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      Mindfulness and Behavior Change

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          Abstract

          Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            Self-efficacy: Toward a unifying theory of behavioral change.

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              Executive Functions

              Executive functions (EFs) make possible mentally playing with ideas; taking the time to think before acting; meeting novel, unanticipated challenges; resisting temptations; and staying focused. Core EFs are inhibition [response inhibition (self-control—resisting temptations and resisting acting impulsively) and interference control (selective attention and cognitive inhibition)], working memory, and cognitive flexibility (including creatively thinking “outside the box,” seeing anything from different perspectives, and quickly and flexibly adapting to changed circumstances). The developmental progression and representative measures of each are discussed. Controversies are addressed (e.g., the relation between EFs and fluid intelligence, self-regulation, executive attention, and effortful control, and the relation between working memory and inhibition and attention). The importance of social, emotional, and physical health for cognitive health is discussed because stress, lack of sleep, loneliness, or lack of exercise each impair EFs. That EFs are trainable and can be improved with practice is addressed, including diverse methods tried thus far.
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                Author and article information

                Contributors
                Journal
                Harv Rev Psychiatry
                Harv Rev Psychiatry
                HVP
                Harvard Review of Psychiatry
                Lippincott Williams & Wilkins
                1067-3229
                1465-7309
                Nov-Dec 2020
                06 November 2020
                : 28
                : 6
                : 371-394
                Affiliations
                From the Department of Psychiatry, Harvard Medical School (Drs. Schuman-Olivier, Trombka, Gawande, Lazar, and Fulwiler); Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA (Drs. Schuman-Oliver, Trombka, Gawande, Dunne, and Fulwiler); Department of Psychiatry, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil (Dr. Trombka); Department of Psychiatry, School of Medicine, Dalhousie University (Dr. Lovas); Brown Mindfulness Center (Drs. Brewer and Loucks), School of Public Health (Dr. Loucks), and Department of Psychiatry (Dr. Brewer), Brown University; Osher Center for Integrative Medicine, Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN (Dr. Vago); Boston College School of Nursing (Dr. Dunne); Department of Psychiatry, Massachusetts General Hospital, Boston, MA (Dr. Lazar); Department of Psychiatry, School of Medicine, University of Massachusetts (Dr. Fulwiler).
                Author notes
                [*] Correspondence: Zev Schuman-Olivier, MD, Director, Center for Mindfulness and Compassion, 1035 Cambridge St., Suite 21A, Cambridge, MA 02141. Email: zschuman@ 123456cha.harvard.edu
                Article
                HVP50201 00003
                10.1097/HRP.0000000000000277
                7647439
                33156156
                1d29e205-e6cb-48fe-b9a7-1bf41cd0eb39
                Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the President and Fellows of Harvard College.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 01 April 2020
                : 22 June 2020
                : 10 August 2020
                : 21 July 2020
                Categories
                Reviews
                Custom metadata
                TRUE

                Clinical Psychology & Psychiatry
                health behavior,mental disorders,mindfulness,motivation,neuroscience,self-management,self-regulation

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