BACKGROUND:Mindfulness meditation (MM), originating from spiritual traditions but widely promoted as a secular and beneficial practice, is increasingly debated due to potential adverse effects, ethical concerns, and its ties with neoliberal imperatives, challenging its image as a universal remedy. Beliefs about MM strongly influence its reception, usage, and effects but remain understudied, especially in comparing meditators and non-meditators. Understanding these beliefs is key to clarifying how lay perceptions align or diverge from scientific frameworks and to grasp individuals' expectations and motivations, notably in clinical contexts. Existing research often overlooks belief content or comparisons between meditators and non-meditators. OBJECTIVE:This study explored the content of beliefs about MM, identified missing elements, and compared meditators' and non-meditators' beliefs. Associations with sociodemographic, motivational, health, and psychological variables were examined. METHODS:167 participants (105 meditators) completed an online survey producing five words linked to MM, rated for valence, plus questionnaires on motivation, beliefs, and personal characteristics. RESULTS:817 free associations were collected; 65% were positive. Hierarchical classification identified five belief categories: "Body-based Relaxation," "Stereotyped Descriptions," "Psychological and Affective Well-Being," "Focus on Inner-Self," and "Experience of MM." Four categories were shared by both groups, with meditators showing more precise, experiential understanding. Beliefs varied with sociodemographic, health, and psychological factors. Core aspects in MM like attention, acceptance, health, collective dynamics and ethical concerns were largely absent. Notably, spirituality was not integrated into the beliefs about MM. CONCLUSIONS:Findings emphasize MM as a self-regulatory and personal development tool shaped by social, psychological and behavioural factors. Recognizing both current and potential MM users' beliefs can improve tailoring of mindfulness interventions and encourage instructors to address ethical and adverse aspects openly, fostering more informed, responsible practice.

Contexte Les troubles dépressifs, qui affectent le rapport à soi et le fonctionnement social, sont plus fréquents au sein des populations vulnérables que dans la population générale. La thérapie cognitive basée sur la pleine conscience (MBCT) a démontré son efficacité dans le traitement de la dépression, mais reste souvent coûteuse ou cantonnée aux structures hospitalières. Les personnes issues de milieux socioéconomiques défavorisés sont sous-représentées dans les protocoles MBCT. En 2023, un projet pilote a été lancé en France afin de remédier à ces inégalités en proposant un accès gratuit aux programmes MBCT sur prescription de professionnels de santé, dans une perspective de justice sociale. Cette étude visait à explorer les caractéristiques sociodémographiques, les appartenances groupales et les motivations des patients ayant accepté de participer aux programmes organisés en centre-ville, ainsi que les obstacles et facilitateurs perçus. Méthode Quatre questions ouvertes portant sur l’appartenance groupale, les motivations, les freins et les facilitateurs liés à l’accès au protocole ont été posées dans un questionnaire en ligne administré aux patients avant le début des cycles MBCT. Des variables sociodémographiques ont également été recueillies. Une analyse de contenu thématique a été menée pour chacune des questions. Résultats L’analyse a mis en évidence une sous-représentation des patients issus de milieux socioéconomiques défavorisés, ainsi qu’une diversité d’appartenances groupales inattendue. La gratuité est apparue comme un facilitateur mineur, peu mentionné dans les motivations. L’expérience collective en groupe a constitué un thème transversal, présent dans les motivations, les obstacles et les facilitateurs, aux côtés de thématiques déjà documentées dans la littérature MBCT et de nouvelles pistes d’analyse. Discussion Les résultats sont discutés à la lumière des enjeux d’inclusion dans les traitements des troubles dépressifs via les MBCT, avec des recommandations en faveur de la poursuite et de l’élargissement du projet pilote.

ObjectiveSince the beginning of COVID-19 pandemic, several studies have shown an increase of psychological distress in the general population. Previous research demonstrated that high levels of anxiety are associated with reporting more somatic symptoms. The ability to adaptively regulate emotions is essential to deal with stressful situations, and it is one of the main components of mindfulness practice. The aim of the present study was to document the effect of mindfulness practice on somatic symptoms and psychological distress in the context of COVID-19 pandemic. MethodsThe study has a descriptive cross-sectional design. During the second wave of COVID-19 pandemic, between November 2020 and January 2021 participants living in France responded to an online survey on the impact of COVID-19 on psychological distress and physical health. The questionnaire included the assessment of COVID-19-related anxiety, mindfulness practice and experience, dispositional mindfulness, somatization, depression, generalized anxiety, and emotion regulation. ResultsA total of 569 people (mean age = 39.8 years, 90% women) were included in the study. COVID-19 related anxiety was associated with higher levels of somatic symptoms, generalized anxiety, and depression. About half of the sample (n = 318, 56%) reported moderate to severe somatic symptoms that were associated with higher levels of depression and anxiety, lower levels of dispositional mindfulness and to the use of maladaptive emotion regulation strategies. Overall, 164 subjects (28.8%) reported practicing meditation. No differences were found in dispositional mindfulness (MAAS score) between beginners and advanced practitioners, regardless of the type, years, frequency, and length of practice. Participants with less experience in mindfulness practice reported a significant higher number of somatic symptoms than non-practitioners and a higher use of rumination. Moreover, mindfulness experience was associated with the use of more adaptive emotion regulation strategies. ConclusionMindfulness meditation has been promoted as a practice enhancing well-being and helping to cope with the psychological impact of stressful events. However, in a distressing situation as COVID-19 pandemic, a limited experience in mindfulness practices might result in the development or endurance of somatic symptoms. Adequate training and a focus on mindful acceptance, may contribute to enhance the effectiveness of mindfulness practice.

Alexithymia is usually described by three main dimensions difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). The most commonly used questionnaire investigating alexithymia, the Toronto Alexithymia Scale (TAS-20), supports this three-factor structure. One important assumption is that alexithymia severity is associated to vulnerability to somatic diseases, among them gastrointestinal disorders. However, the association between alexithymia and gastrointestinal disorders is not systematic, thus questioning the role of alexithymia as a vulnerability factor for those illnesses. A recent factor analysis suggested another four-factor structure for the TAS-20: difficulties in awareness of feelings (DAF), difficulties in interoceptive abilities (DIA), externally oriented thinking (EOT), and poor affective sharing (PAS). We assume that DIA and DAF might be more relevant to investigate the association between alexithymia and gastrointestinal disorders. The rationale is that DIA and DAF reflect impairments in emotion regulation that could contribute to an inappropriate autonomic and HPA axis homeostasis in irritable bowel syndrome (IBS), ulcerative colitis (UC), or Crohn’s disease (CD). The aim of this study was to investigate whether DIA and DAF are associated with the presence of IBS, UC or CD, while checking for anxiety, depression, parasympathetic (vagus nerve) activity and cortisol levels. We recruited control participants (n=26), and patients in remission who were diagnosed with IBS (n=24), UC (n=18), or CD (n=21). Participants completed questionnaires to assess anxiety, depression, and alexithymia. A blood sample and an electrocardiogram were used to measure the level of cortisol and parasympathetic activity, respectively. Logistic regressions with the four-factor structure of the TAS-20 revealed that DIA was a significant predictor of IBS (W(1)=6.27, p=.01). Conversely, DIA and DAF were not significant predictors in CD and UC patients. However, low cortisol level was a significant predictor of UC (W(1)=4.67, p=.035). Additional logistic regressions based on the original 3-factor structure of TAS-20 (DIF, DDF, and EOT) showed that only DDF was a significant predictor of CD [W(1)=6.16, p < .001]. The present study suggests that DIA is an important dimension for assessing potential risk for gastrointestinal diseases, in particular for IBS.

Student distress is considered as a specific public health issue as research has shown increased levels of anxiety, depression, and risk behaviors in this population. Students report high levels of daily hassles, workload, lack of meaning, manageability, and understanding throughout their university years. These factors lead to increased academic burnout. In line with these findings, the current study aimed at assessing the mediating role of sense of coherence in the relationship between daily hassles and academic burnout. Furthermore, in order to assess the importance of sense of coherence in the field of academic burnout research, the percentage of variance of academic burnout explained by the sense of coherence was compared with the percentage of variance explained by optimism-a widely studied protection factor in the field of burnout and negative affect. This paper also reports the French validation of the Maslach Burnout Inventory-Student Survey (MBI-SS) used in this study to assess academic burnout. The sample was composed of 328 students from three French universities. Results indicate that the French version of the three-factor model showed comparable reliability, sensitivity, and construct validity to the original MBI-SS. Sense of coherence played a mediating role between daily hassles and burnout. Furthermore, sense of coherence explained a larger portion of academic burnout variance than optimism. Results are discussed in light of past findings on academic burnout, and future prevention and treatment perspectives are suggested.

BACKGROUND:Negativity is often observed in patients with irritable bowel syndrome (IBS). No study has examined their emotional expressiveness as a marker of emotional reactivity. We investigated IBS patients' vulnerability to an emotional load by associating their expressiveness with psychological and neurophysiological assessments. We hypothesized that IBS would be characterized by a lack of expressiveness coupled with high scores in psychological and neurophysiological parameters.METHODS:We assessed the emotional facial expressions (EMFACS), psychological (anxiety, depression, alexithymia), and neurophysiological (cortisol, heart rate variability (HRV)) parameters of 25 IBS patients and 26 healthy controls (HC) while they watched fear-eliciting movie extracts.KEY RESULTS:Overall, the task elicited an increase in state anxiety and consistent HRV responses. However, IBS patients differed from HC as they displayed more sadness and tended to display more rage. Contrary to HC, IBS patients showed an increase in heart rate and a decrease in parasympathetic regulation, reflecting an enhanced responsiveness corroborated by higher scores in depression and state anxiety. Consistent with their higher difficulty in identifying feelings, a component of alexithymia positively correlated with their expressions of rage, they were not aware of their increase in anxiety during the task, whereas HC were. No linear relationship between patients' expressions and their neurophysiological responses was found.CONCLUSIONS & INFERENCES:Irritable bowel syndrome patients displayed greater emotional expressiveness with negative prevalence. This reflects an emotional vulnerability potentially related to low regulation skills and underscores the importance of considering the central dysregulation hypothesis in IBS as a promising avenue of research.

There is now a large body of evidence suggesting a significant association between emotional discomfort management, disordered eating behaviors and weight status. In the field of overweight and obesity, emotionally driven eating habits that resemble addictive behaviors are considered as a risk factor. This study aimed to investigate in a large sample of French university students 1) the associations between self-reported levels of psychological distress (PD), emotional eating (EE), food addiction (FA) and Body Mass Index (BMI); and 2) the potential mediation effect of eating behaviors (EE and FA) between PD and BMI. The responses of 1051 students (76.3% females) to self-reports assessing PD (Perceived Stress Scale, Hospital Anxiety and Depression Scale), EE (Intuitive Eating Scale-2) and FA (modified Yale Food Addiction Scale) were analysed. Associations between variables (Spearman correlation) and group comparisons by sex and BMI categories (Student's t tests/ANOVA) were tested, followed by Structural Equation Modeling (SEM) by sex. Among females and males, EE and FA scores were positively inter-related and correlated with PD scores and BMI. Moreover, among females and males, SEM showed that both EE and FA acts as mediators between PD and BMI. Hence, among educated young adults, using food consumption for down-regulating negative mood places the individual at risk for overweight and obesity. This study further emphasizes the necessity to take into account emotionally driven and addictive-like eating behaviors in interventions for promoting healthy eating and weight management.

Background Patients with Crohn's disease (CD) in remission are exposed to chronic psychological distress, due to the constant risk of relapse. This permanent situation of anticipation and uncertainty can lead to anxiety, which may, in turn, trigger relapse. We aimed to investigate the effects of uncertainty on behavioral and brain responses to anticipation of visceral discomfort in quiescent CD patients. Methods Barostat-controlled rectal distensions were preceded by cued uncertain or certain anticipation in nine CD patients and nine matched healthy volunteers. Brain responses obtained before distension across the different anticipation conditions in regions of interest (ROI) involved in (anticipation of) pain were measured using functional magnetic resonance imaging and compared between CD and controls. The association between anxiety-related psychological variables and cerebral anticipatory activity was tested. Key Results During uncertainty, CD patients had significantly stronger activations than controls in the cingulate cortex, insula, amygdala, and thalamus with trends in the hippocampus, prefrontal, and secondary somatosensory cortex. In patients, brain responses to uncertainty in the majority of ROI correlated positively with gastrointestinal symptom-specific anxiety, trait-anxiety, and intolerance of uncertainty. Conclusions & Inferences In a context of uncertainty regarding occurrence of uncomfortable visceral sensations, CD is associated with excessive reactivity in brain regions known to be involved in sensory, cognitive and emotional aspects of pain processing and modulation, and threat appraisal. Our findings contribute to a better understanding of the role of emotional and cognitive processes in CD. This may, in turn, lead to the development of new (psycho) therapeutic approaches for management of symptoms and related anxiety.

In the central nervous system, the degree of decline in memory retrieval along the aging process depends on the quantity and quality of the stimuli received during lifetime. The cholinergic system modulates long-term potentiation and, therefore, memory processing. This study evaluated the spatial memory, the synaptic plasticity and the density of cholinergic markers in the hippocampi of mice submitted to cognitive stimulation during lifetime or during their aged phase. Male C57Bl/6 mice (2 months old) were exposed to enriched environment during 15 months (EE-15). An age-matched group was left in standard cages during the same period (SC-15). Spatial memory was evaluated using the Barnes maze at 2, 5, 11 and 17 months of age. At the 17-month-old time point, EE-15 mice showed better performance in the spatial memory task (P < 0.05), when compared to C-15 mice. Other two groups of mice were left in regular cages until the age of 15 months, and then one of the groups was transferred to an enriched environment for two months (EE-2). The other group was kept in regular cages (C-2). After two months of stimulation, EE-2 showed a significant increase in spatial memory (P < 0.01). At the end, brains were extracted and kept at − 80 °C. Slices were obtained from one hemisphere in a cryostat (20 μm, − 18 °C) and thaw-mounted on gelatin coated slides. Synaptic densities, cellular bodies, BDNF densities and α4β2 nicotinic cholinergic receptors (nAChR) were evaluated by immunohistochemistry. Autoradiography for α7 nAChR was conducted using [125I]-α-bungarotoxin. The other half of the brains was used for Western blotting analysis of choline acetyltransferase (ChAT) density. There was no difference in synaptophysin or MAP-2 densities, but BDNF was increased in some hippocampal areas of EE-15 and EE-2, in comparison to control groups. In the same way, increases in ChAT and α7 densities, but not in α4β2, were observed. Both cognitive stimuli during lifetime or during the aged phase improved spatial memory of mice. No difference in structural plasticity was observed, but the maintenance of memory can be due to improvement in long-term potentiation functionality in the hippocampus, modulated, at least, by BDNF and the cholinergic system.

The vagus nerve (VN) is a link between the brain and the gut. The VN is a mixed nerve with anti-inflammatory properties through the activation of the hypothalamic-pituitary-adrenal axis by its afferents and by activating the cholinergic anti-inflammatory pathway through its efferents. We have previously shown that VN stimulation (VNS) improves colitis in rats and that the vagal tone is blunted in Crohn's disease (CD) patients. We thus performed a pilot study of chronic VNS in patients with active CD. Seven patients under VNS were followed up for 6 months with a primary endpoint to induce clinical remission and a secondary endpoint to induce biological (CRP and/or fecal calprotectin) and endoscopic remission and to restore vagal tone (heart rate variability). Vagus nerve stimulation was feasible and well-tolerated in all patients. Among the seven patients, two were removed from the study at 3 months for clinical worsening and five evolved toward clinical, biological, and endoscopic remission with a restored vagal tone. These results provide the first evidence that VNS is feasible and appears as an effective tool in the treatment of active CD.

Le concept d’alimentation émotionnelle se définit comme le fait de moduler la consommation alimentaire en réponse à un ressenti émotionnel plutôt qu’à celui de la faim ou de la satiété [1]. Il postule que l’affectivité ferait partie des traits psychologiques qui augmentent ou diminuent la consommation alimentaire et le contrôle du poids. Le recours à l’alimentation émotionnelle est de plus en plus mis en cause dans la surconsommation (overeating) et l’obésité [2], et les différents sous-types de troubles du comportement alimentaire [3]. Si des études suggèrent qu’adopter un comportement alimentaire « de réconfort » peut avoir des effets délétères, on ne sait pas encore dans quelle mesure certaines ou toutes les émotions sont associées à des modifications importantes de la prise alimentaire. L’objectif de l’étude était de mieux identifier si toutes ou certaines émotions favorisent l’émergence de l’alimentation émotionnelle, et quelles sont les personnes les plus vulnérables. Des étudiants (n = 149 ; âge = 21,5 ± 2,9 ; 81,9 % femmes) ont complété des évaluations de l’alimentation émotionnelle (EMAQ), l’alimentation intuitive (IES), l’addiction à l’alimentation (YFAS) ainsi que la personnalité affective (ANPS). Des corrélations bivariées (Spearman) et des régressions linéaires ont été menées. L’effet de la catégorie d’IMC a été analysé par des tests de Mann-Withney. On retrouve des associations significatives entre la personnalité affective et : la propension à moduler sa prise alimentaire (ex. : EMAQ-émotions négatives/ANPS-négatif Rho = –0,17, p = 0,04 ; IES-Total/ANPS-Tristesse Rho = –0,19, p = 0,03) et à présenter des symptômes d’addiction alimentaire (e.g. YFAS-Sevrage/ANPS-Tristesse Rho = 0,18, p = 0,04). L’alimentation émotionnelle et l’alimentation intuitive prédisent l’IMC (EMAQ-négatif/IMC : = 0,17, p = 0,04 ; IES-Total/IMC : = –0,17, p = 0,04). Le fait de moduler la consommation alimentaire indépendamment de la sensation de faim ou de la satiété (IES-signaux internes) est significativement plus marqué chez les étudiants en surpoids/obèses (p = 0,03). L’étude confirme l’importance de prendre en compte le recours à l’alimentation comme une stratégie potentiellement inadaptée de régulation émotionnelle et ses conséquences sur la santé.

Autonomic dysfunction and mood disorders are frequently described in Crohn's disease (CD) and are known to influence visceral sensitivity. We addressed the link between vagal tone, negative affect, and visceral sensitivity in CD patients without concomitant features of irritable bowel syndrome (IBS). Rectal distensions to a discomfort threshold of 70% and onset of pain were performed in nine CD patients in remission and eight healthy controls. Autonomic parameters were evaluated with heart rate variability and electrodermal reactivity. We showed that CD patients had (i) higher scores of depressive symptomatology (12 ± 3 in patients vs 4 ± 1 in controls on the Center for Epidemiologic Studies‐Depression Scale; p = 0.038), (ii) reduced vagal tone (HF 257 ± 84 ms2 vs 1607 ± 1032 ms2, p = 0.043; LF 455 ± 153 ms2 vs 1629 ± 585 ms2, p = 0.047), (iii) decreased sympathetic reactivity during an aversive stimulus, and (iv) higher tolerance to rectal distension pressures (43 ± 3 mmHg vs 30 ± 2 mmHg, p = 0.002) and low sensitivity index scores. In conclusion, our results provide preliminary evidence that patients with quiescent CD, in the absence of IBS, are hyposensate to experimental rectal distension. These data provide further evidence that anxiety and depressive symptomatology in addition to autonomic dysfunction modulate visceral pain perception in quiescent CD patients in the absence of IBS.

Crohn's disease (CD) and irritable bowel syndrome (IBS) involve brain-gut dysfunctions where vagus nerve is an important component. The aim of this work was to study the association between vagal tone and markers of stress and inflammation in patients with CD or IBS compared to healthy subjects (controls). The study was performed in 73 subjects (26 controls, 21 CD in remission and 26 IBS patients). The day prior to the experiment, salivary cortisol was measured at 8:00 AM and 10:00 PM. The day of the experiment, subjects completed questionnaires for anxiety (STAI) and depressive symptoms (CES-D). After 30 min of rest, ECG was recorded for heart rate variability (HRV) analysis. Plasma cortisol, epinephrine, norepinephrine, TNF-alpha and IL-6 were measured in blood samples taken at the end of ECG recording. Compared with controls, CD and IBS patients had higher scores of state-anxiety and depressive symptomatology. A subgroup classification based on HRV-normalized high frequency band (HFnu) as a marker of vagal tone, showed that control subjects with high vagal tone had significantly lower evening salivary cortisol levels than subjects with low vagal tone. Such an effect was not observed in CD and IBS patients. Moreover, an inverse association (r = -0.48; p<0.05) was observed between the vagal tone and TNF-alpha level in CD patients exclusively. In contrast, in IBS patients, vagal tone was inversely correlated with plasma epinephrine (r = -0.39; p<0.05). No relationship was observed between vagal tone and IL-6, norepinephrine or negative affects (anxiety and depressive symptomatology) in any group. In conclusion, these data argue for an imbalance between the hypothalamus-pituitary-adrenal axis and the vagal tone in CD and IBS patients. Furthermore, they highlight the specific homeostatic link between vagal tone and TNF-alpha in CD and epinephrine in IBS and argue for the relevance of vagus nerve reinforcement interventions in those diseases.

Aim: The vagus nerve (VN) has an anti-inflammatory role through the cholinergic antiinflammatory pathway (Mol Med 2003;9:125-34). VN stimulation (VNS) improves colitis in rats (Auton Neurosci 2011;160:82-9) but has never been used in the treatment of Crohn's disease (CD).We performed a pilot study of VNS in patients with active CD (ClinicalTrials.gov NCT01569503). Methods: Consecutive patients with moderate to severe (220