Journal of Behavioral Medicine

, Volume 35, Issue 3, pp 262–271

Impact of Mindfulness-Based Stress Reduction (MBSR) on attention, rumination and resting blood pressure in women with cancer: A waitlist-controlled study

  • Tavis S. Campbell
  • Laura E. Labelle
  • Simon L. Bacon
  • Peter Faris
  • Linda E. Carlson
Article

Abstract

The present study is a waitlist-controlled investigation of the impact of a Mindfulness-Based Stress Reduction (MBSR) program on mindful attentiveness, rumination and blood pressure (BP) in women with cancer. Female post-treatment cancer patients were recruited from the MBSR program waitlist. Participants completed self-report measures of mindfulness and rumination and measured casual BP at home before and after the 8-week MBSR program or waiting period. MBSR group participants demonstrated higher levels of mindful attentiveness and decreased ruminative thinking following the intervention but no difference in BP, when compared to controls. In the MBSR group, decreases in rumination correlated with decreases in SBP and increases in mindful attention. When participants were assigned to “Higher BP” and “Lower BP” conditions based on mean BP values at week 1, “Higher BP” participants in the MBSR group (n = 19) had lower SBP at week 8 relative to the control group (n = 16). A MBSR program may be efficacious in increasing mindful attention and decreasing rumination in women with cancer. Randomized controlled trials are needed to evaluate an impact on clinically elevated BP.

Keywords

MBSR Cancer Meditation Mindfulness Rumination Blood pressure 

References

  1. Adams, M. J., Lipshultz, S. E., Schwartz, C., Fajardo, L. F., Coen, V., & Constine, L. S. (2003). Radiation-associated cardiovascular disease: Manifestations and management. Seminars in Radiation Oncology, 13, 346–356.PubMedCrossRefGoogle Scholar
  2. Anderson, J. W., Liu, C., & Kryscio, R. J. (2008). Blood pressure response to transcendental meditation: A meta-analysis. American Journal of Hypertension, 21, 310–316.PubMedCrossRefGoogle Scholar
  3. Association for the Advancement of Medical Instrumentation. (1993). American national standard. electronic or automated sphygmomanometers. ANSI/AAMI SP 10–1992. Arlington, VA: AAMI, 40.Google Scholar
  4. Baer, R. A. (2003). Mindfulness training as clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.CrossRefGoogle Scholar
  5. Barnes, V. A., Davis, H. C., Murzynowski, J. B., & Treiber, F. A. (2004). Impact of meditation on resting and ambulatory blood pressure and heart rate in youth. Psychosomatic Medicine, 66, 909–914.PubMedCrossRefGoogle Scholar
  6. Barnes, V. A., Pendergrast, R. A., Harshfield, G. A., & Treiber, F. A. (2008). Impact of breathing awareness meditation on ambulatory blood pressure and sodium handling in prehypertensive African American adolescents. Ethnicity and Disease, 18, 1–5.PubMedGoogle Scholar
  7. Benvenuto, G. M., Ometto, R., Fontanelli, A., Fortunato, A., Ruffini, P. A., Fosser, V., et al. (2003). Chemotherapy-related cardiotoxicity: New diagnostic and preventive strategies. Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, 4, 655–667.Google Scholar
  8. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J. F., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science & Practice, 11, 230–241.CrossRefGoogle Scholar
  9. Brady, S. S., & Matthews, K. A. (2006). Chronic stress influences ambulatory blood pressure in adolescents. Annals of Behavioral Medicine, 31, 80–88.PubMedCrossRefGoogle Scholar
  10. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.PubMedCrossRefGoogle Scholar
  11. Carlson, L. E., Angen, M., Cullum, J., Goodey, E., Koopmans, J., Lamont, L., et al. (2004a). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90, 2297–2304.PubMedGoogle Scholar
  12. Carlson, L. E., & Brown, K. W. (2005). Validation of the mindful attention awareness scale in a cancer population. Journal of Psychosomatic Research, 58, 29–33.PubMedCrossRefGoogle Scholar
  13. Carlson, L. E., Labelle, L. E., Garland, S. N., Hutchins, M. L., & Birnie, K. (2009). Mindfulness-based interventions in oncology. In F. Didonna (Ed.), Clinical handbook of mindfulness (pp. 383–404). New York, NY: Springer.CrossRefGoogle Scholar
  14. Carlson, L. E., Speca, M., Patel, K. D., & Faris, P. (2007). 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. Brain, Behavior, and Immunity, doi:10.1016/j.bbi.2007.04.002
  15. Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65, 571–581.PubMedCrossRefGoogle Scholar
  16. Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004b). 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. Psychoneuroendocrinology, 29, 448–474.PubMedCrossRefGoogle Scholar
  17. Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jr., et al. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA, 289, 2560–2572.PubMedCrossRefGoogle Scholar
  18. Eisenberg, D. M., Delbanco, T. L., Berkey, C. S., Kaptchuk, T. J., Kupelnick, B., Kuhl, J., et al. (1993). Cognitive behavioral techniques for hypertension: Are they effective? Annals of Internal Medicine, 118, 964–972.PubMedGoogle Scholar
  19. Erselcan, T., Kairemo, K. J., Wiklund, T. A., Hernberg, M., Blomqvist, C. P., Tenhunen, M., et al. (2000). Subclinical cardiotoxicity following adjuvant dose-escalated FEC, high-dose chemotherapy, or CMF in breast cancer. British Journal of Cancer, 82, 777–781.PubMedCrossRefGoogle Scholar
  20. Fillingim, R. B., Maixner, W., Bunting, S., & Silva, S. (1998). Resting blood pressure and thermal pain responses among females: Effects on pain unpleasantness but not pain intensity. International Journal of Psychophysiology, 30, 313–318.PubMedCrossRefGoogle Scholar
  21. Fortner, B. V., Stepanski, E. J., Wang, S. C., Kasprowicz, S., & Durrence, H. H. (2002). Sleep and quality of life in breast cancer patients. Journal of Pain and Symptom Management, 24, 471–480.PubMedCrossRefGoogle Scholar
  22. Fredrikson, M., Blumenthal, J. A., Evans, D. D., & Sherwood, A. (1989). Cardiovascular responses in the laboratory and in the natural environment: Is blood pressure reactivity to laboratory-induced mental stress related to ambulatory blood pressure during everyday life? Journal of Psychosomatic Research, 33, 753–762.PubMedCrossRefGoogle Scholar
  23. Gerin, W., Davidson, K. W., Christenfeld, N. J. S., Goyal, T., & Schwartz, J. E. (2006). The role of angry rumination and distraction in blood pressure recovery from emotional arousal. Psychosomatic Medicine, 68, 64–72.PubMedCrossRefGoogle Scholar
  24. He, J., Whelton, P. K., Appel, L. J., Charleston, J., & Klag, M. J. (2000). Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension, 35, 544–549.PubMedGoogle Scholar
  25. Hollis, S., & Campbell, F. (1999). What is meant by intention to treat analysis? survey of published randomised controlled trials. British Medicine Journal, 319, 670–674.CrossRefGoogle Scholar
  26. Jensen, B. V., Skovsgaard, T., & Nielsen, S. L. (2002). Functional monitoring of anthracycline cardiotoxicity: A prospective, blinded, long-term observational study of outcome in 120 patients. Annals of Oncology, 13, 699–709.PubMedCrossRefGoogle Scholar
  27. Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.PubMedCrossRefGoogle Scholar
  28. Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Delacourt.Google Scholar
  29. Key, B. L., Campbell, T. S., Bacon, S. L., & Gerin, W. (2008). The influence of trait and state rumination on cardiovascular recovery from a negative emotional stressor. Journal of Behavioral Medicine, 31, 237–248.PubMedCrossRefGoogle Scholar
  30. King, M. S., Carr, T., & D’Cruz, C. (2002). Transcendental meditation, hypertension and heart disease. Australian Family Physician, 31, 164–168.PubMedGoogle Scholar
  31. Kissane, D. W., Grabsch, B., Love, A., Clarke, D. M., Bloch, S., & Smith, G. C. (2004). Psychiatric disorder in women with early stage and advanced breast cancer: A comparative analysis. Australian and New Zealand Journal of Psychiatry, 38, 320–326.PubMedCrossRefGoogle Scholar
  32. Lamanque, P., & Daneault, S. (2006). Does meditation improve the quality of life for patients living with cancer? [La meditation ameliore-t-elle la qualite de vie des patients vivant avec un cancer?]. Canadian Family Physician [Medecin De Famille Canadien], 52, 474–475.Google Scholar
  33. Ledesma, D., & Kumano, H. (2009). Mindfulness-based stress reduction and cancer: A meta-analysis. Psycho-Oncology, 18, 579. doi:10.1002/pon.1400 CrossRefGoogle Scholar
  34. Lengacher, C. A., Johnson-Mallard, V., Post-White, J., Moscoso, M. S., Jacobson, P. B., & Klein, T. W., et al. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-Oncology. doi:10.1002/pon.1529
  35. Lewington, S., Clarke, R., Qizilbash, N., Peto, R., Collins, R., & Prospective Studies, C. (2002). Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet, 360, 1903–1913.PubMedCrossRefGoogle Scholar
  36. Linden, W., & Satin, J. R. (2007). Avoidable pitfalls in behavioral medicine outcome research. Annals of Behavioral Medicine, 33, 143–147.PubMedCrossRefGoogle Scholar
  37. Mackenzie, M. J., Carlson, L. E., & Speca, M. (2005). Mindfulness-based stress reduction (MBSR) in oncology: Rationale and review. Evidence Based Integrative Medicine, 2, 139–145.CrossRefGoogle Scholar
  38. Manikonda, J. P., Stork, S., Togel, S., Lobmuller, A., Grunberg, I., Bedel, S., et al. (2008). Contemplative meditation reduces ambulatory blood pressure and stress-induced hypertension: A randomized pilot trial. Journal of Human Hypertension, 22, 138–140.PubMedCrossRefGoogle Scholar
  39. Matchim, Y., & Armer, J. M. (2007). Measuring the psychological impact of mindfulness meditation on health among patients with cancer: A literature review. Oncology Nursing Forum, 34, 1059–1066. doi:10.1188/07.ONF.1059-1066 PubMedCrossRefGoogle Scholar
  40. Matthews, K. A., Gump, B. B., & Owens, J. F. (2001). Chronic stress influences cardiovascular and neuroendocrine responses during acute stress and recovery, especially in men. Health Psychology, 6, 403–410.CrossRefGoogle Scholar
  41. Matthews, K. A., Katholi, C. R., McCreath, H., Whooley, M. A., Williams, D. R., Zhu, S., et al. (2004). Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study. Circulation, 110, 74–78.PubMedCrossRefGoogle Scholar
  42. Meinardi, M. T., Gietema, J. A., Van Veldhuisen, D. J., van der Graaf, W. T., De Vries, E. G., & Sleijfer, D. T. (2000). Long-term chemotherapy-related cardiovascular morbidity. Cancer Treatment Reviews, 26, 429–447.PubMedCrossRefGoogle Scholar
  43. Meinardi, M. T., van Veldhuisen, D. J., Gietema, J. A., Dolsma, W. V., Boomsma, F., van den Berg, M. P., et al. (2001). Prospective evaluation of early cardiac damage induced by epirubicin-containing adjuvant chemotherapy and locoregional radiotherapy in breast cancer patients. Journal of Clinical Oncology, 19, 2746–2753.PubMedGoogle Scholar
  44. Montori, V. M., & Guyatt, G. H. (2001). Intention-to-treat principle. Canadian Medical Association Journal, 165, 1339–1341.PubMedGoogle Scholar
  45. O’Brien, E., Petrie, J., Littler, W., de Swiet, M., Padfield, P. L., Altman, D. G., et al. (1993). An outline of the revised british hypertension society protocol for the evaluation of blood pressure measuring devices. Journal of Hypertension, 11, 677–679.PubMedCrossRefGoogle Scholar
  46. O’Brien, E., Waeber, B., Parati, G., Staessen, J., & Myers, M. G. (2001). Blood pressure measuring devices: Recommendations of the european society of hypertension. BMJ, 322, 531–536.PubMedCrossRefGoogle Scholar
  47. Ospina, M. B., Bond, T. K., Karkhaneh, M., Tjosvold, L., Vandermeer, B., Liang, Y., et al. (2007). Meditation practices for health: State of the research. Evidence Report/Technology Assessment No. 155. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  48. Ott, M. J., Norris, R. L., & Bauer-Wu, S. M. (2006). Mindfulness meditation for oncology patients. Integrative Cancer Therapies, 5, 98–108.PubMedCrossRefGoogle Scholar
  49. Parati, G., Stergiou, G. S., Asmar, R., Bilo, G., de Leeuw, P., Imai, Y., et al. (2008). European Society of Hypertension guidelines for blood pressure monitoring at home: A summary report of the second International Consensus Conference on Home Blood Pressure Monitoring. Journal of Hypertension, 26, 1505–1526.PubMedCrossRefGoogle Scholar
  50. Rainforth, M. V., Schneider, R. H., Nidich, S. I., Gaylord-King, C., Salerno, J. W., & Anderson, J. W. (2007). Stress reduction programs in patients with elevated blood pressure: A systematic review and meta-analysis. Current Hypertension Reports, 9, 520–528.PubMedCrossRefGoogle Scholar
  51. Ries, L. A. G., Melbert, D., Krapcho, M., Mariotto, A., Miller, B. A., & Feuer, E. J., et al. (2007). SEER cancer statistics review, 1975–2004. http://www.seer.cancer.gov/csr/1975_2004/.
  52. Rosamond, W., Flegal, K., Furie, K., Go, A., Greenlund, K., Haase, N., et al. (2008). Heart disease and stroke statistics–2008 update: A report from the American heart association statistics committee and stroke statistics subcommittee. Circulation, 117, e25–146.PubMedCrossRefGoogle Scholar
  53. Rosenzweig, S., Reibel, D. K., Greeson, J. M., Edman, J. S., Jasser, S. A., McMearty, K. D., et al. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: A pilot study. Alternative Therapies in Health & Medicine, 13, 36–38.Google Scholar
  54. Schneider, R. H., Staggers, F., Alxander, C. N., Sheppard, W., Rainforth, M., Kondwani, K., et al. (1995). A randomised controlled trial of stress reduction for hypertension in older African Americans. Hypertension, 26, 820–827.PubMedGoogle Scholar
  55. Schroevers, M., Kraaij, V., & Garnefski, N. (2008). How do cancer patients manage unattainable personal goals and regulate their emotions? British Journal of Health Psychology, 13, 551–562.PubMedCrossRefGoogle Scholar
  56. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373–386.PubMedCrossRefGoogle Scholar
  57. Shapiro, S. L., Oman, D., Thoresen, C. E., Plante, T. G., & Flinders, T. (2008). Cultivating mindfulness: Effects on well-being. Journal of Clinical Psychology, 64, 840–862.PubMedCrossRefGoogle Scholar
  58. Smith, J. E., Richardson, J., Hoffman, C., & Pilkington, K. (2005). Mindfulness-based stress reduction as supportive therapy in cancer care: Systematic review. Journal of Advanced Nursing, 52, 315–327.PubMedCrossRefGoogle Scholar
  59. Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom.Med., 62, 613–622.PubMedGoogle Scholar
  60. Speca, M., Carlson, L. E., Mackenzie, M. J., & Angen, M. (2006). Mindfulness-based stress reduction (MBSR) as an intervention for cancer patients. In R. A. Baer (Ed.), Mindfulness-based treatment approaches: A clinician’s guide to evidence base and approaches (pp. 239–261). Burlington, MA: Elsevier.CrossRefGoogle Scholar
  61. Stewart, J. C., Janicki, D. L., & Kamarck, T. W. (2006). Cardiovascular reactivity to and recovery from psychological challenge as predictors of 3-year change in blood pressure. Health Psychology, 25, 111–118.PubMedCrossRefGoogle Scholar
  62. Teasdale, J. D., & Green, H. A. (2004). Ruminative self-focus and autobiographical memory. Personality and Individual Differences, 36, 1933–1943.CrossRefGoogle Scholar
  63. The Trials of Hypertension Prevention Collaborative Research Group. (1997). Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high normal blood pressure. Archives of Internal Medicine, 157, 657–667.CrossRefGoogle Scholar
  64. Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: Distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76, 284–304.PubMedCrossRefGoogle Scholar
  65. Treiber, F. A., Kamarck, T., Schneiderman, N., Sheffield, D., Kapuku, G., & Taylor, T. (2003). Cardiovascular reactivity and development of preclinical and clinical disease states. Psychosomatic Medicine, 65, 46–62.PubMedGoogle Scholar
  66. Vallebona, A. (2000). Cardiac damage following therapeutic chest irradiation. importance, evaluation and treatment. Minerva Cardioangiologica, 48, 79–87.Google Scholar
  67. Van Wielingen, L. E., Carlson, L. E., & Campbell, T. S. (2006). Mindfulness-based stress reduction and acute stress responses in women with cancer. Psychooncology, 15, S42.Google Scholar
  68. Vitaliano, P. P., Scanlan, J. M., Zhang, J., Savage, M. V., & Hirsch, I. B. (2002). A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosomatic Medicine, 64, 418–435.PubMedGoogle Scholar
  69. Wua, J., Kraja, A. T., Oberman, A., Lewis, C. E., Ellison, R. C., & Arnett, D. K. (2005). A summary of the effects of antihypertensive medications on measured blood pressure. American Journal of Hypertension, 18, 935–942.CrossRefGoogle Scholar
  70. Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10, 19–28.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Tavis S. Campbell
    • 1
  • Laura E. Labelle
    • 1
  • Simon L. Bacon
    • 1
  • Peter Faris
    • 1
  • Linda E. Carlson
    • 1
  1. 1.Department of PsychologyUniversity of CalgaryCalgaryCanada

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