<p>Mindfulness is associated with low levels of neuroticism, anxiety, and depressive symptoms, as well as high levels of self-esteem and satisfaction with life (Brown & Ryan, 2003). As part of a 3-month randomized waitlist-controlled trial of the effects of the Transcendental Meditation (TM) program on university students (N=295), we examined the impact of TM practice on mindfulness as measured by the Kentucky Inventory of Mindfulness Skills (KIMS; Baer, Smith, & Allen, 2004). A repeated measures ANOVA on total KIMS scores showed a significant time×treatment interaction, with the TM participants reporting greater increases in mindfulness than the waitlist participants. All KIMS subscales were positively intercorrelated at pretreatment, and there were no differences over time or as a function of treatment condition in subscale intercorrelations. Therefore, previously published findings of a positive correlation between subscales measuring the skills of observing and accepting-without-judgment one's inner experiences only among those with meditation experience may have reflected a self-selection effect rather than a change in the relation of these mindfulness components resulting directly from meditation practice. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–16, 2009.</p>
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OBJECTIVE: Pulmonary rehabilitation improves exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). However, many patients do not have access to pulmonary rehabilitation programs. We hypothesized that an alternative to pulmonary rehabilitation to improve exercise tolerance is the practice of pranayama, or yoga breathing, which could be done independently at home. We also sought to determine whether yoga nonprofessionals could adequately teach pranayama to patients.DESIGN: Proof-of-concept, randomized, double-blind, controlled pilot trial.
SETTINGS/LOCATION: Two academic pulmonary practices.
SUBJECTS: Forty-three patients with symptomatic, moderate-to-severe COPD.
INTERVENTIONS: Twelve weeks of pranayama plus education versus education alone. Two yoga professionals trained the research coordinators to conduct all pranayama teaching and monitored the quality of the teaching and the practice of pranayama by study participants.
OUTCOME MEASURES: The primary outcome was a change in the 6-min walk distance (6MWD). Secondary outcomes included changes in lung function, markers of oxidative stress and systemic inflammation, and measures of dyspnea and quality of life.
RESULTS: The 6MWD increased in the pranayama group (least square mean [95% confidence interval] = 28 m [-5 to 61]) and decreased in the control group (-15 m [-47 to 16]), with a nearly significant treatment effect (p = 0.06) in favor of pranayama. Pranayama also resulted in small improvements in inspiratory capacity and air trapping. Both groups had significant improvements in various measures of symptoms, but no overall differences in respiratory system impedance or markers of oxidative stress or systemic inflammation.
CONCLUSION: This pilot study successfully demonstrated that pranayama was associated with improved exercise tolerance in patients with COPD. Lay personnel were able to adequately teach patients to practice pranayama. These results suggest that pranayama may have significant clinical benefits for symptomatic patients with COPD, a concept that needs to be confirmed in future, larger clinical trials.
Objective: Pulmonary rehabilitation improves exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). However, many patients do not have access to pulmonary rehabilitation programs. We hypothesized that an alternative to pulmonary rehabilitation to improve exercise tolerance is the practice of pranayama, or yoga breathing, which could be done independently at home. We also sought to determine whether yoga nonprofessionals could adequately teach pranayama to patients. Design: Proof-of-concept, randomized, double-blind, controlled pilot trial. Settings/Location: Two academic pulmonary practices. Subjects: Forty-three patients with symptomatic, moderate-to-severe COPD. Interventions: Twelve weeks of pranayama plus education versus education alone. Two yoga professionals trained the research coordinators to conduct all pranayama teaching and monitored the quality of the teaching and the practice of pranayama by study participants. Outcome measures: The primary outcome was a change in the 6-min walk distance (6MWD). Secondary outcomes included changes in lung function, markers of oxidative stress and systemic inflammation, and measures of dyspnea and quality of life.Results: The 6MWD increased in the pranayama group (least square mean [95% confidence interval] = 28 m [-5 to 61]) and decreased in the control group (-15 m [-47 to 16]), with a nearly significant treatment effect ( p = 0.06) in favor of pranayama. Pranayama also resulted in small improvements in inspiratory capacity and air trapping. Both groups had significant improvements in various measures of symptoms, but no overall differences in respiratory system impedance or markers of oxidative stress or systemic inflammation.
Conclusion: This pilot study successfully demonstrated that pranayama was associated with improved exercise tolerance in patients with COPD. Lay personnel were able to adequately teach patients to practice pranayama. These results suggest that pranayama may have significant clinical benefits for symptomatic patients with COPD, a concept that needs to be confirmed in future, larger clinical trials.
OBJECTIVE:It is often assumed that psychosocial pain treatments work because of specific active components of the intervention. The degree to which common factors may contribute to improved pain outcomes is not well researched. The purpose of this study was to examine patient-related and therapist-related common factors during a Mindfulness-Based Cognitive Therapy (MBCT) for headache pain trial.
MATERIALS AND METHODS:
This study was a secondary analysis of a parallel group, unblinded, randomized controlled trial in which MBCT was compared with a control. A series of linear regression models and 1 bootstrap mediation model were conducted with the sample of participants that completed MBCT (N=21).
RESULTS:
In-session participant engagement was positively associated with treatment dose indicators of session attendance (P=0.038) and at-home meditation practice (P=0.027). Therapist adherence and quality were both significant predictors of posttreatment client satisfaction (P=0.038 and 0.034, respectively). Therapist appropriateness was not significantly associated with any of the variables of interest (P>0.05). Baseline pain intensity was positively associated with pretreatment expectations and motivations (P=0.049) and working alliance (P=0.048), and working alliance significantly predicted posttreatment patient satisfaction (P<0.001). Higher pretreatment expectations and motivation significantly predicted greater improvement in pretreatment to posttreatment change in pain interference (P=0.016); however, this relation was fully mediated by baseline pain intensity (P<0.05).
DISCUSSION:
Common factors play an important role in improving pain outcomes and patient satisfaction during a MBCT for headache pain intervention. Stimulating positive pretreatment expectations and patient motivation, as well as building strong rapport is an important component of treatment success.
Objective: To investigate engagement in metacognitive acceptance and subsequent efficacy with respect to decreasing 2 risk factors for disordered eating, body dissatisfaction (BD), and negative affect (NA). Method: In a pilot experiment, 20 female undergraduates (Mage = 24.35, SD = 9.79) underwent a BD induction procedure, received acceptance training using brief written instructions, and were then assessed on engagement in the technique. In a second experiment in which acceptance training was enhanced through the use of video format and a guided experiential exercise, 80 female undergraduates (mean age = 23.59, SD = 8.98) were randomized to an acceptance or control group following the same BD induction. Outcome measures were taken at baseline, postinduction, and posttreatment and consisted of separate visual analogue scales for weight and appearance satisfaction and the NA subscale of the Positive and Negative Affect Scale. Baseline assessments included the Eating Disorder Inventory–BD, Difficulties in Emotion Regulation Scale, Ways of Coping Questionnaire, and the Five Facet Mindfulness Questionnaire. Results: Enhanced training significantly increased engagement in acceptance. Nonengagement was associated with NA, emotion regulation difficulties, and avoidant coping. Acceptance training significantly increased weight and appearance satisfaction and reduced NA relative to control, with no significant differences between those who did and did not engage. Intervention effects were moderated by mindfulness, emotion regulation difficulty, and avoidant coping. Conclusions: Findings provide clarification regarding engagement and lend further support for the utility of acceptance, with particular benefit identified for those “at risk” for emotion regulation difficulty. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
OBJECTIVE: Mindfulness and pain catastrophizing are important constructs in pain research, and there are theoretical reasons for suspecting that measures of the 2 constructs should be related in predictable ways. The present study investigated the association of pain catastrophizing (Pain Catastrophizing Scale) with mindfulness (Five Facet Mindfulness Questionnaire). The Penn State Worry Questionnaire was included to control for confounding of worry; the influence of demographics was explored.METHODS: The participants were 214 undergraduates, who were administered questionnaires via the Internet. Analyses assessed relationships after correcting for attenuation.
RESULTS: The mindfulness scales had intercorrelations with catastrophizing ranging from -0.23 to 0.13; the Non-Judging, Non-Reactivity, and Acting with Awareness mindfulness scales correlated significantly with catastrophizing. However, worry was better correlated (r=0.35) with catastrophizing, and the mindfulness scales were not significantly related to catastrophizing after controlling for worry. Mindfulness scales were significant predictors (P=0.018) of catastrophizing scores in a single-indicator latent variable analysis, and 1 mindfulness scale (Non-Reactivity) contributed uniquely (P=0.006) to prediction. None of the mindfulness scales significantly predicted catastrophizing scores when worry was controlled, but the path from worry to catastrophizing was significant (P=0.048). Sex differences in catastrophizing scores were explained by sex differences on the worry scale (P<0.001).
DISCUSSION: These findings suggest that it is important to assess more general cognitive-emotional constructs, such as worry, when making inferences about the influence of mindfulness or changes in mindfulness upon catastrophic thinking in response to pain.
As contemplative pedagogy on higher education campuses grows, so does interest in supporting additional faculty in using contemplative practices. At our small, liberal arts teachinguniversity in the southeast USA, our faculty contemplative learning circle has steadily widened and worked to integrate mindfulness and other practices into our campus activities.
We became interested in how contemplative practices are already happening in our classrooms without being named as such, and if finding out about them might elucidate opportunities to support faculty in deepening and expanding current efforts. This paper presents
the findings from an interview study with 35 faculty members not formally participating in
faculty activities involving contemplative pedagogy. Faculty spontaneously mentioned some
activities that may be considered contemplative in their descriptions of effective teaching
strategies, such as class discussions, experiential activities, and journaling. Among a provided list of contemplative activities, the most frequently used were discussions/debates,
journaling/reflective writing, and beholding, though the ways in which faculty implemented
the activities varied. Faculty offered many examples of activities that could be considered
contemplative or introspective, and the ways they used the activities differed by discipline.
When asked directly, 18 participants reported that they used contemplative practices or
pedagogy in some way, nine reported that they were uncertain about the definition and/
or whether they used them, and eight responded that they do not use them. Many faculty
members also indicated interest in learning more about how to incorporate contemplative
practices in teaching, suggesting an opportunity for enhanced faculty development efforts.
Despite the vast literature that has implicated asymmetric activation of the prefrontal cortex in approach-withdrawal motivation and emotion, no published reports have directly explored the neural correlates of well-being. Eighty-four right-handed adults (ages 57-60) completed self-report measures of eudaimonic well-being, hedonic well-being, and positive affect prior to resting electroencephalography. As hypothesized, greater left than right superior frontal activation was associated with higher levels of both forms of well-being. Hemisphere-specific analyses documented the importance of goal-directed approach tendencies beyond those captured by approach-related positive affect for eudaimonic but not for hedonic well-being. Appropriately engaging sources of appetitive motivation, characteristic of higher left than right baseline levels of prefrontal activation, may encourage the experience of well-being.
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ObjectivesThis study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy).
Design
A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N = 24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted.
Results
Pain acceptance emerged as a significant mediator of the group-interference relation (p < .05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p < .05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference.
Conclusions
Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache.
ObjectivesOur recent pilot study demonstrated mindfulness-based cognitive therapy (MBCT) is a potentially efficacious headache pain treatment; however, it was not universally effective for all participants. This study sought to explore patient characteristics associated with MBCT treatment response and the potential processes of change that allowed treatment responders to improve and that were potentially lacking in the non-responders.
Design
We implemented a mixed-methods analysis of quantitative and qualitative data. The sample consisted of 21 participants, 14 of whom were classified as treatment responders (≥50% improvement in pain intensity and/or pain interference) and seven as non-responders (<50% improvement).
Setting
The study was conducted at the Kilgo Headache Clinic and the University of Alabama Psychology Clinic.
Intervention
Participants completed an 8-week MBCT treatment for headache pain management.
Measures
Standardized measures of pain, psychosocial outcomes, and non-specific therapy factors were obtained; all participants completed a post-treatment semi-structured interview.
Results
Quantitative data indicated a large effect size difference between responders and non-responders for pre- to post-treatment change in standardized measures of pain acceptance and catastrophizing, and a small to medium effect size differences on treatment dose indicators. Both groups showed improved psychosocial outcomes. Qualitatively, change in cognitive processes was a more salient qualitative theme within treatment responders; both groups commented on the importance of non-specific therapeutic factors. Barriers to mindfulness meditation were also commented on by participants across groups.
Conclusions
Results indicated that change in pain related cognitions during an MBCT intervention for headache pain is a key factor underlying treatment response.
OBJECTIVE:This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes.
MATERIALS AND METHODS:
RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24).
RESULTS:
Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24).
DISCUSSION:
This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.
Purpose: Children of parents with bipolar disorder are at an increased risk of developing mood disorders compared to children without bipolar parents. Early signs of bipolar disorder include symptoms of anxiety, depression, and inattention. Pharmacological interventions for treating these symptoms are often poorly tolerated and may accelerate the onset of manic symptoms. Mindfulness-Based Cognitive Therapy-Child (MBCT-C), an evidence-based manualized 12-week group intervention, has been shown to effectively treat mood and anxiety disorders in children/adolescents. However, there has been no examination of MBCT-C for youth at high risk for bipolar disorder. We examined the effects of MBCT-C on outcomes among youth with anxiety disorders and a familial risk for bipolar disorder.Methods: Participants were 10 children/adolescents (Mage=13.17, SD=1.93; 80% girls; 40% White/African-American) who met DSM-IV criteria for an anxiety disorder (i.e., generalized anxiety disorder, separation anxiety disorder, panic disorder or social phobia) and had at least one parent with bipolar I disorder. A within-subjects, pre-post design was used to examine changes in anxiety, mindfulness, and emotion regulation associated with participation in MBCT-C.
Results: Significant decreases were seen in both child-rated (Mpre=18.5 vs. Mpost=4.7, t=10.8, p<.01) and clinician-rated anxiety symptoms (Mpre=11.1 vs. Mpost=4.3, t=6.1, p<.01). Additionally, reductions in clinician-rated anxiety symptoms were significantly correlated with improvements in mindfulness (r=−.69, p<.05) and emotion regulation (r=−.82, p<.05). No significant changes were seen pre-post intervention in depressive symptoms, mania symptoms, mindfulness, or emotion regulation - though all changes were in the expected direction.
Conclusion: Findings support the preliminary efficacy of MBCT-C in reducing anxiety among youth at risk for bipolar disorder, and suggest that changes in anxiety symptoms may be associated with changes in mindfulness and emotion regulation processes. Further research utilizing an active control group, larger sample size, and objective markers is warranted.
To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0–III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.
OBJECTIVE: We explored the potential impact of mindfulness-based yoga (MBY) for youth with persistent concussion by examining occupation-based and neurophysiological outcomes.METHOD: In this case series design study, 6 youths ages 13-17 yr with concussion symptoms for >4 wk participated in an 8-wk MBY intervention, 1×/wk for 45 min. Participation, self-efficacy, and heart rate variability (24 hr) were collected before, after, and 3 mo after the intervention. Heart rate variability was also measured during each session.
RESULTS: Trends of increased self-efficacy in academic, social, and emotional domains were found after MBY and maintained at 3-mo follow-up. Trends of increasing heart rate variability were also found pre- to postintervention and within the eight MBY sessions.
CONCLUSION: Preliminary results reveal positive trends after a novel, safe intervention for youth with persistent concussion symptoms and the value of exploring both occupation-based and neurophysiological measures. Future research with a larger sample and control group is warranted.
This book describes how practices of mindfulness significantly contribute to teacher professional development by increasing educators' sense of well-being, collegiality, and connection with each other. It will guide other educators to incorporate mindfulness into their professional learning.
Asthma, like many inflammatory disorders, is affected by psychological stress, suggesting that reciprocal modulation may occur between peripheral factors regulating inflammation and central neural circuitry underlying emotion and stress reactivity. Despite suggestions that emotional factors may modulate processes of inflammation in asthma and, conversely, that peripheral inflammatory signals influence the brain, the neural circuitry involved remains elusive. Here we show, using functional magnetic resonance imaging, that activity in the anterior cingulate cortex and insula to asthma-relevant emotional, compared with valence-neutral stimuli, is associated with markers of inflammation and airway obstruction in asthmatic subjects exposed to antigen. This activation accounts for > or =40% of the variance in the peripheral markers and suggests a neural basis for emotion-induced modulation of airway disease in asthma. The anterior cingulate cortex and insula have been implicated in the affective evaluation of sensory stimulation, regulation of homeostatic responses, and visceral perception. In individuals with asthma and other stress-related conditions, these brain regions may be hyperresponsive to disease-specific emotional and afferent physiological signals, which may contribute to the dysregulation of peripheral processes, such as inflammation.
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Objective: We sought to evaluate the neurophysiology of mindfulness-based cognitive therapy for children (MBCT-C) in youth with generalized, social, and/or separation anxiety disorder who were at risk for developing bipolar disorder.Methods: Nine youth (mean age: 13 ± 2 years) with a generalized, social, and/or separation anxiety disorder and a parent with bipolar disorder completed functional magnetic resonance imaging (fMRI) while performing a continuous processing task with emotional and neutral distractors (CPT-END) prior to and following 12 weeks of MBCT-C.
Results: MBCT-C was associated with increases in activation of the bilateral insula, lentiform nucleus, and thalamus, as well as the left anterior cingulate while viewing emotional stimuli during the CPT-END, and decreases in anxiety were correlated with change in activation in the bilateral insula and anterior cingulate during the viewing of emotional stimuli (p < 0.05, uncorrected; p < 0.005 corrected; cluster size, 37 voxels).
Conclusions: MBCT-C treatment in anxious youth with a familial history of bipolar disorder is associated with increased activation of brain structures that subserve interoception and the processing of internal stimuli—functions that are ostensibly improved by this treatment.
For millennia the world’s indigenous peoples have acted as guardians of the web of life for the next seven generations. They’ve successfully managed complex reciprocal relationships between biological and cultural diversity. Awareness of indigenous knowledge is reemerging at the eleventh hour to help avert global ecological and social collapse. Indigenous cultural wisdom shows us how to live in peace--with the earth and one another.Original Instructions evokes the rich indigenous storytelling tradition in this collection of presentations gathered from the annual Bioneers conference. It depicts how the world’s native leaders and scholars are safeguarding the original instructions, reminding us about gratitude, kinship, and a reverence for community and creation. Included are more than 20 contemporary indigenous leaders--such as Chief Oren Lyons, John Mohawk, Winona LaDuke, and John Trudell. These beautiful, wise voices remind us where hope lies.
Objectives:It is not known whether psychosocial chronic pain treatments produce benefits through the unique mechanisms specified by theory. Fundamental to gaining an accurate understanding of this issue is to first determine whether the most widely used process measures assess unique constructs and predict unique variance in pain outcomes. This study examined the associations between the Pain Catastrophizing Scale (PCS), Five-Facet Mindfulness Questionnaire (FFMQ-SF), and the Chronic Pain Acceptance Questionnaire (CPAQ-8), and determined their unique contributions to the prediction of pain intensity, pain interference, and depression.
Methods:
A cross-sectional study was conducted with undergraduate students (N=260) reporting chronic or intermittent pain. Correlations, regression models, and multiple mediation models were performed. Relevant covariates were included.
Results:
The PCS, FFMQ-SF scales, and CPAQ-8 were correlated in mostly expected directions, but not so highly as to indicate redundancy. The PCS significantly predicted pain intensity, interference, and depression. The FFMQ-SF Observing and Describing scales predicted pain intensity; Nonreactivity and Nonjudging significantly predicted interference and depression, respectively. The CPAQ-8 was not a significant predictor in any of the regression models. The PCS was a comparatively stronger mediator than the FFMQ-SF scales in the intensity to interference, and intensity to depression mediation models.
Discussion:
The findings indicate that pain catastrophizing, mindfulness, and pain acceptance are related, but unique constructs. The PCS and select FFMQ-SF scales were uniquely associated with the criterion measures. However, the PCS emerged as the most robust process, highlighting the importance of targeting this cognitive domain in streamlining pain treatments to optimize outcome.
<p>BACKGROUND: Increasingly, researchers attend to both positive and negative aspects of mental health. Such distinctions call for clarification of whether psychological well-being and ill-being comprise opposite ends of a bipolar continuum, or are best construed as separate, independent dimensions of mental health. Biology can help resolve this query--bipolarity predicts 'mirrored' biological correlates (i.e. well-being and ill-being correlate similarly with biomarkers, but show opposite directional signs), whereas independence predicts 'distinct' biological correlates (i.e. well-being and ill-being have different biological signatures). METHODS: Multiple aspects of psychological well-being (eudaimonic, hedonic) and ill-being (depression, anxiety, anger) were assessed in a sample of aging women (n = 135, mean age = 74) on whom diverse neuroendocrine (salivary cortisol, epinephrine, norepinephrine, DHEA-S) and cardiovascular factors (weight, waist-hip ratio, systolic and diastolic blood pressure, HDL cholesterol, total/HDL cholesterol, glycosylated hemoglobin) were also measured. RESULTS: Measures of psychological well-being and ill-being were significantly linked with numerous biomarkers, with some associations being more strongly evident for respondents aged 75+. Outcomes for seven biomarkers supported the distinct hypothesis, while findings for only two biomarkers supported the mirrored hypothesis. CONCLUSION: This research adds to the growing literature on how psychological well-being and mental maladjustment are instantiated in biology. Population-based inquiries and challenge studies constitute important future directions.</p>
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RESEARCH QUESTION: Arthralgia affects postmenopausal breast cancer survivors (BCS) receiving aromatase inhibitors (AI), which may result in reduced function and long-term well-being. This is an exploratory, qualitative investigation of BCS who participated in a yoga-based program to understand impact on joint pain and various aspects of quality of life (QOL) through a yoga program.THEORETICAL FRAMEWORK: Social cognitive theory was used and provided the foundation for developing a yoga intervention through sources of efficacy information: (1) performance accomplishment, (2) structured experience, (3) verbal support from instructor and group, and (4) physical feedback.
METHODOLOGY: Ten postmenopausal women with stage I-III breast cancer and AI associated arthralgia (AIAA) received yoga twice a week for eight weeks for 90 minutes and were instructed to continue in a home-based yoga program. We used social cognitive theory (SCT) to structure a yoga intervention as an ongoing physical activity to manage joint pain and function. Participants completed journal reflections on their experience and received weekly phone calls.
ANALYSIS: Data was collected and analyzed using qualitative methods. Member checks were completed and emergent themes were explored and agreed upon by the research team to ensure reliability and validity of data. Several emergent themes were discovered: Empowerment: Importance of Camaraderie, Community, and Sharing; Pain Relief; Increased Physical Fitness (Energy, Flexibility, and Function); Relieved Stress/Anxiety and Transferability of Yoga through Breathing. These themes were identified through instructor observation, participant observation, and weekly phone call documentation.
INTERPRETATION: Participants experienced an eight-week yoga intervention as an effective physical activity and support group that fostered various improvements in quality of life (QOL) and reduction in AIAA. Participants were highly motivated to improve physical fitness levels and reduce pain. This study revealed benefits from alternative forms of exercise such as yoga to provide a structure, which is transferable in other situations. Information, structured physical guidance in yoga postures, support, and feedback are necessary to foster physical activity for BCS experiencing pain.
IMPLICATIONS FOR CANCER SURVIVORS: Results of this qualitative analysis indicate that interventions to support BCS with AIAA are warranted. Yoga appears to positively impact these side effects of hormonal therapies. Additional research would aid in the development of other interventions.
The authors examined the relative effectiveness of 3 different approaches to the experience of body dissatisfaction compared to a control and ruminative attention control condition, with respect to increasing weight and appearance satisfaction. One hundred female undergraduates (mean age = 24.38, SD = 9.39) underwent a body dissatisfaction induction procedure, which significantly decreased levels of weight and appearance satisfaction. Participants were then randomized, 20 to each of 5 groups: control, ruminative attention control, acceptance, distraction, and cognitive dissonance. With the exception of the control group, participants were briefly trained in their assigned technique and were asked to practice this over the next 5 min while repeated measures of weight and appearance satisfaction were recorded. Acceptance, cognitive dissonance, and distraction were superior to both control conditions in increasing weight satisfaction and were superior to a control condition in improving appearance satisfaction. Only acceptance was superior in improving appearance satisfaction compared to a ruminative attention control. The evidence suggests that acceptance is a promising approach to investigate further with respect to its efficacy for reducing body dissatisfaction. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
OBJECTIVES: Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.METHODS: We conducted a randomized controlled trial of 84 female BC survivors (Stages 0-III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6-week Mindfulness-Based Stress Reduction (MBSR) program designed to self-regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF-36).
RESULTS: Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two-sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.
CONCLUSIONS: Among BC survivors within 18 months of treatment completion, a 6-week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
Objectives: Considerable morbidity persists among survivors of breast cancer (BC) including high levels of psychological stress, anxiety, depression, fear of recurrence, and physical symptoms including pain, fatigue, and sleep disturbances, and impaired quality of life. Effective interventions are needed during this difficult transitional period.Methods: We conducted a randomized controlled trial of 84 female BC survivors (Stages 0–III) recruited from the H. Lee Moffitt Cancer and Research Institute. All subjects were within 18 months of treatment completion with surgery and adjuvant radiation and/or chemotherapy. Subjects were randomly assigned to a 6‐week Mindfulness‐Based Stress Reduction (MBSR) program designed to self‐regulate arousal to stressful circumstances or symptoms (n=41) or to usual care (n=43). Outcome measures compared at 6 weeks by random assignment included validated measures of psychological status (depression, anxiety, perceived stress, fear of recurrence, optimism, social support) and psychological and physical subscales of quality of life (SF‐36).
Results: Compared with usual care, subjects assigned to MBSR(BC) had significantly lower (two‐sided p<0.05) adjusted mean levels of depression (6.3 vs 9.6), anxiety (28.3 vs 33.0), and fear of recurrence (9.3 vs 11.6) at 6 weeks, along with higher energy (53.5 vs 49.2), physical functioning (50.1 vs 47.0), and physical role functioning (49.1 vs 42.8). In stratified analyses, subjects more compliant with MBSR tended to experience greater improvements in measures of energy and physical functioning.
Conclusions: Among BC survivors within 18 months of treatment completion, a 6‐week MBSR(BC) program resulted in significant improvements in psychological status and quality of life compared with usual care.
SummaryBackground
A growing body of research shows that mindfulness meditation can alter neural, behavioral and biochemical processes. However, the mechanisms responsible for such clinically relevant effects remain elusive.
Methods
Here we explored the impact of a day of intensive practice of mindfulness meditation in experienced subjects (n = 19) on the expression of circadian, chromatin modulatory and inflammatory genes in peripheral blood mononuclear cells (PBMC). In parallel, we analyzed a control group of subjects with no meditation experience who engaged in leisure activities in the same environment (n = 21). PBMC from all participants were obtained before (t1) and after (t2) the intervention (t2 − t1 = 8 h) and gene expression was analyzed using custom pathway focused quantitative-real time PCR assays. Both groups were also presented with the Trier Social Stress Test (TSST).
Results
Core clock gene expression at baseline (t1) was similar between groups and their rhythmicity was not influenced in meditators by the intensive day of practice. Similarly, we found that all the epigenetic regulatory enzymes and inflammatory genes analyzed exhibited similar basal expression levels in the two groups. In contrast, after the brief intervention we detected reduced expression of histone deacetylase genes (HDAC 2, 3 and 9), alterations in global modification of histones (H4ac; H3K4me3) and decreased expression of pro-inflammatory genes (RIPK2 and COX2) in meditators compared with controls. We found that the expression of RIPK2 and HDAC2 genes was associated with a faster cortisol recovery to the TSST in both groups.
Conclusions
The regulation of HDACs and inflammatory pathways may represent some of the mechanisms underlying the therapeutic potential of mindfulness-based interventions. Our findings set the foundation for future studies to further assess meditation strategies for the treatment of chronic inflammatory conditions.
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