Evaluation of Vipassana Meditation Course Effects on Subjective Stress,Well‐being,Self‐kindness and Mindfulness in a Community Sample: Post‐course and 6‐month Outcomes

Residential Vipassana meditation courses, which teach mindfulness skills, are widely available globally but under‐evaluated. This study examined effects of a standardized, community‐based Vipassana course, on subjective stress, well‐being, self‐kindness and trait mindfulness in a community sample. Participants completed self‐report measures of these variables at pre‐course and post‐course (n = 122), and outcomes were compared to a control group of early enrollers (EEs) (n = 50) who completed measures at parallel time points before course commencement. Six‐month follow‐up was undertaken in the intervention group (n = 90). Findings, including intention‐to‐complete analyses, suggested positive effects of the Vipassana course in reducing subjective stress and increasing well‐being, self‐kindness and overall mindfulness (present‐moment awareness and non‐reaction). Although some reductions in post‐course gains were found at follow‐up, particularly in stress, follow‐up scores still showed improvements compared to pre‐course scores. Mindfulness change scores between pre‐course and 6‐month follow‐up were moderately to highly correlated with outcome variable change scores, consistent with the idea that effects of the Vipassana course on stress and well‐being operate, at least partially, through increasing mindfulness. The present research underscores the importance of undertaking further investigations into Vipassana courses’ effects and applications. Copyright © 2014 John Wiley & Sons, Ltd.     

Loving‐Kindness Meditation for Posttraumatic Stress Disorder: A Pilot Study

Loving‐kindness meditation is a practice designed to enhance feelings of kindness and compassion for self and others. Loving‐kindness meditation involves repetition of phrases of positive intention for self and others. We undertook an open pilot trial of loving‐kindness meditation for veterans with posttraumatic stress disorder (PTSD). Measures of PTSD, depression, self‐compassion, and mindfulness were obtained at baseline, after a 12‐week loving‐kindness meditation course, and 3 months later. Effect sizes were calculated from baseline to each follow‐up point, and self‐compassion was assessed as a mediator. Attendance was high; 74% attended 9–12 classes. Self‐compassion increased with large effect sizes and mindfulness increased with medium to large effect sizes. A large effect size was found for PTSD symptoms at 3‐month follow‐up (d = ?0.89), and a medium effect size was found for depression at 3‐month follow‐up (d = ?0.49). There was evidence of mediation of reductions in PTSD symptoms and depression by enhanced self‐compassion. Overall, loving‐kindness meditation appeared safe and acceptable and was associated with reduced symptoms of PTSD and depression. Additional study of loving‐kindness meditation for PTSD is warranted to determine whether the changes seen are due to the loving‐kindness meditation intervention versus other influences, including concurrent receipt of other treatments.     

The benefits of meditation vis‐à‐vis emotional intelligence,perceived stress and negative mental health

This paper evaluates the benefits of meditation in regard to emotional intelligence (EI), perceived stress and negative mental health with cross‐sectional and experimental studies. It first studied 351 full‐time working adults with different amounts of experience in meditation for these factors in order to test the hypothesis that their differences in them were based on differences in meditation experience, and found that those participants with greater meditation experience exhibited higher EI, and less perceived stress and negative mental health than those who had less or none. It then randomly divided 20 graduate students with no previous experience of meditation into a mindfulness meditation group (n = 10) and a control group (n = 10), and measured them for the same variable pre‐treatment and post‐treatment to test the hypothesis that meditation training improves people's state, and found that those who completed the mindfulness meditation training demonstrated significant improvements compared to the control group. Copyright © 2009 John Wiley & Sons, Ltd.     

The effects of a mindfulness‐based stress reduction program on stress,mindfulness self‐efficacy,and positive states of mind

Mindfulness‐based stress reduction (MBSR) has grown in popularity over the last two decades, showing efficacy for a variety of health issues. In the current study, we examined the effects of an MBSR intervention on pain, positive states of mind, stress, and mindfulness self‐efficacy. These measures were collected before and following an 8‐week intervention. Post‐intervention levels of stress were significantly lower than pre‐intervention levels, while mindfulness self‐efficacy and positive states of mind were at significantly higher levels. The findings underscore the potential for stress management, awareness and attention training, and positive states of mind using MBSR. Copyright © 2004 John Wiley & Sons, Ltd.     

Consistent‐sufficient sleep predicts improvements in self‐regulatory performance and psychological strain

Sleep may have psychological implications for the stress process because of its effect on self‐regulatory functioning. This study explored the psychological benefits of sleep using an integrated self‐regulatory strength model, which includes resource enhancement in addition to resource replenishment. Combined with the restorative effects of sufficient sleep duration, prolonged consistent sleep practices may build self‐regulatory capacity via exercising self‐control. The proposed sleep sufficiency–consistency interaction predicted improvements in self‐regulatory performance and psychological strain over the course of 5 days. Only consistent–sufficient sleepers experienced an increase in self‐regulatory performance and a decrease in strain. Changes in self‐regulatory strength also predicted changes in strain during the week, rather than the reverse. These findings were robust even when controlling for confounding factors related to dispositional factors, circadian rhythm disruption, typical sleep hygiene, health behaviours and stressors. Much like other routine activities that have shown to increase self‐regulatory strength, continued explorations into the potential resource enhancement aspect of consistent sleep may be a promising topic for stress management research. Copyright © 2010 John Wiley & Sons, Ltd.     

Examining Insomnia During Intensive Treatment for Veterans with Posttraumatic Stress Disorder: Does it Improve and Does it Predict Treatment Outcomes?

Previous research has demonstrated that sleep disturbances show little improvement with evidence-based psychotherapy for posttraumatic stress disorder (PTSD); however, sleep improvements are associated with PTSD treatment outcomes. The goal of the current study was to evaluate changes in self-reported insomnia symptoms and the association between insomnia symptoms and treatment outcome during a 3-week intensive treatment program (ITP) for veterans with PTSD that integrated cognitive processing therapy (CPT), mindfulness, yoga, and other ancillary services. As part of standard clinical procedures, veterans (N = 165) completed self-report assessments of insomnia symptoms at pre- and posttreatment as well as self-report assessments of PTSD and depression symptoms approximately every other day during treatment. Most veterans reported at least moderate difficulties with insomnia at both pretreatment (83.0%–95.1%) and posttreatment (69.1–71.3%). Statistically significant reductions in self-reported insomnia severity occurred from pretreatment to posttreatment; however, the effect size was small, d = 0.33. Longitudinal mixed-effects models showed a significant interactive effect of Changes in Insomnia × Time in predicting PTSD and depression symptoms, indicating that patients with more improvements in insomnia had more positive treatment outcomes. These findings suggest that many veterans continued to struggle with sleep disruption after a 3-week ITP, and successful efforts to improve sleep could lead to better PTSD treatment outcomes. Further research is needed to establish how adjunctive sleep interventions can be used to maximize both sleep and PTSD outcomes.     

Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR)

Mindfulness‐based stress reduction (MBSR) programmes have demonstrated beneficial outcomes in a variety of populations. Self‐compassion and empathy have theoretical connections to mindfulness, the key element of the MBSR programme; however, previous studies examining the programme's impact on self‐compassion or empathy have demonstrated mixed results. This study examined the impact of MBSR on self‐compassion and empathy, as well as on mindfulness, symptoms of stress, mood disturbance and spirituality in a community sample. Significant reductions in symptoms of stress and mood disturbance, as well as increases in mindfulness, spirituality and self‐compassion were observed after programme participation. With regards to empathy, a significant increase was seen in perspective taking and a significant decrease in personal distress; no significant change was observed for empathic concern. Changes in self‐compassion were predicted by changes in mindfulness. Self‐compassion and aspects of empathy revealed strong associations with psychological functioning. Implications of MBSR as an intervention for enhancing self‐compassion and empathy are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Does dispositional mindfulness buffer the links of stressful life experiences with adolescent adjustment and sleep?

According to the mindfulness stress buffering hypothesis, mindfulness protects individuals from negative effects of stress. Prior investigations focused on the potential of mindfulness for reducing internalizing symptoms for adults in the context of general stress. We provided the first test of the mindfulness stress buffering hypothesis in the context of both adolescent general stress and interparental conflict (IPC) in relation to internalizing and externalizing, as well as sleep. Participants were 150 adolescents who reported dispositional mindfulness, perceived stress, IPC, internalizing, and externalizing. Participants wore an actigraph which objectively measured sleep for a week. Results suggested a stress buffering effect of mindfulness for the effects of general stress on internalizing symptoms at trend levels. Mindfulness stress buffering was not evident in relation to externalizing or sleep, or for the effect of IPC appraisals on adjustment or sleep. Greater IPC appraisals were associated with greater sleep onset latency, but mindfulness was not associated with objective measures of sleep quality or quantity. This study indicates that mindfulness may protect adolescents from the internalizing problems that often result from general stress, but that these stress buffering effects of mindfulness may not generalize to all types of stressors or adjustment/health outcomes.     

Insomnia in a displaced population is related to war-associated remembered stress

Although traumatic events are presumed to cause sleep disturbances, particularly insomnia, sleep in populations subjected to forced displacement has received little attention. The present study examined the prevalence of insomnia and associated factors in internally displaced persons (IDPs) from Abkhazia 15 years after displacement to Tbilisi. Detailed subjective information about sleep–wake habits, sleep‐related and stress‐related parameters were obtained from 87 IDPs categorized into good sleepers and insomniacs. The Insomnia Severity Index, Perceived Stress Scale and Beck Depression Inventory were administered. The incidence of insomnia was 41.4%. The majority of insomniacs strongly believed that war‐related stress accounted for the onset of their insomnia. Stepwise regression (95% confidence interval) revealed four variables significantly associated with insomnia status: self‐estimated influence of war related stress (odds ratio (OR) = 2.51), frequency of nightmares (OR = 1.6), Perceived Stress Scale score (OR = 1.14) and Beck Depression Inventory score (OR = 1.12). Insomnia in IDPs was strongly related to war‐associated remembered stress. ?Over thinking’ about major stress exposure enhanced IDPs' vulnerability to insomnia. These findings have implications for the management of insomnia and associated impairment of daytime functioning in IDPs. Copyright © 2011 John Wiley & Sons, Ltd.     

The effects of mindfulness‐based group intervention on the mental health of middle‐aged Korean women in community

This study was conducted to develop a mindfulness and self‐compassion enhancement intervention for middle‐aged women who complained of emotional distress and to ascertain whether participation in the mindfulness‐based programme was associated with an increase in psychological well‐being and the improvement of psychological symptoms. The results showed that time by group interactions were significant in improving psychological well‐being, depression, anxiety, hostility, somatization, positive affect (PA) and negative affect (NA). These results suggest that participants in the mindfulness and self‐compassion group programme appeared to have enhanced psychological well‐being and improved psychological distress. The study findings also suggest that mindfulness and self‐compassion enhancement programme may be an intervention with potential for helping many individuals to learn to deal with emotional distress. Copyright © 2010 John Wiley & Sons, Ltd.     

Increased Mindfulness Skills as Predictors of Reduced Trauma‐Related Guilt in Treatment‐Seeking Veterans

The present study examined the predictive role of increased self‐reported mindfulness skills on reduced trauma‐related guilt in a sample of veterans over the course of residential treatment for posttraumatic stress disorder (PTSD; N = 128). The residential treatment consisted of seven weeks of intensive cognitive processing therapy (CPT) for PTSD, as well as additional psychoeducational groups, including seven sessions on mindfulness skills. Increased mindfulness skills describing, acting with awareness, and accepting without judgment were significantly associated with reductions in trauma‐related guilt over the course of treatment. Increases in the ability to act with awareness and accept without judgment were significantly associated with reductions in global guilt, R ² = .26, guilt distress, R ²= .23, guilt cognitions, R ²= .23, and lack of justification, R ²= .11. An increase in the ability to accept without judgment was the only self‐reported mindfulness skill that was associated with reductions in hindsight bias, β = −.34 and wrongdoing, β = −.44. Increases in self‐reported mindfulness skills explained 15.1 to 24.1% of the variance in reductions in trauma‐related guilt, suggesting that mindfulness skills may play a key role in reducing the experience of trauma‐related guilt during psychotherapy. Our results provide preliminary support for the use of mindfulness groups as an adjunct to traditional evidence‐based treatments aimed at reducing trauma‐related guilt, though this claim needs to be tested further using experimental designs.     

Perceived stress mediates the relationship between mindfulness and negative affect variability: A randomized controlled trial among middle‐aged to older adults

Despite the interest in mindfulness over the past 20 years, studies have only recently begun to examine mindfulness in older adults. The primary aim of this study was to evaluate pretreatment to post‐treatment change in negative affect variability (NAV) following a mindfulness training among 134 mildly stressed, middle‐aged to older adults. The secondary aim was to assess if the effects of mindfulness training on NAV would be partially explained by pretreatment to post‐treatment reductions in perceived stress, a trend that would be congruent with several stress models. In this randomized control trial, participants were assigned to either a 6‐week mindfulness meditation training programme or to a wait list control. Ecological momentary assessment, a data capturing technique that queries about present moment experiences in real time, captured NAV. Mixed‐model ANOVAs and a path analysis were conducted. Participants in the mindfulness meditation training significantly reduced NAV when compared with wait list control participants. Further, there was a significant indirect group effect on reductions in NAV through change in perceived stress. Few studies have tested mechanisms of action, which connect changes that occur during mindfulness training with psychological outcomes in older adults. Understanding the mechanisms by which mindfulness enhances well‐being may optimize interventions.     

Influence of Sleep Disturbance on Global Functioning After Posttraumatic Stress Disorder Treatment

Chronic insomnia and recurrent nightmares are prominent features of posttraumatic stress disorder (PTSD). Evidence from adult research indicates that these sleep disturbances do not respond as well to cognitive–behavioral therapies for PTSD and are associated with poorer functional outcomes. This study examined the effect of prolonged exposure therapy for adolescents versus client‐centered therapy on posttraumatic sleep disturbance, and the extent to which sleep symptoms impacted global functioning among adolescents with sexual abuse‐related PTSD. Participants included 61 adolescent girls seeking treatment at a rape crisis center. The Child PTSD Symptom Scale‐Interview (Foa, Johnson, Feeny, & Treadwell, 2001) was used to assess PTSD diagnosis and severity of symptoms, including insomnia and nightmares. The Children's Global Assessment Scale (Shaffer et al., 1983) was used to assess global functioning. There were significant main effects of time and treatment on insomnia symptoms. Additionally, there was a main effect of time on nightmares. Results also showed that insomnia and nightmares significantly predicted poorer global functioning posttreatment (R² = .21). Despite significant improvements in posttraumatic sleep disturbance, there were still clinically significant insomnia symptoms after treatment, suggesting that additional interventions may be warranted to address residual sleep disturbance in PTSD.     

Effect of Brief Mindfulness Intervention on Tolerance and Distress of Pain Induced by Cold‐Pressor Task

A number of studies have demonstrated that short‐term meditation intervention can lead to greater tolerance and lower pain or distress ratings of experimentally induced pain. However, few attempts have been made to examine the effects of short‐term mindfulness‐based intervention on the tolerance and distress of pain, when delivered in a therapist‐free form. The present research explored the effect of brief mindfulness intervention using pre‐recorded instruction on pain experimentally induced by the cold‐pressor task. The effects of the mindfulness strategy, the distraction strategy and spontaneous strategy, all through the instructions of pre‐recorded voices, were compared. The subjects were drawn from healthy college students and randomly assigned to the aforementioned three groups. Our results showed that compared with using spontaneous strategies, the mindfulness intervention significantly improved the participants' pain tolerance and reduced their immersion distress. The distraction strategy also significantly improved the participants' pain tolerance. However, it did not have a significant effect on the participants' level of distress during the immersion period. Our results suggest that brief mindfulness intervention without a therapist's personal involvement is capable of helping people cope with pain induced by the cold‐pressor task. Copyright © 2012 John Wiley & Sons, Ltd.     

Mindfulness,Self‐Compassion,Posttraumatic Stress Disorder Symptoms,and Functional Disability in U.S. Iraq and Afghanistan War Veterans

Mindfulness and self‐compassion are overlapping, but distinct constructs that characterize how people relate to emotional distress. Both are associated with posttraumatic stress disorder (PTSD) and may be related to functional disability. Although self‐compassion includes mindful awareness of emotional distress, it is a broader construct that also includes being kind and supportive to oneself and viewing suffering as part of the shared human experience—a potentially powerful way of dealing with distressing situations. We examined the association of mindfulness and self‐compassion with PTSD symptom severity and functional disability in 115 trauma‐exposed U.S. Iraq/Afghanistan war veterans. Mindfulness and self‐compassion were each uniquely, negatively associated with PTSD symptom severity. After accounting for mindfulness, self‐compassion accounted for unique variance in PTSD symptom severity (f² = .25; medium ES). After accounting for PTSD symptom severity, mindfulness and self‐compassion were each uniquely negatively associated with functional disability. The combined association of mindfulness and self‐compassion with disability over and above PTSD was large (f² = .41). After accounting for mindfulness, self‐compassion accounted for unique variance in disability (f² = .13; small ES). These findings suggest that interventions aimed at increasing mindfulness and self‐compassion could potentially decrease functional disability in returning veterans with PTSD symptoms.     

Sleep Variability in Military‐Related PTSD: A Comparison to Primary Insomnia and Healthy Controls

Sleep disturbances are prevalent in posttraumatic stress disorder (PTSD) and are associated with a number of adverse health consequences. Few studies have used comprehensive assessment methods to characterize sleep in Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OEF/OIF/OND) veterans with PTSD. OEF/OIF/OND veterans with PTSD and sleep disturbance (n = 45) were compared to patients with primary insomnia (n = 25) and healthy control subjects (n = 27). Participants were assessed using questionnaire‐based measures as well as daily subjective and objective measures of sleep. The 3 groups were compared with regard to (a) group means, (b) intraindividual (i.e., night‐to‐night) variability of sleep, and (c) interindividual (i.e., within‐group) variability of sleep. In terms of group means, only objective sleep efficiency was significantly worse with PTSD than with primary insomnia (d = 0.54). Those with PTSD differed from those with primary insomnia on measures of intraindividual as well as interindividual variability (d = 0.48–0.73). These results suggested sleep symptoms in OEF/OIF/OND veterans with PTSD are more variable across nights and less consistent across patients relative to sleep symptoms in insomnia patients without PTSD. These findings have implications for research, as well as for personalizing treatment for individuals with PTSD.     

Stress‐related growth: pre‐intervention correlates and change following a resilience intervention

Correlates of stress‐related growth and the effectiveness of a resilience intervention to enhance stress‐related growth were examined. College students were randomly assigned to intervention (n = 31) and waiting list control (n = 33) groups. The intervention group received the psychoeducational intervention, Transforming Lives Through Resilience Education, in four weekly 2‐hour sessions. Measures of personal, environmental and stressor characteristics, coping strategies, adjustment and stress‐related growth were assessed. Multiple regressions revealed that pre‐intervention self‐esteem, self‐leadership, hopeful coping and depressive symptoms significantly related to pre‐intervention growth. A repeated measures analysis of variance yielded a significant group by time interaction for total growth; the intervention group showed greater increases in growth pre‐ to post‐intervention compared with the control group. Our results supported the relationships of self‐esteem and adaptive coping strategies to stress‐related growth and introduce a new correlate of growth, self‐leadership, to the literature. In addition, our results highlighted the complex role depressive symptoms may play in relation to growth, indicating that depressive symptoms might decrease one's inner resources while simultaneously serving as a catalyst for growth. Further, the findings supported the resilience intervention as a promising approach to facilitate growth. Copyright © 2009 John Wiley & Sons, Ltd.     

Relationship Between Meditation Depth and Waking Salivary Alpha‐Amylase Secretion Among Long‐Term MBSR Instructors

The purpose of this study was to characterize sympathetic activity by using waking salivary alpha‐amylase (sAA) concentrations in a group of long‐term meditation instructors and to examine the association between meditation (depth, dose and duration) and the waking alpha‐amylase response. Salivary alpha‐amylase samples were collected (immediately upon waking and at 15‐min, 30‐min and 45‐min intervals after waking) from mindfulness‐based stress reduction instructors to determine both the area under the curve and the awakening slope (difference in alpha‐amylase concentrations between waking and 30‐min post‐waking). It was determined through general linear models that neither years of meditation nor meditation dose were associated with the awakening sAA slope, but higher scores for meditation depth (greater depth) was associated with a more negative (or steeper) awakening slope [Quartile (Q)1: ?7 versus Q4: ?21 U/mL; p = 0.06], in fully adjusted models. Older age (p = 0.04) and a later time of waking (p < 0.01) also were associated with less negative awakening slope values. Smoking was associated with lower area under the curve values (smokers: 1716 U/mL versus nonsmokers: 2107 U/mL; p = 0.05) in fully adjusted models. The results suggest a ‘healthy’ sAA waking slope among individuals who meditate more deeply. Copyright © 2016 John Wiley & Sons, Ltd.