RESUMO
BACKGROUND: Individuals with cardiovascular disease (CVD) report psychological distress and poor physical functioning and may benefit from mindfulness training. PURPOSE: To examine the effects of mindfulness-based interventions (MBIs) on psychological and physiological measures in adults with CVD using meta-analysis. METHODS: Comprehensive searches identified studies that (a) evaluated MBIs in adults with CVD or who had experienced a cardiac event, (b) included a comparison condition, and (c) assessed psychological (e.g., anxiety and depression) or physiological (e.g., systolic or diastolic blood pressure [BP]) outcomes. Independent raters coded methodological (e.g., design and quality) and intervention features (e.g., intervention content) as potential moderators. Weighted mean effect sizes (d+), using full information maximum likelihood estimation, were calculated. RESULTS: Of the 1,507 records reviewed, 16 studies met inclusion criteria (N = 1,476; M age = 56 years; 40% women). Compared to controls, participants who received an MBI reported greater improvements in psychological outcomes (i.e., anxiety, depression, distress, and perceived stress: d+s = 0.49 to 0.64). MBI recipients also reduced their systolic (d+ = 0.89, 95% confidence interval [CI] = 0.26, 1.51; k = 7) but not diastolic (d+ = 0.07, 95% CI = -0.47, 0.60; k = 6) BP relative to controls. CONCLUSIONS: MBIs demonstrated favorable effects on psychological and physiological outcomes among adults with CVD. Future research should investigate if such benefits lead to improvements in disease outcomes in studies with longer follow-ups.
Assuntos
Doenças Cardiovasculares/fisiopatologia , Atenção Plena/métodos , Angústia Psicológica , Estresse Psicológico/terapia , Ansiedade/psicologia , Pressão Sanguínea , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/psicologia , Depressão/psicologia , Humanos , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Resultado do TratamentoRESUMO
BACKGROUND: Transcendental Meditation (TM) as a stress management technique may offer an adjunctive strategy to improve health and well-being in adults with cardiovascular disease (CVD). OBJECTIVES: To examine the efficacy of TM to improve aspects of cardiovascular health and psychological functioning in adults with CVD. METHOD: Studies (a) evaluating TM in adults with hypertension or CVD and (b) assessing a physiological or psychological outcome were retrieved and meta-analyzed. Weighted mean effect sizes were computed to assess between- and within-group changes. RESULTS: Nine studies met inclusion criteria (Nâ¯=â¯851; mean ageâ¯=â¯60⯱â¯8 years; 47% women). Between-group analyses revealed no differences between TM and control groups. However, within-group (i.e., pre- to post-intervention) analyses revealed reductions in systolic (d+â¯=â¯0.31) and diastolic (d+â¯=â¯0.53) blood pressure (BP) for the TM group. There were no changes in depressive symptoms for TM or control participants. CONCLUSIONS: TM was associated with within-group (but not between-groups) improvements in BP. Continued research using randomized controlled trials with larger samples, and measuring psychophysiological outcomes at longer follow-up intervals is recommended.
Assuntos
Doenças Cardiovasculares/psicologia , Depressão/psicologia , Meditação/psicologia , Pressão Sanguínea/fisiologia , Humanos , Psicofisiologia/métodos , Estresse Psicológico/psicologiaRESUMO
BACKGROUND: People living with HIV/AIDS (PLWHA) often experience psychological stress associated with disease management. This meta-analysis examines the benefits of yoga interventions on psychological distress among PLWHA. METHODS: Included were studies that (a) evaluated a yoga intervention in PLWHA; (b) provided between-group or within-group changes; and (c) assessed a psychological, physiological, or biomedical outcome. RESULTS: Seven studies sampling 396 PLWHA (M ageâ¯=â¯42 years, SDâ¯=â¯5 years; 40% women) met inclusion criteria. PLWHA who received yoga interventions reported significant improvements in perceived stress (d+ = 0.80, 95% Confidence Interval [CI] = 0.53, 1.07), positive affect (d + = 0.73, 95% CI = 0.49, 0.98), and anxiety (d+ = 0.71, 95% CI = 0.27, 1.14) compared to controls. CONCLUSION: Yoga is a promising intervention for stress management. However, the literature is limited by the small number of studies. Randomized controlled trials with objective measures of HIV-related outcomes are needed to further evaluate the benefits of yoga.
Assuntos
Infecções por HIV , Yoga , Adulto , Feminino , Infecções por HIV/psicologia , Infecções por HIV/terapia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = < 1-20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40-0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within-groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.
Assuntos
Ansiedade/psicologia , Depressão/psicologia , Infecções por HIV/psicologia , Atenção Plena/métodos , Adulto , Contagem de Linfócito CD4 , Humanos , Qualidade de VidaRESUMO
We examined investment in body image among 48 patients diagnosed with, or at risk for malignant melanoma (MM), as well as factors hypothesized as related to increased investment, such as gender, perceived stress, mood, fatigue, and personality characteristics. Investment in body image was evaluated using the Measure of Body Apperception [Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. S., Robinson, D. S., & Moffat, F. L. Jr. (1998). Concern about aspects of body image and adjustment to early state breast cancer. Psychosomatic Medicine, 60, 168-174]. Results showed that women reported more concerns about physical appearance than men, and patients with MM exhibited more concerns about body integrity than at-risk patients. Concerns about body integrity were related to more compulsive personality characteristics, whereas concerns about appearance were associated with more histrionic personality characteristics. Body image investment was related to poorer adjustment as indicated by heightened symptoms of fatigue and stress. This study suggests that further research on investment in body image in this patient population is warranted.
RESUMO
A heightened risk of mood disorders, such as major depression, and acute depressive symptoms has been observed among HIV-seropositive individuals since the start of the AIDS epidemic, and an accumulating body of data now shows that depression may have an impact on morbidity and mortality among individuals with HIV disease. Although the specific physiologic mechanisms involved in this process have not been delineated, there is some evidence to suggest that certain components of innate immunity, including killer lymphocytes such as CD8+ T lymphocytes and natural killer cells, may represent key pathways through which depression affects HIV disease progression. This paper reviews some of the main studies examining the effects of depression on immunity and HIV disease progression and discusses the potential role of killer lymphocytes as an underlying mechanism by which depression may impact morbidity and mortality.
Assuntos
Linfócitos T CD8-Positivos/imunologia , Depressão/imunologia , Transtorno Depressivo Maior/imunologia , Infecções por HIV/imunologia , Células Matadoras Naturais/imunologia , Comorbidade , Depressão/mortalidade , Transtorno Depressivo Maior/mortalidade , Feminino , Infecções por HIV/mortalidade , Humanos , Contagem de Linfócitos , Masculino , Psiconeuroimunologia , Risco , Taxa de SobrevidaRESUMO
Can psychological factors, such as depression, affect human immunodeficiency virus progression? HIV infection is viewed as a chronic illness in which those infected often confront a number of emotional challenges and physical health and disease-related issues. Over the past 20 years, there has been increasing evidence that depression and other mood-related disturbances are commonly observed among HIV-positive individuals. There is also mounting data showing that depressive symptoms might further impact upon specific elements of immune system functioning and influence quality of life and health status. This paper will highlight studies examining the prevalence of depression during HIV infection and review some of the evidence examining the impact of depressive symptoms on immune function and HIV disease progression.