Effects of a mindfulness-based program on the occupational balance and mental health of university students. Protocol for a randomized controlled trial

OBJECTIVE

The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students.

MATERIALS AND METHODS

A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups.

DISCUSSION

It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT05929430.

Mindfulness-oriented recovery enhancement in opioid use disorder: Extended emotional regulation and neural effects and immediate effects of guided meditation in a pilot sample

OBJECTIVE

Mindfulness-Oriented Recovery Enhancement (MORE) is an efficacious intervention to aid recovery from substance use disorder. This study in a pilot sample of individuals in treatment for opioid use disorder (OUD) characterizes longer-term changes after the MORE intervention and immediate effects of a brief MORE guided meditation session.

DESIGN

Twelve female participants in residential treatment for OUD completed an 8-week MORE intervention. Participants completed two sessions: one before and one after the 8-week MORE intervention. Each session included an emotional regulation questionnaire outside an MRI scanner first and then a 10-minute guided MORE meditation inside the scanner during which functional magnetic resonance imaging (fMRI) data were collected. Emotional regulation was measured after 8-weeks of MORE intervention. In addition, functional connectivity (i.e. correlated fMRI signal) between regions in a hypothesized affect regulation network was measured during the meditation state to assess change in brain network function due to 8-weeks of MORE. For each 10-min guided meditation, we also assessed their mood and opioid craving.

RESULTS

Nine participants completed all measurements. Participants' emotional regulation difficulty significantly decreased after 8-weeks of MORE intervention. Furthermore, after 8-weeks of MORE, there was significantly increased connectivity between left ventromedial prefrontal cortex and left amygdala and between left ventrolateral prefrontal cortex and left nucleus accumbens captured during a meditation state. In both sessions, positive mood significantly increased after 10-min of guided mediation, however opioid craving was not significantly influenced.

CONCLUSIONS

This pilot study characterizes potential benefits of 8-week MORE intervention in improving emotional regulation difficulty and brain function. A 10-min guided MORE meditation may immediately improve mood, with potential to reduce acute stress- or cue-provoked craving. These results warrant future studies with larger sample size.

A Randomized Control Trial of Meditation for Mothers Pumping Breastmilk for Preterm Infants

OBJECTIVE

 Mothers of preterm infants face unique challenges in establishing milk supply. We hypothesized that daily meditation practice while pumping would increase milk volume.

STUDY DESIGN

 This was a randomized control trial examining the effect of meditation on the breastmilk supply of women delivering preterm infants. The meditation group engaged in daily use of a mindfulness-focused meditation app in addition to routine lactation support. The primary outcome was mean breastmilk volume on the infant's nineth day of life. Secondary outcomes included use of lactation-promoting behaviors, continuation of breastfeeding, and measures of mental health and breastfeeding self-efficacy by validated questionnaires. In addition to the intention to treat analysis, a per protocol analysis examined the association of frequent meditation with these breastfeeding and mental health outcomes.

RESULTS

 A total of 60 women were analyzed. Mean milk volume was 647.1 ± 467.8 mL in the meditation group and 514.9 ± 393.5 mL in the routine care group (p = 0.27). Median number of pumping sessions was 7 (interquartile range [IQR] 5-8) in the meditation group, compared to 6 (IQR 4-7) in the routine care group (p = 0.11). Other lactation-promoting behaviors, breastfeeding continuation, and questionnaire scores were similar.Adjusting for confounders, we found an increase in breastmilk production of 223.2 mL (95% CI 98.8-347.5, p = 0.001) and in pumping episodes by 0.93 (95% CI 0.16-1.70, p = 0.020) associated with frequent meditation. Skin-to-skin contact was increased to 100% (p = 0.006) among women who meditated seven or more times. Adjusted odds of a clinically significant Edinburgh Postnatal Depression Scale score of >9 was 0.057 (95% CI 0.0014-0.711, p = 0.023) with frequent meditation.

CONCLUSION

 Breastmilk production was similar in mothers practicing meditation compared to those receiving routine lactation support. For women engaging in frequent mediation, there may be an effect in establishing breastmilk supply and reduction of depression symptoms.

KEY POINTS

· Breastmilk is not increased for neonatal intensive care unit (NICU) moms asked to engage in meditation.. · Maternal mental health is not improved among NICU moms asked to meditate.. · However, higher-frequency meditation is associated with increased milk volume and lower odds of high scores on depression screening..

Meditation Moderates the Relationship between Insecure Attachment and Loneliness: A Study of Long-Term Care Residents in Thailand

Background and Objectives: Loneliness is prevalent among residents of long-term care settings, posing significant challenges to their mental wellbeing. Insecure attachment has been identified as a contributing factor to loneliness in this population. Previous research has suggested that meditation may have beneficial effects on mental health outcomes. This study aimed to examine the relationship between meditation, insecure attachment, and loneliness among residents of long-term care facilities in Thailand. Specifically, the study sought to investigate the moderating effect of meditation on the association between insecure attachment (both avoidance and anxiety) and loneliness. Materials and Methods: A cross-sectional study was conducted involving 236 residents living in long-term care homes in Thailand. Participants completed self-report measures including the 18-item Revised Experience of Close Relationship questionnaire (to assess attachment anxiety and avoidance), the Inner Strength-Based Inventory (to measure meditation practice), and the 6-item Revised Version of the University of California Los Angeles Loneliness Scale. Moderation analyses were performed to explore the role of meditation in the relationship between insecure attachment and loneliness. Results: The mean age of participants was 73.52 years, with females accounting for 57.6% of the sample. Among the participants, 58.4% reported engaging in meditation, with practice frequency ranging from often to daily. The mean meditation score was 2.92 out of 5, indicating regular but not daily practice. Meditation was found to moderate the relationship between insecure attachment (both avoidance and anxiety) and loneliness. Specifically, the moderation effect between attachment anxiety and loneliness was significant (B = 0.44, SE = 0.21, 95% CI [0.30, 0.86]), as was the interaction effect between attachment anxiety and loneliness (B = -0.34, SE = 0.17, 95% CI [-0.67, -0.02]). Conclusions: The findings suggest that the impact of meditation practice on loneliness is influenced by an individual's attachment dimension. Meditation demonstrates a moderating effect on attachment avoidance, anxiety, and loneliness, with variations observed in the direction of these effects. The clinical implications of these findings and recommendations for further research are discussed.

Mapping the Current Research on Mindfulness Interventions for Individuals with Cerebral Palsy: A Scoping Review

Cerebral palsy (CP) is a chronic neurological disorder that can cause motor and cognitive disabilities. Mindfulness is a form of meditation that has gained attention as a potential therapeutic intervention for improving the health and well-being of patients with CP. Four databases were searched until January 2023. A scoping review was conducted to explore the role of mindfulness in the management of CP by reviewing the available scientific literature. Studies that examined the effects of mindfulness on motor function, communication, and quality of life in patients with CP were analyzed. The gray literature and reference lists of included articles were not identified. The results were presented in numerical and thematic forms. From an initial pool of 30 registered studies, only 3 met the inclusion criteria. These selected studies reported positive effects of mindfulness interventions on communication abilities and stress management in patients with CP. The available evidence suggests that mindfulness may have beneficial effects on motor function, communication, and quality of life in patients with CP. The findings of this review highlight the potential of mindfulness as a complementary therapy for improving the health and well-being of patients with CP.

[Clinical and Mechanism Research Progress in Amelioration of Mild Cognitive Impairment via Meditation]

Mild cognitive impairment(MCI)has a high risk of progressing to dementia,with no recommended therapies.Recent studies have shown that meditation has huge potential to improve the cognitive function,with low cost and high safety,being suitable to be applied in the treatment of neurological and psychotic disorders.This paper reviews the application and prospects of meditation in treating MCI from the concept,clinical efficacy,and mechanism of meditation,aiming to provide reference for future clinical studies.

Psilocybin enhances insightfulness in meditation: a perspective on the global topology of brain imaging during meditation

In this study, for the first time, we explored a dataset of functional magnetic resonance images collected during focused attention and open monitoring meditation before and after a five-day psilocybin-assisted meditation retreat using a recently established approach, based on the Mapper algorithm from topological data analysis. After generating subject-specific maps for two groups (psilocybin vs. placebo, 18 subjects/group) of experienced meditators, organizational principles were uncovered using graph topological tools, including the optimal transport (OT) distance, a geometrically rich measure of similarity between brain activity patterns. This revealed characteristics of the topology (i.e. shape) in space (i.e. abstract space of voxels) and time dimension of whole-brain activity patterns during different styles of meditation and psilocybin-induced alterations. Most interestingly, we found that (psilocybin-induced) positive derealization, which fosters insightfulness specifically when accompanied by enhanced open-monitoring meditation, was linked to the OT distance between open-monitoring and resting state. Our findings suggest that enhanced meta-awareness through meditation practice in experienced meditators combined with potential psilocybin-induced positive alterations in perception mediate insightfulness. Together, these findings provide a novel perspective on meditation and psychedelics that may reveal potential novel brain markers for positive synergistic effects between mindfulness practices and psilocybin.

Modest Effects of Neurofeedback-Assisted Meditation Using a Wearable Device on Stress Reduction: A Randomized, Double-Blind, and Controlled Study

BACKGROUND

To evaluate the therapeutic effectiveness and safety of a neurofeedback wearable device for stress reduction.

METHODS

A randomized, double-blind, controlled study was designed. Participants had psychological stress with depression or sleep disturbances. They practiced either neurofeedback-assisted meditation (n = 20; female, 15 [75.0%]; age, 49.40 ± 11.76 years) or neurofeedback non-assisted meditation (n = 18; female, 11 [61.1%]; age, 48.67 ± 12.90 years) for 12 minutes twice a day for two weeks. Outcome variables were self-reported questionnaires, including the Korean version of the Perceived Stress Scale, Beck Depression Inventory-II, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and State Trait Anxiety Index, quantitative electroencephalography (qEEG), and blood tests. Satisfaction with device use was measured at the final visit.

RESULTS

The experimental group had a significant change in PSS score after two weeks of intervention compared with the control group (6.45 ± 0.95 vs. 3.00 ± 5.54, P = 0.037). State anxiety tended to have a greater effect in the experimental group than in the control group (P = 0.078). Depressive mood and sleep also improved in each group, with no significant difference between the two groups. There were no significant differences in stress-related physiological parameters, such as stress hormones or qEEG, between the two groups. Subjective device satisfaction was significantly higher in the experimental group than in the control group (P = 0.008).

CONCLUSION

Neurofeedback-assisted meditation using a wearable device can help improve subjective stress reduction compared with non-assisted meditation. These results support neurofeedback as an effective adjunct to meditation for relieving stress.

TRIAL REGISTRATION

Clinical Research Information Service Identifier: KCT0007413.

Reducing Menopausal Symptoms With Mindfulness-Based Meditation

Midlife women often experience menopausal symptoms despite being treated according to clinical guidelines. The consequences of not addressing menopausal symptoms holistically are that 55% of women see primary care providers frequently with menopausal symptom complaints. The problem was women's lack of coping strategies to deal with their symptoms effectively. The interventions aimed to (1) develop a protocol to provide point-of-care mindfulness-based meditation intervention as a standard of care, (2) evaluate improvements in coping self-efficacy skills, and (3) demonstrate the intervention's impact on menopausal symptoms. Twenty women participated in a short meditation intervention at a micro practice in Oregon from January to May 2022 and continued an 8-week home practice. Self-reported measures of menopausal symptoms, coping self-efficacy, and demographic data were collected pre- and pos-tprogram. A percentage of women determined improvements, and t tests evaluated differences between pre-and postintervention assessments. Pearson correlation coefficients identified associations between the Menopausal Rating Scale (MRS), its subscales, and the Coping Self-Efficacy Scale (CSES) postintervention. The women showed 78% improved coping self-efficacy and 89% alleviated menopausal symptoms. The t test revealed a statistically significant change between pre- and post-CSES scores (t17 = 4.19, P < .001) and MRS scores (t17 = 4.78, P < .001). The post-MRS total score was significantly negatively correlated with the post-CSES score (r = -0.49, P = .039), indicating that symptoms decreased as self-efficacy improved. The outcomes of this project show that menopausal women can cope and alleviate their symptoms with an easy and feasible mindfulness-based meditation intervention.

Neural correlates of mindfulness meditation and hypnosis on magnetic resonance imaging: similarities and differences. A scoping review

BACKGROUND

Mindfulness meditation (MM) and hypnosis practices are gaining interest in mental health, but their physiological mechanisms remain poorly understood. This study aimed to synthesize the functional, morphometric and metabolic changes associated with each practice using magnetic resonance imaging (MRI), and to identify their similarities and differences.

METHODS

MRI studies investigating MM and hypnosis in mental health, specifically stress, anxiety, and depression, were systematically screened following PRISMA guidelines from four research databases (PubMed, Web of Science, Embase, PsycINFO) between 2010 and 2022.

RESULTS

In total, 97 references met the inclusion criteria (84 for MM and 13 for hypnosis). This review showed common and divergent points regarding the regions involved and associated brain connectivity during MM practice and hypnosis. The primary commonality between mindfulness and hypnosis was decreased default mode network intrinsic activity and increased central executive network - salience network connectivity. Increased connectivity between the default mode network and the salience network was observed in meditative practice and mindfulness predisposition, but not in hypnosis.

CONCLUSIONS

While MRI studies provide a better understanding of the neural basis of hypnosis and meditation, this review underscores the need for more rigorous studies.

Mindfulness intervention effect on endometriosis-related pain dimensions and its mediator role on stress and vitality: a path analysis approach

Endometriosis-related pain is supposedly mainly responsible for generating psychological stress and deteriorating the quality of life. However, the interaction between these factors has not been investigated, considering its multidimensional nature and through the path of effects of psychosocial approaches. The present study aims to investigate the effect of a brief mindfulness-based intervention (bMBI) on pain dimensions and its mediator role on psychological stress and QoL-Vitality improvement. A secondary analysis of a pilot randomized controlled trial using a series of parallel and serial mediators was carried out. The results showed that bMBI improves the sensory (B = -6.09 [-9.81, -2.52], β = -0.42) and affective (B = -3.40 [-5.02, -1.80], β = -0.47) pain. The bMBI effect on psychological stress reduction was mediated by these changes in sensory (B = -2.81 [-6.06, -0.41], β = -0.21) and affective (B = -1.97 [-5.07, -0.17], β = -0.15) pain. Serial sensory pain and psychological stress reduction (B = 2.27 [0.11, 5.81], β = -0.09) mediated the bMBI effect on quality of life vitality. Meditation training promotes additional improvement in affective and sensory pain characteristics through which psychological stress is reduced. The sensory pain dimension must be positively impacted in combination with psychological stress for the bMBI improves women's vitality. Adding a psychosocial intervention like meditation training to the standard treatment plan may be required for some women to achieve the needed changes to restore well-being.

Effects of 7-minute practices of breathing and meditation on stress reduction

We compared the effects of 7-min practices of breathing and meditation on perceived stress reduction and related affective outcomes (active emotion, serenity, anxiety, and fatigue) during micro-breaks. Undergraduates from two classes (N = 59) completed the 7-point online surveys. Results supported the effects of both practices.

Loving-kindness and compassion meditations in the workplace: A meta-analysis and future prospects

Loving-kindness and compassion meditation (LKCM) have been well applied among employees to improve their health and well-being. Existing studies on LKCM have also provided supportive evidence of its benefits and effectiveness under organizational contexts. The current meta-analytical study aimed to systematically summarise the effects of LKCM in the workplace and to outline directions for future research and practice. Among 327 empirical studies on LKCM published until March 2022, 21 trials focussed on employees and provided sufficient information, which were included in the following meta-analysis. The results showed that LKCM benefited eight categories of workplace outcomes. Specifically, LKCM effectively decreased employees' burnout (g = 0.395, k = 10) and stress (g = 0.544, k = 10) and facilitated their mindfulness (g = 0.558, k = 14), self-compassion (g = 0.646, k = 12), personal mental health (g = 0.308, k = 13), job attitudes (g = 0.283, k = 4), interpersonal relationships (g = 0.381, k = 12), and psychological resources (g = 0.406, k = 6). The results of moderation analyses further indicated that the participants' job type, gender, and the focus of LKCM might differentially fluctuate the magnitude of LKCM effects. To advance research and best practice, we finally pointed out several issues that deserve attention, such as long-term effects, underlying mechanisms, potential moderators, and outcomes or influential factors at the organizational level.

Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis

OBJECTIVE

This systematic review aimed to compile existing evidence examining the effects of mindfulness-based interventions (MBIs) for chronic low back pain (CLBP). CLBP leads to millions of disabled individuals in the United States each year. Current pharmacologic treatments are only modestly effective and may present long-term safety issues. MBIs, which have an excellent safety profile, have been shown in prior studies to be effective in treating CLBP yet remained underutilized.

DESIGN

Ovid/Medline, PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs), pilot RCTs, and single-arm studies that explored the effectiveness of MBIs in CLBP.

METHODS

Separate searches were conducted to identify trials that evaluated MBIs in reducing pain intensity in individuals with CLBP. A meta-analysis was then performed using R v3.2.2, Metafor package v 1.9-7.

RESULTS

Eighteen studies used validated patient-reported pain outcome measures and were therefore included in the meta-analysis. The MBIs included mindfulness meditation, mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-oriented recovery enhancement, acceptance and commitment therapy, dialectical behavioral therapy, meditation-cognitive behavioral therapy, mindfulness-based care for chronic pain, self-compassion course, and loving-kindness course. Pain intensity scores were reported using a numerical rating scale (0 to 10) or an equivalent scale. The meta-analysis revealed that MBIs have a beneficial effect on pain intensity with a large-sized effect in adults with CLBP.

CONCLUSIONS

MBIs seem to be beneficial in reducing pain intensity. Although these results were informative, findings should be carefully interpreted due to the limited data the high variability in study methodologies, small sample sizes, inclusion of studies with high risk of bias, and reliance on pre-post treatment differences with no attention to maintenance of effects. More large-scale RCTs are needed to provide reliable effect size estimates for MBIs in persons with CLBP.

Mind-body therapies adjuvant to chemotherapy improve quality of life and fatigue in top cancers: A systematic review and meta-analysis

BACKGROUND

Breast, lung and colorectal cancers are 3 of the top 4 most common cancers worldwide. Their treatment with chemotherapy often results in adverse effects on quality of life, fatigue and functional exercise capacity amongst patients. Mind-body therapies, including yoga, Tai chi and Qigong, are commonly used as complementary and alternative therapies in cancer. This meta-analysis evaluates the effects of yoga, Tai chi and Qigong in alleviating the adverse effects of chemotherapy.

METHODS

Various databases were systematically interrogated using specific search terms, returning 1901 manuscripts. Removal of duplicates, irrelevant studies, those lacking available data and applying inclusion/exclusion criteria reduced this number to 9 manuscripts for inclusion in the final meta-analyses. Mean differences were calculated to determine pooled effect sizes using RStudio.

RESULTS

This is the first systematic review and meta-analysis to demonstrate significant improvements in fatigue for colorectal cancer patients undergoing chemotherapy with a reduction of -1.40 (95 % CI: -2.24 to -0.56; p = 0.001) observed in mind-body therapy intervention groups.

CONCLUSION

Yoga, Tai chi and Qigong could all be implemented alongside adjuvant therapies to alleviate the adverse effects on colorectal cancer patient fatigue during chemotherapy treatment.

REVIEW REGISTRATION

This systematic review and meta-analysis is registered on InPlasy: registration number INPLASY202390035; doi: https://doi.org/10.37766/inplasy2023.9.0035.

An energizing microintervention: How mindfulness fosters subjective vitality through regulatory processes and flow experience at work

Can adopting one's morning routines influence employees' experiences throughout the day? To answer this focal question, we examine the daily effects of a brief meditation in the morning on well-being throughout the day considering spillover effects from the home to the work domain and back. To identify the dominant underlying mechanisms of this daily spillover, we draw on the personality systems interactions theory that distinguishes between autonomous self-regulation and effortful self-control as two psychological processes that reflect the regulation of thoughts, emotions, and behaviors in alignment or contradiction with one's interests, values, and goals. Accordingly, we hypothesized that meditating in the morning before work fosters autonomous self-regulation and reduces effortful self-control in the work domain, which subsequently facilitates the experience of flow at work and hence fosters subjective vitality in the home domain after work. A quasi-experimental daily-diary study over 10 days with a brief 10-min mindfulness intervention during the final 5 days with 78 participants (588 day-level data points) supported most of our predictions. More specifically, our data suggest a positive indirect effect of the intervention on subjective vitality in the evening via self-regulation and flow experience. However, there was no indirect effect of the intervention on subjective vitality via self-control. The results help to clarify how a mindfulness-based intervention can influence distinct regulatory processes and well-being, crossing boundaries between the work and home domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Global Meditation Practices: A Literature Review

Research has shown that meditation is beneficial for chronic pain, stress, and many physical and mental conditions. The definition of meditation has many forms, is culturally influenced, and is practiced globally. This literature review seeks to report current literature on meditation related to therapeutic outcomes and create a globally informed definition of meditation for health-related purposes. From a western perspective, mindfulness-based stress relief (MBSR) is widely researched. Therefore, 15 studies from peer-reviewed research from 2015 and 2020 were used to examine various forms of meditation and describe a broader range of meditation practices other than MBSR. The different forms of meditation are: Acceptance and Commitment Therapy (Portugal), Active Engagement (Portugal), Adapted Mindfulness Program (Brazil), Adapted Mindfulness Program (Brazil), Cognitively-based Compassionate Training, Loving-kindness (United States, US), Mantra Meditation (US), Mindfulness-based stress reduction (US), Mindfulness-based cognitive therapy (South Korea), Osho (India), Psychoneuroendocrinoimmunology (Italy), Transcendental Meditation (Italy), Spiritual/Secular (US), Sufi (Pakistan), and Vipassana (Australia). The review was completed using a literature search method, and all meditation approaches report positive therapeutic outcomes for all participants (n = 768). This outcome enabled the creation of a broader therapeutic definition of meditation that can be applied in clinical practice.

Clinical Nurse Well-being Improved Through Transcendental Meditation: A Multimethod Randomized Controlled Trial

OBJECTIVE

To evaluate the impact of Transcendental Meditation® (TM®) practice on the multidimensional well-being of nurse clinicians affected by the COVID-19 pandemic.

BACKGROUND

The health of clinical nurses has substantial impact on both the availability of a nursing workforce and the quality and safety of patient care. TM improved health and coping strategies across many populations.

METHODS

Clinical nurses were recruited from 3 Magnet®-designated hospitals during the COVID-19 pandemic. Well-being outcomes included flourishing, burnout, anxiety, and posttraumatic stress disorder. Participants were randomized following completion of baseline surveys into immediate (intervention) or delayed (control) TM instruction. Surveys were repeated at 1 and 3 months following baseline survey or TM instruction. Repeated-measures analysis of variance compared differences in groups over time.

RESULTS

Across the 3 sites, there were 104 clinical nurse participants. Repeated-measures analysis of variance showed significant medium to large effects in improvement over time in well-being measures for the intervention group.

CONCLUSIONS

TM improved multidimensional well-being of clinical nurses by reducing posttraumatic stress disorder, anxiety, and burnout and improving flourishing. TM is easy to practice anywhere. The benefits are immediate and cumulative. Organizations and individual nurses can use TM to support clinical nurses in the difficult and meaningful work of patient care, especially in challenging times. Future studies may consider the feasibility of integrating TM into clinical shifts and evaluating its impact on patient and organizational outcomes.

Implications for a mindfulness-enhanced positive affect induction: A brief commentary toward acute pain management

Over the past decade research has increased on dynamics between mindfulness, positive affect, and pain. While there have been studies examining the direct use of positive psychology for pain management, few have examined the use of a specific mindfulness-enhanced positive affect induction (i.e. a singular brief technique engendering mindfulness and strong positive affect) toward acute pain and pain flare management. This topical commentary discusses the need for such a technique toward bolstered gold-standard interventions, related studies, and possible future directions for acute and post-surgical pain management. Future research is encouraged to build from prior research on loving-kindness meditation and examine novel, brief mindfulness-enhanced positive affect inductions for acute pain management.

An Eight-Week Zen Meditation and Music Programme for Mindfulness and Happiness: Qualitative Content Analysis

Mental wellness can be related to healthier living, the learning process and working environments for people in the university community. A wide range of mental wellness programmes have been explored to provide students with pleasant and satisfying experiences. The purpose of this study is to explore the effects of integrating Zen meditation and music listening on the mindfulness and happiness levels of university music therapy students. A qualitative methodology was used, and data were collected through surveys and semi-structured interviews. To investigate various aspects of data regarding the role of the meditation and music (MM) programme for mindfulness and happiness, this study used thematic analysis within a qualitative research design. The findings of this study suggest that the 8-week Mindfulness Meditation (MM) programme is a potential approach for enhancing mindfulness, happiness and stress management. These results carry broader implications, particularly in terms of supporting mental health resources in higher education. Furthermore, the study contributes to the ongoing discussion regarding the positive impact of combining meditation and music to promote mental well-being. This integrated approach has the potential to strengthen coping strategies and further promote the integration of music and meditation practices in various contexts, including higher education.

An 18-month meditation training selectively improves psychological well-being in older adults: A secondary analysis of a randomised controlled trial

OBJECTIVES

As the world population is ageing, it is vital to understand how older adults can maintain and deepen their psychological well-being as they are confronted with the unique challenges of ageing in a complex world. Theoretical work has highlighted the promising role of intentional mental training such as meditation practice for enhancing human flourishing. However, meditation-based randomised controlled trials in older adults are lacking. We aimed to investigate the effects of meditation training on psychological well-being in older adults.

METHODS

This study presents a secondary analysis of the Age-Well trial (ClinicalTrials.gov: NCT02977819), which randomised 137 healthy older adults (age range: 65 to 84 years) to an 18-month meditation training, an active comparator (English language training), or a passive control. Well-being was measured at baseline, mid-intervention, and 18-month post-randomisation using the Psychological Well-being Scale (PWBS), the World Health Organisation's Quality of Life (QoL) Assessment psychological subscale, and composite scores reflecting the meditation-based well-being dimensions of awareness, connection, insight, and a global score comprising the average of these meditation-based dimensions.

RESULTS

The 18-month meditation training was superior to English training on changes in the global score (0.54 [95% CI: 0.26, 0.82], p = 0.0002) and the subscales of awareness, connection, insight, and superior to no-intervention only on changes in the global score (0.54 [95% CI: 0.26, 0.82], p = 0.0002) and awareness. Between-group differences in psychological QoL in favour of meditation did not remain significant after adjusting for multiple comparisons. There were no between-group differences in PWBS total score. Within the meditation group, psychological QoL, awareness, insight, and the global score increased significantly from baseline to 18-month post-randomisation.

CONCLUSION

The longest randomised meditation training conducted to date enhanced a global composite score reflecting the meditation-based well-being dimensions of awareness, connection, and insight in older adults. Future research is needed to delineate the cognitive, affective, and behavioural factors that predict responsiveness to meditation and thus help refine the development of tailored meditation training.

Epigenetic, psychological, and EEG changes after a 1-week retreat based on mindfulness and compassion for stress reduction in healthy adults: Study protocol of a cross-over randomized controlled trial

INTRODUCTION

The main objective of the study will be to evaluate the effects of two widely used standardized mindfulness-based programs [Mindfulness-Based Stress Reduction (MBSR) and Compassion Cultivation Training (CCT)], on epigenetic, neurobiological, psychological, and physiological variables.

METHODS

The programs will be offered in an intensive retreat format in a general population sample of healthy volunteer adults. During a 7-day retreat, participants will receive MBSR and CCT in a crossover design where participants complete both programs in random order. After finishing their first 3-day training with one of the two programs, participants will be assigned to the second 3-day training with the second program. The effects of the MBSR and CCT programs, and their combination, will be measured by epigenetic changes (i.e., DNA methylation biomarkers), neurobiological and psychophysiological measures (i.e., EEG resting state, EKG, respiration patterns, and diurnal cortisol slopes), self-report questionnaires belonging to different psychological domains (i.e., mindfulness, compassion, well-being, distress, and general functioning), and stress tasks (i.e., an Arithmetic Stress Test and the retrieval of negative autobiographical memories). These measures will be collected from both groups on the mornings of day 1 (pre-program), day 4 (after finishing the first program and before beginning the second program), and day 7 (post-second program). We will conduct a 3-month and a 12-month follow-up using only the set of self-report measures.

DISCUSSION

This study aims to shed light on the neurobiological and psychological mechanisms linked to meditation and compassion in the general population. The protocol was registered at clinicaltrials.gov (Identifier: NCT05516355; August 23, 2022).

Investigation of advanced mindfulness meditation "cessation" experiences using EEG spectral analysis in an intensively sampled case study

Mindfulness meditation is a contemplative practice informed by Buddhism that targets the development of present-focused awareness and non-judgment of experience. Interest in mindfulness is burgeoning, and it has been shown to be effective in improving mental and physical health in clinical and non-clinical contexts. In this report, for the first time, we used electroencephalography (EEG) combined with a neurophenomenological approach to examine the neural signature of "cessation" events, which are dramatic experiences of complete discontinuation in awareness similar to the loss of consciousness, which are reported to be experienced by very experienced meditators, and are proposed to be evidence of mastery of mindfulness meditation. We intensively sampled these cessations as experienced by a single advanced meditator (with over 23,000 h of meditation training) and analyzed 37 cessation events collected in 29 EEG sessions between November 12, 2019, and March 11, 2020. Spectral analyses of the EEG data surrounding cessations showed that these events were marked by a large-scale alpha-power decrease starting around 40 s before their onset, and that this alpha-power was lowest immediately following a cessation. Region-of-interest (ROI) based examination of this finding revealed that this alpha-suppression showed a linear decrease in the occipital and parietal regions of the brain during the pre-cessation time period. Additionally, there were modest increases in theta power for the central, parietal, and right temporal ROIs during the pre-cessation timeframe, whereas power in the Delta and Beta frequency bands were not significantly different surrounding cessations. By relating cessations to objective and intrinsic measures of brain activity (i.e., EEG power) that are related to consciousness and high-level psychological functioning, these results provide evidence for the ability of experienced meditators to voluntarily modulate their state of consciousness and lay the foundation for studying these unique states using a neuroscientific approach.

Do contemplative practices make us more moral?

Contemplative practices are a staple of modern life and have historically been intertwined with morality. However, do these practices in fact improve our morality? The answer remains unclear because the science of contemplative practices has focused on unidimensional aspects of morality, which do not align with the type of interdependent moral functioning these practices aspire to cultivate. Here, we appeal to a multifactor construct, which allows the assessment of outcomes from a contemplative intervention across multiple dimensions of moral cognition and behavior. This offers an open-minded and empirically rigorous investigation into the impact of contemplative practices on moral actions. Using this framework, we gain insight into the effect of mindfulness meditation on morality, which we show does indeed have positive influences, but also some negative influences, distributed across our moral functioning.

Impact of a Stress Reduction, Meditation, and Mindfulness Program in Patients with Chronic Heart Failure: A Randomized Controlled Trial

Heart Failure is a significant public health problem leading to a high burden of physical and psychological symptoms despite optimized therapy. To evaluate primarily the impact of a Stress Reduction, Meditation, and Mindfulness Program on stress reduction of patients with Heart Failure. A randomized and controlled clinical trial assessed the effect of a stress reduction program compared to conventional multidisciplinary care in two specialized centers in Brazil. The data collection period took place between April and October 2019. Thirty-eight patients were included and allocated to the intervention or control groups. The intervention took place over 8 weeks. The protocol assessed the scales of perceived stress, depression, quality of life, anxiety, mindfulness, quality of sleep, a 6-minute walk test, and biomarkers analyzed by a blinded team, considering a p-value <0.05 statistically significant. The intervention resulted in a significant reduction in perceived stress from 22.8 ± 4.3 to 14.3 ± 3.8 points in the perceived stress scale-14 items in the intervention group vs. 23.9 ± 4.3 to 25.8 ± 5.4 in the control group (p-value<0.001). A significant improvement in quality of life (p-value=0.013), mindfulness (p-value=0.041), quality of sleep (p-value<0.001), and the 6-minute walk test (p-value=0.004) was also observed in the group under intervention in comparison with the control. The Stress Reduction, Meditation, and Mindfulness Program effectively reduced perceived stress and improved clinical outcomes in patients with chronic Heart Failure.

Feasibility of Integrating MEditatioN inTO heaRt Disease (the MENTOR Study): A Phase II Randomized Controlled Trial

BACKGROUND

Comorbid depression and/or anxiety symptoms occur in 25% of patients attending cardiac rehabilitation (CR) programs and are associated with poorer prognosis. There is a need to evaluate psychological interventions, including meditation, that have potential to improve psychological health in CR programs.

AIMS

The aim of this study was to determine the feasibility and acceptability of integrating a meditation intervention into an existing Australian CR program for the reduction of depression and anxiety symptoms.

METHODS

This was a mixed-methods feasibility randomized controlled trial. Thirty-one patients with CVD and, at a minimum, mild depression and/or anxiety symptoms were randomized to meditation and standard CR or to standard CR alone. A 16-minute guided group meditation was delivered face-to-face once a week for 6 weeks, with daily self-guided meditation practice between sessions. Feasibility outcomes included screening, recruitment, and retention. Semistructured interviews of patients' (n = 10) and health professionals' (n = 18) perspectives of intervention participation and delivery were undertaken to assess acceptability. Between-group differences in depression, anxiety, stress, self-efficacy for mindfulness, and health status at 6 and 12 weeks were also assessed.

RESULTS AND CONCLUSION

Meditation was considered feasible, with 83% (12/15) of the intervention group completing an average of 3.13 (SD, 2.56) out of 6 group meditation sessions and 5.28 (SD, 8.50) self-guided sessions. Meditation was considered acceptable by patients, clinicians, and health managers. Between-group differences in the number of CR sessions completed favored the intervention group in per-protocol analyses (intervention group vs control group, 12 vs 9 sessions; P = .014), which suggests that meditation may be useful to improve patients' adherence to exercise-based CR program.

Meditation, mindfulness, and acceptance methods in psychotherapy: A systematic review

OBJECTIVE

: Meditation, mindfulness, and acceptance (MMA) methods have gained popularity among psychotherapists and the public. The impact of these strategies as implemented in treatment packages (e.g., mindfulness-based interventions) has been studied extensively. However, the impact of integrating MMA strategies into individual psychotherapy has not been established.

METHODS

: To address this gap in the literature, we conducted a systematic review of empirical (quantitative or qualitative) studies investigating the use of MMA methods during individual psychotherapy in adult samples.

RESULTS

: After reviewing 4671 references, only three studies (one quantitative, two qualitative) met our inclusion criteria. The one experimental study (n = 162) provided no evidence that including mindfulness meditation improved outcomes beyond other active interventions (ds = 0.00-0.12 for effects on general clinical symptoms vs. progressive muscle relaxation and treatment-as-usual, respectively). Two qualitative studies (n = 5 therapist-patient dyads in one study, n = 9 adults in one study) provided preliminary evidence that patients may find MMA methods helpful.

CONCLUSIONS

: We highlight future directions for work in this area, including clarifying optimal dosage and timing, identifying patient characteristics associated with beneficial or adverse effects, investigating cultural adaptations, and clarifying how MMA constructs can be measured within individual psychotherapy. We conclude by highlighting training recommendations and therapeutic practices.

Feasibility of Mindfulness-Based Intervention for Veterans Managing Chronic Pain

Background. Chronic pain impacts people's activity participation, productivity, mental health, and sense of wellbeing. Purpose. This study aimed to (1) evaluate the feasibility of the Mindfulness-Based Chronic Pain Management (MBCPMTM) program on reducing pain perception and enhancing the quality of life, and (2) understand veterans' experience with the program. Method. The pretest-posttest single-group, mixed-methods design was used. Thirty-one veterans were offered the 12-week intervention. The Pain Catastrophizing Scale (PCS) and the Patient-Reported Outcomes Measurement Information System-29 were administered before and after the program. Focus groups and individual interviews were conducted to understand the experience. Findings. Participants' PCS scores improved (Z = -3.116, p = .002), but the pain intensity did not change significantly. Themes from qualitative data include: (1) We are not alone! (2) I have a sense of awareness, choices, and control; and (3) It does work! Implications. The study shows preliminary feasibility of MBCPMTM for veterans. This promising effect supports future rigorous testing of this intervention.

A Meditation Based Cognitive Therapy (HMBCT) for Primary Insomnia: A Treatment Feasibility Pilot Study

Previous research has indicated a critical need for cost-effective alternative therapies. The present pilot study aimed to evaluate a novel, cost-effective therapy for treating insomnia. The study employed a randomized controlled trial with two groups: therapy and control. Participants were screened using research diagnostic criteria for insomnia recommended by the American Academy of Sleep Medicine (AASM) before undergoing simple randomization. The study included participants from Hindu, Muslim, and Christian faiths who were assigned to either the therapy group (Hare Krishna Mantra Based Cognitive Therapy: HMBCT) or the non-therapy group (control with relaxing music). Both groups underwent six weeks of treatment with traditional cognitive-behavioral therapy techniques, including stimulus control, sleep restriction, and sleep hygiene. Each week, participants in the therapy group received six 45-minute sessions of HMBCT in the evening and were asked to practice the therapy in the evening of the day of sleep recording. Sleep quality was assessed using behavioral measures, sleep logs, and polysomnography recordings before and after the six-week treatment period. There was a one-week period before and after the six weeks when no treatment was provided. Results showed that HMBCT significantly improved sleep quality measures, including a 61% reduction in Epworth Sleepiness Scale (ESS) scores and an 80% reduction in Insomnia Severity Index (ISI) scores. Participants did not take any sleep-inducing medication during the study. These findings suggest that adding mantra chanting to traditional cognitive-behavioral therapy may improve sleep quality.

Effects of Meditation Training and Non-Native Language Training on Cognition in Older Adults: A Secondary Analysis of a Randomized Clinical Trial

Importance

Nonpharmacological interventions are a potential strategy to maintain or promote cognitive functioning in older adults.

Objective

To investigate the effects of 18 months' meditation training and 18 months' non-native language training on cognition in older adults.

Design, Setting, and Participants

This study was a secondary analysis of the Age-Well trial, an 18-month, observer-masked, randomized clinical trial with 3 parallel arms. Eligible participants were community-dwelling adults aged 65 years and older residing in Caen, France. Participants were enrolled from November 24, 2016, to March 5, 2018, and randomly assigned (1:1:1) to meditation training, non-native language (English) training, or no intervention arms. Final follow-up was completed on February 6, 2020. Data were analyzed between December 2021 and November 2022.

Interventions

The 18-month meditation and non-native language training interventions were structurally equivalent and included 2-hour weekly group sessions, daily home practice of 20 minutes or longer, and 1 day of more intensive home practice. The no intervention group was instructed not to change their habits and to continue living as usual.

Main Outcomes and Measures

Cognition (a prespecified secondary outcome of the Age-Well trial) was assessed preintervention and postintervention via the Preclinical Alzheimer Cognitive Composite 5 (PACC5), and composites assessing episodic memory, executive function, and attention.

Results

Among 137 randomized participants, 2 were excluded for not meeting eligibility criteria, leaving 135 (mean [SD] age, 69.3 [3.8] years; 83 female [61%]) eligible for analysis. One participant among the remaining 135 did not complete the trial. In adjusted mixed effects models, no interaction effects were observed between visit and group for PACC5 (F2,131.39 = 2.58; P = .08), episodic memory (F2,131.60 = 2.34; P = .10), executive function (F2,131.26 = 0.89; P = .41), or attention (F2,131.20 = 0.34; P = .79). Results remained substantively unchanged across sensitivity and exploratory analyses.

Conclusions and Relevance

In this secondary analysis of an 18-month randomized trial, meditation and non-native language training did not confer salutary cognitive effects. Although further analyses are needed to explore the effects of these interventions on other relevant outcomes related to aging and well-being, these findings did not support the use of these interventions for enhancing cognition in cognitively healthy older adults.

Trial Registration

ClinicalTrials.gov Identifier: NCT02977819.

Editorial Commentary: Meditation Results From Mindfulness and Results in Improved Surgical Performance: 10 Minutes per Day, the Apps Are Free, Why Not Try?

Meditation is a practice that is thousands of years old and has proponents across the spectrum, from artists to athletes. Meditation is not synonymous with mindfulness but is instead a technique to reach the state of mindfulness. Mindfulness itself can be simply described as the state of bringing one's attention to the present moment. Attaining mindfulness allows a surgeon to maintain focus and avoid allowing outside stimuli to affect performance. Attaining mindfulness does not eliminate feelings of anger or frustration but allows a surgeon to respond to such emotions thoughtfully. Surgeons who respond mindlessly to frustration exhibit poor behavior, worse surgical outcomes, and increased exposure to liability. Today, daily mindfulness is attainable in an efficient manner using modern, application (app)-based technology, and positive effects of mindfulness on surgical and clinical performance have been reported across multiple specialties. Practicing mindfulness daily for 10 minutes, including the day of surgery, could improve performance. Mindfulness matters, the apps are free, so why not try?

Review of Headspace: Meditation and sleep

Americans today report facing multiple stressors, including the COVID-19 pandemic (American Psychological Association, 2020), anxiety disorders (American Psychiatric Association, n.d.), chronic stress (Bergland, 2017), and more. As smartphones become increasingly ingrained in our society, many adults seek out self-directed stress management techniques facilitated via smartphone. A plethora of options are available, and mobile health applications have become increasingly popular in recent years (Lau et al., 2020). With over 70 million downloads across available platforms and users in over 190 countries (Headspace Inc., 2022), the mobile application Headspace may be one of the most well-known mobile health apps. As of May 2022; Headspace can be accessed via the mobile app or the product website (https://www .headspace.com/). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Change in Time Perception Following the Place of Pre-Existence Technique

Time perception is closely related to spatial and bodily perception, yet little is known about how this interrelationship is impacted by meditation and biological sex. To examine this, we studied the effects of a stepwise application of three meditation techniques, from focused attention, to open monitoring to non-dual meditation, encompassed in the Place of Pre-Existence technique (PPEt) on the subjective perception of time, space and body using a pre-post research design. A total of 280 participants (mean age = 47.09 years; SD = 10.13; 127:153 males to females) completed the Subjective Time, Self, Space inventory before and after PPEt. Following PPEt, participants perceived time passing as slowing down, while time intensity, relaxation, 'awareness of space' and 'awareness of body' increased, suggesting heightened mindfulness to these constructs following the training. Awareness of space revealed to be modulated by biological sex and meditation expertise, with males showing a decrease of spatial awareness as a function of meditation expertise while females showed an opposite pattern. The speed and intensity of the experience of time both correlated with body and space awareness. In line with previous studies demonstrating a connection between relaxation and perception of time, a significant correlation was found between relaxation and the subjective experience of the intensity of time. The current results are discussed in the context of the embodied experience of time, and the Sphere Model of Consciousness.

Disentangling self from pain: mindfulness meditation-induced pain relief is driven by thalamic-default mode network decoupling

ABSTRACT

For millenniums, mindfulness was believed to diminish pain by reducing the influence of self-appraisals of noxious sensations. Today, mindfulness meditation is a highly popular and effective pain therapy that is believed to engage multiple, nonplacebo-related mechanisms to attenuate pain. Recent evidence suggests that mindfulness meditation-induced pain relief is associated with the engagement of unique cortico-thalamo-cortical nociceptive filtering mechanisms. However, the functional neural connections supporting mindfulness meditation-based analgesia remain unknown. This mechanistically focused clinical trial combined functional magnetic resonance imaging with psychophysical pain testing (49°C stimulation and pain visual analogue scales) to identify the neural connectivity supporting the direct modulation of pain-related behavioral and neural responses by mindfulness meditation. We hypothesized that mindfulness meditation-based pain relief would be reflected by greater decoupling between brain mechanisms supporting appraisal (prefrontal) and nociceptive processing (thalamus). After baseline pain testing, 40 participants were randomized to a well-validated, 4-session mindfulness meditation or book-listening regimen. Functional magnetic resonance imaging and noxious heat (49°C; right calf) were combined during meditation to test study hypotheses. Mindfulness meditation significantly reduced behavioral and neural pain responses when compared to the controls. Preregistered (NCT03414138) whole-brain analyses revealed that mindfulness meditation-induced analgesia was moderated by greater thalamus-precuneus decoupling and ventromedial prefrontal deactivation, respectively, signifying a pain modulatory role across functionally distinct neural mechanisms supporting self-referential processing. Two separate preregistered seed-to-seed analyses found that mindfulness meditation-based pain relief was also associated with weaker contralateral thalamic connectivity with the prefrontal and primary somatosensory cortex, respectively. Thus, we propose that mindfulness meditation is associated with a novel self-referential nociceptive gating mechanism to reduce pain.

Carotid-body modulation through meditation in stage-I hypertensive subjects: Study protocol of a randomized and controlled study

Adjunctive therapy for hypertension is in high demand for clinical research. Therefore, several meta-analyses have provided sufficient evidence for meditation as an adjunct therapy, without being anchored on reliable physiological grounds. Meditation modulates the autonomic nervous system. Herein, we propose a hierarchical-dependent effect for the carotid body (CB) in attenuating blood pressure (BP) and ventilatory variability (VV) fine-tuning due to known nerve connections between the CB, prefrontal brain, hypothalamus, and solitary tract nucleus. The aim of this exploratory study was to investigate the role of CB in the possible decrease in BP and changes in VV that could occur in response to meditation. This was a prospective, single-center, parallel-group, randomized, controlled clinical trial with concealed allocation. Eligible adult subjects of both sexes with stage 1 hypertension will be randomized into 1 of 2 groups: transcendental meditation or a control group. Subjects will be invited to 3 visits after randomization and 2 additional visits after completing 8 weeks of meditation or waiting-list control. Thus, subjects will undergo BP measurements in normoxia and hyperoxia, VV measurements using the Poincaré method at rest and during exercise, and CB activity measurement in the laboratory. The primary outcome of this study was the detection of changes in BP and CB activity after 8 weeks. Our secondary outcome was the detection of changes in the VV at rest and during exercise. We predict that interactions between hyperoxic deactivation of CB and meditation; Will reduce BP beyond stand-alone intervention or alternatively; Meditation will significantly attenuate the effects of hyperoxia as a stand-alone intervention. In addition, VV can be changed, partially mediated by a reduction in CB activity. Trial registration number: ReBEC registry (RBR-55n74zm). Stage: pre-results.

Shared Meditation Involving Cancer Patients, Health Professionals and Third Persons: Perceptions of Participants Through a Focus Group Study

People with cancer often experience psychological distress and in addition, the practice of oncology is one of the most stressful areas of medicine for health professionals. Mindfulness meditation has been used to alleviate stress-related symptoms. We therefore ran a pilot study to assess the feasibility of a mindfulness intervention involving cancer patients, health professionals, and third persons together, as part of a comprehensive project aiming to evaluate the added value of 'meditating together'. Following on from our quantitative analyses of the project, we investigated its qualitative aspects through focus groups to explore the perceptions of participants regarding their experience. Focus groups conducted in 7 patients, 7 health professionals, and 8 third persons after the intervention showed that 'meditating together' was generally appreciated, particularly by patients, who found it motivating and a way to relieve their feelings of loneliness in the face of illness. All participants reported better stress management. They also shared benefits and difficulties concerning the practice of meditation and the programme's modalities. In addition, they all stated that the programme should be lasting. The opinion of the patients (our target population) will be decisive in building an optimized programme that will suit them the best. In conclusion, the protocol and the qualitative findings of the present study validate the rationale for conducting a fully powered randomized trial to demonstrate the potential added value of shared meditation and how it improves well-being by promoting bridge-building between cancer patients, health professionals and others.Trial Registration: ClinicalTrials.gov. NCT04410185. Registered on June 1, 2020.

Man's best friend(s): Effects of a brief befriending meditation on human-animal relations

In two studies using samples representative of the US adult population with regard to age, sex and ethnicity, we investigated relationships between loving-kindness and compassion-based practices with speciesism, animal solidarity and desire to help animals. In a cross-sectional study (Study 1, N = 2,822), results showed that past 30 days practice and estimated lifetime number of hours of lovingkindness or compassion meditation were associated with more animal solidarity and greater desire to help animals. Past 30 days practice was also associated with less speciesism, but only when adjusting for sociodemographic characteristics. In an experimental study (Study 2, N = 1,102), results showed that participants randomized to a befriending meditation (a practice similar to loving-kindness and compassion meditation) condition scored higher on animal solidarity and desire to help animals than participants randomized to a control condition. No significant difference was observed on speciesism, but mediation analyses suggested that effects on all three outcomes were mediated through perceived commonality with animals.

Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults: A Randomized Clinical Trial

IMPORTANCE

Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle interventions.

OBJECTIVE

To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults.

DESIGN, SETTING, AND PARTICIPANTS

This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California, San Diego). A total of 585 older adults (aged 65-84 y) with subjective cognitive concerns, but not dementia, were randomized (enrollment from November 19, 2015, to January 23, 2019; final follow-up on March 16, 2020).

INTERVENTIONS

Participants were randomized to undergo the following interventions: MBSR with a target of 60 minutes daily of meditation (n = 150); exercise with aerobic, strength, and functional components with a target of at least 300 minutes weekly (n = 138); combined MBSR and exercise (n = 144); or a health education control group (n = 153). Interventions lasted 18 months and consisted of group-based classes and home practice.

MAIN OUTCOMES AND MEASURES

The 2 primary outcomes were composites of episodic memory and executive function (standardized to a mean [SD] of 0 [1]; higher composite scores indicate better cognitive performance) from neuropsychological testing; the primary end point was 6 months and the secondary end point was 18 months. There were 5 reported secondary outcomes: hippocampal volume and dorsolateral prefrontal cortex thickness and surface area from structural magnetic resonance imaging and functional cognitive capacity and self-reported cognitive concerns.

RESULTS

Among 585 randomized participants (mean age, 71.5 years; 424 [72.5%] women), 568 (97.1%) completed 6 months in the trial and 475 (81.2%) completed 18 months. At 6 months, there was no significant effect of mindfulness training or exercise on episodic memory (MBSR vs no MBSR: 0.44 vs 0.48; mean difference, -0.04 points [95% CI, -0.15 to 0.07]; P = .50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, -0.04 to 0.17]; P = .23) or executive function (MBSR vs no MBSR: 0.39 vs 0.31; mean difference, 0.08 points [95% CI, -0.02 to 0.19]; P = .12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, -0.03 to 0.18]; P = .17) and there were no intervention effects at the secondary end point of 18 months. There was no significant interaction between mindfulness training and exercise (P = .93 for memory and P = .29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed a significant improvement with either intervention compared with those not receiving the intervention.

CONCLUSIONS AND RELEVANCE

Among older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive function at 6 months. The findings do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02665481.

Using mobile meditation app data to predict future app engagement: an observational study

OBJECTIVE

Meditation with mobile apps has been shown to improve mental and physical health. However, regular, long-term meditation app use is needed to maintain these health benefits, and many people have a difficult time maintaining engagement with meditation apps over time. Our goal was to determine the length of the timeframe over which usage data must be collected before future app abandonment can be predicted accurately in order to better target additional behavioral support to those who are most likely to stop using the app.

METHODS

Data were collected from a randomly drawn sample of 2600 new subscribers to a 1-year membership of the mobile app Calm, who started using the app between July and November of 2018. App usage data contained the duration and start time of all meditation sessions with the app over 365 days. We used these data to construct the following predictive model features: total daily sessions, total daily duration, and a measure of temporal similarity between consecutive days based on the dynamic time warping (DTW) distance measure. We then fit random forest models using increasingly longer periods of data after users subscribed to Calm to predict whether they performed any meditation sessions over 2-week intervals in the future. Model fit was assessed using the area under the receiver operator characteristic curve (AUC), and an exponential growth model was used to determine the minimal amount of data needed to reach an accurate prediction (95% of max AUC) of future engagement.

RESULTS

After first subscribing to Calm, 83.1% of the sample used the Calm app on at least 1 more day. However, by day 350 after subscribing, 58.0% of users abandoned their use of the app. For the persistent users, the average number of daily sessions was 0.33 (SD = 0.02), the average daily duration of meditating was 3.93 minutes (SD = 0.25), and the average DTW distance to the previous day was 1.50 (SD = 0.17). The exponential growth models revealed that an average of 64 days of observations after subscribing to Calm are needed to reach an accurate prediction of future app engagement.

DISCUSSION

Our results are consistent with existing estimates of the time required to develop a new habit. Additionally, this research demonstrates how to use app usage data to quickly and accurately predict the likelihood of users' future app abandonment. This research allows future researchers to better target just-in-time interventions towards users at risk of abandonment.

Personalized Prediction of Response to Smartphone-Delivered Meditation Training: Randomized Controlled Trial

BACKGROUND

Meditation apps have surged in popularity in recent years, with an increasing number of individuals turning to these apps to cope with stress, including during the COVID-19 pandemic. Meditation apps are the most commonly used mental health apps for depression and anxiety. However, little is known about who is well suited to these apps.

OBJECTIVE

This study aimed to develop and test a data-driven algorithm to predict which individuals are most likely to benefit from app-based meditation training.

METHODS

Using randomized controlled trial data comparing a 4-week meditation app (Healthy Minds Program [HMP]) with an assessment-only control condition in school system employees (n=662), we developed an algorithm to predict who is most likely to benefit from HMP. Baseline clinical and demographic characteristics were submitted to a machine learning model to develop a "Personalized Advantage Index" (PAI) reflecting an individual's expected reduction in distress (primary outcome) from HMP versus control.

RESULTS

A significant group × PAI interaction emerged (t₆₅₈=3.30; P=.001), indicating that PAI scores moderated group differences in outcomes. A regression model that included repetitive negative thinking as the sole baseline predictor performed comparably well. Finally, we demonstrate the translation of a predictive model into personalized recommendations of expected benefit.

CONCLUSIONS

Overall, the results revealed the potential of a data-driven algorithm to inform which individuals are most likely to benefit from a meditation app. Such an algorithm could be used to objectively communicate expected benefits to individuals, allowing them to make more informed decisions about whether a meditation app is appropriate for them.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04426318; https://clinicaltrials.gov/ct2/show/NCT04426318.

Contemplative Practices Behavior Is Positively Associated with Well-Being in Three Global Multi-Regional Stanford WELL for Life Cohorts

Positive associations between well-being and a single contemplative practice (e.g., mindfulness meditation) are well documented, yet prior work may have underestimated the strength of the association by omitting consideration of multiple and/or alternative contemplative practices. Moreover, little is known about how contemplative practice behavior (CPB) impacts different dimensions of well-being. This study investigates the relationship of CPB, consisting of four discrete practices (embodied somatic-observing, non-reactive mindfulness, self-compassion, and compassion for others), with multiple dimensions of well-being. As with other canonical lifestyle behaviors, multiple contemplative practices can be integrated into one's daily routine. Thus, it is critical to holistically consider these behaviors, extending them beyond a simple uni-dimensional measure (e.g., daily mindfulness meditation practice). We developed an integrative measure of four types of contemplative practice and found it to be significantly associated with a multi-dimensional measure of well-being. Importantly, our findings were from three large global multi-regional cohorts and compared against better-understood lifestyle behaviors (physical activity). Data were drawn from California/San Francisco Bay Area, (n = 6442), Hangzhou City (n = 10,268), and New Taipei City (n = 3033). In all three cohorts, we found statistically significant (p < 0.05) positive associations between CPB and well-being, both overall and with all of the constituent domains of well-being, comparable to or stronger than the relationship with physical activity across most well-being outcomes. These findings provide robust and cross-cultural evidence for a positive association between CPB and well-being, illuminate dimensions of well-being that could be most influenced by CPB, and suggest CPB may be useful to include as part of fundamental lifestyle recommendations for health and well-being.

Three months-longitudinal changes in relative telomere length, blood chemistries, and self-report questionnaires in meditation practitioners compared to novice individuals during midlife

Aging accelerates during midlife. Researches have shown the health benefits of mind-body intervention (MBI). However, whether MBI is involved with aging process has not been well understood. In this study, we approach to examine the relations of MBI with this process by investigating an aging marker of the peripheral blood, blood chemistry, and self-report questionnaires. A quasi-experimental design was applied. Experienced MBI practitioners participated in a 3-month intensive meditation training, while the age, gender-matched MBI-naïve controls led a normal daily life. Measurements were taken at before and after the 3 months for relative telomere length (RTL), blood chemistry, and self-report questionnaires including items about sleep quality, somatic symptoms, depression, anxiety, stress, emotional intelligence (EI), and self-regulation. For RTL, the repeated measures analysis of variance showed a significant group*time interaction (P = .013) with a significant post hoc result (P = .030) within the control group: RTL was significantly reduced in the control while it was maintained in the meditation group. In repeated measures analysis of variance for blood chemistries, there were significant group differences between the groups in glucose and total protein. In the post hoc comparison analysis, at post measurements, the meditation group exhibited significantly lower values than the control group in both glucose and total protein. There were significant group-wise differences in the correlations of RTL with triglyceride (TG), high-density lipoprotein (HDL), glutamic oxaloacetic transaminase and glutamic pyruvic transaminase. Any of self-report results did not show significant changes in group*time interaction. However, there were group differences with significant (P < .05) or a tendency (.05 < P < .1) level. There were significant improvements in depression, stress and EI as well as tendencies of improvement in sleep quality and anxiety, in the meditation group compared to the control group. Our results suggest that meditation practice may have a potential to modify aging process in molecular cellular level combined with changes in psychological dimension.

Neural Signatures of Pain Modulation in Short-Term and Long-Term Mindfulness Training: A Randomized Active-Control Trial

OBJECTIVE

Mindfulness-based interventions are widely used to target pain, yet their neural mechanisms of action are insufficiently understood. The authors studied neural and subjective pain response in a randomized active-control trial of mindfulness-based stress reduction (MBSR) alongside long-term meditation practitioners.

METHODS

Healthy participants (N=115) underwent functional neuroimaging during a thermal acute pain task before and after random assignment to MBSR (N=28), an active control condition (health enhancement program [HEP]) (N=32), or a waiting list control condition (N=31). Long-term meditators (N=30) completed the same neuroimaging paradigm. Pain response was measured via self-reported intensity and unpleasantness, and neurally via two multivoxel machine-learning-derived signatures: the neurologic pain signature (NPS), emphasizing nociceptive pain processing, and the stimulus intensity independent pain signature-1 (SIIPS1), emphasizing stimulus-independent neuromodulatory processes.

RESULTS

The MBSR group showed a significant decrease in NPS response relative to the HEP group (Cohen's d=-0.43) and from pre- to postintervention assessment (d=-0.47). The MBSR group showed small, marginal decreases in NPS relative to the waiting list group (d=-0.36), and in SIIPS1 relative to both groups (HEP group, d=-0.37; waiting list group, d=-0.37). In subjective unpleasantness, the MBSR and HEP groups also showed modest significant reductions compared with the waiting list group (d=-0.45 and d=-0.55). Long-term meditators reported significantly lower pain than nonmeditators but did not differ in neural response. Within the long-term meditator group, cumulative practice during intensive retreat was significantly associated with reduced SIIPS1 (r=-0.65), whereas daily practice was not.

CONCLUSIONS

Mindfulness training showed associations with pain reduction that implicate differing neural pathways depending on extent and context of practice. Use of neural pain signatures in randomized trials offers promise for guiding the application of mindfulness interventions to pain treatment.

Effects of hypnosis vs mindfulness meditation vs education on chronic pain intensity and secondary outcomes in veterans: a randomized clinical trial

ABSTRACT

Effective, rigorously evaluated nonpharmacological treatments for chronic pain are needed. This study compared the effectiveness of training in hypnosis (HYP) and mindfulness meditation (MM) with an active education control (ED). Veterans (N = 328) were randomly assigned to 8 manualized, group-based, in-person sessions of HYP (n = 110), MM (n = 108), or ED (n = 110). Primary (average pain intensity [API]) and secondary outcomes were assessed at pretreatment, posttreatment, and 3 and 6 months posttreatment. Treatment effects were evaluated using linear regression, a generalized estimating equation approach, or a Fisher exact test, depending on the variable. There were no significant omnibus between-group differences in pretreatment to posttreatment change in API; however, pretreatment to posttreatment improvements in API and several secondary variables were seen for participants in all 3 conditions. Participation in MM resulted in greater decreases in API and pain interference at 6 months posttreatment relative to ED. Participation in HYP resulted in greater decreases in API, pain interference, and depressive symptoms at 3 and 6 months posttreatment compared with ED. No significant differences on outcomes between HYP and MM were detected at any time point. This study suggests that all 3 interventions provide posttreatment benefits on a range of outcomes, but the benefits of HYP and MM continue beyond the end of treatment, while the improvements associated with ED dissipate over time. Future research is needed to determine whether the between-group differences that emerged posttreatment are reliable, whether there are benefits of combining treatments, and to explore moderating and mediating factors.

The Effects of Combined Respiratory-Gated Auricular Vagal Afferent Nerve Stimulation and Mindfulness Meditation for Chronic Low Back Pain: A Pilot Study

OBJECTIVE

Respiratory-gated Auricular Vagal Afferent Nerve stimulation (RAVANS) is a safe nonpharmacological approach to managing chronic pain. The purpose of the current study was to examine (1) the feasibility and acceptability of RAVANS, combined with mindful meditation (MM) for chronic low back pain (CLBP), (2) the potential synergy of MM+RAVANS on improving pain, and (3) possible moderators of the influence of MM+RAVANS on pain.

DESIGN

Pilot feasibility and acceptability study.

SETTING

Pain management center at large academic medical center.

SUBJECTS

Nineteen adults with CLBP and previous MM training.

METHODS

Participants attended two sessions during which they completed quantitative sensory testing (QST), rated pain severity, and completed a MM+stimulation session. Participants received RAVANS during one visit and sham stimulation during the other, randomized in order. Following intervention, participants repeated QST.

RESULTS

MM+RAVANS was well tolerated, acceptable, and feasible to provide relief for CLBP. Both MM+stimulation sessions resulted in improved back pain severity, punctate pain ratings, and pressure pain threshold. Individuals with greater negative affect showed greater back pain improvement from MM+RAVANS while those with greater mindfulness showed greater back pain improvement from MM+sham.

CONCLUSIONS

Results suggest that for CLBP patients with prior MM training, the analgesic effects of MM may have overshadowed effects of RAVANS given the brief single session MM+RAVANS intervention. However, those with greater negative affect may benefit from combined MM+RAVANS.

Beneficial effects of a program of Mindfulness by remote during COVID-19 lockdown

OBJECTIVE

In the emergency context of COVID-19 pandemic and lockdown, mindfulness relaxation techniques can provide a safe and effective strategy to obtain in a reasonably short time some degree of relief from suffering and to guarantee a greater confidence with emotional reactions in the general population.

SUBJECTS AND METHODS

The Mindfulness-Based Stress Reduction program for coping with COVID-19 emergency was designed as an 8-week program during the early phase of lockdown consisting in practice meditation exercises at least once a day guided and structured by certified instructors entered on a free online platform. At the end of the program all participants completed a survey.

RESULTS

A total of 108 surveys were completed (67.6% male; 32.4% female). Despite the difficult moment of lockdown and the fear linked to the pandemic, 61.9% of interviewed subjects declared a state of general well-being from fair to good linked to the practice of mindfulness. Female subjects (p=0.001), married subjects (p=0.05) and people taking pharmacologic therapy demonstrated (p=0.009) significant improvement in daily management of emotions and practical requests during the early phase of the COVID-19 outbreak.

CONCLUSIONS

Mindfulness meditation may be effective in helping people to regulate emotions and to support their mental health during this period of worry and uncertainty.

Advanced Meditation and Vegan Diet Increased Acylglycines and Reduced Lipids Associated with Improved Health: A Prospective Longitudinal Study

Introduction: Samyama is an Isha Yoga 8-day residential meditation/yoga retreat combined with 60 days of preparation with vegan diet. We showed earlier Samyama retreat was associated with lower systemic inflammation and favorable lipid profiles along with other physical and mental health benefits. There is no mechanistic study on the impact of an advanced meditative process on multiple blood lipids and their implications on meditation-related improved physical and mental wellbeing. Methods: Sixty-four Samyama participants on vegan diet had blood sampled immediately before and immediately after the 8-day retreat for lipidomic analysis. The complex plasma lipidome was characterized using high-resolution mass spectrometric analysis and tandem mass spectrometry. Results: Pre- and post-Samyama blood samples of 64 Samyama participants were analyzed. Acylglycines (acetyl, propionyl, butyryl, and valeryl) were increased in the plasma post-Samyama compared with pre-Samyama (p < 0.001). Levels of glycerophosphocholines, glycerophosphoethanolamines, di-unsaturated ethanolamine plasmalogens, cholesterol esters, acylcarnitines, and acylgylcerines (triacylglycerols and diacylglycerols) decreased after the Samyama meditation. Plasma levels of glycerophosphoserines or glycerophosphoinositols were unchanged. Conclusion: An 8-day advanced meditation retreat resulted in increased acylglycines, an endocannabinoid-like fatty acid amide associated with increased cellular anandamide levels, anti-inflammation, analgesia, and vascular relaxation. Other serum lipid levels, including some that are associated with increased risk of atherosclerosis, were reduced following the Samyama program. ClinicalTrials.gov Registration: Identifier: NCT04366544.

Perceived Stress, Resilience, and Wellbeing in Seasoned Isha Yoga Practitioners Compared to Matched Controls During the COVID-19 Pandemic

Background

Yoga practices, including breathing, meditation, and posture protocols (asanas), have been shown to facilitate physical and mental wellbeing.

Methods

Seasoned yoga practitioners were recruited from the Isha Foundation. Recruitment of the comparison group was achieved using snowball sampling and were not yoga practitioners. Participants in the non-yoga group were randomized to a 3-min Isha practice or a comparator group asked to perform 15-min of daily reading. Participants completed a series of web-based surveys (REDCap) at baseline, 6, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess for: perceived stress (PSS), mood states [anxiety and depression (PHQ-4), joy (DPES-Joy subscale)], mindfulness attention and awareness (MAAS), resilience (BRS), mental wellbeing (WEMWBS) and recovery from traumatic event (PTGI). Weekly activity diaries were employed as a tool for collecting compliance information from study participants. Perceived stress scale scores were identified as primary outcome for this study.

Findings

The median Perceived Stress Scale (PSS) score for the yoga practitioners compared to the active and placebo comparators was significantly lower at all time-points: baseline: 11 [IQR 7–15] vs. 16 [IQR 12–21] in both the active and placebo comparators (p &lt; 0.0001); 6 weeks: 9 [IQR 6–13] vs. 12 [IQR 8–17] in the active comparator and 14 [IQR 9–18] in the placebo comparator (p &lt; 0.0001); and 12 weeks: 9 [IQR 5–13] vs. 11.5 [IQR 8–16] in the active comparators and 13 [IQR 8–17] in the placebo comparator (p &lt; 0.0001). Among the randomized participants that were compliant for the full 12 weeks, the active comparators had significantly lower median PSS scores than the placebo comparators 12 weeks [10 (IQR 5–14) vs. 13 (IQR 8–17), p = 0.017]. Further, yoga practitioners had significantly lower anxiety at all three-time points (p &lt; 0.0001), lower depression at baseline and 6 weeks (p &lt; 0.0003), and significantly higher wellbeing (p &lt; 0.0001) and joy (p &lt; 0.0001) at all three-time points, compared to the active and placebo comparator groups.

Interpretation

The lower levels of stress, anxiety, depression, and higher level of wellbeing and joy seen in the yoga practitioners compared to the active and placebo comparators illustrate the impact of regular yoga practices on mental health even during the pandemic.

Trial Registration

ClinicalTrials.gov, identifier: NCT 04498442.

Test of daily app-based mindfulness meditation preceding a planned smoking quit attempt date on abstinence: Protocol for a randomized controlled trial recruiting across the 58 counties of California

A majority of the 34 million people who currently smoke cigarettes report wanting to quit smoking yet most attempts to quit end in relapse. A mindfulness based intervention (MBI) is an intervention package used to reinforce an individual's practice of mindfulness meditation in daily life. MBIs delivered by phone app offer daily prompts to guide bouts of mindfulness meditation, that is, sustained attention to moment-by-moment experience without behavior reactivity. Daily bouts of mindfulness meditation offer individuals a replacement behavior for smoking during a quit attempt, and MBI app instruction aims to increase an individual's skill in non-reactivity when they experience cravings. Our study objective is to test the effect of an app-based MBI on abstinence during a scheduled quit attempt among people who currently smoke and who are willing to make a voluntary quit attempt on a selected near-term date. Our delivery of a smartphone app-based MBI occurs daily for the two weeks preceding a planned quit date. Study participants are randomized to a either a app-based MBI or an app-based psychoeducation control group and asked to self-administer their intervention two times a day in 10-min segments for 14 sequential days for a total of 280 min. This preparatory period capitalizes on time to help participants orient toward a near-term goal to quit smoking, practice mindfulness meditation, and increase the skill of non-reactivity during states of craving to smoke. We recruit people who smoke cigarettes from all 58 counties in California. We test the hypothesis that an app-based MBI will outperform a time-matched psychoeducation control on increasing smoking abstinence. Findings contribute knowledge to the addictions treatment field about whether MBIs delivered by app can increase smoking cessation in a geographically diverse sample.

Targeting Depressive Symptoms in Younger Breast Cancer Survivors: The Pathways to Wellness Randomized Controlled Trial of Mindfulness Meditation and Survivorship Education

PURPOSE

Younger women are at risk for depression and related symptoms following breast cancer. The Pathways to Wellness study, a randomized, multi-institution, three-arm trial, tested the efficacy of two behavioral interventions for younger breast cancer survivors with elevated depressive symptoms: mindful awareness practices (MAPs) and survivorship education (SE) (Clincaltrials.gov identifier: NCT03025139).

METHODS

Women diagnosed with breast cancer at or before 50 years of age who had completed treatment and had elevated depressive symptoms were randomly assigned to 6 weeks of MAPs, SE, or wait-list control (WLC). Assessments were conducted preintervention and postintervention and at 3-month and 6-month postintervention follow-ups. Analyses compared each intervention to WLC using linear mixed models. The primary outcome was change in depressive symptoms from preintervention to postintervention on the Center for Epidemiologic Studies-Depression Scale; secondary outcomes included change in fatigue, insomnia, and vasomotor symptoms.

RESULTS

Two hundred forty-seven women (median age = 46 years) were randomly assigned to MAPs (n = 85), SE (n = 81), or WLC (n = 81). MAPs and SE led to significant decreases in depressive symptoms from preintervention to postintervention relative to WLC (mean change relative to WLC [95% CI]: MAPs, -4.7 [-7.5 to -1.9]; SE, -4.0 [-6.9 to -1.1]), which persisted at 6-month follow-up for MAPs (mean change relative to WLC [95% CI]: MAPs, -3.7 [-6.6 to -0.8]; SE, -2.8 [-5.9 to 0.2]). MAPs, but not SE, also had beneficial effects on fatigue, insomnia, and vasomotor symptoms that persisted at 6-month follow-up (P < .05).

CONCLUSION

Mindfulness meditation and SE reduced depressive symptoms in younger breast cancer survivors. These interventions can be widely disseminated over virtual platforms and have significant potential benefit for quality of life and overall survivorship in this vulnerable group.