Cultivating mindfulness: effects on well-being

There has been great interest in determining if mindfulness can be cultivated and if this cultivation leads to well-being. The current study offers preliminary evidence that at least one aspect of mindfulness, measured by the Mindful Attention and Awareness Scale (MAAS; K. W. Brown & R. M. Ryan, 2003), can be cultivated and does mediate positive outcomes. Further, adherence to the practices taught during the meditation-based interventions predicted positive outcomes. College undergraduates were randomly allocated between training in two distinct meditation-based interventions, Mindfulness Based Stress Reduction (MBSR; J. Kabat-Zinn, 1990; n=15) and E. Easwaran's (1978/1991) Eight Point Program (EPP; n=14), or a waitlist control (n=15). Pretest, posttest, and 8-week follow-up data were gathered on self-report outcome measures. Compared to controls, participants in both treatment groups (n=29) demonstrated increases in mindfulness at 8-week follow-up. Further, increases in mindfulness mediated reductions in perceived stress and rumination. These results suggest that distinct meditation-based practices can increase mindfulness as measured by the MAAS, which may partly mediate benefits. Implications and future directions are discussed.     

Relationships between mindfulness practice and levels of mindfulness,medical and psychological symptoms and well-being in a mindfulness-based stress reduction program

Relationships were investigated between home practice of mindfulness meditation exercises and levels of mindfulness, medical and psychological symptoms, perceived stress, and psychological well-being in a sample of 174 adults in a clinical Mindfulness-Based Stress Reduction (MBSR) program. This is an 8- session group program for individuals dealing with stress-related problems, illness, anxiety, and chronic pain. Participants completed measures of mindfulness, perceived stress, symptoms, and well-being at pre- and post-MBSR, and monitored their home practice time throughout the intervention. Results showed increases in mindfulness and well-being, and decreases in stress and symptoms, from pre- to post-MBSR. Time spent engaging in home practice of formal meditation exercises (body scan, yoga, sitting meditation) was significantly related to extent of improvement in most facets of mindfulness and several measures of symptoms and well-being. Increases in mindfulness were found to mediate the relationships between formal mindfulness practice and improvements in psychological functioning, suggesting that the practice of mindfulness meditation leads to increases in mindfulness, which in turn leads to symptom reduction and improved well-being.     

Trait mindfulness during pregnancy and perception of childbirth

Women’s subjective childbirth experience is a risk factor for postpartum depression and childbirth-related posttraumatic stress symptoms. Subjective childbirth experience is influenced not only by characteristics of the childbirth itself but also by maternal characteristics. A maternal characteristic that may be associated with a more positive childbirth experience is trait mindfulness. The current study aimed to assess this association and to assess whether trait mindfulness during pregnancy had a moderating role in the possible association between non-spontaneous delivery and perception of childbirth. A subsample of 486 women, participating in a longitudinal prospective cohort study (Holistic Approach to Pregnancy and the first Postpartum Year study), completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Women completed the Childbirth Perception Scale and the Edinburgh Postnatal Depression Scale between 7 and 21 days postpartum. The mindfulness facets acting with awareness and non-reacting were significantly associated with a more positive perception of childbirth, after adjusting for covariates. Moderation analyses showed a significant interaction between acting with awareness and non-spontaneous delivery and non-judging and non-spontaneous delivery. Non-spontaneous delivery was associated with a more negative perception of childbirth for low/medium scores of acting with awareness and non-judging, but not for high scores on these mindfulness facets. Trait mindfulness during pregnancy may enhance a positive perception of childbirth. Because this is among the first studies examining the association between maternal dispositional mindfulness and perception of childbirth, future research is needed to confirm the results of the current study.

     

正念训练提升自愿者幸福感的6周随机对照试验

目的:探索正念训练提升普通个体主观幸福感的效果.方法:采用随机对照设计,将招募的72名被试分至正念训练组或对照组(每组36人),训练组进入每周1次,共6次的正念训练,对照组等待6周,直到训练组结束训练后1周进入训练.在训练前、后采用五因素正念度量表(FFMQ)、幸福感指数(IWB)量表和情感平衡量表(ABS)进行网络心理测评,用后测减前测的差值来评估干预效果.结果:训练组有效样本17人,对照组有效样本21人.6周正念训练后,训练组FFMQ[(15.1±9.9) vs.(-0.3±6.8),P＜0.001]、IWB差值[(0.9±1.6)vs.(-0.3±2.6),P=0.050]均高于对照组,而负性情感的差值低于对照组[(-0.4±1.4)vs.(0.5±1.6),P=0.041].结论:本研究提示,正念训练能有效提升参与者的主观幸福感.     

Sex chromosome trisomies in Europe: prevalence, prenatal detection and outcome of pregnancy

This study aims to assess prevalence and pregnancy outcome for sex chromosome trisomies (SCTs) diagnosed prenatally or in the first year of life. Data held by the European Surveillance of Congenital Anomalies (EUROCAT) database on SCT cases delivered 2000–2005 from 19 population-based registries in 11 European countries covering 2.5 million births were analysed. Cases included were livebirths diagnosed to 1 year of age, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly (TOPFA). In all, 465 cases of SCT were diagnosed between 2000 and 2005, a prevalence of 1.88 per 10,000 births (95% CI 1.71–2.06). Prevalence of XXX, XXY and XYY were 0.54 (95% CI 0.46–0.64), 1.04 (95% CI 0.92–1.17) and 0.30 (95% CI 0.24–0.38), respectively. In all, 415 (89%) were prenatally diagnosed and 151 (36%) of these resulted in TOPFA. There was wide country variation in prevalence (0.19–5.36 per 1000), proportion prenatally diagnosed (50–100%) and proportion of prenatally diagnosed resulting in TOPFA (13–67%). Prevalence of prenatally diagnosed cases was higher in countries with high prenatal detection rates of Down syndrome. The EUROCAT prevalence rate for SCTs diagnosed prenatally or up to 1 year of age represents 12% of the prevalence expected from cytogenetic studies of newborn babies, as the majority of cases are never diagnosed or are diagnosed later in life. There is a wide variation between European countries in prevalence, prenatal detection and TOPFA proportions, related to differences in screening policies as well as organizational and cultural factors.     

Grief and its impact on prenatal attachment in the subsequent pregnancy

Summary This article suggests there is a need to reframe the phenomenon of unresolved grief in parents who are in a subsequent pregnancy after a previous loss using a prenatal attachment model. An argument is made for helping parents give meaning to their parenting role for the baby who has died so they can move forward in attaching to the baby in the next pregnancy. It is suggested that a new layer of grief surfaces when parents get pregnant again which can lead to pathology if not recognized by others. Interventions to support the parenting relationship to the baby in the subsequent pregnancy are provided.     

孕中期母血产前筛查回顾性分析

目的 对柳州地区3299例孕中期妇女产前筛查结果进行回顾性分析,建立适合本实验室的血清AFP中位数值,探讨进行筛查的最佳孕周.方法 用酶联免疫法(ELISA)对孕妇血清AFP和Free-βhCG进行检测,并结合孕妇年龄、孕周、体重、有无糖尿病等,采用配套软件估算风险概率.应用EXCEL计算本地区孕妇AFP中位数,比较标化前后检测结果,并对各孕周筛查风险概率进行比较.结果 在3299例孕中期妇女中,DS和神经管缺陷筛查阳性率分别为8.73%和3.30%,检出先天缺陷10例.柳州地区孕中期妇女AFP中位数比内嵌软件中位数平均高9.43%.校正后NTD筛查敏感度提高10.08%;孕14、15、19周筛查阳性率分别为9.26%、8.09%、7.74%,高于其它各孕周筛查阳性率.结论 血清AFP、HCG联合检测,可作为柳州地区孕中期产前筛查优选项目,建立适合本地区的中位数值可提高筛查的准确度,建议以孕16、17、18周为最佳筛查孕周.     

Potential benefits of mindfulness during pregnancy on maternal autonomic nervous system function and infant development

Mindfulness is known to decrease psychological distress. Possible benefits in pregnancy have rarely been explored. Our aim was to examine the prospective association of mindfulness with autonomic nervous system function during pregnancy and with later infant social‐emotional development. Pregnant women (N = 156) completed self‐report mindfulness and emotional distress questionnaires, and had their autonomic function assessed in their first and third trimesters, including heart rate (HR), indices of heart rate variability (HRV), preejection period (PEP), and systolic (SBP) and diastolic blood pressure (DBP). The social‐emotional development of 109 infants was assessed at 4 months of age. More mindful pregnant women had less prenatal and postnatal emotional distress (p < .001) and higher cardiac parasympathetic activity: root mean square of successive differences (RMSSD: p = .03) and high‐frequency (HF) HRV (p = .02). Between the first and third trimesters, women's overall HR increased (p < .001), and HRV (RMSSD, HF HRV, and low‐frequency (LF) HRV: p < .001) and PEP decreased (p < .001). In more mindful mothers, parasympathetic activity decreased less (RMSSD: p = .01; HF HRV: p = .03) and sympathetic activity (inversely related to PEP) increased less (PEP: p = .02) between trimesters. Their offspring displayed less negative social‐emotional behavior (p = .03) compared to offspring of less mindful mothers. Mindfulness in pregnancy was associated with ANS changes likely to be adaptive and with better social‐emotional offspring development. Interventions to increase mindfulness during pregnancy might improve maternal and offspring health, but randomized trials are needed to demonstrate this.     

Molar pregnancy and living normal fetus coexisting until term: prenatal biochemical and sonographic diagnosis

The extremely rare condition of molar pregnancy with a coexisting fetus progressing to a viable infant, is reported. At 20 weeks gestational age, prenatal diagnosis was made by biochemical and sonographic findings, in which elevated free beta-human chorionic gonadotrophin (HCG, 500 ng/ml) was noted and ultrasound showed a well-defined multicystic snowstorm-like mass connecting with placenta. Chromosomal evaluation by amniocentesis was normal (46,XY) and ultrasound showed no fetal abnormalities, so the patient decided to keep the pregnancy and had no significant complications noted in the antepartal period. At 38 weeks gestational age, a Caesarean section was performed due to cephalopelvic disproportion and a 3380 g, living boy was delivered. The infant did not show any abnormality. The placenta and the connecting hydatidiform molar tissue were delivered manually. Subsequently, since persistent elevated beta-HCG was noted 2 months later, the patient was treated with chemotherapy for gestational trophoblastic disease. A normal beta-HCG concentration was noted thereafter. Prenatal differential diagnosis and postnatal management are discussed as well as the rationale for allowing the pregnancy to continue after the diagnosis at 20 weeks gestational age.      

Rapid prenatal diagnosis using targeted exome sequencing: a cohort study to assess feasibility and potential impact on prenatal counseling and pregnancy management

PurposeUnexpected fetal abnormalities occur in 2–5% of pregnancies. While traditional cytogenetic and microarray approaches achieve diagnosis in around 40% of cases, lack of diagnosis in others impedes parental counseling, informed decision making, and pregnancy management. Postnatally exome sequencing yields high diagnostic rates, but relies on careful phenotyping to interpret genotype results. Here we used a multidisciplinary approach to explore the utility of rapid fetal exome sequencing for prenatal diagnosis using skeletal dysplasias as an exemplar.MethodsParents in pregnancies undergoing invasive testing because of sonographic fetal abnormalities, where multidisciplinary review considered skeletal dysplasia a likely etiology, were consented for exome trio sequencing (both parents and fetus). Variant interpretation focused on a virtual panel of 240 genes known to cause skeletal dysplasias.ResultsDefinitive molecular diagnosis was made in 13/16 (81%) cases. In some cases, fetal ultrasound findings alone were of sufficient severity for parents to opt for termination. In others, molecular diagnosis informed accurate prediction of outcome, improved parental counseling, and enabled parents to terminate or continue the pregnancy with certainty.ConclusionTrio sequencing with expert multidisciplinary review for case selection and data interpretation yields timely, high diagnostic rates in fetuses presenting with unexpected skeletal abnormalities. This improves parental counseling and pregnancy management.