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Mindfulness Research

IRWI Mindfulness Meeting February 20, 2014 Kathy Etz, PhD National Institute on Drug Abuse. Mindfulness Research. 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?

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Mindfulness Research

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  1. IRWI Mindfulness Meeting February 20, 2014 Kathy Etz, PhD National Institute on Drug Abuse Mindfulness Research

  2. 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? 2012 SACNAS National Conference

  3. 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 2012 SACNAS National Conference

  4. 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 2012 SACNAS National Conference

  5. 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 2012 SACNAS National Conference

  6. 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. 2012 SACNAS National Conference

  7. 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. 2012 SACNAS National Conference

  8. 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. 2012 SACNAS National Conference

  9. 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 2012 SACNAS National Conference

  10. Research Examples

  11. 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. 2012 SACNAS National Conference

  12. 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 2012 SACNAS National Conference

  13. 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 2012 SACNAS National Conference

  14. 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. 2012 SACNAS National Conference

  15. 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. 2012 SACNAS National Conference

  16. 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? 2012 SACNAS National Conference

  17. Thank you!

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