Datko Michael, Lutz Jacqueline, Gawande Richa, Comeau Alexandra, Gan Jenny, To My Ngoc, Desbordes Gaelle, Griswold Todd, King Jean, Loucks Eric, Napadow Vitaly, Schuman-Olivier Zev
Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, USA; Harvard Medical School, Boston, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA.
Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, USA.
Psychiatry Res Neuroimaging. 2025 Mar;347:111941. doi: 10.1016/j.pscychresns.2024.111941. Epub 2024 Dec 11.
Behavior change often requires overcoming discomfort or difficult emotions. Emotional dysregulation associated with anxiety or depression may prevent behavior change initiation among people managing chronic illness. Mindfulness training may catalyze chronic disease self-management by reducing experiential avoidance of aversive experiences that act as barriers to change initiation. Using a fMRI evoked pain task, we examined the effects of 8 weeks of Mindfulness Training for Primary Care (MTPC) on brain response to the anticipation of a noxious event (i.e., pain) among patients with anxiety and/or depression. We modeled the association between post-MTPC changes in brain response to pain anticipation and post-MTPC Action Plan Initiation (API), a measure of successful initiation of health behavior change. Greater post-MTPC increase in response to pain anticipation in the dorsal medial prefrontal cortex (dmPFC) was associated with higher levels of API (r=0.77, p<0.001). This increase in dmPFC response correlated with post-MTPC self-reported increase in emotion regulation skills related to goal-directed behaviors (r=-0.52, p=0.002). This suggests that mindfulness training increases the capacity to maintain goal-directed behavior in the face of aversive experiences by strengthening neural mechanisms of emotion- and self-regulation supporting successful health behavior change initiation in patients struggling with anxiety and/or depression.
行为改变通常需要克服不适或困难情绪。与焦虑或抑郁相关的情绪失调可能会阻碍慢性病患者开始行为改变。正念训练可能通过减少对厌恶经历的体验性回避来促进慢性病自我管理，而这种体验性回避会阻碍改变的开始。我们使用功能磁共振成像诱发疼痛任务，研究了为期8周的初级保健正念训练（MTPC）对焦虑和/或抑郁患者大脑对有害事件（即疼痛）预期的反应的影响。我们建立了MTPC后大脑对疼痛预期反应的变化与MTPC后行动计划启动（API）之间的关联模型，API是衡量健康行为改变成功启动的指标。MTPC后背内侧前额叶皮层（dmPFC）对疼痛预期的反应增加幅度更大，与更高水平的API相关（r = 0.77，p < 0.001）。dmPFC反应的这种增加与MTPC后自我报告的与目标导向行为相关的情绪调节技能的增加相关（r = -0.52，p = 0.002）。这表明正念训练通过加强情绪和自我调节的神经机制，提高了在面对厌恶经历时维持目标导向行为的能力，从而支持焦虑和/或抑郁患者成功启动健康行为改变。
