The stress reaction is an integrated response to a change in the environment that enables each individual to adapt to demand. While this response is physiologically coordinated by the brain, its phenomenology is expressed in the field of psychology and psychopathology. This interrelation between neurophysiological mechanisms and psychological processes is complex as dynamic interpersonal, biological, and psychocognitive systems interact with contextual and environmental factors to shape adaptation over the life constraints.

This article aims to present the actors of the adjusted stress response, such as coping and coping flexibility, mindfulness and resilience, and their respective neurophysiology.

A model of the relationship between resilience, mindfulness and coping was proposed for optimizing adaptation to stress response.

These focuses are prerequisites for understanding and supporting human adaptation in the everyday environment and promoting efficient management of stress for mental and physical health.

The experience of pain is a combined product of bottom-up and top-down influences mediated by attentional and emotional factors. Meditation states and traits are characterized by enhanced attention/emotion regulation and expanded self-awareness that can be expected to modify pain processing. The main objective of the present study was to explore the effects of long-term meditation on neural mechanisms of pain processing. EEG pain-related oscillations (PROs) were analysed in highly experienced practitioners and novices during a non-meditative resting state with respect to (a) local frequency-specific and temporal synchronizing characteristics to reflect mainly bottom-up mechanisms, (b) spatial synchronizing patterns to reflect the neural communication of noxious information, (c) pre-stimulus oscillations to reflect top-down mechanisms during pain expectancy, and (d) the P3b component of the pain-related potential to compare the emotional/cognitive reappraisal of pain events by expert and novice meditators. Main results demonstrated that in experienced (long-term) meditators as compared to non-experienced (short-term) meditators (1) the temporal and spatial synchronizations of multispectral (from theta-alpha to gamma) PROs were substantially suppressed at primary and secondary somatosensory regions contra-lateral to pain stimulation within 200 ms after noxious stimulus; (2) pre-stimulus alpha activity was significantly increased at the same regions, which predicted the suppressed synchronization of PROs in long-term meditators; (3) the decrease of the P3b component was non-significant. These novel observations provide evidence that even when subjected to pain outside of meditation, experienced meditators exhibit a pro-active top-down inhibition of somatosensory areas resulting in suppressed processing and communication of sensory information at early stages of painful input. The emotional/cognitive appraisal of pain is reduced but remains preserved revealing a capacity of experienced meditators to dissociate pro-active and reactive top-down processes during pain control.

This systematic review and meta-analysis aimed to assess the impact of Acceptance and Commitment Therapy (ACT) on Fear of cancer recurrence (FCR) among cancer survivors.

The various databases including PubMed, EMBASE, CINAHL, Scopus, The Cochrane Library, Wanfang data, CNKI, CBM, and CQVIP were searched from their start dates up to June 1, 2024. Meta-analysis was conducted using RevMan 5.3 and Stata 17.0. Sub-analysis was performed to identify sources of heterogeneity and to mitigate the impact of confounding variables.

The meta-analysis included 11 studies, encompassing 1093 participants. Findings from a random-effects analysis, indicated that ACT significantly reduced FCR in cancer survivors [SMD = -1.26, 95 % CI (-1.70, -0.81), P < 0.05], both at three months follow-up [SMD = -1.76, 95 % CI (-2.75, -0.76), P < 0.05] and six months follow-up [SMD = -0.84, 95 % CI (-1.34, -0.34), P < 0.05]. The results of subgroup analyses revealed that the duration, format, and location of interventions could affect outcomes. At the same time,the results revealed that ACT can reduce anxiety and experiential avoidance in cancer survivors, though its effect on fatigue requires further investigation. The quality assessment results of the included literature ranged from low to high risk of bias.

ACT can effectively reduce FCR, experiential avoidance, and anxiety in cancer survivors, though it did not significantly affect fatigue levels. Further high-quality RCTs are needed to elucidate the effects of ACT on FCR in cancer survivors.

A systematic review and meta-analysis investigated randomized clinical trials (RCTs) of mindfulness-based interventions (MBIs) targeting lifestyle behaviors commonly associated with brain health in adults. Data sources included Ovid Medline, Ovid PsycINFO, CINAHL [EBSCO], Embase, Cochrane Library [Ovid], Web of Science, and https://ClinicalTrials.gov. Studies were screened using Covidence 2.0. A total of 79 published RCTs of MBIs for adults (18+, patient and non-patient populations) targeting one or more lifestyle behavior (physical activity, sleep, diet, alcohol use, tobacco cessation, and social and mental activities) met eligibility criteria. MBIs were associated with reduced sleep disturbance (40/54 RCTs; 3537 participants; SMD = -.53; 95% CI = -.74 to -.32; I 2 = 78%), increased physical activity (9/17 RCTs analyzed; 685 participants; SMD = .72; 95% CI = .04 to 1.40; I 2 = 89%), improved tobacco cessation (8/12 RCTs; 1234 participants; OR = 2.11; 95% CI = 1.12 to 3.97; I 2 = 55%), and lowered alcohol use (4/6 RCTs; 261 participants; SMD = -.39; 95% CI = -.45 to -.32; I 2 = 0%). This review found moderate to high-quality evidence for MBIs targeting sleep, physical activity, alcohol use, and tobacco cessation. Heterogeneity for these outcomes and insufficient data to analyze diet, mental activities, and cognitive functioning limit our ability to draw definitive conclusions about the effects of MBIs on brain health.

This paper investigates the integration of affective computing techniques using biophysical data to advance emotionally aware machines and enhance child-robot interaction (CRI). By leveraging interdisciplinary insights from neuroscience, psychology, and artificial intelligence, the study focuses on creating adaptive, emotion-aware systems capable of dynamically recognizing and responding to human emotional states. Through a real-world CRI pilot study involving the NAO robot, this research demonstrates how facial expression analysis and speech emotion recognition can be employed to detect and address negative emotions in real time, fostering positive emotional engagement. The emotion recognition system combines handcrafted and deep learning features for facial expressions, achieving an 85% classification accuracy during real-time CRI, while speech emotions are analyzed using acoustic features processed through machine learning models with an 83% accuracy rate. Offline evaluation of the combined emotion dataset using a Dynamic Bayesian Mixture Model (DBMM) achieved a 92% accuracy for facial expressions, and the multilingual speech dataset yielded 98% accuracy for speech emotions using the DBMM ensemble. Observations from psychological and technological aspects, coupled with statistical analysis, reveal the robot's ability to transition negative emotions into neutral or positive states in most cases, contributing to emotional regulation in children. This work underscores the potential of emotion-aware robots to support therapeutic and educational interventions, particularly for pediatric populations, while setting a foundation for developing personalized and empathetic human-machine interactions. These findings demonstrate the transformative role of affective computing in bridging the gap between technological functionality and emotional intelligence across diverse domains.

Cannabis is the most widely used drug in the world, and the therapies proposed to help withdrawal are moderately effective. The MACBETH project is a pilot study in France. It evaluates the effectiveness of the mindfulness-based relapse prevention (MBRP) protocol for active cannabis users.

It comprises of two groups, an MBRP group and a Treatment As Usual (TAU) group, each with twenty participants. The primary endpoint reflects the frequency of cannabis use, and some secondary endpoints were evaluated (signs of withdrawal, adherence to treatment, and changes in consumption).

We found no significant difference between the two groups on the primary and secondary endpoints. We found one significant difference in the MBRP group by further analysis for treatment adherence via an indirect criterion, the attendance at all sessions (P-value=0.01). The number of units consumed from week 1 to week 8 significantly differed in the MBRP group (P-value<0.05) but not in the TAU group. The average number of units consumed from week 8 to 12 increased by 1.5 in the MBRP group compared with 3.4 in the TAU group. The MBRP protocol appears to be at least as effective as the TAU protocol on the assessed criteria, and the results seem to be more durable, although not significant (P-value=0.2).

The MBRP protocol shows interesting results compared to TAU in this major public health problem. Further studies could deepen this field of research, especially by following samples over the long-term and measuring cravings. The MBRP protocol is proving to be an effective and serious alternative psychotherapy to drug therapies in the world of addiction.

Violence against women is a common public health problem and causes negative mental health outcomes. Mind-body therapies aim to positively affect a person's mental health by focusing on the interaction between mind, body, and behavior. Therefore, this study aims to evaluate the effect of mind-body therapies on women's mental health.

Randomized controlled trials published in the last 20 years comparing mind-body therapies with active control or waiting lists in women victims of violence were included. Pubmed, Cochrane, Scopus, Web of Science, and CINAHL databases were searched until August 2023. The random effects model and fixed effects model were used for data analysis. The heterogeneity of the study was assessed using the I2 index, and publication bias was assessed using Egger's test and funnel plot.

Twelve eligible studies with a sample size of 440 women victims of violence were selected. Mind-body therapies led to a statistically significant reduction in anxiety scores (SMD: 1.95, 95% CI: 1.01, 2.89), depression scores (SMD: 1.68, 95% CI: 0.83, 2.52) and posttraumatic stress scores (SMD: 0.95, 95% CI: 0.73, 1.18). There was a high level of heterogeneity in the outcome for anxiety (I2 = 85.18), a high level of heterogeneity for depression (I2 = 88.82), and a low level of heterogeneity for PTSD (I2 = 19.61). Results of subgroup analysis based on the number of sessions showed that eight or fewer sessions reduced anxiety (SMD: 3.10, 95% CI: 1.37, 4.83) and depression scores (SMD: 3.44, 95% CI: 1.21, 5.68), while PTSD scores did not change.

Evidence suggests that mind-body therapies may reduce anxiety, depression, and PTSD in women victims of violence.

Within mindfulness-based programs (MBPs), mixed results have been found for the role of childhood trauma as a moderator of depression outcomes. Furthermore, childhood trauma and PTSD symptoms have been identified as possible risk factors for the occurrence of meditation-related adverse effects (MRAE). The present research examined multiple forms of childhood trauma and PTSD symptoms as predictors of depression treatment outcomes and MRAEs. Various forms of childhood trauma (e.g., abuse and neglect) were examined as predictors of depression treatment outcomes and participant attrition using secondary analyses of two MBP clinical trials (N = 52 and 104, respectively). Study 2 also examined meditation-related side effects (MRSE) and MRAE as outcomes and current subclinical and past PTSD symptoms as predictors. Childhood trauma led to worse depression outcomes across both study 1 and study 2, such that total childhood trauma and childhood sexual abuse were significant predictors across both studies. Childhood sexual abuse predicted attrition in study 2. Finally, multiple forms of childhood trauma and PTSD symptoms predicted MRSE, while total childhood trauma, childhood emotional abuse, and subclinical PTSD symptoms predicted lasting MRAE. Childhood trauma and PTSD symptoms may lead to worse outcomes and a greater occurrence of adverse effects within MBPs for active depression. These results call for further trauma-sensitive modifications, safety monitoring, participant screening, and provider education when implementing these programs.

Mind wandering (MW) encompasses both a deliberate and a spontaneous disengagement of attention from the immediate external environment to unrelated internal thoughts. Importantly, MW has been suggested to have an inverse relationship with mindfulness, a state of nonjudgmental awareness of present-moment experience. Although they are, respectively, associated with increased and decreased activity in the default mode network (DMN), the specific contributions of deliberate and spontaneous MW, and their relationships with mindfulness abilities and resting-state macro networks remain to be elucidated. Therefore, resting-state MRI scans from 76 participants were analyzed with group independent component analysis to decompose brain networks into independent macro-networks and to see which of them predicted specific aspects of spontaneous and deliberate MW or mindfulness traits. Our results show that temporal variability of the resting-state DMN predicts spontaneous MW, which in turn is negatively associated with the acting with awareness facet of mindfulness. This finding shows that the DMN is not directly associated with overall mindfulness, but rather demonstrates that there exists a close relationship between DMN and MW, and furthermore, that the involvement of mindfulness abilities in this dynamic may be secondary. In sum, our study contributes to a better understanding of the neural bases of spontaneous MW and its relationship with mindfulness. These results open up the possibility of intervening on specific aspects of our cognitive abilities: for example, our data suggest that training the mindfulness facet acting with awareness would allow lessening our tendency for MW at inopportune times.

Artistic sports have a more positive impact on adolescents on the basis of basic sports. This study delves into the beneficial effects of Artistic sports compared to basic sports in enhancing academic self-efficacy in college students, and investigates the mediating roles of mindfulness, social anxiety, and academic procrastination in this process.

A questionnaire survey was conducted among students in some universities in Gansu Province, collecting a total of 1,976 online questionnaires, including 263 males and 1,713 females, with 1,543 participants in Artistic sports courses and 433 participants in basic sports. Data processing was carried out using SPSS 26.0 software and its plugin PROCESS.

The analysis results indicate significant differences in mindfulness, social anxiety, academic procrastination, and academic self-efficacy among different types of sports training (ps < 0.05); significant correlations were found among all variables (ps < 0.001). Sports training types can directly predict academic self-efficacy (β = 0.069, t = 3.155, p < 0.01), further confirming that sports training types can directly predict academic self-efficacy. Moreover, mindfulness, social anxiety, and academic procrastination play a chain mediating role between Artistic sports and academic self-efficacy.

These findings highlight the potential value of Artistic sports in enhancing academic self-efficacy and provide practical guidance for education policymakers, school administrators, teachers, parents, and students to promote adolescent academic and psychological health development. It is recommended to enhance the promotion and training of Artistic sports.

Neural activity and subjective experiences indicate that breath-awareness practices, which focus on mindful observation of breath, promote tranquil calm and thoughtless awareness.

This study explores the impact of tristage Ānāpānasati-based breath meditation on electroencephalography (EEG) oscillations and self-reported mindfulness states in novice meditators following a period of effortful cognition.

Eighty-nine novice meditators (82 males; Mean Age = 24.59 years) underwent a breath-based meditation intervention consisting of three stages: Resting State (RS), Breath Counting (BC), and Breath Focus (BF). EEG assessed neural oscillatory changes throughout the three stages while providing spectral indices for arousal and cognitive workload (CWL) stagewise. State mindfulness and breath awareness-related self-reported feedback were also collected using the Amsterdam Resting-State Questionnaire (ARSQ) post-BF stage and the curated Breath Count Feedback (BCF) post-BC stage, respectively. The internal reliability and construct validity of the standardised ARSQ and the designed BCF were satisfactorily computed within our sample. A within-subjects cross-sectional neurobehavioural examination of the breath self-regulatory novice experiences was thus conducted.

The breath-based intervention significantly increased alpha power across all stages, indicating relaxation. Theta and delta powers increased during BC and BF in the prefrontal cortex (PFC), suggesting enhanced working memory and focused attention. Gamma power in meditation-associated brain regions and occipital beta oscillations showed significant positive correlations with breath counts, reflecting improved visual and attentional concentration. Lower pre-meditative arousal and smaller in-meditation CWL levels were associated with fewer distractions and increased confidence accuracy during BC.

The results suggest that BC may serve as a valuable tool for improving present-centric control and concentration, highlighting the importance of managing CWL and arousal levels to optimise meditation outcomes.

Being deafblind means my perception differs profoundly from those who are conventionally sighted and have non-impaired hearing. A lot of hidden knowledge is to be found in the disparity between these differing experiences that could be of great value in developing assistive technologies that have a broad scope to engage with both disabled and non-disabled users. This article explores the balancing act between sensory loss and the potential inherent in all of us and how this should be part of the design process of haptic assistive technology.Facing the true impact of my sensory loss, I realised it held the unexpected gift of a-literally-different perspective. I am losing sights and sounds, but the world still reveals itself to me in many ways. Exploring my sensory potential, I combine daily life experiences and theoretical knowledge to better understand how to get the most out of my sensory processing systems. The goal is not to compensate what is lost, but stay connected in a way that enables me to live my life to the fullest.I undertake sensory life hacks based on the brain's unmatched capacity to adjust to circumstances and work with any kind of input. Both predicting processing and neuroplasticity offer an operating system of highly evolved flexibility that allows and even encourages creative solutions. I adjust my coping strategies to align them with these processes shaping my perceptual experience, balancing sensory loss and sensory gain.I believe there is great potential to enrich daily life experiences with haptic assistive technology, building on the natural sensory abilities we have as human beings, co-creating life. However, this comes with challenges: researchers who are not sensorily impaired should consider through experience that we all have limited perception in a way. At the edges of the familiar, you have to face your perceptual limits, pushing you out of your comfort zone and in doing so space is being created for growth; researchers used to the dominance of sight and hearing are less used to consciously experiencing the power of sensory proximity, such as touch and proprioception. These bodily tactile senses, however, are grounding senses in all of us and display a broad scope of sensations to be experienced.The hereditary disease that causes deafblindness forced me to explore the edges of my perception, and instead of devastating loss I discovered a richness of sensory abilities. This article is a plea to dive into this, using my lived experience and critical knowledge. Realising this potential can mean that inclusive research on assistive technologies might really do what it promises, co-creating technologies to enhance life experiences.

Obesity has been identified as a rapidly rising pandemic within the developed world, potentially increasing the risks of type 2 diabetes and cardiovascular disease. Various studies have identified a positive association between stress, elevated cortisol levels and obesity. Mechanisms of the stress response lead to hyperpalatable food preference and increased appetite through the activation of the HPA axis, elevated cortisol and the resulting interactions with the dopaminergic system, neuropeptide Y, ghrelin, leptin and insulin. The methodology of this review involved a Systematic Search of the Literature with a Critical Appraisal of papers considering ashwagandha, mediation and mindfulness in relation to mechanisms of the stress response. It incorporated 12 searches yielding 330 hits. A total of 51 studies met the inclusion criteria and were critically appraised with ARRIVE, SIGN50 and Strobe checklists. Data from the 51 studies was extracted, coded into key themes and summarized in a narrative analysis. Thematic analysis identified 4 key themes related to ashwagandha and 2 key themes related to meditation. Results provide an overview of evidence assessing the efficacy of ashwagandha and meditation in relation to weight loss interventions by supporting the stress response and the pathways highlighted. Results of Clinical studies indicate that ashwagandha supports weight loss through reduced stress, cortisol and food cravings. Pre-clinical studies also suggest that ashwagandha possesses the capacity to regulate food intake by improving leptin and insulin sensitivity and reducing addictive behaviors through dopamine regulation. Clinical studies on meditation indicate it may enhance a weight loss protocol by reducing the stress response, cortisol release and blood glucose and improving eating behaviors.

Epigenetic mechanisms are key processes that constantly reshape genome activity carrying out physiological responses to environmental stimuli. Such mechanisms regulate gene activity without modifying the DNA sequence, providing real-time adaptation to changing environmental conditions. Both favorable and unfavorable lifestyles have been shown to influence body and brain by means of epigenetics, leaving marks on the genome that can either be rapidly reversed or persist in time and even be transmitted trans-generationally. Among virtuous habits, meditation seemingly represents a valuable way of activating inner resources to cope with adverse experiences. While unhealthy habits, stress, and traumatic early-life events may favor the onset of diseases linked to inflammation, neuroinflammation, and neuroendocrine dysregulation, the practice of mindfulness-based techniques was associated with the alleviation of many of the above symptoms, underlying the importance of lifestyles for health and well-being. Meditation influences brain and body systemwide, eliciting structural/morphological changes as well as modulating the levels of circulating factors and the expression of genes linked to the HPA axis and the immune and neuroimmune systems. The current chapter intends to give an overview of pioneering research showing how meditation can promote health through epigenetics, by reshaping the profiles of the three main epigenetic markers, namely DNA methylation, histone modifications, and non-coding RNAs.

This study evaluated the feasibility and satisfaction of using a wearable brain activity sensing device for stress reduction among patients experiencing Long COVID (LC).

Patients with LC (N = 45) were invited to participate in an open-label pilot study. Participants were asked to use a brain-sensing electroencephalogram (S-EEG) wearable device (Muse-S™) daily for 90 days and followed for an additional 90 days (180 days total participation). Study enrollment began June 28, 2022, and ended July 28, 2023.

Patients were predominantly female (82%), white (96%), and with an average age of 47.6 (±12.5) years. At the end of treatment (90 days), cognition, sleep, self-efficacy, and quality-of-life quality of life improved (P < .001 to P = .04). In addition, stress and anxiety were significantly reduced (P < .001). These significant changes persisted by end-of-study (180 days). For stress (P = .023) and anxiety (P = .033), a change from the baseline during follow-up was significantly associated with the amount of S-EEG usage. The end-of-study satisfaction survey indicated that patients were very satisfied with the S-EEG device, and 97% planned to continue using it.

Results suggest that the S-EEG device improved cognition in LC, which is one of the main severe symptoms we see in our LC clinic. In addition, it helped reduce stress and anxiety. These findings have important clinical implications for LC patients using S-EEG as an adjunct to concurrent LC clinical care which includes pharmacotherapies.

Clinical studies have suggested that dysregulation of the neuropeptide Y (NPY) system may play a role in psychiatric disorders, including chronic stress. Meanwhile, Mindfulness Based Stress Reduction (MBSR) has shown promise for stress-related maladies. However, no studies have explored whether MBSR can change plasma NPY concentration in stressed individuals.

Individuals with symptoms of chronic stress were randomly assigned to eight weeks of either MBSR (n = 15), a locally-developed stress reduction intervention (LSR) (n = 15) or a wait-list control group (n = 20). Blood samples were collected at baseline and at a twelve-week follow-up to determine the effects of MBSR or LSR compared to the wait-list control group on NPY levels.

The MBSR group had increased plasma NPY levels after the program compared to the waitlist control group, whereas the LSR group was not statistically different from the other groups.

This pilot study provides evidence of the feasibility of MBSR to alter plasma NPY.

Current models of psychedelic action in the brain propose changes along the dorsal-ventral and anterior-posterior axes but neglect to address the lateral axis. This article proposes a novel model of psychedelic action called HEALS (Hemispheric Annealing and Lateralization Under Psychedelics) which involves the reversal of the typical hierarchical relationship between the two hemispheres of the brain. In typical modes of consciousness, the hemispheres act in parallel process with the left predominating. Under psychedelics, as well as in other altered states of consciousness (ASCs), this hierarchy is reversed, with the right hemisphere released from inhibition by the left. In support of this model, the available neuroimaging evidence for lateralization under psychedelics is reviewed. Then, various cognitive and emotional changes observed under psychedelics are contrasted with those same functions in each hemisphere. These include attention; social and emotional intelligence; creativity and insight; and language. The article concludes with a review of laterality in other ASCs, such as meditative and trance states, and suggests that many phenomena associated with psychedelics, and other ASCs, might be explained by an atypical annealing between the hemispheres toward right hemisphere predominance.

Reward sensitivity is a central maintaining factor of depression. Current treatments fail at sufficiently and reliably modifying reward processing. Therefore, we employed interventions targeting reward sensitivity and evaluated the long-term efficacy of different online interventions, additionally exploring predictors of changes in reward sensitivity.

This four-arm randomized controlled trial (RCT) tested the long-term stability of treatment effects during a four-month follow-up in 127 participants of a two-week online intervention (behavioral activation vs. mindfulness and gratitude vs. combination of both). In addition, we investigated predictors of treatment success defined as improvement in reward sensitivity. Predictors we investigated were depressive expectations, stress and the type of reward implemented in the exercises of the intervention (physical activities and social encounters).

The improvement concerning reward sensitivity, as well as the reduction of anhedonia and depressive symptoms was stable over a four-month follow-up. We did not find evidence for differences between the active intervention groups. Positive changes in depressive expectations were a significant predictor of long-term improvements in reward sensitivity.

Only self-report measures were used and the interpretation of the long-term efficacy of the online interventions is limited since the waitlist control condition was not extended to the follow-up.

Clinicians should focus on violating depressive expectations to facilitate updating the prediction and anticipation of future rewarding experiences. This could be a vital mechanism of change in reward sensitivity. However, future research still needs to unravel what kind of interventions are most effective in targeting reward insensitivity.

This evaluation examines the impacts of Exhale to Inhale's trauma-informed yoga (TIY) on stress, somatic complaints, and self-efficacy among female survivors of intimate partner violence (IPV) and affiliated staff in community-based domestic violence agencies. A two-phase study design was employed, the first of which collected data from in-person group classes and the second from remotely taught classes due to COVID-19 safety restrictions. Collected over 3 years, 526 female survivors (n = 361) and staff (n = 165) from 66 domestic violence agencies completed surveys revealing improved stress, somatic complaints, and self-efficacy following a single TIY session. TIY serves as a capacity-building intervention that is suitable and adaptable for survivors of IPV and the staff at domestic violence agencies.

Depression, the most prevailing mental health condition, remains untreated in over 30% of patients. This cluster presents with sub-clinical inflammation. Investigations trialling anti-inflammatory medications had mixed results. The lack of results may result from inflammation's complexity and targeting only a few of depression's abnormal pathways. Mind-body therapies' biological and neuro-imaging studies offer valuable insights into depression psychopathology. Interestingly, mind-body therapies, like yoga, reverse the aberrant pathways in depression. These aberrant pathways include decreased cognitive function, interoception, neuroplasticity, salience and default mode networks connectivity, parasympathetic tone, increased hypothalamic-pituitary-adrenal (HPA) axis activity, and metabolic hyper/hypofunction. Abundant evidence found yogic techniques improving self-reported depressive symptoms across various populations. Yoga may be more effective in treating depression in conjunction with pharmacological and cognitive therapies. Yoga's psychoneuroimmunology teaches us that reducing allostatic load is crucial in improving depressive symptoms. Mind-body therapies promote parasympathetic tone, downregulate the HPA axis, reduce inflammation and boost immunity. The reduced inflammation promotes neuroplasticity and, subsequently, neurogenesis. Improving interoception resolves the metabolic needs prediction error and restores homeostasis. Additionally, by improving functional connectivity within the salience network, they restore the dynamic switching between the default mode and central executive networks, reducing rumination and mind-wandering. Future investigations should engineer therapies targeting the mechanisms mentioned above. The creation of multi-disciplinary health teams offering a combination of pharmacological, gene, neurofeedback, behavioural, mind-body and psychological therapies may treat treatment-resistant depression.

Lifestyle behavior change and mindfulness have direct and synergistic effects on cognitive functioning and may prevent Alzheimer disease and Alzheimer disease-related dementias (AD/ADRD). We are iteratively developing and testing My Healthy Brain (MHB), the first mindfulness-based lifestyle group program targeting AD/ADRD risk factors in older adults with subjective cognitive decline. Our pilot studies (National Institutes of Health [NIH] stage 1A) have shown that MHB is feasible, acceptable, and associated with improvement in lifestyle behavior and cognitive outcomes.

We will compare the feasibility of MHB versus an education control (health enhancement program [HEP]) in 50 older adults (aged ≥60 y) with subjective cognitive decline and AD/ADRD risk factors. In an NIH stage 1B randomized controlled trial (RCT), we will evaluate feasibility benchmarks, improvements in cognitive and lifestyle outcomes, and engagement of hypothesized mechanisms.

We are recruiting through clinics, flyers, web-based research platforms, and community partnerships. Participants are randomized to MHB or the HEP, both delivered in telehealth groups over 8 weeks. MHB participants learn behavior modification and mindfulness skills to achieve individualized lifestyle goals. HEP participants receive lifestyle education and group support. Assessments are repeated after the intervention and at a 6-month follow-up. Our primary outcomes are feasibility, acceptability, appropriateness, credibility, satisfaction, and fidelity benchmarks. The secondary outcomes are cognitive function and lifestyle (physical activity, sleep, nutrition, alcohol and tobacco use, and mental and social activity) behaviors. Data analyses will include the proportion of MHB and HEP participants who meet each benchmark (primary outcome) and paired samples 2-tailed t tests, Cohen d effect sizes, and the minimal clinically important difference for each measure (secondary outcomes).

Recruitment began in January 2024. We received 225 inquiries. Of these 225 individuals, 40 (17.8%) were eligible. Of the 40 eligible participants, 21 (52.5%) were enrolled in 2 group cohorts, 17 (42.5%) were on hold for future group cohorts, and 2 (5%) withdrew before enrollment. All participants have completed before the intervention assessments. All cohort 1 participants (9/21, 43%) have completed either MHB or the HEP (≥6 of 8 sessions) and after the intervention assessments. The intervention for cohort 2 (12/21, 57%) is ongoing. Adherence rates for the Garmin Vivosmart 5 (128/147, 87.1% weeks) and daily surveys (105/122, 86.1% weeks) are high. No enrolled participants have dropped out. Enrollment is projected to be completed by December 2024.

The RCT will inform the development of a larger efficacy RCT (NIH stage 2) of MHB versus the HEP in a more diverse sample of older adults, testing mechanisms of improvements through theoretically driven mediators and moderators. The integration of mindfulness with lifestyle behavior change in MHB has the potential to be an effective and sustainable approach for increasing the uptake of AD/ADRD risk reduction strategies among older adults.

ClinicalTrials.gov NCT05934136; https://www.clinicaltrials.gov/study/NCT05934136.

DERR1-10.2196/64149.

Background and Objectives: Meditation and mindfulness, rooted in ancient traditions, enhance mental well-being by cultivating awareness and emotional control. It has been shown to induce neuroplasticity, increase cortical thickness, reduce amygdala reactivity, and improve brain connectivity and neurotransmitter levels, leading to improved emotional regulation, cognitive function, and stress resilience. This systematic review will synthesize research on neurobiological changes associated with mindfulness and meditation practices. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases without any search time range. This review has been registered on Open OSF (n) GV2JY. Results: Mindfulness-Based Stress Reduction (MBSR) enhances brain regions related to emotional processing and sensory perception, improves psychological outcomes like anxiety and depression, and exhibits unique mechanisms of pain reduction compared to placebo. Conclusions: This review highlights that mindfulness, particularly through MBSR, improves emotional regulation and brain structure, reduces anxiety, and enhances stress resilience. Future research should focus on diverse populations and naturalistic settings to better understand and optimize these benefits.

Chronic pain (CP) affects about 30% of the global population and poses significant challenges to individuals and healthcare systems worldwide. The interactions between physiological, psychological, and social factors are crucial in the onset and development of CP conditions. This study aimed to evaluate the effectiveness of mindfulness-based intervention, examining its impact on perceived stress (PSS), depression and anxiety (BDI-II, PGWBI/DEP, SAS, STAI Y), sleep quality (PSQI), and mindfulness abilities (MAAS) in individuals with CP. Participants (N = 89, 84.3% female) underwent one of two diagnoses [fibromyalgia (FM) or low back pain (LBP)] and took part in an MBSR intervention. The mindfulness program proved effective in reducing PSQI scores (F = 11.97; p < 0.01) over time, independently of the type of diagnosis. There was also a marginal increase in trait mindfulness as measured by MAAS (F = 3.25; p = 0.07) in both groups. A significant difference between the two groups was found for the effect on PSS: F (1,87) = 6.46; p < 0.05. Mindfulness practice also reduced anxiety in FM and depressive symptoms in LBP, indicating a reduction in psychological distress among participants. Our findings suggest that mindfulness-based interventions may offer promising avenues for personalized pain management in clinical settings.

Persisting Symptoms after Concussion (PSaC) are common and difficult to treat. Mindfulness-based interventions can support recovery but are rarely included in rehabilitative care. We developed OWNMindfulness, an eight-week live-video mindfulness-based group for PSaC.

To assess feasibility and preliminary clinical effects of OWNMindfulness.

Fourteen individuals with PSaC enrolled in this mixed-methods single-arm feasibility study. We assessed enrollment/retention, adherence, fidelity, instrument completion, safety, and satisfaction. We evaluated preliminary trends in the impact of the intervention on mindfulness (CAMS-R), concussion symptoms (PCSS), and QOL (WHOQOL-BREF). Qualitative analysis of exit interviews explored participants' perceptions of the effects of the intervention, and framework analysis assessed adequacy of the quantitative measures to capture perceived effects.

Feasibility results met a priori benchmarks. Mindfulness, concussion symptoms, and QOL scores improved (CAMS-R: adjusted p = 0.01, large effect size; PCSS: adjusted p = 0.03, moderate effect size; WHOQOL-BREF: not significant, small effect size). Qualitative analysis of interview data found benefits including validation, compassion, self-awareness, self-efficacy, concussion symptoms, resilience, life participation, social relationships, and QOL. Framework analysis demonstrated that quantitative tools captured change in concussion symptoms but did not comprehensively assess the other benefits identified through qualitative methods.

OWNMindfulness shows preliminary feasibility and promise for improving clinical outcomes. Results suggest the need for additional quantitative tools for comprehensive measurement of the effects and may point to potential mechanisms of action.

Meditation is a family of ancient and contemporary contemplative mind-body practices that can modulate psychological processes, awareness, and mental states. Over the last 40 years, clinical science has manualized meditation practices and designed various meditation interventions that have shown therapeutic efficacy for disorders including depression, pain, addiction, and anxiety. Over the past decade, neuroimaging has been used to examine the neuroscientific basis of meditation practices, effects, states, and outcomes for clinical and nonclinical populations. However, the generalizability and replicability of current neuroscientific models of meditation have not yet been established, because they are largely based on small datasets entrenched with heterogeneity along several domains of meditation (e.g., practice types, meditation experience, clinical disorder targeted), experimental design, and neuroimaging methods (e.g., preprocessing, analysis, task-based, resting-state, structural magnetic resonance imaging). These limitations have precluded a nuanced and rigorous neuroscientific phenotyping of meditation practices and their potential benefits. Here, we present ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis)-Meditation, the first worldwide collaborative consortium for neuroscientific investigations of meditation practices. ENIGMA-Meditation will enable systematic meta- and mega-analyses of globally distributed neuroimaging datasets of meditation using shared, standardized neuroimaging methods and tools to improve statistical power and generalizability. Through this powerful collaborative framework, existing neuroscientific accounts of meditation practices can be extended to generate novel and rigorous neuroscientific insights that account for multidomain heterogeneity. ENIGMA-Meditation will inform neuroscientific mechanisms that underlie therapeutic action of meditation practices on psychological and cognitive attributes, thereby advancing the field of meditation and contemplative neuroscience.

The present study investigated the effectiveness of a newly developed 8-week meditation program, which included chanting and meditation, on executive functions (EFs) in school-age children. Twenty-five students assigned to an experimental group participated in the meditation program, engaging in daily and weekly activities for 8 weeks. Another 25 students served as a control group and participated in regular school activities. Pretest and posttest assessments included the n-back task for working memory, the go/no-go task for inhibition, and the Wisconsin Card Sorting Test (WCST) for cognitive flexibility. A mixed repeated measures ANOVA was conducted to analyze interaction effects, within-group differences, and between-group differences. The experimental group demonstrated greater improvement compared to the control group across several measures: (1) reaction time in the 1-back task, (2) correct responses in the no-go condition of the go/no-go task, and (3) percentage of correct responses, errors, perseverative errors, non-perseverative errors, perseverative responses, and conceptual level responses in the WCST (p < 0.001). These findings underscore the potential benefits of an 8-week school-based meditation program incorporating chanting and meditation for enhancing EFs in school-age children.

The tripartite classification of mental faculties into cognition, affect, and conation (motivation and action) continues to be the edifice on which the mind and the methods to address mental afflictions are studied. Eastern spiritual traditions offer insights into mental health as it pertains to each of these domains. Following up on our previous paper on the cognition path to psychotherapy (Knowing oneself, or Jnana Yoga), we herein focus on the path of selfless action (Karma Yoga). We review eastern concepts on the nature of karma and the approaches to optimal action (the will to do things, doing the right things, and doing them well). We then place these eastern insights in the context of emerging concepts in psychology on motivation and action. Current psychological concepts such as autonomy and intrinsic motivation, mastery, flow and growth mindset, higher purpose and value driven self-less action, equanimity and balance are convergent with ancient eastern concepts. We also review current neuroscientific underpinnings (such as neural circuitries, neurotransmitter systems and epigenetics and how these facilitate neural plasticity) relevant to karma, including free will, focused action, prosocial behaviors, extrinsic and intrinsic and motivation. These concepts have significant implications for psychotherapeutic models, especially in the areas of positive psychology and preventive psychiatry.

Mental disorders among young adults are a major health challenge. Mindfulness-based stress reduction (MBSR) has in previous research shown positive effects on mental health. However, research evaluating MBSR for young adults with mental disorders is insufficient and qualitative research exploring experiences of the programme is scarce. The aim of this study was to explore experiences of MBSR as a supplementary treatment in psychiatric outpatient care among young adults with moderate to severe mental disorders, from a short- and long-term perspective.

Eleven young adults (aged 18-27 years) who had participated in an MBSR programme were interviewed approximately three months or two years later. The analytic method was Grounded Theory.

The analysis resulted in a theoretical model including one core category and five categories. The model illustrated a learning process, explaining the participants' short- and long-term experiences of learning to pay attention to the body, regulate emotions, a change of attitude towards oneself, and still using skills two years after the programme.

The MBSR programme was experienced as a learning process which improved the longstanding ability to cope with emotional stress in daily life. Tailoring MBSR to individual needs may further enhance its effectiveness.

The experienced short- and long-term health-promotion benefits of an MBSR programme among young adults with mental disorders support its implementation in psychiatric and primary health care. Future research should investigate how to optimise implementation and tailor to individual needs.

Lifestyle interventions are strategies used to self-manage medical conditions, such as epilepsy, and often complement traditional pharmacologic and surgical therapies. The need for integrating evidence-based lifestyle interventions into mainstream medicine for the treatment of epilepsy is evident given that despite the availability of a multitude of treatments with medications and surgical techniques, a significant proportion of patients have refractory seizures, and even those who are seizure-free report significant adverse effects with current treatments. Although the evidence base for complementary medicine is less robust than it is for traditional forms of medicine, the evidence to date suggests that several forms of complementary medicine including yoga, mindfulness meditation, cognitive behavioral therapy, diet and nutrition, exercise and memory rehabilitation, and music therapy may have important roles as adjuncts in the treatment armamentarium for epilepsy. These topics were discussed by a diverse group of medical providers and scientists at the "Lifestyle Intervention for Epilepsy (LIFE)" symposium hosted by Cleveland Clinic. PLAIN LANGUAGE SUMMARY: There are many people with epilepsy who continue to have seizures even though they are being treated with medication or brain surgery. Even after seizures stop, some may experience medication side effects. There is research to suggest that certain lifestyle changes, such as yoga, mindfulness, exercise, music therapy, and adjustments to diet, could help people with epilepsy, when used along with routine treatment. Experts discussed the latest research at the "Lifestyle Intervention for Epilepsy (LIFE)" symposium hosted by Cleveland Clinic.

The IMPACT BCN trial-a parallel-group randomized clinical trial where 1221 pregnant women at high risk for small-for-gestational age (SGA) newborns were randomly allocated at 19- to 23-week gestation into three groups: Mediterranean diet, Mindfulness-based Stress reduction or non-intervention-has demonstrated a positive effect of Mediterranean diet and Stress reduction in the prevention of SGA. However, the mechanism of action of these interventions remains still unclear. The aim of this study is to investigate the effect of Mediterranean diet and Stress reduction on placental volume and perfusion.

Participants in the Mediterranean diet group received monthly individual and group educational sessions, and free provision of extra-virgin olive oil and walnuts. Women in the Stress reduction group underwent an 8-week Stress reduction program adapted for pregnancy, consisting of weekly 2.5-h and one full-day sessions. Non-intervention group was based on usual care. Placental volume and perfusion were assessed in a subgroup of randomly selected women (n = 165) using magnetic resonance (MR) at 36-week gestation. Small placental volume was defined as MR estimated volume <10th centile. Perfusion was assessed by intravoxel incoherent motion.

While mean MR placental volume was similar among the study groups, both interventions were associated with a lower prevalence of small placental volume (3.9% Mediterranean diet and 5% stress reduction vs. 17% non-intervention; p = 0.03 and p = 0.04, respectively). Logistic regression showed that small placental volume was significantly associated with higher risk of SGA in both study groups (OR 7.48 [1.99-28.09] in Mediterranean diet and 20.44 [5.13-81.4] in Stress reduction). Mediation analysis showed that the effect of Mediterranean diet on SGA can be decomposed by a direct effect and an indirect effect (56.6%) mediated by a small placental volume. Similarly, the effect of Stress reduction on SGA is partially mediated (45.3%) by a small placental volume. Results on placental intravoxel incoherent motion perfusion fraction and diffusion coefficient were similar among the study groups.

Structured interventions during pregnancy based on Mediterranean diet or Stress reduction are associated with a lower proportion of small placentas, which is consistent with the previously observed beneficial effects of these interventions on fetal growth.

We argue that researchers should test less, estimate more, and adopt Open Science practices. We outline some of the flaws of null hypothesis significance testing and take three approaches to demonstrating the unreliability of the p value. We explain some advantages of estimation and meta-analysis ("the new statistics"), especially as contributions to Open Science practices, which aim to increase the openness, integrity, and replicability of research. We then describe esci (estimation statistics with confidence intervals): a set of online simulations and an R package for estimation that integrates into jamovi and JASP. This software provides (a) online activities to sharpen understanding of statistical concepts (e.g., "The Dance of the Means"); (b) effects sizes and confidence intervals for a range of study designs, largely by using techniques recently developed by Bonett; (c) publication-ready visualisations that make uncertainty salient; and (d) the option to conduct strong, fair hypothesis evaluation through specification of an interval null. Although developed specifically to support undergraduate learning through the 2nd edition of our textbook, esci should prove a valuable tool for graduate students and researchers interested in adopting the estimation approach. Further information is at ( https://thenewstatistics.com).

This study aims to assess the effect of mindfulness intervention on negative emotions (anxiety and depression) and quality of life in malignant tumor patients.

The databases, including CNKI, VIP, Wanfang, Chinese Biomedical Literature Database disc (CBMdisc), PubMed, Embase, Cochrane Library, and Web of Science (WoS), were searched from inception to January 2024. Randomized controlled trials examining the effects of mindfulness intervention on negative emotions and quality of life in malignant tumor patients were selected. Meta-analysis was conducted using RevMan 5.1.

A total of 11 studies involving 993 patients were included. Compared with usual care, mindfulness intervention effectively reduced anxiety [SMD = -0.81, 95% CI (-1.01, -0.60), p < 0.00001], depression [SMD = -0.86, 95% CI (-1.01, -0.70), p < 0.00001], and improved patients' quality of life [SMD = 0.64, 95% CI (0.50, 0.78), p < 0.00001].

Mindfulness intervention can effectively alleviate negative emotions such as anxiety and depression in malignant tumor patients and positively impact their quality of life.

Although there is an established link between smaller hippocampal volume and anxiety, the longitudinal relations between hippocampus structure and anxiety in diverse youth are not well understood. The present longitudinal study investigated hippocampal volumes related to anxiety symptoms in a sample of Black 8-14-year-old youth (N = 64), a population historically underrepresented in neuroimaging research. Smaller hippocampal volumes were associated with greater anxiety symptoms independent of age, sex, intracranial volume and trauma exposure. Exploratory longitudinal analyses showed smaller hippocampal volume as a predictor for anxiety symptoms (n = 37) and not a consequence of anxiety symptoms (n = 32), however results were inconclusive as this finding was no longer significant after correcting for baseline anxiety symptoms. Overall, this data increases our understanding of potential neurobiological mechanisms for anxiety in a high-risk sample of Black youth and suggests future directions into studying trajectories of developmental risk.

This study evaluated changes in the white matter of the brain and psychological health variables, resulting from a neuroscience-based mindfulness intervention, the Training for Awareness, Resilience, and Action (TARA), in a population of healthy adolescents.

A total of 100 healthy adolescents (57 female, age ranges 14-18 years) were randomized into the 12-week TARA intervention or a waitlist-control group. All participants were imaged with diffusion MRI to quantify white matter connectivity between brain regions. Imaging occurred at baseline/randomization and after 12 weeks of baseline (pre- and post-intervention in the TARA group). We hypothesized that structural connectivity in the striatum and interoceptive networks would increase following the TARA intervention, and that, this increased connectivity would relate to psychological health metrics from the Strengths and Difficulties Questionnaire (SDQ) and the Insomnia Severity Index (ISI). The TARA intervention and all assessments, except for the MRIs, were fully remotely delivered using secure telehealth platforms and online electronic data capture systems.

The TARA intervention showed high consistency, tolerability, safety, recruitment, fidelity, adherence, and retention. After 12 weeks, the TARA group, but not controls, also demonstrated significantly improved sleep quality (p = 0.02), and changes in the right putamen node strength were related to this improved sleep quality (r = -0.42, p = 0.006). Similarly, the TARA group, but not controls, had significantly increased right insula node strength related to improved emotional well-being (r = -0.31, p = 0.04). Finally, we used the network-based statistics to identify a white matter interoception network that strengthened following TARA (p = 0.009).

These results suggest that the TARA mindfulness-based intervention in healthy adolescents is feasible and safe, and it may act to increase structural connectivity strength in interoceptive brain regions. Furthermore, these white matter changes are associated with improved adolescent sleep quality and emotional well-being. Our results suggest that TARA could be a promising fully remotely delivered intervention for improving psychological well-being in adolescents. As our findings suggest that TARA affects brain regions in healthy adolescents, which are also known to be altered during depression in adolescents, future studies will examine the effects of TARA on depressed adolescents.

https://clinicaltrials.gov/study/NCT04254796.

This study analyzed the relationship between mindfulness and variables considered relevant for teacher-student interactions: teacher burnout, general stress, anxiety, depression, and quality of life. We hypothesized that mindfulness would relate negatively with mental health variables and positively with quality of life. We also explored which specific aspects of mindfulness would predict burnout, depression, anxiety, stress, and quality of life. Given the results of regression analyses, mediation models were performed to explore the mechanisms through which different facets of mindfulness affect quality of life. As predicted, the correlation analysis showed that mindfulness and its dimensions were positively associated with the quality of life of the teachers and burnout dimension of personal fulfillment and negatively associated with anxiety, depression, and stress (considering FFMQ total score and most of its dimensions). Consistently, regression analysis showed that the overall level of mindfulness, after controlling for the grade level at which the teacher works, showed significant associations with the level of personal fulfillment, depression, anxiety, stress, and quality of life. The results of the mediation analyses showed that the ability not to judge ourselves was associated with fewer symptoms of depression and stress and, through these pathways, positively affected quality of life. On the other hand, the ability not to react favored quality of life by reducing anxiety and stress. Finally, acting with awareness was the only facet of mindfulness that favored quality of life, affecting one of the dimensions of burnout.

Acute coronary syndrome (ACS) poses a significant threat to health and well-being, although percutaneous coronary intervention (PCI) is an effective treatment method. However, many patients undergoing PCI for coronary heart disease often experience negative emotions such as depression and anxiety, as well as sleep disturbances, poor adherence to medications, and somatic symptoms. These adverse psychological effects can contribute to an increased risk of cardiovascular events. Mindfulness-based stress reduction (MBSR), a highly effective mind-body therapy, has been increasingly utilized in the recovery process of patients with coronary heart disease. Several scholars have conducted mindfulness interventions for post-PCI patients with coronary heart disease and achieved promising outcomes. This article primarily focuses on applying mindfulness-based stress reduction in PCI patients with coronary heart disease and its future prospects.

In stressful situations, to overcome unpleasant emotions, individuals try to manage stress through emotion regulation strategies such as cognitive reappraisal, interoception, and mindfulness.

26 healthy adults underwent a modified version of the Trier Social Stress Test (named the Social Stress Test, SST) while their electrophysiological (EEG) activity was monitored. Participants also completed self-report questionnaires prior to this, including the Five-Facet Mindfulness Questionnaire (FFMQ), Multidimensional Assessment of Interoceptive Awareness (MAIA), Emotional Regulation of Others and Self (EROS), and the Interpersonal Reactivity Index (IRI). Three brain regions of interest (ROIs) were considered in the EEG data processing: frontal, temporo-central, and parieto-occipital. Correlational analyses were performed between psychometric scales and EEG band power spectral values for each ROI.

The results showed positive correlations between interoceptive awareness, mindfulness, and high-frequency EEG bands (beta, alpha, gamma) over frontal ROI, indicating enhanced cognitive processing and emotional regulation. Conversely, emotion regulation and empathy measures correlated positively with low-frequency EEG bands (delta, theta), associated with improved social cognition and top-down regulatory processes.

These findings suggest that EEG correlations of the stress response are connected to emotion regulation mechanisms, emphasizing the importance of body state awareness in managing stress and emotions for overall well-being and quality of life.

Insomnia is a highly prevalent sleep disorder frequently comorbid with mental health conditions in nurses. Despite the effectiveness of evidence-based cognitive behavioral therapy for insomnia (CBT-I), there is a critical need for alternative approaches. This study investigated whether internet-delivered mindfulness-based stress reduction (IMBSR) for insomnia could be an alternative to internet-delivered CBT-I (ICBT-I).

The hypothesis was that the IMBSR would be noninferior to the ICBT-I in reducing the severity of insomnia among nurses with insomnia. Additionally, it was expected that ICBT-I would produce a greater reduction in the severity of insomnia and depression than IMBSR.

Among 240 screened nurses, 134 with insomnia were randomly allocated (IMBSR, n = 67; ICBT-I, n = 67). The assessment protocol comprised clinical interviews and self-reported outcome measures, including the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), the 15-item Five Facet Mindfulness Questionnaire (FFMQ), and the Client Satisfaction Questionnaire (CSQ-I).

The retention rate was 55% with 77.6% (n = 104) of participants completing the study. At post-intervention, the noninferiority analysis of the ISI score showed that the upper limit of the 95% confidence interval was 4.88 (P = 0.46), surpassing the pre-specified noninferiority margin of 4 points. Analysis of covariance revealed that the ICBT-I group had significantly lower ISI (Cohen's d = 1.37) and PHQ-9 (Cohen's d = 0.71) scores than did the IMBSR group. In contrast, the IMBSR group showed a statistically significant increase in the FFMQ-15 score (Cohen's d = 0.67). Within-group differences showed that both the IMBSR and ICBT-I were effective at reducing insomnia severity and depression severity and improving mindfulness.

Overall, nurses demonstrated high levels of satisfaction and adherence to both interventions. The IMBSR significantly reduced insomnia severity and depression, but the findings of this study do not provide strong evidence that the IMBSR is at least as effective as the ICBT-I in reducing insomnia symptoms among nurses with insomnia. The ICBT-I was found to be significantly superior to the IMBSR in reducing insomnia severity, making it a recommended treatment option for nurses with insomnia.