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.
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.
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.