Mindfulness Intervention Telomeres-2024 .pdf

Psychological (Mindfulness) Intervention & Telomeres T. Jacobs et al., 2011 - Select / Unusual Population Population: n = 60 matched on demographics & meditation experience randomized to on-site, 3-month meditation retreat [between 504 - 588 hrs] vs. wait-list controls Participants recruited through...

Psychological (Mindfulness) Intervention & Telomeres T. Jacobs et al., 2011 - Select / Unusual Population Population: n = 60 matched on demographics & meditation experience randomized to on-site, 3-month meditation retreat [between 504 - 588 hrs] vs. wait-list controls Participants recruited through ads (meditation centers, Buddhist magazines & Buddhist websites). Interested individuals applied & were screened (with a 50% acceptance rate) based on: (1) age between 21 – 70y; (2) agreement to refrain from alcoholtobacco-recreational drugs during retreat & for 3 months prior; (3) availability for testing a & willingness to be allocated to either wait-list control group or retreat group Select & Unusual Population - Dedicated Meditators 4) no serious medical/psychological problems; axis I psychiatric impairments were assessed with the M.I.N.I. screen (Sheehan et al., 1998) & a clinical telephone interview with a clinical psychologist; 5) previous participation in 3 or more 5 — 10 day meditation retreats, with at least one led by Alan Wallace, Ph.D., who directed the study retreat Population – Design [stratification was important] Stratified assignment to retreat condition (n = 30) or waitlist control (n = 30), with groups matched on sex (28 men - 32 women), age (M = 48, range 22— 69), years of meditation experience (M = 13 yrs) (Table 1). [What is stratification? 1. Decide on ‘strata’ (pre-defined subdivisions of subjects that assist the obtaining of equivalence across compared groups e.g. equal numbers of males-females); 2. Randomization within strata enables a more precise randomization of subjects to experimental & control grps] Population - higher SES & flexibly ‘employed’ Retreat participants subsidized room/board during retreat ($5300 USD) but were compensated for participation in assessments (at $20/h). Control participants flown to retreat before, during, & after retreat to undergo assessments with retreat participants Controls were on-site for 5 days prior to PBMC collection to adjust to setting & altitude; most of retreat period occurred at-home, living usual daily lives. Controls compensated for participation in assessments & travel [PBMC = Peripheral Blood Mononuclear Cells – any blood cells with a round nucleus such as lymphocytes, monocytes or macrophages] Special Focus on SES & Income Mean education in yrs = 4.8 vs. 5.2 (high ‘mean’) Mean Inome = 7.3 vs. 7.1 (> 70K/yr USD in 2011) What happens on retreat? How was meditation taught? Meditation practices were: Cultivation of attentional skills (Mindfulness of Breath; Open Awareness) Generation of benevolent mental states (LKM - Loving-kindness Meditation) Meetings in mornings/evenings for guided meditations & discussion Participants primarily did solitary meditation sessions, for ~ 6.3 hrs/day Psychological Assessments Psychological assessments at pre & post-retreat At post-retreat, assessments were completed within 2 days of blood sample collection. Follow-up home-based psychological assessments were completed for the retreat group at 5 months following retreat. Self report measures Ryff’s (1989) Well-Being Scale assesses 6 dimensions of function, including: 9-item Purpose in Life subscale assessed changes in experience of: life as meaningful - with clear aims & clear directions 9-item Environmental Mastery subscale measured Perceived Control of situations & circumstances. Mindfulness Five Facet Mindfulness Questionnaire (FFMQ) assesses: 1. 2. 3. 4. 5. observing experience; acting with attentional awareness (meta-attention); non-reactivity to internal experience; describing feelings; non-judging of experience (Baer et al., 2006). Neuroticism: Big Five Inventory (John et al., 1991; John et al., 1999), measures major personality factors: openness (1); conscientiousness (2); extroversion (3); agreeableness (4); neuroticism (5) (O-C-E-A-N) Neuroticism - tendency to experience negative emotions & cognitions associated with a low stress tolerance x x x More + Mfulness + Purpose + Control Less Neuroticism x Mediation Analyses Group (assignment to Retreat Intervention) significantly predicted post treatment telomerase Increases in Perceived Control significantly mediated effects of group on telomerase Reductions in Neuroticism significantly mediated effects of group on telomerase Increases in Purpose in Life significantly mediated effects of group on telomerase Changes in Mindfulness (during retreat) mediate changes in Perceived Control & in Neuroticism Changes in: Changes in Purpose in Life (during retreat) mediate changes in Perceived Control & Neuroticism Discussion Points 1. Telomerase is inversely related to perceived stress (PS) (Epel et al., 2004). PS is reduced by meditative practice (e.g., Brown and Ryan, 2003; Nyklıcke and Kuijpers, 2008) 2. After intensive meditation training, retreat subjects had significantly higher telomerase activity than waitlist controls & psychological improvements on Perceived Control - 1, Purpose in Life - 2 Mindfulness - 3 & Neuroticism - 4 (vs. WCs) Attentional training reduces the frequency of stress cognitions in relation to rumination (past regret) & worry (future anxiety). With repeated returns of attention to ‘present-moment’ awareness (breathing sensations), there are increases in perceived control & purpose in life as present moment experience is perceived as more controllable Mindfulness of Breath & Present Moment Awareness Future Worry Mindfulness mediated Perceived Control & Neuroticism Past Regret Present Moment Awareness Purpose in Life mediated Perceived Control & Neuroticism Mindfulness of Breath & Present Moment Awareness Future Worry Mindfulness mediated Perceived Control & Neuroticism Past Regret Present Moment Awareness As long as awareness is Future-oriented or Past-oriented…. ‘Control’ is impossible Purpose in Life mediated Perceived Control & Neuroticism Discussion Points Intentions & priorities shift, during mindfulness, from hedonic pleasure to contributing to human welfare (‘doing good’) & personal contentment (‘feeling good’) (Nanamoli et al, 1995; Wallace et al, 2006). Sense of purpose - appraisals of life as ‘meaningful’ influence situational stress judgments, resulting in more flexible coping & greater stress resilience (Bower et al., 2008) Greater meaning is associated with lower perceived stress (e.g., Okamoto et al., 2007) When negative circumstances are associated with overall positive meaning, coping improves & physical stress reduces (Epel et al., 1998; Bower et al.,2008). Health-Behaviour Cycles can be initiated & sustained Telomere extension may be final ‘link’ in a ‘chain of healthy interactions’’ Introduction of multiple health-behaviour cycles - 3 criteria 1. Do-able starting point - starts w/small changes that ‘everyone can do’ & builds to & reinforces larger changes 2. Activation of bodily wisdoms/resources resulting in gratifying outcomes 3. Scientifically verifiable; not just due to placebo responses Health-Behaviour Cycles can be initiated & sustained Telomere extension may be final ‘link’ in a ‘chain of healthy interactions’’ Introduction of multiple health-behaviour cycles - 3 criteria Do-able starting point - small changes that ‘everyone can do’.... ‘just be aware of breathing sensations’ (in present moment)...meta-attention, abilities to direct attention (attentional control) Activation of bodily wisdoms/resources resulting in gratifying outcomes...Relaxation effects lead to autonomic balance...it feels better to feel more in control...Meditation releases BDNF (invitalizing physically)...Attentional control can increase without increases in tension