Mindfulness‐based cognitive therapy for residual depressive symptoms

Objectives. Mindfulness‐based cognitive therapy (MBCT) is a new group‐based intervention for prevention of relapse in recurrent depression which has not been scientifically evaluated regarding its clinical effectiveness for ameliorating residual depressive symptoms following a depressive episode. The aim of this study was to assess the efficacy of MBCT in reducing residual depressive symptoms in psychiatric outpatients with recurrent depression, and to particularly explore the effects of mindfulness techniques on rumination. Design. The design of this study was a mixed model complex design. Design 1 consisted of a consecutive series of patients. They were assigned to either MBCT or TAU. The independent variables were time and group allocation, and dependent variables were Beck Depression Inventory (BDI) and Rumination Scale. In Design 2, the TAU group proceeded to complete an MBCT group, and the BDI and Rumination Scale results of the two groups were collapsed. Method. Nineteen patients with residual depressive symptoms following a depressive episode, and who were attending outpatient clinic, were assigned to either MBCT or treatment as usual (TAU), with the TAU group then proceeding to complete an MBCT group. Depressive and ruminative symptoms were assessed before, during, and after treatment, and at one‐month follow‐up. Results. A significant reduction in depressive symptoms was found at the end of MBCT, with a further reduction at one‐month follow‐up. A trend towards a reduction in rumination scores was also observed. Conclusions. Group MBCT has a marked effect on residual depressive symptoms, which may be mediated through the mindfulness‐based cognitive approach towards excessive negative ruminations in patients with residual depressive symptoms following a depressive episode.     

Collaboration in Mindfulness‐Based Cognitive Therapy

In this article, we describe the nature of therapeutic collaboration between psychotherapist and group participants in mindfulness‐based cognitive therapy (MBCT), which occurs in a group format and incorporates cognitive therapy and mindfulness practices with the aim of preventing depression relapse. Collaboration is a central part of two components of MBCT: inquiry and leading mindfulness practices. During the process of inquiry, the therapist‐initiated questions about the participant's moment‐to‐moment experience of the practice occurs in a context of curious, open, and warm attitudes. In addition, collaboration is maintained through co‐participation in mindfulness practices. We provide a case illustration of collaboration in these contexts and conclude with recommendations for clinical practice.     

Mindfulness‐of‐breathing exercise modulates EEG alpha activity during cognitive performance

The present study investigated whether engaging in a mindful breathing exercise would affect EEG oscillatory activity associated with self‐monitoring processes, based on the notion that mindfulness enhances attentional awareness. Participants were assigned to either an audio exercise in mindful breathing or an audio control condition, and then completed a Stroop task while EEG was recorded. The primary EEG measure of interest was error‐related alpha suppression (ERAS), an index of self‐monitoring in which alpha power is reduced, suggesting mental engagement, following errors compared to correct responses. Participants in the mindful‐breathing condition showed increased alpha power during the listening exercise and enhanced ERAS during the subsequent Stroop task. These results indicate enhanced error‐monitoring among those in the mindful‐breathing group.     

Selection history alters attentional filter settings persistently and beyond top‐down control

Visual selective attention is known to be guided by stimulus‐based (bottom‐up) and goal‐oriented (top‐down) control mechanisms. Recent work has pointed out that selection history (i.e., the bias to prioritize items that have been previously attended) can result in a learning experience that also has a substantial impact on subsequent attention guidance. The present study examined to what extent goal‐oriented top‐down control mechanisms interact with an observer's individual selection history in guiding attention. Selection history was manipulated in a categorization task in a between‐subjects design, where participants learned that either color or shape was the response‐relevant dimension. The impact of this experience was assessed in a compound visual search task with an additional color distractor. Top‐down preparation for each search trial was enabled by a pretrial task cue (Experiment 1) or a fixed, predictable trial sequence (Experiment 2). Reaction times and ERPs served as indicators of attention deployment. Results showed that attention was captured by the color distractor when participants had learned that color predicted the correct response in the categorization learning task, suggesting that a bias for predictive stimulus features had developed. The possibility to prepare for the search task reduced the bias, but could not entirely overrule this selection history effect. In Experiment 3, both tasks were performed in separate sessions, and the bias still persisted. These results indicate that selection history considerably shapes selective attention and continues to do so persistently even when the task allowed for high top‐down control.     

The N2cc component as an electrophysiological marker of space‐based and feature‐based attentional target selection processes in touch

An electrophysiological correlate of attentional target selection processes in touch (N2cc component) has recently been discovered in lateralized tactile working memory experiments. This tactile N2cc emerges at the same time as the visual N2pc component but has a different modality‐specific topography over central somatosensory areas. Here, we investigated links between N2cc components and the space‐based versus feature‐based attentional selection of task‐relevant tactile stimuli. On each trial, a pair of tactile items was presented simultaneously to one finger on the left and right hand. Target stimuli were defined by their location (e.g., left index finger; Spatial Attention Task), by a nonspatial feature (continuous vs. pulsed; Feature‐Based Attention Task), or by a combination of spatial and nonspatial features (Conjunction Task). Reliable N2cc components were observed in all three tasks. They emerged considerably earlier in the Spatial Attention Task than in the Feature‐Based Attention Task, suggesting that space‐based selection mechanisms in touch operate faster than feature‐guided mechanisms. The temporal pattern of N2cc components observed in the Conjunction Task revealed that space‐based and feature‐based attention both contributed to target selection, which was initially driven primarily by spatial location. Overall, these findings establish the N2cc component as a new electrophysiological marker of the selective attentional processing of task‐relevant stimuli in touch.     

Acute psychological stress promotes general alertness and attentional control processes: An ERP study

The current study investigated the influence of acute psychological stress on selective attention processes. After an acute stressor or a control condition, 20 participants performed an arrow-based version of the Eriksen flanker task, while ERPs (N1, N2, P3), reaction times, accuracy, subjective stress, and electrocardiogram signal were measured. Results showed elevated self-report stress, negative affect, state anxiety, heart rate, and reduced high-frequency heart rate variability in the stress block than in the control block, indicating that the flanker task was performed in a stressful situation. In the flanker task, faster response and larger flanker effect of accuracy were observed for the stress block relative to the control block, indicating increased arousal level and improved conflict detection under stress. Event-related potentials locked to target stimuli in the flanker task revealed that (a) frontal N1 was amplified in the stress block than in the control block, indicating elevated vigilance level under stress; (b) frontal N2 was increased in the stress block than in the control block for both congruent and incongruent trials, indicating more intensive attention control under stress; and (c) Increased P3 in the stress block than in the control block may reflect more allocation of neural resources as a consequence of improved attentional control under stress. These findings suggest that acute psychological stress increases general alertness and promotes attentional control in selective attention processes.     

Salient‐but‐irrelevant stimuli cause attentional capture in difficult,but attentional suppression in easy visual search

Search for a shape target is difficult when its shape is similar to the shape of the surrounding nontargets and easy when it is dissimilar. We asked whether interference from a salient but irrelevant color singleton depended on search difficulty as manipulated by target‐nontarget similarity. We found that interference was strong in difficult searches, and the occurrence of an electrophysiological index of attentional selectivity (the N2pc component) confirmed that attention was captured by the distractor. In contrast, interference from the distractor was weak with easy searches, and the occurrence of the P_D component confirmed that saliency signals from the distractor were suppressed. The results suggest that attentional suppression of salient but irrelevant distractors is only possible when search is efficient (i.e., with low target‐nontarget similarity), otherwise, attentional capture occurs. Further, we analyzed the Ppc component, a positivity occurring between 100 and 200 ms after stimulus onset contralateral to a salient feature discontinuity. It has been suggested that the Ppc reflects bottom‐up saliency signals, but we found the Ppc to occur only when the salient stimulus was unlikely to be selected, as in efficient searches. Thus, attentional requirements modulate the Ppc component.     

Psychological Treatments for Provoked Vestibulodynia: Integration of Mindfulness‐Based and Cognitive Behavioral Therapies

Provoked vestibulodynia (PVD) is a chronic and distressing genital pain condition involving sharp pain to the vulvar vestibule with lifetime prevalence as high as 12%. PVD is the most prevalent cause of pain during sexual intercourse (dyspareunia) in premenopausal women, and gives rise to considerable sexual and relational concerns. As intercourse for women with PVD is either painful or impossible, PVD has pronounced negative effects on women's romantic relationship adjustment and sexual intimacy, as well as their emotional well‐being and sense of sexual self‐efficacy. Given the low efficacy and high side‐effect profile of medications for the treatment of PVD, attention has shifted toward psychological interventions over the past decade. Psychological treatments for PVD have the advantage of targeting both the experience of pain and its many psychosexual consequences, such as reduced desire and arousal. Cognitive behavioral therapy (CBT) currently represents one of the most popular first‐line psychological interventions for PVD. Mindfulness has been increasingly used alongside, or instead of CBT for a variety of health‐related conditions, particularly with respect to chronic pain disorders and more recently in women with PVD. This review provides a detailed overview of CBT and mindfulness‐based approaches in treating PVD.     

The human pulvinar and stimulus-driven attentional control

The present study compared the behavioral effects of sudden motion onsets or color changes (i.e., featural changes) with the effects of new objects (i.e., multiple changes). Experiments 1 and 2 showed that lesions of the pulvinar affect stimulus-driven attentional control only when it is triggered by featural changes, but not by new objects. Experiment 3 revealed that when appended on a new object, a featural change is processed as a part of a more massive new object: Its attentional effects are larger and remain undisturbed by lesions of the pulvinar. In Experiment 4 a temporal superiority effect was found for featural changes, but not for new objects in healthy subjects. These results suggest that featural changes and new objects may be processed through different pathways and that the pulvinar may be particularly involved in stimulus-driven attentional control by sudden events entailing featural changes.