Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
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Chapter 8 / Meditation and CVD 131<br />
modality using cognitive therapy and MBSR called mindfulness-based<br />
cognitive therapy (MBCT). MBCT patients who had three or more previous<br />
depressive episodes showed a much lower relapse rate (37%) than<br />
the treatment as usual (TAU) group (66%) during the 1-yr study period.<br />
Relapse rates for the MBCT and TAU groups did not differ for patients<br />
who had only one or two previous depressive episodes (59).<br />
There have been numerous uncontrolled studies of the impact of<br />
meditation on psychological symptoms. Kabat-Zinn (60–62) reports<br />
findings from several studies of his MBSR program with patients with<br />
chronic pain that indicate reductions on self-report measures of presentmoment<br />
pain, negative body image, inhibition of activity by pain symptoms,<br />
mood disturbance, and psychological symptomatology, including<br />
depression and anxiety (60–62). These results were maintained for up to<br />
4 yr after the meditation training, with the exception of the measure of<br />
present-moment pain (62). The subjects in this study had received previous<br />
treatment for their chronic pain, with little or no results, making the<br />
positive findings even more impressive in this treatment-resistant<br />
group (60–62).<br />
Kabat-Zinn’s research studying the impact of MBSR programs on<br />
anxiety and panic disorder (63,64) has demonstrated significant reductions<br />
in the severity of symptoms from baseline to postintervention.<br />
Subjects were rigorously assessed using Diagnostic and Statistical<br />
Manual (DSM)-III-R criteria for generalized anxiety disorder or panic<br />
disorder with or without agoraphobia. Clinically and statistically significant<br />
posttreatment reductions were found in both subjective and objective<br />
symptoms of anxiety and depression, and these results were<br />
maintained at the 3-yr follow-up. Unfortunately, 50% of the patients in<br />
the study were also being treated with psychotropic medications during<br />
the MBSR program and approx 50% received additional treatment for<br />
their anxiety disorder after the MBSR treatment, making it difficult to<br />
establish the relative therapeutic contribution of each intervention (63,64).<br />
Despite the methodological flaws, the preponderance of evidence<br />
regarding the impact of MBSR programs on psychological symptoms<br />
does suggest that it may be a useful intervention. However, what is clear<br />
from this research is the need for additional, more rigorous research<br />
investigating this promising clinical tool.<br />
Adverse Impact of Meditation<br />
Although the clinical use of meditation strategies has shown several<br />
positive effects in decreasing autonomic arousal and mediating psychological<br />
and stress symptoms, there is a small body of literature that<br />
suggests there may be some potential adverse meditation effects (65–69).