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FYB Horizons (Stress Management)

Stress Research Studies (various)

Stress and Health

Slow wound healing by psychological stress. Wounds in stressed caregivers take significantly longer to heal (48.7 days vs. 39.3 days): Kiecolt-Glaser, J.K., Marucha, P.T., Malarkey, W.B., Mercado, A.M., & Glaser, R. (1996). Slowing wound healing by psychological stress. Lancet, 346(8984):1194-1196. Thirteen women (mean age 62) caring for demented relatives (high stress) were compared with 13 controls matched for age (60 yo) and family income. Ball subjects underwent a 3.5 mm punch biopsy. Healing was assessed by photography of wound and response to hydrogen peroxide (healing defined as no foaming). Wounds in stressed caregivers took significantly longer to heal (48.7 vs. 39.3 days, p<.05). Furthermore, peripheral blood leukocytes (white blood cells) of caregivers produced significantly less interleukin-1 beta mRNA in response to lipoplysaccharide stimulation (suggesting impaired functioning).

Diseases associated with stress, including asthma, diabetes, gastrointestinal disorders, myocardial infarction, hypertension, cancer, viral infections, and autoimmunity: McEwen, B.S., & Stellar, E. (1993). Stress and the individual mechanisms leading to disease. Archives of International Medicine, 153, 2093-2101. Examines diseases associated with stress, including asthma, diabetes, gastrointestinal disorders, myocardial infarction, hypertension, cancer, viral infections, and autoimmunity; discusses mechanisms, including neurochemistry (serotonin) and immunology (natural killer cell activity and cancer). See recent update in: McEwen, B.S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171-179.

Reducing Anxiety

Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders (generalized anxiety disorder or panic disorder). A significant reduction in symptoms of anxiety and depression was identified during treatment and maintained for at least 3 months after treatment ended. The authors indicated that a 3-year follow-up showed that 18/22 subjects maintained these beneficial effects. Kabat-Zinn, J., Massion, A.O., Kristeller, J., Peterson, L.G., Fletcher, K.E., Pbert, L., Lenderking, W.R., & Santorelli, S.F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry, 149, 936-943. Study of 22 patients referred for meditation and relaxation program who had generalized anxiety disorder or panic disorder (ages 26-65, 17 women). The intervention consisted of a 8-week long course involving weekly 2-hour classes and a 7.5 hour intensive meditation retreat session in week six. Subjects were assessed at the start and end of intervention and at monthly intervals for 3 months after treatment. A significant reduction in symptoms of anxiety and depression was identified during treatment and maintained for at least 3 months after treatment ended. The authors indicated that a 3-year follow-up showed that 18/22 subjects maintained these beneficial effects.

Reducing Chronic Pain

Clinical use of mindfulness meditation for the self-regulation of chronic pain. Investigators found statistically significant reductions in pain symptoms, mood disturbance, and psychological symptoms. Pain-related drug utilization also decreased and self-esteem increased. Improvements was independent of sex, source of referral or type of pain. Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8, 163-190. Investigators compared patients in two hospital clinics involving. One hospital clinic treated patients using "mindfulness meditation"; 90 chronic pain patients received 10 weeks of a Stress-Reduction and Relaxation Program (SSRP). In these patients, investigators found statistically significant reductions in pain symptoms, mood disturbance, and psychological symptoms. Pain-related drug utilization also decreased and self-esteem increased. Improvements was independent of sex, source of referral or type of pain. A comparison group of patients in the other hospital pain clinic (n-21) and referrals to the SRRP from the pain clinic (n=21) did not show similar improvement after traditional treatment protocols. At follow-up improvements were maintained for 15 months for all measures except on measure of pain; the majority of subjects reported high compliance with daily meditation.

Preventing and Treating Substance Abuse

Treating and preventing alcohol, nicotine, and drug abuse through transcendental meditation. There was a significant drop in one or more categories of substance abuse in TM participants relative to controls. Examining tobacco consumption levels, over 80% of those who meditated twice a day quit or decreased smoking after 20 months vs. 55% of irregular mediators and 33% of controls. Gelderloos, P., Walton, K.G., Orme-Johnson, D.W., 7 Alexander, C.N. (1991). Effectiveness of the transcendental meditation program in preventing and treating substance misuse: A Review. International Journal of the Addictions, 26, 293-325. These investigators reviewed 24 studies on the benefits of Transcendental Meditation in treating and preventing substance abuse. They concluded from this review that "all studies showed positive effects of the TM program". Only two studies, however, used longitudinal experimental designs with random assignments of subjects. Myers & Eisner (1974) randomly assigned young male students from a community college (selected from a large pool of volunteers. Sixty were assigned to TM, 60 to karate, and 60 to a no-treatment control group. After 4 months, investigators compared groups on use of marijuana, psychedelics, uppers, downers, and hard drugs. There was a significant drop in one or more categories of substance abuse in TM participants relative to controls. The second study (Bounouar), (1989), examined 925 TM participants and 6,145 controls who attended an introductory lecture on TM. Subjects were followed for 20 months, examining tobacco consumption levels. Over 80% of those who meditated twice a day quit or decreased smoking after 20 months vs. 55% of irregular mediators and 33% of controls (p<.0001). Also see Alexander, C.N., et al (1994). Treating and preventing alcohol, nicotine, and drug abuse through transcendental meditation: A review and meta-analysis. Alcoholism Treatment Quarterly, 11(1/2), 13-87.

Reducing Blood Pressure

Among meditation subjects, there was a drop in systolic BP (SBP) and diastolic BP (DBP). Benson, H. (1977). Systemic hypertension and the relaxation response. New England Journal of Medicine, 296, 1152-1156. This article reviews research on the relaxation response and blood pressure (BP). In one of the studies reviewed, subjects were taught to elicit the relaxation response by meditation for 20 minutes twice/day. Ater two weeks, BPs were measured every two weeks for 6 months (BP's never measured after meditation). Among meditation subjects, there was an average drop in systolic BP (SBP) during the 6 months of 7 mmHG lower than at baseline and diastolic BP (DBP) was 4 mmHG lower than at baseline. Subjects served as their own controls, with a 6-week run-in period when no BP changes were observed before start of study. For subjects who "chose to stop meditation", both SBP and DBP by 14 mmHG in hypertensive patients treated with antihypertensive medication, compared with no statistically significant change in a matched control group. A third study using control group and Buddhist meditation reported reductions of 15 mm SBP and 10 mm DBP in patients with hypertension (NEJM, 1976). Other studies have also shown significant decreases in both SBP and DBP with the relaxation response in normotensive working populations.

Relaxation-based treatments should be given early consideration in light of the evidence of their efficacy. Chesney, M.A., Agras, S., Benson, H., Blumenthal, J.A., Engel, B.T., Foreyt, J.P., Kaufmann, P.G., Levenson, R.M., Pickering, T.G., Randall, W.C., Schwartz, P.J. (1987). Task Force 5: Nonpharmocologic approaches to the treatment of hypertension. Circulation, 76 (Suppl I), 104-109. This is a more recent review of the literature. Authors conclude that since 20 million people in the U.S. alone have mild hypertension (HTN) and drug treatments for HTN have many potential negative side-effects, non-pharmacological treatments "must be explored vigorously" (p 104). Suggests that for the standard care of hypertensive individuals that "Relaxation-based treatments should also be given early consideration in light of the evidence of their efficacy" (p 105).

Heart Disease and Other Cardiovascular Risk Factors

Transcendental Meditation is associated with reduced cardiovascular risk factors such as hypertension, smoking, and cholesterol. Alexander, C.N., Robinson, P., Orme-Johnson, D.W., Schneider, R.H., & Walton, K.G. (1994). Effects of transcendental meditation compared to other methods of relaxation and meditation in reducing risk factors, morbidity and mortality. Homeostasis, 35, 243-264. Review of research showing that TM is associated with reduced cardiovascular risk factors such as hypertension, smoking, and cholesterol.

Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. The meditation group had a 14.7% increase in exercise duration, and an 18.1% delay of onset of ST depression. The meditation group showed significantly greater reduction in rate-pressure products after 3 and 6 minutes of exercise. Zamarra, J.W., Schneider, R.H., Besseghini, I., Robinson, D.K., & Salerno, J.W. (1996). Usefulness of the transcendental meditation program in the treatment of patients with coronary artery disease. American Journal of Cardiology, 77, 867-870. A clinical trial that tested the hypothesis that stress reduction intervention with TM could reduce exercise-induced myocardial ischemia in patients with known CAD (coronary artery disease). 21 pts. with known CAD were recruited from the Buffalo, NY VA Hospital and prospectively studied. Subjects were randomly assigned to TM (n=12) or waitlist control group (n=9). TM group received 10 hrs. of basic instruction and follow-up, including personal instruction for 60 minutes initially and 30 min twice/week for 6-8 months. After 8 months, the TM group had a 14.7% increase in exercise duration (p=.004), and an 18.1% delay of onset of ST depression (p=0.029), whereas control subjects showed no substantial changes in these outcomes. Furthermore, the TM group showed significantly greater reduction in rate-pressure products after 3 and 6 minutes of exercise (p=.02), compared to controls.

The efficacy of the relaxation response in cardiac surgery. The experimental group had lower incidence of supraventricular tachycardia (SVT), a dangerous heart rhythm often complicating cardiac surgery. Leserman, J., Stuart, E.M., Mamish, M.E., & Benson, H. (1989). The efficacy of the relaxation response in preparing for cardiac surgery. Behavioral Medicine, Fall, 111-117. In this study, 27 cardiac surgery patients (mean age 68) were randomly assigned to either educational information + Relaxation Response vs. educational information only. On the Profile of Mood States scale, the relaxation response group experienced significantly greater reductions in tension and anger than the education only group. More importantly, the experimental group had lower incidence of supraventricular tachycardia (SVT) (p=.04), a dangerous heart rhythm often complicating cardiac surgery.

Effect of Dhammakaya meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time. Sudsuang, R., Chentanez, V., & Veluvan, K. (1991). Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time. Physiology & Behavior, 50, 543-548. This was a clinical trial involving 52 males ages 20-25 years practicing Dhammakaya Buddhist meditation (similar to Zen or transcendental meditation). Control group was 30 males of the same age group not meditating. Serum cortisol levels were significantly reduced in treatment group (combined A and B), and was different from controls (p<.01, all comparisons). Serum protein levels increased after 6 weeks for combined group (p<.01) and different from controls (p<.05). Systolic and diastolic blood pressures both significantly different in combined treatment group (p<.01) and significantly different from controls (p<.01). Heart rate significantly different at 3 and 6 weeks (p<.01) and from controls (p<.01 at 3 wks., p<.05 at 6 wks.). Pulmonary function (vital capacity, tidal volume, and maximum voluntary ventilation) significantly different at 3 and 6 weeks (p<.05) before and after in treatment group.

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