Studies Of Mindfulness-based Stress Reduction Research Articles

Serotonin Transporter (SLC6A4) and FK506-Binding Protein 5 (FKBP5) Genotype and Methylation Relationships with Response to Meditation in Veterans with PTSD.

Meditation-based interventions are novel and effective non-pharmacologic treatments for veterans with PTSD. We examined relationships between treatment response, early life trauma exposure, DNA polymorphisms, and methylation in the serotonin transporter (SLC6A4) and FK506-binding protein 5 (FKBP5) genes. DNA samples and clinical outcomes were examined in 72 veterans with PTSD who received meditation-based therapy in two separate studies of mindfulness-based stress reduction (MBSR) and Transcendental Meditation (TM). The PTSD Checklist was administered to assess symptoms at baseline and after 9weeks of meditation intervention. We examined the SLC6A4 promoter (5HTTLPR_L/S insertion/deletion + rs25531_A/G) polymorphisms according to previously defined gene expression groups, and the FKBP5 variant rs1360780 previously associated with PTSD disease risk. Methylation for CpG sites of SLC6A4 (28 sites) and FKBP5 (45 sites) genes was quantified in DNA samples collected before and after treatment. The 5HTTLPR LALA high expression genotype was associated with greater symptom improvement in participants exposed to early life trauma (p = 0.015). Separately, pre to post-treatment change of DNA methylation in a group of nine FKBP5 CpG sites was associated with greater symptom improvement (OR = 2.8, 95% CI 1.1-7.1, p = 0.027). These findings build on a wealth of existing knowledge regarding epigenetic and genetic relationships with PTSD disease risk to highlight the potential importance of SLC6A4 and FKBP5 for treatment mechanisms and as biomarkers of symptom improvement.

Absence of structural brain changes from mindfulness-based stress reduction: Two combined randomized controlled trials.

Studies purporting to show changes in brain structure following the popular, 8-week mindfulness-based stress reduction (MBSR) course are widely referenced despite major methodological limitations. Here, we present findings from a large, combined dataset of two, three-arm randomized controlled trials with active and waitlist (WL) control groups. Meditation-naïve participants (n = 218) completed structural magnetic resonance imaging scans during two visits: baseline and postintervention period. After baseline, participants were randomly assigned to WL (n = 70), an 8-week MBSR program (n = 75), or a validated, matched active control (n = 73). We assessed changes in gray matter volume, gray matter density, and cortical thickness. In the largest and most rigorously controlled study to date, we failed to replicate prior findings and found no evidence that MBSR produced neuroplastic changes compared to either control group, either at the whole-brain level or in regions of interest drawn from prior MBSR studies.

Non-drug Stress Management for Patients with Cancer: A Systematic Review

Background: Patients with cancer suffer from the physical impacts of the disease, including pain in organs where cancer has spread to and treatment side effects. Many factors affect the mental state of cancer patients, especially stress which can cause muscle tension around the affected area and create a higher degree of pain. Stress impacts physical conditions and results in a worse quality of life. Thus, an appropriate approach to cope with, evaluate, and manage stress in cancer patients is considered crucial. Objective: The purpose of this systematic review was to determine and evaluate non-drug stress management guidelines for cancer patients. Methods: A systematic review was undertaken to synthesize knowledge concerning stress and non-drug stress management for cancer patients. Information was sourced from documents and articles published by related institutions in relevant electronic databases, including PubMed, PsycINFO, Dynamed, and ScienceDirect between 2013 and 2019. No limitations were imposed regarding the type of study design previously used. Conference abstracts were not accepted. The quality of all included studies was independently appraised by two review writers. Results: The search generated 129 studies, of which only 20 met the inclusion criteria. The 20 studies cover 11 studies of music for cancer prevention and 6 studies of mindfulness-based stress reduction in cancer patients. The studies utilized both quantitative and qualitative approaches, while three studies of biofeedback in cancer patients only collected quantitative data. For the outcome from the reviews, 6 studies found that music therapy, biofeedback, and mindfulness greatly impact physical alterations such as insomnia, nausea or vomiting, and pain. Furthermore, 17 studies found that non-drug management techniques had a positive impact on psychological adjustments such as stress and anxiety reduction and relaxation promotion. Non-drug stress management such as music, biofeedback, and mindfulness was found to reduce stress among patients. Conclusion: This review confirms that non-drug stress management approaches can reduce suffering, lead to a better quality of life, reduce mortality rates, minimize treatment costs, and prevent and mitigate unwanted symptoms in cancer patients. This approach can be adapted and applied to patients with other diseases in the future. However, because several of the reviewed studies did not have a follow-up period, the present study was unable to collect evidence suggesting how long the observed benefits will remain.

Mindfulness-based stress reduction for women diagnosed with breast cancer.

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness-based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non-judgmental, accepting moment-by-moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer. To assess the effects of mindfulness-based stress reduction (MBSR) in women diagnosed with breast cancer. In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings. Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer. We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta-analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention). Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta-analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta-analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.MBSR may improve quality of life slightly at the end of the intervention (based on low-certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low-certainty evidence from three studies involving 428 participants). Long-term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT-B, 95% CI -5.82 to 5.82; low-certainty evidence).In the short term, MBSR probably reduces fatigue (SMD -0.50, 95% CI -0.86 to -0.14; moderate-certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD -0.29, 95% CI -0.50 to -0.08; moderate-certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD -0.54, 95% CI -0.86 to -0.22; high-certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD -0.38, 95% CI -0.79 to 0.04; moderate-certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short-term depression) are compatible with both an improvement and little to no difference.In the medium term, MBSR probably results in little to no difference in medium-term fatigue (SMD -0.31, 95% CI -0.84 to 0.23; moderate-certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD -0.28, 95% CI -0.49 to -0.07; moderate-certainty evidence; 7 studies; 1094 participants), depression (SMD -0.32, 95% CI -0.58 to -0.06; moderate-certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD -0.27, 95% CI -0.63 to 0.08; moderate-certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.In the long term, moderate-certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD -0.09, 95% CI -0.35 to 0.16; 2 studies; 360 participants) or depression (SMD -0.17, 95% CI -0.40 to 0.05; 2 studies; 352 participants). No long-term data were available for fatigue or quality of sleep.No study reported data on survival or adverse events. MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

Mindfulness-Based Intervention Does Not Influence Cardiac Autonomic Control or the Pattern of Physical Activity in Fibromyalgia During Daily Life: An Ambulatory, Multimeasure Randomized Controlled Trial.

Fibromyalgia (FM) is a syndrome characterized by severe pain, fatigue and sleep disturbance. There is evidence of central hyper-responsiveness to sensory stimulation and impaired cardiovascular autonomic control. Laboratory investigations suggest that mindfulness-based stress reduction (MBSR) may improve autonomic functioning in FM. However, these findings may not reflect what occurs during naturalistic conditions, and MBSR studies during real-life functioning are lacking. We conducted a randomized controlled, 3-armed study with 168 female FM patients. This report describes cardiac, respiratory, and physical activity findings. Eight-week MBSR was compared with wait-list and active control intervention. Ambulatory accelerometry and cardiorespiratory function were monitored over 24-h periods at 3 time points: preintervention, postintervention, and at the 8-week follow-up. Also, baseline levels were compared with an age-matched group of 33 healthy women. Activity heart rate, respiratory sinus arrhythmia, and ventilation were measured. Comparison with controls confirmed differences in cardiac autonomic tone and activity pattern among patients. Most measures also showed effects of time of day and point of measurement. Regarding the intervention study, there were no effects of treatment. In addition, there were no relations between patient-reported clinical improvement and objective physiological or accelerometry parameters. Intervention-related benefits in wellbeing were not associated with changes in daytime cardiorespiratory measures or pattern of physical activity. MBSR did not produce cardiac autonomic benefits or changes in daily activity in FM. Furthermore, the lack of an association between patient-experienced clinical improvement and objective physiological measures suggests that subjective changes in the wellbeing of FM patients over time are not related to alterations in the cardiorespiratory autonomic function or activity levels.

A Promising Practice: School-Based Mindfulness-Based Stress Reduction for Children with Disabilities

Abstract Adults and children around the world are experiencing unhealthy levels of stress. More specifically, the stress levels that children report can have detrimental effects on their social-emotional, physical and academic well-being. Schools are in a unique position to not only address the causes of stress in children's lives, but to also provide strategies to reduce stress. Mindfulness-Based Stress Reduction (MBSR) is one approach that schools can use to teach children how to acknowledge and deal with everyday stressors. This article aims to provide a definition of stress, describe MBSR, and provide a review of the current literature on MBSR studies with children. Additionally, the authors suggest implications for school-based mindfulness approaches to reduce the stress of children with disabilities, and recommendations for future research.

The value of mindfulness meditation in the treatment of insomnia.

Insomnia is the most common reported sleep disorder with limited treatment options including pharmacotherapy and cognitive behavioral therapy for insomnia. Pharmacotherapy can be complicated by tolerance and significant side-effects and cognitive behavioral therapy for insomnia providers are limited in number. This article reviews mindfulness meditation as an additional therapy for insomnia. Both mindfulness-based stress reduction (MBSR) and mindfulness-based therapy for insomnia (MBTI) have been studied in the treatment of insomnia. Randomized controlled studies of MBSR and MBTI have shown overall reduction in sleep latency and total wake time and increase in total sleep time after mindfulness therapy using both patient reported outcome and quantitative measures of sleep. Mindfulness techniques have been shown to be well accepted by patients with long-lasting effects. A three-arm randomized study with MBSR, MBTI, and self-monitoring showed similar improvement in insomnia between the MBSR and MBTI groups, with possibly longer duration of efficacy in the MBTI group. Recent data show that MBTI is also an effective and accepted treatment for insomnia in older patients. Increasing evidence shows that mindfulness meditation, delivered either via MBSR or MBTI, can be successfully used for the treatment of insomnia with good patient acceptance and durable results.

EN

1It is a trib ute to the accumulated wisdom of humankind that a traditional Buddhist meditation practice going back 2500 years, which was originally designed in part to deal with the prob lem of human suffering, has been successfully adapted to prevent the relapse of depression in the modern era. Bud dhist meditation techniques were originally adapted by Jon Kabat-Zinn, founding executive director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School (www .umassmed .edu /Content .aspx?id=43102), for mindfulnessbased stress reduction (MBSR). Reviews of MBSR studies suggest that it decreases depression, anxiety and psychologic distress in people with chronic somatic diseases 2 and that it reduces stress, ruminative thinking and trait anxiety in healthy people. 3 Mindfulness-based cognitive therapy is similar to MBSR and is designed to change some of the cognitions that are associated with depression. 4

Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion

To evaluate and discuss existing studies of mindfulness-based stress reduction (MBSR) among breast cancer survivors. Articles published from 1987-2009 were retrieved using MEDLINE®, CINAHL®, Ovid, and Scopus. Key words, including mindfulness-based stress reduction and mindfulness meditation, were combined with breast cancer. The search resulted in 26 articles that were narrowed down to 16 by selecting only quantitative studies of MBSR conducted with breast cancer (n = 7) or heterogeneous types of cancer in which the predominant cancer was breast cancer (n = 9). Most studies were one-group pre- and post-test design and examined the effect of MBSR on psychological outcomes. Overall, the studies had large effect sizes on perceived stress and state anxiety and medium effect sizes on symptoms of stress and mood disturbance. Four studies measured biologic outcomes and had small effect sizes, except cytokine production, which showed a large effect size at 6- and 12-month follow-ups. Future studies using randomized, control trials and longitudinal, repeated-measures designs are needed. Studies conducted with heterogeneous types of cancer and gender should be analyzed and the results reported separately. The comprehensive summary and critical discussion of existing studies of MBSR usage among breast cancer survivors provide essential information that can be used by nurses and others working in the healthcare setting.

How long does a mindfulness‐based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress

The mindfulness-based stress reduction (MBSR) program was designed to be long enough for participants to grasp the principles of self-regulation through mindfulness and develop skill and autonomy in mindfulness practice. It traditionally consists of 26 hours of session time including eight classes of 2-1/2 hours and an all-day class. The circumstances of some groups exclude them from participating in this standard form and a number of trials have evaluated programs with abbreviated class time. If lower program time demands can lead to similar outcomes in psychological functioning, it would support their utility in these settings and might lead to greater participation. However, the effect of variation in class hours on outcomes has not been systematically studied. To obtain preliminary information related to this question we examined effect sizes for psychological outcome variables in published studies of MBSR, some of which had adapted the standard number of class hours. The correlation between mean effect size and number of in-class hours was nonsignificant for both clinical and nonclinical samples and suggests that adaptations that include less class time may be worthwhile for populations for whom reduction of psychological distress is an important goal and for whom longer time commitment may be a barrier to their ability or willingness to participate. However, the standard MBSR format has accrued the most empirical support for its efficacy and session time may be important to the development of other kinds of program outcomes. The result points to the importance of empirical studies systematically examining this question.

Cultivating mindfulness in health care professionals: A review of empirical studies of mindfulness-based stress reduction (MBSR)

Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.

Measuring the Psychological Impact of Mindfulness Meditation on Health Among Patients With Cancer: A Literature Review

To describe the construct of mindfulness meditation and systematically review instruments measuring the psychological impact of mindfulness-based stress reduction (MBSR) on health among patients with cancer. PubMed, CINAHL, PsycINFO, ISI Web of Knowledge, EBSCO, and published literature (1987-2006). 13 psychological instruments used in seven studies (2000-2005) to measure effects of MBSR on health in patients with cancer were reviewed. Most studies used a one-group pre- and post-test design. The post-MBSR outcomes for each instrument varied, suggesting different yet promising relationships. For some instruments, data were insufficient to conclude sufficiently whether any were strong or appropriate to use in future intervention studies. To enhance knowledge of MBSR, more intervention research studies of MBSR in patients with cancer and reexamination of specific instruments are needed. Based on the review, instruments can measure MBSR effects and found MBSR to be a potentially beneficial oncology nursing intervention.