Journalling

Mindfulness-based interventions in schools—a systematic review and meta-analysis

Charlotte Zenner, Solveig Herrnleben-Kurz, Harald Walach · Frontiers in Psychology · 2014 · 962 citations

School-based mindfulness programs produce a moderate overall benefit (Hedge's g = 0.40) compared to control conditions, with the strongest effects on cognitive performance (g = 0.80) and stress reduction (g = 0.39), but effects on emotional problems and third-party ratings were not statistically significant—meaning if you're a student or parent, the clearest payoff is sharper thinking and less perceived stress, not necessarily fewer emotional difficulties.

Religion, Spirituality, and Health: The Research and Clinical Implications

Harold G. Koenig · ISRN Psychiatry · 2012 · 2,238 citations

This systematic review found consistent evidence that engaging in religious or spiritual practices is associated with better mental health, healthier behaviors, and improved physical health outcomes, suggesting that incorporating such practices could be a beneficial self-experiment for overall well-being.

Assessment of psychotropic-like properties of a probiotic formulation (<i>Lactobacillus helveticus</i>R0052 and<i>Bifidobacterium longum</i>R0175) in rats and human subjects

Michaël Messaoudi, Robert Lalonde, Nicolas Violle +8 more · British Journal Of Nutrition · 2010 · 1,304 citations

A daily probiotic combination of *Lactobacillus helveticus* R0052 and *Bifidobacterium longum* R0175 taken for 30 days reduced anxiety, depression, anger, and stress-related hormone levels in healthy adults, with effect sizes large enough that someone running a self-experiment could reasonably expect to detect a meaningful change in mood and coping ability.

Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association

Daichi Shimbo, Nancy T. Artinian, Jan Basile +4 more · Circulation · 2020 · 365 citations

The diagnosis and management of hypertension, a common cardiovascular risk factor among the general population, have been based primarily on the measurement of blood pressure (BP) in the office. BP may differ considerably when measured in the office and when measured outside of the office setting, and higher out-of-office BP is associated with increased cardiovascular risk independent of office BP. Self-measured BP monitoring, the measurement of BP by an individual outside of the office at home, is a validated approach for out-of-office BP measurement. Several national and international hypertension guidelines endorse self-measured BP monitoring. Indications include the diagnosis of white-coat hypertension and masked hypertension and the identification of white-coat effect and masked uncontrolled hypertension. Other indications include confirming the diagnosis of resistant hypertension and detecting morning hypertension. Validated self-measured BP monitoring devices that use the oscillometric method are preferred, and a standardized BP measurement and monitoring protocol should be followed. Evidence from meta-analyses of randomized trials indicates that self-measured BP monitoring is associated with a reduction in BP and improved BP control, and the benefits of self-measured BP monitoring are greatest when done along with cointerventions. The addition of self-measured BP monitoring to office BP monitoring is cost-effective compared with office BP monitoring alone or usual care among individuals with high office BP. The use of self-measured BP monitoring is commonly reported by both individuals and providers. Therefore, self-measured BP monitoring has high potential for improving the diagnosis and management of hypertension in the United States. Randomized controlled trials examining the impact of self-measured BP monitoring on cardiovascular outcomes are needed. To adequately address barriers to the implementation of self-measured BP monitoring, financial investment is needed in the following areas: improving education and training of individuals and providers, building health information technology capacity, incorporating self-measured BP readings into clinical performance measures, supporting cointerventions, and enhancing reimbursement.

Feasibility and Acceptability of a Resilience Training Program for Intensive Care Unit Nurses

Meredith Mealer, David Conrad, John F. Evans +4 more · American Journal of Critical Care · 2014 · 325 citations

A 12-week multimodal resilience training program for ICU nurses was feasible to deliver and acceptable to participants, but both the intervention and control groups showed similar reductions in PTSD symptoms, meaning the study could not prove the program caused any improvement beyond natural recovery or non-specific effects.

Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial

Isla S. Mackenzie, Amy Rogers, Neil R Poulter +14 more · The Lancet · 2022 · 213 citations

Taking all your blood pressure medications in the evening instead of the morning does not reduce your risk of heart attack, stroke, or cardiovascular death over ~5 years — you can take them whenever is most convenient or minimises side effects.

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial

Robert Zachariae, Ali Amidi, Malene Flensborg Damholdt +5 more · JNCI Journal of the National Cancer Institute · 2017 · 219 citations

A fully automated, six-session internet-delivered cognitive-behavioral therapy program for insomnia (iCBT-I) produced large improvements in insomnia severity (Cohen's d = 1.17) and moderate-to-large improvements in sleep quality, fatigue, and sleep efficiency in breast cancer survivors, with effects maintained at 15-week follow-up — suggesting that a structured online sleep program can work as well as in-person therapy for this population.

Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: A randomized controlled trial

Hester R. Trompetter, Ernst T. Bohlmeijer, M.M. Veehof +1 more · Journal of Behavioral Medicine · 2014 · 258 citations

A Delayed Morning and Earlier Evening Time-Restricted Feeding Protocol for Improving Glycemic Control and Dietary Adherence in Men with Overweight/Obesity: A Randomized Controlled Trial

Evelyn B. Parr, Brooke L. Devlin, Bridget E. Radford +1 more · Nutrients · 2020 · 163 citations

In men with overweight/obesity, eating all meals within an 8-hour window (10:00–18:00) for just 5 days improved nighttime blood sugar control compared to eating across a 15-hour window (07:00–22:00), and participants reported positive feelings about the restricted schedule despite social barriers.

Generative Agents: Interactive Simulacra of Human Behavior

Joon Sung Park, Joseph O’Brien, Carrie J. Cai +3 more · 2023 · 1,345 citations

Generative agents powered by large language models can simulate believable human-like social behaviors—including waking up, working, forming opinions, planning parties, and coordinating group events—without being explicitly programmed for each action, suggesting that AI-driven social simulations could be used to rehearse interpersonal interactions or prototype social dynamics before running real-world experiments.

Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial

Christine Knaevelsrud, Andreas Maercker · BMC Psychiatry · 2007 · 408 citations

BACKGROUND: The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population. Also, the quality of the online therapeutic relationship, its development and its relevance as potential moderator of the treatment effects was investigated. METHOD: Ninety-six patients with posttraumatic stress reactions were allocated at random to ten sessions of Internet-based cognitive behavioural therapy (CBT) conducted over a 5-week period or a waiting list control group. Severity of PTSD was the primary outcome. Secondary outcome variables were depression, anxiety, dissociation and physical health. Follow-up assessments were conducted at the end of treatment and 3 months after treatment. RESULTS: From baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group (intent-to-treat group x time interaction effect size d = 1.40). Additionally, patients of the treatment condition showed significantly greater reduction of co-morbid depression and anxiety as compared to the waiting list condition. These effects were sustained during the 3-months follow-up period. High ratings of the therapeutic alliance and low drop-out rates indicated that a positive and stable therapeutic relationship could be established online. Significant improvement of the online working alliance in the course of treatment and a substantial correlation between the quality of the online relationship at the end of treatment and treatment outcome emerged. CONCLUSION: Interapy proved to be a viable treatment alternative for PTSD with large effect sizes and sustained treatment effects. A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN012606000401550.

Sleep and use of electronic devices in adolescence: results from a large population-based study

Mari Hysing, Ståle Pallesen, Kjell Morten Stormark +3 more · BMJ Open · 2015 · 664 citations

Objectives Adolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep. Design A large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway. Setting Cross-sectional general community-based study. Participants 9846 adolescents from three age cohorts aged 16–19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time. Outcomes Sleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset. Results Adolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose–response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 5 h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7–8 h of sleep (OR=1.64, 95% CI 1.38 to 1.96). Conclusions Use of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices.

Academic Emotions in Students' Self-Regulated Learning and Achievement: A Program of Qualitative and Quantitative Research

Reinhard Pekrun, Thomas Goetz, Wolfram Titz +1 more · Educational Psychologist · 2002 · 3,817 citations

Academic emotions have largely been neglected by educational psychology. In 5 qualitative studies, it was found that students experience a rich diversity of emotions in academic settings. Anxiety was reported most often, but positive emotions were described no less frequently than negative emotions. Based on the studies reviewed in this article, taxonomies of different academic emotions and a self-report instrument measuring students' enjoyment, hope, pride, relief, anger, anxiety, shame, hopelessness, and boredom (Academic Emotions Questionnaire [AEQ]) were developed. Using the AEQ, assumptions of a cognitive-motivational model of the achievement effects of emotions, and of a control/value theory of their antecedents (R. Pekrun, 1992b, 2000), were tested in 7 cross-sectional, 3 longitudinal, and 1 diary study using samples of university and school students. Results showed that academic emotions are significantly related to students' motivation, learning strategies, cognitive resources, self-regulation, and academic achievement, as well as to personality and classroom antecedents. The findings indicate that affective research in educational psychology should acknowledge emotional diversity in academic settings by addressing the full range of emotions experienced by students.

Mindfulness-Based Childbirth and Parenting Education: Promoting Family Mindfulness During the Perinatal Period

Larissa G. Duncan, Nancy Bardacke · Journal of Child and Family Studies · 2009 · 346 citations

We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting (MBCP) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy. MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was developed and refined over the course of 11 years of clinical practice with 59 groups of expectant couples. MBCP is designed to promote family health and well-being through the practice of mindfulness during pregnancy, childbirth, and early parenting. Quantitative results from the current study include statistically significant increases in mindfulness and positive affect, and decreases in pregnancy anxiety, depression, and negative affect from pre- to post-test (p < .05). Effect sizes for changes in key hypothesized intervention mediators were large (d > .70), suggesting that MBCP is achieving its intended effects on maternal well-being during pregnancy. Qualitative reports from participants expand upon the quantitative findings, with the majority of participants reporting perceived benefits of using mindfulness practices during the perinatal period and early parenting. Our future research will involve conducting a randomized controlled trial of MBCP to test effects on psychophysiological stress mechanisms and to examine effects on birth outcomes, family relationship quality, and child development outcomes.

The prevalence and association of stress with sleep quality among medical students

Abdullah I. Almojali, Sami Almalki, Ali Alothman +2 more · Journal of Epidemiology and Global Health · 2017 · 572 citations

Among 700 medical students in Saudi Arabia, 76% reported poor sleep quality and 53% reported high stress; students without stress were 72% less likely to have poor sleep, and those with a GPA below 4.25 had nearly 4 times the risk of poor sleep—suggesting that stress and academic pressure are tightly linked to sleep disruption in high-demand environments.

A Step-by-Step Process of Thematic Analysis to Develop a Conceptual Model in Qualitative Research

Muhammad Naeem, Wilson Ozuem, Kerry E. Howell +1 more · International Journal of Qualitative Methods · 2023 · 1,639 citations

Thematic analysis is a highly popular technique among qualitative researchers for analyzing qualitative data, which usually comprises thick descriptive data. However, the application and use of thematic analysis has also involved complications due to confusion regarding the final outcome’s presentation as a conceptual model. This paper develops a systematic thematic analysis process for creating a conceptual model from qualitative research findings. It explores the adaptability of the proposed process across various research methodologies, including constructivist methodologies, positivist methodologies, grounded theory, and interpretive phenomenology, and justifies their application. The paper distinguishes between inductive and deductive coding approaches and emphasizes the merits of each. It suggests that the derived systematic thematic analysis model is valuable across multiple disciplines, particularly in grounded theory, ethnographic approaches, and narrative approaches, while also being adaptable to more descriptive, positivist-based methodologies. By providing a methodological roadmap, this study enhances the rigor and replicability of thematic analysis and offers a comprehensive strategy for theoretical conceptualization in qualitative research. The contribution of this paper is a systematic six-step thematic analysis process that leads to the development of a conceptual model; each step is described in detail and examples are given.

A multidimensional approach to measuring well-being in students: Application of the PERMA framework

Margaret L. Kern, Lea Waters, Alejandro Adler +1 more · The Journal of Positive Psychology · 2014 · 713 citations

Seligman recently introduced the PERMA model with five core elements of psychological well-being: positive emotions, engagement, relationships, meaning, and accomplishment. We empirically tested this multidimensional theory with 516 Australian male students (age 13-18). From an extensive well-being assessment, we selected a subset of items theoretically relevant to PERMA. Factor analyses recovered four of the five PERMA elements, and two ill-being factors (depression and anxiety). We then explored the nomological net surrounding each factor by examining cross-sectional associations with life satisfaction, hope, gratitude, school engagement, growth mindset, spirituality, physical vitality, physical activity, somatic symptoms, and stressful life events. Factors differentially related to these correlates, offering support for the multidimensional approach to measuring well-being. Directly assessing subjective well-being across multiple domains offers the potential for schools to more systematically understand and promote well-being.

Evaluation of a Seven-Week Web-Based Happiness Training to Improve Psychological Well-Being, Reduce Stress, and Enhance Mindfulness and Flourishing: A Randomized Controlled Occupational Health Study

T. Feicht, Marc Wittmann, Gerald Jose +3 more · Evidence-based Complementary and Alternative Medicine · 2013 · 114 citations

A seven-week online happiness training program significantly improved self-reported happiness, life satisfaction, and quality of life (with large effect sizes of d = 0.93–1.17) while reducing perceived stress and increasing mindfulness and flourishing in employed adults, though it failed to produce measurable changes in objective stress biomarkers (salivary cortisol and alpha-amylase) or attention performance.

Basic psychological need theory: Advancements, critical themes, and future directions

Maarten Vansteenkiste, Richard M. Ryan, Bart Soenens · Motivation and Emotion · 2020 · 1,628 citations

Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness

Sarah N. Garfinkel, Anil K. Seth, Adam B. Barrett +2 more · Biological Psychology · 2014 · 1,561 citations

Interoception refers to the sensing of internal bodily changes. Interoception interacts with cognition and emotion, making measurement of individual differences in interoceptive ability broadly relevant to neuropsychology. However, inconsistency in how interoception is defined and quantified led to a three-dimensional model. Here, we provide empirical support for dissociation between dimensions of: (1) interoceptive accuracy (performance on objective behavioural tests of heartbeat detection), (2) interoceptive sensibility (self-evaluated assessment of subjective interoception, gauged using interviews/questionnaires) and (3) interoceptive awareness (metacognitive awareness of interoceptive accuracy, e.g. confidence-accuracy correspondence). In a normative sample (N=80), all three dimensions were distinct and dissociable. Interoceptive accuracy was only partly predicted by interoceptive awareness and interoceptive sensibility. Significant correspondence between dimensions emerged only within the sub-group of individuals with greatest interoceptive accuracy. These findings set the context for defining how the relative balance of accuracy, sensibility and awareness dimensions explain cognitive, emotional and clinical associations of interoceptive ability.

German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

Christa Scheidt‐Nave, Panagiotis Kamtsiuris, Antje Gößwald +19 more · BMC Public Health · 2012 · 403 citations

BACKGROUND: The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. METHODS/DESIGN: The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18-79 years of age. Another 4193 persons 18-79 years of age were recruited for DEGS1 in 2008-2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18-79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. DISCUSSION: DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health.

Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation

Nicholas T. Van Dam, Marieke K. van Vugt, David R. Vago +12 more · Perspectives on Psychological Science · 2017 · 1,483 citations

During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and "key to building more resilient soldiers." Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.

The Multidimensional Assessment of Interoceptive Awareness (MAIA)

Wolf Mehling, Cynthia Price, Jennifer Daubenmier +3 more · PLoS ONE · 2012 · 1,369 citations

This paper describes the development of a multidimensional self-report measure of interoceptive body awareness. The systematic mixed-methods process involved reviewing the current literature, specifying a multidimensional conceptual framework, evaluating prior instruments, developing items, and analyzing focus group responses to scale items by instructors and patients of body awareness-enhancing therapies. Following refinement by cognitive testing, items were field-tested in students and instructors of mind-body approaches. Final item selection was achieved by submitting the field test data to an iterative process using multiple validation methods, including exploratory cluster and confirmatory factor analyses, comparison between known groups, and correlations with established measures of related constructs. The resulting 32-item multidimensional instrument assesses eight concepts. The psychometric properties of these final scales suggest that the Multidimensional Assessment of Interoceptive Awareness (MAIA) may serve as a starting point for research and further collaborative refinement.

Job Demands–Resources Theory: Ten Years Later

Arnold B. Bakker, Evangelia Demerouti, Ana Isabel Sanz‐Vergel · Annual Review of Organizational Psychology and Organizational Behavior · 2022 · 1,363 citations

Burnout refers to a work-related state of exhaustion and a sense of cynicism. In contrast, work engagement is a positive motivational state of vigor, dedication, and absorption. In this article, we discuss the concepts of burnout and work engagement and review their antecedents and consequences. We look back at our inaugural Annual Reviews article ( Bakker et al. 2014 ) and highlight new empirical findings and theoretical innovations in relationship to job demands–resources (JD-R) theory. We discuss four major innovations of the past decade, namely ( a) the person × situation approach of JD-R, ( b) multilevel JD-R theory, ( c) new proactive approaches in JD-R theory, and ( d) the work–home resources model. After discussing practical implications, we elaborate on more opportunities for future research, including JD-R interventions, team-level approaches, and demands and resources from other life domains.

Grading quality of evidence and strength of recommendations

David C. Atkins, Dana Best, Peter A. Briss +24 more · BMJ · 2004 · 8,422 citations

Abstract Users of clinical practice guidelines and other recommendations need to know how much confidence they can place in the recommendations. Systematic and explicit methods of making judgments can reduce errors and improve communication. We have developed a system for grading the quality of evidence and the strength of recommendations that can be applied across a wide range of interventions and contexts. In this article we present a summary of our approach from the perspective of a guideline user. Judgments about the strength of a recommendation require consideration of the balance between benefits and harms, the quality of the evidence, translation of the evidence into specific circumstances, and the certainty of the baseline risk. It is also important to consider costs (resource utilisation) before making a recommendation. Inconsistencies among systems for grading the quality of evidence and the strength of recommendations reduce their potential to facilitate critical appraisal and improve communication of these judgments. Our system for guiding these complex judgments balances the need for simplicity with the need for full and transparent consideration of all important issues. Clinical guidelines are only as good as the evidence and judgments they are based on. The GRADE approach aims to make it easier for users to assess the judgments behind recommendations

Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q)

Kristine Sørensen, Stephan Van den Broucke, Jürgen M. Pelikan +7 more · BMC Public Health · 2013 · 1,252 citations

BACKGROUND: Several measurement tools have been developed to measure health literacy. The tools vary in their approach and design, but few have focused on comprehensive health literacy in populations. This paper describes the design and development of the European Health Literacy Survey Questionnaire (HLS-EU-Q), an innovative, comprehensive tool to measure health literacy in populations. METHODS: Based on a conceptual model and definition, the process involved item development, pre-testing, field-testing, external consultation, plain language check, and translation from English to Bulgarian, Dutch, German, Greek, Polish, and Spanish. RESULTS: The development process resulted in the HLS-EU-Q, which entailed two sections, a core health literacy section and a section on determinants and outcomes associated to health literacy. The health literacy section included 47 items addressing self-reported difficulties in accessing, understanding, appraising and applying information in tasks concerning decisions making in healthcare, disease prevention, and health promotion. The second section included items related to, health behaviour, health status, health service use, community participation, socio-demographic and socio-economic factors. CONCLUSIONS: By illuminating the detailed steps in the design and development process of the HLS-EU-Q, it is the aim to provide a deeper understanding of its purpose, its capability and its limitations for others using the tool. By stimulating a wide application it is the vision that HLS-EU-Q will be validated in more countries to enhance the understanding of health literacy in different populations.

Maturation of the adolescent brain

Sushil K. Sharma, Arain, Mathur +5 more · Neuropsychiatric Disease and Treatment · 2013 · 1,226 citations

Adolescence is the developmental epoch during which children become adults - intellectually, physically, hormonally, and socially. Adolescence is a tumultuous time, full of changes and transformations. The pubertal transition to adulthood involves both gonadal and behavioral maturation. Magnetic resonance imaging studies have discovered that myelinogenesis, required for proper insulation and efficient neurocybernetics, continues from childhood and the brain's region-specific neurocircuitry remains structurally and functionally vulnerable to impulsive sex, food, and sleep habits. The maturation of the adolescent brain is also influenced by heredity, environment, and sex hormones (estrogen, progesterone, and testosterone), which play a crucial role in myelination. Furthermore, glutamatergic neurotransmission predominates, whereas gamma-aminobutyric acid neurotransmission remains under construction, and this might be responsible for immature and impulsive behavior and neurobehavioral excitement during adolescent life. The adolescent population is highly vulnerable to driving under the influence of alcohol and social maladjustments due to an immature limbic system and prefrontal cortex. Synaptic plasticity and the release of neurotransmitters may also be influenced by environmental neurotoxins and drugs of abuse including cigarettes, caffeine, and alcohol during adolescence. Adolescents may become involved with offensive crimes, irresponsible behavior, unprotected sex, juvenile courts, or even prison. According to a report by the Centers for Disease Control and Prevention, the major cause of death among the teenage population is due to injury and violence related to sex and substance abuse. Prenatal neglect, cigarette smoking, and alcohol consumption may also significantly impact maturation of the adolescent brain. Pharmacological interventions to regulate adolescent behavior have been attempted with limited success. Since several factors, including age, sex, disease, nutritional status, and substance abuse have a significant impact on the maturation of the adolescent brain, we have highlighted the influence of these clinically significant and socially important aspects in this report.

Compassion-focused therapy as guided self-help for enhancing public mental health: A randomized controlled trial.

Marion Sommers‐Spijkerman, Hester R. Trompetter, Karlein M. G. Schreurs +1 more · Journal of Consulting and Clinical Psychology · 2017 · 111 citations

A 9-week guided self-help compassion-focused therapy (CFT) program produced a moderate improvement in well-being (Cohen's d = 0.51) compared to a waitlist control group in adults with low-to-moderate well-being, with gains maintained or amplified at 9-month follow-up — suggesting that learning self-compassion skills through a structured workbook with brief coaching calls can durably boost mental health.

The LIFE-Adult-Study: objectives and design of a population-based cohort study with 10,000 deeply phenotyped adults in Germany

Markus Loeffler, Christoph Engel, Peter Ahnert +54 more · BMC Public Health · 2015 · 369 citations

BACKGROUND: The LIFE-Adult-Study is a population-based cohort study, which has recently completed the baseline examination of 10,000 randomly selected participants from Leipzig, a major city with 550,000 inhabitants in the east of Germany. It is the first study of this kind and size in an urban population in the eastern part of Germany. The study is conducted by the Leipzig Research Centre for Civilization Diseases (LIFE). Our objective is to investigate prevalences, early onset markers, genetic predispositions, and the role of lifestyle factors of major civilization diseases, with primary focus on metabolic and vascular diseases, heart function, cognitive impairment, brain function, depression, sleep disorders and vigilance dysregulation, retinal and optic nerve degeneration, and allergies. METHODS/DESIGN: The study covers a main age range from 40-79 years with particular deep phenotyping in elderly participants above the age of 60. The baseline examination was conducted from August 2011 to November 2014. All participants underwent an extensive core assessment programme (5-6 h) including structured interviews, questionnaires, physical examinations, and biospecimen collection. Participants over 60 underwent two additional assessment programmes (3-4 h each) on two separate visits including deeper cognitive testing, brain magnetic resonance imaging, diagnostic interviews for depression, and electroencephalography. DISCUSSION: The participation rate was 33 %. The assessment programme was accepted well and completely passed by almost all participants. Biomarker analyses have already been performed in all participants. Genotype, transcriptome and metabolome analyses have been conducted in subgroups. The first follow-up examination will commence in 2016.

Retraining Automatic Action Tendencies Changes Alcoholic Patients’ Approach Bias for Alcohol and Improves Treatment Outcome

Reínout W. Wiers, Carolin Eberl, Mike Rinck +2 more · Psychological Science · 2011 · 927 citations

This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or implicitly trained to make avoidance movements (pushing a joystick) in response to alcohol pictures, or to one of two control conditions, in which they received no training or sham training. Four brief sessions of experimental CBM preceded regular inpatient treatment. In the experimental conditions only, patients' approach bias changed into an avoidance bias for alcohol. This effect generalized to untrained pictures in the task used in the CBM and to an Implicit Association Test, in which alcohol and soft-drink words were categorized with approach and avoidance words. Patients in the experimental conditions showed better treatment outcomes a year later. These findings indicate that a short intervention can change alcoholics' automatic approach bias for alcohol and may improve treatment outcome.

Changes in Medical Errors after Implementation of a Handoff Program

Amy J. Starmer, Nancy D. Spector, Rajendu Srivastava +34 more · New England Journal of Medicine · 2014 · 900 citations

BACKGROUND: Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff of information about patient care are lacking. METHODS: We conducted a prospective intervention study of a resident handoff-improvement program in nine hospitals, measuring rates of medical errors, preventable adverse events, and miscommunications, as well as resident workflow. The intervention included a mnemonic to standardize oral and written handoffs, handoff and communication training, a faculty development and observation program, and a sustainability campaign. Error rates were measured through active surveillance. Handoffs were assessed by means of evaluation of printed handoff documents and audio recordings. Workflow was assessed through time-motion observations. The primary outcome had two components: medical errors and preventable adverse events. RESULTS: In 10,740 patient admissions, the medical-error rate decreased by 23% from the preintervention period to the postintervention period (24.5 vs. 18.8 per 100 admissions, P<0.001), and the rate of preventable adverse events decreased by 30% (4.7 vs. 3.3 events per 100 admissions, P<0.001). The rate of nonpreventable adverse events did not change significantly (3.0 and 2.8 events per 100 admissions, P=0.79). Site-level analyses showed significant error reductions at six of nine sites. Across sites, significant increases were observed in the inclusion of all prespecified key elements in written documents and oral communication during handoff (nine written and five oral elements; P<0.001 for all 14 comparisons). There were no significant changes from the preintervention period to the postintervention period in the duration of oral handoffs (2.4 and 2.5 minutes per patient, respectively; P=0.55) or in resident workflow, including patient-family contact and computer time. CONCLUSIONS: Implementation of the handoff program was associated with reductions in medical errors and in preventable adverse events and with improvements in communication, without a negative effect on workflow. (Funded by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, and others.).

Emotion-Regulation Choice

Gal Sheppes, Susanne Scheibe, Gaurav Suri +1 more · Psychological Science · 2011 · 1,416 citations

Despite centuries of speculation about how to manage negative emotions, little is actually known about which emotion-regulation strategies people choose to use when confronted with negative situations of varying intensity. On the basis of a new process conception of emotion regulation, we hypothesized that in low-intensity negative situations, people would show a relative preference to choose to regulate emotions by engagement reappraisal, which allows emotional processing. However, we expected people in high-intensity negative situations to show a relative preference to choose to regulate emotions by disengagement distraction, which blocks emotional processing at an early stage before it gathers force. In three experiments, we created emotional contexts that varied in intensity, using either emotional pictures (Experiments 1 and 2) or unpredictable electric stimulation (Experiment 3). In response to these emotional contexts, participants chose between using either reappraisal or distraction as an emotion-regulation strategy. Results in all experiments supported our hypothesis. This pattern in the choice of emotion-regulation strategies has important implications for the understanding of healthy adaptation.

Supportive Accountability: A Model for Providing Human Support to Enhance Adherence to eHealth Interventions

David C. Mohr, Pim Cuijpers, Kenneth A. Lehman · Journal of Medical Internet Research · 2011 · 1,179 citations

The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

Promoting novelty, rigor, and style in energy social science: Towards codes of practice for appropriate methods and research design

Benjamin K. Sovacool, Jonn Axsen, Steve Sorrell · Energy Research & Social Science · 2018 · 1,133 citations

A series of weaknesses in creativity, research design, and quality of writing continue to handicap energy social science. Many studies ask uninteresting research questions, make only marginal contributions, and lack innovative methods or application to theory. Many studies also have no explicit research design, lack rigor, or suffer from mangled structure and poor quality of writing. To help remedy these shortcomings, this Review offers suggestions for how to construct research questions; thoughtfully engage with concepts; state objectives; and appropriately select research methods. Then, the Review offers suggestions for enhancing theoretical, methodological, and empirical novelty. In terms of rigor, codes of practice are presented across seven method categories: experiments, literature reviews, data collection, data analysis, quantitative energy modeling, qualitative analysis, and case studies. We also recommend that researchers beware of hierarchies of evidence utilized in some disciplines, and that researchers place more emphasis on balance and appropriateness in research design. In terms of style, we offer tips regarding macro and microstructure and analysis, as well as coherent writing. Our hope is that this Review will inspire more interesting, robust, multi-method, comparative, interdisciplinary and impactful research that will accelerate the contribution that energy social science can make to both theory and practice.

Modeling habitual and addictive smartphone behavior

Alexander Johannes Aloysius Maria van Deursen, Colin L. Bolle, Sabrina Hegner +1 more · Computers in Human Behavior · 2015 · 1,027 citations

Human Brain Language Areas Identified by Functional Magnetic Resonance Imaging

Jeffrey R. Binder, Julie A. Frost, Thomas A. Hammeke +3 more · Journal of Neuroscience · 1997 · 1,421 citations

Functional magnetic resonance imaging (FMRI) was used to identify candidate language processing areas in the intact human brain. Language was defined broadly to include both phonological and lexical-semantic functions and to exclude sensory, motor, and general executive functions. The language activation task required phonetic and semantic analysis of aurally presented words and was compared with a control task involving perceptual analysis of nonlinguistic sounds. Functional maps of the entire brain were obtained from 30 right-handed subjects. These maps were averaged in standard stereotaxic space to produce a robust "average activation map" that proved reliable in a split-half analysis. As predicted from classical models of language organization based on lesion data, cortical activation associated with language processing was strongly lateralized to the left cerebral hemisphere and involved a network of regions in the frontal, temporal, and parietal lobes. Less consistent with classical models were (1) the existence of left hemisphere temporoparietal language areas outside the traditional "Wernicke area," namely, in the middle temporal, inferior temporal, fusiform, and angular gyri; (2) extensive left prefrontal language areas outside the classical "Broca area"; and (3) clear participation of these left frontal areas in a task emphasizing "receptive" language functions. Although partly in conflict with the classical model of language localization, these findings are generally compatible with reported lesion data and provide additional support for ongoing efforts to refine and extend the classical model.

Effect of multidimensional lifestyle intervention on fitness and adiposity in predominantly migrant preschool children (Ballabeina): cluster randomised controlled trial

Jardena J. Puder, Pedro Marques‐Vidal, Christian Schindler +6 more · BMJ · 2011 · 230 citations

A one-year multidimensional lifestyle intervention in preschool children from migrant families improved aerobic fitness by about 0.3 shuttle run stages and reduced body fat by about 1.1 percentage points, but did not change BMI — showing that fitness and body composition can improve even when weight doesn't budge.

Rethinking Rumination

Susan Nolen–Hoeksema, Blair E. Wisco, Sonja Lyubomirsky · Perspectives on Psychological Science · 2008 · 4,947 citations

The response styles theory (Nolen-Hoeksema, 1991) was proposed to explain the insidious relationship between rumination and depression. We review the aspects of the response styles theory that have been well-supported, including evidence that rumination exacerbates depression, enhances negative thinking, impairs problem solving, interferes with instrumental behavior, and erodes social support. Next, we address contradictory and new findings. Specifically, rumination appears to more consistently predict the onset of depression rather than the duration, but rumination interacts with negative cognitive styles to predict the duration of depressive symptoms. Contrary to original predictions, the use of positive distractions has not consistently been correlated with lower levels of depressive symptoms in correlational studies, although dozens of experimental studies show positive distractions relieve depressed mood. Further, evidence now suggests that rumination is associated with psychopathologies in addition to depression, including anxiety, binge eating, binge drinking, and self-harm. We discuss the relationships between rumination and worry and between rumination and other coping or emotion-regulation strategies. Finally, we highlight recent research on the distinction between rumination and more adaptive forms of self-reflection, on basic cognitive deficits or biases in rumination, on its neural and genetic correlates, and on possible interventions to combat rumination.

Amygdala–frontal connectivity during emotion regulation

Sarah J. Banks, Kamryn T. Eddy, Mike Angstadt +2 more · Social Cognitive and Affective Neuroscience · 2007 · 1,195 citations

Successful control of affect partly depends on the capacity to modulate negative emotional responses through the use of cognitive strategies (i.e., reappraisal). Recent studies suggest the involvement of frontal cortical regions in the modulation of amygdala reactivity and the mediation of effective emotion regulation. However, within-subject inter-regional connectivity between amygdala and prefrontal cortex in the context of affect regulation is unknown. Here, using psychophysiological interaction analyses of functional magnetic resonance imaging data, we show that activity in specific areas of the frontal cortex (dorsolateral, dorsal medial, anterior cingulate, orbital) covaries with amygdala activity and that this functional connectivity is dependent on the reappraisal task. Moreover, strength of amygdala coupling with orbitofrontal cortex and dorsal medial prefrontal cortex predicts the extent of attenuation of negative affect following reappraisal. These findings highlight the importance of functional connectivity within limbic-frontal circuitry during emotion regulation.

The authentic personality: A theoretical and empirical conceptualization and the development of the Authenticity Scale.

Alex M. Wood, P. Alex Linley, John Maltby +2 more · Journal of Counseling Psychology · 2008 · 1,182 citations

&lt;p&gt;This article describes the development of a measure of dispositional authenticity and tests whether authenticity is related to well-being, as predicted by several counseling psychology perspectives. Scales were designed to measure a tripartite conception of authenticity, comprising self-alienation, authentic living, and accepting external influence, which was supported with exploratory factor analysis. Multigroup confirmatory factor analysis showed that the factor loadings were invariant across sample, ethnicity, and gender. The scale showed substantial discriminant validity from the Big Five personality traits, nonsignificant correlations with social desirability, and 2- and 4-week test-retest correlations ranging from r = .78 to .91. Each subscale was strongly related to self-esteem and aspects of both subjective and psychological well-being. This article provides the first direct test of several theoretical models that view authenticity as integral to well-being.&lt;/p&gt;

The next Big Five Inventory (BFI-2): Developing and assessing a hierarchical model with 15 facets to enhance bandwidth, fidelity, and predictive power.

Christopher J. Soto, Oliver P. John · Journal of Personality and Social Psychology · 2016 · 2,004 citations

(see record 2017-26058-001).In the article, all citations to McCrae and Costa (2008), except for the instance in which it appears in the first paragraph of the introduction, should instead appear as McCrae and Costa (2010). The complete citation should read as follows: McCrae, R. R., & Costa, P. T. (2010). NEO Inventories professional manual. Lutz, FL: Psychological Assessment Resources. The attribution to the BFI-2 items that appears in the Table 6 note should read as follows: BFI-2 items adapted from "Conceptualization, Development, and Initial Validation of the Big Five Inventory-2," by C. J. Soto and O. P. John, 2015, Paper presented at the biennial meeting of the Association for Research in Personality. Copyright 2015 by Oliver P. John and Christopher J. Soto. The complete citation in the References list should appear as follows: Soto, C. J., & John, O. P. (2015, June). Conceptualization, development, and initial validation of the Big Five Inventory-2. Paper presented at the biennial meeting of the Association for Research in Personality, St. Louis, MO. Available from http://www.colby.edu/psych/personality-lab/ All versions of this article have been corrected. All versions of this article have been corrected.] Three studies were conducted to develop and validate the Big Five Inventory-2 (BFI-2), a major revision of the Big Five Inventory (BFI). Study 1 specified a hierarchical model of personality structure with 15 facet traits nested within the Big Five domains, and developed a preliminary item pool to measure this structure. Study 2 used conceptual and empirical criteria to construct the BFI-2 domain and facet scales from the preliminary item pool. Study 3 used data from 2 validation samples to evaluate the BFI-2's measurement properties and substantive relations with self-reported and peer-reported criteria. The results of these studies indicate that the BFI-2 is a reliable and valid personality measure, and an important advance over the original BFI. Specifically, the BFI-2 introduces a robust hierarchical structure, controls for individual differences in acquiescent responding, and provides greater bandwidth, fidelity, and predictive power than the original BFI, while still retaining the original measure's conceptual focus, brevity, and ease of understanding. The BFI-2 therefore offers valuable new opportunities for research examining the structure, assessment, development, and life outcomes of personality traits. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rethinking Feelings: An fMRI Study of the Cognitive Regulation of Emotion

Kevin N. Ochsner, Silvia A. Bunge, James J. Gross +1 more · Journal of Cognitive Neuroscience · 2002 · 2,525 citations

The ability to cognitively regulate emotional responses to aversive events is important for mental and physical health. Little is known, however, about neural bases of the cognitive control of emotion. The present study employed functional magnetic resonance imaging to examine the neural systems used to reappraise highly negative scenes in unemotional terms. Reappraisal of highly negative scenes reduced subjective experience of negative affect. Neural correlates of reappraisal were increased activation of the lateral and medial prefrontal regions and decreased activation of the amygdala and medial orbito-frontal cortex. These findings support the hypothesis that prefrontal cortex is involved in constructing reappraisal strategies that can modulate activity in multiple emotion-processing systems.

The qualitative content analysis process

Satu Elo, Helvi Kyngäs · Journal of Advanced Nursing · 2008 · 22,004 citations

AIM: This paper is a description of inductive and deductive content analysis. BACKGROUND: Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. DISCUSSION: When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. CONCLUSION: Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.

Post-Traumatic Growth After a Myocardial Infarction: A Matter of Personality, Psychological Health, or Cognitive Coping?

Nadia Garnefski, V. Kraaij, Maya J. Schroevers +1 more · Journal of Clinical Psychology in Medical Settings · 2008 · 2,498 citations

The aim of the present study was to focus on the relative contributions of personality, psychological health and cognitive coping to post-traumatic growth in patients with recent myocardial infarction (MI). The sample consisted of 139 patients who had experienced a first-time acute MI between 3 and 12 months before data assessment. Multivariate relationships were tested by means of Structural Equation Modeling. The results showed that besides the contribution of personality and psychological health, a significant amount of variance in growth was explained by the cognitive coping strategies people used to handle their MI. As cognitive coping strategies are generally assumed to be mechanisms that are subject to potential influence and change, this provides us with important targets for intervention.

The theory of constructed emotion: an active inference account of interoception and categorization

Lisa Feldman Barrett · Social Cognitive and Affective Neuroscience · 2016 · 1,415 citations

The science of emotion has been using folk psychology categories derived from philosophy to search for the brain basis of emotion. The last two decades of neuroscience research have brought us to the brink of a paradigm shift in understanding the workings of the brain, however, setting the stage to revolutionize our understanding of what emotions are and how they work. In this article, we begin with the structure and function of the brain, and from there deduce what the biological basis of emotions might be. The answer is a brain-based, computational account called the theory of constructed emotion.

The PERMA-Profiler: A brief multidimensional measure of flourishing

J. Corey Butler, Margaret L. Kern · International Journal of Wellbeing · 2016 · 1,372 citations

In the book Flourish (2011), Seligman defined wellbeing in terms of five pillars: Positive emotion, Engagement, Relationships, Meaning, and Accomplishment, or PERMA. We developed the PERMA-Profiler as a brief measure of PERMA. We first compiled hundreds of theoretically relevant items. Three studies (N = 7,188) reduced, tested, and refined items, resulting in a final set of 15 questions (three items per PERMA domain). Eight additional filler items were added, which assess overall wellbeing, negative emotion, loneliness, and physical health, resulting in a final 23item measure. A series of eight additional studies (N = 31,966) were conducted to test the psychometrics of the measure. The PERMA-Profiler demonstrates acceptable model fit, internal and cross-time consistency, and evidence for content, convergent, and divergent validity. Scores are reported visually as a profile across domains, reflecting the multidimensional nature of flourishing. The PERMA-Profiler adds to the toolbox of wellbeing measures, allowing individuals to monitor their wellbeing across multiple psychosocial domains.

“Kind and Grateful”: A Context-Sensitive Smartphone App Utilizing Inspirational Content to Promote Gratitude

Asma Ghandeharioun, Asaph Azaria, Sara Taylor +1 more · Psychology of Well-Being Theory Research and Practice · 2016 · 63 citations

A smartphone app that delivers inspirational content at contextually optimal moments (after social activity, location change, or physical movement) more than doubled the frequency of gratitude expressions compared to baseline, while a control group that used the app without inspirational content decreased their gratitude expressions by 90% over five weeks.

Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness

David R. Vago, David Silbersweig · Frontiers in Human Neuroscience · 2012 · 1,300 citations

Mindfulness-as a state, trait, process, type of meditation, and intervention has proven to be beneficial across a diverse group of psychological disorders as well as for general stress reduction. Yet, there remains a lack of clarity in the operationalization of this construct, and underlying mechanisms. Here, we provide an integrative theoretical framework and systems-based neurobiological model that explains the mechanisms by which mindfulness reduces biases related to self-processing and creates a sustainable healthy mind. Mindfulness is described through systematic mental training that develops meta-awareness (self-awareness), an ability to effectively modulate one's behavior (self-regulation), and a positive relationship between self and other that transcends self-focused needs and increases prosocial characteristics (self-transcendence). This framework of self-awareness, -regulation, and -transcendence (S-ART) illustrates a method for becoming aware of the conditions that cause (and remove) distortions or biases. The development of S-ART through meditation is proposed to modulate self-specifying and narrative self-networks through an integrative fronto-parietal control network. Relevant perceptual, cognitive, emotional, and behavioral neuropsychological processes are highlighted as supporting mechanisms for S-ART, including intention and motivation, attention regulation, emotion regulation, extinction and reconsolidation, prosociality, non-attachment, and decentering. The S-ART framework and neurobiological model is based on our growing understanding of the mechanisms for neurocognition, empirical literature, and through dismantling the specific meditation practices thought to cultivate mindfulness. The proposed framework will inform future research in the contemplative sciences and target specific areas for development in the treatment of psychological disorders.

Mindfulness Broadens Awareness and Builds Eudaimonic Meaning: A Process Model of Mindful Positive Emotion Regulation

Eric L. Garland, Norman A. S. Farb, Philippe R. Goldin +1 more · Psychological Inquiry · 2015 · 772 citations

Contemporary scholarship on mindfulness casts it as a form of purely nonevaluative engagement with experience. Yet, traditionally mindfulness was not intended to operate in a vacuum of dispassionate observation, but was seen as facilitative of eudaimonic mental states. In spite of this historical context, modern psychological research has neglected to ask the question of how the practice of mindfulness affects downstream emotion regulatory processes to impact the sense of meaning in life. To fill this lacuna, here we describe the mindfulness-to-meaning theory, from which we derive a novel process model of mindful positive emotion regulation informed by affective science, in which mindfulness is proposed to introduce flexibility in the generation of cognitive appraisals by enhancing interoceptive attention, thereby expanding the scope of cognition to facilitate reappraisal of adversity and savoring of positive experience. This process is proposed to culminate in a deepened capacity for meaning-making and greater engagement with life.

European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring

Gianfranco Parati, George S. Stergiou, Roland Asmar +21 more · Journal of Hypertension · 2008 · 839 citations

This document summarizes the available evidence and provides recommendations on the use of home blood pressure monitoring in clinical practice and in research. It updates the previous recommendations on the same topic issued in year 2000. The main topics addressed include the methodology of home blood pressure monitoring, its diagnostic and therapeutic thresholds, its clinical applications in hypertension, with specific reference to special populations, and its applications in research. The final section deals with the problems related to the implementation of these recommendations in clinical practice.