This study examined whether executive function and theory of mind mediate the effects of pediatric traumatic brain injury (TBI) on social adjustment, relative to children with orthopedic injury (OI). Participants included 19 children with severe TBI, 41 children with complicated mild/moderate TBI, and 57 children with OI. They completed measures of executive function, as well as cognitive, affective, and conative theory of mind. Parents provided ratings of children's social adjustment. Children with severe TBI performed more poorly than children with OI on executive function and theory of mind tasks and were rated by parents as having more behavioral symptoms and worse communication and social skills. Executive function and theory of mind were positively correlated with social skills and communication skills, and negatively correlated with behavioral symptoms. In multiple mediator models, theory of mind and executive function were not significant direct predictors of any measure of social adjustment, but mediated the association between injury and adjustment for children with severe TBI. Theory of mind was a significant independent mediator when predicting social skills, but executive function was not. TBI in children, particularly severe injury, is associated with poor social adjustment. The impact of TBI on children's social adjustment is likely mediated by its effects on executive function and theory of mind.

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The growing interest in mindfulness interventions for use in aging samples has been met with promising evidence of cognitive, emotional, and physiological benefits. The purpose of this review is to provide an overview of the impact of mindfulness training on three areas of functioning in older adults: behavioral and neural correlates of attentional performance, psychological well-being, and systemic inflammation. We have previously proposed that mindfulness training is uniquely suited as a rehabilitative tool for conferring both cognitive and emotional benefits for older adults. Specifically, mindfulness training's promotion of focused attention may mitigate the decline of attentional control abilities across late development and allow older adults to capitalize on their preserved emotion regulation abilities. Existing evidence points to some improvements in facets of attentional control in older adults, although some studies have shown no benefits in performance. Further, there is evidence of enhancements in both psychological and physical aspects of well-being, and accompanying improvements in systemic inflammation, following mindfulness training. The scientific investigation of mindfulness training is still relatively nascent, with only a limited number of studies, particularly randomized controlled trials utilizing active comparison conditions. It will be important for future research to incorporate placebo-controlled comparison groups to clearly establish the causal role of mindfulness practices in promoting holistic health in older adults.

Individual differences in dispositional mindfulness and MW propensity explain important variance in attentional performance across age. Increasing present-moment focus and reducing lapses in attention represent important targets for cognitive rehabilitation interventions. (JINS, 2018, 24, 876-888).

This review examines longitudinal studies of changes in attentional control following mindfulness training. A total of 56 retreat studies, feasibility studies, and randomized controlled trials were identified. Outcome measures were broadly categorized based on whether they operated primarily via top-down mechanisms, involving goal-directed modulation of attention via endogenous information, or bottom-up mechanisms, involving attentional capture via exogenous cues. Although many feasibility and retreat studies provide promising evidence supporting gains in both top-down and bottom-up attention following mindfulness training, evidence from randomized controlled trials, especially those involving active control comparison groups, is more mixed. This review calls attention to the urgent need in our field of contemplative sciences for adopting the methodological rigor necessary for establishing the efficacy of mindfulness meditation as a cognitive rehabilitation tool. Although studies including wait-list control comparisons were fruitful in providing initial feasibility data and pre-post effect sizes, there is a pressing need to employ standards that have been heavily advocated in the broader cognitive and physical training literatures. Critically, inclusion of active comparison groups and explicit attention to reduction of demand characteristics are needed to disentangle the effects of placebo from treatment. Further, detailed protocols for mindfulness and control groups and examination of theoretically guided outcome variables with established metrics for reliability and validity are key ingredients in the systematic study of mindfulness meditation. Adoption of such methodological rigor will allow for causal claims supporting mindfulness training as an efficacious treatment modality for cognitive rehabilitation and enhancement.