Objectives: We meta-Analyzed the effect of meditation on blood pressure (BP), including both transcendental meditation and non-Transcendental meditation interventions. Methods: We identified randomized controlled trials (RCTs) that examined the BP responses to meditation interventions through a systematic literature search of the PubMed, ABI/INFORM, MEDLINE, EMBASE, PsycINFO, and CINAHL databases (from January 1980 to October 2015). We meta-Analyzed the change in SBP and DBP, stratified by type of meditation (transcendental meditation vs. nontranscendental meditation intervention) and by type of BP measurement [ambulatory BP monitoring (ABPM) vs. non-ABPM measurement]. Results: Nineteen studies met the eligibility criteria. Among the studies using the ABPM measurement, the pooled SBP effect estimate was-2.49mmHg [95% confidence interval (CI):-7.51, 2.53] for transcendental meditation intervention (statistically insignificant) and-3.77mmHg (95% CI:-5.33,-2.21) for nontranscendental meditation interventions, whereas the pooled DBP effect estimate was-4.26mmHg (95% CI:-6.21,-2.31) for transcendental meditation interventions and-2.18mmHg (95% CI:-4.28,-0.09) for nontranscendental meditation interventions. Among the studies using the non-ABPM measurement, the pooled SBP effect estimate from transcendental meditation interventions was-5.57mmHg (95% CI:-7.41,-3.73) and was-5.09mmHg with non-Transcendental meditation intervention (95% CI:-6.34,-3.85), whereas the pooled effect size in DBP change for transcendental meditation interventions was-2.86mmHg (95% CI:-4.27,-1.44) and was-2.57mmHg (95% CI:-3.36,-1.79) for nontranscendental meditation interventions. Conclusion: Non-Transcendental meditation may serve as a promising alternative approach for lowering both SBP and DBP. More ABPM-measured transcendental meditation interventions might be needed to examine the benefit of transcendental meditation intervention on SBP reduction.

This study aimed to assess the impact of an Mindfulness-based stress reduction (MBSR) intervention in a program serving women who survived Intimate partner violence (IPV). The biopsychosocial model, formulated by Engel, was the theoretical basis of this study. The impact of the MBSR intervention was assessed by qualitatively evaluating researcher notes and 5 participants' journals and reflections, and quantitatively evaluating 16 participants' self-reported stress, mindfulness, well-being, and optimism before and after the intervention. The themes that emerged from the qualitative data included participants' feelings of relaxation or balance, improved self-awareness, mindfulness exercises becoming easier over time, and improved intentionality. The Kentucky Inventory of Mindfulness Skills (KIMS) self-report inventory was used to assess participants' mindfulness. The KIMS instrument is composed of four subscales: observe, describe, act, and accept. There were significant improvements in the describe and accept dimensions of mindfulness from pretest to posttest, after Bonferroni adjustment. The subscale describe measures how well the participants report being able to describe, identify, or observe mental phenomena in a nonjudgmental manner. There were no significant differences from pre to posttest on stress, well-being, and optimism, a non-equivalent dependent variable not expected to change as a result of the intervention, as optimism is presumed to be a stable personality trait. This study may provide a valuable link to the development of coping and treatment strategies for IPV survivors that can be integrated into therapy programs and individual treatment.

BACKGROUND: Patients visit the emergency department (ED) for life-threatening conditions, such as broken bones or chest pain, and non-life threatening conditions such as medication refills and pain management. Patients may make ED visits for non-life threatening conditions because they lack access to primary care. Research has shown that patients who are low-income, have chronic conditions, such as pain, and have depression are among those most likely to use the ED at a high rate. One of the most common reasons for visiting the ED is for pain relief, and therefore an intervention on patient self-management might prevent ED visits. The Program for Integrative Medicine and Health Care Disparities at Boston Medical Center (BMC) developed the Integrative Medicine Group Visit (IMGV) model to address chronic pain and depression among low-income patients, with the goal to improve patient’s adherence to self-management of pain and depression. The IMGV model consists of three non-pharmacologic components: evidence-based complementary medicine, mindfulness-based stress reduction, and group medical visits – all of which have been used to manage pain and depression. In a pre-post study of IMGV conducted in 2014, IMGV was associated with a significant decrease in ED utilization. Currently, the Program is conducting a randomized clinical trial (RCT) to compare a number of outcomes between the IMGV model and standard of care. The aim of this study was to determine if IMGV affects ED utilization in adult patients diagnosed with chronic pain and depression from an urban safety-net hospital population. METHODS: We conducted a secondary database analysis of participants enrolled in the IMGV RCT. The RCT is a two-armed study, and the medical chart review is part of the RCT. The study had patients who sought primary care at BMC and two affiliated outpatient urban community clinics. Only emergency visits made at BMC’s Emergency Department were included in our analysis. The inclusion criteria included reporting a pain level score > 4 on a 0-10 scale and having a score > 5 on the Patient Health Questionnaire-9. The intervention consisted of 10 IMGV sessions over 21 weeks. The control was standard treatment of care. Data extraction was completed in two ways: (1) the BMC Clinical Data Warehouse was extracted from Epic and (2) hand review took place by research assistant. The primary outcomes included ED encounters at two different time points: (1) 90 days before Session 1 and (2) Session 1 to Session 9. The extracted information also included information about patients’ chief complaints and discharge diagnoses. A visit was categorized as being a preventable emergency visit (PEV) or a non-preventable emergency visit (NEPV). Descriptive statistics and two-sample T-tests were used to analyze outcomes. RESULTS: At baseline, 22 of the 31 participants made at least one ED visit in the 90 days before Session 1. At 9-weeks, 14 of the 26 participants made at least ED visit. From baseline to 9-weeks, the number of participants who had at least one ED visit decreased for the intervention group (13 to 4), but increased for the control group (9 to 10). From baseline to 9-weeks, the number of visits decreased among intervention participants (16 to 5) but increased among control participants (11 to 12). The two-sample T-test, which compared the ED utilization among the intervention and control, resulted in the mean values of -0.7333 and 0.0625, respectively. This result indicated that intervention participants had overall lower ED visit use from baseline to 9-weeks. Emergency visits were also analyzed by whether they were PEV or NPEV. Of the 27 ED visits at baseline, 21 were classified as being a PEV, and 6 were classified as being a NPEV. Of the 17 ED visits at 9-weeks, the number of visits decreased for both PEVs (21 to 13) and NPEV (6 to 4). CONCLUSION: We wanted to determine if the IMGV reduces ED utilization in patients with chronic pain and depression. Our results suggest that the IMGV model may be associated with reduced overall ED utilization and reduced preventable ED visits. However, one limitation is that we have a very small sample size. This finding needs to be produced in an adequately powered clinical trial. Further research might explore the mechanisms for how the IMGV model can lead to lower ED utilization among patients with chronic pain and depression.

Inledning: Psykisk ohälsa är ett stort hälsoproblem i dagens samhälle och något som många drabbats av någon gång i livet. Ångestsyndrom är en sjukdom som är förknippad med oro och ängslan och kan ge obehagliga symtom. Syftet med litteraturöversikten var att ta reda på vilka positiva effekter som fysisk aktivitet kan bidra med när det gäller behandlingen av ångest. Metod: Metoden som har används är en allmän litteraturöversikt, där tio artiklar som söks fram i databasen PubMed har använts. Dessa artiklar har analyserats och sammanställs till fem teman. Resultat: Alla artiklarna som är använda i denna här litteraturöversikten, tyder på att fysisk aktivitet hjälper till att minska på ångesten i alla fall något. Olika former av fysisk aktivitet, visar sig vara olika effektivt. Den form som verkar mest effektiv är aerob träning. Diskussion: När det gäller den fysisk aktivitet som behandlingsform, så verkar inte den ångestdämpande effekten vara tillräckligt stor, för att endast kunna använda sig av detta som behandling mot ångest. Däremot är det mycket som tyder på att den är lämplig som en tilläggsbehandling, både för det fysiska och psykiska välbefinnandet.

xv, 173 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Both Buddhist scholars and psychological researchers have suggested that mindfulness practice may result in greater empathy, but previous research has found mixed results. In addition, Buddhist philosophy suggests that mindfulness should influence the perception of and felt connection to others. Little research, however, has examined such an influence. The present studies examined the effect of dispositional mindfulness, as well as short- and long-term mindfulness meditation practice, on trait and state empathy, social perception, and felt connection to others. Study 1 manipulated mindfulness with a guided meditation CD and found that participants in this condition experienced more serenity and less negative emotion relative to control conditions. Study 1 also clarified the relationship between dispositional mindfulness (measured with the Five Facet Mindfulness Questionnaire), empathy (Interpersonal Reactivity Index), and felt connection (Allo-Inclusive Identity Scale). Results showed that different facets of mindfulness had different correlates. Higher observing scores were related to greater empathic concern and perspective taking; higher nonreactivity scores were related to less personal distress; and higher describing scores were associated with greater felt connection to others. Mindfulness was also associated with social perception such that higher nonreactivity scores were associated with greater ease in making emotion inferences from short video clips and higher describing scores were associated with making more mental state inferences in a modified empathic accuracy task. In Study 2, a randomized 8-week mindfulness intervention caused increases in dispositional mindfulness, especially describing scores, relative to a waitlist control condition. The intervention also resulted in increased serenity and joy and decreased negative affect and tension. Except for changes in serenity, these changes were fully mediated by increases in dispositional mindfulness. Those in the intervention condition decreased in personal distress to others' suffering, increased in the amount of mental state inferences they made for empathic accuracy targets, and increased in their ability to make inferences at times when the targets were actually having a thought or feeling. Thus, mindfulness training not only resulted in intrapersonal changes such as greater serenity and less tension; it also increased cognitive and emotional abilities important for empathy toward other people. / Committee in charge: Bertram Malle, Co-Chairperson, Psychology; Sanjay Srivastava, Co-Chairperson, Psychology; Sara Hodges, Member, Psychology; Mark Unno, Outside Member, Religious Studies

Mindfulnessbaserad stressreduktion och mindfulnessbaserad kognitiv terapi är två program som har god evidens vid ett flertal psykiska och fysiska tillstånd. Den övervägande delen av tidigare forskning är dock kvantitativ. Syftet med denna studie var att genom kvalitativ metod undersöka vilka förändringar människor upplever till följd av programmen. Sju tidigare deltagare intervjuades och resultatet bearbetades genom tematisk analys. Resultatet visade att deltagarna upplevde ett ökat psykiskt välmående och en större acceptans för sig själva och sina upplevelser. De beskrev en ökad förmåga till decentrering från tankar och känslor och minskad tendens att reagera automatiskt vid obehag. Många upplevde ökad affekttolerans och en stärkt känsla av agentskap. MBKT-deltagarna beskrev att de lättare kunde släppa taget om grubblerier och ältande. Flera deltagare beskrev att de börjat prioritera egna behov mer och sänka kraven på sig själva. Flera upplevde minskad känslighet för social bedömning och ökad förmåga till gränssättning och självhävdelse i relationer. Många beskrev en minskad känslomässig reaktivitet och ökad mentaliseringsförmåga i påfrestande interpersonella situationer. Vissa upplevde ökad medkänsla med sig själva och andra. Hos en del framkom behov av uppföljning efter avslutat program. Fynden diskuteras med hänsyn till studiens begränsningar och i relation till teori, tidigare studier och möjlig framtida forskning.

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