Reducing adverse effects of childhood Stress and trauma

Ortiz, Robin, and Erica M. Sibinga. “The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma.” Children, vol. 4, no. 3, 2017, pp. 16. Full text.

Abstract. Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood.

In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes.

Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.


Neural mechanisms remain unclear (review)

Tang, Y. Y., Hölzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 16, 213–225. doi:10.1038/nrn3916. Abstract (including 180 references). Full text at lead author’s website.

Research over the past two decades broadly supports the claim that mindfulness meditation — practiced widely for the reduction of stress and promotion of health — exerts beneficial effects on physical and mental health, and cognitive performance. Recent neuroimaging studies have begun to uncover the brain areas and networks that mediate these positive effects.

However, the underlying neural mechanisms remain unclear, and it is apparent that more methodologically rigorous studies are required if we are to gain a full understanding of the neuronal and molecular bases of the changes in the brain that accompany mindfulness meditation.

Efficacy of meditation on stress-related outcomes (review)

Goyal, M., et al.  (2014). Meditation Programs for Psychological Stress and Well-Being. Comparative Effectiveness Reviews, No. 124. Full text.

Objective: Meditation, a mind-body method, employs a variety of techniques designed to facilitate the mind’s capacity to affect bodily function and symptoms. An increasing number of patients are using meditation programs despite uncertainty about the evidence supporting the health benefits of meditation. We aimed to determine the efficacy and safety of meditation programs on stress-related outcomes (e.g., anxiety, depression, stress, distress, well-being, positive mood, quality of life, attention, health-related behaviors affected by stress, pain, and weight) compared with an active control in diverse adult clinical populations.

Conclusions: Meditation programs, in particular mindfulness programs, reduce multiple negative dimensions of psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health as well as stress-related behavioral outcomes.

Moderating effect on emotional distress in Diabetes patients

van Son, J., et al. (2014). The association between mindfulness and emotional distress in adults with diabetes: Could mindfulness serve as a buffer? Results from Diabetes MILES: The Netherlands. Journal of behavioral medicine, 1-10.

From the Abstract. People with diabetes have a higher risk of emotional distress (anxiety, depression) than non-diabetic or healthy controls. Therefore, identification of factors that can decrease emotional distress is relevant. The aim of the present study was to examine (1) the association between facets of mindfulness and emotional distress; and (2) whether mindfulness might moderate the association between potential adverse conditions (stressful life events and comorbidity) and emotional distress.

Analyses were conducted using cross-sectional data: 666 participants with diabetes (type 1 or type 2) completed measures of mindfulness, depressive symptoms, and anxiety symptoms. Hierarchical multiple regression analyses showed significant associations between mindfulness facets (acting with awareness, non-judging, and non-reacting) and symptoms of anxiety and depression.

These mindfulness facets appeared to have a moderating effect on the association between stressful life events and depression and anxiety. However, the association between co-morbidity and emotional distress was largely not moderated by mindfulness. In conclusion, mindfulness is negatively related to both depression and anxiety symptoms in people with diabetes and shows promise as a potentially protective characteristic against the influence of stressful events on emotional well-being.

Mindfulness and behavioral intervention for stress-eating

Corsica, J., et al. (2014). Development of a novel mindfulness and behavioral intervention for stress-eating: A comparative pilot study. Eating Behaviors. In-press. Abstract.

Stress-related eating is increasingly cited as a difficulty in managing healthy eating behaviors and weight. However few interventions have been designed to specifically target stress-related eating. In addition, the optimal target of such an intervention is unclear, as the target might be conceptualized as overall stress reduction or changing emotional eating-related thoughts and behaviors.

This pilot study compared the effects of three interventions targeting those components individually and in combination on stress-related eating, perceived stress, and weight loss to determine whether the two intervention components are effective alone or are more effective when combined. Fifty-three overweight participants (98% female) who reported elevated levels of stress and stress-eating and were at risk for obesity were randomly assigned to one of three six- week interventions: A modified mindfulness-based stress reduction (MBSR) intervention, a cognitive behavioral stress-eating intervention (SEI), and a combined intervention that included all MBSR and SEI components.

All three interventions significantly reduced perceived stress and stress-eating, but the combination intervention resulted in greater reductions and also produced a moderate effect on short term weight loss. Benefits persisted at six week follow-up. The pattern of results preliminarily suggests that the combination intervention (MBSR + SEI) may yield promise in the treatment of stress-related eating.

Interventions in mild cognitive impairment and Alzheimer’s disease

Larouche, E., Hudon, C., & Goulet, S. (2014). Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer’s disease: An interdisciplinary perspective. Behavioural Brain Research. In Press. Abstract.

Highlights: • Hippocampal damage is central in MCI/AD and could be prevented or delayed by mindfulness-based interventions (MBI).  • MBI reduce MCI/AD adverse factors (stress, depression, metabolic syndrome).  • Multiple pathways could explain MBI’s effects on modifiable adverse factors.  • Effects seem based on neuro- endocrine, immune, and transmission regulation.  • MBI show great potential to prevent the neurodegenerative cascade leading to AD.

The present article is based on the premise that the risk of developing Alzheimer’s disease (AD) from its prodromal phase (mild cognitive impairment; MCI) is higher when adverse factors (e.g., stress, depression, and metabolic syndrome) are present and accumulate. Such factors augment the likelihood of hippocampal damage central in MCI/AD aetiology, as well as compensatory mechanisms failure triggering a switch toward neurodegeneration. Because of the devastating consequences of AD, there is a need for early interventions that can delay, perhaps prevent, the transition from MCI to AD.

We hypothesize that mindfulness-based interventions (MBI) show promise with regard to this goal. The present review discusses the associations between modifiable adverse factors and MCI/AD decline, MBI’s impacts on adverse factors, and the mechanisms that could underlie the benefits of MBI. A schematic model is proposed to illustrate the course of C specific to MCI/AD, as well as the possible preventive mechanisms of MBI. Whereas regulation of glucocorticosteroids, inflammation, and serotonin could mediate MBI’s effects on stress and depression, resolution of the metabolic syndrome might happen through a reduction of inflammation and white matter hyperintensities, and normalization of insulin and oxidation.

The literature reviewed in this paper suggests that the main reach of MBI over MCI/AD development involves the management of stress, depressive symptoms, and inflammation. Future research must focus on achieving deeper understanding of MBI’s mechanisms of action in the context of MCI and AD. This necessitates bridging the gap between neuroscientific subfields and a cross-domain integration between basic and clinical knowledge.

Positive effects in the management of MS (review)

Levin, A. B., Hadgkiss, E. J., Weiland, T. J., & Jelinek, G. A. (2014). Meditation as an Adjunct to the Management of Multiple Sclerosis. Neurology Research International. Full text.

From the Abstract. Multiple sclerosis (MS) disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS.

Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL) and improved coping skills.

All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.