Mechanisms of Mindfulness Training and Stress Reduction

 描述(由申请人提供)：越来越多的随机对照试验(RCT)证据表明，正念训练干预可能会减少压力并改善与压力相关的疾病结果。然而，我们对正念训练的潜在积极训练机制知之甚少。虽然人们普遍认为正念训练干预培养了监控和接受当下体验的能力，但目前争论的焦点是，是否每时每刻监控体验的能力是关键，还是监控和非评判性接受体验的能力推动了正念训练干预所观察到的有益效果。这项建议提供了一个新的解释和拆解测试这些假定的机制，正念训练和减轻压力。具体地说，我们预测，尽管学习如何监控当下的体验将改善注意力的行为测量，但学习如何监控并接受当下的体验将减少压力。这些预测将通过招募N=135名有压力的社区成年人来检验，并将他们随机分配到(1)为期8周的基于正念的压力减轻(MBSR)计划，该计划强调在监控和接受当前时刻体验方面的训练(监控接受MBSR条件)；(2)调整后的MBSR条件，强调只监控一个人的当前时刻体验(仅监控MBSR)；或(3)无治疗对照：仅进行评估。参与者将在为期8周的干预期之前和之后立即完成为期3天的日常体验采样(生态瞬间评估)，以测量日常生活中的注意力控制和压力感知。为了测量心理和HPA轴对受控应激源的应激反应，参与者还将在为期3天的干预后评估期后立即完成标准化的急性应激挑战任务(Trier Social Stress Test，TSST)。这个发展中的R21项目提供了第一个正念冥想训练的拆解研究，它利用了现实生活压力(使用EMA)和压力生物标记物(唾液皮质醇)的尖端日常经验样本，并将为在高危应激患者群体中设计更有效(和高效)的正念训练干预措施提供重要的初始信息。

 DESCRIPTION (provided by applicant): There is a growing body of randomized controlled trial (RCT) evidence indicating that mindfulness training interventions may reduce stress and improve stress-related disease outcomes. Yet we know little about the underlying active training mechanisms of mindfulness training. Although it is generally believed that mindfulness training interventions foster a capacity to monitor and accept present moment experience, debate currently focuses on whether it is the capacity to monitor experience moment-by-moment that is critical, or whether it is the capacity to both monitor and non-judgmentally accept experience that drives the salutary effects observed in mindfulness training interventions. This proposal offers a new account and dismantling test of these putative mechanisms of mindfulness training and stress reduction. Specifically, we predict that although learning how to monitor present moment experience will improve behavioral measures of attention, learning how to monitor plus accept present moment experience will reduce stress. These predictions will be tested by recruiting N=135 stressed community adults and randomizing them to either the (1) standard 8-week Mindfulness-Based Stress Reduction (MBSR) program which emphasizes training in both monitoring and accepting present moment experience (Monitor + Accept MBSR condition); (2) an adapted MBSR condition that emphasizes monitoring of one's present moment experience only (Monitor Only MBSR); or (3) No Treatment Control: assessment only. Participants will complete 3-days of daily experience sampling (Ecological Momentary Assessment) immediately before and after the 8-week intervention period to measure attentional control and stress perceptions in daily life. In order to measure psychological and HPA-axis stress reactivity to a controlled stressor, participants will also complete a standardized acute stress challenge task (the Trier Social Stress Test, TSST) immediately following the 3-day post-intervention assessment period. This developmental R21 project provides the first dismantling study of mindfulness meditation training, it utilizes cutting-edge daily experience sampling of real life stress (using EMA) and stress biomarkers (salivary cortisol), and will provide important initial information for designing more effective (and efficient) mindfulness training interventions in at-risk stressed patient populations.