Effects of Mindfulness-Based Stress Reduction on Psychological Symptoms and Telomere Length: A Randomized Active-Controlled Trial

doi:10.1016/j.beth.2020.01.005

Behavior Therapy

Volume 51, Issue 6, November 2020, Pages 984-996

https://doi.org/10.1016/j.beth.2020.01.005 Get rights and content

Highlights

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We examined the effects of MBSR on psychological symptoms and telomere length
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MBSR was more effective than MTSR (active control) in lowering depressive symptoms
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MBSR led to greater increases in trait mindfulness and self-compassion than MTSR
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Both conditions did not differ on their effects on leukocyte telomere length

Abstract

Much research has demonstrated the beneficial effects of mindfulness-based stress reduction (MBSR) on psychological and physical health, but it is not known whether MBSR may impact cellular aging in healthy populations. Further, little research has evaluated MBSR against an active control condition, which precludes strong conclusions regarding the unique effects of mindfulness on psychological functioning. The present study examined the effects of MBSR versus music therapy–based stress reduction (MTSR) on trait mindfulness, self-compassion, and several psychological health outcomes, as well as leukocyte telomere length (LTL). One hundred and fifty eight Singaporean Chinese adults were recruited and randomly assigned to an eight-week MBSR or MTSR course. Participants provided blood samples and completed a battery of self-report measures pre- and post-intervention. Analyses showed that participants in the MBSR condition demonstrated significantly greater improvements in depressive symptoms, trait mindfulness, and self-compassion compared to the control condition. Treatment condition did not predict changes in LTL, anxiety, stress, or happiness, though there was a trend for duration of home mindfulness practice to predict increases in LTL. Overall, the study demonstrated MBSR’s unique effects in reducing depressive symptoms. Improvements in trait mindfulness and self-compassion correspond with theorized mechanisms of change underlying mindfulness training. The lack of intervention effect with regards to LTL suggests that a more intensive intervention may be required for mindfulness to exert noticeable impact on aging at the cellular level, or that the effect may only emerge over a longer term.

Section snippets

participants

Participants were recruited from the National University of Singapore and its larger community via electronic fliers. The study was advertised as a study to evaluate of the effects of a stress reduction intervention, in which participants would be randomly assigned to an MBSR or MTSR program. Participants were deemed eligible if they were Han Chinese, aged between 18 and 55 years old, did not have a current psychological disorder, and had not engaged in mindfulness or meditation practice for

sample characteristics and randomization check

Table 1 shows the demographic characteristics for both conditions at baseline. Participants’ mean age was 27.24 years (SD = 5.24 years). By virtue of the study’s recruitment criteria, all participants were of Chinese ethnicity. The majority of the recruited participants were female (n = 100; 63.3%) and single (80.4%). Most of the participants had at least a bachelor’s degree (94.3%). There were no significant differences between the MBSR and MTSR groups on any of the demographic or outcome

Discussion

The present study aimed to examine the effects of MBSR on psychological health and telomere length, a widely recognized biomarker of cellular aging in a sample of Chinese adults. Results showed that relative to MTSR, an active control condition, MBSR resulted in significantly greater reductions in depressive symptoms, and improvements in trait mindfulness and self-compassion. Both conditions did not differ on changes in LTL, anxiety, stress, and subjective happiness. Further, duration of home

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

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Effect of a lifestyle intervention on telomere length: A systematic review and meta-analysis
2022, Mechanisms of Ageing and Development
Citation Excerpt :
All included studies aimed to evaluate the effect of a lifestyle intervention on TL (Friedenreich et al., 2018; Eigendorf et al., 2019; Freitas-Simoes et al., 2018; García-Calzón et al., 2016; Hovatta et al., 2012; Innes et al., 2018; Keng et al., 2020; Le Nguyen et al., 2019; Mason et al., 2013; Ornish et al., 2013; Puterman et al., 2018; Saki et al., 2016; Sanft et al., 2018; Shin et al., 2008; Werner et al., 2019; Brandao et al., 2020; Kogure et al., 2019; Nickels et al., 2020; Nonino et al., 2018; Tolahunase et al., 2017), mostly as the primary outcome except in four studies that had telomerase activity (Puterman et al., 2018; Werner et al., 2019), obesity indices (Kogure et al., 2019), and oxidant and antioxidant levels (Shin et al., 2008) as main outcomes. Fourteen studies had a control group without intervention and were RCT (Friedenreich et al., 2018; Eigendorf et al., 2019; Freitas-Simoes et al., 2018; García-Calzón et al., 2016; Hovatta et al., 2012; Keng et al., 2020; Le Nguyen et al., 2019; Mason et al., 2013; Puterman et al., 2018; Saki et al., 2016; Sanft et al., 2018; Shin et al., 2008; Werner et al., 2019), except one (Ornish et al., 2013). One RCT compared different interventions (and had no group without intervention) (Innes et al., 2018).
We conducted a systematic review and meta-analysis to assess the effects of lifestyle intervention on telomere length (TL).
Four databases were searched for studies reporting TL in leukocytes, before and after a lifestyle intervention. We computed random-effects meta-analysis on TL within intervention and control group after versus before intervention, and on changes in TL between groups. Sensitivity analyses and Meta-regression were conducted.
We included 20 studies in the systematic review (2995 participants, mean 50.3 years old, 77% women, 2045 following an intervention and 950 controls) and 19 in the meta-analysis. TL were similar at baseline between intervention and control groups. The physical activity ± diet group had an increase in TL (Effect size 0.17, 95%CI 0.03–0.31, p = 0.020) using changes within the intervention group, whereas TL shortened in the control group (−0.32, −0.61 to −0.02, p = 0.037). TL was longer in the physical activity ± diet intervention group (0.24, 0.08–0.40, p = 0.004) compared to controls after the intervention. Sensitivity analysis gave similar results. Meta-regressions demonstrated that combining strength and endurance exercise increased TL more than endurance alone or strength alone.
A lifestyle intervention with physical activity ± diet can increase telomere length, independently of population characteristics or baseline TL.
The effect of mindfulness-based interventions on immunity-related biomarkers: a comprehensive meta-analysis of randomised controlled trials
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One proposed pathway that mindfulness-based interventions (MBIs) may offer a salutogenic effect on somatic disorders is by enhancing immune function. As such, we conducted a meta-analysis of randomised controlled trials examining the effect of MBIs at post-intervention and follow-up for six immune-related biomarkers, including CD4+ cells, C-reactive protein, interleukin-6, nuclear factor-κB, telomere length, and telomerase activity. Potential studies were identified by searching ScienceDirect, Web of Science, Academic Search Complete, AMED, MEDLINE, PsycARTICLES, and PsycINFO. Searches returned 1959 studies, of which 48 (70 effects) were included (N = 4683). Pooled effect sizes indicated a reduction in C-reactive protein (SMCD = -.14, 95% CI [-.26 – -.01]) and interleukin-6 (SMCD = -.35, 95% CI [-.67 – -.03]), and an increase in CD4+ (SMCD = .09, 95% CI [-.05 – .22]), telomere length (SMCD = .12, 95% CI [.00 – .24]) and telomerase activity (SMCD = .81, 95% CI [.17 – 1.46]) at post-intervention. At follow-up, results showed a reduction in interleukin-6 (SMCD = -.13, 95% CI [-.29 – .03]) and C-reactive protein (SMCD = -.39, 95% CI [-.68 – -.10]) and increase in CD4+ (SMCD = .22, 95% CI [-.08 – .52]). Meta-regression results showed that some heterogeneity in effect size could be accounted for by intervention dosage, study population, and study design. Our findings quantify MBIs’ potential for improving immune function and thus impacting somatic disorders.
Addressing the biological embedding of early life adversities (ELA) among adults through mindfulness: Proposed mechanisms and review of converging evidence
2022, Neuroscience and Biobehavioral Reviews
Citation Excerpt :
Two RCTs found greater telomerase activity following mindfulness training compared to waitlist controls among overweight women (Daubenmier et al., 2012) and healthy adults (Jacobs et al., 2011). Two RCTs found no significant differences in telomere length following 8-week MBIs among individuals with mixed-level psychological distress for both within-group comparisons (pre-to-post comparison) and compared to a CBT control (Wang et al., 2017) as well as among healthy adults compared to music-based stress reduction (Keng et al., 2020), though the latter found a trend for increased telomere length for those engaged in more at-home mindfulness practices (Keng et al., 2020). Additionally, a few cross-sectional comparisons have been conducted to compare telomere length of meditators to naïve controls, and found that meditation practitioners have signficiantly longer telomere length (Alda et al., 2016; Hoge et al., 2013).
Early life adversities (ELA) are prevalent and have a profound and adverse impact across the lifespan, including on age-related health outcomes, yet interventions to remediate its adverse impact are scarce. This paper presents evidence for mindfulness training to reduce the elevated mental and physical health risks linked to ELA among adults by targeting biological mechanisms of ELA leading to these adverse health outcomes. We first provide a brief overview of ELA, its adverse health impacts, and mechanisms that might be responsible. Next, we review converging evidence that demonstrates that mindfulness training influences key biological pathways involved in ELA-linked negative health consequences, including (a) brain networks involved in self-regulation, (b) immunity and inflammation, (c) telomere biology, and (d) epigenetic modifications. Further, we review preliminary evidence from mindfulness-based trials that focused on populations impacted by ELA. We discuss limitations of this review and provide recommendations for future research. If effective, a mindfulness-based approach could be an important public health strategy for remediating the adverse mental and physical health consequences of ELA.
An evaluation of a brief guided mindfulness workshop with older adults: A qualitative study
2021, Mental Health and Prevention
While mindfulness practices (MPs) are well studied for their positive results in various populations, effects on older adults remain in early stages of research. Studies considering MPs and older adults have examined the impact of an 8-week or longer intervention. Given the associated practical and economic barriers of long-term interventions, determining the value of a single-session workshop is timely and warranted. The current qualitative study evaluates the impact of a half- day single-session guided mindfulness workshop tailored for older adults. Qualitative data was collected from 20 participants who attended a post-workshop focus group, and grounded theory was used to formulate an explanatory model. The study took place in a small Atlantic Canadian community, and the minimum age for inclusion in the study was 60 years. Post workshop (10-12weeks) results indicate that most participants integrated MPs into their lives, both formally and informally. Many participants described feeling a greater sense of awareness and presence in the moment. Acquired mindfulness techniques were also reported to be useful in promoting relaxation and sleep. The current study identifies some of the subjective benefits of MPs for older adults and suggests further study of MPs and quality of life in older adults.
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Recently, mindfulness interventions have been extensively applied in the field of nursing education. However, no consensus has been reached on whether these interventions can reduce anxiety and depression in nursing students.
This meta-analysis was designed to determine the effect of mindfulness interventions on levels of depression, anxiety, stress and mindfulness for nursing students.
Meta-analysis of randomized controlled trials.
The following Chinese and English databases were searched for relevant articles: Pubmed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wanfang. The search encompassed the establishment of these databases up until January 2020. Two reviewers separately entered the data into Review Manager Software 5.3.
A total of 10 randomized controlled trials (RCTs) were reviewed. It was found that mindfulness interventions significantly lowered levels of depression (SMD = −0.42, 95% CI:−0.56 to −0.28, P < 0.001), anxiety (SMD = −0.32, 95% CI:−0.47 to −0.17, P < 0.001) and stress (SMD = −0.50, 95% CI:−0.65 to −0.35, P < 0.001) in nursing students. Furthermore, the interventions raised levels of mindfulness in this group (SMD = 0.54, 95% CI:0.33–0.75, P < 0.001).
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^☆: This research was supported by a grant from the Templeton World Charity Foundation (TWCF0087), awarded to RPE, SHC and PSL. Some of the work for this paper was based on findings reported in the PhD thesis of Onn-Siong Yim and Master’s thesis of Pei Shan Looi submitted to the National University of Singapore.

¹: Pei Shan Looi, Elysia Li Yan Tan, and Onn-Siong Yim share equal authorship and are all second authors on this paper.

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Effects of Mindfulness-Based Stress Reduction on Psychological Symptoms and Telomere Length: A Randomized Active-Controlled Trial☆

Highlights

Abstract

Section snippets

participants

sample characteristics and randomization check

Discussion

Conflict of Interest Statement

Brain, Behavior, and Immunity

Blood

Biological Psychiatry

Psychoneuroendocrinology

Psychoneuroendocrinology

Clinical Psychology Review

Journal of Immunological Methods

Behaviour Research and Therapy

Behaviour Research and Therapy

General Hospital Psychiatry

Journal of Affective Disorders

Brain, Behavior, and Immunity

Journal of Psychosomatic Research

Mindfulness training as a clinical intervention: A conceptual and empirical review

Clinical Psychology: Science and Practice

Using self-report assessment methods to explore facets of mindfulness

Assessment

Human telomere biology: A contributory and interactive factor in aging, disease risks, and protection

Science

Defining music therapy

Mindfulness-based cancer recovery and supportive-expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

Cancer

Telomere length measurement by a novel monochrome multiplex quantitative PCR method

Nucleic Acids Research

Statistical power analysis for the behavioral sciences

Alterations in brain and immune function produced by mindfulness meditation

Psychosomatic Medicine

Effects of exercise and physical activity on depression

Irish Journal of Medical Science

Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres

Annals of the New York Academy of Sciences