Mindfulness-based Stress Reduction Course Research Articles

Weekly Change in Mindfulness and Perceived Stress in a Mindfulness‐Based Stress Reduction Program

The purpose of the study was to examine weekly change in self-reported mindfulness and perceived stress in participants who completed an 8-week course in mindfulness-based stress reduction (MBSR). Participants were 87 adults with problematic levels of stress related to chronic illness, chronic pain, and other life circumstances (mean age = 49 years, 67% female) participating in MBSR in an academic medical center. They completed weekly self-report assessments of mindfulness skills and perceived stress. It was hypothesized that significant improvement in mindfulness skills would precede significant change in stress. Mindfulness skills and perceived stress both changed significantly from pretreatment to posttreatment. Significant increases in mindfulness occurred by the second week of the program, whereas significant improvements in perceived stress did not occur until week 4. Extent of change in mindfulness skills during the first three weeks predicted change in perceived stress over the course of the intervention. Evidence that changes in mindfulness precede changes in perceived stress in a standard MBSR course is consistent with previous studies suggesting that improvements in mindfulness skills may mediate the effects of mindfulness training on mental health outcomes.

Influence of Mindfulness Practice on Cortisol and Sleep in Long-Term and Short-Term Meditators

Background: There is growing scientific interest in assessing the biological correlates of non-pharmacological interventions such as mindfulness. Examinations of the beneficial effects of mindfulness on hypothalamus-pituitary-adrenocortical system activity (HPA SA) and sleep are sparse. The aim of the present study was to explore the impact of long- and short-term meditation experience on HPA SA and sleep. Method: There were 20 participants, 9 of whom had long-term experience in meditation (mean = 264 months) and 11 novices. Novices underwent an 8-week course in Mindfulness-Based Stress Reduction (MBSR), and cortisol samples were taken in the lab at the beginning and end of the course. To assess the cortisol awakening response, 4 morning cortisol samples were collected. Sleep and mindfulness were assessed by self-rating questionnaires. Results: Among participants with long-term meditation experience, morning cortisol decreased with length of experience. For novices, after an 8-week introductory MBSR course, morning cortisol levels had decreased, while both sleep and self-attribution of mindfulness significantly improved. Cortisol levels did not, however, change between the beginning and end of individual MBSR sessions. Conclusions: The pattern of results lends support to the view that MBSR/meditation has a favorable influence both on biomarkers of stress regulation, such as cortisol secretion, and on sleep.

Mindfulness Based Stress Reduction (MBSR) for Improving Health, Quality of Life, and Social Functioning in Adults

Mind-body interventions to manage stress-related health problems are of widespread interest. One of the best known methods is mindfulness-based stress reduction (MBSR), and MBSR courses are now offered by health services, as well as in social and welfare settings. In this systematic review, we report on the effects of MBSR interventions on health, quality of life, and social functioning. From the more than 3,000 potentially relevant references identified in two extensive searches, we included 31 relevant studies with an overall total of 1,942 participants, each of whom had been randomised to receive MBSR or other treatment strategies (most often a waiting list control). We utilised all outcome data published in the selected studies using a new statistical method for calculating the effect size. This method addressed the problems presented by the interdependence of many measurements of outcomes. 26 of the 31 studies were identified as having data suitable for meta-analysis. MBSR was found to have a moderate and consistent positive effect on mental health outcomes in both patients selected with somatic problems and with mild to moderate psychological problems, and among participants recruited from community settings. MBSR interventions improved outcomes measuring different aspects of personal development and quality of life. The effects on somatic health outcomes were somewhat smaller. No adverse effects were described. Few studies were found that evaluated the impact of MBSR on social functioning, such as the ability to work.

For Whom May Participation in a Mindfulness-Based Stress Reduction Program be Contraindicated?

Mindfulness-Based Stress Reduction (MBSR) programs are offered worldwide. To date, there has been little discussion about for whom participation may not be appropriate. We reviewed the literature pertaining to attrition and adverse effects following participation in MBSR; relatively little was learned in this search. A few clinical trials from Mindfulness-Based Cognitive Therapy (MBCT) provide ideas concerning who may not benefit from this program and who is likely to drop out. There are some case studies of individuals who manifested various mental health issues following experiences with various forms of meditation, but often specifics are missing such that it is not known what type of meditation was practiced or if the individuals in question had previous psychiatric disorders or preexisting conditions that could predispose them to negative outcomes. While we could not provide an empirically based answer to our question, we open the discussion and offer recommendations, especially with regard to preprogram screening, to guide instructors when they form a new group for an MBSR course so that the risk of harm is reduced. We trust that this paper will prompt our colleagues to examine the issue of risk and report adverse events should they occur.

Sustained Impact of MBSR on Stress, Well-Being, and Daily Spiritual Experiences for 1 Year in Academic Health Care Employees

The objectives of the study were (1) to evaluate self-reported stress levels and daily spiritual experiences in academic health care employees before, immediately after, and 1 year after enrolling in a mindfulness-based stress reduction (MBSR) course; and (2) to evaluate the correlation between a potential measure of pulse rate variability and self-reported stress levels. Fifty-nine (59) participants in the MBSR course offered to employees at the University of Texas Medical Branch in Galveston (UTMB) comprised the intervention group, and 94 health care providers in the neonatal nurseries comprised the control group. MBSR is an 8-week course that introduces mindfulness meditation practices. No intervention was offered to the control group. All participants were employees (or relatives of employees) at UTMB. All MBSR participants completed Cohen's Perceived Stress Scale, the SCL-90, the SF-36 Measure of Health and Well-Being, the Daily Spiritual Experiences Scale, and a 5-minute measure of pulse rate coherence. This testing was done before and after the MBSR course and 1 year later. Ninety-four (94) neonatal health care providers completed the same series of questionnaires and pulse rate variability (PRV) measures, with 49 of the 94 completing the questionnaires 2 months and 1 year later. MBSR participants improved on all measures except the physical component score of the SF-36 upon completion of the MBSR course, and these results were maintained at the 1-year follow-up. The control group did not significantly change on any of the measures. PRV as measured by the Heart Math system did not correlate with any of the self-report questionnaires. MBSR effectively reduces self-report measures of stress and increases daily spiritual experiences in employees in an academic health care setting, and these effects are stable for at least 1 year. Using a simple measure of PRV was not a clinically reliable biologic measure of stress.

Mindfulness-Based Stress Reduction (MBSR) for Primary School Teachers

Stress within the teaching profession has a negative impact on the health and well-being of individual teachers and on retention and recruitment for the profession as a whole. There is increasing literature to suggest that Mindfulness is a useful intervention to address a variety of psychological problems, and that Mindfulness-Based Stress Reduction (MBSR) is a particularly helpful intervention for stress. We investigated the effects of teaching a MBSR course to primary school teachers to reduce stress. The MBSR course was taught to a group of primary school teachers and evaluated to establish its effects on levels of anxiety, depression, and stress, as well as movement towards a stated goal and changes in awareness. The results showed improvement for most participants for anxiety, depression, and stress, some of which were statistically significant. There were also significant improvements on two of the four dimensions of a mindfulness skills inventory. These results suggest that this approach could be a potentially cost-effective method to combat teacher stress and burnout.

Mindfulness Based Stress Reduction: effect on emotional distress in diabetes.

Psychological distress is common in patients with diabetes. Little is known about the impact of Mindfulness Based Stress Reduction (MBSR), a non-traditional, cognitive behavioural intervention designed to improve stress management skills, in patients with diabetes. The purpose of this retrospective analysis was to evaluate the impact of MBSR training on mood states in 25 individuals with diabetes. All participants completed the Profile of Mood States Short Form (POMS-SF) at baseline and following eight weeks of MBSR. Overall psychological distress measured by the total mood score (TMS) and six subscales - including tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia, confusion/bewilderment and vigour/activity - were assessed. Overall mood, measured by the TMS, as well as all subscale mood measurements improved significantly from baseline following MBSR training. Compared to population means, those with diabetes had higher distress at baseline and similar levels of distress following MBSR training. The primary reason participants reported for enrolling in the MBSR course was to improve stress management skills. It was concluded that MBSR training is a promising, group-based intervention that can be used to decrease psychological distress in individuals with diabetes who perceive a need for training in stress management.

Effects of Mindfulness-Based Stress Reduction on Quality of Life in Nursing Home Residents: A Feasibility Study

Background: With demographic change, the number of elderly people is increasing. The aging process and associated stress diminishes their quality of life. Mindfulness-based stress reduction (MBSR) has been claimed to reduce stress and alleviate suffering. It might be a useful approach to improve the condition in the elderly. Patients and Methods: To examine feasibility and potential effects of MBSR on nursing home residents in Germany, a non-randomized feasibility study was conducted including 22 participants; 15 of them participated in an 8-week MBSR course, 7 served as untreated comparison group. Health-related quality of life (SF-12), depressive symptoms (GDS-12R), cognitive impairment (MMST), activities of daily living (Barthel Index), satisfaction with life, physical pain and major complaints were assessed pre- and post-intervention. Results: 9 out of 15 course participants completed the course (60%). They showed a significant increase in the SF-12 physical health score (p = 0.017). Depressive symptoms (GDS-12R) significantly declined within the meditation group (p = 0.04) and as compared to the untreated group (p = 0.011). In the comparison group, a significant decrease in major complaints (p = 0.011) and an increase in the SF-12 mental health score were found. The meditation group yielded positive changes in the SF-12 mental health score, in satisfaction with life and in pain intensity. Conclusions: In view of the setting, the completion rate of 60% appears to be acceptable. Significant results suggest that MBSR may help improve health-related quality of life and reduce symptoms of depression. Yet, as participants did not meet the requirement to practice independently, feasibility of conducting MBSR with elderly who live in a nursing home has to be questioned.

A Pilot Study Comparing the Effects of Mindfulness-Based and Cognitive-Behavioral Stress Reduction

The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). Fifty (50) subjects were recruited from the community and took part in MBSR (n = 36) and CBSR (n = 14) courses. Participants self-selected into MBSR or CBSR courses taught at different times. There were no initial differences between the MBSR and CBSR subjects on demographics, including age, gender, education, and income. MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. Perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain, and mindfulness were assessed before and after each course. Pre-post scores for each intervention were compared by using paired t tests. Pre-post scores across interventions were compared by using a general linear model with repeated measures. SETTINGS/LOCATIONS: Weekly meetings for both courses were held in a large room on a university medical center campus. MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain. Future studies should continue to examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.

Mindfulness‐based stress reduction and attentional control

AbstractThis study was designed to test the hypothesis that mindfulness involves sustained attention, attention switching, inhibition of elaborative processing and non‐directed attention. Healthy adults were tested before and after random assignment to an 8‐week Mindfulness‐Based Stress Reduction (MBSR) course (n = 39) or a wait‐list control (n = 33). Testing included measures of sustained attention, attention switching, Stroop interference (as a measure of inhibition of elaborative processing), detection of objects in consistent or inconsistent scenes (as a measure of non‐directed attention), as well as self‐report measures of emotional well‐being and mindfulness. Participation in the MBSR course was associated with significantly greater improvements in emotional well‐being and mindfulness, but no improvements in attentional control relative to the control group. However, improvements in mindfulness after MBSR were correlated with improvements in object detection. We discuss the implications of these results as they relate to the role of attention in mindfulness. Copyright © 2007 John Wiley & Sons, Ltd.

Mindfulness training modifies subsystems of attention

Mindfulness is defined as paying attention in the present moment. We investigate the hypothesis that mindfulness training may alter or enhance specific aspects of attention. We examined three functionally and neuroanatomically distinct but overlapping attentional subsystems: alerting, orienting, and conflict monitoring. Functioning of each subsystem was indexed by performance on the Attention Network Test. Two types of mindfulness training (MT) programs were examined, and behavioral testing was conducted on participants before (Time 1) and after (Time 2) training. One training group consisted of individuals naive to mindfulness techniques who participated in an 8-week mindfulness-based stress reduction (MBSR) course that emphasized the development of concentrative meditation skills. The other training group consisted of individuals experienced in concentrative meditation techniques who participated in a 1-month intensive mindfulness retreat. Performance of these groups was compared with that of control participants who were meditation naive and received no MT. At Time 1, the participants in the retreat group demonstrated improved conflict monitoring performance relative to those in the MBSR and control groups. At Time 2, the participants in the MBSR course demonstrated significantly improved orienting in comparison with the control and retreat participants. In contrast, the participants in the retreat group demonstrated altered performance on the alerting component, with improvements in exogenous stimulus detection in comparison with the control and MBSR participants. The groups did not differ in conflict monitoring performance at Time 2. These results suggest that mindfulness training may improve attention-related behavioral responses by enhancing functioning of specific subcomponents of attention. Whereas participation in the MBSR course improved the ability to endogenously orient attention, retreat participation appeared to allow for the development and emergence of receptive attentional skills, which improved exogenous alerting-related process.

Mindfulness-Based Stress Reduction in Massachusetts Correctional Facilities

Mindfulness-based stress-reduction courses were offered in drug units in six Massachusetts Department of Corrections prisons. A total of 1,350 inmates completed the 113 courses. Evaluation assessments were held before and after each course, and highly significant pre- to post-course improvements were found on widely accepted self-report measures of hostility, self-esteem, and mood disturbance. Improvements for women were greater than those for men, and improvements were also greater for men in a minimum-security, pre-release facility than for those in four medium-security facilities. The results encourage further study and wider use of mindfulness-based stress reduction in correctional facilities.

Teaching Counselors Self-Care through Mindfulness Practices

Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, qigong, and conscious relaxation exercises). Three methods of evaluating this 15-week 3-credit mindfulness-based stress reduction (MBSR) course for counseling students indicated positive changes for students in learning how to manage stress and improve counseling practice. Students reported positive physical, emotional, mental, spiritual, and interpersonal changes and substantial effects on their counseling skills and therapeutic relationships. Information from a focus group, qualitative reports, and quantitative course evaluations were triangulated; all data signified positive student responses to the course, method of teaching, and course instructor. Most students reported intentions of integrating mindfulness practices into their future profession.

Teaching Counselors Self-Care through Mindfulness Practices

Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, qigong, and conscious relaxation exercises). Three methods of evaluating this 15-week 3-credit mindfulness-based stress reduction (MBSR) course for counseling students indicated positive changes for students in learning how to manage stress and improve counseling practice. Students reported positive physical, emotional, mental, spiritual, and interpersonal changes and substantial effects on their counseling skills and therapeutic relationships. Information from a focus group, qualitative reports, and quantitative course evaluations were triangulated; all data signified positive student responses to the course, method of teaching, and course instructor. Most students reported intentions of integrating mindfulness practices into their future profession.

A Preliminary Study of the Effects of a Modified Mindfulness Intervention on Binge Eating

The purpose of this study was to explore the feasibility of a modified mindfulness intervention for reducing binge eating. Participants ( n = 25) were recruited from the general public for a Mindfulness-Based Stress Reduction (MBSR) course. The standard MBSR format was modified to include brief eating exercises. There was no control group. Participants completed the Binge Eating Scale and other self-report measures before and after the course. There was a decline in binge eating as well as state anxiety and depressive symptoms. Reduced binge eating was related to increased self-acceptance and reduced state anxiety. The results are discussed with regard to laying the foundation for future research on the effects of mindfulness on eating.

Longitudinal Impact of Mindfulness Meditation on Illness Burden in Solid-Organ Transplant Recipients

In 2001, more than 24000 solid-organ transplant surgeries were performed in the United States. Although survival rates have steadily risen over the past 2 decades, transplant recipients commonly experience a myriad of symptoms after transplantation that compromise quality of life. Anxiety, depression, and insomnia frequently occur despite excellent function of the transplanted organ. Use of complementary and alternative medicine has risen sharply over the past 10 years, particularly among people with chronic illnesses. Twenty solid-organ transplant recipients were enrolled in a clinical trial of mindfulness-based stress reduction. During the 8-week course, subjects learned various forms of meditation and gentle hatha yoga. Participants were given audiotapes for home practice and maintained practice diaries. Longitudinal analysis focused on the impact of mindfulness-based stress reduction on symptom management, illness intrusion, and transplant-related stressors. Significant improvements in the quality and duration of sleep continued for 6 months after completion of the mindfulness-based stress reduction course. Improvements after the completion of the course were also noted in self-report measures of anxiety and depression. Mindfulness-based stress reduction is an effective treatment in improving the quality and duration of sleep. Because sleep is highly correlated with positive mental health and overall well-being, these findings suggest that mindfulness-based stress reduction has the potential of being an effective, accessible and low-cost intervention that could significantly change transplant recipients' overall health and well-being.