The effect of mindfulness on stimulus over-selectivity and selective attention to threat following acquired brain injury

Objective: The thesis portfolio aimed to explore the effect of mindfulness on cognition in an acquired neurodisability population. Methods: A systematic review of the literature was conducted to determine the effect of mindfulness-based interventions on cognition for those with acquired brain injury, traumatic brain injury and multiple sclerosis. Further to this, a parallel randomised control design was used to explore the effect of a 10-minute mindfulness exercise on stimulus over-selectivity and selective attention to threat in a sample of 42 individuals with acquired brain injury, compared to an unfocused control condition. Computerised measures of stimulus over-selectivity and selective attention to threat (an emotional Stroop) were administered pre- and post-intervention. Results: Six studies met criteria for the systematic review and included participants who had experienced traumatic brain injury, stroke or unspecified acquired brain injury. Results across studies were mixed with regards to effects on different cognitive domains, with the most promising results for selective and sustained attention. However, all papers were at moderate-high risk of bias. In the empirical paper, mindfulness was not found to improve stimulus over-selectivity or selective attention to threat in this sample of individuals with acquired brain injury. Conclusions: More good-quality research is needed to investigate the effect of mindfulness on cognition following acquired neurodisability. It would be particularly beneficial to identify mechanisms of change to establish which aspects of mindfulness work on which cognitive processes for whom. Additionally, more research is needed to further understand specific attentional biases in this population, such as stimulus over-selectivity and selective attention to threat