Mindfulness Based Stress Reduction Research
Major Research Findings
Our work over the past twenty-eight years has shown consistent, reliable, and reproducible demonstrations of major and clinically relevant reductions in medical and psychological symptoms across a wide range of medical diagnoses, including many different chronic pain conditions [Kabat-Zinn, 1982; Kabat-Zinn, Lipworth and Burney, 1985; Kabat-Zinn et al, 1986], other medical diagnoses [Kabat-Zinn and Chapman-Waldrop, 1988]; and in medical patients with a secondary diagnosis of anxiety and/or panic [Kabat-Zinn et al, 1992; Miller et al, 1995], over the eight weeks of the MBSR intervention, and maintenance of these changes in some cases for up to four years of follow-up.
We have also seen consistent, reliable, and reproducible demonstrations of significant and clinically relevant increases in trait measures which are usually stable in adulthood, indicative of enhanced psychological hardiness (Kobasa) and greater sense of coherence (Antonovsky) over the course of the eight week intervention, and maintenance of these gains for up to three years of follow-up. The latter measures indicate a heightened sense of self and self-in-relationship, and a greater ability to find coherence and act effectively under high degrees of stress. These changes enhance the experience of self-efficacy in patients and their view of the value of engaging in their own on-going health and well-being through meditation, yoga, and above all, the systematic cultivation of awareness [Kabat-Zinn, Skillings, and Salmon, manuscript submitted]..
A randomized clinical trial [Kabat-Zinn, Wheeler, et al 1998] showed that patients with moderate to severe psoriasis undergoing phototherapy or photochemotherapy and who listened to guided meditation tapes while receiving the ultraviolet light treatments healed at approximately four times the rate of subjects receiving just the light treatments. Since the delivery of the mind/body element of the intervention was simultaneous and co-extensive with the conventional UV treatments, it is a classic example of both integrative and participatory medicine. The observation of an increased rate of skin clearing among the meditation cohort was seen in two separate studies. This work suggests that the integration of the mind/body element into the more conventional medical treatment resulted in reduced treatment cost (number of treatments to achieve skin clearing) and in the risk of basal cell carcinoma from the UV exposure. It also suggests indirectly that the mind can effect a healing process all the way down to the level of gene expression and control of the cell replication cycle, which may have implications for oncogenic processes. Since the intervention was delivered via an audiotape recording and in the relative isolation of a light booth, social support variables in this study were minimized, allowing us to look at mind/body effects in the absence of this common potential confounder in group interventions (such as MBSR). For such reasons, this experimental system provides a fruitful avenue for the further study of mind/body effects and their psychophysiological pathways and mechanisms.
Another randomized clinical trial (Davidson et al, manuscript in preparation) took the form of a laboratory study of MBSR conducted in collaboration with Dr. Richard Davidson of the Laboratory of Affective Neuroscience at the University of Wisconsin and the MacArthur Foundation's Mind/Body Network and others. We looked at the effects of MBSR training in a workplace setting on brain activity and on immune response to viral challenge, among other variables. Following publication of the manuscript, we will share the specific outcomes of this study with the public.)
A multi-year relationship between the CFM and the team of Drs. John Teasdale of the Medical Research Council's Cognition and Brain Sciences Unit, in Cambridge, UK, Mark Williams of the University of Wales, and Zindel Segal of the University of Toronto and the Clarke Institute of Psychiatry has led to the development of a new approach to cognitive therapy, termed mindfulness-based cognitive therapy, and to major conceptual advances in the modeling of affective change in depressed patients [Teasdale, Segal and Williams, 1995; Teasdale, 1999].
The CFM is also engaged in a number of other research projects including the introduction of MBSR practices into the Bone Marrow Transplant Unit, an integrated MBSR/mindful dietary intervention for men with prostate cancer, and a cost-effectiveness study of MBSR in conjunction with a large HMO.
Since 1992, in conjunction with two neighborhood health centers, we have conducted an inner city MBSR program for the multicultural, multi-ethnic population of Worcester's economically impoverished inner city. This program is free of charge, with on-site mindful childcare, and free travel vouchers to minimize common barriers to attendance. Over 2,000 people have been referred to this program and over 500 have completed it. It is offered entirely in Spanish as well as in English. The outcomes from this MBSR clinic are currently being written up for publication. This and the prison project described below are both examples of integrating mind/body approaches into settings and institutions within society that might further individual and community health and well-being and serve as mitigators to poverty, crime, and violence. At least one other inner city bi-lingual MBSR clinic has developed based on the UMass model, and has reported positive results [Roth and Creaser, 1997)].
Between 1992 and 1996, we delivered MBSR programs to over 1,500 inmates and 100 staff (including the Commissioner of Public Safety and several prison superintendents) of the Massachusetts Department of Corrections, in collaboration with and under the support of the Massachusetts Committee on Criminal Justice. Exciting positive outcomes were observed of in this project, and are currently being written up for publication in the criminal justice literature.