The experience of 6 college-age women with bulimia nervosa was examined after they participated in an 8-week mindfulness-based eating disorder treatment group. This phenomenological study used individual interview and pre- and post-treatment self-portraits. Participants described their experience of transformation from emotional and behavioral extremes, disembodiment, and self-loathing to the cultivation of an inner connection with themselves resulting in greater self-awareness, acceptance, and compassion. They reported less emotional distress and improved abilities to manage stress. This treatment may help the 40% of women who do not improve with current therapies and might be useful to prevent symptoms in younger women.

Eat Disord. 2008 Jan-Feb;16(1):52-72 Proulx K. University of Massachusetts, Amherst, Massachusetts, USA. kproulx55@comcast.net

There is well documented evidence for the increasing widespread use of complementary and alternative medicine in the treatment of physical and psychiatric symptoms and disorders within Western populations. Here we provide a review of the recent literature on evidence for using such interventions in the treatment of anxiety and depression. RECENT FINDINGS: With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression. The association of kava with hepatotoxicity, however, is a significant concern. Promising data continue to emerge for the use of omega-3 fatty acids in managing depression. Evidence for the use of acupuncture in treating anxiety disorders is becoming stronger, although there is currently minimal empirical evidence for the use of aromatherapy or mindfulness-based meditation. SUMMARY: The evidence base for the efficacy of the majority of complementary and alternative interventions used to treat anxiety and depression remains poor. Recent systematic reviews all point to a significant lack of methodologically rigorous studies within the field. This lack of evidence does not diminish the popularity of such interventions within the general Western population.

Curr Opin Psychiatry. 2008 Jan;21(1):37-42. van der Watt G, Laugharne J, Janca A. School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.

The rapid pace of life, eating habits, and environmental pollution have increased stress levels and its related disorders. The complex molecular response to stress is mediated by stress genes and a variety of regulatory pathways. Oxidative stress is internal damage caused by reactive oxygen species. Increasing evidence suggests that chronic psychosocial stress may increase oxidative stress, which in turn may contribute to aging, and etiology of coronary diseases, cancer, arthritis, etc. Psychophysiological concomitants of meditation have been extensively researched, but there are very little data available on biochemical activity leading to relieving stress by causing a relaxation response by Sudarshan Kriya (SK). SK is a breathing technique that involves breathing in three different rhythms. It is preceded by Ujjayi Pranayam (long and deep breaths with constriction at the base of throat) and Bhastrika (fast and forceful breaths through nose along with arm movements). METHODS: Forty-two SK practitioners and 42 normal healthy controls were recruited for our study. The practitioners had practiced SK for at least 1 year. Selected normal healthy controls did not perform any conventional physical exercise or any formal stress management technique. Whole blood was used for glutathione peroxidase estimation and red blood cell lysate was used for superoxide dismutase activity assay and for glutathione estimation. White blood cells were isolated from fresh blood and assayed for gene expression using reverse transcriptase-polymerase chain reaction. The parameters studied are antioxidant enzymes, genes involved in oxidative stress, DNA damage, cell cycle control, aging, and apoptosis. RESULTS: A better antioxidant status both at the enzyme activity and RNA level was seen in SK practitioners. This was accompanied by better stress regulation and better immune status due to prolonged life span of lymphocytes by up-regulation of antiapoptotic genes and prosurvival genes in these subjects. CONCLUSIONS: Our pilot study provides the first evidence suggesting that SK practice may exert effects on immunity, aging, cell death, and stress regulation through transcriptional regulation.

J Psychosom Res. 2008 Feb;64(2):213-8. Sharma H, Datta P, Singh A, Sen S, Bhardwaj NK, Kochupillai V, Singh N. Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

A total of 52 pharmacologically untreated subjects with essential hypertension were randomly allocated to either 8 weeks of contemplative meditation combined with breathing techniques (CMBT) or no intervention in this observer-blind controlled pilot trial. CMBT induced clinically relevant and consistent decreases in heart rate, systolic and diastolic blood pressure if measured during office readings, 24-h ambulatory monitoring and mental stress test. Longer-term studies should evaluate CMBT as an antihypertensive strategy.

J Hum Hypertens. 2008 Feb;22(2):138-40. Manikonda JP, Störk S, Tögel S, Lobmüller A, Grünberg I, Bedel S, Schardt F, Angermann CE, Jahns R, Voelker W.

Prior clinical trials suggest that the Transcendental Meditation technique may decrease blood pressure of normotensive and hypertensive individuals but study-quality issues have been raised. This study was designed to assess effects of Transcendental Meditation on blood pressure using objective quality assessments and meta-analyses.MethodsPubMed and Cochrane databases through December 2006 and collected publications on Transcendental Meditation were searched. Randomized, controlled trials comparing blood pressure responses to the Transcendental Meditation technique with a control group were evaluated. Primary outcome measures were changes in systolic and diastolic blood pressure after practicing Transcendental Meditation or following control procedures. A specific rating system (0-20 points) was used to evaluate studies and random-effects models were used for meta-analyses.ResultsNine randomized, controlled trials met eligibility criteria. Study-quality scores ranged from low (score, 7) to high (16) with three studies of high quality (15 or 16) and three of acceptable quality (11 or 12). The random-effects meta-analysis model for systolic and diastolic blood pressure, respectively, indicated that Transcendental Meditation, compared to control, was associated with the following changes: -4.7 mm Hg (95% confidence interval (CI), -7.4 to -1.9 mm Hg) and -3.2 mm Hg (95% CI, -5.4 to -1.3 mm Hg). Subgroup analyses of hypertensive groups and high-quality studies showed similar reductions.ConclusionsThe regular practice of Transcendental Meditation may have the potential to reduce systolic and diastolic blood pressure by approximately 4.7 and 3.2 mm Hg, respectively. These are clinically meaningful changes.

Anderson JW, Liu C, Kryscio RJ. 1Division of Endocrinology and Molecular Medicine, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.

The practice of yoga regulates body physiology through control of posture, breathing, and meditation. Effects of yoga on autonomic functions of patients with refractory epilepsy, as quantified by standardized autonomic function tests (AFTs), were determined. The yoga group (n=18) received supervised training in yoga, and the exercise group (n=16) practiced simple routine exercises. AFTs were repeated after 10 weeks of daily sessions. Data were compared with those of healthy volunteers (n=142). The yoga group showed significant improvement in parasympathetic parameters and a decrease in seizure frequency scores. There was no improvement in blood pressure parameters in either group. Two patients in the yoga group achieved normal autonomic functions at the end of 10 weeks of therapy, whereas there were no changes in the exercise group. The data suggest that yoga may have a role as an adjuvant therapy in the management of autonomic dysfunction in patients with refractory epilepsy.

Epilepsy Behav. 2008 Feb;12(2):245-52. Epub 2007 Nov 19. Sathyaprabha TN, Satishchandra P, Pradhan C, Sinha S, Kaveri B, Thennarasu K, Murthy BT, Raju TR. Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India.

The author argues for a common denominator between Bion's view and the Buddhist view of mental development. In both thought systems, mental growth is synonymous to learning from experience. The author closely examines Bion's concept of attention and compares it to mindfulness, a major factor in Buddhist meditation. In both doctrines, attention must be isolated from other mental processes in order to attain learning from experience. The author compares reverie to the state of mind of equanimity. She argues that enhancement of the ability of reverie, or improving the inner container such that it can hold any content while unmoved by desire, is the purpose of Buddhist practice. Both view the mind as capable of transcending its own restrictions and 'the capacity to know anything' as attainable through disciplined practice.

Int J Psychoanal. 2007 Dec;88(Pt 6):1507-26. Pelled E. University of Tel-Aviv, Mane 19B, Tel-Aviv 64364, Israel.

The nursing profession is experiencing a crisis in both manpower and the ability to fend off the deleterious effects of burnout. Nursing professionals face extraordinary stress in our present medical environment, and studies have frequently found moderate-to-high levels of burnout among nurses. Nurses experience burnout for a variety of reasons, some inherent to the profession and others related to our 21st-century values that have necessitated multiple breadwinners within the household. Mindful meditation represents a complementary therapy that has shown promise in the reduction of negative stress and those extraneous factors that lead to burnout. A mindful, meditative practice can be another tool with which critical care nurses can regain the control of their careers and personal lives. The purpose of this article is to describe nurse burnout, identify those factors that contribute to burnout, and offer a solution to a continuing problem for nurses.

Holist Nurs Pract. 2008 Jan-Feb;22(1):32-6. Davies WR. University of Phoenix Online Masters in Nursing Education Program, Deborah Clark, Instructor.

ADHD is a childhood-onset psychiatric condition that often continues into adulthood. Stimulant medications are the mainstay of treatment; however, additional approaches are frequently desired. In recent years, mindfulness meditation has been proposed to improve attention, reduce stress, and improve mood. This study tests the feasibility of an 8-week mindfulness training program for adults and adolescents with ADHD. Method: Twenty-four adults and eight adolescents with ADHD enrolled in a feasibility study of an 8-week mindfulness training program. Results: The majority of participants completed the training and reported high satisfaction with the training. Pre-post improvements in self-reported ADHD symptoms and test performance on tasks measuring attention and cognitive inhibition were noted. Improvements in anxiety and depressive symptoms were also observed. Conclusion: Mindfulness training is a feasible intervention in a subset of ADHD adults and adolescents and may improve behavioral and neurocognitive impairments. A controlled clinical study is warranted.

J Atten Disord. 2007 Nov 19 Zylowska L, Ackerman DL, Yang MH, Futrell JL, Horton NI, Hale S, Pataki C, Smalley SL. University of California–Los Angeles.

The purpose of this research is to examine the relation of meditation to power and well-being in Korean adults. Using a quasi-experimental design, meditation was provided through a chakra meditation music program over a 4 week period. The Power as Knowing Participation in Change Tool and the Well-Being Picture Scale were used, after being translated into Korean. Statistically significant interaction effects of power and group (p < .001), and well-being and group (p < .05) were found. Meditation has a potential to facilitate power and well-being in the human and environmental field patterning process.

Nurs Sci Q. 2008 Jan;21(1):49-58. Tae Sook Kim , Jeong Sook Park , Myung Ae Kim . St. Joseph's College, New York.

As incidence of chronic hepatitis C (CHC) in the United States increases, management of physical and psychological symptoms over the long term becomes crucial. Research has shown meditation to be a valuable tool in reducing such symptoms for various chronic illnesses. In particular, the Mindfulness-Based Stress Reduction (MBSR) program offers curriculum that has been shown to influence both physiology and perception of disease states. Although there has been no direct research to date on the effectiveness of the MBSR program for CHC, several studies have shown significant findings affecting other chronic conditions, including heart disease, fibromyalgia, and HIV. The purpose of this literature review is to examine recent research, summarize findings, and indicate appropriate inclusion of MBSR as a primary, secondary, and tertiary treatment option in conjunction with biomedical care for those diagnosed with CHC. Thusly, nurses can better inform their clients with this condition.

J Holist Nurs. 2007 Dec;25(4):265-74; quiz 275-77. J Holist Nurs. 2007 Dec;25(4):265-74; quiz 275-77. Koerbel LS, Zucker DM. University of Massachusetts Amherst, USA Koerbel LS, Zucker DM. University of Massachusetts Amherst, USA

Despite evidence that individuals with schizophrenia spectrum disorders experience significant and persistent symptoms of anxiety, there are few reports of the use of empirically supported treatments for anxiety in this population. This article describes how we have tried to adapt mindfulness interventions to help individuals with schizophrenia who experience significant anxiety symptoms. Although mindfulness has been widely used to help individuals without psychosis, to our knowledge, this is the first study adapting it to help those with schizophrenia manage worry and stress. We provide an overview of the intervention and use an individual example to describe how our treatment development group responded. We also explore directions for future research of mindfulness interventions for schizophrenia.

J Psychosoc Nurs Ment Health Serv. 2007 Nov;45(11):23-9. Davis LW, Strasburger AM, Brown LF. Roudebush VA Medical Center, Indianapolis, IN 46202, USA. louanne.davis@va.gov

The "Triarchic body-pathway relaxation technique" (TBRT) is a form of ancient Chinese mindfulness-based meditation professed to give rise to positive emotions and a specific state of consciousness in which deep relaxation and internalized attention coexist. The purpose of this study was to examine the EEG pattern generated during the practice of this mindfulness exercise, and compare it to music listening which has been shown to induce positive emotions. METHODS: Nineteen college students (aged 19-22 years) participated in the study. Each participant listened to both the TBRT and music audiotapes while EEG was recorded. The order of presentation was counterbalanced to avoid order effect. Two EEG indicators were used: (1) alpha asymmetry index, an indicator for left-sided anterior activation, as measure of positive emotions, and (2) frontal midline theta activity, as a measure for internalized attention. RESULTS: Increased left-sided activation, a pattern associated with positive emotions, was found during both TBRT exercise and music conditions. However, only TBRT exercise was shown to exhibit greater frontal midline theta power, a pattern associated with internalized attention. CONCLUSIONS: These results provided evidence to support that the TBRT gives rise to positive emotional experience, accompanied by focused internalized attention.

Appl Psychophysiol Biofeedback. 2008 Jan 24 Chan AS, Han YM, Cheung MC. Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, aschan@psy.cuhk.edu.hk.

Some contemporary theorists and clinicians champion acceptance and mindfulness-based interventions, such as Acceptance and Commitment Therapy (ACT), over cognitive-behavioral therapy (CBT) for the treatment of emotional disorders. The objective of this article is to juxtapose these two treatment approaches, synthesize, and clarify the differences between them. The two treatment modalities can be placed within a larger context of the emotion regulation literature. Accordingly, emotions can be regulated either by manipulating the evaluation of the external or internal emotion cues (antecedent-focused emotion regulation) or by manipulating the emotional responses (response-focused emotion regulation). CBT and ACT both encourage adaptive emotion regulation strategies but target different stages of the generative emotion process: CBT promotes adaptive antecedent-focused emotion regulation strategies, whereas acceptance strategies of ACT counteract maladaptive response-focused emotion regulation strategies, such as suppression. Although there are fundamental differences in the philosophical foundation, ACT techniques are fully compatible with CBT and may lead to improved interventions for some disorders. Areas of future treatment research are discussed.

Clin Psychol Rev. 2008 Jan;28(1):1-16. Hofmann SG, Asmundson GJ. Department of Psychology, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215-2002, United States.

OBJECTIVES: To review and synthesize the state of research on a variety of meditation practices, including: the specific meditation practices examined; the research designs employed and the conditions and outcomes examined; the efficacy and effectiveness of different meditation practices for the three most studied conditions; the role of effect modifiers on outcomes; and the effects of meditation on physiological and neuropsychological outcomes. DATA SOURCES: Comprehensive searches were conducted in 17 electronic databases of medical and psychological literature up to September 2005. Other sources of potentially relevant studies included hand searches, reference tracking, contact with experts, and gray literature searches. REVIEW METHODS: A Delphi method was used to develop a set of parameters to describe meditation practices. Included studies were comparative, on any meditation practice, had more than 10 adult participants, provided quantitative data on health-related outcomes, and published in English. Two independent reviewers assessed study relevance, extracted the data and assessed the methodological quality of the studies. RESULTS: Five broad categories of meditation practices were identified (Mantra meditation, Mindfulness meditation, Yoga, Tai Chi, and Qi Gong). Characterization of the universal or supplemental components of meditation practices was precluded by the theoretical and terminological heterogeneity among practices. Evidence on the state of research in meditation practices was provided in 813 predominantly poor-quality studies. The three most studied conditions were hypertension, other cardiovascular diseases, and substance abuse. Sixty-five intervention studies examined the therapeutic effect of meditation practices for these conditions. Meta-analyses based on low-quality studies and small numbers of hypertensive participants showed that TM(R), Qi Gong and Zen Buddhist meditation significantly reduced blood pressure. Yoga helped reduce stress. Yoga was no better than Mindfulness-based Stress Reduction at reducing anxiety in patients with cardiovascular diseases. No results from substance abuse studies could be combined. The role of effect modifiers in meditation practices has been neglected in the scientific literature. The physiological and neuropsychological effects of meditation practices have been evaluated in 312 poor-quality studies. Meta-analyses of results from 55 studies indicated that some meditation practices produced significant changes in healthy participants. CONCLUSIONS: Many uncertainties surround the practice of meditation. Scientific research on meditation practices does not appear to have a common theoretical perspective and is characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results.

Evid Rep Technol Assess (Full Rep). 2007 Jun;(155):1-263. Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, Bialy L, Hooton N, Buscemi N, Dryden DM, Klassen TP.

Mindfulness is defined as paying attention in the present moment. We investigate the hypothesis that mindfulness training may alter or enhance specific aspects of attention. We examined three functionally and neuroanatomically distinct but overlapping attentional subsystems: alerting, orienting, and conflict monitoring. Functioning of each subsystem was indexed by performance on the Attention Network Test. Two types of mindfulness training (MT) programs were examined, and behavioral testing was conducted on participants before (Time 1) and after (Time 2) training. One training group consisted of individuals naive to mindfulness techniques who participated in an 8-week mindfulness-based stress reduction (MBSR) course that emphasized the development of concentrative meditation skills. The other training group consisted of individuals experienced in concentrative meditation techniques who participated in a 1-month intensive mindfulness retreat. Performance of these groups was compared with that of control participants who were meditation naive and received no MT. At Time 1, the participants in the retreat group demonstrated improved conflict monitoring performance relative to those in the MBSR and control groups. At Time 2, the participants in the MBSR course demonstrated significantly improved orienting in comparison with the control and retreat participants. In contrast, the participants in the retreat group demonstrated altered performance on the alerting component, with improvements in exogenous stimulus detection in comparison with the control and MBSR participants. The groups did not differ in conflict monitoring performance at Time 2. These results suggest that mindfulness training may improve attention-related behavioral responses by enhancing functioning of specific subcomponents of attention. Whereas participation in the MBSR course improved the ability to endogenously orient attention, retreat participation appeared to allow for the development and emergence of receptive attentional skills, which improved exogenous alerting-related process.

Cogn Affect Behav Neurosci. 2007 Jun;7(2):109-19. Jha AP, Krompinger J, Baime MJ. Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. apjha@psych.upenn.edu

This study investigated differences in brain activation during meditation between meditators and non-meditators. Fifteen Vipassana meditators (mean practice: 7.9 years, 2h daily) and fifteen non-meditators, matched for sex, age, education, and handedness, participated in a block-design fMRI study that included mindfulness of breathing and mental arithmetic conditions. For the meditation condition (contrasted to arithmetic), meditators showed stronger activations in the rostral anterior cingulate cortex and the dorsal medial prefrontal cortex bilaterally, compared to controls. Greater rostral anterior cingulate cortex activation in meditators may reflect stronger processing of distracting events. The increased activation in the medial prefrontal cortex may reflect that meditators are stronger engaged in emotional processing.

Neurosci Lett. 2007 Jun 21;421(1):16-21. Epub 2007 May 25. Hölzel BK, Ott U, Hempel H, Hackl A, Wolf K, Stark R, Vaitl D. Bender Institute of Neuroimaging, Justus-Liebig-University, Giessen, Germany. britta.k.hoelzel@psychol.uni-giessen.de

The present investigation examined the contributions of specific attentional networks to long-term trait effects of meditation. It was hypothesized that meditation could improve the efficiency of executive processing (inhibits prepotent/incorrect responses) or orientational processing (orients to specific objects in the attentional field). Participants (50 meditators and 10 controls) were given the Stroop (measures executive attention) and Global-Local Letters (measures orientational attention) tasks. Results showed that meditation experience was associated with reduced interference on the Stroop task (p < 0.03), in contrast with a lack of effect on interference in the Global-Local Letters task. This suggests that meditation produces long-term increases in the efficiency of the executive attentional network (anterior cingulate/prefrontal cortex) but no effect on the orientation network (parietal systems). The amount of time participants spent meditating each day, rather than the total number of hours of meditative practice over their lifetime, was negatively correlated with interference on the Stroop task (r = -0.31, p < 0.005).

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Natural Stress Relief meditation, a mental technique which is practiced for 15 minutes twice a day, aims to reduce stress and anxiety by eliciting a specific state of physiological rest along with mental alertness. The meditation is taught in a self-administered program, requiring one hour of training during the first three days, followed by the regular twice daily practice. Each 15-min. session consists in sitting quietly with closed eyes while applying a specific mental procedure. To test the effectiveness of meditation in reducing trait anxiety, Spielberger's State-Trait Anxiety Inventory was administered to 25 participants four times over a 3-wk. period: one week before starting to practice the meditation, a few hours before starting, 1 wk. after, and 2 wk. after. The difference in Trait Anxiety score between pretreatment and before starting the practice was not significant, while it was significant both after the first week of practice (Cohen d=.46) and after the first 2 wk. of practice (d=.67).

Psychol Rep. 2007 Aug;101(1):130-4. Coppola F. Istituto Scientia, Massa, Italy. scientia@ipotesi.net

Meditation practices have various health benefits including the possibility of preserving cognition and preventing dementia. While the mechanisms remain investigational, studies show that meditation may affect multiple pathways that could play a role in brain aging and mental fitness. For example, medication may reduce stress-induced cortisol secretion and this could have neuroprotective effects potentially via elevating levels of brain derived neurotrophic factor (BDNF). Meditation may also potentially have beneficial effects on lipid profiles and lower oxidative stress, both of which could in turn reduce the risk for cerebrovascular disease and age-related neurodegeneration. Further, meditation may potentially strengthen neuronal circuits and enhance cognitive reserve capacity. These are the theoretical basis for how medication might enhance longevity and optimal health. Evidence to support a neuroprotective effect comes from cognitive, electroencephalogram (EEG), and structural neuroimaging studies. In one cross-sectional study, meditation practioners were found to have a lower age-related decline in thickness of specific cortical regions. However, the enthusiasm must be balanced by the inconsistency and preliminary nature of existing studies as well as the fact that meditation comprises a heterogenous group of practices. Key future challenges include the isolation of a potential common element in the different meditation modalities, replication of existing findings in larger randomized trials, determining the correct "dose," studying whether findings from expert practioners are generalizable to a wider population, and better control of confounding genetic, dietary and lifestyle influences.

Ann N Y Acad Sci. 2007 Sep 28 Doraiswamy PM, Xiong GL. Psychiatry, Duke University Medical Center, Durham, North Carolina, United States.