- Early studies were pre-post evaluations of change over time; showed improvements in psychological constructs: stress symptoms, mood, quality of life, depression - Biomarker studies: decreases in proinflammatory cytokines, cortisol levels - Symptoms: improved sleep, less fatigue, less pain - Later multiple RCTs confirmed results against waitlist, usual care and active controls. Some large samples () - Qualitative work describes benefits in terms of personal growth, spirituality, coping, and shifting perspectives - Several modifications on traditional group-based MBSR such as fewer sessions, individualized treatments, and home-based audiotape interventions also showed benefit - Some mechanistic work suggests improvements related to decreased rumination, worry, and experiential avoidance
- Strong level 1 evidence for the efficacy of MBSR for improving anxiety, depression, stress, QL, and general well-being in cancer patients. - Weaker evidence for effects on health outcomes and biomarkers - This area is one of the most developed in terms of physical conditions, progressing from small uncontrolled trials to large RCTs against active interventions and multiple narrative and quantitative reviews - Most research still in breast cancer need to expand into other groups
- Early series of pre-post studies by Kabat-Zinn and colleagues showed improved pain outcomes and mood, which were larger than a nonrandomized TAU comparison - A series of studies on ACT for chronic pain showed improvements in mindfulness and acceptance which accounted for change in pain outcomes - Only one RCT in this area found MBSR to be superior to another treatment, one other found it comparable to a standard multidisciplinary pain intervention
- Weak level 2 evidence - 1 very small positive RCT; 1 inconclusive; the bulk are pre-post - Lots of work looking at processes of change, improvements in mindfulness and associations with pain scores
- RCTs comparing MBIs to TAU or waitlist showed improved pain, distress, acceptance, functional, physical, and emotional role performance - Qualitative work shows improvements in hope, relaxation, mindfulness, and ways of relating to pain
- Level 2 evidence for efficacy (Multiple small RCTs) - Interventions were varied: loving-kindness, MBSR, breath therapy - Short or no follow-up periods
- Studies show improvements in sleep, pain, fatigue, coping, in both pre-post and comparisons to nonrandomized groups - Improvement in sense of coherence compared to waitlist - Two RCTs did not find differential benefit of mindfulness versus education support or active controls both groups improved
- Weak level 2 evidence - Not clearly superior to other active control conditions
- 2 RCTs comparing MBIs to CBT and education controls - Primary outcomes typically showed no group differences immediately postinterventions, but on longer follow-up MBSR was superior, and for patients who were depressed at baseline
- Weak level 2 evidence - Nicely controlled and designed studies with large Ns.
- Pre-post studies and small RCTs support MBIs benefits for improving psychological function, emotion regulation, quality of life and coping - 13 RCTs support efficacy of MBIs for decreasing blood pressure
- Level 1 evidence for MBIs in reducing blood pressure - Level 2 evidence for improving psychological functioning including anxiety, depression, quality of life and coping
- Small and larger RCTs comparing MBIs to waitlist, TAU and active controls showed improved psychological function (depression, anxiety), coping, self-care activities - Also showed improvements in glycemic control
- Level 2 evidence for efficacy in reducing anxiety and depression - Weak level 2 evidence for improving indices of glycemic control and neuropathic pain.
- RCTs show efficacy for MBSR improving side-effects of antiretroviral treatment, psychological well-being - One RCT and two nonrandomized studies showed improvement or stability in T-cells and NK cells
- Level 2 evidence for improving psychological functioning, coping with side-effects and stability of CD-4 T-cell counts
- Series of research on an online MBI focusing on acceptance, mindfulness, and exposure therapy has shown efficacy in multiple RCTs for improving IBS symptoms and quality of life, as well as cost-savings, over 1-year of followup - Other RCTs of in-person MBSR confirm its efficacy for symptom reduction
- Strong level 2 evidence for improving IBS symptoms, anxiety and, quality of life both in person and online - Much of the research has studied online mindfulness and acceptance therapy
