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We often comfort those who are distraught by offering them the same advice we would offer ourselves were we in the same situation. Helping others to emotionally self-regulate can sometimes be stressful, however, especially when one’s efforts fail. Mindfulness-Based Stress Reduction (MBSR) can help people regulate their own stress but little is known about whether it can also reduce the stress of trying to help others.
Guendelman et al. [Neuroimgage] used a randomized controlled trial to test the effect of MBSR on participants’ use of acceptance, permission, and cognitive reappraisal strategies to regulate their own stress as well as the stress of another person and examined the brain regions associated with self- and other-regulation.
The researchers randomly assigned 68 German adults (average age = 38 years; 83% female) to either MBSR or a control condition. The MBSR program met in 8 standard weekly 2.5-hour group sessions with an all-day retreat and homework.
The control group met with the same frequency and read, listened to, shared, and discussed works of fiction, myth, and poetry in group and listened to audiobooks at home.
Participants were assessed at baseline and after intervention on a self-other emotional regulation task while undergoing brain functional magnetic resonance imaging (fMRI). The task required participants to alternately try to regulate their own emotions and the emotions of a confederate as they both viewed aversive and neutral photographs.
The photographs included the instructions “Gently accept!”, “Permit the reaction!”, or “This is just a photo!” which the participants alternately voiced to either themselves or the confederate. Participants were instructed as to what these acceptance, permission, and reappraisal strategies involved before beginning the task. These strategies were designed to reflect the strategies often presumed to underlie the effectiveness of MBSR.
Participants were also given false feedback on some trials that they had failed to successfully regulate their own or the confederate’s stress. Participants rated their stress after each photograph.
Study results showed the MBSR group showed significantly lower stress over time during self-regulation reappraisal trials while controls did not (η2p= .11). During self-regulation acceptance trials, the control group experienced increasing levels of stress, while the MBSR group did not (η2p= .09). No significant group x time interactions were found during the other-regulation trials or during any of the “permission” trials.
A complex pattern of significant brain region activation differences were found between the MBSR and control group during self-regulation acceptance, other-regulation reappraisal, and other-regulation acceptance trials.
The group of MBSR participants displayed greater brain activation in the parietal and insular cortices when regulating self-stress and in the precuneus and temporo-parietal junction when regulating other’s stress, especially while using the acceptance strategy. Brain region activation levels were not correlated with changes in self-reported stress.
The study shows MBSR can help participants self-regulate their own stress through both acceptance and cognitive reappraisal strategies but has no effect on the stress of attempting to regulate another person’s emotions.
Interpretation of the study is complicated by the fact that MBSR participants reported significantly greater stress during self-regulation reappraisal trials at baseline.
Guendelman, S., Bayer, M., Prehn, K., & Dziobek, I. (2022). Towards a mechanistic understanding of mindfulness-based stress reduction (MBSR) using an RCT neuroimaging approach: Effects on regulating own stress in social and non-social situations. NeuroImage, 119059.
Link to study
Infants whose mothers were highly stressed during pregnancy often show altered autonomic nervous system responsiveness to stress after birth. This is important because autonomic responsiveness is associated with childhood behavioral problems. For example, dysregulated sympathetic reactivity is associated with antisocial behavior, substance use, and anxiety. Mindfulness-based interventions that reduce maternal stress may potentially exert influence on fetal development.
Noroña-Zhou et al. [Psychosomatic Medicine] compared autonomic and behavioral reactivity and regulation in infants whose mothers with elevated stress had previously participated in either a mindfulness-based program or a control group during pregnancy.
The researchers identified 135 6-month-old infants (46% Mixed Race, 36% Black, 17% White) whose mothers had previously completed an 8-week Mindful Moms Training intervention during pregnancy or had served as controls for that study. The mothers were primarily low-income (median income = $18,000) who reported high levels of stress.
The Mindful Moms program was delivered in eight 2-hour weekly group sessions that combined Mindfulness-Based Stress Reduction, mindful-eating, and support for nutrition and exercise. The control condition was maternity care provided as usual. Previously published results from this trial showed Mindful Moms improved mothers’ levels of stress, depression, activity level, and glucose tolerance relative to controls.
Sixty-five of the infant-mother pairs were assessed at 6 months of age using a five phase “still face” paradigm to induce infant stress. In this, mothers played normally with their infants for 30 seconds, then stopped interacting with or responding to them and maintained a neutral facial expression for another 30 seconds. The parents then resumed normal responsiveness followed by another “still face” episode and a final resumption of normal responsiveness.
Infant electrocardiograms (EKGs) were monitored throughout the task. EKG respiratory sinus arrythmias served as a measure of parasympathetic reactivity and the length of EKG pre-ejection periods served as a measure of sympathetic reactivity. Infant behaviors were videotaped and rated by study blinded observers for fussing, withdrawal, and protest as well as visual engagement with objects in the environment.
Results showed infants in the Mindful Moms group increased their sympathetic activity earlier on in the first still face episode than controls, but that controls showed persistent elevated sympathetic activity throughout the remainder of the task whereas mindful infants returned towards baseline.
While all infants showed some decline in positive visual engagement with objects after the first still face episode, mindful infants declined less and showed greater positive visual engagement than controls during the remainder of the task.
There were no group differences in parasympathetic activity or negative behaviors like fussing or withdrawal.
The findings of the study reveal that infants of stressed mothers who participated in a mindfulness intervention show increased sympathetic responsiveness, better sympathetic recovery, and more persistent visual engagement with the environment in response to stress than controls.
The study is limited by its lack of baseline equivalence for gestational age yet this variable was not influential on the treatment effect when covaried statistically.
Noroña-Zhou, A. N., Coccia, M., Epel, E., Vieten, C., Adler, N. E., Laraia, B., Jones-Mason, K., Alkon, A., & Bush, N. R. (2022). The Effects of a Prenatal Mindfulness Intervention on Infant Autonomic and Behavioral Reactivity and Regulation. Psychosomatic Medicine.
Elevations and large fluctuations in eye fluid pressure are risk factors for glaucoma, a disease that results in optic nerve damage and blindness. Experts disagree on when it is best to monitor eye fluid pressure and when it is best to initiate medical treatment.
While pharmacological treatments reduce glaucoma risk, they can be expensive and cause unwanted side effects. In addition, knowing one is at risk for glaucoma can increase stress which can further elevate eye fluid pressure and decrease quality of life.
Dada et al. [American Journal of Ophthalmology] investigated whether mindfulness meditation could reduce eye fluid pressure and fluid pressure fluctuations, thus delaying or reducing the need for pharmaceutical treatment. Normal eye fluid pressure is ≤ 20 mm Hg, and every 1 mm Hg decrease in pressure results in a 10% decrease in glaucoma risk.
The researchers randomly assigned 60 patients attending a New Delhi glaucoma clinic with eye fluid pressure elevations of 21-30 mm Hg (average age = 52 years) to mindfulness meditation or a wait-list control group. The mindfulness group included two one-hour trainings in breath-focused mindfulness meditation and 60-minutes of daily practice at home for 6 weeks.
Study personnel called participants on a weekly basis to encourage continued practice and insure correct technique. Participants completed assessments at baseline and six weeks after baseline (or after intervention) on measures of eye fluid pressure (taken every 3 hours across a 15-hour interval), optic disc blood vessel density and perfusion, a single 8:00 AM blood serum cortisol, and self-reported quality-of-life.
The results showed the mindfulness group had a significantly greater reduction in eye fluid pressure (-3.9 mm Hg) than controls (-0.18 mm Hg). The mindfulness group also showed significant reductions in diurnal pressure fluctuation (-2.14 mm Hg) while controls did not (-0.20 mm Hg).
Average optic disc blood vessel density and perfusion improved more for mindfulness than control participants. The mindfulness group also reported a significantly greater improvement in quality of life than controls.
Lastly, mindfulness practitioners saw a significantly greater decrease in morning serum cortisol (-2.54 μg/dl) than controls (+0.38 μg/dl). Serum cortisol reductions were correlated with decreased eye fluid pressure (r=-.73), reduced diurnal fluctuation in pressure (r=-.56), and improved quality of life (r=.62).
The study shows mindfulness mediation training can reduce clinically-evaluated risk factors for developing glaucoma. The reported average drop in eye fluid pressure for mindfulness participants reflects a 39% decrease in risk for glaucoma progression.
It is unclear how long this improvement persists, and how much daily meditation practice is needed to maintain it. The study is limited by its lack of published information on the extent of home practice compliance and the absence of an active control.
Dada, T., Mondal, S., Midha, N., Mahalingam, K., Sihota, R., Gupta, S., Angmo, D., & Yadav, R. K. (2022). Effect of mindfulness-based stress reduction on IOP in patients with ocular hypertension: A randomized control trial. American Journal of Ophthalmology.
Mindfulness-based trainings typically combine focused-attention meditation with open-monitoring meditation that involves attending to the entire field of awareness. Little is known about how these different types of meditation uniquely contribute to emotional well-being.
Brown at al. [Psychophysiology] investigated the effects of these meditations, separately and combined, on measures of emotional reactivity and regulation.
The researchers randomly assigned 104 meditation-naïve predominantly female, Caucasian adults (average age = 40 years) with persistent mild-to-severe depression, anxiety, and/or stress to a focused-attention meditation training program, an open-monitoring meditation program, or a Mindfulness-Based Cognitive Therapy (MBCT) program that includes both types of meditation training.
All three programs were offered in formats that included 8 three-hour weekly groups and a full-day retreat. Participants were encouraged to engage in 45 minutes of daily home meditation practice. The focused-attention group used sensations such as the breath to anchor their meditations, while the open-monitoring group used mental noting to attend to the full range of sensory, cognitive, and emotional experiences.
Participants completed baseline and post-training electroencephalographic (EEG) measures of emotional reactivity and regulation. They were presented with a series of computerized positive, negative, and neutral images.
For the first 4 seconds of each image presentation, participants simply looked at the image allowing emotional reactions to arise. During the following 10 seconds they employed the meditative strategy they had been taught to regulate their emotional reactions to the picture—either breathing or mental noting. Participants also rated their mood after each viewing.
An EEG recorded any frontal lobe alpha wave asymmetry in response to the images. Greater left > right frontal alpha wave activity is associated with an approach response to stimuli, while greater right > left frontal alpha wave activity is associated with an avoidance response. Increased left > right activity reflects a decrease in negative emotional responsiveness to a stimulus.
Over the course of training, the MBCT and focused-attention groups showed significantly greater increased leftward shifts in alpha wave asymmetry compared to the open-monitoring group. This was true for both the emotional reactivity and the emotional regulation phases of EEG recording.
All three groups reported improved self-reported mood while viewing negative images from baseline to post-training with open-monitoring (d=0.63) and focused-attention groups (d=0.54) showing larger mood improvements than the MBCT group (d=0.21).
The study shows greater shifts in frontal lobe alpha wave asymmetry for focused-attention and MBCT training, but greater improvement in self-reported mood for open-monitoring training. It is not clear why these EEG and self-report results diverge. The study is limited by the lack of a non-meditation control group.
Brown, K. W., Berry, D., Eichel, K., Beloborodova, P., Rahrig, H., Britton, W. B. (2022). Comparing impacts of meditation training in focused attention, open monitoring, and mindfulness-based cognitive therapy on emotion reactivity and regulation: Neural and subjective evidence from a dismantling study. Psychophysiology.
Trainees in pediatric medical residencies face a high level of occupational demand. Between 39-75% of residents report occupational burnout. This is experienced as emotional exhaustion, impaired work performance, and decreased empathy for patients. Mindfulness training might prevent burnout through its focus on stress management and empathy; however, it requires extra time which overburdened residents lack.
Fraiman et al. [JAMA Pediatrics] developed a mindfulness-based training that could be practically integrated into pediatric residencies and tested whether it could help prevent emotional exhaustion and burnout.
The researchers recruited 15 pediatric medical residency programs that included a total of 365 eligible pediatric residents to participate in the study. Programs were randomly assigned to the mindfulness training or control arm after pairing them on location and size. Six residents declined participation, leading to an initial sample of 359 participants (75% female).
The mindfulness program included 1-hour monthly meetings for the first 7 months of the program. Residents were encouraged but not required to attend, and attendance was not taken. Each monthly meeting began with a social lunch followed by a minute of silence, introductory remarks, a mindfulness exercise, and a subsequent debriefing.
Mindfulness exercises were designed to be ones residents could integrate into their busy days and be relevant to their work. Two weeks after each meeting, residents were invited to utilize a 10-minute pre-recorded guided body scan.
The control arm of the study involved 7 one-hour social lunches without instruction. Residents in both arms were assessed at baseline, 6 months, and 15 months on self-report measures of emotional exhaustion (study primary outcome), depersonalization, empathy, personal accomplishment, burnout, perspective taking, and mindfulness (Five Facet Mindfulness Questionnaire).
Participant dropout rates from the study follow up were 20% at 6 months and 43% at 15 months, and were roughly equal across groups
The results showed no difference between the mindfulness and socializing groups over time on emotional exhaustion, burnout, empathy, perspective taking, or mindfulness. Most residents reported burnout at baseline (75% in the mindfulness group and 60% in the control arm) and burnout increased over time in each group.
By month 15, 84% of the mindfulness group and 88% of the control group reported burnout. Self-reported frequency in use of mindfulness practices did not differ by group, indicating both groups used mindfulness to a similar degree.
The study showed a low-dose, once per monthly mindfulness intervention adapted to the occupational needs of pediatric residents did not outperform a time-matched socializing group on reducing emotional exhaustion and burnout.
Resident burnout rates at baseline were much higher than those reported in prior studies. The adapted program used in this study was much less intensive than most mindfulness programs, not taught by trained mindfulness teachers, and no records were kept of attendance or home practice.
Fraiman, Y. S., Cheston, C. C., Cabral, H. J.,... Sox, C. M. (2022). Effect of a Novel Mindfulness Curriculum on Burnout During Pediatric Internship: A Cluster Randomized Clinical Trial. JAMA Pediatrics.
Our ability to get along well with others depends on being able to read social cues. When a social cue such as a facial expression has an unclear meaning, people are often biased in the way they interpret it. For example, when viewing a facial expression of surprise, some people tend to interpret the expression positively (the person received a gift) while others tend to interpret it negatively (the person witnessed an accident). However, facial expressions alone do not indicate their cause, so the viewers’ assumptions are a function of their unique cognitive bias.
Biases in attributing emotion and cause are tied to brain activity. Negative attributions are associated with activity in emotional centers of the brain (the amygdala), while positive attributions are associated with problem solving regions (the frontal lobes). Negative attributions tend to be more automatic, but positive attributions require more cognitive processing and emotional regulation.
Harp et al. [Journal of Experimental Psychology: General] tested the effects of Mindfulness-Based Stress Reduction (MBSR) on negative and positive biases in response to viewing surprised faces.
The researchers relied on three samples: a cohort of 58 MBSR participants (mean age = 42 years; 90% white), and two independent comparison cohorts drawn from two separate longitudinal studies (Cohort 1: mean age = 45 years; 93% White; Cohort 2: mean age = 40 years; 93% White). MBSR was delivered using the standard 8-week group format with the 8-hour retreat.
Participants in all three cohorts were assessed on an ambiguous social cue task at five separate time points over 16 weeks. For the MBSR cohort, this occurred at baseline, after the first MBSR class, before the last MBSR class, after the last MBSR class, and 8 weeks after the last class. During these assessment sessions, participants viewed computer-presented photographs of happy, angry, and surprised faces and asked to categorize the expressions as positive or negative by clicking on the words “positive” or “negative” with a computer mouse.
The primary outcome measure was the percent of surprised faces that were judged as negative. Participants also completed the Five Facet Mindfulness Questionnaire (FFMQ) at baseline, 8 weeks, and 16 weeks.
The results showed the MBSR group’s judgments of surprised faces became significantly more positive over the course of training and that this shift towards positivity continued to grow though during the two months post-training. This shift to increased positivity was significantly correlated with increased non-reactivity on the FFMQ (r =-.38). This kind of shift towards positivity did not occur in the two untreated comparison groups.
An analysis of computer mouse movements found that the MBSR group’s computer mouse trajectories for surprised faces became significantly more direct over the course of training suggesting the training was helping participants to override their initial negativity bias.
The study shows MBSR decreases participants’ bias to view ambiguous social cues in a negative way, and that this decreased response bias is associated with increased mindful non-reactivity. The study is limited by the absence of a randomized control group.
Harp, N. R., Freeman, J. B., & Neta, M. (2022). Mindfulness-based stress reduction triggers a long-term shift toward more positive appraisals of emotional ambiguity. Journal of Experimental Psychology: General.
Falls are the leading cause of fatal and nonfatal injuries in the elderly. One-third of adults older than 65 and half of those older than 80 fall at least once a year, with 5% of these falls resulting in fracture or hospitalization. Several interventions are shown to be effective in reducing falls including balance training, tai chi, and treadmill exercise.
There is reason to think that greater mindfulness while walking might also be helpful given its attentional focus to sensory experience while walking. Phoobangkerdphol et al. [Clinical Rehabilitation] tested the efficacy of walking meditation practice against conventional balance training in reducing falls in older adults with elevated fall risk.
The researchers randomly assigned 68 Thai Buddhist adults over age 60 who had fallen at least once in the past year (age range = 60-85; 85% female) to either a walking meditation or balance training intervention. Participants attended a training session and were given a brochure and instructional CD to aid practice on their own at home.
All participants were told to practice 20-30 minutes a day, 5-7 days a week and keep daily logs of their assigned practice. At 6 months, participants were given the option of continuing to practice for an additional 3 months, and most of the participants who had completed the six-month program elected to continue to practice.
Walking meditation involved slow paced walking along a 5-meter course with attention to lifting, moving, and placing the feet, shifting weight, and breathing. Balance training included practice marching, reaching, chair standing, and sideways, backwards, and tandem walking.
Participants were assessed at baseline, 6 and 9 months on the time it took to stand up, walk 3-meters, return to the chair, and sit down, the degree they could bend at the waist while standing, and the length of time they could stand on one leg. They were also assessed on a self-report geriatric mental health screening measure and a measure of quality of life.
The results showed improvement on all physical mobility measures for both groups, and to a similar degree at both 6 and 9 months. Improvements were small and below the level of set for minimal clinically important differences.
There were no group differences on the mental health or quality of life measures. Compliance (68% vs. 48%) and program satisfaction (79% vs. 62%) were significantly higher for the balance training group. None of the participants experienced falls by 6 months, but 2 individuals in each group experienced falls by 9 months.
The study shows walking meditation and balance training were equally effective in improving performance of balance and mobility tasks among older adults. The researchers conclude walking meditation could be an alternative to balance training in the elderly to help prevent falls. Participants were less satisfied and compliant with the walking meditation program.
Given improvements in both groups were below the minimal clinically important difference level, a no-treatment control group would have been a useful additional comparator.
Phoobangkerdphol, C., Limampai, P., Dasri, S., & Kuptniratsaikul, V. (2021). Walking meditation versus balance training for improving balance abilities among older adults with history of fall: A randomized controlled trial. Clinical Rehabilitation.
According to the Center for Disease Control, about 70 million Americans suffer from sleep difficulties, with less than half of adult Americans getting the recommended 7-9 hours a night of sleep. Sleep disturbances can lead to daytime sleepiness and impaired daytime cognitive performance as well as increase the risk for cardiovascular diseases including high blood pressure, heart attack, and stroke.
Several behavioral interventions are shown to have some efficacy in improving sleep quality, yet little is known about their relative effectiveness. Kirk et al. [Journal of Cognitive Enhancement] tested the relative efficacy of three different pre-sleep interventions compared to a no-treatment control on sleep outcomes.
Healthy Danish participants (N=38; average age = 28 years; 53% male) completed a cross-over study to assess the effects of three pre-sleep interventions. All participants received all three interventions after an initial one-week baseline period that served as a control condition.
Each intervention lasted one week, with a one-week washout period between each intervention trial. Participants received treatments in a randomized order to counterbalance any order effects.
Participants wore a chest-strapped heart rate monitor to measure heart rate variability and a wrist-worn actigraph. Participants slept wearing this equipment nightly during the baseline period and during the intervention periods to measure parasympathetic activity, sleep time and sleep efficiency.
All three interventions were app-based on a smartphone and listened to for 15-45 minutes at bedtime. Interventions compared were restful instrumental music, sleepcasts (narrative tours of dreamy landscapes), guided mindfulness meditation, and the baseline control period where they slept as normal without an intervention. Mindfulness exercises involved non-judgmental present-moment experiencing of body, breath, and mind.
Participants completed daily sleep diaries as well as self-report sleep and stress questionnaires and a computerized sustained attention task at baseline and post-intervention.
The results showed that only the mindfulness app condition resulted in improved self-report sleep quality (partial η2 = 0.25), lower perceived stress (η2 =0.27) and improved sustained attention on the computerized task (η2 = 0.21). All three treatments showed improved actigraph-measured sleep efficiency compared to the control condition (η2p = 0.71), but sleep efficiency was highest for the mindfulness group (η2 = 0.08).
All three interventions increased heat rate variability during the pre-sleep period compared to the control period (η2 = 0.25), but only the mindfulness group showed higher heart rate variability while asleep (η2 = 0.32).
The study shows an app-delivered guided mindfulness meditation intervention is more effective than two other active pre-sleep interventions in improving perceived subjective sleep quality and objective sleep efficiency in healthy participants. Mindfulness was also most effective in reducing perceived stress and overnight physiological arousal, and improving daytime sustained attention.
Kirk, U., Ngnoumen, C., Clausel, A., & Purvis, C. K. (2021). Using Actigraphy and Heart Rate Variability (HRV) to Assess Sleep Quality and Sleep Arousal of Three App-Based Interventions: Sleep Music, Sleepcasts, and Guided Mindfulness. Journal of Cognitive Enhancement.
Public school teachers often report high levels of job-related stress, burnout, and low job satisfaction. 40% of teachers leave the profession within their first 5 years of teaching. While studies show mindfulness-based interventions can improve teacher well-being, many of these studies lack long-term follow-up, active comparison groups, and objective outcome measures.
Carroll et al. [Mindfulness] evaluated the relative efficacy of Mindfulness-Based Stress Reduction (MBSR) compared to an active comparator program on measures of teacher well-being, emotional regulation, and neuro-cognitive functioning.
The researchers assigned 83 Australian K-12 teachers (average age = 45 years; 88% female) experiencing work-related stress to MBSR or a Health Enhancement Program (HEP). Groups were matched on age, gender, and fMRI eligibility. The 8-week MBSR and HEP programs met weekly in 2.5-hour group sessions with a full-day retreat in week 5 or 6. The MBSR program was a standard MBSR program tailored for teachers.
The HEP program included music therapy, physical activity and functional movement (e.g., walking, stretching, posture, balance, and core strength), and stress management education.
Participants were assessed at baseline, post-intervention, and 5-month follow-up on a battery of self-report measures and computer-administered neuropsychological tests. Self-report measures assessed perceived stress, mood, affect, emotional regulation difficulties, and mindfulness (Five Facet Mindfulness Questionnaire or FFMQ).
The computer-administered neuropsychological tests assessed facial expression recognition, attention, vigilance, executive function, cognitive flexibility, and working visual memory.
A subset of 55 participants also underwent fMRI scanning at baseline and immediate post-intervention. fMRI scans were performed while participants counted the number of words displayed on a computer screen. The words varied in emotional valence, and the researchers expected negative emotional words would slow down response time compared to neutral words (an expectation not borne out in the data). The negative emotional words included words related to the stresses teachers would normally encounter such as “paperwork.”
Attendance in both study groups was high, with participants attending 88% and 89% of the sessions. Both programs received high satisfaction ratings.
All of the self-report measures showed significant improvement over time, regardless of group assignment. In both groups, there were large effect size decreases in stress and burnout, large-to-medium effect size increases in mindfulness, and medium effect size increases in well-being and emotional regulation. Improvements were maintained at 5-month follow-up.
In the overall sample, the percent of teachers stating they intended to quit teaching decreased from 54% at baseline to 31% at post-intervention and 35% at 5-month follow-up. However, there was no group differences detected for intention to quit teaching.
Neuropsychological measures of visual working memory, sustained attention, and cognitive flexibility showed improvement from baseline to post-intervention in both groups. These improvements were maintained on 5-month follow-up.
While the researchers state the MBSR group showed a greater improvement in accuracy on a sustained attention task than controls, the lack of a significant interaction term suggests the groups improved similarly.
The fMRI scans showed that MBSR participants exhibited post-intervention decreases in brain activation in regions associated with emotional processing, while the HEP group did not. These regions included the inferior temporal gyri, left and posterior cingulate gyri, left claustrum, insula, amygdala and cerebellum, and right hippocampus and parahippocampus.
This result suggests the possibility that MBSR participants had become less reactive to negative emotional stimuli as a result of the intervention.
The study shows MBSR and HEP were equally effective in decreasing stress and burnout and improving mindfulness, well-being, emotional regulation, and neurocognitive functioning out to 5 months after intervention.
The only between-group difference was that MBSR participants showed reduced brain reactivity to negative emotional stimuli. This may be an objective brain measure of improved emotional regulation untapped by the self-report measures.
Carroll, A., Sanders-O’Connor, E., Forrest, K., Fynes-Clinton, S., York, A., Ziaei, M., Flynn, L., Bower, J. M., & Reutens, D. (2021). Improving Emotion Regulation, Well-being, and Neuro-cognitive Functioning in Teachers: A Matched Controlled Study Comparing the Mindfulness-Based Stress Reduction and Health Enhancement Programs. Mindfulness.
Prolonged psychological stress can induce a state of chronic low-grade systemic inflammation. Inflammation, in turn, can contribute to the onset or worsening of many physical and mental conditions. Mindfulness-based interventions that reduce stress may also help reduce systemic inflammation.
The body’s inflammatory response is a complex process that involves the activation of immune system cells and the release of proteins known as cytokines. Different cytokines can promote or inhibit inflammation.
Gardi et al. [Psychoneuroimmunology] tested the effects of a 3-day resort-based mindfulness meditation retreat compared to a vacation retreat on perceived stress, stress hormones, and cytokine levels.
The researchers randomly assigned 95 healthy Italian adults (average age = 47 years; 51% male) to a 3-day intensive mindfulness retreat or a 3-day vacation control. The retreat and vacations were held at the same resort. The mindfulness retreat involved 10-hours a day of alternating sitting and walking meditation taught by experienced meditation teachers. Meditations involved attention to and acceptance of the breath, physical sensations, thoughts, and feelings.
The vacation retreat involved unstructured free time allowing participants to rest, walk in nature, read, or socialize with others.
Participants were assessed before and after the 3-day interventions on self-report measures of perceived stress, anxiety, and mindfulness (using the Mindful Attention Awareness Scale) and provided one saliva sample between 5:00-6:00 AM upon awakening before and after retreat.
Saliva samples were assayed for levels of cortisol (a stress hormone) and a panel of pro- and anti-inflammatory cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, IFN- γ, TNF-α, and GM-CSF). Only cortisol and cytokines IL-6, IL-8, and IL-10 were detectable and included in subsequent analyses.
The results showed while both groups reduced perceived stress, only the mindfulness group exhibited significantly decreased anxiety, increased mindfulness, decreased levels of cortisol and pro-inflammatory IL-6 and IL-8, and increased levels of anti-inflammatory IL-10 after the retreat.
Salivary cortisol levels were highly correlated with anxiety and stress in both groups. For example, before the retreat salivary cortisol correlated with anxiety (r=.64) and with perceived stress (r=.98) within the mindfulness group. Similar large correlations were obtained for the vacation group, and for both groups following the retreat.
This is the first study to show a saliva-based anti-inflammatory effect of an intensive mindfulness retreat in a healthy sample. The salutary effects of a 3-day mindfulness retreat were beyond those of 3 days of vacationing.
Salivary cytokine levels differ from blood serum cytokine levels, thus the study is limited when inferring to systemic inflammation. Although correlations between cortisol and stress are quite high in this study, single measures of morning salivary cortisol are not generally considered to be reliable measures of physiological stress.
Gardi, C., Fazia, T., Stringa, B., & Giommi, F. (2022). A short Mindfulness retreat can improve biological markers of stress and inflammation. Psychoneuroendocrinology, 135, 105579.
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