Mindfulness-based stress reduction to enhance psychological functioning and improve inflammatory biomarkers in trauma-exposed women: A pilot study.

Abstract

This study examined the effects of a Mindfulness-Based Stress Reduction (MBSR) program on psychological functioning and inflammatory biomarkers in women with histories of interpersonal trauma. The 8-week MBSR program was conducted at a community-based health center and participants (N = 50) completed several measures of psychological functioning at study entry as well as 4 weeks, 8 weeks, and 12 weeks later. Inflammatory biomarkers were assayed from blood collected at each assessment. A series of linear mixed model analyses were conducted to measure the effect of attendance and time on the dependent variables. Time was associated with significant decreases in perceived stress, depression, trait and state anxiety, emotion dysregulation, and post-traumatic stress symptoms as well as increases in mindfulness. Session attendance was associated with significant decreases in interleukin (IL)-6 levels. This pilot study demonstrated the potential beneficial effects of MBSR on psychological functioning and the inflammatory biomarker IL-6 among trauma-exposed and primarily low-income women. Decreases in inflammation have implications for this population, as interpersonal trauma can instigate chronic physiological dysregulation, heightened morbidity, and premature death. This study’s preliminary results support efforts to investigate biological remediation with behavioral interventions in vulnerable populations.

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

“…The studies reviewed here suggest that mindfulnessbased treatments are effective in reducing symptoms of PTSD, with medium to large within-group effect sizes. 129,131-134, 136-138,142,145 Critically, most of these studies reported low dropout rates (0%-29% attrition), 129,[131][132][133][134]137,138,142,[144][145][146] although higher rates were reported by Gallegos and colleagues, 139 (43% dropout) who cited reasons such as difficulty with childcare and transportation among a sample of mostly women of low socioeconomic status. Such low drop-out rates suggest high acceptability of mindfulness-based treatments among individuals with PTSD and are important given that recent studies highlight 35%-40% dropout rates among individuals receiving evidencebased treatments for PTSD (e.g., CPT, PE), [14][15][16] with PE having significantly higher dropout rates.…”

“…In that study, PTSD symptom reduction was maintained at 3-month follow-up, although attention improvements were not. 129 Similarly, Gallegos and colleagues 139 reported significant reductions in self-reported depressive and PTSD symptoms and improvements in emotion regulation immediately following standard MBSR treatment and at 1-month follow-up among women with a history of interpersonal violence and high perceived stress. However, the authors noted lower retention, with 43% of participants classified as noncompleters.…”

“…137 In addition, MBSR appears to have a high level of acceptability among patients, with most studies reporting low drop-out rates of 10%-22% 129,131,132,134,137,138 (but see the study by Gallegos and colleagues 139 ). With respect to mechanisms of change, aggregate data from 2 studies by Kearney and colleagues 132,133 and 2 unpublished studies reported changes in nonreactivity and acting with awareness on the FFMQ to be most strongly associated with improvements in PTSD symptoms, particularly hyperarousal symptoms.…”

“…151 Although the directionality of the association between cortisol levels and PTSD symptomatology is not clear, the studies reviewed here suggest that mindfulnessbased approaches may be effective in normalizing cortisol response in individuals with PTSD. 135,143 Furthermore, Gallegos and colleagues 139 observed reductions in circulating interleukin-6 (IL-6; an inflammatory biomarker) as a function of increased attendance at MBSR treatment sessions among women with a history of interpersonal trauma. These findings are important in light of consistent reports of increased inflammatory biomarkers among individuals with PTSD and given that proinflammatory cytokines, such as IL-6, have been shown to increase depressive and anxiety symptoms.…”

“…[129][130][131][132][133][134][135][136][137][138][139] In a recent pilot study Cole and colleagues 129 investigated standard MBSR as a treatment for both PTSD symptoms and attention difficulties among veterans with PTSD and a history of mild traumatic brain injury (mTBI), reporting low drop-out rates (10%), significant reductions in self-reported PTSD symptoms and significant improvements on attention measures posttreatment. In that study, PTSD symptom reduction was maintained at 3-month follow-up, although attention improvements were not.…”