Palliat Med. 2007 Apr;21(3):207-17.

Becker G, Xander CJ, Blum HE, Lutterbach J, Momm F, Gysels M, Higginson IJ.

BACKGROUND: Responses to bereavement may be influenced by characteristics such as age or gender, but also by factors like culture and religion. AIM: A systematic review was undertaken to assess whether spiritual or religious beliefs alter the process of grief and/or bereavement. METHODS: Fifteen computerized databases were searched. Thirty-two studies met the inclusion criteria. Evidence was graded according to the standard grading system of the Clinical Outcomes Group and by the SIGNAL score. RESULTS: In total, 5715 persons were examined: 69% women, 87% white, 83% protestant. Ninety-four percent of studies show some positive effects of religious/spiritual beliefs on bereavement, but there was a great heterogeneity regarding included populations and outcome measurements. CONCLUSION: Available data do not allow for a definite answer on whether religious/spiritual beliefs effectively influence bereavement as most studies suffer from weaknesses in design and methodological flaws. Further research is needed. Recommendations for further research are given. Palliative Medicine 2007; 21: 207-217.

Psychosom Med. 2007 Jul;69(6):501-8.

Blumenthal JA, Babyak MA, Ironson G, Thoresen C, Powell L, Czajkowski S, Burg M, Keefe FJ, Steffen P, Catellier D; for the ENRICHD Investigators.

Objective: To assess the prospective relationship between spiritual experiences and health in a sample of patients surviving an acute myocardial infarction (AMI) with depression or low social support. Methods: A subset of 503 patients participating in the enhancing recovery in coronary heart disease (ENRICHD) trial completed a Daily Spiritual Experiences (DSE) questionnaire within 28 days from the time of their AMI. The questionnaire assessed three spirituality variables-worship service/church attendance, prayer/meditation, and total DSE score. Patients also completed the Beck Depression Inventory to assess depressive symptoms and the ENRICHD Social Support Inventory to determine perceived social support. The sample was subsequently followed prospectively every 6 months for an average of 18 months to assess all-cause mortality and recurrent AMI. Results: Of the 503 participants who completed the DSE questionnaire at the time of index AMI, 61 (12%) participants either died or sustained a recurrent MI during the follow-up period. After adjustment for gender, education level, ethnicity, and a composite medical prognosis risk score derived specifically for the ENRICHD trial, we observed no relationship between death or nonfatal AMI and total spirituality as measured by the DSE (p = .446), worship service attendance (p = .120), or frequency of prayer/meditation (p = .679). Conclusion: We found little evidence that self-reported spirituality, frequency of church attendance, or frequency of prayer is associated with cardiac morbidity or all-cause mortality post AMI in patients with depression and/or low perceived support

Am J Kidney Dis. 2007 Jul;50(1):124-32, 132.

Lai CF, Kao TW, Wu MS, Chiang SS, Chang CH, Lu CS, Yang CS, Yang CC, Chang HW, Lin SL, Chang CJ, Chen PY, Wu KD, Tsai TJ, Chen WY.

BACKGROUND: People who have come close to death may report an unusual experience known as a near-death experience (NDE). This study aims to investigate NDEs and their aftereffects in dialysis patients. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: 710 dialysis patients at 7 centers in Taipei, Taiwan. PREDICTOR: Demographic characteristics, life-threatening experience, depression, and religiosity. OUTCOMES: NDE and self-perceived changes in attitudes or behaviors. MEASUREMENTS: Greyson's NDE scale, Royal Free Questionnaire, 10-Question Survey, Ring's Weighted Core Experience Index, and Beck Depression Inventory. RESULTS: 45 patients had 51 NDEs. Mean NDE score was 11.9 (95% confidence interval, 11.0 to 12.9). Out-of-body experience was found in 51.0% of NDEs. Purported precognitive visions, awareness of being dead, and "tunnel experience" were uncommon (<10%). Compared with the no-NDE group, subjects in the NDE group were more likely to be women and younger at life-threatening events. Both frequency of participation in religious ceremonies and pious religious activity correlated significantly with NDE score in patients with NDEs (P < 0.01 and P = 0.01, respectively). The NDE group reported being kinder to others (P = 0.04) and more motivated (P = 0.02) after their life-threatening events than the no-NDE group. LIMITATIONS: Determining the incidence of NDEs is dependent on self-reporting. Many NDEs occurred before the patient began long-term dialysis therapy. Causality between NDE and aftereffects cannot be inferred. CONCLUSIONS: NDE is not uncommon in the dialysis population and is associated with positive aftereffects. Nephrology care providers should be aware of the occurrence and aftereffects of NDEs. The high occurrence of life-threat

J Health Psychol. 2007 Jul;12(4):580-96.

Ai AL, Peterson C, Tice TN, Huang B, Rodgers W, Bolling SF.

To address the inconsistent findings and based on Hegel's dialectic contradictive principle, this study tested a parallel mediation model that may underlie the association of using prayer for coping with cardiac surgery outcomes. Three sequential interviews were conducted with 310 patients who underwent open-heart surgery. A structural equation model demonstrated that optimism mediated the favorable effect of prayer coping. Prayer coping was also related to preoperative stress symptoms, which had a counterbalance effect on outcomes. Age was associated with better preoperative mental health, but age-related chronic conditions were associated with poor outcomes; both of these were mediated through the same mediators.

J Soc Integr Oncol. 2007 Spring;5(2):53-60.

Ambs AH, Miller MF, Smith AW, Goldstein MS, Hsiao AF, Ballard-Barbash R

Religion and spirituality in the context of health care are poorly understood, particularly for individuals with chronic illness. Using data from the 2003 Complementary and Alternative Medicine supplement to the 2001 California Health Interview Survey, we examined whether cancer survivors (n = 1,777) and individuals with other chronic illnesses (n = 4,784) were either more likely to identify themselves as religious and spiritual or more likely to use religious and spiritual practices for health purposes than individuals with no disease (n = 2,342). We observed that cancer survivors and individuals with chronic illnesses were more likely than those with no disease to use religious and spiritual prayer and healing practices. Individuals with chronic diseases were not inherently more likely to identify themselves as religious than were healthy individuals and were only slightly more likely to identify themselves as spiritual. These findings indicate that individuals with cancer and other chronic illnesses may be using religious and spiritual practices as a way to cope with their illness. Future research should continue to examine whether and how religious and spiritual practices are used as complementary or alternative medicine, and health care professionals should ask their patients about such use.

Int J Geriatr Psychiatry. 2007 May 15;

Payman V, George K, Ryburn B.

OBJECTIVES: To determine the prevalence of religious practices and beliefs of depressed elderly Australian inpatients and their relationship to physical, social, and cognitive variables known to influence the prognosis of depression in the elderly. To compare the results obtained with those from similar North American studies. METHODS AND PROCEDURES: Inpatients with a DSM-IV diagnosis of major depression were interviewed on admission to the psychogeriatric unit of a Melbourne geriatric centre. Information collected included patient demographics, intrinsic and extrinsic religiosity, cognitive function, severity of depression, number of chronic illnesses, physical function, and numbers and quality of social support. Pearson correlation and multivariate analysis using a standard regression model were used to examine relationships between the religious and other variables. RESULTS: Of the 86 patients who completed the assessment, 25% attended church regularly and 37% prayed, meditated, or read the Bible, at least once a day. Just over half rarely or never engaged in such behaviours. Three out of every eight patients were 'intrinsically' religious. Religious patients expressed higher levels of social support and physically disabled patients were more likely to be religious. CONCLUSIONS: Depressed elderly Australian inpatients are less religious than their North American counterparts. Nevertheless, religion remains important for a large minority of such individuals. Clinicians need to be aware that such individuals may turn to religion when depressed, especially to cope with the presence of physical disability.

J Nerv Ment Dis. 2007 May;195(5):382-8.

Murray-Swank A, Goldberg R, Dickerson F, Medoff D, Wohlheiter K, Dixon L.

The purpose of this study was to examine the prevalence and correlates of religious participation among persons with co-occurring serious mental illness and type 2 diabetes. Among 201 outpatients, 53% attended religious services, 36% had regular contact with a religious leader, and 15% received assistance from a religious leader. Persons with schizophrenia and African Americans were more likely to attend services and have contact with religious leaders. Both attendance at religious services and regular contact with a religious leader were linked to higher quality of life in selected domains, but not associated with global health ratings or glycosylated hemoglobin (HbA1c) levels. Results indicate that there are important diagnostic and racial differences in religious participation, and that religious participation may be a resilience factor that supports enhanced quality of life for persons with serious mental illness and diabetes.

J Aging Health. 2007 Jun;19(3):537-53.

Benjamins MR, Finlayson M

PURPOSE: The purpose of this study is to examine the use of religious services to improve health among middle-aged and older adults with multiple sclerosis (MS). METHOD: Data from the study "Aging With MS: Unmet Needs in the Great Lakes Region" were used to investigate religious service use among 1,275 adults with MS. RESULTS: The findings indicate that nearly two thirds of the sample currently use religious services to improve their health or well-being. Individuals whose MS is stable and those who have had the disease longer are significantly more likely to use religious services to improve their health. CONCLUSIONS: Religious organizations should continue providing out-reach and increasing accessibility for individuals with disabling conditions. In addition, health care professionals should be aware of the importance of religious services to individuals with MS and do their part to facilitate participation for those who desire it.

BMC Med Educ. 2007 May 2;7:9.

Yi MS, Mrus JM, Mueller CV, Luckhaupt SE, Peterman AH, Puchalski CM, Tsevat J.

BACKGROUND: The stress associated with residency training may place house officers at risk for poorer health. We sought to determine the level of self-reported health among resident physicians and to ascertain factors that are associated with their reported health. METHODS: A questionnaire was administered to house officers in 4 residency programs at a large Midwestern medical center. Self-rated health was determined by using a health rating scale (ranging from 0 = death to 100 = perfect health) and a Likert scale (ranging from "poor" health to "excellent" health). Independent variables included demographics, residency program type, post-graduate year level, current rotation, depressive symptoms, religious affiliation, religiosity, religious coping, and spirituality. RESULTS: We collected data from 227 subjects (92% response rate). The overall mean (SD) health rating score was 87 (10; range, 40-100), with only 4 (2%) subjects reporting a score of 100; on the Likert scale, only 88 (39%) reported excellent health. Lower health rating scores were significantly associated (P < 0.05) with internal medicine residency program, post-graduate year level, depressive symptoms, and poorer spiritual well-being. In multivariable analyses, lower health rating scores were associated with internal medicine residency program, depressive symptoms, and poorer spiritual well-being. CONCLUSION: Residents' self-rated health was poorer than might be expected in a cohort of relatively young physicians and was related to program type, depressive symptoms, and spiritual well-being. Future studies should examine whether treating depressive symptoms and attending to spiritual needs can improve the overall health and well-being of primary care house officers.

Neurology. 2007 May 1;68(18):1509-14.

Kaufman Y, Anaki D, Binns M, Freedman M.

OBJECTIVE: To assess effects of quality of life (QOL), spirituality, and religiosity on rate of progression of cognitive decline in Alzheimer disease (AD). METHODS: In this longitudinal study, we recruited 70 patients with probable AD. The Mini-Mental State Examination was used to monitor the rate of cognitive decline. Religiosity and spirituality were measured using standardized scales that assess spirituality, religiosity, and organizational and private religious practices. We conducted a simultaneous multiple linear regression analysis for factors contributing to rate of cognitive decline. RESULTS: After controlling for baseline level of cognition, age, sex, and education, a slower rate of cognitive decline was associated with higher levels of spirituality (p < 0.05) and private religious practices (p < 0.005). These variables accounted for 17% of the total variance [F(11,58) = 2.24, p < 0.05]. There was no correlation between rate of cognitive decline and QOL. CONCLUSION: Higher levels of spirituality and private religious practices, but not quality of life, are associated with slower progression of Alzheimer disease.

South Med J. 2007 Apr;100(4):349-55.

Knight JR, Sherritt L, Harris SK, Holder DW, Kulig J, Shrier LA, Gabrielli J, Chang G.

BACKGROUND: Previous studies indicate that religiousness is associated with lower levels of substance use among adolescents, but less is known about the relationship between spirituality and substance use. The objective of this study was to determine the association between adolescents' use of alcohol and specific aspects of religiousness and spirituality. METHODS: Twelve- to 18-year-old patients coming for routine medical care at three primary care sites completed a modified Brief Multidimensional Measure of Religiousness/Spirituality; the Spiritual Connectedness Scale; and a past-90-days alcohol use Timeline Followback calendar. We used multiple logistic regression analysis to assess the association between each religiousness/spirituality measure and odds of any past-90-days alcohol use, controlling for age, gender, race/ethnicity, and clinic site. Timeline Followback data were dichotomized to indicate any past-90-days alcohol use and religiousness/spirituality scale scores were z-transformed for analysis. RESULTS: Participants (n = 305) were 67% female, 74% Hispanic or black, and 45% from two-parent families. Mean +/- SD age was 16.0 +/- 1.8 years. Approximately 1/3 (34%) reported past-90-day alcohol use. After controlling for demographics and clinic site, Religiousness/Spirituality scales that were not significantly associated with alcohol use included: Commitment (OR = 0.81, 95% CI 0.36, 1.79), Organizational Religiousness (OR = 0.83, 95% CI 0.64, 1.07), Private Religious Practices (OR = 0.94, 95% CI 0.80, 1.10), and Religious and Spiritual Coping--Negative (OR = 1.07, 95% CI 0.91, 1.23). All of these are measures of religiousness, except for Religious and Spiritual Coping--Negative. Scales that were significantly and negatively associated with alcohol use included: Forgiveness (OR = 0.55, 95% CI 0.42-0.73), Religious and Spiritual Coping--Positive (OR = 0.67, 95% CI 0.51-0.84), Daily Spiritual Experiences (OR = 0.67, 95% CI 0.54-0.84), and Belief (OR = 0.76, 95% CI 0.68-0.83), which are all measures of spirituality. In a multivariable model that included all significant measures, however, only Forgiveness remained as a significant negative correlate of alcohol use (OR = 0.56, 95% CI 0.41, 0.74). CONCLUSIONS: Forgiveness is associated with a lowered risk of drinking during adolescence.

J Adolesc Health. 2007 May;40(5):440-7

Rostosky SS, Danner F, Riggle ED.

PURPOSE: Previous research has documented that substance use peaks during young adulthood and that religiosity provides a protective effect against binge drinking, marijuana use, and cigarette smoking. The majority of these studies do not examine sexual identity as it relates to these factors. Drawing on social influence and developmental theories, we tested the hypothesis that religiosity would provide a protective effect for heterosexual but not sexual minority young adults. METHOD: Waves 1 and 3 of the National Longitudinal Study of Adolescent Health provided data for the study. Three young adult sexual identity groups were formed: sexual minorities who did not report same-sex attraction at Wave 1 (NA), sexual minorities who did report same-sex attraction at Wave 1 (SSA), and heterosexuals (HET) (sample n = 764). RESULTS: Religiosity measured at baseline had no significant effect on past-year substance use, measured six years later in sexual minority young adults. For heterosexual young adults, each unit increase in religiosity reduced the odds of binge drinking by 9%, marijuana use by 20%, and cigarette smoking by 13%. CONCLUSIONS: Religiosity was not protective against substance use in sexual minority young adults, cautioning against over-generalizing previous findings about the protective effects of religiosity. Future studies that 1) consider the social context for sexual identity development, 2) model both risk and protective factors, and 3) use multidimensional measures of religiosity (and spirituality) and sexual identity are needed to build the necessary knowledge base for effective health promotion efforts among sexual minority youth and young adults.

Int J Psychiatry Med. 2006;36(4):435-48.

Obisesan T, Livingston I, Trulear HD, Gillum F.

BACKGROUND: Few data have been published on the association of attendance at religious services with cardiovascular morbidity and dietary and metabolic risk factors in representative samples of populations despite a known inverse association with mortality and smoking. OBJECTIVE: To test the null hypothesis that frequency of attendance at religious services is unrelated to prevalence or levels of cardiovascular disease, dietary and metabolic risk factors. DESIGN: Cross-sectional survey of a large national sample. PARTICIPANTS: American men and women aged 20 years and over with complete data in the Third National Health and Nutrition Examination Survey (N = 14,192). MEASUREMENTS: Self-reported frequency of attendance at religious services, history of doctor-diagnosed diseases, food intake frequency, 24-hour dietary intake, health status, socio-demographic variables and measured serum lipids and body mass index. RESULTS: Weekly attenders were significantly less likely to report stroke, even after adjusting for multiple variables only in African American women OR = 0.35, 95% CI 0.19-0.66, p < 0.01. No association was seen for heart attack or diabetes. Fish intake at least weekly was more common in weekly attenders, significantly so only in African American women (odds ratio 1.24, 95% CI 1.01-1.58, p < 0.05) and in older Mexican American men (odds ratio 2.57, 95% CI 1.45-2.57, p < 0.01). In linear regression analyses, no significant independent associations were seen between attendance frequency and serum lipid levels or dietary intake of energy, or fat in g and % of kcal. CONCLUSION: Hypotheses generated by these analyses are that in African American women stroke is less prevalent and weekly fish intake more prevalent among weekly attenders than others and that there are no significant independent associations of serum lipids, dietary intake, prevalent CHD, or diabetes with frequency of attendance of religious services. Independent testing of these hypotheses in other samples is needed.

Psychol Addict Behav. 2007 Mar;21(1):84-96.

Walker C, Ainette MG, Wills TA, Mendoza D.

The authors tested hypothesized pathways from religiosity to adolescent substance use (tobacco, alcohol, and marijuana) with data from samples of middle school (n = 1,273) and high school students (n = 812). Confirmatory analysis of measures of religiosity supported a 2-factor solution with behavioral aspects (belonging, attendance) and personal aspects (importance, value, spirituality, forgiveness) as distinct factors. Structural modeling analyses indicated inverse indirect effects of personal religiosity on substance use, mediated through more good self-control and less tolerance for deviance. Religiosity was correlated with fewer deviant peer affiliations and nonendorsement of coping motives for substance use but did not have direct effects on these variables. Parental support and parent-child conflict also had significant effects (with opposite direction) on substance use, mediated through self-control and deviance-prone attitudes. Implications for prevention research are discussed. (c) 2007 APA, all rights reserved.

Res Nurs Health. 2007 Apr;30(2):164-74.

Polzer RL

How African Americans with type 2 diabetes perceive the spiritual role of health care providers (HCPs) and the effects of that role on self-management was explored using a qualitative descriptive analysis. The sample consisted of 29 African American men and women ages 40-75 with type 2 diabetes and 5 ministers of African American churches. A spiritual relationship with their health provider was important in helping participants manage their diabetes. Three typologies from a parent study were expanded with a focus in this extended study on the meaning ascribed to spiritual relationships with providers and the impact of these relationships on self-management. Care perceived as spiritual may be an important component of providing culturally sensitive health care to African Americans and may facilitate their self-management. (c) 2007 Wiley Periodicals, Inc.

J Gen Intern Med. 2007 Apr;22(4):470-7.

Bekelman DB, Dy SM, Becker DM, Wittstein IS, Hendricks DE, Yamashita TE, Gottlieb SH.

BACKGROUND: In patients with chronic heart failure, depression is common and associated with poor quality of life, more frequent hospitalizations, and higher mortality. Spiritual well-being is an important, modifiable coping resource in patients with terminal cancer and is associated with less depression, but little is known about the role of spiritual well-being in patients with heart failure. OBJECTIVE: To identify the relationship between spiritual well-being and depression in patients with heart failure. DESIGN: Cross-sectional study. PARTICIPANTS: Sixty patients aged 60 years or older with New York Heart Association class II-IV heart failure. MEASUREMENTS: Spiritual well-being was measured using the total scale and 2 subscales (meaning/peace, faith) of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being scale, depression using the Geriatric Depression Scale-Short Form (GDS-SF). RESULTS: The median age of participants was 75 years. Nineteen participants (32%) had clinically significant depression (GDS-SF > 4). Greater spiritual well-being was strongly inversely correlated with depression (Spearman's correlation -0.55, 95% confidence interval -0.70 to -0.35). In particular, greater meaning/peace was strongly associated with less depression (r = -.60, P < .0001), while faith was only modestly associated (r = -.38, P < .01). In a regression analysis accounting for gender, income, and other risk factors for depression (social support, physical symptoms, and health status), greater spiritual well-being continued to be significantly associated with less depression (P = .05). Between the 2 spiritual well-being subscales, only meaning/peace contributed significantly to this effect (P = .02) and accounted for 7% of the variance in depression. CONCLUSIONS: Among outpatients with heart failure, greater spiritual well-being, particularly meaning/peace, was strongly associated with less depression. Enhancement of patients' sense of spiritual well-being might reduce or prevent depression and thus improve quality of life and other outcomes in this population.

J Gerontol Nurs. 2007 Jan;33(1):32-9.

Molzahn AE.

The purpose of this study was to explore the effects of spirituality on quality of life (QOL) in older adults when age, gender, social support, and health status are controlled. A secondary analysis of data was conducted using results from a cross-sectional survey of older adults. Data were available from a convenience sample of 426 people living in British Columbia, Canada, who volunteered to complete the questionnaire. Instruments included the WHOQOL-100 and a demographic data sheet. The results show spirituality was not a significant factor contributing to QOL in this sample, and that the strongest predictors of overall QOL were social support and health satisfaction. Given difficulties in measuring spirituality and homogeneity of the sample, further research is warranted.

J Trauma Stress. 2007 Jun 27;20(3):239-249

Simpson TL, Kaysen D, Bowen S, Macpherson LM, Chawla N, Blume A, Marlatt GA, Larimer M.

The present study evaluated whether Posttraumatic Stress Disorder (PTSD) symptom severity was associated with participation and treatment outcomes comparing a Vipassana meditation course to treatment as usual in an incarcerated sample. This study utilizes secondary data. The original study demonstrated that Vipassana meditation is associated with reductions in substance use. The present study found that PTSD symptom severity did not differ significantly between those who did and did not volunteer to take the course. Participation in the Vipassana course was associated with significantly greater reductions in substance use than treatment as usual, regardless of PTSD symptom severity levels. These results suggest that Vipassana meditation is worthy of further study for those with comorbid PTSD and substance use problems.

Proc Natl Acad Sci U S A. 2007 Jun 27;

Brefczynski-Lewis JA, Lutz A, Schaefer HS, Levinson DB, Davidson RJ.

Meditation refers to a family of mental training practices that are designed to familiarize the practitioner with specific types of mental processes. One of the most basic forms of meditation is concentration meditation, in which sustained attention is focused on an object such as a small visual stimulus or the breath. In age-matched participants, using functional MRI, we found that activation in a network of brain regions typically involved in sustained attention showed an inverted u-shaped curve in which expert meditators (EMs) with an average of 19,000 h of practice had more activation than novices, but EMs with an average of 44,000 h had less activation. In response to distracter sounds used to probe the meditation, EMs vs. novices had less brain activation in regions related to discursive thoughts and emotions and more activation in regions related to response inhibition and attention. Correlation with hours of practice suggests possible plasticity in these mechanisms.

Behav Res Ther. 2007 May 3;

Koszycki D, Benger M, Shlik J, Bradwejn J.

Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a randomized trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were randomized to an 8-week course of MBSR or 12 weekly sessions of cognitive-behavioral group therapy (CBGT). Although patients in both treatment groups improved, patients receiving CBGT had significantly lower scores on clinician- and patient-rated measures of social anxiety. Response and remission rates were also significantly greater with CBGT. Both interventions were comparable in improving mood, functionality and quality of life. The results confirm that CBGT is the treatment of choice of generalized SAD and suggest that MBSR may have some benefit in the treatment of generalized SAD.

Neurosci Lett. 2007 Jun 21;421(1):16-21.

Hölzel BK, Ott U, Hempel H, Hackl A, Wolf K, Stark R, Vaitl D.

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.

Pain. 2007 May 31;

Morone NE, Greco CM, Weiner DK.

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. Baseline, 8-week and 3-month follow-up measures of pain, physical function, and quality of life were assessed. Eighty-nine older adults were screened and 37 found to be eligible and randomized within a 6-month period. The mean age of the sample was 74.9 years, 21/37 (57%) of participants were female and 33/37 (89%) were white. At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement in the Chronic Pain Acceptance Questionnaire Total Score and Activities Engagement subscale (P=.008, P=.004) and SF-36 Physical Function (P=.03). An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function.

J Fam Pract. 2007 Jun;56(6):483-5.

Powers E, Saultz J, Hamilton A, Lo V.

Counseling, weight loss, exercise, and drinking alcohol all effectively lower low-density lipoprotein cholesterol (LDL-C). Specifically, one to 2 daily drinks of alcohol lowers LDL-C, if consumed regularly for more than 4 weeks (strength of recommendation [SOR]: A, based on consistent results of multiple randomized controlled trials [RCTs]). Counseling by physicians, dieticians, or pharmacists is effective at increasing patient compliance with medications, thereby lowering LDL-C (SOR: C, good evidence that intervention lowers LDL-C, insufficient to prove that it reduces mortality/morbidity). Weight loss has been associated with reductions in LDL-C. However, other factors---including degree of caloric restriction, drug intervention, and diet composition--may play a more significant role than weight loss alone (SOR: A, based on a meta-analysis and consistent results of RCTs). Exercise significantly lowers LDL-C (SOR: A, based on meta-analyses and consistent results of RCTs). Smoking cessation may have a beneficial effect (SOR: B, based on inconsistent results from RCTs that it lowers LDL-C). Exercise-based alternative practices (yoga and tai chi) lower LDL, and meditation may have a beneficial effect (SOR: C, moderate evidence that intervention lowers LDL, insufficient evidence to prove that it reduces mortality/morbidity).

Aging Ment Health. 2007 May;11(3):346-57.

Smith A, Graham L, Senthinathan S.

Mindfulness-based Cognitive Therapy (MBCT) is a meditation-based intervention designed to reduce recurrence in people with histories of relapsing unipolar major depression. MBCT is an eight-session course delivered to groups of participants who are currently not (or only mildly) depressed. We sought to determine whether MBCT is suitable for older people, and what modifications they may require. We recruited 38 participants aged over 65, of whom 30 completed an MBCT course. Their responses at assessment, post-course and one-year follow-up interviews, plus comments at three-monthly 'reunion' meetings, provided data for thematic analysis. Main themes emerging for participants as a group are considered, as are individuals' understandings and uses of MBCT, and how these developed during and following the course. We found MBCT promising as a cost-effective addition to clinicians' repertoire for addressing depression in old age, and identified issues for further research. Participants' comments indicated that they considered MBCT a helpful intervention for older sufferers from recurring depression.

Can J Psychiatry. 2007 Apr;52(4):260-6.

Toneatto T, Nguyen L.

OBJECTIVE: To review the impact of mindfulness-based stress reduction (MBSR) on symptoms of anxiety and depression in a range of clinical populations. METHOD: Our review included any study that was published in a peer-reviewed journal, used a control group, and reported outcomes related to changes in depression and anxiety. We extracted the following key variables from each of the 15 studies identified: anxiety or depression outcomes after the MBSR program, measurement of compliance with MBSR instructions, type of control group included, type of clinical population studied, and length of follow-up. We also summarized modifications to the MBSR program. RESULTS: Measures of depression and anxiety were included as outcome variables for a broad range of medical and emotional disorders. Evidence for a beneficial effect of MBSR on depression and anxiety was equivocal. When active control groups were used, MBSR did not show an effect on depression and anxiety. Adherence to the MBSR program was infrequently assessed. Where it was assessed, the relation between practising mindfulness and changes in depression and anxiety was equivocal. CONCLUSIONS: MBSR does not have a reliable effect on depression and anxiety.

Brain Behav Immun. 2007 May 21;

Carlson LE, Speca M, Patel KD, Faris P.

OBJECTIVES: This study investigated the ongoing effects of participation in a mindfulness-based stress reduction (MBSR) program on quality of life (QL), symptoms of stress, mood and endocrine, immune and autonomic parameters in early stage breast and prostate cancer patients. METHODS: Forty-nine patients with breast cancer and 10 with prostate cancer enrolled in an eight-week MBSR program that incorporated relaxation, meditation, gentle yoga and daily home practice. Demographic and health behaviors, QL, mood, stress symptoms, salivary cortisol levels, immune cell counts, intracellular cytokine production, blood pressure (BP) and heart rate (HR) were assessed pre- and post-intervention, and at 6- and 12-month follow-up. RESULTS: Fifty-nine, 51, 47 and 41 patients were assessed pre- and post-intervention and at 6- and 12-month follow-up, respectively, although not all participants provided data on all outcomes at each time point. Linear mixed modeling showed significant improvements in overall symptoms of stress which were maintained over the follow-up period. Cortisol levels decreased systematically over the course of the follow-up. Immune patterns over the year supported a continued reduction in Th1 (pro-inflammatory) cytokines. Systolic blood pressure (SBP) decreased from pre- to post-intervention and HR was positively associated with self-reported symptoms of stress. CONCLUSIONS: MBSR program participation was associated with enhanced quality of life and decreased stress symptoms, altered cortisol and immune patterns consistent with less stress and mood disturbance, and decreased blood pressure. These pilot data represent a preliminary investigation of the longer-term relationships between MBSR program participation and a range of potentially important biomarkers.

Neuroreport. 2007 May 7;18(7):709-12.

Barnhofer T, Duggan D, Crane C, Hepburn S, Fennell MJ, Williams JM.

This study investigated the effects of a meditation-based treatment for preventing relapse to depression, mindfulness-based cognitive therapy (MBCT), on prefrontal alpha-asymmetry in resting electroencephalogram (EEG), a biological indicator of affective style. Twenty-two individuals with a previous history of suicidal depression were randomly assigned to either MBCT (N=10) or treatment-as-usual (TAU, N=12). Resting electroencephalogram was measured before and after an 8-week course of treatment. The TAU group showed a significant deterioration toward decreased relative left-frontal activation, indexing decreases in positive affective style, while there was no significant change in the MBCT group. The findings suggest that MBCT can help individuals at high risk for suicidal depression to retain a balanced pattern of baseline emotion-related brain activation.

J Psychosom Res. 2007 Mar;62(3):297-300.

Kingston J, Chadwick P, Meron D, Skinner TC.

OBJECTIVE: To investigate the effect of mindfulness training on pain tolerance, psychological well-being, physiological activity, and the acquisition of mindfulness skills. METHODS: Forty-two asymptomatic University students participated in a randomized, single-blind, active control pilot study. Participants in the experimental condition were offered six (1-h) mindfulness sessions; control participants were offered two (1-h) Guided Visual Imagery sessions. Both groups were provided with practice CDs and encouraged to practice daily. Pre-post pain tolerance (cold pressor test), mood, blood pressure, pulse, and mindfulness skills were obtained. RESULTS: Pain tolerance significantly increased in the mindfulness condition only. There was a strong trend indicating that mindfulness skills increased in the mindfulness condition, but this was not related to improved pain tolerance. Diastolic blood pressure significantly decreased in both conditions. CONCLUSION: Mindfulness training did increase pain tolerance, but this was not related to the acquisition of mindfulness skills.

Altern Ther Health Med. 2007 Jan-Feb;13(1):38-44.

Lane JD, Seskevich JE, Pieper CF.

OBJECTIVES: To test a brief, non-sectarian program of meditation training for effects on perceived stress and negative emotion, and to determine effects of practice frequency and test the moderating effects of neuroticism (emotional lability) on treatment outcome. DESIGN AND SETTING: The study used a single-group, open-label, pre-test post-test design conducted in the setting of a university medical center. PARTICIPANTS: Healthy adults (N=200) interested in learning meditation for stress-reduction were enrolled. One hundred thirty-three (76% females) completed at least 1 follow-up visit and were included in data analyses. INTERVENTION: Participants learned a simple mantra-based meditation technique in 4, 1-hour small-group meetings, with instructions to practice for 15-20 minutes twice daily. Instruction was based on a psychophysiological model of meditation practice and its expected effects on stress. OUTCOME MEASURES: Baseline and monthly follow-up measures of Profile of Mood States; Perceived Stress Scale; State-Trait Anxiety Inventory (STAI); and Brief Symptom Inventory (BSI). Practice frequency was indexed by monthly retrospective ratings. Neuroticism was evaluated as a potential moderator of treatment effects. RESULTS: All 4 outcome measures improved significantly after instruction, with reductions from baseline that ranged from 14% (STAI) to 36% (BSI). More frequent practice was associated with better outcome. Higher baseline neuroticism scores were associated with greater improvement. CONCLUSIONS: Preliminary evidence suggests that even brief instruction in a simple meditation technique can improve negative mood and perceived stress in healthy adults, which could yield long-term health benefits. Frequency of practice does affect outcome. Those most likely to experience negative emotions may benefit the most from the intervention.

Ethn Dis. 2007 Winter;17(1)

Jayadevappa R, Johnson JC, Bloom BS, Nidich S, Desai S, Chhatre S, Raziano DB, Schneider R.

OBJECTIVE: To evaluate the effectiveness of a Transcendental Meditation (TM) stress reduction program for African Americans with congestive heart failure (CHF). DESIGN: Randomized, controlled study PARTICIPANTS AND INTERVENTION: We recruited 23 African American patients > or = 55 years of age who were recently hospitalized with New York Heart Association class II or III CHF and with an ejection fraction of < .40. Participants were randomized to either TM or health education (HE) group. MAIN OUTCOME MEASURES: Primary outcome measure was six-minute walk test; secondary outcomes were generic and disease-specific health-related quality of life, quality of well being, perceived stress, Center for Epidemiologic Studies Depression Scale (CES-D), rehospitalizations, brain natriuretic peptide, and cortisol. Changes in outcomes from baseline to three and six months after treatment were analyzed by using repeated measures analysis of variance, covarying for baseline score. RESULTS: For the primary outcome of functional capacity, the TM group significantly improved on the six-minute walk test from baseline to six months after treatment compared to the HE group (P = .034). On the secondary outcome measures, the TM group showed improvements in SF-36 subscales and total score on the Minnesota Living with Heart Failure scale. On the CES-D, the TM group showed significant decrease from baseline to six months compared to the HE group (P = .03). Also, the TM group had fewer rehospitalizations during the six months of followup. CONCLUSIONS: Results indicate that TM can be effective in improving the quality of life and functional capacity of African American CHF patients. Further validation of outcomes is planned via a large, multicenter trial with long-term follow-up.

Arthritis Rheum. 2007 Feb 15;57(1):77-85.

Sephton SE, Salmon P, Weissbecker I, Ulmer C, Floyd A, Hoover K, Studts JL.

OBJECTIVE: Depressive symptoms are common among patients with fibromyalgia, and behavioral intervention has been recommended as a major treatment component for this illness. The objective of this study was to test the effects of the Mindfulness-Based Stress Reduction (MBSR) intervention on depressive symptoms in patients with fibromyalgia. METHODS: This randomized controlled trial examined effects of the 8-week MBSR intervention on depressive symptoms in 91 women with fibromyalgia who were randomly assigned to treatment (n = 51) or a waiting-list control group (n = 40). Eligible patients were at least 18 years old, willing to participate in a weekly group, and able to provide physician verification of a fibromyalgia diagnosis. Of 166 eligible participants who responded to local television news publicizing, 49 did not appear for a scheduled intake, 24 enrolled but did not provide baseline data, and 2 were excluded due to severe mental illness, leaving 91 participants. The sample averaged 48 years of age and had 14.7 years of education. The typical participant was white, married, and employed. Patients randomly assigned to treatment received MBSR. Eight weekly 2.5-hour sessions were led by a licensed clinical psychologist with mindfulness training. Somatic and cognitive symptoms of depression were assessed using the Beck Depression Inventory administered at baseline, immediately postprogram, and at followup 2 months after the conclusion of the intervention. RESULTS: Change in depressive symptoms was assessed using slopes analyses of intervention effects over time. Depressive symptoms improved significantly in treatment versus control participants over the 3 assessments. CONCLUSION: This meditation-based intervention alleviated depressive symptoms among patients with fibromyalgia.

BMC Complement Altern Med. 2007 Jan 25;7:2.

Davis JM, Fleming MF, Bonus KA, Baker TB.

BACKGROUND: Mindfulness means paying attention in the present moment, non-judgmentally, without commentary or decision-making. We report results of a pilot study designed to test the feasibility of using Mindfulness Based Stress Reduction (MBSR) (with minor modifications) as a smoking intervention. METHODS: MBSR instructors provided instructions in mindfulness in eight weekly group sessions. Subjects attempted smoking cessation during week seven without pharmacotherapy. Smoking abstinence was tested six weeks after the smoking quit day with carbon monoxide breath test and 7-day smoking calendars. Questionnaires were administered to evaluate changes in stress and affective distress. RESULTS: 18 subjects enrolled in the intervention with an average smoking history of 19.9 cigarettes per day for 26.4 years. At the 6-week post-quit visit, 10 of 18 subjects (56%) achieved biologically confirmed 7-day point-prevalent smoking abstinence. Compliance with meditation was positively associated with smoking abstinence and decreases in stress and affective distress. DISCUSSIONS AND CONCLUSION: The results of this study suggest that mindfulness training may show promise for smoking cessation and warrants additional study in a larger comparative trial.

Am J Geriatr Psychiatry. 2007 Apr;15(4):292-300. Epub 2006 Dec 8.

Hebert RS, Dang Q, Schulz R.

OBJECTIVE: Providing care to a loved one with dementia and the death of that loved one are generally considered two of the most stressful human experiences. Each puts family caregivers at risk of psychologic morbidity. Although research has suggested that religious beliefs and practices are associated with better mental health, little is known about whether religion is associated with better mental health in family caregivers. Our objective, then, is to explore the relationship between religion and mental health in active and bereaved dementia caregivers. METHODS: A total of 1,229 caregivers of persons with moderate to severe dementia were recruited from six geographically diverse sites in the United States and followed prospectively for up to 18 months. Three measures of religion: 1) the frequency of attendance at religious services, meetings, and/or activities; 2) the frequency of prayer or meditation; and 3) the importance of religious faith/spirituality were collected. Mental health outcomes were caregiver depression (Center for Epidemiological Studies-Depression [CES-D] scale) and complicated grief (Inventory of Complicated Grief [ICG]). RESULTS: Religious beliefs and practices were important to the majority of caregivers. After controlling for significant covariates, the three measures of religion were associated with less depressive symptoms in current caregivers. Frequent attendance was also associated with less depression and complicated grief in the bereaved. CONCLUSIONS: Religious beliefs and practices, and religious attendance in particular, are associated with better mental health in family caregivers of persons with dementia.