Health Psychology Commons^™

A Mobile Game To Support Smoking Cessation: Prototype Assessment, Bethany Raiff

Faculty Scholarship for the College of Science & Mathematics

Background: Cigarette smoking results in an estimated seven million deaths annually. Almost half of all smokers attempt to quit each year, yet only approximately 6% are successful. Although there are multiple effective interventions that can increase these odds, substantial room remains for improvement. One effective approach to helping smokers quit is contingency management, where quitting is incentivized with the delivery of monetary rewards in exchange for objective evidence (e.g., exhaled carbon monoxide levels) of abstinence.

Objective: We assessed the feasibility and promise of Inspired, a contingency management mobile app for smoking cessation that uses game-based rewards to …

Dispositional Mindfulness Uncouples Physiological And Emotional Reactivity To A Laboratory Stressor And Emotional Reactivity To Executive Functioning Lapses In Daily Life, Greg Feldman, Jayne Lavalle, Kelsea Gildawie, Jeffrey M. Greeson

Faculty Scholarship for the College of Science & Mathematics

Both dispositional mindfulness and mindfulness training may help to uncouple the degree to which distress is experienced in response to aversive internal experience and external events. Because emotional reactivity is a transdiagnostic process implicated in numerous psychological disorders, dispositional mindfulness and mindfulness training could exert mental health benefits, in part, by buffering emotional reactivity. The present studies examine whether dispositional mindfulness moderates two understudied processes in stress reactivity research: the degree of concordance between subjective and physiological reactivity to a laboratory stressor (Study 1); and the degree of dysphoric mood reactivity to lapses in executive functioning in daily life (Study …

A Randomized Controlled Trial Of Koru: A Mindfulness Program For College Students And Other Emerging Adults., Jeffrey M Greeson, Michael K Juberg, Margaret Maytan, Kiera James, Holly Rogers

Faculty Scholarship for the College of Science & Mathematics

OBJECTIVE: To evaluate the effectiveness of Koru, a mindfulness training program for college students and other emerging adults.

PARTICIPANTS: Ninety students (66% female, 62% white, 71% graduate students) participated between Fall 2012 and Spring 2013.

METHODS: Randomized controlled trial. It was hypothesized that Koru, compared with a wait-list control group, would reduce perceived stress and sleep problems, and increase mindfulness, self-compassion, and gratitude.

RESULTS: As hypothesized, results showed significant Group (Koru, Wait-List)×Time (Pre, Post) interactions for improvements in perceived stress (F[1, 76.40]=4.50, p=.037, d=.45), sleep problems (F [1, 79.49]=4.71, p=.033, d=.52), mindfulness (F [1, 79.09]=26.80, p

CONCLUSIONS: Results support the …

Decreased Symptoms Of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects Of Religiosity, Spirituality, Trait Mindfulness, Sex, And Age, Jeffrey M. Greeson, Moria J. Smoski, Edward C. Suarez, Jeffrey G. Brantley, Andrew G. Ekblad, Thomas R. Lynch, Ruth Quillian Wolever

Faculty Scholarship for the College of Science & Mathematics

Objective: Mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant's spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness.

Methods: As part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program.

Results: As hypothesized, depressive …

Mindfulness And Rumination As Predictors Of Persistence With A Distress Tolerance Task., Greg Feldman, Emily Dunn, Carrie Stemke, Kelly Bell, Jeffrey M. Greeson

Faculty Scholarship for the College of Science & Mathematics

Distress tolerance (DT) is a proposed transdiagnostic factor in psychopathology, yet sources of individual differences in DT are largely unknown. The present study examined mindfulness and rumination facets as predictors of persistence on a standardized DT task (mirror tracing). Acting with awareness (a facet of mindfulness) and reflection (a potentially adaptive form of rumination) predicted increased DT. Increased task-induced skin conductance reactivity predicted decreased DT. These results held after controlling for task skill and subjective and heart rate reactivity. Together, these results suggest that teaching skills to promote mindful awareness and reflection hold promise as interventions to enhance DT.

Hair Cortisol As A Biomarker Of Stress In Mindfulness Training For Smokers., Simon B Goldberg, Alison R Manley, Stevens S Smith, Jeffrey M Greeson, Evan Russell, Stan Van Uum, Gideon Koren, James M Davis

Faculty Scholarship for the College of Science & Mathematics

OBJECTIVES: Stress is a well-known predictor of smoking relapse, and cortisol is a primary biomarker of stress. The current pilot study examined changes in levels of cortisol in hair within the context of two time-intensity matched behavioral smoking cessation treatments: mindfulness training for smokers and a cognitive-behavioral comparison group.

PARTICIPANTS: Eighteen participants were recruited from a larger randomized controlled trial of smoking cessation.

OUTCOME MEASURES: Hair samples (3 cm) were obtained 1 month after quit attempt, allowing for a retrospective analysis of hair cortisol at preintervention and post-quit attempt time periods. Self-reported negative affect was also assessed before and after …

Development And Preliminary Evaluation Of A Telephone-Based Mindfulness Training Intervention For Survivors Of Critical Illness, Christopher E. Cox, Laura S. Porter, Pamela J. Buck, Mary Hoffa, Derek Jones, Brenda Walton, Catherine L. Hough, Jeffrey M. Greeson

Faculty Scholarship for the College of Science & Mathematics

Rationale: Persistent symptoms of psychological distress represent an unmet need among intensive care unit (ICU) survivors.

Objectives: We aimed to develop and pilot test a simple telephone-based mindfulness training intervention to address this population’s unique needs.

Methods: Open trial involving survivors of medical and surgical critical illness and their informal caregivers, using a pretest–posttest design.

Measurements and Main Results: We developed a six-session, telephone-delivered, ICU survivor–specific mindfulness intervention based on past focus groups, the medical literature, and the precedent of the most effective components of existing mindfulness programs. A total of 11 survivors of mechanical ventilation were enrolled, together with …

Pilates, Mindfulness And Somatic Education, Karen Caldwell, Marianne Adams, Rebecca Quinn, Mandy Harrison, Jeffrey M. Greeson

Faculty Scholarship for the College of Science & Mathematics

The Pilates Method is a form of somatic education with the potential to cultivate mindfulness – a mental quality associated with overall well-being. However, controlled studies are needed to determine whether changes in mindfulness are specific to the Pilates Method or also result from other forms of exercise. This quasi-experimental study compared Pilates Method mat classes and recreational exercise classes on measures of mindfulness and well-being at the beginning, middle and end of a 15 week semester. Total mindfulness scores increased overall for the Pilates Method group but not for the exercise control group, and these increases were directly related …

Loss Of Sustained Activity In The Ventromedial Prefrontal Cortex In Response To Repeated Stress In Individuals With Early-Life Emotional Abuse: Implications For Depression Vulnerability, Lihong Wang, Natalie Paul, Steven J. Stanton, Jeffrey M. Greeson, Moria J. Smoski

Faculty Scholarship for the College of Science & Mathematics

Repeated psychosocial stress in early-life has significant impact on both behavior and neural function which, together, increase vulnerability to depression. However, neural mechanisms related to repeated stress remain unclear. We hypothesize that early-life stress may result in a reduced capacity for cognitive control in response to a repeated stressor, particularly in individuals who developed maladaptive emotional processing strategies, namely trait rumination. Individuals who encountered early-life stress but have adaptive emotional processing, namely trait mindfulness, may demonstrate an opposite pattern. Using a mental arithmetic task to induce mild stress and a mindful breathing task to induce a mindful state, we tested …

A Narrative Review Of Yoga And Mindfulness As Complementary Therapies For Addiction., Surbhi Khanna, Jeffrey M Greeson

Faculty Scholarship for the College of Science & Mathematics

This paper reviews the philosophical origins, current scientific evidence, and clinical promise of yoga and mindfulness as complementary therapies for addiction. Historically, there are eight elements of yoga that, together, comprise ethical principles and practices for living a meaningful, purposeful, moral and self-disciplined life. Traditional yoga practices, including postures and meditation, direct attention toward one's health, while acknowledging the spiritual aspects of one's nature. Mindfulness derives from ancient Buddhist philosophy, and mindfulness meditation practices, such as gentle Hatha yoga and mindful breathing, are increasingly integrated into secular health care settings. Current theoretical models suggest that the skills, insights, and self-awareness …

Psychological And Neural Mechanisms Of Trait Mindfulness In Reducing Depression Vulnerability, Natalie A. Paul, Steven J. Stanton, Jeffrey M. Greeson, Moria J. Smoski, Lihong Wang

Faculty Scholarship for the College of Science & Mathematics

Mindfulness-based interventions are effective for reducing depressive symptoms. However, the psychological and neural mechanisms are unclear. This study examined which facets of trait mindfulness offer protection against negative bias and rumination, which are key risk factors for depression. Nineteen male volunteers completed a 2-day functional magnetic resonance imaging study. One day utilized a stress-induction task and the other day utilized a mindful breathing task. An emotional inhibition task was used to measure neural and behavioral changes related to state negative bias, defined by poorer performance in inhibiting negative relative to neutral stimuli. Associations among trait mindfulness [measured by the Five …

Meditation-State Functional Connectivity (Msfc): Strengthening Of The Dorsal Attention Network And Beyond, Brett Froeliger, Eric L. Garland, Rachel V. Kozink, Leslie A. Modlin, Nan-Kuei Chen, F. Joseph Mcclernon, Jeffrey M. Greeson, Paul Sobin

Faculty Scholarship for the College of Science & Mathematics

Meditation practice alters intrinsic resting-state functional connectivity (rsFC) in the default mode network (DMN). However, little is known regarding the effects of meditation on other resting-state networks. The aim of current study was to investigate the effects of meditation experience and meditation-state functional connectivity (msFC) on multiple resting-state networks (RSNs). Meditation practitioners (MPs) performed two 5-minute scans, one during rest, one while meditating. A meditation naïve control group (CG) underwent one resting-state scan. Exploratory regression analyses of the relations between years of meditation practice and rsFC and msFC were conducted. During resting-state, MP as compared to CG exhibited greater rsFC …

Changes In Spirituality Partly Explain Health-Related Quality Of Life Outcomes After Mindfulness-Based Stress Reduction., Jeffrey M Greeson, Daniel M Webber, Moria J Smoski, Jeffrey G Brantley, Andrew G Ekblad, Edward C Suarez, Ruth Quillian Wolever

Faculty Scholarship for the College of Science & Mathematics

Mindfulness-Based Stress Reduction is a secular behavioral medicine program that has roots in meditative spiritual practices. Thus, spirituality may partly explain Mindfulness-Based Stress Reduction outcomes. Participants (N = 279; M (SD) age = 45(12); 75% women) completed an online survey before and after an 8-week Mindfulness-Based Stress Reduction program. Structural equation modeling was used to test the hypothesis that, following Mindfulness-Based Stress Reduction, the relationship between enhanced mindfulness and improved health-related quality of life is mediated by increased daily spiritual experiences. Changes in both spirituality and mindfulness were significantly related to improvement in mental health. Although the initial mediation hypothesis …

Mindfulness Predicts Less Texting While Driving Among Young Adults: Examining Attention- And Emotion-Regulation Motives As Potential Mediators., Greg Feldman, Jeffrey M. Greeson, Megan Renna, Kendra Robbins-Monteith

Faculty Scholarship for the College of Science & Mathematics

Many young adult drivers read and send text messages while driving despite clear safety risks. Understanding predictors of texting-while-driving may help to indentify relevant targets for interventions to reduce this dangerous behavior. The present study examined whether individual differences in mindfulness is associated with texting-while-driving in a sample of young-adult drivers. Using path analysis, we tested whether this relationship would be mediated by the degree to which individuals use text-messaging as a means of reducing unpleasant emotions (emotion-regulation motives) and the degree to which individuals limit texting in order to focus on present-moment experiences (attention-regulation motives). Individuals lower in mindfulness …

Changes In Mindfulness, Well-Being, And Sleep Quality In College Students Through Taijiquan Courses: A Cohort Control Study, Karen Caldwell, Lisa Emery, Mandy Harrison, Jeffrey M. Greeson

Faculty Scholarship for the College of Science & Mathematics

Objectives: This study sought to determine whether participants in taijiquan classes would report increases in mindfulness greater than that of a comparison group, and whether changes in mindfulness were associated with improvements in mood, perceived stress, self-regulatory self-efficacy, and sleep quality.

Design: The study design was quasi-experimental with repeated measures.

Settings/location: The study was set in a midsized public university.

Subjects: Students aged 18–48 years old enrolled in 15-week courses of either taijiquan (n = 76) or special recreation (control group, n = 132).

Intervention: Chen-style taijiquan classes were offered 2 times per week for 50 minutes each time.

Outcome …

Modifiable Disease Risk, Readiness To Change, And Psychosocial Functioning Improve With Integrative Medicine Immersion Model, Ruth Q. Wolever, Daniel M. Webber, Justin P. Meunier, Jeffrey M. Greeson, Evangeline R. Lausier, Tracy W. Gaudet

Faculty Scholarship for the College of Science & Mathematics

Background—Stroke, diabetes, and coronary heart disease (CHD) remain leading causes of death in the United States and are largely attributable to lifestyle behaviors. Integrative medicine can provide a supportive partnership that focuses on improving health by identifying and implementing lifestyle changes based upon personal values and goals.

Objective—This prospective observational study was designed to assess the effectiveness of an integrative medicine intervention on modifiable disease risk, patient activation, and psychosocial risk factors for stroke, diabetes, and CHD.

Design—Sixty-three adults participated in a 3-day comprehensive, multimodal health immersion program at Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina. Participants …

Differential Effects Of Mindful Breathing, Progressive Muscle Relaxation, And Loving-Kindness Meditation On Decentering And Negative Reactions To Repetitive Thoughts., Greg Feldman, Jeffrey M. Greeson, Joanna Senville

Faculty Scholarship for the College of Science & Mathematics

Decentering has been proposed as a potential mechanism of mindfulness-based interventions but has received limited empirical examination to date in experimental studies comparing mindfulness meditation to active comparison conditions. In the present study, we compared the immediate effects of mindful breathing (MB) to two alternative stress-management techniques: progressive muscle relaxation (PMR) and loving-kindness meditation (LKM) to test whether decentering is unique to mindfulness meditation or common across approaches. Novice meditators (190 female undergraduates) were randomly assigned to complete one of three 15-min stress-management exercises (MB, PMR, or LKM) presented by audio recording. Immediately after the exercise, participants completed measures of …

Developing Mindfulness In College Students Through Movement Based Courses: Effects On Self-Regulatory Self-Efficacy, Mood, Stress, And Sleep Quality, Karen Caldwell, Mandy Harrison, Marianne Adams, Rebecca H. Quin, Jeffrey M. Greeson

Faculty Scholarship for the College of Science & Mathematics

Objective—This study examined whether mindfulness increased through participation in movement based courses and whether changes in self-regulatory self-efficacy, mood, and perceived stress mediated the relationship between increased mindfulness and better sleep.

Participants—166 college students enrolled in the 2007-2008 academic year in 15 week classes in Pilates, Taiji quan, or GYROKINESIS®.

Methods—At beginning, middle, and end of the semester, participants completed measures of mindfulness, self-regulatory self-efficacy, mood, perceived stress and sleep quality.

Results—Total mindfulness scores and mindfulness subscales increased overall. Greater changes in mindfulness were directly related to better sleep quality at the end of the semester after adjusting for sleep …

Stress-Induced Changes In The Expression Of Monocytic Β2-Integrins: The Impact Of Arousal Of Negative Affect And Adrenergic Responses To The Anger Recall Interview, Jeffrey M. Greeson, James G. Lewis, Karen Achanzar, Eugene Zimmerman, Kenneth H. Young, Edward C. Suarez

Faculty Scholarship for the College of Science & Mathematics

Adhesion of circulating monocytes to the vascular endothelium is one of the earliest steps in the development of atherosclerosis. This leukocyte-to-endothelium interaction is mediated in part by β2-integrins, a group of cell adhesion molecules that bind to endothelial ligands. Given the significance of this interaction to atherogenesis, we examined the effects of stress, operationalized as the arousal of negative affect (NA) and cardiovascular and catecholamine responses to the Anger Recall Interview (ARI), on the expression of LFA-1 (CD11a), Mac-1 (CD11b) and p150/95 (CD11c) on circulating monocytes (CD14+). Subjects were 173 healthy, nonsmoking men and women (60% men, 40% minorities, aged …

Mindfulness Research Update: 2008., Jeffrey M Greeson

Faculty Scholarship for the College of Science & Mathematics

OBJECTIVE: To briefly review the effects of mindfulness on the mind, the brain, the body, and behavior. METHODS: Selective review of MEDLINE, PsycINFO, and Google Scholar databases (2003-2008) using the terms "mindfulness", "meditation", "mental health", "physical health", "quality of life", and "stress reduction." A total of 52 exemplars of empirical and theoretical work were selected for review. RESULTS: Both basic and clinical research indicate that cultivating a more mindful way of being is associated with less emotional distress, more positive states of mind, and better quality of life. In addition, mindfulness practice can influence the brain, the autonomic nervous system, …

Integrative Medicine Research At An Academic Medical Center: Patient Characteristics And Health-Related Quality-Of-Life Outcomes., Jeffrey M Greeson, Steven Rosenzweig, Steven C Halbert, Ira S Cantor, Matthew T Keener, George C Brainard

Faculty Scholarship for the College of Science & Mathematics

OBJECTIVE: To characterize patients seeking care at a university-based integrative medicine practice, and to assess short-term changes in health-related quality of life (HRQoL) associated with integrative medical treatment.

DESIGN: Prospective, observational study.

SETTING: This study was conducted at a large U.S. academic medical center affiliated with the Consortium of Academic Health Centers for Integrative Medicine.

PARTICIPANTS: Seven hundred and sixty-three (763) new patients with diverse medical conditions participated in the study. Mean age was 49 years (standard deviation = 16, range = 14-93). Two thirds of patients were women and three quarters were white. The most common International Classification of …