WEEK 9 Mind Body Interventions Mindfulness Mind Body Interventions anything that uses the mind s capacity to affect bodily function and symptoms Types of Mind Body Interventions Traditional Cognitive behavioral therapy Stress Management Support groups Alternative CAM Mediation Tai Chi Yoga Relaxation Hypnosis Imagery Biofeedback Qi Gong Spirituality Dance Art Music Therapy Cam Interventions 38 of Americans reported use of CAM in 2007 survey Growing use of CAM interventions 40 45 of the adults US population have used CAM therapies in the past 12 months In CA 65 have used CAM therapies in the past 12 months Particularly high use among people with chronic medical conditions 80 of breast cancer survivors in CA reported use of CAM in a 2011 report Mind Wandering Happiness Over 2k adults were contacted with iPhones at random moments in the day and were asked how they are doing and if they were thinking about something other than what they are doing Mind wandering occurred in 46 9 of samples People were less happy when their minds were wandering Telomere Length 267 midlife women completed questionnaires and provided blood samples for evaluation of telomere length marker of cell aging Women who reported more mind wandering had shorter telomeres Mindfulness Meditation Mindfulness meditation is currently the most popular type of meditative practice Mindfulness is paying attention to present moment experiences with openness and curiosity without judgment Originated in Eastern meditation practices non secular version popularized by John Kabat Zinn Mindfulness Based Stress Reduction 8 Weekly 3 hour group classes in addition to silent 7 hour retreat and daily homework Focus on cultivating mindfulness through formal practices such as sitting and walking meditations Also integrating mindfulness into daily life to help cope with physical symptoms and emotional situations Empirical Research on Mindfulness Its been investigated in trials with clinical and non clinical populations Medical conditions heart disease HIV cancer diabetes autoimmune disease fibromyalgia pain and obesity Psychiatric conditions depression anxiety eating disorders insomnia Other veterans low income African American older adults medical students and urban youth Effects on Psychological and Physical Outcomes Meta analysis of 47 randomized controlled mediation trials with active control groups 15 psychiatric populations 5 with smokers and alcoholics 5 with chronic pain 16 with diverse medical conditions Mindfulness and the X Y Z Model Few if any studies have examined health effects of mindfulness programs so we cant determine what takes us from X to Z Effects of mindfulness on mechanisms the Y Immune system HPA axis SNS Davidson et al MBSR Trial One of the first MBSR trials to look at immune outcomes Focus on antibody response to vaccination We know that chronic stress decreases the immune system s ability to make antibodies Results Decreases in anxiety Increases in antibody response to the influenza vaccine Mindfulness and HIV MBSR trials for individuals with HIV have shown reduction in medication related side effects and lower avoidance higher positive affect Both have been linked to health outcomes in HIV Creswell et al MBSR Mindfulness based stressed reduction trial Two arm RCT randomized control trials comparing MBSR of 47 HIV men MBSR buffers CD4 T cell decline Mindfulness and Inflammation Two arm RCT comparing mindfulness and lifestyle education on 186 OSU staff members with an elevated CRP inflammation Did low dose MBSR one hour lunchtime meetings per week for 8 weeks Results No change in perceived stress or depression Decrease in CRP in mindfulness group but it wasn t significant and there was no change in any other inflammatory markers Stress Induced Inflammation Two arm RCT comparing 6 week compassion meditation to health education Approach designed to challenge one s unexamined thoughts and emotions toward other people and develop altruistic emotions and behavior Check cortisol inflammatory and behavioral responses to acute stressor in 61 undergrads Results No intervention effect on cortisol IL 6 or distress following acute stressor IL 6 response were correlated with mediation practice those who practiced more showed lower IL 6 levels after stressors Lonely Older Adults Two arm randomized control trials that compared mindfulness to wait list control in 40 lonely older adults Mindfulness group showed decreased loneliness and decreased expression of genes that are pro inflammatory Young Breast Cancer Survivors Younger survivors have higher levels of stress and distress with potential negative implications for cancer outcomes Inflammation predicts poor survival in breast cancer survivors Trial design two arm RCT comparing mindfulness to a waitlist control 6 week mindful awareness program tailored for breast cancer survivors including formal meditation practice informal use of mindfulness and information on health and well being after cancer Results See declines in perceived stress and depressive symptoms from baseline to post treatment in mindfulness group Saw improvements in self compassion Decreased expression of genes that make pro inflammatory cytokines in mindfulness Decrease in key transcription factor that regulates pro inflammatory gene expression NF kB Summary Strong evidence for effect on anxiety and depression Emerging evidence for effects on immune markers and inflammation Beneficial effects observed on some immune outcomes CD4 T cells in HIV antibody response Recent trials have shown reduction in inflammatory gene expression Yoga and Tai Chi Empirical Research on Yoga Yoga is traditionally believed to have beneficial effects on mental and physical health and the body of empirical research is growing Its been studied among patients with asthma cardiac conditions arthritis kyphosis multiple sclerosis epilepsy headache depression diabetes pain GI disorders and addictions Some trials show beneficial effects on cardiopulmonary function perceptual and motor skills and functional abilities as well as mood and pain Cortisol Yoga interventions are associated with reductions in cortisol especially morning cortisol especially morning cortisol levels Acute effects undergrads randomized in a single yoga session had decreases in cortisol relative to African dance or a biology lecture Inflammation Study 1 Observational study compared expert and new yoga practitioners before during and after a standard yoga session and