Chronic Inflammation and Mindfulness Intervention

描述（由申请人提供）：越来越多的证据表明，我们社会中的慢性压力是加速许多疾病状态增加的行为和风险因素的一个促成因素。我们建议评估改良的基于正念的压力减轻（MBSR-ld）的影响，以减少压力和慢性炎症的生物标志物，这些生物标志物是老年疾病的危险因素。将选择具有炎性标志物C-反应蛋白（CRP）（心血管疾病的危险因素）的上三分位值的参与者。我们将使用两组单盲随机平行设计来评估MBSR-ld对35-60岁受试者的心理、生物和复原力测量的影响。我们将比较90名受试者在这个程序与90名受试者的生活方式教育对照组没有正念训练。在随机化之前，将在干预之前和之后施用两周的计算机化每日日记程序，其设计用于评估压力和弹性（压力事件之后的稳态恢复）。在日记周期间，将获得唾液皮质醇（全天4次），以提供生理应激指标。然后，受试者将被随机分配到对照组或正念组。他们将不知道其他减压计划的内容。MBSR-ld和生活方式教育参与者将每周进行一小时的指导，每天进行20分钟的正念或生活方式教育实践，持续8周。两组都将接受问卷调查，评估感知压力，睡眠质量，焦虑，抑郁和正念，以及基线和干预后2个月的压力和炎症标志物的血液检查。干预后2个月重复两周日记和每周皮质醇采样。 该提案的主要具体目的是确定与标准压力减轻方案相比，MBSR-ld是否可以产生慢性炎症和压力（CRP，IL-6和皮质醇）的生物测量的更大降低。第二个具体目标是确定与生活方式教育方案相比，MBSR-ld是否可以更好地改善正念，弹性，感知压力，睡眠质量，焦虑和抑郁症状的测量。 公共卫生相关性：尽管最近的医学进步，美国正在经历各种慢性疾病的流行。 压力大的生活方式和不良的健康行为是造成这种健康危机的主要原因。我们将研究正念冥想的作用，这是一个相对低成本的项目，在减少压力和炎症的生物标志物方面，这些都是衰老疾病的危险因素。

DESCRIPTION (provided by applicant): Increasing evidence suggests that chronic stress in our society is a contributing factor to the behaviors and risk factors that have accelerated the increase in numerous disease states. We propose to evaluate the influence of a modified mindfulness-based stress reduction (MBSR-ld) to decrease biologic markers of stress and chronic inflammation which are risk factors for the diseases of aging. Participants will be selected with upper tertile values of the inflammatory marker C-reactive protein (CRP), a risk factor for cardiovascular disease. We will use a two group single blinded randomized parallel design to assess the effect of MBSR-ld on psychological, biological and resiliency measures among subjects aged 35-60 years. We will compare 90 subjects on this program with 90 subjects from a lifestyle education control group without mindfulness training. Prior to randomization, a two week computerized daily diary program designed to evaluate stress and resiliency (recovery of homeostasis following stressful events) will be administered for two weeks before and after the intervention. During the diary weeks salivary cortisol will be obtained (4 times throughout the day) to provide a physiologic stress measure. The subjects will then be randomized to a control or mindfulness group. They will be blinded as to the content of the other stress reduction program. The MBSR-ld and lifestyle education participants will involve one hour of instruction weekly and 20 minutes of mindfulness or lifestyle education practice daily for 8 weeks. Both groups will receive questionnaires evaluating perceived stress, sleep quality, anxiety, depression, and mindfulness, as well as blood work for stress and inflammatory markers at baseline and 2 months after the interventions. The two week diaries and weekly cortisol sampling will be repeated 2 months post intervention. The primary specific aim of this proposal is to determine if MBSR-ld can produce greater decreases in biologic measures of chronic inflammation and stress (CRP, IL-6 and cortisol) when compared to a standard stress reduction protocol. A secondary specific aim is to determine if MBSR-ld can better improve measures of mindfulness, resiliency, perceived stress, sleep quality, anxiety and depressive symptoms when compared to a lifestyle education protocol. Public Health Relevance: In spite of recent medical advances, the US is experiencing epidemics of various chronic medical conditions. Stressful lifestyle and poor health behaviors are major contributors to this health crisis. We will examine the role of mindfulness meditation, a relatively low cost program, in reducing biologic markers of stress and inflammation which are risk factors for the diseases of aging.