Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective

Abstract

Mindfulness-based interventions have been heralded as promising means of alleviating chronic stress. While meta-analyses indicate that mindfulness-based interventions significantly reduce global measures of stress, how mindfulness-based interventions modulate the specific mechanisms underpinning chronic stress as operationalized by the National Institute of Mental Health research domain criteria (RDoC) of sustained threat has not yet been detailed in the literature. To address this knowledge gap, this article aims to (1) review evidence that mindfulness-based interventions ameliorate each of the 10 elements of behavioral dysregulation characterizing sustained threat via an array of mindful counter-regulatory strategies; (2) review evidence that mindfulness-based interventions modify biological domains implicated in sustained threat, such as the hypothalamic–pituitary–adrenal axis, as well as brain circuits involved in attentional function, limbic reactivity, habit behavior, and the default mode network; and (3) integrate these findings into a novel conceptual framework of mindful self-regulation in the face of stress—the Mindfulness-to-Meaning Theory. Taken together, the extant body of scientific evidence suggests that the practice of mindfulness enhances a range biobehavioral factors implicated in adaptive stress coping and induces self-referential plasticity, leading to the ability to find meaning in adversity. These mechanistic findings can inform the treatment development process to optimize the next generation of mindfulness-based interventions for greater therapeutic efficacy.

A systematic review and meta-analysis of workplace mindfulness training randomized controlled trials.

“…Heterogeneity was high for pooled PSS results and was explored in moderation analyses (reported below). The PSS measure assesses the degree to which situations are appraised as stressful (S. Cohen, Kamarck, & Mermelstein, 1983), so these results could provide support for mindfulness training as a pathway for cultivating the adaptive strategies referred to in the theoretical biobehavioral MTM (Garland et al, 2017) and coping models (Folkman, 2013).…”

Mindfulness Meditation and Psychopathology

“…The range of mechanisms of action proposed in theoretical accounts of MM is substantial enough that cataloguing them fully would be infeasible (see, e.g., Baer 2003; Chambers et al 2009; Creswell & Lindsay 2014; Garland et al 2014a, 2017; Hölzel et al 2011; Lutz et al 2015; Teasdale & Chaskalson 2011a,b; Vago & Silbersweig 2012). However, robust evidence bearing on these proposals, particularly in the context of MMBIs for mental health, remains comparatively more limited (see, e.g., Alsubaie et al 2017, Gu et al 2015, van der Velden et al 2015).…”

“…The RDoC matrix (Insel et al 2010) distinguishes between negative valence systems that drive responses to aversive stimuli and positive valence systems underlying responses to motivational stimuli. Negative valence processes potentially impacted by MM include loss, acute threat, and sustained threat (Garland et al 2017, Hölzel et al 2011, Tang et al 2015). MM also may impact positive valence–related processes including approach, responsiveness to reward, reward anticipation, and habit (Garland & Howard 2018, Hölzel et al 2011, Lutz et al 2015, Tang et al 2015).…”

Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research

“…From a neurobiological perspective, increasing grey matter density, strengthening of white matter tracts, synaptic remodeling, and other neuroplastic modifications to brain structure and function needed to undo the pathophysiology of addiction might require recurrent mindfulness practice for the long-term. From a psychological perspective, long-term mindfulness practice may be needed to induce self-referential plasticity and facilitate flexible reconfiguration of the self-schema in relation to the world [ 88 ] so as to restructure reward processes away from valuation of drug reward and towards valuation of personally meaningful pursuits and relationships [ 23 , 29 ]. This latter process is consistent with the ancient soteriological intention of mindfulness as a means of reducing craving by gaining insight into the true nature of the self as impermanent and interdependent [ 89 ]—paralleling Bateson’s classical cybernetic model of addiction recovery [ 90 ].…”