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MBSR and relaxation both reduce stress, but brain activity differs

Posted 05.17.2018 | by AMRA

Mindfulness-Based Stress Reduction (MBSR) and Relaxation Response (RR) training are both well-established mind-body interventions designed to reduce stress. While there is some overlap between these modalities—both involve meditative attention to bodily sensations—there are also significant differences. MBSR emphasizes non-judgmental awareness to increase acceptance of the present moment, while RR employs muscle relaxation to induce a parasympathetic state that interferes with the fight-or-flight response.

To understand the ways in which these two programs function, Sevinc et al. [Psychosomatic Medicine] tested for commonalties and differences in terms of psychological effects and brain correlates.

The researchers randomly assigned 50 volunteers (64% female, average age = 38 years) to either MBSR or RR with 40 of the volunteers completing the programs. Both programs involved 8 weekly 2-hour group sessions with 20 minutes of daily home practice. RR included a body scan meditation emphasizing muscle relaxation along with breath-focused and mantra-focused meditations.

Participants were assessed at baseline and after the intervention on self-report measures of mindfulness (using the Five Facet Mindfulness Questionnaire or FFMQ), perceived stress, self-compassion, and rumination.

After the intervention, participants underwent fMRI brain scanning while at rest and while engaging in the body scan meditation specific to each program: the RR body scan emphasized relaxing various muscle groups, whereas the MBSR body scan emphasized mindful awareness of body sensations.

The researchers were interested in exploring changes in functional connectivity in specific brain regions of interest. Brain regions exhibiting simultaneous increases and decreases in activity are said to be functionally connected. Usable fMRI data was obtained from 34 participants.

The results showed that both programs significantly reduced perceived stress (RR Cohen’s d=0.5; MBSR d=1.0). After the intervention, RR participants showed significant […]

May 24th, 2018|News|

How are MBSR participants doing 6 years after the program?

Posted 05.17.2018 | by AMRA

Most mindfulness research studies do not follow participants long after the intervention ends. At best, a few studies have followed their participants for up to two years. As a result, little is known about whether the effects of mindfulness-based interventions persist, strengthen, or fade over time. To address this limitation, de Vibe et al. [PLOS One] followed participants for six years after completing a Mindfulness-Based Stress Reduction (MBSR) program.

The researchers randomly assigned 288 Norwegian medical and psychology graduate students (76% female, average age = 24 years) to a slightly abridged form of MBSR or a no-intervention control. The MBSR program consisted of seven 1.5-hour weekly group sessions and required 20 minutes of daily home practice.

Participants were assessed on dispositional mindfulness (using the Five Facet Mindfulness Questionnaire), subjective wellbeing, problem-focused coping and avoidance-focused coping at baseline, one month post-intervention, and at 1, 2, 4, and 6-year follow-up. Problem-focused coping involves facing one’s problems head-on by actively addressing them, while avoidance-focused coping consists of avoiding one’s problems or suppressing thoughts and emotions about them.

Participants also had the opportunity to enroll in a 1.5-hour mindfulness “booster” class each semester. While most attended at least one booster class, 46% never attended any. There were dropouts at each assessment time-point, with 61% of the participants having dropped out of the study by year six. There was no difference between MBSR and control group dropout rates, but participants with higher baseline avoidance-focused coping were significantly more likely to drop out.

Six-year longitudinal growth curves revealed that the MBSR participants showed significant continuing increases in mindfulness and problem–focused coping, with significant continuing decreases in avoidance-focused coping over time. MBSR rates […]

May 17th, 2018|News|

MBSR changes brain networks of opiate dependent patients

Posted 03.14.2018 | by AMRA

The United States is in the midst of an opioid epidemic, with over 42,000 opioid overdose related deaths in 2016. There is a clear need for innovative approaches to help deal with the problems of substance dependency and misuse. Mindfulness-based interventions are sometimes used as adjunctive treatments for substance use disorders, but little is known about how these interventions affect the brains of substance users.

Fahmy et al. [Addictive Behaviors] used structural magnetic resonance imaging (MRI) to investigate brain changes in opiate dependent patients undergoing either treatment-as-usual (TAU), or treatment-as-usual plus Mindfulness-Based Stress Reduction (MBSR).

MRI data were analyzed to identify structural changes in the cellular networks connecting brain regions. The researchers limited their investigation to regions previously shown to be of interest in addiction and mindfulness research. They also looked at whether structural brain network changes were accompanied by meaningful changes in personality traits relevant to recovery and relapse.

The study followed 28 opiate dependent patients (average age = 30 years; 89% male) in a four-week inpatient substance treatment program in Cairo, Egypt. Half the participants were assigned to treatment as usual (TAU) and half to MBSR. Assignment was based on order of enrollment in the study and was not strictly random.

Nineteen participants completed their treatments and post-treatment evaluations. There was no difference in treatment dropout rates. TAU included medication and group cognitive behavioral therapy. The MBSR program was a culturally adopted Arabic-language version of MBSR. Participants completed the Freiburg Mindfulness Inventory (FMI), self-reported measures of distress tolerance, sensation seeking, impulsivity, and addiction severity, and underwent MRI scanning before and after treatment.

MBSR participants showed significant strengthening in the brain networks connecting the prefrontal cortex […]

March 14th, 2018|News|

Elderly taking MBSR improve verbal recall and mental health

Posted 08.24.2017 | by AMRA

Elderly anxiety and depression sufferers often report subjective problems with memory and cognition. They also perform more poorly on objective measures of short-term memory, verbal fluency, and the ability to ignore irrelevant cues while focusing on a task. Stress can play an important role in worsening anxiety and depression and also in degrading cognitive function.

There is evidence that cortisol, a hormone secreted during stress, can have a harmful effect on brain cells in the hippocampus, which may in turn negatively affect memory and cognition. Reducing stress may therefore yield a double benefit: reducing anxiety and depression, and improving memory and cognition.

Wetherell et al. [Journal of Clinical Psychiatry] explored whether Mindfulness-Based Stress Reduction (MBSR) could improve clinical symptoms and cognitive functioning better than a control group in elderly people suffering from anxiety and/or depression who also experience subjective cognitive difficulties.

The researchers randomly assigned 103 elderly patients (average age = 72 years; 75% Female; 83% Caucasian) with clinical diagnoses of anxiety and/or depressive disorders and with subjective cognitive complaints to either an 8-week group MBSR intervention or an 8-week Health Education control intervention. The Health Education groups met for the same frequency and duration as the MBSR groups, but focused on understanding and managing anxiety and depression, eating well, managing medications, and communicating with one’s heath care providers.

Patients were assessed at baseline, at the end of the intervention, and at 3-and-6-month follow-ups. Outcomes were assessed on measures of psychiatric symptoms, verbal memory, verbal fluency, the ability to ignore distracting cues and stay focused on a task, mindfulness (as measured by the Cognitive and Affective Mindfulness Scale-Revised), and average peak salivary cortisol.

Despite randomization, the health […]

August 24th, 2017|News|

New blood marker of Alzheimer’s disease improved by MBSR

Posted 07.19.2017 | by AMRA

Alzheimer’s Disease is a progressive brain disease affecting some five million older Americans. Given the profound personal, social, and economic costs of this disease, scientists are seeking ways to prevent its occurrence and progression. One avenue of investigation involves a protein called Repressor Element 1-Silencing Transcription Factor or REST. REST plays an important role in helping developing cells differentiate as neurons and protects aging brain cells from stress and toxicity.

People with Alzheimer’s have low REST levels, while older adults who retain their cognitive function well into their 90s and 100s have high REST levels. Also, older adults who show neurological changes typical of Alzheimer’s do not progress to show behavioral signs of the disease if their REST levels remain high.

Can raising REST levels reduce the risk for Alzheimer’s? Ashton et al. [Translational Psychiatry] explored this question using a new method for measuring REST in blood plasma. First they investigated whether this new REST measure in blood could discriminate between different levels of Alzheimer’s risk. Second, they studied whether Mindfulness-Based Stress Reduction (MBSR) improved REST levels in a population at risk for potentially developing Alzheimer’s.

The first study compared plasma REST levels in three groups of older (65 years or older) adults: 65 adults with Alzheimer’s, 65 adults with mild cognitive impairment, and 65 healthy adults. There was a significant difference between the Alzheimer’s group and both the healthy and mildly cognitively impaired groups. Mean REST levels were lowest for Alzheimer’s patients (112 pg mL-1) and highest for healthy controls (199 pg mL-1), with mildly cognitive impaired patients measuring in between (194 pg mL-1). Those mildly cognitive impaired who remained stable over time had higher […]

July 19th, 2017|News|

Brain regions connect after mindfulness training

Posted 04.25.2017 | by AMRA

Mindfulness training has been shown to improve performance on behavioral measures of executive control including attention, working memory, emotional and cognitive control, and decision making. Research also suggests that a brain region known as the dorsolateral prefrontal cortex (dlPFC) plays an important role in executive control, serving as the hub of an executive control brain network. The dlPFC has rich anatomical connections to other brain regions that are also thought to be involved in executive control. Does mindfulness training assist executive control by improving the way the dlPFC interrelates with these other brain regions?

One way to test this is by assessing resting state functional connectivity between the dlPFC and other brain regions. Resting state functional connectivity is a measure of how much different brain regions work in tandem. For example, when one region increases activity, other brain regions act in sync with it.

Taren et al. [Psychosomatic Medicine] tested whether mindfulness training increases the functional connectivity between the dlPFC and other executive control brain regions by comparing functional connectivity after either mindfulness training or relaxation training in a randomized, controlled study.

The researchers randomly assigned 35 unemployed, job-seeking adults (average age = 40; 57% male; 66% Caucasian) who reported high levels of stress to either an intensive 3-day residential mindfulness training, or an intensive 3-day residential relaxation training. Mindfulness training was a condensed version of Mindfulness-Based Stress Reduction that included body scanning, sitting, walking, and eating meditations, and mindful yoga. Relaxation training included resting while walking and stretching and didactic presentations, but did not include progressive muscle relaxation.

All participants underwent functional magnetic resonance imaging (fMRI) both at baseline and two weeks after training. The […]

April 25th, 2017|News|

MBSR participants with generalized anxiety disorder miss less work

Posted 03.21.2017 | by AMRA

People with generalized anxiety disorder (GAD) suffer from excessive and uncontrollable worry concerning a broad array of everyday matters (work, money, health, relationships, etc.) along with a range of physical symptoms (headache, fatigue, muscle tension, etc.) associated with stress. As a result, people with GAD often miss days at work and tend to use medical and mental health services at a higher rate than the average person.

GAD is often treated with medication and psychotherapy, and in recent years, mindfulness-based interventions have been added as an additional treatment alongside more traditional approaches.

In a secondary analysis of a previously published randomized, controlled clinical trial, Hoge et al. [Journal of Psychosomatic Medicine] investigated whether Mindfulness-Based Stress Reduction (MBSR) reduced the number of GAD sufferers’ missed days at work and the number of their visits to primary care and mental health care professionals to a greater degree than a stress management education (SME) control.

The 57 individuals with GAD (mean age = 39; 56% female; 83% Caucasian) whose data were analyzed in this study were a subset of a larger cohort of individuals with GAD who were randomly assigned to either a standard 8-week MBSR program or an 8-week SME program. The SME program covered topics relevant to stress including time management, nutrition, exercise, and sleep.

The subgroup of patients whose data was included in this analysis completed the World Health Organization Health Performance and Work Questionnaire (HPQ) at baseline, after intervention, and at 24-week follow-up. The HPQ is a self-report measure of illness-related absences from work and visits to primary care and mental health professionals.

At immediate post-intervention, the MBSR group had significantly decreased the number of partial […]

March 21st, 2017|News|

MBSR for Social Anxiety Disorder promotes positive self-view

Posted 02.16.2017 | by AMRA

Social Anxiety Disorder (SAD) is a psychiatric condition affecting approximately 7% of Americans. Symptoms include fear, embarrassment, and humiliation in social situations, along with avoidance of social interactions. People with SAD have negative beliefs about their social acceptability and self-worth, creating fear that others will discover their self-perceived negative qualities. Altering these negative self-beliefs may be an effective way to reduce the severity of SAD symptoms.

Thurston et al. [Journal of Anxiety Disorders] conducted a randomized, controlled study to test the effects of Mindfulness-Based Stress Reduction (MBSR) and Cognitive Behavioral Group Therapy (CBGT) on positive and negative self-evaluations and their relationship to social anxiety symptoms in patients with SAD.

The researchers randomly assigned 108 volunteers (56% female; mean age = 33 years; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) with SAD to a 12-week MBSR program, CBGT program, or wait-list control. The volunteers completed a Self-Referential Encoding Task (SRET) and a self-report scale of social anxiety at baseline and after the assigned intervention. The SRET was also completed by a separate group of 40 healthy controls that served as a baseline comparison group. The SRET measures participants’ positive and negative self-views by having them select the words that best describe themselves from pairs of computer-presented negative and positive adjectives.

The standard curriculum-based MBSR intervention omitted the usual “retreat day” in the sixth week of the program, but extended the program by adding four additional weekly group sessions so that it better matched the 12-week CBGT program. The CBGT program taught cognitive restructuring and relapse prevention and offered graded exposure to feared social situations, both in-program and the “real world.” Wait-listed controls did not participate […]

February 16th, 2017|News|

Mindfulness and social cooperation in economic decision making

Posted 08.11.2016 | by AMRA


Cooperating with others sometimes requires that we set irrelevant negative emotions aside in order to stay focused on achieving common goals. Can mindfulness meditation improve cooperation with others by strengthening our resistance to being distracted by negative emotions? If so, how is the brain involved in this process?

Kirk et al. [Neuroimage] studied the effects of mindfulness meditation vs. relaxation training on the decision making and brain functioning of volunteers playing a cooperative economic decision making game.

The researchers randomly assigned 51 healthy adult participants (82% Caucasian, 53% female, average age = 32) who volunteered to participate in a stress reduction program to either an 8-week mindfulness training based on Mindfulness-Based Stress Reduction (MBSR), or an 8-week stress reduction program utilizing progressive muscle relaxation, exercise, stretching, and group discussion of stress-reduction topics.

The participants played the computer-based Ultimatum Game before and after training while their brain function was monitored using functional magnetic resonance imaging (fMRI). They also completed the Five Facet Mindfulness Questionnaire (FFMQ) before and after training.

The Ultimatum Game asks participants to consider offers to split $20 between themselves and another player. For example, the computer screen informs participants that someone named “Tom” is offering to split $20 with them 50/50, so that they each would receive $10. Participants then either accept or reject the offer. In reality, the offers weren’t from real people but were computer generated. The offers ranged from equal (50/50) splits to vastly unequal (19/1) splits.

While it makes economic sense to accept all offers since rejecting any offer means getting nothing, participants tend to reject offers that are inequitable and seem unfair. Past research shows that the tendency to reject […]

August 11th, 2016|News|

Older adult cognitive decline improves after mindfulness program

Posted 05.19.2016 | by AMRA


Older adults who complain of subjective cognitive decline (SCD) often appear normal in day-to-day functioning and on clinical assessment, but 60% of them eventually develop either mild cognitive impairment or Alzheimer’s Disease. This makes older adults with SCD a prime target for interventions aimed at preventing or slowing cognitive decline.

Smart et al. [Journal of Alzheimer’s Disease] conducted a randomized controlled pilot study to test the effects of mindfulness training versus a psycho-educational control on measures of attention, brain structure and function, and self-reported cognitive complaints, mood, and mindfulness in adults with SCD.

A sample of 23 healthy older adults and 15 older adults with SCD (predominantly Caucasian men and women, average age = 70) were randomly assigned to either an 8-week mindfulness training based on MBSR that was tailored for older adults, or a 5-week program that provided education on memory and aging, situational factors that affect memory, and strategies to compensate for memory difficulties. Participants completed self-report measures of memory complaints, depression, and mindfulness (the Five Facet Mindfulness Questionnaire, or FFMQ).

They also completed an attentional capacity task that required them to be vigilant and respond or withhold responding to letters presented on a computer screen. An electroencephalogram (EEG) recorded the magnitude of their brain’s P3 evoked response potentials (ERPs) while performing this task. Higher P3 ERPs reflect increased attentional capacity and are known to decrease in amplitude with SCD. All these measures were obtained both before and after intervention. Structural magnetic resonance imaging (MRI) was also included to detect changes in total brain volume from pre- to post- intervention.

Adults with SCD reported a greater number of subjective memory complaints and had a […]

May 19th, 2016|News|