Drinking coffee may be associated with a lower risk of developing multiple sclerosis

Drinking coffee may be associated with a lower risk of developing multiple sclerosis (MS), according to a study released today that will be presented at the American Academy of Neurology's 67th Annual Meeting in Washington, DC, April 18 to 25, 2015.

"Caffeine intake has been associated with a reduced risk of Parkinson's and Alzheimer's diseases, and our study shows that coffee intake may also protect against MS, supporting the idea that the drug may have protective effects for the brain," said study author Ellen Mowry, MD, MCR, with Johns Hopkins University School of Medicine in Baltimore and a member of the American Academy of Neurology.

For the study, researchers looked at a Swedish study of 1,629 people with MS and 2,807 healthy people, and a U.S. study of 1,159 people with MS and 1,172 healthy people. The studies characterized coffee consumption among persons with MS one and five years before MS symptoms began (as well as 10 years before MS symptoms began in the Swedish study) and compared it to coffee consumption of people who did not have MS at similar time periods. The study also accounted for other factors such as age, sex, smoking, body mass index, and sun exposure habits.

The Swedish study found that compared to people who drank at least six cups of coffee per day during the year before symptoms appeared, those who did not drink coffee had about a one and a half times increased risk of developing MS. Drinking large amounts of coffee five or 10 years before symptoms started was similarly protective.

In the US study, people who didn't drink coffee were also about one and a half times more likely to develop the disease than those who drank four or more cups of coffee per day in the year before symptoms started to develop the disease.
"Caffeine should be studied for its impact on relapses and long-term disability in MS as well," said Mowry.

Mindfulness Fights Stress and Depression

-->

Stress

Breast cancer survivors benefit from practicing mindfulness-based stress reduction

Women recently diagnosed with breast cancer have higher survival rates than those diagnosed in previous decades, according to the American Cancer Society. However, survivors continue to face health challenges after their treatments end. Previous research reports as many as 50 percent of breast cancer survivors are depressed. Now, University of Missouri researchers in the Sinclair School of Nursing say a meditation technique can help breast cancer survivors improve their emotional and physical well-being.

Yaowarat Matchim, a former nursing doctoral student; Jane Armer, professor of nursing; and Bob Stewart, professor emeritus of education and adjunct faculty in nursing, found that breast cancer survivors' health improved after they learned Mindfulness-Based Stress Reduction (MBSR), a type of mindfulness training that incorporates meditation, yoga and physical awareness.

"MBSR is another tool to enhance the lives of breast cancer survivors," Armer said. "Patients often are given a variety of options to reduce stress, but they should choose what works for them according to their lifestyles and belief systems."

The MBSR program consists of group sessions throughout a period of eight to ten weeks. During the sessions, participants practice meditation skills, discuss how bodies respond to stress and learn coping techniques. The researchers found that survivors who learned MBSR lowered their blood pressure, heart rate and respiratory rate. In addition, participants' mood improved, and their level of mindfulness increased after taking the class. Armer says, for best results, participants should continue MBSR after the class ends to maintain the positive effects.

"Mindfulness-based meditation, ideally, should be practiced every day or at least on a routine schedule," Armer said. "MBSR teaches patients new ways of thinking that will give them short- and long-term benefits."

Armer says the non-pharmaceutical approach works best as a complement to other treatment options such as chemotherapy, radiation and surgery.

"Post diagnosis, breast cancer patients often feel like they have no control over their lives," Armer said. "Knowing that they can control something -- such as meditation -- and that it will improve their health, gives them hope that life will be normal again."

The study, "Effects of Mindfulness-Based Stress Reduction (MBSR) on Health Among Breast Cancer Survivors," was published in the Western Journal of Nursing Research.

'Mindfulness' exercises help curb stress and fatigue associated with arthritis

"Mindfulness" exercises, which focus on experiencing the present moment, no matter how difficult, can help curb the stress and fatigue associated with painful rheumatoid joint disease, indicates a small study published December 2011 online in the Annals of Rheumatic Diseases.

The authors base their findings on 73 patients between the ages of 20 and 70, all of whom had had painful joint disease, caused by rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis for at least a year.

Half of them were randomly allocated to scheduled "mindfulness" exercises, which took place in 10 group sessions over a period of 15 weeks, plus a booster session around six months after the course had completed.

The sessions, which were facilitated by healthcare professionals trained in mindfulness techniques, addressed particular topics, such as recognising individual limitations, and strong emotions, such as anger, joy, and sorrow.

The exercises, which were part of the Vitality Training Programme of VTP, encouraged participants to become aware of, and deliberately concentrate on their feelings, thoughts and bodily experiences, including pain, without judging or trying to avoid them.

Participants were also given creative exercises, such as guided imagery, music and drawing, and shared their experiences with other members of the group.

The rest of the volunteers randomly allocated to the comparison group were given standard care plus a CD containing similar exercises for use at home, as and when they wanted.

Stress levels, coping abilities, and symptom control, including pain and fatigue, were assessed, using validated scores, immediately after all 10 sessions had finished, and again 12 months later.

In total, 67 participants completed all the assessments. These showed no differences in pain levels, disease activity or the ability to talk about feelings.

But there were significant differences in levels of stress and fatigue.

The number of participants with a high stress score of above 23 in the GHQ-20 questionnaire fell from 13 at the start of the study to two, just 12 months after the sessions had finished. Comparable figures in the comparison group were 10 and eight, respectively.

There was, however, a tangible fall in measured levels of fatigue in the intervention group: no such change was evident in the comparison group.

There have been previous attempts to use psychological and educational tactics to help people with arthritis cope better with the distressing aspects of the disease, but they have tended to be short term, say the authors.

The lasting improvements found with the VTP course "indicate that the participants may have incorporated some mindfulness strategies into their daily lives and that these strategies have strengthened their ability to respond to their stressful experience in a more flexible way," they say.

The authors emphasise that while the treatment of rheumatoid arthritis has improved greatly, it is less effective in those with more established disease, and that ultimately the disease can only be partly controlled, forcing many patients to make very demanding lifestyle changes.

"There is therefore a need for complementary interventions that enhance individuals' health-promoting resources and help them adjust to their disease," they conclude.

Depression

Mindfulness techniques can help protect pregnant women against depression

Pregnant women with histories of major depression are at high risk of becoming depressed again in the months before and after their babies are born. A new study led by the University of Colorado Boulder found that practicing mindfulness techniques--such as meditation, breathing exercises and yoga--could help protect these women against a recurrence.

About 30 percent of women who have struggled with depression in the past relapse during pregnancy, according to past research. In the new study, published November 2014 in the journal Archives of Women's Mental Health, the research team found that pregnant women with histories of depression who participated in Mindfulness Based Cognitive Therapy had a relapse rate of just 18 percent.

"It's important for pregnant women who are at high risk of depression to have options for treatment and prevention," said Sona Dimidjian, an associate professor in CU-Boulder's Department of Psychology and Neuroscience and lead author of the study. "For some women, antidepressant medication is truly a lifesaver, but others want a non-pharmacological intervention. This program focuses on teaching women skills and practices that are designed to help them stay well and care for themselves and their babies during this important time of life."

Mindfulness Based Cognitive Therapy--which combines mindfulness practice with more traditional cognitive behavioral therapy--has been shown to be effective at preventing recurrent episodes of depression in the general population. But few studies of any kind have looked at the effect of mindfulness or cognitive behavioral therapies among pregnant women.

For the current study, funded by the National Institutes of Mental Health, and conducted in collaboration with Sherryl Goodman, a professor at Emory University in Atlanta, 49 women in Colorado and Georgia with at least one prior episode of major depression enrolled in an eight-session class during their pregnancies. During class and using homework assignments, the women worked to develop mindfulness skills.

"Mindfulness is about how to pay attention to your own moment-to-moment experience in a way that is suffused with an openness, curiosity, gentleness and kindness towards oneself," Dimidjian said.

The standard mindfulness practices used in class were tweaked to be more valuable to pregnant women. Lessons included prenatal yoga, walking meditation exercises that could be done later while soothing a baby, and shorter practices that could be easily integrated into the busy lives of new moms. The lessons also specifically addressed worry, which can be common during pregnancy, and put particular focus on kindness for oneself and one's baby.

The research team--which also included CU-Boulder doctoral student Jennifer Felder; Amanda Brown of Emory University in Atlanta; and Robert Gallop of West Chester University in Pennsylvania--surveyed the women for symptoms of depression during their pregnancy and through six months postpartum.

A high percentage of the women who began the courses--86 percent--completed the study, a sign that the women found the sessions valuable, Dimidjian said. The researchers also were struck by the number of pregnant women who expressed interest in participating in a mindfulness program, even though they didn't meet the criteria to participate in this study.

"I was surprised by the level of interest, even among women who didn't have a history of depression," Dimidjian said. "Pregnant women know that the experience of having a child is going to change their lives, and they want to be ready."

Dimidjian has worked to create an online program of Mindfulness Based Cognitive Therapy that could be used as a tool to address the demand by pregnant women and others to develop these skills.

To test the effectiveness of the online program, Dimidjian is now recruiting adult women with a prior history of depression to participate in a new study. The women do not need to be pregnant.

Mindfulness meditation found to be as effective as antidepressants to prevent depression relapse

A new study from the Centre for Addiction and Mental Health (CAMH) has found that mindfulness-based cognitive therapy--using meditation--provides equivalent protection against depressive relapse as traditional antidepressant medication.

The study published in the December 2010 issue of the Archives of General Psychiatry compared the effectiveness of pharmacotherapy with mindfulness-based cognitive therapy (MBCT) by studying people who were initially treated with an antidepressant and then, either stopped taking the medication in order to receive MBCT, or continued taking medication for 18 months.

"With the growing recognition that major depression is a recurrent disorder, patients need treatment options for preventing depression from returning to their lives." said Dr. Zindel Segal, Head of the Cognitive Behaviour Therapy Clinic in the Clinical Research Department at CAMH.

"Data from the community suggest that many depressed patients discontinue antidepressant medication far too soon, either because of side effect burden, or an unwillingness to take medicine for years. Mindfulness-based cognitive therapy is a non pharmacological approach that teaches skills in emotion regulation so that patients can monitor possible relapse triggers as well as adopt lifestyle changes conducive to sustaining mood balance.

Study participants who were diagnosed with major depressive disorder were all treated with an antidepressant until their symptoms remitted. They were then randomly assigned to come off their medication and receive MBCT; come off their medication and receive a placebo; or stay on their medication. The novelty of this design permits comparing the effectiveness of sequencing pharmacological and psychological treatments versus maintaining the same treatment - antidepressants - over time

Participants in MBCT attended 8 weekly group sessions and practiced mindfulness as part of daily homework assignments. Clinical assessments were conducted at regular intervals, and over an 18 month period, relapse rates for patients in the MBCT group did not differ from patients receiving antidepressants (both in the 30% range), whereas patients receiving placebo relapsed at a significantly higher rate (70%).

"The real world implications of these findings bear directly on the front line treatment of depression. For that sizeable group of patients who are unwilling or unable to tolerate maintenance antidepressant treatment, MBCT offers equal protection from relapse,".said Dr. Zindel Segal. "Sequential intervention-- offering pharmacological and psychological interventions-- may keep more patients in treatment and thereby reduce the high risk of recurrence that is characteristic of this disorder.

Mindfulness-based therapy could offer an alternative to antidepressants for preventing depression relapse

The results come from the first ever large study to compare MBCT -- structured training for the mind and body which aims to change the way people think and feel about their experiences -- with maintenance antidepressant medication for reducing the risk of relapse in depression.

The study aimed to establish whether MBCT is superior to maintenance antidepressant treatment in terms of preventing relapse of depression. Although the findings show that MBCT isn't any more effective than maintenance antidepressant treatment in preventing relapse of depression, the results, combined with those of previous trials, suggest that MCBT may offer similar protection against depressive relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.

"Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point," explains Willem Kuyken, lead author and Professor of Clinical Psychology at the University of Oxford in the UK.

"Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly," adds study co-author Professor Richard Byng, from the Plymouth University Peninsula Schools of Medicine and Dentistry, UK. "However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects."

MBCT was developed to help people who have experienced repeated bouts of depression by teaching them the skills to recognise and to respond constructively to the thoughts and feelings associated with relapse, thereby preventing a downward spiral into depression.

In this trial, which was conducted from the University of Exeter, UK, 424 adults with recurrent major depression and taking maintenance antidepressant medication were recruited from 95 primary care general practices across the South West of England. Participants were randomly assigned to come off their antidepressant medication slowly and receive MBCT (212 participants) or to stay on their medication (212 participants).

Participants in the MBCT group attended eight 2 ¼ hour group sessions and were given daily home practice. After the group they had the option of attending 4 follow up sessions over a 12 month period. The MBCT course consists of guided mindfulness practices, group discussion and other cognitive behavioural exercises. Those in the maintenance antidepressant group continued their medication for two years.

All trial participants were assessed at regular intervals over 2 years for a major depressive episode using a psychiatric diagnostic interview tool -- the Structured Clinical Interview for DSM-IV.

Over 2 years, relapse rates in both groups were similar (44% in the MBCT group vs 47% in the maintenance antidepressant medication group). Although five adverse events were reported, including two deaths, across both groups, they were not judged to be attributable to the interventions or the trial.

According to study co-author Professor Sarah Byford, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, UK, "As a group intervention, mindfulness-based cognitive therapy was relatively low cost compared to therapies provided on an individual basis and, in terms of the cost of all health and social care services used by participants during the study, we found no significant difference between the two treatments." 

According to Professor Kuyken, "Whilst this study doesn't show that mindfulness-based cognitive therapy works any better than maintenance antidepressant medication in reducing the rate of relapse in depression, we believe these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions. "*

Study participant Mr Nigel Reed from Sidmouth, Devon, UK, comments that, "Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well."

Writing in a linked Comment, Professor Roger Mulder from the University of Otago in New Zealand says, "Because it is a group treatment that reduces costs and the number of trained staff needed, it might be feasible to offer [mindfulness-based cognitive therapy] as a choice to patients in general practice…We therefore have a promising new treatment that is reasonably cost effective and applicable to the large group of patients with recurrent depression."

---

Mindfulness - Miscellaneous Health Benefits

Miscellaneous Health

Mindfulness intervention for people with diabetes, coronary heart disease

Researchers examine how meditation and mindfulness affect people with diabetes mellitus and coronary heart disease. Mindfulness-based interventions have been hailed as effective in targeting negative cognitions such as worry and thought suppression, but their ability to improve long-term conditions (LTCs) has remained unexamined. Mindfulness, as defined by the study, is a "heightened sense of present centered self-awareness that fosters non-judgmental observations of emotions, bodily states, and other sensations in the attentional field, leading to mental well being."

Mindfulness-based interventions have been hailed as effective in targeting negative cognitions such as worry and thought suppression, but their ability to improve long-term conditions (LTCs) has remained unexamined. In the Open Access article, "A Mixed-Methods Pilot Study of the Acceptability and Effectiveness of a Brief Meditation and Mindfulness Intervention for People with Diabetes and Coronary Heart Disease," published in Behavioral Medicine, researchers examine how meditation and mindfulness affect people with diabetes mellitus and coronary heart disease.

Mindfulness, as defined by the study, is a "heightened sense of present centered self-awareness that fosters non-judgmental observations of emotions, bodily states, and other sensations in the attentional field, leading to mental well being." The study used a sequential mixed methods approach that measured change in worry and thought suppression, and qualitatively explored acceptability, feasibility, and user experience with a focus group and in-depth interviews.

On the importance of mindfulness in improving the health of people with long term conditions, lead author Dr. Peter Coventry has said, "mindfulness based interventions appear to be an acceptable and effective way for some people with long term conditions to regain a sense of balance and self-determination in their lives by allowing them to accept their limitations and focus on what is achievable in the present rather than worrying about the past or what they might not be able to do in the future. In this sense it is a means to help people self-manage their illness and it has the potential to offer people long term benefits if practiced regularly and built into their daily routines."

Meditation and mindfulness skills led to improved sleep, greater relaxation, and more-accepting approaches to illness and illness experience. At the end of the six-week meditation course, worry and thought suppression were significantly reduced. Long term effects were not studied. Overall, however, the data suggest that meditation and mindfulness may have been particularly useful during the early phase of LTCs or immediately after an acute event, when participants' perceived that anxiety and worry were more potent health threats. There is scope to investigate optimal timing of meditation and mindfulness training for people with long term conditions.
 

Mindfulness-based meditation helps teenagers with cancer

Mindfulness-based meditation could lessen some symptoms associated with cancer in teens, according to the results of a clinical trial intervention. Mindfulness-based meditation focuses on the present moment and the connection between the mind and body. Adolescents living with cancer face not only the physical symptoms of their condition, but also the anxiety and uncertainty related to the progression of the disease, the anticipation of physical and emotional pain related to illness and treatment, the significant changes implied in living with cancer, as well as the fear of recurrence after remission

Mindfulness-based meditation could lessen some symptoms associated with cancer in teens, according to the results of a clinical trial intervention led by researchers at the University of Montreal and its affiliated CHU Sainte-Justine children's hospital.

Mindfulness-based meditation focuses on the present moment and the connection between the mind and body. Adolescents living with cancer face not only the physical symptoms of their condition, but also the anxiety and uncertainty related to the progression of the disease, the anticipation of physical and emotional pain related to illness and treatment, the significant changes implied in living with cancer, as well as the fear of recurrence after remission. Catherine Malboeuf-Hurtubise of the university's Department of Psychology presented the findings at the American Psychosomatic Society Meeting in San Francisco.

The researchers asked 13 adolescents with cancer to complete questionnaires covering mood (positive and negative emotions, anxiety and depression), sleep and quality of life. The group was divided in two: a first group of eight adolescents were offered eight mindfulness-based meditation sessions and the remaining five adolescents in the control group were put on a wait-list. The eight sessions were 90 minutes long and took place weekly. After the last meditation session, patients from both groups filled out the same questionnaires a second time. 

"We analyzed differences in mood, sleep and quality of life scores for each participant and then between each group to evaluate if mindfulness sessions had a greater impact than the simple passage of time. We found that teenagers that participated in the mindfulness group had lower scores in depression after our 8 sessions. Girls from the mindfulness group reported sleeping better. We also noticed that they developed mindfulness skills to a greater extent than boys during the sessions," Malboeuf-Hurtubise said. "Our results suggest that mindfulness sessions could be helpful in improving mood and sleep in teenagers with cancer, as previous oncology research suggests with adults."

Differences between both groups were not large enough for the researchers to impute observed benefits solely to the mindfulness component of the sessions. "The social support provided to the adolescents in the mindfulness group could possibly explain observed benefits on mood and sleep," Malboeuf-Hurtubise said. "Nonetheless, mindfulness-based interventions for teenagers with cancer appear as a promising option to lighten psychological inconveniences of living with cancer." The researchers intend to offer members of the control group an opportunity to undertake the meditation sessions.

Mindfulness meditation slows progression of HIV

CD4+ T lymphocytes, or simply CD4 T cells, are the "brains" of the immune system, coordinating its activity when the body comes under attack. They are also the cells that are attacked by HIV, the devastating virus that causes AIDS and has infected roughly 40 million people worldwide. The virus slowly eats away at CD4 T cells, weakening the immune system.

But the immune systems of HIV/AIDS patients face another enemy as well -- stress, which can accelerate CD4 T cell declines. Now, researchers at UCLA report that the practice of mindfulness meditation stopped the decline of CD4 T cells in HIV-positive patients suffering from stress, slowing the progression of the disease. The study was just released July 2008 in the online edition of the journal Brain, Behavior, and Immunity.

Mindfulness meditation is the practice of bringing an open and receptive awareness of the present moment to experiences, avoiding thinking of the past or worrying about the future. It is thought to reduce stress and improve health outcomes in a variety of patient populations.

"This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said lead study author David Creswell, a research scientist at the Cousins Center for Psychoneuroimmunology at UCLA. "The mindfulness program is a group-based and low-cost treatment, and if this initial finding is replicated in larger samples, it's possible that such training can be used as a powerful complementary treatment for HIV disease, alongside medications."

Creswell and his colleagues ran an eight-week mindfulness-based stress-reduction (MBSR) meditation program and compared it to a one-day MBSR control seminar, using a stressed and ethnically diverse sample of 48 HIV-positive adults in Los Angeles. Participants in the eight-week group showed no loss of CD4 T cells, indicating that mindfulness meditation training can buffer declines. In contrast, the control group showed significant declines in CD4 T cells from pre-study to post-study. Such declines are a characteristic hallmark of HIV progression.

Creswell also noted that researchers found a "dose-response" relationship between MBSR class attendance and CD4 T cells, meaning, said Creswell, "the more mindfulness meditation classes people attended, the higher the CD4 T cells at the study's conclusion."

The researchers were also encouraged because the overall CD4 T cell effects remained even after controlling for a number of factors that could have skewed the study results. Most notably, they found equivalent protective effects for participants whether or not they were on antiretroviral medications for HIV. Even participants taking HIV medications showed the CD4 T cell buffering effect after the mindfulness meditation class, Creswell said.

There is emerging evidence from other studies that shows that behavioral stress-management programs can buffer HIV declines in HIV-positive people, Creswell noted. And while there has been an exponential increase of interest in and practice of mindfulness meditation in the West over the past 10 years, this study, he said, is the first to show an HIV disease protective effect with mindfulness meditation training.

In order to understand the health benefits of mindfulness meditation, Creswell and his colleagues at UCLA are now examining the underlying pathways through which mindfulness meditation reduces stress, using brain imaging, genetics and immune system measurements.

"Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress," Creswell said.

Mindfulness meditation may ease fatigue, depression in multiple sclerosis

Learning mindfulness meditation may help people who have multiple sclerosis (MS) with the fatigue, depression and other life challenges that commonly accompany the disease, according to a study published in the September 28, 2010, issue of Neurology®, the medical journal of the American Academy of Neurology.

In the study, people who took an eight-week class in mindfulness meditation training reduced their fatigue and depression and improved overall quality of life compared to people with MS who received only usual medical care. The positive effects continued for at least six months.

"People with MS must often confront special challenges of life related to profession, financial security, recreational and social activities, and personal relationships, not to mention the direct fears associated with current or future physical symptoms and disability. Fatigue, depression and anxiety are also common consequences of having MS." said study author Paul Grossman, PhD, of the University of Basel Hospital in Switzerland. "Unfortunately, the treatments that help slow the disease process may have little direct effect on people's overall quality of life, fatigue or depression. So any complementary treatments that can quickly and directly improve quality of life are very welcome."

For the study, 150 people with mild to moderate MS were randomly assigned to receive either the eight-week meditation training or only usual medical care for MS. The class focused on mental and physical exercises aimed at developing nonjudgmental awareness of the present moment, or mindfulness. The training included weekly classes lasting two and a half hours, plus one all-day retreat and 40 minutes per day of homework assignments.

"MS is an unpredictable disease," Grossman said. "People can go for months feeling great and then have an attack that may reduce their ability to work or take care of their family. Mindfulness training can help those with MS better to cope with these changes. Increased mindfulness in daily life may also contribute to a more realistic sense of control, as well as a greater appreciation of positive experiences that continue be part of life."

Participants in the mindfulness program showed extremely good attendance rates (92%) and reported high levels of satisfaction with the training. Furthermore, very few (5%) dropped out of the course before completion.

Those who went through the mindfulness program improved in nearly every measure of fatigue, depression and quality of life, while those who received usual medical care declined slightly on most of the measures. For example, those with mindfulness training reduced their depressive symptoms by over 30 percent compared to those with no training.

Improvements among mindfulness participants were particularly large for those who showed significant levels of depression or fatigue at the beginning of the study. About 65 percent of participants showed evidence of serious levels of depression, anxiety or fatigue at the start of the study, and this risk group was reduced by a third at the end of training and six months later.

The other benefits of the training were also still apparent six months after the training ended, although they were sometimes reduced compared to right after finishing the training. Reductions in fatigue, however, were stable from the end of treatment to six months later.

An accompanying editorial pointed out that because there was not an active control group (using a different type of intervention), it is unclear that the good results were specifically a result of mindfulness training. However, the editorialists noted that the present study was the largest of its type, and was well-conducted.

Mindfulness meditation may relieve chronic inflammation

People suffering from chronic inflammatory conditions, such as rheumatoid arthritis, inflammatory bowel disease and asthma -- in which psychological stress plays a major role -- may benefit from mindfulness meditation techniques, according to a study by University of Wisconsin-Madison neuroscientists with the Center for Investigating Healthy Minds at the Waisman Center.

Mindfulness-based stress reduction, originally designed for patients with chronic pain, consists of continuously focusing attention on the breath, bodily sensations and mental content while seated, walking or practicing yoga.

While interest in meditation as a means of reducing stress has grown over the years, there has been little evidence to support benefits specific to mindfulness meditation practice. This was the first study designed to control for other therapeutic mechanisms, such as supportive social interaction, expert instruction, or learning new skills.

A class in stress reduction can be beneficial in many ways, some of which have little to do with mindfulness, according to Melissa Rosenkranz, assistant scientist at the center and lead author on the paper, which was published January 2013 in the journal Brain, Behavior and Immunity. For example, learning to manage stress by engaging in regular physical activity may be therapeutic.

"We wanted to develop an intervention that was meant to produce positive change and compare the mindfulness approach to an intervention that was structurally equivalent," Rosenkranz says.

The study compared two methods of reducing stress: a mindfulness meditation-based approach, and a program designed to enhance health in ways unrelated to mindfulness.

The comparison group participated in the Health Enhancement Program, which consisted of nutritional education; physical activity, such as walking; balance, agility and core strengthening; and music therapy. The content of the program was meant to match aspects of the mindfulness instruction in some way.

For example, physical exercise was meant to match walking meditation, without the mindfulness component.

Both groups had the same amount of training, the same level of expertise in the instructors, and the same amount of home practice required by participants.

"In this setting, we could see if there were changes that we could detect that were specific to mindfulness," Rosenkranz explains.

Using a tool called the Trier Social Stress Test to induce psychological stress, and a capsaicin cream to produce inflammation on the skin, immune and endocrine measures were collected before and after training in the two methods. While both techniques were proven effective in reducing stress, the mindfulness-based stress reduction approach was more effective at reducing stress-induced inflammation.

The results show that behavioral interventions designed to reduce emotional reactivity are beneficial to people suffering from chronic inflammatory conditions. The study also suggests that mindfulness techniques may be more effective in relieving inflammatory symptoms than other activities that promote well-being.

Rosenkranz emphasizes that the mindfulness-based approach is not a magic bullet. "This is not a cure-all, but our study does show that there are specific ways that mindfulness can be beneficial, and that there are specific people who may be more likely to benefit from this approach than other interventions."

Significant portions of the population do not benefit from available pharmaceutical treatment options, for example. Some of these patients suffer from negative side effects of the drugs, or simply do not respond to the standard-of-care for treatment of the disorder.

"The mindfulness-based approach to stress reduction may offer a lower-cost alternative or complement to standard treatment, and it can be practiced easily by patients in their own homes, whenever they need," Rosenkranz says.

Mindfulness = Emotional and Physical Well Being

Mindfulness meditation appears to help improve sleep quality

Mindfulness meditation practices resulted in improved sleep quality for older adults with moderate sleep disturbance in a clinical trial comparing meditation to a more structured program focusing on changing poor sleep habits and establishing a bedtime routine, according to a new article.

Mindfulness meditation practices resulted in improved sleep quality for older adults with moderate sleep disturbance in a clinical trial comparing meditation to a more structured program focusing on changing poor sleep habits and establishing a bedtime routine, according to an article published online February 2015 by JAMA Internal Medicine.

Sleep disturbances are a medical and public health concern for our nation's aging population. An estimated 50 percent of individuals 55 years and older have some sort of sleep problem. Moderate sleep disturbances in older adults are associated with higher levels of fatigue, disturbed mood, such as depressive symptoms, and a reduced quality of life, according to the study background.

David S. Black, Ph.D., M.P.H., of the University of Southern California, Los Angeles, and coauthors conducted the small clinical trial in Los Angeles in 2012 and their analysis included 49 individuals (average age 66). The trial included 24 individuals who took part in a standardized mindful awareness practices (MAPs) intervention and 25 individuals who participated in a sleep hygiene education (SHE) intervention. Differences between the groups were measured using the Pittsburgh Sleep Quality Index (PSQI), a widely used self-reported questionnaire of sleep disturbances.

Participants in the MAPs group showed improvement relative to those in the SHE group. The MAPs group had average PSQI scores of 10.2 at baseline and 7.4 after the intervention. The SHE group had average PSQIs of 10.2 at baseline and 9.1 after the intervention, study results show. The MAPs group also showed improvement relative to the SHE group on secondary measures of insomnia symptoms, depression symptoms, fatigue interference and fatigue severity. However, differences between the groups were not seen for anxiety, stress or inflammatory signaling, a measure of which declined in both groups over time.

"According to our findings, mindfulness meditation appears to have a role in addressing the prevalent burden of sleep problems among older adults by remediating their moderate sleep disturbances and deficits in daytime functioning, with short-term effect sizes commensurate with the status quo of clinical treatment approaches for sleep problems. ... Given that standardized mindfulness programs are readily delivered in many communities, dissemination efforts do not serve as a barrier in this instance. ... Pending future replication of these findings, structured mindfulness mediation training appears to have at least some clinical usefulness to remediate moderate sleep problems and sleep-related daytime impairment in older adults," the study concludes.

Commentary: Being Mindful of Later-Life Sleep Quality

In a related commentary, Adam P. Spira, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, writes: "As the authors explain, effective nonpharmacological interventions that are both 'scalable' and 'community accessible' are needed to improve disturbed sleep and prevent clinical levels of insomnia. This is imperative given links between insomnia and poor health outcomes, risks of sleep medication use and the limited availability of health care professionals trained in effective nondrug treatments such as behavior therapy and cognitive behavioral therapy for insomnia. This context makes the positive results of this RCT [randomized clinical trial] compelling."

"This excellent study raises some questions that need to be answered in future research," Spira continues.

"In summary, Black et al are to be applauded for their intriguing study. Other community-based nonpharmacological interventions are needed that improve sleep and perhaps prevent insomnia among older adults. Such interventions may have a key role in safely reducing the morbidity associated with disturbed sleep in later life," Spira concludes.

Mindfulness decreased patients’ desire for prescription drugs

How can people who are dependent on prescription opioids reduce their cravings? Learn to enjoy other aspects of their lives.

That’s the key finding in a new (December 2014) study published in the Journal of Behavioral Medicine by Eric L. Garland, associate professor at the University of Utah College of Social Work. Garland and colleagues studied how an intervention program for chronic pain patients called Mindfulness-Oriented Recovery Enhancement (MORE) decreased patients’ desire for prescription drugs.

The MORE intervention concentrates on helping people to recover a sense of meaning and fulfillment in everyday life, embracing its pleasures and pain without turning to substance use as a coping mechanism. It integrates the latest research on addiction, cognitive neuroscience, positive psychology and mindfulness.  Participants in Garland’s study received eight weeks of instruction in applying mindfulness-oriented techniques to alleviate pain and craving while strengthening positive emotions and the sense of reward and meaning in life.

For example, to enhance their sense of reward in life, participants in Garland’s study were taught a “mindful savoring practice,” in which they focused attention on pleasant experiences such as a beautiful nature scene, sunset or feeling of connection with a loved one. In a meditation session, participants were taught to focus their awareness on colors, textures and scents of a bouquet of fresh flowers and to appreciate joy arising from the experience. As part of their daily homework, they were then asked to practice the meditation technique as a way to enjoy other pleasant life experiences.

Results from Garland’s new research shows that after a sample of chronic pain patients misusing opioids went through MORE, they exhibited increased brain activation on an EEG to natural healthy pleasures. The more their brains became active in response to natural healthy pleasure, the less the patients craved opioids.

“These findings are scientifically important because one of the major theories about how and why addiction occurs asserts that over time drug abusers become dulled to the experience of joy in everyday life, and this pushes them to use higher and higher doses of drugs to feel happiness,” said Garland.

“This study suggests that this process can be reversed. We can teach people to use mindfulness to appreciate and enjoy life more, and by doing that, they may feel less of a need for addictive drugs. It’s a powerful finding.”

Garland’s latest study builds on earlier work published in February in The Journal of Consulting and Clinical Psychology, in which the MORE intervention was found to reduce opioid misuse among a sample of chronic pain patients compared to another sample of chronic pain patients participating in a conventional support group.

The results are of particular interest in Utah, which claims one of the highest prescription drug abuse rates in the U.S.  According to the most recent statistics available from the state Division of Substance Abuse and Mental Health, Utah ranks eighth in the U.S. for its number of deaths attributed to prescription drug overdose.

Evidence supports health benefits of 'mindfulness-based practices'

Specific types of "mindfulness practices" including Zen meditation have demonstrated benefits for patients with certain physical and mental health problems, according to a report in the July Journal of Psychiatric Practice.

"An extensive review of therapies that include meditation as a key component -- referred to as mindfulness-based practices -- shows convincing evidence that such interventions are effective in the treatment of psychiatric symptoms and pain, when used in combination with more conventional therapies," according to Dr William R. Marchand of the George E. Wahlen Veterans Affairs Medical Center and the University of Utah in Salt Lake City.

Mindfulness Techniques Show Health Benefits Dr Marchand reviewed published studies evaluating the health benefits of mindfulness-based practices. Mindfulness has been described as "the practice of learning to focus attention on moment-by-moment experience with an attitude of curiosity, openness, and acceptance." Put another way, "Practicing mindfulness is simply experiencing the present moment, without trying to change anything."

The review focused on three techniques:
• Zen meditation, a Buddhist spiritual practice that involves the practice of developing mindfulness by meditation, typically focusing on awareness of breathing patterns.
• Mindfulness-based stress reduction (MBSR), a secular method of using Buddhist mindfulness, combining meditation with elements of yoga and education about stress and coping strategies.
• Mindfulness-based cognitive therapy (MBCT), which combines MBSR with principles of cognitive therapy (for example, recognizing and disengaging from negative thoughts) to prevent relapse of depression.

Dr Marchand found evidence that MBSR and MBCT have "broad-spectrum" effects against depression and anxiety and can also decrease general psychological distress. Based on the evidence, MBCT can be "strongly recommended" as an addition to conventional treatments (adjunctive treatment) for unipolar depression. Both MBSR and MBCT were effective adjunctive treatments for anxiety.

Research data also supported the effectiveness of MBSR to help reduce stress and promote general psychological health in patients with various medical and/or psychiatric illnesses. On its own, MBSR was helpful in managing stress and promoting general psychological health in healthy people. There was also evidence that Zen meditation and MBSR were useful adjunctive treatments for pain management.

How do these practices work to affect mental and physical health? Dr Marchand discusses recent research showing the impact of mindfulness practices on brain function and structure, which may in part account for their psychological benefits. "These mindfulness practices show considerable promise and the available evidence indicates their use is currently warranted in a variety of clinical situations," he concludes.

The article includes some proposed evidence-based guidelines for incorporating mindfulness-based practices into health care. So far there's little evidence on which patients are most likely to benefit, but Dr Marchand suggests that patient preferences and enthusiasm are a good guide. 

He comments, "The most important considerations may be desire to try a mindfulness-based practice and willingness to engage in the regular practice of seated meditation."

The Importance of Cultivating Mindfulness for Cognitive and Emotional Well-Being in Late Life

The cultivation of mindfulness has received increasing attention over the past 2 decades because of its association with increased psychological well-being and reduced stress-related health disorders. Given the robust positive association between perceived stress and cognitive impairment in late life, a new (October, 2014) study evaluated the association between trait mindfulness, psychological well-being, and cognitive function in 73 healthy community-dwelling older adults.

Controlling for a priori covariates, multivariate regression analyses showed a significant association between trait mindfulness and measures of psychological well-being, including self-reported depressive symptoms, quality of life, and stress profile.

Analyses further showed a significant association between trait mindfulness and executive function, namely set shifting. No association was found for declarative memory. Mediation analyses showed that the association between mindfulness and cognitive function is mediated by perceived stress.

This research supports the importance of cultivating mindfulness in late life to ensure cognitive and emotional well-being.

Just 25 minutes of mindfulness meditation alleviates stress, study shows

Mindfulness meditation has become an increasingly popular way for people to improve their mental and physical health, yet most research supporting its benefits has focused on lengthy, weeks-long training programs. New research is the first to show that brief mindfulness meditation practice -- 25 minutes for three consecutive days -- alleviates psychological stress. The study investigates how mindfulness meditation affects people's ability to be resilient under stress.

Mindfulness meditation has become an increasingly popular way for people to improve their mental and physical health, yet most research supporting its benefits has focused on lengthy, weeks-long training programs.

New research from Carnegie Mellon University is the first to show that brief mindfulness meditation practice -- 25 minutes for three consecutive days -- alleviates psychological stress. Published in the journal Psychoneuroendocrinology, the study investigates how mindfulness meditation affects people's ability to be resilient under stress.

"More and more people report using meditation practices for stress reduction, but we know very little about how much you need to do for stress reduction and health benefits," said lead author J. David Creswell, associate professor of psychology in the Dietrich College of Humanities and Social Sciences.

For the study, Creswell and his research team had 66 healthy individuals aged 18-30 years old participate in a three-day experiment. Some participants went through a brief mindfulness meditation training program; for 25 minutes for three consecutive days, the individuals were given breathing exercises to help them monitor their breath and pay attention to their present moment experiences. A second group of participants completed a matched three-day cognitive training program in which they were asked to critically analyze poetry in an effort to enhance problem-solving skills.

Following the final training activity, all participants were asked to complete stressful speech and math tasks in front of stern-faced evaluators. Each individual reported their stress levels in response to stressful speech and math performance stress tasks, and provided saliva samples for measurement of cortisol, commonly referred to as the stress hormone.

The participants who received the brief mindfulness meditation training reported reduced stress perceptions to the speech and math tasks, indicating that the mindfulness meditation fostered psychological stress resilience. More interestingly, on the biological side, the mindfulness mediation participants showed greater cortisol reactivity.

"When you initially learn mindfulness mediation practices, you have to cognitively work at it -- especially during a stressful task," said Creswell. "And, these active cognitive efforts may result in the task feeling less stressful, but they may also have physiological costs with higher cortisol production."

Creswell's group is now testing the possibility that mindfulness can become more automatic and easy to use with long-term mindfulness meditation training, which may result in reduced cortisol reactivity.

Mindfulness -- awareness of the present moment -- may be an important contributor to better emotional well-being

A new study from the University of Utah shows that individuals who describe themselves as being more mindful have more stable emotions and perceive themselves to have better control over their mood and behavior throughout the day. Higher mindful people also describe less cognitive and physiological activation before bedtime, suggesting that greater emotional stability during the day might even translate into better sleep.

The study results were presented at the annual meeting of the American Psychosomatic Society.

Prior studies of mindfulness -- paying attention in a particular way, on purpose in the present moment and non-judgmentally -- have typically been conducted with participants trained in mindfulness, for example meditation or other interventions. In contrast, this study examines naturally-occurring traits of mindfulness. Using a novel method for data collection, the participants wore a monitor that measured cardiac functioning and were prompted periodically throughout the day to rate their emotional state and mental functioning. Examining these processes during normal daily living builds on prior mindfulness research conducted in laboratory-controlled settings.

"This study gives us a better understanding of how mindfulness affects stress responses throughout the day," says Holly Rau, a graduate student involved with this research. "People who reported higher levels of mindfulness described better control over their emotions and behaviors during the day. In addition, higher mindfulness was associated with lower activation at bedtime, which could have benefits for sleep quality and future ability to manage stress."

How the study was conducted

A total of 38 subjects, recruited from the community and University of Utah undergraduate psychology courses, participated in the study. They ranged in age from 20 to 45, and one-third were male. On the first day of the study, each participant completed a baseline assessment that included standard questionnaires, resting physiological assessment, and cognitive testing before beginning two days of experience sampling.

In the daily life portion of the study, participants wore a cardiac impedance monitor and responded to questions about their emotional state several times a day for two days. At the end of each day, participants also completed questionnaires about their ability to regulate their emotions and behaviors and were asked to rate their level of cognitive and physical arousal before falling asleep.

Researchers found that greater emotional stability, better self-rated control of emotions and behaviors and lower pre-sleep arousal (a measurement of cognitive and physical symptoms of anxiety) were all significantly associated with higher trait mindfulness. Results suggest that mindfulness may be linked to self-regulation throughout the day, and that this may be an important way that mindfulness contributes to better emotional and physical well-being.

Future research will examine the link between moment-to-moment mindfulness, physiological markers of stress throughout the day and sleep quality. Examination of similar measures of mood, self-regulation and sleep quality in everyday life in the context of mindfulness intervention is another important direction for research.

Mindfulness meditation reduces loneliness in older adults

For older adults, loneliness is a major risk factor for health problems -- such as cardiovascular disease and Alzheimer's -- and death. Attempts to diminish loneliness with social networking programs like creating community centers to encourage new relationships have not been effective.

However, a new study led by Carnegie Mellon University's J. David Creswell offers the first evidence that mindfulness meditation reduces loneliness in older adults. Published in "Brain, Behavior & Immunity," the researchers also found that mindfulness meditation -- a 2,500-year-old practice dating back to Buddha that focuses on creating an attentive awareness of the present moment -- lowered inflammation levels, which is thought to promote the development and progression of many diseases. These findings provide valuable insights into how mindfulness meditation training can be used as a novel approach for reducing loneliness and the risk of disease in older adults.

"We always tell people to quit smoking for health reasons, but rarely do we think about loneliness in the same way," said Creswell, assistant professor of psychology within CMU's Dietrich College of Humanities and Social Sciences. "We know that loneliness is a major risk factor for health problems and mortality in older adults. This research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults."

For the study, the research team recruited 40 healthy adults aged 55-85 who indicated an interest in learning mindfulness meditation techniques. Each person was assessed at the beginning and end of the study using an established loneliness scale. Blood samples also were collected.

The participants were randomly assigned to receive either the eight-week Mindfulness-Based Stress Reduction (MBSR) program or no treatment. The MBSR program consisted of weekly two-hour meetings in which participants learned body awareness techniques -- noticing sensations and working on breathing -- and worked their way toward understanding how to mindfully attend to their emotions and daily life practices. They also were asked to practice mindfulness meditation exercises for 30 minutes each day at home and attended a daylong retreat.

The researchers found that eight weeks of the mindfulness meditation training decreased the participants' loneliness. Using the blood samples collected, they found that the older adult sample had elevated pro-inflammatory gene expression in their immune cells at the beginning of the study, and that the training reduced this pro-inflammatory gene expression, as well as a measure of C-Reactive Protein (CRP). These findings suggest that mindfulness meditation training may reduce older adults' inflammatory disease risk.

"Reductions in the expression of inflammation-related genes were particularly significant because inflammation contributes to a wide variety of the health threats including cancer, cardiovascular diseases and neurodegenerative diseases," said study collaborator Steven Cole, professor of medicine and psychiatry and biobehavioral sciences at the UCLA School of Medicine.

While the health effects of the observed gene expression changes were not directly measured in the study, Cole noted that "these results provide some of the first indications that immune cell gene expression profiles can be modulated by a psychological intervention."

Creswell added that while this research suggests a promising new approach for treating loneliness and inflammatory disease risk in older adults, more work needs to be done. "If you're interested in using mindfulness meditation, find an instructor in your city," he said. "It's important to train your mind like you train your biceps in the gym."