(See Mindfulness Meditation for local Mindfulness classes.)
(See Mindfulness Meditation by Jon Kabat-Zinn  for a brief descriptive article.)

(Numbers are PubMed ID numbers)

11523499

2001 Am J Health Promot 15;6:422-32

Williams, K. A., Kolar, M. M., Reger, B. E., and Pearson, J. C.

PURPOSE: To determine if participation in a Wellness-Based Mindfulness Stress Reduction intervention decreases the effect of daily hassles, psychological distress, and medical symptoms. DESIGN: A randomized controlled trial of a stress reduction intervention with a 3-month follow-up. SETTING: A university setting in West Virginia. SUBJECTS: A total of 103 adults, with 59 in the intervention group and 44 in the control group. Eight-five percent of subjects completed the intervention. Fifty-nine percent and 61% of the intervention and control subjects completed the study, respectively. INTERVENTION: The intervention consisted of an 8-week group stress reduction program in which subjects learned, practiced, and applied "mindfulness meditation" to daily life situations. The control group received educational materials and were encouraged to use community resources for stress management. MEASURES: The Daily Stress Inventory assessed the effect of daily hassles, the Revised Hopkins Symptom Checklist measured psychological distress, the Medical Symptom Checklist measured number of medical symptoms, and a Follow-up Questionnaire measured program adherence. RESULTS: Intervention subjects reported significant decreases from baseline in effect of daily hassles (24%), psychological distress, (44%), and medical symptoms (46%) that were maintained at the 3-month follow-up compared to control subjects (repeated measures analysis of variance [ANOVA]; p < .05). CONCLUSIONS: Self-selected community residents can improve their mental and physical health by participating in a stress reduction intervention offered by a university wellness program.

.
14650573
Meditation's impact on chronic illness
2003 Holist Nurs Pract 17(6):309-19
Bonadonna R.
Meditation is becoming widely popular as an adjunct to conventional medical
therapies. This article reviews the literature regarding the experience of
chronic illness, theories about meditation, and clinical effects of this
self-care practice. Eastern theories of meditation include Buddhist psychology.
The word Buddha means the awakened one, and Buddhist meditators have been called
the first scientists, alluding to more than 2500 years of precise, detailed
observation of inner experience. The knowledge that comprises Buddhist
psychology was derived inductively from the historical figure's (Prince
Siddhartha Gautama) diligent self-inquiry. Western theories of meditation
include Jungian, Benson's relaxation response, and transpersonal psychology.
Clinical effects of meditation impact a broad spectrum of physical and
psychological symptoms and syndromes, including reduced anxiety, pain, and
depression, enhanced mood and self-esteem, and decreased stress. Meditation has
been studied in populations with fibromyalgia, cancer, hypertension, and
psoriasis. While earlier studies were small and lacked experimental controls,
the quality and quantity of valid research is growing. Meditation practice can
positively influence the experience of chronic illness and can serve as a
primary, secondary, and/or tertiary prevention strategy. Health professionals
demonstrate commitment to holistic practice by asking patients about use of
meditation, and can encourage this self-care activity. Simple techniques for
mindfulness can be taught in the clinical setting. Living mindfully with chronic
illness is a fruitful area for research, and it can be predicted that evidence
will grow to support the role of consciousness in the human experience of
disease.
 

11543844

2001 Gen Hosp Psychiatry 23;4:183-92

Reibel, D. K., Greeson, J. M., Brainard, G. C., and Rosenzweig, S.

This study examined the effects of mindfulness-based stress reduction (MBSR) on health-related quality of life and physical and psychological symptomatology in a heterogeneous patient population. Patients (n=136) participated in an 8-week MBSR program and were required to practice 20 min of meditation daily. Pre- and post-intervention data were collected by using the Short-Form Health Survey (SF-36), Medical Symptom Checklist (MSCL) and Symptom Checklist-90 Revised (SCL-90-R). Health-related quality of life was enhanced as demonstrated by improvement on all indices of the SF-36, including vitality, bodily pain, role limitations caused by physical health, and social functioning (all P<.01). Alleviation of physical symptoms was revealed by a 28% reduction on the MSCL (P<.0001). Decreased psychological distress was indicated on the SCL-90-R by a 38% reduction on the Global Severity Index, a 44% reduction on the anxiety subscale, and a 34% reduction on the depression subscale (all P<.0001). One-year follow-up revealed maintenance of initial improvements on several outcome parameters. We conclude that a group mindfulness meditation training program can enhance functional status and well-being and reduce physical symptoms and psychological distress in a heterogeneous patient population and that the intervention may have long-term beneficial effects.

12614525

2002 J Altern Complement Med 8:6;719-30; discussion 731-5

Majumdar, M., Grossman, P., Dietz-Waschkowski, B., Kersig, S., and Walach, H.

OBJECTIVES: This exploratory study is the first systematic outcome evaluation to examine the effects of an 8-week meditation-based program in mindfulness in a German sample. DESIGN: Twenty-one (21) participants with chronic physical, psychologic, or psychosomatic illnesses were examined in a longitudinal pretest and post-treatment design with a 3-month follow-up. OUTCOME MEASURES: Both quantitative and qualitative data were gathered. Emotional and general physical well-being, sense of coherence, overall psychologic distress, and satisfaction with life were measured with standardized instruments. RESULTS: Overall, the interventions led to high levels of adherence to the meditation practice and satisfaction with the benefits of the course, as well as effective and lasting reductions of symptoms (especially in psychologic distress, well-being, and quality of life). Changes were of moderate-to-large effect sizes. Positive complementary effects with psychotherapy were also found. CONCLUSIONS: These findings warrant controlled studies to evaluate the efficacy and cost effectiveness of mindfulness-based stress reduction as an intervention for chronic physical and psychosomatic disorders in Germany.

11795623

2002 Altern Ther Health Med 8;1:60-2, 64-6

Roth, B. and Stanley, T. W.

CONTEXT: Research on mindfulness-based stress reduction (MBSR) has focused on measuring symptom reduction in middle-class and working-class populations. The present study examined inner-city patients' healthcare utilization before and after an MBSR intervention. OBJECTIVE: To determine whether completion of an MBSR program resulted in changes in healthcare utilization in an inner-city population. DESIGN: Medical chart review compared the number and diagnoses of health center visits during the year before patients entered the MBSR program with the year following completion of the program. SETTING: The Community Health Center in Meriden, Conn. PATIENTS: The chart review process examined healthcare utilization patterns for 73 patients: 54 who completed the MBSR program in Spanish and 19 who completed the program in English. The focus of this study is a subgroup of 47 patients for whom a complete year of data were available before and after the intervention. INTERVENTION: An 8-week course in MBSR. MAIN OUTCOME MEASURES: The number and diagnoses of patients' health center visits before and after completion of the MBSR program. RESULTS: A significant decrease in the number of chronic care visits was found among the 47 patients for whom complete data were available. The 36 patients who completed the Spanish courses demonstrated a significant decrease in total medical visits and chronic care visits. CONCLUSIONS: The results of this study suggest that MBSR may help contain healthcare costs by decreasing the number of visits made by inner-city patients to their primary care providers after completing the MBSR program.

9078521

1997 Nurse Pract 22;3:150-2, 154, 157 passim

Roth, B. and Creaser, T.

This article describes a bilingual mindfulness meditation-based stress reduction program in an inner-city setting. Mindfulness meditation is defined, and the practices of breathing meditation, eating meditation, walking meditation, and mindful yoga are described. Data analysis examined compliance, medical and psychologic symptom reduction, and changes in self-esteem, of English- and Spanish-speaking patients who completed the 8-week Stress Reduction and Relaxation Program at the Community Health Center in Meriden, Conn. Statistically significant decreases in medical and psychologic symptoms and improvement in self-esteem were found. Many program completers reported dramatic changes in attitudes, beliefs, habits, and behaviors. Despite the limitations of the research design, these findings suggest that a mindfulness meditation course can be an effective health care intervention when utilized by English- and Spanish-speaking patients in an inner-city community health center. The article includes a discussion of factors to be considered when establishing a mindfulness meditation-based stress reduction program in a health care setting.

12889548

2003 Holist Nurs Pract 17:4;201-8

Proulx, K.

Mindfulness-based stress reduction (MBSR) programs may mitigate the effects of stress and disease. This integrative review identified 21 clinical studies on MBSR interventions. Although preliminary findings suggest health enhancement from MBSR, controlled, randomized studies, the operationalization of constructs, and qualitative research are needed.

12424984

2002 Pediatr Nurs 28;5:487-90

Ott, M. J.

Complementary therapies are used in addition to conventional treatments; alternative therapies are generally used instead of conventional treatments. In the Five Domains of complementary and alternative therapies, patient education and cognitive-behavioral approaches are listed as mainstream interventions. Meditation is listed within the mind-body domain as a complementary intervention used to facilitate the mind's ability to affect bodily functions and symptoms.

12883106 
Alterations in brain and immune function produced by mindfulness meditation
2003  Psychosom Med  65:4;564-70
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., and Sheridan, J. F.
OBJECTIVE: The underlying changes in biological processes that are associated with reported changes in mental and physical health in response to meditation have not been systematically explored. We performed a randomized, controlled study on the effects on brain and immune function of a well-known and widely used 8-week clinical training program in mindfulness meditation applied in a work environment with healthy employees. METHODS: We measured brain electrical activity before and immediately after, and then 4 months after an 8-week training program in mindfulness meditation. Twenty-five subjects were tested in the meditation group. A wait-list control group (N = 16) was tested at the same points in time as the meditators. At the end of the 8-week period, subjects in both groups were vaccinated with influenza vaccine. RESULTS: We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine. CONCLUSIONS: These findings demonstrate that a short program in mindfulness meditation produces demonstrable effects on brain and immune function. These findings suggest that meditation may change brain and immune function in positive ways and underscore the need for additional research.

10652635

1999 Appl Psychophysiol Biofeedback 24;3:147-65

Dunn, B. R., Hartigan, J. A., and Mikulas, W. L.

Electroencephalographic (EEG) recordings from 19 scalp recording sites were used to differentiate among two posited unique forms of mediation, concentration and mindfulness, and a normal relaxation control condition. Analyzes of all traditional frequency bandwidth data (i.e., delta 1-3 Hz; theta, 4-7 Hz; alpha, 8-12 Hz; beta 1, 13-25 Hz; beta 2, 26-32 Hz) showed strong mean amplitude frequency differences between the two meditation conditions and relaxation over numerous cortical sites. Furthermore, significant differences were obtained between concentration and mindfulness states at all bandwidths. Taken together, our results suggest that concentration and mindfulness "meditations" may be unique forms of consciousness and are not merely degrees of a state of relaxation.

7776900

1995 Med Hypotheses 44;1:39-46

Massion, A. O., Teas, J., Hebert, J. R., Wertheimer, M. D., and Kabat-Zinn, J.

The objective of this study was to test the hypothesis that the regular practice of mindfulness meditation is associated with increased physiological levels of melatonin. Melatonin may be related to a variety of biologic functions important in maintaining health and preventing disease, including breast and prostate cancer. Previous studies have shown melatonin production is photosensitive and we suggest here that it also may be psychosensitive. A cross-sectional study of 12-hour (20:00-08:00) urinary 6-sulphatoxymelatonin was conducted from which we analyzed data from 8 women who regularly meditate (RM) and 8 women who do not meditate (NM). All samples were collected in the homes of study participants. Volunteers were recruited to provide 12-hour overnight samples of urine. All subjects collected the samples on one night during the same 1-week period. There was no explicit intervention. However, all RM were either graduates of, or teachers in, the University of Massachusetts Stress Reduction and Relaxation Program. The main outcome measure was the total excretion of urinary 6-sulphatoxymelatonin. Multiple linear regression (Proc GLM in SAS) was performed to test the effect of meditation (RM vs NM) on 6-sulphatoxymelatonin. The results of the study were that after controlling for the non-significant effect of menstrual period interval, we found an effect of meditation group (RM vs NM: b = 1.983; F = 6.78; p = 0.02) and age (for each integer year: b = 0.169; F = 8.41; p = 0.01). The conclusion is that study results are consistent with our hypothesis and indicate that melatonin might be a useful parameter in testing similar psycho-social interventions.(ABSTRACT TRUNCATED AT 250 WORDS)

6382145

1984 Percept Mot Skills 58:3;775-84

Brown, D., Forte, M., and Dysart, M.

Practitioners of the mindfulness form of Buddhist meditation were tested for visual sensitivity before and immediately after a 3-mo. retreat during which they practiced mindfulness meditation for 16 hr. each day. A control group composed of the staff at the retreat center was similarly tested. Visual sensitivity was defined in two ways: by a detection threshold based on the duration of simple light flashes and a discrimination threshold based on the interval between successive simple light flashes. All light flashes were presented tachistoscopically and were of fixed luminance. After the retreat, practitioners could detect shorter single-light flashes and required a shorter interval to differentiate between successive flashes correctly. The control group did not change on either measure. Phenomenological reports indicate that mindfulness practice enables practitioners to become aware of some of the usually preattentive processes involved in visual detection. The results support the statements found in Buddhist texts on meditation concerning the changes in perception encountered during the practice of mindfulness.

6382144

1984 Percept Mot Skills 58:3;727-33

Brown, D., Forte, M., and Dysart, M.

Tachistoscopic presentation of light flashes was used to test for differences in visual sensitivity among 3 groups of practitioners of Buddhist mindfulness meditation and non-meditator-controls. Meditation practitioners were able to detect light flashes of shorter duration than the non-meditators. There were no differences among the meditator groups. There were no differences among the groups in ability to discriminate between closely spaced successive light flashes. The lower detection threshold for single light flashes for the meditators may reflect an enduring increase in sensitivity, perhaps the long-term effects of the practice of mindfulness meditation on certain perceptual habit patterns. The lack of significant differences in the discrimination of successive light flashes probably reflects the resistance of other perceptual habit patterns to modification. The results support the statements found in Buddhist texts on meditation concerning the changes in perception encountered during the practice of mindfulness.

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15154154
Mindfulness meditation to reduce symptoms after organ transplant: a pilot study.
2004 Altern Ther Health Med 10(3):58-66
Gross CR, Kreitzer MJ, Russas V, Treesak C, Frazier PA, Hertz MI.
CONTEXT: Solid organ transplant patients require life-long immune suppression
that can produce distressing side effects and complications. OBJECTIVE: To
evaluate the potential of Mindfulness-Based Stress Reduction (MBSR) to reduce
symptoms of depression, anxiety, and sleep disturbance and improve quality of
life after solid organ transplantation. DESIGN: Longitudinal with evaluations at
baseline, postcourse and 3-month follow-up. PARTICIPANTS AND SETTING: Kidney,
lung, or pancreas transplant recipients (N = 20), aged 35 to 59 years, living in
the community. INTERVENTION: An MBSR class (2.5 hours weekly, for 8 weeks),
modeled after the program of Jon Kabat-Zinn. Home practice (goal: 45 minutes, 5
days weekly) was monitored. Main outcome measures: Self-report scales for
depression (CES-D), anxiety (STAI-Y1), and sleep dysfunction (PSQI). RESULTS:
Nineteen participants completed the course. Findings suggest improvement from
baseline symptom scores for depression (P = .006) and sleep (P = .011) at the
completion of the MBSR program. At 3 months, improvement in sleep continued (P =
.002), and a significant improvement in anxiety scores was seen (P = .043);
scores for both symptoms demonstrated a linear trend and dose-response
relationship with practice time. In contrast, depression scores showed a
quadratic trend, and at 3 months were no longer different from baseline. A
composite symptom measure was significantly improved at 3-month follow-up (P =
.007). Global and health-related quality of life ratings were not improved.
Effects of group support and instructor attention were not controlled, and
sample size and follow-up time were limited. A randomized trial to overcome
these shortcomings should be done, as symptom distress in transplant recipients
appears responsive to MBSR.

3897551

1985 J Behav Med 8;2:163-90

Kabat-Zinn, J., Lipworth, L., and Burney, R.

Ninety chronic pain patients were trained in mindfulness meditation in a 10-week Stress Reduction and Relaxation Program. Statistically significant reductions were observed in measures of present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptomatology, including anxiety and depression. Pain-related drug utilization decreased and activity levels and feelings of self-esteem increased. Improvement appeared to be independent of gender, source of referral, and type of pain. A comparison group of pain patients did not show significant improvement on these measures after traditional treatment protocols. At follow-up, the improvements observed during the meditation training were maintained up to 15 months post-meditation training for all measures except present-moment pain. The majority of subjects reported continued high compliance with the meditation practice as part of their daily lives. The relationship of mindfulness meditation to other psychological methods for chronic pain control is discussed.

14749092
Mindfulness-based stress reduction in relation to quality of life, mood,
symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate
(DHEAS) and melatonin in breast and prostate cancer outpatients.
2004 Psychoneuroendocrinology 29(4):448-74
Carlson LE, Speca M, Patel KD, Goodey E.
OBJECTIVES: This study investigated the relationships between a
mindfulness-based stress reduction meditation program for early stage breast and
prostate cancer patients and quality of life, mood states, stress symptoms, and
levels of cortisol, dehydroepiandrosterone-sulfate (DHEAS) and melatonin.
METHODS: Fifty-nine patients with breast cancer and 10 with prostate cancer
enrolled in an eight-week Mindfulness-Based Stress Reduction (MBSR) program that
incorporated relaxation, meditation, gentle yoga, and daily home practice.
Demographic and health behavior variables, quality of life, mood, stress, and
the hormone measures of salivary cortisol (assessed three times/day), plasma
DHEAS, and salivary melatonin were assessed pre- and post-intervention. RESULTS:
Fifty-eight and 42 patients were assessed pre- and post-intervention,
respectively. Significant improvements were seen in overall quality of life,
symptoms of stress, and sleep quality, but these improvements were not
significantly correlated with the degree of program attendance or minutes of
home practice. No significant improvements were seen in mood disturbance.
Improvements in quality of life were associated with decreases in afternoon
cortisol levels, but not with morning or evening levels. Changes in stress
symptoms or mood were not related to changes in hormone levels. Approximately
40% of the sample demonstrated abnormal cortisol secretion patterns both pre-
and post-intervention, but within that group patterns shifted from
"inverted-V-shaped" patterns towards more "V-shaped" patterns of secretion. No
overall changes in DHEAS or melatonin were found, but nonsignificant shifts in
DHEAS patterns were consistent with healthier profiles for both men and women.
CONCLUSIONS: MBSR program enrollment was associated with enhanced quality of
life and decreased stress symptoms in breast and prostate cancer patients, and
resulted in possibly beneficial changes in hypothalamic-pituitary-adrenal (HPA)
axis functioning. These pilot data represent a preliminary investigation of the
relationships between MBSR program participation and hormone levels,
highlighting the need for better-controlled studies in this area.
 

12883107

2003 Psychosom Med 65:4;571-81

Carlson, L. E., Speca, M., Patel, K. D., and Goodey, E.

OBJECTIVES: This study investigated the relationships between a mindfulness-based stress reduction meditation program for early stage breast and prostate cancer patients and quality of life, mood states, stress symptoms, lymphocyte counts, and cytokine production. METHODS: Forty-nine patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program that incorporated relaxation, meditation, gentle yoga, and daily home practice. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-gamma, IL-4, and IL-10 were assessed pre- and postintervention. RESULTS: Fifty-nine and 42 patients were assessed pre- and postintervention, respectively. Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. Although there were no significant changes in the overall number of lymphocytes or cell subsets, T cell production of IL-4 increased and IFN-gamma decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile. CONCLUSIONS: MBSR participation was associated with enhanced quality of life and decreased stress symptoms in breast and prostate cancer patients. This study is also the first to show changes in cancer-related cytokine production associated with program participation.

14629846
Psycho-endocrine-immune response to mindfulness-based stress reduction in
individuals infected with the human immunodeficiency virus: a quasiexperimental
study
2003 J Altern Complement Med 9(5):683-94
Robinson FP, Mathews HL, Witek-Janusek L.
OBJECTIVES: The purpose of this study was to examine the effects of a
structured, 8-week, Mindfulness-Based Stress Reduction (MBSR) program on
perceived stress, mood, endocrine function, immunity, and functional health
outcomes in individuals infected with the human immunodeficiency virus (HIV).
DESIGN: This study used a quasiexperimental, nonrandomized design. METHODS:
Subjects were specifically recruited (nonrandom) for intervention (MBSR) or
comparison group. Data were collected at pretest and post-test in the MBSR group
and at matched times in the comparison group. t Tests where performed to
determine within-group changes and between-group differences. RESULTS: Natural
killer cell activity and number increased significantly in the MBSR group
compared to the comparison group. No significant changes or differences were
found for psychological, endocrine, or functional health variables. CONCLUSIONS:
These results provide tentative evidence that MBSR may assist in improving
immunity in individuals infected with HIV.
 

12505559

2003 J Psychosom Res 54;1:85-91

Shapiro, S. L., Bootzin, R. R., Figueredo, A. J., Lopez, A. M., and Schwartz, G. E.

OBJECTIVE: The diagnosis of breast cancer, the most common type of cancer among American women, elicits greater distress than any other diagnosis regardless of prognosis. Therefore, the present study examined the efficacy of a stress reduction intervention for women with breast cancer. METHODS: As part of a larger, randomized, controlled study of the effects on measures of stress of a mindfulness-based stress reduction (MBSR) intervention for women with breast cancer, the current analyses examined the effects on sleep complaints. RESULTS: Analyses of the data indicated that both MBSR and a free choice (FC) control condition produced significant improvement on daily diary sleep quality measures though neither showed significant improvement on sleep-efficiency. Participants in the MBSR who reported greater mindfulness practice improved significantly more on the sleep quality measure most strongly associated with distress. CONCLUSION: MBSR appears to be a promising intervention to improve the quality of sleep in woman with breast cancer whose sleep complaints are due to stress.

11305069

2001 Support Care Cancer 9:2;112-23

Carlson, L. E., Ursuliak, Z., Goodey, E., Angen, M., and Speca, M.

The goals of this work were to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients immediately after and 6 months after program completion. A convenience sample of eligible cancer patients were enrolled after they had given informed consent. All patients completed the Profile of Mood States (POMS) and Symptoms of Stress Inventory (SOSI) both before and after the intervention and 6 months later. The intervention consisted of a mindfulness meditation group lasting 1.5 h each week for 7 weeks, plus daily home meditation practice. A total of 89 patients, average age 51, provided pre-intervention data. Eighty patients provided post-intervention data, and 54 completed the 6-month follow-up The participants were heterogeneous with respect to type and stage of cancer. Patients' scores decreased significantly from before to after the intervention on the POMS and SOSI total scores and most subscales, indicating less mood disturbance and fewer symptoms of stress, and these improvements were maintained at the 6-month follow-up. More advanced stages of cancer were associated with less initial mood disturbance, while more home practice and higher initial POMS scores predicted improvements on the POMS between the pre- and post-intervention scores. Female gender and more education were associated with higher initial SOSI scores, and improvements on the SOSI were predicted by more education and greater initial mood disturbance. This program was effective in decreasing mood disturbance and stress symptoms for up to 6 months in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and educational background, and with disparate ages.

11020090

2000 Psychosom Med 62:5;613-22

Speca, M., Carlson, L. E., Goodey, E., and Angen, M.

OBJECTIVE: The objective of this study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients. METHODS: A randomized, wait-list controlled design was used. A convenience sample of eligible cancer patients enrolled after giving informed consent and were randomly assigned to either an immediate treatment condition or a wait-list control condition. Patients completed the Profile of Mood States and the Symptoms of Stress Inventory both before and after the intervention. The intervention consisted of a weekly meditation group lasting 1.5 hours for 7 weeks plus home meditation practice. RESULTS: Ninety patients (mean age, 51 years) completed the study. The group was heterogeneous in type and stage of cancer. Patients' mean preintervention scores on dependent measures were equivalent between groups. After the intervention, patients in the treatment group had significantly lower scores on Total Mood Disturbance and subscales of Depression, Anxiety, Anger, and Confusion and more Vigor than control subjects. The treatment group also had fewer overall Symptoms of Stress; fewer Cardiopulmonary and Gastrointestinal symptoms; less Emotional Irritability, Depression, and Cognitive Disorganization; and fewer Habitual Patterns of stress. Overall reduction in Total Mood Disturbance was 65%, with a 31% reduction in Symptoms of Stress. CONCLUSIONS: This program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages. cancer, stress, mood, intervention, mindfulness.

11072058

2000 Gen Hosp Psychiatry 22;6:425-31

Mills, N. and Allen, J.

This study investigated the effectiveness of a short course of mindfulness of movement to help with symptom management in eight people with multiple sclerosis. Progress was compared to a control group who were asked to continue with their current care. Each participant received six individual one-to-one sessions of instruction. They were also provided with audio and videotape aides. Each participant was assessed on a test of balance, pre- and post-intervention, and at 3-month follow-up. All participants completed a rating of change of 22 symptoms relevant to multiple sclerosis. A close relative or friend was also asked to assess independently the degree of change. The mindfulness group reported improvement over a broad range of symptoms. This was verified by the relatives' independent rating and maintained at 3 month follow-up. The control group showed no improvement but instead tended towards a deterioration on many of the items. The physical assessment of balance also showed a significant improvement for the mindfulness group. This improvement was maintained at 3 month follow-up. In conclusion, training in mindfulness of movement appeared to result in improved symptom management for this group of people with multiple sclerosis. This was a pilot study, using small numbers, so the results need to be treated with caution. Several improvements to the experimental design are suggested. The role of individual therapeutic ingredients is discussed.

9773769

Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA)

1998 Psychosom Med 60;5:625-32

Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M. J., Cropley, T. G., Hosmer, D., and Bernhard, J. D.

OBJECTIVE: This study tests the hypothesis that stress reduction methods based on mindfulness meditation can positively influence the rate at which psoriasis clears in patients undergoing phototherapy or photochemotherapy treatment. METHODS: Thirty-seven patients with psoriasis about to undergo ultraviolet phototherapy (UVB) or photochemotherapy (PUVA) were randomly assigned to one of two conditions: a mindfulness meditation-based stress reduction intervention guided by audiotaped instructions during light treatments, or a control condition consisting of the light treatments alone with no taped instructions. Psoriasis status was assessed in three ways: direct inspection by unblinded clinic nurses; direct inspection by physicians blinded to the patient's study condition (tape or no-tape); and blinded physician evaluation of photographs of psoriasis lesions. Four sequential indicators of skin status were monitored during the study: a First Response Point, a Turning Point, a Halfway Point, and a Clearing Point. RESULTS: Cox-proportional hazards regression analysis showed that subjects in the tape groups reached the Halfway Point (p = .013) and the Clearing Point (p = .033) significantly more rapidly than those in the no-tape condition, for both UVB and PUVA treatments. CONCLUSIONS: A brief mindfulness meditation-based stress reduction intervention delivered by audiotape during ultraviolet light therapy can increase the rate of resolution of psoriatic lesions in patients with psoriasis.

9682514

1998 Altern Ther Health Med 4;2:67-70

Singh, B. B., Berman, B. M., Hadhazy, V. A., and Creamer, P.

BACKGROUND: Fibromyalgia is a syndrome characterized by widespread musculoskeletal pain and multiple tender points as well as high levels of self-reported disability and poor quality of life. OBJECTIVES: In this pilot study, a mind-body approach (cognitive-behavioral therapy) was tested that has been successful in treating chronic back pain patients to determine whether it would improve function, decrease perceived pain, and improve mood state for fibromyalgia patients. PARTICIPANTS: 28 patients recruited from the greater Baltimore area. INTERVENTION: Eight weekly sessions, 2 1/2 hours each, with three components: an educational component focusing on the mind-body connection, a portion focusing on relaxation response mechanisms (primarily mindfulness meditation techniques), and a qigong movement therapy session. MAIN OUTCOME MEASURES: Data collection instruments were the Fibromyalgia Impact Questionnaire, the Health Assessment Questionnaire, the Beck Depression Inventory, the Coping Strategies Questionnaire, the helplessness subscale of the Arthritis Attitudes Index, the Medical Outcomes Study Short Form General Health Survey, and a double-anchored 100-mm visual analog scale to assess sleep. RESULTS: Twenty patients completed the study. Standard outcome measures showed significant reduction in pain, fatigue, and sleeplessness; and improved function, mood state, and general health following an 8-week intervention. CONCLUSION: A mind-body intervention including patient education, meditation techniques, and movement therapy appears to be an effective adjunctive therapy for patients with fibromyalgia.

8704849

1996 J Wound Ostomy Continence Nurs 23;1:38-45

Trunnell, E. P.

Persons with a stoma must contend not only with the immediate physical changes produced by the operation but also with psychologic adjustments, changes in body image, changes in self-concept, and the chronic stress of stoma care and physical functioning. Mindfulness training can enable these persons to make the necessary adjustments in a more realized and conscious manner. The practice of mindfulness training has been demonstrated to be effective in dealing with clinical and psychologic problems. Mindfulness is defined as being fully awake and is characterized as being nonjudging, having a beginner's mind, being trusting, nonstriving, accepting, and letting go. Mindfulness training is described, and roadblocks to the practice of mindfulness are discussed and exemplified. Resources on the practice of mindfulness and applications to persons with ostomies are provided. Mindfulness training is proposed as an adjunct to patient education or support groups.

12392366

2002 Chang Gung Med J 25;8:538-41

Sun, T. F., Kuo, C. C., and Chiu, N. M.

In the West, the use of the methods of alternative medicine, including meditation, has been on the rise. In the US, Kabat-Zinn and associates have pioneered the extensive use of mindfulness meditation (MM) for the treatment of people facing pain and illness. Among the essentials of MM is the observation of bodily sensations, including pain. In Taiwan, despite the deep cultural roots of meditation, its therapeutic use has received little attention from institutionalized medicine. We report on the case of a man who was prone to developing severe headaches due to activities requiring extreme concentration. He learned to control his pain and discomfort through mindfulness meditation, although this practice in fact induced headaches initially. It is suggested that training in MM may be a medically superior and cost-effective alternative to pain medication for the control of headaches with no underlying organic causes in highly motivated patients.

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9097338

1997 Psychother Psychosom 66;2:97-106

Astin, J. A.

BACKGROUND: This study examined the effects of an 8-week stress reduction program based on training in mindfulness meditation. Previous research efforts suggesting this program may be beneficial in terms of reducing stress-related symptomatology and helping patients cope with chronic pain have been limited by a lack of adequate comparison control group. METHODS: Twenty-eight individuals who volunteered to participate in the present study were randomized into either an experimental group or a nonintervention control group. RESULTS: Following participation, experimental subjects, when compared with controls, evidenced significantly greater changes in terms of: (1) reductions in overall psychological symptomatology; (2) increase in overall domain-specific sense of control and utilization of an accepting or yielding mode of control in their lives, and (3) higher scores on a measure of spiritual experiences. CONCLUSIONS: The techniques of mindfulness meditation, with their emphasis on developing detached observation and awareness of the contents of consciousness, may represent a powerful cognitive behavioral coping strategy for transforming the ways in which we respond to life events. They may also have potential for relapse prevention in affective disorders.

3881049

1985 Am J Psychiatry 142:1;1-8

Kutz, I., Borysenko, J. Z., and Benson, H.

A framework for the integration of meditation and psychotherapy is presented through a consideration of the psychobiological nature of meditation (the relaxation response) and discussion of a traditional meditation practice (mindfulness meditation) as an effective cognitive technique for the development of self-awareness. The mechanisms by which the emotional and cognitive changes of meditation can be of therapeutic value are explored and the synergistic advantages of the combination of psychotherapy and meditation are discussed.

11802836

2001 Br J Med Psychol 74 Part 2:197-212

Mason, O. and Hargreaves, I.

Psychotherapeutic interventions containing training in mindfulness meditation have been shown to help participants with a variety of somatic and psychological conditions. Mindfulness-based cognitive therapy (MBCT) is a meditation-based psychotherapeutic intervention designed to help reduce the risk of relapse of recurrent depression. There is encouraging early evidence from multi-centre randomized controlled trials. However, little is known of the process by which MBCT may bring therapeutic benefits. This study set out to explore participants' accounts of MBCT in the mental-health context. Seven participants were interviewed in two phases. Interview data from four participants were obtained in the weeks following MBCT. Grounded theory techniques were used to identify several categories that combine to describe the ways in which mental-health difficulties arose as well as their experiences of MBCT. Three further participants who have continued to practise MBCT were interviewed so as to further validate, elucidate and extend these categories. The theory suggested that the preconceptions and expectations of therapy are important influences on later experiences of MBCT. Important areas of therapeutic change ('coming to terms') were identified, including the development of mindfulness skills, an attitude of acceptance and 'living in the moment'. The development of mindfulness skills was seen to hold a key role in the development of change. Generalization of these skills to everyday life was seen as important, and several ways in which this happened, including the use of breathing spaces, were discussed. The study emphasized the role of continued skills practice for participants' therapeutic gains. In addition, several of the concepts and categories offered support to cognitive accounts of mood disorder and the role of MBCT in reducing relapse.

10965637

2000 J Consult Clin Psychol 68;4:615-23

Teasdale, J. D., Segal, Z. V., Williams, J. M., Ridgeway, V. A., Soulsby, J. M., and Lau, M. A.

This study evaluated mindfulness-based cognitive therapy (MBCT), a group intervention designed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence. Recovered recurrently depressed patients (n = 145) were randomized to continue with treatment as usual or, in addition, to receive MBCT. Relapse/recurrence to major depression was assessed over a 60-week study period. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.

7649463

1995 Gen Hosp Psychiatry 17;3:192-200

Miller, J. J., Fletcher, K., and Kabat-Zinn, J.

A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.

1609875

1992 Am J Psychiatry 149;7:936-43

Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., Lenderking, W. R., and Santorelli, S. F.

OBJECTIVE: This study was designed to determine the effectiveness of a group stress reduction program based on mindfulness meditation for patients with anxiety disorders. METHOD: The 22 study participants were screened with a structured clinical interview and found to meet the DSM-III-R criteria for generalized anxiety disorder or panic disorder with or without agoraphobia. Assessments, including self-ratings and therapists' ratings, were obtained weekly before and during the meditation-based stress reduction and relaxation program and monthly during the 3-month follow-up period. RESULTS: Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects--changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A comparison of the study subjects with a group of nonstudy participants in the program who met the initial screening criteria for entry into the study showed that both groups achieved similar reductions in anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting generalizability of the study findings. CONCLUSIONS: A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, panic disorder, or panic disorder with agoraphobia.

11180145

2001 J Clin Psychol 57;2:169-81

Wolfsdorf, B. A. and Zlotnick, C.

Affect dysregulation is pervasive among women with histories of childhood sexual abuse. It is an important aspect of the clinical presentation of posttraumatic stress disorder (PTSD), a disorder that frequently characterizes survivors of childhood abuse. Based on distinctions between approach and avoidance orientations to coping, there is controversy regarding whether initial treatment for trauma survivors should employ an exposure-based approach to increase affect or an affect-management approach to reduce it. In this article, we review theoretical and empirical literature regarding affect dysregulation and its relations with childhood sexual abuse and PTSD. We then describe a new affect-management group for adult survivors of childhood sexual abuse that is based on a stage approach to the treatment of trauma. This group emphasizes skill acquisition, symptom reduction, and patient stabilization. Affect-management strategies such as mindfulness, crisis planning, and challenging distorted thinking are presented to patients. Preliminary research findings support the use of this treatment.

12242579

2002 Eur Arch Psychiatry Clin Neurosci 252;4:177-84

Hesslinger, B., Tebartz van Elst, L., Nyberg, E., Dykierek, P., Richter, H., Berner, M., and Ebert, D.

In clinical practice many adult patients with attention deficit hyperactivity disorder (ADHD) ask for an additional psychotherapeutic intervention besides the medical therapy. In this paper we present a structured skill training program particularly tailored for adult patients with ADHD. The program is based on the principles of cognitive-behavioral treatment for borderline personality disorder developed by M. Linehan. It was modified to suit the special needs of adult patients with ADHD. In this exploratory pilot study we tested this program in a group setting. The following elements were presented: neurobiology of ADHD, mindfulness, chaos and control, behavior analysis, emotion regulation, depression, medication in ADHD, impulse control, stress management, dependency, ADHD in relationship and self respect. In an open study design patients were assessed clinically using psychometric scales (Attention Deficit Hyperactivity Disorder Checklist according to DSM-IV, 16 items of the SCL-90-R, Beck-Depression Inventory, visual analogue scale) prior to and following group therapy. This treatment resulted in positive outcomes in that patients improved on all psychometric scales.

12192632

2002 Dtsch Med Wochenschr 127;34-35:1742-7

Michalsen, A., Richarz, B., Reichardt, H., Spahn, G., Konietzko, N., Dobos, G. J., and Reichart, H.

BACKGROUND AND OBJECTIVE: Smoking prevalence in Germany remains high instead of public information and education. Smoke free hospitals are propagated, but frequently the smoking prevalence in hospital staff is even higher than in the general population. The objectives of the study were to determine the prevalence of smoking amongst hospital employees in a German teaching hospital and subsequently to promote and optimise smoking cessation within controlled trial with additional evaluation of mindfulness based stress reduction, supported by a common workplace action. PATIENTS AND METHODS: A hospital survey was carried out by anonymous questionnaires. Participation in a physician-supervised smoking cessation program with nicotine replacement, brief intervention and, additionally, in a 20-hour stress reduction program over 8 weeks (group B) was offered to all smokers. Primary outcomes were abstinence rates at 3 months, secondary endpoints included abstinence rates at 6 months, cigarette consumption in smokers and expiratory CO-concentration. RESULTS: Out of 345 employees 296 (86 %) revealed their smoking status, 140 were smokers (47,3 %). 116 of 140 smokers agreed with participation in a smoking cessation program. 53 subjects participated additionally in the stress reduction groups (Group B), 63 subjects wished no additional stress reduction (Group A). Abstinence rates at 3 and 6 months were 38,2 % and 29,7 % for all subjects. Participants with stress reduction showed non-significant higher abstinence rates (3 months: A: 35 % vs. B: 42 % and 6 months: A: 20 % vs. B: 41,2 %), a significant lower CO-concentration and a lower smoking intensity in recurrent smokers. CONCLUSION: With a common work place action a substantial part of employees quits smoking. Thus, the study provides support for the active promotion of physician-supervised smoking cessation programs among hospital employees. Supportive mindfulness-based stress reduction may enhance smoking cessation, yet has to be further tested in larger randomised controlled trials.

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15295915
Mindfulness meditation: a path of transformation & healing.
2004 J Psychosoc Nurs Ment Health Serv 42(7):22-9
Ott MJ.
As nurses, we have the unique privilege of witnessing and nurturing the healing
process of the whole person--mind, body, and spirit. Teaching mindfulness
meditation is a nursing intervention that can foster healing. The consistent
practice of mindfulness meditation has been shown to decrease the subjective
experience of pain and stress in a variety of research settings. Formal and
informal daily practice fosters development of a profound inner calmness and
nonreactivity of the mind, allowing individuals to face, and even embrace, all
aspects of daily life, regardless of circumstances. By emphasizing being, not
doing, mindfulness meditation provides a way through suffering for patients,
families, and staff. This practice allows individuals to become compassionate
witnesses to their own experiences, to avoid making premature decisions, and to
be open to new possibilities, transformation, and healing.

15303583
Does mindfulness decrease stress and foster empathy among nursing students?
2004 J Nurs Educ 43(7):305-12
Beddoe AE, Murphy SO.
This pilot study of baccalaureate nursing students explored the effects of an
8-week mindfulness-based stress reduction (MBSR) course on stress and empathy.
The course was intended to provide students with tools to cope with personal and
professional stress and to foster empathy through intrapersonal knowing. A
convenience sample of 16 students participated in the course, used guided
meditation audiotapes at home, and completed journal assignments. Stress and
empathy were measured using paired sample t tests. Participation in the
intervention significantly reduced students' anxiety (p > .05). Favorable trends
were observed in a number of stress dimensions including attitude, time
pressure, and total stress. Two dimensions of empathy--personal distress and
fantasy--also demonstrated favorable downward trends. Regular home meditation
was correlated with additional benefit. Participants reported using meditation
in daily life and experiencing greater well-being and improved coping skills as
a result of the program. Findings suggest that being mindful may also decrease
tendencies to take on others' negative emotions. Coping with stress and
fostering the affective domain are important facets of nursing education that
may be facilitated by mindfulness training.
 

10478689

1999 JAMA 282;9:833-9

Epstein, R. M.

Mindful practitioners attend in a nonjudgmental way to their own physical and mental processes during ordinary, everyday tasks. This critical self-reflection enables physicians to listen attentively to patients' distress, recognize their own errors, refine their technical skills, make evidence-based decisions, and clarify their values so that they can act with compassion, technical competence, presence, and insight. Mindfulness informs all types of professionally relevant knowledge, including propositional facts, personal experiences, processes, and know-how, each of which may be tacit or explicit. Explicit knowledge is readily taught, accessible to awareness, quantifiable and easily translated into evidence-based guidelines. Tacit knowledge is usually learned during observation and practice, includes prior experiences, theories-in-action, and deeply held values, and is usually applied more inductively. Mindful practitioners use a variety of means to enhance their ability to engage in moment-to-moment self-monitoring, bring to consciousness their tacit personal knowledge and deeply held values, use peripheral vision and subsidiary awareness to become aware of new information and perspectives, and adopt curiosity in both ordinary and novel situations. In contrast, mindlessness may account for some deviations from professionalism and errors in judgment and technique. Although mindfulness cannot be taught explicitly, it can be modeled by mentors and cultivated in learners. As a link between relationship-centered care and evidence-based medicine, mindfulness should be considered a characteristic of good clinical practice.

10219225

1999 Acad Med 74;4:420-4

Connelly, J.

Medical practice is beset by interruptions, contests for the attention of the physician, and urgent demands that diminish the attentiveness required for the humanistic care of patients. This essay discusses skills for "being in the present moment" that can help doctors to overcome distractedness. Because of some striking similarities between the experience of reading poetry and the attentiveness required of medicine, the author uses 19th- and 20th-century American poetry to illustrate the state of mindfulness and "being in the moment," and suggests the helpfulness of poetry in developing these skills in physicians. Applying these skills in everyday practice rewards the physician with renewed energy, a fresh perspective, and increased strength while preventing the stress and harm caused by a distracted or inattentive practice.

10326854

1999 Am J Surg 177;4:331-6

Cauraugh, J. H., Martin, M., and Martin, K. K.

BACKGROUND: This work is part of an ongoing effort to introduce an innovative medical teaching technique to assist the efficient acquisition of surgical hand skills required to perform an inguinal hernia repair with a McVay technique. The purpose was to determine the effect of expert cognitive modeling, auditory elaboration, and split-screen video analysis on the surgical hand movements required while performing inguinal hernia surgery on cadavers. PURPOSE: Six surgical residents were videotaped performing a McVay procedure inguinal hernia in a pretest-posttest control group design. The experimental group received expert cognitive modeling, auditory elaboration, and split-screen analysis after the pretest. RESULTS: A distinct advantage for surgical instrument control and manipulation was found for the experimental group on the posttest surgeries. Less time was required to perform the operation, and more purposeful movements were exhibited by the experimental group. CONCLUSION: The treatment condition favored mindfulness learning of the McVay technique for an inguinal hernia repair.

9891256

1998 J Behav Med 21;6:581-99

Shapiro, S. L., Schwartz, G. E., and Bonner, G.

The inability to cope successfully with the enormous stress of medical education may lead to a cascade of consequences at both a personal and professional level. The present study examined the short-term effects of an 8-week meditation-based stress reduction intervention on premedical and medical students using a well-controlled statistical design. Findings indicate that participation in the intervention can effectively (1) reduce self-reported state and trait anxiety, (2) reduce reports of overall psychological distress including depression, (3) increase scores on overall empathy levels, and (4) increase scores on a measure of spiritual experiences assessed at termination of intervention. These results (5) replicated in the wait-list control group, (6) held across different experiments, and (7) were observed during the exam period. Future research should address potential long-term effects of mindfulness training for medical and premedical students.