Theoretical rationale for MMBI

Mindfulness has been previously defined as comprising four components: Attention regulation, body awareness, emotion regulation, and change in perspective on the self (Holzel et al. 2011). As a set of self-regulatory mechanisms, mindfulness has been theorized to comprise at least two distinct neurophysiological pathways. The first, top-down pathway involves enhanced attention capacity attenuating automatic emotional reactivity, while the second, bottom-up pathway involves attenuated limbic activity without the need for conscious control. Neuroimaging evidence indicates that FA primarily recruits top-down processing, and OM recruits bottom-up processing (Chiesa et al. 2013).

Attention regulation and reappraisal

The attention regulation component of mindfulness (Holzel et al. 2011) is theoretically congruent with the concept of top-down processing (Chiesa et al. 2013) and can be understood as an enhancement of top-down appraisal mechanisms that remediate negative attributional biases (Beck 2008). This aspect of the clinical utility of mindfulness is consistent with the theory that appraisal can refine the meaning of emotions and reduce the perceived unpleasantness of negatively valenced stimuli (Panksepp 1998). It is this reappraisal dimension that Kabat-Zinn stressed in his formulation of mindfulness as a practice of enhanced, deliberate, directed attention that entails “paying attention in a particular way: On purpose, in the present moment, and nonjudgmentally” (1994, p. 4). Several subtly contrasting empirical constructs subsequently emerged that similarly emphasized this reappraisal dimension. Hayes (2004), for example, described this process as cognitive defusion, while other related constructs included reperceiving (Carmody et al. 2009). Bishop and colleagues’ (2004) definition emphasized an attitude of openness and acceptance. Baer and colleagues (2008) outlined a five-facet model of mindfulness in which two of the facets are non-judging of inner experience and non-reactivity to inner experience. All of these definitions emphasize the appraisal function of present moment attention.

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