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Dispositional mindfulness predicts attenuated waking salivary cortisol levels in cancer survivors: a latent growth curve analysis

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Abstract

Purpose

Cancer survivors experience significant stress and diminished well-being long after treatment. Dispositional mindfulness is linked with salutary coping with stress and enhanced well-being, with potentially beneficial effects on stress-related hormones. In the present study, we evaluated dispositional mindfulness as a predictor of changes in waking salivary cortisol levels among a sample of cancer survivors.

Methods

Mindfulness, well-being, and saliva samples were collected at baseline and at 4- and 12-week follow-ups. Latent growth curve analysis was conducted to examine baseline dispositional mindfulness as a predictor of changes in waking salivary cortisol over time, and regression analyses examined associations between well-being and cortisol.

Results

Findings indicated that cancer survivors who reported lower baseline levels of dispositional mindfulness exhibited increases in waking cortisol over time, whereas those who reported higher baseline dispositional mindfulness showed comparatively stable waking cortisol over the study period. Furthermore, increases in waking cortisol were associated with decreased well-being over the study period.

Conclusions

This study provides preliminary evidence that cancer survivors with higher levels of dispositional mindfulness may be buffered from deleterious changes in cortisol secretion.

Implications for Cancer Survivors

Enhanced dispositional mindfulness may promote salutary neuroendocrine function among cancer survivors and thereby improve well-being during the survivorship process.

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References

  1. Carver CS, Smith RG, Petronis VM, Antoni MH. Quality of life among long-term survivors of breast cancer: different types of antecedents predict different classes of outcomes. Psycho-Oncology. 2006;15:749–58.

    Article  PubMed  Google Scholar 

  2. Gotay CC, Muraoka MY. Quality of life in long-term survivors of adult-onset cancers. JNCI J Natl Cancer Inst. 1998;90:656–67.

    Article  CAS  PubMed  Google Scholar 

  3. Helgeson VS, Snyder P, Seltman H. Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol. 2004;23:3.

    Article  PubMed  Google Scholar 

  4. Antonovsky A. Unraveling the mystery of health. San Francisco: Jossey-Bass; 1987.

    Google Scholar 

  5. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13:27–45.

    Article  PubMed  Google Scholar 

  6. Hanley A, Garland E, Canto A, Warner A, Hanley R, Dehili V, et al. Dispositional mindfulness and bias in self-theories. Mindfulness. 2013;1–6.

  7. Garland EL, Boettiger C, Gaylord S, Chanon V, Howard M. Mindfulness is inversely associated with alcohol attentional bias among recovering alcohol-dependent adults. Cogn Ther Res. 2012;36:441–50.

    Article  Google Scholar 

  8. Weinstein N, Brown KW, Ryan RM. A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. J Res Pers. 2009;43:374–85.

    Article  Google Scholar 

  9. Walach H, Buchheld N, Buttenmüllerc V, Kleinknechtc N, Schmidta S. Measuring mindfulness —the Freiburg Mindfulness Inventory. Personal Individ Differ. 2006;40:1543–55.

    Article  Google Scholar 

  10. Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med. 2008;31:23–33.

    Article  PubMed  Google Scholar 

  11. Kirschbaum C, Hellhammer DH. Salivary cortisol in psychobiological research: an overview. Neuropsychobiology. 1989;22:150–69.

    Article  CAS  PubMed  Google Scholar 

  12. Carlson LE, Speca M, Faris P, Patel KD. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behav Immun. 2007;21:1038–49.

    Article  CAS  PubMed  Google Scholar 

  13. Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 2004;29:448–74.

    Article  CAS  PubMed  Google Scholar 

  14. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET). JCO. 2013;31:3119–26.

    Article  Google Scholar 

  15. Matousek RH, Dobkin PL, Pruessner J. Cortisol as a marker for improvement in mindfulness-based stress reduction. Complement Ther Clin Pract. 2010;16:13–9.

    Article  PubMed  Google Scholar 

  16. Chida Y, Steptoe A. Cortisol awakening response and psychosocial factors: a systematic review and meta-analysis. Biol Psychol. 2009;80:265–78.

    Article  PubMed  Google Scholar 

  17. Clow A, Hucklebridge F, Stalder T, Evans P, Thorn L. The cortisol awakening response: More than a measure of HPA axis function. Neurosci Biobehav Rev. 2010;35:97–103.

    Article  CAS  PubMed  Google Scholar 

  18. Adam EK, Hawkley LC, Kudielka BM, Cacioppo JT. Day-to-day dynamics of experience–cortisol associations in a population-based sample of older adults. Proc Natl Acad Sci. 2006;103:17058–63.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Dahlgren A, Kecklund G, Theorell T, AAkerstedt T. Day-to-day variation in saliva cortisol—relation with sleep, stress and self-rated health. Biol Psychol. 2009;82:149–55.

    Article  PubMed  Google Scholar 

  20. Vreeburg SA, Kruijtzer BP, van Pelt J, van Dyck R, DeRijk RH, Hoogendijk WJ, et al. Associations between sociodemographic, sampling and health factors and various salivary cortisol indicators in a large sample without psychopathology. Psychoneuroendocrinology. 2009;34:1109–20.

    Article  CAS  PubMed  Google Scholar 

  21. Wilhelm I, Born J, Kudielka BM, Schlotz W, Wüst S. Is the cortisol awakening rise a response to awakening? Psychoneuroendocrinology. 2007;32:358–66.

    Article  CAS  PubMed  Google Scholar 

  22. Buske-Kirschbaum A. Cortisol responses to stress in allergic children: interaction with the immune response. Neuroimmunomodulation. 2009;16:325–32.

    Article  CAS  PubMed  Google Scholar 

  23. Kudielka BM, Kirschbaum C. Awakening cortisol responses are influenced by health status and awakening time but not by menstrual cycle phase. Psychoneuroendocrinology. 2003;28:35–47.

    Article  CAS  PubMed  Google Scholar 

  24. Quirin M, Pruessner JC, Kuhl J. HPA system regulation and adult attachment anxiety: individual differences in reactive and awakening cortisol. Psychoneuroendocrinology. 2008;33:581–90.

    Article  CAS  PubMed  Google Scholar 

  25. Ebrecht M, Hextall J, Kirtley L-G, Taylor A, Dyson M, Weinman J. Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology. 2004;29:798–809.

    Article  CAS  PubMed  Google Scholar 

  26. Huber TJ, Issa K, Schik G, Wolf OT. The cortisol awakening response is blunted in psychotherapy inpatients suffering from depression. Psychoneuroendocrinology. 2006;31:900–4.

    Article  CAS  PubMed  Google Scholar 

  27. Miller GE, Chen E, Zhou ES. If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortiocal axis in humans. Psychol Bull. 2007;133:25–45.

    Article  PubMed  Google Scholar 

  28. Bower JE. Cancer-related fatigue: Links with inflammation in cancer patients and survivors. Brain Behav Immun. 2007;21:863–71.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Hsiao F-H, Chang K-J, Kuo W-H, Huang C-S, Liu Y-F, Lai Y-M, et al. A longitudinal study of cortisol responses, sleep problems, and psychological well-being as the predictors of changes in depressive symptoms among breast cancer survivors. Psychoneuroendocrinology. 2013;38:356–66.

    Article  CAS  PubMed  Google Scholar 

  30. Jager A, Sleijfer S, van der Rijt CCD. The pathogenesis of cancer related fatigue: Could increased activity of pro-inflammatory cytokines be the common denominator? Eur J Cancer. 2008;44:175–81.

    Article  CAS  PubMed  Google Scholar 

  31. Rich T, Innominato PF, Boerner J, Mormont MC, Iacobelli S, Baron B, et al. Elevated serum cytokines correlated with altered behavior, serum cortisol rhythm, and dampened 24-hour rest-activity patterns in patients with metastatic colorectal cancer. Clin Cancer Res. 2005;11:1757–64.

    Article  CAS  PubMed  Google Scholar 

  32. Abercrombie HC, Giese-Davis J, Sephton S, Epel ES, Turner-Cobb JM, Spiegel D. Flattened cortisol rhythms in metastatic breast cancer patients. Psychoneuroendocrinology. 2004;29:1082–92.

    Article  CAS  PubMed  Google Scholar 

  33. Van der Pompe G, Antoni MH, Heijnen CJ. Elevated basal cortisol levels and attenuated ACTH and cortisol responses to a behavioral challenge in women with metastatic breast cancer. Psychoneuroendocrinology. 1996;21:361–74.

    Article  PubMed  Google Scholar 

  34. Sephton SE, Dhabhar FS, Keuroghlian AS, Giese-Davis J, McEwen BS, Ionan AC, et al. Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer. Brain Behav Immun. 2009;23:1148–55.

    Article  CAS  PubMed  Google Scholar 

  35. Mormont MC, Lévi F. Circadian-system alterations during cancer processes: A review. Int J Cancer. 1997;70:241–7.

    Article  CAS  PubMed  Google Scholar 

  36. Sephton SE, Sapolsky RM, Kraemer HC, Spiegel D. Diurnal cortisol rhythm as a predictor of breast cancer survival. J Natl Cancer Inst. 2000;92:994–1000.

    Article  CAS  PubMed  Google Scholar 

  37. Sephton S, Spiegel D. Circadian disruption in cancer: a neuroendocrine-immune pathway from stress to disease? Brain Behav Immun. 2003;17:321–8.

    Article  CAS  PubMed  Google Scholar 

  38. Touitou Y, Lévi F, Bogdan A, Benavides M, Bailleul F, Misset J-L. Rhythm alteration in patients with metastatic breast cancer and poor prognostic factors. J Cancer Res Clin Oncol. 1995;121:181–8.

    Article  CAS  PubMed  Google Scholar 

  39. Sephton SE, Lush E, Dedert EA, Floyd AR, Rebholz WN, Dhabhar FS, et al. Diurnal cortisol rhythm as a predictor of lung cancer survival. Brain Behav Immun. 2013;30:S163–70.

    Article  CAS  PubMed  Google Scholar 

  40. Nakamura Y, Lipschitz DL, Kuhn R, Kinney AY, Donaldson GW. Investigating efficacy of two brief mind–body intervention programs for managing sleep disturbance in cancer survivors: a pilot randomized controlled trial. J Cancer Surviv. 2013;7:165–82.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Hays RD, Martin SA, Sesti AM, Spritzer KL. Psychometric properties of the medical outcomes study sleep measure. Sleep Med. 2005;6:41–4.

    Article  PubMed  Google Scholar 

  42. Bech P. Measuring the dimensions of psychological general well-being by the WHO-5. QoL Newsl. 2004;32:15–6.

    Google Scholar 

  43. Preacher KJ, Wichman AL, MacCallum RC, Briggs NE. Latent growth curve modeling. Los Angeles: Sage; 2008.

    Google Scholar 

  44. Browne MW, Cudeck R. Alternative ways of assessing model fit. SAGE FOCUS EDITIONS. 1993;154:136–136.

  45. Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107:238–46.

    Article  CAS  PubMed  Google Scholar 

  46. Kline RB. Principles and practice of structural equation modeling. NY: Guilford Press; 1998.

    Google Scholar 

  47. Brown KW, Weinstein N, Creswell JD. Trait mindfulness modulates neuroendocrine and affective responses to social evaluative threat. Psychoneuroendocrinology. 2012;37:2037–41.

    Article  CAS  PubMed  Google Scholar 

  48. Laurent H, Laurent S, Hertz R, Egan-Wright D, Granger DA. Sex-specific effects of mindfulness on romantic partners’ cortisol responses to conflict and relations with psychological adjustment. Psychoneuroendocrinology [Internet]. [cited 2013 Nov 21]; Available from: http://www.sciencedirect.com/science/article/pii/S0306453013002680

  49. Vedhara K, Miles J, Bennett P, Plummer S, Tallon D, Brooks E, et al. An investigation into the relationship between salivary cortisol, stress, anxiety and depression. Biol Psychol. 2003;62:89–6.

    Article  PubMed  Google Scholar 

  50. Buchanan TW, Kern S, Allen JS, Tranel D, Kirschbaum C. Circadian regulation of cortisol after hippocampal damage in humans. Biol Psychiatry. 2004;56:651–6.

    Article  CAS  PubMed  Google Scholar 

  51. Bruehl H, Wolf OT, Convit A. A blunted cortisol awakening response and hippocampal atrophy in type 2 diabetes mellitus. Psychoneuroendocrinology. 2009;34:815–21.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  52. Holzel BK, Carmody J, Vangel M, Congleton C, Yerramsetti SM, Gard T, et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011;191:36–43.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Luders E, Thompson PM, Kurth F, Hong J-Y, Phillips OR, Wang Y, et al. Global and regional alterations of hippocampal anatomy in long-term meditation practitioners. Hum Brain Mapp. 2013;34:3369–75.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Luders E, Toga AW, Lepore N, Gaser C. The underlying anatomical correlates of long-term meditation: larger hippocampal and frontal volumes of gray matter. Neuroimage. 2009;45:672–8.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Froeliger B, Garland EL, McClernon FJ. Yoga Meditation Practitioners Exhibit Greater Gray Matter Volume and Fewer Reported Cognitive Failures: Results of a Preliminary Voxel-Based Morphometric Analysis. Evidence-Based Complementary and Alternative Medicine [Internet]. 2012 [cited 2013 May 20];2012. Available from: http://www.hindawi.com.proxy.lib.fsu.edu/journals/ecam/2012/821307/abs/

  56. MacMillan HL, Georgiades K, Duku EK, Shea A, Steiner M, Niec A, et al. Cortisol Response to Stress in Female Youths Exposed to Childhood Maltreatment: Results of the Youth Mood Project. Biol Psychiatry. 2009;66:62–8.

    Article  PubMed  Google Scholar 

  57. Schlotz W, Hammerfald K, Ehlert U, Gaab J. Individual differences in the cortisol response to stress in young healthy men: Testing the roles of perceived stress reactivity and threat appraisal using multiphase latent growth curve modeling. Biol Psychol. 2011;87:257–64.

    Article  PubMed  Google Scholar 

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Acknowledgments

ELG was supported by grant National Institute on Drug Abuse 1R34DA037005 during the preparation of this manuscript. The (parent) study reported was supported by National Institutes of Health (NIH) Award R21 AT002209 to YN from the National Center for Complementary and Alternative Medicine (NCCAM). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NCCAM, NIDA, or NIH. NIH, NIDA, and NCCAM had no role in the conduct of the study, collection, management, analysis, and interpretation of the data and preparation, review or approval of the manuscript.

Conflict of interest

Eric Garland, Anna Beck, David Lipschitz, and Yoshio Nakamura declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Supportive Oncology and Survivorship Program, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA

    Eric L. Garland & Anna C. Beck

  2. Pain Research Center, Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA

    David L. Lipschitz & Yoshio Nakamura

  3. Utah Center for Exploring Mind-Body Interactions, Pain Research Center, University of Utah School of Medicine, Salt Lake City, UT, USA

    Yoshio Nakamura

  4. College of Social Work, University of Utah, Salt Lake City, UT, 84112, USA

    Eric L. Garland

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  1. Eric L. Garland
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  2. Anna C. Beck
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  3. David L. Lipschitz
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  4. Yoshio Nakamura
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Correspondence to Yoshio Nakamura.

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Garland, E.L., Beck, A.C., Lipschitz, D.L. et al. Dispositional mindfulness predicts attenuated waking salivary cortisol levels in cancer survivors: a latent growth curve analysis. J Cancer Surviv 9, 215–222 (2015). https://doi.org/10.1007/s11764-014-0402-2

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  • DOI: https://doi.org/10.1007/s11764-014-0402-2

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