Dismantling Mindfulness: Contributions of Attention vs. Acceptance

描述（由申请人提供）：冥想，特别是正念冥想，是最受欢迎的补充和替代医学（CAM）疗法之一，用于缓解情绪压力，抑郁和焦虑，这些情绪压力是主要的，或者是次要的，是另一种健康状况。虽然标准化的冥想治疗方案，如正念减压（MBSR）和正念认知疗法（MBCT）已经可靠地显示出对情绪障碍和健康的持续改善，但它们包含了太多不同的成分和实践，以至于无法确定其中的有效成分。正念由两个部分组成：1)注意力调节部分，这被认为是通过集中意识练习培养的；2)接受、非评判的心理立场，这被认为是通过开放监控练习培养的。本项目旨在为关注型和接纳型冥想建立单独的实践标准，比较它们的临床疗效，并研究它们在具有临床显著水平的持续负面影响和抑郁的个体中的单独作用机制。集中意识（FA） vs开放监测（OM） vs无治疗（等候名单）对照的临床益处和作用机制将通过这8周干预的三臂随机对照试验进行检验。结果变量包括负面影响（抑郁、焦虑、压力）和幸福感。假设的中介过程包括客观测量的注意力、情绪调节和它们所依赖的基本清醒。除了研究应用之外，培训计划还包括以下方面的正规教育：1)基于冥想的临床试验方法和情感障碍；2)注意力、情绪、睡眠倾向的心理生理学测量；3)与治疗研究相关的生物统计学方法。这次培训为我成为一名独立的以病人为中心的研究人员的长期目标做好了准备。通过正式的教学指导和来自该领域经验丰富的领导者的强有力的指导，我将开发必要的工具来阐明哪些冥想练习对情绪障碍最有帮助，以及通过哪些认知和神经生理机制。

DESCRIPTION (provided by applicant): Meditation, particularly mindfulness meditation, is one of the most popular Complementary and Alternative Medicine (CAM) therapies for alleviating emotional stress, depression and anxiety that are either primary, or secondary to another health condition. While standardized meditation-based treatment packages like Mindfulness Based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT) have reliably shown sustained improvements in emotional disturbances and wellbeing, they contain so many different components and practices that the active ingredient cannot be ascertained. Mindfulness is comprised of 1) an attention regulation component, which is thought to be cultivated with focused awareness practice, and 2) an accepting, non-judgmental mental stance, which is thought to be cultivated through open-monitoring practice. This project aims to create separate practice criteria for attention and acceptance-focused meditations, compare their clinical efficacy and investigate their separate mechanisms of action in individuals with clinically significant levels of persistent negative affect and depression. The clinical benefit and mechanism of action of focused awareness (FA) vs open-monitoring (OM) vs a no-treatment (waitlist) control will be examined with a three- armed randomized control trial of these eight week interventions. Outcome variables include negative affect (depression, anxiety, stress) and wellbeing. Hypothesized mediating processes include objectively measured attention, emotion regulation and the basic wakefulness on which they depend. In addition to the research application, the training program includes formal education in 1) meditation-based clinical trials methodology and affective disorders, 2) psychophysiological measurement of attention, emotion, sleep propensity and 3) biostatistical methods related to treatment studies. This training prepares me to meet my long-term objective of becoming an independent patient- oriented researcher. Through formal didactic instruction and strong mentoring from experienced investigators who are leaders in the field, I will develop the requisite tools to shed light on which meditation practices are the most helpful for emotional disturbances and by what cognitive and neurophysiological mechanisms.