A pilot field trial: Evaluating the effectiveness of psychoeducation materials and a brief sleep, media-multitasking and mindfulness meditation intervention for university students

A PILOT FIELD TRIAL: EVALUATING THE EFFECTIVENESS OF

PSYCHOEDUCATION MATERIALS AND A BRIEF SLEEP,

MEDIA-MULTITASKING AND MINDFULNESS MEDITATION

INTERVENTION FOR UNIVERSITY STUDENTS.

HANS CHUNG LAI TUNG

DEPARTMENT OF PSYCHOLOGY

NATIONAL UNIVERSITY OF SINGAPORE

2015/2016

RUNNING HEAD: Effectiveness of a brief sleep, media-multitasking and

mindfulness intervention.

A pilot field trial: Evaluating the effectiveness of psychoeducation materials and a

brief sleep, media-multitasking and mindfulness meditation intervention for university

students.

Chung Lai Tung Hans

Thesis Submitted in Partial Fulfilment of the Requirements for

The Degree of Bachelor of Social Sciences with Honours (Psychology)

2015/2016

i

Acknowledgements

I would like to thank my supervisors, Dr. Power and Dr. Gregor for their

invaluable support in guiding me along with this thesis. Dr. Gregor, for your realistic

advice in keeping my ambitious goals and ideas in check, and for providing me with

the rich starting materials upon which this thesis is based. I will forever keep the

lesson in mind to not hinder my future progress and success by “Nobel prize”

thinking. To Dr. Power, thank you so much for your unwavering support and patience

in guiding me through the process of formulating this thesis. I am truly and sincerely

touched by the long hours you spent with me helping me to understand the statistics

behind my data, especially when I was overwhelmed by the sheer amount of

measures. I have learnt so much from you these past few months. Thank you for

bearing with my “creative” ideas of reference conditions, dual repeated-measures type

of conceptualizations given my unfamiliarity with multivariate models. You have

certainly enlightened me to a different world of statistics. I hope you have enjoyed the

past few months with me as well and I wish you a good read ahead.

The findings in this thesis would not have been possible without the tenacious

support of my 67 participants. Your efforts have truly made a difference in this

important milestone of my life. Thank you for bearing with the long sessions of pre

and post-testing phases and the multiple health behaviours you attempted to change. I

know it was not an easy ask of you during that period. Seriously, thank you for

responding to my recruitment calls from all sorts of avenues in a time when I was so

worried about having to face you all, to potentially postpone the study. I hope you

have enjoyed the graphic e-book designed for you. Our relationship should not end

with this thesis as I hope that you will continue to practice being mindful, sleep more

ii

and media-multitask less for your long term benefit. Read on to find out more (you

should also have received this with an email to more resources).

To all the friends I’ve met and made in NUS, and also from beyond, thank you

for being a part of my journey in school and contributing in your own ways to make

me who I am. I know I haven’t always been around (busy working outside), but I truly

appreciate the companionship and friendships we have. Thank you for all the words of

encouragement you have gifted me. They have helped me get through the process

along the way.

To my girlfriend, Kimberly for always being there for me when I am at my

lowest, dealing with disappointment, frustrations and grief. Thank you for never

failing to be my support system and to care for me so selflessly these past few

months. I love you.

To my family, who have been with me for the past 24+ years. Thank you for

giving me a loving home to return to even though we may not always adequately and

efficaciously expressed our love for each other. To my mum for always supporting me

and encouraging me to do my best, and for that, to my father as well who always tries

to make us happy and works so hard to provide for us. To my brother, I know we

aren’t chatty but I know we both care for each other. Thank you.

Lastly, I would like to thank someone who has been there for me since I was 9

months old. Thank you auntie Betty for always being there for me and entertaining

my various antics for the past 24 years. You have worked so hard to take care of our

family for so many years. I will miss our bantering and me coming home every day to

say hello. I still walk past the room at night expecting to see you sleeping there. I was

heartbroken that you had to leave just 2 weeks before this was due but I know that it’s

time for you to go back to your family. You came over when Christopher was just 9

iii

years old and you’ve missed him growing up just to watch us grow up. Thank you for

the sacrifices you’ve made and for the love you have for all of us. We love you too.

See you soon.

This thesis is dedicated to all those who have made a difference in my life, regardless

how big or small the impact.

iv

Abstract

Psychoeducational materials were compiled targeting health behaviours (sleep,

media-multitasking, mindfulness) in undergraduate students. 67 students were

recruited and randomly assigned to 3 conditions: Control, Psychoeducation only and

psychoeducation with Practice. Intervention conditions were tasked with behavioural

change (10 days), after receiving a psychoeducation module. The Headspace Take10

guided meditation was a structured intervention for Practice subjects along with daily

text reminders. Behaviours (PSQI, MMI, Mindful habits) and outcomes (PANAS,

ERQ, DASS-21, CAMS-R, Stroop test) were measured at pre-test and post-test.

Results revealed limited success. Psychoeducation alone (versus Controls) was not

successful in behavioural change and subsequent outcomes. Only Practice subjects

significantly increased mindful practice duration, of which change scores as a

covariate predicted significant differences in reappraisal strategies that were also

found. Mindfulness levels did approach significant increase. Over the study but not

differentially across the conditions, sleep duration, media-multitasking, DASS-21

subscales and negative affect improved. Limitations included small sample size, study

timing and brief intervention length. The inefficacy of psychoeducation was discussed

within the Information-Motivation-Strategy model of health behaviour change, where

weaknesses in motivation and strategy were assessed. The findings demonstrate

promising mindfulness increases with brief intervention and also suggests the

predictive utility of mindfulness practice on increased usage of reappraisal strategies.

Future research should improve the psychoeducation and interventions to better

produce holistic outcomes for the university population.

Keywords: mindfulness meditation, sleep, media-multitasking,

psychoeducation, pilot field trial

v

Table of Contents

Acknowledgements ...................................................................................................... i

Abstract ....................................................................................................................... iv

Table of Contents .........................................................................................................v

List of Tables ............................................................................................................. vii

List of Figures ........................................................................................................... viii

List of Appendices ...................................................................................................... ix

Introduction ..................................................................................................................1

Emotion Regulation ................................................................................................... 1

Mental Health ............................................................................................................. 5

Sleep Behaviours: Trends and Effects among University Students .................... 7

Media-Multitasking Behaviours: Trends and Effects among University

Students ..................................................................................................................... 12

Mindfulness and Its Beneficial Effects ................................................................. 16

Mindfulness for Students ........................................................................................ 22

Objectives and Experimental Design .................................................................... 24

Predictions and Hypotheses .................................................................................... 24

Methods .......................................................................................................................25

Subjects and Recruitment ........................................................................................ 25

Experimental Design................................................................................................ 25

Measures and Protocol ............................................................................................ 25

Procedure ................................................................................................................... 32

vi

Results .........................................................................................................................36

Statistical Analyses .................................................................................................. 36

Behavioural Measures ............................................................................................. 41

Outcome Measures ................................................................................................... 53

Psychoeducation Test Scores .................................................................................. 65

Programme Evaluation ............................................................................................ 65

Further Analyses and Observations ....................................................................... 65

Summary of Key Results......................................................................................... 66

Discussion....................................................................................................................67

Mindfulness Training Predicting the Use of Reappraisal Strategies ................. 67

Promising Changes in Mindfulness Levels within a Brief 10-Days Training . 70

Behavioural and Outcome Improvements across Time: Academic Situation

and Environment ...................................................................................................... 70

Interventions in the Present Study and Suggestions for Improvement ............. 72

Limitations of the Present Study ............................................................................ 80

Promising Attitudes from the Intervention ........................................................... 81

Conclusion: Implications, Future Developments and Research ........................ 82

References ...................................................................................................................85

Appendices ................................................................................................................113

vii

List of Tables

Table 1.1 Descriptive Statistics (Behavioural measures) ...........................................37

Table 1.2 Descriptive Statistics (Outcome measures) ................................................38

Table 1.3 Descriptive Statistics (Programme Evaluation – post-test only) ................39

Table 2.1 Pairwise comparisons for weekly mindful practice duration (different

condition-pairs at each time level). .............................................................................43

Table 2.2 Pairwise comparisons for weekly mindful practice duration (different time-

pairs at each condition level). ......................................................................................44

Table 3.1 Pairwise comparisons for weekly mindful practice duration (different

gender-pairs at each time level). .................................................................................47

Table 3.2 Pairwise comparisons for weekly mindful practice duration (different time-

pairs at each gender level). ..........................................................................................48

Table 4.1 Pairwise comparisons for CAMS-R (different condition-pairs at each time

level). ............................................................................................................................57

Table 4.2 Pairwise comparisons for CAMS-R (different time-pairs at each condition

level) .............................................................................................................................58

Table 5.1 Pairwise comparisons for reappraisal (different condition-pairs at each

time level). ....................................................................................................................61

Table 5.2 Pairwise comparisons for reappraisal (different time-pairs at each

condition level).............................................................................................................62

viii

List of Figures

Figure 1. Study timeline. .............................................................................................35

Figure 2. Interaction effects of condition across time for weekly mindful practice

duration. .......................................................................................................................42

Figure 3. Interaction effects of gender across time for weekly mindful practice

duration. .......................................................................................................................46

Figure 4. Side-by-side paired comparisons of female interaction effects of condition

across time for weekly mindful practice duration........................................................50

Figure 5. Side-by-side paired comparisons of male interaction effects of condition

across time for weekly mindful practice duration........................................................52

Figure 6. Interaction effects of condition across time for CAMS-R. ..........................56

ix

List of Appendices

Appendix A: Participation Information Sheet ...........................................................113

Appendix B: Consent Form .......................................................................................115

Appendix C: Positive and Negative Affect Schedule (PANAS) ...............................116

Appendix D: Emotion Regulation Questionnaire (ERQ) ..........................................118

Appendix E: Depression Anxiety Stress Scales - 21 (DASS-21) ..............................120

Appendix F: Cognitive and Affective Mindfulness Scale - Revised (CAMS-R) ......123

Appendix G: Mindful Lifestyle Habits Questionnaire ...............................................125

Appendix H: Pittsburgh Sleep Quality Index (PSQI) ................................................126

Appendix I: Media Multitasking Index (MMI) .........................................................130

Appendix J: Stroop Test Stimuli ................................................................................137

Appendix K: Psychoeducation Materials...................................................................140

Appendix L: 10-Day Challenge Worksheet ...............................................................164

Appendix M: Psychoeducation Test ..........................................................................166

Appendix N: Program Evaluation (Psychoeducation and Practice Conditions Only)

....................................................................................................................................170

Appendix O: Schedule of Text Reminders ................................................................175

Appendix P.1: Sleep Duration (PSQI) Analyses .......................................................183

Appendix P.2: Media-Multitasking (MMI) Analyses ................................................185

Appendix P.3: Sleep Quality (PSQI) Analyses..........................................................187

Appendix P.4: Weekly Mindful Practice Duration Analyses ....................................189

Appendix P.5: Depression (DASS-21) Analyses.......................................................201

x

Appendix P.6: Anxiety (DASS-21) Analyses ............................................................203

Appendix P.7: Stress (DASS-21) Analyses ...............................................................211

Appendix P.8: Negative Affect (PANAS) Analyses .................................................213

Appendix P.9: Incongruent Trials Mean Response Time (Stroop) Analyses ............215

Appendix P.10: Congruent Trials Mean Response Time (Stroop) Analyses ............217

Appendix P.11: Stroop Effect Analyses ....................................................................220

Appendix P.12: Mindfulness (CAMS-R) Analyses ...................................................223

Appendix P.13: Reappraisal (ERQ) Analyses ...........................................................231

Appendix P.14: Suppression (ERQ) Analyses...........................................................241

Appendix P.15: Positive Affect (PANAS) Analyses .................................................243

Appendix P.16: Psychoeducation Test Analyses .......................................................245

Appendix P.17: Programme Evaluation Analyses .....................................................247

Appendix P.18: Further Analyses ..............................................................................268

Appendix Q: Challenges Faced .................................................................................278

Appendix R: Gratitude Expression ............................................................................290

Effectiveness of a brief sleep, media-multitasking and mindfulness intervention. 1

Introduction

The pursuit of a university education can be a challenging endeavour, with

competition, workload and deadlines contributing to a stressful environment. In a

recent study, 30.5% of students cited educational progress as a source of stress

(Ramezankhani, et al., 2013). Behavioural adaptations of students within such an

environment may be potentially costly, both physical and mentally; for example,

sacrificing sleep, mindlessness or multitasking.

However, life is not only about the pursuit of academic grades and

performance, as students might be inclined to (Hwee, 2014). Other domains like

positive emotions, physical well-being, social relationships and activities, personal

growth and self-acceptance also matter and contribute holistically to our quality of life

(Burckhardt & Anderson, 2003), subjective (Diener & Chan, 2011) and psychological

well-being (Ryff & Keyes, 1995). This study aims to achieve holistic outcomes in

some of these areas, specifically in mental health, emotion regulation and

mindfulness. The goal is to motivate students to adopt more adaptive health

behaviours in sleep, multitasking and mindfulness through psychoeducation and also

a brief intervention; assisting them in achieving these holistic outcomes.

Emotion Regulation

The process model of emotion regulation (Gross & John, 2003) has been well-

established and researched upon since its conception. The process model posits two

key processes of emotion regulation: the reappraisal process targeting cognitive

change antecedent to emotional response and the suppression process targeting the

experiential, behavioural and physiological emotional responses. Cognitive

reappraisal has the effect of changing the emotional response outcome before it even


occurs while expressive suppression involves active management (suppression) of the

emotional response that has already occurred.

The differential outcomes of cognitive reappraisal and expressive suppression

strategies have been well documented. Reappraisal is associated with greater

interpersonal functioning, wellbeing, experience and expression of positive emotions

but lesser for negative emotions, while suppression shows the opposite relationship

(Gross & John, 2003; Haga, Kraft, & Corby, 2009; John & Gross, 2004). More

importantly, reappraisal is superior in modifying responses to negative stimuli,

decreasing cardiovascular response (Cavanagh, 2013; Richards & Gross, 1999) while

suppression actually increases amygdala activation (Vanderhasselt, Baeken, Van

Schuerbeek, Luypaert, & De Raedt, 2013). Reappraisal has also been shown to be

faster, with more fronto-cingulate activity (which suppression did not demonstrate)

(Vanderhasselt, Baeken, Van Schuerbeek, Luypaert, & De Raedt, 2013); earlier

prefrontal cortex (PFC) responses and also decreased amygdala and insular responses

as opposed to suppression (Goldin, McRae, Ramel, & Gross, 2008). However,

suppression did also demonstrate decrease in the subjective emotional experience and

emotional behaviours (not for reappraisal) (Goldin, McRae, Ramel, & Gross, 2008).

Suppression has also been associated with costs beyond the affective and

physiological domains. The process of suppression compromises memory in

subsequent recall (Richards & Gross, 1999), which was differential from reappraisal

strategies (Richards & Gross, 2000). Suppressors also had poorer self-reported

memory as well. This resource-depletion effect of suppression also implicates neural

correlates of performance monitoring, differentially resulting in reduced error

detection (error-related negativity) as well as reduced accuracy on incongruent Stroop

trials (Wang & Yang, 2014).


Emotional problems are a frequent issue in clinical psychopathology (Sheppes,

Suri, & Gross, 2015) and mental health issues may potentially arise from

contributions of a failure to regulate emotions or using the wrong emotion regulation

strategy (e.g. situational avoidance in phobias and anxiety) (Gross & Jazaieri, 2014).

Specifically to reappraisal and suppression, positive correlations have been found

with depression and use of suppression. However, suppression strategies did not

predict depressive symptoms, but instead depressive symptoms preceded increased

usage of suppression strategies in adolescents (Larsen, et al., 2013). This

“suppression-preference” relationship extends to clinical depression where subjects

greatly suppressed both positive and negative emotions compared to healthy controls

(Beblo, et al., 2012). This suppression was also closely associated to depressive

symptoms and the fear of emotions. Reappraisal on the other hand, was found to be

better at regulating both physiological arousal and subjective feeling of anxiety than

suppression strategies (Hofmann, Heering, Sawyer, & Asnaani, 2009). While these

studies further emphasize the benefits of reappraisal over suppression in the

presentation of psychopathology, one study does argue for a balanced and adaptive

use of these strategies contingent on the situational context. Eftekhari, Zoellner and

Vigil (2009) found that a high reappraisal and low suppression combination group

presented with the lowest reports of depression, anxiety and post-traumatic stress

disorder in contrast with other combinations: high regulators, moderate

reappraisal/low suppression and low regulators. In fact, low regulators presented with

the highest reports of problems, supporting the contribution of failure of regulation to

psychopathology.

There are however some alternative findings regarding reappraisal and

suppression that further inform their utility. Kalokerinos, Greenaway and Denson


(2015) found that reappraisal downregulated both positive and negative emotional

experiences while suppression did not. They suggested that suppression might have

the benefit of suppressing displays of positive emotion behaviour while not detracting

from the positive experience which may be useful in some situations (which may

require humility). Suppression was also found to be faster than reappraisal in response

to negative stimuli for Chinese subjects, although this came at a greater cognitive

(increased neural activity) cost (Yuan, et al., 2015). Yuan, Liu, Ding and Yang (2014)

also found support for suppression in a Chinese sample in its effectiveness in reducing

depressive experiences and its physiological markers. However, their comparison was

with acceptance strategies rather than reappraisal. Geisler and Schröder-Abé (2015)

also found support for suppression but in individuals with high self-regulatory

strength. These individuals had higher high-frequency heart rate variability (HF-

HRV) and using suppression was not associated with any increase in negative affect

unlike those with lower HF-HRV. Interestingly, mindfulness training may provide a

solution to better use of suppression strategies with its similarities to self-regulation

training (MacKenzie & Baumeister, 2015) and utility in reducing HF-HRV (Krygier,

et al., 2013).

Emotion regulation has also been implicated in academic domains. Gumora

and Arsenio (2002) found that emotion regulation, dispositional affect tendencies and

negative academic affect independently and uniquely predicted academic achievement

(GPA) in middle-schoolers. Research with younger children also found that those who

had poorer emotion regulation had trouble learning, and were less productive and

accurate on homework (Graziano, Reavis, Keane, & Calkins, 2007), suggesting that

such academic activities may arouse emotions which require regulation. They also

found that children with better emotion regulation had a more positive relationship


with their teachers, which may potentially lead to academic favoritism in the

classroom influencing academic achievement. Specifically, reappraisal of negative

stimuli was found to enhance learning and memory outcomes on an educational task,

with larger benefits for children with poorer emotion regulation skills (Davis &

Levine, 2013). While these studies concentrate on early education, they suggest the

importance of emotion regulation and academic emotions (Pekrun, Goetz, Titz, &

Perry, 2002) in outcomes of academic achievement. The learning and memory

benefits of reappraisal (Davis & Levine, 2013; Richards & Gross, 1999; 2000) also

demonstrate the importance and utility of reappraisal strategies of emotion regulation.

Adaptive emotion regulation will therefore be an extremely useful outcome for

university students in their academics as well as mental health, especially with

reappraisal strategies.

Mental Health

Depression, anxiety and stress are common mental health issues on the rise

among university students (American College Health Association, 2000; 2008).

Various studies have investigated and verified the problems of these three key mental

health issues in the university setting and stage of life transition, suggesting a pressing

need to provide interventions to alleviate such risks and issues (Bitsika, Sharpley, &

Rubenstein, 2010; Mahmoud J., Staten, Hall, & Lennie, 2012; Mahmoud J., Staten,

Lennie, & Hall, 2015; Ramezankhani, et al., 2013; Regehr, Glancy, & Pitts, 2013).

In the local context, the Singapore Mental Health Study (Chong, et al., 2012)

found that younger Singaporeans (18 to 34 years) were at the highest lifetime

prevalence risk of developing Major Depressive Disorder (MDD) (8.6% compared to

5.8% in the overall population sample). Other areas where younger Singaporeans

presented with greater risk were Bipolar I & II disorders (2.0% versus 1.2% overall),


Generalized Anxiety Disorder (GAD) (1.2% versus 0.9% overall), Obsessive

Compulsive Disorder (OCD) (4.0% versus 3.0% overall) and alcohol abuse (4.2%

versus 3.1% overall). In fact this age group had a lifetime prevalence risk of 16.9% of

developing any disorder compared to 12.0% of the population sample. Further

analysis into the domain of anxiety found that this younger age group presented with

more severe expressions of generalized anxiety (Lee, Sagayadevan, Vaingankar,

Chong, & Subramaniam, 2015). Surprisingly, local rates of GAD are much lower than

western samples, although Chong, et al., (2012) suggests some cultural and

methodological reasons for this. Even more interestingly, those who had received at

least university education also demonstrated higher risk for MDD (7.8%) and OCD

(3.8%) compared to other education levels (Chong, et al., 2012). While the age range

in question is rather wide and covers ages and individuals other than a student

population, the results do suggest that mental health risk does have a positive

relationship with having a university education. This is contrary to research from

other countries about the protective effects of higher education against mental health

problems (Murrell, Salsman, & Meeks, 2003; Wickrama, O’Neal, & Lott, 2012).

Research from other cultures and countries however, agree that students in this stage

of life transition do face much challenges in the psychosocial, academic and financial

domains, putting them in a vulnerable position to attract mental health issues

(Bouteyre, Maurel, & Bernaud, 2007; Dyson & Renk, 2006; Eisenberg, Gollust,

Golberstein, & Hefner, 2007; Verger, Guagliardo, Gilbert, Rouillon, & Kovess-

Masfety, 2010). With a recent campus suicide in the National University of

Singapore, this might be even more relevant than ever (Yahoo! Newsroom, 2013).

Research also links mental health directly with academic performance, where poorer

mental health predicts poorer academic achievements and improvements in mental


health correspond accordingly in academic performance (Murphy, et al., 2015). Thus,

addressing the mental health of university students with the various health behaviours

during their most vulnerable stage of life will be extremely relevant and useful,

especially when they transition into the working world.

Sleep Behaviours: Trends and Effects among University Students

Our nightly sleep is an important behaviour and process to allow our bodies to

relax and repair itself. It has a crucial role in maintaining physiological homeostasis

and psychological balance (Chittora, et al., 2015). According to the National Sleep

Foundation (USA), the recommended sleep duration for university students (young

adults, 18 to 25 years) is 7 to 9 hours. They also recommend not sleeping less than 6

or more than 11 hours a night (Hirshkowitz, et al., 2015). The problem is rather

serious here among undergraduates students in Asia compared to their Western

counterparts (Chee, 2013). In fact, a study on undergraduate students from two

Singapore universities found an average sleep duration of 6.2 hours (Khalik, 2013),

which hovers close to the boundary of the non-recommended duration (Hirshkowitz,

et al., 2015).

Demands from academic study may be time consuming and a pressing reason

for getting less sleep (Chee, 2013; Lo, Leong, Loh, Dijk, & Chee, 2014); however

accumulating sleep debt can have significant repercussions for one’s health, in terms

of physical, mental and emotional health as well as cognitive performance (Baum, et

al., 2014; Morin & Ware, 1996; Mullington, Haack, Toth, Serrador, & Meier-Ewert,

2009; Orzeł-Gryglewska, 2010; Pilcher & Huffcutt, 1996).

Sleep deprivation can cause serious health issues, increasing cardiovascular

disease risk factors: increased blood pressure, glucose metabolism, hormonal

regulation (especially the growth hormone) and inflammation (Mullington, Haack,


Toth, Serrador, & Meier-Ewert, 2009; Orzeł-Gryglewska, 2010); and also increased

pain sensitivity, depressed immune response and higher risk of obesity and diabetes

(Orzeł-Gryglewska, 2010).

Sleep deprivation can also leave lasting effects on the brain, with potential

neurocognitive and neurodegenerative consequences (Chittora, et al., 2015). For

example, sleep-deprived brain cells will gradually deteriorate due to increased cortisol

levels in the brain (Gopalakrishnan, Ji, & Cirelli, 2004), and staying awake for 72

hours will reduce the brain’s metabolic rate by 6 to 8% (Chittora, et al., 2015). One

important finding is that sleep deprivation may impose oxidative stress on the

hippocampus (Süer, et al., 2011) which can lead to impairment of memory function

(Silva, et al., 2004). It has also been reported to negatively influence brain plasticity

and neurogenesis (Chittora, et al., 2015).

The consequential impact on cognitive function and performance as a result of

neurological impairments is not to be underestimated. Impaired perception

concentration difficulties, slower reaction times, reduced performance and efficiency

are some of the many problems that can result from sleep deprivation (Orzeł-

Gryglewska, 2010). Attentional impairment is one of these serious consequence of

insufficient sleep (Caldwell, Prazinko, & Caldwell, 2003; Johnson, 1982; Meddis,

1982), specifically causing inattentional lapses during the performance of tasks

(Elkin & Murray, 1974; Pilcher & Walters, 1997; Polzella, 1975; Williams & Lubin,

1967); longer sleep microepisodes (Thomas, et al., 2003) and even reduced attention

to external stimuli (Hockey, 1970).

The impact on learning and memory is thus of grave concern as well. Various

studies have demonstrated the benefits of sufficient sleep on memory functioning for

learning (Jenkins & Dallenbach, 1995; Peigneux, Laureys, Delbeuck, & Maquet,


2001; Smith, 1995). Some research has also highlighted the dependent relationships

that learning abilities have with sleep (Fallone, Owens, & Deane, 2002; Samkoff &

Jacques, 1991; Wolfson & Carskadon, 2003). Several interesting studies have also

investigated the effects of sleep on learning at the cellular level. Research suggests

that a key function of sleep is to consolidate and optimize synaptic circuits to

strengthen salient memory traces of important memories among the distracting

multitude of memories made during waking hours (Wang, Grone, Colas, Appelbaum,

& Mourrain, 2011). Some of this evidence also suggest that sleep magnifies the state

of plasticity for such memory trace optimization. Huber, Ghilardi, Massimini and

Tononi (2004) found that slow wave activity in the membrane potential of cortical

neurons during sleep was a cellular process that represented learning as opposed to

metabolic fatigue, justifying a cellular demand for sleep and the synaptic processes

that accompany it. It is thus not surprising that majority of sleep research agrees upon

the detrimental effects of sleep deprivation on academic performance (Gilbert &

Weaver, 2010; Gomes, Tavares, & de Azevedo, 2011; Killgore & Killgore, 2007;

Lund, Reider, Whiting, & Prichard, 2010; Meijer, 2008; Pilcher & Walters, 1997;

Trockel, Barnes, & Egget, 2000; Wolfson & Carskadon, 2003).

Sleep research has not only focused on outcomes but also the practical ways

deprivation affects the skills required for academic performance. Verbal expression of

thoughts and concepts are important skills in the university context; for example,

giving graded presentations, class participation and dissertation defense are all parts

of the university experience which require this skill that can be compromised by sleep

deficits (Harrison & Horne, 1997). Flexible and innovative thinking, planning and

decision making are other important skills compromised by rigid thinking and

perseverative errors (Harrison & Horne, 1999) as well as risky decision making


(Killgore, Balkin, & Wesensten, 2006). These performance and skill deficits should

be apparent to students in their daily work. However, Pilcher and Walters (1997)

found that sleep deprived students had the illusion that they had put in more

concentration and effort into the task and estimated their performance much higher

than non-sleep deprived students, contrary to the actual task performance. This study

demonstrated the students’ lack of awareness of the negative impact sleep deprivation

has on their performance abilities.

More importantly, sleep has a negative effect on academic motivation, a key

contributor to academic performance (Gilbert & Weaver, 2010). Edens (2006) found

that students who were sleepier had tendencies toward greater procrastination if they

were not motivated by grades, lower self-efficacy and more focused on performance

goals (grades) than mastery of materials. This negative impact on academic

motivation undermines the pursuit of a university education.

Sleep loss also has well established negative effects on mood and emotion

regulation (Baum, et al., 2014; Pilcher & Walters, 1997; Talbot, McGlinchey, Kaplan,

Dahl, & Harvey, 2010). Pilcher and Walters (1997) even suggested that the

debilitating effects of slep deprivation might have even more serious consequences

for mood than cognitive and motor performance deficits. Poorer sleep has been found

to be correlated with emotion regulation difficulties (Sandru & Voinescu, 2014).

Sleep deprivation studies provide clearer instances of these associations. Short-term

partial sleep deprivation has been shown to reduce positive affect (Talbot,

McGlinchey, Kaplan, Dahl, & Harvey, 2010) as well as positive emotionality (to

valenced stimuli) and increase negative emotionality and affect (Danielsson,

MacDonald, Jansson-Fröjmark, Linton, & Harvey, 2011). Baum and colleagues

(2014), restricted sleep for 5 nights in school-going adolescents to a mere 6.5 hours a


night. They found that this minor sleep restriction, albeit more long-term (5 nights to

simulate chronicity), resulted in worsened mood and poorer emotion regulation. On

the flipside, sleep extension (recovery of pre-existing sleep debt) for 9 nights

improved mood, decrease amygdala blood blow (emotional reactivity) and enhanced

negative functional connectivity of the amygdala and frontal pole, a pathway for

emotion regulation (Motomura, et al., 2014). These recoveries were erased following

a night of total sleep deprivation, supporting the critical role of sleep in emotion

regulation. Research on reappraisal strategies of emotion regulation have produced

mixed results. Minkel and colleagues (2012) did not find that sleep duration variations

predicted disruptions to neural circuits of reappraisal. However, the subjects in their

study had mostly good or mild sleep duration ratings, which may explain their

findings. On the other hand, Mauss, Troy and LeBourgeois (2013) found that poorer

sleep quality correlated with reduced usage of reappraisal.

Depression is one of the most common psychopathologies associated with

insomnia (Tsuno, Besset, & Ritchie, 2005), although the nature of this relationship

with sleep difficulties lacks the body of evidence for causal effects of sleep on

psychopathology (Morin & Ware, 1996). Still, the severity of sleep disturbances has

been shown to have a positive relationship with comorbid psychopathology (Morin &

Ware, 1996). Recent research however, offers perspectives in supporting a

bidirectional relationship between sleep and depression (Riemann, Berger, &

Voderholzer, 2001). One key hormone which controls this relationship is melanin-

concentrating hormone (MCH) which controls both rapid-eye-movement (REM) sleep

and pathophysiology of depression (Torterolo, et al., 2015). Short sleep durations

have also been found to have associations with the risk of stress symptoms (An, Jang,

& Kim, 2015) and be predictive of chronic courses of depression and anxiety (van


Mill, Vogelzangs, van Someren, Hoogendijk, & Penninx, 2013). A study on

undergraduate students also revealed that good and poor quality sleepers had

significantly different levels of depression, anxiety and stress symptoms, with

emotion regulation difficulties as a correlate (Markarian, Pickett, Deveson, & Kanona,

2013).

Given the many physical, neurological, cognitive, academic, emotion

regulation and mental health costs of sleep deprivation, the current nightly state of

affairs for local university students seems to be in need of change, which this study

aims to improve.

Media-Multitasking Behaviours: Trends and Effects among University Students

Multitasking as a strategy is often used to resist against the limited resource of

time; an attempt to complete at least two discrete tasks simultaneously. Yet this

perception of simultaneous completion might be an illusion. Medina (2014), a

molecular biologist, even claims that true multitasking is a biological impossibility,

ostensibly from the perspective of task-switching.

Multitasking can be explored from various cognitive perspectives, namely

dual-tasking or task-switching (Worringer, et al., 2015). Salvucci, Taatgen, and Borst

(2009) proposed the multitasking continuum, as a unified theory of mutitasking;

ranging from concurrent multitasking (dual-tasking perspective) to sequential

multitasking (task-switching perspective), with time before switching tasks increasing

in this direction along the continuum. Dual-tasking paradigms posit simultaneous

performance of two tasks, albeit with associated cognitive and performance costs (Hu,

et al., 2015). Ophir, Nass, and Wagner (2009) emphasised the central role of task-

switching: switching between two different tasks in the process of multitasking. This

process is not simultaneous but instead reflects the temporal order of switching


between tasks. They developed the Media Multitasking Index (MMI) to assess media-

multitasking behaviours across twelve different forms of media, so as to discriminate

between heavy and light media multitaskers. Their influential study found significant

differences in cognitive control through various tasks like the Stroop, stop-signal,

task-switching, and two- and three-back tasks. They found that heavy media-

multitaskers actually performed much worse at task-switching, becoming more

susceptible to interference from irrelevant stimuli: in either the environment or

memory representations. Alzahabi (2015) further expanded on task-switching

research and found that advanced preparation (time for processing) and passive decay

(of interference from previous tasks) were independent factors influencing task-

switching performance.

Other research has also found that better working memory capacity

(specifically the processing and storage components) predicts better multitasking

performance (Colom, Martínez-Molina, Shih, & Santacreu, 2010), highlighting the

relationship between limited cognitive resources and multitasking, regardless of task-

switching or dual-tasking perspectives.

The ubiquitous rise of digital devices, social media and the internet has

resulted in the proliferation of media-multitasking (Wang & Tchernev, 2012). This

has profound implications for learning and academic performance. A recent study

found that majority of students reported media-multitasking on at least two tasks, and

that this was detrimental to their ability to focus on reading for academic purposes

(Mokhtari, Delello, & Reichard, 2015). One key media-multitasking paradigm

involves texting in classes and lectures. 90% of university students reported receiving

texts and 86% reported texting someone while in class (Clayson & Haley, 2013).

Texting in class predicted significantly lower grade performance (Clayson & Haley,


2013; Ellis & Jauregui, 2010; Rosen, Lim, Carrier, & Cheever, 2011). Additionally,

other research found similar negative influences on grade performance with laptop

multitasking (Sana, Weston, & Cepeda, 2013; Zhang, 2015); Facebook (Rosen,

Carrier, & Cheever, 2013) and electronic media in general (Jacobsen & Forste, 2011).

Laptop multitasking even hindered learning of nearby peers (Sana, Weston, &

Cepeda, 2013). Multitasking has also been shown to reduce mental fluidity (Clayson

& Haley, 2013) and cause learning to be inflexible in novel situations (Foerde,

Knowlton, & Poldrack, 2006).

Despite conscious acceptance that texting in class was disruptive to learning

(approximately 75%), 40% still felt that such behaviour was acceptable, signifying

underlying rewards that may overcome the cognitive understanding of multitasking

costs (Rosen, Lim, Carrier, & Cheever, 2011). Wang and Tchernev (2012) found that

while cognitive needs drove media-multitasking behaviour, such needs were not being

gratified. Instead, emotional and habitual needs were by-products being gratified,

implicitly reinforcing the association of pleasant feelings of relaxation and

entertainment with media-multitasking behaviours, leading to increased media-

multitasking.

This is despite findings that only 2.5% of the population (generalized from a

sample of 200 participants) are actually “supertaskers” (Watson & Strayer, 2010).

Watson and Strayer (2010), coined the term “supertaskers” during their accidental

discovery (Strayer & Watson, 2012) of subjects who demonstrated no performance

deficits between single and dual-task conditions. These “supertaskers” were in the top

quartiles of performance and their frequency was significantly greater than chance

(Watson & Strayer, 2010). Further research on “supertaskers” found they had

significantly more efficient recruitment of the anterior cingulate and posterior


frontopolar prefrontal cortices than controls matched for working memory capacity,

suggesting fundamental neural difference in processing efficiency and attentional

control (Medeiros-Ward, Watson, & Strayer, 2015), proving Medina (2014) wrong on

the biological impossibility of true multitasking. Still, this statistical improbability

does not seem to affect self-confidence of poor multitaskers’ abilities to multitask

despite anticipating (inaccurately) the costs of divided attention in multitasking

(Finley, Benjamin, & McCarley, 2014).

Research on the profile of multitaskers suggest that they have significantly

inflated perceptions of their ability and are typically high on levels of impulsivity and

sensation seeking, low on executive control and less able to block out distractions

(Sanbonmatsu, Strayer, Medeiros-Ward, & Watson, 2013) as well as lacking in self-

regulation (Zhang, 2015). Interestingly, heavy media-multitasking was associated

with significantly higher levels of depression and social anxiety symptoms as well

(Becker, Alzahabi, & Hopwood, 2013), perhaps due to the reduced grey matter

density in the anterior cingulate cortex (ACC) and its reduced functional connectivity

with the precuneus correlated with the decreased socio-emotional regulation (Loh &

Kanai, 2014).

The various evidence of performance impairment, emotion regulation and

mental health associations due to media-multitasking have demonstrated negative

consequences. Within the context of university students, this is especially relevant as

such bad habits can carry over into the workplace (Mokhtari, Delello, & Reichard,

2015), extending the cycle of performance deficits. While it may be impossible to

entirely eliminate media-multitasking behaviours in our media-rich environments,

education of the costs and proper, adaptive usage of various media may help reduce


the prevalence and effects of such media-multitasking behaviours, beginning with the

university context.

Mindfulness and Its Beneficial Effects

Mindfulness has its roots in Eastern Buddhist traditions, from being firstly

translated from the Pali word sati in 1881 (Gethin, 2011) and then subsequently

introduced into the clinical context of psychotherapy by Jon Kabat-Zinn as

Mindfulness-Based Stress Reducation (MBSR) (Kabat-Zinn, 1996) and subsequent

modifications into Mindfulness-Based Cognitive Therapy (MBCT) (Segal, Williams,

& Teasdale, 2002).

Mindfulness has been described as the “non-elaborative, non-judgemental,

present-centred awareness in which each thought, feeling, or sensation that arises in

the attentional field is acknowledged and accepted as it is” (Bishop, et al., 2004).

Bishop and his colleagues (2004), as various experts on mindfulness, have come to a

formal consensus to propose a two-component model of mindfulness. Firstly,

mindfulness requires self-regulated attention to focus on the immediate experience, or

present moment, so as to recognize and be aware of emotions, behaviours and

thoughts in the moment. The key here is the direction of attention towards the

immediate experience of any “content objects” that may arise. Secondly, mindfulness

adopts various attitudes and perspectives to inform the experience of these “objects”

of attention within the present moment. Kabat-Zinn (1996) emphasizes seven key

attitudes as the foundation of mindfulness practice: non-judging, patience, beginner’s

mind, trust, non-striving, acceptance, letting go. Commitment, self-discipline and

intentionality are also values he encourages for approaching mindfulness practice.

The Eastern and Western approaches to mindfulness differ on various

perspectives, although they are similar in some of the psychological processes


involved. Eastern approaches emphasize the experience of meditation practice, where

mindfulness is cultivated, while Western approaches, primarily developed by Ellen

Langer, views mindfulness, as opposed to mindlessness, as a desireable result of

novelty-seeking orientations to envionmental stimuli. (Carmody, 2014). Both

approaches are similar in that they utilize the process of attention or awareness to

bring into focus the familiar or preconceived ‘objects’ we may not be consciously

aware of, and to bring into awareness the unconcious processes that shape and

contribute to this familiarity or preconception (Carmody, 2014). They also similarly

focus on the present moment (Kabat-Zinn, 1996; Langer, 2014); as well as novelty

(Langer, 2014) or curiosity (with the attitude of a beginner’s mind) (Kabat-Zinn,

1996). While the outcome of mindfulness is desired, both approaches differ in the

practices as well as the objectives for mindfulness.

The Western approach focuses on the paradigm of novelty-seeking in new

meanings and categories, to cast persons, objects or situations in new light and reduce

potential inherent biases previously assumed as stable and unchanging within the

mindlessness perspective (Langer, 2014). In this respect, mindfulness training is

primarily a cognitive event, through which the process of creating novel perspectives

motivates attentional redirection to the stimulus as well as allows for the overcoming

of pre-existing, stable and habitual biases or categorizations which have formed the

basis for attribution theory. Langer’s development of the Western approach first rose

from the question of whether people were even thinking, given the effects of priming

and attribution theory perspectives. Thus for the Western approach, mindfulness

through novelty is the means to the end of biases and erroneous attributions and rigid,

unchanging perspectives.


In contrast, Eastern approaches to mindfulness place heavy emphasis on the

practice of mindfulness meditation to cultivate mindfulness. The two-component

model of mindfulness by Bishop and his colleagues (2004) portrays the operational

definition of mindfulness from this Eastern tradition. The passive self-observational

and non-judgemental attitudes of Eastern tradition contrasts with the proactive change

of cognitive constructions and active engagement in the Western approach. Moreover,

Bishop and his colleagues (2004) contrast Langer’s approach as dealing primarily

with external stimuli and their properties while the Eastern approach deals primarily

with internal stimuli (thoughts, feelings and sensations). To be fair, Langer’s approach

also highlights the internal phenomenological experience of engagement in her

cognitive perspective of mindfulness (Langer, 2014). It is important to note that

though Eastern approaches emphasize meditation practice to cultivate mindfulness, it

is by no means the only way to achieve the state of mindfulness; the key skills and

habits cultivated will allow for mindfulness to be evoked and generalized to attention

in everyday situations, allowing us to navigate our lives more mindfully (Bishop, et

al., 2004). The goal of mindfulness is then the state of mindfulness.

The non-striving attitude of mindfulness best captures this catch-22 situation

of mindfulness practice as both the means and the end. As Kabat-Zinn (1996)

describes “meditation is dfferent from all other human activities. Although it takes a

lot of work and energy of a certain kind, ultimately mediation is non-doing. It has no

goal other than for you to be yourself. The irony is that you already are.”

It can perhaps be considered that Eastern approaches to mindfulness may be

more comprehensive than Western approaches. Both approaches allow for novel

perspective-taking but the additional attitudes (Kabat-Zinn, 1996) further enhances

and operates in service of this outcome. The attitudes of non-judging, patience, trust,


non-striving, acceptance and letting go has the fundamental purpose of reducing

resistance, to allow mindfulness to have greater coherence with our lives. Given the

internal focus of Eastern mindfulness (thoughts, feelings and sensations), the potential

for resistance may be rather high. Adopting a beginner’s mind attitude to our internal

worldview might seem threatening to our self-esteem; a challenge to the pre-existing

construals of self and self in the world. The attitudinal advantage of the Eastern

approach allows for a comprehensive and coherent incorporation of mindfulness into

our daily lives.

Mindfulness-based therapies have been shown improve the symptoms of

insomnia (Ong, Ulmer, & Manber, 2012). In fact, mindfulness has also been shown to

improve sleep quality (Brand, Holsboer-Trachsler, Naranjo, & Schmidt, 2012) and

directly predict well-being as well as indirectly through the self-regulation of sleep

(Howell, Digdon, & Buro, 2010; Howell, Digdon, Buro, & Sheptycki, 2008). The

benefits of mindfulness thus extend into healthy self-regulation of sleep behaviours as

proposed by Shapiro and Schwartz (2000a; 2000b). An interesting study on emotion

regulation and sleep found that experiential emotion regulation (similar to Eastern

mindfulness) predicted better sleep quality (duration, efficiency, fewer awakenings

etc.) than cognitive analytical emotion regulation (similar to Western mindfulness)

when subjects were exposed to an emotional failure experience prior to sleep

(Vandekerckhove, et al., 2012), suggesting that mindfulness-like emotion regulation

more effectively overcomes emotional obstacles to sleep behaviours and quality.

Mindfulness in the Eastern tradition and media-multitasking are conceptually

opposed to each other since mindfulness predicates present moment attentional focus

on a singular task while media-multitasking divides attention (Finley, Benjamin, &

McCarley, 2014), increasing attentional failures (Ralph, Thomson, Cheyne, & Smilek,


2014). There is however, a lack of present literature exploring the relationship

between mindfulness and media-multitasking even though habits of mindfulness

should theoretically lead to reduced habits of media-multitasking. One study does

investigate this relationship, but within the Western approach to mindfulness (Ie,

2012). Counterintuitively, Ie and colleagues attempt to improve media-multitasking

with inducements of mindfulness states. Their study failed to find improvements in

media-multitasking ability although they did find that younger subjects (controls) with

greater trait mindfulness did present with better media-multitasking ablities,

suggesting that mindfulness could improve media-multitasking. Given that

mindfulness and meditation predicts better attentional performance and cognitive

flexibility on the Stroop paradigm and other measures (Fan, Tang, Tang, & Posner,

2014; Moore & Malinowski, 2009; Rodriguez Vega, et al., 2014) the conclusion and

premise from Ie and her colleagues is not surprising.

Mindfulness meditation has been shown to provide physical improvements,

with improved immune function corresponding to left anterior brain activation

(Davidson, et al., 2003) and reduced perception of nociceptive pain with associated

neurological activity (Zeidan, et al., 2011). Mindfulness has also been shown to

improve cognitive function, increasing working memory capacity, test performance as

well as reducing mind wandering (increase in sustained attentional focus) (Chambers,

Lo, & Allen, 2008; Mrazek, Franklin, Phillips, Baird, & Schooler, 2013) which is

associated with reduction in cognitive performance (Mooneyham & Schooler, 2013).

Neuroimaging research further confirms this research, with increases in grey matter

concentrations within the left hippocampus, posterior cingulate cortex, temporo-

parietal junction and cerebellum, some of which are associated with learning and

memory processes (Hölzel, et al., 2011). Mindfulness seems to improve cognitive


performance, especially in stress tests of interference on the Stroop paradigm, through

neural regulation of alpha wave activity, resulting in reduced interference (Fan, Tang,

Tang, & Posner, 2014) and improved (faster) attentional processing (Kerr, et al.,

2011) as well as better attentional control (Rodriguez Vega, et al., 2014). Improved

cognitive flexibility (Moore, 2013; Moore & Malinowski, 2009) and rational

decision-making (Kirk, Downar, & Montague, 2011) are also further benefits of

mindfulness.

Mindfulness also reduces emotional reactivity (Keng, Smoski, & Robins,

2011), mediating psychological distress (Britton, Shahar, Szepsenwol, & Jacobs,

2012), which suggests the adoption of adaptive emotion regulation strategies.

Research by Hölzel, and colleagues (2011) also found increased grey matter

concentration in brain regions associated with emotion regulation and perspective

taking which is related to reappraisal. Some studies have linked mindfulness and

mindfulness training with suppression (Dick, Niles, Street, DiMartino, & Mitchell,

2014; Riley, 2014) as well as neural pathways in reappraisal strategies of emotion

regulation (Opialla, et al., 2015). Mindfulness has also been conceptually linked with

reappraisal strategies of positive emotion regulation (Garland, Farb, Goldin, &

Fredrickson, 2015) and improved emotion regulation (Turner, 2014). In contrast,

suppression and mindfulness have demonstrated differential neural pathways

(Murakami, et al., 2015) and oppositional predictions of psychological health

(Tamagawa, et al., 2013). It is thus not surprising that mindfulness is also associated

with affective benefits (Davis & Hayes, 2011). Davidson and colleagues (2003) found

increased activation in the left anterior region of the brain associated with positive

affect. Other reasearch has also found the positive relationship of mindfulness with

positive affect (Jimenez, Niles, & Park, 2010; Mandal, 2012), and the negative


relationship with negative affect (Mandal, 2012; Sears & Kraus, 2009; Vickery &

Dorjee, 2015; Vinci, et al., 2014). Mindfulness is also associated with the emotional

down-regulation of arousal in the amygdala expression (Lutz, et al., 2014) and

increased empathy (Shapiro, Schwartz, & Bonner, 1998).

Mindfulness-based interventions have also been relatively successfully

implemented to tackle various mental health issues (Cavanagh, et al., 2013; Gu,

Strauss, Bond, & Cavanagh, 2015; Keng, Smoski, & Robins, 2011; Song & Lindquist,

2015), improving symptoms of depression (Dimidjian, et al., 2014; Piet & Hougaard,

2011), anxiety (Chen, Yang, Wang, & Zhang, 2013; Tacón, McComb, Caldera, &

Randolph, 2003) and stress (Britton, Shahar, Szepsenwol, & Jacobs, 2012). A meta-

analysis by Khoury and colleagues (2013) even claims that mindfulness-based

interventions are especially effective for depression, anxiety and stress.

With the cognitive, mental and emotional health benefits of mindfulness,

introducing mindfulness training to university students will potentially give them a

useful tool to flourish in their university life.

Mindfulness for Students

Mindfulness-based interventions have shown promising effects in schools,

reducing stress, depressive and anxious symptoms (Kuyken, et al., 2013; Lynch,

Gander, Kohls, Kudielka, & Walach, 2011; Ramler, Tennison, Lynch, & Murphy,

2015; Shapiro, Schwartz, & Bonner, 1998); first year school adjustment (Ramler,

Tennison, Lynch, & Murphy, 2015); increasing well-being (Kuyken, et al., 2013);

increasing empathy (Shapiro, Schwartz, & Bonner, 1998); as well as increasing

mindfulness (Lynch, Gander, Kohls, Kudielka, & Walach, 2011). In a meta-analytic

review of mindfulness-based interventions in schools, Zenner, Herrnleben-Kurz and

Walach (2013) found that such studies held promise in improving cognitive


performance, and stress resilience, although they did mention that there was great

heterogeniety in the age, interventions as well as measurments for these studies. On

the educational front, Felver, Doerner, Jones, Kaye and Merrell (2013) have appealed

for the inclusion of mindfulness interventions for school populations, either as

universal, targeted or intensive individual interventions. Similarly, one of the few

studies (Lynch, Gander, Kohls, Kudielka, & Walach, 2011; Ramler, Tennison, Lynch,

& Murphy, 2015; Shapiro, Schwartz, & Bonner, 1998) on university populations, has

argued for greater adoption for mindfulness in the university setting, even as a

universal intervention, citing the mindfulness cultivation rates of their non-volunteer

sample (Ramler, Tennison, Lynch, & Murphy, 2015).

The present study joins the body of existing studies researching mindfulness-

based interventions for university student populations. One key difference is the

incorporation of two other holistic health behaviours in addition to mindfulness

training in the meditation form, namely, improving sleep quality (emphasis on

duration) as well as reducing media-multitasking behaviours. As Shapiro and

Schwartz (2000a; 2000b) discussed, mindfulness and its attentional focus on the body

promotes greater self-regulation of health behaviours, hinting at a possible reinforcing

impact on mindfulness training for healthier sleep and media-multitasking behaviours.

To date, the present study may be the only one to incorporate both sleep and

media-multitasking with mindfulness as a combined intervention program to

holistically tackle mindfulness, mental health, emotion regulation as well as cognitive

performance (Stroop paradigm) within the same design. Given the overlaps of the

three health behaviours with each other as well as with the various outcomes

previously elaborated, it is hoped that this holistic combination will yield significant

impact in improving the lives of university students.


Objectives and Experimental Design

A set of psychoeducational materials targeting university students were

designed to provide didactic information in terms of health behaviours and habits:

multitasking, sleep, mind wandering and mindfulness. Information was aligned to

motivate students that such health behaviours would contribute to peak performance

in their lives, especially with relevance to their academic outcomes. A set of simple

behaviour changes were included as a structured intervention to complement the

efficacy of the psychoeducation materials and provide guidelines for behavioural

change.

The objective of this study was to evaluate the efficacy of the

psychoeducational materials, a complementary structured intervention in inspiring

behavioural change as well as the subsequent beneficial outcomes. The structured

intervention was a brief 10 day program focusing on the additional habit of

mindfulness meditation and habit changes in sleep and multitasking.

The present study employed a 3*2 mixed design, where subjects underwent 3

differing levels of intervention independently: Control condition, Psychoeducation

only condition, and the Psychoeducation with practice (Practice) condition; and were

assessed at 2 different points in time: pre-test and post-test.

Predictions and Hypotheses

It was hypothesized that increasing levels of intervention would yield greater

behaviour change in sleep, multitasking and mindfulness habits (none in Control).

This would be reflected in a condition*time interaction effect. It was also predicted

that such changes in behaviour (as a covariate) would improve mental health,

reappraisal strategies, positive affect, mindfulness and reduce, negative affect and

Stroop interference effects (condition*time).


Methods

Subjects and Recruitment

A total of 73 university undergraduates were recruited from the National

University of Singapore. Of the subjects recruited, 6 subjects either withdrew their

consent or were non-responsive. This resulted in the participation of a total of 67

subjects: 27 females (M = 21.81 years, SD = 1.50 years) and 40 males (M = 23.57

years, SD = .87 years).

Subjects were recruited through an online appeal on social media pages of

various university groups. As part of the recruitment, subjects were provided with the

Participation Information Sheet (Appendix A) for information about the study as well

as a Consent Form (Appendix B) to provide informed consent for participation in this

study. Subjects then provided their demographic information as well as contact details

for subsequent contact for the study. They were then informed of the exact dates of

the study which was conducted across a period of twelve days in the month of

November, 2015.

Experimental Design

A 3 (intervention condition: control, psychoeducation only, psychoeducation

with practice) x 2 (time: pre-test, post-test) repeated measures design was conducted.

Dependent variables measured can be broadly classified into behavioural, outcome as

well as programme evaluation measures.

Measures and Protocol

Positive and negative affect schedule (PANAS). This mood scale developed

by Watson, Clark and Tellegen (1988) consists a total of 20 items (Appendix C); 10

items measuring positive affect and negative affect each. The items were rated on a 5-

point Likert scale, on the extent subjects ‘felt this way during the past week’. The


scale ranged from 1 to 5: ‘Very slightly or not at all’, ‘A little’, ‘Moderately’, ‘Quite a

bit’, and ‘Extremely’ respectively.

Scores for each of the 20 items were summed up for both positive and

negative affect to constitute the total score of each respective affect. Scores range

from a possible 10 to 50 with higher scores denoting greater levels of the respective

affect. The mean scores for the original study were 33.3 (SD = 7.2) for positive affect

(PA) and 17.4 (SD = 6.2) for negative affect (NA). The scale also demonstrated good

internal consistency (PA: α = .88; NA: α = .85), low intercorrelation (r = -.22) and

relatively stable test-retest reliability across 2 months (PA: r = .48; NA: r = .42)

(Watson, Clark, & Tellegen, 1988).

Emotion regulation questionnaire (ERQ). This questionnaire by Gross and

John (2003) evaluates two emotion regulation strategies; reappraisal and suppression.

The questionnaire consists a total of 10 statements (Appendix D); 6 statements

measuring reappraisal and 4 statements measuring suppression. Each statement

demonstrated either reappraisal or suppression strategies. Subjects were asked to rate

their agreement with the statements on a 7-point Likert scale, from 1 to 7: ‘Strongly

disagree’ to ‘Strongly agree’. Higher scores represented greater identification with the

statement’s strategy.

Scores for each of the 10 statements were summed up and then averaged for

both suppression and reappraisal strategies to constitute the representative score of

each strategy. This scale has been shown to have good internal consistency

(reappraisal: α = .79; suppression: α = .73) and relatively good test-retest reliability

across 3 months (both reappraisal and suppression: r = .69) (Gross & John, 2003).

Depression anxiety stress scales (DASS-21). This revised scale (Antony,

Bieling, Cox, Enns, & Swinson, 1998) measures mental health in three symptomatic


subscales: depression, anxiety and stress. The scale consists a total of 21 statements

(Appendix E) as opposed to the original DASS, a 42-statement scale (Lovibond &

Lovibond, 1995). There were 7 statements measuring depression, anxiety and stress

symptoms each. Subjects were asked to rate on a 4-point Likert scale how much each

statement applied to them ‘over the past week’. The scale ranged from 0 to 3: ‘Did not

apply to me at all’, ‘Applied to me to some degree or some of the time’, ‘Applied to

me to a considerable degree, or a good part of time’ and ‘Applied to me very much, or

most of the time’ respectively.

For each subscale of the DASS-21, scores on the respective 7 statements were

summed and doubled for the respective total scores of depression, anxiety and stress

symptoms. Scores range from a possible 0 to 42 with higher scores denoting greater

levels of the respective symptoms. In a more recent study of a large non-clinical

sample (Henry & Crawford, 2005), the mean scores were 5.66 (SD = 7.74) for

depression, 3.76 (SD = 5.90) for anxiety, and 9.46 (SD = 8.40) for stress. The same

study also found good internal consistency for the subscales (depression: α = .88;

anxiety: α = .82; stress: α = .90).

Cognitive and affective mindfulness scale - revised (CAMS-R). This scale

by Feldman, Hayes, Kumar, Greeson and Laurenceau (2007) consists 10 statements

assessing mindfulness levels (Appendix F). These statements were rated on a 4-point

Likert scale ranging from 1 to 4: ‘Rarely/Not at all’, ‘Sometimes’, ‘Often’ and

‘Almost always’ respectively.

The scores for the statements were summed to derive the total score on the

CAMS-R. Scores range from a possible 10 to 40, with higher scores denoting higher

levels of mindfulness. The scale also demonstrated acceptable internal consistency (α

= .76), good convergent validity with other mindfulness scales (Freiburg Mindfulness


Inventory: r = .69; Mindfulness Attention Awareness Scale: r =.46) (Feldman, Hayes,

Kumar, Greeson, & Laurenceau, 2007).

Mindfulness lifestyle habits questionnaire. This simple questionnaire was

designed for this study to investigate the mindful habits of subjects and consisted 6

items (Appendix G). Of primary importance was their practice frequency and average

duration, the product of which yielded a weekly practice duration. Subjects were first

given a psychoeducation check to assess their knowledge of mindfulness. They were

then explicitly asked if they practiced mindfulness. Those who responded

affirmatively went on to indicate the weekly practice frequency, average duration of

each day’s practice and the type of mindful practices they engaged in.

Pittsburgh sleep quality index (PSQI). This questionnaire by Buysse,

Reynolds, Monk, Berman and Kupfer (1989) assess the sleep quality of individuals.

The questionnaire consists 10 questions on various sleep habits (Appendix H),

covering 7 subcomponents of sleep quality: duration of sleep, sleep disturbance, sleep

latency, day dysfunction due to sleepiness, sleep efficiency, overall sleep quality and

usage of sleep medication. One question was left out as it did not contribute to the

scoring of the PSQI. Of particular interest for this study was information pertaining to

the subcomponent of duration of sleep.

The questionnaire was scored according to the authors’ instructions (Appendix

H). Each subcomponent yielded scores ranging from 0 to 3 and the sum of these

scores constituted the total PSQI score. Scores range from a possible 0 to 21, with

higher scores representing poorer sleep quality (≤ 5 good sleep quality; > 5 poor sleep

quality). The authors found an overall group mean of 7.4 (SD = 5.1) among a sample

of controls, and subjects with depression or sleep problems. The scale also


demonstrated good internal consistency (α = .83) and test-retest reliability (Buysse,

Reynolds, Monk, Berman, & Kupfer, 1989).

Media multitasking index (MMI). This was a trait media multitasking index

developed by Ophir, Nass and Wagner (2009) to discriminate between heavy and

light media mutitaskers. The original task consisted of 12 media forms. After

discussion with the input of one of the authors, it was decided to reduce the number to

10 media forms in the current study. For brevity, non-music audio was removed as it

was deemed the least pervasive form of media consumption in a visually-dominated

environment. Text messaging and instant messaging were collapsed into a single

media form to account for the technological improvements that have given rise to

instant messaging applications on smartphones that are functionally equivalent to text

messaging. Also, caveats were added to several other media forms like social media

browsing for web surfing and internet calls for telephone and mobile phone calls.

Subjects were asked how many hours a week they engaged with each of the

media forms (hi). They were then given the media multitasking matrix, which rated

the frequency of using the other 9 media forms while using the specific media form in

question. There was thus a total of 9 matrices (Appendix I). The rating responses were

as follows: ‘Most of the time’, ‘Some of the time’, A little of the time’ and ‘Never’

with the respective scores of 1, 0.67, 0.33 and 0.

For each medium in question, the sum of ratings of the 9 other media

constituted the mean number of other media used (mi) while engaging on the medium

in question. The index indicates the overall level of media multitasking each subject

engages in for an hour of media consumption. The authors (Ophir, Nass, & Wagner,

2009), found a mean MMI score of 4.38 (SD = 1.52). The following formula

describes the MMI:


∑𝑚𝑖 × ℎ𝑖

ℎ𝑡𝑜𝑡𝑎𝑙

10

𝑖=1

Stroop test. This was a colour-identification task based on the work of John

Ridley Stroop (1935) measuring the inteference of colour-word incongruency on

reaction times (MacLeod, 1991). The task was based on the Psytoolkit platform

developed by Dr. Gijsbert Stoet (University of Glasgow, United Kingdom) using

various software and programing languages. No changes were made to the task on the

platform beyond the provision of practice trials and increasing the number of actual

trials.

There were 4 colours (green, yellow, blue, red) and their corresponding name-

words for this task, yielding a total of 16 possible colour-word combinations as

stimuli; 4 congruent and 12 incongruent combinations. Subject were to respond to the

color of the stimuli and ignore any interference from any incongruent word stimulus.

Responses were assigned as the keyboard keys ‘g’, ‘y’, ‘b’ and ‘r’ for the colors

green, yellow, blue and red respectively (Appendix J). The word stimuli presented

was in Arial font size 26 (Appendix J). Subjects were firstly presented with the

instructions for the task, and had to press the spacebar to advance to the task. They

then performed 20 practice trials before coming to a page informing them that they

had finished the practice and pressing the spacebar to move forward would bring them

to the 120 actual trials. Subjects were not informed of the number of trials they had to

complete.

The order of presentation of the stimuli was as follows. First a blank screen

was shown for 500ms, followed by a white fixation cross (200ms) (Appendix J) and

then a blank screen again for 100ms. After which the task stimulus of 1 of 16

combinations was randomly presented for a maximum of 2000ms or until the subjects

http://www.psytoolkit.org/


keyed in their response after which a feedback of their accuracy was immediately

presented for 500ms (Appendix J). This constituted 1 trial after which the process

looped back to the beginning and recurred for the remaining trials.

Reaction times were measured from the onset of stimulus presentation to the

response entry time by subjects. Accuracy of the response included a timeout value to

account for trials where subjects failed to key in a response within the 2000ms

timeframe.

Psychoeducation materials. An e-book was designed with didactic

information on four main topics: mindfulness, mind wandering, multitasking and

sleep (Appendix K). Research and evidence were distilled into relevant information

for university students, as well as the various costs or benefits and relevant strategies

to implement. The materials and information in this e-book were collated by Dr.

Gregor Lange (National University of Singapore) as a precursory draft of a final book

on strategies in various life domains to improve health behaviours and subsequently

peak performance of university students.

Headspace. The Headspace application is a mobile application available on

IOS and Android operating systems. It provides short 10-minute guided mindfulness

meditation sessions for individuals, narrated by Andy Puddicombe, a former Buddhist

monk.

For this current study, the free Take10 programme was used, which provided

subjects with ten days of unique and progressive 10-minute guided mindfulness

meditation sessions.

My 10-day challenge worksheet. This worksheet provided specific

instructions for subjects to reduce multitasking, get eight hours of sleep and practice

ten minutes of mindfulness meditation for a period of ten days (Appendix L). The

https://www.headspace.com/


worksheet also provided instructions to download a guided meditation mobile

application, Headspace for their 10-Day Challenge.

Psychoeducation test. Based on the psychoeducation materials, 12 questions

were formulated to assess subject’s knowledge and recall of the materials read, half of

which were multiple choice and the other half free response. For each of the four

topics, there were 3 questions asked (Appendix M).

Programme evaluation. The programme evaluation was specifically designed

to investigate subjects’ perceptions of behaviour and outcome changes, as well as

their propensity to maintain (if they expressed change) or change (if they expressed

no change) their behaviours more adaptively. These attitudes and perceptions were

explicitly expressed in individual questions rated on a 7-point Likert scale or as binary

yes or no answers (Appendix N). Feedback about challenges and potential

improvements were also collected.

Procedure

After recruitment, subjects were randomly assigned, controlling for gender,

into one of three experimental conditions: Control condition, Psychoeducation only

condition, and the Psychoeducation with practice (Practice) condition. Subjects were

then informed of which dates they had to respond according to their condition:

Control subjects on days 1 and 12, and Psychoeducation and Practice subjects on days

1, 2 and 12. Figure 1 summarizes the timeline of the study for the various conditions.

Pre-testing. All subjects firstly underwent the pre-testing phase on the first

day to record their baseline measures on the PANAS, ERQ, DASS-21, CAMS-R,

Mindful Lifestyle Habits Questionnaire, PSQI, MMI and the Stroop Test. These

measures were recorded online using the Google forms and Psytoolkit (Stroop Test)

platforms.


Psychoeducation. On the second day, subjects in the Psychoeducation and

Practice conditions were given an e-book of psychoeducation materials titled: Holistic

Strategies for Effective Students; Mindfulness, Mind Wandering, Multitasking & Sleep

(Appendix K) to peruse. Additionally, subjects in the Practice condition were shown a

My 10-Day Challenge (Challenge) worksheet (Appendix L) for them to keep track of

their progress, beginning that day. Subjects were then given a psychoeducation test to

quiz them on the materials they had just read.

Day 1 of challenge. At the end of the psychoeducation test, subjects (both

conditions) were provided links to download the e-book and the worksheet (Practice

condition). Later on in the same day, these subjects each received an individualized

text message (Appendix O). The message encouraged subjects to put into practice the

various strategies they had learnt from the booklet. They were urged to implement

these habit changes over the next ten days, beginning that day. Subjects in the Practice

condition were also welcomed to the first day of their challenge and reminded to use

the Headspace application for their guided meditation.

Days 2 to 10 of challenge. From the third to eleventh day of the study,

subjects in the Practice condition received daily text reminders (Appendix O) to keep

on track with their practice in line with the Challenge. Messages welcomed them to

the specific day of the Challenge, provided some snippets of information from the e-

book in line with the four topics and lastly a specific reminder to practice ten minutes

of mindful meditation. Subjects in the Control and Psychoeducation conditions

received no reminders during this period.

Post-testing. On the twelfth and final day, all subjects underwent the post-

testing phase to record changes in measures on the PANAS, ERQ, DASS-21, CAMS-

R, Mindful Lifestyle Habits Questionnaire, PSQI, MMI and the Stroop Test.


Additionally, subjects in the Psychoeducation and Practice conditions also did the

Psychoeducation test and a Programme evaluation.

Debrief. Upon completion of the study, all subjects were debriefed on the

objectives, different conditions and procedures. They were also provided the links to

download the e-book and worksheet.


Day 1 2 3 4 5 6 7 8 9 10 11 12

Control Pre-test No action taken Post-test

Psychoeducation Pre-test

a) Read Psychoeducation

e-book

b) Psychoeducation Test

c) Encouraged to practice

for the next 10 days

No reminders Post-test

Practice Pre-test

a) Read Psychoeducation

e-book

b) Issued My 10-Day

Challenge Worksheet

c) Psychoeducation Test

d) Encouraged to practice

for the next 10 days

Daily text reminders Post-test

Figure 1. Study timeline.


Results

Statistical Analyses

Data collected were analysed using the IBM Statistical Package for Social

Sciences Statistics 20 software. Descriptive statistics of the pre-test and post-test

variables were first derived. Tables 1.1, 1.2 and 1.3 summarize the descriptive

statistics for the various behavioural, outcome and other measures respectively.

As the experimental design consisted a repeated set of measures (pre-test and

post-test), a 3 x 2 x 2 repeated measures analysis of variance (RM-ANOVA) was used

to analyse the various dependent measures individually or their subscales (where

applicable). Condition (3) and gender (2) were entered as between-subjects factors

and Time (2) as a within-subjects factor. As the repeated measures only involved 2

levels (pre-test and post-test), sphericity was assumed for all within-subjects effects.

Thus all reported F-ratios for RM-ANOVA are the sphericity assumed values.

Pairwise comparisons were also conducted for variables with significant interaction

effects on the RM-ANOVA. The conservative Pillai’s trace correction was selected as

the reported statistic for multivariate analysis of these pairwise comparisons.

Analysis of variance (ANOVA) was also used to explore between-subjects

effects. Bonferroni correction was used for post-hoc analyses when between-subjects

interaction effects were significant and for non-predicted pair-wise comparisons for

within-subjects interaction effects.


Table 1.1

Descriptive Statistics (Behavioural measures)

Pre-test Post-test

N Mean

Std.

Deviation Mean

Std.

Deviation

Sleep Duration 67 6.43 1.36 7.02 1.35

PSQI 67 5.73 2.85 4.33 2.03

MMI 67 3.37 1.27 2.61 1.67

Weekly Mindful Practice (mins) 67 36.21 107.78 40.87 83.91

Valid N (listwise) 67


Table 1.2

Descriptive Statistics (Outcome measures)

Pre-test Post-test

N Mean Std.

Deviation

Mean Std.

Deviation

Depression (DASS-21) 67 12.93 11.23 9.64 10.08

Anxiety (DASS-21) 67 9.25 7.86 5.79 6.40

Stress (DASS-21) 67 14.63 9.05 10.69 8.83

Positive Affect (PANAS) 67 28.57 8.02 29.04 7.89

Negative Affect (PANAS) 67 26.33 8.10 21.99 8.09

Reappraisal (ERQ) 67 4.92 .98 4.89 .97

Suppression (ERQ) 67 4.17 1.15 4.27 1.062

CAMS-R 67 24.00 5.16 24.06 5.23

Stroop Effect 67 95.11 64.93 91.38 52.72

Incongruent Mean Response Time 67 807.72 130.41 762.83 114.29

Congruent Mean Response Time 67 712.61 133.90 671.46 105.57

Psychoeducation test 47 16.15 2.43 15.88 2.60



Table 1.3

Descriptive Statistics (Programme Evaluation – post-test only)

Psychoeducation

(N = 23)

Practice

(N = 24)

N Mean Std.

Deviation

Mean Std.

Deviation

Reminders’ Usefulness 24 - - 5.13 1.45

Workload change 47 4.30 1.52 4.46 1.77

Mindfulness practice behaviour

change 47 4.30 .97

5.71 1.23

Overall Total 47 5.02 1.31 - -

Mindfulness practice

behavioural maintenanceb 31 2.00 .00

1.85 .37

Overall Total 31 1.90 .30 - -

Mindfulness practice future

behaviour change 16 4.67 1.72

5.50 .58


Sleep behaviour change 47 4.22 1.00 4.50 1.02


Sleep behavioural maintenanceb 20 1.67 .50 1.73 .47


Sleep future behaviour change 27 4.71 1.73 4.69 1.75


Multitasking behaviour changea 47 4.96 1.11 5.21 1.06


Multitasking behavioural

maintenanceb 36 2.00 .00

2.00 .00


Multitasking future behaviour

change 11 3.57 2.15

4.75 2.06



Table 1.3 (continued)

Psychoeducation

(N = 23)

Practice

(N = 24)

N Mean Std.

Deviation

Mean Std.

Deviation

Mood outcome change 47 4.30 .56 4.92 .97


Mindfulness level outcome

change 47 4.52 .51

5.42 .97


Cognitive functioning outcome

change 47 4.35 .49

4.54 .93


Overall benefit received 4.83 .58 5.21 .72


Change your life for the betterb 47 1.87 .34 1.92 .28



a. Reverse-scored such that increased multitasking behaviour (not desirable) is scored below 4 and

reduced multitasking behaviour (desirable) is scored above 4.

b. Scored such that No is 1 and Yes is 2.


Behavioural Measures

Main effects of time. There was a significant main effect of time for increased

sleep duration (F (1, 61) = 11.51, p < .01; Appendix P.1), decreased media-

multitasking (F (1, 61) = 16.64, p < .001; Appendix P.2), and reduced (increased

PSQI) sleep quality (F (1, 61) = 16.39, p < .001; Appendix P.3). No other significant

effects were found.

Weekly mindful practice duration (mindful practice duration). No main

effects of time, condition or gender were found for mindful practice duration

(Appendix P.4). However, tests of within-subjects effects revealed a significant two-

way interaction effect of condition*time as predicted (F (2, 61) = 4.47, p < .05). A

significant interaction effect of gender*time was also found (F (1, 61) = 4.80, p

< .05). No other significant effects were found.

Pairwise comparisons for the condition*time effect (Figure 2) revealed that

subjects in the Practice condition had significantly higher mindful practice duration

than the other two conditions (Table 2.1), but only at the post-test (F (2, 61) = 4.56, p

< .05). The other two conditions did not differ significantly from each other. It was

also revealed that only subjects in the Practice condition (Table 2.2) significantly

increased their mindful practice duration over time (Pillai’s trace = .11, F (1, 61) =

7.78, p < .01).


Figure 2. Interaction effects of condition across time for weekly mindful practice

duration.


Table 2.1

Pairwise comparisons for weekly mindful practice duration (different condition-pairs at each time level).

timeWeeklyMindful

Practice (I) Condition (J) Condition

Mean Difference

(I-J) Std. Error Sig.b

95% Confidence Interval for Differenceb

Lower Bound Upper Bound

Pre-test

Control Psychoeducation -29.087 33.234 .385 -95.543 37.370

Practice -12.755 33.695 .706 -80.132 54.623

Psychoeducation Control 29.087 33.234 .385 -37.370 95.543

Practice 16.332 32.592 .618 -48.839 81.503

Practice Control 12.755 33.695 .706 -54.623 80.132

Psychoeducation -16.332 32.592 .618 -81.503 48.839

Post-test


Practice -68.940* 24.582 .007 -118.094 -19.787


Practice -56.207* 23.776 .021 -103.751 -8.663

Practice Control 68.940* 24.582 .007 19.787 118.094

Psychoeducation 56.207* 23.776 .021 8.663 103.751

Based on estimated marginal means

*. The mean difference is significant at the .05 level.

b. Adjustment for multiple comparisons: Least Significant Difference (equivalent to no adjustments).


Table 2.2

Pairwise comparisons for weekly mindful practice duration (different time-pairs at each condition level).

Condition

(I)

timeWeeklyMindful

Practice

(J)

timeWeeklyMindful

Practice Mean Difference (I-J) Std. Error Sig.b

95% Confidence Interval for

Differenceb


Control Pre-test

Post-test

Post-test 5.639 18.814 .765 -31.982 43.260

Pre-test -5.639 18.814 .765 -43.260 31.982


Post-test

Post-test 21.992 17.607 .216 -13.214 57.199

Pre-test -21.992 17.607 .216 -57.199 13.214

Practice Pre-test Post-test -50.547* 18.125 .007 -86.790 -14.303

Post-test Pre-test 50.547* 18.125 .007 14.303 86.790





Pairwise comparisons (Bonferroni adjusted) for the gender*time effect (Figure

3) revealed that female subjects had significantly higher mindful practice duration

(Table 3.1) than the males only at the post-test (F (1, 61) = 4.31, p < .05) but not at

pre-test. An approaching significance effect (Table 3.2) of female subjects increasing

their mindful practice duration over time (Pillai’s trace = .06, F (1, 61) = 3.589, p

= .063) was also found.

These results demonstrated the observations that (i) the significant

condition*time interaction was due to the effect of the Practice condition over time;

(ii) the gender*time interaction was due to female subjects’ significantly higher

mindful practice durations than males at the post-test and (iii) perhaps also their

approaching significance increase in mindful practice duration over time. Given these

results, it was possible to infer and suggest that the effects of the Practice condition

over time may have been caused by the female subjects in that condition despite the

lack of a significant three-way condition*gender*time interaction effect (F (2, 61)

= .83, p = .439). As such, pairwise comparisons were conducted for this 3-way

interaction.


Figure 3. Interaction effects of gender across time for weekly mindful practice

duration.


Table 3.1

Pairwise comparisons for weekly mindful practice duration (different gender-pairs at each time level).

timeWeeklyMindful

Practice (I) Gender (J) Gender Mean Difference (I-J) Std. Error Sig.b


Differenceb


Pre-test Male

Female

Female 4.986 27.089 .855 -49.181 59.154

Male -4.986 27.089 .855 -59.154 49.181

Post-test Male

Female

Female -41.035* 19.762 .042 -80.551 -1.518

Male 41.035* 19.762 .042 1.518 80.551



b. Adjustment for multiple comparisons: Bonferroni.


Table 3.2

Pairwise comparisons for weekly mindful practice duration (different time-pairs at each gender level).

Gender

(I)

timeWeeklyMindful

Practice

(J)

timeWeeklyMindful

Practice Mean Difference (I-J) Std. Error Sig.b


Differenceb


Male Pre-test

Post-test

Post-test 15.372 13.393 .256 -11.408 42.152

Pre-test -15.372 13.393 .256 -42.152 11.408

Female Pre-test

Post-test

Post-test -30.649 16.178 .063 -62.999 1.701

Pre-test 30.649 16.178 .063 -1.701 62.999





Pairwise comparisons (Bonferroni adjusted) of the three-way interaction

(Appendix P.4) revealed that female subjects in the Practice condition did indeed have

significantly higher mindful practice durations than female subjects in the other two

conditions (Figure 4), but only at post-test (F (2, 61) = 4.85, p < .05). However,

individual pairwise comparison between Practice and Psychoeducation conditions was

only marginally significant (p = .050). That this effect at post-test was not found for

male subjects supported the integration of observations (i) and (ii); the inference that

significant differences at post-test due to the Practice condition was also due to the

female subjects in that condition. Observation (ii) was also corroborated in this

pairwise comparison, where in the Practice condition only, females had significantly

higher mindful practice durations than males (F (1, 61) = 7.57, p < .01) at post-test.


Figure 4. Side-by-side paired comparisons of female interaction effects of condition across time for weekly mindful practice duration.


The integration of observations (i), (ii) and (iii) was also found to be

supported. Female subjects in the Practice condition significantly increased their

mindful practice duration over time (Pillai’s trace = .08, F (1, 61) = 5.22, p < .05), and

this increase was not significant for the males in that condition (Pillai’s trace = .04, F

(1, 61) = 2.56, p > .05). However, there was also another significant effect in the

Psychoeducation condition (iv). Male subjects in the Psychoeducation condition

significantly decreased (Figure 5) their mindful practice duration over time (Pillai’s

trace = .11, F (1, 61) = 7.50, p < .01).


Figure 5. Side-by-side paired comparisons of male interaction effects of condition across time for weekly mindful practice duration.


Given the three corroborating evidence for the pairwise comparisons (2

univariate and 1 multivariate), it is possible that female subjects in the Practice

condition were the main driving force behind the significant interaction effects of

condition*time and gender x time. Also, the non-corroborated finding of observation

(iv) may provide insight into the lack of a significant three-way interaction effect. In

the pairwise comparisons, males in the Psychoeducation showed significant decrease

in opposing direction with the significant increase by females in the Practice

condition. Also this effect by the males was extremely significant (p < .01), compared

to the effect by the females which was sufficiently significant (p < .05). These issues

may have potentially muted the three-way interaction effect of condition*gender*time

and hidden the consistent effects by females in the Practice condition.

Outcome Measures

Main effect of time. There was a significant main effect of time for decreases

in depression (F (1, 61) = 8.63, p < .01; Appendix P.5), anxiety (F (1, 61) = 30.04, p

< .001; Appendix P.6), stress (F (1, 61) = 13.74, p < .001; Appendix P.7) and negative

affect scores (F (1, 61) = 17.25, p < .001; Appendix P.8) as well as incongruent (F (1,

61) = 23.66, p < .001; Appendix P.9) and congruent mean response times (F (1, 61) =

16.13, p < .001; Appendix P.10) on Stroop trials. No other significant effects were

found for these measures other than anxiety which had a condition*gender interaction

effect (F (2, 61) = 5.93, p < .005; see Appendix P.6 for extended results).

Main effect of Gender. There was a significant between-subjects main effect

of gender for the Stroop effect. Male subjects had significantly larger Stroop effect

scores than females (F (1, 61) = 4.23, p < .05; see Appendix P.11 for extended

results).


Mindfulness (CAMS-R). There was a significant between-subjects main

effect of condition (F (2, 61) = 4.91, p < .05). However, Levene’s test was violated

for the post-test (F (5, 61) = 4.32, p < .005) but not the pre-test (F (5, 61) = .43,

p > .05). Post hoc tests (Bonferroni adjusted) revealed that subjects in the Control

condition had significantly higher average CAMS-R scores than the other two

conditions (Appendix P.12). However, given the Levene’s test violation, paired-

comparisons of t-tests were conducted to account for variance assumptions.

The paired-comparisons of t-tests confirmed this relationship between the

Control and Psychoeducation (equal variances assumed, t (41) = 2.85, p < .01) and the

Control and Practice conditions (equal variances assumed, t (42) = 2.36, p < .05).

No other significant effects were found, although the within-subjects

condition*time effect did approach significance (F (2, 61) = 2.49, p = .092). Given the

significantly higher average CAMS-R scores in the Control condition and the

approaching significance condition*time interaction effect, pairwise comparisons

were conducted to further investigate the potential condition*time interaction.

Pairwise comparisons for the condition*time interaction effect (Figure 6)

revealed that at pre-test, subjects in the Control condition had significantly higher

CAMS-R scores than the other two conditions (F (2, 61) = 6.01, p < .005). At post-

test however, this effect only approached significance (F (2, 61) = 3.07, p = .054),

perhaps due to the non-significant (p = .502) difference between the Control and

Practice conditions’ CAMS-R scores (Table 4.1). This suggests that subjects in the

Practice condition increased their CAMS-R score over time to reduce the significant

gap with subjects in the Control condition.

This seems to be supported by the non-significant change in CAMS-R scores

across time for the Control condition (Table 4.2). However, the increase in CAMS-R


scores for the Practice condition only approached significance (Pillai’s trace = .05, F

(1, 61) = 3.48, p = .067)

It was possible that the significantly higher CAMS-R scores in the Control

subjects muted the condition*time interaction effects. However, the approaching

significance increase in scores for the Practice subjects across time demonstrated that

this was too weak an effect to yield a significant condition*time interaction.


Figure 6. Interaction effects of condition across time for CAMS-R.


Table 4.1

Pairwise comparisons for CAMS-R (different condition-pairs at each time level).

timeCAMSR (I) Condition (J) Condition

Mean Difference




Pre-test

Control Psychoeducation 4.057* 1.481 .024 .410 7.704

Practice 4.876* 1.502 .006 1.179 8.574

Psychoeducation Control -4.057* 1.481 .024 -7.704 -.410

Practice .819 1.453 1.000 -2.757 4.396

Practice Control -4.876* 1.502 .006 -8.574 -1.179

Psychoeducation -.819 1.453 1.000 -4.396 2.757

Post-test


Practice 2.232 1.598 .502 -1.702 6.166

Psychoeducation Control -3.902* 1.576 .048 -7.782 -.021

Practice -1.669 1.546 .853 -5.474 2.136

Practice Control -2.232 1.598 .502 -6.166 1.702

Psychoeducation 1.669 1.546 .853 -2.136 5.474





Table 4.2

Pairwise comparisons for CAMS-R (different time-pairs at each condition level)

Condition (I) timeCAMSR (J) timeCAMSR Mean Difference (I-J) Std. Error Sig.b


Differenceb


Control Pre-test

Post-test

Post-test .894 .974 .362 -1.053 2.841

Pre-test -.894 .974 .362 -2.841 1.053


Post-test

Post-test .738 .911 .421 -1.083 2.560

Pre-test -.738 .911 .421 -2.560 1.083

Practice Pre-test Post-test -1.750 .938 .067 -3.625 .125

Post-test Pre-test 1.750 .938 .067 -.125 3.625




Reappraisal (ERQ). No main effects of time, condition or gender were found

for reappraisal scores (Appendix P.13). However, tests of within-subjects effects

revealed a significant two-way interaction effect of condition*time as predicted (F (2,

61) = 3.72, p < .05). A significant three-way interaction effect of

condition*gender*time was also found (F (2, 61) = 3.47, p < .05). No other significant

effects were found.

Pairwise comparisons for the condition*time interaction effect (Figure 7)

revealed that subjects in the Practice condition did not have significantly higher

(Table 5.1) reappraisal scores than the other two conditions at the post-test (F (2, 61)

= 2.13, p > .05). The condition*time interaction effect was therefore caused by

subjects in the Practice condition who significantly increased (Table 5.2) their

reappraisal scores over time (Pillai’s trace = .08, F (1, 61) = 5.24, p < .05).

It was also noted that while the univariate statistic for differences between

conditions at post-test did not demonstrate significant contrasts, the pairwise

differences in estimated marginal means between Practice and Control as well as

Practice and Psychoeducation conditions (Table 5.1) did approach significance (p

= .068 and p = .094 respectively). It was possible that perhaps the extremely non-

significant (p = .83) pair of Control and Psychoeducation conditions at post-test may

have further muted the marginal significance of the other two condition pairs in the

univariate test.


Figure 7. Interaction effects of condition across time for reappraisal (ERQ).


Table 5.1

Pairwise comparisons for reappraisal (different condition-pairs at each time level).

timeReappraisalERQ (I) Condition (J) Condition

Mean Difference




Pre-test

Control Psychoeducation -.056 .306 .855 -.669 .556

Practice .104 .311 .739 -.517 .725

Psychoeducation Control .056 .306 .855 -.556 .669

Practice .160 .300 .596 -.441 .761

Practice Control -.104 .311 .739 -.725 .517

Psychoeducation -.160 .300 .596 -.761 .441

Post-test


Practice -.545 .293 .068 -1.132 .041

Psychoeducation Control .063 .289 .828 -.515 .642

Practice -.482 .284 .094 -1.049 .085

Practice Control .545 .293 .068 -.041 1.132

Psychoeducation .482 .284 .094 -.085 1.049





Table 5.2

Pairwise comparisons for reappraisal (different time-pairs at each condition level)

Condition

(I)

timeReappraisalERQ

(J)

timeReappraisalERQ Mean Difference (I-J) Std. Error Sig.b


Differenceb


Control Pre-test

Post-test

Post-test .207 .200 .305 -.193 .608

Pre-test -.207 .200 .305 -.608 .193


Post-test

Post-test .200 .187 .290 -.175 .575

Pre-test -.200 .187 .290 -.575 .175

Practice Pre-test Post-test -.442* .193 .026 -.828 -.056

Post-test Pre-test .442* .193 .026 .056 .828





Pairwise comparisons (Bonferroni adjusted) of the three-way interaction

(Appendix P.13) revealed that female subjects in the Practice condition had

significantly higher reappraisal scores than females in the other two conditions

(Figure 8), but only at post-test (F (2, 61) = 4.03, p < .05). However, individual

pairwise comparisons showed only marginal significance between the Practice and

Psychoeducation conditions (p = .054). This effect at post-test was not found for male

subjects in the Practice condition. This was further corroborated by the significant

increase over time, in reappraisal scores, only in females from the Practice condition

(Pillai’s trace = .13, F (1, 61) = 8.82, p < .01). As a result, male and female

reappraisal scores for the Practice condition significantly differed at post-test (F (1,

61) = 7.34, p < .01).

The convergence of evidence from the condition*time and the

condition*gender*time interaction effects point towards the female subjects in the

practice condition as the main source of change in reappraisal scores contributing to

these effects. This was despite the result of such change (overall) not being significant

across the conditions at post-test. However, the three-way interaction revealed that

when males were removed from the analysis, Practice condition females had

significantly higher reappraisal scores than the other two conditions at post-test. This

suggests that the lack of significant change from the males in the Practice condition,

as well as the marginally significant pairwise comparison between Practice and

Psychoeducation conditions for females at post-test may have contributed to muting

the post-test cross-condition effects for the two-way condition*time interaction.


Figure 8. Side-by-side paired comparisons of female interaction effects of condition across time for reappraisal (ERQ).


No significant outcome effects. No significant effects were found for

suppression (Appendix P.14), and positive affect (Appendix P.15).

Psychoeducation Test Scores

There were no significant differences in psychoeducation test scores

(Appendix P.16).

Programme Evaluation

Only attitudes on changes in mindful practice, mood and mindfulness levels

demonstrated a main effect of condition (see Appendix P.17 for extended results).

Further Analyses and Observations

Given the similar findings between the dependent variables of reappraisal

scores (outcome) and mindful practice duration (behaviour), change scores of mindful

practice duration were entered as a covariate into the RM ANOVA for reappraisal

scores to determine if the variation in mindful practice duration would predict the

previous effects in reappraisal scores.

A significant within-subjects three way interaction of condition*gender*time

was found (F (2, 60) = 3.37, p < .05) indicating that after partialing out the effects of

the covariate, the three-way interaction remained significant as before; ergo, the

covariate did not contribute to this effect as previously found (Appendix P.18).

However, the two way within-subjects interaction of condition*time had now lost its

significance (F (2, 60) = 2.82, p = .068), indicating that the covariate did contribute to

the significant effect of this interaction previously found.

Pairwise comparisons revealed that at post-test, mean differences between the

Practice and Control (p = .177) as well as Psychoeducation (p = .245) conditions

became even more insignificant, compared to the marginal significance found

previously, yielding a similarly insignificant effect across conditions at post-test (F (2,


60) = 2.23, p > .05). However, the Practice condition retained its significant increase

in reappraisal scores over time (Pillai’s trace = .06, F (1, 60) = 4.07, p < .05),

although this was approaching the confidence interval boundary (p = .048). This

suggests that partialing out the covariate’s effects was sufficient to reduce the overall

significance of condition*time but not for the specific across time increases in the

Practice condition found earlier.

Pairwise comparisons for the three way interaction also revealed that the

previously found effects retained their significance. Differences across conditions for

females at post-test (F (2, 60) = 4.12, p < .05); across time for females in the Practice

condition (Pillai’s trace = .11, F (1.00, 60.00) = 7.41, p < .01); and across genders in

the Practice condition at post-test (F (1, 60) = 7.50, p < .01) remained significant,

despite partialing out the covariate’s effects. This suggests that the covariate was not

essential in predicting this three way interaction effect.

Additionally, the covariate of mindful practice duration was run for CAMS-R

scores and the covariate of sleep duration change for reappraisal scores but no

significant effects were found.

Summary of Key Results

In summary, mindful practice duration and reappraisal scores were the only

two dependent variables with the predicted within-subjects condition*time interaction

effects and entering change scores for mindful practice duration as a covariate

supported it as a predictor for reappraisal scores. These two variables also

demonstrated gender influences through gender*time (mindful practice duration) or

three way (reappraisal) interaction effects.


MMI, sleep duration, PSQI, depression, anxiety, stress, negative affect and

MRT on both congruent and incongruent trials showed significant within-subjects

main effect of time.

CAMS-R and Stroop effect showed significant between-subjects effects of

condition and gender respectively and there was potential for the marginally

significant condition*time effect for CAMS-R.

Discussion

While it was predicted that both the Psychoeducation and Practice conditions

would have significantly different behavioural and outcome changes from the Control

condition (and differences between themselves), the results did not demonstrate that

psychoeducation alone was sufficient to induce significant behavioural changes and

the subsequent outcomes, perhaps indicating the need for a structured intervention

plan like in the Practice condition. Even so, not all the predicted effects were found

for the Practice condition as findings were limited to mindfulness practices. Also,

mindfulness practice did not differentially reinforce health behaviours of sleep and

media-multitasking as proposed given that such behavioural changes did not differ

across the conditions.

Mindfulness Training Predicting the Use of Reappraisal Strategies

The results revealed that females in the Practice condition seemed to be

driving the condition*time and gender*time effects for mindful practice duration

although the three way interaction lacked significance. This was paralleled in the

analysis of reappraisal scores with females in the Practice condition driving the three

way interaction and condition*time effects. Together, this evidence seemed to suggest

a reasonable convergence that the antecedent mindful practice for subjects in the


Practice condition might have been the cause of the change in reappraisal scores,

perhaps even driven by females.

The finding of a female-driven three way interaction for reappraisal scores

remained unexplained, due to a lack of covariate effect (the three way interaction

remained significant); although some research does suggest that females are likely to

use several emotion regulation strategies much more than men (Nolen-Hoeksema &

Aldao, 2011). However, entering change scores for mindful practice duration as a

covariate did render the condition*time effect insignificant, suggesting that this

change in mindfulness practice contributed to the significantly higher reappraisal

scores for the Practice condition at post-test (but not across time in the Practice

condition, although the covariate did reduce significance to closely approach the

confidence interval boundary). This significant covariate effect on reappraisal scores

suggests the predictive value of mindfulness training (Practice condition) in

increasing the usage of reappraisal strategies of emotion regulation.

Recent research seems to support this proposition. Garland and his colleagues

(2015) recently proposed a process model of mindful positive emotion regulation, of

which reappraisal was central to the process. They argued that mindfulness, which has

several key attitudes like beginner’s mind, non-judging, acceptance, and letting go

(Kabat-Zinn, 1996), interrupts automatic or default stress appraisals or reactivity, and

opens up the search of novel perspectives (beginner’s mind, similar to Langer’s

(2014) conception of mindfulness) to inform and reframe stressful situations or

emotions; essentially the process of cognitive reappraisal. They also emphasize the

enhancing effects that mindfulness has on reappraisal as the attentional features of

mindulness bring into focus the awareness of “contents of consciousness” and the

meta-awareness of the “process of consciousness.” This has the effect of forming


psychological distance and promoting the separation of thoughts from facts (Segal,

Williams, & Teasdale, 2002), further reinforcing reappraisal strategies and outcomes.

Neuroscience research also supports the enahancing role of mindfulness in reappraisal

strategies with their common neural circuitry in emotion-processing regions of the

brain, like the amygdala and structures of the prefrontal cortex that regulate the limbic

regions (Lutz, et al., 2014; Opialla, et al., 2015). Individuals regulating emotion with

reappraisal of negative stimuli predicted greater activity in reappraisal regions of the

brain when they had higher mindful tendencies, including the dorsomedial prefrontal

cortex and other dorsal areas (Modinos, Ormel, & Aleman, 2010). Importantly, this

was correlated to greater reductions in emotional response to negative stimuli in the

amygdala, demonstrating the enhancing effects of mindfulness on reappraisal

strategies. When comparing between mindfulness and reappraisal strategies, both

strategies overlapped in activation of established regions of emotion regulation

processes (medial prefrontal cortex, amygdala) in the brain (Opialla, et al., 2015). In

line with these perspectives and neurological evidence, the findings of the present

study do suggest that mindfulness practice induces greater usage of reappraisal

strategies for emotion regulation, although further, more intervention-specific

research is required to advance this hypothesis. It is also important however, to

recognize the existence of contrasting evidence between reappraisal and mindfulness,

in both brain activation as well as contextual scenarios: larger depletion of cognitive

resources for reappraisal (Keng, 2012), and reappraisal mediating relationships of

mindfulness with depression but not anxiety (Desrosiers, Vine, Klemanski, & Nolen‐

Hoeksema, 2013).


Promising Changes in Mindfulness Levels within a Brief 10-Days Training

Given the significant increases in mindfulness practice from the Practice

condition, it would have seemed likely that the most direct outcome would have

presented itself in the CAMS-R scores, a measure of trait mindfulness levels.

However, CAMS-R scores only showed a marginally significant increase for subjects

in the Practice condition, although subjects in the Psychoeducation and Practice

conditions may have erroneously held attitudes that their mindfulness levels had

increased (mean attitude scores were 4.98 out of 7, where 4 was the semantic

equivalent of no change). Given the short time-frame of 10 days (of just 10 minutes a

day), there may have been insufficient experiential depth for subjects who used

Headspace to significantly improve their trait mindfulness levels over time in

comparison to the specific process links of mindfulness practice with cognitive

reappraisal as discussed earlier.

One important finding however, was the significantly higher average

mindfulness of the Control subjects which may have muted the marginally significant

increase for Practice condition subjects. Moreover, the CAMS-R is just one of at least

five other similar measures of trait mindfulness (Siegling & Petrides, 2013), the most

comprehensive of which is the five-facet mindfulness questionnaire (FFMQ), a

factorial-analysis constructed scale from the various mindfulness scales, including the

CAMS-R, providing greater breadth and depth. The present study did not use the

FFMQ as it was too lengthy (39 items).

Behavioural and Outcome Improvements across Time: Academic Situation and

Environment

Sleep duration increased significantly across the duration of the present study

while sleep quality and media multitasking decreased significantly (PSQI scores


increased). The divergent directions of sleep duration and quality may perhaps be

attributed to the formulation of sleep quality which incorporates hygiene factors

beyond sleep duration, like sleep disturbances and day disturbances, indicating such

factors (not the focus of this study) may have increased over the study to significantly

impact and reduce sleep quality.

There was also a significant reduction in negative outcome measures of

depression, anxiety, stress and negative affect, but no increase in positive affect over

time. MRT of both congruent and incongruent Stroop trials significantly decreased as

well.

The study began on the final week of classes for the semester and ended

midway into the study break week prior to the final examinations. The last projects or

assignments of the semester usually have deadlines not exceeding the final week of

classes. This academic situation and environment may have contributed to the

significant improvement in negative outcomes and both types of Stroop trials, given

the immediate saliency of emotional and cognitive relief following completion of

final projects and assignments. Although attitudes of workload change may not have

reflected this (mean attitude scores were 4.38 out of 7, where 4 was the semantic

equivalent of no change), the upcoming final examinations may have influenced those

attitudes.

This academic situational environment may also potentially explain the

increased sleep duration as well as reduction in media multitasking. Additionally, the

significant increase in sleep to approximately 7 hours was at the bottom of

recommended range by the National Sleep Foundation (Hirshkowitz, et al., 2015).

Given the significant improvements in sleep duration to adequate recommended

levels, the reduction of negative outcomes may have been further bolstered by the


improved sleep durations. This would not be surprising given that strong relationships

have been consistently documented between sleep duration and depression

(Fernandez‐Mendoza, et al., 2015; Furihata, et al., 2015; Perlman, Johnson, &

Mellman, 2006; Zhai, Zhang, & Zhang, 2015), anxiety (Potvin, Lorrain, Belleville,

Grenier, & Préville, 2014; Prather, Vogelzangs, & Penninx, 2015; van Mill,

Vogelzangs, van Someren, Hoogendijk, & Penninx, 2013), stress (An, Jang, & Kim,

2015; Mezick, Matthews, Hall, Richard Jennings, & Kamarck, 2014), negative affect

(Kalmbach, Pillai, Roth, & Drake, 2014; Minkel, et al., 2012; Seixas, et al., 2015),

and the benefits of sleep recovery (Motomura, et al., 2014). Attitudes on mood

changes by the Psychoeducation and Practice conditions seemed to reflect this (mean

attitude scores were 4.62 out of 7, where 4 was the semantic equivalent of no change).

These findings however, are contrary to the reduction in sleep quality (Potvin,

Lorrain, Belleville, Grenier, & Préville, 2014). There were also no corresponding

improvements in positive affect, reappraisal and the Stroop effect.

Interventions in the Present Study and Suggestions for Improvement

Psychoeducation as a standalone intervention. Given that the behavioural

change differences in both intervention conditions was in the specific mindfulness

practice, the structured intervention in the form of Headspace may have been a

contributing factor to this difference. In fact, both conditions demonstrated no

significant differences in psychoeducation knowledge both right after completing the

psychoeducation module and at post-test, indicating similar competence in the

knowledge of costs, benefits and strategies which were tested.

The Headspace application offered practical support in the form of a

structured intervention, especially with the guided meditation. One subject even

poignantly commented, “The process of learning mindfulness could be done in a


video/audio form instead of word form that had to be read.” Moreover, subjects in the

Practice condition did get daily reminders, which has been shown to increase

treatment adherence (Fenerty, West, Davis, Kaplan, & Feldman, 2011). Some subjects

in the Psychoeducation condition reflected the lack of reminders as challenge to their

behavioural change (Appendix Q). Much feedback was also given about the challenge

of finding the time (competing resources with academic and social pursuits) to

practice mindfulness. By contrast, subjects in the Practice condition did provide some

positive feedback about having the Headspace application for their practice, although

some did reflect about the time issue as well. These two differences were the main

factors separating the two conditions in the domain of mindful practice.

Understanding these issues from the perspective of the Information-

Motivation-Strategy (IMS) Model of health behaviour change (DiMatteo & DiNicola,

1982) may shed some light on the inefficacy of the standalone psychoeducation

module. The model suggests that the health behaviour changes proposed would

require three factors; information (health literacy, beliefs, knowledge, recall of what

to do which are provided by the psychoeducation module), motivation (incorporated

in the psychoeducation module as the cost or benefits of the behaviour) and strategy

(physical, social or practical tools, like Headspace which demonstrated success in the

Practice condition).

The psychoeducation module serves as a primary information device fulfilling

the information component of the IMS model. It is likely that the failure to action may

have come from the weakness of the module to provide sufficient motivation and

strategy as components in the IMS model. Information alone may be insufficient to

result in behaviour change. A relevant study found that sleep hygiene awareness was

not strongly correlated to actual practices; ergo knowledge did not equate to practice


(Brown, Buboltz Jr, & Soper, 2002). Motivation and strategies to reduce motivational

barriers may be necessary to put such knowledge into actionable changes.

Motivation and strategy: sleep and multitasking. Within the

psychoeducation module, the primary device of motivation was in the relevant costs

and benefits to the subjects, which were tied to desirable outcomes in health,

emotional and academic functioning and success. This may not have been sufficient

given the overall lack of behaviour change.

The psychoeducational material included both beneficial (improving sleep and

reducing multitasking) as well as cost information regarding maladaptive behaviours.

Theories of loss aversion would suggest that framing the psychoeducation materials

from the perspective of a valence (attractive possession) and possession loss (Brenner,

Rottenstreich, Sood, & Bilgin, 2007) might yield greater motivation and subsequently

behaviour to avoid such losses beyond just perception of benefits and costs. This

might take the form for example of losing close friends (attractive possession)

because insufficient sleep may compromise interpersonal interactions with foul mood

(poorer emotion regulation). The crucial issue would be to accurately identify the

variety of “attractive possessions” that would be lost.

Additionally, a study examining motivational components of alcohol

interventions found better results when comparing the discrepancy of actual

behaviours with drinking norms than with ideal drinking behaviours in a bid to

investigate the contextual efficacy of cognitive dissonance as a motivational impetus

(McNally & Palfai, 2003). While alcohol consumption behaviours hold different

functions and needs from sleep (biological) and media-multitasking (emotional), the

phenomenon of self versus norm cognitive dissonance may similarly provide more

effective motivation than didactically prescribing ideal behaviours in comparison with


self. It is noted that alcohol study made use of group discussion as a mode of

intervention.

However, as this intervention was largely designed to be a self-directed

programme (originally a part of a book), in-person structured interventions may

contravene this ideal and goal which would further compete with time resources from

the subjects. Perhaps then, one possible solution to enhance motivation would be

through a behavioural contract or action plan to create expectancy effects and also

engage the cognitive dissonance of behavioural non-performance (Martin, Haskard-

Zolnierek, & DiMatteo, 2010) although the schedule of consequences would have to

be self-maintained and controlled in this paradigm.

The general lack of strategy, which may have been present in this study, could

have been a potential cost, increasing barriers to motivation. The component

interventions involved broad, general goals of “sleeping at least 8 hours a night”,

“stop multitasking” or to “practice 10 minutes of mindfulness meditation every day,”

albeit with guided suggestions and instructions. This was contrasted with the

structured and practical support of the Headspace application, which provided guided

meditation every day of the intervention. While this was not the original intention for

the Practice condition (see below), behavioural contracts and a specific structured

intervention as practical support for sleep and multitasking behaviours would likely

have yielded greater behaviour change, beyond the Control condition.

Sleep and multitasking behaviours also presented with different challenges

than mindfulness which may have required greater motivation and strategy to tackle.

Firstly, sleep and multitasking behaviours are naturally pre-existing behaviours where

attitudes and beliefs have been entrenched, requiring much motivation and practical

strategy to modify. This is opposed to mindfulness which was a novel behaviour to


most of the subjects. The structured intervention thus provided sufficient practical

support to help with this behaviour change in the Practice condition, even though

motivation and strategy was not sufficient in the Psychoeducation condition.

Secondly, behaviour change predicates opposing challenge to said behaviour.

Increasing sleep duration competes with time resources, which subjects in both

conditions reflected as a main challenge due to their workload. In contrast,

mindfulness meditation required only 10 minutes compared to the hour timescale of

sleep change. This may have been a relative time-scarcity barrier to change even

though subjects did sleep more overall. The reflections of subjects on media-

multitasking inhibition (Appendix Q) revealed that they realised it was not an easy

task to change their habit, hinting at the intrinsic motivation of emotional

gratifications reinforcing their media-multitasking behaviours (Sanbonmatsu, Strayer,

Medeiros-Ward, & Watson, 2013).

As mentioned earlier, structured interventions were originally intended for

sleep and media-multitasking behaviours to provide practical support as a strategy in

managing these behaviours. However, due to the increased operational complexity

and potentially laborious workload for the subjects (concurrent with recruitment

challenges) as detailed below, these intervention plans were dropped from the present

study.

Original intervention for sleep. The Sleep Time mobile application was

originally proposed as a sleep tracking tool since it demonstrated high accuracy in

sleep-wake detection in clinical trials (Bhat, et al., 2014). This would have served to

feedback on subjects’ sleep duration, highlighting the salience of their current

behaviour and motivating them to change in comparison with the ideal sleep proposed

to them. This program however does assume that awareness of one’s sleep hygiene

http://www.azumio.com/s/sleeptime/index.html


factors (sleep duration) would lead to behavioural changes. This would be challenging

in the face of assignments and deadlines competing for time. Moreover, awareness

does not always lead to change (Brown, Buboltz Jr, & Soper, 2002).

Recent research suggests that reducing work-family conflict through social

and organizational change improves sleep duration (Olson, et al., 2015). This might

be a potential intervention for future research, although it does go beyond the scope of

self-directed help in context of the present study.

Original intervention for media-multitasking. In a bid to increase the costs of

and interrupt media-multitasking, StayFocusd and Forest were proposed as

technological aids. StayFocusd is a browser extension which would have allowed

subjects to track time on their website browsing (feedback similar to sleep above) and

more importantly set daily time limits to block websites (social media sites etc.) and

structurally inhibit and control media-multitasking through such scarcity-rationing,

access denial and built-in challenges to access restoration. They also have a “Nuclear

Option” which is irreversible and only resets on the next day. Such negative

punishments notwithstanding, Forest focuses on positive reinforcement as well

(Schacter, Gilbert, & Wegner, 2011; Skinner, 1938). Forest grows trees (visually), for

pre-set time intervals, to grow a forest as a reward for users. It is available both on

mobile phones and internet browsers on computers. Accessing websites on the

“Blacklist” or exiting the phone application would “kill” the currently “growing” tree.

This visual reward-tracking would provide a strongly motivating and practical

structured intervention strategy to modify media-multitasking behaviours, effectively

replacing the emotional gratification “reward” (Sanbonmatsu, Strayer, Medeiros-

Ward, & Watson, 2013). Interestingly, Forests’ tagline is “Forest: Stay focused, be

present”, in line with the practice of mindfulness.

http://www.transfusionmedia.com/

http://www.forestapp.cc/


Gneezy, Meier, and Rey-Biel (2011) would however caution againt such

external incentives to replace intrinsic motivations as behaviour would likely resume

once the incentives are removed (for instance subjects can stop using the programs).

Instead, the crowding-out effect (Gneezy, Meier, & Rey-Biel, 2011) on intrinsic

motivation could potentially be employed (counterintuitively) against emotional

gratifications from media-multitasking. Rewarding media-multitasking behaviours

would ‘crowd-out’ the intrinsic motivations underlying this behaviour, such that

incentive removal would result in cessation of media-multitasking. Such an

intervention would however be risky and require expert supervision to determine

when intrinsic motivations have been ‘crowded-out.’

Original intervention for a social support network. Originally, it was proposed

that subjects would be responsible to remind two other subjects (and subsequently be

reminded by two others) to engage in the desired behaviours and to share their

personal growth and journey in the programme. This would essentially establish an

overlapping (for operational redundancy) looped social network where subjects would

be engaged in establishing social support and subjective norms in others’ adherence

behaviours.

Social support can also be a huge motivational factor, enhancing perceived

behavioural control and informing subjective norms to empower behavioural

intentions to change (Theory of Planned Behaviour) as well as a strategic social tool

(IMS model) (Martin, Haskard-Zolnierek, & DiMatteo, 2010). Peer support has been

shown to increase adherence to an online psychoeducation programme for bipolar

patients (Proudfoot, et al., 2012), superior to usual care for depression (Pfeiffer,

Heisler, Piette, Rogers, & Valenstein, 2011) and improved drug adherence (Horvath,

et al., 2013). Benefits have even been shown for the providers of peer support


(Schwartz & Sendor, 1999). Specifically, group interventions have been shown to be

useful for mindfulness-based interventions (Hassed, De Lisle, Sullivan, & Pier, 2009;

Sharplin, et al., 2010), with added benefits of peer learning.

Mindfulness meditation and Headspace. The contrasting behavioural

changes between the two intervention conditions reflected the differences in both

motivational and strategy components of the IMS model of health behaviour change.

As mentioned, written instructions were given to both conditions as to how to carry

out the mindfulness meditation practice. However, this was a novel, unfamiliar

behaviour, unlike sleep or media-multitasking. Motivational factors may not have

been sufficient to overcome this challenge of novelty as well as that of time

constraints. Mindfulness was framed within a gain perspective as it was behavioural

addition not a modification, unlike sleep and media-multitasking. However,

behavioural contracts and action plans as discussed earlier could still be applied to

enhance motivation for behaviour change.

The key driver for change in this present study seemed to be the structured

intervention of having the Headspace application for subjects to follow. However, not

all the predicted effects were found. In contrast, the only other known study involving

Headspace found increases in positive affect and decreases in depression as compared

to controls after 10 days as well (Howells, Ivtzan, & Eiroa-Orosa, 2014). It is

important to note the sample biases in their study as they primarily recruited

“happiness-seekers” to investigate their experiences with Headspace, which may have

resulted in a positive results search bias given their purposive sampling techniques. In

contrast, the present study was purposive only to the general population of university

students. Given the contrasting findings between the Psychoeducation and Practice


conditions, there appears to be no inherent motivations to behavioural change guiding

this present study to form a similar positive results search bias.

Mindfulness Based Stress Reduction (MBSR), as advanced by Jon Kabat-

Zinn, was designed as an 8 week intervention with 45 minutes of formal practice

every day (Kabat-Zinn, 1996), while the present study utilized a brief 10-day

programme of just 10 minutes a day. The relatively much shorter length of the study

may be the reason why not all the predicted effects were found for those in the

Practice condition. It is important emphasize the point that mindfulness is not

equivalent to meditation (Bishop, et al., 2004). Instead the practice of meditation

serves the purpose of cultivating mindfulness to generalize into the way we deal with

and be mindful in other contexts of our lives, beyond the formal practice sessions.

This practice would necessarily need to extend and maintain beyond the short 10 days

of the present study for long term effects and benefits.

Limitations of the Present Study

In addition to the issues raised earlier; the short intervention timeframe,

motivation, strategy, and timing of the study, there were other limitations to the

present study.

Due to the timing coupled with the length of the study, recruitment of subjects

was extremely challenging and resulted in a relatively small sample sizes for each

condition (20, 23 and 24 subjects in order of increasing intervention). Thus the results

and findings from this study will require cautious interpretation and only non-

generalizable conclusions (specific to the present study population) could be made.

Given that this is a pilot intervention study however, the findings will provide general

directions for future research to explore and enhance.


With the recruitment challenges, the present study was also unable to pre-

select and pre-qualify only meditation-naïve subjects to enhance the contextual

relevance and significance of the findings.

Moreover, given the significantly higher CAMS-R scores in the Control

condition, matching subjects into the various conditions after the pre-test may have

been a better design to statistically remove this confound. Despite this, given the

multitude of pre-test measures, matching subjects would have been an extremely

challenging effort should subjects present with significant individual differences on

more than one measure.

The length of the pre-test and post-test measures also meant that subjects

would require approximately 25 to 30 minutes for each session. This raised the

potential for task fatigue which could influence the accuracy of subjects’ responses.

Outcome measures were intentionally presented first to minimize task fatigue

influence on these critical measures. The only exception was for the Stroop test as it

was run on a separate platform and was thus presented as the final task. This may

have contributed to the lack of significant predicted effects for Stroop performance.

Lastly, the study was conducted at the subjects’ convenience due to

recruitment challenges. Meaning to say, the environment under which the subjects

took the pre-test, psychoeducation module and post-test were not controlled for. This

may have led to extraneous environmental influences at these various test points.

Subjects were however, given heavily-emphasized instructions to participate in these

test points while in a quiet and comfortable environment.

Promising Attitudes from the Intervention

Despite these limitations, subjects in the Psychoeducation and Practice

condition did rate the study highly in terms of the overall benefits felt (means of 4.83


and 5.21 respectively out of 7, where 4 was the semantic equivalent of no change) and

that the programme changed their lives for the better (42 out of 47 responded yes). In

fact, some subjects expressed their gratitude for being recruited in the present study

(Appendix R). More importantly, attitudes to either behavioural maintenance or future

behavioural change were generally favourable, indicating the conscious knowledge

and awareness of the benefits and need for this programme, as promoted through the

psychoeducation element of the study. These attitude ratings were held within single

face-valid items on the backdrop of reduced emotional and cognitive load after the

final week of the semester. As such, caution is advised on definitive conclusions from

these attitudes, especially with binary yes or no attitudes.

Conclusion: Implications, Future Developments and Research

The present study may have been too ambitious in introducing two additional

components of intervention to the primary mindfulness training component, despite

the goals for a holistic and comprehensive intervention. In fact, the original intentions

for the sleep, multitasking and social support component would have added layers of

complexity to the design of the 10 day programme.

Even so, the intervention programme for the Practice condition did show

promising effects of increased usage of reappraisal strategies and an approaching

increase in mindfulness levels within the constraints of a short time-frame and the

demands of final week deadlines, supporting the albeit limited efficacy of the

programme. The finding of the link between mindfulness practice of the Eastern

traditions and the associated increase in reappraisal strategies as the related

psychological constructs proposed by the Western traditions of mindfulness further

emphasizes the conceptual similarities behind both traditions, despite their differences


in formal practice. Further research could also investigate the results on suppression

strategies of emotion regulation as well to examine any potential contrasts.

Given the documented benefits of these health behaviours (see Introduction),

future research should look into further developing and enhancing the

psychoeducation materials and design of the present intervention programme. For

example, redesigning the psychoeducational materials to activate “loss aversion” as

well as incorporating short homework tasks of behavioural contracts and action plans

to enhance the motivational components of the psychoeducation materials so as to

inspire greater behaviour change in future versions of this programme.

Future research can also look into implementing the various structured

interventions for sleep and media-multitasking behaviours beyond the

psychoeducational component to provide the practical strategies and resources for

improved probability of such health behaviour change. These behavioural

interventions could be separately investigated to assess their individual efficacies

before combining all three behavioural changes into a holistic programme like the

present study. Research into the proposed social support network could further

enhance these interventions.

Most importantly, future research should increase the length of the

mindfulness intervention to further explore its effects among the student population.

Long-term follow-ups on behavioural maintenance and outcomes would also provide

validation of the long-term efficacy of such an intervention programme to improve the

design and delivery.

In conclusion, it is hoped that future research can expand on the lessons and

findings from the present study to develop evidence-based, student-targeted

interventions incorporating sleep, media-multitasking and mindfulness that will help


improve students’ health behaviours and subsequently mood, emotion regulation,

mental health and cognitive performance.


References

American College Health Association. (2008). American College Health Association-

National college health assessment Spring 2007 reference group data report

(Abridged). Journal of American College Health, 56, 469–480.

Alzahabi, R. (2015). An individual differences approach to investigate task-switching

and its relationship to media multitasking. (Doctoral dissertation, MICHIGAN

STATE UNIVERSITY).

American College Health Association. (2000). American College Health Association-

National College Health Assessment: Reference Group Executive Summary

Spring 2000. Retrieved from American College Health Association:

http://www.acha-ncha.org/docs/ACHA-

NCHA_Reference_Group_ExecutiveSummary_Spring2000.pdf

An, K., Jang, J., & Kim, J. (2015). Sedentary Behavior and Sleep Duration Are

Associated with Both Stress Symptoms and Suicidal Thoughts in Korean

Adults. The Tohoku journal of experimental medicine, 237(4), 279-286.

Antony, M., Bieling, P., Cox, B., Enns, M., & Swinson, R. (1998). Psychometric

properties of the 42-item and 21-item versions of the Depression Anxiety

Stress Scales in clinical groups and a community sample. Psychological

assessment, 10(2), 176-181.

Baum, K., Desai, A., Field, J., Miller, L., Rausch, J., & Beebe, D. (2014). Sleep

restriction worsens mood and emotion regulation in adolescents. Journal of

Child Psychology and Psychiatry, 55(2), 180-190.

Beblo, T., Fernando, S., Klocke, S., Griepenstroh, J., Aschenbrenner, S., & Driessen,

M. (2012). Increased suppression of negative and positive emotions in major

depression. Journal of affective disorders, 141(2), 474-479.


Becker, M., Alzahabi, R., & Hopwood, C. (2013). Media multitasking is associated

with symptoms of depression and social anxiety. Cyberpsychology, Behavior,

and Social Networking, 16(2), 132-135.

Bhat, S., Ferraris, A., Gupta, D., Mozafarian, M., DeBari, V., Gushway-Henry,

N., . . . Chokroverty, S. (2014). Is There a Clinical Role For Smartphone Sleep

Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to

Polysomnography. Journal of clinical sleep medicine: JCSM: official

publication of the American Academy of Sleep Medicine, 11(7), 709-715.

Bishop, S., Lau, M., Shapiro, S., Carlson, L., Anderson, N., Carmody, J., . . . Devins,

G. (2004). Mindfulness: A proposed operational definition. Clinical

psychology: Science and practice, 11(3), 230-241.

Bitsika, V., Sharpley, C., & Rubenstein, V. (2010). What Stresses University

Students: An Interview Investigation of the Demands of Tertiary Studies.

Australian journal of guidance and counselling, 20(1), 41-54.

Bouteyre, E., Maurel, M., & Bernaud, J. (2007). Daily hassles and depressive

symptoms among first year psychology students in France: The role of coping

and social support. Stress and Health, 23(2), 93-99.

Brand, S., Holsboer-Trachsler, E., Naranjo, J., & Schmidt, S. (2012). Influence of

mindfulness practice on cortisol and sleep in long-term and short-term

meditators. Neuropsychobiology, 65(3), 109-118.

Brenner, L., Rottenstreich, Y., Sood, S., & Bilgin, B. (2007). On the psychology of

loss aversion: Possession, valence, and reversals of the endowment effect.

Journal of Consumer Research, 34(3), 369-376.


Britton, W., Shahar, B., Szepsenwol, O., & Jacobs, W. (2012). Mindfulness-based

cognitive therapy improves emotional reactivity to social stress: results from a

randomized controlled trial. Behavior Therapy, 43(2), 365-380.

Brown, F., Buboltz Jr, W., & Soper, B. (2002). Relationship of sleep hygiene

awareness, sleep hygiene practices, and sleep quality in university students.

Behavioral medicine, 28(1), 33-38.

Burckhardt, C., & Anderson, K. (2003). The Quality of Life Scale (QOLS):

reliability, validity, and utilization. Health and quality of life outcomes, 1, 60.

Buysse, D., Reynolds, C., Monk, T., Berman, S., & Kupfer, D. (1989). The Pittsburgh

Sleep Quality Index: a new instrument for psychiatric practice and research.

Psychiatry research, 28(2), 193-213.

Caldwell, J., Prazinko, B., & Caldwell, J. (2003). Body posture affects

electroencephalographic activity and psychomotor vigilance task performance

in sleep-deprived subjects. Clinical Neurophysiology, 114(1), 23-31.

Carmody, J. (2014). Eastern and Western Approaches to Mindfulness - Similarities,

Differences, and Clinical Implications. In A. Ie, C. Ngnoumen, & E. Langer,

The Wiley Blackwell Handbook of Mindfulness (pp. 48-57). Chichester, West

Sussex: Wiley Blackwell.

Cavanagh, C. (2013). Emotion Regulation and Cardiovascular Response to Emotion

Provocation: Reappraisal versus Suppression. Masters Dissertation, WEST

VIRGINIA UNIVERSITY.

Cavanagh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., & Jones, F. (2013). A

randomised controlled trial of a brief online mindfulness-based intervention.

Behaviour research and therapy, 51(9), 573-578.


Chambers, R., Lo, B., & Allen, N. (2008). The impact of intensive mindfulness

training on attentional control, cognitive style, and affect. Cognitive therapy

and research, 32(3), 303-322.

Chee, M. (2013). Sleep, public health and wellness: the elephant in the room. Annals

of the Academy of Medicine, 42(3), 105-107.

Chen, Y., Yang, X., Wang, L., & Zhang, X. (2013). A randomized controlled trial of

the effects of brief mindfulness meditation on anxiety symptoms and systolic

blood pressure in Chinese nursing students. Nurse education today, 33(10),

1166-1172.

Chittora, R., Jain, A., Suhalka, P., Sharma, C., Jaiswal, N., & Bhatnagar, M. (2015).

Sleep deprivation: Neural regulation and consequences. Sleep and Biological

Rhythms, 13(3), 210-218.

Chong, S., Abdin, E., Vaingankar, J., Heng, D., Sherbourne, C., Yap, M., . . .

Subramaniam, M. (2012). A population-based survey of mental disorders in

Singapore. Annals of the Academy of Medicine-Singapore, 41(2), 49-66.

Clayson, D., & Haley, D. (2013). An Introduction to Multitasking and Texting

Prevalence and Impact on Grades and GPA in Marketing Classes. Journal of

Marketing Education, 35(1), 26-40.

Colom, R., Martínez-Molina, A., Shih, P., & Santacreu, J. (2010). Intelligence,

working memory, and multitasking performance. Intelligence, 38(6), 543-551.

Danielsson, N., MacDonald, S., Jansson-Fröjmark, M., Linton, S., & Harvey, A.

(2011). Short-term partial sleep deprivation: Effects on emotion regulation of

healthy adults. Sleep Medicine, 12, S14.


Davidson, R., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli,

S., . . . Sheridan, J. (2003). Alterations in brain and immune function produced

by mindfulness meditation. Psychosomatic medicine, 65(4), 564-570.

Davis, D., & Hayes, J. (2011). What are the benefits of mindfulness? A practice

review of psychotherapy-related research. Psychotherapy, 48(2), 198-208.

Davis, E., & Levine, L. (2013). Emotion regulation strategies that promote learning:

Reappraisal enhances children’s memory for educational information. Child

development, 84(1), 361-374.

Desrosiers, A., Vine, V., Klemanski, D., & Nolen‐Hoeksema, S. (2013). Mindfulness

and emotion regulation in depression and anxiety: common and distinct

mechanisms of action. Depression and anxiety, 30(7), 654-661.

Dick, A., Niles, B., Street, A., DiMartino, D., & Mitchell, K. (2014). Examining

mechanisms of change in a yoga intervention for women: The influence of

mindfulness, psychological flexibility, and emotion regulation on PTSD

symptoms. Journal of clinical psychology, 70(12), 1170-1182.

Diener, E., & Chan, M. (2011). Happy people live longer: Subjective well‐being

contributes to health and longevity. Applied Psychology: Health and Well‐

Being, 3(1), 1-43.

DiMatteo, M., & DiNicola, D. (1982). Achieving patient compliance: The psychology

of the medical practitioner's role. Pergamon general psychology series.

Dimidjian, S., Beck, A., Felder, J., Boggs, J., Gallop, R., & Segal, Z. (2014). Web-

based Mindfulness-based Cognitive Therapy for reducing residual depressive

symptoms: An open trial and quasi-experimental comparison to propensity

score matched controls. Behaviour research and therapy, 63, 83-89.


Dyson, R., & Renk, K. (2006). Freshmen adaptation to university life: Depressive

symptoms, stress, and coping. Journal of clinical psychology, 62(10), 1231-

1244.

Edens, K. (2006). The relationship of university students' sleep habits and academic

motivation. NASPA Journal of Student Affairs Research and Practice, 43(3),

432-445.

Eftekhari, A., Zoellner, L., & Vigil, S. (2009). Patterns of emotion regulation and

psychopathology. Anxiety, Stress, & Coping, 22(5), 571-586.

Eisenberg, D., Gollust, S., Golberstein, E., & Hefner, J. (2007). Prevalence and

correlates of depression, anxiety, and suicidality among university students.

American Journal of Orthopsychiatry, 77(4), 534-542.

Elkin, A., & Murray, D. (1974). The effects of sleep loss on short-term recognition

memory. Canadian Journal of Psychology/Revue canadienne de psychologie,

28(2), 192-198.

Ellis, Y. D., & Jauregui, A. (2010). The effect of multitasking on the grade

performance of business students. Research in Higher Education Journal, 8,

1-10.

Fallone, G., Owens, J., & Deane, J. (2002). Sleepiness in children and adolescents:

clinical implications. Sleep medicine reviews, 6(4), 287-306.

Fan, Y., Tang, Y., Tang, R., & Posner, M. (2014). Short term integrative meditation

improves resting alpha activity and stroop performance. Applied

psychophysiology and biofeedback, 39(3), 213-217.

Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J. (2007).

Mindfulness and emotion regulation: The development and initial validation


of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R).

Journal of Psychopathology and Behavioral Assessment, 29(3), 177-190.

Felver, J., Doerner, E., Jones, J., Kaye, N., & Merrell, K. (2013). Mindfulness in

school psychology: applications for intervention and professional practice.

Psychology in the Schools, 50(6), 531-547.

Fenerty, S., West, C., Davis, S., Kaplan, S., & Feldman, S. (2011). The effect of

reminder systems on patients’ adherence to treatment. Patient preference and

adherence, 6, 127-135.

Fernandez‐Mendoza, J., Shea, S., Vgontzas, A., Calhoun, S., Liao, D., & Bixler, E.

(2015). Insomnia and incident depression: role of objective sleep duration and

natural history. Journal of sleep research, 24(4), 390-398.

Finley, J., Benjamin, A., & McCarley, J. (2014). Metacognition of multitasking: How

well do we predict the costs of divided attention? Journal of experimental

psychology: applied, 20(2), 158–165.

Foerde, K., Knowlton, B., & Poldrack, R. (2006). Modulation of competing memory

systems by distraction. Proceedings of the National Academy of Sciences,

103(31), 11778-11783.

Furihata, R., Uchiyama, M., Suzuki, M., Konno, C., Konno, M., Takahashi, S., . . .

Akashiba, T. (2015). Association of short sleep duration and short time in bed

with depression: A Japanese general population survey. Sleep and Biological

Rhythms, 13(2), 136-145.

Garland, E., Farb, N., Goldin, P., & Fredrickson, B. (2015). Mindfulness broadens

awareness and builds eudaimonic meaning: a process model of mindful

positive emotion regulation. Psychological Inquiry, 26(4), 293-314.


Geisler, F., & Schröder-Abé, M. (2015). Is emotion suppression beneficial or

harmful? It depends on self-regulatory strength. Motivation and Emotion,

39(4), 553-562.

Gethin, R. (2011). On some definitions of mindfulness. Contemporary Buddhism,

12(1), 263-279.

Gilbert, S., & Weaver, C. (2010). Sleep quality and academic performance in

university students: A wake-up call for college psychologists. Journal of

college student psychotherapy, 24(4), 295-306.

Gneezy, U., Meier, S., & Rey-Biel, P. (2011). When and why incentives (don't) work

to modify behavior. The Journal of Economic Perspectives, 25(4), 191-209.

Goldin, P., McRae, K., Ramel, W., & Gross, J. (2008). The neural bases of emotion

regulation: reappraisal and suppression of negative emotion. Biological

psychiatry, 63(6), 577-586.

Gomes, A., Tavares, J., & de Azevedo, M. (2011). Sleep and academic performance

in undergraduates: a multi-measure, multi-predictor approach. Chronobiology

Internationa, 28(9), 786-801.

Gopalakrishnan, A., Ji, L., & Cirelli, C. (2004). Sleep deprivation and cellular

responses to oxidative stress. Sleep, 27(1), 27-35.

Graziano, P., Reavis, R., Keane, S., & Calkins, S. (2007). The role of emotion

regulation in children's early academic success. Journal of school psychology,

45(1), 3-19.

Gross, J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology

an affective science perspective. Clinical Psychological Science, 2(4), 387-

401.


Gross, J., & John, O. (2003). Individual Differences in Two Emotion Regulation

Processes: Implications for Affect, Relationships, and Well-Being. Journal of

Personality and Social Psychology, 85(2), 348-362.

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based

cognitive therapy and mindfulness-based stress reduction improve mental

health and wellbeing? A systematic review and meta-analysis of mediation

studies. Clinical psychology review, 37, 1-12.

Gumora, G., & Arsenio, W. (2002). Emotionality, emotion regulation, and school

performance in middle school children. Journal of school psychology, 40(5),

395-413.

Haga, S., Kraft, P., & Corby, E. (2009). Emotion regulation: Antecedents and well-

being outcomes of cognitive reappraisal and expressive suppression in cross-

cultural samples. Journal of Happiness Studies, 10(3), 271-291.

Harrison, Y., & Horne, J. (1997). Sleep deprivation affects speech. Sleep: Journal of

Sleep Research & Sleep Medicine, 20(10), 871-877.

Harrison, Y., & Horne, J. (1999). One night of sleep loss impairs innovative thinking

and flexible decision making. Organizational behavior and human decision

processes, 78(2), 128-145.

Hassed, C., De Lisle, S., Sullivan, G., & Pier, C. (2009). Enhancing the health of

medical students: outcomes of an integrated mindfulness and lifestyle

program. Advances in health sciences education, 14(3), 387-398.

Henry, J., & Crawford, J. (2005). The short‐form version of the Depression Anxiety

Stress Scales (DASS‐21): Construct validity and normative data in a large

non‐clinical sample. British Journal of Clinical Psychology, 44(2), 227-239.


Hirshkowitz, M., Whiton, K., Albert, S., Alessi, C., Bruni, O., DonCarlos, L., . . .

Hillard, P. (2015). National Sleep Foundation’s sleep time duration

recommendations: methodology and results summary. Sleep Health, 1(1), 40-

43.

Hockey, G. (1970). Changes in attention allocation in a multicomponent task under

loss of sleep. British Journal of Psychology, 61(4), 473-480.

Hofmann, S., Heering, S., Sawyer, A., & Asnaani, A. (2009). How to handle anxiety:

The effects of reappraisal, acceptance, and suppression strategies on anxious

arousal. Behaviour research and therapy, 389-394.

Hölzel, B., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S., Gard, T., &

Lazar, S. (2011). Mindfulness practice leads to increases in regional brain gray

matter density. Psychiatry Research: Neuroimaging, 191(1), 36-43.

Horvath, K., Oakes, J., Rosser, B., Danilenko, G., Vezina, H. A., Williams, M., &

Simoni, J. (2013). Feasibility, acceptability and preliminary efficacy of an

online peer-to-peer social support ART adherence intervention. AIDS and

Behavior, 17(6), 2031-2044.

Howell, A., Digdon, N., & Buro, K. (2010). Mindfulness predicts sleep-related self-

regulation and well-being. Personality and Individual Differences, 48(4), 419-

424.

Howell, A., Digdon, N., Buro, K., & Sheptycki, A. (2008). Relations among

mindfulness, well-being, and sleep. Personality and Individual Differences,

45(8), 773-77.

Howells, A., Ivtzan, I., & Eiroa-Orosa, F. (2014). Putting the ‘app’in Happiness: A

Randomised Controlled Trial of a Smartphone-Based Mindfulness

Intervention to Enhance Wellbeing. Journal of Happiness Studies, 1-23.


Hu, C., Huang, K., Hu, X., Liu, Y., Yuan, F., Wang, Q., & Fu, G. (2015). Measuring

the cognitive resources consumed per second for real-time lie-production and

recollection: a dual-tasking paradigm. Frontiers in psychology, 6, 596.

Huber, R., Ghilardi, M., Massimini, M., & Tononi, G. (2004). Local sleep and

learning. Nature, 6995, 78-81.

Hwee, O. H. (2014, January 23). NUS rolls out 'grade-free' system for its freshmen.

Retrieved October 30, 2015, from Straits Times:

http://www.straitstimes.com/singapore/nus-rolls-out-grade-free-system-for-its-

freshmen

Ie, A. H. (2012). Mindful multitasking: The relationship between mindful flexibility

and media multitasking. Computers in Human Behavior, 28(4), 1526-1532.

Jacobsen, W., & Forste, R. (2011). The wired generation: Academic and social

outcomes of electronic media use among university students.

Cyberpsychology, Behavior, and Social Networking, 14(5), 275-280.

Jenkins, J., & Dallenbach, K. (1995). Oblivescence during sleep and waking. The

American Journal of Psychology, 35(4), 605-612.

Jimenez, S., Niles, B., & Park, C. (2010). A mindfulness model of affect regulation

and depressive symptoms: Positive emotions, mood regulation expectancies,

and self-acceptance as regulatory mechanisms. Personality and individual

differences, 49(6), 645-65.

John, O. P., & Gross, J. (2004). Healthy and unhealthy emotion regulation:

Personality processes, individual differences, and life span development.

Journal of personality, 72(6), 1301-1334.

Johnson, L. (1982). Sleep deprivation and performance. Biological rhythms, sleep,

and performance, 111-141.


Kabat-Zinn, J. (1996). Mindfulness meditation: What it is, what it isn’t, and its role in

health care and medicine. In Y. Haruki, Y. Ishii, & M. Suzuki, Comparative

and psychological study on meditation (pp. 161-169). Netherlands: Eburon.

Retrieved from

http://www.umassmed.edu/contentassets/24cd221488584125835e2eddce7dbb

89/mbsr_standards_of_practice_2014.pdf

Kalmbach, D., Pillai, V., Roth, T., & Drake, C. (2014). The interplay between daily

affect and sleep: a 2‐week study of young women. Journal of sleep research,

23(6), 636-645.

Kalokerinos, E., Greenaway, K., & Denson, T. (2015). Reappraisal but not

suppression downregulates the experience of positive and negative emotion.

Emotion, 15(3), 271-275.

Keng, S. (2012). A Laboratory Investigation of Mindfulness and Reappraisal As

Emotion Regulation Strategies. Doctoral dissertation, Duke University.

Keng, S., Smoski, M., & Robins, C. (2011). Effects of mindfulness on psychological

health: A review of empirical studies. Clinical psychology review, 31(6),

1041-1056.

Kerr, C., Jones, S., Wan, Q., Pritchett, D., Wasserman, R., Wexler, A., . . . Moore, C.

(2011). Effects of mindfulness meditation training on anticipatory alpha

modulation in primary somatosensory cortex. Brain research bulletin, 85(3),

96-103.

Khalik, S. (2013, May 22). Lack of sleep is nothing to yawn about. Retrieved October

25, 2015, from Straits Times: http://www.straitstimes.com/singapore/lack-of-

sleep-is-nothing-to-yawn-about


Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., . . .

Hofmann, S. (2013). Mindfulness-based therapy: A comprehensive meta-

analysis. Clinical Psychology Review, 33(6), 763-771.

Killgore, W., & Killgore, D. (2007). Morningness-eveningness correlates with verbal

ability in women but not men. Perceptual and motor skills, 104(1), 335-338.

Killgore, W., Balkin, T., & Wesensten, N. (2006). Impaired decision making

following 49 h of sleep deprivation. Journal of sleep research, 15(1), 7-13.

Kirk, U., Downar, J., & Montague, P. (2011). Interoception drives increased rational

decision-making in meditators playing the ultimatum game. Frontiers in

Neuroscience, 5, 49.

Krygier, J., Heathers, J., Shahrestani, S., Abbott, M., Gross, J., & Kemp, A. (2013).

Mindfulness meditation, well-being, and heart rate variability: a preliminary

investigation into the impact of intensive Vipassana meditation. International

Journal of Psychophysiology, 89(3), 305-313.

Kuyken, W., Weare, K., Ukoumunne, O., Vicary, R., Motton, N., Burnett, R., . . .

Huppert, F. (2013). Effectiveness of the Mindfulness in Schools Programme:

non-randomised controlled feasibility study. The British Journal of Psychiatry,

203(2), 126-131.

Langer, E. (2014). Mindfulness Forward and Back. In A. Ie, C. Ngnoumen, & E.

Langer, The Wiley Blackwell Handbook of Mindfulness (pp. 7-20). Chichester,

West Sussex: Wiley Blackwell.

Larsen, J., Vermulst, A., Geenen, R., Van Middendorp, H., English, T., Gross, J., . . .

Engels, R. (2013). Emotion Regulation in Adolescence A Prospective Study of

Expressive Suppression and Depressive Symptoms. The Journal of Early

Adolescence, 33(2), 184-200.


Lee, S., Sagayadevan, V., Vaingankar, J., Chong, S., & Subramaniam, M. (2015).

Subthreshold and threshold DSM-IV generalized anxiety disorder in

Singapore: Results from a nationally representative sample. Journal of anxiety

disorders, 32, 73-80.

Lo, J., Leong, R., Loh, K., Dijk, D., & Chee, M. (2014). Young adults’ sleep duration

on work days: differences between East and West. Frontiers in neurology, 5,

81.

Loh, K., & Kanai, R. (2014). Higher media multi-tasking activity is associated with

smaller gray-matter density in the anterior cingulate cortex. PloS one, 9(9),

e106698.

Lovibond, S., & Lovibond, P. (1995). Manual for the Depression Anxiety Stress

Scales. (2nd. ed.). Sydney: Psychology Foundation.

Lund, H., Reider, B., Whiting, A., & Prichard, J. (2010). Sleep patterns and predictors

of disturbed sleep in a large population of college students. Journal of

adolescent health, 46(2), 124-132.

Lutz, J., Herwig, U., Opialla, S. H., Jäncke, L., Rufer, M., Grosse, H., & Brühl, A.

(2014). Mindfulness and emotion regulation—an fMRI study. Social

Cognitive and Affective Neuroscience, 9(6), 776-785.

Lynch, S., Gander, M., Kohls, N., Kudielka, B., & Walach, H. (2011). Mindfulness‐

based coping with university life: A non‐randomized wait‐list‐controlled pilot

evaluation. Stress and Health, 27(5), 365-375.

MacKenzie, M., & Baumeister, R. (2015). Self-Regulatory Strength and Mindfulness.

In B. Ostafin, M. Robinson, & B. Meier, Handbook of Mindfulness and Self-

Regulation (pp. 95-105). New York: Springer.


MacLeod, C. (1991). Half a century of research on the Stroop effect: an integrative

review. Psychological bulletin, 109(2), 163-203.

Mahmoud, J., Staten, R., Hall, L., & Lennie, T. (2012). The relationship among young

adult college students’ depression, anxiety, stress, demographics, life

satisfaction, and coping styles. Issues in mental health nursing, 33(3), 149-

156.

Mahmoud, J., Staten, R., Lennie, T., & Hall, L. (2015). The Relationships of Coping,

Negative Thinking, Life Satisfaction, Social Support, and Selected

Demographics With Anxiety of Young Adult College Students. Journal of

Child and Adolescent Psychiatric Nursing, 28(2), 97-108.

Mandal, S. P. (2012). Mental health and mindfulness: Mediational role of positive and

negative affect. SIS Journal of Projective Psychology and Mental Health,

19(2), 150-159.

Markarian, S., Pickett, S., Deveson, D., & Kanona, B. (2013). A model of BIS/BAS

sensitivity, emotion regulation difficulties, and depression, anxiety, and stress

symptoms in relation to sleep quality. Psychiatry research, 210(1), 281-286.

Martin, L., Haskard-Zolnierek, K., & DiMatteo, M. (2010). Health behavior change

and treatment adherence: Evidence-based guidelines for improving

healthcare. USA: Oxford University Press.

Mauss, I., Troy, A., & LeBourgeois, M. (2013). Poorer sleep quality is associated

with lower emotion-regulation ability in a laboratory paradigm. Cognition &

emotion, 27(3), 567-576.

McNally, A., & Palfai, T. (2003). Brief group alcohol interventions with college

students: Examining motivational components. Journal of drug education,

33(2), 159-176.


Meddis, R. (1982). Cognitive dysfunction following loss of sleep. The pathology and

psychology of cognition, 225-252.

Medeiros-Ward, N., Watson, J., & Strayer, D. (2015). On supertaskers and the neural

basis of efficient multitasking. Psychonomic bulletin & review, 22(3), 876-

883.

Medina, J. (2014). Brain Rules : 12 Principles for Surviving and Thriving at Work,

Home, and School. Seattle, WA: Pear Press.

Meijer, A. (2008). Chronic sleep reduction, functioning at school and school

achievement in preadolescents. Journal of sleep research, 17(4), 395-405.

Mezick, E., Matthews, K., Hall, M., Richard Jennings, J., & Kamarck, T. (2014).

Sleep duration and cardiovascular responses to stress in undergraduate men.

Psychophysiology, 51(1), 88-96.

Minkel, J., Banks, S., Htaik, O., Moreta, M., Jones, C., McGlinchey, E., . . . Dinges,

D. (2012). Sleep deprivation and stressors: evidence for elevated negative

affect in response to mild stressors when sleep deprived. Emotion, 12(5),

1015-1020.

Minkel, J., McNealy, K., Gianaros, P., Drabant, E., Gross, J., Manuck, S., & Hariri,

A. (2012). Sleep quality and neural circuit function supporting emotion

regulation. Biology of mood & anxiety disorders, 2(1), 22-30.

Modinos, G., Ormel, J., & Aleman, A. (2010). Individual differences in dispositional

mindfulness and brain activity involved in reappraisal of emotion. Social

Cognitive and Affective Neuroscience, 5(4), 369–377.

Mokhtari, K., Delello, J., & Reichard, C. (2015). Connected Yet Distracted:

Multitasking Among College Students. Journal of College Reading and

Learning, 45(2), 164-180.


Mooneyham, B., & Schooler, J. (2013). The costs and benefits of mind-wandering: a

review. Canadian Journal of Experimental Psychology/Revue canadienne de

psychologie expérimentale, 67(1), 11-18.

Moore, A., & Malinowski, P. (2009). Meditation, mindfulness and cognitive

flexibility. Consciousness and cognition, 18(1), 176-186.

Moore, B. (2013). Propensity for experiencing flow: The roles of cognitive flexibility

and mindfulness. The Humanistic Psychologist, 41(4), 319-332.

Morin, C., & Ware, J. (1996). Sleep and psychopathology. Applied and Preventive

Psychology, 5(4), 211-224.

Motomura, Y., K. S., Nakazaki, K., Oba, K., Katsunuma, R., Katayose, Y., . . .

Mishima, K. (2014). Recovery from potential sleep debt via sleep extension

may improve emotion regulation. International Journal of Psychophysiology,

2(94), 227.

Motomura, Y., Kitamura, S., Nakazaki, K., Oba, K., Katsunuma, R., Katayose, Y., . . .

Mishima, K. (2014). Recovery from potential sleep debt via sleep extension

may improve emotion regulation. International Journal of Psychophysiology,

2(94), 227.

Mrazek, M., Franklin, M., Phillips, D., Baird, B., & Schooler, J. (2013). Mindfulness

training improves working memory capacity and GRE performance while

reducing mind wandering. Psychological Science, 24(5), 776-781.

Mullington, J., Haack, M., Toth, M., Serrador, J., & Meier-Ewert, H. (2009).

Cardiovascular, inflammatory, and metabolic consequences of sleep

deprivation. Progress in cardiovascular diseases, 51(4), 294-302.


Murakami, H., Katsunuma, R., Oba, K., Terasawa, Y., Motomura, Y., Mishima, K., &

Moriguchi, Y. (2015). Neural networks for mindfulness and emotion

suppression. PloS one, 10(6), e0128005.

Murphy, J., Guzmán, J., McCarthy, A., Squicciarini, A., George, M., Canenguez,

K., . . . Jellinek, M. (2015). Mental health predicts better academic outcomes:

a longitudinal study of elementary school students in Chile. Child Psychiatry

& Human Development, 46(2), 245-256.

Murrell, S., Salsman, N., & Meeks, S. (2003). Educational attainment, positive

psychological mediators, and resources for health and vitality in older adults.

Journal of Aging and health, 15(4), 591-615.

Nolen-Hoeksema, S., & Aldao, A. (2011). Gender and age differences in emotion

regulation strategies and their relationship to depressive symptoms.

Personality and Individual Differences, 51(6), 704-708.

Olson, R., Crain, T., Bodner, T., King, R., Hammer, L., Klein, L., . . . Buxton, O.

(2015). A workplace intervention improves sleep: results from the randomized

controlled Work, Family, and Health Study. Sleep Health, 1(1), 55-65.

Ong, J., Ulmer, C., & Manber, R. (2012). Improving sleep with mindfulness and

acceptance: A metacognitive model of insomnia. Behaviour Research and

Therapy, 50(11), 651-660.

Ophir, E., Nass, C., & Wagner, A. (2009). Cognitive control in media multitaskers.

Proceedings of the National Academy of Sciences, 106(37), 15583-15587.

Opialla, S., Lutz, J., Scherpiet, S., Hittmeyer, A., Jäncke, L., Rufer, M., . . . Brühl, A.

(2015). Neural circuits of emotion regulation: A comparison of mindfulness-

based and cognitive reappraisal strategies. European Archives of Psychiatry

and Clinical Neuroscience, 265(1), 45-55.


Orzeł-Gryglewska, J. (2010). Consequences of sleep deprivation. International

journal of occupational medicine and environmental health, 23(1), 95-114.

Peigneux, P., Laureys, S., Delbeuck, X., & Maquet, P. (2001). Sleeping brain,

learning brain. The role of sleep for memory systems. Neuroreport, 12(18),

A111-A124.

Pekrun, R., Goetz, T., Titz, W., & Perry, R. (2002). Academic emotions in students'

self-regulated learning and achievement: A program of qualitative and

quantitative research. Educational psychologist, 37(2), 91-105.

Perlman, C., Johnson, S., & Mellman, T. (2006). The prospective impact of sleep

duration on depression and mania. Bipolar disorders, 8(3), 271-274.

Pfeiffer, P., Heisler, M., Piette, J., Rogers, M., & Valenstein, M. (2011). Efficacy of

peer support interventions for depression: a meta-analysis. General hospital

psychiatry, 33(1), 29-36.

Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for

prevention of relapse in recurrent major depressive disorder: a systematic

review and meta-analysis. Clinical psychology review, 31(6), 1032-1040.

Pilcher, J., & Huffcutt, A. (1996). Effects of sleep deprivation on performance: a

meta-analysis. Sleep: Journal of Sleep Research & Sleep Medicine., 19(4),

318-326.

Pilcher, J., & Walters, A. (1997). How sleep deprivation affects psychological

variables related to college students' cognitive performance. Journal of

American College Health, 46(3), 121-126.

Polzella, D. (1975). Effects of sleep deprivation on short-term recognition memory.

Journal of Experimental Psychology: Human Learning and Memory, 1(2),

194-200.


Potvin, O., Lorrain, D., Belleville, G., Grenier, S., & Préville, M. (2014). Subjective

sleep characteristics associated with anxiety and depression in older adults: a

population‐based study. International journal of geriatric psychiatry, 29(12),

1262-1270.

Prather, A., Vogelzangs, N., & Penninx, B. (2015). Sleep duration, insomnia, and

markers of systemic inflammation: Results from the Netherlands Study of

Depression and Anxiety (NESDA). Journal of psychiatric research, 60, 95-

102.

Proudfoot, J., Parker, G., Manicavasagar, V., Hadzi-Pavlovic, D., Whitton, A.,

Nicholas, J., . . . Burckhardt, R. (2012). Effects of adjunctive peer support on

perceptions of illness control and understanding in an online psychoeducation

program for bipolar disorder: a randomised controlled trial. Journal of

affective disorders, 142(1), 98-105.

Ralph, B., Thomson, D., Cheyne, J., & Smilek, D. (2014). Media multitasking and

failures of attention in everyday life. Psychological research, 78(5), 661-669.

Ramezankhani, A., Gharlipour, Z., Heydarabadi, A., Tavassoli, E., Motalebi, M.,

Barekati, H., . . . Moosavi, S. (2013). Perceived social support, depression, and

perceived stress in university students. Journal of Paramedical Sciences, 4(4),

Perceived social support, depression, and perceived stress in university

students.

Ramler, T., Tennison, L., Lynch, J., & Murphy, P. (2015). Mindfulness and the

college transition: The efficacy of an adapted mindfulness-based stress

reduction intervention in fostering adjustment among first-year students.

Mindfulness, 7(1), 1-10.


Regehr, C., Glancy, D., & Pitts, A. (2013). Interventions to reduce stress in university

students: A review and meta-analysis. Journal of affective disorders, 148(1),

1-11.

Richards, J., & Gross, J. (1999). Composure at any cost? The cognitive consequences

of emotion suppression. Personality and Social Psychology Bulletin, 25(8),

1033-1044.

Richards, J., & Gross, J. (2000). Emotion regulation and memory: the cognitive costs

of keeping one's cool. Journal of personality and social psychology, 79(3),

410-424.

Riemann, D., Berger, M., & Voderholzer, U. (2001). Sleep and depression—results

from psychobiological studies: an overview. Biological psychology, 57(1), 67-

103.

Riley, B. (2014). Experiential avoidance mediates the association between thought

suppression and mindfulness with problem gambling. Journal of Gambling

Studies, 30(1), 163-171.

Rodriguez Vega, B., Melero-Llorente, J., Bayon Perez, C., Cebolla, S., Mira, J. V., &

Fernández-Liria, A. (2014). Impact of mindfulness training on attentional

control and anger regulation processes for psychotherapists in training.

Psychotherapy Research, 24(2), 202-213.

Rosen, L., Carrier, L., & Cheever, N. (2013). Facebook and texting made me do it:

Media-induced task-switching while studying. Computers in Human Behavior,

29(3), 948-958.

Rosen, L., Lim, A., Carrier, L., & Cheever, N. (2011). An empirical examination of

the educational impact of text message-induced task switching in the


classroom: Educational implications and strategies to enhance learning.

Psicología educativa, 17(2), 163-177.

Ryff, C., & Keyes, C. (1995). The structure of psychological well-being revisited.

Journal of personality and social psychology, 69(4), 719–727.

Salvucci, D., Taatgen, N., & Borst, J. (2009). Toward a unified theory of the

multitasking continuum: From concurrent performance to task switching,

interruption, and resumption. Proceedings of the SIGCHI conference on

human factors in computing systems (pp. 1819-1828). ACM.

Samkoff, J., & Jacques, C. (1991). A review of studies concerning effects of sleep

deprivation and fatigue on residents' performance. Academic Medicine,

66(11), 687-693.

Sana, F., Weston, T., & Cepeda, N. (2013). Laptop multitasking hinders classroom

learning for both users and nearby peers. Computers & Education, 62, 24-31.

Sanbonmatsu, D., Strayer, D., Medeiros-Ward, N., & Watson, J. (2013). Who multi-

tasks and why? Multi-tasking ability, perceived multi-tasking ability,

impulsivity, and sensation seeking. PloS one, 8(1), e54402.

Sandru, C., & Voinescu, B. (2014). The relationship between emotion regulation,

dysfunctional beliefs about sleep and sleep quality-an exploratory study.

Journal of Evidence-Based Psychotherapies, 14(2), 249-257.

Schacter, D., Gilbert, D., & Wegner, D. (2011). B. F. Skinner: The role of

reinforcement and Punishment. In Psychology; Second Edition (pp. 278-288).

New York: Worth, Incorporated.

Schwartz, C., & Sendor, R. (1999). Helping others helps oneself: response shift

effects in peer support. Social science & medicine, 48(11), 1563-1575.


Sears, S., & Kraus, S. (2009). I think therefore I om: Cognitive distortions and coping

style as mediators for the effects of mindfulness meditation on anxiety,

positive and negative affect, and hope. Journal of clinical psychology, 65(6),

561-573.

Segal, Z., Williams, J., & Teasdale, J. (2002). Mindfulness-based cognitive therapy

for depression. New York, NY: Guilford Press.

Seixas, A., Nunes, J., Airhihenbuwa, C., Williams, N., Pandi-Perumal, S., James, C.,

& Jean-Louis, G. (2015). Linking emotional distress to unhealthy sleep

duration: analysis of the 2009 National Health Interview Survey.

Neuropsychiatric disease and treatment, 11, 2425–2430.

Shapiro, S., & Schwartz, G. (2000a). Intentional systemic mindfulness: an integrative

model for self-regulation and health. Advances in mind-body medicine., 16(2),

128-134.

Shapiro, S., & Schwartz, G. (2000b). The role of intention in self-regulation: Toward

intentional systemic mindfulness. In M. Boekaerts, P. Pintrich, & M. Zeidner,

Handbook of self-regulation. (pp. 253-273). San Diego, CA, US: Academic

Press.

Shapiro, S., Schwartz, G., & Bonner, G. (1998). Effects of mindfulness-based stress

reduction on medical and premedical students. Journal of behavioral

medicine, 21(6), 581-599.

Sharplin, G., Jones, S., Hancock, B., Knott, V., Bowden, J., & Whitford, H. (2010).

Mindfulness-based cognitive therapy: an efficacious community-based group

intervention for depression and anxiety in a sample of cancer patients. Medical

Journal of Australia, 193(5), S79-S82.


Sheppes, G., Suri, G., & Gross, J. (2015). Emotion regulation and psychopathology.

Annual review of clinical psychology, 11, 379-405.

Siegling, A., & Petrides, K. (2013). Measures of trait mindfulness: Convergent

validity, shared dimensionality, and linkages to the five-factor model.

Frontiers in psychology, 5, 1164-1164.

Silva, R., Abilio, V., Takatsu, A., Kameda, S., Grassl, C., Chehin, A., . . . Tufik, S. F.-

F. (2004). Role of hippocampal oxidative stress in memory deficits induced by

sleep deprivation in mice. Neuropharmacology, 46(6), 895-903.

Skinner, B. (1938). The behavior of organisms: an experimental analysis. New York:

Appleton Century Crofts.

Smith, C. (1995). Sleep states and memory processes. Behavioural brain research,

69(1), 137-145.

Song, Y., & Lindquist, R. (2015). Effects of mindfulness-based stress reduction on

depression, anxiety, stress and mindfulness in Korean nursing students. Nurse

education today, 35(1), 86-90.

Strayer, D., & Watson, J. (2012). Supertaskers and the multitasking brain. Scientific

American Mind, 23(1), 22-29.

Stroop, J. (1935). Studies of interference in serial verbal reactions. Journal of

experimental psychology, 18(6), 643-662.

Süer, C., Dolu, N., Artis, A., Sahin, L., Yilmaz, A., & Cetin, A. (2011). The effects of

long-term sleep deprivation on the long-term potentiation in the dentate gyrus

and brain oxidation status in rats. Neuroscience research, 70(1), 71-77.

Sundem, G. (2012, February 24). This is Your Brain on Multitasking: Brains of

multitaskers are structurally different than brains of monotaskers. Retrieved

from Psychology Today (Brain Trust):


https://www.psychologytoday.com/blog/brain-trust/201202/is-your-brain-

multitasking

Tacón, A., McComb, J., Caldera, Y., & Randolph, P. (2003). Mindfulness meditation,

anxiety reduction, and heart disease: a pilot study. Family & community

health, 26(1), 25-33.

Talbot, L., McGlinchey, E., Kaplan, K., Dahl, R., & Harvey, A. (2010). Sleep

deprivation in adolescents and adults: changes in affect. Emotion, 10(6), 831.

Tamagawa, R., Giese‐Davis, J., Speca, M., Doll, R., Stephen, J., & Carlson, L.

(2013). Trait mindfulness, repression, suppression, and self‐reported mood and

stress symptoms among women with breast cancer. Journal of clinical

psychology, 69(3), 264-277.

Thomas, M., Sing, H., Belenky, G., Holcomb, H., Mayberg, H., Dannals, R., . . .

Redmond, D. (2003). Neural basis of alertness and cognitive performance

impairments during sleepiness II. Effects of 48 and 72 h of sleep deprivation

on waking human regional brain activity. Thalamus & Related Systems, 2(3),

199-229.

Torterolo, P., Scorza, C., Lagos, P., Urbanavicius, J., Benedetto, L., Pascovich, C., . . .

Monti, J. (2015). Melanin-concentrating hormone (MCH): role in REM sleep

and depression. Frontiers in neuroscience, 9, 475.

Trockel, M., Barnes, M., & Egget, D. (2000). Health-related variables and academic

performance among first-year college students: implications for sleep and

other behaviors. Journal of American college health, 49(3), 125-131.

Tsuno, N., Besset, A., & Ritchie, K. (2005). Sleep and depression. Journal of Clinical

Psychiatry, 66(10), 1254-1269.


Turner, K. (2014). Mindfulness Skills Training: A Pilot Study of Changes in

Mindfulness, Emotion Regulation, and Self-Perception of Aging in Older

Participants. Activities, Adaptation & Aging, 38(2), 156-167.

van Mill, J., Vogelzangs, N., van Someren, E., Hoogendijk, W., & Penninx, B.

(2013). Sleep duration, but not insomnia, predicts the 2-year course of

depressive and anxiety disorders. The Journal of clinical psychiatry, 75(2),

119-126.

Vandekerckhove, M., Kestemont, J., Weiss, R., Schotte, C., Exadaktylos, V., Haex,

B., . . . Gross, J. (2012). Experiential versus analytical emotion regulation and

sleep: Breaking the link between negative events and sleep disturbance.

Emotion, 12(6), 1415-1421.

Vanderhasselt, M., Baeken, C., Van Schuerbeek, P., Luypaert, R., & De Raedt, R.

(2013). Inter-individual differences in the habitual use of cognitive reappraisal

and expressive suppression are associated with variations in prefrontal

cognitive control for emotional information: an event related fMRI study.

Biological psychology, 92(3), 433-439.

Verger, P., Guagliardo, V., Gilbert, F., Rouillon, F., & Kovess-Masfety, V. (2010).

Psychiatric disorders in students in six French universities: 12-month

prevalence, comorbidity, impairment and help-seeking. Social psychiatry and

psychiatric epidemiology, 45(2), 189-199.

Vickery, C., & Dorjee, D. (2015). Mindfulness Training in Primary Schools

Decreases Negative Affect and Increases Meta-Cognition in Children.

Frontiers in Psychology, 6(603), 2025.

Vinci, C., Peltier, M., Shah, S., Kinsaul, J., Waldo, K., McVay, M., & Copeland, A.

(2014). Effects of a brief mindfulness intervention on negative affect and urge


to drink among college student drinkers. Behaviour research and therapy, 59,

82-93.

Wang, G., Grone, B., Colas, D., Appelbaum, L., & Mourrain, P. (2011). Synaptic

plasticity in sleep: learning, homeostasis and disease. Trends in neurosciences,

34(9), 452-463.

Wang, Y., & Yang, L. (2014). Suppression (but Not Reappraisal) Impairs subsequent

error detection: An ERP study of emotion regulation's resource-depleting

effect. PloS one, 9(4), e96339.

Wang, Z., & Tchernev, J. (2012). The “myth” of media multitasking: Reciprocal

dynamics of media multitasking, personal needs, and gratifications. Journal of

Communication, 62(3), 493-513.

Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation of brief

measures of positive and negative affect: the PANAS scales. Journal of

personality and social psychology, 54(6), 1063-1070.

Watson, J., & Strayer, D. (2010). Supertaskers: Profiles in extraordinary multitasking

ability. Psychonomic bulletin & review, 17(4), 479-485.

Wickrama, K., O’Neal, C., & Lott, R. (2012). Early community contexts,

race/ethnicity and young adult CVD risk factors: the protective role of

education. Journal of community health, 37(4), 781-790.

Williams, H., & Lubin, A. (1967). Speeded addition and sleep loss. Journal of

Experimental Psychology, 73(2), 313-317.

Wolfson, A., & Carskadon, M. (2003). Understanding adolescent's sleep patterns and

school performance: a critical appraisal. Sleep medicine reviews, 7(6), 491-

506.


Worringer, B., Langner, R., Koch, I., Eickhoff, S., Rottschy, C., & Binkofski, F.

(2015). Investigating Neural Correlates of Dual-Tasking and Task-Switching:

A Meta-Analytic Approach. Conference Abstract: XII International

Conference on Cognitive Neuroscience (ICON-XII). Frontiers of Human

Neuroscience. doi:10.3389/conf.fnhum.2015.217.00033

Yahoo! Newsroom. (2013, April 24). NUS scholar found dead in UTown campus.

Retrieved from Yahoo! News: https://sg.news.yahoo.com/nus-scholar-found-

dead-in-utown-campus-185329134.html

Yuan, J., Liu, Y., Ding, N., & Yang, J. (2014). The regulation of induced depression

during a frustrating situation: Benefits of expressive suppression in Chinese

individuals. PloS one, 9(5), e97420.

Yuan, J., Long, Q., Ding, N., Lou, Y., Liu, Y., & Yang, J. (2015). Suppression

dampens unpleasant emotion faster than reappraisal: Neural dynamics in a

Chinese sample. Science China Life Sciences, 58(5), 480-491.

Zeidan, F., Martucci, K., Kraft, R., Gordon, N., McHaffie, J., & Coghill, R. (2011).

Brain mechanisms supporting the modulation of pain by mindfulness

meditation. The Journal of Neuroscience, 31(14), 5540-5548.

Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2013). Mindfulness-based

interventions in schools-a systematic review and meta-analysis. Frontiers in

psychology, 5, 603-603.

Zhai, L., Zhang, H., & Zhang, D. (2015). Sleep duration and depression among adults:

a meta-analysis of prospective studies. Depression and anxiety, 32(9), 664-

670.

Zhang, W. (2015). Learning variables, in-class laptop multitasking and academic

performance: A path analysis. Computers & Education, 81, 82-88.


Appendices

Appendix A: Participation Information Sheet



Appendix B: Consent Form


Appendix C: Positive and Negative Affect Schedule (PANAS)

(Watson, Clark, & Tellegen, 1988)

This scale consists of a number of words that describe different feelings and emotions. Read each item and then select the number from

the scale below next to each word. Indicate to what extent you have felt this way over the past week.

1

Very Slightly or

Not at All

2

A Little

3

Moderately

4

Quite a Bit

5

Extremely

1) Interested ○ ○ ○ ○ ○ 2) Distressed ○ ○ ○ ○ ○

3) Excited ○ ○ ○ ○ ○

4) Upset ○ ○ ○ ○ ○

5) Strong ○ ○ ○ ○ ○

6) Guilty ○ ○ ○ ○ ○

7) Scared ○ ○ ○ ○ ○

8) Hostile ○ ○ ○ ○ ○

9) Enthusiastic ○ ○ ○ ○ ○

10) Proud ○ ○ ○ ○ ○


1

Very Slightly or

Not at All

2

A Little

3

Moderately

4

Quite a Bit

5

Extremely

11) Irritable ○ ○ ○ ○ ○ 12) Alert ○ ○ ○ ○ ○

13) Ashamed ○ ○ ○ ○ ○

14) Inspired ○ ○ ○ ○ ○

15) Nervous ○ ○ ○ ○ ○

16) Determined ○ ○ ○ ○ ○

17) Attentive ○ ○ ○ ○ ○

18) Jittery ○ ○ ○ ○ ○

19) Active ○ ○ ○ ○ ○

20) Afraid ○ ○ ○ ○ ○

Scoring Instructions:

Positive Affect Score: Add the scores on items 1, 3, 5, 9, 10, 12, 14, 16, 17, and 19. Scores can range from 10 – 50, with higher scores

representing higher levels of positive affect.

Negative Affect Score: Add the scores on items 2, 4, 6, 7, 8, 11, 13, 15, 18, and 20. Scores can range from 10 – 50, with lower scores

representing lower levels of negative affect.


Appendix D: Emotion Regulation Questionnaire (ERQ)

(Gross & John, 2003)

We would like to ask you some questions about your emotional life, in particular, how you control (that is, regulate and manage) your

emotions. The questions below involve two distinct aspects of your emotional life.

One is your emotional experience, or what you feel like inside.

The other is your emotional expression, or how you show your emotions in the way you talk, gesture, or behave.

Although some of the following questions may seem similar to one another, they differ in important ways. For each item, please answer

using the following scale:

1

Strongly

Disagree

2

3

4

Neutral

5

6 7

Strongly

Agree

1) When I want to feel more positive emotion (such as

joy or amusement), I change what I’m thinking about. ○ ○ ○ ○ ○ ○ ○

2) I keep my emotions to myself. ○ ○ ○ ○ ○ ○ ○

3) When I want to feel less negative emotion (such as

sadness or anger), I change what I’m thinking about. ○ ○ ○ ○ ○ ○ ○

4) When I am feeling positive emotions, I am careful not

to express them. ○ ○ ○ ○ ○ ○ ○


1

Strongly

Disagree

2

3

4

Neutral

5

6

7

Strongly

Agree

5) When I’m faced with a stressful situation, I make

myself think about it in a way that helps me stay calm. ○ ○ ○ ○ ○ ○ ○

6) I control my emotions by not expressing them. ○ ○ ○ ○ ○ ○ ○

7) When I want to feel more positive emotion, I change

the way I’m thinking about the situation. ○ ○ ○ ○ ○ ○ ○

8) I control my emotions by changing the way I think

about the situation I’m in. ○ ○ ○ ○ ○ ○ ○

9) When I am feeling negative emotions, I make sure not

to express them. ○ ○ ○ ○ ○ ○ ○

10) When I want to feel less negative emotion, I change

the way I’m thinking about the situation. ○ ○ ○ ○ ○ ○ ○

Scoring (no reversals):

Reappraisal Items: 1, 3, 5, 7, 8, 10

Suppression Items: 2, 4, 6, 9.


Appendix E: Depression Anxiety Stress Scales - 21 (DASS-21)

(Lovibond & Lovibond, 1995)

Please read each statement and select a number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past week.

There are no right or wrong answers. Do not spend too much time on any statement.

0

Did not

apply

to me at

all

1

Applied to me

to some degree,

or some of the

time

2

Applied to me to

a considerable

degree, or a good

part of time

3

Applied to me

very much, or

most of the

time

1) I found it hard to wind down ○ ○ ○ ○

2) I was aware of dryness of my mouth ○ ○ ○ ○

3) I couldn't seem to experience any positive feeling at all ○ ○ ○ ○

4) I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion)

○ ○ ○ ○

5) I found it difficult to work up the initiative to do things ○ ○ ○ ○

6) I tended to over-react to situations ○ ○ ○ ○

7) I experienced trembling (eg, in the hands) ○ ○ ○ ○

8) I felt that I was using a lot of nervous energy ○ ○ ○ ○


0

Did not

apply

to me at

all

1

Applied to me

to some degree,

or some of the

time

2

Applied to me to

a considerable

degree, or a good

part of time

3

Applied to me

very much, or

most of the

time

9) I was worried about situations in which I might panic and make a fool of myself

○ ○ ○ ○

10) I felt that I had nothing to look forward to ○ ○ ○ ○

11) I found myself getting agitated ○ ○ ○ ○

12) I found it difficult to relax ○ ○ ○ ○

13) I felt down-hearted and blue ○ ○ ○ ○

14) I was intolerant of anything that kept me from getting on with what I was doing

○ ○ ○ ○

15) I felt I was close to panic ○ ○ ○ ○

16) I was unable to become enthusiastic about anything ○ ○ ○ ○

17) I felt I wasn't worth much as a person ○ ○ ○ ○

18) I felt that I was rather touchy ○ ○ ○ ○

19) I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat)

○ ○ ○ ○


0

Did not

apply

to me at

all

1

Applied to me

to some degree,

or some of the

time

2

Applied to me to

a considerable

degree, or a good

part of time

3

Applied to me

very much, or

most of the

time

20) I felt scared without any good reason ○ ○ ○ ○

21) I felt that life was meaningless ○ ○ ○ ○

Scoring Instructions:

Depression: Add the scores on items 2, 4, 7, 9, 15, 19, 20; and multiply the sum by 2. Scores can range from 0 – 42, with higher scores

representing higher levels of depression.

Anxiety: Add the scores on items 3, 5, 10, 13, 16, 17, 21; and multiply the sum by 2. Scores can range from 0 – 42, with lower scores

representing lower levels of anxiety.

Stress: Add the scores on items 1, 6, 8, 11, 12, 14, 18; and multiply the sum by 2. Scores can range from 0 – 42, with higher scores representing

higher levels of stress.


Appendix F: Cognitive and Affective Mindfulness Scale - Revised (CAMS-R)

(Feldman, Hayes, Kumar, Greeson, & Laurenceau, 2007)

This scale consists of a number of words that describe different feelings and emotions. Read each item and then select the number from

the scale below next to each word. Indicate to what extent you have felt this way over the past week.

1

Rarely/Not at All

2

Sometimes

3

Often

4

Almost Always

1) It is easy for me to concentrate on what I

am doing. ○ ○ ○ ○

2) I can tolerate emotional pain. ○ ○ ○ ○

3) I can accept things I cannot change. ○ ○ ○ ○

4) I can usually describe how I feel at the

moment in considerable detail. ○ ○ ○ ○

5) I am easily distracted. (R) ○ ○ ○ ○

6) It’s easy for me to keep track of my

thoughts and feelings. ○ ○ ○ ○

7) I try to notice my thoughts without

judging them. ○ ○ ○ ○

8) I am able to accept the thoughts and

feeling I have. ○ ○ ○ ○


1

Rarely/Not at All

2

Sometimes

3

Often

4

Almost Always

9) I am able to focus on the present moment. ○ ○ ○ ○

10) I am able to pay close attention to one

thing for a long time. ○ ○ ○ ○

Scoring instructions:

Item 5 is reverse scored.

Sum of all scores reflect extent of mindful qualities.


Appendix G: Mindful Lifestyle Habits Questionnaire

Knowledge check (pre-test only).

1. Do you know what mindfulness is?

a. Yes

b. No

2. What is mindfulness?

Habits.

3. Do you practice mindfulness? (meditation is considered mindfulness practice)

a. Yes

b. No

If yes, carry on to question 4, if no, end of questionnaire.

4. Currently, how many days a week do you practice mindfulness?

a. 1 e. 5

b. 2 f. 6

c. 3 g. 7

d. 4

5. During the day(s) you practice mindfulness, what is the average duration (mins) of

your practice?

mins

6. What are the main mindful practices that you have?

a. Breathing d. Eating

b. Meditation e. Others: _______________________

c. Yoga


Appendix H: Pittsburgh Sleep Quality Index (PSQI)

(Buysse, Reynolds, Monk, Berman, & Kupfer, 1989)

1. During the past week, what time have you usually gone to bed at night?

BED TIME (0000 – 2359)

2. During the past week, how long (in minutes) has it usually taken you to fall asleep

each night?

NUMBER OF MINUTES

3. During the past week, what time have you usually gotten up in the morning?

GETTING UP TIME (0000 – 2359)

4. During the past week, how many hours of actual sleep did you get at night? (This

may be different than the number of hours you spent in bed.)

HOURS OF SLEEP PER NIGHT (0000 – 2359)

5. During the past week, how often have you had trouble sleeping because you . . .

0

Not

during

the past

week

1

Less

than

once

2

Once or

twice

3

Three

or more

times

a) Cannot get to sleep within 30

minutes ○ ○ ○ ○

b) Wake up in the middle of the

night or early morning ○ ○ ○ ○

c) Have to get up to use the

bathroom ○ ○ ○ ○

d) Cannot breathe comfortably ○ ○ ○ ○

e) Cough or snore loudly ○ ○ ○ ○

f) Feel too cold ○ ○ ○ ○

g) Feel too hot ○ ○ ○ ○

h) Had bad dreams ○ ○ ○ ○

i) Have pain ○ ○ ○ ○


0

Not

during

the past

week

1

Less

than

once

2

Once or

twice

3

Three

or more

times

j) Other reason(s), please

describe

__________________________________

How often during the past

month have you had trouble

sleeping because of this?

○ ○ ○ ○

6. During the past month, how would you rate your sleep quality overall?

0

Very good

1

Fairly good

2

Fairly bad

3

Very Bad

○ ○ ○ ○

7. During the past month, how often have you taken medicine to help you sleep

(prescribed or "over the counter")?

0

Not during the

past week

1

Less than

once

2

Once or

twice

3

Three or

more times

○ ○ ○ ○

8. During the past month, how often have you had trouble staying awake while

driving, eating meals, or engaging in social activity?

0

Not during the

past week

1

Less than

once

2

Once or

twice

3

Three or

more times

○ ○ ○ ○

9. During the past month, how much of a problem has it been for you to keep up

enough enthusiasm to get things done?

0

No problem at

all

1

Only a very

slight

problem

2

Somewhat

of a

problem

3

A very big

problem

○ ○ ○ ○


Scoring:

For each question / subscale, minimum score = 0 (better); maximum score = 3

(worse).

Duration of sleep (PSQIDURAT).

IF Q4 ≥ 7, THEN set value to 0.

IF Q4 < 7 and ≥ 6, THEN set value to 1.

IF Q4 < 6 and ≥ 5, THEN set value to 2.

IF Q4 < 5, THEN set value to 3.

Sleep disturbance (PSQIDISTB).

Sum of Q5b to Q5j. If no response for Q5j, set value of Q5j to 0.

IF sum = 0, THEN set value to 0.

IF sum ≥ 1 and ≤ 9, THEN set value to 1.

IF sum > 9 and ≤ 18, THEN set value to 2.

IF sum > 18, THEN set value to 3.

Sleep latency (PSQILATENT).

Firstly, recode Q2 into Q2new as follows:

IF Q2 ≥ 0 and ≤ 15, THEN set value to 0.

IF Q2 > 15 and ≤ 30, THEN set value to 1.

IF Q2 > 30 and ≤ 60, THEN set value to 2.

IF Q2 > 60, THEN set value to 3.

Next, sum Q5a and Q2new:

IF Q5a + Q2new = 0, THEN set value to 0.

IF Q5a + Q2new ≥ 1 and ≤ 2, THEN set value to 1.




Day dysfunction due to sleepiness (PSQIDAYDYS).

IF Q8 + Q9 = 0, THEN set value to 0.

IF Q8 + Q9 ≥ 1 and ≤ 2, THEN set value to 1.



Sleep efficiency (PSQIHSE).

newtib = number of hours (ratio to the seconds) between Q1 and Q3, BED

TIME and GETTING UP TIME.

tmphse = (Q4 / newtib) * 100

IF tmphse ≤ 85, THEN set value to 0.

IF tmphse < 85 and ≥ 75, THEN set value to 1.

IF tmphse < 75 and ≥ 65, THEN set value to 2.

IF tmphse < 65, THEN set value to 3.

Overall sleep quality (PSQISLPQUAL).

Q6, actual value 0 – 3.

Need medication to sleep (PSQIMEDS).

Q7, actual value 0 – 3.

PSQI total.

PSQIDURAT + PSQIDISTB + PSQILATEN + PSQIDAYDYS + PSQIHSE +

PSQISLPQUAL + PSQIMEDS = PSQI total score

PSQI ≤ 5 associated with good sleep quality.

PSQI > 5 associated with poor sleep quality.


Appendix I: Media Multitasking Index (MMI)

(Ophir, Nass, & Wagner, 2009)

Kindly record the number of hours you spent the past week on the following

mediums (hi):

1. Print media __________ hours

(reading, like newspapers, digital texts etc.)

2. Television __________ hours

3. Computer-/device-based video __________ hours

(YouTube, online television episodes etc.)

4. Music __________ hours

5. Video/computer/mobile games __________ hours

6. Telephone/mobile phone/internet calls __________ hours

(SMS, WhatsApp, WeChat, Line, Facebook chat, Google chat, QQ, IRC, etc.)

7. Text/instant messaging __________ hours

8. Email __________ hours

9. Web surfing/social media browsing __________ hours

(Facebook, Instagram, Reddit, 9gag, Pinterest etc.)

10. Other computer-based applications __________ hours

(Word, PowerPoint, Excel, Photoshop etc.)


Please indicate how often you concurrently use the following media concurrently with

Print media (reading, like newspapers, digital texts etc.):

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never

Television ○ ○ ○ ○

Computer-based video (YouTube, online television episodes etc.) ○ ○ ○ ○

Music ○ ○ ○ ○

Video / Computer / Mobile games ○ ○ ○ ○

Telephone / Mobile phone voice calls ○ ○ ○ ○

Text / Instant messaging (SMS, WhatsApp, WeChat, Line, Facebook

chat, Google chat, QQ, IRC, etc.) ○ ○ ○ ○

Email ○ ○ ○ ○

Web surfing / Social Media browsing (Facebook, Instagram, Reddit, 9gag,

Pinterest etc.) ○ ○ ○ ○

Other computer-based applications (Word, PowerPoint, Excel, Photoshop etc.) ○ ○ ○ ○



Television:

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never

Computer-based video (YouTube, online television episodes etc.) ○ ○ ○ ○

Music ○ ○ ○ ○





Email ○ ○ ○ ○






Computer-based video (YouTube, online television episodes etc.):

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never

Music ○ ○ ○ ○





Email ○ ○ ○ ○





Music:

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never





Email ○ ○ ○ ○






Video / Computer games:

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never




Email ○ ○ ○ ○





Telephone / Mobile phone voice calls:

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never



Email ○ ○ ○ ○






Text / Instant messaging (SMS, WhatsApp, WeChat, Line, Facebook chat,

Google chat, QQ, IRC, etc.):

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never

Email ○ ○ ○ ○





Email:

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never






Pinterest etc.):

1

Most of

the time

0.67

Some of

the time

0.33

A little of

the time

0

Never



Scoring:

hi: total number of hours in the past week for each media form.

htotal: total number of hours in the past week across all 10 media forms.

mi: mean number of 9 other media used while engaging in medium in question

= sum of scores of the 9 other media while engaging in the medium in question.

MMI = ∑𝑚𝑖 × ℎ𝑖

ℎ𝑡𝑜𝑡𝑎𝑙

10

𝑖=1


Appendix J: Stroop Test Stimuli

(Stroop, 1935) http://www.psytoolkit.org/experiment-library/stroop.html

Instructions.

http://www.psytoolkit.org/experiment-library/stroop.html


Word stimuli.

White fixation cross.


Accuracy feedback.


Appendix K: Psychoeducation Materials

Holistic Strategies for Effective Students; Mindfulness, Mind Wandering, Multitasking & Sleep (begins on the next page).

The following contains the low resolution version due to space constraints. For a higher resolution, kindly visit the following link:

Holistic Strategies for Effective Students; Mindfulness, Mind Wandering, Multitasking & Sleep

http://www.slideshare.net/HansChung1/holistic-strategies-for-effective-students-mindfulness-mind-wandering-multitasking-sleep

























Appendix L: 10-Day Challenge Worksheet

(Begins on the next page)



Appendix M: Psychoeducation Test

Correct options are bolded.

7. How often does our mind wander?

a. 19% of the time c. 58.6% of the time

b. 46.9% of the time d. 10% of the time

8. How is mind wandering related to happiness?

a. Even if I have happy thoughts while mind wandering, I will be unhappier

in the long run.

b. Mind wandering helps to improve happiness as it relieves stress.

c. Mind wandering will make people unhappy as they are wasting time.

d. Mind wandering improves happiness as it triggers our creative aspect.

9. Mind wandering and depression are related through the process of

a. Rumination. c. Lack of sensitivity to the

environment.

b. Creativity leading to reduced

depressive symptoms.

d. None of the above.

10. Using electronic devices before sleeping will cause me to take longer to fall

asleep.

a. True b. False


11. Why is it so?

Light suppresses melatonin which regulates sleep / tells your body it’s not time to

sleep yet.

Answers must demonstrate knowledge of the causation (light – 0.5 marks),

mechanism (hormones / melatonin – 0.5 marks) and effect (sleep regulation /

not time to sleep / or any reasonable variation of this).

12. List 3 ways that you can get a better night’s sleep:

1 mark for each correct answer up to a maximum 3 marks:

“Not worrying about getting

insufficient sleep.”

“Following a routine to “tell” my body it

is time to fall asleep.”

“Practicing mindfulness.” “Worrying more about not getting

enough sleep.” “Darkening my bedroom.”

“Avoiding exercise before bed time”

Or any other reasonable changes to behaviour or environment in service of

better sleep.

13. People are generally good at multitasking.

a. True b. False

14. If I multitask, I can do tasks more efficiently and better

a. True b. False


15. Name 3 problems associated with multitasking:


“Feel more stress.” “Unable to apply what I have learnt.”

“Less creative.” “Finish my work slower.”

“Produce worse work.” “May get significantly lower test

results.”

Or any other reasonable problems.

16. What is mindfulness?

“Awareness that arises through paying attention, on purpose, in the present

moment, non-judgementally.”

Answers must demonstrate knowledge of the mechanism (attention / paying

attention / awareness / or any reasonable variation of this – 0.5 marks),

temporality (moment-to-moment / in the moment / immediate experience / or

any reasonable variation of this – 0.5 marks) and attitudes (any one of the 7

attitudes).


17. Name 3 attitudes of mindfulness:


“Non-judging.” “Non-striving.”

“Patience.” “Acceptance.”

“Beginner’s mind.” “Letting go.”

“Trust.”

18. Name 3 benefits of mindfulness:


“Less stress.” “Increased empathy.”

“Improve relationships.” “Rational decision making.”

“Positive emotions.” “Reduce mind wandering.”

“Memory improvements.” “Immune system boost.”

“Grey matter increases.” “Reduce pain.”

Or any other reasonable variations.


Appendix N: Program Evaluation (Psychoeducation and Practice Conditions

Only)

1. Answer this question honestly. Did you read all of the material in the book

provided at the beginning of the study?

1

Not at all

2

Less than half of it

3

More than half of it

4

Yes, all of it

○ ○ ○ ○

2. Answer this question honestly. How useful did you find the daily reminders in

helping you achieve the desired habits? (Practice condition only.)

1

Not at all

useful

2

Not

useful

3

Slightly

not useful

4

No

difference

5

Slightly

useful

6

Useful

7

Very

useful

○ ○ ○ ○ ○ ○ ○

3. Comparing right now to just before this program (11 days ago), how much did

your workload change?

1

Much

less than

before

2

Less than

before

3

Slightly

less than

before

4

The same

as before

5

Slightly

more than

before

6

More

than

before

7

Much

more than

before

○ ○ ○ ○ ○ ○ ○

4. Over the past 10 days, how much sleep did you get?

1

Much

less than

usual

2

Less than

usual

3

Slightly

less than

usual

4

The same

as usual

5

Slightly

more than

usual

6

More

than

usual

7

Much

more than

usual

○ ○ ○ ○ ○ ○ ○

If Q4 ≤ 4, proceed to Q5, if Q4 > 4, proceed to Q6.


5. Do you feel you need to make changes to improve your sleep habits (for the

better)?

1

I do not

need to

change

2

3

4

5

6

7

I intend

to change

○ ○ ○ ○ ○ ○ ○

6. Do you plan to maintain the changes you have made in your sleep habits?

Yes No

○ ○

7. Over the past 10 days, how much did you multitask (less is better)?

7

Much

less than

usual

6

Less than

usual

5

Slightly

less than

usual

4

The same

as usual

3

Slightly

more than

usual

2

More

than

usual

1

Much

more than

usual

○ ○ ○ ○ ○ ○ ○

Scoring here reflects reversed scores.

If Q7 ≥ 4, proceed to Q8, if Q7 < 4, proceed to Q9.

8. Do you feel you need to make changes to improve your multitasking habits (for

the better)?

1

I do not

need to

change

2

3

4

5

6

7

I intend

to change

○ ○ ○ ○ ○ ○ ○


9. Do you plan to maintain the changes you have made in your multitasking habits?

Yes No

○ ○

10. Over the past 10 days, how much mindfulness practice did you get?

1

Much

less than

usual

2

Less than

usual

3

Slightly

less than

usual

4

The same

as usual

5

Slightly

more than

usual

6

More

than

usual

7

Much

more than

usual

○ ○ ○ ○ ○ ○ ○

If Q10 ≤ 4, proceed to Q11, if Q10 > 4, proceed to Q12.

11. Do you feel you need to make changes to improve your mindfulness habits (for

the better)?

1

I do not

need to

change

2

3

4

5

6

7

I intend

to change

○ ○ ○ ○ ○ ○ ○

12. Do you plan to maintain the changes you have made in your mindfulness habits?

Yes No

○ ○

13. Over the past 10 days, how has your mood changed?

1

Much

worse

2

Worse

3

Slightly

worse

4

The same

5

Slightly

better

6

Better

7

Much

better

○ ○ ○ ○ ○ ○ ○


14. Over the past 10 days, how has your cognitive functioning changed?

1

Much

worse

2

Worse

3

Slightly

worse

4

The same

5

Slightly

better

6

Better

7

Much

better

○ ○ ○ ○ ○ ○ ○

15. Over the past 10 days, how has your mindfulness / awareness changed?

1

Much

worse

2

Worse

3

Slightly

worse

4

The same

5

Slightly

better

6

Better

7

Much

better

○ ○ ○ ○ ○ ○ ○

16. Over the past 10 days, how do you feel the program has benefitted you overall?

1

I am truly

worse off

2

I am

worse off

3

I am

slightly

worse off

4

I am the

same

5

I have

benefitted

slightly

6

I have

benefitted

7

I have

benefitted

a lot

○ ○ ○ ○ ○ ○ ○

17. Do you believe that the strategies provided will change your life for the better?

Yes No

○ ○

18. What were some challenges with regards to changing your sleep habits?

19. What were some challenges with regards to changing your multitasking habits?


20. What were some challenges with regards to changing your mindfulness habits?

21. Suggestions for improvement:


Appendix O: Schedule of Text Reminders

Day 1 (Psychoeducation condition).

Hi name,

Thank you for taking the time today to go through the Psychoeducation

Module. You are strongly encouraged to put into practice the various strategies you

have learnt.

Over the next 10 days, starting today, do try and ensure you minimize your

multitasking, get at least 8 hours of sleep and also just engage in just 10 minutes of

mindful meditation every day! (Instructions in book.)

I wish you the best of luck on your journey!

Sincerely yours,

Hans Chung

Day 1 (Practice condition).

Hi name,

Welcome to Day 1 of your 10 Day Challenge!

Thank you for taking the time today to go through the Psychoeducation

Module.

Over the next 10 days, starting today, you are strongly encouraged to put into

practice the various strategies you have learnt.

Do try and ensure you minimize your multitasking, get at least 8 hours of

sleep and also just engage in just 10 minutes of mindful meditation every day! (The

Headspace app will guide you along in your meditation practice)

I wish you the best of luck on your journey!

Sincerely yours,

Hans Chung



Hi name,


As you go about your day, be mindful of your body and feelings. Remember,

it is not about judging them, but just being aware that they are there. It would be good

to minimize your multitasking and to engage in a simple 10 minute mindful

meditation to boost your day.

Sincerely yours,

Hans Chung


Hi name,


I hope you got a good night’s rest. While you are going about your tasks

today, be mindful of what you are doing. If you notice yourself multitasking, it might

be useful to take a step back and ask yourself, is that really helping?

Maybe taking a step back to reorganize and redirect your efforts and attention

can help you be more effective at your tasks. Remember, multitasking is just task

switching and it comes at a cost!

As always, just a simple 10 minute mindful meditation will help you start the

day.

Sincerely yours,

Hans Chung



Hi name,


Sleep is an integral part of our lives. It helps you reduce stress, rest and repair

your body. Our daily use of devices can interfere with our sleep. Do be mindful to

avoid checking your phone, emails etc. just before you sleep as that means you’ll take

longer to fall asleep!

Remember, falling asleep is like letting go, one of the 7 attitudes in

Mindfulness, so your daily 10 minutes of mindful meditation will be really useful in

practicing that.

Sincerely yours,

Hans Chung


Hi name,

Congratulations, you have reached Day 5 of your 10 Day Challenge!

As you go through your day, it will be natural to find your mind wandering

about. That’s okay. Just be mindful and aware of it, and gently and kindly bring your

mind back to focus on your tasks. No need to judge or change anything, just notice it

and bring your attention back.

As always, your daily mindful meditation will help you get on track.

Sincerely yours,

Hans Chung



Hi name,


You’ve completed 5 days of mindful meditation thus far and you might be

thinking, maybe it’s okay to skip one day. Indeed, you might be rather busy and you

may not have the time. But taking a pause from the rush-rush-rush might actually just

help you use your time better!

Mindfulness is not a goal-seeking activity. It is non-striving. Approach your

daily 10 minutes of mindful meditation with a beginner’s mind. Each session is a new

experience; no moment is exactly the same and can offer new learnings within you

every time.

Sincerely yours,

Hans Chung



Hi name,

So far, you have learnt much about sleep and multitasking as well as

mindfulness. Integrating these habit changes in you daily life may be a little challenge

but with time and practice, you will be able to get use to forming these habits.

Being mindful while you go about your day will be very useful in helping you

cultivate a habit of mindfulness, to be fully aware and present in the immediate

experience. As with your daily 10 minutes of mindful meditation, it may be useful to

ground yourself to the immediate experience by returning to your breath before

exploring other aspects of your experience; the sensations in your body, the emotions

you feel, the thoughts you have etc.

As always, remember to practice your daily 10 minutes of mindful meditation.

Sincerely yours,

Hans Chung



Hi name,


Hopefully, you have been getting your 8 hours of sleep daily and are feeling

the effects of a good night’s rest. By now, you should have a better grasp on your

multitasking behaviors to improve your focus and experience on your immediate tasks

at hand.

Remember to trust yourself in your own experience, and to have patience with

your feelings and emotions. These are some of the attitudes in practicing a more

mindful lifestyle. This will of course be bolstered by your daily 10 minutes of mindful

meditation, so do remember to practice.

Sincerely yours,

Hans Chung



Hi name,


As you go about your day, your mind may wander or you may start to

multitask. All this is normal, there is no need to judge yourself over it. As you have

practiced in your daily mindful meditation, just bring your attention back to the

present and carry on. You may even find it useful to bring your focus back on the

breath before you carry on with your tasks, bringing even greater focus and attention

to the task after that.

Also, do remember to get your 8 hours of sleep tonight. Your rest is important

for your body and brain function.

Sincerely yours,

Hans Chung



Hi name,

Congratulations, you have reached the Final Day of your 10 Day Challenge!

You have come so far since you first started out, making changes to your sleep

habits, multitasking habits and also improving the mindfulness of your immediate

experience. I hope that you have felt and experienced for yourself the benefits from

this program.

As you come to the end of this 10 Day Challenge, do take a moment to give

gratitude and thanks to yourself for coming this far, and for all the benefits that you

have gifted to yourself. Your efforts over the past 10 days have definitely been

fruitful.

The challenge may end today, but your journey will still go on. So do

remember to engage in your daily 10 minutes of mindful meditation daily, get enough

sleep and avoid multitasking.

I wish you the best of luck in your journey ahead! :)

Sincerely yours,

Hans Chung


Appendix P.1: Sleep Duration (PSQI) Analyses

Descriptive Statistics

Condition Gender Mean Std. Deviation N

Pretest Sleep

Duration

Control

Male 6.3864 .87581 11

Female 6.2589 1.53402 9

Total 6.3290 1.18269 20

Psychoeducation

Male 6.5769 1.32045 13

Female 6.8080 1.89730 10

Total 6.6774 1.56122 23

Practice

Male 6.2969 1.28847 16

Female 6.2037 1.42863 8

Total 6.2658 1.30610 24

Total

Male 6.4125 1.17745 40

Female 6.4459 1.61251 27

Total 6.4260 1.35787 67

Posttest Sleep

Duration

Control

Male 6.7273 1.08082 11

Female 6.7500 .94491 9

Total 6.7375 .99544 20

Psychoeducation

Male 7.0000 1.77951 13

Female 7.4170 1.71432 10

Total 7.1813 1.72459 23

Practice

Male 7.1544 1.39785 16

Female 6.9963 .83056 8

Total 7.1017 1.22069 24

Total

Male 6.9868 1.43387 40

Female 7.0700 1.24947 27

Total 7.0203 1.35337 67


Tests of Within-Subjects Effects

Measure: MEASURE_1

Source Type III Sum of

Squares

df Mean Square F Sig.

timeSleepDuration

Sphericity Assumed 10.900 1 10.900 11.506* .001

Greenhouse-Geisser 10.900 1.000 10.900 11.506* .001

Huynh-Feldt 10.900 1.000 10.900 11.506* .001

Lower-bound 10.900 1.000 10.900 11.506* .001

timeSleepDuration

* Condition

Sphericity Assumed .951 2 .475 .502 .608

Greenhouse-Geisser .951 2.000 .475 .502 .608

Huynh-Feldt .951 2.000 .475 .502 .608

Lower-bound .951 2.000 .475 .502 .608

timeSleepDuration

* Gender



Huynh-Feldt .065 1.000 .065 .068 .794

Lower-bound .065 1.000 .065 .068 .794

timeSleepDuration

* Condition *

Gender



Huynh-Feldt .099 2.000 .050 .052 .949

Lower-bound .099 2.000 .050 .052 .949

Error(timeSleepDur

ation)

Sphericity Assumed 57.791 61 .947

Greenhouse-Geisser 57.791 61.000 .947

Huynh-Feldt 57.791 61.000 .947

Lower-bound 57.791 61.000 .947

*. Significant at the .01 level.


Appendix P.2: Media-Multitasking (MMI) Analyses

A three-way within-subjects interaction effect of condition*gender*time did

approach significance (F (2, 61) = 2.69, p = .076).



Pretest MMI

Control

Male 3.7408 1.43036 11

Female 2.9693 1.15242 9

Total 3.3936 1.33831 20

Psychoeducation

Male 3.3650 1.06923 13

Female 3.5884 1.54321 10

Total 3.4621 1.26912 23

Practice

Male 3.3807 1.21256 16

Female 2.9889 1.42639 8

Total 3.2501 1.27032 24

Total

Male 3.4746 1.21222 40

Female 3.2044 1.36781 27

Total 3.3657 1.27405 67

Posttest MMI

Control

Male 2.9405 2.10090 11

Female 2.7555 1.03624 9

Total 2.8572 1.66856 20

Psychoeducation

Male 2.9685 2.15745 13

Female 2.0301 1.46982 10

Total 2.5605 1.91020 23

Practice

Male 2.4052 1.50344 16

Female 2.5609 1.46074 8

Total 2.4571 1.45916 24

Total

Male 2.7355 1.87296 40

Female 2.4292 1.32519 27

Total 2.6120 1.66962 67



Measure: MEASURE_1


Squares


timeMMI



Huynh-Feldt 16.875 1.000 16.875 16.643* .000

Lower-bound 16.875 1.000 16.875 16.643* .000

timeMMI *

Condition

Sphericity Assumed 1.190 2 .595 .587 .559

Greenhouse-Geisser 1.190 2.000 .595 .587 .559

Huynh-Feldt 1.190 2.000 .595 .587 .559

Lower-bound 1.190 2.000 .595 .587 .559

timeMMI * Gender



Huynh-Feldt .001 1.000 .001 .001 .979

Lower-bound .001 1.000 .001 .001 .979

timeMMI *

Condition *

Gender

Sphericity Assumed 5.448 2 2.724 2.687 .076

Greenhouse-Geisser 5.448 2.000 2.724 2.687 .076

Huynh-Feldt 5.448 2.000 2.724 2.687 .076

Lower-bound 5.448 2.000 2.724 2.687 .076

Error(timeMMI)

Sphericity Assumed 61.852 61 1.014

Greenhouse-Geisser 61.852 61.000 1.014

Huynh-Feldt 61.852 61.000 1.014

Lower-bound 61.852 61.000 1.014



Appendix P.3: Sleep Quality (PSQI) Analyses



Pretest PSQI

Control

Male 5.27 2.284 11

Female 6.56 4.613 9

Total 5.85 3.483 20

Psychoeducation

Male 5.38 2.468 13

Female 5.10 2.424 10

Total 5.26 2.397 23

Practice

Male 6.38 3.096 16

Female 5.50 1.852 8

Total 6.08 2.733 24

Total

Male 5.75 2.677 40

Female 5.70 3.148 27

Total 5.73 2.853 67

Posttest PSQI

Control

Male 4.27 2.149 11

Female 4.89 2.028 9

Total 4.55 2.064 20

Psychoeducation

Male 4.85 1.994 13

Female 3.50 2.068 10

Total 4.26 2.094 23

Practice

Male 4.06 2.081 16

Female 4.50 2.000 8

Total 4.21 2.021 24

Total

Male 4.38 2.047 40

Female 4.26 2.049 27

Total 4.33 2.033 67



Measure: MEASURE_1


Squares


timePSQI



Huynh-Feldt 58.166 1.000 58.166 16.386* .000

Lower-bound 58.166 1.000 58.166 16.386* .000

timePSQI *

Condition

Sphericity Assumed 1.894 2 .947 .267 .767

Greenhouse-Geisser 1.894 2.000 .947 .267 .767

Huynh-Feldt 1.894 2.000 .947 .267 .767

Lower-bound 1.894 2.000 .947 .267 .767

timePSQI * Gender



Huynh-Feldt .153 1.000 .153 .043 .836

Lower-bound .153 1.000 .153 .043 .836

timePSQI *

Condition *

Gender



Huynh-Feldt 8.712 2.000 4.356 1.227 .300

Lower-bound 8.712 2.000 4.356 1.227 .300

Error(timePSQI)



Huynh-Feldt 216.534 61.000 3.550

Lower-bound 216.534 61.000 3.550



Appendix P.4: Weekly Mindful Practice Duration Analyses



Pretest Weekly

Mindful Practice

Total

Control

Male 30.64 66.802 11

Female 16.67 40.000 9

Total 24.35 55.436 20

Psychoeducation

Male 83.08 181.723 13

Female 22.40 35.164 10

Total 56.70 139.515 23

Practice

Male 6.56 19.725 16

Female 66.25 185.371 8

Total 26.46 107.415 24

Total

Male 38.05 112.040 40

Female 33.48 103.186 27

Total 36.21 107.783 67

Posttest Weekly

Mindful Practice

Total

Control

Male 14.636 33.4911 11

Female 21.389 56.7185 9

Total 17.675 44.2351 20

Psychoeducation

Male 19.492 47.9571 13

Female 42.000 38.7291 10

Total 29.278 44.7018 23

Practice

Male 40.031 31.3563 16

Female 133.875 202.0300 8

Total 71.312 122.9050 24

Total

Male 26.372 38.7890 40

Female 62.352 121.7053 27

Total 40.872 83.9067 67



Measure: MEASURE_1


Squares


timeWeeklyMindful

Practice

Sphericity Assumed 1854.125 1 1854.125 .529 .470

Greenhouse-Geisser 1854.125 1.000 1854.125 .529 .470

Huynh-Feldt 1854.125 1.000 1854.125 .529 .470

Lower-bound 1854.125 1.000 1854.125 .529 .470

timeWeeklyMindful

Practice * Condition



Huynh-Feldt 31306.630 2.000 15653.315 4.467* .015

Lower-bound 31306.630 2.000 15653.315 4.467* .015

timeWeeklyMindful

Practice * Gender



Huynh-Feldt 16825.529 1.000 16825.529 4.801* .032

Lower-bound 16825.529 1.000 16825.529 4.801* .032

timeWeeklyMindful

Practice * Condition

* Gender



Huynh-Feldt 5848.100 2.000 2924.050 .834 .439

Lower-bound 5848.100 2.000 2924.050 .834 .439

Error(timeWeeklyM

indfulPractice)



Huynh-Feldt 213757.991 61.000 3504.229

Lower-bound 213757.991 61.000 3504.229


Pairwise comparisons (condition x time).

Estimates

Measure: MEASURE_1

Condition timeWeeklyMindful

Practice

Mean Std. Error 95% Confidence Interval


Control 1 23.652 24.266 -24.871 72.175

2 18.013 17.703 -17.386 53.412

Psychoeducation 1 52.738 22.709 7.329 98.148

2 30.746 16.567 -2.381 63.873

Practice 1 36.406 23.378 -10.340 83.153

2 86.953 17.055 52.850 121.056


Pairwise comparisons (different condition-pairs at each time level).

Pairwise Comparisons

Measure: MEASURE_1

timeWeekly

MindfulPract

ice

(I) Condition (J) Condition Mean

Difference

(I-J)

Std. Error Sig.b 95% Confidence

Interval for Differenceb

Lower

Bound

Upper

Bound

1


Practice -12.755 33.695 .706 -80.132 54.623

Psychoeduca

tion

Control 29.087 33.234 .385 -37.370 95.543

Practice 16.332 32.592 .618 -48.839 81.503

Practice Control 12.755 33.695 .706 -54.623 80.132


2


Practice -68.940* 24.582 .007 -118.094 -19.787

Psychoeduca

tion

Control 12.734 24.246 .601 -35.748 61.215

Practice -56.207* 23.776 .021 -103.751 -8.663


Psychoeducation 56.207* 23.776 .021 8.663 103.751




Univariate Tests

Measure: MEASURE_1

timeWeeklyMindfulPractice Sum of Squares df Mean Square F Sig.

1

Contrast 9038.118 2 4519.059 .388 .680

Error 711203.306 61 11659.071

2

Contrast 56539.087 2 28269.543 4.556 .014

Error 378511.653 61 6205.109

Each F tests the simple effects of Condition within each level combination of the other effects shown.

These tests are based on the linearly independent pairwise comparisons among the estimated

marginal means.


Pairwise comparisons (different time-pairs at each condition level).


Measure: MEASURE_1

Condition (I)

timeWeekl

yMindfulPr

actice

(J)

timeWeekl

yMindfulPr

actice

Mean

Difference

(I-J)

Std. Error Sig.b 95% Confidence Interval

for Differenceb

Lower Bound Upper

Bound

Control 1

2

2 5.639 18.814 .765 -31.982 43.260

1 -5.639 18.814 .765 -43.260 31.982

Psychoeducation 1

2

2 21.992 17.607 .216 -13.214 57.199

1 -21.992 17.607 .216 -57.199 13.214

Practice 1 2 -50.547* 18.125 .007 -86.790 -14.303

2 1 50.547* 18.125 .007 14.303 86.790




Multivariate Tests

Condition Value F Hypothesis df Error df Sig.

Control

Pillai's trace .001 .090a 1.000 61.000 .765

Wilks' lambda .999 .090a 1.000 61.000 .765

Hotelling's trace .001 .090a 1.000 61.000 .765

Roy's largest root .001 .090a 1.000 61.000 .765

Psychoeducation

Pillai's trace .025 1.560a 1.000 61.000 .216

Wilks' lambda .975 1.560a 1.000 61.000 .216

Hotelling's trace .026 1.560a 1.000 61.000 .216

Roy's largest root .026 1.560a 1.000 61.000 .216

Practice

Pillai's trace .113 7.777a 1.000 61.000 .007

Wilks' lambda .887 7.777a 1.000 61.000 .007



Each F tests the multivariate simple effects of timeWeeklyMindfulPractice within each level

combination of the other effects shown. These tests are based on the linearly independent pairwise

comparisons among the estimated marginal means.

a. Exact statistic


Pairwise comparisons (gender x time).

Estimates

Measure: MEASURE_1

Condition timeWeeklyMindful

Practice



Male 1 40.092 17.274 5.551 74.633

2 24.720 12.602 -.479 49.919

Female 1 35.106 20.867 -6.620 76.831

2 65.755 15.223 35.315 96.195

Pairwise comparisons (different gender-pairs at each time level).


Measure: MEASURE_1

timeWeekly

MindfulPract

ice

(I) Gender (J) Gender Mean

Difference

(I-J)



Lower

Bound

Upper

Bound

1 Male

Female

Female 4.986 27.089 .855 -49.181 59.154

Male -4.986 27.089 .855 -59.154 49.181

2 Male

Female

Female -41.035* 19.762 .042 -80.551 -1.518

Male 41.035* 19.762 .042 1.518 80.551



b. Adjustment for multiple comparisons: Bonferroni).

Univariate Tests

Measure: MEASURE_1

timeWeeklyMindfulPractice Sum of Squares df Mean Square F Sig.

1

Contrast 395.053 1 395.053 .034 .855

Error 711203.306 61 11659.071

2

Contrast 26753.935 1 26753.935 4.312 .042

Error 378511.653 61 6205.109

Each F tests the simple effects of Gender within each level combination of the other effects shown.


marginal means.


Pairwise comparisons (different time-pairs at each gender level).


Measure: MEASURE_1

Gender (I)

timeWeekl

yMindfulPr

actice

(J)

timeWeekl

yMindfulPr

actice

Mean

Difference

(I-J)


for Differenceb

Lower Bound Upper

Bound

Male 1

2

2 15.372 13.393 .256 -11.408 42.152

1 -15.372 13.393 .256 -42.152 11.408

Female 1 2 -30.649 16.178 .063 -62.999 1.701

2 1 30.649 16.178 .063 -1.701 62.999



Multivariate Tests

Gender Value F Hypothesis df Error df Sig.

Male

Pillai's trace .021 1.317a 1.000 61.000 .256

Wilks' lambda .979 1.317a 1.000 61.000 .256



Female

Pillai's trace .056 3.589a 1.000 61.000 .063

Wilks' lambda .944 3.589a 1.000 61.000 .063



Each F tests the multivariate simple effects of timeWeeklyMindfulPractice within each level

combination of the other effects shown. These tests are based on the linearly independent pairwise

comparisons among the estimated marginal means.

a. Exact statistic


Pairwise comparisons (condition x gender x time).

Estimates

Measure: MEASURE_1

Condition Gender timeWeeklyM

indfulPractice



Control

Male 1 30.636 32.556 -34.464 95.737

2 14.636 23.751 -32.856 62.129

Female 1 16.667 35.992 -55.305 88.638

2 21.389 26.258 -31.116 73.894

Psychoeducation

Male 1 83.077 29.947 23.193 142.961

2 19.492 21.848 -24.195 63.179

Female 1 22.400 34.145 -45.878 90.678

2 42.000 24.910 -7.811 91.811

Practice

Male 1 6.563 26.994 -47.416 60.541

2 40.031 19.693 .652 79.410

Female 1 66.250 38.176 -10.087 142.587

2 133.875 27.850 78.185 189.565


Pairwise comparisons (different condition-pairs at each gender & time

level).


Measure: MEASURE_1

Gender timeWeek

lyMindful

Practice


Differenc

e (I-J)


Interval for

Differenceb

Lower

Bound

Upper

Bound

Male

1


Practice 24.074 42.292 1.000 -80.040 128.188


Practice 76.514 40.318 .187 -22.740 175.769

Practice Control -24.074 42.292 1.000 -128.188 80.040


2

Control Psychoeducation -4.856 32.271 1.000 -84.300 74.589

Practice -25.395 30.853 1.000 -101.349 50.559

Psychoeducation Control 4.856 32.271 1.000 -74.589 84.300

Practice -20.539 29.413 1.000 -92.948 51.870

Practice Control 25.395 30.853 1.000 -50.559 101.349

Psychoeducation 20.539 29.413 1.000 -51.870 92.948

Female

1

Control Psychoeducation -5.733 49.612 1.000 -127.868 116.401

Practice -49.583 52.467 1.000 -178.747 79.581


Practice -43.850 51.218 1.000 -169.938 82.238

Practice Control 49.583 52.467 1.000 -79.581 178.747

Psychoeducation 43.850 51.218 1.000 -82.238 169.938

2

Control

Psychoeducation -20.611 36.193 1.000 -109.712 68.490

Practice -

112.486* 38.277 .014 -206.715 -18.257


Practice -91.875 37.365 .050 -183.860 .110


Psychoeducation 91.875 37.365 .050 -.110 183.860





Univariate Tests

Measure: MEASURE_1

Gender timeWeeklyMindfulPractice Sum of Squares df Mean Square F Sig.

Male

1 Contrast 42824.494 2 21412.247 1.837 .168

Error 711203.306 61 11659.071

2 Contrast 5115.471 2 2557.735 .412 .664

Error 378511.653 61 6205.109

Female

1 Contrast 12362.841 2 6181.420 .530 .591

Error 711203.306 61 11659.071

2 Contrast 60168.144 2 30084.072 4.848 .011

Error 378511.653 61 6205.109

Each F tests the simple effects of Condition within each level combination of the other effects shown. These tests

are based on the linearly independent pairwise comparisons among the estimated marginal means.

Pairwise comparisons (different time-pairs at each condition & gender

level).


Measure: MEASURE_1

Condition Gender (I)

timeWeeklyM

indfulPractice

(J)

timeWeeklyM

indfulPractice

Mean

Difference

(I-J)

Std.

Error

Sig.b 95% Confidence Interval

for Differenceb

Lower

Bound

Upper

Bound

Control

Male 1 2 16.000 25.241 .529 -34.473 66.473

2 1 -16.000 25.241 .529 -66.473 34.473

Female 1 2 -4.722 27.906 .866 -60.523 51.078

2 1 4.722 27.906 .866 -51.078 60.523

Psychoedu

cation

Male 1 2 63.585* 23.219 .008 17.156 110.013

2 1 -63.585* 23.219 .008 -110.013 -17.156

Female 1 2 -19.600 26.473 .462 -72.537 33.337

2 1 19.600 26.473 .462 -33.337 72.537

Practice

Male 1 2 -33.469 20.929 .115 -75.319 8.382

2 1 33.469 20.929 .115 -8.382 75.319

Female 1 2 -67.625* 29.598 .026 -126.810 -8.440

2 1 67.625* 29.598 .026 8.440 126.810





Multivariate Tests

Condition Gender Value F Hypothesis df Error df Sig.

Control

Male

Pillai's trace .007 .402a 1.000 61.000 .529

Wilks' lambda .993 .402a 1.000 61.000 .529



Female

Pillai's trace .000 .029a 1.000 61.000 .866

Wilks' lambda 1.000 .029a 1.000 61.000 .866



Psychoeducation

Male

Pillai's trace .109 7.499a 1.000 61.000 .008

Wilks' lambda .891 7.499a 1.000 61.000 .008



Female

Pillai's trace .009 .548a 1.000 61.000 .462

Wilks' lambda .991 .548a 1.000 61.000 .462



Practice

Male

Pillai's trace .040 2.557a 1.000 61.000 .115

Wilks' lambda .960 2.557a 1.000 61.000 .115



Female

Pillai's trace .079 5.220a 1.000 61.000 .026

Wilks' lambda .921 5.220a 1.000 61.000 .026



Each F tests the multivariate simple effects of timeWeeklyMindfulPractice within each level combination of the

other effects shown. These tests are based on the linearly independent pairwise comparisons among the

estimated marginal means.

a. Exact statistic


Pairwise comparisons (different gender-pairs at each condition & time

level).


Measure: MEASURE_1

Condition timeWeeklyM

indfulPractice


Difference

(I-J)


Interval for

Differenceb

Lower

Bound

Upper

Bound

Control

1 Male Female 13.970 48.532 .774 -83.076 111.016

Female Male -13.970 48.532 .774 -111.016 83.076

2 Male Female -6.753 35.406 .849 -77.550 64.045

Female Male 6.753 35.406 .849 -64.045 77.550

Psychoedu

cation

1 Male Female 60.677 45.418 .187 -30.141 151.495

Female Male -60.677 45.418 .187 -151.495 30.141

2 Male Female -22.508 33.133 .500 -88.762 43.747

Female Male 22.508 33.133 .500 -43.747 88.762

Practice

1 Male Female -59.687 46.755 .207 -153.181 33.806

Female Male 59.687 46.755 .207 -33.806 153.181

2 Male Female -93.844* 34.109 .008 -162.050 -25.638

Female Male 93.844* 34.109 .008 25.638 162.050





Univariate Tests

Measure: MEASURE_1

Condition timeWeeklyMindfulPractice Sum of Squares df Mean Square F Sig.

Control

1 Contrast 966.005 1 966.005 .083 .774

Error 711203.306 61 11659.071

2 Contrast 225.703 1 225.703 .036 .849

Error 378511.653 61 6205.109

Psychoeducation

1 Contrast 20809.546 1 20809.546 1.785 .187

Error 711203.306 61 11659.071

2 Contrast 2863.370 1 2863.370 .461 .500

Error 378511.653 61 6205.109

Practice

1 Contrast 19000.521 1 19000.521 1.630 .207

Error 711203.306 61 11659.071

2 Contrast 46968.797 1 46968.797 7.569 .008

Error 378511.653 61 6205.109

Each F tests the simple effects of Gender within each level combination of the other effects shown. These tests



Appendix P.5: Depression (DASS-21) Analyses



Pretest DASS-21

(Depression)

Control

Male 10.36 12.452 11

Female 17.56 15.420 9

Total 13.60 13.971 20

Psychoeducation

Male 10.15 6.706 13

Female 10.60 12.002 10

Total 10.35 9.138 23

Practice

Male 14.13 10.570 16

Female 16.25 10.873 8

Total 14.83 10.483 24

Total

Male 11.80 10.013 40

Female 14.59 12.840 27

Total 12.93 11.229 67

Posttest DASS-21

(Depression)

Control

Male 8.55 8.768 11

Female 17.11 16.526 9

Total 12.40 13.212 20

Psychoeducation

Male 9.85 5.625 13

Female 5.20 5.827 10

Total 7.83 6.058 23

Practice

Male 8.13 9.135 16

Female 11.00 12.282 8

Total 9.08 10.112 24

Total

Male 8.80 7.881 40

Female 10.89 12.738 27

Total 9.64 10.084 67



Measure: MEASURE_1


Squares


timeDepressionDA

SS21



Huynh-Feldt 326.088 1.000 326.088 8.632 .005

Lower-bound 326.088 1.000 326.088 8.632 .005

timeDepressionDA

SS21 * Condition



Huynh-Feldt 106.380 2.000 53.190 1.408 .252

Lower-bound 106.380 2.000 53.190 1.408 .252

timeDepressionDA

SS21 * Gender



Huynh-Feldt 7.779 1.000 7.779 .206 .652

Lower-bound 7.779 1.000 7.779 .206 .652

timeDepressionDA

SS21 * Condition *

Gender



Huynh-Feldt 69.309 2.000 34.655 .917 .405

Lower-bound 69.309 2.000 34.655 .917 .405

Error(timeDepressio

nDASS21)



Huynh-Feldt 2304.264 61.000 37.775

Lower-bound 2304.264 61.000 37.775



Appendix P.6: Anxiety (DASS-21) Analyses

A between-subjects condition*gender interaction effect was also found (F (2,

61) = 5.93, p < .005). Levene’s test was revealed to be violated for the pre-test (F (5,

61) = 4.84, p < .005), but not the post-test (F (5, 61) = 2.04, p > .05). No other

significant effects were found.

Paired comparisons of t-tests revealed that in the Psychoeducation condition

only, males had significantly higher average anxiety scores (equal variances assumed,

t (21) = 2.51, p < .05). The reverse was approaching significance in the Practice

condition where females had higher anxiety scores than males (equal variances not

assumed, t (9.65) = 1.88, p = .091). Between the Control and Psychoeducation

conditions, females in the Control condition had higher Anxiety scores that

approached significance (equal variances not assumed, t (10.32) = 2.09, p = .063).

Females in the Practice condition had significantly higher average anxiety scores than

those in the Psychoeducation condition (equal variances not assumed, t (7.95) = 2.59,

p < .05). This evidence suggest that female subjects in the Psychoeducation condition

had much lower Anxiety scores than males in the same condition and females in the

other two conditions (although comparison with the Control condition females only

approached significance). Caution was noted regarding the Levene’s violation in the

univariate between-subjects analysis when understanding these implications.




Pretest DASS-21

(Anxiety)

Control

Male 7.64 5.427 11

Female 11.56 7.535 9

Total 9.40 6.589 20

Psychoeducation

Male 9.85 6.189 13

Female 5.00 4.643 10

Total 7.74 5.979 23

Practice

Male 7.50 6.673 16

Female 16.75 13.090 8

Total 10.58 10.052 24

Total

Male 8.30 6.136 40

Female 10.67 9.751 27

Total 9.25 7.815 67

Posttest DASS-21

(Anxiety)

Control

Male 3.64 3.075 11

Female 6.89 7.491 9

Total 5.10 5.600 20

Psychoeducation

Male 8.15 6.805 13

Female 2.60 2.836 10

Total 5.74 6.039 23

Practice

Male 4.63 6.270 16

Female 10.00 8.816 8

Total 6.42 7.483 24

Total

Male 5.50 5.953 40

Female 6.22 7.111 27

Total 5.79 6.402 67



Measure: MEASURE_1


Squares


timeAnxietyDASS2

1



Huynh-Feldt 442.271 1.000 442.271 30.036* .000

Lower-bound 442.271 1.000 442.271 30.036* .000

timeAnxietyDASS2

1 * Condition



Huynh-Feldt 48.083 2.000 24.041 1.633 .204

Lower-bound 48.083 2.000 24.041 1.633 .204

timeAnxietyDASS2

1 * Gender



Huynh-Feldt 24.324 1.000 24.324 1.652 .204

Lower-bound 24.324 1.000 24.324 1.652 .204

timeAnxietyDASS2

1 * Condition *

Gender



Huynh-Feldt 18.016 2.000 9.008 .612 .546

Lower-bound 18.016 2.000 9.008 .612 .546

Error(timeAnxietyD

ASS21)



Huynh-Feldt 898.210 61.000 14.725

Lower-bound 898.210 61.000 14.725



Levene's Test of Equality of Error Variancesa

F df1 df2 Sig.

Pretest DASS-21 (Anxiety) 4.835 5 61 .001

Posttest DASS-21 (Anxiety) 2.037 5 61 .086

Tests the null hypothesis that the error variance of the dependent variable is equal across

groups.

a. Design: Intercept + Condition + Gender + Condition * Gender

Within Subjects Design: timeAnxietyDASS21

Tests of Between-Subjects Effects

Measure: MEASURE_1

Transformed Variable: Average


Squares


Intercept 7831.468 1 7831.468 102.142 .000

Condition 251.032 2 125.516 1.637 .203

Gender 114.650 1 114.650 1.495 .226

Condition * Gender 909.402 2 454.701 5.930 .004

Error 4677.027 61 76.673


Pairwise comparisons (gender, split by condition).

Group Statistics (AverageAnxiety)

Condition Gender N Mean Std. Deviation Std. Error Mean

Control Male 11 5.6364 3.52910 1.06406

Female 9 9.2222 7.27629 2.42543

Psychoeducation Male 13 9.0000 6.00000 1.66410

Female 10 3.8000 2.93636 .92856

Practice Male 16 6.0625 6.12611 1.53153

Female 8 13.3750 10.12687 3.58039

Independent Samples Test (AverageAnxiety)

Levene’s Test

for Equality

of Variances t-test for Equality of Means

F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Control

Equal

variances

assumed

10.389 .005 -1.446 18 .165 -3.58586 2.48023 -8.79662 1.62491

Equal

variances

not

assumed

-1.354 11.048 .203 -3.58586 2.64857 -9.41222 2.24050

Psychoe

ducatio

n

Equal

variances

assumed

2.919 .102 2.510 21 .020 5.20000 2.07204 .89097 9.50903

Equal

variances

not

assumed

2.729 18.274 .014 5.20000 1.90564 1.20070 9.19930

Practice

Equal

variances

assumed

5.872 .024 -2.213 22 .038 -7.31250 3.30394 -14.16445 -.46055

Equal

variances

not

assumed

-1.878 9.645 .091 -7.31250 3.89420 -16.03276 1.40776


Pairwise comparisons (condition, split by gender).

Control and psychoeducation.


Gender Condition N Mean Std. Deviation Std. Error Mean

Male Control 11 5.6364 3.52910 1.06406

Psychoeducation 13 9.0000 6.00000 1.66410

Female Control 9 9.2222 7.27629 2.42543

Psychoeducation 10 3.8000 2.93636 .92856


Levene’s Test

for Equality


F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Male

Equal

variances

assumed

1.594 .220 -1.632 22 .117 -3.36364 2.06052 -7.63689 .90962

Equal

variances

not

assumed

-1.703 19.839 .104 -3.36364 1.97521 -7.48600 .75873

Female

Equal

variances

assumed

14.067 .002 2.174 17 .044 5.42222 2.49469 .15888 10.68557

Equal

variances

not

assumed

2.088 10.320 .063 5.42222 2.59710 -.34026 11.18470


Control and practice.



Male Control 11 5.6364 3.52910 1.06406

Practice 16 6.0625 6.12611 1.53153

Female Control 9 9.2222 7.27629 2.42543

Practice 8 13.3750 10.12687 3.58039


Levene’s Test

for Equality


F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Male

Equal

variances

assumed

.555 .463 -.207 25 .837 -.42614 2.05393 -4.65629 3.80402

Equal

variances

not

assumed

-.229 24.436 .821 -.42614 1.86489 -4.27145 3.41917

Female

Equal

variances

assumed

1.818 .198 -.980 15 .343 -4.15278 4.23875 -13.18745 4.88189

Equal

variances

not

assumed

-.960 12.581 .355 -4.15278 4.32457 -13.52721 5.22165


Psychoeducation and practice.



Male Psychoeducation 13 9.0000 6.00000 1.66410

Practice 16 6.0625 6.12611 1.53153

Female Psychoeducation 10 3.8000 2.93636 .92856

Practice 8 13.3750 10.12687 3.58039


Levene’s Test

for Equality


F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Male

Equal

variances

assumed

.100 .754 1.296 27 .206 2.93750 2.26664 -1.71327 7.58827

Equal

variances

not

assumed

1.299 26.009 .205 2.93750 2.26159 -1.71119 7.58619

Female

Equal

variances

assumed

19.305 .000 -2.863 16 .011 -9.57500 3.34460 -16.66524 -2.48476

Equal

variances

not

assumed

-2.589 7.945 .032 -9.57500 3.69884 -18.11476 -1.03524


Appendix P.7: Stress (DASS-21) Analyses



Pretest DASS-21

(Stress)

Control

Male 13.82 9.009 11

Female 11.11 9.333 9

Total 12.60 9.017 20

Psychoeducation

Male 13.23 6.954 13

Female 13.00 9.104 10

Total 13.13 7.765 23

Practice

Male 15.25 8.575 16

Female 22.75 10.416 8

Total 17.75 9.696 24

Total

Male 14.20 8.049 40

Female 15.26 10.483 27

Total 14.63 9.047 67

Posttest DASS-21

(Stress)

Control

Male 10.36 8.286 11

Female 11.33 10.100 9

Total 10.80 8.907 20

Psychoeducation

Male 10.92 7.193 13

Female 8.20 6.215 10

Total 9.74 6.777 23

Practice

Male 9.13 9.605 16

Female 16.25 11.536 8

Total 11.50 10.604 24

Total

Male 10.05 8.345 40

Female 11.63 9.576 27

Total 10.69 8.825 67



Measure: MEASURE_1


Squares


timeStressDASS21



Huynh-Feldt 465.529 1.000 465.529 13.737* .000

Lower-bound 465.529 1.000 465.529 13.737* .000

timeStressDASS21

* Condition



Huynh-Feldt 115.054 2.000 57.527 1.698 .192

Lower-bound 115.054 2.000 57.527 1.698 .192

timeStressDASS21

* Gender



Huynh-Feldt .578 1.000 .578 .017 .896

Lower-bound .578 1.000 .578 .017 .896

timeStressDASS21

* Condition *

Gender



Huynh-Feldt 51.248 2.000 25.624 .756 .474

Lower-bound 51.248 2.000 25.624 .756 .474

Error(timeStressDA

SS21)



Huynh-Feldt 2067.201 61.000 33.889

Lower-bound 2067.201 61.000 33.889



Appendix P.8: Negative Affect (PANAS) Analyses



Pretest PANAS

(Negative Affect)

Control

Male 26.18 6.322 11

Female 26.56 10.678 9

Total 26.35 8.312 20

Psychoeducation

Male 25.54 6.359 13

Female 26.40 9.204 10

Total 25.91 7.543 23

Practice

Male 26.13 9.010 16

Female 27.87 8.626 8

Total 26.71 8.735 24

Total

Male 25.95 7.348 40

Female 26.89 9.213 27

Total 26.33 8.097 67

Posttest PANAS

(Negative Affect)

Control

Male 22.09 8.179 11

Female 24.00 8.832 9

Total 22.95 8.306 20

Psychoeducation

Male 23.00 5.354 13

Female 23.30 7.379 10

Total 23.13 6.159 23

Practice

Male 18.94 9.263 16

Female 22.38 9.899 8

Total 20.08 9.408 24

Total

Male 21.12 7.897 40

Female 23.26 8.346 27

Total 21.99 8.088 67



Measure: MEASURE_1


Squares


timeNAPANAS



Huynh-Feldt 550.472 1.000 550.472 17.248* .000

Lower-bound 550.472 1.000 550.472 17.248* .000

timeNAPANAS *

Condition



Huynh-Feldt 78.119 2.000 39.060 1.224 .301

Lower-bound 78.119 2.000 39.060 1.224 .301

timeNAPANAS *

Gender



Huynh-Feldt 6.252 1.000 6.252 .196 .660

Lower-bound 6.252 1.000 6.252 .196 .660

timeNAPANAS *

Condition *

Gender



Huynh-Feldt 8.663 2.000 4.332 .136 .873

Lower-bound 8.663 2.000 4.332 .136 .873

Error(timeNAPAN

AS)



Huynh-Feldt 1946.850 61.000 31.916

Lower-bound 1946.850 61.000 31.916



Appendix P.9: Incongruent Trials Mean Response Time (Stroop) Analyses



Pretest Incongruent

Mean Response

Time

Control

Male 777.9155 82.92885 11

Female 842.4333 176.68877 9

Total 806.9485 133.59955 20

Psychoeducation

Male 853.6331 136.58525 13

Female 826.2040 139.46668 10

Total 841.7074 135.37446 23

Practice

Male 758.8656 122.34788 16

Female 809.6413 113.94286 8

Total 775.7908 119.63097 24

Total

Male 794.9038 122.57564 40

Female 826.7063 141.45523 27

Total 807.7197 130.41420 67

Posttest Incongruent

Mean Response

Time

Control

Male 730.5818 68.61727 11

Female 786.4067 139.05367 9

Total 755.7030 106.91780 20

Psychoeducation

Male 800.1846 85.39391 13

Female 779.3210 173.22922 10

Total 791.1135 127.92772 23

Practice

Male 732.9775 104.36930 16

Female 759.1100 111.94878 8

Total 741.6883 105.24591 24

Total

Male 754.1610 93.20708 40

Female 775.6944 140.85658 27

Total 762.8387 114.29257 67



Measure: MEASURE_1


Squares


timeMeanResponse

TimeIncongruent



Huynh-Feldt 69258.700 1.000 69258.700 23.656* .000

Lower-bound 69258.700 1.000 69258.700 23.656* .000

timeMeanResponse

TimeIncongruent *

Condition



Huynh-Feldt 1150.094 2.000 575.047 .196 .822

Lower-bound 1150.094 2.000 575.047 .196 .822

timeMeanResponse

TimeIncongruent *

Gender



Huynh-Feldt 632.605 1.000 632.605 .216 .644

Lower-bound 632.605 1.000 632.605 .216 .644

timeMeanResponse

TimeIncongruent *

Condition *

Gender



Huynh-Feldt 1336.345 2.000 668.173 .228 .797

Lower-bound 1336.345 2.000 668.173 .228 .797

Error(timeMeanRes

ponseTimeIncongru

ent)



Huynh-Feldt 178591.150 61.000 2927.724

Lower-bound 178591.150 61.000 2927.724



Appendix P.10: Congruent Trials Mean Response Time (Stroop) Analyses

No other significant effects were found, although the between-subjects main

effect of gender approached significance, where female subjects had higher MRT on

congruent trials (F (1, 61) = 3.14, p = .082).



Pretest Congruent

Mean Response

Time

Control

Male 666.0436 65.45248 11

Female 724.8167 147.08461 9

Total 692.4915 110.74151 20

Psychoeducation

Male 755.2515 153.02242 13

Female 763.8110 152.14643 10

Total 758.9730 149.20110 23

Practice

Male 662.0563 109.38000 16

Female 730.7438 160.39062 8

Total 684.9521 129.32909 24

Total

Male 693.4413 121.63146 40

Female 741.0152 148.04963 27

Total 712.6128 133.90085 67

Posttest Congruent

Mean Response

Time

Control

Male 634.1418 36.72324 11

Female 714.0300 126.54791 9

Total 670.0915 95.47457 20

Psychoeducation

Male 675.4577 86.03524 13

Female 710.5560 162.49142 10

Total 690.7178 123.10726 23

Practice

Male 638.1575 85.07968 16

Female 686.1200 114.87392 8

Total 654.1450 96.28292 24

Total

Male 649.1758 75.83675 40

Female 704.4737 133.30200 27

Total 671.4600 105.57155 67



Measure: MEASURE_1


Squares


timeMeanResponseTime

Congruent



Huynh-Feldt 52664.465 1.000 52664.465 16.128 .000

Lower-bound 52664.465 1.000 52664.465 16.128 .000


Congruent * Condition



Huynh-Feldt 11658.698 2.000 5829.349 1.785 .176

Lower-bound 11658.698 2.000 5829.349 1.785 .176


Congruent * Gender



Huynh-Feldt 640.109 1.000 640.109 .196 .660

Lower-bound 640.109 1.000 640.109 .196 .660


Congruent * Condition *

Gender



Huynh-Feldt 3588.800 2.000 1794.400 .550 .580

Lower-bound 3588.800 2.000 1794.400 .550 .580

Error(timeMeanResponse

TimeCongruent)



Huynh-Feldt 199194.861 61.000 3265.490

Lower-bound 199194.861 61.000 3265.490




F df1 df2 Sig.

Pretest Congruent

Mean Response

Time

1.993 5 61 .092

Posttest Congruent

Mean Response

Time

3.270 5 61 .011

Tests the null hypothesis that the error variance of the

dependent variable is equal across groups.

a. Design: Intercept + Condition + Gender + Condition *

Gender

Within Subjects Design:

timeMeanResponseTimeCongruent


Measure: MEASURE_1



Squares


Intercept 61709116.738 1 61709116.738 2452.945 .000

Condition 58031.777 2 29015.889 1.153 .322

Gender 78897.972 1 78897.972 3.136 .082

Condition * Gender 13363.894 2 6681.947 .266 .768

Error 1534586.743 61 25157.160


Appendix P.11: Stroop Effect Analyses

The assumption of equality of error variances (Levene’s test) was not violated

(Pre-test: F (5, 61) = .55, p > .05; Post-test: F (5, 61) = 1.51, p > .05). No other

significant effects were found, although the within-subjects condition*time effect did

approach significance (F (2, 61) = 2.73, p = .073).



Pretest Stroop

Effect

Control

Male 111.8718 54.36916 11

Female 117.6167 81.16335 9

Total 114.4570 65.86403 20

Psychoeducation

Male 98.3815 80.84477 13

Female 62.3930 52.09484 10

Total 82.7343 70.76720 23

Practice

Male 96.8094 56.68093 16

Female 78.8975 58.94222 8

Total 90.8388 56.80682 24

Total

Male 101.4625 63.61810 40

Female 85.6911 66.91398 27

Total 95.1069 64.93204 67

Posttest Stroop

Effect

Control

Male 96.4400 58.69390 11

Female 72.3767 65.62821 9

Total 85.6115 61.46137 20

Psychoeducation

Male 124.7269 46.25919 13

Female 68.7650 48.38615 10

Total 100.3957 54.12572 23

Practice

Male 94.8200 42.85344 16

Female 72.9900 45.09524 8

Total 87.5433 43.89856 24

Total

Male 104.9853 49.40623 40

Female 71.2207 51.83551 27

Total 91.3787 52.71920 67



F df1 df2 Sig.

Pretest Stroop

Effect .549 5 61 .739

Posttest Stroop

Effect 1.514 5 61 .199



a. Design: Intercept + Condition + Gender + Condition *

Gender

Within Subjects Design: timeStroopEffect


Measure: MEASURE_1



Squares


Intercept 1060485.682 1 1060485.682 225.908 .000

Condition 4298.291 2 2149.146 .458 .635

Gender 19863.636 1 19863.636 4.231 .044

Condition * Gender 7717.751 2 3858.876 .822 .444

Error 286354.423 61 4694.335



Measure: MEASURE_1


Squares


timeStroopEffect



Huynh-Feldt 1134.550 1.000 1134.550 .538 .466

Lower-bound 1134.550 1.000 1134.550 .538 .466

timeStroopEffect *

Condition



Huynh-Feldt 11523.554 2.000 5761.777 2.731 .073

Lower-bound 11523.554 2.000 5761.777 2.731 .073

timeStroopEffect *

Gender



Huynh-Feldt 2545.407 1.000 2545.407 1.206 .276

Lower-bound 2545.407 1.000 2545.407 1.206 .276

timeStroopEffect *

Condition *

Gender



Huynh-Feldt 883.952 2.000 441.976 .209 .812

Lower-bound 883.952 2.000 441.976 .209 .812

Error(timeStroopEff

ect)



Huynh-Feldt 128708.644 61.000 2109.978

Lower-bound 128708.644 61.000 2109.978


Appendix P.12: Mindfulness (CAMS-R) Analyses



Pretest CAMS-R

Control

Male 26.36 5.182 11

Female 27.89 5.667 9

Total 27.05 5.316 20

Psychoeducation

Male 24.54 4.034 13

Female 21.60 4.402 10

Total 23.26 4.361 23

Practice

Male 22.00 4.351 16

Female 22.50 5.782 8

Total 22.17 4.752 24

Total

Male 24.02 4.742 40

Female 23.96 5.808 27

Total 24.00 5.155 67

Posttest CAMS-R

Control

Male 24.91 4.527 11

Female 27.56 7.073 9

Total 26.10 5.803 20

Psychoeducation

Male 23.46 2.570 13

Female 21.20 4.756 10

Total 22.48 3.764 23

Practice

Male 23.63 4.319 16

Female 24.38 7.855 8

Total 23.87 5.574 24

Total

Male 23.93 3.852 40

Female 24.26 6.870 27

Total 24.06 5.234 67



Measure: MEASURE_1


Squares


timeCAMSR



Huynh-Feldt .049 1.000 .049 .005 .943

Lower-bound .049 1.000 .049 .005 .943

timeCAMSR *

Condition



Huynh-Feldt 46.675 2.000 23.337 2.487 .092

Lower-bound 46.675 2.000 23.337 2.487 .092

timeCAMSR *

Gender



Huynh-Feldt 3.703 1.000 3.703 .395 .532

Lower-bound 3.703 1.000 3.703 .395 .532

timeCAMSR *

Condition *

Gender



Huynh-Feldt .974 2.000 .487 .052 .949

Lower-bound .974 2.000 .487 .052 .949

Error(timeCAMSR)



Huynh-Feldt 572.338 61.000 9.383

Lower-bound 572.338 61.000 9.383




F df1 df2 Sig.

Pretest CAMS-R .426 5 61 .829

Posttest CAMS-R 4.318 5 61 .002


groups.


Within Subjects Design: timeCAMSR


Measure: MEASURE_1



Squares


Intercept 74243.938 1 74243.938 1855.859 .000

Condition 392.575 2 196.288 4.907 .011

Gender .043 1 .043 .001 .974


Error 2440.315 61 40.005

Multiple Comparisons

Measure: MEASURE_1


Difference

(I-J)



Lower

Bound

Upper

Bound

Bonferroni


Practice 3.55* 1.354 .033 .22 6.89

Psychoeduca

tion

Control -3.71* 1.367 .026 -7.07 -.34

Practice -.15 1.305 1.000 -3.36 3.06

Practice Control -3.55* 1.354 .033 -6.89 -.22

Psychoeducation .15 1.305 1.000 -3.06 3.36

Based on observed means.

The error term is Mean Square(Error) = 20.003



Pairwise comparisons (condition).

Control and psychoeducation.

Group Statistics (AverageCAMSR)


AverageCAMSR Control 20 26.5750 5.14596 1.15067

Psychoeducation 23 22.8696 3.30708 .68957

Independent Samples Test (AverageCAMSR)

Levene’s Test

for Equality


F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Averag

eCAMS

R

Equal

variances

assumed

3.187 .082 2.846 41 .007 3.70543 1.30219 1.07560 6.33527

Equal

variances

not

assumed

2.762 31.580 .009 3.70543 1.34148 .97151 6.43936

Control and practice.



AverageCAMSR Control 20 26.5750 5.14596 1.15067

Practice 24 23.0208 4.83753 .98746


Independent Samples Test (MeanCAMSR)

Levene’s Test

for Equality


F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Averag

eCAMS

R

Equal

variances

assumed

.002 .964 2.358 42 .023 3.55417 1.50760 .51171 6.59662

Equal

variances

not

assumed

2.344 39.564 .024 3.55417 1.51628 .48859 6.61974

Psychoeducation and practice.



AverageCAMSR Psychoeducation 23 22.8696 3.30708 .68957

Practice 24 23.0208 4.83753 .98746

Independent Samples Test (AverageCAMSR)

Levene’s Test

for Equality


F Sig. t df

Sig.

(2-

tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Averag

eCAMS

R

Equal

variances

assumed

4.734 .035 -.125 45 .901 -.15127 1.21395 -2.59628 2.29375

Equal

variances

not

assumed

-.126 40.767 .901 -.15127 1.20440 -2.58403 2.28149



Estimates

Measure: MEASURE_1

Condition timeCAMSR Mean Std. Error 95% Confidence Interval


Control 1 27.126 1.082 24.963 29.289

2 26.232 1.151 23.931 28.534

Psychoeducation 1 23.069 1.012 21.045 25.093

2 22.331 1.077 20.177 24.484

Practice 1 22.250 1.042 20.166 24.334

2 24.000 1.109 21.783 26.217




Measure: MEASURE_1

timeCAMSR (I) Condition (J) Condition Mean

Difference

(I-J)



Lower

Bound

Upper

Bound

1


Practice 4.876* 1.502 .006 1.179 8.574

Psychoeduca

tion

Control -4.057* 1.481 .024 -7.704 -.410

Practice .819 1.453 1.000 -2.757 4.396

Practice Control -4.876* 1.502 .006 -8.574 -1.179

Psychoeducation -.819 1.453 1.000 -4.396 2.757

2


Practice 2.232 1.598 .502 -1.702 6.166

Psychoeduca

tion

Control -3.902* 1.576 .048 -7.782 -.021

Practice -1.669 1.546 .853 -5.474 2.136

Practice Control -2.232 1.598 .502 -6.166 1.702

Psychoeducation 1.669 1.546 .853 -2.136 5.474




Univariate Tests

Measure: MEASURE_1

timeCAMSR Sum of Squares df Mean Square F Sig.

1 Contrast 278.241 2 139.120 6.006 .004

Error 1413.065 61 23.165

2 Contrast 161.009 2 80.505 3.070 .054

Error 1599.587 61 26.223



marginal means.




Measure: MEASURE_1

Condition (I)

timeCAMS

R

(J)

timeCAMS

R

Mean

Difference

(I-J)


for Differenceb

Lower Bound Upper

Bound

Control 1

2

2 .894 .974 .362 -1.053 2.841

1 -.894 .974 .362 -2.841 1.053

Psychoeducation 1

2

2 .738 .911 .421 -1.083 2.560

1 -.738 .911 .421 -2.560 1.083

Practice 1 2 -1.750 .938 .067 -3.625 .125

2 1 1.750 .938 .067 -.125 3.625



Multivariate Tests


Control

Pillai's trace .014 .843a 1.000 61.000 .362

Wilks' lambda .986 .843a 1.000 61.000 .362



Psychoeducation

Pillai's trace .011 .657a 1.000 61.000 .421

Wilks' lambda .989 .657a 1.000 61.000 .421



Practice

Pillai's trace .054 3.482a 1.000 61.000 .067

Wilks' lambda .946 3.482a 1.000 61.000 .067



Each F tests the multivariate simple effects of timeCAMSR within each level combination of the other

effects shown. These tests are based on the linearly independent pairwise comparisons among the

estimated marginal means.

a. Exact statistic


Appendix P.13: Reappraisal (ERQ) Analyses



Pretest ERQ

(Reappraisal)

Control

Male 4.7727 1.17231 11

Female 5.1111 1.23705 9

Total 4.9250 1.18215 20

Psychoeducation

Male 5.2315 .94716 13

Female 4.7650 .73013 10

Total 5.0287 .87369 23

Practice

Male 4.7813 .77336 16

Female 4.8950 1.19028 8

Total 4.8192 .90788 24

Total

Male 4.9252 .95120 40

Female 4.9189 1.02903 27

Total 4.9227 .97560 67

Posttest ERQ

(Reappraisal)

Control

Male 4.8027 1.17160 11

Female 4.6667 1.45497 9

Total 4.7415 1.27225 20

Psychoeducation

Male 4.8469 .64405 13

Female 4.7490 .95420 10

Total 4.8043 .77537 23

Practice

Male 4.7288 .65877 16

Female 5.8313 .70778 8

Total 5.0963 .84696 24

Total

Male 4.7875 .80571 40

Female 5.0422 1.17255 27

Total 4.8901 .97008 67



Measure: MEASURE_1


Squares


timeReappraisalER

Q



Huynh-Feldt .004 1.000 .004 .010 .919

Lower-bound .004 1.000 .004 .010 .919

timeReappraisalER

Q * Condition



Huynh-Feldt 2.956 2.000 1.478 3.720* .030

Lower-bound 2.956 2.000 1.478 3.720* .030

timeReappraisalER

Q * Gender

Sphericity Assumed .688 1 .688 1.732 .193

Greenhouse-Geisser .688 1.000 .688 1.732 .193

Huynh-Feldt .688 1.000 .688 1.732 .193

Lower-bound .688 1.000 .688 1.732 .193

timeReappraisalER

Q * Condition *

Gender



Huynh-Feldt 2.761 2.000 1.381 3.474* .037

Lower-bound 2.761 2.000 1.381 3.474* .037

Error(timeReapprais

alERQ)



Huynh-Feldt 24.240 61.000 .397

Lower-bound 24.240 61.000 .397



Estimates

Measure: MEASURE_1

Condition timeReappraisalERQ Mean Std. Error 95% Confidence Interval


Control 1 4.942 .224 4.495 5.389

2 4.735 .211 4.312 5.157

Psychoeducation 1 4.998 .209 4.580 5.417

2 4.798 .198 4.403 5.193

Practice 1 4.838 .216 4.407 5.269

2 5.280 .203 4.873 5.687




Measure: MEASURE_1

timeReappra

isalERQ


Difference

(I-J)



Lower

Bound

Upper

Bound

1


Practice .104 .311 .739 -.517 .725

Psychoeduca

tion

Control .056 .306 .855 -.556 .669

Practice .160 .300 .596 -.441 .761

Practice Control -.104 .311 .739 -.725 .517

Psychoeducation -.160 .300 .596 -.761 .441

2


Practice -.545 .293 .068 -1.132 .041

Psychoeduca

tion

Control .063 .289 .828 -.515 .642

Practice -.482 .284 .094 -1.049 .085





Univariate Tests

Measure: MEASURE_1

timeReappraisalERQ Sum of Squares df Mean Square F Sig.

1

Contrast .288 2 .144 .145 .865

Error 60.437 61 .991

2

Contrast 3.757 2 1.878 2.128 .128

Error 53.850 61 .883



marginal means.




Measure: MEASURE_1

Condition (I)

timeReapp

raisalERQ

(J)

timeReapp

raisalERQ

Mean

Difference

(I-J)


for Differenceb

Lower Bound Upper

Bound

Control 1

2

2 .207 .200 .305 -.193 .608

1 -.207 .200 .305 -.608 .193

Psychoeducation 1

2

2 .200 .187 .290 -.175 .575

1 -.200 .187 .290 -.575 .175

Practice 1 2 -.442* .193 .026 -.828 -.056

2 1 .442* .193 .026 .056 .828




Multivariate Tests


Control

Pillai's trace .017 1.070a 1.000 61.000 .305

Wilks' lambda .983 1.070a 1.000 61.000 .305



Psychoeducation

Pillai's trace .018 1.141a 1.000 61.000 .290

Wilks' lambda .982 1.141a 1.000 61.000 .290



Practice

Pillai's trace .079 5.241a 1.000 61.000 .026

Wilks' lambda .921 5.241a 1.000 61.000 .026



Each F tests the multivariate simple effects of timeReappraisalERQ within each level combination of

the other effects shown. These tests are based on the linearly independent pairwise comparisons among

the estimated marginal means.

a. Exact statistic



Estimates

Measure: MEASURE_1

Condition timeReapprais

alERQ

Gender Mean Std. Error 95% Confidence Interval


Control

1 Male 4.773 .300 4.173 5.373

Female 5.111 .332 4.448 5.775

2 Male 4.803 .283 4.236 5.369

Female 4.667 .313 4.040 5.293

Psychoeducation

1 Male 5.232 .276 4.680 5.784

Female 4.765 .315 4.136 5.394

2 Male 4.847 .261 4.326 5.368

Female 4.749 .297 4.155 5.343

Practice

1 Male 4.781 .249 4.284 5.279

Female 4.895 .352 4.191 5.599

2 Male 4.729 .235 4.259 5.198

Female 5.831 .332 5.167 6.496



level).


Measure: MEASURE_1

timeRe

apprais

alERQ

Gender (I) Condition (J) Condition Mean

Differenc

e (I-J)


Interval for

Differenceb

Lower

Bound

Upper

Bound

1

Male

Control Psychoeducation -.459 .408 .795 -1.463 .545

Practice -.009 .390 1.000 -.968 .951

Psychoeducation Control .459 .408 .795 -.545 1.463

Practice .450 .372 .691 -.465 1.365

Practice Control .009 .390 1.000 -.951 .968

Psychoeducation -.450 .372 .691 -1.365 .465

Female

Control Psychoeducation .346 .457 1.000 -.780 1.472

Practice .216 .484 1.000 -.975 1.407

Psychoeducation Control -.346 .457 1.000 -1.472 .780

Practice -.130 .472 1.000 -1.292 1.032

Practice Control -.216 .484 1.000 -1.407 .975

Psychoeducation .130 .472 1.000 -1.032 1.292

2

Male

Control Psychoeducation -.044 .385 1.000 -.992 .903

Practice .074 .368 1.000 -.832 .980

Psychoeducation Control .044 .385 1.000 -.903 .992

Practice .118 .351 1.000 -.745 .982

Practice Control -.074 .368 1.000 -.980 .832

Psychoeducation -.118 .351 1.000 -.982 .745

Female

Control Psychoeducation -.082 .432 1.000 -1.145 .980

Practice -1.165* .457 .040 -2.289 -.041

Psychoeducation Control .082 .432 1.000 -.980 1.145

Practice -1.082 .446 .054 -2.179 .015

Practice Control 1.165* .457 .040 .041 2.289

Psychoeducation 1.082 .446 .054 -.015 2.179





Univariate Tests

Measure: MEASURE_1

timeReappraisal

ERQ

Gender Sum of Squares df Mean Square F Sig.

1

Male Contrast 1.807 2 .904 .912 .407

Error 60.437 61 .991

Female Contrast .574 2 .287 .290 .750

Error 60.437 61 .991

2

Male Contrast .104 2 .052 .059 .943

Error 53.850 61 .883

Female Contrast 7.110 2 3.555 4.027 .023

Error 53.850 61 .883




level).


Measure: MEASURE_1


timeReapprais

alERQ

(J)

timeReapprais

alERQ

Mean

Difference

(I-J)

Std.

Error


for Differenceb

Lower

Bound

Upper

Bound

Control

Male 1 2 -.030 .269 .911 -.567 .507

2 1 .030 .269 .911 -.507 .567

Female 1 2 .444 .297 .140 -.150 1.039

2 1 -.444 .297 .140 -1.039 .150

Psychoedu

cation

Male 1 2 .385 .247 .125 -.110 .879

2 1 -.385 .247 .125 -.879 .110

Female 1 2 .016 .282 .955 -.548 .580

2 1 -.016 .282 .955 -.580 .548

Practice

Male 1 2 .052 .223 .815 -.393 .498

2 1 -.052 .223 .815 -.498 .393

Female 1 2 -.936* .315 .004 -1.567 -.306

2 1 .936* .315 .004 .306 1.567





Multivariate Tests


Control

Male

Pillai's trace .000 .012a 1.000 61.000 .911

Wilks' lambda 1.000 .012a 1.000 61.000 .911



Female

Pillai's trace .035 2.237a 1.000 61.000 .140

Wilks' lambda .965 2.237a 1.000 61.000 .140



Psychoeducation

Male

Pillai's trace .038 2.420a 1.000 61.000 .125

Wilks' lambda .962 2.420a 1.000 61.000 .125



Female

Pillai's trace .000 .003a 1.000 61.000 .955

Wilks' lambda 1.000 .003a 1.000 61.000 .955



Practice

Male

Pillai's trace .001 .055a 1.000 61.000 .815

Wilks' lambda .999 .055a 1.000 61.000 .815



Female

Pillai's trace .126 8.824a 1.000 61.000 .004

Wilks' lambda .874 8.824a 1.000 61.000 .004



Each F tests the multivariate simple effects of timeReappraisalERQ within each level combination of the other

effects shown. These tests are based on the linearly independent pairwise comparisons among the estimated

marginal means.

a. Exact statistic



level).


Measure: MEASURE_1


alERQ


Difference

(I-J)


Interval for

Differenceb

Lower

Bound

Upper

Bound

Control

1 Male Female -.338 .447 .452 -1.233 .556

Female Male .338 .447 .452 -.556 1.233

2 Male Female .136 .422 .748 -.708 .981

Female Male -.136 .422 .748 -.981 .708

Psychoedu

cation

1 Male Female .467 .419 .270 -.371 1.304

Female Male -.467 .419 .270 -1.304 .371

2 Male Female .098 .395 .805 -.692 .888

Female Male -.098 .395 .805 -.888 .692

Practice

1 Male Female -.114 .431 .793 -.976 .748

Female Male .114 .431 .793 -.748 .976

2 Male Female -1.103* .407 .009 -1.916 -.289

Female Male 1.103* .407 .009 .289 1.916





Univariate Tests

Measure: MEASURE_1

Condition timeReappraisalERQ Sum of Squares df Mean Square F Sig.

Control

1 Contrast .567 1 .567 .572 .452

Error 60.437 61 .991

2 Contrast .092 1 .092 .104 .748

Error 53.850 61 .883

Psychoeducation

1 Contrast 1.230 1 1.230 1.242 .270

Error 60.437 61 .991

2 Contrast .054 1 .054 .061 .805

Error 53.850 61 .883

Practice

1 Contrast .069 1 .069 .070 .793

Error 60.437 61 .991

2 Contrast 6.483 1 6.483 7.343 .009

Error 53.850 61 .883




Appendix P.14: Suppression (ERQ) Analyses

A marginally significant between-subjects interaction effect of

condition*gender was found (F (2, 61) = 3.04, p = .055). The assumption of equality

of error variances (Levene’s test) was not violated (Pre-test: F (5, 61) = .66, p > .05;

Post-test: F (5, 61) = 1.01, p > .05).



Pretest ERQ

(Suppression)

Control

Male 4.4318 .80693 11

Female 3.9167 1.03078 9

Total 4.2000 .92694 20

Psychoeducation

Male 4.3077 1.33913 13

Female 4.1000 1.15590 10

Total 4.2174 1.23928 23

Practice

Male 3.8750 1.17969 16

Female 4.5625 1.38712 8

Total 4.1042 1.26602 24

Total

Male 4.1688 1.14688 40

Female 4.1759 1.17427 27

Total 4.1716 1.14912 67

Posttest ERQ

(Suppression)

Control

Male 4.6364 .85413 11

Female 3.9167 1.13192 9

Total 4.3125 1.02878 20

Psychoeducation

Male 4.1923 .85485 13

Female 4.2500 .79057 10

Total 4.2174 .80941 23

Practice

Male 3.9063 1.20718 16

Female 5.0313 1.26376 8

Total 4.2812 1.31528 24

Total

Male 4.2000 1.03031 40

Female 4.3704 1.11883 27

Total 4.2687 1.06183 67



F df1 df2 Sig.

Pretest ERQ (Suppression) .662 5 61 .653

Posttest ERQ (Suppression) 1.008 5 61 .421


groups.


Within Subjects Design: timeSupressionERQ


Measure: MEASURE_1



Squares


Intercept 2307.310 1 2307.310 1132.705 .000

Condition .449 2 .224 .110 .896

Gender .161 1 .161 .079 .779


Error 124.256 61 2.037


Appendix P.15: Positive Affect (PANAS) Analyses

A marginally significant within-subjects interaction effect of gender*time was

found (F (1, 61) = 3.90, p = .053).



Pretest PANAS

(Positive Affect)

Control

Male 32.09 6.715 11

Female 27.33 11.779 9

Total 29.95 9.383 20

Psychoeducation

Male 31.31 4.854 13

Female 27.80 8.548 10

Total 29.78 6.775 23

Practice

Male 25.50 8.198 16

Female 27.75 6.798 8

Total 26.25 7.685 24

Total

Male 29.20 7.356 40

Female 27.63 8.971 27

Total 28.57 8.017 67

Posttest PANAS

(Positive Affect)

Control

Male 29.45 9.059 11

Female 27.67 13.019 9

Total 28.65 10.742 20

Psychoeducation

Male 28.69 2.869 13

Female 31.30 5.293 10

Total 29.83 4.207 23

Practice

Male 28.00 8.877 16

Female 29.88 6.578 8

Total 28.63 8.085 24

Total

Male 28.63 7.365 40

Female 29.67 8.713 27

Total 29.04 7.888 67



Measure: MEASURE_1


Squares


timePAPANAS



Huynh-Feldt 9.076 1.000 9.076 .529 .470

Lower-bound 9.076 1.000 9.076 .529 .470

timePAPANAS *

Condition



Huynh-Feldt 61.911 2.000 30.956 1.804 .173

Lower-bound 61.911 2.000 30.956 1.804 .173

timePAPANAS *

Gender



Huynh-Feldt 66.967 1.000 66.967 3.903 .053

Lower-bound 66.967 1.000 66.967 3.903 .053

timePAPANAS *

Condition *

Gender



Huynh-Feldt 57.797 2.000 28.899 1.684 .194

Lower-bound 57.797 2.000 28.899 1.684 .194

Error(timePAPANA

S)



Huynh-Feldt 1046.499 61.000 17.156

Lower-bound 1046.499 61.000 17.156


Appendix P.16: Psychoeducation Test Analyses



Immediate

Psychoeducation

Total

Psychoeducation

Male 14.769 3.0112 13

Female 17.300 2.0710 10

Total 15.870 2.8889 23

Practice

Male 16.344 1.8323 16

Female 16.563 2.2271 8

Total 16.417 1.9262 24

Total

Male 15.638 2.5139 29

Female 16.972 2.1107 18

Total 16.149 2.4337 47

Posttest

Psychoeducation

Total

Psychoeducation

Male 15.500 3.2275 13

Female 16.250 2.6484 10

Total 15.826 2.9488 23

Practice

Male 16.094 2.5963 16

Female 15.625 1.5295 8

Total 15.937 2.2713 24

Total

Male 15.828 2.8576 29

Female 15.972 2.1860 18

Total 15.883 2.5964 47



Measure: MEASURE_1


Squares


timeTotalPsychoed



Huynh-Feldt 3.115 1.000 3.115 .907 .346

Lower-bound 3.115 1.000 3.115 .907 .346

timeTotalPsychoed

* Condition



Huynh-Feldt 1.034 1.000 1.034 .301 .586

Lower-bound 1.034 1.000 1.034 .301 .586

timeTotalPsychoed

* Gender



Huynh-Feldt 8.359 1.000 8.359 2.435 .126

Lower-bound 8.359 1.000 8.359 2.435 .126

timeTotalPsychoed

* Condition *

Gender



Huynh-Feldt 1.640 1.000 1.640 .478 .493

Lower-bound 1.640 1.000 1.640 .478 .493

Error(timeTotalPsyc

hoed)



Huynh-Feldt 147.626 43.000 3.433

Lower-bound 147.626 43.000 3.433


Appendix P.17: Programme Evaluation Analyses

Analyses in this section only involve either one or both the Psychoeducation

and Practice conditions as the following variables are specific to their respective

experimental manipulations. Univariate analysis of variance (ANOVA) was used as

these variables were measured at post-test only. Attitudes to the programme were

obtained. Scores ranged from 1 to 7 where 4 was set as the baseline attitude of no

change and higher scores represented better attitudes (except for workload change).

For binary yes or no questions, responses of no were given a value of 1 and responses

of yes a value of 2.

Reminders’ Usefulness.



Practice

Male 5.19 1.642 16

Female 5.00 1.069 8

Total 5.13 1.454 24


Workload change. No significant effects were found between the conditions.



Psychoeducation

Male 4.69 1.377 13

Female 3.80 1.619 10

Total 4.30 1.521 23

Practice

Male 4.37 1.928 16

Female 4.63 1.506 8

Total 4.46 1.769 24

Total

Male 4.52 1.682 29

Female 4.17 1.581 18

Total 4.38 1.636 47


Dependent Variable: Workload Change

F df1 df2 Sig.

.886 3 43 .456



a. Design: Intercept + Condition + Gender + Condition

* Gender


Dependent Variable: Workload Change


Squares


Corrected Model 5.112a 3 1.704 .621 .605

Intercept 839.631 1 839.631 305.982 .000

Condition .707 1 .707 .258 .614

Gender 1.132 1 1.132 .413 .524


Error 117.994 43 2.744

Total 1026.000 47

Corrected Total 123.106 46

a. R Squared = .042 (Adjusted R Squared = -.025)


Behaviour change. There was significant main effect of condition for

attitudes on changes in mindfulness practice. Subjects in the Practice condition rated

their changes in mindfulness practice behaviours significantly higher than those in the

Psychoeducation condition (F (1, 43) = 18.58, p < .001). Females also rated their

change as higher than males (F (1, 43) = 2.93, p = .094) but this main effect of gender

only approached significance. Equality of error variances was assumed (F (3, 43) =

1.31, p > .05). Attitudes on sleep and multitasking behavioural changes were not

significant.


Mindfulness practice behaviour change.



Psychoeducation

Male 4.00 .816 13

Female 4.70 1.059 10

Total 4.30 .974 23

Practice

Male 5.56 1.153 16

Female 6.00 1.414 8

Total 5.71 1.233 24

Total

Male 4.86 1.274 29

Female 5.28 1.364 18

Total 5.02 1.310 47


Dependent Variable: Self Report Mindfulness Change

F df1 df2 Sig.

1.307 3 43 .284




* Gender


Dependent Variable: Self Report Mindfulness Change


Squares


Corrected Model 26.941a 3 8.980 7.421 .000

Intercept 1126.627 1 1126.627 930.963 .000

Condition 22.485 1 22.485 18.580 .000

Gender 3.551 1 3.551 2.934 .094

Condition * Gender .189 1 .189 .156 .695

Error 52.037 43 1.210

Total 1264.000 47


a. R Squared = .341 (Adjusted R Squared = .295)


Sleep behaviour change.



Psychoeducation

Male 4.38 .768 13

Female 4.00 1.247 10

Total 4.22 .998 23

Practice

Male 4.38 1.025 16

Female 4.75 1.035 8

Total 4.50 1.022 24

Total

Male 4.38 .903 29

Female 4.33 1.188 18

Total 4.36 1.009 47


Dependent Variable: Self Report Sleep Change

F df1 df2 Sig.

.786 3 43 .508




* Gender


Dependent Variable: Self Report Sleep Change


Squares


Corrected Model 2.524a 3 .841 .816 .492

Intercept 841.293 1 841.293 816.109 .000

Condition 1.504 1 1.504 1.459 .234

Gender .000 1 .000 .000 .988


Error 44.327 43 1.031

Total 941.000 47




Multitasking behaviour change.



Psychoeducation

Male 4.62 1.044 13

Female 5.40 1.075 10

Total 4.96 1.107 23

Practice

Male 5.19 1.109 16

Female 5.25 1.035 8

Total 5.21 1.062 24

Total

Male 4.93 1.100 29

Female 5.33 1.029 18

Total 5.09 1.080 47


Dependent Variable: Self Report Multitasking Change

F df1 df2 Sig.

.069 3 43 .976




* Gender


Dependent Variable: Self Report Multitasking Change


Squares



Intercept 1147.898 1 1147.898 998.891 .000

Condition .489 1 .489 .425 .518

Gender 1.969 1 1.969 1.714 .197


Error 49.414 43 1.149

Total 1269.000 47




Outcome change. Attitudes on outcome changes showed a significant main

effect of condition only on changes in mood (F (1, 43) = 4.79, p < .05) and

mindfulness level (F (1, 43) = 15.29, p < .001), with subjects in the Practice condition

giving significantly higher ratings. Levene’s test for mood changes was not violated

(F (3, 43) = 2.79, p > .05). However, caution should be taken when interpreting the

results for attitudes on mindfulness level change as the Levene’s test was violated (F

(3, 43) = 3.49, p = .024). Independent-samples t-tests revealed that Levene’s adjusted

(equal variances not assumed) values for attitudes of mindfulness level change

revealed a significant t-statistic (t (35.07) = 3.97, p < .001) assuring that these

attitudinal differences held up after adjustment.

Attitudes on cognitive functioning and overall program benefits did not

demonstrate the same main effect of condition, although this was approaching

significance for attitudes on the overall program benefits. In a binary yes or no

question on whether subjects believed these strategies would change their life for the

better, there was also no significant main effect of condition.


Mood outcome change.



Psychoeducation

Male 4.23 .439 13

Female 4.40 .699 10

Total 4.30 .559 23

Practice

Male 5.06 .929 16

Female 4.63 1.061 8

Total 4.92 .974 24

Total

Male 4.69 .850 29

Female 4.50 .857 18

Total 4.62 .848 47


Dependent Variable: Self Report Mood Change

F df1 df2 Sig.

2.786 3 43 .052




* Gender


Dependent Variable: Self Report Mood Change


Squares



Intercept 920.795 1 920.795 1438.732 .000

Condition 3.064 1 3.064 4.788 .034

Gender .197 1 .197 .309 .581


Error 27.520 43 .640

Total 1035.000 47




Mindfulness level outcome change.



Psychoeducation

Male 4.38 .506 13

Female 4.70 .483 10

Total 4.52 .511 23

Practice

Male 5.31 .946 16

Female 5.63 1.061 8

Total 5.42 .974 24

Total

Male 4.90 .900 29

Female 5.11 .900 18

Total 4.98 .897 47


Dependent Variable: Self Report Mindfulness Level

Change

F df1 df2 Sig.

3.486 3 43 .024




* Gender


Dependent Variable: Self Report Mindfulness Level Change


Squares



Intercept 1100.054 1 1100.054 1785.706 .000

Condition 9.421 1 9.421 15.293 .000

Gender 1.082 1 1.082 1.756 .192

Condition * Gender 2.283E-005 1 2.283E-005 .000 .995

Error 26.489 43 .616

Total 1202.000 47




Pairwise comparisons (condition).

Group Statistics

Source Condition N Mean Std. Deviation Std. Error Mean

Self Report Mindfulness

Level Change

Psychoeducation 23 4.52 .511 .106

Practice 24 5.42 .974 .199

Independent Samples Test

Levene’s

Test for

Equality of

Variances t-test for Equality of Means

F Sig. t df

Sig.

(2-tailed)

Mean

Difference

Std. Error

Difference

95% Confidence

Interval of the

Difference

Lower Upper

Self

Report

Mindful

ness

Level

Change

Equal

variances

assumed

9.471 .004 -3.918 45 .000 -.895 .228 -1.355 -.435

Equal

variances

not

assumed

-3.967 35.067 .000 -.895 .226 -1.353 -.437


Cognitive functioning outcome change.



Psychoeducation

Male 4.23 .439 13

Female 4.50 .527 10

Total 4.35 .487 23

Practice

Male 4.50 .966 16

Female 4.63 .916 8

Total 4.54 .932 24

Total

Male 4.38 .775 29

Female 4.56 .705 18

Total 4.45 .746 47


Dependent Variable: Self Report Cognitive

Functioning Change

F df1 df2 Sig.

2.588 3 43 .065




* Gender


Dependent Variable: Self Report Cognitive Functioning Change


Squares


Corrected Model .934a 3 .311 .543 .656

Intercept 874.886 1 874.886 1524.148 .000

Condition .426 1 .426 .743 .393

Gender .426 1 .426 .743 .393


Error 24.683 43 .574

Total 955.000 47




Overall benefit received.



Psychoeducation

Male 4.69 .480 13

Female 5.00 .667 10

Total 4.83 .576 23

Practice

Male 5.19 .834 16

Female 5.25 .463 8

Total 5.21 .721 24

Total

Male 4.97 .731 29

Female 5.11 .583 18

Total 5.02 .675 47


Dependent Variable: Self Report Overall Program

Benefit

F df1 df2 Sig.

.414 3 43 .744




* Gender


Dependent Variable: Self Report Overall Program Benefit


Squares


Corrected Model 2.272a 3 .757 1.741 .173

Intercept 1111.920 1 1111.920 2555.900 .000

Condition 1.524 1 1.524 3.503 .068

Gender .376 1 .376 .864 .358


Error 18.707 43 .435

Total 1206.000 47




Change your life for the better.



Psychoeducation

Male 1.77 .439 13

Female 2.00 .000 10

Total 1.87 .344 23

Practice

Male 1.94 .250 16

Female 1.88 .354 8

Total 1.92 .282 24

Total

Male 1.86 .351 29

Female 1.94 .236 18

Total 1.89 .312 47


Dependent Variable: Self Report Belief Program

Changes Life for Better

F df1 df2 Sig.

6.075 3 43 .002




* Gender


Dependent Variable: Self Report Belief Program Changes Life for Better


Squares


Corrected Model .348a 3 .116 1.210 .317

Intercept 157.736 1 157.736 1646.197 .000

Condition .005 1 .005 .054 .818

Gender .078 1 .078 .811 .373

Condition * Gender .236 1 .236 2.463 .124

Error 4.120 43 .096

Total 173.000 47




Behavioural maintenance. Only those who rated above 4 for their self-report

on behaviour change (independent across respective self-reported behaviours)

answered questions about behavioural maintenance. Subjects rated in a binary yes or

no their intention to maintain their behaviours. No significant effects were found

between the conditions.


Mindfulness practice.



Psychoeducation

Male 2.00 .000 3

Female 2.00 .000 8

Total 2.00 .000 11

Practice

Male 1.77 .439 13

Female 2.00 .000 7

Total 1.85 .366 20

Total

Male 1.81 .403 16

Female 2.00 .000 15

Total 1.90 .301 31


Self Report Mindfulness Maintain Change

F df1 df2 Sig.

12.798 3 27 .000




* Gender


Self Report Mindfulness Maintain Change


Squares


Corrected Model .402a 3 .134 1.568 .220

Intercept 89.013 1 89.013 1041.453 .000

Condition .079 1 .079 .919 .346

Gender .079 1 .079 .919 .346


Error 2.308 27 .085

Total 115.000 31




Sleep.



Psychoeducation

Male 1.60 .548 5

Female 1.75 .500 4

Total 1.67 .500 9

Practice

Male 1.71 .488 7

Female 1.75 .500 4

Total 1.73 .467 11

Total

Male 1.67 .492 12

Female 1.75 .463 8

Total 1.70 .470 20


Dependent Variable: Self Report Sleep Maintain

Change

F df1 df2 Sig.

.266 3 16 .849




* Gender


Dependent Variable: Self Report Sleep Maintain Change


Squares


Corrected Model .071a 3 .024 .092 .963

Intercept 55.092 1 55.092 213.504 .000

Condition .015 1 .015 .060 .810

Gender .041 1 .041 .159 .696


Error 4.129 16 .258

Total 62.000 20




Multitasking.



Psychoeducation

Male 2.00 .000 8

Female 2.00 .000 8

Total 2.00 .000 16

Practice

Male 2.00 .000 13

Female 2.00 .000 7

Total 2.00 .000 20

Total

Male 2.00 .000 21

Female 2.00 .000 15

Total 2.00 .000 36


Future behaviour change. Only those who rated 4 and below for their self-

report on behaviour change (independent across respective self-reported behaviours)

answered questions about future behaviour change. No significant effects were found

between the conditions.


Mindfulness practice.



Psychoeducation

Male 4.50 1.841 10

Female 5.50 .707 2

Total 4.67 1.723 12

Practice

Male 5.33 .577 3

Female 6.00 . 1

Total 5.50 .577 4

Total

Male 4.69 1.653 13

Female 5.67 .577 3

Total 4.87 1.544 16


Dependent Variable: Self Report Mindfulness Need to

Change

F df1 df2 Sig.

2.385 3 12 .120




* Gender


Dependent Variable: Self Report Mindfulness Need to Change


Squares


Corrected Model 4.083a 3 1.361 .516 .679

Intercept 235.402 1 235.402 89.205 .000

Condition .920 1 .920 .348 .566

Gender 1.437 1 1.437 .544 .475


Error 31.667 12 2.639

Total 416.000 16




Sleep.



Psychoeducation

Male 4.50 2.204 8

Female 5.00 1.095 6

Total 4.71 1.773 14

Practice

Male 4.78 1.563 9

Female 4.50 2.380 4

Total 4.69 1.750 13

Total

Male 4.65 1.835 17

Female 4.80 1.619 10

Total 4.70 1.728 27


Dependent Variable: Self Report Sleep Need to

Change

F df1 df2 Sig.

2.881 3 23 .058




* Gender


Dependent Variable: Self Report Sleep Need to Change


Squares


Corrected Model 1.074a 3 .358 .108 .955

Intercept 540.161 1 540.161 162.283 .000

Condition .076 1 .076 .023 .881

Gender .076 1 .076 .023 .881


Error 76.556 23 3.329

Total 675.000 27




Multitasking.



Psychoeducation

Male 4.00 2.449 5

Female 2.50 .707 2

Total 3.57 2.149 7

Practice

Male 4.00 1.732 3

Female 7.00 . 1

Total 4.75 2.062 4

Total

Male 4.00 2.070 8

Female 4.00 2.646 3

Total 4.00 2.098 11


Dependent Variable: Self Report Multitasking Need to

Change

F df1 df2 Sig.

2.689 3 7 .127




* Gender


Dependent Variable: Self Report Multitasking Need to Change


Squares



Intercept 150.615 1 150.615 34.567 .001

Condition 9.959 1 9.959 2.286 .174

Gender 1.107 1 1.107 .254 .630


Error 30.500 7 4.357

Total 220.000 11




Appendix P.18: Further Analyses



Pretest ERQ

(Reappraisal)

Control

Male 4.7727 1.17231 11

Female 5.1111 1.23705 9

Total 4.9250 1.18215 20

Psychoeducation

Male 5.2315 .94716 13

Female 4.7650 .73013 10

Total 5.0287 .87369 23

Practice

Male 4.7813 .77336 16

Female 4.8950 1.19028 8

Total 4.8192 .90788 24

Total

Male 4.9252 .95120 40

Female 4.9189 1.02903 27

Total 4.9227 .97560 67

Posttest ERQ

(Reappraisal)

Control

Male 4.8027 1.17160 11

Female 4.6667 1.45497 9

Total 4.7415 1.27225 20

Psychoeducation

Male 4.8469 .64405 13

Female 4.7490 .95420 10

Total 4.8043 .77537 23

Practice

Male 4.7288 .65877 16

Female 5.8313 .70778 8

Total 5.0963 .84696 24

Total

Male 4.7875 .80571 40

Female 5.0422 1.17255 27

Total 4.8901 .97008 67



Measure: MEASURE_1


Squares


timeReappraisalER

Q



Huynh-Feldt .001 1.000 .001 .003 .955

Lower-bound .001 1.000 .001 .003 .955

timeReappraisalER

Q *

WeeklyPracticeTota

lChange



Huynh-Feldt .092 1.000 .092 .229 .634

Lower-bound .092 1.000 .092 .229 .634

timeReappraisalER

Q * Condition



Huynh-Feldt 2.269 2.000 1.134 2.819 .068

Lower-bound 2.269 2.000 1.134 2.819 .068

timeReappraisalER

Q * Gender

Sphericity Assumed .514 1 .514 1.276 .263

Greenhouse-Geisser .514 1.000 .514 1.276 .263

Huynh-Feldt .514 1.000 .514 1.276 .263

Lower-bound .514 1.000 .514 1.276 .263

timeReappraisalER

Q * Condition *

Gender



Huynh-Feldt 2.715 2.000 1.358 3.373* .041

Lower-bound 2.715 2.000 1.358 3.373* .041

Error(timeReapprais

alERQ)



Huynh-Feldt 24.148 60.000 .402

Lower-bound 24.148 60.000 .402




Estimates

Measure: MEASURE_1

Condition timeReappraisalERQ Mean Std. Error 95% Confidence Interval


Control 1 4.927a .224 4.478 5.376

2 4.727a .213 4.301 5.153

Psychoeducation 1 4.960a .213 4.533 5.387

2 4.777a .202 4.372 5.182

Practice 1 4.904a .227 4.450 5.358

2 5.316a .215 4.885 5.746

a. Covariates appearing in the model are evaluated at the following values: Change Score Weekly Mindful

Practice Total = 4.663.



Measure: MEASURE_1

timeReappra

isalERQ


Difference

(I-J)



Lower

Bound

Upper

Bound

1


Practice .023 .322 1.000 -.771 .817

Psychoeduca

tion

Control .033 .308 1.000 -.725 .791

Practice .056 .320 1.000 -.733 .845



2


Practice -.589 .306 .177 -1.342 .164

Psychoeduca

tion

Control .051 .292 1.000 -.668 .769

Practice -.538 .304 .245 -1.287 .210






Univariate Tests

Measure: MEASURE_1

timeReappraisalERQ Sum of Squares df Mean Square F Sig.

1

Contrast .031 2 .016 .016 .984

Error 59.557 60 .993

2

Contrast 3.982 2 1.991 2.229 .116

Error 53.592 60 .893



marginal means.



Measure: MEASURE_1

Condition (I)

timeReapp

raisalERQ

(J)

timeReapp

raisalERQ

Mean

Difference

(I-J)


for Differenceb

Lower Bound Upper

Bound

Control 1

2

2 .200 .202 .325 -.204 .605

1 -.200 .202 .325 -.605 .204

Psychoeducation 1

2

2 .183 .192 .345 -.202 .567

1 -.183 .192 .345 -.567 .202

Practice 1 2 -.412* .204 .048 -.820 -.003

2 1 .412* .204 .048 .003 .820





Multivariate Tests


Control

Pillai's trace .016 .984a 1.000 60.000 .325

Wilks' lambda .984 .984a 1.000 60.000 .325



Psychoeducation

Pillai's trace .015 .905a 1.000 60.000 .345

Wilks' lambda .985 .905a 1.000 60.000 .345



Practice

Pillai's trace .063 4.066a 1.000 60.000 .048

Wilks' lambda .937 4.066a 1.000 60.000 .048



Each F tests the multivariate simple effects of timeReappraisalERQ within each level combination of

the other effects shown. These tests are based on the linearly independent pairwise comparisons among

the estimated marginal means.

a. Exact statistic


Estimates

Measure: MEASURE_1


alERQ

Gender Mean Std. Error 95% Confidence Interval


Control

1 Male 4.743a .302 4.139 5.347

Female 5.111a .332 4.447 5.775

2 Male 4.787a .287 4.214 5.360

Female 4.667a .315 4.037 5.297

Psychoeducation

1 Male 5.134a .295 4.543 5.724

Female 4.786a .316 4.155 5.418

2 Male 4.794a .280 4.234 5.354

Female 4.761a .300 4.161 5.360

Practice

1 Male 4.823a .253 4.317 5.328

Female 4.985a .365 4.255 5.716

2 Male 4.751a .240 4.271 5.231

Female 5.880a .346 5.187 6.573

a. Covariates appearing in the model are evaluated at the following values: Change Score Weekly Mindful Practice

Total = 4.663.



level).


Measure: MEASURE_1

timeRe

apprais

alERQ

Gender (I) Condition (J) Condition Mean

Differenc

e (I-J)


Interval for

Differenceb

Lower

Bound

Upper

Bound

1

Male


Practice -.079 .397 1.000 -1.058 .899


Practice .311 .400 1.000 -.675 1.297

Practice Control .079 .397 1.000 -.899 1.058

Psychoeducation -.311 .400 1.000 -1.297 .675

Female

Control Psychoeducation .325 .458 1.000 -.804 1.454

Practice .126 .494 1.000 -1.090 1.341

Psychoeducation Control -.325 .458 1.000 -1.454 .804

Practice -.199 .478 1.000 -1.377 .979

Practice Control -.126 .494 1.000 -1.341 1.090

Psychoeducation .199 .478 1.000 -.979 1.377

2

Male


Practice .036 .377 1.000 -.893 .964

Psychoeducation Control .007 .393 1.000 -.961 .976

Practice .043 .380 1.000 -.893 .978



Female


Practice -1.213* .468 .036 -2.367 -.060


Practice -1.120* .454 .049 -2.237 -.002

Practice Control 1.213* .468 .036 .060 2.367

Psychoeducation 1.120* .454 .049 .002 2.237





Univariate Tests

Measure: MEASURE_1

timeReappraisal

ERQ

Gender Sum of Squares df Mean Square F Sig.

1

Male Contrast .990 2 .495 .499 .610

Error 59.557 60 .993

Female Contrast .511 2 .255 .257 .774

Error 59.557 60 .993

2

Male Contrast .013 2 .007 .007 .993

Error 53.592 60 .893

Female Contrast 7.367 2 3.684 4.124 .021

Error 53.592 60 .893




level).


Measure: MEASURE_1


timeReapprais

alERQ

(J)

timeReapprais

alERQ

Mean

Difference

(I-J)

Std.

Error


for Differenceb

Lower

Bound

Upper

Bound

Control

Male 1 2 -.044 .272 .873 -.588 .500

2 1 .044 .272 .873 -.500 .588

Female 1 2 .444 .299 .142 -.154 1.043

2 1 -.444 .299 .142 -1.043 .154

Psychoedu

cation

Male 1 2 .340 .266 .206 -.192 .872

2 1 -.340 .266 .206 -.872 .192

Female 1 2 .026 .284 .928 -.543 .595

2 1 -.026 .284 .928 -.595 .543

Practice

Male 1 2 .071 .228 .755 -.384 .527

2 1 -.071 .228 .755 -.527 .384

Female 1 2 -.895* .329 .008 -1.552 -.237

2 1 .895* .329 .008 .237 1.552





Multivariate Tests


Control

Male

Pillai's trace .000 .026a 1.000 60.000 .873

Wilks' lambda 1.000 .026a 1.000 60.000 .873



Female

Pillai's trace .036 2.209a 1.000 60.000 .142

Wilks' lambda .964 2.209a 1.000 60.000 .142



Psychoeducation

Male

Pillai's trace .026 1.633a 1.000 60.000 .206

Wilks' lambda .974 1.633a 1.000 60.000 .206



Female

Pillai's trace .000 .008a 1.000 60.000 .928

Wilks' lambda 1.000 .008a 1.000 60.000 .928



Practice

Male

Pillai's trace .002 .098a 1.000 60.000 .755

Wilks' lambda .998 .098a 1.000 60.000 .755



Female

Pillai's trace .110 7.410a 1.000 60.000 .008

Wilks' lambda .890 7.410a 1.000 60.000 .008



Each F tests the multivariate simple effects of timeReappraisalERQ within each level combination of the other

effects shown. These tests are based on the linearly independent pairwise comparisons among the estimated

marginal means.

a. Exact statistic



level).


Measure: MEASURE_1


alERQ


Difference

(I-J)


Interval for

Differenceb

Lower

Bound

Upper

Bound

Control

1 Male Female -.368 .449 .415 -1.266 .530

Female Male .368 .449 .415 -.530 1.266

2 Male Female .120 .426 .779 -.732 .972

Female Male -.120 .426 .779 -.972 .732

Psychoedu

cation

1 Male Female .347 .438 .431 -.529 1.223

Female Male -.347 .438 .431 -1.223 .529

2 Male Female .033 .415 .936 -.797 .864

Female Male -.033 .415 .936 -.864 .797

Practice

1 Male Female -.163 .435 .709 -1.032 .706

Female Male .163 .435 .709 -.706 1.032

2 Male Female -1.129* .412 .008 -1.954 -.305

Female Male 1.129* .412 .008 .305 1.954





Univariate Tests

Measure: MEASURE_1

Condition timeReappraisalERQ Sum of Squares df Mean Square F Sig.

Control

1 Contrast .667 1 .667 .672 .415

Error 59.557 60 .993

2 Contrast .071 1 .071 .079 .779

Error 53.592 60 .893

Psychoeducation

1 Contrast .624 1 .624 .629 .431

Error 59.557 60 .993

2 Contrast .006 1 .006 .006 .936

Error 53.592 60 .893

Practice

1 Contrast .139 1 .139 .140 .709

Error 59.557 60 .993

2 Contrast 6.701 1 6.701 7.502 .008

Error 53.592 60 .893




Appendix Q: Challenges Faced

1. What were some challenges with regards to changing your sleep habits?

I had to shift my bed time forward slightly each day as I had a habit of sleeping

late.

Had a lot of things to do so it was hard to get at least 8 hours of sleep

When you have to do work, you have to do work, no matter how much you'd like to

change your sleep habits... Change can't just be accomplished in 10 days,

particularly as time-sensitive a 10 days as the ones towards the end of the semester

and into reading week, haha.

Some of the challenges included wanting to complete some work before I sleep. If I

were to complete the work, I would sleep later so I had to force myself to stop and

wake up the next morning to continue.

I could not sleep more as I had the same amount of things to do but the day did not

get any longer :(

Returning home later than usual and having assignments to finish

Habit to still use the phone to check social media before sleep

Exam period, hence there is a need to stay up for revision

I get bored without my phone so I'm not very good at trying to sleep early

social activities late at night, and fixed time for waking up

exam period coming

The existing workload

The amount of assignments/project deadlines at the end meant rushing for them as

a priority before sleep. Student mentality, I guess?

Also habitual late sleeping is very hard to get rid of.


I somehow still woke up in the middle of the night, although I made sure there were

changes to my environment (not too hot for example), and kept a good routine

before sleep.

Perhaps its just that I produce too much body heat when I sleep, causing me to

wake up in the middle of the night.

didn't do anything

inability to tune in to the new routine immediately

Had to stay up to meet deadlines

Sleeping on time. Stretch more.

Mind drift to things happening in the day

I had assignments to do.

The demands of school and other responsibilities need to be met

because of school workload, an early night seems impossible at this stage

- Studying for a test or completing a paper often requires me to work beyond

midnight.

- CCA responsibilities prevent me from starting my work early so that I can finish

early and sleep.

- No time to catch up in the morning because of early class.

Not being able to use electronics were a bit difficult

Trying to sleep at least 8 hours or more when I usually get lesser sleep.

I sleep later than usual but I wake up later than usual as well. This is because I'm

trying to finish the work I have set for the day.


Impossible to change the schedule so suddenly

Some days I nap in the afternoon, so I fall asleep a little later at night (2am). But

when I don't nap i usually sleep around 12am

work commitments

Social activites/htht with friends happen late at night. I like bonding with my

friends whom I do not get to interact with during office hours

wasn't able to get full 8hrs of sleep as this was done during exams period

Sleeping pattern was habitual therefore it was hard to change. I has several

instances when I had to wake up earlier than usual so that decreased the amount of

sleep I had for the day

Too much work to do to actually find time to sleep early.

Sharing rooms with siblings makes it difficult for everyone to sleep at the same

time. Therefore, I had to discipline myself to ensure I get to bed early even if the

rest have not yet.

Assignment rushing and deadlines.

not using phone before sleeping.

- One hour before bed time not looking at my phone or computer.

No challenges actually. I had all the time in the world to sleep.

Too hooked onto devices

I think one main challenge is when I have friends who talk to me about their

troubles. This usually happens late at night and so in order to give them a listening

ear I'll also have to stay up late with them.

Having lots of work and revision to complete still

I think generally it was difficult to get an increased amount of sleep with an

increased workload


Staying awake in the afternoons (not taking naps)

there are more distractions in the day, so night is still the best time to do things

clash with finals. poor timing

I simply had too many obligations to fulfill in the later half of the 10 days. I had

work to complete within a limited span of time, and I had various project meetings

to attend to. Within the limited span of time, I had to sacrifice my sleep to ensure

that I met deadlines.

I was used to using my phone before sleeping and it was hard to kick that habit.

it's a long term issue, difficult to change with a ten day exercise

2. What were some challenges with regards to your changing multitasking

habits?

I multi-tasked out of habit, but gently reminded myself to stop and focus anon one

thing at a time.

Not much since I don't really multitask but one challenge would probably be that I

feel less productive

Old habits die hard -- also the feeling of being more productive since you're

technically trying to finish two things at once, however fallacious that is.

It was tempting to use my electronic devices while I was studying but I

remembered reading that multitasking would decrease the efficiency of performing

those multiple tasks, so I decided against that.

Work got more and more mundane that if i did not do something else while doing

work, I would have fallen asleep.

hmm. Do not really multi-task.

Too many things to do in a short period of time


same as the above

I get anxious when doing one thing, afraid that I'd forget something else.

lack of discipline

Having the will to focus on the task

Habits. After a while boredom sets in from just doing one thing that it's tempting to

multitask instead.

I don't usually multi-task to begin with, so its not too bad.

didn't do anything

habitual actions are hard to overcome. it comes naturally. needs abit more effort in

doing it

Distractions are always prsent

Distractions. Laptop. Phone.

Time pressure. Distractions on the computer

I had different submissions due.

Inability to focus long doing the same thing over and over

my phone. very hard to not multitask when im so addicted to my phone

- Well, habit would be the biggest challenge. But I'm very aware now and try to

avoid it all costs.

No difficulties; no reason to multitask

I had to be consciously aware to stop multi-tasking and stop being so distracted. I

did not even realise that I was multi-tasking at times and I had to stop it.

When I use the computer I like to have a lot of tabs open and I still have the habit

of clicking another tab when I get bored.

Felt like not enough time for everything


There are distractions everywhere. While doing one thing, I might suddenly get

reminded of another thing and have the urge to do it at the same, in case I forget

about it later. So it's been challenging to force myself not to attend to the other

thing.

it is essential in work to multitask e.g. writing minutes while in meeting. answering

calls while doing other work. it is difficult to not multitask. also, listening to songs

while reading a book/exercising

It's a habit difficult to shake because I will jump onto a task the moment my mind

worries about it

hard to stop using electronic devices while eating when I'm alone

I get distracted by electronic devices, and it is hard to overcome the temptation of

switching tabs while using the laptop to do work. Lack of sleep on some days didn't

help as well, it made me sluggish and more prone to multitasking

Feeling constantly like I should be making better use of my time (i.e. multitasking),

feeling guilty, restless (but yes I know it's not actually better I guess)

During eating, I will feel extremely tempted to reach for my laptop or phone just to

have something to watch while I finish my meal. But keeping in mind the benefits

of doing just one thing at a time, I managed to hold it off for the most part. The

only exception made was when I was on the toilet, but I aim to try and do the same

for that as well in the future.

None

trying not to use phone while doing school work.

- It's a very compulsive, habitual, automatic behavior. Hard to change.

Very difficult. My phone called to me constantly. Very hard to change multitasking

Still too hooked onto devices


When work is heavy I tend to want to switch to some entertainment frequently.

Also, because it can be quite weird to be on a bus but be looking around I will

unwittingly pick up my phone to look at it instead and end up multitasking on it.


There were many distractions and I had to constantly keep myself in check

The addiction to multitasking. Just don't want to work/study

not much problem in the first place


I was using the multi-tasking to escape my stress anxiety relating to my tasks at

hand.

I usually listen to songs while working and it was hard to not to do it this time.


3. What were some challenges with regards to your changing mindfulness

habits?

I had to change my mindset about having some quiet alone time. Mindfulness can

be done with a small window of time, and does not take much time.

It was hard especially when finals are nearing and I have a lot to get done and I

tend to plan ahead and it gets stressful sometimes I can't focus

Again, old habits die hard -- this needs to be a conscious change to be undertaken,

and sometimes there's the restlessness that there might be something else you

should be doing.

I increased the amount of time I meditated everyday but I usually meditate at night

so after a certain threshold, e.g. about 7 minutes, I would start falling asleep. I


started to try to mediate in the morning or afternoon when I am less tired (and when

my melatonin levels are lower!).

It was hard not to get distracted by the multiple things happening at once.

trying to find a peaceful time and place to meditate,

Need self-reminders

couldnt find time to practice

Nothing.

-

Setting time aside to practise it

No reminders (sorry! :/), and no incentive to actually practice it every day. At the

same time, shortly after the pre-test study were massive project deadlines that the

task to practice mindfulness was pretty much neglected, opting to continue with

what I've been doing to achieve my goals.

Setting aside a time to really stop and do so. Without a particular guide/follow-up

from the education component of mindfulness, it felt easy for me to slip back to my

past habits (and very difficult to maintain my new habits of mindfulness)

didn't do anything

Nil

Hard at the start

Studies.

Not enough practice

Lack of time and space

Mindfulness is more unconscious thought; to change it requires conscious effort,

which takes time

sometimes i forget to take time off to practice mindulness.


- Having to constantly remind myself to be mindful.

- Catching myself multi tasking more than I admit to.

- The horror of how much my mind wanders!!

However, the breathing practices helped me sleep better.

Having to focus on my work, without allowing my mind to wander

Being more aware and less judgemental is very hard as I think I tend to be very

harsh on myself. Trying to let go is another challenge as I feel weird trying to 'let

go'

Sometimes I don't feel like practicing so I stop before the 10 mins are up.

It is a very abrupt change

It takes alot of discipline. I try to do it the moment I wake up, but some days I get

lazy and push it to a later time... and I've forgotten to do it on a few days.

not used to it so a little challenging to be entirely mindful

Not really challenging with the take 10 program - though after that I won't know

what to do

on some days it was especially hard to sit still for 10min

Set aside 10minutes on most days to do the exercise on the app. Most of the time I

fell asleep in the middle of it.

Feelings of unease and gotta be constantly aware of being focused

Sometimes I find myself forcing my mind not to think. In my mind, I will be

constantly repeating the lyrics and rhythms to songs over and over and over again,

and I found that forcing myself to stop just makes it even worse. I have found

however that it only happens if I dont do the meditation session earlier in the day, it

will affect my mood for the rest of the day.


Commitment of time to remember to find time and sit down to do the practice

maintaining my focus.

trying to stay awake and focused when I'm very tired.

- To find a good place to do it. My room has mosquitoes and they drive me nuts!

Erm, I skipped maybe one day only? Not too much of a challenge

Spending the time for it

Some challenges are religious, I think it didn't take me long to realise that

mindfulness has some roots in buddhism or hinduism and this made me slightly

uncomfortable and wary of the practice.

Also, sometimes the instructions are just unclear, for instance, I'm not certain

whether I'm supposed to just let my thoughts flow or not, since the narrator says to

let the thoughts come but to focus when the mind starts wandering. Yet, it seems

that a wandering mind= letting your thoughts flow for me.


I think it took abit of discipline at the start to stick to the 10mins everyday, it got

much easier once I got into the swing of things

Too little patience for that

lack of discipline


I like using the app, but on occasions I forgot my earphones and thus I could not do

the take-10 session in private. I was also on the move a lot the past 10 days.

I used to daydream quite abit and it was difficult to get it back on track during the

sessions.



4. Suggestions for improvement:

NIL

The timing of the exercise, though I think this has more to do with me than with

your experiment -- you probably arranged for it to be at precisely a period where

we'd be a bit more stressed out than usual... I thought I would be able to balance

mindfulness practice/self-care with trying to finish my own work, but in weighing

one against the other academics clearly won, unfortunately. But that might be my

own issue.

My suggestions for improvement are included in the questions above.

The process of learning mindfulness could be done in a video/audio form instead of

word form that had to be read.

-

NIL

-

I need to have better sleeping habits

Some reminders or follow-ups would be good.

Nil

Focus more on early completion.

Nil

-

NIL

-

-

A buddy system within the participants/with my friends will be great

Perhaps not to do it at the end of the day when I am too tired.

I think the sleep part is truly quite impossible. There's honestly too much work to

do.

None I have in mind. Good luck for your thesis! :)


- I think mindful eating is a good way to get used to mindfulness.

Erm... Tell us explicitly how to manage multitasking

I think that mindfulness is a really difficult discipline and should be pursued in a

group where members keep each other accountable. Alternatively, it'd be ideal if

the experimenter had an easy way of monitoring our mindspace accounts to see if

we've been doing the mediations daily, at a consistent timing etc.

NIL

NA

really appreciate this Hans. It was quite timely.

No idea. Haha I'm doing this just before the deadline. I have another assignment

I'm attending to at the moment, so I'm taking a break from that.

NIL

a more long drawn process would be more accurate


Appendix R: Gratitude Expression

“really appreciate this Hans. It was quite timely.”

- Quote from subject in Practice condition in the suggestions response.