Background Mindfulness-Based Stress Reduction (MBSR) has the potential to reduce worry and improve cognitive functioning. Objectives In this treatment development project, we examined MBSR in older adults with worry symptoms and co-occurring cognitive dysfunction. We examined (1) acceptability of MBSR, (2) whether MBSR needs to be lengthened providing more repetition, (3) MBSR's benefits for worry reduction and cognitive improvements, and (4) continued use of MBSR techniques during follow-up. Method Two sites (St. Louis and San Diego) enrolled individuals aged 65+ with significant anxiety-related distress plus subjective cognitive dysfunction, into traditional 8-session MBSR groups and 12-session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques. Results Participants (N=34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for six months post-instruction and found them helpful in stressful situations. There was no evidence that the extended 12-week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8-week MBSR. Conclusions These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co-occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value.

This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.

ClinicalTrials.gov identifier: NCT01693874.

In spite of the existence of good empirically supported treatments for posttraumatic stress disorder (PTSD), consumers and providers continue to ask for more options for managing this common and often chronic condition. Meditation-based approaches are being widely implemented, but there is minimal research rigorously assessing their effectiveness. This article reviews meditation as an intervention for PTSD, considering three major types of meditative practices: mindfulness, mantra, and compassion meditation. The mechanisms by which these approaches may effectively reduce PTSD symptoms and improve quality of life are presented. Empirical evidence of the efficacy of meditation for PTSD is very limited but holds some promise. Additional evaluation of meditation-based treatment appears to be warranted.

The ability to pay close attention to the present moment can be a crucial factor for performing well in a competitive situation. Training mindfulness is one approach to potentially improve elite athletes’ ability to focus their attention on the present moment. However, virtually nothing is known about whether these types of interventions alter neural systems that are important for optimal performance. This pilot study examined whether an intervention aimed at improving mindfulness [Mindful Performance Enhancement, Awareness and Knowledge (mPEAK)] changes neural activation patterns during an interoceptive challenge. Participants completed a task involving anticipation and experience of loaded breathing during functional magnetic resonance imaging recording. There were five main results following mPEAK training: (1) elite athletes self-reported higher levels of interoceptive awareness and mindfulness and lower levels of alexithymia; (2) greater insula and anterior cingulate cortex (ACC) activation during anticipation and post-breathing load conditions; (3) increased ACC activation during the anticipation condition was associated with increased scores on the describing subscale of the Five Facet Mindfulness Questionnaire; (4) increased insula activation during the post-load condition was associated with decreases in the Toronto Alexithymia Scale identifying feelings subscale; (5) decreased resting state functional connectivity between the PCC and the right medial frontal cortex and the ACC. Taken together, this pilot study suggests that mPEAK training may lead to increased attention to bodily signals and greater neural processing during the anticipation and recovery from interoceptive perturbations. This association between attention to and processing of interoceptive afferents may result in greater adaptation during stressful situations in elite athletes.

Background/Aims Age-related cognitive decline is a pervasive problem in our aging population. To date, no pharmacological treatments to halt or reverse cognitive decline are available. Behavioral interventions, such as physical exercise and Mindfulness-Based Stress Reduction, may reduce or reverse cognitive decline, but rigorously designed randomized controlled trials are needed to test the efficacy of such interventions. Methods Here, we describe the design of the Mindfulness, Education, and Exercise study, an 18-month randomized controlled trial that will assess the effect of two interventions—mindfulness training plus moderate-to-vigorous intensity exercise or moderate-to-vigorous intensity exercise alone—compared with a health education control group on cognitive function in older adults. An extensive battery of biobehavioral assessments will be used to understand the mechanisms of cognitive remediation, by using structural and resting state functional magnetic resonance imaging, insulin sensitivity, inflammation, and metabolic and behavioral assessments. Results We provide the results from a preliminary study (n = 29) of non-randomized pilot participants who received both the exercise and Mindfulness-Based Stress Reduction interventions. We also provide details on the recruitment and baseline characteristics of the randomized controlled trial sample (n = 585). Conclusion When complete, the Mindfulness, Education, and Exercise study will inform the research community on the efficacy of these widely available interventions improve cognitive functioning in older adults.

Mindfulness-Based Stress Reduction (MBSR) courses are being taught around the world in various contexts and targeted to various populations. The program has been intentionally designed without a detailed teaching manual so as to allow instructors to respond to what is called for in each teaching moment. It also affords tailoring the program to specific circumstances such as when working with persons suffering from depression or substance abuse. But how does one remain true to core teaching intentions and program components, while undertaking such tailoring? Modifications to the format and content of MBSR have been reported but little is known if these adaptations influence outcomes and processes underlying change compared to the basic curriculum. Here we discuss what we consider to be essential aspects of the program to be carefully considered when adapting it. We describe selected adaptations of MBSR to highlight the types of changes made and report results when data are available. We conclude with suggestions pertaining to how to best remain authentic while being imaginative regarding the administration of MBSR in non-medical settings (e.g., prison) and for special populations (e.g., women with addictions).

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