Mindfulness-based intervention and happiness

Malboeuf-Hurtubise, Catherine, et al. “The Impact of a Mindfulness-Based Intervention on Happiness: A Reflection on the Relevance of Integrating a Positive Psychology Framework within Mindfulness Research in Youth.” International Journal of Applied Positive Psychology, 2017, pp. 1-15. Full text.

Mindfulness-based interventions (MBIs) are increasingly implemented in school settings to alleviate psychological distress in elementary and high school students. Recently, authors have brought forward the fact that the focus and aims of MBIs in clinical settings are largely placed on reducing negative variables and symptoms associated to mental health disorders. Thus, these may not allow us to fully understand how and in which contexts MBIs can be useful in adult populations. As MBIs aim to help people bring focus to the present moment and awareness to all aspects of experience, both the positive and the negative, it appears relevant to study their potential to improve on positive variables, such as happiness.

This paper aims to engage in a reflection on the relevance of incorporating a positive psychology framework within MBI research in youth. Specifically, the importance of measuring the impact of MBIs on positive variables such as happiness are discussed.

Long meditation retreat and the experience of stress

Jacobs, T. L., et al. (2011). Intensive meditation training, immune cell telomerase activity, and psychological mediators. Psychoneuroendocrinology, 36(5), 664-681. Full text.  

From the Abstract. Telomerase activity is a predictor of long-term cellular viability, which decreases with chronic psychological distress. Buddhist traditions claim that meditation decreases psychological distress and promotes well-being. Therefore, we investigated the effects of a 3-month meditation retreat on telomerase activity and two major contributors to the experience of stress: Perceived Control (associated with decreased stress) and Neuroticism (associated with increased subjective distress).

Methods. We used mediation models to test whether changes in Perceived Control and Neuroticism explained meditation retreat effects on telomerase activity. In addition, we investigated whether two qualities developed by meditative practice, increased Mindfulness and Purpose in Life, accounted for retreat-related changes in the two stress-related variables and in telomerase activity.

Retreat participants (n = 30) meditated for ∼6 h daily for 3 months and were compared with a wait-list control group (n = 30) matched for age, sex, body mass index, and prior meditation experience. Retreat participants received instruction in concentrative meditation techniques and complementary practices used to cultivate benevolent states of mind. Psychological measures were assessed pre- and post-retreat. Peripheral blood mononuclear cell samples were collected post-retreat for telomerase activity.

Results. Telomerase activity was significantly greater in retreat participants than in controls at the end of the retreat. Increases in Perceived Control, decreases in Neuroticism, and increases in both Mindfulness and Purpose in Life were greater in the retreat group. Mediation analyses indicated that the effect of the retreat on telomerase was mediated by increased Perceived Control and decreased Neuroticism. In turn, changes in Perceived Control and Neuroticism were both partially mediated by increased Mindfulness and Purpose in Life. Additionally, increases in Purpose in Life directly mediated the telomerase group difference, whereas increases in Mindfulness did not.

Conclusions. This is the first study to link meditation and positive psychological change with telomerase activity. Although we did not measure baseline telomerase activity, the data suggest that increases in perceived control and decreases in negative affectivity contributed to an increase in telomerase activity, with implications for telomere length and immune cell longevity. Further, Purpose in Life is influenced by meditative practice and directly affects both perceived control and negative emotionality, affecting telomerase activity directly as well as indirectly.

Does mindfulness reduce symptoms of fibromyalgia?

Tobin, J. (2014). Effect of mindfulness-based interventions on symptoms of fibromyalgia: A meta-analysis (Doctoral dissertation, California State University, Fullerton). 

From the Abstract. Mindfulness provides an alternative or supplement to traditional pharmacological treatment of fibromyalgia, but it is not yet clear how effective it is in reducing symptoms. The purpose of this meta-analysis was to explore the efficacy of mindfulness-based interventions on fibromyalgia impact, pain severity, and psychological distress in adults diagnosed with fibromyalgia. A total of 11 randomized controlled trials were included in the analysis, all of which measured at least one of the designated outcomes.

Studies’ data was pooled and standardized mean differences were calculated. Results showed a moderate to large intervention effect for each outcome. Subgroup analyses were conducted for each outcome based on control group type (active versus wait list), and for each outcome, all subgroups’ SMD significantly favored the experimental condition, with the exception of the active controls for psychological distress.

… While this analysis yielded results suggesting the efficacy of mindfulness in reducing symptoms of fibromyalgia, future meta-analyses may consider including studies of more diverse methodological quality to create more robust and powerful effect sizes, while exploring methodology as a potential moderator.

Beneficial for medical and psychiatric illness

Marchand, W. R. (2012). Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice, 18(4), 233-252.

Abstract: Mindfulness has been described as a practice of learning to focus attention on moment-by-moment experience with an attitude of curiosity, openness, and acceptance. Mindfulness practices have become increasingly popular as complementary therapeutic strategies for a variety of medical and psychiatric conditions.

This paper provides an overview of three mindfulness interventions that have demonstrated effectiveness for psychiatric symptoms and/or pain. The goal of this review is to provide a synopsis that practicing clinicians can use as a clinical reference concerning Zen meditation, mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT). All three approaches originated from Buddhist spiritual practices, but only Zen is an actual Buddhist tradition. MBSR and MBCT are secular, clinically based methods that employ manuals and standardized techniques.

Studies indicate that MBSR and MBCT have broad-spectrum antidepressant and antianxiety effects and decrease general psychological distress. MBCT is strongly recommended as an adjunctive treatment for unipolar depression. The evidence suggests that both MBSR and MBCT have efficacy as adjunctive interventions for anxiety symptoms. MBSR is beneficial for general psychological health and stress management in those with medical and psychiatric illness as well as in healthy individuals. Finally, MBSR and Zen meditation have a role in pain management.

Chronic pain and the role of home meditation practice

Rosenzweig, S., et al. (2010). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68 (1), 29. Full text.

From the Abstract: This study compared changes in bodily pain, health-related quality of life (HRQoL), and psychological symptoms during an 8-week mindfulness-based stress reduction (MBSR) program among groups of participants with different chronic pain conditions.

Outcomes differed in significance and magnitude across common chronic pain conditions. Diagnostic subgroups of patients with arthritis, back/neck pain, or two or more comorbid pain conditions demonstrated a significant change in pain intensity and functional limitations due to pain following MBSR.

Participants with arthritis showed the largest treatment effects for HRQoL and psychological distress. Patients with chronic headache/migraine experienced the smallest improvement in pain and HRQoL. Patients with fibromyalgia had the smallest improvement in psychological distress.

Greater home meditation practice was associated with improvement on several outcome measures, including overall psychological distress, somatization symptoms, and self-rated health, but not pain and other quality of life scales.

Decreases the effect of daily hassles, psychological distress, and medical symptoms

Williams, K.A., et al. (2001). Evaluation of a Wellness-based Mindfulness Stress Reduction Intervention: A Controlled Trial. [Abstract]. American Journal of Health Promotion, 15(6), 422-432.

Purpose. To determine if participation in a Wellness-Based Mindfulness Stress Reduction intervention decreases the effect of daily hassles, psychological distress, and medical symptoms.

Subjects. A total of 103 adults, with 59 in the intervention group and 44 in the control group. Eight-five percent of subjects completed the intervention. Fifty-nine percent and 61% of the intervention and control subjects completed the study, respectively.

Intervention. The intervention consisted of an 8-week group stress reduction program in which subjects learned, practiced, and applied “mindfulness meditation” to daily life situations. The control group received educational materials and were encouraged to use community resources for stress management.

Results. Intervention subjects reported significant decreases from baseline in effect of daily hassles (24 %), psychological distress, (44 %), and medical symptoms (46 %) were maintained at the 3-month follow-up compared to control subjects..

Conclusions. Self-selected community residents can improve their mental and physical health by participating in a stress reduction intervention offered by a university wellness program.

Reduction in distress through brief mindfulness intervention

Sass, S.M., Berenbaum, H., & Abrams, E.M. (2013). Discomfort with emotion moderates distress reduction in a brief mindfulness intervention. International Journal of Behavioral Consultation and Therapy, 7(4), 24-27. Full article.

Abstract: The goal of this study was to investigate moderators of mindfulness training. The present study employed a brief form of mindfulness training with moderately dis participants. Psychological distress was measured before and after a five-session mindfulness intervention. Two hypothesized moderators of treatment outcome, discomfort with emotion and mindfulness were measured before the intervention.

Consistent with previous research, the brief mindfulness intervention was associated with reductions in psychological distress with a large pre-post effect size. Importantly, reductions in distress were significantly moderated by discomfort with emotion. Individuals reporting the most discomfort with emotion showed less reduction in distress after the mindfulness intervention. Results highlight the importance of investigating moderators of mindfulness intervention outcome.