마음챙김 기반 치료의 기전 및 신경생물학적 근거
Mechanism of Mindfulness-Based Intervention and Neurobiological Basis
2
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
Mindfulness is a process in which all thoughts, feelings, sensations, and all phenomena that happen to me are uncritically recognized as they are, so that they are eventually accepted and released without identifying or automatically responding to them. The clinical effects of mindfulness-based therapy have already been demonstrated in several studies. However, consistent results have not been reported for the mechanism of mindfulness-based treatment. Thus, this review aimed to describe a systematic review of the literature and research on the mechanisms of mindfulness-based interventions. Experienced meditators showed a physiological change in a ‘wakeful hypometabolic state’ during mindfulness meditation. In mindfulness meditation, it is known that certain areas other than brain activation during relaxation are additionally activated, particularly activation of fronto-limbic and fronto-parietal neural networks. The psychological mechanisms include meta-cognitive awareness, emotion regulation, reduction of automatic and self-referential thinking, concentration control, self-compassion, improvement of value clarification and self-regulation, exposure, extinction, and reconsolidation. Of the brain regions with changes in activity associated with mindfulness meditation, prefrontal cortex, the default mode network including cortical midline structures were associated with emotion regulation, concentration control, and reduction of automatic and self-referential thinking. In addition, brain regions associated with mindfulness meditation have been reported in the hippocampus, amygdala, and medical frontal cortices associated with memory reconsolidation and fear extinction. Thus, mindfulness-based interventions have a psychological and neurobiological effect with a special mechanism different from other psychological interventions, so that mindfulness based intervention can be an effective therapeutic intervention with a different mechanism from other psychological techniques.
Abstract
Mindfulness is a process in which all thoughts, feelings, sensations, and all phenomena that happen to me are uncritically recognized as they are, so that they are eventually accepted and released without identifying or automatically responding to them. The clinical effects of mindfulness-based therapy have already been demonstrated in several studies. However, consistent results have not been reported for the mechanism of mindfulness-based treatment. Thus, this review aimed to describe a systematic review of the literature and research on the mechanisms of mindfulness-based interventions. Experienced meditators showed a physiological change in a ‘wakeful hypometabolic state’ during mindfulness meditation. In mindfulness meditation, it is known that certain areas other than brain activation during relaxation are additionally activated, particularly activation of fronto-limbic and fronto-parietal neural networks. The psychological mechanisms include meta-cognitive awareness, emotion regulation, reduction of automatic and self-referential thinking, concentration control, self-compassion, improvement of value clarification and self-regulation, exposure, extinction, and reconsolidation. Of the brain regions with changes in activity associated with mindfulness meditation, prefrontal cortex, the default mode network including cortical midline structures were associated with emotion regulation, concentration control, and reduction of automatic and self-referential thinking. In addition, brain regions associated with mindfulness meditation have been reported in the hippocampus, amygdala, and medical frontal cortices associated with memory reconsolidation and fear extinction. Thus, mindfulness-based interventions have a psychological and neurobiological effect with a special mechanism different from other psychological interventions, so that mindfulness based intervention can be an effective therapeutic intervention with a different mechanism from other psychological techniques.
참고문헌 (82)
- 대한신경정신의학회, "신경정신의학" (2017), 아이엠이즈컴퍼니
- Black DS, "Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances : a randomized clinical trial", JAMA Intern Med, 175, pp.494~501 (2015)
- Falsafi N, "A randomized controlled trial of mindfulness versus yoga : Effects on depression and", or anxiety in college students, 2016, pp.22, 483~497
- Michalak J, "Mindfulness-based cognitive therapy and a group version of the cognitive behavioral analysis system of psychotherapy for chronic depression : Follow-up data of a randomized controlled trial and the moderating role of childhood adversities", Psychother Psychosom, 85, pp.378~380 (2016)
- Hoge EA, "Randomized controlled trial of mindfulness meditation for generalized anxiety disorder : effects on anxiety and stress reactivity", J Clin Psychiatry, 74, pp.786~792 (2013)
- Feuille M, "Pain, mindfulness, and spirituality:A randomized controlled trial comparing effects of mindfulness and relaxation on pain-related outcomes in migraineurs", J Health Psychol, 20, pp.1090~1106 (2015)
- Shorey RC, "A randomized controlled trial of a mindfulness and acceptance group therapy for residential substance use patients", Subst Use Misuse, 52, pp.1400~1410 (2017)
- Ruffault A, "Randomized controlled trial of a 12-month computerized mindfulness-based intervention for obese patients with binge eating disorder : The MindOb study protocol", Contemp Clin Trials, 49, pp.126~133 (2016)
- Goldberg SB, "Mindfulness-based interventions for psychiatric disorders : A systematic review and meta-analysis", Clin Psychol Rev, 59, pp.52~60 (2018)
- Gu J, "How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies", Clin Psychol Rev, 37, pp.1~12 (2015)
- Tang YY, "The neuroscience of mindfulness meditation", Nat Rev Neurosci, 16, pp.213~225 (2015)
- Marchand WR, "Neural mechanisms of mindfulness and meditation : Evidence from neuroimaging studies", World J Radiol, 6, pp.471~479 (2014)
- Alda M, "Zen meditation, length of telomeres, and the role of experiential avoidance and compassion", Mindfulness(NY), 7, pp.651~659 (2016)
- Epel E, "Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres", Ann N Y Acad Sci, 1172, pp.34~53 (2009)
- Cahn BR, "Meditation states and traits: EEG, ERP, and neuroimaging studies", Psychol Bull, 132, pp.180~211 (2006)
- Jevning R, "The physiology of meditation: a review. A wakeful hypometabolic integrated response", Neurosci Biobehav Rev, 16, pp.415~424 (1992)
- Brefczynski-Lewis JA, "Neural correlates of attentional expertise in long-term meditation practitioners", Proc Natl Acad Sci U S A, 104, pp.11483~11488 (2007)
- Lazar SW, "Functional brain mapping of the relaxation response and meditation", Neuroreport, 11, pp.1581~1585 (2000)
- Hölzel BK, "Differential engagement of anterior cingulate and adjacent medial frontal cortex in adept meditators and non-meditators", Neurosci Lett, 421, pp.16~21 (2007)
- Farb NA, "Attending to the present : mindfulness meditation reveals distinct neural modes of self-reference", Soc Cogn Affect Neurosci, 2, pp.313~322 (2007)
- Newberg A, "The measurement of regional cerebral blood flow during the complex cognitive task of meditation : a preliminary SPECT study", Psychiatry Res, 106, pp.113~122 (2001)
- Aftanas LI, "Human anterior and frontal midline theta and lower alpha reflect emotionally positive state and internalized attention : high-resolution EEG investigation of meditation", Neurosci Lett, 310, pp.57~60 (2001)
- Barnhofer T, "Effects of meditation on frontal alpha-asymmetry in previously suicidal individuals", Neuroreport, 18, pp.709~712 (2007)
- Olendzki A., "Unlimiting mind: The radically experiential psychology of Buddhism" (2010), Wisdom Publications
- Carmody J, "An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program", J Clin Psychol, 65, pp.613~626 (2009)
- Kerr CE, "Developing an observing attitude : an analysis of meditation diaries in an MBSR clinical trial", Clin Psychol Psychother, 18, pp.80~93 (2011)
- Fresco DM, "Initial psychometric properties of the experiences questionnaire : validation of a self-report measure of decentering", Behav Ther, 38, pp.234~246 (2007)
- Shahar B, "Mechanisms of change in mindfulness-based cognitive therapy for depression : Preliminary evidence from a randomized controlled trial", Int J Cogn Ther, 3, pp.402~418 (2010)
- Teasdale JD, "Metacognitive awareness and prevention of relapse in depression : empirical evidence", J Consult Clin Psychol, 70, pp.275~287 (2002)
- Hargus E, "Effects of mindfulness on meta-awareness and specificity of describing prodromal symptoms in suicidal depression", Emotion, 10, pp.34~42 (2010)
- Teasdale JD, "Metacognition, mindfulness and the modification of mood disorders", Clin Psychol Psychother, 6, pp.146~155 (1999)
- Fresco DM, "Relationship of posttreatment decentering and cognitive reactivity to relapse in major depression", J Consult Clin Psychol, 75, pp.447~455 (2007)
- Gross JJ, "Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being", J Pers Soc Psychol, 85, pp.348~362 (2003)
- Gross JJ, "Hiding feelings : the acute effects of inhibiting negative and positive emotion", J Abnorm Psychol, 106, pp.95~103 (1997)
- Quirk GJ, "Prefrontal involvement in the regulation of emotion : convergence of rat and human studies", Curr Opin Neurobiol, 16, pp.723~727 (2006)
- Brown KW, "Mindfulness : Theoretical Foundations and Evidence for its Salutary Effects", Psychol Inq, 18, pp.211~237 (2007)
- Chambers R, "Mindful emotion regulation : An integrative review", Clin Psychol Rev, 29, pp.560~572 (2009)
- Ochsner KN, "The cognitive control of emotion", Trends Cogn Sci, 9, pp.242~249 (2005)
- Rolls ET, "The orbitofrontal cortex and beyond : from affect to decision-making", Prog Neurobiol, 86, pp.216~244 (2008)
- Chiesa A, "Mindfulness: Topdown or bottom-up emotion regulation strategy?", Clin Psychol Rev, 33, pp.82~96 (2013)
- Buckner RL, "The brain's default network: anatomy, function, and relevance to disease", Ann N Y Acad Sci, 1124, pp.1~38 (2008)
- Marchand WR., "Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen mediation for depression, anxiety, pain, and psychological distress", J Psychiatr Pract, 18, pp.233~252 (2012)
- Gu J, "How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies", Clin Psychol Rev, 37, pp.1~12 (2015)
- Northoff G, "Self-referential processing in our brain--a meta-analysis of imaging studies on the self", Neuroimage, 31, pp.440~457 (2006)
- McKiernan KA, "Interrupting the"stream of consciousness" : an fMRI investigation", Neuroimage, 29, pp.1185~1191 (2006)
- Smith H, "Buddhism: A concise introduction" (2003), HarperCollins
- Tang YY, "Shortterm meditation training improves attention and self-regulation", Proc Natl Acad Sci USA, 104, pp.17152~17156 (2007)
- Slagter HA, "Mental training affects distribution of limited brain resources", PLoS Biol, 5, pp.e138~ (2007)
- van den Hurk PA, "Greater efficiency in attentional processing related to mindfulness meditation", Q J Exp Psychol(Hove), 63, pp.1168~1180 (2010)
- MacLean KA, "Intensive meditation training improves perceptual discrimination and sustained attention", Psychol Sci, 21, pp.829~839 (2010)
- MacCoon DG, "No sustained attention differences in a longitudinal randomized trial comparing mindfulness based stress reduction versus active control", PLoS One, 9, pp.e97551~ (2014)
- Hasenkamp W, "Mind wandering and attention during focused meditation : a fine-grained temporal analysis of fluctuating cognitive states", Neuroimage, 59, pp.750~760 (2012)
- Tang YY, "Central and autonomic nervous system interaction is altered by short-term meditation", Proc Natl Acad Sci U S A, 106, pp.8865~8870 (2009)
- Tang YY, "Short-term meditation induces white matter changes in the anterior cingulate", Proc Natl Acad Sci U S A, 107, pp.15649~15652 (2010)
- Goldin PR, "Effects of mindfulness-based stress reduction(MBSR)on emotion regulation in social anxiety disorder", Emotion, 10, pp.83~91 (2010)
- Pagnoni G, "Age effects on gray matter volume and attentional performance in Zen meditation", Neurobiol Aging, 28, pp.1623~1627 (2007)
- Farb NA, "Mindfulness meditation training alters cortical representations of interoceptive attention", Soc Cogn Affect Neurosci, 8, pp.15~26 (2013)
- Neff K, "Self-compassion : An alternative conceptualization of a healthy attitude toward oneself", Self Identity, 2, pp.85~101 (2003)
- Hollis-Walker L, "Mindfulness, self-compassion, and happiness in non-meditators: A theoretical and empirical examination", Pers Individ Dif, 50, pp.222~227 (2011)
- Birnie K, "Exploring self-compassion and empathy in the context of mindfulness-based stress reduction(MBSR)", Stress Health, 26, pp.359~371 (2010)
- Kuyken W, "How does mindfulness-based cognitive therapy work?", Behav Res Ther, 48, pp.1105~1112 (2010)
- Van Dam NT, "Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression", J Anxiety Disord, 25, pp.123~130 (2011)
- Birnie K, "Psychological benefits for cancer patients and their partners participating in mindfulness-based stress reduction(MBSR)", Psychooncology, 19, pp.1004~1009 (2010)
- Shapiro SL, "Mindfulness-based stress reduction for health care professionals : Results from a randomized trial", Int J Stress Manag, 12, pp.164~176 (2005)
- Shapiro SL, "Teaching self-care to caregivers : Effects of mindfulness-based stress reduction on the mental health of therapists in training", Train Educ Prof Psychol, 1, pp.105~115 (2007)
- Abercrombie PD, "Lessons learned : providing a mindfulness-based stress reduction program for low-income multiethnic women with abnormal pap smears", Holist Nurs Pract, 21, pp.26~34 (2007)
- Bergen-Cico D, "Examining the efficacy of a brief mindfulness-based stress reduction(Brief MBSR)program on psychological health", J Am Coll Health, 61, pp.348~360 (2013)
- Keng S-L, "Effects of mindfulness on psychological health : A review of empirical studies", Clin Psychol Rev, 31, pp.1041~1056 (2011)
- Shapiro SL, "Mechanisms of mindfulness", J Clin Psychol, 62, pp.373~386 (2006)
- Ryan RM, "Nature and autonomy : an organizational view of social and neurobiological aspects of self-regulation in behavior and development", Dev Psychopathol, 9, pp.701~728 (1997)
- Brown KW, "The benefits of being present : Mindfulness and its role in psychological well-being", J Pers Soc Psychol, 84, pp.822~848 (2003)
- Ryan RM, "Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being", Am Psychol, 55, pp.68~78 (2000)
- Baer RA, "Using self-report assessment methods to explore facets of mindfulness", Assessment, 13, pp.27~45 (2006)
- Baer RA, "Mindfulness training as a clinical intervention : A conceptual and empirical review", Clin Psychol(New York), 10, pp.125~143 (2003)
- Kabat-Zinn J, "An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation : theoretical considerations and preliminary results", Gen Hosp Psychiatry, 4, pp.33~47 (1982)
- Segal ZV, "Mindfulnessbased cognitive therapy for depression: A new approach to preventing relapse" (2002), Guilford Press
- Wells A, "Modelling cognition in emotional disorder : The S-REF model", Behav Res Ther, 34, pp.881~888 (1996)
- Bishop SJ, "Neurocognitive mechanisms of anxiety : an integrative account", Trends Cogn Sci, 11, pp.307~316 (2007)
- Phelps EA, "Extinction learning in humans : role of the amygdala and vmPFC", Neuron, 43, pp.897~905 (2004)
- Hölzel BK, "Mindfulness practice leads to increases in regional brain gray matter density", Psychiatry Res, 191, pp.36~43 (2011)
- Hölzel BK, "Stress reduction correlates with structural changes in the amygdala", Soc Cogn Affect Neurosci, 5, pp.11~17 (2010)
- Hölzel BK, "Investigation of mindfulness meditation practitioners with voxel-based morphometry", Soc Cogn Affect Neurosci, 3, pp.55~61 (2008)