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导致行为和风险因素的一个促成因素，这些因素加速了许多疾病状态的增加。我们建议评估改良的基于正念的减压法(MBSR-LD)对降低压力和慢性炎症的生物标记物的影响，这些生物标记物是老年病的风险因素。参与者将被选为炎症标记物C-反应蛋白(CRP)的高三分位数，这是心血管疾病的风险因素。我们将使用两组单盲随机平行设计来评估MBSR-LD对年龄在35-60岁的受试者的心理、生物和弹性测量的影响。我们将把这个项目中的90名受试者与没有进行正念训练的90名生活方式教育控制组的受试者进行比较。在随机化之前，一项为期两周的计算机化每日日记计划将在干预前后两周进行，旨在评估压力和弹性(应激事件后体内平衡的恢复)。在日记的几周中，唾液皮质醇将被获取(全天4次)，以提供生理压力测量。然后，受试者将被随机分为控制组或正念组。他们将对其他减压计划的内容视而不见。MBSR-LD和生活方式教育参与者将包括每周1小时的指导和每天20分钟的正念或生活方式教育练习，为期8周。两组都将在基线和干预后2个月接受问卷调查，评估感知的压力、睡眠质量、焦虑、抑郁和正念，以及血液工作中的压力和炎症标记物。干预后2个月重复两周日记和每周皮质醇采样。 该建议的主要具体目的是确定与标准的减压方案相比，MBSR-LD是否可以在慢性炎症和应激的生物学指标(CRP、IL-6和皮质醇)方面产生更大的降低。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：尽管最近医学取得了进步，但美国正在经历各种慢性疾病的流行病。紧张的生活方式和不良的健康行为是造成这场健康危机的主要原因。我们将研究正念冥想在减少压力和炎症的生物标记物方面的作用，正念冥想是一种相对低成本的计划，这些生物标志物是老年病的风险因素。

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.