Effect of Mindfulness-Based Stress Reduction on dehydroepiandrosterone-sulfate in adults with self-reported stress. A randomized trial.
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SUBMITTER: Jorgensen MA
PROVIDER: S-EPMC8604255 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveThe aim of the study was to assess the effect of mindfulness-based stress reduction (MBSR) on anxiety and self-efficacy in coping with childbirth.Material and methodsThis randomized controlled trial was conducted on 70 pregnant women in Abyek city of Qazvin province in Iran. The convenient sampling method was recruited. Samples were assigned to control and intervention groups using random blocks. In addition to routine care, individuals in the intervention group received 6 MBSR training sessions. The data gathering questionnaire in this study included mindfulness, Pregnancy-Related Anxiety Questionnaire, and self-efficacy in coping with childbirth questionnaire.ResultsThere was no statistically significant difference between the demographic characteristics in the control and intervention groups. The results of the analysis of variance (ANOVA) with repeated measures indicated the effect of time on the change in the total score of anxiety in the intervention group (p = .001). There was a significant difference between the two groups (p = .001). Also, the results of ANOVA with repeated measures showed that time had no impact on the score of self-efficacy in delivery coping (p = 0/1) and that there was no significant difference between the two groups in this respect (p = .6).ConclusionThe result of this study showed that mindfulness reduces anxiety of pregnant mothers, and it is suggested that mindfulness programs be educated for healthcare providers and pregnant mothers to reduce maternal anxiety and improve pregnancy outcomes and delivery.
| S-EPMC7177577 | biostudies-literature
Project description:ObjectiveMindfulness interventions have been effective for improving a range of health outcomes; however, pathways underlying these effects remain unclear. Inflammatory processes may play a role, possibly through increased resistance of immune cells to the anti-inflammatory effects of glucocorticoids (i.e., glucocorticoid resistance, or GCR). Here, we conducted an initial examination of whether mindfulness training mitigates GCR among lonely older adults.MethodsLonely older adults (65-85 years; n = 190) were randomly assigned to an 8-week Mindfulness-Based Stress Reduction (MBSR) or a matched Health Enhancement Program (HEP). Whole blood drawn before and after the intervention and at 3-month follow-up was incubated with endotoxin and varying concentrations of dexamethasone, and interleukin-6 production was assessed using enzyme-linked immunosorbent assay. GCR was assessed as the concentration of dexamethasone required to decrease the stimulated interleukin-6 response by 50% (half maximal inhibitory concentration), with higher concentrations indicating greater GCR. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR versus HEP) effects.ResultsThere was no overall time by condition effect on GCR across all time points. However, a significant time by condition effect was observed from preintervention to postintervention (d = 0.29), such that MBSR buffered increases in GCR observed in the HEP group. Although MBSR showed small, nonsignificant reductions in GCR from preintervention to 3-month follow-up, group differences were not maintained at the 3-month follow-up (d = 0.10).ConclusionsResults suggest that MBSR may protect against declines in the sensitivity of immune cells to the anti-inflammatory effects of glucocorticoids among at-risk lonely older adults and show value in studying this biological mechanism in future trials.Trial Registration: Clinical Trials identifier NCT02888600.
| S-EPMC8254739 | biostudies-literature
Project description:Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents.To determine the effectiveness of MBSR in reducing burnout in residents.A randomized controlled trial comparing MBSR with a waitlist control group.Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred.The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day.The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory-Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work-home interference, mindfulness skills, self-compassion, positive mental health, empathy and medical errors. Assessment took place at baseline and post-intervention approximately 3 months later.Of the 148 residents participating, 138 (93%) completed the post-intervention assessment. No significant difference in emotional exhaustion was found between the two groups. However, the MBSR group reported significantly greater improvements than the control group in personal accomplishment (p?=?0.028, d?=?0.24), worry (p?=?0.036, d?=?0.23), mindfulness skills (p?=?0.010, d?=?0.33), self-compassion (p?=?0.010, d?=?0.35) and perspective-taking (empathy) (p?=?0.025, d?=?0.33). No effects were found for the other measures. Exploratory moderation analysis showed that the intervention outcome was moderated by baseline severity of emotional exhaustion; those with greater emotional exhaustion did seem to benefit.The results of our primary outcome analysis did not support the effectiveness of MBSR for reducing emotional exhaustion in residents. However, residents with high baseline levels of emotional exhaustion did appear to benefit from MBSR. Furthermore, they demonstrated modest improvements in personal accomplishment, worry, mindfulness skills, self-compassion and perspective-taking. More research is needed to confirm these results.
| S-EPMC5880763 | biostudies-other
Project description:Psychological distress is common in patients with diabetes. Little is known about the impact of Mindfulness Based Stress Reduction (MBSR), a non-traditional, cognitive behavioural intervention designed to improve stress management skills, in patients with diabetes. The purpose of this retrospective analysis was to evaluate the impact of MBSR training on mood states in 25 individuals with diabetes. All participants completed the Profile of Mood States Short Form (POMS-SF) at baseline and following eight weeks of MBSR. Overall psychological distress measured by the total mood score (TMS) and six subscales - including tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia, confusion/bewilderment and vigour/activity - were assessed. Overall mood, measured by the TMS, as well as all subscale mood measurements improved significantly from baseline following MBSR training. Compared to population means, those with diabetes had higher distress at baseline and similar levels of distress following MBSR training. The primary reason participants reported for enrolling in the MBSR course was to improve stress management skills. It was concluded that MBSR training is a promising, group-based intervention that can be used to decrease psychological distress in individuals with diabetes who perceive a need for training in stress management.
| S-EPMC5542414 | biostudies-other
Project description:Patient-reported outcomes such as health-related quality of life (HRQOL) are impaired in cirrhosis due to under-treated mood and sleep disorders, which can adversely impact their caregivers. Mindfulness-based stress reduction (MBSR) can improve patient-reported outcomes (PRO) in non-cirrhotic patients but their impact in cirrhosis is unclear. To evaluate the effect of MBSR and supportive group therapy on mood, sleep and HRQOL in cirrhotic patients and their caregivers.Cirrhotic outpatients with mild depression (Beck Depression Inventory (BDI)>14) on screening with an adult caregiver were enrolled. At baseline, BDI, sleep (Pittsburgh sleep quality index PSQI, Epworth Sleepiness Scale, ESS), anxiety (Beck Anxiety inventory) and HRQOL (Sickness Impact Profile, SIP) for both patients/caregivers and caregiver burden (Zarit Burden Interview Short-form, ZBI-SF and perceived caregiver burden, PCB) and patient covert HE(CHE) status were measured. Patients who had BDI>14 at baseline, along with their caregivers then underwent a structured MBSR program with four weekly hour-long group sessions interspersed with home practice using CDs. After the last group, all questionnaires were repeated.20 patient/caregiver dyads were included. All patients were men (60±8 years MELD 12.9±5.7, 14 prior hepatic encephalopathy (HE)) while most caregivers (n=15) were women (55±12 years, 23±14 years of relationship, 65% spouses). There was no change in patient BDI between screening and baseline (20.1±11.2 vs. 19.0±10.6, P=0.81). All dyads were able to complete the four MBSR+supportive group therapy sessions. There was a significant improvement in BDI (19.0±10.6 vs.15.6±8.2 P=0.01), PSQI (7.2±3.7 vs. 5.5±3.7, P<0.001) and overall HRQOL (25.0±13.2 vs. 17.7±14.0,P=0.01) but not in anxiety or CHE rates in patients. Similarly caregiver burden (ZBI-SF13.0±9.0 vs. 9.8±6.9,P=0.04, Perceived burden 72.1±29.9 vs. 63.0±14.5,P=0.05) and depression reduced (BDI 9.1±7.8 vs. 5.9±6.0,P=0.03) while caregiver sleep quality (7.2±3.7 vs. 5.5±3.7,P<0.001) improved. Prior HE did not affect PRO change after MBSR+supportive groups but the ZBI-SF of caregivers taking care of HE patients improved to a greater extent (delta -1.1±6.5 vs. 7.4±5.3 HE, P=0.04).A short program of mindfulness and supportive group therapy significantly improves PRO and caregiver burden in cirrhotic patients with depression. This non-pharmacological method could be a promising approach to alleviate psychosocial stress in patients with end-stage liver disease and their caregivers.
| S-EPMC5539344 | biostudies-literature
Project description:OBJECTIVE:Evidence links depression and stress to more rapid progression of HIV-1 disease. We conducted a randomized controlled trial to test whether an intervention aimed at improving stress management and emotion regulation, mindfulness-based stress reduction (MBSR), would improve immunological (i.e. CD4+ T-cell counts) and psychological outcomes in persons with HIV-1 infection. METHODS:We randomly assigned participants with HIV-1 infection and CD4 T-cell counts >350?cells/?l who were not on antiretroviral therapy in a 1:1 ratio to either an MBSR group (n?=?89) or an HIV disease self-management skills group (n?=?88). The study was conducted at the University of California at San Francisco. We assessed immunologic (CD4, c-reactive protein, IL-6, and d-dimer) and psychological measures (Beck Depression Inventory for depression, modified Differential Emotions Scale for positive and negative affect, Perceived stress-scale, and mindfulness) at 3, 6 and 12?months after initiation of the intervention; we used multiple imputation to address missing values. RESULTS:We observed statistically significant improvements from baseline to 3-months within the MBSR group in depression, positive and negative affect, perceived stress, and mindfulness; between group differences in change were significantly greater in the MBSR group only for positive affect (per item difference on DES-positive 0.25, 95% CI 0.049, 0.44, p?=?.015). By 12?months the between group difference in positive affect was not statistically significant, although both groups had trends toward improvements compared to baseline in several psychological outcomes that were maintained at 12-months; these improvements were only statistically significant for depression and negative affect in the MBSR group and perceived stress for the control group. The groups did not differ significantly on rates of antiretroviral therapy initiation (MBSR?=?39%, control?=?29%, p?=?.22). After 12?months, the mean decrease in CD4+ T-cell count was 49.6?cells/?l in participants in the MBSR arm, compared to 54.2?cells/?l in the control group, a difference of 4.6?cells favoring the MBSR group (95% CI, -44.6, 53.7, p?=?.85). The between group differences in other immunologic-related outcomes (c-reactive protein, IL-6, HIV-1 viral load, and d-dimer) were not statistically significant at any time point. CONCLUSIONS:MBSR improved positive affect more than an active control arm in the 3?months following the start of the intervention. However, this difference was not maintained over the 12-month follow-up and there were no significant differences in immunologic outcomes between intervention groups. These results emphasize the need for further carefully designed research if we are to translate evidence linking psychological states to immunological outcomes into evidence-based clinical practices.
| S-EPMC7656978 | biostudies-literature
Project description:Psychological and behavioural interventions may be effective in reducing menopause-related symptoms. This randomized controlled trial aimed to evaluate the effectiveness of Mindfulness-based Stress Reduction (MBSR) in reducing menopause-related symptoms by comparing with an active control group, the menopause education control (MEC). Symptomatic peri-menopausal and post-menopausal women with mild to moderate symptoms were recruited. The primary outcome was overall menopausal symptoms measured by modified Greene Climacteric Scale (GCS). Secondary outcomes include subscales of the GCS perceived stress, mindfulness and health related Quality of Life. All outcome measures were collected at baseline, 2 months (immediately post intervention), 5 and 8 months (3 and 6 months post intervention respectively). Both MBSR (n?=?98) and MEC (n?=?99) groups reported a reduction in total GCS score at 8 months. Between group analysis show significant symptom score reduction in MBSR group on Anxiety and Depression subscales of GCS. No differences were found between groups on other GCS subscales and majority of the secondary outcome measures. The findings show that menopausal symptoms in both MBSR and MEC significantly reduced over the study period. MBSR show a greater reduction of psychological symptoms of depression and anxiety above active controls but do not reduce other somatic, urogenital and vasomotor symptoms.
| S-EPMC5919973 | biostudies-other
Project description:Lonely older adults have increased expression of pro-inflammatory genes as well as increased risk for morbidity and mortality. Previous behavioral treatments have attempted to reduce loneliness and its concomitant health risks, but have had limited success. The present study tested whether the 8-week Mindfulness-Based Stress Reduction (MBSR) program (compared to a Wait-List control group) reduces loneliness and downregulates loneliness-related pro-inflammatory gene expression in older adults (N = 40). Consistent with study predictions, mixed effect linear models indicated that the MBSR program reduced loneliness, compared to small increases in loneliness in the control group (treatment condition × time interaction: F(1,35) = 7.86, p = .008). Moreover, at baseline, there was an association between reported loneliness and upregulated pro-inflammatory NF-?B-related gene expression in circulating leukocytes, and MBSR downregulated this NF-?B-associated gene expression profile at post-treatment. Finally, there was a trend for MBSR to reduce C Reactive Protein (treatment condition × time interaction: (F(1,33) = 3.39, p = .075). This work provides an initial indication that MBSR may be a novel treatment approach for reducing loneliness and related pro-inflammatory gene expression in older adults.
| S-EPMC3635809 | biostudies-literature
Project description:The symptom burden of HIV-associated neurocognitive disorder (HAND) is high among older individuals, and treatment options are limited. Mindfulness-based stress reduction (MBSR) has potential to improve neurocognitive performance, psychosocial wellbeing, and quality of life, but empirical studies in this growing vulnerable population are lacking. In this trial, participants (N = 180) age 55 and older who are living with HIV infection, are on combination antiretroviral therapy with suppressed viral loads, and yet continue to experience behavioral and cognitive symptoms of HAND, are randomized to MBSR or to a waitlist control arm that receives MBSR following a 16-week period of standard care. Primary outcomes (attention, executive function, stress, anxiety, depression, everyday functioning, quality of life) and potential mediators (affect, mindfulness) and moderators (social support, loneliness) are assessed at baseline and weeks 8, 16, and 48 in both groups, with an additional assessment at week 24 (post-MBSR) in the crossover control group. Assessments include self-report and objective measures (e.g., neuropsychological assessment, neurological exam, clinical labs). In addition, a subset of participants (n = 30 per group) are randomly selected to undergo fMRI to evaluate changes in functional connectivity networks and their relationship to changes in neuropsychological outcomes. Forthcoming findings from this randomized controlled trial have the potential to contribute to a growing public health need as the number of older adults with HAND is expected to rise.
| S-EPMC7686285 | biostudies-literature
Project description:Patients who have received solid organ transplants continue to experience a myriad of complex symptoms related to their underlying disease and to chronic immunosuppression that reduce the quality of life. Beneficial nonpharmacologic therapies to address these symptoms have not been established in the transplant population.Assess the efficacy of mindfulness-based stress reduction (MBSR) in reducing symptoms of anxiety, depression, and poor sleep in transplant patients.Controlled trial with a two-staged randomization. Recipients of kidney, kidney/pancreas, liver, heart, or lung transplants were randomized to MBSR (n=72) or health education (n=66) initially or after serving in a waitlist. Mean age was 54 years (range 21-75); 55% were men, and 91% were white.MBSR, a mindfulness meditation training program consisting of eight weekly 2.5-hour classes; health education, a peer-led active control.Anxiety (State-Trait Anxiety Inventory), depression (Center for Epidemiologic Studies Depression Scale), and sleep quality (Pittsburgh Sleep Quality Index) scales assessed by self-report at baseline, 8 weeks, 6 months, and 1 year.Benefits of MBSR were above and beyond those afforded by the active control. MBSR reduced anxiety and sleep symptoms (P < .02), with medium treatment effects (.51 and .56) at 1 year compared to health education in intention-to-treat analyses. Within the MBSR group, anxiety, depression, and sleep symptoms decreased and quality-of-life measures improved by 8 weeks (P < .01, all), and benefits were retained at 1 year (P < .05, all). Initial symptom reductions in the health education group were smaller and not sustained. Comparisons to the waitlist confirmed the impact of MBSR on both symptoms and quality of life, whereas health education improvements were limited to quality-of-life ratings.MBSR reduced distressing symptoms of anxiety, depression, and poor sleep and improved quality of life. Benefits were sustained over 1 year. A health education program provided fewer benefits, and effects were not as durable. MBSR is a relatively inexpensive, safe, and effective community-based intervention.
| S-EPMC3076132 | biostudies-literature