Longitudinal impact of mindfulness meditation on illness burden in solid-organ transplant recipients

Mindfulness and meditation as an adjunctive treatment for adolescents involved in the juvenile justice system: Is repairing the brain and nervous system possible?

Adolescents involved in the juvenile justice system are prone to more traumatic events than other adolescents, leaving them in danger of developmental difficulties. Trauma exposure is predictive of poor outcomes including mental and physical health issues as well as criminal activity. Current treatment approaches either have a nominal effect on recidivism rates or increase the likelihood of future criminal offenses. This article explores adolescent brain development, the unique difficulties that juvenile justice youth face, and mindfulness meditation as an adjunctive treatment to system-based treatment. Mindfulness meditation may be a way to redress damage to the brain and facilitate healthy brain development, thus impacting prosocial behavior. Practice implications include integrating mindfulness meditation as an important part of rehabilitative efforts with juvenile justice youth.

Korean-Americans' Knowledge about Depression and Attitudes about Treatment Options

The purpose of this pilot study was to explore first-generation Korean-Americans' knowledge about depression and attitudes about depression treatment options. Self-report survey data were gathered from 73 first-generation Korean-Americans (KAs) using instruments developed for this study. The data were analyzed using descriptive and inferential statistics including t-tests. Data indicated participants lacked knowledge about depression. Among all depression treatment options, exercise was the option that first-generation KAs were most willing to try and was rated as having the least shame attached to it. Taking an antidepressant was the option KAs reported being most unwilling to try and had the highest shame attached to it. No significant differences in knowledge about depression and attitudes about depression treatment options were found between low and high acculturation groups, with the exception that the high acculturation group demonstrated more agreement than the low acculturation group with the item that emotional symptoms, such as mood changes, can be depression symptoms. These results suggest that initiating depression treatment with exercise may be the most acceptable starting point in treating depression in first-generation KA immigrants.

The effects of mindfulness-based stress reduction on objective and subjective sleep parameters in women with breast cancer: a randomized controlled trial

OBJECTIVE

The purpose of this study was to investigate the effects of mindfulness-based stress reduction for breast cancer survivors (MBSR(BC)) on multiple measures of objective and subjective sleep parameters among breast cancer survivors (BCS).

METHODS

Data were collected using a two-armed randomized controlled design among BCS enrolled in either a 6-week MBSR(BC) program or a usual care (UC) group with a 12-week follow-up. The present analysis is a subset of the larger parent trial (ClinicalTrials.gov Identifier: NCT01177124). Seventy-nine BCS participants (mean age 57 years), stages 0-III, were randomly assigned to either the formal (in-class) 6-week MBSR(BC) program or UC. Subjective sleep parameters (SSP) (i.e., sleep diaries and the Pittsburgh Sleep Quality Index (PSQI)) and objective sleep parameters (OSP) (i.e., actigraphy) were measured at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) or UC program.

RESULTS

Results showed indications of a positive effect of MBSR(BC) on OSP at 12 weeks on sleep efficiency (78.2% MBSR(BC) group versus 74.6% UC group, p = 0.04), percent of sleep time (81.0% MBSR(BC) group versus 77.4% UC group, p = 0.02), and less number waking bouts (93.5 in MBSR(BC) group versus 118.6 in the UC group, p < 0.01). Small nonsignificant improvements were found in SSP in the MBSR(BC) group from baseline to 6 weeks (PSQI total score, p = 0.09). No significant relationship was observed between minutes of MBSR(BC) practice and SSP or OSP.

CONCLUSIONS

These data suggest that MBSR(BC) may be an efficacious treatment to improve objective and subjective sleep parameters in BCS.

A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students

BACKGROUND

Previous studies suggested that mindfulness meditation effectively reduced stress-related anxiety and depression symptoms, but no research has evaluated the efficacy of mindfulness meditation in nurses and nursing students in China.

OBJECTIVES

To evaluate the effects of brief mindfulness meditation on the anxiety and depression symptoms and autonomic nervous system activity in Chinese nursing students.

DESIGN

A randomized controlled trial.

SETTING

A medical university in Guangzhou, China.

PARTICIPANTS

One hundred and five nursing students were randomly approached by email and seventy-two responded. Sixty recruited students were randomized into meditation and control group (n=30 each) after screening and exclusion due to factors known to influence mood ratings and autonomic nervous system measures.

METHODS

The meditation group performed mindfulness meditation 30 min daily for 7 consecutive days. The control group received no intervention except pre-post treatment measurements. The Self-Rating Anxiety Scale and Self-Rating Depression Scale were administered to participants, and heart rate and blood pressure were measured. Pre- and post-treatment data were analyzed using repeated-measures analysis of variance.

RESULTS

Differences between pre- and post-treatment Self-Rating Anxiety Scale scores were significantly larger in the meditation group than in the control group, but no similar effect was observed for Self-Rating Depression Scale scores. Systolic blood pressure was reduced more after the intervention in the meditation group than in the control group, with an average reduction of 2.2 mmHg. A moderate level of anxiety was associated with the maximum meditation effect.

CONCLUSIONS

Brief mindfulness meditation was beneficial for Chinese nursing students in reducing anxiety symptoms and lowering systolic blood pressure. Individuals with moderate anxiety are most likely to benefit from a short-term mindfulness meditation program.

Mindfulness meditation: a primer for rheumatologists

Over the past decade, there has been an increasing interest in meditation as a mind-body approach, given its potential to alleviate emotional distress and promote improved well being in a variety of populations. The overall purpose of this review is to provide the practicing rheumatologist with an overview of mindfulness and how it can be applied to Western medical treatment plans to enhance both the medical and psychological care of patients.

Nurses' experiences, expectations, and preferences for mind-body practices to reduce stress

BACKGROUND

Most research on the impact of mind-body training does not ask about participants' baseline experience, expectations, or preferences for training. To better plan participant-centered mind-body intervention trials for nurses to reduce occupational stress, such descriptive information would be valuable.

METHODS

We conducted an anonymous email survey between April and June, 2010 of North American nurses interested in mind-body training to reduce stress. The e-survey included: demographic characteristics, health conditions and stress levels; experiences with mind-body practices; expected health benefits; training preferences; and willingness to participate in future randomized controlled trials.

RESULTS

Of the 342 respondents, 96% were women and 92% were Caucasian. Most (73%) reported one or more health conditions, notably anxiety (49%); back pain (41%); GI problems such as irritable bowel syndrome (34%); or depression (33%). Their median occupational stress level was 4 (0 = none; 5 = extreme stress). Nearly all (99%) reported already using one or more mind-body practices to reduce stress: intercessory prayer (86%), breath-focused meditation (49%), healing or therapeutic touch (39%), yoga/tai chi/qi gong (34%), or mindfulness-based meditation (18%). The greatest expected benefits were for greater spiritual well-being (56%); serenity, calm, or inner peace (54%); better mood (51%); more compassion (50%); or better sleep (42%). Most (65%) wanted additional training; convenience (74% essential or very important), was more important than the program's reputation (49%) or scientific evidence about effectiveness (32%) in program selection. Most (65%) were willing to participate in a randomized trial of mind-body training; among these, most were willing to collect salivary cortisol (60%), or serum biomarkers (53%) to assess the impact of training.

CONCLUSIONS

Most nurses interested in mind-body training already engage in such practices. They have greater expectations about spiritual and emotional than physical benefits, but are willing to participate in studies and to collect biomarker data. Recruitment may depend more on convenience than a program's scientific basis or reputation. Knowledge of participants' baseline experiences, expectations, and preferences helps inform future training and research on mind-body approaches to reduce stress.

The contribution of mindfulness practice to a multicomponent behavioral sleep intervention following substance abuse treatment in adolescents: a treatment-development study

Poor sleep is common in substance use disorders (SUDs) and is a risk factor for relapse. Within the context of a multicomponent, mindfulness-based sleep intervention that included mindfulness meditation (MM) for adolescent outpatients with SUDs (n = 55), this analysis assessed the contributions of MM practice intensity to gains in sleep quality and self-efficacy related to SUDs. Eighteen adolescents completed a 6-session study intervention and questionnaires on psychological distress, sleep quality, mindfulness practice, and substance use at baseline, 8, 20, and 60 weeks postentry. Program participation was associated with improvements in sleep and emotional distress, and reduced substance use. MM practice frequency correlated with increased sleep duration and improvement in self-efficacy about substance use. Increased sleep duration was associated with improvements in psychological distress, relapse resistance, and substance use-related problems. These findings suggest that sleep is an important therapeutic target in substance abusing adolescents and that MM may be a useful component to promote improved sleep.

A qualitative analysis of mindfulness-based cognitive therapy (MBCT) in Parkinson's disease

OBJECTIVES

To analyse the experiences of participants with Parkinson's disease (PD), who participated in an 8-week mindfulness-based cognitive therapy (MBCT) course.

DESIGN AND METHOD

Interpretative phenomenological analysis guided the design and method used in this study. A total of twelve participants (seven men and five women) with PD were recruited prior to and following participation in an MBCT course and interviewed with a semi-structured interview schedule. One participant who opted out of the course was also interviewed. The researcher also participated in another MBCT course to enhance their understanding of the participants' experience, keeping a detailed diary as a means of acknowledging bias in the analysis process. Themes were summarized from transcripts and later classified into superordinate themes, which were compared across all cases. Transcripts were also read and analysed by a second author and participants were given the opportunity to comment upon emerging themes.

RESULTS

Major themes included (1) changing patterns of coping; (2) the role of mindfulness in consolidating existing coping skills in the context of loss; (3) group support in the context of loss and society that stigmatizes difference; and (4) the dualism of experience between Parkinson's and mindful meditation.

CONCLUSIONS

This study has indicated that MBCT could benefit people with PD and was an acceptable form of group intervention.

"I felt like a new person." the effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries

To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP), we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an 8-week mindfulness meditation program. Participants were 27 adults > or = 65 years of age with CLBP of at least moderate severity and of at least 3 months duration. We found several themes reflecting the beneficial effects of mindfulness meditation on pain, attention, sleep, and achieving well-being. Various methods of pain reduction were used, including distraction, increased body awareness leading to behavior change, better pain coping, and direct pain reduction through meditation. Participants described improved attention skills. A number of participants reported improved sleep latency as well as quality of sleep. Participants described achieving well-being during and after a meditation session that had immediate effects on mood elevation but also long-term global effects on improved quality of life. Several themes were identified related to pain reduction, improved attention, improved sleep, and achieving well-being resulting from mindfulness meditation that suggest it has promising potential as a nonpharmacologic treatment of chronic pain for older adults.

PERSPECTIVE

Community-dwelling older adults with chronic low back pain experience numerous benefits from mindfulness meditation including less pain, improved attention, better sleep, enhanced well-being, and improved quality of life. Additional research is needed to determine how mindfulness meditation works and how it might help with other chronic illnesses.

Melatonin, environmental light, and breast cancer

Although many factors have been suggested as causes for breast cancer, the increased incidence of the disease seen in women working in night shifts led to the hypothesis that the suppression of melatonin by light or melatonin deficiency plays a major role in cancer development. Studies on the 7,12-dimethylbenz[a]anthracene and N-methyl-N-nitrosourea experimental models of human breast cancer indicate that melatonin is effective in reducing cancer development. In vitro studies in MCF-7 human breast cancer cell line have shown that melatonin exerts its anticarcinogenic actions through a variety of mechanisms, and that it is most effective in estrogen receptor (ER) alpha-positive breast cancer cells. Melatonin suppresses ER gene, modulates several estrogen dependent regulatory proteins and pro-oncogenes, inhibits cell proliferation, and impairs the metastatic capacity of MCF-7 human breast cancer cells. The anticarcinogenic action on MCF-7 cells has been demonstrated at the physiological concentrations of melatonin attained at night, suggesting thereby that melatonin acts like an endogenous antiestrogen. Melatonin also decreases the formation of estrogens from androgens via aromatase inhibition. Circulating melatonin levels are abnormally low in ER-positive breast cancer patients thereby supporting the melatonin hypothesis for breast cancer in shift working women. It has been postulated that enhanced endogenous melatonin secretion is responsible for the beneficial effects of meditation as a form of psychosocial intervention that helps breast cancer patients.

Sleep disruption frequency in rheumatoid arthritis: perceived stress predicts poor outcome over one year

BACKGROUND

Sleep is an important daily process that can be disrupted by chronic illnesses including rheumatoid arthritis (RA).

AIMS

We tested whether demographic, medical and psychological factors act as predictors of change in frequency of sleep disruption associated with RA.

METHODS

A cohort of 129 White British people with RA (mean duration of RA 7.19 years; mean age 55.40 years; 75% women) was followed for one year. Self-report questionnaires were employed to record demographic information and assess participants' sleep disruption (on a 4-point frequency scale), morning stiffness (duration), pain and fatigue (visual analogue scales), impact of disability, anxiety, depression, stress, coping, illness perceptions and self-efficacy. Hospital notes were reviewed for duration of RA, antidepressant use and comorbidity.

RESULTS

Participants were split into those with sleep disruption that was consistently infrequent or decreasing in frequency (n = 56; 43%) and those with sleep disruption that was consistently frequent or increasing in frequency (n = 73; 57%). Results of a logistic regression demonstrated that greater perceived stress at baseline predicted sleep disruption that was consistently frequent or increasing in frequency over the year. Change in sleep disruption frequency was not predicted by any other assessed variable. Perceived stress at the end of the year was not predicted by change in frequency of sleep disruption.

CONCLUSIONS

Self-reported frequency of sleep disruption among people with RA relates to perceived stress. Psychoeducational programmes that help people with RA manage their stress may be a non-pharmacological method of improving sleep quality and therefore merits testing in specific interventional studies.

Effect of Mindfulness-Based stress reduction in rheumatoid arthritis patients

OBJECTIVE

To assess the effect of a meditation training program, Mindfulness-Based Stress Reduction (MBSR), on depressive symptoms, psychological status, and disease activity in patients with rheumatoid arthritis (RA) through a randomized, waitlist-controlled pilot study.

METHODS

Participants were randomized to either an MBSR group, where they attended an 8-week course and 4-month maintenance program, or to a waitlist control group, where they attended all assessment visits and received MBSR free of charge after study end. Participants received usual care from their rheumatologists throughout the trial. Self-report questionnaires were used to evaluate depressive symptoms, psychological distress, well-being, and mindfulness. Evaluation of RA disease activity (by Disease Activity Score in 28 joints) included examination by a physician masked to treatment status. Adjusted means and mean changes in outcomes were estimated in mixed model repeated measures analyses.

RESULTS

Sixty-three participants were randomized: 31 to MBSR and 32 to control. At 2 months, there were no statistically significant differences between groups in any outcomes. At 6 months, there was significant improvement in psychological distress and well-being (P = 0.04 and P = 0.03, respectively), and marginally significant improvement in depressive symptoms and mindfulness (P = 0.08 and P = 0.09, respectively). There was a 35% reduction in psychological distress among those treated. The intervention had no impact on RA disease activity.

CONCLUSION

An 8-week MBSR class was not associated with change in depressive symptoms or other outcomes at 2-month followup. Significant improvements in psychological distress and well-being were observed following MBSR plus a 4-month program of continued reinforcement. Mindfulness meditation may complement medical disease management by improving psychological distress and strengthening well-being in patients with RA.