People with multiple sclerosis (PwMS) report greater emotion dysregulation, which is associated with increased symptoms of depression and anxiety, and reduced quality of life. Given the transdiagnostic significance of emotion dysregulation, the current study was designed to assess the feasibility and treatment effects of mindfulness meditation in reducing emotion dysregulation for PwMS. Method: Sixty-one PwMS were randomized to 1 of 3 groups: 4-week mindfulness-based training (MBT), 4-week adaptive cognitive training (aCT), or a waitlist control group. Using self-report and behavioral measures, we examined the effects of MBT on emotion dysregulation, use of emotion regulation strategies, experience of negative and positive affect, and overall quality of life. Results: Mindfulness training was associated with reduced emotion dysregulation compared with the adaptive cognitive training and the waitlist control group ( p 2 ϭ .20). Relative to the waitlist group, the MBT group also demonstrated reductions on a composite score of preservative cognition, measuring rumination and worry ( p 2 ϭ .15). However, there was no differential use of emotion regulation strategies or between-groups differences in overall quality of life as a function of training. Conclusions: Our pilot study provides preliminary support for MBT to reduce self-reported emotion dysregulation in PwMS. Given the widespread prevalence of mental health disturbances in this population, MBT can serve as a promising rehabilitation tool for PwMS (clinicaltrials.gov # NCT02717429). Impact and ImplicationsThis pilot RCT provides support for a brief, 4-week, mindfulness-based training to reduce emotion dysregulation in individuals with multiple sclerosis (MS). This study makes a significant contribution to the literature by comparing mindfulness training to an active control group, matching important intervention components, including group-based format, facilitator contact, and homework assignments, and implementing strategic recruitment efforts to minimize demand characteristics. Critically, MS-related declines in physical and cognitive functioning may serve as barriers to other potential psychosocial interventions targeting emotion dysregulation, thus making this brief, group-based, mindfulness training an ideal candidate for improving psychosocial wellness in those with MS.

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Background Mindfulness meditation is a form of mind–body intervention that has increasing scientific support for its ability to reduce age-related declines in cognitive functioning, improve affective health, and strengthen the neural circuitry supporting improved cognitive and affective health. However, the majority of existent studies have been pilot investigations with small sample sizes, limited follow-up data, and a lack of attention to expectancy effects. Here, we present the study design of a Phase I/II, efficacy trial—HealthyAgers trial—that examines the benefits of a manualized mindfulness-based stress reduction program in improving attentional control and reducing mind-wandering in older adults. Methods One hundred fifty older adults (ages 65–85 years) will be randomized into one of two groups: an eight-week mindfulness program or an eight-week, placebo-controlled, lifestyle education program. Behavioral and neuroimaging assessments are conducted before and after the training. Participants are then invited to booster sessions once every three months for a period of 12 months with post-intervention follow-up assessments conducted at 6-months and 12-months. The primary outcomes for the study are behavioral measures of attentional control and mind-wandering. Additional, secondary outcomes include network strength in an a priori defined neuromarker of attentional control, fluid and everyday cognition, emotion regulation strategy use, and markers of inflammation. Discussion This study will establish the efficacy of a group-based, low-cost mind–body intervention for the inter-related facets of attentional control and mind-wandering in older adults. Strengths of this study include a well-designed, placebo-controlled comparison group, use of web/mobile application to track study adherence, and longitudinal follow-up. Trial registration Clinicaltrials.gov (#NCT03626532). Registered August 4, 2018.

This secondary analysis of a pilot randomized controlled trial in people with multiple sclerosis (PwMS) aimed to compare mindfulness-based training (MBT), adaptive cognitive training (aCT), and a waitlist control (WL) on the use of emotion regulation strategies during daily worries and ruminations. Further, we examined cognitive functioning as a moderator of training effects. Research Method/Design: Sixty-one PwMS were randomized into an MBT, aCT, or a WL control group for four weeks. Participants completed daily diaries assessing their use of emotion regulation strategies and measures of cognitive functioning at pre-and posttraining. The frequency of acceptance use, maladaptive strategies, and cognitive reappraisal, as well as the success of acceptance use, were the primary outcomes of interest. We also examined whether a cognitive composite score moderated treatment gains. Results: Relative to pretraining, at posttraining, participants in the MBT group used acceptance more frequently, and this change was significantly greater compared to the change in aCT and WL groups. Training did not have differential effects on the frequency of maladaptive strategy and cognitive reappraisal use or on the success of acceptance use. Cognitive functioning did not moderate observed treatment gains. Conclusion/ Implications: Our findings, based on this pilot study, suggest that after brief training in mindfulness meditation, PwMS used more acceptance strategies to regulate their emotions. Future studies with larger sample sizes, longer duration of treatment, and longitudinal follow-up are needed to better understand the efficacy of mindfulness mediation for promoting affective and cognitive health in PwMS. Impact and ImplicationsThese secondary analyses of a pilot randomized controlled trial explored the preliminary effects of mindfulness-based training (MBT) on the use of emotion regulation strategies in people with multiple sclerosis (PwMS). Emotion dysregulation has garnered increased support as a transdiagnostic factor underlying psychological disturbances. This study found that a four-week mindfulness program increased the use of acceptance-an adaptive emotion regulation strategy-during daily episodes of worry and rumination compared with an active and a passive control group. Although pretraining differences in acceptance use between the three groups necessitate further research, additional analyses that identified medium effects for the MBT group, provide preliminary evidence that mindfulness training may in fact increase the frequency of acceptance use in PwMS. This study contributes to the literature by exploring the impact of mindfulness training on emotion regulation strategy use in a population with chronic health issues that experiences increased rates of mood and anxiety disorders. This study is the first to examine changes in This investigation was supported (in part) by Grant PP2183 from the National Multiple Sclerosis Society.Jaqueline A. Nicholas has received research grants from PCORI, Novartis, Biogen Idec, a...