Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis

Pascoe, Michaela C.; Thompson, David R.; Jenkins, Zoe; Ski, Chantal F.

doi:10.1016/j.jpsychires.2017.08.004

Cited by 364 publications

(294 citation statements)

References 72 publications

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“…Mindfulness appears to modulate the relationship between acute stressors of various types and physiological responses. [57][58][59] Thus, the rationale of a stress-reduction treatment to reduce migraine frequency makes intuitive sense, even though mindfulness-based interventions including MBCT-M have consistently failed to produce clinically meaningful or statistically significant improvements in headache days. 24 It is possible that typical 8-week training is insufficient to produce clinically meaningful changes in mindfulness skills, or consistent reduction in stress, to meaningfully reduce headache days.…”

Section: Discussionmentioning

confidence: 99%

Does Mindfulness‐Based Cognitive Therapy for Migraine Reduce Migraine‐Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial

et al. 2019

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Objective The current Phase 2b study aimed to evaluate the efficacy of mindfulness‐based cognitive therapy for migraine (MBCT‐M) to reduce migraine‐related disability in people with migraine. Background Mindfulness‐based interventions represent a promising avenue to investigate effects in people with migraine. MBCT teaches mindfulness meditation and cognitive‐behavioral skills and directly applies these skills to address disease‐related cognitions. Methods Participants with migraine (6‐30 headache days/month) were recruited from neurology office referrals and local and online advertisements in the broader New York City area. During the 30‐day baseline period, all participants completed a daily headache diary. Participants who met inclusion and exclusion criteria were randomized in a parallel design, stratified by chronic migraine status, to receive either 8 weekly individual MBCT‐M sessions or 8 weeks of waitlist/treatment as usual (WL/TAU). All participants completed surveys including primary outcome evaluations at Months 0, 1, 2, and 4. All participants completed a headache diary during the 30‐day posttreatment evaluation period. Primary outcomes were the change from Month 0 to Month 4 in the headache disability inventory (HDI) and the Migraine Disability Assessment (MIDAS) (total score ≥ 21 indicating severe disability); secondary outcomes (headache days/30 days, average headache attack pain intensity, and attack‐level migraine‐related disability [Migraine Disability Index (MIDI)]) were derived from the daily headache diary. Results Sixty participants were randomized to receive MBCT‐M (n = 31) or WL/TAU (n = 29). Participants (M age = 40.1, SD = 11.7) were predominantly White (n = 49/60; 81.7%) and Non‐Hispanic (N = 50/60; 83.3%) women (n = 55/60; 91.7%) with a graduate degree (n = 35/60; 55.0%) who were working full‐time (n = 38/60; 63.3%). At baseline, the average HDI score (51.4, SD = 19.0) indicated a moderate level of disability and the majority of participants (50/60, 83.3%) fell in the “Severe Disability” range in the MIDAS. Participants recorded an average of 16.0 (SD = 5.9) headache days/30 days, with an average headache attack pain intensity of 1.7 on a 4‐point scale (SD = 0.3), indicating moderate intensity. Average levels of daily disability reported on the MIDI were 3.1/10 (SD = 1.8). For the HDI, mean scores decreased more from Month 0 to Month 4 in the MBCT‐M group (−14.3) than the waitlist/treatment as an usual group (−0.2; P < .001). For the MIDAS, the group*month interaction was not significant when accounting for the divided alpha, P = .027; across all participants in both groups, the estimated proportion of participants falling in the “Severe Disability” category fell significantly from 88.3% at Month 0 to 66.7% at Month 4, P < .001. For diary‐reported headache days/30 days an average headache attack pain intensity, neither the group*month interaction (Ps = .773 and .888, respectively) nor the time effect (Ps = .059 and .428, respectively) was significant. Mean MIDI scores decreased in the ...

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Section: Discussionmentioning

confidence: 99%

Does Mindfulness‐Based Cognitive Therapy for Migraine Reduce Migraine‐Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial

et al. 2019

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“…27 Such physiological processes are thought to be mechanisms by which meditation interventions produce beneficial outcomes. 27 Such physiological processes are thought to be mechanisms by which meditation interventions produce beneficial outcomes.…”

Section: Discussionmentioning

confidence: 99%

Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer

et al. 2019

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Objective Women with metastatic breast cancer (MBC) report high levels of disease‐related symptoms including pain, fatigue, psychological distress, and sleep disturbance. Mindfulness may be particularly relevant to women with MBC given the high symptom burden and psychological toll of this disease; however, the topic is understudied among this patient population. Therefore, we aimed to test the associations between mindfulness and patient‐reported symptoms among a sample of women with MBC. Methods Sixty‐four women with MBC completed baseline questionnaires of mindfulness (Five Facet Mindfulness Questionnaire‐Short Form [FFMQ‐SF]) and symptoms of pain severity and interference, fatigue, psychological distress, and sleep disturbance as part of a randomized controlled trial of a Mindful Yoga intervention. Correlational analyses of data collected at baseline tested associations between the five mindfulness facets (observing, describing, acting with awareness, nonjudging, and nonreactivity) and patient‐reported measures of symptoms. Results Overall, higher mindfulness was associated with lower symptom levels including lower pain severity, pain interference, fatigue, anxiety, depression, and sleep disturbance. However, degree of association varied by mindfulness facet. Nonreactivity, nonjudging, and describing showed the most frequent associations and largest effect sizes across symptoms, while observing showed the least frequent associations and lowest effect sizes. Conclusions Mindfulness—and in particular nonreactivity, nonjudging, and describing—may be a personal resource for women with MBC in coping with complex symptoms of this life‐threatening illness. Findings are discussed relative to their implications for interventions aimed at increasing mindfulness in this vulnerable population.

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“…Yet, as suggested by the current results, body awareness does not appear to be specific to the context of intervention and training. On the biological level, mindfulness training increases the activity of prefrontal regulatory regions which inhibit central stress processing regions (e.g., the amygdala), and reduces and modulates the reactivity of these regions (Creswell and Lindsay 2014; for meta-analytic evidence of the effects of mindfulness on physiological markers of stress, see Pascoe et al 2017). Traditional Buddhist meditation typically starts with an initial training of attention regulation, often focusing on localized bodily sensations (e.g., respiration), before proceeding to a more general stage where awareness does not depend on the conscious selection and deselection of the attentional focus and which finally may result in psychological well-being (Hölzel et al 2011;Lutz et al 2008).…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Mindfulness in the General Population

et al. 2018

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Previous research among experienced meditators suggests that the associations of trait mindfulness with mental health are mediated by emotion regulation, body awareness, and a less static perspective of the self. The present study sought to elucidate whether this mediational model is also applicable to the general population and whether further potential mechanisms of action need to be included. Meditators and nonmeditators differ in overall mindfulness levels, but also in the structural properties of mindfulness facets. Meditation experience might bring about a change of variables that explain the associations of mindfulness with mental health. We examined the confirmatory fit of the mediational model in a large, German-speaking general population sample (N = 1133) with structural equation modeling, and investigated in an exploratory fashion whether further mediating variables needed to be included in the model. As a side goal, the structural properties of a short form of the Five Facet Mindfulness Questionnaire (FFMQ) were re-examined. Results suggest that variables and mechanisms which mediate the associations between trait mindfulness and mental health are the same for meditators and the general population. Differences pertain to the strength and direction of some of these associations. The short-form FFMQ is recommended for further research. It was replicably shown to have a two-factor higher-order structure. Findings are discussed with regard to mindfulness training and intervention. Potential mechanisms of action may not be intervention-specific, but may also explain the links between trait mindfulness and mental health.

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Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis

Cited by 364 publications

References 72 publications

Does Mindfulness‐Based Cognitive Therapy for Migraine Reduce Migraine‐Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial

Does Mindfulness‐Based Cognitive Therapy for Migraine Reduce Migraine‐Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial

Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer

Mechanisms of Mindfulness in the General Population

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