Healthy Minds Index: A brief measure of the core dimensions of well-being.

We developed a self-report measure of psychological well-being for teens and adults, the Healthy Minds Index, based on a novel theory that four trainable pillars underlie well-being: awareness, connection, insight, and purpose. Ninety-seven items were developed and revised by experts and guided by qualitative testing with teens (n = 32; average age = 16.0 years). After assessing the internal validity and factor structure in teens (n = 1607; average age = 16.7 years) and adults (n = 420; average age = 45.6 years), we reduced the survey to 17 items. We then validated the factor structure, internal and convergent and divergent validity, and retest reliability of the 17-item Healthy Minds Index in two new teen samples (study 1: n = 1492, average age = 15.7 years; study 2: n = 295, average age = 16.1 years), and one adult sample (n = 285; average age = 45.3 years). The Healthy Minds Index demonstrated adequate validity and provided a comprehensive measure of a novel theory of psychological well-being that includes two domains not found in other conceptualizations of this construct-awareness and insight. This measure will be invaluable for primary research on well-being and as a translational tool to assess the impact and efficacy of widely used behavioral training programs on these core dimensions of wellbeing.

Is informal practice associated with outcomes in loving-kindness and compassion training? Evidence from pre-post and daily diary assessments.

We investigated whether informal meditation practice (i.e., self-reported application of meditative techniques outside a period of formal meditation) was associated with outcomes in smartphone-based loving-kindness and compassion training. Meditation-naïve participants (n = 351) with clinically elevated symptoms completed measures of psychological distress, loneliness, empathy, and prosociality at baseline and following a two-week intervention. Informal practice, psychological distress, and loneliness were also assessed daily. Steeper increases in informal practice had small associations with pre-post improvements in distress (r = -.18, p = .008) and loneliness (r = -.19, p = .009) but not empathy or prosociality. Using a currently recommended approach for establishing cross-lagged effects in longitudinal data (latent curve model with structured residuals), higher current-day informal practice was associated with decreased next-day distress with a very small effect size (ßs = -.06 to -.04, p = .018) but not decreased next-day loneliness. No cross-lagged associations emerged from distress or loneliness to informal practice. Findings suggest that further investigation into a potential causal role of informal practice is warranted. Future studies experimentally manipulating informal practice are needed.

How often should I meditate? A randomized trial examining the role of meditation frequency when total amount of meditation is held constant.

Meditation apps are the most commonly used mental health apps. However, the optimal dosing of app-delivered meditation practice has not been established. We examined whether the distribution of meditation practices across a day impacted outcomes in a distressed population. We investigated the effects of meditation practice frequency in a 2-week compassion-based meditation intervention delivered via the Healthy Minds Program app. Undergraduates with clinically elevated depression and/or anxiety (N = 351) were randomized to a massed (one 20-min meditation per day) or distributed condition (two 10-min meditations per day). Psychological distress (primary outcome; composite of depression and anxiety), experiential avoidance, fear of missing out, loneliness, and self-compassion were assessed pre- and post-intervention. Psychological distress, loneliness, and informal meditation practice were also assessed daily. Practice time and frequency were assessed using app data. Results support feasibility of the study design, success of the manipulation, and acceptability of the intervention. Pooled across conditions, participants exhibited pre-post improvements on all outcomes (absolute value of ds = 0.12-0.63, p ≤ .010) and trajectories of improvement on daily distress and loneliness (p ≤ .010). No between-group differences were observed on changes in pre-post or daily measures (ps = .158-.729). When total amount of meditation practice per day is held constant, the distribution of practice may not influence outcomes for distressed beginners. Although only a first test of dose frequency effects, findings support flexibility in the distribution of meditation throughout the day, which may increase accessibility. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Randomized Controlled Trial of a Smartphone-Based Well-Being Training in Public School System Employees During the COVID-19 Pandemic.

While the extraordinary pressures of the COVID-19 pandemic on student mental health have received considerable attention, less attention has been placed on educator well-being. School system employees play a vital role in society, and teacher levels of well-being are associated with the educational outcomes of young people. We extend extant research on the prevalence and correlates of educator distress during the pandemic by reporting on a pragmatic randomized wait-list controlled trial (N=662; 64% teachers) of an innovative mental health promotion strategy implemented during the pandemic; a free four-week smartphone-based meditation app designed to train key constituents of well-being (Healthy Minds Program; HMP). Following our preregistered analysis plan and consistent with hypotheses, assignment to the HMP predicted significantly larger reductions in psychological distress, our primary outcome, at post-intervention (Cohen's d=-0.52, 95% confidence interval [-0.68, -0.37], p<.001) and at the three-month follow-up (d=-0.33 [-0.48, -0.18], p<.001). Also consistent with hypotheses, we observed similar indications of immediate and sustained benefit following the HMP on all six preregistered secondary outcomes selected to tap skills targeted in the app (e.g., perseverative thinking, social connection, well-being; absolute ds=0.19-0.42, all ps<.031 corrected except mindful action at follow-up). We found no evidence for elevated adverse events and the HMP was equally effective among participants with elevated baseline anxiety and depressive symptoms. These data suggest that the HMP may be an effective and scalable approach to supporting the mental health and well-being of teachers and other school system employees, with implications for employee retention and performance, and student outcomes.

Alliance With an Unguided Smartphone App: Validation of the Digital Working Alliance Inventory.

The working alliance may be relevant in unguided smartphone-based interventions, but no validated measure exists. We evaluated the psychometric properties of the six-item Digital Working Alliance Inventory (DWAI) using a cross-sectional survey of meditation app users (n = 290) and the intervention arm of a randomized trial testing a smartphone-based meditation app (n = 314). Exploratory factor analysis suggested a single-factor solution which was replicated using longitudinal confirmatory factor analysis. The DWAI showed adequate internal consistency and test-retest reliability. Discriminant validity was supported by a lack of association with social desirability, psychological distress, and preference for a waitlist condition. Convergent validity was supported by positive associations with perceived app effectiveness and preference for an app condition. Supporting predictive validity, DWAI scores positively predicted self-reported and objective app utilization. When assessed at Weeks 3 or 4 of the intervention, but not earlier, DWAI scores predicted pre-post reductions in psychological distress.

The plasticity of well-being: A training-based framework for the cultivation of human flourishing.

Research indicates that core dimensions of psychological well-being can be cultivated through intentional mental training. Despite growing research in this area and an increasing number of interventions designed to improve psychological well-being, the field lacks a unifying framework that clarifies the dimensions of human flourishing that can be cultivated. Here, we integrate evidence from well-being research, cognitive and affective neuroscience, and clinical psychology to highlight four core dimensions of well-being-awareness, connection, insight, and purpose. We discuss the importance of each dimension for psychological well-being, identify mechanisms that underlie their cultivation, and present evidence of their neural and psychological plasticity. This synthesis highlights key insights, as well as important gaps, in the scientific understanding of well-being and how it may be cultivated, thus highlighting future research directions.

Testing the Efficacy of a Multicomponent, Self-Guided, Smartphone-Based Meditation App: Three-Armed Randomized Controlled Trial.

BACKGROUND: A growing number of randomized controlled trials (RCTs) suggest psychological benefits associated with meditation training delivered via mobile health. However, research in this area has primarily focused on mindfulness, only one of many meditative techniques. OBJECTIVE: This study aims to evaluate the efficacy of 2 versions of a self-guided, smartphone-based meditation app-the Healthy Minds Program (HMP)-which includes training in mindfulness (Awareness), along with practices designed to cultivate positive relationships (Connection) or insight into the nature of the self (Insight). METHODS: A three-arm, fully remote RCT compared 8 weeks of one of 2 HMP conditions (Awareness+Connection and Awareness+Insight) with a waitlist control. Adults (≥18 years) without extensive previous meditation experience were eligible. The primary outcome was psychological distress (depression, anxiety, and stress). Secondary outcomes were social connection, empathy, compassion, self-reflection, insight, rumination, defusion, and mindfulness. Measures were completed at pretest, midtreatment, and posttest between October 2019 and April 2020. Longitudinal data were analyzed using intention-to-treat principles with maximum likelihood. RESULTS: A total of 343 participants were randomized and 186 (54.2%) completed at least one posttest assessment. The majority (166/228, 72.8%) of those assigned to HMP conditions downloaded the app. The 2 HMP conditions did not differ from one another in terms of changes in any outcome. Relative to the waitlist control, the HMP conditions showed larger improvements in distress, social connectedness, mindfulness, and measures theoretically linked to insight training (d=-0.28 to 0.41; Ps≤.02), despite modest exposure to connection- and insight-related practice. The results were robust to some assumptions about nonrandom patterns of missing data. Improvements in distress were associated with days of use. Candidate mediators (social connection, insight, rumination, defusion, and mindfulness) and moderators (baseline rumination, defusion, and empathy) of changes in distress were identified. CONCLUSIONS: This study provides initial evidence of efficacy for the HMP app in reducing distress and improving outcomes related to well-being, including social connectedness. Future studies should attempt to increase study retention and user engagement. TRIAL REGISTRATION: ClinicalTrials.gov NCT04139005; https://clinicaltrials.gov/ct2/show/NCT04139005.

Mindfulness and the contemplative life: pathways to connection, insight, and purpose.

Despite the growing popular and scientific interest in mindfulness and other forms of meditation, there are important gaps in our understanding of the full range of contemplative practices and the manner in which specific forms of meditation may contribute to well-being. In this article, we discuss the relationship between mindfulness and other forms of meditation, such as those related to prosocial qualities, cognitive insight, and meaning and purpose. We propose that mindfulness plays an important role as a foundation for other contemplative practices. We also discuss the importance of worldview as a variable in mindfulness practice and raise questions that may guide future research in this area.

Outstanding Challenges in Scientific Research on Mindfulness and Meditation.

Van Dam et al. raise a number of critical issues in contemporary research on mindfulness and meditation and offer a prescriptive agenda for future work in this area. While we agree with all of the key points made in their article, there are a number of important issues omitted that are central to a comprehensive agenda for future research in this area. This commentary highlights five key points: (a) Many of the key methodological issues the article raises are not specific to research on mindfulness; (b) contemplative practices are varied, and the landscape of modern scientific research has evolved to focus almost exclusively on one or two types of practice to the exclusion of other forms of practice that are potentially highly impactful;

Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice.

Scientific research highlights the central role of specific psychological processes, in particular those related to the self, in various forms of human suffering and flourishing. This view is shared by Buddhism and other contemplative and humanistic traditions, which have developed meditation practices to regulate these processes. Building on a previous paper in this journal, we propose a novel classification system that categorizes specific styles of meditation into attentional, constructive, and deconstructive families based on their primary cognitive mechanisms. We suggest that meta-awareness, perspective taking and cognitive reappraisal, and self-inquiry may be important mechanisms in specific families of meditation and that alterations in these processes may be used to target states of experiential fusion, maladaptive self-schema, and cognitive reification.