Stress management minus woo

[casebro]

Hmmm, I suppose that, what with the the HPA axis (hypothalamus-pituitary-adrenal), even the mental changes involved should change the adrenal hormone level. I wonder why none of the studies quoted didn't show any lab tests? Would a subject have to be totally buzzed up to show any irregularities to begin with? Mere 'normal stress' doesn't raise adrenals? Or is the "normal range" way to broad? I believe the normal range is about 300% wide.

 

[casebro]

Here's a talk I found about the cognitive neuroscience of mindfulness meditation:

Yes, but isn't the point to make improvements in the physical body, rather than making the brain relaxed? Shouldn't the improvemnts show in something physically quantifiable? Or is the whole stress-abatement thing totally wooo?

 

[andyandy]

Yes, but isn't the point to make improvements in the physical body, rather than making the brain relaxed? Shouldn't the improvemnts show in something physically quantifiable? Or is the whole stress-abatement thing totally wooo?

there aren't two separate systems - the "mind" and the "body" - there is only system which is a combination of the two. It doesn't really therefore make sense to operate on some sort of mind-body dualist level. If you are suffering from chronic pain and meditation makes that pain abate then why does it matter where that pain was originating? Either it was originating from a structural deficit and it is the interpretation of that pain stimulus that has been modified, or it was originating from a psychosomatic level, and the brain interpretation has been modifed. Either of these cases are "successes" in terms of improvements in quality of life and yet neither would be physically quantifiable. Stress and chronic pain reduction is only woo if you operate solely on physical empiricism (ie. ignore the mind, ignore the peer reviewed evidence and dismiss all forms of subjective pain scale and quality of life assessments as useless).

 

[andyandy]

A couple more abstracts re stress/chronic pain and meditation

Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.
Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D.
J Psychosom Res. 2010 Jan;68(1):29-36.

OBJECTIVE: This study compared changes in bodily pain, health-related quality of life (HRQoL), and psychological symptoms during an 8-week mindfulness-based stress reduction (MBSR) program among groups of participants with different chronic pain conditions.

METHODS: From 1997-2003, a longitudinal investigation of chronic pain patients (n=133) was nested within a larger prospective cohort study of heterogeneous patients participating in MBSR at a university-based Integrative Medicine center. Measures included the Short-Form 36 Health Survey and Symptom Checklist-90-Revised. Paired t tests were used to compare pre-post changes on outcome measures. Differences in treatment effect sizes were compared as a function of chronic pain condition. Correlations were examined between outcome parameters and home meditation practice.

RESULTS: Outcomes differed in significance and magnitude across common chronic pain conditions. Diagnostic subgroups of patients with arthritis, back/neck pain, or two or more comorbid pain conditions demonstrated a significant change in pain intensity and functional limitations due to pain following MBSR. Participants with arthritis showed the largest treatment effects for HRQoL and psychological distress. Patients with chronic headache/migraine experienced the smallest improvement in pain and HRQoL. Patients with fibromyalgia had the smallest improvement in psychological distress. Greater home meditation practice was associated with improvement on several outcome measures, including overall psychological distress, somatization symptoms, and self-rated health, but not pain and other quality of life scales.

CONCLUSION: MBSR treatment effects on pain, HRQoL and psychological well-being vary as a function of chronic pain condition and compliance with home meditation practice.

http://www.ncbi.nlm.nih.gov/pubmed/...med_ResultsPanel.Pubmed_RVDocSum&ordinalpos=9



The effect of meditation on physical and mental health in junior college students: a quasi-experimental study.
J Nurs Res. 2009 Dec;17(4):261-9.
Yang KP, Su WM, Huang CK.

BACKGROUND: Physical stress and mental stress are increasingly common phenomena in our rapidly changing and stressful modern society. Research has found meditation to produce positive and demonstrable stress reduction effects on brain and immune functions. This study is grounded in traditional Chinese philosophical mores that teach a process summarized by the keynote activities of "calm, still, quiet, consider, and get" and the potential of this process to reduce stress in adolescents.

PURPOSE: The purpose of this study was to examine the effects of meditation on the physical and mental health of junior college students.

METHODS: This research employed a quasi-experimental design. Participants included 242 freshmen from a junior college in Taiwan selected using a convenience sampling technique. Participants were then randomly separated into experimental (n = 119) and control (n = 123) groups. The project duration was 18 weeks, during which the experimental group received 2 hours of meditation treatment per week, for a total of 36 hours. Both groups completed pretest and posttest Life Adaptation Scale forms, which included questionnaires addressing information on physical and mental distress and positive and negative coping strategies. Data were analyzed using analysis of covariance.

RESULTS: Findings showed that the effect of the experiment treatment was significant when student physical and mental distress pretest scores were controlled. Physical and mental symptoms in the experimental group were lower than those in the control group.

CONCLUSIONS: Meditation can help students to adapt to life stressors. This study also provides support for traditional Chinese wisdom, which promotes meditation as one way to improve health.
http://www.ncbi.nlm.nih.gov/pubmed/...ed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=11

 

[casebro]

No blood pressure test results?

No galvanic skin response?

No increase in longevity?

No decrease in morbidity?

No decrease in arrests for assault?

Fewer cavities?

Frequency of love making?

Weight loss?

But an increase in feeling good from feel good counseling. Gosh what a shock.

But not one physical measurement to discuss?

Sounds like FSM-damned Woo to me.

 

[andyandy]

But not one physical measurement to discuss?

Sounds like FSM-damned Woo to me.

You seem to have quite a bizare attitude to this. If you can't measure it on a nice empirical physical scale it doesn't exist! I've already asked, do you completely reject the use of all subjective pain scale and quality of life assessments? Do you reject all the peer reviewed evidence? Do you reject any considerations of the mind at all?

It seems like you're operating under some mind body dualist mindset where the mind can be neatly separated from the body and then ignored. Strange.

And you have ignored the physical measurements I've already posted.

RESULTS: Findings showed that the effect of the experiment treatment was significant when student physical and mental distress pretest scores were controlled. Physical and mental symptoms in the experimental group were lower than those in the control group.

RESULTS: Electroencephalographic (EEG) studies have revealed a significant increase in alpha and theta activity during meditation. Neuroimaging studies showed that MM practice activates the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC) and that long-term meditation practice is associated with an enhancement of cerebral areas related to attention. From a clinical viewpoint, Mindfulness-Based Stress Reduction (MBSR) has shown efficacy for many psychiatric and physical conditions and also for healthy subjects, Mindfulness-Based Cognitive Therapy (MBCT) is mainly efficacious in reducing relapses of depression in patients with three or more episodes, Zen meditation significantly reduces blood pressure and Vipassana meditation shows efficacy in reducing alcohol and substance abuse in prisoners. However, given the low-quality designs of current studies it is difficult to establish whether clinical outcomes are due to specific or non-specific effects of MM.

 

[andyandy]

.

But not one physical measurement to discuss?

Sounds like FSM-damned Woo to me.

I get the feeling you're set against this regardless of the evidence, nevertheless to address your list.

Blood pressure:

Am J Hypertens. 2009 Dec;22(12):1326-31. Epub 2009 Oct 1.

A randomized controlled trial on effects of the Transcendental Meditation program on blood pressure, psychological distress, and coping in young adults.
Nidich SI, Rainforth MV, Haaga DA, Hagelin J, Salerno JW, Travis F, Tanner M, Gaylord-King C, Grosswald S, Schneider RH.

BACKGROUND: Psychological distress contributes to the development of hypertension in young adults. This trial assessed the effects of a mind-body intervention on blood pressure (BP), psychological distress, and coping in college students. METHODS: This was a randomized controlled trial (RCT) of 298 university students randomly allocated to either the Transcendental Meditation (TM) program or wait-list control. At baseline and after 3 months, BP, psychological distress, and coping ability were assessed. A subgroup of 159 subjects at risk for hypertension was analyzed similarly. RESULTS: Changes in systolic BP (SBP)/diastolic BP (DBP) for the overall sample were -2.0/-1.2 mm Hg for the TM group compared to +0.4/+0.5 mm Hg for controls (P = 0.15, P = 0.15, respectively). Changes in SBP/DBP for the hypertension risk subgroup were -5.0/-2.8 mm Hg for the TM group compared to +1.3/+1.2 mm Hg for controls (P = 0.014, P = 0.028, respectively). Significant improvements were found in total psychological distress, anxiety, depression, anger/hostility, and coping (P values < 0.05). Changes in psychological distress and coping correlated with changes in SBP (P values < 0.05) and DBP (P values < 0.08). CONCLUSIONS: This is the first RCT to demonstrate that a selected mind-body intervention, the TM program, decreased BP in association with decreased psychological distress, and increased coping in young adults at risk for hypertension. This mind-body program may reduce the risk for future development of hypertension in young adults.

With regards to Morbidity:

Am J Cardiol. 2005 May 1;95(9):1060-4.

Long-term effects of stress reduction on mortality in persons > or = 55 years of age with systemic hypertension.
Schneider RH, Alexander CN, Staggers F, Rainforth M, Salerno JW, Hartz A, Arndt S, Barnes VA, Nidich SI.

Psychosocial stress contributes to high blood pressure and subsequent cardiovascular morbidity and mortality. Previous controlled studies have associated decreasing stress with the Transcendental Meditation (TM) program with lower blood pressure. The objective of the present study was to evaluate, over the long term, all-cause and cause-specific mortality in older subjects who had high blood pressure and who participated in randomized controlled trials that included the TM program and other behavioral stress-decreasing interventions. Patient data were pooled from 2 published randomized controlled trials that compared TM, other behavioral interventions, and usual therapy for high blood pressure. There were 202 subjects, including 77 whites (mean age 81 years) and 125 African-American (mean age 66 years) men and women. In these studies, average baseline blood pressure was in the prehypertensive or stage I hypertension range. Follow-up of vital status and cause of death over a maximum of 18.8 years was determined from the National Death Index. Survival analysis was used to compare intervention groups on mortality rates after adjusting for study location. Mean follow-up was 7.6 +/- 3.5 years. Compared with combined controls, the TM group showed a 23% decrease in the primary outcome of all-cause mortality after maximum follow-up (relative risk 0.77, p = 0.039). Secondary analyses showed a 30% decrease in the rate of cardiovascular mortality (relative risk 0.70, p = 0.045) and a 49% decrease in the rate of mortality due to cancer (relative risk 0.49, p = 0.16) in the TM group compared with combined controls. These results suggest that a specific stress-decreasing approach used in the prevention and control of high blood pressure, such as the TM program, may contribute to decreased mortality from all causes and cardiovascular disease in older subjects who have systemic hypertension.

Physical changes

Prog Neuropsychopharmacol Biol Psychiatry. 2005 Feb;29(2):327-31. Epub 2004 Dec 29.

Effect of Zen Meditation on serum nitric oxide activity and lipid peroxidation.
Kim DH, Moon YS, Kim HS, Jung JS, Park HM, Suh HW, Kim YH, Song DK.

This study was designed to investigate the effect of Zen Meditation on serum nitric oxide activity (NO) and oxidative stress (lipid peroxidation). The experimental group included 20 subjects who had practiced the Zen Meditation program in Meditation Center located in Seoul, South Korea. The control group included 20 subjects who did not practice any formal stress management technique and were age and sex matched with experimental group. To provide an assessment of nitric oxide production, the serum level of nitrate/nitrite was determined using the Griess reagent. Malondialdehyde (MDA) concentration was measured as a convenient index of lipid peroxidation by thiobarbituric acid (TBA) method. Meditation group showed a significant higher level of serum nitrate+nitrite concentration and a significant reduced level of serum malondialdehyde (MDA) than control group. A comprehensive randomized controlled trial should be performed to prove the causal relationship between meditation and level of nitric oxide or oxidative stress in reducing cardiovascular risk factors.

Physical measurements:

nt J Psychophysiol. 2009 Feb;71(2):170-6. Epub 2008 Sep 30.

Effects of Transcendental Meditation practice on brain functioning and stress reactivity in college students.
Travis F, Haaga DA, Hagelin J, Tanner M, Nidich S, Gaylord-King C, Grosswald S, Rainforth M, Schneider RH.

This randomized controlled trial investigated effects of Transcendental Meditation (TM) practice on Brain Integration Scale scores (broadband frontal coherence, power ratios, and preparatory brain responses), electrodermal habituation to 85-dB tones, sleepiness, heart rate, respiratory sinus arrhythmia, and P300 latencies in 50 college students. After pretest, students were randomly assigned to learn TM immediately or learn after the 10-week posttest. There were no significant pretest group differences. A MANOVA of students with complete data (N=38) yielded significant group vs treatment interactions for Brain Integration Scale scores, sleepiness, and habituation rates (all p<.007). Post hoc analyses revealed significant increases in Brain Integration Scale scores for Immediate-start students but decreases in Delayed-start students; significant reductions in sleepiness in Immediate-start students with no change in Delayed-start students; and no changes in habituation rates in Immediate-start students, but significant increases in Delayed-start students. These data support the value of TM practice for college students.

The question really should be why are you so opposed to something with such a wealth of peer reviewed data behind it? How can it possibily be relevant to describe it as "woo" - when you lump it together with things like reiki or homeopathy which violate our understanding of the physical world. This has solid science behind it - goodness, go on pubmed and there are dozens if not hundreds of studies on the positive benefit of meditation. So why is it woo?

 

[Dancing David]

Any studies done with results quantifiable from outside the subjects own mind? I think placebos have toooo big of an effect on mental image, hard to show actual physical improvement. I'd guess some measurement would be something like lower stress hormone levels?

It is questionable that the 'placebo effect' is more that regression to the mean.

 

[Dancing David]

Also mindfullness meditation (of which there are several) is learning to do one thing at a time, stop multitasking and focus on the moment.

This can decrease stress entrainment considerably, where no matter what you are doing you worry about other stuff.

 

[sleepy_lioness]

Well that's positive news....hopefully it'll continue to grow in popularity....

Really based on the evidence for it efficiancy it should be being recommended by every GP in the country for every patient with a long term chronic pain condition, with stress or with depression. Can you imagine if GlobalPharmaCorp brought out a pill with the same proven health benefits, and with absolutely no side effects? It'd be marketed as a new wonder drug.....and GPs would be only too happy to prescribe it. And yet, because meditation isn't a pill, because it sounds a bit "hippy-ish", it remains woefully neglected.

MBCT is becoming more available on the NHS, but at the moment it still depends where you live as to whether there's a service.

I'd just like to challenge the 'no side effects' thing. Just about any intervention that you do with people has the potential to have side effects. I almost gave up MBCT the first week because the meditation triggered a really horrible bout of depersonalisation/derealisation which lasted several days and was one of the most frightening things that has ever happened to me - I had to visit A&E to get checked out. The psychiatrist leading my group told me this was a not uncommon side effect - indeed, he'd personally experienced it when he began meditating. It did go away, and I'm very glad I stuck with the course because it helped me immeasurably, but that was a very nasty side effect.

 

[andyandy]

I'd just like to challenge the 'no side effects' thing. Just about any intervention that you do with people has the potential to have side effects. I almost gave up MBCT the first week because the meditation triggered a really horrible bout of depersonalisation/derealisation which lasted several days and was one of the most frightening things that has ever happened to me - I had to visit A&E to get checked out. The psychiatrist leading my group told me this was a not uncommon side effect - indeed, he'd personally experienced it when he began meditating. It did go away, and I'm very glad I stuck with the course because it helped me immeasurably, but that was a very nasty side effect.

That's really interesting - not something i'd considered. Can you expand at all on the experience? Was it depressive?

 

[Roma]

Hmmmm.....a mom going to school wants to reduce stress.....

okay that's not that hard, all you need to do is lower your standards,

1.) no one will die if the house isn't clean
2.) left over pizza is a nutritous breakfast
3.) give the kids a bath at night and put them to bed in their clothes for next day
4.) bed time stories will be read from your text book, (that'll put them to sleep)
5.) any complaints from anyone will be considered volunteering
6.) find a quiet place on campus and get there early, stay late
7.) get as much sleep as you can
8.) stay away from junk food and sugar
9.) wear comfortable clothes
10.) get to the gym or play outside with the kids, exercise reduces stress

 

[sleepy_lioness]

That's really interesting - not something i'd considered. Can you expand at all on the experience? Was it depressive?

To be honest, I can't really recall now - it was a couple of years back. I don't think it felt depressive, but it did induce a lot of anxiety. Basically I felt like I wasn't in my body any more, I was sort of floating somewhere behind my head, and I watched myself doing all my actions without being involved in them, if that makes any sense. I was terrified the whole time that I would do something stupid like walk in front of a bus, because I felt like I had little control over my actions (I wasn't suicidal at all, just felt like my body was out of my control). The world felt like a film or a dream, I'd somehow lost my sense of self and didn't know if I'd ever get it back. Apparently these sorts of feelings, or milder feelings of being spaced out, are relatively common to people who try meditation for the first time.

 

[casebro]

I get the feeling you're set against this regardless of the evidence, nevertheless to address your list.

Blood pressure:



With regards to Morbidity:



Physical changes



Physical measurements:



The question really should be why are you so opposed to something with such a wealth of peer reviewed data behind it? How can it possibily be relevant to describe it as "woo" - when you lump it together with things like reiki or homeopathy which violate our understanding of the physical world. This has solid science behind it - goodness, go on pubmed and there are dozens if not hundreds of studies on the positive benefit of meditation. So why is it woo?

Until this post of your's (#27) nobody had dug out any cites showing any measurable physical improvements. Oh, they were all peer-reviewed, but generally used the grading system based on subjects feelings. You know, "On a scale of one to ten, with one being terrible, and ten being all sweetness and light, how is your chakra today?" Substitute any thing for chakra- depression, pain, suicidal tendencies...

I'll re-read and digest the links you gave.

And remember, the whole scheme is to prevent disease states that are supposedly caused by 'stress'.

My own attitude? Just being skeptical, again. My skepticism is based on personal experience. Meditation/relaxation/self hypnosis works for me to a limited degree. I can raise the temperature of my hands 4°. I can remember the combination to a safe that I hadn't opened in seven years. But it didn't lower my familial hypertension a bit. I started that excursion because I was supposedly tense due to suffering abuse. Turned out that biopsy shows a "congenital hereditary myopathy". Mental stress not involved. So no improvement. Hey, I tried it. It didn't work. Reason enough to be skeptical?

 

[casebro]

To be honest, I can't really recall now - it was a couple of years back. I don't think it felt depressive, but it did induce a lot of anxiety. Basically I felt like I wasn't in my body any more, I was sort of floating somewhere behind my head, and I watched myself doing all my actions without being involved in them, if that makes any sense. I was terrified the whole time that I would do something stupid like walk in front of a bus, because I felt like I had little control over my actions (I wasn't suicidal at all, just felt like my body was out of my control). The world felt like a film or a dream, I'd somehow lost my sense of self and didn't know if I'd ever get it back. Apparently these sorts of feelings, or milder feelings of being spaced out, are relatively common to people who try meditation for the first time.

Isn't that the peak of attainment in meditation?

The 'self hypnosis for self improvement' branch of the art uses the "watch your self, as if you are outside your body..." point to tell your self to improve. Introspection, I suppose?

 

[casebro]

I get the feeling you're set against this regardless of the evidence, nevertheless to address your list.

Blood pressure:

I don't think 2% drop in systolic bp is what people have in mind. And it was amongst subject who were "pre-hypertensive or class one", as in mild problem anyhow.

With regards to Morbidity:

Hey, the subject population was OOOOold. Heart attack down rate down 30%? Cancer death rate down 49%? I guess I think there was something wrong with the study design, but I'm not much of a statistician. Anybody else?

Physical changes

Study size of 20 subjects? The abstract says "significant higher levels of Nitrate". but doesn't give a number. Might it be statisitaclly significant without being medically significant?

Physical measurements:

small group size, 38. I don't understand what they measured, but they didn't bother to report results for some things, I suppose that meant no improvement in those things? Heart rate and sinus arrythmias were two, they sound to me like important indicators of stress.

Oh well.

 

[Dancing David]

Isn't that the peak of attainment in meditation?

The 'self hypnosis for self improvement' branch of the art uses the "watch your self, as if you are outside your body..." point to tell your self to improve. Introspection, I suppose?

Well there are hundreds of meditation techniques, mindfullness is about learning to focus on onething at a time, it is not the induction of trance states. In fact you should become more aware of your body during mindfullness.

 

[fls]

Hey, the subject population was OOOOold. Heart attack down rate down 30%? Cancer death rate down 49%? I guess I think there was something wrong with the study design, but I'm not much of a statistician. Anybody else?

This is the study:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1482831/

Of note, there were no mortality differences between TM and usual care. Multiple comparisons were made, most of which showed no difference, and a few were selected post hoc on the basis of their (uncorrected) p-values. I'm not sure I would be convinced by that, either.

Study size of 20 subjects? The abstract says "significant higher levels of Nitrate". but doesn't give a number. Might it be statisitaclly significant without being medically significant?

small group size, 38. I don't understand what they measured, but they didn't bother to report results for some things, I suppose that meant no improvement in those things? Heart rate and sinus arrythmias were two, they sound to me like important indicators of stress.

Neither involve outcomes, which is what we are interested in (including subjective outcomes like well-being).

Linda

 

[jon]

Hmmmm.....a mom going to school wants to reduce stress.....

okay that's not that hard, all you need to do is lower your standards,

Actually, that's pretty good advice If you've got a heavy workload, you won't be able to do some things to the high standard you might like - so prioritise what's important to you, and don't stress about minor things.

Doing some kind of exercise will be a good thing, and some kind of relaxation/meditation might be useful. Cutting back on the caffeine may help (if you consume much of the stuff) and if you drink then you should limit your consumption of alcohol - a very common, but often unhelpful way to deal with stress.

Of course, if the stress is posing particular problems you should speak to your doctor. There is often lots you can do yourself to improve matters, though.

 

[rroden]

I'm working full time, part time (about 5-10 hours/week), and a full time student right now. I found sitting down and scheduling everything on a calendar (I used Google calendar since it syncs with my phone and I already had an account) has helped me a lot. I was staying up till 2 every night trying to keep up with everything, but now I get a good nights sleep and am slightly ahead in most of my classes.