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Published online Aug doi: [/peds] implemented among youth aged 6 to 18 years in school, clinic, and community settings.
Table of contents

Research using rigorous design methodology including random assignment studies indicates that at least some forms of meditation do create measurable changes in physiology, cognition, and behaviour. In response to this research both Christianity and Judaism began to rediscover and emphasise their own traditions of meditation. Often these meditations are contemplative, but within any religious tradition a range of meditations can be found.

In contemplative meditations meaning is important and in the case of religious meditations the meaning will be in the context of a system of beliefs. This contrasts with Transcendental Meditation where there is neither concentration nor contemplation but simply a technique that enables a person to transcend, ie, go beyond, the whole process of meditation. The problem is that there can be a tendency to assume that research on a particular type of meditation applies to all methods. As a result, the general public has the impression that meditation in general is useful for relaxation and coping with stress.

However, the idea that all methods of meditation produce the same results is not an accurate reflection of the evidence that has been published in leading peer-reviewed journals. Different meditations affect the brain differently. Electroencephalographic EEG research has found that different methods of meditation have their own individual EEG signature.

This agrees with studies that directly compare one technique with another and analyses of data pooled from all relevant research meta-analyses. These have found that different methods of meditation or relaxation vary in their effectiveness. Meditations from religious traditions will produce effects. This is true in the sense that everything we do influences brain functioning. The question is what are the effects? The only way to know is to measure scientifically. In the absence of research any comments about the effects of a specific method of meditation must be regarded as speculation or gossip.

Recent data demonstrate that different, and equally relevant, patterns of findings are obtained depending on whether AUC is calculated as the area from the initial value AUC i or from the ground—or zero—value AUC g for the variable of interest Pruessner et al. In the current study we computed both AUC metrics using the trapezoidal formula to evaluate the effect of compassion meditation on IL-6 and cortisol responses to the TSST Pruessner et al. For all other analyses, IL-6 concentrations were log transformed to improve normality.

To evaluate relationships between meditation practice and responses to the TSST restricted to the meditation group , Pearson partial moment correlations were employed controlling for time of TSST administration. Correlations were performed with and without adjustment for baseline i. For these analyses, meditation practice time was considered to be the mean number of practice sessions per week, and maximal TSST IL-6 and cortisol responses were considered to be the IL-6 and cortisol values at 90 and 30 minutes respectively corresponding to the maximal responses in these variables in the sample as a whole - see below.

Ninety-three individuals signed consent and were screened for study participation. Twenty-eight participants withdrew from the study after randomization but prior to completing the TSST 12 from the meditation group and 16 from the control group. Primary reasons for withdrawal included scheduling conflicts, desire to discontinue meditation training or being disqualified from i. Participants who withdrew did not differ from those who completed the study in terms age, sex, BMI or baseline IDS-SR depressive symptom scores data not shown.

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The average time spent meditating per session outside of class was No significant correlations were found between any demographic or clinical variables i. In-class practice sessions lasted 20 minutes. Average time for at-home practice sessions was Immediately prior to the TSST i. Post hoc analyses indicated that in the sample as a whole, plasma IL-6 concentrations were significantly greater than baseline at 60, 75, and 90 minutes after the start of the TSST, with the maximal response occurring at 90 minutes T6.

Post hoc analysis revealed that plasma cortisol responses were significantly greater than baseline 30 and 45 minutes after the start of the TSST, with maximal absolute values 30 minutes after the start of the TSST. No main effect of group assignment was observed for either biological IL Repeating the analysis with an ANCOVA strategy that adjusted for baseline values of each variable produced similar results.

No main effect of group compassion meditation vs. Similar results were obtained when practice time was considered as minutes spent practicing during the study rather than number of practice sessions data not shown. Class attendance in the health discussion control group was not associated with any TSST outcome variables. Because we found no main effect of group assignment meditation vs. Similarly, these groups did not differ in baseline i.

Neither practice group differed in either maximal or AUC IL-6 responses from control participants, whose values were intermediate between the high and low practice meditation groups Figure 6. Neither practice group differed significantly from control participants 6a. The current study adds to a growing literature on the potential impact of meditation on physiologic parameters relevant to health, including immune and neuroendocrine responses to stress. Although no main effect of compassion meditation training on innate immune, HPA axis or behavioral responses to a laboratory psychosocial stressor was found, within the group of participants randomized to meditation training, we observed significant correlations between amount of meditation practice and innate immune and behavioral responses to psychosocial stress.

No correlation was observed between amount of practice and cortisol responses to the TSST. While it is certainly plausible that practicing compassion meditation might reduce innate immune and distress responses to stress, it is also possible that an unwillingness or inability to practice meditation might be associated with a tendency toward increased innate immune and emotional responses to psychosocial stress.

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Meditation, religion and science

To address this issue, exploratory analyses were conducted by examining high and low meditation practice groups as determined by a median split in mean number of weekly practice sessions and comparing these groups to control participants in terms of IL-6 and POMS responses to the TSST. These analyses indicated that the association between practice time and immune and behavioral outcomes was not accounted for by the fact that participants who practiced less had increased responses to the TSST when compared to controls.

Rather, their responses were no different than controls and were significantly higher than those of participants above the median in practice time. Several explanations for our findings warrant consideration. The lack of a main effect of group raises the possibility that compassion meditation training may have limited impact on health-relevant physiological or behavioral responses to psychosocial stress.

Alternatively, however, it may be that the effect of compassion meditation on stress responses is dose dependent and only apparent in individuals who commit to some minimum amount of practice time. Most of our participants practiced less than the recommendation of one session per day, and less than has been reported in some Carlson et al. The finding of an association between amount of practice and outcomes in the current study must be placed within the context of a literature on relationships between meditation practice time and outcomes that is contradictory.

For example, in very advanced practitioners Lutz et al. On the other hand, practice time during MBSR was not associated with improved antibody responses to an influenza vaccine in healthy subjects Davidson et al. Interestingly, several recent studies that found an association between practice time and outcome failed to show an effect of group assignment i. Similarly, associations between practice time and outcome do not seem significantly more likely to occur in studies with high amounts of practice time than in studies with significantly lower levels of subject participation.

Given the fact that the compassion meditation program used in the current study built sequentially from attention training through increasingly difficult, emotionally challenging, mental exercises i. In this scenario, participants who were more engaged in the process may have been more likely to have been exposed to the downstream emphasis on training in compassion which occurred in later sessions and that might have been disproportionately associated with responses to the TSST.

Interestingly in this regard, an association between practice time and physiological, behavioral or neural outcomes has been observed in the three prior published studies that have examined compassion-based meditation practices Lutz et al. The current study adds to an emerging database suggesting that meditation may affect immune system functioning Taylor, ; Carlson et al.

In one of the few randomized studies to examine the issue, Davidson et al. In contradistinction to our results, no association was seen between meditation practice time and immune outcomes, despite the fact that mean at-home practice times were similar between the studies 2. While the reasons for this discrepancy remain to be determined, the current study extends Davidson's findings regarding acquired immunity by demonstrating that practicing meditation may also affect innate immune responses.

Moreover, our findings complement the observation that MBSR enhanced responses to an immunological challenge by suggesting that the practice of meditation may also optimize immune responses to a psychosocial stressor. Findings from the current study may have intriguing health implications, especially if replicated with a design that more definitively establishes a causal connection between meditation practice time and innate immune responses to psychosocial stress.

Innate immune inflammatory signaling pathways are increasingly implicated in the pathogenesis of vascular disease Willerson et al. Stress—and stress-related conditions such as major depression—have been repeatedly shown to be risk factors for these illnesses Evans et al. Interestingly, both stress acute and chronic and major depression are also associated with increased activity in innate immune inflammatory pathways, suggesting that these pathways may be a mechanism by which stress and depression are transduced into medical illness Lutgendorf et al. Moreover, the induction of innate immune inflammatory pathways in response to psychosocial stress may also represent a mechanism linking stress to depression, given that humans chronically exposed to innate immune cytokines for therapeutic purposes develop high rates of depression Raison et al.

A primary limitation of the current study is that although we observed an association between amount of meditation practice and reduced IL-6 and distress responses to the TSST, the study design, combined with the lack of a main effect of meditation, does not allow inferences about the causal relationship between practice time and these outcomes. We know of no data showing that responses to the TSST predict the subsequent occurrence of a complex behavior such as practicing meditation.

However, responses to laboratory stressors have been cross-sectionally associated with behavioral states such as depression Heim et al. Nonetheless, depressive symptoms at the start of the study in this non-clinical population did not predict subsequent amount of practice in the meditation group, and no differences in depressive symptom scores at the start of the study were observed between participants in the high practice, low practice or control groups.

The ambiguity in our dataset regarding whether TSST findings represent outcome or predictor variables has important implications for the potential of compassion meditation as an intervention for stress related conditions. To our knowledge, the question of whether pre-existing behavioral or physiological traits such as stress reactivity might predispose some individuals to be more able to effectively practice meditation—and presumably gain greater benefit--has yet to be addressed.

The identification of such traits would be an important step in targeting meditation interventions to individuals most likely to benefit Lutz et al. On the other hand, if our TSST findings reflect a dose-dependent effect of practicing compassion meditation on innate immune and behavioral responses to psychosocial stress, this would suggest that the practice might merit further examination as a health intervention for conditions in which psychosocial stress is believed to contribute to pathogenesis.

Sitting-Meditation Interventions Among Youth: A Review of Treatment Efficacy

Clearly, an important next step in the evaluation of compassion meditation will be to address these issues with a study design that clarifies causal connections underlying associations between factors likely to mediate health-relevant outcomes, such as practice time, and those outcomes themselves. In terms of effects on stress responses, an example of such a design would be to administer the TSST prior to and upon completion of meditation training in participants randomized to compassion meditation or a control condition. Given the long-recognized ability of cortisol to suppress innate immune activity, it is intriguing that participants who practiced compassion meditation had reduced IL-6 responses in the absence of clear changes in cortisol reactivity to the TSST.

The current study adds to a conflicting literature on whether meditation affects peripheral cortisol levels, and if so, whether it increases or decreases cortisol release MacLean et al. To our knowledge, only one previous study has examined the effect of meditation training on cortisol responses to a laboratory stressor and found results similar to ours. In that study, Tang et al. Similarly, between-group differences in cortisol responses to the TSST might have emerged had the study been conducted in a larger population. These factors highlight the importance of replicating the current findings by examining a wider array of neuroendocrine and innate immune variables in a larger participant sample using a longitudinal design.

Several additional limitations of the current study are worth noting. Although we implemented a health discussion group as a comparator condition to control for several non-specific aspects of meditation training, such as psychoeducation and group support, that might influence stress reactivity, it is possible that other non-specific aspects of meditation training not well matched by the control condition may have contributed to study findings.

Because participants were told at the outset that they were enrolling in a meditation study, randomization to the meditation group may have produced increased positive expectancy bias compared to the control condition, despite the fact that all participants randomized to the control group were guaranteed meditation training in the next semester. Similarly, we did not specifically assess participant perceptions of study instructors, and it is possible that differences in charisma between meditation and control group leaders might have influenced outcomes in either direction.

Thus it is possible that associations between TSST outcomes and practice reflect a generalized effect of the time and effort involved in practicing rather than a specific effect of meditation practice per se. An important next step will be to devise and implement at-home activities for the control condition that more closely match the time and tenor of the practice required to learn compassion meditation.

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1. Introduction

Author manuscript; available in PMC Jan 1. Cole d Research Design Associates, Inc. Author information Copyright and License information Disclaimer. The publisher's final edited version of this article is available at Psychoneuroendocrinology. See other articles in PMC that cite the published article. Summary Meditation practices may impact physiological pathways that are modulated by stress and relevant to disease. Introduction Increasing evidence suggests that meditation practices may impact physiological pathways, including the immune and neuroendocrine systems, which are modulated by stress and are relevant to disease development and progression Taylor, ; Carlson et al.

Overview of Study Procedures The study occurred during spring and fall semesters of the academic year. Recruitment, randomization and allocation concealment All subjects were recruited from a health education class at Emory University. Table 1 Elements and schedule of compassion meditation training program. Developing basic concentration and mental stability. Participants taught basic attentional meditation practice i. Introduction of mindfulness i. Participants instructed in the techniques of non-judgmental observation of the processes of thought and bodily sensation.

Use of concentrative and mindfulness techniques to explore universal human desires for happiness and wishes to avoid suffering as a prelude toward the practice of developing compassion for the self. Continuing meditation on the thought that the self shares with all people a desire for happiness and a wish to avoid suffering, as well as a struggle to attain these goals.

Meditative reflection on the disadvantages of selfishness and a self-centered attitude and the advantages of considering the welfare of others. Participants guided through meditative techniques aimed at generating compassionate emotions and cognitions for those emotionally close to them. Meditation aimed at attempting to generate compassionate emotions not only for friends, but also for strangers and people participants do not like. Open in a separate window. Statistical Analysis Demographic and clinical characteristics of the sample were compared using t-tests for continuous variables and Chi-Square for categorical variables.

Study Implications Several explanations for our findings warrant consideration. How hot is the link? A mechanism converting psychosocial stress into mononuclear cell activation. Inflammatory responses to psychological stress in fatigued breast cancer survivors: A hotline to better data. Good Clinical Practice Journal. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction MBSR in breast and prostate cancer outpatients.

Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate DHEAS and melatonin in breast and prostate cancer outpatients. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program.

Loving-kindness meditation for chronic low back pain: Results from a pilot trial. Childhood maltreatment predicts adult inflammation in a life-course study. Alterations in brain and immune function produced by mindfulness meditation. Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Depression in the medical setting: Compassionate mind training for people with high shame and self-criticism: Interleukin-6 and tumor necrosis factor-alpha production after acute psychological stress, exercise, and infused isoproterenol: Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood.

A pilot randomized trial assessing the effects of autogenic training in early stage cancer patients in relation to psychological status and immune system responses. Eur J Oncol Nurs. Tumour-mediated upregulation of chemoattractants and recruitment of myeloid cells predetermines lung metastasis. Hostile marital interactions, proinflammatory cytokine production, and wound healing. Chronic stress and age-related increases in the proinflammatory cytokine IL