Scientific research holds a central place at the Center for Mindfulness in Medicine, Health Care, and Society and in the ongoing investigation, understanding, and dissemination of MBSR. Since 1979, the Center for Mindfulness has been dedicated to the ongoing investigation of the attributes and qualities of mindfulness and its role in health and healthcare through an active program of clinical and basic science research. Our clinical program is a primary laboratory for these investigations, utilizing randomized clinical trials to evaluate the MBSR curriculum and approach for particular clinical diagnoses and populations, for the integration of mindfulness into existing treatment protocols, and as a means of examining and understanding the basic biological mechanisms of mindfulness.
Here are some of our most recent findings about the effectiveness of mindfulness practice:
Mindfulness practice lead to increases in region brain gray matter density
Britta K. Hözel, James Carmody, Mark Vangel, Christina Congleton, Sita M. Yerramsetti, Tim Gard, Sara W. Lazar
Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular, but to date little is known about neural mechanisms associated with these interventions. Mindfulness-Based Stress Reduction (MBSR), one of the most widely used mindfulness training programs, has been reported to produce positive effects on psychological well-being and to ameliorate symptoms of a number of disorders. Here, we report a controlled longitudinal study to investigate pre-post changes in brain gray matter concentration attributable to participation in an MBSR program. Anatomical magnetic resonance (MR) images from 16 healthy, meditation-naïve participants were obtained before and after they underwent the 8-week program. Changes in gray matter concentration were investigated using voxel-based morphometry, and compared with a waiting list control group of 17 individuals. Analyses in a priori regions of interest confirmed increases in gray matter concentration within the left hippocampus. Whole brain analyses identified increases in the posterior cingulate cortex, the temporo-parietal junction, and the cerebellum in the MBSR group compared with the controls. The results suggest that participation in MBSR is associated with changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.
Hölzel, B., and J. Carmody, M. Vangel, C. Congleton, S. Yerramsetti, T. Gard, S. Lazar. “Mindfulness practice leads to increases in regional brain gray matter density.” Psychiatry Research: Neuroimaging 191 (2011): 36-43.
Mindfulness training for coping with hot flashes: results of a randomized trial
James Francis Carmody, Sybil Crawford, Elena Salmoirago-Blotcher, Katherine Leung, Linda Churchill, and Nicholas Olendzki
Objective: The aim of this study was to analyze the effect of participation in a mindfulness training program (mindfulness-based stress reduction, [MBSR]) on the degree of bother from hot flashes and night sweats.
Methods: This study was a randomized trail of 110 late perimenopausal and early postmenopausal women experiencing an average of 5 or more moderate or severe hot flashes (including night sweats)/day. A wait-list control (WLC) was used with 3-month postintervention follow-up. The main outcome was the degree of bother from hot flashes and night sweats in the previous 24 hours. Secondary measures were hot flash intensity, quality of life, insomnia, anxiety, and perceived stress.
Results: Baseline average (SD) hot flash frequency was 7.87 (3.44) and 2.81 (1.76) night sweats/day. Mean (SD) bothersomeness score was 3.18 (0.55: “moderately bothered/extremely bothered”). All analyses were intention to treat and were controlled for baseline values. Within-women changes in bother from hot flash differed significantly by treatment arm (week x treatment arm interaction, P = 0.042). At completion of the intervention, bother in the MBSR arm decreased on average by 14.77% versus 6.79% for WLC. At 20 weeks, total reduction in bother for MBSR was 21.62% and 10.50% for WLC. Baseline-adjusted changes in hot flash intensity did not differ between treatment arms (week x treatment arm interaction, P = 0.692). The MBSR are made clinically significant improvements in quality of life (P = 0.022), subjective sleep quality (P = 0.009), anxiety (P = 0.005), and perceived stress (P = 0.001). Improvements were maintained 3 months postintervention.
Conclusion: Our data suggests that MBSR may be clinically significant resource in reducing the degree of bother and distress women experience from hot flashes and night sweats.
Carmody, J., and S. Crawford, E. Salmoirago-Blotcher, K. Leung, L. Churchill, N. Olendzki. “Mindfulness training for coping with hot flashes: results of a randomized trial.” Menopause: The Journal of The North American Menopause Society Volume 18 (2011), Number 6.
Stress reduction correlates with structural changes in the amygdala
Britta K. Hölzel, James Carmody, Karleyton C. Evans, Elizabeth A. Hoge, Jeffery A. Dusek, Lucas Morgan, Roger K Pitman, and Sara W. Lazar
Stress has significant adverse effects on health and is a risk factor for many illnesses. Neurobiological studies have implicated the amygdala as a brain structure crucial in stress responses. Whereas hyperactive amygdala function is often observed during stress conditions, cross-sectional reports of difference in gray matter structure have been less consistent. We conducted a longitudinal MRI studio to investigate the relationship between changes in perceived stress with changes in amygdala gray matter density following a stress-reduction intervention. Stressed but otherwise healthy individuals (N=26) participated in an 8-week mindfulness-based stress reduction intervention. Perceived stress was rated on the perceived stress scale (PSS) and anatomical MR images were acquired pre- and post-intervention. PSS change was used as the predictive regressor for changes in gray matter density within the bilateral amygdalae. Following intervention, participants reported significantly reduced perceived stress. Reductions in perceived stress correlated positively with decreases in right basolateral amygdala gray matter density. Whereas prior studies found gray matter modifications resulting from acquisition of abstract information, motor and language skills, this study demonstrates that neuroplastic changes are associated with improvements in a psychological state variable.
Hölzel, B., and J. Carmody, K. Evans, E. Hoge, J. Dusek, L. Morgan, R. Pitman, S. Lazar. “Stress reduction correlates with structural changes in the amygdala.” Social Cognitive and Affective Neuroscience (2009): 1-7.
How Long Does a Mindfulness-Based Stress Reduction Program Need to Be? A Review of Class Contact Hours and Effect Sizes for Psychological Distress
James Carmody and Ruth A. Baer
The mindfulness-based stress reduction (MBSR) program was designed to be long enough for participants to grasp the principles of self-regulation through mindfulness and develop skill and autonomy in mindfulness practice. It traditionally consists of 26 hours of session time included eight classes of 2-1/2 hours and an all-day class. The circumstances of some groups exclude them from participating in this standard form and a number of trials have evaluated programs with abbreviated class time. If lower program time demands can lead to similar outcomes in psychological functioning, it would support their utility in these setting and might lead to greater participation. However, the effect of variation in class hours on outcomes has not been systematically studied. To obtain preliminary information related to this question we examined effect sizes for psychological outcome variables in publishes studies of MBSR, some of which had adapted the standard number of class hours. The correlation between mean effect size and number of in-class hours was nonsignificant for both clinical and nonclinical samples and suggests that adaptations that include less class time me be worthwhile for populations for whom reduction of psychological distress is an important goal and for whom longer time commitment may be a barrier to their ability or willingness to participate. However, the standard MBSR format has accrued the most empirical support for its efficacy and session time may be important to the development of other kinds of program outcomes. The result points to the importance of empirical studies systematically examining this question.
Carmody, J., and R. Baer. “How Long Does a Mindfulness-Based Stress Reduction Program Need to Be? A Review of Class Contact Hours and Effect Sizes for Psychological Distress.” Journal of Clinical Psychology 65 (2009): 627-638.
An Empirical Study of the Mechanisms of Mindfulness in a Mindfulness-Based Stress Reduction Program
James Carmody, Ruth A. Baer, and Emily L. B. Lykins
S. L. Shapiro and colleagues (2006) have described a testable theory of the mechanisms of mindfulness and how it affects positive change. They describe a model in which mindfulness training leads to a fundamental change in relationship to experience (reperceiving), which leads to changes in self-regulation, values clarification, cognitive and behavioral flexibility, and exposure. These four variables, in turn, result in salutogenic outcomes. Analyses of responses from participants in a mindfulness-based stress-reduction program did not support the mediating effect of change in reperceiving on the relationship of mindfulness with those four variables. However, when mindfulness and reperceiving scores were combined, partial support was found for the mediating effect of the four variables on measures of psychological distress. Issues arising in attempts to test the proposed theory are discussed, including the description of the model variable and the challenges to their assessment.
Carmody, J., and R. Baer, E. Lykins, N. Olendzki. “An Empirical Study of the Mechanisms of Mindfulness in a Mindfulness-Based Stress Reduction Program.” Journal of Clinical Psychology 65 (2009): 1-14.