MBSR/Meditation:
Journal Articles
A. MEDICAL TOPICS
1. Cancer
-
Top of Articles Page -
Top of Page
- A.O.
Masson, J. Teas, J.R. Hebert, Wertheimer and J. Kabat-Zinn., Meditation,
Melatonin and Breast/Prostate Cancer: Hypothesis and Preliminary
Data. Medical Hypotheses (1995). Click
here for Abstract
- Kabat-Zinn, J., Massion, A. O., Hebert, J. R., and Rosenbaum,
E., Meditation. Textbook on Psycho-Oncology (1998)
66:767-779.
2. Chronic
Disease -
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Top of Page
- Judith
K. Ockene, Glorian Sorensen, Jon Kabat-Zinn, Ira S. Ockene,
M.D., Gary Donnelly., Benefits and Costs of Lifestyle Change
to Reduce Risk of Chronic Disease. Preventive Medicine
17, 224-234 (1988). Click
here for Abstract
3. Chronic
Pain -
Top of Articles Page -
Top of Page
-
Kabat-Zinn. J., An out-patient program in Behavioral Medicine
for chronic pain patients based on the practice of mindfulness
meditation: Theoretical considerations and preliminary results.
General Hospital Psychiatry (1982) 4:33-47. Click
here for Abstract
- Kabat-Zinn, J., Lipworth, L. and Burney, R. The clinical
use of mindfulness meditation for the self-regualtion of chronic
pain. J. Behav. Med. (1985) 8:163-190. Click
here for Abstract
- Kabat-Zinn, J., Lipworth, L., Burney, R. and Sellers, W., Four
year follow-up of a meditation-based program for the
self-regulation of chronic pain: Treatment outcomes and
compliance. Clin. J. Pain (1986) 2:159-173. Click
here for Abstract
- Ockene, J., Sorensen, G., Kabat-Zinn, Ockene, I.S., and
Donnelly, G. Benefits and costs of lifestyle change to reduce
risk of chronic disease. Preventive medecine, (1988)
17:224-234.
- Randolph, PD, Caldera YM, Tacone AM et al. The long term
combined effects of medical treatment and a mindfulness-based
behavioral program for the multidisciplinary management of
chronic pain in West Texas. Pain Digest (1999)
9:103-112. Click
here for Abstract
4. EEG
-
Top of Articles Page -
Top of Page
- Michael
A. West., Meditation and the EEG. Psychological
Medicine, 1980, 10, 369-375. Click
here for Abstract
5.
Fibromyalgia -
Top of Articles Page
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Top of Page
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Goldenberg, DL., Kaplin, KH, Nadeau, MG., et al. A controlled
study of a stress reduction, cognitive-behavioral treatment
program in fibromyalgia. Musculoskeletal Pain (1994)
2:53-66.
- Kenneth H. Kaplan, M.D, Don L. Goldenberg, M.D., and
MaureenGalvin-Nadeau, M.S., C.S., The Impact of a
Meditation-Based Stress Reduction Program on Fibromyalgia. General
Hospital Psychiatry 15, 284-289, 1993. Click
here for Abstract
6.
Medical Students -
Top of Articles Page
-
Top of Page
- Ockene, Ira.
S. Ockene, Kabat-Zinn, Greene, David Frid, Teaching
Risk-factor counseling skills to medical students, house staff,
and fellows. Prev Med 1990;6 (suppl 1): 35-42. Click
here for Abstract
- ShaunaL. Shapiro, Gary E. Schwartz, Ginny Bonner., Effects
of Mindfulness-Based Stress Reduction on Medical and Premedical
Students. Journal of Behavioral, Vol. 21, No. 6, 1998
Click
here for Abstract
7. Psoriasis
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Top of Articles Page
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Top of Page
- Bernhard, J.,
Kristeller, J. and Kabat-Zinn, Effectiveness of relaxation
and visualization techniques as an adjunct to phototherapy and
photochemotherapy of psoriasis. Journal of Acad.
Dermatology (1988) 19:572-573.
- Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf,
M., Cropley, T. G., Hosmer, D., and Bernhard, J., Influence
of a mindfulness-based stress reduction intervention on rates of
skin clearing in patients with moderate to severe psoriasis
undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom.
Med. (1998) 60:625-632. Click
here for Abstract
8. Sleep -
Top of Articles Page
-
Top of Page
- Pagano, R.R.
et al. Sleep during transcendental meditation. Science
1976 Jan 23;191(4224):308-10. Click
here for Abstract
9.
Hypertension -
Top of Articles Page
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Top of Page
- Wasir,
H.S. Meditation and hypertension. Natl. Med. J. India.
1995 May-Jun;8(3):101-2
B. Psychiatric/Psychological
Topics
1. Anxiety
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Top of Articles Page
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Top of Page
- Kabat-Zinn,
J., Massion, A. O., Kristeller, J., Peterson, L.G., Fletcher,
K., Pbert, L., Linderking, W., Santorelli, S. F., Effectiveness
of a meditation-based stress reduction program in the treatment
of anxiety disorders. Am. J. Psychiatry (1992)
149:936-943. Click
here for Abstract
- Kabat-Zinn, J., Chapman, A. and Salmon, P., The
relationship of cognitive and somatic components of anxiety to
patient preference for alternative relaxation techniques. Mind/Body
Medicine (1997) 2:101-109. Click
here for Abstract
- Miller, J., Fletcher, K. and Kabat-Zin, J., Three-year
follow-up and clinical implications of a mindfulness-based
stress reduction intervention in the treatment of anxiety
disorders. Gen. Hosp. Psychiatry (1995) 17:192-200. Click
here for Abstract
- Roth, B. and Creaser, T. Mindfulness meditation-based
stress reduction: Experience with a bilingual inner-city program.
The Nurse Practitioner (1997) 22:150-176.
2. Miscellaneous
Papers on Mindfulness, MBSR and Meditation -
Top of Articles Page
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- Allan B.
Chinen., Modes Of Understanding And Mindfulness In Clinical
Medicine. Theoretical Medicine 9 (1988) 45-71. Click
here for Abstract
- Astin, JA Stress reduction through mindfulness meditation:
Effects on psychosocial symptomatology, sense of control, and
spiritual experiences. Psychother Psychosom (1997)
66:97-106. Click
here for Abstract
- Brown, D. et al. Differences in visual sensitivity among
mindfulness meditators and non-meditators. Percept. Mot.
Skills. 1984 Jun;58(3):727-33. Click
here for Abstract
- Connelly J. Being in the present moment: developing the
capacity for mindfulness in medicine. Acad. Med. 1999
Apr: 74(4): 420-4 Click
here for Abstract
- Delmonte, M.M. Some cognitive aspects of meditation
practice. Percept. Mot. Skills. 1983 Dec:57(3
Pt.2):1160-2. Click
here for Abstract
- Delmonte, M.M. Physiological concomitants of meditation
practice. Int. J. Psychosom. 1984;31(4):23-36. Click
here for Abstract
- Daniel Brown, Michael Forte, Michael Dysart, Differences in
visual sensitivity among mindfulness meditators and non-meditators.
Percept. Mot. Skills. 1984, 58, 727-733.
- Dunn, B.R. et al. Concentration and mindfulness
meditations; unique forms of consciousness? Applied
Psychophysiol Biofeedback. 1999 Sep: 24(3):147-65.
Click
here for Abstract
- Fenwick, P. Can we still recommend meditation? Br.
Med. J. (Clin Res Ed). 1983 Nov 12;287(6403):1401
- Kabat-Zinn, J. and Chapman-Waldrop, A. Compliance with an
outpatient stress reduction program: rates and predictors of
completion. J. Behav. Med. (1988) 11:333-351. Click
here for Abstract
- Kabat-Zinn, PH.D, Mindful Meditation: Health benefit of an
ancient Buddhist practice. Mind/Body Medicine Goleman
& Gurin (Eds). Consumer Reports Books, NY. 1993.
- Kedrick, Zen in the Art of Sherlock Holmes. Utne
Reader Jan-Feb 2000
- Marlatt, G.A., Mindfulness and metaphor in relapse
prevention: an interview with G. Alan Marlatt. Journal of
American Diet Assoc. 1994 Aug:94(8):846-8.
- Moore, N.G. The center for mindfulness in medicine:
meditation training for the body's innate wisdom. Altern
Ther Health Med. 1998 Mar: 4(2): 32-3.
- Peter Fenwick., Can we still recommend Meditation. Senior
Lecturer and Consultant Psychiatrist, Maudsley Hospital,
London.
- Ronald M. Epstein., Mindful Practice. JAMA, Sept 1,
1999-Vol 282, No. 9 Click
here for Abstract
- Roth B, et al. Mindfulness meditation-based stress
reduction: experience with a bilingual inner-city program. Nurse
Pract. 1997 Mar:22 (2): 150-2, 154, 157. Click
here for Abstract
- Salmon, P. G., Santorelli, S. F., Kabat-Zinn, J., Intervention
elements promoting adherence to mindfulness-based stress
reduction programs in the clinical behavioral medicine setting.
Handbook of Health Behavior Change, 2nd edition (1998)
10:239-266. Click
here for Abstract
- Santorelli, S.F., A qualitative case analysis of
mindfulness meditation training in an outpatient stress
reduction clinic, and its implications for self-knowledge. Doctoral
Dissertation, University of Massachusetts, School of Education.
University Microfilms International, Kalamazoo, MI (1992).
- Shapiro, SL and Schwartz, GE. Mindfulness in medical
education: Fostering the health of physicians and medical
practice. Integrative Med (1998) 1:93-94.
- Shapiro, SL and Schwartz, GE. The role of intention in
self-regulation: Toward intentional systemic mindfulness. In
Boekaerts, M. Pintrich, PR, and Zeidner, M (Eds) Handbook of
Self-Regulation. Academic Press, New York (1999, in press).
- Teasdale, Zindel, J.Mark G. Williams, Ridgeway, Soulsby, Lau. Prevention
of Relapse/Recurrence in Major Depression by Mindfulness-Based
Cognitive Therapy. Click
here for Abstract
3. Meditation
and Psychotherapy -
Top of Articles Page
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Top of Page
- Ilan
Kutz, Joan Z. Borysenko, Herbert Benson., Meditation and
Psychotherapy: A Rationale for the Integretion of Dynamic
Psychotherapy, the Relaxation Response, and Mindfulness
Meditation. Am J Psychiatry 142:1, Jan 1985. Click
here for Abstract
- Williams JMG, Teasdale JD, Segal ZV, and Soulsby J. Mindfulness-based
cognitive therapy reduces overgeneral autobiographical memory in
formerly depressed patients. J. Abnorm Psychol (in
press).
4.
Meditation & Lifespan -
Top of Articles Page
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- C.N
Alexander, E.J Langer, R.I. Newman, H.M. Chandler, John L.
Davies, Transcendental Meditation, Mindfulness, and
longevity: An Experimental Study With the Elderly. Journal
of Personality and social Psychology 1989, vol. 57, No. 6,
950-964. Click
here for Abstract
5. Mood
Disorders -
Top of Articles Page
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- Teasdale, J.
D., Segal, Z. V., and Williams, J. M. C., How does cognitive
therapy prevent depressive relapse and why should attentional
control (mindfulness) help? Behav. Res. Ther. (1995)
33:25-39. Click
here for Abstract
- Teasdale, J. D., Metacognition, mindfulness and the
modification of mood disorders. Clin. Psychol. Psychother.
(1999) 6:146-155. Click
here for Abstract
Available
Chapters & Monographs:
- Kabat-Zinn,
J., A teaching Mandala of MBSR, Centre for Mindfulness
(1997)
- Kabat-Zinn, J., Catalyzing movement toward a more
contemplative/sacred-appreciating/non-dualistic society. The
Project on the Contemplative Mind in Society (1996)
- Kabat-Zinn, J., Mindfulness meditation: Health benefits of
an ancient Buddhist practice. Mind/Body Medicine, Goleman
& Gurin (Eds), Consumer Reports Books, NY. (1993).
- Santorelli, S. F., Mindfulness and master in the workplace:
21 Ways to reduce stress during the workday. Engaged
Buddhist Reader, Ten years of engaged Buddhist Publishing (1996)
Parallax Press.
- Santorelli, S. F., A qualitative case analysis of
mindfulness meditation training in an outpatient stress
reduction clinic and its implications for the development of
self-knowledge.
Abstracts
- Top of Page
A.O.
Masson, J. Teas, J.R. Hebert, Wertheimer and J. Kabat-Zinn., Meditation,
Melatonin and Breast/Prostate Cancer: Hypothesis and Preliminary
Data. Medical Hypotheses (1995).
- Abstract: Back
to Reference
-
Objective of
this study was to test the hypothesis that the regular
practice of mindfulness meditation is associated with
increased physiological levels of melatonin. Melatonin may be
related to a variety of biologic functions important in
maintaining health and preventing disease, including breast
and prostate cancer. Previous studies have shown melatonin
production is photosensitive and we suggest here that it also
may be psychosensitive.
A
cross-sectional study of 12-hour (20:00 - 08:00) urinary
6-sulphatoxymelatonin was conducted from which we analyzed
data from 8 women who regularly meditate (RM) and 8 women who
do not meditate (NM). All samples were collected in the homes
of study participants. Volunteers were recruited to provide
12-hour overnight samples of urine. All subjects collected the
samples on one night during the same 1-week period. There was
no explicit intervention. However, all RM were either
graduates of, or teachers in, the University of Massachusetts
Stress Reduction and Relaxation Program.
The main
outcome measure was the total excretion of urinary
6-sylphatoxymelatonin. Multiple linear regression (Proc GLM in
SAS) was performed to test the effect of meditation (RM vs NM)
on 6-sulphatoxymelatonin.
The results
of the study were that after controlling for the
non-significant effect of menstrual period interval, we found
an effect of meditation group (RM vs NM: b=1.9833; F=6.78;
p=0.02) and age (for each integer year: b=0.169; F-8.41;
p=0.01). The conclusion is that study results are consistent
with our hypothesis and indicate that melatonin might be a
useful parameter in testing similar psychosocial
interventions. Given that two intervention studies have
provided support for the concept of psycho-physiological
interactions in survival among cancer patients, applications
of our findings might be pertinent to the area of breast and
prostate cancer.
Judith
K. Ockene, Glorian Sorensen, Jon Kabat-Zinn, Ira S. Ockene,
M.D., Gary Donnelly., Benefits and Costs of Lifestyle Change to
Reduce Risk of Chronic Disease. Preventive Medicine 17,
224-234 (1988).
- Abstract: Back
to Reference
-
Individuals
do not benefit equally from attempts to change their
lifestyles in an effort to lower their risk for disease or to
improve their quality of life. A change in one lifestyle
behavior may cause an increase in another risk factor and
reduce the benefits of the anticipated change. The social
environment exerts pressures and makes available resources
that also influence the benefits and costs of a particular
health behavior change. These pressures and resources vary
depending on the individual and his or her social context.
This article uses the target behavior of smoking as an example
of a lifestyle change and considers the benefits and costs
that interventionists need to be aware of if they are to
effectively facilitate health behavior change. This approach
requires the identification of resources at different levels
of the environment (e.g., family, community, institutions)
that may influence the cost/benefit ratio. Such an analysis is
appropriate whether one is considering a model of individual
behavior change or a public health model that seeks to
intervene at the community-wide level to promote health and
reduce disease risk among a large segment of the population.
Specific recommendations based on this approach are offered
and it is concluded that both individual and public health
approaches are necessary to achieve optimal health behavior
change in our population and to optimize the cost/benefit
ratio of such change for all individuals.
Kabat-Zinn.
J., An out-patient program in Behavioral Medicine
for chronic pain patients based on the practice of mindfulness
meditation: Theoretical considerations and preliminary results.
General Hospital Psychiatry (1982) 4:33-47.
- Abstract: Back
to Reference
-
The practice
of mindfulness meditation was used in a 10-week Stress
Reduction and Relaxation Program to train chronic pain
patients in self-regulation. The meditation facilitates an
attentional stance towards proprioception known as detached
observation. This appears to cause an “uncoupling” of the
sensory dimension of the pain experience from the
affective/evaluative alarm reaction and reduce the experience
of suffering via cognitive reappraisal. Data are presented on
51 chronic pain patients who had not improved with traditional
medical care. The dominant pain categories were low back, neck
and shoulder, and headache. Facial pain, angina pectoris,
noncoronary chest pain, and GI pain were also represented. At
10 weeks, 65% of the patients showed a reduction of >33% in
the mean total Pain Rating Index (Melzack) and 50% showed a
reduction of >50%. Similar decreases were recorded on other
pain indices and in the number of medical symptoms reported.
Large and significant reductions in mood disturbance and
psychiatric symptomatology accompanied these changes and were
relatively stable on follow-up. These improvements were
independent of the pain category. We conclude that this form
of meditation can be used as the basis for an effective
behavioral program in self-regulation for chronic pain
patients. Key features of the program structure and the
limitations of the present uncontrolled study are discussed.
Kabat-Zinn,
J., Lipworth, L. and Burney, R. The clinical use of
mindfulness meditation for the self-regualtion of chronic pain.
J. Behav. Med. (1985) 8:163-190.
- Abstract: Back
to Reference
-
Ninety
chronic pain patients were trained in mindfulness meditation
in a 10-week Stress Reduction and Relaxation Program.
Statistically significant reductions were observed in measures
of present-moment pain, negative body image, inhibition of
activity by pain, symptoms, mood disturbance, and
psychological symptomatology, including anxiety and
depression. Pain-related drug utilization decreased and
activity levels and feelings of self-esteem increased.
Improvement appeared to be independent of gender, source of
referral, and type of pain. A comparison group of pain
patients did not show significant improvement on these
measures after traditional treatment protocols. At follow-up,
the improvements observed during the meditation training were
maintained up to 15 months post- meditation training for all
measures except present-moment pain. The majority of subjects
reported continued high compliance with the meditation
practice as part of their daily lives. The relationship of
mindfulness meditation to other psychological methods for
chronic pain control is discussed. Key Words: meditation;
pain; self-regulation; coping stress.
Kabat-Zinn, J.,
Lipworth, L., Burney, R. and Sellers, W., Four
year follow-up of a meditation-based program for the
self-regulation of chronic pain: Treatment outcomes and compliance.
Clin. J. Pain (1986) 2:159-173.
- Abstract: Back
to Reference
-
Two hundred
twenty-five chronic pain patients were studied following
training in mindfulness meditation. Large and significant
overall improvements were recorded post-intervention in
physical and psychological status. These gains were maintained
at follow-up in the majority of subjects. Follow-up times
ranged from 2.5 to 48 months. Status on the McGill Melzack
Pain Rating Index (PRI), however, tended to revert to
preintervention levels following the intervention. Most
subjects reported a high degree of adherence with the
meditation techniques, maintenance of improved status over
time, and a high degree of importance attributed to the
training program. We conclude that such training can have
long-term benefit for chronic pain patients. Key Words:
Chronic pain - Self-regulation - Meditation - Stress
reduction- Relaxation.
Kabat-Zinn, J.,
Lipworth, L., Burney, R. and Sellers, W., Four
year follow-up of a meditation-based program for the
self-regulation of chronic pain: Treatment outcomes and compliance.
Clin. J. Pain (1986) 2:159-173.
- Abstract: Back
to Reference
-
Two hundred
twenty-five chronic pain patients were studied following
training in mindfulness meditation. Large and significant
overall improvements were recorded post-intervention in
physical and psychological status. These gains were maintained
at follow-up in the majority of subjects. Follow-up times
ranged from 2.5 to 48 months. Status on the McGill Melzack
Pain Rating Index (PRI), however, tended to revert to
preintervention levels following the intervention. Most
subjects reported a high degree of adherence with the
meditation techniques, maintenance of improved status over
time, and a high degree of importance attributed to the
training program. We conclude that such training can have
long-term benefit for chronic pain patients. Key Words:
Chronic pain - Self-regulation - Meditation - Stress
reduction- Relaxation.
Randolph,
PD, Caldera YM, Tacone AM et al. The long term combined
effects of medical treatment and a mindfulness-based behavioral
program for the multidisciplinary management of chronic pain in
West Texas. Pain Digest (1999) 9:103-112.
- Abstract: Back
to Reference
-
Chronic pain
requires multimodal assessment and treatment for proper
management. Psychological interventions emphasizing
mindfulness-based self-regulation may be a valuable tool in
the treatment armamentarium of multidisciplinary care. Jon
Kabat-Zinn (1) has treated chronic pain effectively with the
use of mindfulness meditation and hatha yoga, although their
combined effect with medical interventions has not been
adequately demonstrated. It is also uncertain whether
meditative techniques with their religious, philosophical, and
theoretical underpinnings in Buddhism are effective as
mainstream health-care options, particularly among individuals
who adhere to Christian beliefs and ideology. The purpose of
this study is to investigate whether the combination of
medical treatment and patient participation in a
mindfulness-based behavioral program is more effective than
medical treatment alone to determine whether this combination
results in long-term decreases in suffering among multiple
pain indices. Further, the study determines whether patient
participation in a mindfulness-based group intervention is
successful among a sample if individuals in West Texas
primarily describing themselves as Christian in religious
orientation.
Michael
A. West., Meditation and the EEG. Psychological
Medicine, 1980, 10, 369-375.
- Abstract: Back
to Reference
-
Previous
research on meditation and the EEG is described, and findings
relating to EEG patterns during meditation are discussed.
Comparisons of meditation with other altered states are
reviewed and it is concluded that, on the basis of existing
EEG evidence, there is some reason for differentiating between
meditation and drowsing. Research on alpha-blocking and
habituation of the blocking response during meditation is
reviewed, and the effects of meditation on EEG patterns
outside of meditation are described. In conclusion, the need
for more precisely formulated research is pointed out.
Kenneth
H. Kaplan, M.D, Don L. Goldenberg, M.D., and MaureenGalvin-Nadeau,
M.S., C.S., The Impact of a Meditation-Based Stress Reduction
Program on Fibromyalgia. General Hospital Psychiatry 15,
284-289, 1993.
- Abstract: Back
to Reference
-
Fibromyalgia
is a chronic illness characterized by widespread pain,
fatigue, sleep disturbance, and resistance to treatment. The
purpose of this study was to evaluate the effectiveness of a
meditation-based stress reduction program on fibromyalgia.
Seventy-seven patients meeting the 1990 criteria of the
American College of Rheumatology for fibromyalgia took part in
a 10-week group outpatient program. Therapists followed a
carefully defined treatment approach and met weekly to further
promote uniformity. Patients were evaluated before and after
the program. Initial evaluation included a psychiatric
structured clinical interview (SCID). Outcome measures
included visual analog scales to measure global well being,
pain, sleep, fatigue, and feeling refreshed in the morning.
Patients also completed a medical symptom checklist, SCL-90-R,
Coping Strategies Questionnaire, Fibromyalgia Impact
Questionnaire, and the Fibromyalgia Attitude Index. Although
the mean scores of all the patients completing the program
showed improvement, 51% showed moderate to marked improvement
and only they were counted as "responders". These
preliminary findings suggests that a meditation-based stress
reduction program is effective for patients with fibromyalgia.
Ockene,
Ira. S. Ockene, Kabat-Zinn, Greene, David Frid, Teaching
Risk-factor counseling skills to medical students, house staff,
and fellows. Prev Med 1990;6 (suppl 1): 35-42.
- Abstract:
Back
to Reference
-
It is
important to teach risk-factor counseling skills to medical
students, primary care residents, and fellows in
cardiovascular medicine. To do this, it is necessary to teach
assessment and intervention skills based on the theory and
techniques of preventive and behavioral medicine. Physicians
should be taught to think in terms of the patient in the
context of his or her lifestyle and other interacting factors
affecting health and disease, and should develop a new medical
"culture" within which the risk-factor and lifestyle
antecedents and correlates of illness can be reorganized,
discussed, and approached therapeutically. In this approach to
physician training, risk-factor intervention skills training
is integrated into existing teaching vehicles to minimize the
burden on the curriculum and maximize the extent to which the
material can be incorporated into the daily practice of
medicine. The objectives associated with training in
behavioral medicine skills and examples demonstrating how
specific teaching vehicles that are already established in
most institutions can be used to accomplish this training are
presented. Strategies for motivating physicians to practice
prevention with their patients also are discussed.
ShaunaL.
Shapiro, Gary E. Schwartz, Ginny Bonner., Effects of
Mindfulness-Based Stress Reduction on Medical and Premedical
Students. Journal of Behavioral, Vol. 21, No. 6, 1998
- Abstract:
Back
to Reference
-
The inability
to cope successfully with the enormous stress of medical
education may lead to a cascade of consequences at both a
personal and professional level. The present study examined
the short-term effects of an 8-week meditation-based stress
reduction intervention on premedical and medical students
using a well-controlled statistical designs. Findings indicate
that participation in the intervention can effectively (1)
reduce self-reported state and trait anxiety, (2) reduce
reports of overall psychological distress including
depression, (3) increase scores on overall empathy levels, and
(4) increase scores on a measure of spiritual experiences
assessed at termination of intervention. These results (5)
replicated in the wait-list control group, (6) held across
different experiments, and (7) were observed during the exam
period. Future research should address potential long-term
effects of mindfulness training for medical and premedical
students.
Kabat-Zinn,
J., Wheeler, E., Light, T., Skillings, A., Scharf, M., Cropley,
T. G., Hosmer, D., and Bernhard, J., Influence of a
mindfulness-based stress reduction intervention on rates of skin
clearing in patients with moderate to severe psoriasis undergoing
phototherapy (UVB) and photochemotherapy (PUVA). Psychosom.
Med. (1998) 60:625-632.
- Abstract:
Back
to Reference
-
Objective:
This study tests the hypothesis that stress reduction methods
based on mindfulness meditation can positively influence the
rate at which psoriasis clears in patients undergoing
phototherapy or photochemotherapy treatment.
Methods:
Thirty-seven patients with psoriasis about to undergo
ultraviolet phototherapy (UVB) or photochemotherapy (PUVA)
were randomly assigned to one of two conditions: a mindfulness
meditation-based stress reduction intervention guided by audio
taped instructions during light treatments, or a control
condition consisting of the light treatments alone with no
taped instructions. Psoriasis status was assessed in three
ways: direct inspection by unblinded clinic nurses; direct
inspection by physicians blinded to the patient’s study
condition (tape or no-tape); and blinded physician evaluation
of photographs of psoriasis lesions. Four sequential
indicators of skin status were monitored during the study: a
First Response Point, a Turning Point, a Halfway Point, and a
Clearing Point. Results: Cox-proportional hazards regression
analysis showed that subjects in the tape groups reached the
Halfway Point (p = .013) and the Clearing Point (p = .033)
significantly more rapidly than those in the no-tape
condition, for both UVB and PUVA treatments. Overall the
meditators cleared at approximately four times the rate of
those subjects receiving light treatment without the guided
meditation tape intervention.
Conclusions:
A brief mindfulness meditation-based stress reduction
intervention delivered by audiotape during ultraviolet light
therapy can increase the rate of resolution of psoriatic
lesions in-patients with psoriasis. Key words: psoriasis,
phototherapy, photochemotherapy, meditation, mindfulness,
relaxation.
Pagano,
R.R. et al. Sleep during transcendental meditation. Science
1976 Jan 23;191(4224):308-10.
- Abstract:
Back
to Reference
-
Five
experienced practitioners of transcendental meditation spent
appreciable parts of meditation sessions in sleep stages 2, 3,
and 4. Time spent in each sleep stage varied both between
sessions for a given subject and between subjects. In
addition, we compare electroencephalogram records made during
meditation with those made during naps taken at the same time
of day. The range of states observed during meditation does
not support the view that meditation produces a single, unique
state of consciousness.
Kabat-Zinn,
J., Massion, A. O., Kristeller, J., Peterson, L.G., Fletcher,
K., Pbert, L., Linderking, W., Santorelli, S. F., Effectiveness
of a meditation-based stress reduction program in the treatment of
anxiety disorders. Am. J. Psychiatry (1992)
149:936-943.
- Abstract:
Back
to Reference
-
Objective:
This study was designed to determine the effectiveness of a
group stress reduction program based on mindfulness meditation
for patients with anxiety disorders. Method: The 22 study
participants were screened with a structured clinical
interview and found to meet the DSM-III-R criteria for
generalized anxiety disorder or panic disorder with or without
agoraphobia. Assessments, including self-ratings and
therapists’ ratings, were obtained weekly before and during
the meditation-based stress reduction and relaxation program
and monthly during the 3-month follow-up period. Results:
Repeated measures analyses of variance documented significant
reductions in anxiety and depression scores after treatment
for 20 of the subjects - changes that were maintained at
follow-up. The number of subjects experiencing panic symptoms
was also substantially reduced. A comparison of the study
subjects with a group of nonstudy participants in the program
who met the initial screening criteria for entry into the
study showed that both groups achieved similar reductions in
anxiety scores on the SCL-90-R and on the Medical Symptom
Checklist, suggesting generalizability of the study findings.
Conclusions: A group mindfulness meditation training program
can effectively reduce symptoms of anxiety and panic and can
help maintain these reductions in patients with generalized
anxiety disorder, panic disorder, or panic disorder with
agoraphobia.
Kabat-Zinn,
J., Chapman, A. and Salmon, P., The relationship of
cognitive and somatic components of anxiety to patient preference
for alternative relaxation techniques. Mind/Body Medicine
(1997) 2:101-109.
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Background:
The relationship between cognitive/somatic response pattern
for anxiety and preference for different relaxation techniques
was evaluated in an exploratory study of 135 medical patients
referred for mindfulness-based stress reduction training, in
which they practiced three major stress-reduction techniques.
Method:
Following intervention, patients rated on visual analogue
scales, how much they liked each of three techniques: sitting
meditation, a body scan meditation, and Hatha Yoga, which
differed in primary cognitive/somatic orientation but shared
the unifying attentional stance characteristic of mindfulness
meditation.
Results: Of
the 74 patients who showed pre-treatment levels of anxiety
above the mean for the entire group, 29 (39%) showed a pattern
in which either the cognitive or the somatic component of
anxiety predominated. The high cognitive/low somatic anxiety
subgroup (n = 9) showed a significant preference for the most
somatic technique (Hatha Yoga) and liked least the most
cognitive technique (sitting meditation). The high somatic/low
cognitive anxiety subgroup (n = 20) showed the inverse
response. The body scan, with both cognitive and somatic
qualities, was preferred to an intermediate degree by both
groups. Irrespective of an individual’s mode of anxiety
expression or technique preference, participation in the
mindfulness-based stress reduction program appeared to be
effective in reducing overall anxiety levels.
Conclusions:
These findings differ from several previous studies of anxiety
modality (cognitive or somatic) and relaxation technique
preference that used nonclinical populations, and appear
inconsistent with Davidson and Schwartz’ hypothesis that
treatment of anxiety is best oriented toward the mode in which
it is expressed.
Miller,
J., Fletcher, K. and Kabat-Zin, J., Three-year follow-up and
clinical implications of a mindfulness-based stress reduction
intervention in the treatment of anxiety disorders. Gen.
Hosp. Psychiatry (1995) 17:192-200.
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A previous
study of 22 medical patients with DSM-III-R-defined anxiety
disorders showed clinically and statistically significant
improvements in subjective and objective symptoms of anxiety
and panic following an 8-week outpatient physician-referred
group stress reduction intervention based on mindfulness
meditation. Twenty subjects demonstrated significant
reductions in Hamilton and Beck Anxiety and Depression scores
postintervention and at 3-month follow-up. In this study,
3-year follow-up data were obtained and analyzed on 18 of the
original 22 subjects to probe long-term effects. Repeated
measures analysis showed maintenance of the gains obtained in
the original study on the Hamilton [F (2,32) = 13.22; p<
0.001] and Beck [F (2,32) = 9.83; p< 0.001] anxiety scales
as well as on their respective depression scales, on the
Hamilton panic score, the number and severity of panic
attacks, and on the Mobility Index-Accompanied and the Fear
Survey. A 3-year follow-up comparison of this cohort with a
larger group of subjects from the intervention who had met
criteria for screening for the original study suggests
generalizability of the results obtained with the smaller,
more intensively studied cohort. Ongoing compliance with the
meditation practice was also demonstrated in the majority of
subjects at 3 years. We conclude that an intensive but
time-limited group stress reduction intervention based on
mindfulness meditation can have long-term beneficial effects
in the treatment of people diagnosed with anxiety disorders.
Allan
B. Chinen., Modes Of Understanding And Mindfulness In Clinical
Medicine. Theoretical Medicine 9 (1988) 45-71.
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Beginning
with a case vignette, this paper uses a semiotic approach to
several different kinds of understanding used in clinical
medicine. By outlining semiotic structures, four distinct
"modes of understanding" can be defined: (1) the
representational mode, corresponding to scientific medicine;
(2) the pragmatic corresponding mode, the basic standpoint of
medicine; (3) the hermeneutic mode, underlying the empathic
humanistic spirit of medicine; and (4) the ontologic mode,
associated with both the ethical and ritual aspects of
medicine. Clarifying the relationship between these modes
common confusions in clinical situations. Although experienced
clinicians intuitively use these different modes, they do not
necessarily reflect upon them. They are instead mindful of
them, and this unique multi-modal consciousness, provides a
model for integrating theory and practice.
Astin,
JA Stress reduction through mindfulness meditation: Effects on
psychosocial symptomatology, sense of control, and spiritual
experiences. Psychother Psychosom (1997) 66:97-106.
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Background:
This study examined the effects of an 8-week stress reduction
program based on training in mindful meditation. Previous
research efforts suggesting this program may be beneficial in
terms of reducing stress related symptomatology and helping
patients cope with chronic pain have been limited by a lack of
adequate comparison control groups. Methods: Twenty-eight
individuals who volunteered to participate in the present
study were randomized into either an experimental group or a
nonintervention control group. Results: Following
participation, experimental subjects, when compared with
controls, evidenced significantly greater changes in terms of:
1) reductions in overall psychological symptomatology; 2)
increases in overall domain-specific sense of control and
utilization of an accepting or yielding mode of control in
their lives, and 3) higher scores on a measure of spiritual
experiences. Conclusions: The techniques of mindfulness
meditation, with their emphasis on developing detached
observation and awareness of the contents of consciousness,
may represent a powerful cognitive behavioral coping strategy
for transforming the ways in which we respond to life events.
They may also have potential for relapse prevention in
affective disorders.
Brown,
D. et al. Differences in visual sensitivity among
mindfulness meditators and non-meditators. Percept. Mot.
Skills. 1984 Jun;58(3):727-33.
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Tachistoscopic
presentation of light flashes was used to test for differences
in visual sensitivity among 3 groups of practitioners of
Buddhist mindfulness meditation and non-meditator-controls.
Meditation practitioners were able to detect light flashes of
shorter duration than the non-meditators. There were no
differences among the meditator groups. There were no
differences among the groups in ability to discriminate
between closely spaced successive light flashes. The lower
detection threshold for single light flashes for the
meditators may reflect an enduring increase in sensitivity,
perhaps the long-term effects of the practice of mindfulness
meditation on certain perceptual habit patterns. The lack of
significant differences in the discrimination of successive
light flashes probably reflects the resistance of other
perceptual habit patterns modification. The results support
the statements found in Buddhist texts on meditation
concerning the changes in perception encountered during the
practice of mindfulness.
Connelly
J. Being in the present moment: developing the capacity for
mindfulness in medicine. Acad. Med. 1999 Apr: 74(4):
420-4
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Medical
practice is beset by interruptions, contests for the attention
of the physician, and urgent demands that diminish the
attentiveness required for the humanistic care of patients.
This essay discusses skills for "being in the present
moment" that can help doctors to overcome distractedness.
Because of some striking similarities between the experience
of reading poetry and the attentiveness required of medicine,
the author uses 19th and 20th-century American poetry to
illustrate the state of mindfulness and "being in the
moment," and suggests the helpfulness of poetry in
developing these skills in physicians. Applying these skills
in everyday practice rewards the physician with renewed
energy, a fresh perspective, and increased strength while
preventing the stress and harm caused by a distracted or
inattentive practice.
Delmonte,
M.M. Some cognitive aspects of meditation practice. Percept.
Mot. Skills. 1983 Dec:57(3 Pt.2):1160-2.
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This article
reviews the role of some cognitive factors in practice of
meditation. It is suggested that more attention should be
given to such covert of meditation as expectations, attitudes,
and imagery, etc. Non-observable subjective during meditation
have not been adequately researched.
Delmonte,
M.M. Physiological concomitants of meditation practice.
Int. J. Psychosom. 1984;31(4):23-36.
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Meditation
has been extensively researched in terms of psychological
responsivity. Although practice is associated with both state
and trait (long-term) decrements in arousal (especially in
blood pressure, muscle tension and respiratory indices) there
is generally no compelling evidence to suggest superiority to
other established relaxation techniques (except, perhaps, in
the case of blood pressure). At best meditation appears to be
somewhat more relaxing than eyes-closed rest. There is little
to support the notion of unique state effects associated with
practice. However, meditators appear to show stronger recovery
responses to stressful stimuli that controls. This finding
warrants further investigation. Meditation is increasingly
gaining prominence as a self-management and personal
development technique as well as becoming more prevalent in
the clinical setting as an adjunct to psychotherapy (1-3).
This is particularly true in the case of Transcendental
Meditation ™ and its non-cultic or clinically adapted
variants. However, there is no extensive up to date review of
the research literature dealings with the psychophysiological
effects of meditation practice. This article addresses that
issue by reviewing the effects of meditation.
Dunn,
B.R. et al. Concentration and mindfulness meditations;
unique forms of consciousness? Applied Psychophysiol
Biofeedback. 1999 Sep: 24(3):147-65.
- Abstract:
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Electroencephalographic
(EEG) recordings from 19 scalp recording sites were used to
differentiate among two posited unique forms of mediation,
concentration and mindfulness, and a normal relaxation control
condition. Analyzes of all traditional frequency bandwidth
data (i.e., delta 1-3 Hz; theta, 4-7 Hz; alpha, 8-12 Hz; beta
1, 13-25 Hz; beta 2, 26-32 Hz) showed strong mean amplitude
frequency differences between the two meditation conditions
and relaxation over numerous cortical sites. Furthermore,
significant differences were obtained between concentration
and mindfulness states at all bandwidths. Taken together, our
results suggest that concentration and mindfulness
"meditations" may be unique forms of consciousness
and are not merely degrees of a state of relaxation.
Kabat-Zinn,
J. and Chapman-Waldrop, A. Compliance with an
outpatient stress reduction program: rates and predictors of
completion. J. Behav. Med. (1988) 11:333-351.
- Abstract:
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The rate at
which medical patients physician-referred to an 8-week stress
reduction program completed the prescribed intervention was
measured and predictors of compliance sought. Seven hundred
eighty-four consecutive patients who enrolled in the program
over a 2-year period were studied. Of these, 598 (76%)
completed the program and 186 (24%) did not. Multiple
regression analysis showed that (1) among chronic pain
patients, only sex discriminated between completers and
noncompleters, with females more than twice as likely to
complete the program as males (odds ratio = 2.4; 95% CI = 1.2,
4.4; (2) among patients with stress-related disorders, only
the OC scores of the SCL-90-R discriminated between completers
and noncompleters (odds ratio = 2.0; 95% CI = 1.2, 3.4).
Completion rates for specific diagnoses are reported and
discussed. The high rate of completion observed for this
intensive program in health behavior change is discussed in
terms of the design features and therapeutic modalities of the
intervention. Key Words: compliance; stress; pain; meditation.
Ronald
M. Epstein., Mindful Practice. JAMA, Sept 1,
1999-Vol 282, No. 9
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Mindful
practitioners attend in a nonjudgmental way to their own
physical and mental processes during ordinary, everyday tasks.
This critical self-reflection enables physicians to listen
attentively to patient's distress, recognize their own errors,
refine their technical skills, make evidence-based decisions,
and clarify their values so that they can act with compassion,
technical competence, presence, and insight. Mindfulness
informs all types of professionally relevant knowledge,
including propositional facts, personal experiences,
processes, and know-how, each of which may be tacit or
explicit. Explicit knowledge is readily taught, accessible to
awareness, quantifiable and easily translated into
evidence-based guidelines. Tacit knowledge is usually learned
during observation and practice, includes prior experiences,
theories-in-action, and deeply held values, and is usually
applied more inductively. Mindful practitioners use a variety
of means to enhance their ability to engage in
moment-to-moment self-monitoring, bring to consciousness their
tacit personal knowledge and deeply held values, use
peripheral vision and subsidiary awareness to become aware of
new information and perspectives, and adopt curiosity in both
ordinary and novel situations. In contrast, mindlessness may
account for some deviations from professionalism and errors in
judgement and technique. Although mindfulness cannot be taught
explicitly, it can be modeled by mentors and cultivated in
learners. As a link between relationship-centered care and
evidence-based medicine, mindfulness should be considered a
characteristic of good clinical practice.
Roth
B, et al. Mindfulness meditation-based stress reduction:
experience with a bilingual inner-city program. Nurse Pract.
1997 Mar:22 (2): 150-2, 154, 157.
- Abstract:
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This article
describes a bilingual mindfulness meditation-based stress
reduction program in an inner-city setting. Mindfulness
meditation is defined, and the practices of breathing
meditation, eating meditation, walking meditation and mindful
yoga are described. Data analysis examined compliance, medical
and psychologic symptom reduction, and changes in self-esteem,
of English and Spanish-speaking patients who completed the 8
week Stress Reduction and Relaxation Program at the community
Health Center in Meriden, Conn. Statistically significant
decreases in medical and psychologic symptoms and improvement
in self-esteem were found. Many program completers reported
dramatic changes in attitudes, beliefs, habits, and behaviors.
Despite the limitations of the research design, these findings
suggest that a mindfulness meditation course can be an
effective health care intervention when utilized by English-
and Spanish-speaking patients in an inner-city community
health center. The article includes a discussion of factors to
be considered when establishing a mindfulness meditation-based
stress reduction program in a health care setting.
Salmon,
P. G., Santorelli, S. F., Kabat-Zinn, J., Intervention elements
promoting adherence to mindfulness-based stress reduction programs
in the clinical behavioral medicine setting. Handbook of
Health Behavior Change, 2nd edition (1998) 10:239-266.
- Abstract:
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The Medicine
of the 21st century will be far more overtly participatory
than its late 20th-century counterpart. While medicine has
always been participatory to one degree or another in that its
practice takes place at the intersection of two interacting
worlds, that of the physician and that of the patient, the
point of view of the patient in modern scientific medicine has
frequently been considered less relevant to treatment than
that of the physician or of the dictates of medicine itself.
Sometimes the patient's point of view or feelings can be
ignored completely and remain unknown (Toombs, 1993).
Teasdale,
Zindel, J.Mark G. Williams, Ridgeway, Soulsby, Lau. Prevention
of Relapse/Recurrence in Major Depression by Mindfulness-Based
Cognitive Therapy.
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This study
evaluated mindfulness-based cognitive therapy (MBCT), a group
intervention designed to train recovered recurrently depressed
patients to disengage from dysphoria-activated depressogenic
thinking that may mediate relapse/recurrence. Recovered
recurrently depressed patients (n = 145) were randomized to
continue with treatment as usual or, in addition, to receive
MBCT. Relapse/recurrence to major depression was assessed over
a 60-week study period. For patients with 3 or more previous
episodes of depression (77% of the sample), MBCT significantly
reduced risk of relapse/recurrence. For patients with only 2
previous episodes, MBCT did not reduce relapse/recurrence.
MBCT offers a promising cost-efficient psychological approach
to preventing relapse/recurrence in recovered recurrently
depressed patients.
Ilan
Kutz, Joan Z. Borysenko, Herbert Benson., Meditation and
Psychotherapy: A Rationale for the Integretion of Dynamic
Psychotherapy, the Relaxation Response, and Mindfulness Meditation.
Am J Psychiatry 142:1, Jan 1985.
- Abstract:
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A framework
for the integration of meditation and psychotherapy is
presented through a consideration of the psychological nature
of meditation (the relaxation response) and discussion of a
traditional meditation practice (mindfulness meditation) as an
effective cognitive technique for the development of
self-awareness. The mechanisms by which the emotional and
cognitive changes of meditation can be of therapeutic value
are explored and the synergistic advantages of the combination
of psychotherapy and meditation are discussed.
C.N
Alexander, E.J Langer, R.I. Newman, H.M. Chandler, John L.
Davies, Transcendental Meditation, Mindfulness, and longevity:
An Experimental Study With the Elderly. Journal of
Personality and social Psychology 1989, vol. 57, No. 6,
950-964.
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Can direct
change in state of consciousness through specific mental
techniques extend human life and reverse age-related declines?
To address this question, 73 residents of 8 homes for the
elderly (mean age = 81 years) were randomly assigned among no
treatment and 3 treatments highly similar in external
structure and expectations: the Transcendental Meditation ™
program, mindfulness training (MF) in active distinction
making, or a relaxation (low mindfulness) program. A planned
comparison indicated that the "restful alert" TM
group improved most, followed by MF, in contrast to relaxation
and no-treatment groups, on paired associate learning; 2
measures of cognitive flexibility; mental health; systolic
blood pressure; and ratings of behavioral flexibility, aging,
and treatment efficacy. The MF group improved most, followed
by TM, on perceived control and word fluency. After 3 years,
survival rate was 100% for TM and 87.5% for MF in contrast to
lower rates for other groups.
Teasdale,
J. D., Segal, Z. V., and Williams, J. M. C., How does
cognitive therapy prevent depressive relapse and why should
attentional control (mindfulness) help? Behav. Res. Ther.
(1995) 33:25-39.
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There is
encouraging evidence that structured psychological treatments
for depression, in particular cognitive therapy, can
subsequent relapse after the period of initial treatment has
been completed. However, there is continuing need for
prophylactic psychological approaches that can be administered
to recovered patients in euthymic mood. An
information-processing analysis of depressive maintenance and
relapse is used to define the requirements for effective
prevention, and to propose mechanisms through which cognitive
therapy achieves its prophylactic effects. This analysis
suggests that similar effects can be achieved using techniques
of stress-reduction based on the skills of attentional control
taught in mindfulness meditation. An information-processing
analysis is presented of mindfulness and mindlessness, and of
their relevance to preventing depressive relapse. This
analysis provides the basis for the development of Attentional
Control Training, a new approach to preventing relapse that
integrates features of cognitive therapy and mindfulness
training and is applicable to recovered depressed patients.
Teasdale,
J. D., Metacognition, mindfulness and the
modification of mood disorders. Clin. Psychol. Psychother.
(1999) 6:146-155.
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A distinction
is made between metacognitive knowledge (knowing that thoughts
are not necessarily always accurate) and metacognitive insight
(experiencing thoughts as events in the field of awareness,
rather than as direct readouts on reality). This distinction,
and its relevance to preventing relapse and recurrence in
depression, is examined within the Interacting Cognitive
Subsystems (ICS) theoretical framework. This analysis
suggests, as an alternative to cognitive therapy with its
focus on changing the content of depression-related thought,
the strategy of changing the configuration, or mode, within
which depression-related thoughts and feelings are processed,
i.e. Changing one's relationship to inner experience.
Specifically, facilitating a metacognitive insight mode, in
which thoughts are experienced simply as events in the mind,
offers an alternative strategy. Mindfulness training teaches
skills to enter this mode, and forms a central component of
Mindful-based Cognitive Therapy, a novel, cost-efficient group
preventative programme, for which there is encouraging
evidence of effectiveness. Available Chapters &
Monographs:
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‘Knowing,
understood as a state of mind,
is…. a state of closure that structures further
experience.
Unknowing, by contrast, is a state of openness
that does not foreclose experience through predetermined
structure.’
(Stephen Kurtz)
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