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Fan C, Wu M, Liu H, Chen X, Gao Z, Zhao X, Zhou J, Jiang Z. Effects of meditation on neural responses to pain: A systematic review and meta-analysis of fMRI studies. Neurosci Biobehav Rev 2024; 162:105735. [PMID: 38821153 DOI: 10.1016/j.neubiorev.2024.105735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 06/02/2024]
Abstract
This systematic review investigates the impact of meditation on neural responses to pain, as measured by functional magnetic resonance imaging (fMRI). Up to March 2024, we conducted searches across four databases for human studies implementing fMRI to assess the efficacy of meditation for pain relief. Eighteen studies met the inclusion criteria. Our systematic review indicates that activation of the insula, anterior cingulate cortex, and orbitofrontal cortex is positively associated with meditation for pain relief, while activity in regions like the amygdala and medial prefrontal cortex is negatively correlated with pain relief. Meta-analyses consistently reveal the involvement of various brain regions, including the insula, putamen, amygdala, anterior cingulate cortex, precentral gyrus, postcentral gyrus, inferior parietal lobule, superior temporal gyrus, inferior frontal gyrus, and caudate nucleus, in meditation-induced alleviation of pain. These findings suggest ccthat meditation acts on specific brain regions related to pain, mood, and cognition, providing insight into the potential mechanisms underlying the pain-alleviating effects of meditation on both pain sensations and emotional experiences.
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Affiliation(s)
- Cheng Fan
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710004, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China
| | - Mengjiao Wu
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Department of Rehabilitation Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
| | - Hong Liu
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
| | - Xiaolin Chen
- Department of Rehabilitation, Dongguan Songshan Lake Tungwah Hospital, DongGuan 523000, China
| | - Zhen Gao
- Department of Rehabilitation, Fuzhou Second Hospital, Fuzhou 350122, China
| | - Xin Zhao
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
| | - Jianhao Zhou
- The First Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China
| | - Zheng Jiang
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou 350122, China; College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
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Raugh IM, Strauss GP. Integrating mindfulness into the extended process model of emotion regulation: The dual-mode model of mindful emotion regulation. Emotion 2024; 24:847-866. [PMID: 37843512 PMCID: PMC11009092 DOI: 10.1037/emo0001308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Extensive research has been conducted regarding how people manage their emotions. Within this research, there has been growing attention toward the role of mindfulness in emotion regulation. While prior reviews have discussed mindfulness in the context of emotion regulation, they have not provided a thorough integration using the prevailing models of emotion regulation or mindfulness. The present review discusses the Extended Process Model of Emotion Regulation and Monitoring and Acceptance Theory of mindfulness in order to propose a novel integrated framework, the Dual-mode Model of Mindful Emotion Regulation (D-MER). This model proposes two "modes" of mindfulness: Implementation and facilitation. Implementation posits that mindfulness skills can be used as emotion regulation strategies through attentional deployment and cognitive change. Facilitation posits that mindfulness as a state or trait affects emotion generation and regulation through effects on cognitive processes and positive or negative valence systems. Further, the D-MER posits that mindfulness experience can improve the efficiency of mindfulness-based emotion regulation strategies (implementation) while effects of mindfulness on emotion regulation processes become increasingly trait-like and automatic over time (facilitation). Empirical and theoretical support for this model are discussed, specific hypotheses to guide further research are provided, and clinical implications are presented. Use of this model may identify mechanisms underlying the interaction between mindfulness and emotion regulation which can be used in ongoing affective and clinical research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Lu C, Moliadze V, Nees F. Dynamic processes of mindfulness-based alterations in pain perception. Front Neurosci 2023; 17:1253559. [PMID: 38027503 PMCID: PMC10665508 DOI: 10.3389/fnins.2023.1253559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Mindfulness-based processes have been shown to enhance attention and related behavioral responses, including analgesia, which is discussed as an effective method in the context of pain interventions. In the present review, we introduce the construct of mindfulness, delineating the concepts, factors, and processes that are summarized under this term and might serve as relevant components of the underlying mechanistic pathways in the field of pain. We also discuss how differences in factors such as definitions of mindfulness, study design, and strategies in mindfulness-based attention direction may need to be considered when putting the findings from previous studies into a whole framework. In doing so, we capitalize on a potential dynamic process model of mindfulness-based analgesia. In this respect, the so-called mindfulness-based analgesia may initially result from improved cognitive regulation strategies, while at later stages of effects may be driven by a reduction of interference between both cognitive and affective factors. With increasing mindfulness practice, pathways and mechanisms of mindfulness analgesia may change dynamically, which could result from adaptive coping. This is underlined by the fact that the neural mechanism of mindfulness analgesia is manifested as increased activation in the ACC and aINS at the beginner level while increased activation in the pINS and reduced activation in the lPFC at the expert level.
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Affiliation(s)
| | | | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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Voss S, Boachie DA, Nieves N, Gothe NP. Mind-body practices, interoception and pain: a scoping review of behavioral and neural correlates. Ann Med 2023; 55:2275661. [PMID: 37939212 PMCID: PMC10768869 DOI: 10.1080/07853890.2023.2275661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE Chronic pain is a significant source of suffering in the United States, and many individuals increasingly turn towards yoga for pain relief. However, little is known regarding how yoga improves pain. Herein we seek to examine the scope of the literature linking mind-body practices, pain and interoception; an emerging mechanism by which yoga may improve chronic pain. METHODS This scoping review followed the five-stage methodological framework proposed by Arksey and O'Malley to examine behavioral and neural correlates of interoception in mind-body practices and pain. A broad search of the Pubmed, CINAHL, SportDiscus, Scopus, PsychInfo, and SocIndex databases was conducted, utilizing three clusters of search terms: (1) interoceptive terms, (2) mind-body terms, and (3) pain terms. RESULTS A combined total of 690 articles were screened, and 24 findings included for analysis. Sixteen studies examined interoceptive outcomes in response to mind-body practices for chronic pain, and 8 studies examined interoceptive outcomes in response to evoked-pain tasks in experienced mind-body practitioners. Only three studies linked yoga, interoception and pain. CONCLUSION This review relied on the broader mind-body literature to inform our analyses as the literature examining yoga, pain and interoception remains limited. Interoceptive techniques including attending to and acceptance of bodily sensations, appear to be key therapeutic mechanisms in mind-body practices for chronic pain. Future yoga-based interventions would benefit examining interoceptive outcomes and integrating interoceptive strategies to facilitate the pain-modulating benefits of yoga.
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Affiliation(s)
- Stephanie Voss
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
- Occupational Therapy, Shirley Ryan Ability Lab, Chicago, IL, USA
| | - Daniel A. Boachie
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
| | - Norberto Nieves
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
| | - Neha P. Gothe
- Department of Kinesiology and Community Health, University of IL Urbana-Champaign, Champaign, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Champaign, IL, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
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Siew S, Yu J. Mindfulness-based randomized controlled trials led to brain structural changes: an anatomical likelihood meta-analysis. Sci Rep 2023; 13:18469. [PMID: 37891243 PMCID: PMC10611804 DOI: 10.1038/s41598-023-45765-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023] Open
Abstract
Mindfulness has become increasingly popular and the practice presents in many different forms. Research has been growing extensively with benefits shown across various outcomes. However, there is a lack of consensus over the efficacy of randomized controlled mindfulness interventions, both traditional and mind-body formats. This study aimed to investigate the structural brain changes in mindfulness-based interventions through a meta-analysis. Scopus, PubMed, Web of Science, and PsycINFO were searched up to April 2023. 11 studies (n = 581) assessing whole-brain voxel-based grey matter or cortical thickness changes after a mindfulness RCT were included. Anatomical likelihood estimation was used to carry out voxel-based meta-analysis with leave-one-out sensitivity analysis and behavioural analysis as follow-ups. One significant cluster (p < 0.001, Z = 4.76, cluster size = 632 mm3) emerged in the right insula and precentral gyrus region (MNI = 48, 10, 4) for structural volume increases in intervention group compared to controls. Behavioural analysis revealed that the cluster was associated with mental processes of attention and somesthesis (pain). Mindfulness interventions have the ability to affect neural plasticity in areas associated with better pain modulation and increased sustained attention. This further cements the long-term benefits and neuropsychological basis of mindfulness-based interventions.
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Affiliation(s)
- Savannah Siew
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
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Pommy J, Smart CM, Bryant AM, Wang Y. Three potential neurovascular pathways driving the benefits of mindfulness meditation for older adults. Front Aging Neurosci 2023; 15:1207012. [PMID: 37455940 PMCID: PMC10340530 DOI: 10.3389/fnagi.2023.1207012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Mindfulness meditation has been shown to be beneficial for a range of different health conditions, impacts brain function and structure relatively quickly, and has shown promise with aging samples. Functional magnetic resonance imaging metrics provide insight into neurovascular health which plays a key role in both normal and pathological aging processes. Experimental mindfulness meditation studies that included functional magnetic resonance metrics as an outcome measure may point to potential neurovascular mechanisms of action relevant for aging adults that have not yet been previously examined. We first review the resting-state magnetic resonance studies conducted in exclusively older adult age samples. Findings from older adult-only samples are then used to frame the findings of task magnetic resonance imaging studies conducted in both clinical and healthy adult samples. Based on the resting-state studies in older adults and the task magnetic resonance studies in adult samples, we propose three potential mechanisms by which mindfulness meditation may offer a neurovascular therapeutic benefit for older adults: (1) a direct neurovascular mechanism via increased resting-state cerebral blood flow; (2) an indirect anti-neuroinflammatory mechanism via increased functional connectivity within the default mode network, and (3) a top-down control mechanism that likely reflects both a direct and an indirect neurovascular pathway.
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Affiliation(s)
- Jessica Pommy
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Colette M. Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Andrew M. Bryant
- Department of Neurology, The Ohio State University, Columbus, OH, United States
| | - Yang Wang
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
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Schmidt H, Pilat C. Effects of meditation on pain intensity, physical function, quality of life and depression in adults with low back pain - A systematic review with meta-analysis. Complement Ther Med 2023; 72:102924. [PMID: 36709927 DOI: 10.1016/j.ctim.2023.102924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a common biopsychosocial health problem. Meditation may provide a complementary treatment option for LBP patients. OBJECTIVES The aim of this systematic review with meta-analysis was to examine the effects of meditation on pain intensity, functional disability, quality of life, and depression in LBP populations. METHODS This systematic review was conducted according to the PRISMA Guidelines. PubMed, Web of Science, CENTRAL, CamQuest and PubPsych were searched up to a publication date of June 2020. Inclusion criteria were RCTs or non-RCTs with LBP patients, aged at least 18 years, the application of a specific meditation technique, and pain intensity and/or functional disability as outcomes. Pooled SMDs were calculated at post-treatment and follow up. The Cochrane risk-of-bias tool was used to estimate risk of bias. The overall quality of evidence was assessed using the GRADE approach. RESULTS 12 studies with a total of 1005 participants were included in this review. Compared to controls, meditation solely showed a significant positive effect on pain intensity (SMD = -0.27 [CI -0.43; -0.11]; p = 0.001; based on 10 studies with 934 participants) and physical quality of life (SMD = 0.21 [CI 0.07; 0.36]; p = 0.005; based on 5 studies with 756 participants) at post-treatment. At follow up (mean 20 weeks, range 4-52) there were no significant effects anymore. The quality of the evidence was moderate due to study limitations and imprecision. CONCLUSIONS Meditation seems to be promising with regard to reducing short-term pain intensity in patients with LBP. However, additional well-designed and large trials are required in order to draw more reliable conclusions.
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Affiliation(s)
- Helena Schmidt
- Institute of Sports Science, Department of Exercise Physiology and Sports Therapy, Justus-Liebig-University Gießen, Kugelberg 62, 35394 Giessen, Germany
| | - Christian Pilat
- Institute of Sports Science, Department of Exercise Physiology and Sports Therapy, Justus-Liebig-University Gießen, Kugelberg 62, 35394 Giessen, Germany.
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A Systematic Review Exploring the Effectiveness of Mindfulness for Sexual Functioning in Women with Cancer. PSYCH 2023. [DOI: 10.3390/psych5010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Sexual intimacy is a basic human need that is associated with quality of life whereby its absence can significantly impact both interpersonal and personal wellbeing. This systematic review aimed to provide an up-to-date evaluation of the available literature on mindfulness treatments for sexual functioning in women diagnosed with cancer. Electronic searches including PubMed, PsycINFO, Web of Science and registered clinical trials yielded 10 studies that met the inclusion criteria. The results showed that treatment intervention designs varied and included mixed methods, randomised clinical trials, single arm non-randomised trials and those with the absence of any control. Furthermore, both brief and longer-term mindfulness interventions were trialled across different sexual domains. Whilst inconclusive, mindfulness-based interventions appear to support sexual function and quality of life in both early- and post-cancer survivors. However, in some instances, there were outcome inconsistencies in sexual desire, arousal and orgasm. This review has identified a current shortage in research on the effectiveness of mindfulness-based treatments for supporting sexual functioning in women with cancer; and so far, no research has been conducted in palliative care. This unmet need in supporting sexual functioning in women with cancer, including palliative care, carries important implications for both psychosexual and oncological healthcare services as sexual intimacy does not end with cancer diagnosis or prognosis.
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Mackey S, Gilam G, Darnall B, Goldin P, Kong JT, Law C, Heirich M, Karayannis N, Kao MC, Tian L, Manber R, Gross J. Mindfulness-Based Stress Reduction, Cognitive Behavioral Therapy, and Acupuncture in Chronic Low Back Pain: Protocol for Two Linked Randomized Controlled Trials. JMIR Res Protoc 2022; 11:e37823. [PMID: 36166279 PMCID: PMC9555327 DOI: 10.2196/37823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nonpharmacologic mind-body therapies have demonstrated efficacy in low back pain. However, the mechanisms underlying these therapies remain to be fully elucidated. OBJECTIVE In response to these knowledge gaps, the Stanford Center for Low Back Pain-a collaborative, National Institutes of Health P01-funded, multidisciplinary research center-was established to investigate the common and distinct biobehavioral mechanisms of three mind-body therapies for chronic low back pain: cognitive behavioral therapy (CBT) that is used to treat pain, mindfulness-based stress reduction (MBSR), and electroacupuncture. Here, we describe the design and implementation of the center structure and the associated randomized controlled trials for characterizing the mechanisms of chronic low back pain treatments. METHODS The multidisciplinary center is running two randomized controlled trials that share common resources for recruitment, enrollment, study execution, and data acquisition. We expect to recruit over 300 chronic low back pain participants across two projects and across different treatment arms within each project. The first project will examine pain-CBT compared with MBSR and a wait-list control group. The second project will examine real versus sham electroacupuncture. We will use behavioral, psychophysical, physical measure, and neuroimaging techniques to characterize the central pain modulatory and emotion regulatory systems in chronic low back pain at baseline and longitudinally. We will characterize how these interventions impact these systems, characterize the longitudinal treatment effects, and identify predictors of treatment efficacy. RESULTS Participant recruitment began on March 17, 2015, and will end in March 2023. Recruitment was halted in March 2020 due to COVID-19 and resumed in December 2021. CONCLUSIONS This center uses a comprehensive approach to study chronic low back pain. Findings are expected to significantly advance our understanding in (1) the baseline and longitudinal mechanisms of chronic low back pain, (2) the common and distinctive mechanisms of three mind-body therapies, and (3) predictors of treatment response, thereby informing future delivery of nonpharmacologic chronic low back pain treatments. TRIAL REGISTRATION ClinicalTrials.gov NCT02503475; https://clinicaltrials.gov/ct2/show/NCT02503475. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37823.
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Affiliation(s)
- Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Gadi Gilam
- The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Beth Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Philippe Goldin
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, United States
| | - Jiang-Ti Kong
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Christine Law
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Marissa Heirich
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Nicholas Karayannis
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Ming-Chih Kao
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University, Palo Alto, CA, United States
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - James Gross
- Department of Psychology, Stanford University, Palo Alto, CA, United States
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Wexler RS, Fox DJ, Edmond H, Lemau J, ZuZero D, Bollen M, Montenegro D, Parikshak A, Thompson AR, Carlson NL, Carlson HL, Wentz AE, Bradley R, Hanes DA, Zwickey H, Pickworth CK. Protocol for mindfulness-oriented recovery enhancement (MORE) in the management of lumbosacral radiculopathy/radiculitis symptoms: A randomized controlled trial. Contemp Clin Trials Commun 2022; 28:100962. [PMID: 35812821 PMCID: PMC9260614 DOI: 10.1016/j.conctc.2022.100962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Lumbosacral radiculopathy/radiculitis (LR) or "sciatica" is a commonly intractable sequelae of chronic low back pain (LBP), and challenges in the treatment of LR indicate that persistent pain may have both mechanical and neuropathic origins. Mindfulness-based interventions have been demonstrated to be effective tools in mitigating self-reported pain in LBP patients. This paper describes the protocol for a randomized controlled trial (RCT) evaluating the effects of the specific mindfulness-based intervention Mindfulness-Oriented Recovery Enhancement (MORE) on LR symptoms and sequelae, including mental health and physical function. Methods Participants recruited from the Portland, OR area are screened before completing a baseline visit that includes a series of self-report questionnaires and surface electromyography (sEMG) of the lower extremity. Upon enrollment, participants are randomly assigned to the MORE (experimental) group or treatment as usual (control) group for 8 weeks. Self-reported assessments and sEMG studies are repeated after the intervention is complete for pre/post-intervention comparisons. The outcome measures evaluate self-reported pain, physical function, quality of life, depression symptoms, trait mindfulness, and reinterpretation of pain, with surface electromyography (sEMG) findings evaluating objective physical function in patients with LR. To our knowledge, this is the first trial to date using an objective measure, sEMG, to evaluate the effects of a mindfulness-based intervention on LR symptoms. Hypotheses We hypothesize that MORE will be effective in improving self-reported pain, physical function, quality of life, depression symptoms, mindfulness, and reinterpretation of pain scores after 8 weeks of mindfulness training as compared to treatment as usual. Additionally, we hypothesize that individuals in the MORE group with abnormal sEMG findings at baseline will have improved sEMG findings at their 8-week follow-up visit.
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Affiliation(s)
- Ryan S. Wexler
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Devon J. Fox
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Hannah Edmond
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Johnny Lemau
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Danielle ZuZero
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Melissa Bollen
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Diane Montenegro
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Anand Parikshak
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Austin R. Thompson
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Nels L. Carlson
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Hans L. Carlson
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Anna E. Wentz
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
- Herbert Wertheim School of Public Health and Human Longevity Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Douglas A. Hanes
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | - Courtney K. Pickworth
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
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11
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Phan-Le NT, Brennan L, Parker L. The search for scientific meaning in mindfulness research: Insights from a scoping review. PLoS One 2022; 17:e0264924. [PMID: 35507587 PMCID: PMC9067662 DOI: 10.1371/journal.pone.0264924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 02/18/2022] [Indexed: 11/19/2022] Open
Abstract
There are on-going debates about what is and is not 'mindfulness'. These debates are stifling rigorous academic research as scientific precision is a precursor to shared meaning. While mindfulness is a growing field of research, these divergent and conflated meanings are limiting deeper interdisciplinary research. Interventions designed in one practice context may not be useful in other contexts because meaning is not transferred between settings. This review clarifies the various research domains that study mindfulness and the conceptual and operational definitions in each domain. This two-stage study comprises a scoping review of mindfulness classifications and a comparative content mapping of mindfulness studies from 2015 to 2021. The initial comprehensive search strategy followed the preferred reporting items for scoping reviews and meta-analysis (PRISMA) method. The comparative analysis was conducted using Leximancer. Findings illustrate a complex growing research corpus on mindfulness that is somewhat confused. The results from the scoping review show three shared domains in mindfulness classifications: short-term effects of mindfulness, long-term effects of mindfulness, and mindfulness practices. The results from the content mapping show four domains of mindfulness research: mental health, behavioural change, cognitive neuroscience, and ethical mindfulness. Operational definitions of mindfulness are not articulated clearly in these domains. Conceptual and operational definitions in the 'ethical mindfulness' domain are not yet developed. To enhance scientific progress in mindfulness research, further investigations of mindfulness classifications need to be developed. Content mapping and semantic typology is a potential candidate for future classification. More attention should be paid to developing operational definitions according to specific research domains. Scholars in the ethical mindfulness domain will need solid conceptual and operational definitions to support their research efforts.
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Affiliation(s)
- Nhat Tram Phan-Le
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Linda Brennan
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Lukas Parker
- School of Media and Communication, RMIT University, Melbourne, Australia
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12
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Gan Q, Ding N, Bi G, Liu R, Zhao X, Zhong J, Wu S, Zeng Y, Cui L, Wu K, Fu Y, Chen Z. Enhanced Resting-State Functional Connectivity With Decreased Amplitude of Low-Frequency Fluctuations of the Salience Network in Mindfulness Novices. Front Hum Neurosci 2022; 16:838123. [PMID: 35308619 PMCID: PMC8927720 DOI: 10.3389/fnhum.2022.838123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Mindfulness and accordant interventions are often used as complementary treatments to psychological or psychosomatic problems. This has also been gradually integrated into daily lives for the promotion of psychological well-being in non-clinical populations. The experience of mindful acceptance in a non-judgmental way brought about the state, which was less interfered by a negative effect. Mindfulness practice often begins with focused attention (FA) meditation restricted to an inner experience. We postulate that the brain areas related to an interoceptive function would demonstrate an intrinsic functional change after mindfulness training for the mindful novices along with paying more attention to internal processes. To further explore the influence of mindfulness on the organization of the brain regions, both functional connectivity (FC) in the voxel and the region of interest (ROI) level were calculated. In the current study, 32 healthy volunteers, without any meditation experiences, were enrolled and randomly assigned to a mindfulness-based stress reduction group (MBSR) or control group (CON). Participants in the MBSR group completed 8 weeks of mindfulness-based stress reduction (MBSR) and rated their mindfulness skills before and after MBSR. All subjects were evaluated via resting-state functional MRI (rs-fMRI) in both baselines and after 8 weeks. They also completed a self-report measure of their state and trait anxiety as well as a positive and negative affect. Pre- and post-MBSR assessments revealed a decreased amplitude of low-frequency fluctuations (ALFF) in the right anterior cingulate gyrus (ACC.R), left anterior and posterior insula (aIC.L, pIC.L), as well as left superior medial frontal gyrus (SFGmed.L) in MBSR practitioners. Strengthened FC between right anterior cingulate cortex (ACC.R) and aIC.R was observed. The mean ALFF values of those regions were inversely and positively linked to newly acquired mindful abilities. Along with a decreased negative affect score, our results suggest that the brain regions related to attention and interoceptive function were involved at the beginning of mindfulness. This study provides new clues in elucidating the time of evaluating the brain mechanisms of mindfulness novices.
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Affiliation(s)
- Quan Gan
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Ning Ding
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
| | - Guoli Bi
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Department of Magnetic Resonance Imaging, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Ruixiang Liu
- Department of Clinical Psychology, The Second People’s Hospital of Yunnan Province, Kunming, China
| | - Xingrong Zhao
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingmei Zhong
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Shaoyuan Wu
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yong Zeng
- Department of Clinical Psychology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Liqian Cui
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kunhua Wu
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- Department of Magnetic Resonance Imaging, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yunfa Fu
- School of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, China
| | - Zhuangfei Chen
- Medical Faculty, Kunming University of Science and Technology, Kunming, China
- *Correspondence: Zhuangfei Chen,
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13
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Chang YC, Lin GM, Yeh TL, Chang YM, Yang CH, Lo C, Yeh CY, Hu WY. Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer. Support Care Cancer 2022; 30:4315-4325. [PMID: 35092484 PMCID: PMC8799961 DOI: 10.1007/s00520-021-06540-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/05/2021] [Indexed: 12/02/2022]
Abstract
Purpose There have been few studies using mindfulness-based stress reduction (MBSR) to improve sexual function in Asian women with breast cancer. This study aimed to evaluate the impact of mindfulness intervention on female sexual function, mental health, and quality of life in patients with breast cancer. Methods Fifty-one women with breast cancer were allocated into 6-week MBSR (n=26) sessions or usual care (n=25), without differences in group characteristics. The research tools included the Female Sexual Function Index (FSFI), the Depression Anxiety Stress Scales-21 (DASS-21), and the EuroQol instrument (EQ-5D). The Greene Climacteric Scale (GCS) was used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention scores in each scale. Statistical analyses consisted of the descriptive dataset and Mann-Whitney ranked-pairs test. Results Although MBSR did not significantly improve sexual desire and depression in patients with breast cancer, MBSR could improve parts of female sexual function [i.e., Δarousal: 5.73 vs. -5.96, Δlubrication: 3.35 vs. -3.48, and Δsatisfaction: 8.48 vs. 1.76; all p <.005], with a range from small to medium effect sizes. A significantly benefits were found on mental health [Δanxiety: -10.92 vs.11.36 and Δstress: -10.96 vs.11.40; both p <.001], with large effect sizes, ranging from 0.75 to 0.87. Conclusion Our study revealed that MBSR can improve female sexual function and mental health except for sexual desire and depression in women with breast cancer. Medical staff can incorporate MBSR into clinical health education for patients with breast cancer to promote their overall quality of life.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, 406040, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Gen-Min Lin
- Departments of Medicine, Hualien-Armed Forces General Hospital, Hualien, Tri-Service General Hospital, National Defense Medical Center, Taipei City, 100, Taiwan
| | - Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu 300, and Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, 100, Taiwan
| | - Yuh-Ming Chang
- Department of Neurology, Hsinchu Mackay Memorial Hospital, Hsinchu, 300, Taiwan
| | - Ching-Hsu Yang
- Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Chi Lo
- Department of Hospitality Management, Chung Hua University, Hsinchu, Taiwan
| | - Chun-Yin Yeh
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, 700, Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, 100, Taiwan. .,Department of Nursing, National Taiwan University Hospital, Taipei City, 10051, Taiwan.
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14
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Santamaría-Peláez M, González-Bernal JJ, Verdes-Montenegro-Atalaya JC, Pérula-de Torres LÁ, Roldán-Villalobos A, Romero-Rodríguez E, Hachem Salas N, Magallón Botaya R, González-Navarro TDJ, Arias-Vega R, Valverde FJ, Jiménez-Barrios M, Mínguez LA, León-del-Barco B, Soto-Cámara R, González-Santos J. Mindfulness-Based Program for Anxiety and Depression Treatment in Healthcare Professionals: A Pilot Randomized Controlled Trial. J Clin Med 2021; 10:jcm10245941. [PMID: 34945237 PMCID: PMC8708843 DOI: 10.3390/jcm10245941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; η2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; η2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; η2 = 0.071-F (2.79) = 2.874; p = 0.049; η2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs.
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Affiliation(s)
- Mirian Santamaría-Peláez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
| | - Jerónimo Javier González-Bernal
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
- Correspondence: (J.J.G.-B.); (J.G.-S.)
| | | | - Luis Ángel Pérula-de Torres
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | - Ana Roldán-Villalobos
- Carlos Castilla del Pino Health Center, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | - Esperanza Romero-Rodríguez
- Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - Rosa Magallón Botaya
- IIS-Aragon—Group B21-R17, Family and Community Medicine Teaching Department of Zaragoza Sector 1, Institute of Health Carlos III—REDIAPP 06/18, University of Zaragoza, 50018 Zaragoza, Spain;
| | | | - Raquel Arias-Vega
- Castello Health Center (Madrid), Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - María Jiménez-Barrios
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
| | | | - Benito León-del-Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, 10071 Caceres, Spain;
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
| | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
- Correspondence: (J.J.G.-B.); (J.G.-S.)
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15
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Hashizume S, Nakano M, Kubota K, Sato S, Himuro N, Kobayashi E, Takaoka A, Fujimiya M. Mindfulness intervention improves cognitive function in older adults by enhancing the level of miRNA-29c in neuron-derived extracellular vesicles. Sci Rep 2021; 11:21848. [PMID: 34750393 PMCID: PMC8575875 DOI: 10.1038/s41598-021-01318-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 10/26/2021] [Indexed: 01/13/2023] Open
Abstract
Although mindfulness-based stress reduction (MBSR) improves cognitive function, the mechanism is not clear. In this study, people aged 65 years and older were recruited from elderly communities in Chitose City, Japan, and assigned to a non-MBSR group or a MBSR group. Before and after the intervention, the Japanese version of the Montreal Cognitive Assessment (MoCA-J) was administered, and blood samples were collected. Then, neuron-derived extracellular vesicles (NDEVs) were isolated from blood samples, and microRNAs, as well as the target mRNAs, were evaluated in NDEVs. A linear mixed model analysis showed significant effects of the MBSR x time interaction on the MoCA-J scores, the expression of miRNA(miR)-29c, DNA methyltransferase 3 alpha (DNMT3A), and DNMT3B in NDEVs. These results indicate that MBSR can improve cognitive function by increasing the expression of miR-29c and decreasing the expression of DNMT3A, as well as DNMT3B, in neurons. It was also found that intracerebroventricular injection of miR-29c mimic into 5xFAD mice prevented cognitive decline, as well as neuronal loss in the subiculum area, by down-regulating Dnmt3a and Dnmt3b in the hippocampus. The present study suggests that MBSR can prevent neuronal loss and cognitive impairment by increasing the neuronal expression of miR-29c.
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Affiliation(s)
- Shin Hashizume
- Department of Anatomy, Sapporo Medical University School of Medicine, W17, S1, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Masako Nakano
- Department of Anatomy, Sapporo Medical University School of Medicine, W17, S1, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan.
| | - Kenta Kubota
- Department of Anatomy, Sapporo Medical University School of Medicine, W17, S1, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
- Department of Physical Therapy, Hokkaido Chitose Rehabilitation College, Chitose, Hokkaido, Japan
| | - Seiichi Sato
- Division of Signaling in Cancer and Immunology, Institute for Genetic Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Molecular Medical Biochemistry Unit, Biological Chemistry and Engineering Course, Graduate School of Chemical Sciences and Engineering, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Nobuaki Himuro
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Eiji Kobayashi
- Department of Anatomy, Sapporo Medical University School of Medicine, W17, S1, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
- Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, Eniwa, Hokkaido, Japan
| | - Akinori Takaoka
- Division of Signaling in Cancer and Immunology, Institute for Genetic Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Molecular Medical Biochemistry Unit, Biological Chemistry and Engineering Course, Graduate School of Chemical Sciences and Engineering, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mineko Fujimiya
- Department of Anatomy, Sapporo Medical University School of Medicine, W17, S1, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
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16
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Braden BB, Pagni BA, Monahan L, Walsh MJM, Dixon MV, Delaney S, Ballard L, Ware JE. Quality of life in adults with autism spectrum disorder: influence of age, sex, and a controlled, randomized mindfulness-based stress reduction pilot intervention. Qual Life Res 2021; 31:1427-1440. [PMID: 34655389 DOI: 10.1007/s11136-021-03013-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Adults with autism spectrum disorder (ASD) consistently report worse functional health and well-being, compared to neurotypical (NT) peers. In a series of studies, we aimed to elucidated the effects of sex, age, and their interaction on health-related quality of life (HRQoL) and evaluated the effectiveness of mindfulness-based stress reduction (MBSR) for improving health-, disability-, and autism-related QoL, with possible sex and age outcome moderators, in adults with ASD. METHODS Study 1 used the 36-Item Short Form Survey to compare mental and physical HRQoL composite scores in adults with ASD (n = 67) and matched NT adults (n = 66). Study 2 was a randomized pilot evaluation of the effect of MBSR, compared to an active control intervention with social support and relaxation education (support/education; n = 56), on the World Health Organization QoL BREF, Disability, and Autism-Specific scales in adults with ASD. RESULTS In Study 1, we replicated findings that mental HRQoL is worse in both men and women with ASD, compared to NT counterparts, but physical HRQoL is only worse in women with ASD. We present novel findings that older age is associated with better mental HRQoL in women with ASD only. In Study 2, MBSR improved disability-related QoL in adults with ASD over and above the support/education intervention, but both interventions improved mental HRQoL. Lastly, both interventions were more effective for HRQoL improvements in women with ASD. CONCLUSION Findings encourage precision medicine approaches tailored to age and sex groups for best HRQoL outcomes in adults with ASD. ClinicalTrials.gov Identifier: NCT04017793.
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Affiliation(s)
- B Blair Braden
- College of Health Solutions, Arizona State University, Tempe, AZ, USA.
| | - Broc A Pagni
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Leanna Monahan
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Melissa J M Walsh
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Maria V Dixon
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Shanna Delaney
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Lisa Ballard
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - John E Ware
- College of Health Solutions, Arizona State University, Tempe, AZ, USA.,Department of Medicine, Tufts Medical Center, Boston, MA, USA
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17
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Andersen E, Geiger P, Schiller C, Bluth K, Watkins L, Zhang Y, Xia K, Tauseef H, Leserman J, Gaylord S, Girdler S. Effects of Mindfulness-Based Stress Reduction on Experimental Pain Sensitivity and Cortisol Responses in Women With Early Life Abuse: A Randomized Controlled Trial. Psychosom Med 2021; 83:515-527. [PMID: 33259351 PMCID: PMC8164640 DOI: 10.1097/psy.0000000000000889] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Early life abuse (ELAb) initiates pathophysiological cascades resulting in long-term maladaptive stress responsivity, hyperalgesia, and an increased risk of psychopathology. Mindfulness-based stress reduction (MBSR) is effective in modifying psychological and somatic symptoms; thus, we predicted that MBSR would be particularly efficacious for women with ELAb. METHOD Medically healthy women (mean age = 31 years) with or without a history of early (≤13 years) physical or sexual abuse provided self-report measures and were tested in the laboratory before and after randomization to standard MBSR (n = 52) or social support (SSG) (n = 60) for 8 weeks. The laboratory procedure involved pain testing using the cold pressor and temporal summation of heat pain (indexing central sensitization) procedures, and exposure to the Trier Social Stress Test. Plasma cortisol in response to the experimental protocol was assessed as area under the curve (AUC). RESULTS The interventions differentially impacted pain sensitivity and cortisol AUC for women with ELAb, as MBSR increased the temporal summation of heat pain intensity ratings (p = .024) and reduced cortisol AUC (p = .004). For women without ELAb, MBSR decreased cold pressor tolerance (p = .045) and decreased the temporal summation of heat pain intensity ratings relative to SSG (p = .024). Both MBSR and SSG improved depression symptoms and emotion regulation abilities (p values < .001); however, MBSR was associated with greater benefits in describing emotions (p = .008) and impulse control (p = .017) for women with ELAb. CONCLUSIONS Women with ELAb benefited from MBSR-specific improvements in central sensitization, mindfulness skills, and emotion regulation abilities. This is the first study to examine the efficacy of MBSR in modifying affective and somatic symptoms based on ELAb status and provides evidence for considering ELAb in tailoring treatment approaches.Trial Registration: ClinicalTrials.gov Identifier: NCT01995916; https://clinicaltrials.gov/ct2/show/NCT01995916.
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Affiliation(s)
| | - Paul Geiger
- Department of Psychiatry, University of North Carolina-Chapel Hill
| | - Crystal Schiller
- Department of Psychiatry, University of North Carolina-Chapel Hill
| | - Karen Bluth
- Department of Psychiatry, University of North Carolina-Chapel Hill
| | - Lana Watkins
- Department of Psychiatry and Behavioral Sciences, Duke
University
| | - Ying Zhang
- Department of Biostatistics, University of North Carolina- Chapel
Hill
| | - Kai Xia
- Department of Psychiatry, University of North Carolina-Chapel Hill
| | - Hafsah Tauseef
- Department of Psychiatry, University of North Carolina-Chapel Hill
| | - Jane Leserman
- Department of Psychiatry, University of North Carolina-Chapel Hill
| | - Susan Gaylord
- Department of Physical Medicine and Rehabilitation, University of
North Carolina-Chapel Hill
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina-Chapel
Hill
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18
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Burgess EE, Selchen S, Diplock BD, Rector NA. A Brief Mindfulness-Based Cognitive Therapy (MBCT) Intervention as a Population-Level Strategy for Anxiety and Depression. Int J Cogn Ther 2021; 14:380-398. [PMID: 33897938 PMCID: PMC8057287 DOI: 10.1007/s41811-021-00105-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 11/28/2022]
Abstract
Mindfulness-based interventions (MBIs) have emerged as clinically effective interventions for anxiety and depression although there are significant barriers to their access in the general population. The present study examined the effectiveness of a 5-week abbreviated mindfulness-based cognitive therapy (MBCT) intervention for a physician-referred, treatment-seeking, community sample (N = 54) with mood and/or anxiety symptom burden. Treatment effects demonstrated significant reductions in mood and anxiety symptom severity and significant increases in general well-being. Observed effect sizes were generally large, with high response and remission rates. The present study offers preliminary support that an abbreviated MBCT protocol can offer large treatment effects for decreasing mood and anxiety symptoms and could potentially offer an effective population-level strategy to improve cost-effectiveness and access to care.
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Affiliation(s)
- Emilee E Burgess
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, Ontario M4N 3M5 Canada
| | - Steven Selchen
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, Ontario M4N 3M5 Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario Canada.,Joseph Brant Hospital, Burlington, Ontario Canada
| | - Benjamin D Diplock
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, Ontario M4N 3M5 Canada
| | - Neil A Rector
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, Ontario M4N 3M5 Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
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19
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Pérula-de Torres LÁ, Verdes-Montenegro-Atalaya JC, Melús-Palazón E, García-de Vinuesa L, Valverde FJ, Rodríguez LA, Lietor-Villajos N, Bartolomé-Moreno C, Moreno-Martos H, García-Campayo J, González-Santos J, Rodríguez-Fernández P, León-del-Barco B, Soto-Cámara R, González-Bernal JJ. Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4340. [PMID: 33923868 PMCID: PMC8073262 DOI: 10.3390/ijerph18084340] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022]
Abstract
Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
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Affiliation(s)
- Luis Ángel Pérula-de Torres
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (Imibic), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - Elena Melús-Palazón
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Leonor García-de Vinuesa
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, 14001 Córdoba, Spain;
| | | | - Luis Alberto Rodríguez
- Family and Community Medicine Teaching Department of Ponferrada, Ponferrada, 24400 León, Spain;
| | - Norberto Lietor-Villajos
- Family and Community Medicine Teaching Department of Jaen, 23007 Jaen, Spain; (F.J.V.); (N.L.-V.)
| | - Cruz Bartolomé-Moreno
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Herminia Moreno-Martos
- Multi-Professional Teaching Unit for Family and Community Care of Almería, 04009 Almería, Spain;
| | | | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
| | | | - Benito León-del-Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, 10071 Caceres, Spain;
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
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Turpyn CC, Chaplin TM, Fischer S, Thompson JC, Fedota JR, Baer RA, Martelli AM. Affective Neural Mechanisms of a Parenting-Focused Mindfulness Intervention. Mindfulness (N Y) 2021; 12:392-404. [PMID: 33737986 PMCID: PMC7962669 DOI: 10.1007/s12671-019-01118-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Behavioral evidence suggests that parenting-focused mindfulness interventions can improve parenting practices and enhance family wellbeing, potentially operating through altered emotional processing in parents. However, the mechanisms through which parent mindfulness interventions achieve their positive benefits have not yet been empirically tested, knowledge which is key to refine and maximize intervention effects. Thus, as part of a randomized controlled trial, the present study examined the affective mechanisms of an 8-week parenting-focused mindfulness intervention, the Parenting Mindfully (PM) intervention, versus a minimal-intervention parent education control. METHODS Twenty highly stressed mothers of adolescents completed pre- and post-intervention behavioral and fMRI sessions, in which mothers completed a parent-adolescent conflict interaction, fMRI emotion task, and fMRI resting state scan. Mothers reported on their mindful parenting, and maternal emotional reactivity to the parent-adolescent conflict task was assessed via observed emotion expression, self-reported negative emotion, and salivary cortisol reactivity. RESULTS Results indicated that the PM intervention increased brain responsivity in left posterior insula in response to negative affective stimuli, and altered resting state functional connectivity in regions involved in self-reference, behavioral regulation, and social-emotional processing. Changes in mothers' brain function and connectivity were associated with increased mindful parenting and decreased emotional reactivity to the parent-adolescent conflict task. CONCLUSIONS Findings suggest that mindfulness-based changes in maternal emotional awareness at the neurobiological level are associated with decreased emotional reactivity in parenting interactions, illuminating potential neurobiological targets for future parent-focused intervention.
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Affiliation(s)
- Caitlin C Turpyn
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Tara M Chaplin
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Sarah Fischer
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - James C Thompson
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - John R Fedota
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Ruth A Baer
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Alexandra M Martelli
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
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Brintz CE, Roth I, Faurot K, Rao S, Gaylord SA. Feasibility and Acceptability of an Abbreviated, Four-Week Mindfulness Program for Chronic Pain Management. PAIN MEDICINE (MALDEN, MASS.) 2020; 21:2799-2810. [PMID: 32897319 PMCID: PMC7685688 DOI: 10.1093/pm/pnaa208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The Mindfulness-Based Stress Reduction program is effective at improving chronic pain outcomes, but the time demand hinders participation. This preliminary study evaluated the feasibility, acceptability, and potential effects of providing an abbreviated mindfulness program for patients with chronic pain. DESIGN A single-arm, mixed-methods, pre-post intervention study. SETTING An outpatient rehabilitation clinic at an academic medical center. SUBJECTS Participants were N = 23 adults with chronic pain who were new to mindfulness practice. METHODS Mindfulness-based Stress Reduction was adapted to shorten the program to four weekly 90-minute sessions and to focus content on pain management. Three cohorts of six to nine participants completed baseline and post-treatment measures of 1) patient-reported outcomes, including pain intensity, pain interference, physical functioning, depressive/anxiety symptoms, positive affect and well-being, and sleep disturbance; 2) pain medication dosages; 3) psychosocial variables including pain acceptance, pain catastrophizing, and perceived stress; 4) dispositional mindfulness, as well as postintervention structured interviews about their experiences. RESULTS Acceptable rates of retention and attendance and high ratings of satisfaction indicated that the intervention was feasible and acceptable. In interviews, participants found the program acceptable and beneficial and provided suggestions to improve it. From pre- to post-treatment, significant improvements were reported in all measures except physical functioning and anxiety. CONCLUSIONS In adults with chronic pain, a four-week mindfulness program is feasible and acceptable, addresses the barrier of a lengthy program, and may improve quality of life and psychological functioning. An appropriately powered randomized controlled trial with a comparison group is needed to assess the intervention's effectiveness.
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Affiliation(s)
- Carrie E Brintz
- Division of Pain Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Isabel Roth
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Keturah Faurot
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Sanjana Rao
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Susan A Gaylord
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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Pain relief for osteoarthritis through combined treatment (PROACT): Protocol for a randomized controlled trial of mindfulness meditation combined with transcranial direct current stimulation in non-Hispanic black and white adults with knee osteoarthritis. Contemp Clin Trials 2020; 98:106159. [PMID: 32992020 DOI: 10.1016/j.cct.2020.106159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022]
Abstract
Knee osteoarthritis (OA) is a leading cause of late life pain and disability, and non-Hispanic black (NHB) adults experience greater OA-related pain and disability than non-Hispanic whites (NHWs). Recent evidence implicates psychosocial stress, cognitive-attentional processes, and altered central pain processing as contributors to greater OA-related pain and disability among NHBs. To address these ethnic/race disparities, this clinical trial will test whether a mindfulness intervention (Breathing and Attention Training, BAT) combined with transcranial direct current stimulation (tDCS) will enhance pain modulatory balance and pain-related brain function, reduce clinical pain, and attenuate ethnic differences therein, among NHBs and NHWs with knee OA. Participants will complete assessments of clinical pain, function, psychosocial measures, and quantitative sensory testing (QST), including mechanical temporal summation and conditioned pain modulation. Neuroimaging will be performed to examine pain-related brain structure and function. Then, participants will be randomized to one of four groups created by crossing two BAT conditions (Real vs. Sham) with two tDCS conditions (Real vs. Sham). Participants will then undergo five treatment sessions during which the assigned BAT and tDCS interventions will be delivered concurrently for 20 min over one week. After the fifth intervention session, participants will undergo assessments of clinical pain and function, QST and neuroimaging identical to the pretreatment measures, and monthly follow-up assessments of pain will be conducted for three months. This will be the first study to determine whether mindfulness and tDCS treatments will show additive or synergistic effects when combined, and whether treatment effects differ across ethnic/race groups.
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Billones R, Saligan L. What Works in Mindfulness Interventions for Medically Unexplained Symptoms? A Systematic Review. Asian Pac Isl Nurs J 2020; 5:1-11. [PMID: 32704524 PMCID: PMC7373253 DOI: 10.31372/20200501.1082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background/Purpose: Mindfulness-based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines (PRISMA) and the modified Oxford Quality Scoring System (Jadad score) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or Fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. Results/Conclusions: MBIs showed large effects on: symptom severity (d = 0.82), pain intensity (d = 0.79), depression (d = 0.62), and anxiety (d = 0.67). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the nonjudgmental observance of the experience in the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.
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Affiliation(s)
- Ruel Billones
- National Institute of Nursing Research, NIH, United States
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The Effects of Teaching Mindfulness on Stress in Physical Therapy Students – A Randomized Controlled Trial. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pontin EE, Hanna J, Senior A. Piloting a Mindfulness-Based Intervention to Veterinary Students: Learning and Recommendations. JOURNAL OF VETERINARY MEDICAL EDUCATION 2020; 47:327-332. [PMID: 31194632 DOI: 10.3138/jvme.0618-076r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Veterinary students experience high levels of psychological distress including anxiety, stress, perceived stress and depression. The inability to cope with the demands of veterinary training has personal and professional consequences. Existing evidence shows that mindfulness-based interventions (MBI) can reduce stress in students, but more research on how MBIs are introduced into the veterinary curriculum is required. The first aim of the pilot study was to design and deliver a bespoke MBI to third-year veterinary students at the University of Liverpool Institute of Veterinary Science. The second aim was to gain feedback from those taking part, thus using their experiences to explore the challenges of introducing an MBI into a veterinary curriculum. By doing this, we aim to reflect and learn for future interventions. Qualitative feedback provided by participants of the MBI focus group was analyzed using thematic analysis and organized into two main themes: (1) "Taking Part in the MBI and Beyond-What it Was Like and What Has the MBI Done for Me?" and (2) "Mindfulness for Veterinary Students-Reflections, Challenges, and Making it Happen." Experiences and outcomes of the MBI were positive. However, implementation into the veterinary curriculum was found to be challenging. This pilot study provides clear recommendations to support the future integration and delivery of MBIs into a veterinary curriculum.
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Cognitive Biases Toward Pain: Implications for a Neurocognitive Processing Perspective in Chronic Pain and its Interaction With Depression. Clin J Pain 2020; 35:252-260. [PMID: 30499835 DOI: 10.1097/ajp.0000000000000674] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Information-processing biases such as attentional, interpretation, and memory biases are supposed to play a role in the exacerbation and maintenance of chronic pain. Current research in the area of cognitive biases shows that all these biases seem to have an influence on attention to, interpretation of, and recall of pain and can lead to maladaptive strategies and the exacerbation of pain. METHODS We conducted a narrative literature review, considering evidence extracted from various databases including PubMed, MEDLINE, Science Direct, and ProQuest. Search terms included cognitive biases, neurocognitive processing, chronic pain, and depression. RESULTS The literature on attentional, interpretative, and memory biases in experimental and chronic pain, as well as their neuronal underpinnings, suggests that the depression of chronic pain patients may differ from the depression of patients without pain. Depressed pain patients show a recall bias for illness-related and health-related stimuli, whereas depressed patients without pain show a bias for depression-related stimuli. In addition, research has shown that catastrophizing, helplessness/hopelessness, and thought suppression as psychological responses to pain are mediators of the relationship between chronic pain and depression. CONCLUSIONS Current research supports the importance of individual diagnosis of chronic pain patients and their response patterns of pain, psychological processing, and information processing. This leads to the conclusion that depressed pain patients need other clinical interventions when compared with depressed patients without pain. Previous research showed that a combination of a cognitive-behavioral therapy with mindfulness meditation seems to be a promising approach.
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Patel A, Sharma PSVN, Kumar P. Application of Mindfulness-Based Psychological Interventions in Infertility. J Hum Reprod Sci 2020; 13:3-21. [PMID: 32577063 PMCID: PMC7295259 DOI: 10.4103/jhrs.jhrs_51_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/25/2019] [Accepted: 11/22/2019] [Indexed: 11/25/2022] Open
Abstract
Living mindfully helps one gain a deeper understanding into realities of life. It enables people to witness suffering, desire, attachments, and impermanence without any fear, anxiety, anger, or despair. This is considered the hallmark of true psychological insight. As a skill, mindfulness can be inculcated by anyone. Mindfulness helps in attending, getting aware and understanding experiences in a compassion and open-minded way. Research suggests that applying mindfulness in daily life has been known to tame our emotional mind and enabled people to perceive things “as they are” without ascribing expectations, judgments, cynicism, or apprehensions to them. This review unravels the therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility.
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Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, MAHE, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Manipal Assisted Reproduction Centre, Kasturba Medical College, MAHE, Manipal, Karnataka, India
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Bernier Carney KM, Young EE, Guite JW, Starkweather AR. A Systematic Review of Biological Mechanisms and Chronic Pain Outcomes During Stress Reduction Interventions. Biol Res Nurs 2020; 22:205-216. [PMID: 32174159 DOI: 10.1177/1099800420907964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nonpharmacologic stress reduction interventions provide an opportunity to modify chronic pain trajectories; however, the biological mechanisms underlying these interventions are poorly understood. OBJECTIVES To examine clinical literature published in 2012-2018 with the goals of (1) identifying which biological mechanisms or biomarkers are currently being measured in nonpharmacologic stress reduction intervention studies for individuals with chronic pain and (2) evaluating the evidence to determine whether these stress reduction interventions lead to changes in (a) pain outcomes and/or (b) measured biomarkers. DATA SOURCES Scientific articles in the electronic databases PubMed/Medline, Cumulative Index of Nursing and Allied Health Literature, PsychINFO, and SCOPUS following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. STUDY SELECTION Randomized controlled trials and quasi-experimental studies that recruited subjects with a chronic pain condition, examined a relationship between a nonpharmacologic stress reduction intervention and pain-related outcome(s), and included measurement of a biomarker. RESULTS The 13 articles that met inclusion criteria spanned four nonpharmacologic stress reduction categories: mindfulness-based stress reduction, physical exercise, manual therapies, and biofeedback. Methods for studying biomarkers included measuring biological samples, neurological function, and autonomic control. Although all studies investigated both biological measures and pain outcomes, only three demonstrated an association between the biomarker(s) and pain-related outcomes. CONCLUSIONS The results of this review highlight the complex nature of stress-pain relationships and the lack of rigorous clinical research identifying specific stress-related biological factors that modulate pain outcomes. Stress reduction interventions remain a favorable method for symptom management in patients living with chronic pain, but consistency in study measures and design is needed for robust evaluation.
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Affiliation(s)
| | - Erin E Young
- Department of Anesthesiology, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Jessica W Guite
- Center for Advancement in Managing Pain Affiliate, School of Nursing, University of Connecticut, Storrs, CT, USA
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Casals-Gutiérrez S, Abbey H. Interoception, mindfulness and touch: A meta-review of functional MRI studies. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Pagni BA, Walsh MJM, Foldes E, Sebren A, Dixon MV, Guerithault N, Braden BB. The neural correlates of mindfulness-induced depression reduction in adults with autism spectrum disorder: A pilot study. J Neurosci Res 2020; 98:1150-1161. [PMID: 32090389 DOI: 10.1002/jnr.24600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/16/2020] [Accepted: 02/04/2020] [Indexed: 12/17/2022]
Abstract
Adults with autism spectrum disorder (ASD) experience high rates of depression and anxiety, and some evidence suggests mindfulness-based stress reduction (MBSR) is effective in reducing these symptoms. However, the neural mechanisms of symptom alleviation, and benefit of MBSR beyond education/support groups are unknown. Maladaptive forms of self-reflection are linked to ASD, depression, and anxiety. In this pilot study, we hypothesized (a) MBSR would reduce depression and anxiety in adults with ASD and (b) a mechanism of symptom alleviation would be increased blood oxygen level-dependent signal in neural self-reflection hubs. Twenty-eight adults were randomly assigned to an 8-week MBSR group (n = 15) or a support group (n = 13) that met for the same amount of time with relaxation education materials. Based on previous self-reflection literature in ASD, regions of interest (ROIs) were middle cingulate cortex (MCC) and ventromedial prefrontal cortex (vmPFC). Only the MBSR group demonstrated significant reductions in depression, and neither group significantly changed in anxiety. Only the MBSR group increased activity of right MCC during self-reflection, and the increase correlated with depression alleviation. There were no changes in vmPFC for the MBSR group or either ROI for the support/education group. Seed-to-voxel connectivity analysis revealed that only the MBSR group increased functional connectivity between right MCC and pre/postcentral gyrus, suggesting MBSR may increase primary sensorimotor input to higher order cognitive brain regions. Taken together, MBSR may be effective for reducing depression in adults with ASD, and the neural mechanism may be increasing frontal circuit involvement during self-directed thought.
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Affiliation(s)
- Broc A Pagni
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Melissa J M Walsh
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Emily Foldes
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Ann Sebren
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Maria V Dixon
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | | | - B Blair Braden
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Lewis CR, Preller KH, Braden BB, Riecken C, Vollenweider FX. Rostral Anterior Cingulate Thickness Predicts the Emotional Psilocybin Experience. Biomedicines 2020; 8:biomedicines8020034. [PMID: 32085521 PMCID: PMC7168190 DOI: 10.3390/biomedicines8020034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/02/2023] Open
Abstract
Psilocybin is the psychoactive compound of mushrooms in the psilocybe species. Psilocybin directly affects a number of serotonin receptors, with highest affinity for the serotonin 2A receptor (5HT-2Ar). Generally, the effects of psilocybin, and its active metabolite psilocin, are well established and include a range of cognitive, emotional, and perceptual perturbations. Despite the generality of these effects, there is a high degree of inter-individual variability in subjective psilocybin experiences that are not well understood. Others have shown brain morphology metrics derived from magnetic resonance imaging (MRI) can predict individual drug response. Due to high expression of serotonin 2A receptors (5HT-2Ar) in the cingulate cortex, and its prior associations with psilocybin, we investigate if cortical thickness of this structure predicts the psilocybin experience in healthy adults. We hypothesized that greater cingulate thickness would predict higher subjective ratings in sub-scales of the Five-Dimensional Altered State of Consciousness (5D-ASC) with high emotionality in healthy participants (n = 55) who received oral psilocybin (either low dose: 0.160 mg/kg or high dose: 0.215 mg/kg). After controlling for sex, age, and using false discovery rate (FDR) correction, we found the rostral anterior cingulate predicted all four emotional sub-scales, whereas the caudal and posterior cingulate did not. How classic psychedelic compounds induce such large inter-individual variability in subjective states has been a long-standing question in serotonergic research. These results extend the traditional set and setting hypothesis of the psychedelic experience to include brain structure metrics.
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Affiliation(s)
- Candace R. Lewis
- Translational Genomics Research Institute, Neurogenomics Division, Phoenix, AZ 85004, USA
- Neuropsychopharamacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich 8032, Switzerland; (K.H.P.); (F.X.V.)
- Correspondence: ; Tel.: +1-602-343-8400
| | - Katrin H. Preller
- Neuropsychopharamacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich 8032, Switzerland; (K.H.P.); (F.X.V.)
| | - B. Blair Braden
- Arizona State University, College of Health Solutions, Tempe 85281, AZ 85004, USA; (B.B.B.); (C.R.)
| | - Cory Riecken
- Arizona State University, College of Health Solutions, Tempe 85281, AZ 85004, USA; (B.B.B.); (C.R.)
| | - Franz X. Vollenweider
- Neuropsychopharamacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry, Zurich 8032, Switzerland; (K.H.P.); (F.X.V.)
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Pérula-de Torres LA, Atalaya JCVM, García-Campayo J, Roldán-Villalobos A, Magallón-Botaya R, Bartolomé-Moreno C, Moreno-Martos H, Melús-Palazón E, Liétor-Villajos N, Valverde-Bolívar FJ, Hachem-Salas N, Rodríguez LA, Navarro-Gil M, Epstein R, Cabezón-Crespo A, Moreno CMV. Controlled clinical trial comparing the effectiveness of a mindfulness and self-compassion 4-session programme versus an 8-session programme to reduce work stress and burnout in family and community medicine physicians and nurses: MINDUUDD study protocol. BMC FAMILY PRACTICE 2019; 20:24. [PMID: 30727962 PMCID: PMC6364464 DOI: 10.1186/s12875-019-0913-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/25/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Health personnel are susceptible to high levels of work stress and burnout due to the psychological and emotional demands of their work, as well as to other aspects related to the organisation of that work. This paper describes the rationale and design of the MINDUUDD study, the aim of which is to evaluate the effectiveness of a mindfulness and self-compassion 4-session programme versus the standard 8-session programme to reduce work stress and burnout in Family and Community Medicine and Nursing tutors and residents. METHODS The MINDUDD study is a multicentre cluster randomised controlled trial with three parallel arms. Six Teaching Units will be randomised to one of the three study groups: 1) Experimental Group-8 (EG8); 2) Experimental Group-4 (EG4) Control group (CG). At least 132 subjects will participate (66 tutors/66 residents), 44 in the EG8, 44 in the EG4, and 44 in the CG. Interventions will be based on the Mindfulness-Based Stress Reduction (MBSR) program, including some self-compassion practices of the Mindful Self-Compassion (MSC) programme. The EG8 intervention will be implemented during 8 weekly face-to-face sessions of 2.5 h each, while the EG4 intervention will consist of 4 sessions of 2.5 h each. The participants will have to practice at home for 30 min/day in the EG8 and 15 min/day in the EG4. The Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale (SCS), Perceived Stress Questionnaire (PSQ), Maslach Burnout Inventory (MBI), Jefferson Scale of Physician Empathy (JSPE), and Goldberg Anxiety-Depression Scale (GADS) will be administered. Measurements will be taken at baseline, at the end of the programs, and at three months after completion. The effect of the interventions will be evaluated by bivariate and multivariate analyses (Multiple Linear Regression). DISCUSSION If the abbreviated mindfulness programme is at least as effective as the standard program, its incorporation into the curriculum and training plans will be easier and more appropriate. It will also be more easily applied and accepted by primary care professionals because of the reduced resources and means required for its implementation, and it may also extend beyond care settings to academic and teaching environments as well. TRIAL REGISTRATION The study has been registered at ClinicalTrials.gov ( NCT03629457 ; date of registration: 13.08.2018).
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Affiliation(s)
- Luis-Angel Pérula-de Torres
- Clinical and Epidemiological Research Group in Primary Care (GICEAP), IMIBIC/Reina Sofía University Hospital/University of Córdoba, Primary Care Prevention and Health Promotion Research Network (RedIAPP), Family and Community Medicine Teaching Unit of Córdoba, Córdoba, Spain
| | | | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centre for Biomedical Research Network on Mental Health, Zaragoza, Spain
- Miguel Servet Hospital, University of Zaragoza, Zaragoza, Spain
| | - Ana Roldán-Villalobos
- Clinical and Epidemiological Research Group in Primary Care (GICEAP), IMIBIC/Reina Sofía University Hospital/University of Córdoba. Family and Community Medicine Teaching Unit of Córdoba, Córdoba, Spain
| | - Rosa Magallón-Botaya
- Arrabal Health Centre. Primary Care Prevention and Health Promotion Research Network (RedIAPP), University of Zaragoza, Health Research Institute of Aragón, Zaragoza, Spain
| | | | - Herminia Moreno-Martos
- UGC Almería Periphery. Retamar Health Center, Research Network on Communication and Health (RICyS) of the Program Communication and Health (semFYC), Almería, Spain
| | - Elena Melús-Palazón
- Family and Community Care Teaching Unit of Zaragoza Sector I, Zaragoza, Spain
| | | | | | | | - Luis-Alberto Rodríguez
- Familiar and Community Attention Multiprofessional Teaching Unit of León II, Ponferrada, León, Spain
| | - Mayte Navarro-Gil
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | | | | | - the collaborative group of the MINDUUDD study
- Clinical and Epidemiological Research Group in Primary Care (GICEAP), IMIBIC/Reina Sofía University Hospital/University of Córdoba, Primary Care Prevention and Health Promotion Research Network (RedIAPP), Family and Community Medicine Teaching Unit of Córdoba, Córdoba, Spain
- Comuneros Health Center, Research Network on Communication and Health (RICyS) of the Communication and Health program (semFYC), Burgos, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centre for Biomedical Research Network on Mental Health, Zaragoza, Spain
- Miguel Servet Hospital, University of Zaragoza, Zaragoza, Spain
- Clinical and Epidemiological Research Group in Primary Care (GICEAP), IMIBIC/Reina Sofía University Hospital/University of Córdoba. Family and Community Medicine Teaching Unit of Córdoba, Córdoba, Spain
- Arrabal Health Centre. Primary Care Prevention and Health Promotion Research Network (RedIAPP), University of Zaragoza, Health Research Institute of Aragón, Zaragoza, Spain
- Family and Community Care Teaching Unit of Zaragoza Sector I, Zaragoza, Spain
- UGC Almería Periphery. Retamar Health Center, Research Network on Communication and Health (RICyS) of the Program Communication and Health (semFYC), Almería, Spain
- Belén Health Centre, Jaén, Spain
- Family and Community Medicine Teaching Unit of Jaén, Jaén, Spain
- Mediterranean Health Centre, Torrecárdenas, Almería, Spain
- Familiar and Community Attention Multiprofessional Teaching Unit of León II, Ponferrada, León, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- University of Rochester Medical Center, New York, USA
- Family and Community Medicine Teaching Unit of Burgos, Burgos, Spain
- Family and Community Medicine Teaching Unit of Córdoba. Lucena II Health Centre, Córdoba, Spain
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Chen J, Wang Z, Tu Y, Liu X, Jorgenson K, Ye G, Lin C, Liu J, Park J, Lang C, Liu B, Kong J. Regional Homogeneity and Multivariate Pattern Analysis of Cervical Spondylosis Neck Pain and the Modulation Effect of Treatment. Front Neurosci 2018; 12:900. [PMID: 30574062 PMCID: PMC6292425 DOI: 10.3389/fnins.2018.00900] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 11/19/2018] [Indexed: 11/13/2022] Open
Abstract
Objects: We investigated brain functional alteration in patients with chronic cervical spondylosis neck pain (CSNP) compared to healthy controls (HCs) and the effect of intervention. Methods: 104 CSNP patients and 96 matched HCs were recruited. Patients received 4 weeks of treatment. Resting-state fMRI and Northwick Park Neck Pain Questionnaire (NPQ) were collected before and after treatment. Resting state regional homogeneity (rs-ReHo) and multivariate pattern analysis (MVPA) were applied to (1) investigate rs-ReHo differences between CSNP patients and controls and the effect of longitudinal treatment and (2) classify CSNP patients from HCs and predict clinical outcomes before treatment using MVPA. Results: We found that (1) CSNP patients showed decreased rs-ReHo in the left sensorimotor cortex and right temporo-parietal junction (rTPJ), and rs-ReHo at the rTPJ significantly increased after treatment; (2) rs-ReHo at rTPJ was associated with NPQ at baseline, and pre- and post-treatment rs-ReHo changes at rTPJ were associated with NPQ changes in CSNP patients; and (3) MVPA could discriminate CSNP patients from HCs with 72% accuracy and predict clinical outcomes with a mean absolute error of 19.6%. Conclusion: CSNP patients are associated with dysfunction of the rTPJ and sensorimotor area. Significance: rTPJ plays on important role in the pathophysiology and development of CSNP.
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Affiliation(s)
- Jun Chen
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zengjian Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiheng Tu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Xian Liu
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Kristen Jorgenson
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Guoxi Ye
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Chenlin Lin
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jianhua Liu
- Key Laboratory for Studying Regularities and Mechanism of Acu-moxibustion, Department of Acu-moxibustion, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Joel Park
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Courtney Lang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Bo Liu
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
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Kootstra TJM, Wilkens SC, Menendez ME, Ring D. Is Physician Empathy Associated With Differences in Pain and Functional Limitations After a Hand Surgeon Visit? Clin Orthop Relat Res 2018; 476:801-807. [PMID: 29481341 PMCID: PMC6260057 DOI: 10.1007/s11999.0000000000000077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In prior work we demonstrated that patient-rated physician empathy was the strongest driver of patient satisfaction after a visit to an orthopaedic hand surgeon. Data from the primary care setting suggest a positive association between physician empathy and clinical outcomes, including symptoms of the common cold. It is possible that an empathic encounter could make immediate and measureable changes in a patient's mindset, symptoms, and functional limitations. QUESTIONS/PURPOSES (1) Comparing patients who rated their physicians as perfectly empathic with those who did not, is there a difference in pre- to postvisit change in Patient Reported Outcome Measurement Information System (PROMIS) Upper Extremity Function scores? (2) Do patients who gave their physicians perfectly empathic ratings have a greater decrease in pre- to postvisit change in Pain Intensity, PROMIS Pain Interference, and PROMIS Depression scores? METHODS Between September 2015 and February 2016, based on the clinic patient flow, 134 new patients were asked to participate in this study. Eight patients were in a rush to leave the surgeon's office, which left us with a final cohort of 126 patients. Directly before and directly after the appointment with their physician, patients were asked to complete three PROMIS Computerized Adaptive Tests (CAT; Upper Extremity Function, Pain Interference, and Depression) as well as an ordinal rating of pain intensity. After the visit, participants were asked to rate their physician using the Consultation And Relational Empathy (CARE) measure. Based on prior experience, we dichotomized the CARE score anticipating a substantial skew: 54 patients (43%) rated their physician perfectly empathic. RESULTS Between patients who rated physicians as perfectly empathic and those who did not, there was no difference in the pre- to postvisit change in PROMIS Upper Extremity Function CAT score (perfect empathy: 0.84 ± 2.94; less than perfect empathy: -0.23 ± 3.12; mean difference: 0.23; 95% confidence interval [CI], -0.31 to 0.77; p = 0.054). There was a small decrease in Pain Intensity (perfect empathy: -0.96 ± 2.08; less than perfect empathy: -0.33 ± 1.03; mean difference: -0.60; 95% CI, -0.88 to -0.32; p = 0.028). There were no differences in PROMIS Pain Interference score (perfect empathy: -1.33 ± 2.85; less than perfect empathy: -1.37 ± 3.12; mean difference: -1.35; 95% CI, -1.88 to -0.83; p = 0.959) or PROMIS Depression scores (perfect empathy: -1.51 ± 4.02; less than perfect empathy : -1.21 ± 3.83; mean difference: -1.34; 95% CI, -2.03 to -0.65; p = 0.663). CONCLUSIONS A single visit with a surgeon rated perfectly empathic is not associated with change in upper extremity-specific limitations or coping mechanisms or a noticeable change in pain scores during the visit, as these differences were below the minimum clinically important difference. Future research should address the influence of empathy on patient-reported outcomes and physician empathy over time in contrast to a single office visit. LEVEL OF EVIDENCE Level II, prognostic study.
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Mauri A, Tomas M, Ongaro G, Riccato O. Benessere percepito e pratiche mindfulness in pazienti ospedalieri. ACTA ACUST UNITED AC 2018. [DOI: 10.3280/pds2018-001009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
PURPOSE OF REVIEW Due to medical advances and an aging population, the number of cancer survivors continues to rise. Survivors often experience late and long-term sequelae of cancer and its treatment (e.g., fatigue, pain, fear of recurrence, and stress). As a result, some patients have utilized or expressed interest in integrative medicine (IM) modalities for prevention of recurrence, optimizing health, enhancing quality of life, and managing symptoms. The purpose of this review is to focus on research published during the past year that informs our understanding of the utility of IM for cancer survivors. RECENT FINDINGS Physical activity, diet, dietary supplements, mind-body modalities, acupuncture, and massage therapy all may play a role in the management of the physical (e.g., fatigue and pain) and emotional (e.g., anxiety and fear) issues faced by cancer survivors. SUMMARY IM therapies are appealing to and utilized by many cancer survivors and may reduce symptom burden. Clinicians who provide cancer survivorship care may improve patient care by understanding the evidence for and against their use.
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Demarzo M, Montero-Marin J, Puebla-Guedea M, Navarro-Gil M, Herrera-Mercadal P, Moreno-González S, Calvo-Carrión S, Bafaluy-Franch L, Garcia-Campayo J. Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study. Front Psychol 2017; 8:1343. [PMID: 28848465 PMCID: PMC5550824 DOI: 10.3389/fpsyg.2017.01343] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/24/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. Clinical Trials.gov Registration ID: NCT02643927
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Affiliation(s)
- Marcelo Demarzo
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion, Universidade Federal de Sao PauloSao Paulo, Brazil.,Hospital Israelita Albert EinsteinSao Paulo, Brazil
| | - Jesus Montero-Marin
- Faculty of Health Sciences and Sports, University of ZaragozaHuesca, Spain.,Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centro de Investigación Biomédica en Red de Salud MentalZaragoza, Spain
| | - Marta Puebla-Guedea
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centro de Investigación Biomédica en Red de Salud MentalZaragoza, Spain
| | - Mayte Navarro-Gil
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centro de Investigación Biomédica en Red de Salud MentalZaragoza, Spain
| | - Paola Herrera-Mercadal
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centro de Investigación Biomédica en Red de Salud MentalZaragoza, Spain
| | | | | | | | - Javier Garcia-Campayo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centro de Investigación Biomédica en Red de Salud MentalZaragoza, Spain.,Miguel Servet Hospital, University of ZaragozaZaragoza, Spain
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Moriarty O, Ruane N, O'Gorman D, Maharaj CH, Mitchell C, Sarma KM, Finn DP, McGuire BE. Cognitive Impairment in Patients with Chronic Neuropathic or Radicular Pain: An Interaction of Pain and Age. Front Behav Neurosci 2017; 11:100. [PMID: 28659771 PMCID: PMC5468384 DOI: 10.3389/fnbeh.2017.00100] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 05/11/2017] [Indexed: 11/13/2022] Open
Abstract
A growing body of empirical research has confirmed an association between chronic pain and cognitive dysfunction. The aim of the present study was to determine whether cognitive function is affected in patients with a diagnosis of chronic neuropathic or radicular pain relative to healthy control participants matched by age, gender, and years of education. We also examined the interaction of pain with age in terms of cognitive performance. Some limitations of previous clinical research investigating the effects of chronic pain on cognitive function include differences in the pain and cognitive scale materials used, and the heterogeneity of patient participants, both in terms of their demographics and pathological conditions. To address these potential confounds, we have used a relatively homogenous patient group and included both experimental and statistical controls. We have also specifically investigated the interaction effect of pain and age on cognitive performance. Patients (n = 38) and controls (n = 38) were administered a battery of cognitive tests measuring IQ, spatial and verbal memory, attention, and executive function. Educational level, depressive symptoms, and state anxiety were assessed as were medication usage, caffeine, and nicotine consumption to control for possible confounding effects. Both the level of depressive symptoms and the state anxiety score were higher in chronic pain patients than in matched control participants. Chronic pain patients had a lower estimated IQ than controls, and showed impairments on measures of spatial and verbal memory. Attentional responding was altered in the patient group, possibly indicative of impaired inhibitory control. There were significant interactions between chronic pain condition and age on a number of cognitive outcome variables, such that older patients with chronic pain were more impaired than both age-matched controls and younger patients with chronic pain. Chronic pain did not appear to predict performance on the Wisconsin Card Sorting Task, which was used a measure of executive function. This study supports and extends previous research indicating that chronic pain is associated with impaired memory and attention. Perspective: Compared to healthy control participants, patients with chronic neuropathic or radicular pain showed cognitive deficits which were most pronounced in older pain patients.
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Affiliation(s)
- Orla Moriarty
- Pharmacology and Therapeutics, School of Medicine, National University of IrelandGalway, Ireland.,Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland
| | - Nancy Ruane
- Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland.,Division of Pain Medicine, Galway University HospitalGalway, Ireland
| | - David O'Gorman
- Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland.,Division of Pain Medicine, Galway University HospitalGalway, Ireland
| | - Chris H Maharaj
- Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland.,Division of Pain Medicine, Galway University HospitalGalway, Ireland
| | - Caroline Mitchell
- Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland.,Division of Pain Medicine, Galway University HospitalGalway, Ireland
| | - Kiran M Sarma
- Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland.,School of Psychology, National University of IrelandGalway, Ireland
| | - David P Finn
- Pharmacology and Therapeutics, School of Medicine, National University of IrelandGalway, Ireland.,Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland
| | - Brian E McGuire
- Centre for Pain Research, National Centre for Biomedical Engineering Science, National University of IrelandGalway, Ireland.,Division of Pain Medicine, Galway University HospitalGalway, Ireland.,School of Psychology, National University of IrelandGalway, Ireland
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Bremner JD, Mishra S, Campanella C, Shah M, Kasher N, Evans S, Fani N, Shah AJ, Reiff C, Davis LL, Vaccarino V, Carmody J. A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder. Front Psychiatry 2017; 8:157. [PMID: 28890702 PMCID: PMC5574875 DOI: 10.3389/fpsyt.2017.00157] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 08/09/2017] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Brain imaging studies in patients with post-traumatic stress disorder (PTSD) have implicated a circuitry of brain regions including the medial prefrontal cortex, amygdala, hippocampus, parietal cortex, and insula. Pharmacological treatment studies have shown a reversal of medial prefrontal deficits in response to traumatic reminders. Mindfulness-based stress reduction (MBSR) is a promising non-pharmacologic approach to the treatment of anxiety and pain disorders. The purpose of this study was to assess the effects of MBSR on PTSD symptoms and brain response to traumatic reminders measured with positron-emission tomography (PET) in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) combat veterans with PTSD. We hypothesized that MBSR would show increased prefrontal response to stress and improved PTSD symptoms in veterans with PTSD. METHOD Twenty-six OEF/OIF combat veterans with PTSD who had recently returned from a combat zone were block randomized to receive eight sessions of MBSR or present-centered group therapy (PCGT). PTSD patients underwent assessment of PTSD symptoms with the Clinician-Administered PTSD Scale (CAPS), mindfulness with the Five Factor Mindfulness Questionnaire (FFMQ) and brain imaging using PET in conjunction with exposure to neutral and Iraq combat-related slides and sound before and after treatment. Nine patients in the MBSR group and 8 in the PCGT group completed all study procedures. RESULTS Post-traumatic stress disorder patients treated with MBSR (but not PCGT) had an improvement in PTSD symptoms measured with the CAPS that persisted for 6 months after treatment. MBSR also resulted in an increase in mindfulness measured with the FFMQ. MBSR-treated patients had increased anterior cingulate and inferior parietal lobule and decreased insula and precuneus function in response to traumatic reminders compared to the PCGT group. CONCLUSION This study shows that MBSR is a safe and effective treatment for PTSD. Furthermore, MBSR treatment is associated with changes in brain regions that have been implicated in PTSD and are involved in extinction of fear responses to traumatic memories as well as regulation of the stress response.
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Affiliation(s)
- James Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Department of Radiology, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States.,Department of Psychiatry, University of Alabama, Birmingham, AL, United States.,The Tuskegee VA Medical Center, Tuskegee, AL, United States
| | - Sanskriti Mishra
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Carolina Campanella
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Majid Shah
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Nicole Kasher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Sarah Evans
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Amit Jasvant Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Collin Reiff
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Lori L Davis
- Atlanta VA Medical Center, Decatur, GA, United States.,Department of Psychiatry, University of Alabama, Birmingham, AL, United States.,The Tuskegee VA Medical Center, Tuskegee, AL, United States
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - James Carmody
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Gotink RA, Meijboom R, Vernooij MW, Smits M, Hunink MM. 8-week Mindfulness Based Stress Reduction induces brain changes similar to traditional long-term meditation practice – A systematic review. Brain Cogn 2016; 108:32-41. [DOI: 10.1016/j.bandc.2016.07.001] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 06/24/2016] [Accepted: 07/05/2016] [Indexed: 01/01/2023]
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Braden BB, Pipe TB, Smith R, Glaspy TK, Deatherage BR, Baxter LC. Brain and behavior changes associated with an abbreviated 4-week mindfulness-based stress reduction course in back pain patients. Brain Behav 2016; 6:e00443. [PMID: 26925304 PMCID: PMC4754498 DOI: 10.1002/brb3.443] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 12/17/2015] [Accepted: 12/19/2015] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Mindfulness-based stress reduction (MBSR) reduces depression, anxiety, and pain for people suffering from a variety of illnesses, and there is a growing need to understand the neurobiological networks implicated in self-reported psychological change as a result of training. Combining complementary and alternative treatments such as MBSR with other therapies is helpful; however, the time commitment of the traditional 8-week course may impede accessibility. This pilot study aimed to (1) determine if an abbreviated MBSR course improves symptoms in chronic back pain patients and (2) examine the neural and behavioral correlates of MBSR treatment. METHODS Participants were assigned to 4 weeks of weekly MBSR training (n = 12) or a control group (stress reduction reading; n = 11). Self-report ratings and task-based functional MRI were obtained prior to, and after, MBSR training, or at a yoked time point in the control group. RESULTS While both groups showed significant improvement in total depression symptoms, only the MBSR group significantly improved in back pain and somatic-affective depression symptoms. The MBSR group also uniquely showed significant increases in regional frontal lobe hemodynamic activity associated with gaining awareness to changes in one's emotional state. CONCLUSIONS An abbreviated MBSR course may be an effective complementary intervention that specifically improves back pain symptoms and frontal lobe regulation of emotional awareness, while the traditional 8-week course may be necessary to detect unique improvements in total anxiety and cognitive aspects of depression.
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Affiliation(s)
- B Blair Braden
- Department of Neuroimaging Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix Arizona
| | - Teri B Pipe
- College of Nursing and Health Innovation Arizona State University Phoenix Arizona
| | - Ryan Smith
- Department of Neuroimaging Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix Arizona; Departments of Psychiatry and Psychology University of Arizona Tucson Arizona
| | - Tyler K Glaspy
- Department of Neuroimaging Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix Arizona
| | - Brandon R Deatherage
- Department of Neuroimaging Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix Arizona
| | - Leslie C Baxter
- Department of Neuroimaging Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix Arizona
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