Download Mindfulness Research

Mindfulness Research, Neuroscience & Theoretical Formulations
Professor Rob MacFadden
October 23, 2015
Content taken directly from: Holzel, B., Lazar, S., Gard, T., Schuman-Olivier, Z., Vago,
D., Ott, U.(2011). How does Mindfulness Meditation work? Proposing mechanisms of
action from a conceptual and neural perspective. Perspectives on Psychological
Science 6 (6), 537-559.
Beneficial effects of Mindfulness Meditation found for:
Improved immune functioning (Carlson et al., 2007; Davidson et al., 2003)
Reduced blood pressure & cortisol level (Carson et al., 2007)
Depression (Hoffmann et al., 2010; Teasdale et al., 2000)
Chronic pain (Grossman et al., 2007)
Anxiety (Hoffman et al., 2010; Roemer et al., 2008)
Substance abuse (Bowen et al., 2006)
Eating disorders (Tapper et al., 2009)
Psychological well-being in healthy participants (Carmody & Baer, 2008; Chiesa &
Serretti, 2009)
Cognitive Functioning (Jha et al., 2007; Ortner et al., 2007; Pagnoni & Cekie, 2007)
Some Ideas:
Intentionally paying attention with a non-judgmental attitude may lead to important
change in perspective: a decentering.
Involves insight, exposure, non-attachment, enhanced mind-body functioning,
integrated functioning.
Symptom reduction through exposure, cognitive change, self-management,
relaxation & acceptance.
Factor Analysis of Existing Mindfulness Questionnaires (Baer et al., 2006) found five
facets: observing (attending to internal & external stimuli); describing (using words
to label stimuli); acting with awareness (attending to ones actions, not
automaticity); non-judging of internal experience (let thoughts & feelings come and
go).
Definition: Non-judgmental attention to experiences in the present moment (KabatZinn, 1990). Involves attention on the experience of thoughts, body sensations,
emotions and observing them as they arise and go away.
Two central components: (1 ) regulation of attention to keep it on the immediate
experience; (2) approaching experiences with curiosity, openness, and acceptance,
regardless of whether they are positive or negative.
Researchers (Holzel et al., 2011, p. 539) from a neuroscience perspective:
Mechanism
1. Attention
regulation
2. Body
awareness
3. Emotional
regulation:
reappraisal
4. Emotion
regulation:
exposure,
extinction,
reconsolidation
5. Change in
perspective on
the self
Instructions
Attention &
returning to
attention
Focus on
internal or
external
experience
Accepting nonjudgmentally
Exposing
oneself to
whatever is in
field of
awareness;
letting oneself
be affected by
it; refraining
from internal
reactivity
Detachment
with static
sense of self
Changes
Enhanced
ability to
attend, orient,
Enhanced
body
awareness
Increases in
positive
reappraisal
Increase in
non-reactivity
to inner
experiences
Self-reported
changes in self
Brain Areas
Anterior
Cingulate
Cortex
Insula,
temporoparietal
junction
Dorsal,
prefrontal
cortex PFC
Ventro-medial
PFC,
hippocampus,
amygdala
Medial PFC,
posterior
cingulate
cortex, insula,
parietal
junction
1. Attention Regulation
Critical first skill
Repeated practice
Strengthened ability
ACC detects conflicts (distractions) & alerts other systems to regulate
ACC with frontal insular cortex, involved in activation of different
brain networks, strengthening cognitive control
ACC activated in attention exercises, may reduce activation once
control strengthen
Cortical thickness of ACC greater in experienced mediators
Promising but no research yet for ADHD; some early research for
bipolar disorders in strengthening cognitive functioning
2
2. Body Awareness
Ability to notice subtle bodily sensations
Focus is usually on internal body sensations including sensations related to
emotions or physical sensations
Reports of better bodily awareness & of internal sensations
Includes greater emotional awareness & ability to differentiate sensations
Insula key player in this and some research to indicate increased insula and
somatosensory activity in meditators
Some research showing greater cortical thickness in right anterior insula
By becoming more aware of bodily sensations, this can lead to better
awareness of feelings, since bodily sensations are essential in having a sense
of a feeling. So increased awareness of emotions and subsequent feelings are
crucial to emotional regulation. Bodily awareness is connected to recovery
process in borderline personality disorder, eating disorders and substance
abuse disorders as examples.
Regarding empathy, accurate internal awareness of one’s own sensations
import precondition for empathic response. The insula and temporopariental junction is impacted in awareness of one’s own body sensations, in
social cognition and empathic responses.
3. Emotion Regulation
Mindfulness can result in improvement in emotion regulation.
Can reduce emotional reactivity
Decrease in negative mood states
Improved positive mood states
Reduced distractive and ruminative thoughts and behaviours
Can increase left prefrontal activation leading to more positive emotions
Prefrontal control systems module emotions and the amygdala and dorsal
regions of lateral PFC, ventral PFC
The ACC (monitors control processes)
Typical pattern: increased PFC, decreased amygdala
PFC projections to amygdala exert inhibitory top down control
Mindfulness activates regions relevant to emotional regulation
Improved emotion regulation underlying Mindfulness likely accounts for
stress reduction & reducing depression symptoms.
Cognitive Reappraisal
Reinterpreting one’s meaning of a stimulus
Mindfulness involves positive reappraisal
Mindfulness reconstrues stimuli as beneficial, meaningful or benign
Reappraisal involves dorsolateral PFC, orbito PFC and ACC
Some dispute, findings suggesting Mindfulness involves nonappraisal
3
Exposure, extinction, reconsolidation
Mindfulness encourages exposure to the experience, welcoming it,
refraining from engaging in internal activity towards it, bring
acceptance to bodily and affective responses
Turn towards negative emotions, which pass away leaving a sense of
safety or well-being
Mindfulness avoids enacting safety strategies (e.g, avoiding contact,
blocking thoughts, feelings), and focuses attention on responses
High level of relaxation (parasympathetic tone) and decreased
sympathetic tone paired with negative stimuli may decrease
negativity
Extinction does not erase original association but is thought to form
new memory trace or reconsolidate old memory with new (relaxed)
contextual associations.
Extinction involves vmPFC and this is strengthened through
Mindfulness practice.
Brain network crucial for extinction of condition fear responses and
its retention. This network seems to strengthen through Mindfulness.
VmPFC involved. Cortical thickness of vmPFC positive correlated with
extinction recall.
Hippocampus and VmPFC work together during extinction recall to
inhibit fear.
When people regulate their emotions, the hippocampus and the
vmPFC involved. This suppresses fear allowing control over
behavioural reactions to emotions. Neuroimaging studies have shown
that the hippocampus and VmPFC are dysfunctional in PTSD and
depression.
Mediators show greater gray matter in the hippocampus for
mediators vs non-mediators. Detectable within 8 weeks for new
mediators using MBSR.
Reduced scores on perceived stress correlated with a decrease in gray
matter in the right amygdala.
4. Change in perspective on the self
Buddhist teaching says there is no such thing as a permanent,
unchanging self. Self is a product of ongoing mental processes. Paying
close attention to the changing nature of self, leads to the
4
deconstruction of the self. Changing perception of the self, leads to
enduring happiness. It uproots clinging, attachment and hositility.
More positive self-concept, more self-esteem and higher acceptance of
self. Brain structures that support self-referntial processing appear
impacted by Mindfulness. Medial PFC, posterior cingulate cortex and
the inferior parietal lobule are involved.
5. Self-Compassion
Involves self kindness (being kind and understanding towards oneself
in situations of perceived inadequacy or suffering rather than being
harshly self critical); common humanity (perceiving one’s experience
as part of the larger human experience; and mindfulness, defined as
holding one’s painful thoughts and feelings in balance awareness,
rather than over-identifying with them.
Mindfulness & self-compassion are highly correlated. Cultivation of
self-compassion viewed as explaining much of the success of
Mindfulness-based interventions.
Self-compassion scores increase with Mindfulness experience. Feeling
compassion for oneself is an act of emotional regulation.
References
Baer, R.A., Smith, G.T., Hopkins, J., Krietemeyer, J., & Toney, L.
(2006). Using self-report assessment methods to explore facets
of mindfulness. Assessment, 13, 27–45.
Bowen, S., Witkiewitz, K., Dillworth, T.M., Chawla, N., Simpson,
T.L., Ostafin, B.D., Marlatt, G.A. (2006). Mindfulness meditation
and substance use in an incarcerated population. Psychology
of Addictive Behaviors, 20, 343–347.
Carlson, L.E., Speca, M., Faris, P., & Patel, K.D. (2007). One year
pre-post intervention follow-up of psychological, immune, endocrine
and blood pressure outcomes of mindfulness-based stress
reduction (MBSR) in breast and prostate cancer outpatients.
Brain, Behavior, and Immunity, 21, 1038–1049.
Carmody, J., & Baer, R.A. (2008). Relationships between mindfulness
practice and levels of mindfulness, medical and psychological
symptoms and well-being in a mindfulness-based stress
reduction program. Journal of Behavioral Medicine, 31, 23–33.
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction
5
for stress management in healthy people: A review and metaanalysis.
Journal of Alternative and Complementary Medicine,
15, 593–600.
Davidson, R.J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M.,
Muller, D., Santorelli, S.F.,Sheridan, J.F. (2003). Alterations
in brain and immune function produced by mindfulness meditation.
Psychosomatic Medicine, 65, 564–570.
Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper, U.
(2007). Mindfulness training as an intervention for fibromyalgia:
Evidence of postintervention and 3-year follow-up benefits
in well-being. Psychotherapy and Psychosomatics, 76, 226–233.
Hofmann, S.G., Sawyer, A.T., Witt, A.A., & Oh, D. (2010). The effect
of mindfulness-based therapy on anxiety and depression: A metaanalytic
review. Journal of Consulting and Clinical Psychology,
78, 169–183.
Jha, A.P., Krompinger, J., & Baime, M.J. (2007). Mindfulness training
modifies subsystems of attention. Cognitive, Affective, &
Behavioral Neuroscience, 7, 109–119.
Ortner, C.N.M., Kilner, S.J., & Zelazo, P.D. (2007). Mindfulness
meditation and reduced emotional interference on a cognitive
task. Motivation and Emotion, 31, 271–283.
Pagnoni, G., & Cekic, M. (2007). Age effects on gray matter volume
and attentional performance in Zen meditation. Neurobiology of
Aging, 28, 1623–1627.
Roemer, L., Orsillo, S.M., & Salters-Pedneault, K. (2008). Efficacy
of an acceptance-based behavior therapy for generalized anxiety
disorder: Evaluation in a randomized controlled trial. Journal of
Consulting and Clinical Psychology, 76, 1083–1089.
Tapper, K., Shaw, C., Ilsley, J., Hill, A.J., Bond, F.W., & Moore, L.
(2009). Exploratory randomised controlled trial of a mindfulnessbased weight loss intervention for women. Appetite, 52,
396–404.
Teasdale, J.D., Williams, J.M., Soulsby, J.M., Segal, Z.V., Ridgeway,
V.A., & Lau, M.A. (2000). Prevention of relapse/recurrence in
major depression by mindfulness-based cognitive therapy. Journal
of Consulting and Clinical Psychology, 68, 615–623.
6
7