Mindfulness Research

IRWI Mindfulness MeetingFebruary 20, 2014

Kathy Etz, PhDNational Institute on Drug Abuse

What Can Research Add?

Question for the group – What purpose can research serve to support

mindfulness based interventions in Indian Country? What kind of research/knowledge?▪ Western? Indigenous? Both?

What are the precise definitions of mindfulness based practices? And what would it look like in Indian Country?▪ Same as many traditional practices? Or the active

ingredient might be the same? Or is it different?▪ Culturally congruent, but different?▪ Adapt for indigenous groups?

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NIH Reporter Search

“Mindfulness”: 115 records

“Mindfulness Based Stress Reduction” – 55 records

“Meditation” – 86 records

NIDA, NCCAM, NINR, NIMH, NICHD, NIDDK, NCI etc.

50 Clinical trials in last five years

2003 – 52 papers, 2012 477

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NIH Funded Mindfulness Research Focuses on a Range of Topics

Impact of Mindfulness Practice on Disease Outcome/ General Health

Bio-Markers of Mindfulness Practice FMRI EEG, etc.

Mindfulness Practice Integrated into Intervention Research Enhance Treatment (Cancer) As Prevention As Treatment (Smoking Cessation, Drug

Addiction) Use in technology

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State of the Science

Biomarker evidence that meditation, mindfulness practice has impact metabolism, heart rate, respiration, blood

pressure and brain chemistry (stress response) Increase gamma wave activity Increase gray matter White matter changes

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State of the Science

Established benefits of mindfulness practices for: chronic pain Lower cortisol response Increase immune response fibromyalgia, cancer patients drug addiction coronary artery disease etc.

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Gaps: Concerns over methodological rigor

NCCAM meta-analysis (2007) reviewed 813 studies involving five broad categories of

meditation Concluded, "Scientific research on meditation practices …is

characterized by poor methodological quality. Firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence. Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results." (p. 6).

Research quality is improving. Of the 400 clinical studies, 10% were found to be good

quality.

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Gaps: What are we talking about?

Important to define mindfulness based practice, outcomes of interest

One study indicated that mental silence critical – otherwise results similar to simply relaxing.

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Obtaining Funding for Research

Despite some controversy, efficacy of mindfulness based practice sufficiently established that exploring impact in interventions can do well in review

Review of summary statements suggests potential impact does not appear to be questioned

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Research Examples

Department of Ed: Mindfulness for Providers Efficacy Grant – Patricia Jennings

Garrison Institute CARE (Cultivating Awareness and Resilience in Education)

Emotion skills instruction to promote understanding, recognition and regulation of emotion.

To reduce stress, and to promote awareness and presence applied to teaching

Introduces basic mindfulness activities short periods of silent reflection, activities that

demonstrate how to bring mindfulness to challenging situations teachers often encounter.

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CDART - Center for Drug Abuse Research Translation

An especially innovative aspect of the proposed work is that it will test the hypothesis that individuals high in urgency will be more responsive to an intervention that promotes emotional self-regulation (i.e., mindfulness training) relative to an intervention tailored to high sensation seekers

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Reducing Stress with Parenting-Focused Mindfulness to Prevent Youth Substance Use

Parent stress as a risk factor for adolescent substance use and HIV risk behaviors.

Risk may be exacerbated in low-income families who face multiple chronic stressors.

Mindfulness-based stress reduction (MBSR) is an empirically-supported treatment that reduces stress in adults.

We hypothesize that parenting-focused MBSR (P-MBSR) will decrease parent stress, improve parenting behavior and the parent-child relationship, decrease youth bio-behavioral arousal, and prevent risk for substance use and HIV risk behaviors.

At pre- and post-intervention, adaptive and mindful parenting behaviors and parent and youth bio-behavioral stress responses will be measured using a cutting-edge laboratory paradigm that models parent-adolescent interactions and youth emotional and physiological responses to interactions

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Neural and Behavioral Correlates of the Impact of Meditation

The impact of meditation on the regulation of emotion is perhaps the most salient effect of meditation for the average practitioner. Yet the mechanisms responsible for these alterations are pooriy understood and the consequences of these changes have not been characterized. The purpose of this project is to examine the impact of these two forms of meditation on the neural, biobehavioral and hormonal correlates of emotion regulation among naive practitioners who learn mindfulness-based stress reduction (MBSR) and among Long-Term Meditators (LTMs). . Facial electromyography (fEMG) will be recorded from corrugator and zygomatic muscle regions in the scanner to provide real-time online objective measures of emotion during the regulation conditions. Saliva will be collected for three consecutive days, three times/day just prior to each lab visit to provide measures of Cortisol and total Cortisol output to relate to the fMRI measures.

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Efficacy Trial of a Mindfulness-Enhanced Strengthening Families Program

This study proposes to test the efficacy of a Mindfulness-enhanced version of the Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14) within a randomized study that will also attempt to replicate and extend research findings for SFP 10-14. The SFP 10-14 program is an evidence-based program with demonstrated effects on parenting practices and youth problem behaviors.

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Research: Moving Forward What role will research play? What type of

research?? And what purpose can research serve? ▪ Ensure dollars spent on most efficacious programs

Identify gap areas for indigenous populations What type of mindfulness based practice? Situate in context of broader science

Operational definitions What is mindfulness based practice?

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Thank you!