How Mindfulness and Meditation Programming Can Benefit Mental Health Disorders

Journal Article Critique: “How do mindfulness and compassion programs improve mental health and well-being? The role of attentional processing of emotional information” by Roca et al. ()

Summary:

Today, depression and anxiety are widespread and the need for the benefits that can accrue to properly administered mindfulness and compassion programs has never been more critical. Mindfulness and compassion programs take a skills-building approach to cultivating inner resources key to mental health and well-being that are increasing in popularity due to their proven efficacy. Though both mindfulness and compassion interventions show psychological benefits, their mechanisms may differ. To distinguish these factors more accurately, the broad research question of this study was to determine if structured mindfulness and compassion training alter distribution of attentional resources to emotional information, relative to a non-intervention control group. The authors examined these issues by hypothesizing that: 1) the practice of both mindfulness and compassion meditation would improve the distribution of attentional resources towards emotional information; 2) attentional changes would significantly mediate the positive outcomes of the programs; and 3) attentional changes would be a key component of the emotional regulation processes predicting psychological distress and well-being improvements (2). The general research design was naturalistic and the psychological constructs used were relevant for this purpose which were succinctly operationalized as “self-reported measures of psychological distress, emotion regulation, and well-being” (2). The authors point out that the research to date demonstrates meditation-linked attention changes towards emotional information mediate gains in wellbeing and distress reduction; however, they also note that the majority of studies to date have only scrutinized mindfulness mechanisms with respect to these variables of interest. Therefore, the authors emphasize the need to explore alternative practices such as compassion, timely comparisons between differing meditative techniques. Based on the results of their study, the authors conclude that meditation may promote more flexible and balanced attention to emotional information by individual suffering from a wide range of mental health disorders, which may be a key to what they describe as the “transdiagnostic mechanism” that underly its proven benefits on emotional distress and well-being (8). Given the increasing prevalence of mental health disorders in the United States, these findings have significant implications for all mental healthcare practitioners.

Critique:

To their credit, the study’s overall goal was to determine if structured mindfulness and compassion training alter distribution of attentional resources to emotional information, relative to a non-intervention control group was made clear by the authors early on. It was less clear, however, whether lay readers or even seasoned professionals could appreciate the importance of this research based on the introductory rationale provided by the authors. Notwithstanding this potential constraint, this study did have multiple strengths that contributed to the trustworthiness of the findings that emerged. For instance, the authors took great pains to explain their methodology and research instruments that had known validity and reliability.

Likewise, the authors attempted to use a series of graphs to facilitate understanding of their research strategy and design, but there were some problems with these as well. For instance, while the presentation of data in Figure 1 (“Participation in CONSORT Program”) was straightforward and understandable, the subsequent figures use arcane symbology to express trends, hierarchal relationships and statistical results in ways that defy easy comprehension. In particular, understanding the findings presented in Figures 2 (“Emotional AB task trial sequence …”) and Figure 4 (“Serial mediations with attentional improvements …”) is challenging and even impossible for all but a few expert practitioners in these data analytical methods.

In fact, even Table 1, which presents the results of the administration of one of the research instruments is essentially meaningless without constant double-checking to identify otherwise-unidentifiable acronyms, columnar headings and abbreviations. In other words, rather than facilitating understanding, the authors’ use of a table and figures simply muddied the research waters to the extent that readers must rely solely on the textual elements. In their defense, the authors are presenting some complex statistical findings in the table and figures, but there is also a certain “Here’s the data -- let them figure it out” quality to their presentation that could use improvement. In sum, one of the study’s main strengths is seriously offset by these corresponding weaknesses. The table could be substantially improved by dividing it into three separate tables, each depicting the respective findings from the various tests that were used in the study. This approach would also allow the authors additional room to avoid the esoterica that characterizes the data display at present. In addition, figures that depict the statistical results that are currently shown in Table 1 would also substantially facilitate comprehension.

Notwithstanding these weaknesses, however, the study did have some other strengths that lent substantial credibility to their research design and findings. For example, the study has demonstrated internal and external reliability and validity based on the authors’ selection of research instruments. Likewise, the constructs used were relevant for the stated purposes of the research and the statistical analyses were appropriate.

Although the authors provide a brief description of demographic breakdown of their 103 participants, they do not describe in any detail where the volunteers for this study were recruited beyond describing it as a “community setting” that does not convey any useful information. Likewise, because this was a novel study that represented the first effort to describe more fully the key mechanisms that mediate the demonstrated beneficial effects of two popular meditation programs on mental health, it is especially noteworthy that the authors did not identify any limitations to their research, including any potential participant bias that was based on their self-selection of treatment interventions. This potential limitation could be avoided in future studies through an experimental design that randomly assigned the participants to control and experimental groups, a strategy the authors report that was not possible with this study due to “our naturalistic design in a real-world community setting” (1); the authors, though, do not clarify or elaborate with respect to this constraint.

Future studies that explored other constructs beyond those examined by the authors such as attentional improvements as mediators of psychological outcomes and emotion regulation as mediators of the changes could shed additional light on the precise mechanisms that are involved in mediating emotional distress and improving individual well-being using mindfulness and meditation programs. This would be an important addition to the growing body of knowledge concerning these types of interventions which may be unfamiliar to some mental health practitioners.