Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review.

BACKGROUND: Only a small number of articles have investigated the relationship between mindfulness-based interventions (MBIs) and biomarkers. The aim of this systematic review was to study the effect of MBIs on specific biomarkers (cytokines, neuropeptides and C-reactive protein (CRP)) in both healthy subjects and cancer patients. METHODS: A search was conducted using PubMed, EMBASE, PsycINFO and the Cochrane library between 1980 and September 2016. RESULTS: A total of 13 studies with 1110 participants were included. In the healthy population, MBIs had no effect on cytokines, but were found to increase the levels of the neuropeptide insulin-like growth factor 1 (IGF-1). With respect to neuropeptide Y, despite the absence of post-intervention differences, MBIs may enhance recovery from stress. With regard to CRP, MBIs could be effective in lower Body Mass Index (BMI) individuals. In cancer patients, MBIs seem to have some effect on cytokine levels, although it was not possible to determine which specific cytokines were affected. One possibility is that MBIs might aid recovery of the immune system, increasing the production of interleukin (IL)-4 and decreasing interferon gamma (IFN-γ). CONCLUSIONS: MBIs may be involved in changes from a depressive/carcinogenic profile to a more normalized one. However, given the complexity and different contexts of the immune system, and the fact that this investigation is still in its preliminary stage, additional randomized controlled trials are needed to further establish the impact of MBI programmes on biomarkers in both clinical and non-clinical populations.

An Internet-Based Intervention for Depression in Primary Care in Spain: A Randomized Controlled Trial.

BACKGROUND: Depression is the most prevalent cause of illness-induced disability worldwide. Face-to-face psychotherapeutic interventions for depression can be challenging, so there is a need for other alternatives that allow these interventions to be offered. One feasible alternative is Internet-based psychological interventions. This is the first randomized controlled trial (RCT) on the effectiveness of an Internet-based intervention on depression in primary health care in Spain. OBJECTIVE: Our aim was to compare the effectiveness of a low-intensity therapist-guided (LITG) Internet-based program and a completely self-guided (CSG) Internet-based program with improved treatment as usual (iTAU) care for depression. METHODS: Multicenter, three-arm, parallel, RCT design, carried out between November 2012 and January 2014, with a follow-up of 15 months. In total, 296 adults from primary care settings in four Spanish regions, with mild or moderate major depression, were randomized to LITG (n=96), CSG (n=98), or iTAU (n=102). Research completers at follow-up were 63.5%. The intervention was Smiling is Fun, an Internet program based on cognitive behavioral therapy. All patients received iTAU by their general practitioners. Moreover, LITG received Smiling is Fun and the possibility of psychotherapeutic support on request by email, whereas CSG received only Smiling is Fun. The main outcome was the Beck Depression Inventory-II at 3 months from baseline. Mixed-effects multilevel analysis for repeated measures were undertaken. RESULTS: There was no benefit for either CSG [(B coefficient=-1.15; P=.444)] or LITG [(B=-0.71; P=.634)] compared to iTAU, at 3 months. There were differences at 6 months [iTAU vs CSG (B=-4.22; P=.007); iTAU vs LITG (B=-4.34; P=.005)] and 15 months [iTAU vs CSG (B=-5.10; P=.001); iTAU vs LITG (B=-4.62; P=.002)]. There were no differences between CSG and LITG at any time. Adjusted and intention-to-treat models confirmed these findings. CONCLUSIONS: An Internet-based intervention for depression combined with iTAU conferred a benefit over iTAU alone in the Spanish primary health care system. TRIAL REGISTRATION: Clinicaltrials.gov NCT01611818; https://register.clinicaltrials.gov/prs/app/action/SelectProtocol? selectaction=Edit&uid=U0001NPQ&ts=2&cx=gctdh2&sid=S0003KJ6 (Archived by WebCite at http://www.webcitation.org/6jbsUvUDz).

Variables Associated With Negotiation Effectiveness: The Role of Mindfulness.

Negotiation is the main mean of conflict resolution. Despite its capital importance, little is known about influencing variables or effective interventions. Mindfulness has shown to improve subjects' performance in different settings but until now, no study has shown its impact in negotiation. The aim of this study is to analyze which variables are associated with effectiveness and to determine if meditators are more effective in negotiation. A cross-sectional descriptive study was carried out. The study variables were: socio-demographic variables, negotiation effectiveness (Negotiation Effectiveness Questionnaire), mindfulness (Five Facets of Mindfulness Questionnaire), emotional intelligence (Trait Meta-Mood Scale Questionnaire), personality (NEO-FFI personality inventory), motivation (McClelland Questionnaire), and negotiation style (Rahim Organizational Conflict Inventory-II). A correlational study and a multivariate model were developed. Negotiation effectiveness was associated with age, mindfulness, emotional intelligence, extraversion, openness, conscientiousness, achievement motivation, integrating, dominating, and compromising negotiation styles and inversely correlated toward neuroticism. The effectiveness of the negotiation is explained by the variables clarity, age, conscientiousness, dominating, and compromising style. Meditators were found to be more effective than non-meditators.

Religiosity and Meditation Practice: Exploring Their Explanatory Power on Psychological Adjustment.

There has been increased interest in the relationships between religiosity, meditation practice and well-being, but there is lack of understanding as to how specific religious components and distinct meditation practices could influence different positive and negative psychological adjustment outcomes. The aim of this study was to assess the explanatory power of religious beliefs and the practice of prayer, focused attention (FA), open monitoring (OM), and compassion meditation (CM) on psychological adjustment, taking into consideration a number of practice-related variables such as session length, frequency of practice and lifetime practice. Psychological adjustment was assessed by means of happiness, positive affect, depression, negative affect, and emotional overproduction. A cross-sectional design was used, with a final sample comprising 210 Spanish participants who completed an online assessment protocol. Hierarchical regressions were performed, including age, sex and psychotropic medication use in the first step as possible confounders, with the addition of religious beliefs and the practice of prayer, FA, OM, and CM in the second step. FA session length was related to all psychological adjustment outcomes: happiness (ΔR 2 = 0.09, p = 0.002; ß = 0.25, p = 0.001), positive affect (ΔR 2 = 0.09, p = 0.002; ß = 0.18, p = 0.014), depression (ΔR2 = 0.07, p = 0.004; ß = -0.27, p < 0.001), negative affect (ΔR 2 = 0.08, p = 0.007; ß = -0.27, p < 0.001) and emotional overproduction (ΔR 2 = 0.07, p = 0.013; ß = -0.23, p = 0.001). CM session length was related to positive affect (ß = 0.18, p = 0.011). CM practice frequency was associated with happiness (ΔR 2 = 0.06, p = 0.038; ß = 0.16, p = 0.041). Lifetime practice of FA was related to happiness (ΔR 2 = 0.08, p = 0.007; ß = 0.21, p = 0.030) and OM to emotional overproduction (ΔR 2 = 0.08, p = 0.037; ß = -0.19, p = 0.047). Religious beliefs and prayer seemed to be less relevant than meditation practices such as FA, OM, and CM in explaining psychological adjustment. The distinct meditation practices might be differentially related to distinct psychological adjustment outcomes through different practice-related variables. However, research into other forms of institutional religiosity integrating social aspects of religion is required.

Effects of Mindfulness-Based Interventions on Salivary Cortisol in Healthy Adults: A Meta-Analytical Review.

Objective: The aim of the present study was to elucidate the effects of Mindfulness-based interventions (MBIs) on salivary cortisol levels in healthy adult populations. Method: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), published between January 1980 and June 2015 in PubMed, EMBASE, PsycINFO and the Cochrane library. The PRISMA and Cochrane guidelines were followed. The pooled effect sizes were calculated with the random-effects model, using Hedges' g-values, and heterogeneity was measured using the I2 statistic. The contribution of different characteristics of participants and programmes were assessed by meta-regression models, using beta coefficients. Results: Five RCTs with 190 participants in total were included in this systematic review. The overall effect size (ES) for improving the state of health related to cortisol levels was moderately low (g = 0.41; p = 0.025), although moderate heterogeneity was found (I2 = 55; p = 0.063). There were no significant differences between active (g = 0.33; p = 0.202) and passive (g = 0.48; p = 0.279) controls, but significant differences were found when comparing standard (g = 0.81; p = 0.002) and raw (g = 0.03; p = 0.896) measures. The percentage of women in each study was not related to ES. Nevertheless, age (beta = -0.03; p = 0.039), the number of sessions (beta = 0.33; p = 0.007) and the total hours of the MBI (beta = 0.06; p = 0.005) were significantly related to ES, explaining heterogeneity (R2 = 1.00). Conclusions: Despite the scarce number of studies, our results suggest that MBIs might have some beneficial effect on cortisol secretion in healthy adult subjects. However, there is a need for further RCTs implemented in accordance with standard programmes and measurements of salivary cortisol under rigorous strategies in healthy adult populations.