Improve Resilience in First-Responders with a Smartphone Mindfulness App

Improve Resilience in First-Responders with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“The mindfulness practices work at both a preventative and remedial level by assisting them to maintain higher levels of resilience to deal with their emergency responder roles and helping to reduce and cease distressing reactions after difficult personal and traumatic incidents.” – Mark Molony

 

First responders such as firefighters and police experience a great deal of stress and frequent traumatic events and as a part of their jobs. The first-responders need to be resilient in the face of these difficult circumstances to cope with the stress. It is possible that mindfulness training might help. Mindfulness has been shown to increase resilience and reduce the psychological and physiological responses to stress. So, it is reasonable to infer that mindfulness training may help to develop resilience in first-responders and be of benefit to their mental health.

 

In today’s Research News article “Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/), Joyce and colleagues examine the ability of mindfulness training delivered with a smartphone app to increase the levels of resilience in first-responders. They recruited Primary Rescue and Hazmat firefighters and randomly assigned their stations to either receive 6, 20-25 minute, sessions  of mindfulness training or to an Healthy Living control condition. The mindfulness training was based upon Acceptance and Compassion Therapy (ACT) and emphasized mindfulness, self-acceptance, and compassion. Both programs were delivered through a smartphone app. The first-responders were measured before and after training and 6 months later for mindfulness, resilience, cognitive fusion, experiential avoidance and psychological inflexibility, self-compassion, optimism, coping orientation, and life purpose.

 

They found that in comparison to baseline and the control condition, participation in the mindfulness training resulted in a significant increase in adaptive resilience and mindfulness which continued to increase over the 6-month follow-up period. Significant differences in optimism, and the use of instrumental and emotional support were present at the end of training but were not sustained at follow-up. Interestingly, there were no significant differences in “bounce-back” resilience.

 

Adaptive resilience involves the ability to adapt to stressful life circumstances and events. It involves the “individual’s ability to tolerate experiences such as change, personal problems, illness, pressure, failure, and painful feelings.” On the other hand, “bounce-back” resilience involves the ability to recover from stressful events. Since mindfulness focuses the individual on the present moment, it would be expected that it would influence the experience and coping with stressful events as they’re occurring. This is the case with adaptive resilience. On the other hand, mindfulness moves attention away from past events and would thus not be expected to influence coping with past stressful events as is the case with “bounce-back” resilience. Hence, it makes sense that mindfulness training would affect adaptive resilience and not “bounce-back” resilience.

 

It is important for the well-being of first responders that they be able to cope with the, at times, intense stress and trauma involved in their jobs. Hence, mindfulness training may be very beneficial as the present results suggest. This may help to prevent illness, burnout, and post-traumatic stress disorder (PTSD). In addition, the fact that mindfulness was taught with a smartphone app is important as it makes the training convenient and adaptable to the individual’s schedule. It is also highly scalable allowing for inexpensive widespread availability of the training.

 

So, Improve Resilience in First-Responders with a Smartphone Mindfulness App.

 

“Because PTSD is an anxiety disorder, episodes of distress occur when a person begins to worry about the future based on previous painful, intense or stressful memories. Meditation can help bring that person’s attention back to the current moment, which reduces or eliminates anxiety.” – Erin Fletcher

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Joyce, S., Shand, F., Lal, T. J., Mott, B., Bryant, R. A., & Harvey, S. B. (2019). Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. Journal of medical Internet research, 21(2), e12894. doi:10.2196/12894

 

Abstract

Background

A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.

Objective

This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.

Methods

We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.

Results

Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).

Conclusions

The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399574/

 

Lower PTSD Symptoms and Risk of Suicide in Firefighters are Associated with Mindfulness

Lower PTSD Symptoms and Risk of Suicide in Firefighters are Associated with Mindfulness

 

By John M. de Castro, Ph.D.

 

“I’m convinced [mindfulness] could be a powerful antidote to what I see happening to my peers, both as retirees and active personnel. We have high rates of suicide and PTSD. It can lead you to some pretty dark places.” – Gary Gonzalez

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime with 7%-8% of the population developing Post-Traumatic Stress Disorder (PTSD). It involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

First responders such as firefighters and police experience traumatic events as part of their jobs and many develop symptoms of PTSD. This is responsible for the fact that wore firefighters and police officers die by suicide than all line-of-duty deaths combined. 103 firefighters and 140 police officers died by suicide in 2017, compared to 93 firefighter and 129 officer line-of-duty deaths. Obviously, this is a troubling problem that needs to be addressed. There are a number of therapies that have been developed to treat PTSD. One of which, mindfulness training has been found to be particularly effective.  Indeed, mindfulness has been shown to has been shown to reduce suicidality and to reduce the impact of trauma on the individual.

 

In today’s Research News article “Posttraumatic stress disorder symptoms and mindfulness facets in relation to suicide risk among firefighters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434694/), Stanley and colleagues examine the relationship of mindfulness to PTSD symptoms and suicide risk in firefighters. They recruited firefighters (94% male) and had them complete an online survey measuring mindfulness, lifetime exposure to trauma, PTSD symptoms, and suicide risk severity.

 

They found that the higher the levels of mindfulness the lower the levels of PTSD symptoms and suicide risk. They also found that the higher the levels of PTSD symptoms the higher the levels of suicide risk. A moderation analysis indicated that the effect of PTSD symptoms on suicide risk severity was lowered by mindfulness, particularly the mindfulness facets of acting with awareness and non-judging of inner experience.

 

It should be noted that these findings are correlations and thus there cannot be definitive conclusions about causation. Nevertheless, the results suggest that mindfulness is associated with lower Post-Traumatic Stress Disorder (PTSD) and lower risk of suicide among firefighters. In addition, being able to act with awareness and to experience feelings without judgement may be particularly strongly associated with a lower association between the symptoms of PTSD and the risk of suicide. These results suggest that a randomized clinical trial of the ability of mindfulness training to lower PTSD symptoms and suicide risk is warranted.

 

First responders have a tough job. They are not only exposed to immediate risks to their safety but also long-term risks associated with the trauma experienced in the course of their jobs. Mindfulness may be very helpful for firefighters. It may have the ability to help them withstand the long-term consequences of the trauma they experience. Perhaps mindfulness may make a tough, but important, job less costly for the firefighters mental health.

 

“Firefighters are more likely to die by suicide than to die on the job. We heavily invest in protective equipment to keep them physically safe – special masks, boots, jackets, pants. So why don’t we spend any money to protect their minds?” – Rich Landward

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Stanley, I. H., Boffa, J. W., Tran, J. K., Schmidt, N. B., Joiner, T. E., & Vujanovic, A. A. (2019). Posttraumatic stress disorder symptoms and mindfulness facets in relation to suicide risk among firefighters. Journal of clinical psychology, 75(4), 696–709. doi:10.1002/jclp.22748

 

Abstract

Objective:

Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk among firefighters. Few studies have examined modifiable factors, such as mindfulness facets, that might attenuate this association. This study examined the interactive effects of PTSD symptoms and mindfulness facets in relation to suicide risk among firefighters.

Method:

Overall, 831 career firefighters were assessed for PTSD symptoms, mindfulness facets, and suicide risk via the PTSD Checklist for DSM‐5, Five Facet Mindfulness Questionnaire, and Suicidal Behaviors Questionnaire—Revised, respectively.

Results:

Greater PTSD symptoms were associated with more severe suicide risk; however, higher levels of two specific mindfulness facets, acting with awareness and nonjudging of inner experience, attenuated this association. By contrast, higher levels of the observing facet of mindfulness potentiated the association between PTSD symptoms and suicide risk.

Conclusions:

Suicide prevention initiatives among firefighters, particularly those experiencing trauma‐related sequelae, might benefit from the inclusion of mindfulness‐based practices alongside frontline empirically‐supported approaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434694/

 

Improved Executive Attention with Mindfulness is Mediated by Brain Processing

Improved Executive Attention with Mindfulness is Mediated by Brain Processing

 

By John M. de Castro, Ph.D.

 

With practice, we can strengthen the part of our brain that helps focus and sustain attention. Building that strength has enormous payoffs in performance, relationships and a sense of well-being.” – Laurie Cameron

 

One of the primary effects of mindfulness training is an improvement in the ability to pay attention to the task at hand and ignore interfering stimuli. This is an important consequence of mindfulness training and produces improvements in thinking, reasoning, and creativity. The importance of heightened attentional ability to the individual’s ability to navigate the demands of complex modern life cannot be overstated. It helps in school, at work, in relationships, or simply driving a car. As important as attention is, it’s surprising that little is known about the mechanisms by which mindfulness improves attention

 

There is evidence that mindfulness training improves attention by altering the brain. It appears That mindfulness training increases the size, connectivity, and activity of areas of the brain that are involved in paying attention. A common method to study the activity of the nervous system is to measure the electrical signal at the scalp above brain regions. Changes in this activity are measurable with mindfulness training.

 

One method to observe attentional processing in the brain is to measure the changes in the electrical activity that occur in response to specific stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time. The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. The P3 response in the evoked potential (ERP) is a positive going electrical response occurring between a 2.5 to 5 tenths of a second following the target stimulus presentation. The P3 component is thought to reflect attentional processing.

 

In today’s Research News article “). Clarifying the relationship between mindfulness and executive attention: A combined behavioral and neurophysiological study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374600/), Lin and colleagues recruited female college students who did not have a mindfulness practice and measured their trait mindfulness and tested them for attention with a flanker task where the participant had to respond to a stimulus and ignore irrelevant but distracting material. During the task the Electroencephalogram (EEG) was recorded and the brain electrical response to the stimulus recorded (ERP).

 

They found that the higher the level of the student’s mindfulness the better they performed on the flanker task, indicating better executive attention. Also, the higher the level of mindfulness, the smaller the P3 component in the event-related potential (ERP) when highly distracting flanker material was present. Mediation analysis revealed that mindfulness was associated by better performance both directly by being associated with fewer errors and also indirectly by being associated with a smaller P3 component in the ERP which, in turn, was associated with fewer errors.

 

These results suggest that mindfulness is associated with better executive attention allowing the individual to better ignore distractions. It appears to do so in two ways, directly and also by influencing a brain mechanism that heightens attention. This is an important benefit of mindfulness as better attentional ability is important for virtually every aspect of life from school performance to social interactions. This study suggests that a brain mechanism may, in part, be responsible for this important benefit of mindfulness.

 

Hence, improved executive attention with mindfulness is mediated by brain processing.

 

“Being able to exercise focused attention simply means being able to direct your attention, becoming aware if your mind has wandered, and then being able to redirect your focus.” – Rich Fernandez

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lin, Y., Fisher, M. E., & Moser, J. S. (2018). Clarifying the relationship between mindfulness and executive attention: A combined behavioral and neurophysiological study. Social cognitive and affective neuroscience, 14(2), 205–215. Advance online publication. doi:10.1093/scan/nsy113

 

Abstract

Mindfulness is frequently associated with improved attention. However, the nature of the relationship between mindfulness and executive attention, a core function of the attentional system, is surprisingly unclear. Studies employing behavioral measures of executive attention have been equivocal. Although neuroscientific studies have yielded more consistent findings, reporting functional and structural changes in executive attention brain regions, the observed changes in brain activity have not been linked to behavioral performance. The current study aimed to fill these gaps in the literature by examining the extent to which trait mindfulness related to behavioral and neurophysiological (indexed by the stimulus-locked P3) measures of executive attention. Results revealed that higher trait mindfulness was related to less flanker interference on accuracy and reaction time, consistent with enhanced executive attention. Critically, mediational analyses showed that the P3 accounted for the relationship between trait mindfulness and executive attention performance, elucidating a neural mechanism through which mindfulness enhances executive attention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374600/

 

Improve Psychological Well-Being with Mindfulness Regardless of the Amount of Practice

Improve Psychological Well-Being with Mindfulness Regardless of the Amount of Practice

 

By John M. de Castro, Ph.D.

 

“No matter what stage of life you are in, the goal of meditating is to find that silence within you, of letting go of external stressors, and accessing calm, tranquility, and feeling that all is well from within. You will reap the benefits of feeling better. And when you feel better, you can be your best self.” – Carol Melnick

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits. With impacts so great it is important to know how to optimize the development of mindfulness. But it is unclear exactly what kind and how much of training is essential to producing maximum benefits.

 

In today’s Research News article “Adherence to Practice of Mindfulness in Novice Meditators: Practices Chosen, Amount of Time Practiced, and Long-Term Effects Following a Mindfulness-Based Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419774/), Ribeiro and colleagues recruited healthy older adults, aged 50 to 80 years, who had not engaged in mindfulness practices and were moderately stressed. They were randomly assigned to either a wait-list control group or to receive a 6-week mindfulness training based upon the Mindfulness-Based Cognitive Therapy (MBCT) program. They met once a week for 60-90 minutes and were instructed to practice at home for 30-45 minutes daily. They were measured before and after training and 8 weeks later for neuroticism, perceived stress, expectancy, mindfulness, quality of life, depression, and adherence to mindfulness practice.

 

They found that the participants continued meditation after the training averaging 23 minutes per day for 76% of days and 8 weeks later significantly less averaging 16 minutes per day for 55% of days. Their preferred practice was body scan meditation, followed by sitting meditation and the most popular sitting meditation was breath following. In comparison to the baseline and the wait-list control group, mindfulness practice produced significant improvements in well-being including reductions in perceived stress, depression, and neuroticism and increases in mindfulness and the quality of life. These effects persisted from the end of training to the 8-week follow-up. There were no significant effects of expectancy, amount of practice, or type of practice on the results.

 

These results are similar to previous reports that mindfulness practice reduces perceived stress, depression, and neuroticism and increases in mindfulness and quality of life that continue beyond the end of training. Unlike previous research, however, they did not find any influence of the types, amounts, or patterns of practice on well-being. This may be due to a ceiling effects as the adherence and amount of practice was relatively high. It could also be due to the age of participants. Future studies may clarify these possibilities. Nevertheless, it is clear that mindfulness practice improves well-being in older adults.

 

So, improve psychological well-being with mindfulness regardless of the amount of practice.

 

Ultimately, engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.” – Jennifer Wolkin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ribeiro, L., Atchley, R. M., & Oken, B. S. (2017). Adherence to Practice of Mindfulness in Novice Meditators: Practices Chosen, Amount of Time Practiced, and Long-Term Effects Following a Mindfulness-Based Intervention. Mindfulness, 9(2), 401–411.

 

Abstract

In this study, we objectively tracked the duration, frequency, and the preferred practices chosen by novice mindfulness practitioners following a mindfulness meditation (MM) intervention. A sample of 55 mildly stressed participants, aged 50 to 80 years old, underwent an individual 6-week MM intervention and had their guided meditation home practice electronically recorded during the intervention and the 8-week post-intervention period. Participants’ psychological well-being was assessed through self-report measures of mindfulness, quality of life, and symptoms of depression and stress. Results evidenced a high adherence to practice, with an average of ~23 minutes per day during the intervention and ~16 minutes per day in the follow-up period. Body scan, sitting meditation, and breathing space were the most popular meditation practices among participants. Our results showed significant alterations in self-reported measures over time, suggesting improvements in stress and overall quality of life. Changes in the self-report measures did not correlate with MM practice time, which suggests that other psychological phenomena, including quality of meditation practice, influence these outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419774/

 

Reduce Worry and Rumination and Improve Emotion Regulation Lowering Anxiety and Depression with Mindfulness

Reduce Worry and Rumination and Improve Emotion Regulation Lowering Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“The practice of mindfulness teaches us a different way to relate to our thoughts, feelings, and emotions as they arise. It is about learning to approach and acknowledge whatever is happening in the present moment, setting aside our lenses of judgment and just being with whatever is there, rather than avoiding it or needing to fix it.” – Elisha Goldstein

 

Mindfulness training has been shown through extensive research to be effective in improving the physical and psychological condition of otherwise healthy people and also treating the physical and psychological issues of people with illnesses. This has led to an increasing adoption of mindfulness techniques for the health and well-being of both healthy and ill individuals.

 

Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness, particularly anxiety and depression. Fortunately, worry and rumination may be interrupted by mindfulness and emotion regulation improved by mindfulness. These may be some of the mechanisms by which mindfulness training improves anxiety and depression. In today’s Research News article “Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00506/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_934868_69_Psycho_20190314_arts_A ), Parmentier and colleagues examine the ability of mindfulness to improve emotion regulation and reduce worry and rumination and thereby improve anxiety and depression.

 

They recruited adult participants online and had them complete an online survey measuring mindfulness, anxiety, depression, rumination, worry, emotion regulation, and meditation history. They found that meditation practice was not associated with anxiety or depression directly but rather through its positive association with mindfulness which was strongly negatively associated with anxiety and depression. Mindfulness was associated with lower levels of anxiety and depression directly and also indirectly through its association with rumination and worry and the emotion regulation mechanisms of suppression and reappraisal. Mindfulness was associated with lower levels of suppression, rumination, and worry and higher levels of reappraisal. which in turn were associated with anxiety and depression.

 

These findings suggest that meditation practice increases mindfulness and this decreases anxiety and depression. It does so directly and indirectly. Mindfulness reduces the tendency to suppress, prevent, anxiety and depression from arising which allows for full mindful appreciation of these emotions and as a result produces an actual reduction in them. It also decreases worry and rumination that normally heighten anxiety and depression. At the same time mindfulness increases reappraisal, heightening the ability to investigate the causes of anxiety and depression, resulting in their reduction. Worry and rumination were the most powerful mediating factors while suppression and reappraisal were still significant factors but substantially weaker.

 

These results support the conclusion that mindfulness directly decreases anxiety and depression. But mindfulness also acts indirectly by affecting has a number of psychological processes including improving emotion regulation and by decreasing the counterproductive cognitive processes of worry and rumination.

 

So, reduce worry and rumination and improve emotion regulation lowering anxiety and depression with mindfulness.

 

“With mindfulness practice, we can learn how to unhook from rumination and cut ourselves (and others) the slack requisite for increasing clarity and ease of being.” – Mitch Abblett

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Parmentier FBR, García-Toro M, García-Campayo J, Yañez AM, Andrés P and Gili M (2019) Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Front. Psychol. 10:506. doi: 10.3389/fpsyg.2019.00506

 

The present study examined the effects of mindfulness on depression and anxiety, both direct and indirect through the mediation of four mechanisms of emotional regulation: worry, rumination, reappraisal and suppression. Path analysis was applied to data collected from an international and non-clinical sample of 1151 adults, including both meditators and non-meditators, who completed an online questionnaire battery. Our results show that mindfulness are related to lower levels of depression and anxiety both directly and indirectly. Suppression, reappraisal, worry and rumination all acted as significant mediators of the relationship between mindfulness and depression. A similar picture emerged for the relationship between mindfulness and anxiety, with the difference that suppression was not a mediator. Our data also revealed that the estimated number of hours of mindfulness meditation practice did not affect depression or anxiety directly but did reduce these indirectly by increasing mindfulness. Worry and rumination proved to be the most potent mediating variables. Altogether, our results confirm that emotional regulation plays a significant mediating role between mindfulness and symptoms of depression and anxiety in the general population and suggest that meditation focusing on reducing worry and rumination may be especially useful in reducing the risk of developing clinical depression.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00506/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_934868_69_Psycho_20190314_arts_A

 

Reduce Stress and Improve Behavior in Mothers and Children with Autism Spectrum Disorder or Intellectual Disabilities with Mindfulness

Reduce Stress and Improve Behavior in Mothers and Children with Autism Spectrum Disorder or Intellectual Disabilities with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness meditation helps people with intellectual disabilities and autism spectrum disorder reduce their mental and physical problems.” – Yoon-Suk Hwang

 

Autism spectrum disorder (ASD) is a developmental disability that tends to appear during early childhood and affect the individual throughout their lifetime. It affects a person’s ability to communicate, and interact with others, delays learning of language, makes eye contact or holding a conversation difficult, impairs reasoning and planning, narrows and intensifies interests, produces poor motor skills and sensory sensitivities, and is frequently associated with sleep and gastrointestinal problems. ASD is a serious disorder that impairs the individual’s ability to lead independent lives including complete an education, enter into relationships or find and hold employment. Mindfulness training has been shown to be helpful in treating ASD.

 

Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime. Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have one or more developmental disabilities. Many individuals with intellectual and developmental disabilities are highly aggressive and at time combative.  Caring for children and adults with intellectual and developmental disabilities can be difficult.

 

Providing care for a child with autism or a developmental disability can be particularly challenging. These children’s behavior is characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These make it difficult to relate to the child and receive the kind of positive feelings that often help to support caregiving. The challenges of caring for a child with autism or a developmental disability require that the parent be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction.

 

In today’s Research News article “Effects of Mindfulness-Based Positive Behavior Support (MBPBS) Training Are Equally Beneficial for Mothers and Their Children With Autism Spectrum Disorder or With Intellectual Disabilities.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00385/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_934868_69_Psycho_20190314_arts_A ), Singh and colleagues recruited mothers of adolescents, aged 13 to 17 years, who had autism or a developmental disability. They were observed and their behavior measured over a 10-week baseline period and then provided a 3-day Mindfulness-Based Positive Behavior Support (MBPBS) program consisting of training in meditation and intervening to produce positive behaviors. Daily home practice was encouraged. They were then measured over the subsequent 30 weeks. Measurements were taken of meditation practice and perceived stress and the child’s aggressive and disruptive behaviors, and compliance with the mother’s requests.

 

They found that during the 10-week baseline that stress levels and the children’s behaviors were stable and unchanging. But during the 30-week follow-up period the mothers had large and significant reductions in perceived stress. They also found that the children displayed large significant increases with compliance with the mother’s requests and large significant decreases in aggressive and disruptive behaviors. Hence the Mindfulness-Based Positive Behavior Support (MBPBS) produced marked benefits for the mothers and also the children with autism or a developmental disability.

 

These are exciting results but the lack of a control condition limits the generalizability of the results. Nevertheless they suggest that a brief, 3-day, program can produce large positive benefits for both the mothers and the children. The improvements in the mothers’ stress levels were probably due to the improvements in the children’s behavior. This all suggests that this or similar programs should be implemented to greatly improve caregiving for children with autism or developmental disabilities.

 

So, reduce stress and improve behavior in mothers and children with autism spectrum disorder or intellectual disabilities with mindfulness.

 

interventions that target stress reduction in parents of children with intellectual and developmental disabilities may be an effective way to improve caregiver well-being and have collateral effects on child behavior and parent-child interactions.” – Laura Lee McIntyre

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Singh NN, Lancioni GE, Karazsia BT, Myers RE, Hwang Y-S and Anālayo B (2019) Effects of Mindfulness-Based Positive Behavior Support (MBPBS) Training Are Equally Beneficial for Mothers and Their Children With Autism Spectrum Disorder or With Intellectual Disabilities. Front. Psychol. 10:385. doi: 10.3389/fpsyg.2019.00385

 

Parenting a child with autism spectrum disorder (ASD) or intellectual disabilities (IDs) can be stressful for many parents. Mindfulness-Based Positive Behavior Support (MBPBS) is a customized mindfulness program that enables parents and other caregivers to reduce their perceived psychological stress to normative levels through mindfulness procedures and to support children with ASD or ID to self-manage their challenging behaviors through positive behavior support (PBS). In this study, we evaluated whether MBPBS would have differential effects on the stress levels of mothers of adolescents with ASD (n = 47) or with ID (n = 45) and the effects of the program on the aggressive, disruptive, and compliance behaviors of their children. Both groups of mothers participated in the 40-week study (10 weeks control and 30 weeks MBPBS program), rated their own stress levels, and collected daily observational data on the adolescents’ behavior. Results showed significant reductions in the level of stress in both groups of mothers, but no differential effects on mothers of children with ASD or with ID. In addition, significant reductions in aggression and disruptive behavior and increases in compliance behaviors were observed in the adolescents in both groups. The results suggest that MBPBS is equally beneficial for mothers of adolescents with ASD or ID. In the present study, although the mothers of children with ID had slightly higher levels of stress at baseline and mothers of children with ASD had lower levels of stress following the MBPBS program, the program can be considered equally effective in reducing the stress levels of both groups of mothers. This suggests that the program may be effective regardless of baseline levels of mothers’ stress.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00385/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_934868_69_Psycho_20190314_arts_A

 

Have Consistent Physiological Responses to Differing Circumstances with Mindfulness

Have Consistent Physiological Responses to Differing Circumstances with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Heart rate variability differs from basic heart rate tracking that measures beats per minute in that it actually measures the time variance between heartbeats. With this heart rate variability, you can actually get a good picture of the resilience of the heart organ, which is a good predictor of both well-being and longevity.” – Kyle Pearce

 

In our lives we are confronted with a variety of situations and environments. In order to successfully navigate these differing situations, we must be able to adapt and self-regulate. The Autonomic Nervous System (ANS) is designed to adapt physiologically to the varying demands on us. It is composed of 2 divisions; the sympathetic division underlies activation, including increases in heart rate and blood pressure, while the parasympathetic division underlies relaxation, including decreases in heart rate and blood pressure. A measure of the balance between these systems is provided by the variability of the heart rate.

 

Heart Rate Variability (HRV) refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Mindfulness has been associated with a psychological flexibility and a greater ability to adapt appropriately to differing situations. It makes sense then to investigate the relationship of mindfulness to and Heart Rate Variability (HRV).

 

In today’s Research News article “Trait Mindfulness Is Associated With the Self-Similarity of Heart Rate Variability.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00314/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_925884_69_Psycho_20190305_arts_A ), Sun and colleagues recruited college students and had them complete a measures of mindfulness. The students were also measured for heart rate variability (HRV) under 4 3-minute conditions, “a calming phase, a mental arithmetic task, a recovery phase, and mindfulness practice.”

 

They found that the participants level of mindfulness was not significantly associated with any direct measures of heart rate variability. Rather, mindfulness was associated with the consistency of heart rate variability between the response on different tasks. Hence, students high in mindfulness tended to have heart rate variability responses in the different phases that were very similar. In other words, heart rate variability during calming, mental arithmetic, and mindfulness practice were very consistent.

 

These results are correlational and as such conclusions about causation cannot be reached. But it can be speculated that mindfulness keeps the responses of the autonomic nervous system consistent making it easier to cope with varying circumstances. This level consistent responding may promote health and well-being. This suggests that greater focus on what is happening in the moment (mindfulness) may promote the ability to regulate one’s physiological responses and thereby to adapt to differing circumstances.

 

So, have consistent physiological responses to differing circumstances with mindfulness.

 

“Meditation is one technique that may help improve Heart Rate Variability (HRV) in both the short term and long-term. The end goal is not just to increase HRV, but it is to help the body better recover from stress related damages.” – Sam Sly

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sun S, Hu C, Pan J, Liu C and Huang M (2019) Trait Mindfulness Is Associated With the Self-Similarity of Heart Rate Variability. Front. Psychol. 10:314. doi: 10.3389/fpsyg.2019.00314

 

Previous studies have linked trait mindfulness with better self-regulation and adaptation. Heart rate variability (HRV) is a good physiological indicator of the capacity for self-regulation and adaptation. The present study explored the relationship between trait mindfulness and HRV from the viewpoint of crosstalking between different HRV parameter pairs, which would reflect the dynamic interactions between each pair of HRV parameters in different processes. We measured the trait mindfulness of seventy-four undergraduate students and recorded nine HRV parameters during the following four consecutive experimental phases: (1) calming phase, (2) mental arithmetic task phase, (3) recovery phase, and (4) mindfulness practice phase. The relationship between trait mindfulness and HRV was explored at the following three levels: (1) the absolute level, i.e., HRV parameters in four different states, (2) the difference-change level, i.e., differences in HRV parameters between different states, and (3) the crosstalking level, i.e., self-similarity of crosstalking HRV parameter pairs. The results supported the following hypothesis: trait mindfulness, as measured by the Mindful Attention Awareness Scale (MAAS), was significantly and positively correlated with the self-similarity of crosstalking HRV parameter pairs but was not significantly correlated with the HRV parameters at the difference-change and absolute levels. These findings indicate that as trait mindfulness increases, the ability to maintain ANS function homeostasis improves.

HIGHLIGHTS

– Trait mindfulness is associated with better self-regulation and adaptation.

– Heart rate variability (HRV) is a good physiological indicator of the capacity for self-regulation and adaptation.

– Trait mindfulness is significantly correlated with self-similarity of crosstalking HRV parameter pairs but not with the HRV parameters at the difference-change or absolute levels.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00314/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_925884_69_Psycho_20190305_arts_A

 

Enhance Flow in Athletes with Mindfulness

Enhance Flow in Athletes with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness-based interventions for sports are effective because they help athletes direct their attention to the current athletic task, while minimizing external distractions.” – Mitch Plemmons

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including mindfulness training. It has been shown to improve attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training has been employed by athletes and even by entire teams to enhance their performance.

 

Flow refers to a state of mind that is characterized by a complete absorption with the task at hand, often resulting in enhanced skilled performance. The flow state underlies the athletes’ feelings and thoughts when they recall the best performances of their careers. It is obvious that the notion of flow and mindfulness have great similarity. There is little known, however, about the relationship between mindfulness and flow in athletes.

 

In today’s Research News article “Mindfulness training enhances flow state and mental health among baseball players in Taiwan.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307497/ ), Chen and colleagues recruited the members of an elite male baseball team in Taiwan and provided them with a 4-session mindfulness training including meditation, yoga, and discussion of the application of mindfulness to their sport. They were measured before and after training and 4 weeks later for depression, anxiety, eating disorders, sleep quality, competitive anxiety, mindfulness, and flow state.

 

They found that after training and at follow-up there was a significant increase in sleep quality and flow state and a significant decrease in eating disorders and competitive anxiety. In addition, the higher the level of mindfulness of the player, the greater the level of flow state. They also saw a non-significant increase in the team’s performance after the training.

 

These are interesting results but conclusions need to be tempered with the fact that there wasn’t a control condition. This leaves many alternative confounding interpretations. Nevertheless, these pilot findings suggest that further research is warranted to investigate the effect of mindfulness training on athletic flow state. These results contribute to the growing body of research that suggests that being mindful produces enhanced athletic performance.

 

So, enhance flow in athletes with mindfulness.

 

“Achieving peak performance and especially being able to develop flow experiences in athletes is the holy grail of sport psychology.  . . researches are getting one step closer to unveiling the psychological factors that influence flow experiences, and mindfulness could be an essential part of the puzzle.” – Carmilo Saenz

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Chen, J. H., Tsai, P. H., Lin, Y. C., Chen, C. K., & Chen, C. Y. (2018). Mindfulness training enhances flow state and mental health among baseball players in Taiwan. Psychology research and behavior management, 12, 15-21. doi:10.2147/PRBM.S188734

 

Abstract

Objective

To examine the effect of mindfulness-based training on performance and mental health among a group of elite athletes.

Methods

This study aimed to evaluate the effect of mindful sport performance enhancement (MSPE) on mental health, flow state, and competitive state anxiety using a 4-week workshop. We recruited an amateur baseball team (N=21) in Taiwan, and collected information by self-reported questionnaires administered before, immediately after, and at a 4-week follow-up. The primary outcome was to evaluate sports performance by flow state and competitive state anxiety, which included self-confidence, somatic anxiety, and cognitive anxiety. The secondary outcome was to explore whether MSPE intervention can improve anxiety, depression, sleep disturbance, and eating disorders.

Result

After the workshop and follow-up 1 month later, we found improvements in flow state (P=0.001; P=0.045), cognitive anxiety in competitive anxiety (P=0.056; P=0.008), global eating disorder (P=0.009; P<0.001), marked shape concern (P=0.005; P<0.001), and weight concern (P=0.007; P<0.001). Scores of sleep disturbance (P=0.047) showed significant improvement at follow-up. We also found significant association between flow state and mindfulness ability (P<0.001).

Conclusion

This is the first mindfulness intervention to enhance athletes’ performance in Taiwan, and also the first application of MSPE for team sports. Our study results suggested that mindfulness ability is associated with flow state, and that MSPE is a promising training program for strengthening flow state and mental health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307497/

 

Improve Balanced Time Perspective with Mindfulness

Improve Balanced Time Perspective with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It is how we think about the future that determines whether the outcome is beneficial. You can think about what you want and how to make it happen, or you can think about what you don’t want and worry about how to prevent it from happening. The first way increases your chances of bringing positive emotions and experiences into your life, while the second causes you to experience negative emotions about things that may never happen; further, it decreases the amount of time and energy you have for creating positive experiences.” – Jannice Vilhauer

 

Mindfulness stresses present moment awareness, minimizing focus on past memories and

future planning. But, to effectively navigate the environment it is necessary to remember past experiences and project future consequences of behavior. So, there is a need to be balanced such that the amount of attention focused on the past, present, and future is balanced. This has been termed as balanced time perspective. It is possible that mindfulness helps balance time perspective or that it might even overly emphasize the present moment to the detriment of balance. The relationship of mindfulness to this balanced time perspective has not been previously investigated.

 

In today’s Research News article “Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395405/), Ge and colleagues recruited college students and measured them for mindfulness, self-compassion, subjective well-being, balanced time perspective, and time perspective including subscales measuring past negative, past positive, present fatalistic, present hedonistic, and future.

 

They found that mindfulness was positively related to balanced time perspective directly with the higher the levels of mindfulness the better the balance in time perspective. They also observed that mindfulness was positively related to balanced time perspective indirectly through self-compassion and subjective well-being such that high levels of mindfulness was associated with higher levels of self-compassion and subjective well-being which, in turn, were associated with higher balanced time perspective.

 

These results are interesting and for the first time demonstrate a positive relationship of mindfulness to balanced time perspective. Since a balanced time perspective may be seen as an adaptive mix of past, present, and future perspectives, it is possible that this is one of the reasons that mindfulness has such positive effects on mental health and well-being. So, mindfulness may be beneficial not just by increasing present moment awareness but also by producing appropriate allocation of attention to the past or the future where appropriate. It remains for future research to examine these possibilities.

 

So, improve balanced time perspective with mindfulness.

 

“while a mindfulness exercise that shifts attention to internal events extends one’s experience of time, a mindfulness exercise that shifts attention to an external event could potentially make time feel like it’s passing more quickly.” – Emily Nauman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ge, J., Wu, J., Li, K., & Zheng, Y. (2019). Self-Compassion and Subjective Well-Being Mediate the Impact of Mindfulness on Balanced Time Perspective in Chinese College Students. Frontiers in Psychology, 10, 367. doi:10.3389/fpsyg.2019.00367

 

Abstract

Balanced time perspective is associated with optimal social functioning and provides psychological benefits in times of stress. Previous studies have found that mindfulness is positively associated with balanced time perspective and might promote it. However, the mechanism through which mindfulness affects balanced time perspective remains unexplored. The purpose of the present study was to investigate the mediating role of self-compassion and subjective well-being in the relationship between mindfulness and balanced time perspective. A total of 754 Chinese college students, aged 17–27 years, completed the Chinese versions of the Five-Facet Mindfulness Questionnaire, Self-Compassion Scale, Subjective Well-Being Scale, and Zimbardo Time Perspective Inventory. There were significant positive correlations between mindfulness, self-compassion, subjective well-being, and balanced time perspective. Structural equation modeling indicated that in addition to the direct influence of mindfulness on balanced time perspective, self-compassion and subjective well-being played a partial mediating role. On the basis of these findings, we conclude that mindfulness has an important positive influence on balanced time perspective, and highlights the crucial role of the self-compassion in cultivating a balanced time perspective. Limitations of the present study are also discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395405/

 

Social Mindfulness is Reduced in Patients with Psychosis

Social Mindfulness is Reduced in Patients with Psychosis

 

By John M. de Castro, Ph.D.

 

“There is increasing evidence that specially adapted mindfulness techniques can be used safely and effectively in the management and treatment of severe mental health problems, such as psychosis.” – Carly Samson

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments.

 

Mindfulness training has been shown to be beneficial for patients with psychosis. Individuals with psychosis almost always have difficulties with social functioning. It is reasonable then to investigate the social mindfulness of patients having their first psychotic episode. In today’s Research News article “). Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381043/ ), Lemmers-Jansen and colleagues recruited patients having their first psychotic episode aged 16 to 22 years, individuals at high clinical risk for developing psychosis, and healthy control participants..

 

The participants were measured for social mindfulness, intelligence, and positive and negative symptoms of psychosis. In the social mindfulness task, the participants made a choice that would either enhance (socially mindful) or decrease (socially unmindful) choices for another unseen participant. They performed the task initially without instruction and again after being instructed “to keep the other’s best interest in mind.” The participants performed the social mindfulness task while undergoing functional Magnetic Resonance Scans (f-MRI) of their brains.

 

They found that the patients with their first psychotic episode tended to make less socially mindful choices both before and after instruction than either the individuals at high clinical risk for developing psychosis, and healthy control participants. In addition, the patients with psychosis showed less activation of the caudate during mindful choices and less activation of the medial and dorsal prefrontal cortex and the cingulate cortex during unmindful choices that the other groups.

 

The neural findings suggest that the psychotic patients used less higher-level thinking when making socially unmindful choices (prefrontal cortex) and received less reward for making socially mindful choices (caudate). This suggests that the psychotic patients are less mindful because they’re responding with less thought and with less reinforcement for making socially mindful choices. Regardless, it is clear that a laboratory test confirms what is reported in the patients that they respond less well to social situations.

 

Fears about meditation triggering psychosis were holding back progress in this area, despite growing evidence that a specially adapted form of mindfulness training could prove safe and very beneficial for these patients.” – Plastic Brain

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lemmers-Jansen, I., Fett, A. J., Van Doesum, N. J., Van Lange, P., Veltman, D. J., & Krabbendam, L. (2019). Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk. Frontiers in human neuroscience, 13, 47. doi:10.3389/fnhum.2019.00047

 

Abstract

Background: Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: the ability and willingness to see and consider another person’s needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms.

Methods: Twenty FEP, 17 CHR and 46 healthy controls, aged 16–31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction “to keep the other’s best interest in mind.” As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color).

Results: FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorsolateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls.

Discussion: FEP showed a trend toward more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381043/