Attention to internal body sensations is practiced in most meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundalini) to an age- and body mass index-matched group of nonmeditators. Contrary to our prediction, we found no evidence that meditators were superior to nonmeditators in the heartbeat detection task, across several sessions and respiratory modulation conditions. Compared to nonmeditators, however, meditators consistently rated their interoceptive performance as superior and the difficulty of the task as easier. These results provide evidence against the notion that practicing attention to internal body sensations, a core feature of meditation, enhances the ability to sense the heartbeat at rest.

Khalsa SS, Rudrauf D, Damasio AR, Davidson RJ, Lutz A, Tranel D. Neuroscience Graduate Program, Department of Neurology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. sahib-khalsa@uiowa.edu Psychophysiology. 2008 Jul;45(4):671-7.

The hematopoietic stem cell transplant (HSCT) experience is emotionally and physically stressful for cancer patients who undergo this procedure. Mindfulness-based interventions have been studied in patients with various diagnoses, including cancer, although minimal work has applied this intervention to hospitalized patients. Use of mindfulness meditation has potential to provide HSCT patients with coping skills to deal with unpleasant symptoms and an uncertain future. This exploratory study examined feasibility, physiological arousal, and psychological and physical symptoms in HSCT patients participating in a mindfulness meditation intervention that begins before and continues throughout hospitalization and involves one-on-one guided sessions and daily practice using a 17-minute meditation CD. Of the 20 participants, 78.9% completed the intervention. Statistically significant decreases in heart and respiratory rates and improvements in symptoms immediately before and after each session were found. These findings demonstrate feasibility and preliminary support of a mindfulness meditation intervention with symptomatic, hospitalized cancer patients.

Bauer-Wu S, Sullivan AM, Rosenbaum E, Ott MJ, Powell M, McLoughlin M, Healey MW. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA. sbauerw@emory.edu Integr Cancer Ther. 2008 Jun;7(2):62-9.

Migraine headaches are associated with symptoms of depression and anxiety (Waldie and Poulton Journal of Neurology, Neurosurgery, and Psychiatry 72: 86-92, 2002) and feelings of low self-efficacy (French et al. Headache, 40: 647-656, 2000). Previous research suggests that spiritual meditation may ameliorate some of the negative traits associated with migraine headaches (Wachholtz and Pargament Journal of behavioral Medicine, 30: 311-318, 2005). This study examined two primary questions: (1) Is spiritual meditation more effective in enhancing pain tolerance and reducing migraine headache related symptoms than secular meditation and relaxation? and, (2) Does spiritual meditation create better mental, physical, and spiritual health outcomes than secular meditation and relaxation techniques? Eighty-three meditation naïve, frequent migraineurs were taught Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Secular Meditation, or Muscle Relaxation which participants practiced for 20 min a day for one month. Pre-post tests measured pain tolerance (with a cold pressor task), headache frequency, and mental and spiritual health variables. Compared to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and negative affect, as well as greater increases in pain tolerance, headache-related self-efficacy, daily spiritual experiences, and existential well being.

Wachholtz AB, Pargament KI. Department of Psychiatry, University of Mass Medical Center, 55 Lake Ave, Worcester, MA, 01655, USA, WachholA@ummhc.org. J Behav Med. 2008 Aug;31(4):351-66.

Chronic pain is a complex phenomenon that causes a significant disruption in the lives of those affected. Chronic pain is difficult to treat and challenges healthcare professionals' abilities to implement effective treatments. Therefore, chronic pain sufferers often seek complementary alternative medicine therapies such as meditation. Literature reviews have examined studies using mindfulness-based stress reduction program as an intervention for a variety of health problems. However, no reviews exist looking at a specific patient population's utilization of meditation-based programs. Therefore, the purpose of this integrative review is to examine studies that have investigated meditation as an intervention for chronic pain, identify gaps in the literature, and make recommendations for further research.

Teixeira ME. Hightstown Medical Associates, East Windsor, NJ 08520, USA. Bet3079@comcast.net Holist Nurs Pract. 2008 Jul-Aug;22(4):225-34.

To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP), we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an 8-week mindfulness meditation program. Participants were 27 adults >/=65 years of age with CLBP of at least moderate severity and of at least 3 months duration. We found several themes reflecting the beneficial effects of mindfulness meditation on pain, attention, sleep, and achieving well-being. Various methods of pain reduction were used, including distraction, increased body awareness leading to behavior change, better pain coping, and direct pain reduction through meditation. Participants described improved attention skills. A number of participants reported improved sleep latency as well as quality of sleep. Participants described achieving well-being during and after a meditation session that had immediate effects on mood elevation but also long-term global effects on improved quality of life. Several themes were identified related to pain reduction, improved attention, improved sleep, and achieving well-being resulting from mindfulness meditation that suggest it has promising potential as a nonpharmacologic treatment of chronic pain for older adults. PERSPECTIVE: Community-dwelling older adults with chronic low back pain experience numerous benefits from mindfulness meditation including less pain, improved attention, better sleep, enhanced well-being, and improved quality of life. Additional research is needed to determine how mindfulness meditation works and how it might help with other chronic illnesses.

Morone NE, Lynch CS, Greco CM, Tindle HA, Weiner DK. Department of Medicine, Division of General Internal Medicine, Pittsburgh, Pennsylvania. J Pain. 2008 Jun 10.

The purpose of this study was to examine the outcomes of individual Buddhist counseling interventions for patients suffering from symptoms of anxiety. A single-group pretest and posttest design was used to measure outcomes. Twenty-one patients participated in the study as voluntary subjects, all of whom completed two sessions of Buddhist counseling interventions. The individual Buddhist counseling program was developed by the investigators based on the Buddhist doctrine. The outcomes were evaluated with the use of the State-Trait Anxiety Inventory. Data were analyzed using the Friedman test, which provides an indicator for evidence-based outcomes related to anxiety reduction scores. The results revealed that the scores on the state anxiety test in relation to the trait anxiety test had been reduced at the 1-month follow-up. The findings from content analysis showed that when the patients practiced mindfulness, they were able to accept unpleasant situations calmly. Sixteen patients were prescribed lower doses of antianxiety medications. Furthermore, medication was discontinued for two patients, and three other patients continued their prescribed medication regimen completely. The study indicates that counseling as a basis from Buddhist principles has the potential to benefit patients with emotional anxiety-based problems.

Rungreangkulkij S, Wongtakee W. Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand. somrun@kku.ac.th Arch Psychiatr Nurs. 2008 Jun;22(3):127-34.

This randomized pilot study investigated the effects of meditation with yoga (and psychoeducation) versus group therapy with hypnosis (and psychoeducation) versus psychoeducation alone on diagnostic status and symptom levels among 46 individuals with long-term depressive disorders. Results indicate that significantly more meditation group participants experienced a remission than did controls at 9-month follow-up. Eight hypnosis group participants also experienced a remission, but the difference from controls was not statistically significant. Three control participants, but no meditation or hypnosis participants, developed a new depressive episode during the study, though this difference did not reach statistical significance in any case. Although all groups reported some reduction in symptom levels, they did not differ significantly in that outcome. Overall, these results suggest that these two interventions show promise for treating low- to moderate-level depression. Copyright 2008 Wiley Periodicals, Inc.

Butler LD, Waelde LC, Hastings TA, Chen XH, Symons B, Marshall J, Kaufman A, Nagy TF, Blasey CM, Seibert EO, Spiegel D. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-571, USA. butler@stanford.edu J Clin Psychol. 2008 Jul;64(7):806-20.

The novelty of this study was to investigate the changes in cardiorespiratory and metabolic intensity brought about by the practice of pranayamas (breathing exercises of yoga) and meditation during the same hatha-yoga session. The technique applied was the one advocated by the hatha-yoga system. Nine yoga instructors-five females and four males, mean age of 44 +/- 11, 6, were subjected to analysis of the gases expired during three distinct periods of 30 min: rest, respiratory exercises and meditative practice. A metabolic open circuit computerized system was applied (VO2000, MedGraphics-USA). The oxygen uptake (VO(2)) and the carbon dioxide output (VCO(2)) were statistically different (P Appl Psychophysiol Biofeedback. 2008 Mar 4 Danucalov MA, Simões RS, Kozasa EH, Leite JR. Unidade de Medicina Comportamental, Depto. de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925, CEP 04024-002, Sao Paulo, Brazil.

Previous research on assessment of mindfulness by self-report suggests that it may include five component skills: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. These elements of mindfulness can be measured with the Five Facet Mindfulness Questionnaire (FFMQ). The authors investigated several aspects of the construct validity of the FFMQ in experienced meditators and nonmeditating comparison groups. Consistent with predictions, most mindfulness facets were significantly related to meditation experience and to psychological symptoms and well-being. As expected, relationships between the observing facet and psychological adjustment varied with meditation experience. Regression and mediation analyses showed that several of the facets contributed independently to the prediction of well-being and significantly mediated the relationship between meditation experience and well-being. Findings support the construct validity of the FFMQ in a combination of samples not previously investigated.

Assessment. 2008 Feb 29 Baer RA, Smith GT, Lykins E, Button D, Krietemeyer J, Sauer S, Walsh E, Duggan D, Williams JM.

Meditation can be conceptualized as a family of complex emotional and attentional regulatory training regimes developed for various ends, including the cultivation of well-being and emotional balance. Among these various practices, there are two styles that are commonly studied. One style, focused attention meditation, entails the voluntary focusing of attention on a chosen object. The other style, open monitoring meditation, involves nonreactive monitoring of the content of experience from moment to moment. The potential regulatory functions of these practices on attention and emotion processes could have a long-term impact on the brain and behavior.

Trends Cogn Sci. 2008 Mar 6 Lutz A, Slagter HA, Dunne JD, Davidson RJ. Waisman Laboratory for Brain Imaging and Behavior, Department of Psychology, University of Wisconsin, Madison, WI 53705, USA.

Here we report that a specific form of yoga can generate controlled high-frequency gamma waves. For the first time, paroxysmal gamma waves (PGW) were observed in eight subjects practicing a yoga technique of breathing control called Bhramari Pranayama (BhPr). To obtain new insights into the nature of the EEG during BhPr, we analyzed EEG signals using time-frequency representations (TFR), independent component analysis (ICA), and EEG tomography (LORETA). We found that the PGW consists of high-frequency biphasic ripples. This unusual activity is discussed in relation to previous reports on yoga and meditation. It is concluded this EEG activity is most probably non-epileptic, and that applying the same methodology to other meditation recordings might yield an improved understanding of the neurocorrelates of meditation.

Conscious Cogn. 2008 Feb 23 Vialatte FB, Bakardjian H, Prasad R, Cichocki A. RIKEN Brain Science Institute, Laboratory for Advanced Brain Signal Processing, 2-1 Hirosawa, Wako-Shi, Saitama-Ken 351-0198, Japan.

The effects of a mindfulness-based procedure, called Meditation on the Soles of the Feet, were evaluated as a cognitive-behavioral intervention for physical aggression in 6 offenders with mild intellectual disabilities. They were taught a simple meditation technique that required them to shift their attention and awareness from the precursors of aggression to the soles of their feet, a neutral point on their body. Results showed that physical and verbal aggression decreased substantially, no Stat medication or physical restraint was required, and there were no staff or peer injuries. Benefit-cost analysis of lost days of work and cost of medical and rehabilitation because of injury caused by these individuals in both the 12 months prior to and following mindfulness-based training showed a 95.7% reduction in costs. This study suggests that this procedure may be a clinically effective and cost-effective method of enabling adult offenders with intellectual disabilities to control their aggression.

Behav Modif. 2008 Mar 24 Singh NN, Lancioni GE, Winton AS, Singh AN, Adkins AD, Singh J. ONE Research Institute.

Recent brain imaging studies using functional magnetic resonance imaging (fMRI) have implicated insula and anterior cingulate cortices in the empathic response to another's pain. However, virtually nothing is known about the impact of the voluntary generation of compassion on this network. To investigate these questions we assessed brain activity using fMRI while novice and expert meditation practitioners generated a loving-kindness-compassion meditation state. To probe affective reactivity, we presented emotional and neutral sounds during the meditation and comparison periods. Our main hypothesis was that the concern for others cultivated during this form of meditation enhances affective processing, in particular in response to sounds of distress, and that this response to emotional sounds is modulated by the degree of meditation training. The presentation of the emotional sounds was associated with increased pupil diameter and activation of limbic regions (insula and cingulate cortices) during meditation (versus rest). During meditation, activation in insula was greater during presentation of negative sounds than positive or neutral sounds in expert than it was in novice meditators. The strength of activation in insula was also associated with self-reported intensity of the meditation for both groups. These results support the role of the limbic circuitry in emotion sharing. The comparison between meditation vs. rest states between experts and novices also showed increased activation in amygdala, right temporo-parietal junction (TPJ), and right posterior superior temporal sulcus (pSTS) in response to all sounds, suggesting, greater detection of the emotional sounds, and enhanced mentation in response to emotional human vocalizations for experts than novices during meditation. Together these data indicate that the mental expertise to cultivate positive emotion alters the activation of circuitries previously linked to empathy and theory of mind in response to emotional stimuli.

PLoS ONE. 2008 Mar 26;3(3):e1897. Lutz A, Brefczynski-Lewis J, Johnstone T, Davidson RJ. University of Wisconsin, Madison, Wisconsin, United States of America. alutz@wisc.edu

Objectives: The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). Subjects: Fifty (50) subjects were recruited from the community and took part in MBSR (n = 36) and CBSR (n = 14) courses. Participants self-selected into MBSR or CBSR courses taught at different times. There were no initial differences between the MBSR and CBSR subjects on demographics, including age, gender, education, and income. Intervention: MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. Design: Perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain, and mindfulness were assessed before and after each course. Pre-post scores for each intervention were compared by using paired t tests. Pre-post scores across interventions were compared by using a general linear model with repeated measures. Settings/Locations: Weekly meetings for both courses were held in a large room on a university medical center campus. Results: MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. Conclusions: While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain. Future studies should continue to examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.

J Altern Complement Med. 2008 Mar 27 Smith BW, Shelley BM, Dalen J, Wiggins K, Tooley E, Bernard J. University of New Mexico, Albuquerque, NM.

Objective: Assess changes in quality of life and in sense of coherence (SOC), after an intervention involving a self-development course using mind-body medicine (MBM) activities. Design A questionnaire study using a health-related quality of life (HRQOL) instrument, the SWEDQUAL, with 13 subscales and scores ranging from 0 to 100, combined with the SOC-13 scale, healthcare utilisation, medication and sick listing data. Setting A training centre for MBM. Eligible course attendants (study group, SG, n = 83) assessed their HRQOL before and 6 months after a 1-week course. A control group (CG) of individuals who had previously attended the course (n = 69), matched for age, sex and length of course time to the SG, also made assessments. Main outcome Changes in HRQOL and SOC in SG and CG. Results Of the 13 HRQOL subscales, eight showed clinically significant improvement in the SG (>9%, p < 0.01), namely, General health perceptions (9%), Emotional well-being [negative (45%) and positive (26%)], Cognitive functioning (24%), Sleep (15%), Pain (10%), Role limitation due to emotional health (22%) and Family functioning (16%). Sexual, marital and physical function and role in the SG as well as all CG scores were similar to average population values. The assessed SOC also improved in the SG after intervention (p < 0.01), challenging previous statements of 'the stableness of SOC'. Use of psychotropic medication was slightly reduced in the younger aged SG participants after intervention. Conclusions This group of men and women (SG), starting from a clinically significant low health assessment, had improved their HRQOL and SOC after the course intervention.

Qual Life Res. 2008 Apr;17(3):367-376. Fernros L, Furhoff AK, Wändell PE. Karolinska Institutet/Stockholm County Council's Center for Family and Community Medicine, Huddinge, Sweden, lotta.fernros@sll.se.

Individuals with Prader-Willi syndrome have hyperphagia, a characteristic eating disorder defined by a marked delay in the satiety response when compared to controls. This eating disorder has been particularly difficult to control. The authors taught and evaluated effectiveness of regular exercise alone, regular exercise plus healthy eating, and mindfulness-based strategies combined with exercise and healthy eating to an adolescent with this syndrome. Mindfulness-based strategies included mindful eating, visualizing and labeling hunger, and rapidly shifting attention away from hunger by engaging in Meditation on the Soles of the Feet. On average, when compared to baseline levels, there were decreases in weight with regular exercise and exercise plus healthy eating, but the most consistent and sustained changes were evidenced when mindfulness training was added to exercise and healthy eating. The adolescent continued using the mindfulness health wellness program and further reduced his weight during the 3-year follow-up period.

Behav Modif. 2008 Mar;32(2):167-81. Singh NN, Lancioni GE, Singh AN, Winton AS, Singh J, McAleavey KM, Adkins AD. ONE Research Institute, Midlothian, Virginia, USA. nirbsingh52@aol.com

Substantial evidence indicates that psychosocial stress contributes to hypertension and cardiovascular disease (CVD). Previous meta-analyses of stress reduction and high blood pressure (BP) were outdated and/or methodologically limited. Therefore, we conducted an updated systematic review of the published literature and identified 107 studies on stress reduction and BP. Seventeen trials with 23 treatment comparisons and 960 participants with elevated BP met criteria for well-designed randomized controlled trials and were replicated within intervention categories. Meta-analysis was used to calculate BP changes for biofeedback, -0.8/-2.0 mm Hg (P = NS); relaxation-assisted biofeedback, +4.3/+2.4 mm Hg (P = NS); progressive muscle relaxation, -1.9/-1.4 mm Hg (P = NS); stress management training, -2.3/-1.3 mm (P = NS); and the Transcendental Meditation program, -5.0/-2.8 mm Hg (P = 0.002/0.02). Available evidence indicates that among stress reduction approaches, the Transcendental Meditation program is associated with significant reductions in BP. Related data suggest improvements in other CVD risk factors and clinical outcomes.

Curr Hypertens Rep. 2007 Dec;9(6):520-8. Rainforth MV, Schneider RH, Nidich SI, Gaylord-King C, Salerno JW, Anderson JW.

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.

Mindfulness meditation (MfM) is a mind-body therapy identified by the National Center for Complementary and Alternative Medicine. Initially taught in a formal classroom setting, MfM is a sustainable intervention with minimal costs that can be used over time. For veterans, after mastery, this technique shows promise in improving health outcomes and quality of life. This article describes MfM, discusses the conceptual framework and evidence-based research for MfM, and identifies the implications of MfM use by health care providers who are caring for war veterans.

AAOHN J. 2008 Aug;56(8):357-63. Cuellar NG. School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.

This randomized controlled trial investigated effects of Transcendental Meditation (TM) practice on Brain Integration Scale scores (broadband frontal coherence, power ratios, and preparatory brain responses), electrodermal habituation to 85-dB tones, sleepiness, heart rate, respiratory sinus arrhythmia, and P300 latencies in 50 college students. After pretest, students were randomly assigned to learn TM immediately or learn after the 10-week posttest. There were no significant pretest group differences. A MANOVA of students with complete data (N=38) yielded significant group vs treatment interactions for Brain Integration Scale scores, sleepiness, and habituation rates (all p<.007). Post hoc analyses revealed significant increases in Brain Integration Scale scores for Immediate-start students but decreases in Delayed-start students; significant reductions in sleepiness in Immediate-start students with no change in Delayed-start students; and no changes in habituation rates in Immediate-start students, but significant increases in Delayed-start students. These data support the value of TM practice for college students.

Int J Psychophysiol. 2008 Sep 30. Travis F, Haaga DA, Hagelin J, Tanner M, Nidich S, Gaylord-King C, Grosswald S, Rainforth M, Schneider RH. Center for the Brain, Consciousness and Cognition, Maharishi University of Management, 1000 North 4th Street, Fairfield, IA 52557, United States.

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.

This study aims at investigating changes in heart rate variability (HRV) measured during meditation. The statistical and spectral measures of HRV from the RR intervals were analyzed. Results indicate that meditation may have different effects on health depending on frequency of the resonant peak that each meditator can achieve. The possible effects may concern resetting baroreflex sensitivity, increasing the parasympathetic tone, and improving efficiency of gas exchange in the lung.

Int J Cardiol. 2007 Aug 29 Phongsuphap S, Pongsupap Y, Chandanamattha P, Lursinsap C. Department of Computer Science, Faculty of Science, Mahidol University, Rama 6 road, Ratchathewi, Bangkok 10400, Thailand.