This study contributes to ongoing scholarship at the nexus of translational research, education reform, and the developmental and prevention sciences. It reports 2-year experimental impacts of a universal, integrated school-based intervention in social-emotional learning and literacy development on children's social-emotional, behavioral, and academic functioning. The study employed a school-randomized, experimental design with 1,184 children in 18 elementary schools. Children in the intervention schools showed improvements across several domains: self-reports of hostile attributional bias, aggressive interpersonal negotiation strategies, and depression, and teacher reports of attention skills, and aggressive and socially competent behavior. In addition, there were effects of the intervention on children's math and reading achievement for those identified by teachers at baseline at highest behavioral risk. These findings are interpreted in light of developmental cascades theory and lend support to the value of universal, integrated interventions in the elementary school period for promoting children's social-emotional and academic skills.
Planned and reflexive behaviors often occur in the presence of emotional stimuli and within the context of an individual's acute emotional state. Therefore, determining the manner in which emotion and attention interact is an important step toward understanding how we function in the real world. Participants in the current investigation viewed centrally displayed, task-irrelevant, face distractors (angry, neutral, happy) while performing a lateralized go/no-go continuous performance task. Lateralized go targets and no-go lures that did not spatially overlap with the faces were employed to differentially probe processing in the left (LH) and right (RH) cerebral hemispheres. There was a significant interaction between expression and hemisphere, with an overall pattern such that angry distractors were associated with relatively more RH inhibitory errors than neutral or happy distractors and happy distractors with relatively more LH inhibitory errors than angry or neutral distractors. Simple effects analyses confirmed that angry faces differentially interfered with RH relative to LH inhibition and with inhibition in the RH relative to happy faces. A significant three-way interaction further revealed that state anxiety moderated relations between emotional expression and hemisphere. Under conditions of low cognitive load, more intense anxiety was associated with relatively greater RH than LH impairment in the presence of both happy and threatening distractors. By contrast, under high load, only angry distractors produced greater RH than LH interference as a function of anxiety.
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Owing to its benefits on various cognitive aspects, one’s emotions and wellbeing, meditation has drawn interest from several researchers and common public alike. We have different meditation practices associated with many cultures and traditions across the globe. Current literature suggests significant changes in the neural activity among the different practices of meditation, as each of these practices contributes to distinct physiological and psychological effects. Although this is the case, we want to find out if there is an underlying commonality among all these different practices. So, we ask the following questions related to different practices of meditation, the traditional goal of meditation and its significance - What is the central purpose of meditation? Do traditions define the final goal of all the practices of meditation? Are the purpose and goal of these practices different or is there a common goal to be attained through all these distinct practices? Embracing the traditional perspective, through this paper, we want to emphasize, although these techniques and practices may appear different on the periphery, eventually, they seem to subject one to the same experience at the end; a natural meditative state (discussed in various spiritual traditions as the goal of meditation). In view of future studies on different meditation practices and also those exploring this subjective state, we offer some interesting ideas based on the traditional insights on meditation. In this context, we would also like to make a few comments on the way contemporary researchers view different practices of meditation.
INTRODUCTION: Little is known about the adoption of evidence-based practice (EBP) by yoga therapists (YTs). OBJECTIVE: To determine the attitudes, skills, training, use, barriers and facilitators to the use of EBP amongst North American YTs DESIGN: Cross-sectional, descriptive survey METHODS: Self-identified YTs practicing in North America were invited to participate in an online survey. YT attitudes, skills, training, utilisation, barriers to use, and facilitators of EBP use were measured using the 84-item Evidence-Based practice Attitude and utilization SurvEy (EBASE). RESULTS: 367 members responded ( approximately 20% of eligible participants). Attitudes towards EBP were generally positive with 88% agreeing that professional literature and research findings were useful for the practice of yoga therapy. Most (80%) were interested in improving their skills and the majority agreed that EBP improves the quality of care (68%), assists in making decisions (74%) and takes into account the YTs clinical experience when making clinical decisions (59%). Moderate to moderately-high levels of perceived skill in EBP were reported mostly utilizing online search engines (51%). Lack of clinical evidence was the only notable barrier to uptake reported by YTs (48%). Facilitators to EBP included access to online EBP education materials (70.6%), ability to download full-text journal articles and access to free online databases in the workplace (67.3%). CONCLUSION: North American YTs report positive attitudes, moderate to moderately-high levels of perceived skill and moderate uptake of EBP. This aligns them with other complementary and integrative health practitioners. Initiatives to support the adoption of EBP are proposed as a means of improving best practice in yoga therapy.
Resilience is the ability to adapt successfully in the face of stress and adversity. Stressful life events, trauma, and chronic adversity can have a substantial impact on brain function and structure, and can result in the development of posttraumatic stress disorder (PTSD), depression and other psychiatric disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, and are thus thought to be resilient. Resilience as successful adaptation relies on effective responses to environmental challenges and ultimate resistance to the deleterious effects of stress, therefore a greater understanding of the factors that promote such effects is of great relevance. This review focuses on recent findings regarding genetic, epigenetic, developmental, psychosocial, and neurochemical factors that are considered essential contributors to the development of resilience. Neural circuits and pathways involved in mediating resilience are also discussed. The growing understanding of resilience factors will hopefully lead to the development of new pharmacological and psychological interventions for enhancing resilience and mitigating the untoward consequences.
OBJECTIVE: Nearly 38% of U.S. adults use complementary and alternative medicine approaches to manage physical conditions (e.g., chronic pain, arthritis, cancer, heart disease, and high blood pressure) and psychological or emotional health concerns (e.g., post-traumatic stress disorder, anxiety, and depression). Research evidence has accumulated for yoga as an effective treatment approach for these conditions. Further, yoga has increased in popularity among healthcare providers and the general population. Given these trends, this study explored perceptions about yoga as a viable complementary treatment to which health professions students would refer patients. PARTICIPANTS: More than 1500 students enrolled in health professions programs at a Pacific Northwest school were enrolled; data were obtained from 478 respondents. DESIGN: The study assessed willingness to refer patients to yoga as a complementary and alternative medicine for 27 symptoms (identified in the literature as having evidence for yoga's utility), which were subsequently grouped into skeletal, physical, and psychological on the basis of factor analysis. Responses were assessed using a mixed-model analysis of variance with health profession and yoga practitioner as between-subjects variables and symptoms as a within-subjects factor. RESULTS: In descending order of likelihood to refer patients to yoga were students in occupational therapy, physician assistant program, psychology, physical therapy, pharmacy, dental hygiene, speech and audiology, and optometry. All groups perceived yoga's greatest utility for skeletal symptoms, followed by psychological and physical symptoms. Findings also revealed a significant positive relationship between level of personal yoga practice and willingness to refer patients to yoga. CONCLUSIONS: Although students expressed some openness to referring patients to yoga, ratings of appropriateness were not accurately aligned with extant evidence base. Personal experience seemed to be a salient factor for accepting yoga as a referral target. These findings suggest the importance of developing strategies to make health professionals more aware of the merits of yoga, regardless of whether they themselves are yoga practitioners.
Childhood is considered as the most important phase in life, which determines the quality of health, well being, learning and behaviour across the lifespan. This may be the reason for giving the foremost position for Balacikitsa among Ashtangas (8 branches) of Ayurveda. The regional growth of indigenous medicine gave significant contribution for the development of primary health care. Kerala has major contribution of many authentic textbooks of Balacikitsa like Arogyakalpadruma, Vaidya Tarakam etc. These are more practically oriented and it can be considered as a physician's quick reference hand book. Many new diseases which are not mentioned in classical textbooks have found their place in these books. Medications like Praakaara yoga, Uramarunnuprayoga were administered in children as a mode of immunization, which helps in the maintenance of health and prevention of disease. Many diseases like Karappan (balavisarpa), Shakarogas etc. were common in Kerala and various indigenous treatment modalities were developed for such diseases. Single drug Prayogas with herbs like Mayaphal (galls), Tripadi (DesmodiumTriflorum L.), etc. and yogams like Nalikerakwatha (Putapakakalpana), Mukkuti (Takrakalpana) etc. were practiced commonly. Many effective therapies like Shashtikapindasweda, Thalapothichil (Sirolepa) etc. are an inevitable part of Balacikitsa. In this paper, an attempt is made to compile the theoretical concepts and unique practices of Balacikitsa in Kerala and to convey it's importance. The present article also addresses, how these vernacular books and traditional knowledge waned away from the Mainstream Ayurveda.
The purposes of the present survey research in diabetic patients were 1) to determine characteristics of complementary/alternative medicine (CAM) use, 2) to identify factors related to CAM use such as sociodemographic, adverse effects, and quality of life, and 3) to determine differences between patients who used and did not use CAM. The data was collected through developed questionnaires and SF-36 scale Thai version. Samples were 159 diabetes patients over 18 years of age or older who came for treatment at Suppasitthiprasong Hospital, Ubon Ratchathani Province, Thailand. The results indicated that the prevalence of CAM use was rather high (47.8%). The most common types of CAM used were yoga/exercise (32.8%), unchanged form of herbal medicine (29.9%), and changed form herbal medicine (17.8%). The average expense of CAM use was dollar 8.58 per person per month. Thus, if the percentage of CAM use and the cost were true for other Thai diabetic patients throughout Thailand, CAM use expenditure for the whole country would be about dollar 915,250-1,545,750 per month, which is quite high for a small country like Thailand. Most patients (64.4%) who used CAM did not inform their doctors about their CAM use. Results also indicated that government official patients were more likely to use CAM than those of farmer patients significantly (p-value = 0.03, odds ratio = 12.11). In addition, the present study found that patients who had a higher income were more likely to use CAM than those of lower income patients significantly (p - value = 0.04, odds ratio = 1.01). However, other factors such as age, sex, marital status, level of education, health insurance coverage status, duration of time to treat, occurrence of adverse effects, and quality of life were not different between the patients who used CAM and who did not use CAM. Physicians should pay more attention to the CAM use of patients since they used CAM without informing physicians and some herbal medicines may cause hypoglycemia. However, the study results had some limitations to apply to other Thai populations since the sample were Suppasitthiprasong patients who may be different from other Thai populations in many ways such as their local culture, belief, and CAM use types and cost.
Purpose: The main objective of this study was to investigate the prevalence of complementary and alternative medicine (CAM) use, types and reasons for use, and determinants of use among survivors of childhood cancer. Methods: An interviewer-based survey of CAM use was administered to 197 survivors or their guardians. Demographic data, CAM therapies used, purpose and referral for use, and communication about use was collected. Results: A total of 115 (58%) survivors reported using CAM in survivorship, 72% of which used biologically based therapies. The majority of therapies were used for relaxation and stress management (15%), referred for use by the parent (25%), reported as very effective (62%), and initiated 0 to 4 years after completion of cancer treatment (41%). Among CAM users, young adults used manipulative and body-based therapies [odds ratio (OR) = 3.3; 95% confidence interval (CI), 1.4-7.8] and mind-body therapies (OR = 2.8, 95% CI: 1.2-6.4) more than children. Use of mind-body therapies was associated with not attending religious services regularly (OR = 2.4; P < 0.01). Half (51%) of all CAM therapies were disclosed to the physician. Conclusions: Survivors of childhood cancer frequently use CAM for health promotion and mitigation of physical and psychological conditions. Clinicians should consider the role of CAM in the adoption of healthy lifestyles among this population.
We interviewed 300 patients (54.7% male; mean age was 65.8 +/- 9.5) attending the Movement Disorders Clinic at the Buenos Aires University Hospital to determine the prevalence of CATs use and their association with demographic, social, or disease-specific characteristics among patients with Parkinson's disease (PD) in Buenos Aires, Argentina. We found that 25.7% of the PD patients interviewed (77/300) stated they had used CATs to improve their PD symptoms whereas 38.0% (114/300) had used some CATs without any relation to PD, at least once in life. At the moment of the interview, CATs prevalence use was 50.6% in the former group and 25.0% in the latter. The use of CATs was much more frequent among women and more common in the 50- to 69-year age group. Friends and neighbors of the patients had most frequently recommended these therapies. No major association was observed between CATs use and the duration of the disease, side of initial involvement, PD phenotype, or the IIoehn and Yahr staging. Acupuncture, homeopathy, yoga, and therapeutic massage were the most widely used therapies. After the initiation of conventional treatment the use of massage, yoga, and acupuncture in patients using CATs to improve PD significantly increased. Neurologists should be aware and inquire about the use of CATs to rule out potentially harmful effects. (C) 2010 Movement Disorder Society
OBJECTIVE: This report presents national estimates of the use of complementary health approaches among children aged 4-17 years in the United States. Selected modalities are compared for 2007 and 2012 to examine changes over time. METHODS: Data from the 2007 and 2012 National Health Interview Survey (NHIS) were analyzed for this report. The combined sample included 17,321 interviews with knowledgeable adults about children aged 4-17 years. Point estimates and estimates of their variances were calculated using SUDAAN software to account for the complex sampling design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. RESULTS: The use of complementary health approaches among children did not change significantly since 2007 (from 12.0% in 2007 to 11.6% in 2012). However, one approach, the use of traditional healers, showed a statistically significant decrease in use, from 1.1% in 2007 to 0.1% in 2012. No other significant decreases were identified. An increase in the use of yoga was observed during this period (from 2.3% in 2007 to 3.1% in 2012). Nonvitamin, nonmineral dietary supplements; chiropractic or osteopathic manipulation; and yoga, tai chi, or qi gong were the most commonly used complementary health approaches in both 2007 and 2012. Also consistent between 2007 and 2012 was that complementary health approaches were most frequently used for back or neck pain, head or chest cold, anxiety or stress, and other musculoskeletal conditions.
The objective of this study was to examine the usefulness of a mindfulness-based cognitive therapy (MBCT) for treating insomnia symptoms in patients with anxiety disorder. Nineteen patients with anxiety disorder were assigned to an 8-week MBCT clinical trial. Participants showed significant improvement in Pittsburgh Sleep Quality Index (Z = -3.46, p = 0.00), Penn State Worry Questionnaire (Z = -3.83, p = 0.00), Ruminative Response Scale (Z = -3.83, p = 0.00), Hamilton Anxiety Rating Scale (Z = -3.73, p = 0.00), and Hamilton Depression Rating Scale scores (Z = -3.06, p = 0.00) at the end of the 8-week program as compared with baseline. Multiple regression analysis showed that baseline Penn State Worry Questionnaire scores were associated with baseline Pittsburgh Sleep Quality Index scores. These findings suggest that MBCT can be effective at relieving insomnia symptoms by reducing worry associated sleep disturbances in patients with anxiety disorder. However, well-designed, randomized, controlled trials are needed to confirm our findings.
The efficacy of meditation-relaxation techniques has been widely researched in the laboratory, but their effectiveness for management of stress in organizational settings is still relatively unexplored. The present study compared relaxation and control conditions as part of a program of stress-reduction in industry. A total of 154 New York Telephone employees self-selected for stress learned one of three techniques--clinically standardized meditation (CSM), respiratory one method meditation (ROM) or progressive relaxation (PMR)--or served as waiting list controls. At 5.5 months, the treatment groups showed clinical improvement in self-reported symptoms of stress, but only the meditation groups (not the PMR group) showed significantly more symptom reduction than the controls. The meditation groups had a 78% compliance rate at 5.5 months with treatment effect seen whether subjects practiced their techniques frequently or occasionally. The safe and inexpensive semi-automated meditation training has considerable value for stress-management programs in organizational settings.
CONTEXT: Use of complementary and alternative medicine (CAM) by children under 18 y of age in the United States is becoming more prevalent. According to an analysis of procedures in chiropractic practices in 2010, more than 96% of chiropractors in the United States recommended use of movement therapies (MT) and relaxation techniques (RT) to their patients. The extent of use of these methods as treatment options for specific health conditions in children, however, has been underexplored in the United States. OBJECTIVES: The current study assessed use of MT and RT in children for treatment of various health conditions, as reported in the 2007 National Health Interview Survey (NHIS), and also examined variations in use across various sociodemographic categories. DESIGN: Secondary data from the 2007 National Health Interview Survey (NHIS) Child Alternative Medicine file were analyzed, and the research team generated weighted frequencies and inferential statistics. OUTCOME MEASURES: Odds ratios (OR) and 95% confidence intervals (CI) were computed through binary logistic regression to assess use of MT and RT as functions of various sociodemographic variables. RESULTS: Within the 12 mo prior to the survey, MT and RT use was reported by 2.5% and 2.9% of respondents, respectively. MT, primarily yoga, was used for the control and reduction of anxiety and stress (31.4%), asthma (16.2%), and back/neck pain (15.3%). Alternatively, RT, such as controlled breathing exercises (2.1%) and meditation (2.3%), was used for anxiety and stress (41.4%) and attention-deficit disorders (ADDs) (16.0%). Although data screening did not produce obvious predictors for RT use, age, gender, race/ethnicity, and parents' education levels were potential predictors of MT use. For example, respondents aged 10 y (OR = 0.4; 95% CI, 0.3-0.6), and males reported lower MT use than females (OR = 0.5; 95% CI, 0.3-0.7). CONCLUSION: MT and RT are used by several million children in the United States each year. The current research suggests that early training on MT and RT can be seen as a useful tool that can help prevent or manage certain health problems. In addition to an examination of their role in primary prevention, the use of MT and RT should be explored further to determine how these therapies work with respect to specific health conditions.
Yoga, meditation, and use of chiropractors are types of complementary health approaches developed outside of mainstream Western medicine (1-2). Although complementary health approaches as a whole are not widely used among children, previous work has established a rise in the use of selected approaches over time (3). This report presents the most recent national estimates of use of the three most prevalent approaches during the past 12 months, among children aged 4-17 years in the United States. Comparable estimates from 2012 are also included to examine changes over time.
OBJECTIVES: Affective neuroscience research that investigates core symptoms of pediatric bipolar disorder (PBD) may be effective in differentiating PBD phenotypes. The current study used affect-modulated startle to examine potential differences in reactivity to emotional stimuli (reward and punishment) in narrow and broad phenotype PBD and controls.
METHODS: Thirty children meeting DSM-IV bipolar disorder criteria (i.e. narrow phenotype PBD with defined manic episodes with elevated/expansive mood), 19 children meeting criteria for severe mood dysregulation (i.e. broad phenotype with chronic irritability, hyper-reactivity, and hyperarousal), and 19 controls completed a lottery startle paradigm involving reward (money) and punishment (loud noise). Startle probes were presented during anticipation of the emotional stimulus, immediately following the presentation of the stimulus, or during return to baseline following the stimulus.
RESULTS: By self-report, patients and controls found the putative punishment to be preferable to the neutral condition. In the reward condition, patient samples reported greater arousal than did controls, but no between-group differences were found on the magnitude of startle response during the reward, punishment, or neutral conditions.
CONCLUSIONS: The failure to find differences in affect-modulated startle between control children and those with narrow or broad PBD phenotypes speaks to the methodological challenges associated with studying reward mechanisms in PBD. Alternative paradigms that focus on different aspects of reward mechanisms are discussed.
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The purpose of this exploratory study was to investigate the effectiveness of a modified mindfulness-based cognitive therapy intervention using individual counseling sessions to reduce stress and increase levels of mindfulness among nursing students. An AB single-subject experimental design replicated three times was implemented. Results indicated reduced stress in two out of three participants and increased mindfulness levels in all participants. Implications for college counselors and counselors working with clients in high-stress occupations are provided. Additionally, the results show promise for the use of mindfulness-based cognitive therapy in individual counseling.
Mindfulness is a terrific tool for anxiety. It’s more than a mere tool, however. Mindfulness is a way of experiencing yourself and the world that allows you to live fully and completely without anxiety getting in your head and in your way.Mindfulness is many things. Mindfulness is
being present in the moment, right here and right now;
focusing on what’s around you to pull your thoughts away from the anxious ones in your head;
attending to all your senses so you feel and experience things other than the physical symptoms of anxiety;
letting yourself be as you are without fighting with and getting tangled in anxiety;
living in the present, ready to live fully without anxiety being at the forefront of your thoughts and emotions.
Studies on the potential benefits of conveying biofeedback stimulus using a musical signal have appeared in recent years with the intent of harnessing the strong effects that music listening may have on subjects. While results are encouraging, the fundamental question has yet to be addressed, of how combined music and biofeedback compares to the already established use of either of these elements separately. This experiment, involving young adults (N = 24), compared the effectiveness at modulating participants' states of physiological arousal of each of the following conditions: A) listening to pre-recorded music, B) sonification biofeedback of the heart rate, and C) an algorithmically modulated musical feedback signal conveying the subject's heart rate. Our hypothesis was that each of the conditions (A), (B) and (C) would differ from the other two in the extent to which it enables participants to increase and decrease their state of physiological arousal, with (C) being more effective than (B), and both more than (A). Several physiological measures and qualitative responses were recorded and analyzed. Results show that using musical biofeedback allowed participants to modulate their state of physiological arousal at least equally well as sonification biofeedback, and much better than just listening to music, as reflected in their heart rate measurements, controlling for respiration-rate. Our findings indicate that the known effects of music in modulating arousal can therefore be beneficially harnessed when designing a biofeedback protocol.
Teaching social-emotional skills to secondary students has been linked to higher student achievement, more positive student motivation and more socially acceptable classroom behaviors (Elias & Arnold, 2006; Weissburg et al., 2003; Kress et al., 2004). Much of the current literature on social-emotional learning (SEL) focuses on research. This piece provides educators with a plan for teaching key social and emotional skills in secondary mathematics classrooms using three key "entry points": (1) the redefining of "lesson planning," (2) the establishment of an SEL-conducive climate, and (3) the inclusion of student refection and self-assessment.
Background: School-based social-emotional and character development (SECD) programs can influence not only SECD but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. Methods: The longitudinal study used a matched-pair, cluster-randomized controlled design. Student-reported disaffection with learning and academic grades, and teacher ratings of academic ability and motivation were assessed for a cohort followed from grades 3 to 8. Aggregate school records were used to assess standardized test performance (for entire school, cohort, and demographic subgroups) and absenteeism (entire school). Multilevel growth-curve analyses tested program effects. Results: PA significantly improved growth in academic motivation and mitigated disaffection with learning. There was a positive impact of PA on absenteeism and marginally significant impact on math performance of all students. There were favorable program effects on reading for African American boys and cohort students transitioning between grades 7 and 8, and on math for girls and low-income students. Conclusions: A school-based SECD program was found to influence academic outcomes among students living in low-income, urban communities. Future research should examine mechanisms by which changes in SECD influence changes in academic outcomes.
Although lung cancer is perceived as a dire diagnosis, increases in the 5-year survival rate of individuals with non-small cell lung cancer (NSCLC) have been reported. Survivors, however, continue to be excessively burdened with symptoms such as respiratory distress which interfere with functioning and quality of life. While exercise and physical activity are strongly recommended, NSCLC survivors may be reluctant to participate due to actual or anticipated shortness of breath exacerbated with movement.This quasi-experimental, intervention-only pilot study aimed to determine the effects of an 8-week standardized yoga protocol for Stage I-IIIa NSCLC survivors (n=9). The protocol was developed within the Viniyoga (Hatha) tradition with respiratory experts. Breathing ease, dyspnea, oxygen saturation, and respiratory function were explored in relationship to yoga practice (45-minute sessions once per week and home practice) using repeated-measures analysis. Number of participants reporting dyspnea ranged from 25 to 50% prior to practice with no significant increase during sessions, and moderate decreases noted at times. Oxygen saturation remained high and vital signs stable; forced expiratory volume in 1 second (FEV1) values increased significantly over the 14-week study period (p<0.0001). Yoga, with an emphasis on postures coordinated with breathing and meditation practices, offers a potentially feasible and beneficial option that requires further study in this population.
Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η(2) = .18). There were significant improvements over time for general distress (η(2) = .09), anxiety (η(2) = .08), hostility (η(2) = .07), and medical symptoms (η(2) = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.
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Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η2 = .18). There were significant improvements over time for general distress (η2 = .09), anxiety (η2 = .08), hostility (η2 = .07), and medical symptoms (η2 = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.
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