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Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework

  • Psychological Aspects of Cardiovascular Diseases (A Steptoe, Section Editor)
  • Published:
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Abstract

The purpose of this review is to provide (1) a synopsis on relations of mindfulness with cardiovascular disease (CVD) and major CVD risk factors, and (2) an initial consensus-based overview of mechanisms and theoretical framework by which mindfulness might influence CVD. Initial evidence, often of limited methodological quality, suggests possible impacts of mindfulness on CVD risk factors including physical activity, smoking, diet, obesity, blood pressure, and diabetes regulation. Plausible mechanisms include (1) improved attention control (e.g., ability to hold attention on experiences related to CVD risk, such as smoking, diet, physical activity, and medication adherence), (2) emotion regulation (e.g., improved stress response, self-efficacy, and skills to manage craving for cigarettes, palatable foods, and sedentary activities), and (3) self-awareness (e.g., self-referential processing and awareness of physical sensations due to CVD risk factors). Understanding mechanisms and theoretical framework should improve etiologic knowledge, providing customized mindfulness intervention targets that could enable greater mindfulness intervention efficacy.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68. US Government Agency for Health Care Research and Qualty (AHRQ)-commissioned systematic review including mindfulness meditation RCTs with active control groups.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Tang YY, Holzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015;16(4):213–25. Thorough review on mechanims by which mindfulness can influence mental health.

    Article  CAS  PubMed  Google Scholar 

  3. Khoury B, Lecomte T, Fortin G, et al. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013;33(6):763–71.

    Article  PubMed  Google Scholar 

  4. Strauss C, Cavanagh K, Oliver A, Pettman D. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLoS ONE. 2014;9(4), e96110.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  5. O’Reilly GA, Cook L, Spruijt-Metz D, Black DS. Mindfulness-based interventions for obesity-related eating behaviours: a literature review. Obes Rev. 2014;15(6):453–61.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Olson KL, Emery CF. Mindfulness and weight loss: a systematic review. Psychosom Med. 2015;77(1):59–67.

    Article  PubMed  Google Scholar 

  7. Abbott RA, Whear R, Rodgers LR, et al. Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials. J Psychosom Res. 2014;76(5):341–51. doi:10.1016/j.jpsychores.2014.02.012. Methodologically well-performed systematic review and meta-analysis on mindfulness interventions and blood pressure.

    Article  PubMed  Google Scholar 

  8. de Souza IC, de Barros VV, Gomide HP, et al. Mindfulness-based interventions for the treatment of smoking: a systematic literature review. J Altern Complement Med. 2015;21(3):129–40. doi:10.1089/acm.2013.0471.

    Article  PubMed  Google Scholar 

  9. Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. Geneva: World Health Organization; 2011.

    Google Scholar 

  10. Onken LS, Carroll KM, Shoham V, Cuthbert BN, Riddle M. Reenvisioning clinical science: unifying the discipline to improve the public health. Clin Psychol Sci. 2014;2(1):22–34. Article reconceptualizing the importance of understanding mechanisms when developing behavioral intervention studies.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Epstein RM. Mindful practice. JAMA. 1999;282(9):833–9.

    Article  CAS  PubMed  Google Scholar 

  12. Bishop SR, Lau M, Shapiro S, et al. Mindfulness: a proposed operational definition. Clin Psychol-Sci Pr. 2004;11(3):230–41.

    Article  Google Scholar 

  13. Dreyfus G. Is mindfulness present-centred and non-judgmental? A discussion of the cognitive dimensions of mindfulness. Contemp Buddhism. 2011;12:41–54.

    Article  Google Scholar 

  14. Gethin R. Buddhist conceptualizations of mindfulness. In: Brown KW, Creswell JD, Ryan RM, editors. Handbook of mindfulness. New York: The Guilford Press; 2015. This is a chapter from a recently published textbook on mindfulness; the textbook includes a well-done overview of mindfulness theory and associations with health.

    Google Scholar 

  15. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Personal Soc Psychol. 2003;84(4):822–48.

    Article  Google Scholar 

  16. Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4(1):33–47.

    Article  CAS  PubMed  Google Scholar 

  17. Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press; 2002.

    Google Scholar 

  18. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: an experiential approach to behavior change. 1999.

  19. Freedland KE. Demanding attention: reconsidering the role of attention control groups in behavioral intervention research. Psychosom Med. 2013;75(2):100–2. This article provides important information to aid selection of ideal control groups, relevent to mindfulness research.

    Article  PubMed  Google Scholar 

  20. Freedland KE, Mohr DC, Davidson KW, Schwartz JE. Usual and unusual care: existing practice control groups in randomized controlled trials of behavioral interventions. Psychosom Med. 2011;73(4):323–35. This article also provides important information to aid selection of ideal control groups, relevent to mindfulness research.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Visted E, Jollestad J, Nielsen MB, Nielsen GH. The impact of group-based mindfulness training on self-reported mindfulness: a systematic review and meta-analysis. Mindfulness. February 2014. Article providing systematic review that informs validity and reliabliity of dispositional mindfulness measures.

  22. Park T, Reilly-Spong M, Gross CR. Mindfulness: a systematic review of instruments to measure an emergent patient-reported outcome (PRO). Qual Life Res. 2013;22(10):2639–59. Article providing systematic review that informs validity and reliabliity of dispositional mindfulness measures.

    Article  PubMed  Google Scholar 

  23. Loucks EB, Britton WB, Howe CJ, Eaton CB, Buka SL. Positive associations of dispositional mindfulness with cardiovascular health: the New England Family Study. Int J Behav Med. 2015;22(4):540–50. This is the first observational study to evaluate associations of dipositional mindfulness with cardiovascular health.

    Article  PubMed  Google Scholar 

  24. Salmoirago-Blotcher E, Husinger M, Morgan L, Fischer D, Carmody J. Mindfulness-based stress reduction and change in health-related behaviors. J Evid Based Complement Altern Med. 2013;18(4):243–7.

    Article  Google Scholar 

  25. Ulmer CS, Stetson BA, Salmon PG. Mindfulness and acceptance are associated with exercise maintenance in YMCA exercisers. Behav Res Ther. 2010;48(8):805–9.

    Article  PubMed  Google Scholar 

  26. Chatzisarantis NL, Hagger MS. Mindfulness and the intention-behavior relationship within the theory of planned behavior. Personal Soc Psychol Bull. 2007;33(5):663–76.

    Article  Google Scholar 

  27. Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2009;52(2):396–404.

    Article  PubMed  Google Scholar 

  28. Moffitt R, Mohr P. The efficacy of a self-managed Acceptance and Commitment Therapy intervention DVD for physical activity initiation. Br J Health Psychol. 2015;20(1):115–29.

    Article  PubMed  Google Scholar 

  29. Ivanova E, Jensen D, Cassoff J, Gu F, Knauper B. Acceptance and commitment therapy improves exercise tolerance in sedentary women. Med Sci Sports Exerc. 2015;47(6):1251–8.

    Article  PubMed  Google Scholar 

  30. Kangasniemi AM, Lappalainen R, Kankaanpaa A, Tolvanen A, Tammelin T. Towards a physically more active lifestyle based on one’s own values: the results of a randomized controlled trial among physically inactive adults. BMC Public Health. 2015;15:260.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Tsafou KE, De Ridder DT, van Ee R, Lacroix JP. Mindfulness and satisfaction in physical activity: a cross-sectional study in the Dutch population. J Health Psychol. 2015. doi:10.1177/1359105314567207.

    PubMed  Google Scholar 

  32. Brewer JA, Mallik S, Babuscio TA, et al. Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug Alc Depend. 2011;119(1–2):72–80.

    Article  Google Scholar 

  33. Davis JM, Goldberg SB, Anderson MC, Manley AR, Smith SS, Baker TB. Randomized trial on mindfulness training for smokers targeted to a disadvantaged population. Subst Use Misuse. 2014;49(5):571–85.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Davis JM, Manley AR, Goldberg SB, Stankevitz KA, Smith SS. Mindfulness training for smokers via web-based video instruction with phone support: a prospective observational study. BMC Complement Alt Med. 2015;15:95.

    Article  Google Scholar 

  35. Ruscio AC, Muench C, Brede E, Waters AJ. Effect of brief mindfulness practice on self-reported affect, craving, and smoking: a pilot randomized controlled trial using ecological momentary assessment. Nicotine Tobac Res. 2015.

  36. Garrison KA, Pal P, Rojiani R, Dallery J, O’Malley SS, Brewer JA. A randomized controlled trial of smartphone-based mindfulness training for smoking cessation: a study protocol. BMC Psychiatr. 2015;15:83.

    Article  Google Scholar 

  37. Karyadi KA, VanderVeen JD, Cyders MA. A meta-analysis of the relationship between trait mindfulness and substance use behaviors. Drug Alc Depend. 2014.

  38. Carim-Todd L, Mitchell SH, Oken BS. Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature. Drug Alc Depend. 2013;132(3):399–410.

    Article  Google Scholar 

  39. Schuman-Olivier Z, Hoeppner BB, Evins AE, Brewer JA. Finding the right match: mindfulness training may potentiate the therapeutic effect of nonjudgment of inner experience on smoking cessation. Subst Use Misuse. 2014;49(5):586–94.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a randomized controlled trial. Health Ed Behav. 2014;41:145–54.

    Article  Google Scholar 

  41. Carmody JF, Olendzki BC, Merriam PA, Liu Q, Qiao Y, Ma Y. A novel measure of dietary change in a prostate cancer dietary program incorporating mindfulness training. J Acad Nutr Dietetics. 2012;112:1822–7.

    Article  Google Scholar 

  42. Salmoirago-Blotcher E, Morgan L, Fischer D, Carmody J. Mindfulness-based stress reduction and change in health-related behaviors. J Evid-Based Complement Altern Med. 2013;18:243–7.

    Article  Google Scholar 

  43. Kearney DJ, Milton ML, Malte CA, McDermott KA, Martinez M, Simpson TL. Participation in mindfulness-based stress reduction is not associated with reductions in emotional eating or uncontrolled eating. Nutr Res. 2012;32(6):413–20.

    Article  CAS  PubMed  Google Scholar 

  44. Ouwens MA, Schiffer AA, Visser LI, Raeijmaekers NJ, Nyklicek I. Mindfulness and eating behaviour styles in morbidly obese males and females. Appetite. 2015;87:62–7.

    Article  CAS  PubMed  Google Scholar 

  45. Tak SR, Hendrieckx C, Nefs G, Nyklicek I, Speight J, Pouwer F. The association between types of eating behaviour and dispositional mindfulness in adults with diabetes. Results from Diabetes MILES. The Netherlands. Appetite. 2015;87:288–95.

    Article  PubMed  Google Scholar 

  46. Godsey J. The role of mindfulness based interventions in the treatment of obesity and eating disorders: an integrative review. Complement Ther Med. 2013;21(4):430–9.

    Article  PubMed  Google Scholar 

  47. Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav. 2014;15(2):197–204.

    Article  PubMed  Google Scholar 

  48. Olson KL, Emery CF. Mindfulness and weight loss: a systematic review. Psychosom Med. 2015;77:59–67.

    Article  PubMed  Google Scholar 

  49. Fulwiler C, Brewer JA, Loucks EB. Curr Cardiovasc Dis Risk Rep. 2015.

  50. Blom K, Baker B, How M, et al. Hypertension analysis of stress reduction using mindfulness meditation and yoga: results from the harmony randomized controlled trial. Am J Hypertens. 2014;27(1):122–9.

    Article  PubMed  Google Scholar 

  51. de la Fuente M, Franco C, Salvador M. Reduction of blood pressure in a group of hypertensive teadhers through a program of mindfulness meditation. Psicol Conductual. 2010;18:533–52.

    Google Scholar 

  52. Hughes JW, Fresco DM, Myerscough R, van Dulmen M, Carlson LE, Josephson R. Randomized controlled trial of Mindfulness-Based Stress Reduction for prehypertension. Psychosom Med. 2013;75:721–8.

    Article  PubMed  Google Scholar 

  53. Hartmann M, Kopf S, Kircher C, et al. Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-study). Diabet Care. 2012;35(5):945–7.

    Article  Google Scholar 

  54. Goldstein CM, Josephson R, Xie S, Hughes JW. Current perspectives on the use of meditation to reduce blood pressure. Intern J Hypertens. 2012;2012:578397.

    Article  Google Scholar 

  55. Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol. 2007;75(2):336–43.

    Article  PubMed  Google Scholar 

  56. Youngwanichsetha S, Phumdoung S, Ingkathawornwong T. The effects of mindfulness eating and yoga exercise on blood sugar levels of pregnant women with gestational diabetes mellitus. Appl Nurs Res. 2014;27(4):227–30.

    Article  PubMed  Google Scholar 

  57. van Son J, Nyklicek I, Pop VJ, Blonk MC, Erdtsieck RJ, Pouwer F. Mindfulness-based cognitive therapy for people with diabetes and emotional problems: long-term follow-up findings from the DiaMind randomized controlled trial. J Psychosom Res. 2014;77(1):81–4.

    Article  PubMed  Google Scholar 

  58. Tovote KA, Schroevers MJ, Snippe E, et al. Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with diabetes: a randomized trial. Psychother Psychosom. 2015;84(3):186–7.

    Article  PubMed  Google Scholar 

  59. Segal ZV, Williams JMG, Teasdale JD, Kabat-Zinn J. Mindfulness-based cognitive therapy for depression. New York: The Guildford Press; 2012.

    Google Scholar 

  60. Kabat-Zinn J. Full catastrophe living: using the wsidom of your body and mind to face stress, pain, and illness. New York: Bantam; 2013. Foundational book describing Mindfulness-Based Stress Reduction intervention.

    Google Scholar 

  61. Azam MA, Katz J, Fashler SR, Changoor T, Azargive S, Ritvo P. Heart rate variability is enhanced in controls but not maladaptive perfectionists during brief mindfulness meditation following stress-induction: A stratified-randomized trial. Internat J Psychophys. 2015.

  62. Bhatnagar R, Phelps L, Rietz K, et al. The effects of mindfulness training on post-traumatic stress disorder symptoms and heart rate variability in combat veterans. J Altern Complement Med. 2013;19(11):860–1.

    Article  PubMed  Google Scholar 

  63. Gallegos AM, Lytle MC, Moynihan JA, Talbot NL. Mindfulness-Based Stress Reduction to enhance psychological functioning and improve inflammatory biomarkers in trauma-exposed women: a pilot study. Psychol Trauma. 2015. doi:10.1037/tra0000053.

    PubMed  Google Scholar 

  64. Malarkey WB, Jarjoura D, Klatt M. Workplace based mindfulness practice and inflammation: a randomized trial. Brain Behav Immun. 2013;27(1):145–54.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Creswell JD, Irwin MR, Burklund LJ, et al. Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behav Immun. 2012;26(7):1095–101.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  66. Holzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 2011;6(6):537–59. Foundational paper describing mechanisms by which mindfulnes meditaiton could influence neurophysiology and self-regulation.

    Article  PubMed  Google Scholar 

  67. Vago DR, Silbersweig DA. Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness. Front Hum Neurosci. 2012;6:296.

    Article  PubMed Central  PubMed  Google Scholar 

  68. Valeri L, Vanderweele TJ. Mediation analysis allowing for exposure-mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros. Psychol Methods. 2013;18(2):137–50. Important new innovations in statistical approaches for mediation analyses with fewer assumptions than prior methods, and now have fairly user-friendly macros.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clin Psychol Rev. 2015;37:1–12. One of the first papers to perform mediation analyses to evlaute evidence behind plausible mediatiors between mindfluness interventions and health.

    Article  CAS  PubMed  Google Scholar 

  70. Artinian NT, Fletcher GF, Mozaffarian D, et al. Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation. 2010;122(4):406–41.

    Article  PubMed  Google Scholar 

  71. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6–245.

    Article  PubMed  Google Scholar 

  72. Tang YY, Ma Y, Wang J, et al. Short-term meditation training improves attention and self-regulation. Proc Natl Acad Sci U S A. 2007;104(43):17152–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  73. Festinger L. Cognitive dissonance. Sci Am. 1962;207:93–102.

    Article  CAS  PubMed  Google Scholar 

  74. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.

    Article  CAS  PubMed  Google Scholar 

  75. Deci EL, Eghrari H, Patrick BC, Leone DR. Facilitating internalization: the self-determination theory perspective. J Pers. 1994;62(1):119–42.

    Article  CAS  PubMed  Google Scholar 

  76. Richardson S, Shaffer JA, Falzon L, Krupka D, Davidson KW, Edmondson D. Meta-analysis of perceived stress and its association with incident coronary heart disease. Am J Cardiol. 2012;110(12):1711–6.

    Article  PubMed Central  PubMed  Google Scholar 

  77. Kivimaki M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet. 2012;380(9852):1491–7. doi:10.1016/S0140-6736(12)60994-5. Important collaborative effort to merge data across many studies to evaluate associations of job strain with CVD.

    Article  PubMed Central  PubMed  Google Scholar 

  78. Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: a meta-analysis of prospective evidence. Hypertension. 2010;55(4):1026–32.

    Article  CAS  PubMed  Google Scholar 

  79. Radley J, Morilak D, Viau V, Campeau S. Chronic stress and brain plasticity: mechanisms underlying adaptive and maladaptive changes and implications for stress-related CNS disorders. Neurosci Biobehav Rev. 2015. doi:10.1016/j.neubiorev.2015.06.018.

    PubMed  Google Scholar 

  80. Appelhans BM. Neurobehavioral inhibition of reward-driven feeding: implications for dieting and obesity. Obesity. 2009;17(4):640–7.

    Article  CAS  PubMed  Google Scholar 

  81. Lieberman LS. Dietary, evolutionary, and modernizing influences on the prevalence of type 2 diabetes. Annu Rev Nutr. 2003;23:345–77.

    Article  CAS  PubMed  Google Scholar 

  82. Brewer JA, Elwafi HM, Davis JH. Craving to quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions. Psychol Addict Behav. 2013;27(2):366–79.

    Article  PubMed Central  PubMed  Google Scholar 

  83. Brand M, Young KS, Laier C. Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings. Front Hum Neurosci. 2014;8:375.

    Article  PubMed Central  PubMed  Google Scholar 

  84. Elwafi HM, Witkiewitz K, Mallik S, Iv TA, Brewer JA. Mindfulness training for smoking cessation: moderation of the relationship between craving and cigarette use. Drug Alc Depend. 2013;130(1–3):222–9.

    Article  Google Scholar 

  85. Lachman ME, Weaver SL. The sense of control as a moderator of social class differences in health and well-being. J Pers Soc Psychol. 1998;74(3):763–73.

    Article  CAS  PubMed  Google Scholar 

  86. Kelly JF, Greene MC. Where there’s a will there’s a way: a longitudinal investigation of the interplay between recovery motivation and self-efficacy in predicting treatment outcome. Psychol Addictive Behav. 2013.

  87. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.

    Article  CAS  PubMed  Google Scholar 

  88. Ajzen I. Theories of cognitive self-regulation: the theory of planned behavior. Org Behav Hum Decis Process. 1991;50(2):179–211.

    Article  Google Scholar 

  89. Jerant A, Moore M, Lorig K, Franks P. Perceived control moderated the self-efficacy-enhancing effects of a chronic illness self-management intervention. Chron Illness. 2008;4(3):173–82.

    Article  Google Scholar 

  90. Ajzen I. Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. J Appl Soc Psychol. 2002;32(4):665–83.

    Article  Google Scholar 

  91. Surtees PG, Wainwright NW, Luben R, Khaw KT, Day NE. Mastery, sense of coherence, and mortality: evidence of independent associations from the EPIC-Norfolk Prospective Cohort Study. Health Psychol. 2006;25(1):102–10.

    Article  PubMed  Google Scholar 

  92. Steptoe A, Wardle J. Locus of control and health behaviour revisited: a multivariate analysis of young adults from 18 countries. Br J Psychol. 2001;92(Pt 4):659–72.

    Article  CAS  PubMed  Google Scholar 

  93. Margolin A, Schuman-Olivier Z, Beitel M, Arnold RM, Fulwiler CE, Avants SK. A preliminary study of spiritual self-schema (3-S(+)) therapy for reducing impulsivity in HIV-positive drug users. J Clin Psychol. 2007;63(10):979–99. doi:10.1002/jclp.20407.

    Article  PubMed  Google Scholar 

  94. McCubbin T, Dimidjian S, Kempe K, Glassey MS, Ross C, Beck A. Mindfulness-based stress reduction in an integrated care delivery system: one-year impacts on patient-centered outcomes and health care utilization. Permanente J. 2014;18(4):4–9.

    Article  Google Scholar 

  95. Neff K, Dahm K. Self-Compassion: what it is, what it does, and how it relates to mindfulness. In: Robinson M, Meier B, Ostafin B, editors. Mindfulness and Self-Regulation. New York: Springer; 2015.

    Google Scholar 

  96. Kuyken W, Watkins E, Holden E, et al. How does mindfulness-based cognitive therapy work? Behav Res Therapy. 2010;48(11):1105–12.

    Article  Google Scholar 

  97. Lillis J, Levin ME, Hayes SC. Exploring the relationship between body mass index and health-related quality of life: a pilot study of the impact of weight self-stigma and experiential avoidance. J Health Psychol. 2011;16(5):722–7.

    Article  PubMed  Google Scholar 

  98. Neff KD. The role of self-compassion in development: a healthier way to relate to oneself. Hum Dev. 2009;52(4):211–4.

    Article  PubMed Central  PubMed  Google Scholar 

  99. Breines JG, Chen S. Self-compassion increases self-improvement motivation. Personal Soc Psychol Bull. 2012;38(9):1133–43.

    Article  Google Scholar 

  100. Terry ML, Leary MR, Mehta S, Henderson K. Self-compassionate reactions to health threats. Personal Soc Psychol Bull. 2013;39(7):911–26.

    Article  Google Scholar 

  101. Thurston RC, Kubzansky LD. Women, loneliness, and incident coronary heart disease. Psychosom Med. 2009;71(8):836–42.

    Article  PubMed Central  PubMed  Google Scholar 

  102. Hemingway H, Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ. 1999;318(7196):1460–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  103. Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A. 2013;110(15):5797–801.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  104. Mantzios M, Giannou K. Group vs. Single mindfulness meditation: exploring avoidance, impulsivity, and weight management in two separate mindfulness meditation settings. Appl Psychol Health Well-Being. 2014;6(2):173–91.

    Article  PubMed  Google Scholar 

  105. Loucks EB. Meditation intervention reviews: selecting ideal control groups for meditation interventions. JAMA Int Med. 2014;174(7):1194–5.

    Article  Google Scholar 

  106. Raichle ME, MacLeod AM, Snyder AZ, Powers WJ, Gusnard DA, Shulman GL. A default mode of brain function. Proc Natl Acad Sci U S A. 2001;98(2):676–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  107. Gusnard DA, Raichle ME, Raichle ME. Searching for a baseline: functional imaging and the resting human brain. Nat Rev Neurosci. 2001;2(10):685–94.

    Article  CAS  PubMed  Google Scholar 

  108. Whitfield-Gabrieli S, Moran JM, Nieto-Castanon A, Triantafyllou C, Saxe R, Gabrieli JD. Associations and dissociations between default and self-reference networks in the human brain. NeuroImage. 2011;55(1):225–32.

    Article  PubMed  Google Scholar 

  109. Brewer JA, Worhunsky PD, Gray JR, Tang YY, Weber J, Kober H. Meditation experience is associated with differences in default mode network activity and connectivity. Proc Natl Acad Sci U S A. 2011;108(50):20254–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  110. Brewer JA, Garrison KA, Whitfield-Gabrieli S. What about the “Self” is Processed in the Posterior Cingulate Cortex? Front Hum Neurosci. 2013;7:647.

    Article  PubMed Central  PubMed  Google Scholar 

  111. Garrison KA, Santoyo JF, Davis JH, Thornhill TA, Kerr CE, Brewer JA. Effortless awareness: using real time neurofeedback to investigate correlates of posterior cingulate cortex activity in meditators’ self-report. Front Hum Neurosci. 2013;7:440.

    Article  PubMed Central  PubMed  Google Scholar 

  112. Garrison KA, Scheinost D, Worhunsky PD, et al. Real-time fMRI links subjective experience with brain activity during focused attention. NeuroImage. 2013.

  113. Garrison KA, Zeffiro TA, Scheinost D, Constable RT, Brewer JA. Meditation leads to reduced default mode network activity beyond an active task. Cog Affect Behav Neurosci. 2015.

  114. Kerr CE, Josyula K, Littenberg R. Developing an observing attitude: an analysis of meditation diaries in an MBSR clinical trial. Clin Psychol Psychother. 2011;18:80–93.

    Article  PubMed Central  PubMed  Google Scholar 

  115. Fresco DM, Moore MT, van Dulmen MH, et al. Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behav Ther. 2007;38(3):234–46.

    Article  PubMed  Google Scholar 

  116. Safran J, Segal ZV. Interpersonal process in cognitive therapy. New York: Basic Books; 1990.

    Google Scholar 

  117. Bernstein A, Hadash Y, Lichtash Y, Tanay G, Shepherd K, Fresco DM. Decentering and related constructs: a critical review and meta-cognitive processes model. Perspectiv Psychol Sci. 2015.

  118. Ayduk O, Kross E. From a distance: implications of spontaneous self-distancing for adaptive self-reflection. J Pers Soc Psychol. 2010;98(5):809–29.

    Article  PubMed Central  PubMed  Google Scholar 

  119. Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of Mindfulness. J Clin Psychol. 2006;62:373–86.

    Article  PubMed  Google Scholar 

  120. Miller WR. Motivational interviewing: research, practice, and puzzles. Addict Behav. 1996;21(6):835–42.

    Article  CAS  PubMed  Google Scholar 

  121. Baer RA, Smith GT, Allen KB. Assessment of mindfulness by self-report: the Kentucky inventory of mindfulness skills. Assessment. 2004;11:191–206.

    Article  PubMed  Google Scholar 

  122. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: an experiential approach to behavior change. 1999.

  123. Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006;62(3):373–86.

    Article  PubMed  Google Scholar 

  124. Jacobs TL, Epel ES, Lin J, et al. Intensive meditation training, immune cell telomerase activity, and psychological mediators. Psychoneuroendocrinol. 2011;36:664–81.

    Article  CAS  Google Scholar 

  125. Carmody J, Baer RA, Lykins EL, Olendzki N. An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program. J Clin Psychol. 2009;65:613–26.

    Article  PubMed  Google Scholar 

  126. Roos CR, Kirouac M, Pearson MR, Fink BC, Witkiewitz K. Examining temptation to drink from an existential perspective: associations among temptation, purpose in life, and drinking outcomes. Psychol Addict Behav. 2015. doi:10.1037/adb0000063.

    Google Scholar 

  127. Pearson MR, Brown D, Bravo A, Witkiewitz K. Staying in the moment and inding purpose: The associations of trait mindfulness, decentering, and purpose in life with depressive symptoms, anxiety symptoms, and alcohol-related problems. Mindfulness. 2015;6.

  128. Farb NA, Segal ZV, Mayberg H, et al. Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference. Soc Cogn Affect Neurosci. 2007;2(4):313–22.

    Article  PubMed Central  PubMed  Google Scholar 

  129. Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A. The multidimensional assessment of interoceptive awareness (MAIA). PLoS ONE. 2012;7(11), e48230.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  130. Mehling WE, Gopisetty V, Daubenmier J, Price CJ, Hecht FM, Stewart A. Body awareness: construct and self-report measures. PLoS ONE. 2009;4(5), e5614.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  131. Silverstein RG, Brown AC, Roth HD, Britton WB. Effects of mindfulness training on body awareness to sexual stimuli: implications for female sexual dysfunction. Psychosom Med. 2011;73(9):817–25.

    Article  PubMed Central  PubMed  Google Scholar 

  132. Bornemann B, Herbert BM, Mehling WE, Singer T. Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training. Front Psychol. 2014;5:1504.

    PubMed Central  PubMed  Google Scholar 

  133. Hill DM, Craighead LW, Safer DL. Appetite-focused dialectical behavior therapy for the treatment of binge eating with purging: a preliminary trial. Int J Eat Disord. 2011;44(3):249–61.

    Article  PubMed  Google Scholar 

  134. Ekkekakis P, Parfitt G, Petruzzello SJ. The pleasure and displeasure people feel when they exercise at different intensities: decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Med. 2011;41(8):641–71.

    Article  PubMed  Google Scholar 

  135. Rhodes RE, Kates A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med. 2015. doi:10.1007/s12160-015-9704-5.

    Google Scholar 

  136. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.

    Article  PubMed Central  PubMed  Google Scholar 

  137. Moher D, Hopewell S, Schulz KF, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869.

    Article  PubMed Central  PubMed  Google Scholar 

  138. Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Ann Intern Med. 2008;148(4):295–309.

    Article  PubMed  Google Scholar 

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Acknowledgments

This publication was supported by grant number UH2AT009145 from the National Institutes of Health (NIH), specifically the National Center for Complementary and Integrative Health (NCCIH) and the Office of Behavioral and Social Sciences Research (OBSSR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, OBSSR, or the NIH.

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Authors and Affiliations

  1. Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI, 02906, USA

    Eric B. Loucks

  2. Harvard Medical School, Boston, MA, USA

    Zev Schuman-Olivier & Gaelle Desbordes

  3. Cambridge Health Alliance, Cambridge, MA, USA

    Zev Schuman-Olivier

  4. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

    Willoughby B. Britton

  5. Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA

    Willoughby B. Britton

  6. Department of Psychological Sciences, Kent State University, Kent, OH, USA

    David M. Fresco

  7. Massachussetts General Hospital, Boston, MA, USA

    Gaelle Desbordes

  8. Department of Medicine, University of Massachusetts, Worcester, MA, USA

    Judson A. Brewer

  9. Department of Psychiatry, University of Massachusetts, Worcester, MA, USA

    Judson A. Brewer & Carl Fulwiler

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  1. Eric B. Loucks
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  2. Zev Schuman-Olivier
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Correspondence to Eric B. Loucks.

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Eric B. Loucks, Zev Schuman-Olivier, Willoughby B. Britton, David M. Fresco, Gaelle Desbordes, Judson A. Brewer, and Carl Fulwiler declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Psychological Aspects of Cardiovascular Diseases

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Loucks, E.B., Schuman-Olivier, Z., Britton, W.B. et al. Mindfulness and Cardiovascular Disease Risk: State of the Evidence, Plausible Mechanisms, and Theoretical Framework. Curr Cardiol Rep 17, 112 (2015). https://doi.org/10.1007/s11886-015-0668-7

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