Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].
<b><i>Introduction:</i></b> Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. <b><i>Objective:</i></b> To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. <b><i>Methods:</i></b> SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up). <b><i>Results:</i></b> One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, <i>n</i> = 73; HSMP, <i>n</i> = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: –1.25 points; 95% CI –4.76 to 2.25) or at follow-up (adjusted change difference: –0.43 points; 95% CI –2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: –3.43 points; 95% CI –5.27 to –1.59; HSMP: –2.29 points; 95% CI –4.14 to –0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms. <b><i>Conclusions:</i></b> A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. <b><i>ClinicalTrials.gov identifier:</i></b> NCT03005652.
Visuo-spatial context and emotional valence are powerful cues to episodic retrieval, but the contribution of these inputs to semantic cognition has not been widely investigated. We examined the impact of visuo-spatial, facial emotion and prosody cues and miscues on the retrieval of dominant and subordinate meanings of ambiguous words. Cue photographs provided relevant visuo-spatial or emotional information, consistent with the interpretation of the ambiguous word being probed, while miscues were consistent with an alternative interpretation. We compared the impact of these cues in healthy controls and semantic aphasia patients with deficient control over semantic retrieval following left-hemisphere stroke. Patients showed greater deficits in retrieving the subordinate meanings of ambiguous words, and stronger effects of cueing and miscuing relative to healthy controls. These findings suggest that contextual cues that guide retrieval to the appropriate semantic information reduce the need to constrain semantic retrieval internally, while miscues that are not aligned with the task increase the need for semantic control. Moreover, both valence and visuo-spatial context can prime particular semantic interpretations, in line with theoretical frameworks that argue meaning is computed through the integration of these features. In semantic aphasia, residual comprehension relies heavily on facial expressions and visuospatial cues. This has important implications for patients, their families and clinicians when developing new or more effective modes of communication.
The primary aim of this study was to investigate the relationship between meditation experience and repetitive negative thinking (RNT) in regular meditators with a wide range of experience, and to examine the extent to which self-compassion and mindfulness mediate this relationship. RNT is a transdiagnostic process that is implicated in the development and maintenance of several mental health disorders. Converging evidence suggests that meditation practice is associated with improved mental health and may reduce levels of RNT. Increased levels of self-compassion and mindfulness have been associated with decreased levels of RNT and proposed as theoretically consistent mediators by which meditation practice exerts its beneficial effects; however, they are seldom considered in combination. In a cross-sectional design, 1281 meditators (mean age = 44.7 years, SD = 13.9, 53.7% female) completed questionnaires about meditation experience, RNT, self-compassion, and mindfulness. Linear regression and generalised structural equation models were used to examine the data. Longer duration of meditation experience was associated with lower levels of RNT and higher levels of self-compassion and mindfulness. Meditation experience was associated with RNT indirectly through self-compassion, but not through mindfulness. The results offer preliminary support for longer-term meditation as a potential means for reducing the maladaptive process of RNT. Clinically, self-compassion could be identified as a promising treatment target for interventions.
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