S16: Mechanisms of Stress Reduction & Resilience during Mindfulness-Based Interventions

Jeffrey Greeson1, Erica Sibinga2,Elizabeth Hoge3, Kathleen Lustyk4, Joel Grow 4; Wolf Mehling5

1Duke University, NC, USA; 2Johns Hopkins School of Medicine, Baltimore, MD, USA; 3Harvard Medical School / Massachusetts General Hospital, Boston, MA, USA; 4University of Washington, WA, USA; 5University of California San Francisco, CA, USA


Our symposium examines the effect of mindfulness training on psychological and biological variables that may be involved in its mechanism of action. First, Dr. Greeson will present an open trial of 322 Mindfulness-Based Stress Reduction (MBSR) program participants, designed to examine changes in "transdiagnostic" risk factors (such as sleep disturbance, rumination, and avoidance).  Structural equation modeling methods found that patient-reported increases in mindfulness were directly correlated with decreased symptoms of anxiety and depression, and with decreased scores on transdiagnostic risk processes such as rumination, avoidance, and suppression, suggesting that mental health benefits associated with MBSR may be due in part to shifts toward more mindful emotion regulation. Dr. Sibinga will then discuss an RCT comparing MBSR with an active control program for boys at an urban middle school. Forty-one predominantly African American participants were randomly assigned to an MBSR or control (Healthy Topics-HT) program.  Following the programs, MBSR boys had less anxiety, rumination, and negative coping than HT boys, as well as apparent attenuation of cortisol increase through the academic term. These results suggest MBSR reduces stress and anxiety and improves coping, enhancing self-regulatory processes for urban male youth.  Next, Dr. Hoge will present a study of MBSR vs. an active control for Generalized Anxiety Disorder, utilizing a laboratory behavioral stress challenge administered pre and post-intervention, with the hypothesis that patients learning mindfulness would become more "resilient" to the stress compared to controls.  The MBSR group's positive self-statements about their performance significantly increased compared to the control, and female MBSR participants had larger decreases in anxiety than the control females.  Biomarkers’ relationship to psychological variables will be presented.  MBSR was associated with greater "resilience" to a laboratory stress challenge in women. Dr. Lustyk will present data on how Mindfulness-Based Relapse Prevention (MBRP) affects psychophysiological responses to stress provocation. MBRP may exert its therapeutic effects through stress reduction; to test this, post-treatment differences in psychophysiological responses to a cognitive stressor were investigated. MBRP, Relapse Prevention (RP), and Standard Aftercare (SA) participants underwent a laboratory stressor while hemodynamics, anxiety, and craving were monitored. MBRP participants showed less heart rate reactivity, anxiety, and craving than the other groups post-stressor. Conversely, only MBRP participants showed increased high frequency heart rate variability from baseline to stressor that was inversely related to anxiety post-stressor.

Lastly, Dr. Mehling will present research on interoceptive body awareness as potential mechanism for mindfulness practices (e.g. body scan, yoga, breathing in MBSR). Body awareness is an ambiguous construct that can be viewed both as maladaptive when associated with hypervigilance and anxiety or as beneficial when associated with mindfulness. A ‘state of the science’ overview specific to the measurement and study of body awareness with its multiple dimensions will be illustrated with findings from research by his team on pain, sexual trauma, substance abuse and obesity.

We will discuss the implications of these findings on understandings of mechanisms of mindfulness mediation and suggest future research.