Impact of a Mindfulness-Based Stress Reduction Program on Psychological Well-Being, Cortisol, and Inflammation in Women Veterans

Abstract

Background Women veterans experience higher levels of stress-related symptoms than their civilian counterparts. Psychological stress is associated with greater inflammation and may increase risk for cardiovascular disease (CVD). Mindfulness-based stress reduction (MBSR) has been found to improve psychological well-being in other populations but no randomized controlled trials (RCT) have been conducted examining the impact of MBSR on well-being and inflammation in women veterans at risk for CVD. Objective Determine the effectiveness of MBSR in improving psychological well-being, cortisol, and inflammation associated with CVD in women veterans. Design The design is a RCT comparing MBSR to an active control condition (ACC) consisting of a health education program. Participants Women veterans (N=164) with risk factors for CVD from the Chicagoland area participated in the study. Intervention An 8-week MBSR program with weekly 2.5-h classes was compared to an ACC consisting of an 8-week health promotion education program with weekly 2.5-h classes. Main Measures The outcomes were psychological well-being [perceived stress, depressive symptoms, loneliness, and post-traumatic stress disorder (PTSD)] symptoms and stress-related markers, including diurnal salivary cortisol and cytokines interleukin-6 (IL-6) and interferon gamma (IFN-γ). Data were collected at baseline, 4 weeks (mid-point of intervention), 8 weeks (completion of intervention), and 6 months after completion of MBSR or ACC. Key Results Compared to the ACC, women who participated in MBSR reported less perceived stress, loneliness, and symptoms of PTSD. Although there were no significant differences between groups or changes over time in IL-6 or IFN-γ, participants in the MBSR program demonstrated a more rapid decline in diurnal salivary cortisol as compared to those in the ACC. Conclusions MBSR was found to improve psychological well-being and decrease diurnal salivary cortisol in women veterans at risk for CVD. Health care providers may consider MBSR for women veterans as a means by which to improve their psychological well-being.

Yoga resilience training to prevent the development of posttraumatic stress disorder in active-duty first responders: A cluster randomized controlled trial.

“…Our findings support previous trials on MBE interventions for trauma-exposed populations on posttraumatic stress symptoms (Kelly & Garland, 2016; Saban et al, 2022) and the small effect size at postintervention is consistent with a previous review on MBE for preventing the development of PTSD (Tan et al, 2023). While we did not find any differential effects on individuals with full PTSD, our significant findings for individuals with subthreshold PTSD have important implications around early interventions and possible selective prevention of PTSD (Fink et al, 2018).…”

Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis

“…One study involved a sample of survivors with previous interpersonal violence 65. Three studies involved populations with non-interpersonal trauma, which included male veterans with previous service in Afghanistan or Iraq,66 women veterans with combat exposure,68 earthquake survivors70 and a mixed sample of active-duty military personnel with ongoing exposure and military veterans with previous exposure 69. The final study comprised of junior medical doctors with ongoing exposure through their occupation, although more than half of the study participants also reported previous interpersonal trauma 67.…”

“…All six studies involved the use of yoga. Three studies involved yoga as a stand-alone intervention,66 67 70 each with varying styles of yoga, and three studies involved MBSR, a broader intervention that includes meditation, yoga and facilitated group discussions 65 68 69. One MBSR study included trauma-focused group discussions,65 while the other two MBSR studies were not trauma-focused 68 69.…”

“…Three studies involved yoga as a stand-alone intervention,66 67 70 each with varying styles of yoga, and three studies involved MBSR, a broader intervention that includes meditation, yoga and facilitated group discussions 65 68 69. One MBSR study included trauma-focused group discussions,65 while the other two MBSR studies were not trauma-focused 68 69. The duration of intervention delivery mostly ranged from 6 to 8 weeks,57 65 67 70 with the exception of one study that was delivered over 7 consecutive days 66.…”

Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment

“…The pathophysiological basis for these associations is poorly understood, but activation of inflammation and the hypothalamic-pituitary-adrenal axis have been postulated as potential mechanisms . Interventions for improving nutritional patterns or reducing stress in adults have both been described to induce changes in inflammation and oxidation and the hypothalamic-pituitary-adrenal axis . However, to our knowledge, no randomized clinical trials have evaluated the effects of structured dietary or stress reduction lifestyle interventions during pregnancy on improving offspring neurodevelopment.…”