- 10 of the best meditation retreats in the UK and Europe | Travel | The Guardian
- The Five Mindfulness Trainings
The back-translation process did not lead to any changes in original item wording. Two questions refer to quality of life and satisfaction with health, while the other 24 items are grouped into four domains: physical, psychological, social relationships, and environment. Participants rate their quality of life aspects on a 5-point scale over the last two weeks. Total score is the sum of all 26 items maximum , with higher scores reflecting higher QOL.
We used the Italian version of the scale [ 19 ]. The inventory is composed of 90 items, each one of them representing a psychological symptom. It also provides a Global Severity Index, designed to measure overall psychological distress. We use the validated Italian version [ 21 ]. We compared a single-factor model with a three-factor model, based on the original LMS structure. We also tested a hierarchical model with a second order factor that was related to the three identified sub-scales.
First, we tested a single-factor model in which all items contribute to an overall mindfulness factor. We then tested the three-factor model that was identified in the original version [ 4 ]. The three factors were allowed to inter-correlate. The factorial structure is reported in Fig.
Correlations among the LMS factors were all significant ranging from. To test the validity of the total LMS score, we tested a second order factor model relating all the three components to a second order latent construct. We tested a hierarchical model with first order factors as the three sub-scales and a general second order factor LMS total score, i. The model is reported in Fig. The average value of the LMS composite score was The internal consistency of the three sub-scales i.
The average item-total correlation was. The details of item-total correlations, mean, variance, and alpha-if-item deleted for each item are provided in the supplementary materials Additional file 1 : Table S2.
Together with mindfulness, we assessed quality of life and psychological symptoms. The original tri-dimensional factor structure of the LMS was confirmed. This suggests that the construct of mindfulness as developed by Langer [ 1 ] in the U. All three factors Novelty Seeking, Novelty Producing, and Engagement were correlated with each other, an indication that they all refer to the same mindfulness construct.
That reflects the findings of the original version of the scale [ 4 ]. However, while the findings support a significant relationship between the 3 factors, these correlations are not perfect, suggesting that they also retain or contribute something distinctive and separate to the mindfulness construct. As expected, Langerian mindfulness was positively associated with QOL and negatively associated with many psychological symptoms. Better physical and psychological well-being, as well as satisfying social relationships, tended to be associated with high mindfulness.
Mindfulness resulted in a negative association with adverse psychological symptoms. In particular, it demonstrated a negative relationship with obsessive-compulsive symptoms, interpersonal sensitivity, depressive features, hostility, and phobic anxiety. Certain components of mindfulness provided higher negative correlations with psychological symptoms than others; specifically, the Engagement subscale was highly negatively associated with most psychological symptoms, and was also negatively associated with anxiety, paranoid ideation, and psychoticism.
This finding is not particularly surprising, since people with higher levels of adverse psychological symptoms e. In this way, psychological problems can be interpreted in terms of mindlessness, which is the opposite of mindfulness, remaining entrenched in previous established categories is one of the main characteristics of anxiety and depression, and of obsessive thoughts. These categories are what the cognitive-behavioral therapy approach refers to as irrational thoughts [ 23 ]. On the other hand, a mindful attitude can promote psychological adaptation, with an openness to new information, resulting in higher flexibility and resilience [ 1 ].
It has been previously indicated that these attitudes reduce psychological distress and improve QOL and psychological well-being [ 9 ]. A mindful attitude could therefore promote well-being by reducing distress and helping solve psychological problems. The impact of this mindfulness construct appears to result in greater psychological well-being, better physical health, and improved social relationships. In this sense the entire bio-psycho-social model of the person [ 24 ] can be influenced by mindfulness. The interpretation of the direction of the results was theory-driven, in line with our hypothesis.
However, given the correlational design, it could also be argued that psychological symptoms and low QoL promote mindlessness, or that all these constructs depend on another third variable. The design and the inferences that can be drawn from it constitute a study limitation. Strong inferences about the causal direction should be drawn from studies with an experimental design.
Randomized controlled trials about Langerian mindfulness, QOL and psychological well-being are warranted to explore what seems to be a promising association. Our data reflected undergraduate students in psychology, with a large presence of female participants. However, we cannot assume that the conclusions can be extended to the entire population despite the common procedure of including students in scientific studies and extending the results to the general population. Another danger to the external validity is the level of distress that is reported by the sample of students.
This is in line with previous studies that found students to be more distressed than the general population [ 25 ]. These issues suggest the need for further studies to verify the extension of these results to different populations. Despite a few limitations, this is the first study to our knowledge that explores the connection between Langerian Mindfulness, psychological symptoms and quality of life, with the potential exception of people with Amyotrophic Lateral Sclerosis [ 14 ]. Our results suggest by increasing mindfulness as reflected in the Langerian construct, both QOL and psychological well-being will improve.
The theoretical construct of mindfulness according to Langer does not require meditation or similar forms of training to be increased [ 26 ]. That is in line with the findings from other studies that showed changes on some mindfulness scales conducting informal practices such as dishwashing [ 27 ]. Mindfulness is a skill that can be improved by small cognitive exercises that do not require an extensive time investment [ 28 , 29 ].
The simplicity of the approach, easily applicable in different contexts, could helpfully inform future clinical and social applications. Item-total statistics. FP conceived of the study, collected the data and helped to draft the manuscript. KB helped conceiving the study, interpreting results, and writing the manuscript. DP helped conceiving the study and writing the manuscript. All authors read and approved the final manuscript. All participants were voluntary who consented to participate in the study. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material. Francesco Pagnini, Email: ti. Katherine E. Bercovitz, Email: ude. Deborah Phillips, Email: ude. National Center for Biotechnology Information , U. Health Qual Life Outcomes. Published online Feb 6. Francesco Pagnini , 1, 2 Katherine E. Bercovitz , 2 and Deborah Phillips 2. Author information Article notes Copyright and License information Disclaimer.
Corresponding author. Received Nov 3; Accepted Jan Abstract Background Noticing new things, accepting the continuously changing nature of circumstances, and flexibly shifting perspectives in concert with changing contexts constitute the essential features of Langerian mindfulness.
Methods We translated the LMS into Italian, analyzed its factor structure, and investigated the correlation between mindfulness and quality of life and psychological well-being in a sample of Italian students Results The primary analysis found a significant negative correlation between mindfulness and psychological symptoms including obsessive-compulsive tendencies, depression, anxiety, and paranoid ideation. Electronic supplementary material The online version of this article Background Langerian mindfulness is defined as the process of paying attention on purpose to the present moment, of being aware of novelty in experiences or situations, and of perceiving differences in contexts and events [ 1 ].
Results First, we tested a single-factor model in which all items contribute to an overall mindfulness factor. Open in a separate window.see
10 of the best meditation retreats in the UK and Europe | Travel | The Guardian
Conclusions Despite a few limitations, this is the first study to our knowledge that explores the connection between Langerian Mindfulness, psychological symptoms and quality of life, with the potential exception of people with Amyotrophic Lateral Sclerosis [ 14 ]. Acknowledgements We sincerely thank Dr. Francesca Graziano for the great nerd-ish support. Availability of data and materials Please contact author for data requests. Consent for publication All participants provided consent to publish aggregated data. Competing interests The authors declare that they have no competing interests.
Footnotes Electronic supplementary material The online version of this article Contributor Information Francesco Pagnini, Email: ti. References 1. Langer E. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Pract.
- Meditation and singing, UK, various.
- Associated Data.
- ISBN 13: 9788804659617.
- The Philosophy of Loyalty.
Langer E, Moldoveanu M. The construct of mindfulness. J Soc Issues. Most importantly, an interesting correlation between the increase in right insula thickness and the decrease in alexithymia levels during the MBSR training were observed. Moreover, a multivariate pattern classification approach allowed to identify a cluster of regions more responsive to MBSR training across subjects.
Taken together, these findings documented the significant impact of a brief MBSR training on brain structures, as well as stressing the idea of MBSR as a valuable tool for alexithymia modulation, also originally providing a plausible neurobiological evidence of a major role of right insula into mediating the observed psychological changes. This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. Neuroimaging data are stored on a server of the University of Siena and will be available upon request. Requests should be sent to: Emiliano Santarnecchi emilianosantarnecchi gmail. Competing interests: The authors have declared that no competing interests exist.
In general, mindfulness meditation based programs lead to changes in the attitude of the practitioners towards their thoughts, sensations and emotions. This can be considered useful in reducing stress symptoms in non-clinical populations  ,  and may help patients cope with a wide variety of clinical conditions, such as anxiety  ,  , depression  ,  , substance abuse  and chronic pain .
A growing body of literature has proposed possible neuroanatomical changes due to mindfulness and other meditation style trainings, mainly using a cross-sectional approach. For instance, almost ten years ago Lazar and colleagues  have originally reported a significant increase of cortical thickness in the right insula and frontal lobes of expert meditators insight meditation , by the means of surface-based cortical thickness measurement. Due to the cross-sectional nature of these studies, no causal relationship between meditation practice and brain anatomical changes can be drawn.
Moreover, it is worthwhile to note that all these studies were conducted on expert meditators belonging to different traditions. These may include focused attention meditation, which involves moment by moment selective attention focused on a particular object e. It is evidently impossible to generalize the effect of various meditative methods on brain structure and function and it is not the purpose of this paper to compare different meditative methods. Using VBM, the authors demonstrated anatomical changes after the MBSR program, showing an increase in grey matter concentration values of posterior cingulate cortex, temporal-parietal junction and cerebellum in the MBSR group in respect to a wait-control group.
Considering the different available approaches for the neuroanatomical changes evaluation - which are often exclusively focused on one specific brain property e. Moreover, whether such morphometric changes also correspond to modifications at behavioral and psychological levels remains to be investigated, opening the interesting opportunity to understand the neurobiological underpinnings of the documented effects of MBSR on depression and anxiety symptomatology. In the present study, we aimed to expand previous findings by adopting multiple methods for longitudinal gray matter morphometric analyses.
VBCT has been used as a complementary analysis to VBM, since it offers increased sensitivity to morphometric properties of more convoluted brain regions and consequently guarantees an increased probability of detecting modifications in deep brain structures which might be involved in meditation practice . Furthermore, we additionally correlated longitudinal changes in anatomical structures with several psychological indices evaluated before and after the MBSR training. Forty-eight right-handed participants were recruited from the responders to an announcement for an 8-week mindfulness-based training, promoted by the Department of Neurological, Neurosurgical and Behavioral Sciences, University of Siena, Italy.
Participants were randomly assigned to 2 groups. All study protocols and consenting procedures were approved by the Ethical Committee of the University of Siena, written informed consent was obtained from all participants according to the Declaration of Helsinki. MBSR is an 8-week intensive program that involves daily exercises in focusing attention on the present moment, as described by Kabat-Zinn and colleagues .
Core components include practicing body scanning, sitting meditation, walking meditation and mindful stretching movements. The program features weekly 2. Between class 6 and 7 the participants are invited to a whole day silent retreat 7 hours. The program was conducted by 2 instructors S. The participants were asked to write about their daily meditation activities describing the kind of meditation performed and the length of the practice. The program additionally consists of an informal practice designed to allow the subject to direct awareness towards specific observations of everyday life, such as the moment of eating, capturing pleasant and unpleasant events, dialogical interactions, and more.
MRI examinations of all participants were performed at a 1. Participants completed the following psychological tests under the supervision of three expert psychologists and psychiatrists M. The TAS is a self-report questionnaire that reveals the alexithymia construct. Alexithymia refers to a condition in which people have trouble identifying and describing emotions and tend to minimize their emotional experience and focus their attention externally.
- Fates Intervention?
- Marriage with my Kingdom: The Courtships of Queen Elizabeth I.
- The Rising (The Age of Darkness Book 1).
- Manger le livre (Figures) (French Edition).
In the initial validation study  , exploratory factor analysis of the TAS yielded a three factor structure congruent with the theoretical construct of alexithymia: 1 difficulty in identifying feelings and bodily sensations of emotional arousal; 2 difficulty in describing feelings to others, 3 externally-oriented thinking. It is composed of 20 items rated on a 5-point Likert scale, ranging from 1 strongly disagree to 5 strongly agree.
Total scores range from 20 to The validity of the three factor structure has been demonstrated in the Italian version by confirmatory factor analysis . PSWQ is made up of a list of 16 worry-based dysfunctional characteristics. Higher scores indicate greater worry. This is a self-report questionnaire for measuring anxiety in adults. This measure consists of 21 items multiple-choice self-report items to assess the intensity of depression in clinical and normal populations.
BDI-II values different aspects of depression: symptoms of depression such as hopelessness and irritability, cognition such as guilt, as well as physical symptoms such as fatigue, weight loss and lack of interest in sex. The measures ask respondents to endorse statements characterizing how they have been feeling throughout the previous 2 weeks.
The MAAS consists of 15 items that can value the individual differences in frequency of mindful states and produce a total score of mindfulness.
Participants have to indicate how frequently they have the experience shown in each item with a score from 1 to 6 on a Likert scale: 1 almost always to 6 almost never. Briefly, all the images of each participant are registered to correct for position but not size and the normalization estimates are derived from the first baseline scan only.
The estimated normalization parameters are then applied to all images of one subject. The hidden Markov Random Field model was applied in all segmentation processes in order to remove isolated voxels. Grey matter maps have been spatially normalized using a modulation procedure, which leads to an estimation of the absolute volume of grey matter structures gray matter volume - GMV. After spatial normalization, the data were smoothed with an 8 mm FWHM full width at half maximum Gaussian kernel.
Differently from surface-based methods, voxel-based cortical thickness measurements do not require the construction of a three-dimensional surface model. Grey and white matter boundaries are instead defined on the basis of voxel information  ,  and cortical thickness is then calculated at every volumetric point within the cortex defined as 0. To obtain an accurate spatial normalization, deformation fields obtained from normalization of GM probability maps to the average size template and then to MNI were also applied to obtained VBCT maps.
Regionally-specific differences in cortical thickness between pre and post MBSR maps were then compared on a voxel-by-voxel basis. Age, gender and total brain volume TBV i. T0 brain volumes and pre-post MBSR differences i. Specifically, we tried to unveil possible interactions between the effect of MBSR training on i both psychological and neuroanatomical profiles of each subject pre-post interaction , or ii their pre-MBSR psychological profile testing for possible predispositions to MBSR training.
In order to obtain a global overview of the impact of the MBSR program over cortical structures we also performed a multivariate pattern analysis classification procedure on the cortical thickness data. Trying to discriminate MBSR trainees and wait-list subjects on the basis of their anatomical changes across the 8 weeks, we calculated the difference between pre-MBSR and post-MBSR whole brain cortical thickness values for each participant. Whole brain map has been consequently parcellated into 90 regions according to the AAL atlas  , and regional thickness differences were used as classification parameters features of brain response to MBSR.
Results of the between-groups comparison of age, gender and total brain volume are reported in Table 1. Results of the psychometric test comparisons are displayed in Table 1.
The Five Mindfulness Trainings
Briefly, participants in the two groups did not differ for age, gender distribution or TBV. No clusters of GMV reached the statistical significance threshold either for main or interaction effects.
Specifically, panels A and C show axial, coronal and sagittal views of right somatosensory cluster, while B and D show the cluster located in the right insula. To verify that such correlation was not due to spurious variability in brain volume estimations, the same analysis was repeated in control subjects with no significant results.
Thus, in order to control for such statistical artifact, additional control analyses were performed by calculating the within-subjects variance of psychological and anatomical measurements, and quantifying the RTM effect using the approach suggested in . No significant changes in the correlation coefficients were detected after compensating for RTM influence. SVM classification indicated a pattern of brain regions that discriminated MBSR trainees from control subjects with a correct classification rate of Features that overcame the 90th percentile were plotted on a three-dimensional glass brain in order to show brain areas that contributed the most to subjects identification Fig.
The classifier weights were higher in a group of regions located in the bilateral anterior cingulate cortex, bilateral insula, bilateral superior frontal gyrus medial part , bilateral middle frontal gyrus, bilateral temporal pole, bilateral angular gyrus, bilateral precentral gyrus, left parahippocampal gyrus. Panel A and B report a surface-based representation of average cortical thickness values for MBSR-trainees before and after the course. By computing the pre-post MBSR difference in cortical thickness level for both MBSR trainees and wait-list subjects, and by calculating this value for each of the 90 regions composing the AAL anatomical atlas, a support vector machine algorithm has been trained into discriminate the two groups.
Results indicates an average identification accuracy equal to The last decade has revealed growing evidence of anatomical and functional brain modifications associated with meditation practices, with results referring to a large variety of different methods of meditation. Noteworthy, evidence is often derived from cross-sectional studies based on subjects with a long-history of meditation practice. Finally, a significant negative correlation between alexithymia level and pre-post MBSR changes in insular thickness was also observed.
Both brain imaging and electrophysiological studies have suggested that right insula is a key node for interoception, awareness of body movements and emotional awareness  , due to its extensive viscera-sensory inputs from the periphery and reciprocal connections with limbic, somatosensory, prefrontal and temporal cortices  , .
The insula has been specifically linked to the monitoring of visceral parts of the body, and its possible role into the re-representation of interoception offers a possible basis for its involvement in all subjective feelings . As for MBSR, using a fine anatomical parcellation analysis of insula activity, Farb and colleagues  showed higher activation of the anterior dysgranular insular regions in MBSR trainees with respect to controls during an interoceptive attention task, while in another study they demonstrated a reduced insula deactivation in MBSR practitioners during a sadness provocation task, which may be interpreted as increased interoceptive awareness and thus a lesser propensity to process highly-emotional incoming stimuli .
Accordingly, the increase of insula thickness observed in our participants may be the result of their increased awareness through paying attention moment to moment in a non-judgmental way of bodily sensations from the most subtle to the most evident. Interestingly, the insular lobe seems to be also involved in the cognitive processing of nociceptive stimuli, with an increase in its activity measured using arterial spin labeling after just 4 days of mindfulness training associated with a significantly diminished pain perception in healthy subjects .
In conclusion, our results confirm insula high responsiveness to MBSR and put forward the feasibility of a plasticity-related response even after a brief mindfulness training exposure. We also observed an MBSR-induced thickness change in right somatosensory cortex, a region associated with sensory-discriminative processing of nociceptive information . As with the insula, this region is often associated with meditation practice, with findings of increased activation during experiential focusing  and observation of neutral and sad clips  in MBSR trainees.
Accordingly, as suggested by evidence of increased alpha-band modulation after mindfulness training observed in this region using magneto-electroencephalography MEG  , repeated increases of average activation in the somatosensory cortex during the program could be responsible for the observed effect. Multivariate pattern analysis revealed a large number of regions which seem to be highly informative for the identification of MBSR trainees.
Interestingly, this pool of regions, encompassing frontal lobe, anterior cingulate cortex, insula, temporal pole, somatosensory cortex, angular and parahippocampal gyri, have been separately reported in previous anatomical or functional studies on different types of meditation  , . In light of the sensory and cognitive functions they are associated with, these regions may compose an unspecific network of areas that are highly sensitive to meditation practicing in general.
Besides morphometric changes, a significant after-training reduction of several psychological indexes related to worry, state anxiety, depression and alexithymia were observed, while no significant changes or correlation with the MAAS were detected. More interestingly, the correlation between alexithymia levels and anatomical changes after mindfulness exposure gives reason of previous evidences correlating the insula and alexithymia levels in several morphometric studies not specifically involving meditation.
For instance, in a positron emission tomography PET study, Kano and colleagues highlighted how individuals scoring higher than the clinical cut-off on the TAS showed hyperactivity of the right insula  , interpreting this hyperactivation as the tendency of these individuals to exacerbate physical illness, possibly caused by an unpleasant internal signal amplification. Moreover, in a study using film clips to elicit emotional responses  , the authors documented increased activity in the bilateral insula in TAS high-scorers compared to low-scorers, along with increased sensory and motor cortices activity.
Indeed, the functions associated with the insula seems to resemble the mental state promoted through mindfulness, while they are basically opposite to the theoretical description of alexithymia, which is intended as a reduction or incapacity to experience or verbalize emotions . A similar finding regarding the insula has been documented by Farb and colleagues  , by looking at differences in brain activation in response to different types of self-reference monitoring tasks in both novices and MBSR-trained subjects.