Mechanisms of Mindfulness-based Interventions

The state of mindfulness can be described as a form of meta-awareness in which attention is
allocated to the present moment of external and internal sensory or mental experience,
without reactivity, and without dwelling on any particular sensory or mental object with
judgement or evaluation. Mindfulness-based Interventions (MBIs) are a family of standardized
cognitive and behavioral therapies that focus on cultivating mindfulness-related skills for
improving maladaptive cognitive, emotional, and behavioral processes.

MBIs have been developed for a wide range of problems, disorders, and populations and are
increasingly available in a variety of health settings. Empirically supported MBIs include
acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999), dialectical
behavior therapy (DBT; Linehan, 1993), mindfulness-based cognitive therapy (MBCT; Segal,
Williams, & Teasdale, 2002), and mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982,
1990). Variations on these approaches, including integration of mindfulness training into
individual psychotherapy from diverse perspectives, also have been described (Germer, Siegel,
& Fulton, 2005). As the empirical evidence for the efficacy of these interventions continues
to grow, the importance of investigating the mechanisms or processes by which they lead to
beneficial outcomes is increasingly recognized. This mixed methods study proposes to
investigate proposed neurobiological, physiological, psycho-social-behavioral, and cognitive
mechanisms by which MBIs may improve health outcomes. Target (mechanism) engagement is
expected to facilitate identification of individuals who are most likely to benefit (or not)
from MBIs and further develop targeted interventions for optimization of delivery. Although
there are very specific aims and hypotheses to be tested, this preliminary exploratory
investigation will provide feasibility data and allow for refining existing hypotheses for
larger research proposals to be submitted for extramural grant support.

Across all ARMS:

- At prescreen, must be currently registered for MBCT or MBSR; at posttest, must have
attended five of eight sessions for "completion".

- Must possess English language skills sufficient for providing informed consent,
completing questionnaires, and understanding instructions

- Age range: 18-55

- Right-handed

- If currently taking maintenance anti-depressant and/or anti-anxiety medication, must
have a "stable" regimen as indexed by no medication or dosage changes within the past
three months

- No prior diagnosis of bipolar I, bipolar II, psychotic personality disorder,
borderline personality disorder, and/or narcissistic personality disorder

- No current history (< 6 months) of substance abuse/dependence

- No current history (< 6 months) of regular meditation practice (>1 session/week; >10
min/session)

- No history of medical illness associated with possible changes in cerebral tissue or
cerebrovasculature or with neurologic abnormality (e.g., seizure disorder,
cerebrovascular or neoplastic lesion, neurodegenerative disorder, or significant head
trauma, defined by loss of consciousness of ≥ 5 minutes)

- No current suicidal ideation

Eligibility for Depression Cohort:

- Reports having been diagnosed with non-psychotic unipolar major depressive disorder
(MDD)

- ≥3 previous episodes of MDD

- Beck Depression Inventory-II (BDI-II) score between 14 and 28 (an indicator of
depressive symptoms of mild to moderate severity)

- No fMRI contraindications: pregnancy, claustrophobia, or presence of a ferromagnetic
object, including orthodontic braces

Eligibility for Anxiety Cohort:

- Reports having been diagnosed with an anxiety disorder (i.e., generalized anxiety
disorder, panic disorder, specific phobia)

- Score of ≥40 on the Trait subscale of the Spielberger State-Trait Anxiety Inventory
(an indicator of anxious symptoms of moderate to high severity)

Eligibility for High Stress Cohort:

- Reports of High Stress as measured by perceived Stress Scale

Eligibility for Drawing Blood:

- At least 110 pounds

- Not pregnant

- Generally healthy by self-report (i.e., free of cold and flu symptoms on the day of
collection, no infections within two weeks prior to collection, no symptoms of a heart
condition within six months prior to collection, no known sickle cell disease)

- Including the study draw, blood donation for clinical or research purposes within the
preceding eight weeks will not exceed 550 mL

- No more than one blood draw will have occurred during the preceding week