Hypotheses involving mediation are common in the behavioral sciences. Mediation exists when a predictor affects a dependent variable indirectly through at least one intervening variable, or mediator. Methods to assess mediation involving multiple simultaneous mediators have received little attention in the methodological literature despite a clear need. We provide an overview of simple and multiple mediation and explore three approaches that can be used to investigate indirect processes, as well as methods for contrasting two or more mediators within a single model. We present an illustrative example, assessing and contrasting potential mediators of the relationship between the helpfulness of socialization agents and job satisfaction. We also provide SAS and SPSS macros, as well as Mplus and LISREL syntax, to facilitate the use of these methods in applications.

https://link.springer.com/content/pdf/10.3758/BRM.40.3.879.pdf

Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models

Numerous studies show that happy individuals are successful across multiple life domains, including marriage, friendship, income, work performance, and health. The authors suggest a conceptual model to account for these findings, arguing that the happiness-success link exists not only because success makes people happy, but also because positive affect engenders success. Three classes of evidence--crosssectional, longitudinal, and experimental--are documented to test their model. Relevant studies are described and their effect sizes combined meta-analytically. The results reveal that happiness is associated with and precedes numerous successful outcomes, as well as behaviors paralleling success. Furthermore, the evidence suggests that positive affect--the hallmark of well-being--may be the cause of many of the desirable characteristics, resources, and successes correlated with happiness. Limitations, empirical issues, and important future research questions are discussed.

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The Benefits of Frequent Positive Affect: Does Happiness Lead to Success?

Interest in mindfulness and its enhancement has burgeoned in recent years. In this article, we discuss in detail the nature of mindfulness and its relation to other, established theories of attention and awareness in day-to-day life. We then examine theory and evidence for the role of mindfulness in curtailing negative functioning and enhancing positive outcomes in several important life domains, including mental health, physical health, behavioral regulation, and interpersonal relationships. The processes through which mindfulness is theorized to have its beneficial effects are then discussed, along with proposed directions for theoretical development and empirical research.

http://www.gruberpeplab.com/teaching/psych231_fall2013/documents/231_Brown2007.pdf

Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects

The prevalence and cost of chronic pain is a major physical and mental health care problem in the United States today. As a result, there has been a recent explosion of research on chronic pain, with significant advances in better understanding its etiology, assessment, and treatment. The purpose of the present article is to provide a review of the most noteworthy developments in the field. The biopsychosocial model is now widely accepted as the most heuristic approach to chronic pain. With this model in mind, a review of the basic neuroscience processes of pain (the bio part of biopsychosocial), as well as the psychosocial factors, is presented. This spans research on how psychological and social factors can interact with brain processes to influence health and illness as well as on the development of new technologies, such as brain imaging, that provide new insights into brain-pain mechanisms.

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The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions

To flourish means to live within an optimal range of human functioning, one that connotes goodness, generativity, growth, and resilience. This definition builds on path-breaking work that measures mental health in positive terms rather than by the absence of mental illness (Keyes, 2002). Flourishing contrasts not just with pathology but also with languishing: a disorder intermediate along the mental health continuum experienced by people who describe their lives as “hollow” or “empty.” Epidemiological work suggests that fewer than 20% of U.S. adults flourish and that the costs of languishing are high; relative to flourishing (and comparable to depression), languishing brings more emotional distress, psychosocial impairment, limitations in daily activities, and lost work days (Keyes, 2002).

What predicts whether people will flourish or languish? Are the predictors similar for individuals, relationships, and larger groups? Drawing together existing theory and research on affect and nonlinear dynamic systems, we propose that a key predictor of flourishing is the ratio of positive to negative affect.

Over time, and in both private and social contexts, people experience a range of pleasant and unpleasant emotions and moods, and they express a variety of positive and negative evaluative sentiments or attitudes. We use affect to represent this spectrum of valenced feeling states and attitudes, with positive affect and positivity interchangeably representing the pleasant end (e.g., feeling grateful, upbeat; expressing appreciation, liking) and negative affect and negativity representing the unpleasant end (e.g., feeling contemptuous, irritable; expressing disdain, disliking). The affective texture of a person’s life—or of a given relationship or group—can be represented by its positivity ratio, the ratio of pleasant feelings and sentiments to unpleasant ones over time. Past research has shown that for individuals, this ratio predicts subjective well-being (Diener, 2000; Kahneman, 1999). Pushing further, we hypothesize that—for individuals, relationships, and teams—positivity ratios that meet or exceed a certain threshold characterize human flourishing. Although both negative and positive affect can produce adaptive and maladaptive outcomes, a review of the benefits of positive affect provides a particularly useful backdrop for our theorizing.

/pdf/positive-affect-and-the-complex-dynamics-of-human-22j2vf3cvp.pdf

Positive Affect and the Complex Dynamics of Human Flourishing.

http://www.personal.kent.edu/%7Edfresco/mindfulness/BT_Carson_MBRE.pdf

Mindfulness-based relationship enhancement

When a patient suffers from chronic pain and disability there are different ways of approaching the problem. One approach is to focus on the patient’s environment and opportunities for overt behavior change (Fordyce, 1976). A second approach is to seek direct change in thoughts, beliefs, emotions, or sensations (e.g. Turk et al., 1983). This latter approach is sensible and is concordant with the stated aims of most chronic pain sufferers seeking treatment. Recent developments within Psychology suggest a third approach, an approach that builds on the successes of the first two approaches, appreciates the importance of both overt and covert aspects of the pain experience, but may lead to treatment for chronic pain that differs substantially from treatments in the past. It may be useful to frame the treatment of chronic pain practically, as a problem of acceptance and change. Somewhat paradoxically, there may be occasions when helpful change in the quality of a patient’s life can only occur when some aspects of the problem are accepted as they are. Change efforts may then be directed away from struggles that keep the person stuck, such as with unwanted thoughts, feelings, or sensations, toward situations that yield overall better results, such as a course of action that is personally meaningful and satisfying.

Acceptance and change in the context of chronic pain

Purpose: Loving-kindness meditation has been used for centuries in the Buddhist tradition to develop love and transform anger into compassion. This pilot study tested an 8-week loving-kindness program for chronic low back pain patients. Method: Patients (N = 43) were randomly assigned to the intervention or standard care. Standardized measures assessed patients’ pain, anger, and psychological distress. Findings: Post and follow-up analyses showed significant improvements in pain and psychological distress in the loving-kindness group, but no changes in the usual care group. Multilevel analyses of daily data showed that more loving-kindness practice on a given day was related to lower pain that day and lower anger the next day. Conclusions: Preliminary results suggest that the loving-kindness program can be beneficial in reducing pain, anger, and psychological distress in patients with persistent low back pain. Implications: Clinicians may find loving-kindness meditation helpful in the treatment of patients with persistent pain.

Loving-kindness meditation for chronic low back pain: results from a pilot trial.

A mounting body of literature recommends that treatment for fibromyalgia (FM) encompass medications, exercise and improvement of coping skills. However, there is a significant gap in determining an effective counterpart to pharmacotherapy that incorporates both exercise and coping. The aim of this randomized controlled trial was to evaluate the effects of a comprehensive yoga intervention on FM symptoms and coping. A sample of 53 female FM patients were randomized to the 8-week Yoga of Awareness program (gentle poses, meditation, breathing exercises, yoga-based coping instructions, group discussions) or to wait-listed standard care. Data were analyzed by intention to treat. At post-treatment, women assigned to the yoga program showed significantly greater improvements on standardized measures of FM symptoms and functioning, including pain, fatigue, and mood, and in pain catastrophizing, acceptance, and other coping strategies. This pilot study provides promising support for the potential benefits of a yoga program for women with FM.

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A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia

Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA–IIB). Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.

James W. Carson

Papers

Mindfulness-based relationship enhancement

Acceptance and change in the context of chronic pain

Loving-kindness meditation for chronic low back pain: results from a pilot trial.

A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia

Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.