Psychoneuroendocrinoimmunology-based meditation (PNEIMED) training reduces salivary cortisol under basal and stressful conditions in healthy university students: Results of a randomized controlled study.

BACKGROUND: Meditation represents an effective and safe practice to lower distress and promote well-being. PsychoNeuroEndocrinoImmunology-based Meditation (PNEIMED) is a validated method that can reduce stress-related symptoms and salivary cortisol secretion. To date, few randomised controlled trials (RCTs) have assessed cortisol levels through salivary samples, collected both in the morning phase and during acute mental stress elicitation, in healthy young subjects following brief meditation training. AIM: The present study aims to investigate, in healthy young undergraduate students, the effects of a brief PNEIMED training course on HPA axis by measuring salivary cortisol levels. METHODS: Forty students attending the Faculty of Psychology, without comorbidities and previous experience of meditation, were enrolled in the study. Twenty subjects were randomly assigned to 30 h of PNEIMED training (intervention group, IG), and twenty subjects were randomly assigned to 30 h of academic lessons (control group, CG). Salivary cortisol measures included basal morning (t0 = baseline time, collected 30 min after waking) and under stress-eliciting task values. Cortisol measurement under the stress-eliciting task was provided through the Subtraction Stress Task (SST) at scheduled time intervals (t1 = 5 min pre-SST, t2 = 10 min post-SST, t3 = 30 min = post-SST). Salivary cortisol was measured among all subjects (IG + CG) at the beginning (pre-test) and at the end (post-test, four days later) of the study. RESULTS: ANOVA between-group analysis of basal diurnal salivary cortisol showed a significant hormone deflection in the IG at the end of the PNEIMED course (post-test) when compared to the CG (IG post-test 5.64 ± 4.2 vs CG post-test 9.44 ± 4.9; F1,38 = 6.838; p = 0.013). RM-ANOVA within-group analysis for the IG also showed that time and condition effects were statistically significant, with Ftime = 5.438; p = 0.002 and Fcondition = 10.478; p = 0.004, respectively. The IG group presented a significant reduction in basal morning cortisol at the end of the PNEIMED course (post-test) compared to the salivary concentration at baseline (pre-test) (IG pre-test 9.42 ± 6.0 vs IG post-test 5.64 ± 4.2; F1,38 8,354; p = 0.009). RM-ANOVA for the control group showed only the main effect of time (F1,38 = 40.348; p < 0.001). Regarding cortisol measures under the SST-stress eliciting task, ANOVA between-groups analysis showed higher cortisol levels in the IG than in the CG before the PNEIMED course, with significant differences between groups at time t2 and time t3. After the PNEIMED course, the cortisol levels in the IG had decreased, although the differences between groups were not significant. Interestingly, ANOVA within-groups analysis showed that in the IG, the cortisol levels post-test (after the PNEIMED course) were lower than at pre-test (before the PNEIMED course), showing a significant difference of cortisol salivary concentration between conditions at t3 (F = 5.326; p = 0.032). In the control group, the post-hoc analyses for pairwise comparisons between conditions (pre-test vs post-test) did not show significant differences. CONCLUSION: Although the low number of subjects enrolled in the study does not allow for definitive conclusions to be drawn, the present findings confirmed the capability of the PNEIMED method to lower stress hormone secretion both at baseline and under acute mental stimulation in a group of young naïve practitioners and make a contribution to the existing literature by increasing the number of published RCTs about the topic.

Brief training of psychoneuroendocrinoimmunology-based meditation (PNEIMED) reduces stress symptom ratings and improves control on salivary cortisol secretion under basal and stimulated conditions.

CONTEXT: Meditation is proposed as an anti-stress practice lowering allostatic load and promoting well-being, with brief formats providing some of the benefits of longer interventions. OBJECTIVES: PsychoNeuroEndocrinoImmunology-based meditation (PNEIMED) combines the teaching of philosophy and practice of Buddhist meditation with a grounding in human physiology from a systemic and integrative perspective. We evaluated the effects of four-day PNEIMED training (30 h) on subjective and objective indices of stress in healthy adults. DESIGN: A non-randomized, controlled, before-and-after study was conducted. Participants (n = 125, mostly health practitioners) answered a questionnaire rating stress symptom before (T0) and after (Tf) a PNEIMED course. In an additional sample (n = 40; smokers, overweight persons, women taking contraceptives, and subjects with oral pathologies were excluded), divided into PNEIMED-attending (intervention, n = 21) and non-meditating (control, n = 19) groups, salivary cortisol was measured upon awakening and during a challenging mental task. RESULTS: Self-rated distress scores were highly reduced after the PNEIMED course. In the intervention group, improvement of psychological well-being was accompanied by decrease in cortisol levels at awakening. No T0-vs-Tf changes in distress scores and morning cortisol were found in controls. Based on baseline-to-peak increment of cortisol response at T0, 26 subjects (n = 13 for each group) were classified as task-responders. The amplitude and duration of the cortisol response decreased after PNEIMED, whereas no effects were found in controls. CONCLUSIONS: Brief PNEIMED training yields immediate benefits, reducing distress symptoms and adrenocortical activity under basal and stimulated conditions. PNEIMED may represent an effective practice to manage stress and anxiety, particularly among subjects facing a multitude of job-related stressors, such as healthcare workers.