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Mindfulness as Mediator Shauna L. Shapiro, Ph.D. Doug Oman


Mindfulness as Mediator Shauna L. Shapiro, Ph.D. Doug Oman, Ph.D. Carl E. Thoresen, Ph.D. Thomas G. Plante, Ph.D. Tim Flinders, B.A. Background Mindfulness is a core ... – PowerPoint PPT presentation

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Title: Mindfulness as Mediator Shauna L. Shapiro, Ph.D. Doug Oman

Mindfulness as Mediator
  • Shauna L. Shapiro, Ph.D.
  • Doug Oman, Ph.D.
  • Carl E. Thoresen, Ph.D.
  • Thomas G. Plante, Ph.D.
  • Tim Flinders, B.A.

  • Mindfulness is a core element of spiritual
  • Recently, the psychological construct mindfulness
    has received a great deal of theoretical
    attention concerning its potential role in
    positive psychological functioning. Yet little
    research has examined whether interventions can
    measurably increase mindfulness, and what are its
    beneficial effects.
  • The current randomized controlled trial examined
    the effects of two meditation-based interventions
    on the construct of mindfulness itself to
    determine if mindfulness can be developed and if
    the development of mindfulness leads to positive

  • To See Clearly

Mindfulness Defined
  • The awareness that emerges through paying
    attention on purpose, in the present moment, and
    non-judgmentally to the unfolding of experience
    moment to moment.
  • Kabat-Zinn, 2003, p. 145

Core Elements of Mindfulness
  • Paying attention Attention
  • On purpose Intention
  • Nonjudgmentally Attitude

Mindfulness is considered a skill that can be
developed through meditation practice.
  • Yet little research has explicitly examined what
    types of practices actually cultivate mindfulness.

The current study compared the effects on
mindfulness of two distinct meditation
  • 1. Mindfulness-Based Stress Reduction
  • 2. Eswaran Eight Point Program

  • (1) To evaluate the effects on cultivating
  • (2) To determine if mindfulness and/or adherence
    to treatment mediated positive well-being outcomes

  • 47 participants were randomly allocated between
    the MBSR (n16) and EPP (n16) training groups,
    and a wait-list control group (n15).
  • Pretest, posttest, and 8-week follow-up data were
    gathered on self-report outcome measures.

  • Mindfulness-Based Stress Reduction (MBSR)
  • Easwarans Eight Point Program (EPP)
  • Both group trainings took place in 8 weekly
    meetings of 90 minutes each.
  • Each involved instruction in a form of sitting
    meditation, informal corollary practices, and
    cultivation of attitudinal and motivational

  • MBSR intervention modeled after the MBSR training
    developed by Kabat-Zinn and colleagues.
  • Participants received training in (1) Mindful
    Sitting Meditation (2) Body Scan, (3) Mindful
    Movement, and (4) Lovingkindness meditation.
  • Inherent in all these techniques is an emphasis
    on mindfulness, intentionally bringing attention
    to present moment in a nonjudgmental way.
  • In addition to formal meditation practices,
    didactic presentation and dialogue emphasized how
    to bring mindfulness into daily life, including
    topics such as mindful eating, mindfulness in
    relationship, mindfulness at work and school, and
    a mindful approach to pain, suffering and stress.

  • EPP instruction emphasized core Eight Point
    Program practices.
  • Point 1 Passage Meditation, the foundation of
    the EPP, is a concentrative method of sitting
    meditation where the focus is not on the breath
    (as in MBSR), but on a memorized inspirational
    passage. During sitting meditation, one slowly
    mentally recites a memorized passage from a
    scripture or a major spiritual figure.
  • Point 2 of the EPP involves frequent repetition
    throughout the day of a mantram, sometimes called
    a holy name, such as Om mani padme hum
    (Buddhist), Jesus (Christian), or others from all
    major traditions. A mantram is used to stabilize
    attention throughout the day.
  • Points 3 (slowing down) and 4 (focused
    attention), also practiced throughout the day,
    involve cultivating mental habits and states that
    are similar to mindfulness.
  • The remaining points were presented more briefly
    5) training the senses, 6) putting others first,
    7) spiritual fellowship, and 8) inspirational

  • Both programs are integrated and incorporate
    multiple practices that perform many analogous
    functions, however, these functions are
    sometimes accomplished in different ways. For
  • MBSR program uses sitting meditation that
    emphasizes mindfulness, whereas the EPP program
    uses a concentrative method.
  • MBSR program has a strong mindful movement
    component, whereas the EPP program teaches the
    mantram and other practices that can be combined
    with everyday movements, such as walking, to
    foster integration of body and mind.
  • MBSR teaches sitting meditation that incorporates
    a wider attentional field, the EPP program
    encourages wider attention through slowing
  • MBSR explicitly encourages cultivation of loving
    kindness and compassion, the EPP encourages
    cultivation these through putting others first
    as well as meditating on passages that endorse
    kindness and compassion.

  • MINDFULNESS Mindful attention and awareness
    scale (MAAS see Brown Ryan, 2003).
  • 15-item trait measure of ones ability to attend
    to present moment experiences in everyday
  • Likert scale ranging from 0 (almost always) to 6
    (almost never) to assess such items as, I find
    myself listening to someone with one ear, doing
    something else at the same time and I tend to
    walk quickly to get where Im going without
    paying attention to what I experience along the
  • Reliable internal consistency (coefficient alpha
  • Scores on the MAAS are significantly higher for
    practitioners of mindfulness meditation than for
    control groups of non-meditators.

Additional Measures
  • Perceived stress was measured with a 10-item
    version of the well-known Perceived Stress Scale
    developed by Cohen and colleagues (Cohen
    Williamson, 1988).
  • Rumination was measured with a 12-item subscale
    of the Rumination and Reflection Questionnaire
    (Trapnell Campbell, 1999).
  • Forgiveness of others was measured with a 6-item
    subscale of the Heartland Forgiveness Scale
    (Thompson Snyder, 2003).

Adherence Measures
  • Adherence during training. Meditation practice
    was measured by self-report diaries that recorded
    daily practice. The MBSR group was instructed in
    four types of practice 1) formal sitting
    practice, 2) mindful movement, 3) body scan
    meditation, and 4) informal practices. At each
    subsequent meeting (weeks 2 through 8), MBSR
    participants reported the number of minutes that
    they had engaged in each practice during each day
    of the previous week. The average number of
    minutes per day was calculated.
  • EPP participants were instructed in formal
    sitting meditation at Meeting 1, mantram
    repetition at Meeting 4, and spiritual reading at
    Meeting 6. Means were calculated from their
    reported number of minutes engaged in sitting
    meditation (7 weeks reports) and reading (2
    weeks reports). Also calculated was the mean
    number of occasions during the day in which
    participants repeated the mantram (4 weeks

  • Undergraduate students at a private Jesuit
  • Primarily 18 years old (59), first-year (66),
    female (80), white (73), and were Roman
    Catholic (49) or had no religious affiliation
  • 44 of 47 participants in the intervention groups
    completed Our post-randomization dropout rate of
    6, is lower than most meditation intervention

  • Hypothesis 1 Do MBSR and EPP intervention
    cultivate mindfulness as compared to a wait-list
    control group?
  • Hypothesis 2 Do increases in mindfulness mediate
    positive change in outcome measures?
  • Hypothesis 3 Does adherence predict positive
    change in outcome measures?

  • Hypothesis 1 MBSR and EPP interventions each
    significantly increased mindfulness compared to
    the no treatment control group. Main effects on
    mindfulness were about 2/3 of a standard
    deviation above the control group.
  • Notably, treatment effects on mindfulness (MAAS)
    were larger at 8-week follow-up than at
    post-test, significantly so (plt.05) for the EPP
  • Such gains over time are unusual and contrast
    with the more common observation of temporal
    decay of many types of treatment effects.
  • However, these findings are consistent with the
    definition of mindfulness as a skill that can be
    developed over time with practice

Results Hypothesis 2 3
  • Hypothesis 2
  • Increases in mindfulness significantly mediated
    reductions in perceived stress and rumination,
    but not forgiveness.
  • Hypothesis 3
  • In the MBSR group, two measures of diary
    adherence were predictive informal practices
    predicted less stress (plt.05) and mindful
    movement predicted forgiveness (p lt .10).
  • Similarly, in the EPP group, diary records of
    mantram and sitting each predicted less stress
    and more forgiveness. Less stress was also
    predicted by EPP diary records of spiritual
    reading (plt.05).

Future Directions
  • The current findings are consistent with
    preliminary research that mindfulness can be
    cultivated and mindfulness is beneficial for
    ones well being.
  • It will be important for future research to
    continue to broaden the exploration of how to
    teach mindfulness, specifically in what capacity
    and in what context. Future research could help
    determine if specific practices and contexts are
    more suited to specific populations versus
  • Finally, it will be important to explore
    mechanisms of action, determining the processes
    through which mindfulness brings about positive

Thank you for your kind attention.
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