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Arthroscopic surgery of the knee and shoulder involves inserting a pencil-thin lens and lighting system though a small incision in the human body to view injured connective tissue. Joint repair is then performed with specialized instruments inserted through separate small incisions.
Although orthopedic residents learn to perform this precise surgery on arthroscopy simulators, it is often hard for trainees to retain a high level of proficiency. In part, this is because surgical performance is negatively impacted by factors such as operating room distractions and the surgeon’s mental state.
Li et al. [Arthroscopy] tested whether a mindfulness meditation app could improve orthopedic residents’ performance during arthroscopic surgical simulation as well as reduce stress and distraction.
The researchers randomly assigned 43 male meditation-naïve and arthroscopically-naive orthopedic residents in Guangzhou, China (average age = 26 years) to one of three training conditions. On the first day of the study, all residents attended a didactic lecture on knee arthroscopic surgery and performed practice surgery using an arthroscopic simulator. Residents continued simulator practice until they attained two consecutive perfect scores on a set of surgical tasks.
Performance scoring was calculated by a pre-programmed simulator algorithm using a scoring system developed by the Arthoscopy Association of North America. It included measures like procedure time, camera path length, and degree of simulated cartilage injury.
After that initial arthroscopic training, two of the groups meditated 10-minutes a day for a total of 10 days using the Tide smartphone app. The app included guided audio meditations focusing on topics such as acceptance, calmness, and bodily and emotional awareness.
On day 11, residents were re-evaluated on the arthroscopic simulator performance. One-half of the meditation-trained residents meditated for 10 minutes immediately prior to the evaluation, and the other half did not. Residents reported their stress and mindfulness (Cognitive and Affective Mindfulness Scale-Revised) on day 1 and day 11 of the study.
The results showed that meditation-trained residents who meditated immediately before the simulator evaluation performed significantly better than meditation-trained residents who did not meditate immediately before the evaluation. This improvement was noted on several measures including total simulator score, surgery completion time, and injury to cartilage.
In addition, meditation-trained residents who did not meditate immediately prior to the evaluation showed significantly less skill deterioration over the course of the eleven days than residents in the non-meditation control.
Both groups of meditators showed significantly reduced stress over time compared to the non-meditators who reported increased stress levels (partial η2=0.67). Mindfulness scores improved for both mindfulness groups and declined for non-meditating controls (partial η2=0.50).
The study shows meditation app use can reduce the normal deterioration in arthroscopic surgical skills over time, and that meditating immediately before a surgical evaluation can improve surgical performance by orthopedic residents. Meditation may accomplish this by reducing stress and improving attentional skills during a surgical task.
The study’s generalizability is limited by its reliance on a male-only sample and a simulated rather than real-life surgical outcome, and by the absence of an active control group.
Li, W., Meng, X., Zhang, K.-J., Yang, Z., Feng, Z., Tong, K., & Tian, J. (2022). Meditation Using a Mobile App Improves Surgery Trainee Performance: A Simulation-Based Randomized Controlled Trial. Arthroscopy: The Journal of Arthroscopic & Related Surgery.
Link to study
There is some evidence that mindfulness training improves cognitive function and emotion regulation in adult samples. Less is known whether a similar effect generalizes to adolescents, given that adolescence is a developmental period in which cognitive and self-regulation functions are in the process of maturing.
Dumontheil et al. [Journal of Adolescence] tested the effect of mindfulness versus relaxation training on task-based cognitive performance and brain responsiveness to emotional stimuli in adolescents and adults. Their intent was to discern whether adults and adolescents responded to mindfulness training in the same way.
The researchers randomly assigned healthy, meditation-naïve British adolescent (N=28; average age = 14 years) and adult females (N= 23; average age = 28 years) to mindfulness or relaxation training. Trainings were offered in 8 weekly 90-minute group-based sessions with daily homework practice assigned.
Mindfulness training was based on “Learning to BREATHE,” a public school-based program founded on the principles of Mindfulness-Based Stress Reduction. Relaxation training taught a variety of unspecified relaxation techniques and skills.
Participants were assessed before and immediately after the training conditions on two computerized tasks. One task was used to assess attention control and a second emotional “N-back” task was used to assess emotion regulation. Participants completed these tasks while undergoing functional brain scans (fMRI).
The attention control task had participants view computer presented slides with a fixation cross with asterisks above or below the cross. The asterisks cued participants to look where a stimulus would most likely subsequently appear. The stimulus consisted of a set of arrows either all aligned in the same direction or with one misaligned arrow.
The attention control task required participants had to judge whether the stimulus arrows were all in alignment. The asterisk cueing where the stimulus was likely to appear was misleading 20% of the time. This required participants to reorient their attention when the stimulus finally appeared.
The emotional “N-back” task had participants view a series of computer-presented slides with a numeral appearing on each slide. Participants had to respond whenever a numeral was identical to one presented two slides earlier. Some numerals were presented alone, but others were flanked by pictures of happy, sad, or fearful faces that served as emotional distractors.
The results showed the misleading asterisks slowed attention task reaction time for the entire sample. Over the course of multiple trials, this slowing in reaction time significantly decreased in the mindfulness group but not in the relaxation control (d = -0.57). This effect was similar for adults and adolescents.
The study groups were similar on emotional “N-back task” accuracy and reaction time. However, adolescents in the mindfulness group showed a significant decrease in left amygdala activation in response to the emotional faces, whereas adolescents in the relaxation group and adults in either training group did not.
The amygdala is a part of the brain’s limbic system that is implicated in emotional responding. Decreased amygdala activation may indicate that the adolescent mindfulness group was better able to focus on the stimulus and ignore the task-irrelevant distracting emotional faces.
This study shows that mindfulness as compared to relaxation training results in improved reorientation of attention for adults and adolescents and improved emotional regulation in adolescents but not adults. This suggests that mindfulness training might offer a unique benefit for adolescents in terms of emotion regulation.
The study is limited by its small sample size, lack of predefined fMRI regions of interest, and by the use of a single teacher facilitating both groups.
Dumontheil, I., Lyons, K. E., Russell, T. A., & Zelazo, P. D. (2022). A preliminary neuroimaging investigation of the effects of mindfulness training on attention reorienting and amygdala reactivity to emotional faces in adolescent and adult females. Journal of Adolescence.
Asthma is a chronic disease characterized by airway inflammation, obstruction, and hyper-reactivity that affects 8% of the U.S. population. Symptom severity is often exacerbated by psychological stress, and stress-reduction techniques may have an important role in asthma control.
Higgins et al. [Brain, Behavior, & Immunity] conducted a randomized, controlled study to test whether Mindfulness-Based Stress Reduction (MBSR) improves asthma control and reduces airway inflammation.
The researchers randomly assigned 73 adults with clinically diagnosed asthma (average age = 38 years; 59% female) to either MBSR or a wait-list control. MBSR was the standard 8-week group intervention including the intensive one-day meditation retreat.
Study assessments were conducted at baseline, the midpoint of the intervention, post-intervention, and at four monthly follow-ups. Participants were assessed on self-reported asthma severity, the amount of nitric oxide in their breath, sputum and blood eosinophil counts, and self-report measures of stress and mindfulness (the Five Facet Mindfulness Questionnaire).
Nitric oxide is a biomarker for airway inflammation. Eosinophils are white cells in the blood that are elevated in inflammatory diseases. Nitric oxide and eosinophil levels are up-regulated by separate interleukin pathways (IL-13 and IL-5 respectively). Nitric oxide is a specific biomarker for Type 2 asthma, the most common asthma subtype.
At baseline, asthma severity was significantly associated with higher levels of stress and general psychological symptomatology. Over the course of treatment, the MBSR group showed increased levels of mindfulness and decreased levels of psychological symptomatology compared to the control group.
Self-reported asthma severity showed significantly greater improvement in the MBSR group as compared to the control group (d = 0.76), and this benefit was maintained throughout the 4-month follow-up period.
Thirty-two percent of participants in the MBSR group showed clinically meaningful asthma improvement compared to only 13% of the control group. There was a modest but significant decrease in nitric oxide levels for MBSR group compared to the control group. Sputum and blood eosinophils showed no significant differences by study group.
The study shows MBSR improves self-reported asthma control and decreases nitric oxide levels in people with asthma. The study was limited by its use of a waiting list control and by measuring only two inflammatory biomarkers.
Higgins, E. T., Davidson, R. J., Busse, W. W., Klaus, D. R., Bednarek, G. T., Goldman, R. I., Sachs, J., & Rosenkranz, M. A. (2022). Clinically relevant effects of Mindfulness-Based Stress Reduction in individuals with asthma. Brain, Behavior, & Immunity - Health.
The meconium, a newborn infant’s first stool, contains a rich diversity of bacterial species. Observational studies show that newborns from distressed mothers differ in terms of the frequency of bacterial species in their meconium. Differences in gut bacteria are associated with health in adults, and these differences could also play a role in newborn development.
Zhang et al. [Psychoneuroendocrinology] tested the effect of a mindfulness-based intervention on distress among pregnant mothers reporting elevated distress and examined their newborn infants’ meconium bacteria.
The researchers randomly assigned 160 distressed pregnant women in Shandong Province, China (mean age = 30 years) to either prenatal care as usual or prenatal care plus a 6-week mindfulness-based intervention. The women were classified as distressed based on baseline cut-off scores on self-report measures of anxiety and depression.
Mindfulness training was delivered individually over six weeks via a WeChat cellphone app. On the first day of each of the six weeks, the women viewed a 10 to 20-minute pre-recorded introduction to the topic of the week. On the following six days of each week, they engaged in 10-30 minutes of formal and informal theme-related mindfulness practices.
Themes included an introduction to mindfulness, awareness of present-moment experience, identifying avoidances, automatic vs. mindful responding, and mindfulness in childbirth. Meditation exercises were like those in Mindfulness-Based Stress Reduction (MBSR).
Maternal anxiety and depression self-report scores were collected at post-intervention. Stool from infant bowel movements during their first 48 hours after delivery were collected by maternity ward staff and sequenced for bacterial DNA identification.
There are two types of measures of bacterial diversity in stool samples: alpha and beta diversity. Alpha diversity is a measure of biodiversity within a single sample, whereas beta diversity is a measure of the similarity or dissimilarity of two samples.
Post-intervention results showed significantly lower average anxiety and depression self-report scores among women in the mindfulness compared to the control group. The study groups did not differ in stool alpha diversity.
Significant differences emerged by group, however, in stool beta diversity. Specifically, infant stools in the mindfulness group had higher levels of Bifidobacterium and Blautia, while infant stools from control mothers had higher levels of Staphylococcus.
The study shows that a mindfulness intervention for psychologically distressed pregnant women raises the level of “healthy” bacteria in their newborn infants’ gut systems Studies show Bifidobacterium levels are associated with neuropsychological development in children, and Blautia levels are shown to be lower in depressed adults.
The study is limited by its measuring stool meconium bacteria at only one time point, and the DNA sequencing method used could not correlate specific bacterial strains with maternal psychological variables.
Zhang, X., Mao, F., Li, Y., Wang, J., Wu, L., Sun, J., & Cao, F. (2022). Effects of a maternal mindfulness intervention targeting prenatal psychological distress on infants’ meconium microbiota: A randomized controlled trial. Psychoneuroendocrinology, 145, 105913.
Differing regions of the human brain work in tandem to form large-scale integrated brain networks. Three large-scale brain region networks organize much of human brain activity: the Central Executive Network (CEN), the Salience Network (SN), and the Default Mode Network (DMN).
The CEN is dominant when we are deliberately focusing on a task, the SN is dominant when we are evaluating sensory input in preparing to respond, and the DMN is dominant when we are off-task and mind-wandering.
These networks are relevant to mindfulness meditation which involves deliberate attentional focus (CEN) on bodily sensations (SN) that minimizes mind-wandering (DMN). Much of the research on the effect of mindfulness meditation training on these brain networks is limited by small sample sizes, correlational findings, and the lack of control groups.
Bremer et al. [Scientific Reports] tested the longitudinal effect of mindfulness training on the functional connectivity between these brain networks using functional magnetic resonance imaging (fMRI) with adult participants.
The researchers assigned 46 German meditation-naïve adults (50% male; average age = 35) to 31 days of either web-based mindfulness or health education training. Initial assignment was random, but researchers slightly adjusted the assignments to equalize the sex and age of the groups.
Participants underwent resting-state fMRI brain scans before and after intervention. Trainings involved daily 10-15-minute audio and video content. Mindfulness training was developed by a MBSR instructor. Health training involved excerpts from popular science broadcasts on a broad array of health topics. Participants needed to complete at least 23 sessions to be included in the data analysis.
fMRI data were analyzed for functional connectivity, dynamic functional connectivity, and seed-based connectivity. Functional connectivity measures how much two brain networks are interconnected at a given time. Dynamic functional connectivity measures how much connectivity between networks fluctuates in tandem over time. Seed-based connectivity measures how regions of interest interact with the whole brain.
While the functional connectivity analysis showed no significant effects, the dynamic functional connectivity analysis showed the mindfulness training group had increased dynamic functional connectivity between regions of the DMN and regions of the SN while controls did not.
Seed-based connectivity analysis (using the DMN and SN regions identified in the prior analysis as seeds) found similar increases in connectivity between regions of the DMN and SN in the mindfulness group but not controls.
The researchers interpret this greater functional connectivity as reflecting an individual’s growing awareness of when they are mind-wandering during mindfulness practice and using that awareness as a signal to return to focusing.
This study shows an increased DMN-SN dynamic functional connectivity after mindfulness training in naïve meditators. These brain findings offer some neural function correlates of how meditators track mind-wandering and re-focus attention.
The researchers caution that focused-attention and open-monitoring meditations would probably result in different patterns of connectivity.
Bremer, B., Wu, Q., Mora Álvarez, M. G., Hölzel, B. K., Wilhelm, M., Hell, E., Tavacioglu, E. E., Torske, A., & Koch, K. (2022). Mindfulness meditation increases default mode, salience, and central executive network connectivity. Scientific Reports.
Does mindfulness practice increase altruism? Research suggests the answer is mixed. For example, mindfulness practice is shown to increase altruistic behavior among people who have a strong predisposition to altruism but decrease it when they are self-centered.
Interpreting the data from existing studies can be difficult because studies vary as to whether they teach mindfulness in conjunction with lovingkindness and compassion or as a stand-alone attentional practice.
Malin & Gumpel [Mindfulness] conducted an experiment to test whether a brief mindfulness practice affected people’s willingness to help someone in distress. They also examined whether mindfulness practice had a larger effect on helping behavior in people with higher initial levels of empathy.
The researchers randomly assigned 189 Israeli undergraduates (85% female; mean age = 21 years) to either mindfulness practice, listening to music, or listening to a lecture. Interventions and data collection were administered by Zoom.
The mindfulness group involved two 30-minute guided meditations offered one week apart. Meditation focused on non-judgmental observation of sensations, thoughts, and feelings during a body scan. Meditation training did not include training in loving-kindness or compassion.
Music and lecture control conditions were also offered in two 30-minute Zoom sessions one week apart. The music intervention consisted of relaxing classical music, and the lecture topics focused on empathy and help-giving. Participants were assessed prior to the intervention on a self-report measure of capacity for empathy.
At the end of the second intervention session, participants listened to a pre-recorded sham interview with a college student named “Anna.” Anna was alleged to be part of the college radio station’s effort to determine what content interested students. In the interview, Anna described her difficulties struggling with a chronic illness.
Study participants then completed questionnaires measuring state mindfulness and their empathic response to Anna. They were also provided an opportunity to register to volunteer for an organization that helped people like Anna. Participants intending to volunteer could also submit their personal information so that the volunteer organization could contact them.
Study results showed the mindfulness group had a significantly greater proportion of participants willing to volunteer to help people like Anna than the control groups. Thirty-six percent of the mindfulness group left contact information so that they could volunteer, while 14% of the music and 16% of the lecture group did.
Baseline empathy levels significantly predicted self-reported empathy for “Anna” in the mindfulness group (b=1.40), but not in the music (b=0.28) or lecture (b=0.09) groups. Specifically, mindfulness practice increased empathic responding in participants with high baseline levels of empathy and decreased empathic responding in those with low baseline levels of empathy. Listening to music or a lecture on empathy did not show this effect.
Self-reported empathy for “Anna” correlated with a willingness to volunteer in the mindfulness (r=.38) and music groups (r=.30) but not in the lecture group (r=.04).
The results show that guided meditation practice can increase the intention to volunteer to help a stranger in distress (at least shortly after mindfulness practice). People with high baseline levels of empathy have higher levels of empathic response to a person in distress after mindfulness practice. On the other hand, mindfulness decreases empathic responsiveness in people with low baseline levels of empathy.
The study is limited to the degree that it measures intent to volunteer rather than actual volunteering.
Malin, Y., & Gumpel, T. P. (2022). Short Mindfulness Meditation Increases Help-Giving Intention Towards a Stranger in Distress. Mindfulness.
Adolescents and young adults are more likely to newly acquire HIV infections than other age groups. This young cohort is also less likely to access medical care, adhere to antiretroviral therapy, or achieve viral suppression when compared to older age cohorts.
Sibinga et al. [AIDS Care] evaluated whether Mindfulness-Based Stress Reduction (MBSR) could increase medication compliance and help reduce HIV viral load in adolescents and young adults living with HIV infection.
The researchers randomly assigned 74 HIV positive adolescents and young adults aged 13-24 (average age = 21; 92% Black) to MBSR, health education, or medical treatment as usual. The MBSR program included 8 weekly 2-hour sessions and a 3-hour retreat. MBSR content was modified to make it more relevant to urban youth.
The 8-week health education control was matched to MBSR in terms of the length and frequency of meetings and group size. It offered didactic information on physical activity, nutrition, weight, and personal care. Treatment as usual consisted of clinic visits and lab work every 3-6 months.
Data analysis showed no significant differences between the health education (N=32) and treatment as usual (N= 8) groups on any variables, and so the groups were combined as a single control group to compare against the MBSR group. While this was not the original plan for the trial, it added more power to compare MBSR to a study control group.
Average MBSR attendance was 6 sessions with 5 participants attending no sessions. Average health education attendance was 5 sessions with 7 participants attending no sessions.
Participants were assessed at baseline, post-treatment, and 6- and 12-month follow up on medication adherence (as measured by a self-report questionnaire of pills prescribed and taken and of missed doses per week), HIV viral load, and CD4 cell counts. Viral load is a measure of the presence of the virus in the bloodstream. CD4 count is a measure of cellular-based immunity. Higher viral load and lower CD4 count are indicators of disease progression.
Within-group results showed participants in both MBSR and the combined control group attained significantly higher rates of medication adherence at post-treatment (OR = 1.81) and 6-month follow-up (OR = 3.95) than at baseline. The MBSR group had a significantly greater increase in medication adherence at post-treatment than the control group (OR = 2.50). This relative improvement did not persist at 12 months.
At immediate post-treatment, there was a trend toward a greater MBSR HIV viral load decrease compared to the control group. This trend became significant when only participants who attended at least one intervention session were included in the analysis. CD4 levels were unchanged in both groups after the intervention.
The study shows a MBSR program modified to meet the needs of urban youth can significantly improve antiretroviral medication adherence for up to six months relative to a health education intervention. The study is limited by its reliance on a self-report measure of medication adherence given the limitations of human recall of taking pills as well as reporting bias.
Sibinga, E. M. S., Webb, L., Perin, J., Tepper, V., Kerrigan, D., Grieb, S., Denison, J., & Ellen, J. (2022). Mindfulness instruction for medication adherence among adolescents and young adults living with HIV: A randomized controlled trial. AIDS Care.
Our decision making is often biased in favor of benefit to ourselves. When categorizing whether possessions belong to us or someone else, we tend to be more accurate and make the decision more rapidly when the possessions are our own. This experimental result has been found so often that some researchers believe self-prioritizing is an inevitable part of decision-making. Interventions that reduce ego-involvement may reduce this type of self-bias.
In two separate experiments, Golubickis et al. [Psychonomic Bulletin and Review] tested whether a brief mindfulness meditation could reduce or eliminate decision-making self-bias compared to a control intervention.
In the first experiment, the researchers randomly assigned 160 undergraduates (83% female; average age = 22 years) to a brief mindfulness meditation or a control group. Participants accessed the experiment through an internet web portal. Once on the website, participants engaged in a 5-minute pre-recorded guided exercise. The mindfulness group was instructed to attend to their breathing non-judgmentally and to disidentify with thoughts. The control group was instructed to allow their minds to wander and immerse themselves in their thoughts, emotions, and memories.
After the guided exercises, participants were shown images on the computer of pens and pencils. Half of each study group was instructed to think of the pencils as their own and the pens as belonging to a friend. The other half of each study group was told to think of the pencils as their own and the pens as belonging to a friend. Participants were then shown 200 images of pens and pencils for 100 milliseconds each and asked to indicate whether each object was their own or belonged to the friend by pushing keyboard keys.
The second experiment was identical to the first, except the control group was assigned a different task. Participants were 160 undergraduates (74% female; average age = 22 years). In this study, the study control group was given 5 minutes to solve a visual puzzle task which involved constructing shapes out of polygons. This problem-solving task was selected by the researchers to rule out the possibility that the control group task in the first study may have inadvertently increased self-focused ego involvement.
Control groups in both studies were significantly more accurate in identifying items belonging to themselves than those belonging to friends. They also had quicker reaction times to their own objects as opposed to objects belonging to friends. Conversely, the mindfulness group responded to self-identified and other-identified items with equal accuracy and speed.
The researchers subsequently performed a computer modeling drift diffusion analysis. This type of analysis is designed to sort out whether study group differences are due to differences in processing stimulus information or due to differences in preparing to respond. Computer modeling in this way suggested the mindfulness group was more cautious about making a response about ownership, needed more information before deciding, and more quickly absorbed information about the pens and pencils.
This study shows a brief web-based guided mindfulness meditation can reduce self-bias in categorizing possessions as belonging to oneself. Thus, it supports the idea that mindfulness helps reduce certain types of ego-bias in cognitive processing related to ownership of inexpensive items.
Golubickis, M., Tan, L. B. G., Saini, S., Catterall, K., Morozovaite, A., Khasa, S., & Macrae, C. N. (2022). Knock yourself out: Brief mindfulness-based meditation eliminates self-prioritization. Psychonomic Bulletin & Review.
Our body’s adaptive response to a stressor occurs in temporal phases and is the outcome of complex interactions between the sympathetic and parasympathetic nervous systems and the endocrine system. This phased time scale is the outcome of feedback loops between the systems and the time it takes for stress hormones to both enter the blood stream and subsequently be deactivated. Many studies ignore this complexity by measuring stress at a single timepoint or with only a sole biomarker.
Gamaiunova, et al. [Biological Psychology] tested the effects of two different mindfulness-based interventions on multiple biological measures of stress across different temporal phases of the stress response. A better understanding of the temporal dynamics of these measures might help us better understand discrepancies between studies that show different results.
The researchers randomly assigned 99 healthy Swiss adult volunteers to Mindfulness-Based Stress Reduction (MBSR), Buddhist-enhanced Mindfulness-Based Stress Reduction (MBSR-B), or a waitlist control. Attrition was high, and data from only 65 participants (average age = 29 years; 65% female) were analyzed. MBSR was taught in 8 weekly 2.5-hour sessions with a 7th week retreat day and 55 minutes a day of homework. MBSR-B was similarly structured but included additional material on the Buddhist themes of impermanence, ethics, lovingkindness, compassion, non-self, and craving.
Following the study interventions, participants completed a social stress task in a laboratory setting. After being hooked up to an electrocardiograph (EKG), participants rested for ten minutes. Participants were then given 15 minutes to prepare a talk as part of a stress task. During the stress task, participants gave 5-minute speeches and engaged in 5 minutes of mental arithmetic while being recorded on camera and observed by two research assistants wearing white lab coats. The participants then remained in the lab for a 30-minute recovery period. EKGs were recorded from the start of the rest period through the recovery period.
Saliva samples of cortisol (a stress hormone) and α-amylase (a surrogate for serum epinephrine and norepinephrine) were drawn during the rest, anticipation, task, and recovery periods. EKGs were analyzed for heart rate variability and the duration of the pre-ejection period. Heart rate variability increases due to parasympathetic activity, and the pre-ejection period shortens due to sympathetic activity. Participants were also asked to rate their positive and negative affect during rest, anticipation, task, and recovery.
The results showed both MBSR groups had significantly lower cortisol levels under the curve during the anticipatory period than controls (d=0.78-0.82). They also showed significantly lower relative percent decreases in pre-ejection period duration than controls during the anticipatory (d=0.71-0.82) and task (d=0.70-0.87) periods, but not during the recovery period. Both MBSR groups showed a significantly lesser relative percent decrease in heart rate variability during the anticipatory (d = 0.72-0.88) and task (d = 0.88-1.05) periods than controls, but only the MBSR-B group showed a significant effect (d = 1.10) during the recovery period when compared to the control group.
The MBSR-B group reported smaller increases in negative affect than controls during the anticipatory phase (d=.97) while both treatment groups reported smaller increases in negative affect during the task phase (d=0.95-0.88). The treatment groups also reported smaller declines in positive affect than controls during the task phase (d =0.95-0.91). No between-group differences were noted for α-amylase levels.
The study shows MBSR and MBSR-B both reduce subjective and biological components of the laboratory-induced stress response, but these effects vary depending on the measure used and the phase of the stress response during which they were measured. The study was limited in its power to detect significant differences due to its relatively high attrition rate.
Gamaiunova, L., Kreibig, S. D., Dan-Glauser, E., Pellerin, N., Brandt, P.-Y., & Kliegel, M. (2022). Effects of Two Mindfulness Based Interventions on the Distinct Phases of the Stress Response Across Different Physiological Systems. Biological Psychology.
Ulcerative colitis is a debilitating chronic inflammatory bowel disease with symptoms that include diarrhea, abdominal pain, fecal incontinence, fever, and fatigue. The disease is characterized by acute symptomatic flares interspersed with periods of asymptomatic remission. Flares can be triggered by stress, and mindfulness-based interventions may have a role to play in disease management.
Jedel et al. [Inflammatory Bowel Diseases] tested whether mindfulness-based stress reduction (MBSR) could reduce symptom flare frequency and severity in patients with inactive ulcerative colitis.
The researchers randomly assigned 43 meditation-naïve ulcerative colitis patients with inactive disease (average age = 42 years; 58% female; 72% Caucasian) to either modified MBSR or a psychoeducational control. MBSR was delivered in 8 weekly 1½-2-hour weekly group sessions with a 4-hour retreat in the 7th week. The shortened session lengths were made to accommodate the very small class sizes.
The psychoeducational control consisted of similarly structured group sessions with didactic material on the causes of physical illness, the effects of stress on physical health, the protective role of exercise, and cardiovascular disease risk factors.
Participants completed assessments at baseline, post-intervention, and 6- and 12-month follow-up. Participants completed measures of perceived stress, depression, anxiety, sleep quality, mindfulness (Five-Facet Mindfulness Questionnaire), disease symptoms and quality of life. They also submitted stool, urine, and blood samples, and were given sigmoidoscopies.
Stool samples were evaluated for levels of calprotectin which is associated with bowel inflammation, and urine samples were evaluated for levels of cortisol (a stress hormone). Blood samples were assessed for the proinflammatory biomarkers IL-6, IL-8, and C-reactive protein.
The results showed MBSR participants experienced significantly fewer flares: none of the 20 MBSR participants experienced flares while 5 of the 23 controls did. There were no significant between-group differences on any biological or psychological measure once participants who experienced flares were excluded. Those who experienced flares were excluded because the steroid treatment they received for their flares would have influenced their biological markers.
Mindfulness scores were significantly correlated with decreased perceived stress scores (r= -.54) and calprotectin levels were correlated with elevated urinary cortisol (r = .37), supporting the role of stress in ulcerative colitis.
The study shows that MBSR reduced the incidence of symptom flares in ulcerative colitis patients relative to a psychoeducation program.
The study is limited by its small sample size. The researchers also interpreted MBSR as having a positive effect on several psychological variables (e.g., mindfulness, depression) because of significant within-group improvements on these variables over time even though there were no between-group differences on these variables.
Jedel, S., Beck, T., Swanson, G., Hood, M. M., Voigt, R. M., Gorenz, A., Jakate, S., Raeisi, S., Hobfoll, S., & Keshavarzian, A. (2022). Mindfulness Intervention Decreases Frequency and Severity of Flares in Inactive Ulcerative Colitis Patients: Results of a Phase II, Randomized, Placebo-Controlled Trial. Inflammatory Bowel Diseases.
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