The purpose of this study is to investigate changes in functional neural activation during self-regulation tasks before compared to after the Mindfulness Training for Primary Care intervention (see MINDFUL-PC (Phase 3) clinical trial). The study will also look at whether chronic disease self-management action plan initiation and successful engagement of self-report and behavioral self-regulation targets relates to the observed brain activation changes after compared to before the mindfulness intervention.
The investigators will investigate the effects of MTPC on pre/post changes in neural function with self-regulation target engagement, using self-appraisal, cuff pain and pain anticipation, and interoceptive attention fMRI tasks among primary care patients with an anxiety or depressive disorder. Primary outcome for this study is evaluating the changes in OFC activation during self-criticism blocks within a self-appraisal fMRI task. Secondary outcomes include changes in activation during self-appraisal fMRI task, pain regulation task, and interoceptive attention task, and the relationship of these targets with medical regimen adherence.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
21
For intervention description see Mindfulness Training for Primary Care (MTPC) in the study "MINDFUL-PC: Integrating Mindfulness Into the Patient-Centered Medical Home (Phase 3)"
Cambridge Health Alliance Center for Mindfulness and Compassion
Somerville, Massachusetts, United States
Change in orbitofrontal cortex activation during the self-criticism condition in self-appraisal task
This task involves asking the participant to read about situations and imagine him/herself being self-critical or self-reassuring in these conditions.
Time frame: Weeks 8 - 10
Change in insula activation during an interoceptive attention task
This task contrasts an interoceptive attention condition with an exteroceptive attention condition.
Time frame: Weeks 8 - 10
Changes in the rostral anterior cingulate cortex and adjacent medial prefrontal cortex (rACC/mPFC) during the anticipation of pain
This task involves a pressure cuff which is placed on participant's calf and is inflated for periods of 30 seconds to a medium intense pain, as rated by the participants.
Time frame: Weeks 8 - 10
Change in activation of the medial prefrontal cortex during the self-criticism condition in self-appraisal task
This task involves asking the participant to read about situations and imagine him/herself being self-critical or self-reassuring in these conditions.
Time frame: Weeks 8 - 10
Correlations between brain activation changes and chronic disease self-management action plan initiation
Patient self-reported Action Plan Initiation Survey (APIS-5) is a 5-item questionnaire in which patients are asked to list their action plan SMART goal created during the study, and determine whether they met or did not meet the goal using a 7-point Likert scale with scores \>=5 representing self-reported initiation of the goal.
Time frame: Weeks 8 - 10
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