Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of recurrence among breast cancer (BC) survivors. However, the effects of MBSR (BC) on telomere length (TL) and telomerase activity (TA), known markers of cellular aging, psychological stress, and disease risk, are not known. This randomized, wait-listed, controlled study, nested within a larger trial, investigated the effects of MBSR (BC) on TL and TA. BC patients (142) with Stages 0-III cancer who had completed adjuvant treatment with radiation and/or chemotherapy at least 2 weeks prior to enrollment and within 2 years of completion of treatment with lumpectomy and/or mastectomy were randomly assigned to either a 6-week MBSR for BC program or a usual care. Assessments of TA and TL were obtained along with psychological measurements at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) program. The mean age of 142 participants was 55.3 years; 72% were non-Hispanic White; 78% had Stage I or II cancer; and 36% received both chemotherapy and radiation. In analyses adjusted for baseline TA and psychological status, TA increased steadily over 12 weeks in the MBSR(BC) group (approximately 17%) compared to essentially no increase in the control group (approximately 3%, p<.01). In contrast, no between-group difference was observed for TL (p = .92). These results provide preliminary evidence that MBSR(BC) increases TA in peripheral blood mononuclear cells from BC patients and have implications for understanding how MBSR(BC) may extend cell longevity at the cellular level.

BACKGROUND: Telomerase activity is a predictor of long-term cellular viability, which decreases with chronic psychological distress (Epel et al., 2004). Buddhist traditions claim that meditation decreases psychological distress and promotes well-being (e.g., Dalai Lama and Cutler, 2009). Therefore, we investigated the effects of a 3-month meditation retreat on telomerase activity and two major contributors to the experience of stress: Perceived Control (associated with decreased stress) and Neuroticism (associated with increased subjective distress). We used mediation models to test whether changes in Perceived Control and Neuroticism explained meditation retreat effects on telomerase activity. In addition, we investigated whether two qualities developed by meditative practice, increased Mindfulness and Purpose in Life, accounted for retreat-related changes in the two stress-related variables and in telomerase activity. METHODS: Retreat participants (n=30) meditated for∼6h daily for 3 months and were compared with a wait-list control group (n=30) matched for age, sex, body mass index, and prior meditation experience. Retreat participants received instruction in concentrative meditation techniques and complementary practices used to cultivate benevolent states ofmind (Wallace, 2006). Psychological measures were assessed pre- and post-retreat. Peripheral blood mononuclear cell samples were collected post-retreat for telomerase activity. Because there were clear, a priori hypotheses, 1-tailed significance criteria were used throughout. RESULTS: Telomerase activity was significantly greater in retreat participants than in controls at the end of the retreat (p<0.05). Increases in Perceived Control, decreases in Neuroticism, and increases in both Mindfulness and Purpose in Life were greater in the retreat group (p<0.01). Mediation analyses indicated that the effect of the retreat on telomerase was mediated by increased Perceived Control and decreased Neuroticism. In turn, changes in Perceived Control and Neuroticism were both partially mediated by increased Mindfulness and Purpose in Life. Additionally, increases in Purpose in Life directly mediated the telomerase group difference, whereas increases in Mindfulness did not. CONCLUSIONS: This is the first study to link meditation and positive psychological change with telomerase activity. Although we did not measure baseline telomerase activity, the data suggest that increases in perceived control and decreases in negative affectivity contributed to an increase in telomerase activity, with implications for telomere length and immune cell longevity. Further, Purpose in Life is influenced by meditative practice and directly affects both perceived control and negative emotionality, affecting telomerase activity directly as well as indirectly.

OBJECTIVE: The objective of this study was to explore the feasibility and efficacy of adding integrative qigong meditation to residential treatment for substance abuse.

METHODS: Qigong meditation, which blends relaxation, breathing, guided imagery, inward attention, and mindfulness to elicit a tranquil state, was introduced into a short-term residential treatment program. At first clients chose to participate in qigong meditation on a voluntary basis during their evening break. Later they chose to participate in either meditation or Stress Management and Relaxation Training (SMART) twice a day as part of the scheduled treatment. Weekly questionnaires were completed by 248 participants for up to 4 weeks to assess their changes in treatment outcomes. Participants in the meditation group were also assessed for quality of meditation to evaluate the association between quality and treatment outcome.

RESULTS: Most clients were amenable to meditation as part of the treatment program, and two thirds chose to participate in daily meditation. While both groups reported significant improvement in treatment outcome, the meditation group reported a significantly higher treatment completion rate (92% versus 78%, p<01) and more reduction in craving than did the SMART group. Participants whose meditation was of acceptable quality reported greater reductions in craving, anxiety, and withdrawal symptoms than did those whose meditation was of low quality. Female meditation participants reported significantly more reduction in anxiety and withdrawal symptoms than did any other group.

CONCLUSIONS: Qigong meditation appears to contribute positively to addiction treatment outcomes, with results at least as good as those of an established stress management program. Results for those who meditate adequately are especially encouraging. Meditative therapy may be more effective or acceptable for female drug abusers than for males. Further study is needed to assess ways to improve substance abusers' engagement and proficiency in meditation.

Mindfulness-based meditation interventions have become increasingly popular in contemporary psychology. Other closely related meditation practices include loving-kindness meditation (LKM) and compassion meditation (CM), exercises oriented toward enhancing unconditional, positive emotional states of kindness and compassion. This article provides a review of the background, the techniques, and the empirical contemporary literature of LKM and CM. The literature suggests that LKM and CM are associated with an increase in positive affect and a decrease in negative affect. Preliminary findings from neuroendocrine studies indicate that CM may reduce stress-induced subjective distress and immune response. Neuroimaging studies suggest that LKM and CM may enhance activation of brain areas that are involved in emotional processing and empathy. Finally, preliminary intervention studies support application of these strategies in clinical populations. It is concluded that, when combined with empirically supported treatments, such as cognitive-behavioral therapy, LKM and CM may provide potentially useful strategies for targeting a variety of different psychological problems that involve interpersonal processes, such as depression, social anxiety, marital conflict, anger, and coping with the strains of long-term caregiving.

Mindfulness-based meditation interventions have become increasingly popular in contemporary psychology. Other closely related meditation practices include loving-kindness meditation (LKM) and compassion meditation (CM), exercises oriented toward enhancing unconditional, positive emotional states of kindness and compassion. This article provides a review of the background, the techniques, and the empirical contemporary literature of LKM and CM. The literature suggests that LKM and CM are associated with an increase in positive affect and a decrease in negative affect. Preliminary findings from neuroendocrine studies indicate that CM may reduce stress-induced subjective distress and immune response. Neuroimaging studies suggest that LKM and CM may enhance activation of brain areas that are involved in emotional processing and empathy. Finally, preliminary intervention studies support application of these strategies in clinical populations. It is concluded that, when combined with empirically supported treatments, such as cognitive-behavioral therapy, LKM and CM may provide potentially useful strategies for targeting a variety of different psychological problems that involve interpersonal processes, such as depression, social anxiety, marital conflict, anger, and coping with the strains of long-term caregiving.

Relatively short telomere length may serve as a marker of accelerated aging, and shorter telomeres have been linked to chronic stress. Specific lifestyle behaviors that can mitigate the effects of stress might be associated with longer telomere lengths. Previous research suggests a link between behaviors that focus on the well-being of others, such as volunteering and caregiving, and overall health and longevity. We examined relative telomere length in a group of individuals experienced in Loving-Kindness Meditation (LKM), a practice derived from the Buddhist tradition which utilizes a focus on unselfish kindness and warmth towards all people, and control participants who had done no meditation. Blood was collected by venipuncture, and Genomic DNA was extracted from peripheral blood leukocytes. Quantitative real time PCR was used to measure relative telomere length (RTL) (Cawthon, 2002) in fifteen LKM practitioners and 22 control participants. There were no significant differences in age, gender, race, education, or exposure to trauma, but the control group had a higher mean body mass index (BMI) and lower rates of past depression. The LKM practitioners had longer RTL than controls at the trend level (p=.083); among women, the LKM practitioners had significantly longer RTL than controls, (p=.007), which remained significant even after controlling for BMI and past depression. Although limited by small sample size, these results offer the intriguing possibility that LKM practice, especially in women, might alter RTL, a biomarker associated with longevity.

Relatively short telomere length may serve as a marker of accelerated aging, and shorter telomeres have been linked to chronic stress. Specific lifestyle behaviors that can mitigate the effects of stress might be associated with longer telomere lengths. Previous research suggests a link between behaviors that focus on the well-being of others, such as volunteering and caregiving, and overall health and longevity. We examined relative telomere length in a group of individuals experienced in Loving-Kindness Meditation (LKM), a practice derived from the Buddhist tradition which utilizes a focus on unselfish kindness and warmth towards all people, and control participants who had done no meditation. Blood was collected by venipuncture, and Genomic DNA was extracted from peripheral blood leukocytes. Quantitative real time PCR was used to measure relative telomere length (RTL) (Cawthon, 2002) in fifteen LKM practitioners and 22 control participants. There were no significant differences in age, gender, race, education, or exposure to trauma, but the control group had a higher mean body mass index (BMI) and lower rates of past depression. The LKM practitioners had longer RTL than controls at the trend level (p=.083); among women, the LKM practitioners had significantly longer RTL than controls, (p=.007), which remained significant even after controlling for BMI and past depression. Although limited by small sample size, these results offer the intriguing possibility that LKM practice, especially in women, might alter RTL, a biomarker associated with longevity.

In this article, we describe the clinical applicability of loving-kindness meditation (LKM) to individuals suffering from schizophrenia-spectrum disorders with persistent negative symptoms. LKM may have potential for reducing negative symptoms such as anhedonia, avolition, and asociality while enhancing factors consistent with psychological recovery such as hope and purpose in life. Case studies will illustrate how to conduct this group treatment with clients with negative symptoms, the potential benefits to the client, and difficulties that may arise. Although LKM requires further empirical support, it promises to be an important intervention since there are few treatments for clients afflicted with negative symptoms.

In this article, we describe the clinical applicability of loving-kindness meditation (LKM) to individuals suffering from schizophrenia-spectrum disorders with persistent negative symptoms. LKM may have potential for reducing negative symptoms such as anhedonia, avolition, and asociality while enhancing factors consistent with psychological recovery such as hope and purpose in life. Case studies will illustrate how to conduct this group treatment with clients with negative symptoms, the potential benefits to the client, and difficulties that may arise. Although LKM requires further empirical support, it promises to be an important intervention since there are few treatments for clients afflicted with negative symptoms.

BACKGROUND:Meditation is associated with lower blood pressure, but little is known about how loving-kindness meditation affects nitric oxide (NO) metabolism, a key mediator of cardiovascular physiology associated with vasodilation.

METHODS:We studied seven inexperienced and five experienced healthy meditators at one study visit, after they refrained from eating nitrate-rich foods for at least 12h. Participants completed questionnaires on demographics and meditation practices. We measured nitrite and nitrate and self-reported stress at baseline, after a neutral reading period (prior to meditation), immediately after, and 10 min following a standardized 20-min loving-kindness meditation.

RESULTS:The 12 subjects had a mean age of 51 years, and two were male. Stress was significantly lower at baseline in the experienced group (15 vs. 49 on 100 point scale, P<.05) as was heart rate (HR) [68.1± 0.5 beats per minute (bpm) vs. 73.4 ± 0.7 bpm, P<.05]. Stress levels fell significantly with meditation (52 vs. 11, P<.05), while relaxation increased (55 vs. 89, P<.05) in the inexperienced group. Plasma nitrite levels were not significantly higher, but nitrate levels were more than twice as high (P<.05) for experienced vs. inexperienced meditators before and after loving-kindness meditation.

CONCLUSION:Loving-kindness meditation is associated with stress reduction in inexperienced meditators. Experienced meditators had higher nitrate levels, trended toward having higher nitrite levels, and had significantly lower stress levels than inexperienced meditators. Nitric oxide metabolism may be involved in the cardiovascular effects of persistent meditation practice. Larger longitudinal studies would be fruitful to better understand the mechanisms involved.

Unlike younger women, the risk of cardiovascular disease in older women matches or exceeds that of men. Excessive cortisol may play a role in this increased risk. Here we explore the possibility that the Transcendental Meditation (TM) program may reduce the cortisol response to a metabolic stressor as a way of reducing disease risk in older women. Data from 16 women who were long-term practitioners of transcendental meditation (mean = 23 y) were compared with data from 14 control women matched for age (mean = 75 y, range = 65-92 y). Data on demographics, disease symptoms, and psychological variables were collected, and cortisol response to a metabolic stressor (75 g of glucose, orally) was examined in saliva and urine. Pre-glucose levels of salivary cortisol were identical for the two groups. Post-glucose cortisol rose faster in the controls and was significantly higher than that in the TM women (P<1 3 10(-4)). Urinary excretion of cortisol during this period was 3 times higher in controls than in the TM women (2.4 +/- 0.17 and 0.83 +/- 0.10 microg/h, respectively; P = 2 x 10(-4)). In addition, the number of months practicing transcendental meditation was inversely correlated with CVD risk factors. Lower cortisol response to metabolic challenge may reflect improved endocrine regulation relevant to the disease-preventing effects of transcendental meditation in older women.

Objective. To determine the effect of six weeks of yoga and meditation on medical students' levels of perceived stress and sense of wellbeing prior to taking their exams. Methods. We conducted a prospective case-control study of first-through-third-year medical students at our academic institution, measuring levels of perceived stress and sense of wellbeing before and after a six-week yoga and meditation intervention. Questionnaires used for evaluation included the perceived stress scale (PSS) and self-assessment surveys (SAS). The postintervention surveys were completed on the day of the students' written exams. Results. A total of thirteen women and fourteen men participated. Median age was 28 (24 yrs-32 yrs). 48.1% were Caucasian, 7.4% Black, 11.1% Hispanic, 11.1% Asian, and 22.2% other. Paired t-tests showed a statistically significant reduction in perceived stress (18.44 versus 14.52; p = 0.004) after the six-week yoga and meditation program. After the yoga intervention, self-assessment survey results showed a significant improvement in feelings of peace, focus, and endurance. Improvements in happiness, positivity, personal satisfaction, and self-confidence were also seen. An improvement in unsubstantiated parameters such as patience and fatigue was observed. Conclusion. Yoga and meditation may be effective in reducing stress levels and improving aspects of personal wellbeing in medical students.

Objective. To determine the effect of six weeks of yoga and meditation on medical students' levels of perceived stress and sense of wellbeing prior to taking their exams. Methods. We conducted a prospective case-control study of first-through-third-year medical students at our academic institution, measuring levels of perceived stress and sense of wellbeing before and after a six-week yoga and meditation intervention. Questionnaires used for evaluation included the perceived stress scale (PSS) and self-assessment surveys (SAS). The postintervention surveys were completed on the day of the students' written exams. Results. A total of thirteen women and fourteen men participated. Median age was 28 (24 yrs-32 yrs). 48.1% were Caucasian, 7.4% Black, 11.1% Hispanic, 11.1% Asian, and 22.2% other. Paired t-tests showed a statistically significant reduction in perceived stress (18.44 versus 14.52; p = 0.004) after the six-week yoga and meditation program. After the yoga intervention, self-assessment survey results showed a significant improvement in feelings of peace, focus, and endurance. Improvements in happiness, positivity, personal satisfaction, and self-confidence were also seen. An improvement in unsubstantiated parameters such as patience and fatigue was observed. Conclusion. Yoga and meditation may be effective in reducing stress levels and improving aspects of personal wellbeing in medical students.

Medical yoga is defined as the use of yoga practices for the prevention and treatment of  medical conditions. Beyond the physical elements of yoga, which are important and effective for  strengthening  the  body,  medical  yoga  also  incorporates  appropriate  breathing  techniques,  mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have  shown that yoga can positively impact the body in many ways, including helping to regulate blood  glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It  also has been shown to have important psychological benefits, as the practice of yoga can help to  increase mental energy and positive feelings, and decrease negative feelings of aggressiveness,  depression and anxiety.

Medical yoga is defined as the use of yoga practices for the prevention and treatment of  medical conditions. Beyond the physical elements of yoga, which are important and effective for  strengthening  the  body,  medical  yoga  also  incorporates  appropriate  breathing  techniques,  mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have  shown that yoga can positively impact the body in many ways, including helping to regulate blood  glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It  also has been shown to have important psychological benefits, as the practice of yoga can help to  increase mental energy and positive feelings, and decrease negative feelings of aggressiveness,  depression and anxiety.

Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. Meditation instruction and practice is widely accessible and inexpensive and may thus be a potential attractive cost-effective adjunct to more traditional medical therapies. Accordingly, this American Heart Association scientific statement systematically reviewed the data on the potential benefits of meditation on cardiovascular risk. Neurophysiological and neuroanatomical studies demonstrate that meditation can have long-standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established. Further research on meditation and cardiovascular risk is warranted. Such studies, to the degree possible, should utilize randomized study design, be adequately powered to meet the primary study outcome, strive to achieve low drop-out rates, include long-term follow-up, and be performed by those without inherent bias in outcome.

BACKGROUND:While effective therapies for preventing or slowing cognitive decline in at-risk populations remain elusive, evidence suggests mind-body interventions may hold promise.

OBJECTIVES:In this study, we assessed the effects of Kirtan Kriya meditation (KK) and music listening (ML) on cognitive outcomes in adults experiencing subjective cognitive decline (SCD), a strong predictor of Alzheimer's disease.

METHODS:Sixty participants with SCD were randomized to a KK or ML program and asked to practice 12 minutes/day for 3 months, then at their discretion for the ensuing 3 months. At baseline, 3 months, and 6 months we measured memory and cognitive functioning [Memory Functioning Questionnaire (MFQ), Trail-making Test (TMT-A/B), and Digit-Symbol Substitution Test (DSST)].

RESULTS:The 6-month study was completed by 53 participants (88%). Participants performed an average of 93% (91% KK, 94% ML) of sessions in the first 3 months, and 71% (68% KK, 74% ML) during the 3-month, practice-optional, follow-up period. Both groups showed marked and significant improvements at 3 months in memory and cognitive performance (MFQ, DSST, TMT-A/B; p's≤0.04). At 6 months, overall gains were maintained or improved (p's≤0.006), with effect sizes ranging from medium (DSST, ML group) to large (DSST, KK group; TMT-A/B, MFQ). Changes were unrelated to treatment expectancies and did not differ by age, gender, baseline cognition scores, or other factors.

CONCLUSIONS:Findings of this preliminary randomized controlled trial suggest practice of meditation or ML can significantly enhance both subjective memory function and objective cognitive performance in adults with SCD, and may offer promise for improving outcomes in this population.

BACKGROUND:While effective therapies for preventing or slowing cognitive decline in at-risk populations remain elusive, evidence suggests mind-body interventions may hold promise.

OBJECTIVES:In this study, we assessed the effects of Kirtan Kriya meditation (KK) and music listening (ML) on cognitive outcomes in adults experiencing subjective cognitive decline (SCD), a strong predictor of Alzheimer's disease.

METHODS:Sixty participants with SCD were randomized to a KK or ML program and asked to practice 12 minutes/day for 3 months, then at their discretion for the ensuing 3 months. At baseline, 3 months, and 6 months we measured memory and cognitive functioning [Memory Functioning Questionnaire (MFQ), Trail-making Test (TMT-A/B), and Digit-Symbol Substitution Test (DSST)].

RESULTS:The 6-month study was completed by 53 participants (88%). Participants performed an average of 93% (91% KK, 94% ML) of sessions in the first 3 months, and 71% (68% KK, 74% ML) during the 3-month, practice-optional, follow-up period. Both groups showed marked and significant improvements at 3 months in memory and cognitive performance (MFQ, DSST, TMT-A/B; p's≤0.04). At 6 months, overall gains were maintained or improved (p's≤0.006), with effect sizes ranging from medium (DSST, ML group) to large (DSST, KK group; TMT-A/B, MFQ). Changes were unrelated to treatment expectancies and did not differ by age, gender, baseline cognition scores, or other factors.

CONCLUSIONS:Findings of this preliminary randomized controlled trial suggest practice of meditation or ML can significantly enhance both subjective memory function and objective cognitive performance in adults with SCD, and may offer promise for improving outcomes in this population.