Research from multiple fields and methodologies has aligned in recent years to support the development of biological models of mechanisms underlying effects of mindfulness practices in adults. Mindfulness-based programs for young children have proliferated in recent years but research examining the effects of these programs and practices is less conclusive, generally showing small mixed effects. Questions about age of initiation and the format, dosage and emphasis of programs represent a significant challenge that will require integrated multidisciplinary collaboration. The current study demonstrates the feasibility, sensitivity and reliability of electroencephalographic (EEG) measures of attention, and salivary measures of stress, in measuring biological changes associated with mindfulness practices in children aged five to seven years. Widely used and reliable behavioral measures showed no significant differences between groups whereas EEG measures showed significant group differences in event-related potentials associated with different attention networks elicited by the Attention Network Task for Children (ANT-C). The multiple salivary measures of stress showed mixed differences in slope by measure and group, some of which were predicted and align with previous literature, albeit not reaching statistical significance. Together, results demonstrate the value of utilizing multiple biological measures, particularly functional brain imaging, as a means to gain insights into the effects of mindfulness-based practices in young children. Additional data and more rigorous study designs are needed to directly associate observed differences with specific mindfulness programs and practices, but data suggest mindfulness practices enhance attentional and executive control which in turn could support enhanced regulation of the stress response system. Mindfulness based interventions and programs in early development have the potential to protect and enhance the development of critical biological systems that support academic achievement, health and wellbeing.

*LITERATURE REVIEW* Abstract Background: Insomnia is an increasing public health epidemic, affecting healthy, sub-clinical and clinical populations. Cognitive Behaviour Therapy for insomnia (CBT-I) is the most evidence-based treatment endorsed by the National Institute of Clinical Excellence (NICE) which provides guidance to health and social services in England. Research has demonstrated, however, that CBT-I has low or uncertain efficacy within various populations including those with coexisting health problems and clinical diagnoses. Furthermore, CBT-I is not accessible to most people due to poor prioritisation within services and a paucity of clinicians skilled in insomnia treatment. There is an urgent need to develop alternative interventions for this persistent and highly debilitating complaint. Acceptance based approaches to insomnia including mindfulness-based stress reduction (MBSR) provide an alternative model for holistic treatment of sleep distress. Objectives: This review summarises and synthesises the available literature investigating the effectiveness of MBSR as a treatment for insomnia in community and clinical populations (with some specific populations excluded). Method: Systematic review of all relevant quantitative and qualitative literature to date using PsycINFO, PsycARTICLES and Web of Knowledge databases. Results: 13 relevant articles were included (3 abstracts): randomised control trials (RCTs), experimental, quasi-experimental and qualitative studies. Conclusions: Overall, the limited research in this area was assessed to be of moderate quality and to provide preliminary evidence that MBSR offers an effective intervention for insomnia symptoms and disorder in various populations. The review highlighted the paucity of research specifically MBSR AND INSOMNIA SYMPTOMS 10 investigating the acceptability of MBSR as an insomnia treatment, particularly for more complex presentations. It is possible that MBSR provides holistic and bi-directional benefits for sleep and emotional well-being, however, further research is required to determine how participants experience the course process in relation to their sleep. Keywords: Insomnia, CBT-I, MBSR. *EMPIRICAL PAPER* Abstract: There is an urgent need to improve the availability and acceptability of interventions for insomnia. Low-levels of help-seeking and high levels of functional impairment are often characteristic of individuals with unremitting complaints. Ambivalence about the significance of insomnia and/or a helpless resignation can be further compounded by lack of available treatments and socio-cultural attitudes towards sleep. Insomnia is often complicated with coexisting mental and physical health problems, a syndromal presentation. Theoretical and empirical evidence suggests that eight-week, mindfulness-based stress reduction (MBSR) programmes may offer a holistic intervention to relieve emotional disturbance that may underlie the complaint. This research sought to understand the experience of MBSR for individuals in the community with persistent insomnia, to gain insight into its acceptability. Methods: Holloway and Jefferson’s psychosocial method was used which posits the ‘defended subject’ as key to data construction and analysis (2013). Defences, free associations, researcher-interviewee dynamic, textual information, cultural and sociological knowledge all contributed to an understanding of the ‘whole’ of the experience of interviewees as communicated within Free Association Narrative Interviewing. Results: Results indicate that for highly defended individuals with insomnia, MBSR can be a challenging intervention to engage with and to embody. Barriers to acceptability included: limited insight into emotional distress, (unconscious) relational secondary gains to insomnia, limited understanding of sleep as a physiological process, restricted understanding or misconceptions about mindfulness prior to participation, resistance to acknowledging insomnia MBSR AND INSOMNIA SYMPTOMS 66 as a mental health complaint and practical issues of delivery. Researcher-interviewee dynamics suggested significant unmet relational needs of many interviewees. An exceptional case was discussed where relational distress was not understood to underlie insomnia and where significant benefits to sleep were reported from MBSR. Conclusion: The methodology enabled novel insights into the challenges for highly defended individuals with complex insomnia for accessing MBSR. By contrast, it is possible that for less complex but acute and recurrent insomnia, MBSR is more readily acceptable. Study limitations, future research needs and recommendations for improving the acceptability of MBSR for complex cases of insomnia are discussed.

Background. Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention treatment for people in remission from major depression (rMDD). The neuropsychological mechanisms of MBCT are largely unknown. The key theoretical mechanisms of MBCT include self-compassion and rumination, with other mindfulness-based studies suggesting mechanisms across domains of attention, emotional processing, and cognitive flexibility. The aims of this thesis were to investigate the neuropsychological and neuroimaging mechanisms of MBCT in rMDD and to investigate relationships with relapse six months beyond MBCT. Paper One. 40 MBCT, 33 Treatment As Usual (TAU), and 42 healthy volunteers (HVs) took part. Experimental tasks for self-compassion and rumination were completed at baseline and post-session, alongside self-report questionnaires. Results showed increases for self-compassion following MBCT, with non-specific reductions for rumination. Paper Two. 40 MBCT, 33 TAU, and 42 HV participants took part. Tasks of attention, emotional processing, and cognitive flexibility were completed at baseline and post-session. Results showed increases in positive emotions post-MBCT, with non-specific changes for face emotion recognition and affective attentional bias tasks both post-MBCT and TAU. There were no changes over time for sustained attention or cognitive flexibility. Paper Three. 16 rMDD participants completed baseline and post-MBCT fMRI tasks of sustained attention and self-blame. Results showed reduced activation over time in the bilateral dACC in self-blame contrasts but no activation changes for sustained attention. Paper Four. 69 rMDD participants (38 MBCT & 31 TAU) completed task-based and self-report assessments up to six months follow-up. Non-relapsing MBCT participants showed increased self-compassion post-session which was maintained in follow-up. MBCT non-relapsing and TAU participants showed reduced rumination post-session and in follow-up. Conclusions. MBCT encourages a move towards more self-compassionate, positive processing but does not alter more automatic, bottom-up levels of processing. MBCT initiates a process for change beyond the course, particularly for self-compassion. Findings have theoretical and clinical implications and extend our understanding of the mechanisms of MBCT in rMDD participants.

This dissertation examined the relationship of attachment to three related but separate constructs: religiosity, spirituality, and mindfulness. The sample consisted of 2020 adults living in Israel. Each participant completed a series of self-report measures online, including the Experiences in Close Relationships Scale, Religious Commitment Inventory, Daily Spiritual Experiences, Spirituality Scale (including the sub-scales of Spiritual Self-Discovery, Spiritual Eco-Awareness, and Spiritual Relationships), Langer Mindfulness Scale, and a demographic questionnaire. Correlation and regression analyses were employed to assess for significant relationships between attachment and the outcome variables. Correlational findings indicated that Spiritual Self-Discovery and the Religious Commitment Inventory were both significantly correlated with attachment, whereas mindfulness was not found to be significantly correlated with attachment. Results of the regression analysis showed that none of the outcome variables produced significant quadratic or interaction models. Overall, this study indicates that the constructs of religiosity, spirituality, and mindfulness each have distinct relationships with adult attachment. The findings provide modest support for the previous literature on the compensation model, that religiosity can serve as a compensatory strategy for insecure attachment; the findings expand on the model by indicating that at least one aspect of spirituality (Spiritual Self-Discovery) may also serve as a compensatory mechanism. Findings also provide modest support for bolstering secure attachment through increased religious and spiritual belief. However, the significant findings were sparse and modest, bringing into question the extent to which religiosity, spirituality, and mindfulness really are related to attachment in any clinically significant way.

Originally derived from Eastern religions, the concept of mindfulness has been adapted and validated by psychology and medical science within recent decades. This project describes some of the religious viewpoints associated with mindfulness and its related practices, such as meditation. The primary focus however, are the forays into scientific study using validated methodology to understand what mindfulness can and cannot affect as it relates to physical and mental health. The initial studies serve as proof of concept and cover simple reductions in symptomology and suffering for conditions like anxiety and depression. The scope of mindfulness application grew as research progressed, leading to more focused studies involving the extreme stress of medical students, the lifespan of the elderly, and autobiographical memory for those in remission who had depression. Like all respectable scientific experimentation, having the ability to quantify the results and observations seen is accounted for by these studies. Furthermore, a cohesive model and adapted measurement scale are discussed to denote the clout carried by mindfulness and related practices. In closing, discussion of current research directions are given along with a re-emphasis of conclusions established in the literature.

MOTIVATION Mindfulness is the active pursuit of focused attention, and through practice has been shown to benefit psychological and physical well-being. While mindfulness is not a new idea, it has only tangentially been linked to Interior Design such as through performative objects (Niedderer, 2007 and 2014) which promote personal reflection before enacting a choice. If mindfulness is the active pursuit of mental presence, then Attention Restoration Theory (ART) is a passive route by which environmental cues imbue a resurgence in attention capacity (Kaplan, 2001). ART studies exemplified successful restoration through scenes of nature, and unsuccessfully in outdoor urban scenes (Berto, 2005) while interior environments went unexamined. Encouraging mindfulness and ART through interior design is worth exploring as it converges from the studies of Niedderer, Kaplan, and Berto. PROBLEM How can mindfulness be supported by, or achieved through interior design, and what design principle(s) align with the practice of mindfulness? How can interior spaces and artifacts facilitate ART to passively or unconsciously support mindfulness in a residence? METHODS Evaluations of mindfulness and ART case studies as related to design, and environmental interpretation will inform associative aspects to understand and employ relevant design elements. RESULTS People prefer different spaces in which to experience mindfulness where the variety of colors, sound levels, lighting, privacy, smells, and textures affect them to be attuned. Based on an site interview, the designer is informed on specific interaction styles, design attributes, and solutions to pursue. Questions prompting personal reflection will lead to a personalized design which was determined to be an important psychological tool to achieving mindfulness. The use of warm and cool colors were found to be more intriguing than achromatic settings. Placing design artifacts in the space which encouraged or even required interaction from the client were found to encourage their mental presence in the moment as well. Views to outdoor, natural scenery from the space or at a minimum objects that represent nature add to the presence of mind and attention restoration. The designer educates the client on the impact of pertinent design principles such as light, color, scale, balance, texture, and harmony to obtain design by-in. REFLECTIONS/CONCLUSIONS Creating a mental and physical connection for the client to the space is essential to achieving mindfulness through interior design. Mindfulness and Attention Restoration Theory augment each other from different psychological and physiological positions when the client is actively and passively engaged with their surroundings; linking the two through interior environments is key. A designed residential space that reflects the inhabitant’s interactive tendencies, prompts exploration, requires choice, and arouses intrigue will promote mindfulness, and attention restoration. Incorporating textured surfaces, natural materials, interactive objects, and purposeful views are important design goals. 1. Niedderer, K. (2007). Designing Mindful Interaction: The Category of Performative Object. Design Issues, 23(1), 3-17. DOI: 10.1162/desi.2007.23.1.3 2. Niedderer, K. (2014). “Mediating Mindful Social Interactions Through Design.” The Wiley Blackwell Handbook of Mindfulness. Ie, A. (Ed.). Chichester, UK: John Wiley & Sons. 345-366. DOI: 10.1002/9781118294895 3. Kaplan, S. (2001). Meditation, Restoration, and the Management of Mental Fatigue. Environment and Behavior, 33(4), 480-506. DOI: 10.1177/00139160121973106 4. Berto, R. (2005). Exposure to restorative environments helps restore attentional capacity. Journal of Environmental Psychology, 25(3), 249-259.

Mechanisms of change in psychotherapy must be empirically investigated to shed light on how particular therapies work, as well as common mechanisms that may be at work across modalities. The current study investigated a proposed mechanism of change in a mindfulness intervention; this proposed mechanism, experiential avoidance (EA), may function more broadly as a mediator of change across multiple therapies. The primary hypothesis was that gains in mindfulness over the course of Mindfulness-Based Stress Reduction (MBSR) would be associated with reductions in negative affect, and that changes in EA would mediate the relation between changes in mindfulness and negative affect. The role of EA in mediating the effect of mindfulness on positive affect, disability, and life satisfaction was also investigated. Participants (N = 106) completed questionnaires before and after an 8-week MBSR program. A subset of participants (n = 74) completed questionnaires at the mid-point of treatment, and recorded time spent on mindfulness practice and level of relaxation after homework completion. Mediation analyses were conducted in which relations between change in predictor (mindfulness), mediator (EA), and outcome measures over the course of the intervention were assessed using regression steps, followed by PRODCLIN. Participants reported significant improvements in mindfulness, reductions in EA and disability, and improved affect and life satisfaction from pre- to post-MBSR. The relation between increased mindfulness and reduced negative affect over the course of the intervention was partially mediated by reduced EA. No evidence was found for relaxation as an additional mediator of the relation between mindfulness and negative affect. The relation between increased mindfulness and positive affect over the course of the intervention was fully mediated by decreased behavioral avoidance. Reductions in behavioral avoidance also fully mediated the relation between increased mindfulness and reduced disability. The relation between increased mindfulness and increased life satisfaction was mediated by EA. More mindfulness practice was linked with greater positive affect; the relation between practice and positive affect was mediated by EA. This study offers support for EA as a mediator of the effect of mindfulness on multiple outcomes, while highlighting a mechanism of change that may pertain across psychotherapeutic modalities.

<p>Mindfulness i klinisk behandling är ingen enhetlig företeelse. Ett flertal sätt att definiera, operationalisera och tillämpa mindfulness samexisterar i det kliniska rummet. Syftet med denna studie var att åskådliggöra terapeuters kvalitativt varierande sätt att beskriva, använda och uppleva mindfulness i klinisk behandling och att undersöka faktorer av betydelse för dessa variationer. Elva terapeuters arbete studerades genom semistrukturerade intervjuer varpå en teoristyrd tematisk analys av intervjumaterialet genomfördes. Resultatet går i linje med den internationella forskningsdebatten och åskådliggör ett stort antal variationer av hur terapeuter beskriver, tillämpar och upplever sitt arbete med mindfulness. Beskrivningarna varierar på en bred skala, från teknik till andlighet, stresshantering till upplysning. Variationer som framkom i terapeutisk tillämpning kan delas in i tre delar; mindfulness för terapeuten, mindfulness i relation till klienten och mindfulness som intervention för klienten. Av skiftande betydelse för dessa var psykoterapeutisk inriktning, klientens problematik och egen erfarenhet av mindfulness, varav den mest inflytelserika var egen erfarenhet, i vilken utsträckning terapeuten själv utövat mindfulness och i vilken kontext.</p>

<p>För att undersöka vad medveten närvaro kan betyda i dialektisk beteendeterapi (DBT) meningskoncentrerades nio intervjuer. Medveten närvaro hade en positiv betydelse för samtliga deltagare. Det centrala för deltagarna var färdigheterna observera och en sak i taget. Färdigheterna hjälpte patienterna att stanna upp i ett negativt händelseförlopp. Behandlarna menade att medveten närvaro hjälpte vid stressrelaterade situationer. Samtliga deltagare underströk betydelsen av färdighetsträningen i grupp och praktiska övningar. Det fanns ett tydligt behov av att förenkla teorin kring medveten närvaro i DBT samt att medveten närvaro behövde få ett större utrymme. Om medveten närvaro kan hjälpa patienter i DBT att stanna upp i ett destruktivt händelseförlopp så är det en verkan av stor betydelse för patienterna såväl som för anhöriga och sjukvården.</p>

<p>This study was conducted to examine the primary theoretical relation between metacognition andmindfulness. 98 university students participated, the possible influence of their age and number ofeducation years on the concepts were also examined. A short version of the MetacognitiveAwareness Inventory along with the Philadelphia Mindfulness Scale were employed to measure theconcepts. The results indicated that awareness, a central component of mindfulness wassignificantly related to metacognition. The results suggest that the concepts to some extent areinterrelated. Comparisons were made between students above, and below the median of age (22),and education years (1.5); no significant differences in metacognition or mindfulness were found.Neither were age and education years together significantly associated with the concepts.</p>