Annals of Behavioral Medicine

, Volume 33, Issue 1, pp 11–21 | Cite as

A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction

  • Shamini Jain
  • Shauna L. Shapiro
  • Summer Swanick
  • Scott C. Roesch
  • Paul J. Mills
  • Iris Bell
  • Gary E. R. Schwartz

Abstract

Background: Although mindfulness meditation interventions have recently shown benefits for reducing stress in various populations, little is known about their relative efficacy compared with relaxation interventions.Purpose: This randomized controlled trial examines the effects of a 1-month mindfulness meditation versus somatic relaxation training as compared to a control group in 83 students (M age=25; 16 men and 67 women) reporting distress.Method: Psychological distress, positive states of mind, distractive and ruminative thoughts and behaviors, and spiritual experience were measured, while controlling for social desirability.Results: Hierarchical linear modeling reveals that both meditation and relaxation groups experienced significant decreases in distress as well as increases in positive mood states over time, compared with the control group (p<.05 in all cases). There were no significant differences between meditation and relaxation on distress and positive mood states over time. Effect sizes for distress were large for both meditation and relaxation (Cohen’s d=1.36 and .91, respectively), whereas the meditation group showed a larger effect size for positive states of mind than relaxation (Cohen’s d=.71 and .25, respectively). The meditation group also demonstrated significant pre-post decreases in both distractive and ruminative thoughts/behaviors compared with the control group (p<.04 in all cases; Cohen’s d=.57 for rumination and .25 for distraction for the meditation group), with mediation models suggesting that mindfulness meditation’s effects on reducing distress were partially mediated by reducing rumination. No significant effects were found for spiritual experience.Conclusions: The data suggest that compared with a no-treatment control, brief training in mindfulness meditation or somatic relaxation reduces distress and improves positive mood states. However, mindfulness meditation may be specific in its ability to reduce distractive and ruminative thoughts and behaviors, and this ability may provide a unique mechanism by which mindfulness meditation reduces distress.

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References

  1. (1).
    Eisenberg DM, Davis RB, Ettner SL, et al: Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey.Journal of the American Medical Association. 1998,280:1569–1575.PubMedCrossRefGoogle Scholar
  2. (2).
    Kabat-Zinn J, Lipworth L, Burney R, Sellers W: Four-year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance.Clinical Journal of Pain. 1986,2:159–173.Google Scholar
  3. (3).
    Carlson LE, Speca M, Patel KD, Goodey E: 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 2003,65:571–581.PubMedCrossRefGoogle Scholar
  4. (4).
    Miller JJ, Fletcher K, Kabat-Zinn J: Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders.General Hospital Psychiatry. 1995,17:192–200.PubMedCrossRefGoogle Scholar
  5. (5).
    Speca M, Carlson LE, Goodey E, Angen M: 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.Psychosomatic Medicine. 2000,62:613–622.PubMedGoogle Scholar
  6. (6).
    Kabat-Zinn J:Full Catastrophe Living. New York: Delta Books, 1990.Google Scholar
  7. (7).
    Nhat Hanh T:The Path of Emancipation. Berkeley, CA: Parallax Press, 2001.Google Scholar
  8. (8).
    Rosenzweig S, Reibel DK, Greeson JM, et al: Mindful-ness-based stress reduction lowers psychological distress in medical students.Teaching and Learning in Medicine. 2003,15:88–92.PubMedCrossRefGoogle Scholar
  9. (9).
    Shapiro SL, Schwartz GE, Bonner G: Effects of mindfulness-based stress reduction on medical and premedical students.Journal of Behavioral Medicine. 1998,21:581–599.PubMedCrossRefGoogle Scholar
  10. (10).
    Astin JA: Stress reduction through mindfulness meditation. Effects on psychological symptomatology, sense of control, and spiritual experiences.Psychotherapy and Psychosomatics. 1997,66:97–106.PubMedCrossRefGoogle Scholar
  11. (11).
    Benson H:The Relaxation Response. New York: Avon Books, 1975.Google Scholar
  12. (12).
    Piazza-Waggoner CA, Cohen LL, Kohli K, Taylor BK: Stress management for dental students performing their first pediatric restorative procedure.Journal of Dental Education. 2003,67:542–548.PubMedGoogle Scholar
  13. (13).
    Luebbert K, Dahme B, Hasenbring M: The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non-surgical cancer treatment: A meta-analytical review.Psychooncology. 2001,10:490–502.PubMedCrossRefGoogle Scholar
  14. (14).
    Stetter F, Kupper S: Autogenic training: A meta-analysis of clinical outcome studies.Applied Psychophysiology and Biofeedback. 2002,27:45–98.PubMedCrossRefGoogle Scholar
  15. (15).
    Davidson RJ, Schwartz GE: Psychobiology of relaxation and related states. In Monstofsky D (ed),Behavior Modification and Control of Physiological Activity. Englewood Cliffs, NJ: Prentice-Hall, 1976.Google Scholar
  16. (16).
    Kabat-Zinn J, Massion AO, Kristeller J, et al.: Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders.American Journal of Psychiatry. 1992,149:936–943.PubMedGoogle Scholar
  17. (17).
    Chang V, Palesh O, Caldwell R, et al: The effects of a mindfulness-based stress reduction program on stress, mindfulness self-efficacy, and positive states of mind.Stress and Health. 2004,20:141–147.CrossRefGoogle Scholar
  18. (18).
    Mor N, Winquist J: Self-focused attention and negative affect: A meta-analysis.Psychological Bulletin 2002,128:638–662.PubMedCrossRefGoogle Scholar
  19. (19).
    Lam D, Schuck N, Smith N, Farmer A, Checkley S: Response style, interpersonal difficulties and social functioning in major depressive disorder.Journal of Affective Disorders. 2003,75:279–283.PubMedCrossRefGoogle Scholar
  20. (20).
    Nolen-Hoeksema S: The role of rumination in depressive disorders and mixed anxiety/depressive symptoms.Journal of Abnormal Psychology. 2000,109:504–511.PubMedCrossRefGoogle Scholar
  21. (21).
    Segerstrom SC, Tsao JC, Alden LE, Craske MG: Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood.Cognitive Therapy and Research. 2000,24:671–688.CrossRefGoogle Scholar
  22. (22).
    Ramel V, Goldin P, Carmona P, McQuaid JR: The effects of mindfulness meditation on cognitive processes and affect in patients with past depression.Cognitive Therapy and Research. 2004,28:433–455.CrossRefGoogle Scholar
  23. (23).
    Schwarzer R: Thought control of action: Interfering self-doubts. In Saronson I, Pierce G, Saronson B (eds),Cognitive Interference. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 1996.Google Scholar
  24. (24).
    Kabat-Zinn J: 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. 1982,4:33–47.PubMedCrossRefGoogle Scholar
  25. (25).
    Shapiro SL, Schwartz GE: Intentional systemic mindfulness: An integrative model for self-regulation and health.Advances in Mind Body Medicine. 2000,16:128–134.PubMedGoogle Scholar
  26. (26).
    Linden W: The autogenic training method of J.H. Schultz. In Lehrer P, Woolfolk R (eds),Principles and Practice of Stress Management. New York: Guilford, 1993.Google Scholar
  27. (27).
    Derogatis LR:BSI: Administration, Scoring, and Procedures Manual I. Minneapolis, MN: National Computer Systems, 1993.Google Scholar
  28. (28).
    Derogatis LR, Savitz KL: The SCL-90-R, Brief Symptom Inventory, and Matching Clinical Rating Scales. In Maruish M (ed),The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 1999.Google Scholar
  29. (29).
    Horowitz M, Adler N, Kegeles S: A scale for measuring the occurrence of positive states of mind: A preliminary report.Psychosomatic Medicine. 1988,50:477–483.PubMedGoogle Scholar
  30. (30).
    Williams JM, Hogan TD, Andersen MB: Positive states of mind and athletic injury risk.Psychosomatic Medicine. 1993,55:468–472.PubMedGoogle Scholar
  31. (31).
    Nolen-Hoeksema S, Morrow J, Fredrickson BL: Response styles and the duration of episodes of depressed mood.Journal of Abnormal Psychology. 1993,102:20–28.PubMedCrossRefGoogle Scholar
  32. (32).
    Kass J, Friedman R, Leserman J, Zuttermeister P, Benson H: Health outcomes and a new measure of spiritual experience.Journal for the Scientific Study of Religion. 1991,30:203–211.CrossRefGoogle Scholar
  33. (33).
    VandeCreek L, Ayres S, Bassham M: Using INSPIRIT to conduct spiritual assessment.Journal of Pastoral Care. 1995,49:83–89.PubMedGoogle Scholar
  34. (34).
    Reynolds WM: Development of reliable and valid short forms of the Marlowe-Crowne Social Desirability Scale.Journal of Clinical Psychology. 1982,38:119–125.CrossRefGoogle Scholar
  35. (35).
    Loo R, Thorpe K: Confirmatory factor analyses of the full and short versions of the Marlowe-Crowne Social Desirability Scale.Journal of Social Psychology. 2000,140:628–635.PubMedCrossRefGoogle Scholar
  36. (36).
    Byrk AS, Raudenbush SW:Hierarchical Linear Models: Application and Data Analysis Methods. Newbury Park, CA: Sage, 1992.Google Scholar
  37. (37).
    Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology. 1986,51:1173–1182.PubMedCrossRefGoogle Scholar
  38. (38).
    Holmbeck GN: Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures.Journal of Consulting and Clinical Psychology. 1997,65:599–610.PubMedCrossRefGoogle Scholar
  39. (39).
    Cohen J:Statistical Power Analysis for the Behavioral Sciences (2nd Ed.), Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 1998.Google Scholar
  40. (40).
    Rosnow RL, Rosenthal R: Computing contrasts, effect sizes, and counternulls on other people’s published data: General procedures for research consumers.Psychological Methods. 1996,1:331–340.CrossRefGoogle Scholar
  41. (41).
    Adler NE, Horowitz M, Garcia A, Moyer A: Additional validation of a scale to assess positive states of mind.Psychosomatic Medicine. 1998,60:26–32.PubMedGoogle Scholar
  42. (42).
    Steptoe A, Wardle J: Positive affect and biological function in everyday life.Neurobiology of Aging. 2005,26:108.PubMedCrossRefGoogle Scholar
  43. (43).
    Carlson LE, Speca M, Patel KD, Goodey E: 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. 2004,29:448–474.PubMedCrossRefGoogle Scholar
  44. (44).
    Teasdale JD, Segal Z, Williams JM: How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help?Behavioral Research and Therapy. 1995,33:25–39.CrossRefGoogle Scholar
  45. (45).
    Teasdale JD, Moore RG, Hayhurst H, et al: Metacognitive awareness and prevention of relapse in depression: empirical evidence.Journal of Consulting and Clinical Psychology. 2002,70:275–287.PubMedCrossRefGoogle Scholar
  46. (46).
    Oikawa M: Distraction as an intervention for depression: The distraction process.Japanese Journal of Educational Psychology. 2002,50:185–192.Google Scholar
  47. (47).
    Fennell MJ, Teasdale JD, Jones S, Damle A: Distraction in neurotic and endogenous depression: An investigation of negative thinking in major depressive disorder.Psychological Medicine. 1987,17:441–452.PubMedCrossRefGoogle Scholar
  48. (48).
    Schmaling KB, Dimidjian S, Katon W, Sullivan M: Response styles among patients with minor depression and dysthymia in primary care.Journal of Abnormal Psychology. 2002,111:350–356.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Behavioral Medicine 2003

Authors and Affiliations

  • Shamini Jain
    • 5
  • Shauna L. Shapiro
    • 1
  • Summer Swanick
    • 2
  • Scott C. Roesch
    • 3
  • Paul J. Mills
    • 4
  • Iris Bell
    • 2
  • Gary E. R. Schwartz
    • 2
  1. 1.Department of PsychologySanta Clara UniversityUSA
  2. 2.Department of PsychologyUniversity of ArizonaUSA
  3. 3.Department of PsychologySan Diego State UniversityUSA
  4. 4.Department of PsychiatryUniversity of CaliforniaSan DiegoUSA
  5. 5.Clinical PsychologySDSU/UCSD Joint Doctoral ProgramSan Diego

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