Mechanisms of Mindfulness and Stress Resilience: A Mobile App Mindfulness Training Study

Mindfulness meditation practices are widely used among the general public, with people
seeking to reduce stress, pain, inflammation, depression, and disease symptoms. Moreover,
randomized controlled trials have shown mindfulness training programs to be effective in
improving a broad range of psychological and physical health outcomes, particularly among
populations with high stress burdens. Still, little is known about the mechanisms underlying
mindfulness training that drive these effects. This study tests the active components of
mindfulness that impact stress responding and health biomarkers.

The study separates attention and acceptance mindfulness instructions into three 14-day
training programs delivered to a stressed adult population: (1) attention and acceptance
instructions, (2) attentional monitoring instructions only, or (3) analytic thinking with no
mindfulness instruction. Intervention programs are delivered on participants' own
smartphones, providing a platform for maximal experimental control in testing the active
ingredients of mindfulness training.

Participants are recruited from the Pittsburgh community. At a baseline laboratory session,
they complete psychosocial questionnaires and tasks and provide a dried blood spot sample.
On their own, they complete pre- and post-intervention Ecological Momentary Assessment
measures of stress, attention, and acceptance in daily life. Between these assessments,
participants have 14 days to complete their randomly assigned 14-lesson intervention
program. Participants return to the lab for post-intervention assessments (questionnaires,
tasks, dried blood sample), listen to a final training session from their intervention
program, and complete the Trier Social Stress Test. Participants are compensated.

Inclusion Criteria:

- English speaking

- Moderate- to high-stress (4-item Perceived Stress Scale score of 6 or higher)

Exclusion Criteria:

- Diagnosis of chronic mental (e.g., recurrent depression, schizophrenia, personality
disorder) or physical disease (e.g., cancer, HIV, heart disease, diabetes, bleeding
disorder)

- Hospitalization in past 3 months

- Medication use that interferes with HPA-axis activity (e.g., corticosteroids)

- Current oral contraceptive use

- Current antibiotic, antiviral, or antimicrobial treatment

- Travel outside the country within the past 6 months to any country on the CDC travel
alert list

- Recreational drug use, excessive alcohol or tobacco use

- Significant experience with or daily practice of mindfulness meditation or related
mind-body practice