices. Results indicate that engaging in formal (but not informal) mindfulness practice was associated with decreased rumination, which was associated with symptom alleviation.

Emotion research has been divided by debate as to whether emotions are universal in form or cognitively constructed. We review an emerging approach that focuses on function rather than form. Functional affective science suggests that the particular origin of an emotion is relatively unimportant; instead, emotions can be understood in terms of a rapidly deployed set of mechanisms that structure perception, cognition and behavior to facilitate goal fulfillment. Evidence from this approach suggests at least three major functions of emotion: sensory gating, embodying affect, and integrating knowledge toward goal resolution. These functions appear to be universal and automatically activated, yet also moderated by conscious representation and regulatory efforts.

Background Mindfulness training (MT) programs represent an approach to attention training with well-validated mental health benefits. However, research supporting MT efficacy is based predominantly on weekly-meeting, facilitator-led, group-intervention formats. It is unknown whether participants might benefit from neurofeedback-assisted, technology-supported MT (N-tsMT), in which meditation is delivered individually, without the need for a facilitator, travel to a training site, or the presence of a supportive group environment. Mirroring the validation of group MT interventions, the first step in addressing this question requires identifying whether N-tsMT promotes measurable benefits. Here, we report on an initial investigation of a commercial N-tsMT system. Methods In a randomized, active control trial, community-dwelling healthy adult participants carried out 6 weeks of daily practice, receiving either N-tsMT (n = 13), or a control condition of daily online math training (n = 13). Training effects were assessed on target measures of attention and well-being. Participants also completed daily post-training surveys assessing effects on mood, body awareness, calm, effort, and stress. Results Analysis revealed training effects specific to N-tsMT, with attentional improvements in overall reaction time on a Stroop task, and well-being improvements via reduced somatic symptoms on the Brief Symptom Inventory. Attention and well-being improvements were correlated, and effects were greatest for the most neurotic participants. However, secondary, exploratory measures of attention and well-being did not show training-specific effects. N-tsMT was associated with greater body awareness and calm, and initially greater effort that later converged with effort in the control condition. Conclusions Preliminary findings indicate that N-tsMT promotes modest benefits for attention and subjective well-being in a healthy community sample relative to an active control condition. However, the findings would benefit from replication in a larger sample, and more intensive practice or more comprehensive MT instruction might be required to promote the broader benefits typically reported in group format, facilitated MT. Trial registration Current Controlled Trials ISRCTN43629398. Retrospectively registered on June 16, 2016. Electronic supplementary material The online version of this article (doi:10.1186/s40359-016-0168-6) contains supplementary material, which is available to authorized users.

One component of mindfulness training (MT) is the development of interoceptive attention (IA) to visceral bodily sensations, facilitated through daily practices such as breath monitoring. Using functional magnetic resonance imaging (fMRI), we examined experience-dependent functional plasticit yi n accessing interoceptive representations by comparing graduates of a Mindfulness-Based Stress Reduction course to a waitlisted control group. IA to respiratory sensations was contrasted against two visual tasks, controlling for attentional requirements non-specific to IA such as maintaining sensation and suppressing distraction. In anatomically partitioned analyses of insula activity, MT predicted greater IA-related activity in anterior dysgranular insula regions, consistent with greater integration of interoceptive sensation with external context. MT also predicted decreased recruitment of the dorsomedial prefrontal cortex (DMPFC) during IA, and altered functional connectivity between the DMPFC and the posterior insula, putative primary interoceptive cortex. Furthermore, meditation practice compliance predicted greater posterior insula and reduced visual pathway recruitment during IA. These findings suggest that interoceptive training modulates task-specific cortical recruitment, analogous to training-related plasticity observed in the external senses. Further, DMPFC modulation of IA networks may be an important mechanism by which MT alters information processing in the brain, increasing the contribution of interoception to perceptual experience.

Contemporary scholarship on mindfulness casts it as a form of purely non-evaluative engagement with experience. Yet, traditionally mindfulness was not intended to operate in a vacuum of dispassionate observation, but was seen as facilitative of eudaimonic mental states. In spite of this historical context, modern psychological research has neglected to ask the question of how the practice of mindfulness affects downstream emotion regulatory processes to impact the sense of meaning in life. To fill this lacuna, here we describe the Mindfulness-to-Meaning Theory, from which we derive a novel process model of mindful positive emotion regulation informed by affective science, in which mindfulness is proposed to introduce flexibility in the generation of cognitive appraisals by enhancing interoceptive attention, thereby expanding the scope of cognition to facilitate reappraisal of adversity and savoring of positive experience. This process is proposed to culminate in a deepened capacity for meaning-making and greater engagement with life.

Mindfulness, an ancient spiritual practice, is becoming an increasingly popular component of communication courses, training individuals to reserve judgment in their dealings with others. However, the effects of mindfulness in communication courses are not well researched. We compared students taking an introductory communication course that included a mindfulness component (N=20) against a control group of students taking an equivalent course without mindfulness content (N=24). Both groups improved in their positive reappraisal tendencies following communication training; however, the groups appeared to differ in how they positively reappraised situations. Only the mindfulness group demonstrated improved mindfulness scores following training, accounting for that group's increases in positive reappraisal, and providing evidence for mindfulness training as one mechanism for reducing negative reactivity in communication.

The presence of emotional stimuli results in a central/peripheral tradeoff effect in memory: memory for central details is enhanced at the cost of peripheral items. It has been assumed that emotion-modulated differences in memory are the result of differences in attention, but this has not been tested directly. The present experiment used eye movement monitoring as an index of overt attention allocation and mediation analysis to determine whether differences in attention were related to subsequent memory. Participants viewed negative and neutral scenes surrounded by three neutral objects and were then given a recognition memory test. The results revealed evidence in support of a central/peripheral tradeoff in both attention and memory. However, contrary with previous assumptions, whereas attention partially mediated emotion-enhanced memory for central pictures, it did not explain the entire relationship. Further, although centrally presented emotional stimuli led to decreased number of eye fixations toward the periphery, these differences in viewing did not contribute to emotion-impaired memory for specific details pertaining to the periphery. These findings suggest that the differential influence of negative emotion on central versus peripheral memory may result from other cognitive influences in addition to overt visual attention or on postencoding processes.

Recovery from emotional challenge and increased tolerance of negative affect are both hallmarks of mental health. Mindfulness training (MT) has been shown to facilitate these outcomes, yet little is known about its mechanisms of action. The present study employed functional MRI (fMRI) to compare neural reactivity to sadness provocation in participants completing 8 weeks of MT and waitlisted controls. Sadness resulted in widespread recruitment of regions associated with self-referential processes along the cortical midline. Despite equivalent self-reported sadness, MT participants demonstrated a distinct neural response, with greater right-lateralized recruitment, including visceral and somatosensory areas associated with body sensation. The greater somatic recruitment observed in the MT group during evoked sadness was associated with decreased depression scores. Restoring balance between affective and sensory neural networks—supporting conceptual and body based representations of emotion— could be one path through which mindfulness reduces vulnerability to dysphoric reactivity.

We investigated self-regulatory focus (Higgins, 1997, 1998) as one source of variation in encoding of, and memory for, emotional words. Participants wrote about their hopes and aspirations (promotion focus) or duties and obligations (prevention focus). In a subsequent incidental encoding task during functional magnetic resonance imaging (fMRI), participants evaluated emotional (positive and negative) and neutral words as either good or bad. A surprise memory test followed, outside the scanner. We observed a dissociation in posterior cingulate cortex (PCC), where activity during the evaluation task was greater when words were focus-consistent (positive for the promotion focus group, negative for the prevention focus group). Similarly, activity in a parahippocampal region was related to subsequent memory, but only for focus-consistent words. Given the role of the PCC in self-referential processing and episodic retrieval, and the parahippocampus in memory-related processing, these data suggest that regulatory focus influences which items are preferentially associated with self-referential information in memory. Such preferential processing may help explain why events are remembered differently by different individuals, which subsequently may influence interpersonal interactions.

© 2015 Farb, Daubenmier, Price, Gard, Kerr, Dunn, Klein, Paulus and Mehling. Interoception can be broadly defined as the sense of signals originating within the body. As such, interoception is critical for our sense of embodiment, motivation, and well-being. And yet, despite its importance, interoception remains poorly understood within modern science. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It is hoped that this integrative effort will advance our understanding of how interoception determines well-being, and identify the central challenges to such understanding. To this end, we introduce an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind-body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a person's sense of presence and agency in the world.

People vary in how they remember the past: some recall richly detailed episodes; others more readily access the semantic features of events. The neural correlates of such trait-like differences in episodic and semantic remembering are unknown. We found that self-reported individual differences in how one recalls the past were related to predictable intrinsic connectivity patterns of the medial temporal lobe (MTL) memory system. A pattern of MTL connectivity to posterior brain regions supporting visual-perceptual processing (occipital/parietal cortices) was related to the endorsement of episodic memory-based remembering (recalling spatiotemporal event information), whereas MTL connectivity to inferior and middle prefrontal cortical regions was related to the endorsement of semantic memory-based remembering (recalling facts). These findings suggest that the tendency to engage in episodic autobiographical remembering is associated with accessing and constructing detailed images of a past event in memory, while the tendency to engage in semantic autobiographical remembering is associated with organizing and integrating higher-order conceptual information. More broadly, these findings suggest that differences in how people naturally use memory are instantiated though distinct patterns of MTL functional connectivity.