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Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction

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Abstract

Mindfulness-Based Stress Reduction is a secular behavioral medicine program that has roots in meditative spiritual practices. Thus, spirituality may partly explain Mindfulness-Based Stress Reduction outcomes. Participants (N = 279; M (SD) age = 45(12); 75% women) completed an online survey before and after an 8-week Mindfulness-Based Stress Reduction program. Structural equation modeling was used to test the hypothesis that, following Mindfulness-Based Stress Reduction, the relationship between enhanced mindfulness and improved health-related quality of life is mediated by increased daily spiritual experiences. Changes in both spirituality and mindfulness were significantly related to improvement in mental health. Although the initial mediation hypothesis was not supported, an alternate model suggested that enhanced mindfulness partly mediated the association between increased daily spiritual experiences and improved mental health-related quality of life (indirect effect: β = 0.07, P = 0.017). Effects on physical health-related quality of life were not significant. Findings suggest a novel mechanism by which increased daily spiritual experiences following Mindfulness-Based Stress Reduction may partially explain improved mental health as a function of greater mindfulness.

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Notes

  1. When comparing Mindfulness-Based Stress Reduction program cycles with the longer survey format (year 1) versus the shorter format (year 2), one-way ANOVA revealed no significant differences in the number of participants that enrolled in the study (F = 2.53, P = .16), completed the baseline survey (F = .47, P = .52), or completed the endpoint survey (F = .21, P = .67). Likewise the availability of study compensation was not associated with a significant difference in the number of enrolled participants (F = 5.43, P = .06), baseline survey completers (F = 5.45, P = .06), or endpoint completers (F = 2.81, P = .15). Pearson’s Chi-Square and Fisher’s Exact Test indicated that demographic characteristics also remained consistent when study compensation was offered.

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Acknowledgments

This research was supported by grant K99 AT004945 from the National Center for Complementary & Alternative Medicine (NCCAM) to JMG. MJS was supported by K23 MH087754 from the National Institute of Mental Health (NIMH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health (NIH). Additional support was provided by a research infrastructure grant from the Fannie E. Rippel foundation. We thank Katie Strobush and Janna Fikkan, Ph.D., for their assistance with recruitment. We thank all of the expert Mindfulness-Based Stress Reduction program instructors at Duke Integrative Medicine (Mary Matthews Brantley, M.A., LMFT; Sasha Loring, M.Ed., LCSW; Maya McNeilly, Ph.D.; Jeanne van Gemert, M.A., M.F.A., LMBT, LPC; and Ron Vereen, M.D.) for their intellectual contributions to study design and data interpretation. Finally, we thank all of the study participants who volunteered their time to complete our survey.

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Author notes

  1. Daniel M. Webber

    Present address: University of Arkansas for Medical Sciences, Little Rock, AR, USA

Authors and Affiliations

  1. Duke Integrative Medicine, Duke University Medical Center, Box 102904, Durham, NC, 27710, USA

    Jeffrey M. Greeson, Daniel M. Webber, Jeffrey G. Brantley & Ruth Quillian Wolever

  2. Cognitive and Behavioral Research and Treatment Program, Duke University Medical Center, Durham, NC, USA

    Moria J. Smoski

  3. Centre for Addiction and Mental Health, Toronto, ON, Canada

    Andrew G. Ekblad

  4. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Edward C. Suarez

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  1. Jeffrey M. Greeson
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Correspondence to Jeffrey M. Greeson.

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Greeson, J.M., Webber, D.M., Smoski, M.J. et al. Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction. J Behav Med 34, 508–518 (2011). https://doi.org/10.1007/s10865-011-9332-x

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