Peak experiences during insight mindfulness meditation retreats and their salutary and adverse impact: A prospective matched-controlled intervention study.

OBJECTIVE: We sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary or intense subjective experiences during meditation-based interventions. To do so, we empirically characterized such peak experiences during an intensive meditation intervention and their impact postintervention. METHOD: We conducted a preregistered prospective intervention study among 96 adults who registered for 6-day insight (Vipassana) mindfulness meditation retreats and 47 matched controls. Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and systematically matched to retreat participants on age and lifetime meditation experience. Measures included the novel Peak Meditative Experience Scale and the Impact of PMES. RESULTS: Seventeen peak experiences that were primarily pleasant (e.g., deep and unusual peace, aha! Moment) occurred more frequently among retreat participants than among matched controls in daily living (ps < .05; mean ϕ = .33). In contrast, 14 peak experiences that were mostly unpleasant (e.g., flashbacks, overwhelming sadness) occurred at similar rates in both groups (ps > .05). At 2-week follow-up, the perceived impact of all pleasant and most unpleasant peak experiences was more salutary than adverse (ps ≤ .015; M Cohen's d = 1.61). CONCLUSIONS: Peak experiences that resulted from meditation retreats were primarily pleasant and had a large salutary impact postretreat. Inconsistent with conclusions from uncontrolled retrospective studies, findings document that intensive insight mindfulness meditation training in retreats may not contribute to unpleasant peak experiences and even when they occurred their impact was typically more salutary than adverse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Looking inside the black box of mindfulness meditation: Investigating attention and awareness during meditation using the mindful awareness task (MAT).

Training attention and awareness in mindfulness meditation is theorized to be essential for the cultivation of mindfulness and its salutary outcomes. Yet, the empirical foundation for this central premise in mindfulness science is surprisingly small due to a limited methodological capacity to measure attention and awareness during mindfulness meditation. Accordingly, we set out to measure and study these processes in a laboratory study (N = 143, 76.92% female) using a novel behavioral measurement paradigm-the mindful awareness task (MAT). We empirically characterized attention and awareness during mindfulness meditation and found novel behavioral evidence indicating that, as long-theorized, these processes were related to previous mindfulness meditation practice, attitudinal qualities of mindfulness, attention regulation, and mental health. Furthermore, we found that the accuracy of self-reported mindfulness was, paradoxically, dependent on behavioral capacities for mindful awareness; and that sustained visual attention and executive functions, measured via cognitive-experimental tasks, were not meaningfully related to attention and awareness during mindfulness meditation. In contrast, the MAT demonstrated sound psychometric performance as a measure of mindful awareness, and may overcome significant limitations of extant mindfulness measurement methods. Collectively, findings challenge conceptual and methodological assumptions in mindfulness science, provide a novel paradigmatic direction for research on mindfulness, and present long-awaited evidence that attention and awareness during mindfulness meditation may indeed be fundamental to its practice, cultivation, and salutary functions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effect of mindfulness-based trauma recovery for refugees on shame and guilt in trauma recovery among African asylum-seekers.

We sought to, first, better understand the role of emotional responding, and specifically shame and guilt, in trauma recovery among asylum-seekers following forced displacement; and, second, to explore whether therapeutic effects of a mindfulness- and compassion-based intervention on trauma recovery among asylum-seekers are mediated by therapeutic effects of the intervention on shame and guilt. Study aims were tested through a randomized waitlist-controlled trial of a 9-week Mindfulness-Based Trauma Recovery for Refugees program among a community sample of 158 Eritrean asylum-seekers (55.7% female) residing in an unstable high-risk urban postdisplacement setting in the Middle East (Israel). First, in a cross-product test of parallel mediation, we found that shame, but not guilt, mediated the preintervention associations between traumatic stress exposure history, as well as current postmigration living difficulties, and current posttraumatic stress (abShame = .035, 95% CI [.024, .048], abShame = .183, 95% CI [.122, .249]) and depression (abShame = .384, 95% CI [.234, .55], abShame = .405, 95% CI [1.117, 2.693]) symptom severity. Second, in a linear mixed effects model of mediation, we found that reduced shame from pre- to postintervention, mediated the effect of MBTR-R, relative to waitlist control, on improved posttraumatic stress (ACMEShame = -.18, BCa 95% CI [-.34, -.04]) and depression (ACMEShame = -1.78, BCa 95% CI [-3.29, -.29]) symptom severity outcomes. Findings provide insight into the potential role of shame in trauma- and stress-related recovery among FDPs (forcibly displaced people). Findings indicate that mindfulness- and compassion-based training promotes trauma recovery, in part, through reducing feelings of shame postdisplacement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Candidate mechanisms of action of mindfulness-based trauma recovery for refugees (MBTR-R): Self-compassion and self-criticism.

OBJECTIVE: Mindfulness- and compassion-based interventions may represent a promising intervention approach to the global mental health crisis of forced displacement. Specifically, Mindfulness-Based Trauma Recovery for Refugees (MBTR-R)-a mindfulness- and compassion-based, trauma-sensitive, and socioculturally adapted intervention for refugees and asylum-seekers-has recently demonstrated randomized control evidence of therapeutic efficacy and safety. Yet, little is known about potential mechanisms underlying these therapeutic effects for trauma recovery and for refugees and asylum-seekers. METHOD: Thus, we examined adaptive and maladaptive forms of self-referentiality, namely self-compassion and self-criticism, as mechanisms of action for trauma recovery in a randomized wait-list control trial of MBTR-R among a community sample of 158 traumatized and chronically stressed asylum-seekers (46% female) in an urban postdisplacement setting (Middle East). Self-compassion and self-criticism were measured vis-à-vis an experimental Self-Referential Encoding Task (SRET) designed to quantify cognitive processes underlying self-compassion and self-criticism using diffusion modeling, a computational modeling approach to quantify cognitive processes underlying decision-making from behavioral reaction time data. RESULTS: Findings indicate that self-compassion and self-criticism were associated with trauma- and stress-related psychopathology at preintervention. Relative to wait-list controls, MBTR-R led to significant elevation in self-compassion, and reduction in self-criticism, from pre to postintervention. Finally, pre to postintervention change in self-criticism significantly mediated therapeutic effects of MBTR-R on depression and posttraumatic stress disorder (PTSD) outcomes, while pre to postintervention change in self-compassion only mediated therapeutic effects on PTSD outcomes. CONCLUSIONS: Findings speak to the importance of (mal)adaptive self-referentiality as a target mechanism in MBIs and trauma recovery broadly, and among refugees and asylum-seekers specifically. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Metacognitive Processes of Decentering Scale: Development and initial validation of trait and state versions.

The ability to decenter from internal experiences is important for mental health. Consequently, improving decentering is a common therapeutic target, particularly for mindfulness-based interventions. However, extant decentering measures are limited as they fail to directly assess all 3 metacognitive processes recently theorized to subserve decentering. We thus conducted 4 studies to develop and test the Metacognitive Processes of Decentering-Trait (MPoD-t) and State (MPoD-s) scales. Consistent with the metacognitive processes model, exploratory factor analysis (N = 355) and then bifactor exploratory structural equation modeling (N = 275) indicated the MPoD-t was composed of three independent yet interrelated lower-order factors, metaawareness, (dis)identification with internal experience, and (non)reactivity to internal experience, which subserved an emergent, higher-order, decentering factor. We next found evidence of the MPoD-t's convergent validity; as well as known-groups criterion validity, wherein mindfulness practitioners reported higher MPoD-t scores than nonpractitioners. Item response theory analyses were then used to identify a subset of 3 MPoD-t items for the MPoD-s. Finally, we found evidence that the MPoD-s was sensitive to changes in state decentering following a brief mindfulness induction relative to an active control condition; and that MPoD-s changes mediated the effect of mindfulness on levels of pain and related outcomes among a sample of preoperative surgery patients (N = 82). These studies indicate the trait and state versions of the MPoD may prove useful for the study of decentering and its constituent metacognitive processes. As such, the MPoD may help advance our understanding of how the metacognitive processes of decentering support mental health and well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Behavioral assessment of mindfulness: defining features, organizing framework, and review of emerging methods.

The development and implementation of psychometrically sound behavioral measures of mindfulness are important to advancing the science of mindfulness. To help organize, conceptualize, and guide the development of behavioral measures of mindfulness, we propose defining features, and a four-domain framework, of the behavioral assessment of mindfulness. The framework domains include measurement of (I) objects of mindful awareness, (II) time-course of mindful awareness, (III) sensitivity of mindful awareness, and (IV) attitudes toward present moment experience. We describe mindfulness processes in each domain, and review extant behavioral method(s) and specific behavioral measure(s) of mindfulness processes per domain. Four of the 12 reviewed measures demonstrate acceptable reliabilities and preliminary evidence of construct validity as measures of mindfulness processes.

Metacognitive processes model of decentering: emerging methods and insights.

We previously proposed that three metacognitive processes - meta-awareness, disidentification from internal experience, and reduced reactivity to thought content - together constitute decentering. We review emerging methods to study these metacognitive processes and the novel insights they provide regarding the nature and salutary function(s) of decentering. Specifically, we review novel psychometric studies of self-report scales of decentering, as well as studies using intensive experience sampling, novel behavioral assessments, and experimental micro-interventions designed to target the metacognitive processes. Findings support the theorized inter-relations of the metacognitive processes, help to elucidate the pathways through which they may contribute to mental health, and provide preliminary evidence of their salutary roles as mechanisms of action in mindfulness-based interventions.

Experiential self-referential and selfless processing in mindfulness and mental health: Conceptual model and implicit measurement methodology.

We propose that Experiential Self-Referential Processing (ESRP)-the cognitive association of present moment subjective experience (e.g., sensations, emotions, thoughts) with the self-underlies various forms of maladaptation. We theorize that mindfulness contributes to mental health by engendering Experiential Selfless Processing (ESLP)-processing present moment subjective experience without self-referentiality. To help advance understanding of these processes we aimed to develop an implicit, behavioral measure of ESRP and ESLP of fear, to experimentally validate this measure, and to test the relations between ESRP and ESLP of fear, mindfulness, and key psychobehavioral processes underlying (mal)adaptation. One hundred 38 adults were randomized to 1 of 3 conditions: control, meta-awareness with identification, or meta-awareness with disidentification. We then measured ESRP and ESLP of fear by experimentally eliciting a subjective experience of fear, while concurrently measuring participants' cognitive association between her/himself and fear by means of a Single Category Implicit Association Test; we refer to this measurement as the Single Experience & Self Implicit Association Test (SES-IAT). We found preliminary experimental and correlational evidence suggesting the fear SES-IAT measures ESLP of fear and 2 forms of ESRP- identification with fear and negative self-referential evaluation of fear. Furthermore, we found evidence that ESRP and ESLP are associated with meta-awareness (a core process of mindfulness), as well as key psychobehavioral processes underlying (mal)adaptation. These findings indicate that the cognitive association of self with experience (i.e., ESRP) may be an important substrate of the sense of self, and an important determinant of mental health. (PsycINFO Database Record

Decentering and Related Constructs: A Critical Review and Metacognitive Processes Model.

The capacity to shift experiential perspective-from within one's subjective experience onto that experience-is fundamental to being human. Scholars have long theorized that this metacognitive capacity-which we refer to as decentering-may play an important role in mental health. To help illuminate this mental phenomenon and its links to mental health, we critically examine decentering-related constructs and their respective literatures (e.g., self-distanced perspective, cognitive distancing, cognitive defusion). First, we introduce a novel metacognitive processes model of decentering. Specifically, we propose that, to varying degrees, decentering-related constructs reflect a common mental phenomenon subserved by three interrelated metacognitive processes: meta-awareness, disidentification from internal experience, and reduced reactivity to thought content. Second, we examine extant research linking decentering-related constructs and their underlying metacognitive processes to mental health. We conclude by proposing future directions for research that transcends decentering-related constructs in an effort to advance the field's understanding of this facet of human experience and its role in (mal)adaptation.