Adolescents with cronic diseases

Abujaradeh, H., et al. (2018). Mindfulness-Based Interventions among Adolescents with Chronic Diseases in Clinical Settings: A Systematic Review. Journal of Pediatric Health Care, https://doi.org/10.1016/j.pedhc.2018.04.001. Online ahead of publication.

Abstract. We aimed to determine the benefits/efficacy of mindfulness-based interventions (MBIs) implemented among adolescents with chronic diseases in clinical settings.

Nineteen eligible studies were included in this review. Fifteen studies included adolescents with psychiatric or pain disorders, and four included adolescents with a chronic physical disorders. Psychological outcomes and pain were examined in most studies with effect sizes for MBIs ranging from small to large.

MBI studies conducted in clinical settings mainly engaged adolescents with psychiatric or pain disorders. The effectiveness of MBIs on improving psychological outcomes were inconsistent. Large randomized trials are needed to examine the effectiveness of MBIs and should expand to include adolescents with chronic physical diseases.

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Mindfulness-based treatment of addiction: the next wave of research

Garland, E. L., & Howard, M. O. (2018). Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research. Addiction science & clinical practice, vol. 13, no1, pp. 14, https://doi.org/10.1186/s13722-018-0115-3. Full text.

Abstract. Contemporary advances in addiction neuroscience have paralleled increasing interest in the ancient mental training practice of mindfulness meditation as a potential therapy for addiction. In the past decade, mindfulness-based interventions (MBIs) have been studied as a treatment for an array addictive behaviors, including drinking, smoking, opioid misuse, and use of illicit substances like cocaine and heroin.

This article reviews current research evaluating MBIs as a treatment for addiction, with a focus on findings pertaining to clinical outcomes and biobehavioral mechanisms. Studies indicate that MBIs reduce substance misuse and craving by modulating cognitive, affective, and psychophysiological processes integral to self-regulation and reward processing.

This integrative review provides the basis for manifold recommendations regarding the next wave of research needed to firmly establish the efficacy of MBIs and elucidate the mechanistic pathways by which these therapies ameliorate addiction. Issues pertaining to MBI treatment optimization and sequencing, dissemination and implementation, dose–response relationships, and research rigor and reproducibility are discussed.

Meditation and prosocial behaviors (review & meta-analysis)

Kreplin, U., Farias, M., & Brazil, I. A. (2018). The limited prosocial* effects of meditation: A systematic review and meta-analysis. Scientific reports, vol. 8, no. 1, pp. 2403, DOI:10.1038/s41598-018-20299-z. Full text.

 Abstract. Many individuals believe that meditation has the capacity to not only alleviate mental-illness but to improve prosociality. This article systematically reviewed and meta-analysed the effects of meditation interventions on prosociality in randomized controlled trials of healthy adults.

Five types of social behaviours were identified: compassion, empathy, aggression, connectedness and prejudice. Although we found a moderate increase in prosociality following meditation, further analysis indicated that this effect was qualified by two factors: type of prosociality and methodological quality.

Meditation interventions had an effect on compassion and empathy, but not on aggression, connectedness or prejudice. We further found that compassion levels only increased under two conditions: when the teacher in the meditation intervention was a co-author in the published study; and when the study employed a passive (waiting list) control group but not an active one.

Contrary to popular beliefs that meditation will lead to prosocial changes, the results of this meta-analysis showed that the effects of meditation on prosociality were qualified by the type of prosociality and methodological quality of the study. We conclude by highlighting a number of biases and theoretical problems that need addressing to improve quality of research in this area.

* Prosocial behavior, or “voluntary behavior intended to benefit another”, is a social behavior that “benefit[s] other people or society as a whole”, “such as helping, sharing, donating, co-operating, and volunteering” (Wikipedia).

Is meditation associated with altered brain structure?

Fox, K. C., et al. (2014). Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neuroscience & Biobehavioral Reviews, no. 43, pp. 48-73, https://doi.org/10.1016/j.neubiorev.2014.03.016. Full text.

From the Abstract. Numerous studies have begun to address how the brain’s gray and white matter may be shaped by meditation. This research is yet to be integrated, however, and two fundamental questions remain: Is meditation associated with altered brain structure? If so, what is the magnitude of these differences?

To address these questions, we reviewed and meta-analyzed 123 brain morphology differences from 21 neuroimaging studies examining ∼300 meditation practitioners. Anatomical likelihood estimation meta-analysis found eight brain regions consistently altered in meditators, including areas key to meta-awareness (frontopolar cortex/BA 10), exteroceptive and interoceptive body awareness (sensory cortices and insula), memory consolidation and reconsolidation (hippocampus), self and emotion regulation (anterior and mid cingulate; orbitofrontal cortex), and intra- and interhemispheric communication (superior longitudinal fasciculus; corpus callosum). 

Publication bias and methodological limitations are strong concerns, however. Further research using rigorous methods is required to definitively link meditation practice to altered brain morphology.

For an update by the same authors, see “Alterations in the structure of the brain — review & implications.” 

Alterations in the structure of the brain — review & implications

Fox, Kieran C. R., & Rael B. Cahn. (2018). “Meditation and the brain in health and disease.” Forthcoming in The Oxford Handbook of Meditation, Farias, Brazier, & Lalljee, Eds. Full text.

The aim of this chapter is to provide an accessible introduction to the neuroscience of meditation. First, we review studies examining the relationship between meditation and alterations in the structure of the brain’s grey and white matter (so-called morphometric neuroimaging).

Next, we discuss findings from functional neuroimaging methods, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scans, and what they have taught us about the brain’s patterns of activity during different forms of meditation, how meditation alters the brain’s response to various tasks and experiences, and how the expertise of long-term meditators might be harnessed to help us explore subtle aspects of human cognition.

Third, we review electrophysiological methods of measuring brain activity during meditation, such as electroencephalography (EEG), and how these findings relate to what we have learned from morphometric and functional neuroimaging.

Finally, we discuss the implications of this research and of meditation more generally for brain health and psychological well-being. Specifically, we focus on how meditation might ameliorate the deficits related to cognitive aging, as well as help ameliorate the symptoms and underlying neural substrates associated with neurodegenerative and psychiatric disease.

Sleep problems among older adults

MacLeod, S., et al. Practical non-pharmacological intervention approaches for sleep problems among older adults. Geriatric Nursing. In Print. Full article

Abstract. Poor sleep is common among older adults, often caused by multiple underlying factors such as chronic stress. Poor sleep is subsequently associated with negative health outcomes including higher morbidity and mortality.

Our primary purpose is to explore practical non-pharmacological intervention approaches integrating stress management to improve sleep quality among older adults. In doing so, we highlight approaches that appear to hold promise in real-world settings with older individuals.

We conducted a tailored literature review specifically on approaches to improve sleep quality among older adults, with emphasis on those integrating stress management. Online search engines were reviewed to identify research in these areas.

Various non-pharmacological intervention approaches, such as mindfulness and cognitive behavioral therapy, have shown promise in improving sleep quality and health outcomes within this population. Those integrating chronic stress management appear to be particularly successful. Thus further development of multidimensional sleep interventions integrating stress management with seniors is warranted.

Meditation and cardiovascular risk

Jamerson, K., et al. (2017). Meditation and Cardiovascular Risk. Journal of the American Heart Association. Vol. 6, no. 10, 

From the Abstract. Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. …

Neurophysiological and neuroanatomical studies demonstrate that meditation can have long‐standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. …

Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline‐directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established.