Abstract
Objectives: While mindfulness-based interventions have received widespread application in both clinical and non-clinical populations, the mechanism by which mindfulness meditation improves well-being remains elusive. One possibility is that mindfulness training alters the processing of emotional information, similar to prevailing cognitive models of depression and anxiety. The aim of this study was to investigate the effects of mindfulness training on emotional information processing (i.e., memory) biases in relation to both clinical symptomatology and well-being in comparison to active control conditions. Methods: Fifty-eight university students (28 female, age = 20.1 ± 2.7 years) participated in either a 12-week course containing a “meditation laboratory” or an active control course with similar content or experiential practice laboratory format (music). Participants completed an emotional word recall task and self-report questionnaires of well-being and clinical symptoms before and after the 12-week course. Results: Meditators showed greater increases in positive word recall compared to controls [F(1, 56) = 6.6, p = 0.02]. The meditation group increased significantly more on measures of well-being [F(1, 56) = 6.6, p = 0.01], with a marginal decrease in depression and anxiety [F(1, 56) = 3.0, p = 0.09] compared to controls. Increased positive word recall was associated with increased psychological well-being (r = 0.31, p = 0.02) and decreased clinical symptoms (r = −0.29, p = 0.03). Conclusion: Mindfulness training was associated with greater improvements in processing efficiency for positively valenced stimuli than active control conditions. This change in emotional information processing was associated with improvements in psychological well-being and less depression and anxiety. These data suggest that mindfulness training may improve well-being via changes in emotional information processing. Future research with a fully randomized design will be needed to clarify the possible influence of self-selection.
Introduction
Mindfulness-based interventions (MBI), including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), are accumulating growing empirical support for improvements in psychological well-being in a wide range of clinical and non-clinical populations (Baer, 2003; Grossman et al., 2004; but see also Ospina et al., 2007). MBI were originally introduced as behavioral interventions to be practiced by chronic pain patients (Kabat-Zinn, 1982) and have now been shown to positively affect clinical outcomes when practiced by clinicians (Epstein, 1999; Grepmair et al., 2007). Researchers have proposed a variety of means by which this process may produce enhancements in well-being (Bishop, 2002; Dimidjian and Linehan, 2003; Shapiro et al., 2006), but the mechanism of action remains unclear.
One possibility is that mindfulness training alters the processing of emotional information, similar to prevailing cognitive models of depression and anxiety (Beck, 1987; Hakamata et al., 2010). These models are based on observations that distressed individuals process emotional information differently than healthy, happy individuals (Beck, 1987; Hakamata et al., 2010). Distressed (depressed or anxious) individuals have attentional and memory biases toward negative stimuli and away from positive stimuli (Burt et al., 1995; Mathews and MacLeod, 2005; Kellough et al., 2008; Disner et al., 2011). Healthy individuals, in contrast, have a preferential bias toward positive stimuli (Gotlib et al., 2004; Reidy, 2004) that is associated with a wide range of adaptive qualities and greater well-being (Taylor and Brown, 1988; Scheier et al., 2001). In contrast, both the presence of negative biases and/or the lack of positive biases are predictive of future episodes of depression and anxiety and may play a role in causing or maintaining these disorders (Mathews and MacLeod, 2005; Disner et al., 2011). Furthermore, successful modification of cognitive biases parallels symptom improvement following cognitive behavioral therapy (Pishyar et al., 2008), pharmacotherapy (Mogg et al., 2004), or systematic training aimed at altering biases (Hakamata et al., 2010; Beard et al., 2011).
These emotional biases in both attention and memory are thought to be caused by an imbalance of top-down cortical control and a prepotency of bottom-up subcortical reactivity, or more specifically, poor prefrontal attentional control over the amygdala (Beck, 2008; Disner et al., 2011). Depressed and anxious patients show increased amygdala activity and decreased activation of the anterior cingulate cortex (ACC) and lateral prefrontal cortex (PFC) in response to negative stimuli (Browning et al., 2010; Disner et al., 2011). The amygdala is a key component in emotion processing in the brain, and is critically involved in fear conditioning and threat detection (Davis, 1992; LeDoux, 2003; Arne, 2005). The PFC is thought to play a key role in cognitive control and attentional mechanisms (Miller and Cohen, 2001; Nagahama et al., 2001), and the ACC has been implicated in cognitive control functions such as error detection (Carter et al., 1998) and attention (Weissman et al., 2005). The ACC and PFC exert inhibitory control on limbic structures such as the amygdala (Mayberg et al., 1999; Davidson et al., 2000; Ochsner et al., 2002, 2004; Ochsner and Gross, 2005; Urry et al., 2006). Lack of such inhibitory control results in a hyperactive amygdala (Siegle et al., 2002, 2007b) and an associated increase in sympathetic hyperarousal, emotional reactivity, affective disturbance (Baxter et al., 1989; Bench et al., 1993; Mayberg et al., 1999; Davidson et al., 2000; Clark et al., 2002; Siegle and Hasselmo, 2002; Siegle et al., 2002; Blumberg et al., 2004; Meyer et al., 2004) and biases in attention and memory away from positive stimuli and toward negative stimuli (Fales et al., 2008; Beevers et al., 2010; Koster et al., 2010).
Poor prefrontal control or “hypofrontality” is ubiquitous across a wide range of psychiatric conditions, including depression, anxiety, substance abuse, attention deficit disorders and schizophrenia (Clark et al., 2009; Couyoumdjian et al., 2010). Restoration of PFC functioning in these conditions parallels response to treatment in both pharmacological and behavioral interventions (Liotti and Mayberg, 2001; Liotti et al., 2002; Davidson et al., 2003a; Hugdahl et al., 2007). Because impairment of prefrontal attention circuits plays such a central role in emotional disturbance, many researchers have attempted to use deliberate attention training or cognitive “remediation” exercises to restore prefrontal functioning (Wells, 2000; Penades et al., 2006; Siegle et al., 2007a; O’Connell et al., 2008). This so-called “cognitive bias modification” (CBM) training, in which patients learn to shift attention toward positive stimuli or away from negative stimuli (Koster et al., 2009; Beard et al., 2011) represents “a focused attempt to teach patients one specific skill, attention control” (Hakamata et al., 2010). Results indicate that successful modification of cognitive biases resulted in decreased symptoms of anxiety and depression and greater well-being in clinical populations (Mathews and MacLeod, 2005; Mathews et al., 2007; Salemink et al., 2007; Beard and Amir, 2008; Li et al., 2008; Amir et al., 2009; Hazen et al., 2009; Klumpp and Amir, 2009; Schmidt et al., 2009; See et al., 2009; Sin and Lyubomirsky, 2009; Eldar and Bar-Haim, 2010; Hakamata et al., 2010). Thus, classic CBT may be moving toward the incorporation of “procedures [that] may alter cognitive biases through a more implicit, experiential process” (Beard et al., 2011).
A substantial body of research supports the use of meditation-based mental training as candidate for strengthening or rehabilitating prefrontal attentional control systems. There are several different forms and many variations of meditation training, but a central feature is the systematic training of attentional capacities (Lutz et al., 2008).
Meditation training is associated with better performance on a wide range of prefrontally mediated attention tasks (Valentine and Sweet, 1999; Wenk-Sormaz, 2005; Brefczynski-Lewis et al., 2007; Chan and Woollacott, 2007; Jha et al., 2007; Pagnoni and Cekic, 2007; Slagter et al., 2007; Srinivasan and Baijal, 2007; Tang et al., 2007; Chambers et al., 2008; Bushell, 2009; Lutz et al., 2009; Goldin and Gross, 2010), with increased activity in the (lateral) PFC (Herzog et al., 1990; Jevning et al., 1996; Khushu et al., 2000; Lazar et al., 2000; Baerentsen et al., 2001; Newberg et al., 2001; Ritskes et al., 2003; Brefczynski-Lewis et al., 2007; Creswell et al., 2007; Farb et al., 2007, 2010; Holzel et al., 2007), larger frontal gray matter volumes (Lazar et al., 2005; Pagnoni and Cekic, 2007; Hölzel et al., 2008; Luders et al., 2009), and decreased levels of negative affect, anxiety, and depression (Kabat-Zinn et al., 1992; Shapiro et al., 1998; Speca et al., 2000; Grossman et al., 2004; Allen et al., 2006; Jain et al., 2007; Kenny and Williams, 2007; Kuyken et al., 2008; Witek-Janusek et al., 2008). Meditation training is associated with greater PFC inhibition of the amygdala (Brefczynski-Lewis et al., 2007; Creswell et al., 2007; Farb et al., 2007; Goldin and Gross, 2010; Hölzel et al., 2010; Way et al., 2010), less emotional reactivity (Britton et al., in press) and decreased sympathetic hyperarousal (Sudsuang et al., 1991; MacLean et al., 1994; Carlson et al., 2007; Britton et al., 2010).
Even though Beard et al. (2011) lists mindfulness training as a CBM exercise, only a handful of studies have examined the effects of mindfulness on cognitive biases. The existing studies are also constrained by a number of methodological limitations. While two studies have found that MBCT was associated with decreased depression-related memory impairment (over-general memory, or the tendency to summarize rather than recall specific details), the target variable was memory specificity, not memory valence (Williams et al., 2000; Heeren et al., 2009), and does not address the issue of emotional biases. In a sample of fibromyalgia patients, Vago and Nakamura (2011) found that an 8 week mindfulness training was associated with altered threat-related attentional biases compared to no-treatment control (as evidenced by decreased avoidance of pain–threat words during early stages of attention in fibromyalgia patients and improved disengagement from pain–threat words during later stages of attention). Cognitive bias was only assessed post-intervention, however, and baseline differences were not assessed. In a sample of undergraduates, Alberts and Thewissen (2011) found that a 12-min breath awareness induction prior to verbal learning task resulted in decreased memory for negative words compared to a control group that received no induction. However, one-time mindfulness inductions do not necessarily generalize to longer-term mindfulness training (Davidson, 2010). Furthermore, mindfulness induction just prior to the task introduces the confound of state, rather than trait, effects of meditation. A standard multi-week mindfulness intervention would yield more conclusive results about trait effects of mindfulness training.
In addition to the design limitations, the control groups in the above studies did not receive any comparable intervention, and thus it cannot be concluded that the effects on cognitive bias were due to meditation practice, rather than non-specific effects of deliberate effort, expectation, group interaction or didactic content. We attempted to address this methodological limitation by comparing meditation participants to participants who also received a similar ratio of didactic to experiential body-based attention training (music) or similar didactic content but did not meditate. It should be noted that participants self-selected, and were not randomly assigned to their courses.
Another limitation of existing mindfulness and cognitive bias studies, and the cognitive bias literature in general, is the narrow focus on negative affect and psychopathology without including the full range of positive affect and well-being. The World Health Organization’s (1948) definition of health is “not merely the absence of disease or infirmity” but “a state of complete physical, mental and social well-being.” Mindfulness training differs from most psychotherapy in that it is sought not only for relief of suffering, but also for greater well-being and quality of life (Carmody and Baer, 2008; NCCAM, 2009; Schroevers and Brandsma, 2010), constructs that are related but functionally distinct (Ryff et al., 2006). Thus, this paper’s inclusion of psychological well-being, in addition to distress, will serve to address an important outcome of mindfulness training, as well as extend the investigation of cognitive biases into the domain of well-being.
A final limitation of mindfulness research in general is the widespread reliance on self-report measures, which are subject to a wide array of biases, including memory bias (Schwarz, 1999; Baumeister et al., 2007) and treatment expectations (Howard and Dailey, 1979; Howard, 1980; Geers and Rose, 2011). Indeed, self-reports may be especially problematic in mindfulness interventions because they alter introspective ability (Davidson, 2010). Our use of an objective task to assess emotional bias is intended to introduce an alternative to self-reports.
In order to address these gaps in the literature, the present study assessed objective emotional information processing in relation to both psychological well-being and depression/anxiety before and after 12 weeks of mindfulness training or comparable didactic/experiential learning. Cognitive models predict that biases operate at all levels of processing, including attention, encoding and retrieval (Bradley et al., 1994). While research findings about emotional biases in attention have been inconsistent, more robust findings have been found at the deepest levels of processing, i.e., with biases in explicit memory recall (Baños et al., 2001). We therefore chose to use an explicit memory task as our measure of emotional information processing. We hypothesized that (1) mindfulness would improve emotional information processing (increased positive word recall and/or decreased negative word recall), (2) mindfulness training would decrease depression/anxiety and increase psychological well-being, (3) emotional information processing improvements would accompany improvements in depression/anxiety and well-being.
Materials and Methods
Participants
Undergraduates (N = 58, 28 female, Age = 20.10 ± 2.67 years, range 17–35 years) were recruited from three types of courses at Brown University (Providence, RI, USA): (a) “Meditation laboratories” or (b) Music, or (c) Religious Studies, with the understanding that the results of their training in these courses would be the subject of the current study. Meditation Labs courses consisted of lecture and practice-based learning components in mindfulness meditation. Control courses were chosen for similar course format (Music) or content (Religious/East Asian Studies). Participants were recruited in the first week of classes and completed written informed consent procedures. The study protocol was approved by the Brown University Institution Review Board. There were no exclusion criteria besides age.
Procedures
Participants completed assessments at the beginning and end of a 12-week course. Assessments included self-report questionnaires and a 2-hour in-lab neuropsychological battery. The experiments were conducted between January 2008 and December 2010 on Brown University campus in Providence, RI, USA. No adverse events occurred during the course of the study.
Word recall task
Two lists of 22 words were selected from affective norms for English words (ANEW; Bradley and Lang, 1999). Each list included six positive (normative valence = 7.5 ± 0.40, arousal = 5.8 ± 0.80), six negative (valence = 2.6 ± 0.73, arousal = 5.5 ± 1.37), and six neutral words (valence = 5.18 ± 0.34, arousal = 3.84 ± 0.48), as well as two extra neutral “buffer” words at the beginning and end of the presentation to control for primacy and recency effects. Lists were balanced for valence, arousal, length, and frequency of appearance in the English language. Words were block randomized with no words of the same valence appearing consecutively. Words were presented on a 15′′ computer screen using DMDX software (Forster and Forster, 2003). Based on the suggestions of Koster et al. (2010) to assess multiple modalities in the same subject to confirm that the findings are not limited to any one form of processing, subjects received a visually presented list followed by an aurally presented list. The first list was presented visually in white font on a black background, the second aurally at a volume level set by participants. Subjects were asked to rate each word (1–9) on two dimensions, pleasantness and arousal to ensure depth of processing. Two separate sets of lists were counterbalanced for pre- and post-treatment administration. Participants were told that they “may be asked to recall these words sometime in the future,” Immediately after presentation, participants were asked to recall the words in any order. There was no time limit.
Self-report measures
The mood and anxiety symptom questionnaire (MASQ; Clark and Watson, 1991) is a 90-item questionnaire assessing symptoms specific to depression (anhedonia, low positive affect) or anxiety (physiological hyperarousal) as well as symptoms of general distress related to both. Response options range from 1 (not at all) to 5 (extremely). The possible range of scores is 90–450. We used the aggregate MASQ score, in which higher scores indicate greater levels of anxiety/depression. Cronbach’s alpha was 0.92.
The Scales of Psychological Well-Being (SPWB; Ryff, 1989) is an 84 item questionnaire assessing psychological well-being across six domains: positive relations with others, autonomy, environmental mastery, personal growth, purpose in life, and self-acceptance. Response options range from one (strongly disagree) to six (strongly agree). The possible range of scores is from 84 to 504. We used aggregate SPWB score, in which higher scores indicate greater psychological well-being. Cronbach’s alpha was 0.96.
Meditation labs
Meditation labs were scheduled for 1 h three times per week and included approximately 30 min of a specific contemplative practice from Buddhist or Taoist traditions. The meditation laboratory was taught by the course professor and fourth author (Harold Roth), a published scholar of Buddhist and Taoist contemplative practices with over 30 years of personal practice experience in the Rinzai Zen tradition. The meditation period was followed by a 5- to 10-min written reflection and question–answer period. Many students also meditated outside of class, although this was optional.
Meditation training included both Samatha and Vipassana forms of practice, which included focused awareness training on a single object (like the breath) or a class of objects (like body sensations), but did not include objectless meditation (open monitoring or choiceless awareness). Meditation instruction emphasized attention allocation rather than the acceptance that is central to Western styles of mindfulness, although it incorporated ideals of letting go of evaluation.
Control courses
Music professors with comparable competence led music courses with music practice labs. These courses were structured similarly to Meditation Labs courses with comparable ratios of lecture- and practice-based learning of music. Two types of content-matched courses were included: Religious Studies or East Asian Studies courses by the same professor who led the meditation courses, and Religious Studies courses that were voted by students as being “inspirational and transformative” in content, but did not include meditation labs.
Statistical analyses
Preliminary analyses
All variables were examined for normality and baseline differences between groups were examined using box-and-whisker plots and t-tests or χ2 tests. Recall did not differ between visual versus aural presentation so subsequent analyses used word totals summed across both modalities.
Main analyses
The primary purpose of this study was to discover if emotional information processing (emotional word recall), clinical symptoms, and psychological well-being were differentially affected by meditation than by control classes. We first examined whether intervention-specific effects on recall depended on the valence of the words recalled using a three-way repeated-measures ANOVA design. Within-subjects variables of this three-way ANOVA were TIME (two levels: pre, post) and VALENCE (three levels: positive, negative, neutral). The between-subjects variable was GROUP (two levels: Meditation, Control.) We then examined intervention-specific changes separately for positive, negative, and neutral word counts using two-way repeated-measures ANOVAs (Group × Time). We examined effects on clinical symptoms (MASQ aggregate score) and psychological well-being (SPWB aggregate score) using two-way repeated-measures ANOVAs (Group × Time). Paired samples t-tests (pre–post) were used to determine the specific effect of each intervention for any variables with significant Group × Time interactions.
Secondary analyses
We examined the relationships among changes in cognitive bias, changes in clinical symptoms, and changes in psychological well-being. We calculated change scores by subtracting pre-intervention scores from post-intervention scores for each of our variables, and calculated Pearson product–moment correlation coefficients among these change scores for positive, negative, and neutral recall, and MASQ and SPWB aggregate scores.
Data were analyzed using SPSS 17.0 software (2007). Statistical significance was set at alpha levels <0.05, two-tailed. Results are reported as mean ± SD or number/percentage unless otherwise indicated. Effect sizes were reported as partial η2 ( small = 0.01, medium = 0.06, large = 0.14; Green and Salkind, 2005).
Results
Preliminary analyses
First, all variables were examined for normality. Box-and-whisker plots showed no outliers at pre- or post-intervention testing for any variables.
Baseline characteristics
Controls (N = 23, 14 female, Age = 19.2 ± 0.99 years) and meditators (N = 35, 14 female, Age = 20.6 ± 3.24) did not differ by age [t(56) = 1.98, p > 0.05] or gender [χ2(1, N = 58) = 2.42, p > 0.1]. Recall of visually presented words did not differ from recall of aurally presented words [t(56) < 0.2, all p > 0.05]. Positive word recall at pre-intervention was higher for controls than meditators [t(56) = 3.14, p = 0.003]; no other variables differed between groups at baseline. Table 1 summarizes the baseline word recall and self-report measure characteristics. As reported elsewhere (Silverstein et al., 2011), all subjects completed measures of clinical psychopathology and a 2-hour neuropsychological test battery of cognitive capacities, including memory, attention and motor speed. The clinical assessments indicated that our sample was fairly typical of a college sample, with depression and anxiety symptoms in the “mild” range. No clinically significant impairments in neuropsychological performance were noted.
Table 1
| Controls N = 23 | Meditators N = 35 | F(1, 56) | |||||
|---|---|---|---|---|---|---|---|
| Mean | SD | Mean | SD | Time | Group | Time × group | |
| Baseline total words | 19.4 | 3.86 | 17.4 | 4.82 | 3.26 | 3.67 | 0.005 |
| Exit total words | 20.8 | 5.27 | 18.9 | 4.90 | |||
| Baseline positive words | 5.4 | 1.41 | 4.0 | 1.92 | 0.41 | 3.2 | 6.60* |
| Exit positive words | 4.9 | 1.66 | 4.9 | 2.09 | |||
| Baseline negative words | 4.8 | 1.75 | 4.4 | 1.72 | 1.66 | 0.005 | 1.8 |
| Exit negative words | 5.3 | 2.05 | 4.8 | 1.77 | |||
| Baseline neutral words | 4.6 | 1.95 | 4.6 | 2.16 | 1.09 | 1.47 | 2.65 |
| Exit neutral words | 5.5 | 2.33 | 4.4 | 1.91 | |||
| Baseline MASQ score | 118.7 | 17.05 | 121.3 | 23.33 | 0.19 | 0.09 | 3.01 |
| Exit MASQ score | 123.9 | 19.79 | 118.1 | 23.53 | |||
| Baseline SPWB score | 373.2 | 45.84 | 368.2 | 40.53 | 3.85 | 0.1 | 6.62* |
| Exit SPWB score | 371.2 | 44.53 | 383.1 | 41.79 | |||
Mean (SD) of word recall and self-report measures before and after training in meditators and controls.
MASQ, mood and anxiety symptom questionnaire, SPWB, scales of psychological well-being. *p < 0.05.
Main analysis: Word recall data
A significant Group × Time × Valence interaction [F(2, 55) = 4.66, p = 0.011, η2 = 0.15] suggested that treatment effects on word recall depended on word valence. A significant Group × Time interaction [F(1, 56) = 6.61, p = 0.013, η2 = 0.11] for positive words indicated that changes in positive recall depended on the type of training. Meditators showed significant increases in positive word recall [t(34) = 2.39, p = 0.023] while controls showed non-significant decreases in positive word recall [t(22) = −1.41, p > 0.1; Figure 1). No significant main or interaction effects were found for negative, neutral, or total word recall.
Figure 1
Main analysis: Self-report data
Psychological well-being
Significant Group × Time interaction effects [F(1, 56) = 6.62, p = 0.013, η2 = 0.11] indicated that changes in SPWB scores depended on training type. Psychological well-being (SPWB total score) significantly increased in meditators [t(34) = 3.55, p = 0.001], and non-significantly decreased in controls [t(22) = −0.40, p > 0.6; Figure 2). There were no significant main effects of Time or Group.
Figure 2
Depression/anxiety
A trend level Group × Time interaction effect for MASQ scores [F(1, 56) = 3.01, p = 0.088, η2 = 0.05] indicated that change in mood was weakly related to training type. Controls exhibited a non-significant increase in MASQ scores [t(22) = 0.142, p = 0.17] while the meditators exhibited a non-significant decrease [t(34) = −1.019, p = 0.315]. There were no significant main effects of Time or Group.
Secondary analyses: Correlations
Pearson product–moment correlation coefficients (Table 2) were used to determine the relationships among changes in word recall and changes in clinical symptoms and psychological well-being. Increased positive recall was associated with increased psychological well-being [r(56) = 0.31, p = 0.018; Figure 3) and decreased clinical symptoms [r(56) = −0.29, p = 0.027; Figure 4). Increased psychological well-being was also associated with decreased clinical symptoms [r(56) = −0.61, p < 0.001; Figure 5).
Table 2
| Correlations (N = 58) | ||
|---|---|---|
| MASQ change | SPWB change | |
| Total words change | −0.170 | 0.226 |
| Positive words change | −0.290* | 0.310* |
| Negative words change | −0.037 | 0.111 |
| Neutral words change | −0.011 | 0.024 |
| MASQ change | −0.614** | |
Pearson product–moment correlation coefficients.
MASQ, mood and anxiety symptom questionnaire, SPWB, scales of psychological well-being *p < 0.05, **p < 0.01.
Figure 3
Figure 4
Figure 5
Discussion
Undergraduates completed an emotional word recall task and self-report measures of anxiety/depression and well-being before and after 12 weeks of either mindfulness meditation or an active control condition. Results indicate that mindfulness training was associated with significantly higher increases in positive word recall and well-being than controls, and increases in positive word recall were associated with improvements in anxiety/depression and psychological well-being. Each of these findings will be discussed in detail below.
Mindfulness training and cognitive bias
The meditation participants showed significantly greater increases in positive word recall than did students in control courses. This increase in positive words occurred in the context of no change in either total word or negative word recall, which suggests an increased efficiency in positive information processing.
This pattern of findings may have a number of different explanations, as several brain areas have been associated with both meditation training and more positive/less negative memory biases. Meditation training has been associated with the neural substrates of positive affect and well-being, specifically greater activity in the left versus right PFC (Davidson et al., 2003b; Davidson, 2004; Barnhofer et al., 2010; Keune et al., 2011; Moyer et al., 2011), and increased dopaminergic tone (Kjaer et al., 2002; Burgdorf and Panksepp, 2006). The pattern of left PFC activation, which leads to greater regulation of the amygdala, coupled with dopamine, is thought to underlie a preferential tendency toward positive and rewarding stimuli (Disner et al., 2011). Neuroimaging studies have also shown that the rostral ACC is differentially activated in meditators (Lazar et al., 2000; Baerentsen et al., 2001; Holzel et al., 2007), This area is associated with trait positivity bias and optimism (Sharot et al., 2007, 2011), and dysfunction in this area is associated with deficient disengagement from negative stimuli and depression (Elliott et al., 2002; Mitterschiffthaler et al., 2008; Eugene et al., 2010).
The (right) insula, which has been found to have greater gray matter concentration (Hölzel et al., 2008, 2011) and thickness (Lazar et al., 2005) in meditators and greater activation following mindfulness training (Farb et al., 2007; Grant et al., 2010) has also been found to be associated with memory for positively valenced words (Lewis et al., 2007). The insula is thought to be involved in interoception and visceral awareness (Critchley et al., 2004), which are central components of mindfulness training. The meditator begins by focusing on a body-based meditation object (sensations of breathing), and re-engages body awareness as a method of disengaging from distracting thoughts. In this model, greater body awareness should be directly related with decreased distraction and greater ability to disengage attention and to redirect it according to goals. Indeed, in a study of this same sample, Silverstein et al. (2011) found greater interoceptive awareness in meditators compared to controls, and the improved body awareness was associated with decreased negative evaluative thinking, anxiety, and depression.
One proposed mechanism of depressive symptomatology reduction in mindfulness-based therapies is the reduction of overactive resting amygdala activity. Mindfulness has been associated with decreased right amygdala activity at rest and in response to negative stimuli (Way et al., 2010). In a study of expert and novice meditators, Brefczynski-Lewis et al. (2007) found a negative correlation between hours of practice and right amygdala activity. Such reductions in amygdala activity may underlie decreased facilitation of attention to negative stimuli (Disner et al., 2011; Way et al., 2010) and in turn modulate preferential recall of positively versus negatively valenced information.
Cognitive biases are partly due to difficulties in adaptively disengaging cognitive resources from negative and/or non-positive information (Fox et al., 2001; Joormann et al., 2007; Joormann and Gotlib, 2008; Gotlib and Joormann, 2010). Mindfulness facilitates adaptive disengagement of cognitive resources during the attentional blink task (Slagter et al., 2009), and may likewise facilitate adaptive disengagement of resources from emotional information that does not support emotional regulatory goals. Newly emancipated cognitive resources may then be more appropriately allocated to processing positive information in accordance with mental health goals (Josephson, 1996; Rusting and DeHart, 2000). For example, mindfulness may allow one to clear the contents of working memory in preparation for positively reappraising a distressing situation (Garland et al., 2009).
It is interesting to note that the change in emotional processing in this study was specific to positive information. Neither group showed significant changes in negative word recall, which contrasts the decrease in negative cognitive biases seen in previous mindfulness studies (Williams et al., 2000; Alberts and Thewissen, 2011; Vago and Nakamura, 2011). This absence of negative information processing changes may stem from our sample of healthy volunteers who have minimal levels of clinical distress, and by extension, negative bias. There is evidence to suggest that as one’s well-being declines from a healthy, happy state, the first information processing change is the disappearance of the positive bias (Reidy, 2004), followed by the emergence of a bias toward negative information. Thus, positive information processing may be a more sensitive indicator of pre-clinical psychological disturbance than increased negative information processing (Matt et al., 1992; Hirsch and Mathews, 2000).
Mindfulness training, psychological well-being, and clinical symptoms
Meditation lab participants showed a significantly greater enhancement in psychological well-being than control participants, which parallels many other studies that mindfulness training increases positive emotions (Anderson et al., 2007; Ortner et al., 2007; Nyklícek and Kuijpers, 2008; Zautra et al., 2008; Bränström et al., 2010; Schroevers and Brandsma, 2010; Geschwind et al., 2011), well-being (Shapiro et al., 1998; Ortner et al., 2007; Carmody and Baer, 2008), empathy (Shapiro et al., 1998; Krasner et al., 2009), resilience (Orzech et al., 2009), and subjective quality of life (Reibel et al., 2001; Shapiro et al., 2005; Nyklícek and Kuijpers, 2008; Fang et al., 2010), and that people are more happy when they are in a mindful state (Brown and Ryan, 2003; Killingsworth and Gilbert, 2010). Along these lines, a recent experience sampling study found that MBCT was associated with “increased experience of momentary positive emotions as well as greater appreciation of, and enhanced responsiveness to, pleasant daily life activities” (Geschwind et al., 2011), a finding that was independent of accompanying decreases in rumination, worry, and negative affect.
Mindfulness training has been hypothesized to increase well-being by enhancing the clarity and vividness of everyday experience (Brown and Ryan, 2003). One recent analysis of the impact of the various components of mindfulness indicated that increased attention regulation – awareness of and attention to daily experiences – are related to increased positive affect, while decreases in negative affect may be due to the development of a more accepting, open, and curious attitude to unpleasant experiences (Schroevers and Brandsma, 2010). Enhanced engagement with present-moment experiences due to meditation practice may thus broaden the scope of attention (Lutz et al., 2008) and allow greater awareness of pleasant situations.
This augmented engagement with an environment by means of enhanced attentional focus facilitates the process of “savoring,” by which one becomes more consciously aware of pleasant experiences (Bryant, 1989). Savoring may serve to maintain and prolong positive emotions, thereby contributing to an upward spiral of psychological well-being (Tugade and Fredrickson, 2007), and to subjective well-being later in life (Bryant, 1989; Meehan et al., 1993).
While meditation was associated with greater well-being, the effect did not reach significance for clinical symptoms. This finding may be related to a floor effect for clinical symptoms in a non-clinical population, or a difference in sensitivity between the two instruments. Nevertheless, the pattern that mindfulness increases positive states more than it deceases negative ones is paralleled in both memory bias and self-report measures. As with cognitive bias, it makes sense that the spectrum of well-being to psychopathology also would begin with a decrease in positive states, and then progress to an increase in negative ones. Indeed, low psychological well-being has been shown to be a strong predictor of depression later in life (Wood and Joseph, 2010).
Correlations among emotional information processing, depression/anxiety, and psychological well-being
Increases in positive word recall were associated with increases in self-reported well-being and decreases in depression and anxiety, which indicates that biases in emotional word recall have convergent and divergent validity with self-report measures and their parallel modification with treatment. Associations have been found between trait positivity biases and well-being in both cross-sectional and prospective studies (Taylor and Brown, 1988; Scheier et al., 2001). Other studies have found that changing attentional bias by methods such as CBM results in decreased anxiety and depression and increased well-being in clinical populations (Mathews et al., 2007; Salemink et al., 2007; Beard and Amir, 2008; Sin and Lyubomirsky, 2009).
Previous research has found that changes in cognitive biases correlate with changes in self-reported symptoms in studies of cognitive behavioral therapy (Pishyar et al., 2008) and pharmacotherapy (Mogg et al., 2004); this study extends these findings to mindfulness training. This study did not examine whether CBM mediated these improvements, and further research would be needed to establish whether cognitive bias change is a therapeutic mechanism for mindfulness-based therapies, as it appears to be for psycho- and pharmacotherapies (Harmer et al., 2003; Browning et al., 2010).
Clinical implications
The results from this study have a number of possible implications. First, it has been hypothesized that mindfulness differs from cognitive behavioral therapy (CBT) by focusing on one’s relationship to thoughts and emotions, rather than changing their content or valence (Segal et al., 2002; Beck, 2008). While the two methods may still differ in approach, these findings, as well as other findings of mindfulness-induced alterations in cognitive biases (Williams et al., 2000; Heeren et al., 2009; Alberts and Thewissen, 2011; Vago and Nakamura, 2011), suggest that the resulting alteration of emotional information processing may be similar to that seen in CBT. CBT is hypothesized to work by providing patients with repeated experiences of refocusing attention away from automatic negative schemas toward alternative views or ideas (Teasdale et al., 1995; Beck, 2008). If positive information processing is indeed a mechanism of mindfulness-based therapies, it can be more effectively incorporated into treatment (Kazdin and Nock, 2003), and future research should include CBM interventions (Bar-Haim, 2010) as active control groups.
A second implication of this study is the introduction of an easily administered, objective measure that may serve as a more viable alternative to self-reports. Our study suggests that explicit memory biases are more sensitive to change than self-reports and not as subject to demand characteristics or confounded by increased self-awareness. Indeed, objective measures of cognitive biases have been found to be better at predicting emotional and physiological reactions to stress than self-report measures (MacLeod and Hagan, 1992; van den Hout et al., 1995; Fox et al., 2010; Beard, 2011). Furthermore, differential changes in positive versus negative biases may yield more precise information about emotional information processing. For example, results from this study suggest that changes in positive emotional processing may be one of the earliest and subtlest indicators of emotional well-being or decline.
Study limitations and strengths
The study has a number of strengths that improve upon past methodology, including a longitudinal design with active controls, an objective measure of emotional information processing and the inclusion of well-being as an outcome measure in addition to distress.
The study also has a number of limitations. The healthy college sample limits the ability to generalize to a treatment-seeking clinical sample. Because participants chose their courses and were not randomized, the differences in outcome may be due in part to baseline group differences. Indeed, the meditation lab participants had significantly lower positive recall and (non-significant) lower levels of well-being and higher levels of distress than controls at baseline. The baseline differences may reflect the impact of previous training on the part of control subjects. Meditation lab participants were mostly naïve or relatively inexperienced in mindfulness, while musicians were fairly advanced, with hundreds of lifetime practice hours prior to the intervention. Music training enhances executive function (Chandrasekaran and Kraus, 2010; Kraus and Chandrasekaran, 2010), which may have resulted in more adaptive information processing biases in this group at baseline.
Alternatively, meditation lab participants may have self-selected for this course because they were experiencing emotional difficulties and hoped to attain some therapeutic benefit from the course. These baseline differences raise the possibility that the meditators’ disproportionate increase in positive word recall may be a form of regression to the mean. It is also possible that the effects on recall memory and well-being of mindfulness training is only observed in people who are intrinsically motivated to do this training, and are therefore prone to placebo-effect-like confounds. However, placebo-like effects due to self-selection and expectations could also apply to students who self-selected for music courses. Given that this is the first study to measure cognitive bias both before and after a multi-week mindfulness intervention, it still represents an improvement over past studies with only one-time point (Vago and Nakamura, 2011) or brief induction procedure (Alberts and Thewissen, 2011). Future studies should employ a longitudinal design with a randomized sample to control for baseline differences.
We chose explicit memory biases because they have been more consistently documented than biases in earlier stages of processing (Mathews and MacLeod, 2005; Joormann and Gotlib, 2008). However, use of a free recall task limits the ability to disentangle if the observed effect of mindfulness on memory is due to differences in attention, encoding or retrieval of emotional information.
While our findings suggest that positive information processing may be a mechanism by which mindfulness training improves well-being, the pre–post-design could only support correlations and not a proper test of mediation. Future studies must include assessments at multiple time points, in order to establish a timeline of change that can be used to determine mediation (Kazdin and Nock, 2003) with appropriate designs and analyses (Kraemer et al., 2002, 2008; Kazdin, 2007).
Conclusion
Positive word recall and psychological well-being improved in parallel during a 12-week mindfulness intervention compared to active controls. These data suggest that changes in emotional information processing, specifically improved processing of positive stimuli, may be a mechanism by which mindfulness increases well-being.
Statements
Acknowledgments
Funding for this study was provided by grants T32-AT001287, MH067553-05, and K23 AT006328-01A1 from the National Institutes of Health, the Mind and Life Institute, and the Frederick Lenz and Hershey Foundations. We give special thanks to the research assistants at the Brown Contemplative Studies Research Laboratory and the research participants for their time and effort. Role of Funding Source: The sponsors had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
1
AlbertsH.ThewissenR. (2011). The effect of a brief mindfulness intervention on memory for positively and negatively valenced stimuli. Mindfulness (N. Y.)2, 73–77.10.1007/s12671-011-0044-7
2
AllenN. B.ChambersR.KnightW. (2006). Mindfulness-based psychotherapies: a review of conceptual foundations, empirical evidence and practical considerations. Aust. N. Z. J. Psychiatry40, 285–294.10.1080/j.1440-1614.2006.01794.x
3
AmirN.BeardC.BurnsM.BomyeaJ. (2009). Attention modification program in individuals with generalized anxiety disorder. J. Abnorm. Psychol.118, 28–33.10.1037/a0012589
4
AndersonN. D.LauM. A.SegalZ. V.BishopS. R. (2007). Mindfulness-based stress reduction and attentional control. Clin. Psychol. Psychother.14, 449–463.10.1002/cpp.544
5
ArneÑ. (2005). The role of the amygdala in human fear: automatic detection of threat. Psychoneuroendocrinology30, 953–958.10.1016/j.psyneuen.2005.03.019
6
BaerR. A. (2003). Mindfulness training as a clinical Intervention: a conceptual and empirical review. Clin. Psychol. Sci. Pract.10, 125–143.10.1093/clipsy.bpg015
7
BaerentsenK. B.HartvigN. V.Stødkilde-JørgensenH.MammenJ. (2001). Onset of meditation explored with fMRI. Neuroimage13, 297.10.1016/S1053-8119(01)91640-4
8
BañosR. M.MedinaP. M.PascualJ. (2001). Explicit and implicit memory biases in depression and panic disorder. Behav. Res. Ther.39, 61–74.10.1016/S0005-7967(99)00158-8
9
Bar-HaimY. (2010). Research review: attention bias modification (ABM): a novel treatment for anxiety disorders. J. Child Psychol. Psychiatry51, 859–870.10.1111/j.1469-7610.2010.02251.x
10
BarnhoferT.ChittkaT.NightingaleH.VisserC.CraneC. (2010). State effects of two forms of meditation on prefrontal EEG asymmetry in previously depressed individuals. Mindfulness (N Y)1, 21–27.10.1007/s12671-010-0004-7
11
BaumeisterR. F.VohsK. D.FunderD. C. (2007). Psychology as the science of self-reports and finger movements: whatever happened to actual behavior?Perspect. Psychol. Sci.2, 396–403.10.1111/j.1745-6916.2007.00051.x
12
BaxterL. R.Jr.SchwartzJ. M.PhelpsM. E.MazziottaJ. C.GuzeB. H.SelinC. E.GernerR. H.SumidaR. M. (1989). Reduction of prefrontal cortex glucose metabolism common to three types of depression. Arch. Gen. Psychiatry46, 243–250.10.1001/archpsyc.1989.01810030049007
13
BeardC. (2011). Cognitive bias modification for anxiety: current evidence and future directions. Expert Rev. Neurother.11, 299–311.10.1586/ern.10.194
14
BeardC.AmirN. (2008). A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms. Behav. Res. Ther.46, 1135–1141.10.1016/j.brat.2008.05.012
15
BeardC.WeisbergR. B.AmirN. (2011). Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial. Depress. Anxiety28, 981–988.10.1002/da.20873
16
BeckA. T. (1987). Cognitive models of depression. J. Cogn. Psychother.1, 5–37.
17
BeckA. T. (2008). The evolution of the cognitive model of depression and its neurobiological correlates. Am. J. Psychiatry165, 969–977.10.1176/appi.ajp.2008.08050721
18
BeeversC. G.ClasenP.SticeE.SchnyerD. (2010). Depression symptoms and cognitive control of emotion cues: a functional magnetic resonance imaging study. Neuroscience167, 97–103.10.1016/j.neuroscience.2010.01.047
19
BenchC. J.FristonK. J.BrownR. G.FrackowiakR. S.DolanR. J. (1993). Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions. Psychol. Med.23, 579–590.10.1017/S0033291700025368
20
BishopS. R. (2002). What do we really know about mindfulness-based stress reduction?Psychosom. Med.64, 71–83.
21
BlumbergH. P.KaufmanJ.MartinA.CharneyD. S.KrystalJ. H.PetersonB. S. (2004). Significance of adolescent neurodevelopment for the neural circuitry of bipolar disorder. Ann. N. Y. Acad. Sci.1021, 376–383.10.1196/annals.1308.048
22
BradleyB. P.MoggK.WilliamsR. (1994). Implicit and explicit memory for emotional information in non-clinical subjects. Behav. Res. Ther.32, 65–78.10.1016/0005-7967(94)90095-7
23
BradleyM. M.LangP. J. (1999). Affective Norms for English Words (ANEW): Stimuli, Instruction Manual and Affective Ratings. Gainesville, FL: The Center for Research in Psychophysiology, University of Florida.
24
BränströmR.KvillemoP.BrandbergY.MoskowitzJ. (2010). Self-report mindfulness as a mediator of psychological well-being in a stress reduction intervention for cancer patients: a randomized study. Ann. Behav. Med.39, 151–161.10.1007/s12160-010-9168-6
25
Brefczynski-LewisJ. A.LutzA.SchaeferH. S.LevinsonD. B.DavidsonR. J. (2007). Neural correlates of attentional expertise in long-term meditation practitioners. Proc. Natl. Acad. Sci. U.S.A.104, 11483–11488.10.1073/pnas.0606552104
26
BrittonW. B.BootzinR. R.HaynesP.FridelK. W. (2010). “Polysomnographic and subjective sleep profiles before and after mindfulness-based cognitive therapy in partially remitted depression,” in 8th Annual Scientific Conference for Clinicians, Researchers and Educators: Investigating and Integrating Mindfulness in Medicine, Health Care, and Society, Worcester, MA.
27
BrittonW. B.ShaharB.SzepsenwolO.JacobsW. J. (in press). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behav. Ther.
28
BrownK. W.RyanR. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. J. Pers. Soc. Psychol.84, 822–848.10.1037/0022-3514.84.4.822
29
BrowningM.HolmesE.HarmerC. (2010). The modification of attentional bias to emotional information: a review of the techniques, mechanisms, and relevance to emotional disorders. Cogn. Affect. Behav. Neurosci.10, 8–20.10.3758/CABN.10.1.8
30
BryantF. B. (1989). A four-factor model of perceived control: avoiding, coping, obtaining, and savoring. J. Pers.57, 773–797.10.1111/j.1467-6494.1989.tb00494.x
31
BurgdorfJ.PankseppJ. (2006). The neurobiology of positive emotions. Neurosci. Biobehav. Rev.30, 173–187.10.1016/j.neubiorev.2005.06.001
32
BurtD. B.ZembarM. J.NiedereheG. (1995). Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. Psychol. Bull.117, 285–305.10.1037/0033-2909.117.2.285
33
BushellW. C. (2009). New beginnings: evidence that the meditational regimen can lead to optimization of perception, attention, cognition, and other functions. Ann. N. Y. Acad. Sci.1172, 348–361.10.1111/j.1749-6632.2009.04538.x
34
CarlsonL. E.SpecaM.FarisP.PatelK. 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 Behav. Immun.21, 1038–1049.10.1016/j.bbi.2007.04.002
35
CarmodyJ.BaerR. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J. Behav. Med.31, 23–33.10.1007/s10865-007-9130-7
36
CarterC. S.BraverT. S.BarchD. M.BotvinickM. M.NollD.CohenJ. D. (1998). Anterior cingulate cortex, error detection, and the online monitoring of performance. Science280, 747–749.10.1126/science.280.5364.747
37
ChambersR.LoB.AllenN. (2008). The impact of intensive mindfulness training on attentional control, cognitive style, and affect. Cognit. Ther. Res.32, 303–322.10.1007/s10608-007-9119-0
38
ChanD.WoollacottM. (2007). Effects of level of meditation experience on attentional focus: is the efficiency of executive or orientation networks improved?J. Altern. Complement. Med.13, 651–657.10.1089/acm.2007.7022
39
ChandrasekaranB.KrausN. (2010). Music, noise-exclusion, and learning. Music Percept. Interdiscip. J.27, 297–306.10.1525/mp.2010.27.4.297
40
ClarkL.ChamberlainS. R.SahakianB. J. (2009). Neurocognitive mechanisms in depression: implications for treatment. Annu. Rev. Neurosci.32, 57–74.10.1146/annurev.neuro.31.060407.125618
41
ClarkL.IversenS. D.GoodwinG. M. (2002). Sustained attention deficit in bipolar disorder. Br. J. Psychiatry180, 313–319.10.1192/bjp.180.4.313
42
ClarkL. A.WatsonD. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. J. Abnorm. Psychol.100, 316–336.10.1037/0021-843X.100.3.316
43
CouyoumdjianA.SdoiaS.TempestaD.CurcioG.RastelliniE.DE GennaroL.FerraraM. (2010). The effects of sleep and sleep deprivation on task-switching performance. J. Sleep Res.19, 64–70.10.1111/j.1365-2869.2009.00774.x
44
CreswellJ. D.WayB. M.EisenbergerN. I.LiebermanM. D. (2007). Neural correlates of dispositional mindfulness during affect labeling. Psychosom. Med.69, 560–565.10.1097/PSY.0b013e3180f6171f
45
CritchleyH. D.WiensS.RotshteinP.OhmanA.DolanR. J. (2004). Neural systems supporting interoceptive awareness. Nat. Neurosci.7, 189–195.10.1038/nn1176
46
DavidsonR. J. (2004). Well-being and affective style: neural substrates and biobehavioural correlates. Philos. Trans. R. Soc. Lond. B Biol. Sci.359, 1395–1411.10.1098/rstb.2004.1510
47
DavidsonR. J. (2010). Empirical explorations of mindfulness: conceptual and methodological conundrums. Emotion10, 8–11.10.1037/a0018480
48
DavidsonR. J.IrwinW.AnderleM. J.KalinN. H. (2003a). The neural substrates of affective processing in depressed patients treated with venlafaxine. Am. J. Psychiatry160, 64–75.10.1176/appi.ajp.160.1.64
49
DavidsonR. J.Kabat-ZinnJ.SchumacherJ.RosenkranzM.MullerD.SantorelliS. F.UrbanowskiF.HarringtonA.BonusK.SheridanJ. F. (2003b). Alterations in brain and immune function produced by mindfulness meditation. Psychosom. Med.65, 564–570.10.1097/01.PSY.0000077505.67574.E3
50
DavidsonR. J.JacksonD. C.KalinN. H. (2000). Emotion, plasticity, context, and regulation: perspectives from affective neuroscience. Psychol. Bull.126, 890–909.10.1037/0033-2909.126.6.890
51
DavisM. (1992). The role of the amygdala in fear and anxiety. Annu. Rev. Neurosci.15, 353–375.10.1146/annurev.ne.15.030192.002033
52
DimidjianS.LinehanM. M. (2003). Defining an agenda for future research on the clinical application of mindfulness practice. Clin. Psychol. Sci. Pract.10, 166–171.10.1093/clipsy.bpg019
53
DisnerS. G.BeeversC. G.HaighE. A.BeckA. T. (2011). Neural mechanisms of the cognitive model of depression. Nat. Rev. Neurosci.12, 467–477.10.1038/nrm3166
54
EldarS.Bar-HaimY. (2010). Neural plasticity in response to attention training in anxiety. Psychol. Med.40, 667–677.10.1017/S0033291709990766
55
ElliottR.RubinszteinJ. S.SahakianB. J.DolanR. J. (2002). The neural basis of mood-congruent processing biases in depression. Arch. Gen. Psychiatry59, 597–604.10.1001/archpsyc.59.7.597
56
EpsteinR. M. (1999). Mindful practice. JAMA282, 833–839.10.1001/jama.282.9.833
57
EugeneF.JoormannJ.CooneyR. E.AtlasL. Y.GotlibI. H. (2010). Neural correlates of inhibitory deficits in depression. Psychiatry Res.181, 30–35.10.1016/j.pscychresns.2009.07.010
58
FalesC. L.BarchD. M.RundleM. M.MintunM. A.SnyderA. Z.CohenJ. D.MathewsJ.ShelineY. I. (2008). Altered emotional interference processing in affective and cognitive-control brain circuitry in major depression. Biol. Psychiatry63, 377–384.10.1016/j.biopsych.2007.06.012
59
FangC. Y.ReibelD. K.LongacreM. L.RosenzweigS.CampbellD. E.DouglasS. D. (2010). Enhanced psychosocial well-being following participation in a mindfulness-based stress reduction program is associated with increased natural killer cell activity. J. Altern. Complement. Med.16, 531–538.10.1089/acm.2009.0018
60
FarbN. A.SegalZ. V.MaybergH.BeanJ.MckeonD.FatimaZ.AndersonA. K. (2007). Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference. Soc. Cogn. Affect. Neurosci.2, 313–322.10.1093/scan/nsm030
61
FarbN. A. S.AndersonA. K.MaybergH.BeanJ.MckeonD.SegalZ. V. (2010). Minding one’s emotions: mindfulness training alters the neural expression of sadness. Emotion10, 25–33.10.1037/a0019263
62
ForsterK. I.ForsterJ. C. (2003). DMDX: a windows display program with millisecond accuracy. Behav. Res. Methods Instrum. Comput.35, 116–124.10.3758/BF03195503
63
FoxE.CahillS.ZougkouK. (2010). Preconscious processing biases predict emotional reactivity to stress. Biol. Psychiatry67, 371–377.10.1016/j.biopsych.2009.11.018
64
FoxE.RussoR.BowlesR.DuttonK. (2001). Do threatening stimuli draw or hold visual attention in subclinical anxiety?J. Exp. Psychol. Gen.130, 681–700.10.1037/0096-3445.130.4.681
65
GarlandE.GaylordS.ParkJ. (2009). The role of mindfulness in positive reappraisal. Explore (N Y)5, 37–44.10.1016/j.explore.2008.10.001
66
GeersA.RoseJ. (2011). Treatment choice and placebo expectation effects. Soc. Personal. Psychol. Compass5, 734–750.10.1111/j.1751-9004.2011.00385.x
67
GeschwindN.PeetersF.DrukkerM.Van OsJ.WichersM. (2011). Mindfulness training increases momentary positive emotions and reward experience in adults vulnerable to depression: a randomized controlled trial. J. Consult. Clin. Psychol.79, 618–628.10.1037/a0024595
68
GoldinP. R.GrossJ. J. (2010). Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion10, 83–91.10.1037/a0018441
69
GotlibI. H.JoormannJ. (2010). Cognition and depression: current status and future directions. Annu. Rev. Clin. Psychol.6, 285–312.10.1146/annurev.clinpsy.121208.131305
70
GotlibI. H.KrasnoperovaE.YueD. N.JoormannJ. (2004). Attentional biases for negative interpersonal stimuli in clinical depression. J. Abnorm. Psychol.113, 127–135.10.1037/0021-843X.113.3.386
71
GrantJ. A.CourtemancheJ. R. M.DuerdenE. G.DuncanG. H.RainvilleP. (2010). Cortical thickness and pain sensitivity in Zen meditators. Emotion10, 43–53.10.1037/a0018334
72
GreenS. B.SalkindN. J. (2005). Using SPSS for Windows and Macintosh: Analysing and Understanding Data. Upper Saddle River, NJ: Prentice Hall.
73
GrepmairL.MitterlehnerF.LoewT.BachlerE.RotherW.NickelM. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: a randomized, double-blind, controlled study. Psychother. Psychosom.76, 332–338.10.1159/000107560
74
GrossmanP.NiemannL.SchmidtS.WalachH. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. J. Psychosom. Res.57, 35–43.10.1016/S0022-3999(03)00573-7
75
HakamataY.LissekS.Bar-HaimY.BrittonJ. C.FoxN. A.LeibenluftE.ErnstM.PineD. S. (2010). Attention bias modification treatment: a meta-analysis toward the establishment of novel treatment for anxiety. Biol. Psychiatry68, 982–990.10.1016/j.biopsych.2010.07.021
76
HarmerC. J.HillS. A.TaylorM. J.CowenP. J.GoodwinG. M. (2003). Toward a neuropsychological theory of antidepressant drug action: increase in positive emotional bias after potentiation of norepinephrine activity. Am. J. Psychiatry160, 990–992.10.1176/appi.ajp.160.5.990
77
HazenR. A.VaseyM. W.SchmidtN. B. (2009). Attentional retraining: a randomized clinical trial for pathological worry. J. Psychiatr. Res.43, 627–633.10.1016/j.jpsychires.2008.07.004
78
HeerenA.Van BroeckN.PhilippotP. (2009). The effects of mindfulness on executive processes and autobiographical memory specificity. Behav. Res. Ther.47, 403–409.10.1016/j.brat.2009.01.017
79
HerzogH.LeleV. R.KuwertT.LangenK. J.Rota KopsE.FeinendegenL. E. (1990). Changed pattern of regional glucose metabolism during yoga meditative relaxation. Neuropsychobiology23, 182–187.10.1159/000119450
80
HirschC. R.MathewsA. (2000). Impaired positive inferential bias in social phobia. J. Abnorm. Psychol.109, 705–712.10.1037/0021-843X.109.4.705
81
HölzelB. K.CarmodyJ.EvansK. C.HogeE. A.DusekJ. A.MorganL.PitmanR. K.LazarS. W. (2010). Stress reduction correlates with structural changes in the amygdala. Soc. Cogn. Affect. Neurosci.5, 11–17.10.1093/scan/nsp034
82
HölzelB. K.CarmodyJ.VangelM.CongletonC.YerramsettiS. M.GardT.LazarS. W. (2011). Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res.191, 36–43.10.1016/j.pscychresns.2010.08.006
83
HölzelB. K.OttU.GardT.HempelH.WeygandtM.MorgenK.VaitlD. (2008). Investigation of mindfulness meditation practitioners with voxel-based morphometry. Soc. Cogn. Affect. Neurosci.3, 55–61.10.1093/scan/nsm038
84
HolzelB. K.OttU.HempelH.HacklA.WolfK.StarkR.VaitlD. (2007). Differential engagement of anterior cingulate and adjacent medial frontal cortex in adept meditators and non-meditators. Neurosci. Lett.421, 16–21.10.1016/j.neulet.2007.04.074
85
HowardG. S. (1980). Response-shift bias: a problem in evaluating interventions with pre/post self-reports. Eval. Rev.4, 93–106.10.1177/0193841X8000400105
86
HowardG. S.DaileyP. R. (1979). Response-shift bias: a source of contamination of self-report measures. J. Appl. Psychol.64, 144–150.10.1037/0021-9010.64.2.144
87
HugdahlK.SpechtK.BiringerE.WeisS.ElliottR.HammarÖ.ErslandL.LundA. (2007). Increased parietal and frontal activation after remission from recurrent major depression: a repeated fMRI study. Cognit. Ther. Res.31, 147–160.10.1007/s10608-006-9116-8
88
JainS.ShapiroS. L.SwanickS.RoeschS. C.MillsP. J.BellI.SchwartzG. E. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann. Behav. Med.33, 11–21.10.1207/s15324796abm3301_2
89
JevningR.AnandR.BiedebachM.FernandoG. (1996). Effects on regional cerebral blood flow of transcendental meditation. Physiol. Behav.59, 399–402.10.1016/0031-9384(95)02006-3
90
JhaA. P.KrompingerJ.BaimeM. J. (2007). Mindfulness training modifies subsystems of attention. Cogn. Affect. Behav. Neurosci.7, 109–119.10.3758/CABN.7.2.109
91
JoormannJ.GotlibI. H. (2008). Updating the contents of working memory in depression: interference from irrelevant negative material. J. Abnorm. Psychol.117, 182–192.10.1037/0021-843X.117.1.182
92
JoormannJ.YoonK. L.ZetscheU. (2007). Cognitive inhibition in depression. Appl. Prev. Psychol.12, 128–139.10.1016/j.appsy.2007.09.002
93
JosephsonB. R. (1996). Mood regulation and memory: repairing sad moods with happy memories. Cogn. Emot.10, 437–444.10.1080/026999396380222
94
Kabat-ZinnJ. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations, and preliminary results. Gen. Hosp. Psychiatry4, 33–47.10.1016/0163-8343(82)90026-3
95
Kabat-ZinnJ.MassionA.KristellerJ.PetersonL.FletcherK.PbertL.LenderkingW.SantorelliS. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am. J. Psychiatry149, 936–943.
96
KazdinA. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annu. Rev. Clin. Psychol.3, 1–27.10.1146/annurev.clinpsy.3.022806.091432
97
KazdinA. E.NockM. K. (2003). Delineating mechanisms of change in child and adolescent therapy: methodological issues and research recommendations. J. Child Psychol. Psychiatry44, 1116–1129.10.1111/1469-7610.00195
98
KelloughJ. L.BeeversC. G.EllisA. J.WellsT. T. (2008). Time course of selective attention in clinically depressed young adults: an eye tracking study. Behav. Res. Ther.46, 1238–1243.10.1016/j.brat.2008.07.004
99
KennyM. A.WilliamsJ. M. (2007). Treatment-resistant depressed patients show a good response to mindfulness-based Cognitive therapy. Behav. Res. Ther.45, 617–625.10.1016/j.brat.2006.04.008
100
KeuneP. M.BostanovV.HautzingerM.KotchoubeyB. (2011). Mindfulness-based cognitive therapy (MBCT), cognitive style, and the temporal dynamics of frontal EEG alpha asymmetry in recurrently depressed patients. Biol. Psychol.88, 243–252.10.1016/j.biopsycho.2011.08.008
101
KhushuS.TellesS.KumaranS.NaveenK. V.TripathiR. P. (2000). Frontal activation during meditation based on functional magnetic resonance imaging (fMRI). Indian J. Physiol. Pharmacol.44, 34.
102
KillingsworthM. A.GilbertD. T. (2010). A wandering mind is an unhappy mind. Science330, 932–932.10.1126/science.1192439
103
KjaerT. W.BertelsenC.PicciniP.BrooksD.AlvingJ. R.LouH. C. (2002). Increased dopamine tone during meditation-induced change of consciousness. Brain Res. Cogn. Brain Res.13, 255–259.10.1016/S0926-6410(01)00106-9
104
KlumppH.AmirN. (2009). Examination of vigilance and disengagement of threat in social anxiety with a probe detection task. Anxiety Stress Coping22, 283–296.10.1080/10615800802449602
105
KosterE. H. W.De RaedtR.LeymanL.De LissnyderE. (2010). Mood-congruent attention and memory bias in dysphoria: exploring the coherence among information-processing biases. Behav. Res. Ther.48, 219–225.10.1016/j.brat.2009.11.004
106
KosterE. H. W.FoxE.MacleodC. (2009). Introduction to the special section on cognitive bias modification in emotional disorders. J. Abnorm. Psychol.118, 1–4.10.1037/a0014379
107
KraemerH.KiernanM.EssexM.KupferD. J. (2008). How and why criteria defining moderators and mediators differ between the Baron & Kenny and MacArthur approaches. Health Psychol.27, S101–S108.10.1037/0278-6133.27.2(Suppl.).S101
108
KraemerH. C.WilsonG. T.FairburnC. G.AgrasW. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Arch. Gen. Psychiatry59, 877–883.10.1001/archpsyc.59.10.877
109
KrasnerM. S.EpsteinR. M.BeckmanH.SuchmanA. L.ChapmanB.MooneyC. J.QuillT. E. (2009). Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA302, 1284–1293.10.1001/jama.2009.1384
110
KrausN.ChandrasekaranB. (2010). Music training for the development of auditory skills. Nat. Rev. Neurosci.11, 599–605.10.1038/nrm2968
111
KuykenW.ByfordS.TaylorR. S.WatkinsE.HoldenE.WhiteK.BarrettB.ByngR.EvansA.MullanE.TeasdaleJ. D. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. J. Consult. Clin. Psychol.76, 966–978.10.1037/a0013786
112
LazarS. W.BushG.GollubR. L.FricchioneG. L.KhalsaG.BensonH. (2000). Functional brain mapping of the relaxation response and meditation. Neuroreport11, 1581–1585.10.1097/00001756-200005150-00041
113
LazarS. W.KerrC. E.WassermanR. H.GrayJ. R.GreveD. N.TreadwayM. T.McgarveyM.QuinnB. T.DusekJ. A.BensonH.RauchS. L.MooreC. I.FischlB. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport16, 1893–1897.10.1097/01.wnr.0000186598.66243.19
114
LeDouxJ. (2003). The emotional brain, fear, and the amygdala. Cell. Mol. Neurobiol.23, 727–738.10.1023/A:1025048802629
115
LewisP. A.CritchleyH. D.RotshteinP.DolanR. J. (2007). Neural correlates of processing valence and arousal in affective words. Cereb. Cortex17, 742–748.10.1093/cercor/bhk024
116
LiS.TanJ.QianM.LiuX. (2008). Continual training of attentional bias in social anxiety. Behav. Res. Ther.46, 905–912.10.1016/j.brat.2008.04.005
117
LiottiM.MaybergH. S. (2001). The role of functional neuroimaging in the neuropsychology of depression. J. Clin. Exp. Neuropsychol.23, 121–136.10.1076/jcen.23.1.121.1223
118
LiottiM.MaybergH. S.McginnisS.BrannanS. L.JerabekP. (2002). Unmasking disease-specific cerebral blood flow abnormalities: mood challenge in patients with remitted unipolar depression. Am. J. Psychiatry159, 1830–1840.10.1176/appi.ajp.159.11.1830
119
LudersE.TogaA. W.LeporeN.GaserC. (2009). The underlying anatomical correlates of long-term meditation: larger hippocampal and frontal volumes of gray matter. Neuroimage45, 672–678.10.1016/j.neuroimage.2008.12.061
120
LutzA.SlagterH. A.DunneJ. D.DavidsonR. J. (2008). Attention regulation and monitoring in meditation. Trends Cogn. Sci. (Regul. Ed.)12, 163–169.10.1016/j.tics.2008.01.005
121
LutzA.SlagterH. A.RawlingsN. B.FrancisA. D.GreischarL. L.DavidsonR. J. (2009). Mental training enhances attentional stability: neural and behavioral evidence. J. Neurosci.29, 13418–13427.10.1523/JNEUROSCI.1614-09.2009
122
MacLeanC. R.WaltonK. G.WennebergS. R.LevitskyD. K.MandarinoJ. V.WaziriR.SchneiderR. H. (1994). Altered responses of cortisol, GH, TSH and testosterone to acute stress after four months’ practice of transcendental meditation (TM). Ann. N. Y. Acad. Sci.746, 381–384.10.1111/j.1749-6632.1994.tb39261.x
123
MacLeodC.HaganR. (1992). Individual differences in the selective processing of threatening information, and emotional responses to a stressful life event. Behav. Res. Ther.30, 151–161.10.1016/0005-7967(92)90138-7
124
MathewsA.MacLeodC. (2005). Cognitive vulnerability to emotional disorders. Annu. Rev. Clin. Psychol.1, 167–195.10.1146/annurev.clinpsy.1.102803.143916
125
MathewsA.RidgewayV.CookE.YiendJ. (2007). Inducing a benign interpretational bias reduces trait anxiety. J. Behav. Ther. Exp. Psychiatry38, 225–236.10.1016/j.jbtep.2006.10.011
126
MattG. E.VázquezC.CampbellW. K. (1992). Mood-congruent recall of affectively toned stimuli: a meta-analytic review. Clin. Psychol. Rev.12, 227–255.10.1016/0272-7358(92)90116-P
127
MaybergH. S.LiottiM.BrannanS. K.McginnisS.MahurinR. K.JerabekP. A.SilvaJ. A.TekellJ. L.MartinC. C.LancasterJ. L.FoxP. T. (1999). Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am. J. Psychiatry156, 675–682.
128
MeehanM. P.DurlakJ. A.BryantF. B. (1993). The relationship of social support to perceived control and subjective mental health in adolescents. J. Community Psychol.21, 49–55.10.1002/1520-6629(199301)21:1<49::AID-JCOP2290210106>3.0.CO;2-I
129
MeyerS. E.CarlsonG. A.WiggsE. A.MartinezP. E.RonsavilleD. S.Klimes-DouganB.GoldP. W.Radke-YarrowM. (2004). A prospective study of the association among impaired executive functioning, childhood attentional problems, and the development of bipolar disorder. Dev. Psychopathol.16, 461–476.10.1017/S095457940404461X
130
MillerE. K.CohenJ. D. (2001). An integrative theory of prefrontal cortex function. Annu. Rev. Neurosci.24, 167–202.10.1146/annurev.neuro.24.1.167
131
MitterschiffthalerM. T.WilliamsS. C.WalshN. D.CleareA. J.DonaldsonC.ScottJ.FuC. H. (2008). Neural basis of the emotional stroop interference effect in major depression. Psychol. Med.38, 247–256.10.1017/S0033291707001523
132
MoggK.BaldwinD. S.BrodrickP.BradleyB. P. (2004). Effect of short-term SSRI treatment on cognitive bias in generalised anxiety disorder. Psychopharmacology (Berl.)176, 466–470.10.1007/s00213-004-1902-y
133
MoyerC. A.DonnellyM. P. W.AndersonJ. C.ValekK. C.HuckabyS. J.WiederholtD. A.DotyR. L.RehlingerA. S.RiceB. L. (2011). Frontal electroencephalographic asymmetry associated with positive emotion is produced by very brief meditation training. Psychol. Sci.22, 1277–1279.10.1177/0956797611418985
134
NagahamaY.OkadaT.KatsumiY.HayashiT.YamauchiH.OyanagiC.KonishiJ.FukuyamaH.ShibasakiH. (2001). Dissociable mechanisms of attentional control within the human prefrontal cortex. Cereb. Cortex11, 85–92.10.1093/cercor/11.1.85
135
NCCAM. (2009). Meditation: An Introduction. Uses of Meditation in the United States. Available at: http://nccam.nih.gov/health/meditation/overview.htm#meditation.
136
NewbergA.AlaviA.BaimeM.PourdehnadM.SantannaJ.D’AquiliE. (2001). The measurement of regional cerebral blood flow during the complex cognitive task of meditation: a preliminary SPECT study. Psychiatry Res.106, 113–122.10.1016/S0925-4927(01)00074-9
137
NyklícekI.KuijpersK. (2008). Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: is increased mindfulness indeed the mechanism?Ann. Behav. Med.35, 331–340.10.1007/s12160-008-9030-2
138
OchsnerK. N.BungeS. A.GrossJ. J.GabrieliJ. D. E. (2002). Rethinking feelings: an fMRI study of the cognitive regulation of emotion. J. Cogn. Neurosci.14, 1215–1229.10.1162/089892902760807212
139
OchsnerK. N.GrossJ. J. (2005). The cognitive control of emotion. Trends Cogn. Sci. (Regul. Ed.)9, 242–249.10.1016/j.tics.2005.03.010
140
OchsnerK. N.KnierimK.LudlowD. H.HanelinJ.RamachandranT.GloverG.MackeyS. C. (2004). Reflecting upon feelings: an fMRI study of neural systems supporting the attribution of emotion to self and other. J. Cogn. Neurosci.16, 1746–1772.10.1162/0898929042947829
141
O’ConnellR. G.BellgroveM. A.DockreeP. M.LauA.FitzgeraldM.RobertsonI. H. (2008). Self-alert training: volitional modulation of autonomic arousal improves sustained attention. Neuropsychologia46, 1379–1390.10.1016/j.neuropsychologia.2007.12.018
142
OrtnerC.KilnerS.ZelazoP. (2007). Mindfulness meditation and reduced emotional interference on a cognitive task. Motiv. Emot.31, 271–283.10.1007/s11031-007-9076-7
143
OrzechK. M.ShapiroS. L.BrownK. W.MckayM. (2009). Intensive mindfulness training-related changes in cognitive and emotional experience. J. Posit. Psychol.4, 212–222.10.1080/17439760902819394
144
OspinaM. B.BondK.KarkhanehM.TjosvoldL.VandermeerB.LiangY.BialyL.HootonN.BuscemiN.DrydenD. M.KlassenT. P. (2007). Meditation practices for health: state of the research. Evid. Rep. Technol. Assess. (Full Rep.)155, 1–263.
145
PagnoniG.CekicM. (2007). Age effects on gray matter volume and attentional performance in Zen meditation. Neurobiol. Aging28, 1623–1627.10.1016/j.neurobiolaging.2007.06.008
146
PenadesR.CatalanR.SalameroM.BogetT.PuigO.GuarchJ.GastoC. (2006). Cognitive remediation therapy for outpatients with chronic schizophrenia: a controlled and randomized study. Schizophr. Res.87, 323–331.10.1016/j.schres.2006.04.019
147
PishyarR.HarrisL. M.MenziesR. G. (2008). Responsiveness of measures of attentional bias to clinical change in social phobia. Cogn. Emot.22, 1209–1227.10.1080/02699930701686008
148
ReibelD. K.GreesonJ. M.BrainardG. C.RosenzweigS. (2001). Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population. Gen. Hosp. Psychiatry23, 183–192.10.1016/S0163-8343(01)00149-9
149
ReidyJ. (2004). Trait anxiety, trait depression, worry, and memory. Behav. Res. Ther.42, 937–948.10.1016/j.brat.2003.07.005
150
RitskesR.Ritskes-HoitingaM.Stødkilde-JørgensenH.BaerentsenK. B.HartmanT. (2003). MRI scanning during Zen meditation: the picture of enlightenment. Constuctivism Hum. Sci.8, 85–89.
151
RustingC. L.DeHartT. (2000). Retrieving positive memories to regulate negative mood: consequences for mood-congruent memory. J. Pers. Soc. Psychol.78, 737–752.10.1037/0022-3514.78.4.737
152
RyffC. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J. Pers. Soc. Psychol.57, 1069–1081.10.1037/0022-3514.57.6.1069
153
RyffC. D.Dienberg LoveG.UrryH. L.MullerD.RosenkranzM. A.FriedmanE. M.DavidsonR. J.SingerB. (2006). Psychological well-being and ill-being: do they have distinct or mirrored biological correlates?Psychother. Psychosom.75, 85–95.10.1159/000090892
154
SaleminkE.Van Den HoutM.KindtM. (2007). Trained interpretive bias and anxiety. Behav. Res. Ther.45, 329–340.10.1016/j.brat.2006.04.004
155
ScheierM. F.CarverC. S.BridgesM. W. (2001). “Optimism, pessimism, and psychological well-being,” in Optimism & Pessimism: Implications for Theory, Research, and Practice (Washington, DC: American Psychological Association), 189–216.
156
SchmidtN. B.RicheyJ. A.BucknerJ. D.TimpanoK. R. (2009). Attention training for generalized social anxiety disorder. J. Abnorm. Psychol.118, 5–14.10.1037/a0013643
157
SchroeversM. J.BrandsmaR. (2010). Is learning mindfulness associated with improved affect after mindfulness-based cognitive therapy?Br. J. Psychol.101, 95–107.10.1348/000712609X424195
158
SchwarzN. (1999). Self-reports: how the questions shape the answers. Am. Psychol.54, 93–105.10.1037/0003-066X.54.2.93
159
SeeJ.MacleodC.BridleR. (2009). The reduction of anxiety vulnerability through the modification of attentional bias: a real-world study using a home-based cognitive bias modification procedure. J. Abnorm. Psychol.118, 65–75.10.1037/a0014377
160
SegalZ. V.WilliamsJ. M. G.TeasdaleJ. D. (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.
161
ShapiroS. L.AstinJ. A.BishopS. R.CordovaM. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomized trial. Int. J. Stress Manag.12, 164–176.10.1037/1072-5245.12.2.164
162
ShapiroS. L.CarlsonL. E.AstinJ. A.FreedmanB. (2006). Mechanisms of mindfulness. J. Clin. Psychol.62, 373–386.10.1002/jclp.20237
163
ShapiroS. L.SchwartzG. E.BonnerG. (1998). Effects of Mindfulness-based stress reduction on medical and premedical students. J. Behav. Med.21, 581–599.10.1023/A:1018700829825
164
SharotT.KornC. W.DolanR. J. (2011). How unrealistic optimism is maintained in the face of reality. Nat. Neurosci.14, 1475–1479.10.1038/nn.2949
165
SharotT.RiccardiA. M.RaioC. M.PhelpsE. A. (2007). Neural mechanisms mediating optimism bias. Nature450, 102–105.10.1038/nature06280
166
SiegleG.GhinassiF.ThaseM. (2007a). Neurobehavioral therapies in the 21st century: summary of an emerging field and an extended example of cognitive control training for depression. Cognit. Ther. Res.31, 235–262.10.1007/s10608-006-9118-6
167
SiegleG. J.ThompsonW.CarterC. S.SteinhauerS. R.ThaseM. E. (2007b). Increased amygdala and decreased dorsolateral prefrontal BOLD responses in unipolar depression: related and independent features. Biol. Psychiatry61, 198–209.10.1016/j.biopsych.2006.05.048
168
SiegleG. J.HasselmoM. E. (2002). Using connectionist models to guide assessment of psychological disorder. Psychol. Assess.14, 263–278.10.1037/1040-3590.14.3.263
169
SiegleG. J.SteinhauerS. R.ThaseM. E.StengerV. A.CarterC. S. (2002). Can’t shake that feeling: event-related fMRI assessment of sustained amygdala activity in response to emotional information in depressed individuals. Biol. Psychiatry51, 693–707.10.1016/S0006-3223(02)01314-8
170
SilversteinR.BrownA.RothH.BrittonW. B. (2011). Mindfulness training improves interoceptive awareness to sexual stimuli: implications for healthy female sexual functioning. Psychosom. Med.73, 817–825.10.1097/PSY.0b013e318234e628
171
SinN. L.LyubomirskyS. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J. Clin. Psychol.65, 467–487.10.1002/jclp.20593
172
SlagterH. A.LutzA.GreischarL. L.FrancisA. D.NieuwenhuisS.DavisJ. M.DavidsonR. J. (2007). Mental training affects distribution of limited brain resources. PLoS Biol.5, e138.10.1371/journal.pbio.0050138
173
SlagterH. A.LutzA.GreischarL. L.NieuwenhuisS.DavidsonR. J. (2009). Theta phase synchrony and conscious target perception: impact of intensive mental training. J. Cogn. Neurosci.21, 1536–1549.10.1162/jocn.2009.21125
174
SpecaM.CarlsonL. E.GoodeyE.AngenM. (2000). A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom. Med.62, 613–622.
175
SrinivasanN.BaijalS. (2007). Concentrative meditation enhances preattentive processing: a mismatch negativity study. Neuroreport18, 1709–1712.10.1097/WNR.0b013e3282f0d2d8
176
SudsuangR.ChentanezV.VeluvanK. (1991). Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time. Physiol. Behav.50, 543–548.10.1016/0031-9384(91)90543-W
177
TangY. Y.MaY.WangJ.FanY.FengS.LuQ.YuQ.SuiD.RothbartM. K.FanM.PosnerM. I. (2007). Short-term meditation training improves attention and self-regulation. Proc. Natl. Acad. Sci. U.S.A.104, 17152–17156.10.1073/pnas.0702553104
178
TaylorS. E.BrownJ. D. (1988). Illusion and well-being – a social psychological perspective on mental-health. Psychol. Bull.103, 193–210.10.1037/0033-2909.103.2.193
179
TeasdaleJ. D.SegalZ.WilliamsJ. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help?Behav. Res. Ther.33, 25–39.10.1016/0005-7967(94)E0011-7
180
TugadeM.FredricksonB. (2007). Regulation of positive emotions: emotion regulation strategies that promote resilience. J. Happiness Stud.8, 311–333.10.1007/s10902-006-9015-4
181
UrryH. L.Van ReekumC. M.JohnstoneT.KalinN. H.ThurowM. E.SchaeferH. S.JacksonC. A.FryeC. J.GreischarL. L.AlexanderA. L.DavidsonR. J. (2006). Amygdala and ventromedial prefrontal cortex are inversely coupled during regulation of negative affect and predict the diurnal pattern of cortisol secretion among older adults. J. Neurosci.26, 4415–4425.10.1523/JNEUROSCI.3215-05.2006
182
VagoD.NakamuraY. (2011). Selective attentional bias towards pain-related threat in fibromyalgia: preliminary evidence for effects of mindfulness meditation training. Cognit. Ther. Res.1–14.10.1007/s10608-011-9391-x
183
ValentineE. R.SweetP. L. G. (1999). Meditation and attention: a comparison of the effects of concentrative and mindfulness meditation on sustained attention. Ment. Health Religion Cult.2, 59–70.10.1080/13674679908406332
184
van den HoutM.TenneyN.HuygensK.MerckelbachH.KindtM. (1995). Responding to subliminal threat cues is related to trait anxiety and emotional vulnerability: a successful replication of Macleod and Hagan (1992). Behav. Res. Ther.33, 451–454.10.1016/0005-7967(94)00062-O
185
WayB.CreswellJ. D.EisenbergerN. I.LiebermanM. D. (2010). Dispositional mindfulness and depressive symptomatology: correlations with limbic and self-referential neural activity at rest. Emotion10, 12–24.10.1037/a0018312
186
WeissmanD. H.GopalakrishnanA.HazlettC. J.WoldorffM. G. (2005). Dorsal anterior cingulate cortex resolves conflict from distracting stimuli by boosting attention toward relevant events. Cereb. Cortex15, 229–237.10.1093/cercor/bhh125
187
WellsA. (2000). Emotional Disorders and Metacognition: Innovative Cognitive Therapy. New York: Wiley.
188
Wenk-SormazH. (2005). Meditation can reduce habitual responding. Altern. Ther. Health Med.11, 42–58.
189
WilliamsJ. M. G.TeasdaleJ. D.SegalZ. V.SoulsbyJ. (2000). Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. J. Abnorm. Psychol.109, 150–155.10.1037/0021-843X.109.1.150
190
Witek-JanusekL.AlbuquerqueK.ChroniakK. R.ChroniakC.Durazo-ArvizuR.MathewsH. L. (2008). Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain Behav. Immun.22, 969–981.10.1016/j.bbi.2008.04.074
191
WoodA. M.JosephS. (2010). The absence of positive psychological (eudemonic) well-being as a risk factor for depression: a ten year cohort study. J. Affect. Disord.122, 213–217.10.1016/j.jad.2009.06.032
192
World Health Organization. (1948). Preamble to the Constitution of the World Health Organization as Adopted by the International Health Conference, New York.
193
ZautraA. J.DavisM. C.ReichJ. W.NicassarioP.TennenH.FinanP.KratzA.ParrishB.IrwinM. R. (2008). Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. J. Consult. Clin. Psychol.76, 408–421.10.1037/0022-006X.76.3.408
Summary
Keywords
emotional information processing, mindfulness, memory
Citation
Roberts-Wolfe D, Sacchet MD, Hastings E, Roth H and Britton W (2012) Mindfulness Training Alters Emotional Memory Recall Compared to Active Controls: Support for an Emotional Information Processing Model of Mindfulness. Front. Hum. Neurosci. 6:15. doi: 10.3389/fnhum.2012.00015
Received
28 October 2011
Accepted
14 January 2012
Published
13 February 2012
Volume
6 - 2012
Edited by
Jack Van Honk, Utrecht University, Netherlands
Reviewed by
Franco Cauda, University of Turin, Italy; David Terburg, Universiteit Utrecht, Netherlands
Copyright
© 2012 Roberts-Wolfe, Sacchet, Hastings, Roth and Britton.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial License, which permits non-commercial use, distribution, and reproduction in other forums, provided the original authors and source are credited.
*Correspondence: Willoughby Britton, Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, 185 Brown Street Providence, RI 02906, USA. e-mail: willoughby_britton@brown.edu
This article was submitted to Frontiers in Emotion Science, a specialty of Frontiers in Human Neuroscience.
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