Meditation-Based Therapies for Chronic Neuropathy: A Systematic Review and Meta-Analysis.

Mind-body therapies have been found to be effective in a variety of pathologies. The purpose of this study was to evaluate the efficacy of meditation-based therapies in relieving the symptoms severity, quality of life, stress and other associated mood conditions, in individuals with chronic neuropathy of various etiologies. A systematic review of randomized controlled trials, involving adult patients with persistent peripheral neuropathy, was performed. Seven article databases were searched. A meta-analysis was conducted to assess the benefits of meditation-based therapy on symptomatology, quality of life, anxiety, depression, perceived stress, sleep quality and mindfulness score. Ten of the 1133 reviewed papers were selected for quantitative review. The meditation group had a lower standardized mean difference (SMD) score (-0.47 (95% CI: -0.97 to 0.02), p=0.062) for neuropathic pain severity score; lower anxiety scores (-2.5 (95% CI: -3.68 to -1.32), p=<0.001); lower depression scores (-1.53 (95% CI: -2.12 to -0.93), p=<0.001); lower perceived stress (-1.06 (95% CI: -3.15 to 1.04), p=0.323); higher quality of life scores (2.19 (95% CI: -0.65 to 5.03), p=0.13); lower sleep quality scores (-1.27 (95% CI: -4.22 to 1.67), p=0.397); higher mindfulness scores (6.71 (95% CI: 4.09 to 9.33), p=<0.001); and lower pain severity at 1 to 1.5 follow up (-1.75 (95% CI: -2.98 to -0.51), p=0.006). Some of the results were characterized by a substantial, statistically significant heterogeneity. Nevertheless, a major part of the results pointed in the same direction, improving symptomatology with meditation-based therapy. The studies had a risk of bias mostly regarding the measurement of the outcome, randomization process and selection of the reported result. The current study discovered that the meditation group had significantly lower pain (at 1 to 1.5 months follow-up) anxiety, and depression scores and higher mindfulness scores at the end of the interventions.

Improving Prefrontal Oxygenation and Cardiac Autonomic Activity Following Meditation: A Functional Near-Infrared Spectroscopy (fNIRS) Study.

OBJECTIVE: The empirical evidence explicitly demonstrates that meditation practice enhances both brain functions and mental well-being. A meditative relaxation approach called the mind sound resonance technique (MSRT) has shown promising effects on children, adolescents, and people with psychological illnesses. This study aimed to investigate the effects of MSRT practice on brain hemodynamics, heart rate variability (HRV), mindfulness, and anxiety levels in college students. METHODS: Fifty volunteers in all genders (females, n = 30; males, n = 20) aged between 19 and 30 years were chosen from an educational institute and allocated into two groups, i.e., MSRT (n = 25) and supine rest (SR; n = 25). Enrolled participants were measured cerebral hemodynamics and HRV before, during, and after the MSRT or SR practice. The self-reported assessments including state anxiety and mindfulness were assessed before and after the intervention. RESULTS: The results demonstrated that practicing MSRT significantly improved oxygenation (p < 0.05) in the right prefrontal cortex (PFC) and increased low-frequency (LF) (p < 0.05) and decreased high-frequency (HF) (p < 0.05) component of HRV when compared to the baseline. The between-group analysis showed a significant difference between MSRT and SR in the standard deviation of the normal-to-normal (SDNN) (p < 0.05) component of HRV. CONCLUSION: These crumbs of evidence imply that MSRT sessions may foster the development of anxiety-related coping skills by elevating mindfulness, promoting PFC oxygenation, and modulating HRV in MSRT practitioners.

The effect of mindfulness meditation on depressive symptoms during the COVID-19 pandemic: a systematic review and meta-analysis.

Currently, 280 million people worldwide experience depression, ranking it third in the global burden of disease. The incidence of depression has risen due to the COVID-19 pandemic, making it essential to examine evidence-based practices in reducing depressive symptoms during this unprecedented time. This systematic review and meta-analysis aim to analyze randomized controlled trials during the COVID-19 pandemic that evaluated the effect of mindfulness meditation on depressive symptoms in individuals with depression. Four databases (PubMed, Embase, Web of Science, and Scopus) were searched in November 2023 using search terms including meditation, mindfulness, depression, and depressive symptoms. The meta-analysis was conducted using Review Manager 5.4 software (Cochrane Collaboration). A random model and Standard Mean Difference analysis with 95% CIs were used for continuous variables. The systematic review included 26 RCT studies. The meta-analysis showed significant effects of mindfulness meditation interventions (SMD = - 1.14; 95% CI - 1.45 to - 0.83; P < 0.001) in reducing depressive symptoms compared to comparison groups. The findings suggest a positive effect of mindfulness meditation on depressive symptoms in individuals with depression during the COVID-19 pandemic.

Mindfulness meditation and placebo modulate distinct multivariate neural signatures to reduce pain.

BACKGROUND: Rather than a passive reflection of nociception, pain is shaped by the interplay between one's experiences, current cognitive-affective states, and expectations. The placebo-response, a paradoxical yet reliable phenomenon, is postulated to reduce pain by engaging mechanisms shared with "active" therapies. It has been assumed that mindfulness meditation, practiced by sustaining nonjudgmental awareness of arising sensory events, merely reflects mechanisms evoked by placebo. Recently, brain-based multivariate pattern analysis (MVPA) has been validated to successfully disentangle nociceptive-specific, negative-affective, and placebo-based dimensions of the subjective pain experience. METHODS: To determine if mindfulness meditation engages distinct brain mechanisms from placebo and sham-mindfulness to reduce pain, MVPA pain signatures were applied across two randomized clinical trials that employed overlapping psychophysical pain testing procedures (49°C noxious heat; visual analogue pain scales) and distinct fMRI techniques (blood-oxygen-level dependent; perfusion-based). After baseline pain testing, 115 healthy participants were randomized into a four-session mindfulness meditation (n = 37), placebo-cream conditioning (n = 19), sham-mindfulness meditation (n = 20), or book-listening (n = 39) intervention. After each intervention, noxious heat was administered during fMRI and each manipulation. RESULTS: A double dissociation in the MVPA signatures supporting pain regulation was revealed by mindfulness meditation as compared to placebo-cream. Mindfulness meditation produced significantly greater reductions in pain intensity and pain unpleasantness ratings, nociceptive-specific and negative-affective pain signatures when compared to placebo-cream, sham-mindfulness meditation and controls. Placebo-cream only reduced the placebo-based signature. CONCLUSIONS: Mindfulness meditation and placebo engage distinct neural pain signatures to reduce pain to demonstrate mechanistic granularity between placebo and mindfulness.

Efficacy of yoga for posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials.

Yoga is an increasingly popular complementary intervention to reduce posttraumatic stress disorder (PTSD) symptoms and related comorbidities, but its safety and treatment efficacy are not firmly established. We conducted a systematic review and meta-analysis of existing randomized control trials (RCTs) of yoga interventions for PTSD and related secondary outcomes (e.g., depression). Initial search results found over 668 potential papers. Twenty met inclusion criteria (e.g., RCTs on adult participants with PTSD that evaluated safety or efficacy outcomes). Meta-analysis indicated that, compared to control interventions, participation in yoga interventions significantly improved self-report PTSD (standardized mean difference [SMD]: -0.51; 95 % confidence interval [CI]: -0.68, -0.35) and immediate (SMD: -0.39; 95 % CI: -0.56, -0.22) and long-term (SMD: -0.44; 95 % CI: -0.74, -0.13) depression symptoms. However, using clinician-reported assessments, yoga interventions were not associated with improved PTSD symptoms. Type of yoga differentially predicted outcomes. Sensitivity analysis showed consistent effect sizes when omitting each study from main analyses. Six studies reported whether any serious adverse events occurred. None were indicated. No publication bias was found, although individual intervention studies tended to be high in bias. Results suggest yoga is likely a safe and effective complementary intervention for reducing PTSD and depressive symptoms in individuals with PTSD. More rigorous RCTs are warranted.

Mindfulness-based eating awareness training versus itself plus implementation intention model: a randomized clinical trial.

BACKGROUND: Obesity causes many physical and mental illnesses. This study compares mindfulness-based eating awareness training (MB-EAT) versus MB-EAT plus implementation intention model for effectiveness on body mass index (BMI), weight self-efficacy, and physical activity in obese women with BMIs ≤ 25 (n = 52). METHODS: In this randomized clinical trial, the participants were selected by the simple random sampling method and randomly divided into three groups. A 12-session MB-EAT of 150 min per session was performed for experimental group I. The experimental group II received MB-EAT alone for physical activity planning and MB-EAT plus implementation intention; also, both groups were compared to the control group. Data were measured by the scales, a questionnaire, and a checklist, and the P-values are based on the results of the generalized estimating equation (GEE) test. P < 0.001 were considered the significance level. RESULTS: The MB-EAT and MB-EAT + implementation intention effectiveness on the two experimental groups' BMI, weight self-efficacy, and physical activity was significantly different from the control group. In the integrated group versus the MB-EAT group, BMI, physical activity, and physical discomfort, were more effective than the weight self-efficacy subscales. Both intervention groups were effective on BMI, weight self-efficacy, and physical activity, but the integrated group's effectiveness was more. CONCLUSIONS: The MB-EAT effectiveness trial is theory-based, reducing weight and the psychological and behavioral consequences of overweight and obese adults. The MB-EAT + the Implementation intention model is to plan regular and daily exercise according to each individual's specific circumstances. TRIAL REGISTRATION: The trial registration number: (IRCT20200919048767N1).

Meditation for the reduction of perioperative anxiety in patients undergoing oncology surgery: A scoping review.

Objective: Patients undergoing surgery, particularly patients undergoing surgery for oncology diagnoses, experience anxiety. Surgery remains the primary treatment for many common types of cancer. One promising potential intervention to alleviate anxiety in the preoperative and postoperative period is meditation, an integrative medicine intervention. However, there remains a gap in the literature regarding the effectiveness of meditation to alleviate anxiety during the perioperative time period. Methods: The scoping review was conducted using the Arksey and O'Malley framework to synthesize the study findings and was reported with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The review included EMBASE, PubMed, Web of Science, CINAHL Plus, Scopus, and Cochrane Review databases from 2013 through 2024. All identified articles were exported to the online systematic review software, Covidence. Results: A total of 538 initial citations were identified, 415 titles and abstracts were screened, and 83 full-text articles reviewed. Six studies were finally included. The data extracted from the literature included: study purpose, study design, sample size, preoperative or postoperative timeframe, instrument to evaluate anxiety, and conclusions. Conclusions: For patients undergoing oncology surgery, the perioperative period can be filled with anxiety. Guided, mindfulness, and loving-kindness meditation may be helpful in reducing anxiety, particularly in patients undergoing surgery for breast cancer during the postoperative period. However, the current literature is extremely limited. Future research should expand on the preliminary effectiveness to broader populations and carefully target the highest-risk populations for the ideal time point for interventions.

Complementary and Alternative Therapies for Psoriasis.

Despite recent advancements in psoriasis treatment, challenges in management persist. Recently, there has been a rising interest amongst patients in complementary and alternative medicines (CAM), driven by the desire for more natural, holistic approaches and dissatisfaction with conventional treatments. Up to 41% of patients with psoriasis reported using alternative therapies and 39.5% use complementary therapies (Murphy EC, Nussbaum D, Prussick R, Friedman AJ (2019) Use of complementary and alternative medicine by patients with psoriasis. J Am Acad Dermatol 81:280-283). Despite their rapidly growing prevalence, literature on CAM therapies for psoriasis is lacking, making their recommendation difficult. Since the last systematic review on this topic published in 2018, evidence for new alternative therapies has emerged, promoting a further investigation of their efficacy (Gamret AC, Price A, Fertig RM, Lev-Tov H, Nichols AJ (2018) Complementary and Alternative Medicine Therapies for Psoriasis: A Systematic Review. JAMA Dermatol 154:1330-1337). This systematic review aims to compile recent literature on the most studied alternative therapies for psoriasis and further discuss their effectiveness in order to counsel clinicians in guiding patients on the use of these non-standard approaches. A literature search was conducted in the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov databases for randomized controlled trials (RCT) on complementary and alternative therapies in psoriasis from March 2018 through April 2024, resulting in 12 studies being included in this review. The preliminary results for many treatments such as curcumin, dietary modification and additions, indigo naturalis, meditation, acupuncture, and balneotherapy showed positive clinical effects. However, additional well-designed randomized trials are needed to confirm the potential beneficial effects and to establish safety of use.

Effects of an online mindfulness-based intervention on brain haemodynamics: a pilot randomized controlled trial using functional near-infrared spectroscopy.

Although many neuroimaging studies have evaluated changes in the prefrontal cortex during mindfulness-based interventions, most of these studies were cross-sectional studies of skilled participants or involved pre-post comparisons before and after a single session. While functional near-infrared spectroscopy is a useful tool to capture changes in the hemodynamic response of the prefrontal cortex during continuous mindfulness-based intervention, its ability to detect the accumulated effects of continuous mindfulness-based intervention is currently unclear. We investigated whether a 12-wk online mindfulness-based intervention changed the hemodynamic response of the prefrontal cortex during a verbal fluency task. Eighty-two healthy university students were randomly allocated to a 12-wk online mindfulness-based intervention group or a wait-list control group. The integral values of oxygenated hemoglobin measured using functional near-infrared spectroscopy before and after the intervention were compared to the values in the wait-list group. The intervention condition showed significantly greater functional near-infrared spectroscopy signal activation than the control condition; however, the effect sizes before and after the intervention were small. Thus, continuous mindfulness-based intervention could alter prefrontal cortex function, and functional near-infrared spectroscopy could be useful for measuring the accumulated effects of continuous mindfulness-based interventions. With a better understanding of the association between mindfulness and functional near-infrared spectroscopy signals, functional near-infrared spectroscopy can be used for biofeedback analyses.

Global Effect on Cortical Activity in Young Indian Males in Response to "OM" Chanting: A High-Density Quantitative Electro-Encephalography Study.

Background: Meditation using the "OM" mantra is the most widely used practice in India. Though reports have been published about the relaxation effect during both verbal "OM" chanting and listening to "OM" chanting, there is a paucity of literature concerning the cortical areas activated/deactivated after verbal "OM" chanting and listening to "OM" chanting using quantitative electro-encephalography (qEEG). Purpose: The objective of this study was to compare the effects of verbal "OM" chanting and listening to "OM" chanting on cortical sources as compared to baseline, as assessed by qEEG. Method: Twenty adult male subjects with a mean age of 27.5 ± 7.5 years and no past or present history of psychiatric, neurological, or auditory disorders or previous exposure to yoga and meditation were recruited from the undergraduate and postgraduate student population of AIIMS, New Delhi. Subjects were given a paradigm designed using E-prime for both verbal and listening to "OM" chanting of 5 min each and a 5-min relaxation period in between the tasks. Electroencephalography recording was done using a 128-channel geodesic sensor net with band-pass filtered at 1-70 Hz, and 20-sec data of eyes-closed condition, post-verbal "OM", and post-listening to "OM" chanting were segmented and pre-processed. Further, source analysis was performed on the data using standardized low-resolution electromagnetic tomography. Result: The pre (baseline) versus post-verbal "OM" (p < .05) and post-listening to "OM" (p < .05) chanting showed significant differences in similar cortical areas in both verbal "OM" and listening to "OM" chanting except the three areas, that is, the orbital gyrus, the rectal gyrus, and the sub-callosal gyrus, which were additionally activated post-listening to "OM" chanting. Both verbal and listening to "OM" chanting induced activation of similar cortical areas, which were classified as the nodes/hubs of specific resting-state networks (RSNs) such as the attentional network, frontoparietal control network, and default mode network. Conclusion: The study results suggest that "OM" chanting could facilitate flexible switching between various RSNs to induce a relaxed state and could improve attention simultaneously.Both verbal and listening to "OM" chanting induced common activated areas that are classified into frontoparietal, dorsal attention, and default mode network areas. And it is hypothesized that flexible switching between these RSNs could induce a relaxed state and improve attention simultaneously with the possible role of the frontoparietal network.

Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain.

Background: Until recently, treatments for chronic pain commonly relied on in-person interventions, and despite more hybrid care options today, capacity for delivery remains challenged. Digital programs focusing on the psychosocial aspects of pain may provide low-barrier alternatives. Aims: Through a randomized controlled trial, we investigated the effectiveness of a multimodal mobile application. Methods: Participants (n = 198; 82% women, mean age = 46.7 [13.1] years; mean pain duration 13.6 [11.2] years) with nonmalignant chronic pain were randomized to either a 6-week intervention (n = 98) or a wait-listed usual care group (n = 100). The intervention involved regular engagement with a user-guided mobile application (Curable Inc.) informed by the biopsychosocial model of pain that included pain education, meditation, cognitive behavioral therapy, and expressive writing. The co-primary outcomes were pain severity and interference at 6 weeks. Results: We observed significant improvements in the intervention group compared to the control group with estimated changes of -0.67 (95% confidence interval [CI] -1.04 to -0.29, P < .001, d = 0.43) and -0.60 (95% CI -1.18 to -0.03, P = .04, d = 0.27) for pain severity and interference, respectively. There were significant improvements across secondary outcomes (Patient-Reported Outcome Measurement Information System pain interference; pain catastrophizing; anxiety, depression; stress). Frequency of app use was correlated with improved pain interference (P < .001) and pain catastrophizing (P = 0.018), and changes from baseline persisted in the intervention group at 12 weeks (P < .05). Conclusions: A short-term mobile app intervention resulted in significant improvements across physical and mental health outcomes compared to wait-listed usual care.

Contexte : Jusqu'à récemment, les traitements pour la douleur chronique se faisaient principalement en personne. Bien que de plus en plus d'options de soins hybrides soient désormais disponibles, la capacité à fournir ces soins demeure un défi. Les programmes numériques qui se concentrent sur les aspects psychosociaux de la douleur peuvent offrir des solutions de rechange présentant peu de barrières.Objectifs : Dans le cadre d'un essai contrôlé randomisé, nous avons étudié l'efficacité d'une application mobile multimodale.Méthodes : Les participants (n = 198 ; 82 % de femmes, âge moyen = 46,7 [13,1] ans; durée moyenne de la douleur 13,6 [11,2] ans) souffrant de douleur chronique non cancéreuse ont été répartis au hasard entre une intervention de six semaines (n = 98) et un groupe de soins habituels sur liste d'attente (n = 100). L'intervention consistait en l'utilisation régulière d'une application mobile guidée par l'utilisateur, basée sur le modèle biopsychosocial de la douleur comprenant l'éducation à la douleur, la méditation, la thérapie cognitivo-comportementale et l'écriture expressive. Les résultats coprimaires étaient l'intensité de la douleur et l'interférence à six semaines.Résultats : Nous avons observé des améliorations significatives dans le groupe d'intervention par rapport au groupe témoin, avec des changements estimés de -0,67 (intervalle de confiance à 95 % [IC] -1,04 à -0,29, P < 0,001, d = 0,43) et -0,60 (IC 95 % -1,18 à -0,03, P = 0,04, d = 0,27) pour l'intensité de la douleur et l'interférence, respectivement. Des améliorations significatives ont été observées pour les résultats secondaires (interférence de la douleur selon le système d'information sur les mesures de résultats rapportés par les patients; catastrophisation de la douleur; anxiété; dépression et stress). La fréquence d'utilisation de l'application était corrélée à une amélioration de l'interférence de la douleur (P < 0,001) et de la catastrophisation de la douleur (P = 0,018). De plus, les changements par rapport à l'état initial ont persisté dans le groupe d'intervention après 12 semaines (P < 0,05).Conclusions : Une intervention à court terme au moyen d'une application mobile a permis d'améliorer de manière significative les résultats en matière de santé physique et mentale comparativement aux soins habituels sur liste d'attente.

Neuromodulation and meditation: A review and synthesis toward promoting well-being and understanding consciousness and brain.

The neuroscience of meditation is providing insight into meditation's beneficial effects on well-being and informing understanding of consciousness. However, further research is needed to explicate mechanisms linking brain activity and meditation. Non-invasive brain stimulation (NIBS) presents a promising approach for causally investigating neural mechanisms of meditation. Prior NIBS-meditation research has predominantly targeted frontal and parietal cortices suggesting that it might be possible to boost the behavioral and neural effects of meditation with NIBS. Moreover, NIBS has revealed distinct neural signatures in long-term meditators. Nonetheless, methodological variations in NIBS-meditation research contributes to challenges for definitive interpretation of previous results. Future NIBS studies should further investigate core substrates of meditation, including specific brain networks and oscillations, and causal neural mechanisms of advanced meditation. Overall, NIBS-meditation research holds promise for enhancing meditation-based interventions in support of well-being and resilience in both non-clinical and clinical populations, and for uncovering the brain-mind mechanisms of meditation and consciousness.

Short Mindfulness Meditations During Breaks and After Work in Everyday Nursing Care: A Simple Strategy for Promoting Daily Recovery, Mood, and Attention?

BACKGROUND: Nurses experience high job demands, which makes recovery particularly necessary to maintain well-being and performance. However, these demands also make recovery challenging. Short mindfulness meditations could potentially help alleviate this paradox. METHODS: Two ecological momentary intervention studies were conducted among geriatric nurses (Study 1: break study) and hospital nurses (Study 2: after-work study) to investigate whether short audio-guided mindfulness meditations are beneficial for recovery during breaks and psychological detachment after work. Furthermore, break recovery and after-work detachment were examined as mediators of the associations between mindfulness meditations and after-break/after-sleep mood and attention after respective recovery periods. Multilevel path models were based on a sample of 38 nurses and 208 after-break surveys in the break study and 26 nurses and 192 after-sleep surveys in the after-work study. RESULTS: Compared to breaks spent as usual, breaks that incorporated short mindfulness meditations were associated with higher break recovery, which mediated the positive associations between mindful breaks and after-break calmness, valence, and energetic arousal. Only with certain constraints did mindfulness meditations predict a lower rate of attention failures. In the after-work study, short mindfulness meditations were positively related to psychological detachment, which mediated the positive associations between the intervention and after-sleep valence and calmness. CONCLUSION/APPLICATION TO PRACTICE: Both pilot studies showed that short mindfulness meditations aid in recovery among nurses. However, to fully utilize the advantages of recovery-promoting breaks, structural changes are necessary to ensure that breaks of an appropriate duration are consistently implemented.

Interoceptive brain network mechanisms of mindfulness-based training in healthy adolescents.

Introduction: This study evaluated changes in the white matter of the brain and psychological health variables, resulting from a neuroscience-based mindfulness intervention, the Training for Awareness, Resilience, and Action (TARA), in a population of healthy adolescents. Methods: A total of 100 healthy adolescents (57 female, age ranges 14-18 years) were randomized into the 12-week TARA intervention or a waitlist-control group. All participants were imaged with diffusion MRI to quantify white matter connectivity between brain regions. Imaging occurred at baseline/randomization and after 12 weeks of baseline (pre- and post-intervention in the TARA group). We hypothesized that structural connectivity in the striatum and interoceptive networks would increase following the TARA intervention, and that, this increased connectivity would relate to psychological health metrics from the Strengths and Difficulties Questionnaire (SDQ) and the Insomnia Severity Index (ISI). The TARA intervention and all assessments, except for the MRIs, were fully remotely delivered using secure telehealth platforms and online electronic data capture systems. Results: The TARA intervention showed high consistency, tolerability, safety, recruitment, fidelity, adherence, and retention. After 12 weeks, the TARA group, but not controls, also demonstrated significantly improved sleep quality (p = 0.02), and changes in the right putamen node strength were related to this improved sleep quality (r = -0.42, p = 0.006). Similarly, the TARA group, but not controls, had significantly increased right insula node strength related to improved emotional well-being (r = -0.31, p = 0.04). Finally, we used the network-based statistics to identify a white matter interoception network that strengthened following TARA (p = 0.009). Discussion: These results suggest that the TARA mindfulness-based intervention in healthy adolescents is feasible and safe, and it may act to increase structural connectivity strength in interoceptive brain regions. Furthermore, these white matter changes are associated with improved adolescent sleep quality and emotional well-being. Our results suggest that TARA could be a promising fully remotely delivered intervention for improving psychological well-being in adolescents. As our findings suggest that TARA affects brain regions in healthy adolescents, which are also known to be altered during depression in adolescents, future studies will examine the effects of TARA on depressed adolescents. Clinical trial registration: https://clinicaltrials.gov/study/NCT04254796.

Mind-body therapy for treating fibromyalgia: a systematic review.

OBJECTIVE: Fibromyalgia is a chronic and disabling condition that presents management challenges for both patients and healthcare providers. The objective of this systematic review was to summarize current evidence on the effectiveness and safety of mind-body therapies in the treatment and/or management of fibromyalgia. METHODS: We searched MEDLINE, EMBASE, PsycINFO, AMED, and CINAHL databases from their inception to December 2023. Eligible articles included adults diagnosed with fibromyalgia participating in a mind-body therapy intervention and were published from the beginning of 2012 onwards. We assessed the quality of the studies using the Joanna Briggs Institute Critical Appraisal Checklists. RESULTS: Of 3866 records screened, 27 studies (30 articles) met our inclusion criteria, in which 22 were randomized controlled trials and 5 were quasi-experimental studies. Mind-body therapies included guided imagery (n = 5), mindfulness-based stress reduction (n = 5), qi gong (n = 5), tai chi (n = 5), biofeedback (n = 3), yoga (n = 2), mindfulness awareness training (n = 1), and progressive muscle relaxation (n = 1). With the exception of mindfulness-based stress reduction, all therapies had at least one study showing significant improvements in pain at the end of treatment. Multiple studies on guided imagery, qi gong, and tai chi observed significant improvements in pain, fatigue, multidimensional function, and sleep. Approximately one-third of the studies reported on adverse events. CONCLUSIONS: This review suggests that mind-body therapies are potentially beneficial for adults with fibromyalgia. Further research is necessary to determine if the positive effects observed post-intervention are sustained. STUDY REGISTRATION: Open Science Framework (https://osf.io) (September 12, 2023; https://doi.org/10.17605/osf.io/6w7ac).

Effects of Virtual Reality (VR)-Based Meditation on Sleep Quality, Stress, and Autonomic Nervous System Balance in Nursing Students.

This study aimed to determine the effects of virtual reality (VR)-based meditation on the sleep quality, stress, and autonomic nervous system balance of nursing students. Nursing students were categorized into experimental groups I (VR-based meditation) and II (concentration meditation) and a control group. Before the study's initiation, we measured the participants' general characteristics, and a sleep measurement device was used to measure sleep quality. Stress levels and heart rate variability were measured before and after study completion. On the first day, all three groups slept without any intervention. On days 2-6, only experimental groups I and II implemented the intervention before sleeping. We found that the subjective sleep quality, wakefulness after sleep onset, sleep efficiency, deep sleep quality, subjective stress, objective stress, and autonomic nervous system balance of the VR meditation group were significantly better than those of the other groups. Our results reveal that the participants who underwent VR-based meditation experienced better sleep quality, lower stress levels, and improved autonomic nervous system balance compared with those in the concentration meditation and control groups. Thus, VR-based meditation effectively enhances sleep quality, lowers stress levels, and improves autonomic nervous system balance in nursing students.

Increased wakefulness as measured by the WAKE-16 is related to mindfulness and emotional self-regulation in experienced Buddhist meditators.

INTRODUCTION: We tested and validated the German version of a new instrument for measuring "wakefulness," defined as "an expansive, higher-functioning, and stable state of being in which a person's vision of and relationship to the world are transformed, along with their subjective experience, their sense of identity and their conceptual outlook" (Taylor, 2017, p. 22). METHODS: In order to test the construct validity of the new instrument (Inventory of Secular/Spiritual Wakefulness; WAKE-16), we performed a parametric comparison between a group of expert meditators (n=36) with a history of predominantly meditating in silence and demographically matched non-meditators (n=36) for the WAKE-16 and two conceptually related questionnaires of mindfulness and emotion regulation. RESULTS: Significantly higher scores for the meditators on the WAKE-16 indicate construct validity of the new instrument. Meditators scored higher on the two mindfulness subscales "presence" and "acceptance," as well as on the SEE subscales of emotion regulation and body-related symbolization of emotions. Within the group of meditators, there were significant correlations between wakefulness and mindfulness, accepting one's own emotions, and experiencing overwhelming emotions. The only significant correlation in non-meditators was found between wakefulness and accepting one's own emotions. DISCUSSION: The new instrument shows construct validity by discriminating between the two groups. Correlations between wakefulness and related psychological constructs indicate convergent validity. Future studies could attempt to increase discriminatory accuracy of the definition of wakefulness, as well as finding objective methods of measuring.

Psychoanalysis of the unspectacular.

From the perspective of a poet and first-year psychoanalytic training candidate, this paper develops Jeremy Safran's ideas about the dialectic between psychoanalysis and Buddhism by drawing an analogy between their processes and those of a poetry practice to define an alternative to pathological dissociation under capitalist systems of value. The paper details the writer's experience of working a day job in an office and the pathological dissociation which she subsequently attempts to overcome and critique through writing poetry. Various poems written at work are shared and analyzed as evidence. Drawing from Safran's edited volume, Psychoanalysis and Buddhism, the author then identifies aspects of Zen Buddhist meditation practice and the psychoanalytic process that focus on connecting with reality, however conflicted, as opposed to escaping it. This paper was written under the mentorship of the psychoanalyst and Zen teacher Barry Magid.

Documenting and defining emergent phenomenology: theoretical foundations for an extensive research strategy.

Meditation, psychedelics, and other similar practices or induction methods that can modulate conscious experience, are becoming increasingly popular in clinical and non-clinical settings. The phenomenology associated with such practices or modalities is vast. Many similar effects and experiences are also reported to occur spontaneously. We argue that this experiential range is still not fully described or understood in the contemporary literature, and that there is an ethical mandate to research it more extensively, starting with comprehensive documentation and definition. We review 50 recent clinical or scientific publications to assess the range of phenomena, experiences, effects, after-effects, and impacts associated with a broad variety of psychoactive compounds, meditative practices, and other modalities or events. This results in a large inventory synthesizing the reports of over 30,000 individual subjects. We then critically discuss various terms and concepts that have been used in recent literature to designate all or parts of the range this inventory covers. We make the case that specialized terminologies are needed to ground the nascent research field that is forming around this experiential domain. As a step in this direction, we propose the notion of "emergence" and some of its derivatives, such as "emergent phenomenology," as possibly foundational candidates.