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Research Notes: Mindfulness Training for Prader-Willi Syndrome (PWS)See also: Research by Jon Kabat-Zinn and others has shown that mindfulness training can provide significant benefit for those with chronic pain conditions, including significant reductions in the amount of perceived pain. That suggests that mindfulness training might also be helpful for the chronic hunger often experienced by those with PWS. Mindfulness training has also been shown to be beneficial for anxiety and mood disorders (also common in PWS). Support Care Cancer. 2007 Jul 5. GOALS OF WORK: The aim of this study was to compare a mindfulness-based stress reduction (MBSR) program and a healing through the creative arts (HA) program on measures of post-traumatic growth (PTGI-R), spirituality (FACIT-Sp), stress (SOSI), and mood disturbance (POMS) in cancer patients. MATERIALS AND METHODS: A sample of cancer outpatients (MBSR, n = 60; HA, n = 44) with a variety of diagnoses chose to attend either an 8-week MBSR program or a 6-week HA program and were assessed pre- and post-intervention. The majority of participants were female, married, and had breast cancer. MAIN RESULTS: Repeated measures analysis of variance indicated that participants in both groups improved significantly over time on overall post-traumatic growth (p = 0.015). Participants in the MBSR group improved on measures of spirituality more than those in the HA group (p = 0.029). Participants in the MBSR group also showed more improvement than those in HA on measures of anxiety (POMS, p = 0.038), anger (POMS, p = 0.004), overall stress symptoms (SOSI, p = 0.041), and mood disturbance (POMS, p = 0.023). Several main effects of time were also observed in both groups. These results were found despite attrition in both groups. CONCLUSIONS: Both programs may improve facilitation of positive growth after traumatic life experiences for those who choose to participate. MBSR may be more helpful than HA in enhancing spirituality and reducing stress, depression, and anger. J Trauma Stress. 2007 Jun. The present study evaluated whether Posttraumatic Stress Disorder (PTSD) symptom severity was associated with participation and treatment outcomes comparing a Vipassana meditation course to treatment as usual in an incarcerated sample. This study utilizes secondary data. The original study demonstrated that Vipassana meditation is associated with reductions in substance use. The present study found that PTSD symptom severity did not differ significantly between those who did and did not volunteer to take the course. Participation in the Vipassana course was associated with significantly greater reductions in substance use than treatment as usual, regardless of PTSD symptom severity levels. These results suggest that Vipassana meditation is worthy of further study for those with comorbid PTSD and substance use problems. Brain Behav Immun. 2007 May 21. OBJECTIVES: This study investigated the ongoing effects of participation in a mindfulness-based stress reduction (MBSR) program on quality of life (QL), symptoms of stress, mood and endocrine, immune and autonomic parameters in early stage breast and prostate cancer patients. METHODS: Forty-nine patients with breast cancer and 10 with prostate cancer enrolled in an eight-week MBSR program that incorporated relaxation, meditation, gentle yoga and daily home practice. Demographic and health behaviors, QL, mood, stress symptoms, salivary cortisol levels, immune cell counts, intracellular cytokine production, blood pressure (BP) and heart rate (HR) were assessed pre- and post-intervention, and at 6- and 12-month follow-up. RESULTS: Fifty-nine, 51, 47 and 41 patients were assessed pre- and post-intervention and at 6- and 12-month follow-up, respectively, although not all participants provided data on all outcomes at each time point. Linear mixed modeling showed significant improvements in overall symptoms of stress which were maintained over the follow-up period. Cortisol levels decreased systematically over the course of the follow-up. Immune patterns over the year supported a continued reduction in Th1 (pro-inflammatory) cytokines. Systolic blood pressure (SBP) decreased from pre- to post-intervention and HR was positively associated with self-reported symptoms of stress. CONCLUSIONS: MBSR program participation was associated with enhanced quality of life and decreased stress symptoms, altered cortisol and immune patterns consistent with less stress and mood disturbance, and decreased blood pressure. These pilot data represent a preliminary investigation of the longer-term relationships between MBSR program participation and a range of potentially important biomarkers. Can J Psychiatry. 2007 Apr. OBJECTIVE: To review the impact of mindfulness-based stress reduction (MBSR) on symptoms of anxiety and depression in a range of clinical populations. METHOD: Our review included any study that was published in a peer-reviewed journal, used a control group, and reported outcomes related to changes in depression and anxiety. We extracted the following key variables from each of the 15 studies identified: anxiety or depression outcomes after the MBSR program, measurement of compliance with MBSR instructions, type of control group included, type of clinical population studied, and length of follow-up. We also summarized modifications to the MBSR program. RESULTS: Measures of depression and anxiety were included as outcome variables for a broad range of medical and emotional disorders. Evidence for a beneficial effect of MBSR on depression and anxiety was equivocal. When active control groups were used, MBSR did not show an effect on depression and anxiety. Adherence to the MBSR program was infrequently assessed. Where it was assessed, the relation between practising mindfulness and changes in depression and anxiety was equivocal. CONCLUSIONS: MBSR does not have a reliable effect on depression and anxiety. J Psychosom Res. 2007 Mar. OBJECTIVE: To investigate the effect of mindfulness training on pain tolerance, psychological well-being, physiological activity, and the acquisition of mindfulness skills. METHODS: Forty-two asymptomatic University students participated in a randomized, single-blind, active control pilot study. Participants in the experimental condition were offered six (1-h) mindfulness sessions; control participants were offered two (1-h) Guided Visual Imagery sessions. Both groups were provided with practice CDs and encouraged to practice daily. Pre-post pain tolerance (cold pressor test), mood, blood pressure, pulse, and mindfulness skills were obtained. RESULTS: Pain tolerance significantly increased in the mindfulness condition only. There was a strong trend indicating that mindfulness skills increased in the mindfulness condition, but this was not related to improved pain tolerance. Diastolic blood pressure significantly decreased in both conditions. CONCLUSION: Mindfulness training did increase pain tolerance, but this was not related to the acquisition of mindfulness skills. Arthritis Rheum. 2007 Feb 15. OBJECTIVE: Depressive symptoms are common among patients with fibromyalgia, and behavioral intervention has been recommended as a major treatment component for this illness. The objective of this study was to test the effects of the Mindfulness-Based Stress Reduction (MBSR) intervention on depressive symptoms in patients with fibromyalgia. METHODS: This randomized controlled trial examined effects of the 8-week MBSR intervention on depressive symptoms in 91 women with fibromyalgia who were randomly assigned to treatment (n = 51) or a waiting-list control group (n = 40). Eligible patients were at least 18 years old, willing to participate in a weekly group, and able to provide physician verification of a fibromyalgia diagnosis. Of 166 eligible participants who responded to local television news publicizing, 49 did not appear for a scheduled intake, 24 enrolled but did not provide baseline data, and 2 were excluded due to severe mental illness, leaving 91 participants. The sample averaged 48 years of age and had 14.7 years of education. The typical participant was white, married, and employed. Patients randomly assigned to treatment received MBSR. Eight weekly 2.5-hour sessions were led by a licensed clinical psychologist with mindfulness training. Somatic and cognitive symptoms of depression were assessed using the Beck Depression Inventory administered at baseline, immediately postprogram, and at followup 2 months after the conclusion of the intervention. RESULTS: Change in depressive symptoms was assessed using slopes analyses of intervention effects over time. Depressive symptoms improved significantly in treatment versus control participants over the 3 assessments. CONCLUSION: This meditation-based intervention alleviated depressive symptoms among patients with fibromyalgia. Ann Behav Med. 2007 Feb. BACKGROUND: Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions. PURPOSE: This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age = 25; 16 men and 67 women) reporting distress. Method: Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability. RESULTS: Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p < .05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen's d = 1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen's d =.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p < .04 in all cases; Cohen's d = .57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation's effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience. CONCLUSIONS: The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress. Addict Behav. 2007 Jan 23. Previous studies have demonstrated that attempts to suppress thoughts about using substances may actually lead to increases in substance use. Vipassana, a mindfulness meditation practice, emphasizes acceptance, rather than suppression, of unwanted thoughts. A study by Bowen and colleagues examining the effects of a Vipassana course on substance use in an incarcerated population showed significant reductions in substance use among the Vipassana group as compared to a treatment - usual control condition [Bowen S., Witkiewitz K., Dillworth T.M., Chawla N., Simpson T.L., Ostafin B.D., et al. (2006). Mindfulness Meditation and Substance Use in an Incarcerated Population. Psychology of Addictive Behaviors.]. The current study further examines the mediating effects of thought suppression in the relationship between participation in the course and subsequent alcohol use. Those who participated in the course reported significant decreases in avoidance of thoughts when compared to controls. The decrease in avoidance partially mediated effects of the course on post-release alcohol use and consequences. Altern Ther Health Med. 2007 Jan-Feb. OBJECTIVES: To test a brief, non-sectarian program of meditation training for effects on perceived stress and negative emotion, and to determine effects of practice frequency and test the moderating effects of neuroticism (emotional lability) on treatment outcome. DESIGN AND SETTING: The study used a single-group, open-label, pre-test post-test design conducted in the setting of a university medical center. PARTICIPANTS: Healthy adults (N=200) interested in learning meditation for stress-reduction were enrolled. One hundred thirty-three (76% females) completed at least 1 follow-up visit and were included in data analyses. INTERVENTION: Participants learned a simple mantra-based meditation technique in 4, 1-hour small-group meetings, with instructions to practice for 15-20 minutes twice daily. Instruction was based on a psychophysiological model of meditation practice and its expected effects on stress. OUTCOME MEASURES: Baseline and monthly follow-up measures of Profile of Mood States; Perceived Stress Scale; State-Trait Anxiety Inventory (STAI); and Brief Symptom Inventory (BSI). Practice frequency was indexed by monthly retrospective ratings. Neuroticism was evaluated as a potential moderator of treatment effects. RESULTS: All 4 outcome measures improved significantly after instruction, with reductions from baseline that ranged from 14% (STAI) to 36% (BSI). More frequent practice was associated with better outcome. Higher baseline neuroticism scores were associated with greater improvement. CONCLUSIONS: Preliminary evidence suggests that even brief instruction in a simple meditation technique can improve negative mood and perceived stress in healthy adults, which could yield long-term health benefits. Frequency of practice does affect outcome. Those most likely to experience negative emotions may benefit the most from the intervention. J Altern Complement Med. 2006 Oct. BACKGROUND: Meditative techniques are sought frequently by patients coping with medical and psychological problems. Because of their increasingly widespread appeal and use, and the potential for use as medical therapies, a concise and thorough review of the current state of scientific knowledge of these practices as medical interventions was conducted. PURPOSE: To systematically review the evidence supporting efficacy and safety of meditative practices in treating illnesses, and examine areas warranting further study. Studies on normal healthy populations are not included. METHODS: Searches were performed using PubMed, PsycInfo, and the Cochrane Database. Keywords were Meditation, Meditative Prayer, Yoga, Relaxation Response. Qualifying studies were reviewed and independently rated based on quality by two reviewers. Mid-to-high-quality studies (those scoring above 0.65 or 65% on a validated research quality scale) were included. RESULTS: From a total of 82 identified studies, 20 randomized controlled trials met our criteria. The studies included 958 subjects total (397 experimentally treated, 561 controls). No serious adverse events were reported in any of the included or excluded clinical trials. Serious adverse events are reported in the medical literature, though rare. The strongest evidence for efficacy was found for epilepsy, symptoms of the premenstrual syndrome and menopausal symptoms. Benefit was also demonstrated for mood and anxiety disorders, autoimmune illness, and emotional disturbance in neoplastic disease. CONCLUSIONS: The results support the safety and potential efficacy of meditative practices for treating certain illnesses, particularly in nonpsychotic mood and anxiety disorders. Clear and reproducible evidence supporting efficacy from large, methodologically sound studies is lacking. Psychol Addict Behav. 2006 Sep. Despite the availability of various substance abuse treatments, alcohol and drug misuse and related negative consequences remain prevalent. Vipassana meditation (VM), a Buddhist mindfulness-based practice, provides an alternative for individuals who do not wish to attend or have not succeeded with traditional addiction treatments. In this study, the authors evaluated the effectiveness of a VM course on substance use and psychosocial outcomes in an incarcerated population. Results indicate that after release from jail, participants in the VM course, as compared with those in a treatment-as-usual control condition, showed significant reductions in alcohol, marijuana, and crack cocaine use. VM participants showed decreases in alcohol-related problems and psychiatric symptoms as well as increases in positive psychosocial outcomes. The utility of mindfulness-based treatments for substance use is discussed. Tidsskr Nor Laegeforen. 2006 Aug 10. BACKGROUND: Training based on mindfulness has developed into a method for managing stress and health problems over the last 25 years. MATERIAL AND METHODS: 144 patients (88% women), troubled by stress and chronic illness, used the method (8-week course) in a randomised controlled study in general practice. Effects on quality of life (QoL) were measured using the WHOQOL-BREF questionnaire (WHO). Subjective health was measured using the Subjective Health Complaint (SHC) inventory and the Hopkins Symptom Checklist (SCL-5). RESULTS: 92% of the patients completed all 8 weeks of the course. The participants rated its importance to 8.5 on a scale from 1 to 10. An increase in QoL and subjective health from start to finish of the course (p < 0.001) was observed, while the control group remained unchanged. The changes in QoL were maintained at 3 and 6 months follow-up, while subjective health continued to improve during that period. Changes were independent of age, sex, education and marital-, work- and health insurance status. Improvements were positively correlated with the self-reported amount of mindfulness training. Effect sizes (Cohen's d) were in the range of 0.5-0.6 and were highest for mental symptoms and mental function. INTERPRETATION: The method gives the patients a tool they can use to improve their health and QoL. By increased understanding and ability to deal with ones own health the patients seem to see themselves and their lives in a new way. The method may be suitable for schools and universities in addition to patient education centres. Integr Cancer Ther. 2006 Jun. The purpose of this article is to (1) provide a comprehensive over view and discussion of mindfulness meditation and its clinical applicability in oncology and (2) report and critically evaluate the existing and emerging research on mindfulness meditation as an intervention for cancer patients. Using relevant keywords, a comprehensive search of MEDLINE, PsycInfo, and Ovid was completed along with a review of published abstracts from the annual conferences sponsored by the Center for Mindfulness in Medicine, Health Care, and Society and the American Psychosocial Oncology Society. Each article and abstract was critiqued and systematically assessed for purpose statement or research questions, STUDY DESIGN: The search produced 9 research articles published in the past 5 years and 5 conference abstracts published in 2004. Most studies were conducted with breast and prostate cancer patients, and the mindfulness intervention was done in a clinic-based group setting. Consistent benefits--improved psychological functioning, reduction of stress symptoms, enhanced coping and well-being in cancer outpatients--were found. More research in this area is warranted: using randomized, controlled designs, rigorous methods, and different cancer diagnoses and treatment settings; expanding outcomes to include quality of life, physiological, health care use, and health-related outcomes; exploring mediating factors; and discerning dose effects and optimal frequency and length of home practice. Mindfulness meditation has clinically relevant implications to alleviate psychological and physical suffering of persons living with cancer. Use of this behavioral intervention for oncology patients is an area of burgeoning interest to clinicians and researchers. BMC Psychiatry. 2006 Apr 7. BACKGROUND: Mindfulness Based Cognitive Therapy (MBCT) is an 8-week course developed for patients with relapsing depression that integrates mindfulness meditation practices and cognitive theory. Previous studies have demonstrated that non-depressed participants with a history of relapsing depression are protected from relapse by participating in the course. This exploratory study examined the acceptability and effectiveness of MBCT for patients in primary care with active symptoms of depression and anxiety METHODS: 13 patients with recurrent depression or recurrent depression and anxiety were recruited to take part in the study. Semi-structured qualitative interviews were conducted three months after completing the MBCT programme. A framework approach was used to analyse the data. Beck depression inventories (BDI-II) and Beck anxiety inventories (BAI) provided quantitative data and were administered before and three months after the intervention. RESULTS: The qualitative data indicated that mindfulness training was both acceptable and beneficial to the majority of patients. For many of the participants, being in a group was an important normalising and validating experience. However most of the group believed the course was too short and thought that some form of follow up was essential. More than half the patients continued to apply mindfulness techniques three months after the course had ended. A minority of patients continued to experience significant levels of psychological distress, particularly anxiety.Statistically significant reductions in mean depression and anxiety scores were observed; the mean pre-course depression score was 35.7 and post-course score was 17.8 (p = 0.001). A similar reduction was noted for anxiety with a mean pre-course anxiety score of 32.0 and mean post course score of 20.5 (p = 0.039). Overall 8/11 (72%) patients showed improvements in BDI and 7/11 (63%) patients showed improvements in BAI. In general the results of the qualitative analysis agreed well with the quantitative changes in depression and anxiety reported. CONCLUSION: The results of this exploratory mixed methods study suggest that mindfulness based cognitive therapy may have a role to play in treating active depression and anxiety in primary care. Can Fam Physician. 2006 Apr. OBJECTIVE: To determine whether interventions that promote meditation improve quality of life in cancer patients. DATA SOURCES: MEDLINE data bank (1966 to 2004) using the terms "spiritual well-being" and the MeSH terms "meditation", "neoplasm", "cancer", and "spiritual therapies". STUDY SELECTION: Clinical trials evaluating the effect of meditation on cancer patients.SYNTHESIS Five studies were retained; none were designed in a way that made it possible to evaluate the effect of meditation exclusively or its effect on quality of life compared with a neutral intervention. Only 1 evaluated spiritual well-being. Four reported a significant improvement in symptoms of depression and anxiety when the study group's preintervention and post-intervention scores were compared. In the 2 studies that included a control intervention, participants preferred the meditation intervention. CONCLUSION: The design of studies to evaluate the effect of meditation on cancer patients did not make it possible to clearly identify the effect of meditation alone. These studies did show, however, that mood and anxiety parameters tend to improve--something that has been documented in other populations - and that spiritual well-being tends to improve as well. The main biases preventing a generalization of the effects of meditation are simultaneous evaluation of several interventions, "diluting" the effect of meditation; the lack of control groups receiving a comparable intervention; and the selection of study populations favourable to the intervention. There is increasing recognition of the effect of improved spiritual well-being on quality of life, even though most tools for measuring quality of life do not have a section for measuring spiritual well-being. Failing to take this aspect into account could be causing us to miss certain effects of meditation. In order to determine whether meditation should be offered to terminally ill patients, we need studies that do not contain these biases - studies designed to measure spiritual well-being. Soc Work Health Care. 2006. OBJECTIVES: Given the demands of caring for chronically ill children, it is not surprising that caregivers often experience high levels of chronic stress. A Mindfulness-Based Stress Reduction (MBSR) program may offer relief to these caregivers by providing tools for self-care and heath promotion that otherwise may be lacking. METHODS: MBSR classes were offered without restriction to parents of children attending various clinics at a large urban children's medical centre. Caregivers completed the Profile of Mood States (POMS) and Symptoms of Stress Inventory (SOSI) both before and after program participation. RESULTS: Forty-four caregivers participated in one of seven group MBSR sessions that were offered between August 2001 and February 2004. Most were mothers of children with special needs and various chronic conditions, who had been diagnosed an average of 7 years previous. Prior to the intervention, caregivers reported very high levels of stress and mood disturbance. These decreased substantially over the 8-week program, with an overall reduction in stress symptoms of 32% (p < .001), and in total mood disturbance of 56% (p < .001). CONCLUSIONS: This brief MBSR program for caregivers of chronically ill children was successful in significantly decreasing substantial stress symptoms and mood disturbance. Further studies would benefit from using more rigorous methodology and applying the program to other groups of chronically stressed caregivers. J Gen Intern Med. 2005 Dec. BACKGROUND: Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain. OBJECTIVE: To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood. DESIGN: Randomized trial comparing MBSR or massage with standard care. PARTICIPANTS: Thirty patients with chronic musculoskeletal pain. MEASUREMENTS: Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12. RESULTS: The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with -1.7 in the standard care group (P<.04). CONCLUSIONS: It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain. J Adv Nurs. 2005 Nov. AIM: This paper reports a systematic review and critical appraisal of the evidence on the effectiveness of Mindfulness-Based Stress Reduction for cancer supportive care. BACKGROUND: The experience of cancer can have a negative impact on both psychological and physical health and on quality of life. Mindfulness-Based Stress Reduction is a therapy package that has been used with patients with a variety of conditions. In order to draw conclusions on its effectiveness for cancer patients, the evidence requires systematic assessment. METHODS: A comprehensive search of major biomedical and specialist complementary medicine databases was conducted. Additionally, efforts were made to identify unpublished and ongoing research. Relevant research was categorized by study type and appraised according to study design. Clinical commentaries were obtained for each study and included in the review. RESULTS: Three randomized controlled clinical trials and seven uncontrolled clinical trials were found. A lack of relevant qualitative research studies was identified. Studies report positive results, including improvements in mood, sleep quality and reductions in stress. A dose-response effect has been observed between practice of Mindfulness-Based Stress Reduction and improved outcome. A number of methodological limitations were identified. Modifications to the traditional Mindfulness-Based Stress Reduction programme make comparison between studies difficult and a lack of controlled studies precludes any firm conclusion on efficacy. CONCLUSION: Mindfulness-Based Stress Reduction has potential as a clinically valuable self-administered intervention for cancer patients. Further research into its efficacy, feasibility and safety for cancer patients in the nursing context is recommended. Prog Transplant. 2005 Jun. BACKGROUND: In 2001, more than 24000 solid-organ transplant surgeries were performed in the United States. Although survival rates have steadily risen over the past 2 decades, transplant recipients commonly experience a myriad of symptoms after transplantation that compromise quality of life. Anxiety, depression, and insomnia frequently occur despite excellent function of the transplanted organ. Use of complementary and alternative medicine has risen sharply over the past 10 years, particularly among people with chronic illnesses. METHODS: Twenty solid-organ transplant recipients were enrolled in a clinical trial of mindfulness-based stress reduction. During the 8-week course, subjects learned various forms of meditation and gentle hatha yoga. Participants were given audiotapes for home practice and maintained practice diaries. Longitudinal analysis focused on the impact of mindfulness-based stress reduction on symptom management, illness intrusion, and transplant-related stressors. RESULTS: Significant improvements in the quality and duration of sleep continued for 6 months after completion of the mindfulness-based stress reduction course. Improvements after the completion of the course were also noted in self-report measures of anxiety and depression. CONCLUSIONS: Mindfulness-based stress reduction is an effective treatment in improving the quality and duration of sleep. Because sleep is highly correlated with positive mental health and overall well-being, these findings suggest that mindfulness-based stress reduction has the potential of being an effective, accessible and low-cost intervention that could significantly change transplant recipients' overall health and well-being. Int J Behav Med. 2005. Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature. Mindfulness meditation has demonstrated clinical benefits for a variety of patient populations in other areas of functioning. This study examined the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program on the sleep quality of a heterogeneous sample of 63 cancer patients. Overall sleep disturbance was significantly reduced (p < .001) and participants reported that their sleep quality had improved (p .001). There was also a significant reduction in stress (p < .001), mood disturbance (p = .001), and fatigue (p < .001). The associations among these changes and implications for improving quality of life of cancer patients are discussed. J Altern Complement Med. 2004 Oct. OBJECTIVE: Stress has been cited as a causal factor in heart disease. The objective of this study was to examine the effects of an 8-week mindfulness-based stress-reduction program on the resting levels of stress hormones, physical functioning, and submaximal exercise responses in women with heart disease. SUBJECTS: Random selection with the numbers 1 and 2 were used to assign 18 women (60 +/-6.3 years old) with documented histories of heart disease to a treatment group (n = 9) or a control group (n = 9). Speilberger's state anxiety scores for the treatment (M = 37.88; standard deviation (SD) = 10.91) and control group (M = 43.22; SD = 12.26) were not significantly different prior to the start of the study. However, their scores fell in the upper percentile rank for normal adults in their age category. INTERVENTION: The intervention was provided one night each week for 2 hours over a period of 8 weeks. The intervention included didactic, inductive, and experiential modes of learning regarding stress responses and mindfulness skill-development training. DESIGN: Pre-post test hormonal measurements and physical function were analyzed using a 2 (group) by 2 (time) analysis of variance (ANOVA) with repeated measures following the 8-week program. Submaximal exercise responses were also compared between the treatment group and the control group following the 8-week program. A 2 (group) by 3 (time) ANOVA with repeated measures was used to analyze the data. SETTINGS/LOCATION: Weekly meetings were held on a university medical school campus. Submaximal exercise responses were recorded while participants cycled on a stationary bike in an applied physiology laboratory following the 8-week program. RESULTS: There were no significant main effects or interaction for the resting levels of stress hormones or physical functioning. There were no significant interactions for the submaximal exercise responses, however, there were significant main effects between groups for ventilation [F(2,32) = 7.65, p < .01, f = 0.8], and between group [F(1,16) = 8.84, p < .01, f = 0.8] and time [F(2,32) = 10.42, p < .01, f = 0.9], for breathing frequency. CONCLUSION: While the 8-week stress reduction program for women with heart disease did not show significant interactions between groups for resting levels of stress hormones, physical functioning, or submaximal exercise responses, there was a significant difference in breathing patterns between the 2 groups during exercise following the mindfulness-based stress-reduction program. There was also a trend for change in the intervention group in the resting levels of cortisol and physical function scores that was not seen in the control group. Future studies could use the effect size generated from this pilot study to calculate the number of subjects needed for adequate power to detect significant differences between groups. Adv Mind Body Med. 2004 Summer. 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. J Psychosom Res. 2004 Jul. OBJECTIVE: Mindfulness-based stress reduction (MBSR) is a structured group program that employs mindfulness meditation to alleviate suffering associated with physical, psychosomatic and psychiatric disorders. The program, nonreligious and nonesoteric, is based upon a systematic procedure to develop enhanced awareness of moment-to-moment experience of perceptible mental processes. The approach assumes that greater awareness will provide more veridical perception, reduce negative affect and improve vitality and coping. In the last two decades, a number of research reports appeared that seem to support many of these claims. We performed a comprehensive review and meta-analysis of published and unpublished studies of health-related studies related to MBSR. METHODS: Sixty-four empirical studies were found, but only 20 reports met criteria of acceptable quality or relevance to be included in the meta-analysis. Reports were excluded due to (1) insufficient information about interventions, (2) poor quantitative health evaluation, (3) inadequate statistical analysis, (4) mindfulness not being the central component of intervention, or (5) the setting of intervention or sample composition deviating too widely from the health-related MBSR program. Acceptable studies covered a wide spectrum of clinical populations (e.g., pain, cancer, heart disease, depression, and anxiety), as well as stressed nonclinical groups. Both controlled and observational investigations were included. Standardized measures of physical and mental well-being constituted the dependent variables of the analysis. RESULTS: Overall, both controlled and uncontrolled studies showed similar effect sizes of approximately 0.5 (P<.0001) with homogeneity of distribution. CONCLUSION: Although derived from a relatively small number of studies, these results suggest that MBSR may help a broad range of individuals to cope with their clinical and nonclinical problems. J Psychosoc Nurs Ment Health Serv. 2004 Jul. 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. Altern Ther Health Med. 2004 May-Jun. 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. Psychoneuroendocrinology. 2004 May. 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. Psychosom Med. 2004 Jan-Feb. OBJECTIVE: To determine whether completing a mindfulness-based stress reduction (MBSR) program would affect the general health, health-related quality of life, sleep quality, and family harmony of Spanish- and English-speaking medical patients at an inner-city health center. MATERIALS AND METHODS: An intervention group of 68 patients (48 Spanish-speaking and 20 English-speaking) completed the SF-36 Health Survey and two additional questions about sleep quality and family harmony before and after completing the 8-week MBSR program. A comparison group of 18 Spanish-speaking patients who received no intervention completed the same questionnaire at the same intervals. RESULTS: Sixty-six percent of the total intervention group completed the 8-week MBSR program. There was significant comorbidity of medical and mental health diagnoses among the intervention and comparison groups, with no differences in the mean number of diagnoses of the total intervention group, the comparison group, or the Spanish- or English-speaking intervention subgroups. Compared with the comparison group, the intervention group showed statistically significant improvement on five of the eight SF-36 measures, and no improvement on the sleep quality or family harmony items. CONCLUSIONS: MBSR may be an effective behavioral medicine program for Spanish- and English-speaking inner-city medical patients. Suggestions are given for future research to help clarify the program's effectiveness for this population. Holist Nurs Pract. 2003 Nov-Dec. 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. J Altern Complement Med. 2003 Oct. 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 were 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. J Rheumatol. 2003 Oct. OBJECTIVE: To test the short and longterm benefits of an 8 week mind-body intervention that combined training in mindfulness meditation with Qigong movement therapy for individuals with fibromyalgia syndrome (FM). METHODS: A total of 128 individuals with FM were randomly assigned to the mind-body training program or an education support group that served as the control. Outcome measures were pain, disability (Fibromyalgia Impact Questionnaire), depression, myalgic score (number and severity of tender points), 6 minute walk time, and coping strategies, which were assessed at baseline and at 8, 16, and 24 weeks. RESULTS: Both groups registered statistically significant improvements across time for the Fibromyalgia Impact Questionnaire, Total Myalgic Score, Pain, and Depression, and no improvement in the number of feet traversed in the 6 minute walk. However, there was no difference in either the rate or magnitude of these changes between the mind-body training group and the education control group. Salutary changes occurring by the eighth week (which corresponded to the end of the mind-body and education control group sessions) were largely maintained by both groups throughout the 6 month followup period. CONCLUSION: While both groups showed improvement on a number of outcome variables, there was no evidence that the multimodal mind-body intervention for FM was superior to education and support as a treatment option. Additional randomized controlled trials are needed before interventions of this kind can be recommended for treatment of FM. Psychosom Med. 2003 Jul-Aug. 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. Psychosom Med. 2003 Jul-Aug. 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. Fam Community Health. 2003 Jan-Mar. Heart disease is the leading cause of death among Americans each year, yet the misperception still exists that cardiovascular disease is not a serious health problem for women. Evidence indicates that anxiety contributes to the development of heart disease. The primary purpose of this study was to assess the effectiveness of Kabat-Zinn's mindfulness-based stress reduction program to reduce anxiety in women with heart disease. Anxiety, emotional control, coping styles, and health locus of control were compared in a treatment and control group of women with heart disease. Post-intervention analyses provide initial support for beneficial effects of this program. J Psychosom Res. 2003 Jan. 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. J Altern Complement Med. 2002 Dec. 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. Chang Gung Med J. 2002 Aug. 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. Psychosom Med. 2002 Jan-Feb. OBJECTIVE: Mindfulness-Based Stress Reduction (MBSR) is a clinical program, developed to facilitate adaptation to medical illness, which provides systematic training in mindfulness meditation as a self-regulatory approach to stress reduction and emotion management. There has been widespread and growing use of this approach within medical settings in the last 20 years, and many claims have been made regarding its efficacy. This article will provide a critical evaluation of the available state of knowledge regarding MBSR and suggestions for future research. METHODS: A review of the current literature available within the medical and social sciences was undertaken to provide an evaluation regarding what we know about the construct of mindfulness, the effectiveness of MBSR, and mechanisms of action. RESULTS: There has been a paucity of research and what has been published has been rife with methodological problems. At present, we know very little about the effectiveness of this approach. However, there is some evidence that suggests that it may hold some promise. CONCLUSIONS: The available evidence does not support a strong endorsement of this approach at present. However, serious investigation is warranted and strongly recommended. Altern Ther Health Med. 2002 Jan-Feb. 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. Am J Health Promot. 2001 Jul-Aug. 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. Gen Hosp Psychiatry. 2001 Jul-Aug. 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. Support Care Cancer. 2001 Mar. 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. Psychosom Med. 2000 Sep-Oct. 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. Journal of Health Psychology. 1999. The efficacy of a 6-week meditation-based group intervention for Binge Eating Disorder (BED) was evaluated in 18 obese women, using standard and eating-specific mindfulness meditation exercises. A single-group extended baseline design assessed all variables at 3 weeks pre- and post-, and at 1, 3, and 6 weeks; briefer assessment occurred weekly. Binges decreased in frequency, from 4.02/week to 1.57/week (p< .001), and in severity. Scores on the Binge Eating Scale (BES) and on the Beck Depression and Anxiety Inventories decreased significantly; sense of control increased. Time using eating-related meditations predicted decreases on the BES (r = .66, p< .01). Results suggest that meditation training may be an effective component in treating BED. Nurse Pract. 1997 Mar. 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. Psychother Psychosom. 1997. 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. Gen Hosp Psychiatry. 1995 May. 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. Am J Psychiatry. 1992 Jul. 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. J Behav Med. 1985 Jun. 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. Gen Hosp Psychiatry. 1982 Apr. The practice of mindfulness meditation was used in a 10-week Stress Reduction and Relaxation Program to train chronic pain patients in self-regulation. The meditation facilitates an attentional stance towards proprioception known as detached observation. This appears to cause an "uncoupling " of the sensory dimension of the pain experience from the affective/evaluative alarm reaction and reduce the experience of suffering via cognitive reappraisal. Data are presented on 51 chronic pain patients who had not improved with traditional medical care. The dominant pain categories were low back, neck and shoulder, and headache. Facial pain, angina pectoris, noncoronary chest pain, and GI pain were also represented. At 10 weeks, 65% of the patients showed a reduction of greater than or equal to 33% in the mean total Pain Rating Index (Melzack) and 50% showed a reduction of greater than or equal to 50%. Similar decreases were recorded on other pain indices and in the number of medical symptoms reported. Large and significant reductions in mood disturbance and psychiatric symptomatology accompanied these changes and were relatively stable on follow-up. These improvements were independent of the pain category. We conclude that this form of meditation can be used as the basis for an effective behavioral program in self-regulation for chronic pain patients. Key features of the program structure, and the limitations of the present uncontrolled study are discussed. Am J Clin Hypn. 1982 Oct-1983 Jan. No abstract available. Practitioner. 1982 Sep. No abstract available. Aust Fam Physician. 1981 Mar. No abstract available. Med J Aust. 1980 Feb 9. No abstract available. J Am Soc Psychosom Dent Med. 1980. No abstract available. Med J Aust. 1979 Nov 17. No abstract available. Practitioner. 1979 Jan. No abstract available. Med J Aust. 1978 Oct 21. No abstract available. J Am Soc Psychosom Dent Med. 1978. No abstract available. Med J Aust. 1976 Jul 31. No abstract available. From http://www.yangsheng.info/qigongetcancer/observations/meares/medintensive.htm - There is evidence to suggest that some cancers are influenced by immunological reactions. There is some similarity between immunological reactions and allergic reactions. Some allergic reactions can be modified by meditative experience. Furthermore. some cancers are influenced by endocrine reactions, and some endocrine reactions can be modified by meditative experience. With these ideas in mind I wrote to your correspondence column (Journal, October 25) seeking referral of suitable cancer patients to conduct a small private experiment to see if the progress of their condition could be influenced by intensive meditation. Only three patients made themselves available and two of them soon dropped out of the experiment. The third patient, a single woman aged 49 years, has continued steadfastly in the experiment for the past six months. She has pathologically proven carcinomas of both breasts. She had been given radical radiotherapy to both breasts, with initial regression of the tumours. However, they soon recurred and she developed radiologically proven metastases in the spine. She underwent oophorectomy. There was a remission of symptoms, but she relapsed again and had treatment with Lactril (an extract of the apricot kernel) in Mexico. Her condition deteriorated and she required a blood transfusion. Treatment with cytotoxic drugs had been strongly advised, but for reasons of her own the patient kept putting off the decision to accept the treatment. When I first saw the patient six months ago she was frail, debilitated, and in pain. Her left breast was wooden and immovable on the chest wall and the skin over it was so tight that it appeared in danger of rupture. The right breast had t large, wooden lumps in it and the nipple was retracted. Her general condition continued to deteriorate for the first six weeks in which I saw her. Her weakness became greater and she had severe pain in the back. Her condition necessitated two more transfusions. She developed ascites which had to be tapped on two occasions. After six weeks further deterioration gradually ceased. Strength began to return. After the second paracentesis her abdomen started to refill, but the fluid has been reabsorbed. Three months ago the patient was barely able to keep down any food at all, whereas now she says she has enjoyed steak and onions. Initially she barely had the strength to come to my rooms and now she has been swimming in a friend's pool. She has had no analgesic treatment at all for the past ten weeks. The left breast is still hard, but there are definite soft patches developing in the under surface. It is now freely movable on the chest wall, and the skin is still tight, but very much less so than when the patient first presented. The nipple of the right breast is no longer retracted. Her abdomen is now soft to palpation. Her face has filled out, but there is still very marked loss of flesh above and below the clavicles, in spite of the loss of fluid from her abdomen, in the last seven weeks she has. gained 9 lb in weight. In the six months the patient has attended more than 100 sessions of intensive meditation in a small group under my guidance. She has also practised what I have shown her for many hours, both in my rooms and at her home. Whatever the final outcome of her condition may be, there is no doubt that the progress of her condition has undergone a dramatic change for the better after the intensive meditation, and that this change is much more than the relief of pain and improved attitude of mind which one might expect from intensive meditation. The purpose of this preliminary report is to request the referral of other patients to see if it is possible to repeat this very favourable effect. Such patients must have active cancer with the diagnosis proven beyond all possible doubt. They must be fully aware that their attending me is in the nature of an experi-ment and that there is no evidence to suggest that the favourable result in this first case can be repeated. They must have decided for reasons of their own not to pursue further orthodox anti-cancer treatment, but must be prepared to continue with their present medical attendant for their ordinary medical needs and for monthly assessment of their condition. They must be prepared to attend my rooms every weekday for three months and to practise what I show them for two or three hours at home each day. Above all they must be capable of developing a sense of complete commitment to the venture. |