IMPORTANCEMany people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.OBJECTIVE To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.EVIDENCE REVIEW We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals.FINDINGS After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03-0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies). CONCLUSIONS AND RELEVANCEClinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.

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Objectives: The objectives of this study were to assess the general acceptability and to assess domains of potential effect of a mindfulness-based stress reduction (MBSR) program for human immunodeficiency virus (HIV)-infected and at-risk urban youth. Methods: Thirteen-to twenty-one-year-old youth were recruited from the pediatric primary care clinic of an urban tertiary care hospital to participate in 4 MBSR groups. Each MBSR group consisted of nine weekly sessions of MBSR instruction. This mixed-methods evaluation consisted of quantitative data-attendance, psychologic symptoms (Symptom Checklist 90-Revised), and quality of life (Child Health and Illness Profile-Adolescent Edition)-and qualitative data-in-depth individual interviews conducted in a convenience sample of participants until interview themes were saturated. Analysis involved comparison of pre-and postintervention surveys and content analysis of interviews. Results: Thirty-three (33) youth attended at least one MBSR session. Of the 33 who attended any sessions, 26 youth (79%) attended the majority of the MBSR sessions and were considered ''program completers.'' Among program completers, 11 were HIV-infected, 77% were female, all were African American, and the average age was 16.8 years. Quantitative data show that following the MBSR program, participants had a significant reduction in hostility ( p ¼ 0.02), general discomfort ( p ¼ 0.01), and emotional discomfort ( p ¼ 0.02). Qualitative data (n ¼ 10) show perceived improvements in interpersonal relationships (including less conflict), school achievement, physical health, and reduced stress. Conclusions: The data suggest that MBSR instruction for urban youth may have a positive effect in domains related to hostility, interpersonal relationships, school achievement, and physical health. However, because of the small sample size and lack of control group, it cannot be distinguished whether the changes observed are due to MBSR or to nonspecific group effects. Further controlled trials should include assessment of the MBSR program's efficacy in these domains.

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BACKGROUND AND OBJECTIVE: Many urban youth experiencesignificant and unremitting negative stressors, including those associated with community violence, multigenerational poverty, failing educational systems, substance use, limited avenues for success, health risks, and trauma. Mindfulness instruction improves psychological functioning in a variety of adult populations; research on mindfulness for youth is promising, but has been conducted in limited populations. Informed by implementation science, we evaluated an adapted mindfulness-based stress reduction (MBSR) program to ameliorate the negative effects of stress and trauma among low-income, minority, middle school public school students.

Studies report that women use as much or more physical intimate partner violence (IPV) as men. Most of these studies measure IPV by counting the number of IPV acts over a specified time period, but counting acts captures only one aspect of this complex phenomenon. To inform interventions, women’s motivations for using IPV must be understood. A systematic review therefore was conducted to summarize evidence regarding women’s motivations for the use of physical IPV in heterosexual relationships. Four published literature databases were searched, and. articles that met inclusion criteria were abstracted. This was supplemented with a bibliography search and expert consultation. Eligible studies included English-language publications that directly investigated heterosexual women’s motivations for perpetrating non-lethal, physical IPV. Of the 144 potentially eligible articles, 23 met inclusion criteria. Over two-thirds of studies enrolled participants from IPV shelters, courts, or batterers’ treatment programs. Women’s motivations were primarily assessed through interviews or administration of an author-created questionnaire. Anger and not being able to get a partner’s attention were pervasive themes. Self-defense and retaliation also were commonly cited motivations, but distinguishing the two was difficult in some studies. Control was mentioned, but not listed as a primary motivation. IPV prevention and treatment programs should explore ways to effectively address women’s relationship concerns and ability to manage anger, and should recognize that women commonly use IPV in response to their partner’s violence.

The use of CAM therapies is common for children with SCD. Prayer, relaxation techniques, and spiritual healing were the most commonly reported CAM therapies. Because clinical studies have shown the benefit of spiritual and relaxation practices for SCD and this study shows that these CAM therapies are being used commonly by SCD families, future research should focus on spiritual and relaxation practices for children with SCD.

Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.