be provided withfive (5) published scientific articles, each of which reports research relevant to the general topics of this unit. From this set of 5 papers, you are required toselect one (1) article onlyand respond to a series of questions on the response sheet provided. These questions relate to the background to the research topic, the method, results, conclusion, and future directions, as well as checking understanding of what constitutes an appropriate academic source and the structure of a research report. As a final component of Assessment 2, you are asked to articulate specific study plans you will put in place in order to complete Assessment 4, in line with the approach taught in tutorials in Weeks 1 and 2.
By completing this task, you can obtain feedback on your general comprehension of the research, your approach to academic writing, and your general approach to sustainable study practices. Completing Assessment 2 therefore best prepares you to adequately completeAssessment 4. Feedback on Assessment 2 will be provided in enough time to be integrated into responses for Assessment 4.
PLEASE KEEP TO 800 WORDS!!
Effects of Mindfulness-Based Stress Reduction (MBSR) on Emotion Regulation in Social Anxiety Disorder Philippe R. Goldin and James J. Gross Department of Psychology, Stanford University Abstract Mindfulness-based stress reduction (MBSR) is an established program shown to reduce symptoms of stress, anxiety, and depression. MBSR is believed to alter emotional responding by modifying cognitive–affective processes. Given that social anxiety disorder (SAD) is characterized by emotional and attentional biases as well as distorted negative self-beliefs, we examined MBSR- related changes in the brain-behavior indices of emotional reactivity and regulation of negative self-beliefs in patients with SAD. Sixteen patients underwent functional MRI while reacting to negative self-beliefs and while regulating negative emotions using 2 types of attention deployment emotion regulation—breath-focused attention and distraction-focused attention. Post-MBSR, 14 patients completed neuroimaging assessments. Compared with baseline, MBSR completers showed improvement in anxiety and depression symptoms and self-esteem. During the breath- focused attention task (but not the distraction-focused attention task), they also showed (a) decreased negative emotion experience, (b) reduced amygdala activity, and (c) increased activity in brain regions implicated in attentional deployment. MBSR training in patients with SAD may reduce emotional reactivity while enhancing emotion regulation. These changes might facilitate reduction in SAD-related avoidance behaviors, clinical symptoms, and automatic emotional reactivity to negative self-beliefs in adults with SAD. Keywords social anxiety; neuroimaging; mindfulness; attention; emotion The concept of mindfulness has attracted attention in the domains of basic emotion research, clinical science, and social–cognitive–affective neuroscience. The most studied form of mindfulness training in the United States is mindfulness-based stress reduction (MBSR), a structured group program of mindfulness training developed by Kabat-Zinn (1990). There is also increasing interest in mindfulness-based exercises in the context of clinical interventions for anxiety and depression disorders, as well as other clinical problems (Allen, Chambers, & Knight, 2006; Carmody, 2009). At this stage in the field’s development, we believe it is useful to apply Western psychological models of cognitive–affective processes to the study of mindfulness in order © 2010 American Psychological Association Correspondence concerning this article should be addressed to Philippe R. Goldin, Department of Psychology, Jordan Hall, Building 420, Stanford, CA 94305-2130. pgoldin@stanford.edu. NIH Public Access Author Manuscript Emotion. Author manuscript; available in PMC 2014 October 21. Published in final edited form as: Emotion. 2010 February ; 10(1): 83–91. doi:10.1037/a0018441. N IH -P A A uthor M anuscript N IH -P A A uthor M anuscript N IH -P A A uthor M anuscript to clarify how mindfulness training works (Carmody, 2009). More specifically, we suggest that an emotion regulation framework (Gross, 2007) may help clarify the processes that underlie MBSR, processes that may be distinct from those implicated in other more traditional modalities such as cognitive–behavioral therapy (Hofmann & Asmundson, 2008). Mindfulness-Based Stress Reduction MBSR consists of multiple forms of mindfulness practice, including formal and informal meditation practice, as well as hatha yoga (Kabat-Zinn, 1990). The formal practice consists of breath-focused attention, body scan-based attention to the transient nature of sensory experience, shifting attention across sensory modalities, open monitoring of moment-to- moment experience, walking meditation, and eating meditation. Informal practice entails brief pauses involving volitionally shifting attention to present moment awareness. Together, this package of mindfulness practices aims to enhance the ability to observe the immediate content of experience, specifically, the transient nature of thoughts, emotion, memories, mental images, and physical sensation. Two specific forms of nonelaborative, nonconceptual attention-focusing meditations that are introduced in MBSR are (a) focused attention defined as object-based (e.g., sensations induced during breathing) volitional selective attention in the present moment with ongoing assessment of the quality of attention, and (b) open monitoring defined as settling attention into a state of mere observation or monitoring in the present moment on any experience (thought, emotion, physical sensation) without any explicit focus on an object (Lutz, Slagter, Dunne, & Davidson, 2008). Although there is no explicit instruction in changing the nature of thinking, or emotional reactivity, MBSR has been shown to diminish the habitual tendency to emotionally react to and ruminate about transitory thoughts and physical sensations (Ramel, Goldin, Carmona, & McQuaid, 2004; Teasdale et al., 2000); reduce stress, depression, and anxiety symptoms (Chiesa & Serretti, 2009; Evans et al., 2008; Segal, Williams, & Teasdale, 2002); modify distorted patterns of self-view (Goldin, Ramel, & Gross, 2009); amplify immune functioning (Davidson et al., 2003); enhance behavioral self-regulation (Lykins & Baer, 2009); and improve volitional orienting of attention (Jha, Krompinger, & Baime, 2007). Recent functional neuroimaging studies of MBSR have provided evidence of reduced narrative and conceptual and increased experiential and sensory self-focus at post-MBSR (Farb et al., 2007) and decreased conceptual–linguistic self-referential processing from pre- to post- MBSR (Goldin, Ramel, et al., 2009). MBSR and Emotion Regulation Theorists have suggested that MBSR may reduce symptoms of stress, anxiety, and depression by modifying emotion regulation abilities, but it is not yet clear which specific abilities may be enhanced by MBSR (Chambers, Gullone, & Allen, 2009). This is because emotion regulation refers to a variety of strategies that can be implemented at different points during the emotion-generative process to influence which emotions arise, when and how long they occur, and how these emotions are experienced and expressed (Gross, 2007). Goldin and Gross Page 2 Emotion. Author manuscript; available in PMC 2014 October 21. N IH -P A A uthor M anuscript N IH -P A A uthor M anuscript N IH -P A A uthor M anuscript Distinct forms of emotion regulation have their own neural circuitry and temporal features (Goldin, McRae, Ramel, & Gross, 2008). The process model of emotion regulation (Gross, 1998) proposes five families of emotion regulation strategies, including situation selection, situation modification, attentional deployment, cognitive change, and response modulation. There is evidence that MBSR and long-term mindfulness meditation practice may directly influence attentional deployment, specifically the ability to exert cognitive control of negative rumination (Ramel et al., 2004), self-focused attention (Goldin, Ramel, et al., 2009), attention allocation and regulation (Slagter, Lutz, Greischar, Nieuwenhuis, & Davidson, 2008), and orienting to a spatial cue (Jha et al., 2007). Lutz et al. (2008) have proposed that such training of attention is expected to result in “improvement in the capacity to disengage from aversive emotional stimuli … enabling greater emotional flexibility” (p. 4). However, the proposed effects of MBSR on emotional reactivity and attentional deployment require empirical investigation. MBSR, Emotion Regulation, and Social Anxiety Disorder One clinical context in which MBSR’s effects of emotion regulation might be investigated is social anxiety disorder (SAD). SAD is a very common psychiatric condition that is characterized by intense fear of evaluation in social or performance situations (Jefferys, 1997). Patients with SAD have a strong tendency to focus on both internal cues (e.g., negative thoughts and self-imagery) and external cues (e.g., other’s facial expressions) during social situations (Schultz & Heimberg, 2008). This attentional focus serves to maintain social anxiety symptoms by interfering with habituation processes that lead to corrective learning in vivo and during cognitive-behavioral therapy (Heimberg & Becker, 2002). Recent electrophysiological studies have demonstrated that adults with SAD demonstrate abnormal attentional processes consisting of early hypervigilance followed by attentional avoidance (i.e., reduced visual processing) of social threat stimuli (Mueller et al., 2008). Studies have shown that adults with SAD show diminished recruitment of brain networks implicated in cognitive regulation (dorsolateral prefrontal cortex [PFC], dorsal anterior cingulate cortex) and in attention regulation (posterior cingulate/precuneus, inferior parietal lobe, supramarginal gyrus) during cognitive reappraisal of emotional reactivity to social threat (Goldin, Manber, Hakimi, Canli, & Gross, 2009) and to negative self-beliefs (Goldin, Manber Ball, Werner, Heimberg, & Gross, 2009). Two studies have examined the impact of MBSR on SAD. One study found equivalent improvement in patients with generalized SAD on mood, functionality, and quality of life with either 8-week MBSR or 12-week cognitive–behavioral group therapy (CBGT), but significantly lower scores on clinician- and patient-rated measures of social anxiety for CBGT compared with the MBSR group (Koszycki, Benger, Shlik, & Bradwejn, 2007). A recent study of MBSR for adults with generalized SAD showed reduced anxiety, negative self-view, and conceptual-linguistic self-referential processing along with increased self- esteem and positive self-view (Goldin, Ramel, et al., 2009). However, little is yet known about how MBSR influences the neural bases of emotional reactivity and emotion Goldin and Gross Page 3 Emotion. Author manuscript; available in PMC 2014 October 21. N IH -P A A uthor M anuscript N IH -P A A uthor M anuscript N IH -P A A uthor M anuscript regulation, particularly when someone with SAD is challenged with social anxiety-related negative self-beliefs, which are a core feature of SAD. The Present Study To investigate MBSR-related changes in emotion reactivity and regulation of negative self- beliefs in patients with SAD, we assessed clinical symptoms and obtained behavioral and neural measures of emotional reactivity and regulation at baseline and post-MBSR. Clinically, we expected MBSR-related changes, including reduced symptoms of anxiety and depression and enhanced self-esteem in patients with SAD. In the emotion regulation task, we examined two forms of attention deployment: breath-focused attention (the target regulation strategy) and distraction-focused attention (a control regulation strategy). We expected MBSR-related changes in relation to the breath-focused mindful attention, including (a) decreased negative emotion after implementing breath-focused attention, (b) decreased brain activity in emotion-related limbic activity (i.e., amygdala), and (c) increased activity in attention-related brain regions, but (d) no change related to distraction-based attention. Method Participants Sixteen right-handed adult patients (nine women) diagnosed with primary generalized SAD met DSM-IV criteria based on the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV; DiNardo, Brown, & Barlow, 1994). Based on the interview, past comorbid conditions included two patients with obsessive–compulsive disorder, three with dysthymia, and four with major depressive disorder; current conditions included three with generalized anxiety disorder, three with specific phobia, and one with panic disorder without agoraphobia. Patients were on average middle age (M = 35.2