Lobsang Tenzin Negi

Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress

Meditation practices may impact physiological pathways that are modulated by stress and relevant to disease. While much attention has been paid to meditation practices that emphasize calming the mind, improving focused attention, or developing mindfulness, less is known about meditation practices that foster compassion. Accordingly, the current study examined the effect of compassion meditation on innate immune, neuroendocrine and behavioral responses to psychosocial stress and evaluated the degree to which engagement in meditation practice influenced stress reactivity. Sixty-one healthy adults were randomized to 6 weeks of training in compassion meditation (n=33) or participation in a health discussion control group (n=28) followed by exposure to a standardized laboratory stressor (Trier social stress test [TSST]). Physiologic and behavioral responses to the TSST were determined by repeated assessments of plasma concentrations of interleukin (IL)-6 and cortisol as well as total distress scores on the Profile of Mood States (POMS). No main effect of group assignment on TSST responses was found for IL-6, cortisol or POMS scores. However, within the meditation group, increased meditation practice was correlated with decreased TSST-induced IL-6 (r(p)=-0.46, p=0.008) and POMS distress scores (r(p)=-0.43, p=0.014). Moreover, individuals with meditation practice times above the median exhibited lower TSST-induced IL-6 and POMS distress scores compared to individuals below the median, who did not differ from controls. These data suggest that engagement in compassion meditation may reduce stress-induced immune and behavioral responses, although future studies are required to determine whether individuals who engage in compassion meditation techniques are more likely to exhibit reduced stress reactivity.

Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary, non-meditative state

The amygdala has been repeatedly implicated in emotional processing of both positive and negative-valence stimuli. Previous studies suggest that the amygdala response to emotional stimuli is lower when the subject is in a meditative state of mindful-attention, both in beginner meditators after an 8-week meditation intervention and in expert meditators. However, the longitudinal effects of meditation training on amygdala responses have not been reported when participants are in an ordinary, non-meditative state. In this study, we investigated how 8 weeks of training in meditation affects amygdala responses to emotional stimuli in subjects when in a non-meditative state. Healthy adults with no prior meditation experience took part in 8 weeks of either Mindful Attention Training (MAT), Cognitively-Based Compassion Training (CBCT; a program based on Tibetan Buddhist compassion meditation practices), or an active control intervention. Before and after the intervention, participants underwent an fMRI experiment during which they were presented images with positive, negative, and neutral emotional valences from the IAPS database while remaining in an ordinary, non-meditative state. Using a region-of-interest analysis, we found a longitudinal decrease in right amygdala activation in the Mindful Attention group in response to positive images, and in response to images of all valences overall. In the CBCT group, we found a trend increase in right amygdala response to negative images, which was significantly correlated with a decrease in depression score. No effects or trends were observed in the control group. This finding suggests that the effects of meditation training on emotional processing might transfer to non-meditative states. This is consistent with the hypothesis that meditation training may induce learning that is not stimulus- or task-specific, but process-specific, and thereby may result in enduring changes in mental function.

Engagement with Cognitively-Based Compassion Training is associated with reduced salivary C-reactive protein from before to after training in foster care program adolescents

BACKGROUND Children exposed to early life adversity (ELA) have been shown to have elevated circulating concentrations of inflammatory markers that persist into adulthood. Increased inflammation in individuals with ELA is believed to drive the elevated risk for medical and psychiatric illness in the same individuals. This study sought to determine whether Cognitively Based Compassion Training (CBCT) reduced C-reactive protein (CRP) in adolescents in foster care with high rates of ELA, and to evaluate the relationship between CBCT engagement and changes in CRP given prior evidence from our group for an effect of practice on inflammatory markers. It was hypothesized that increasing engagement would be associated with reduced CRP from baseline to the 6-week assessment. METHODS Seventy-one adolescents in the Georgia foster care system (31 females), aged 13-17, were randomized to either 6 weeks of CBCT or a wait-list condition. State records were used to obtain information about each participants history of trauma and neglect, as well as reason for placement in foster care. Saliva was collected before and again after 6 weeks of CBCT or the wait-list condition. Participants in the CBCT group completed practice diaries as a means of assessing engagement with the CBCT. RESULTS No difference between groups was observed in salivary CRP concentrations. Within the CBCT group, practice sessions during the study correlated with reduced CRP from baseline to the 6-week assessment. CONCLUSIONS Engagement with CBCT may positively impact inflammatory measures relevant to health in adolescents at high risk for poor adult functioning as a result of significant ELA, including individuals placed in foster care. Longer term follow-up will be required to evaluate if these changes are maintained and translate into improved health outcomes.

Innate immune, neuroendocrine and behavioral responses to psychosocial stress do not predict subsequent compassion meditation practice time

Increasing data suggest that meditation impacts stress-related physiological processes relevant to health and disease. For example, our group recently reported that the practice of compassion meditation was associated with reduced innate immune (plasma interleukin [IL]-6) and subjective distress responses to a standardized laboratory psychosocial stressor (Trier Social Stress Test [TSST]). However, because we administered a TSST after, but not prior to, meditation training in our initial study, it remained possible that associations between practice time and TSST outcomes reflected the fact that participants with reduced stress responses prior to training were more able to practice compassion meditation, rather than that meditation practice reduced stress responses. To help resolve this ambiguity, we conducted the current study to evaluate whether innate immune, neuroendocrine and behavioral responses to a TSST conducted prior to compassion meditation training in an independent sample of 32 medically health young adults would predict subsequent amount of meditation practice time during a compassion meditation training protocol identical to the one used in our first study. No associations were found between responses to a TSST administered prior to compassion meditation training and subsequent amount of meditation practice, whether practice time was considered as a continuous variable or whether meditators were divided into high and low practice time groups based on a median split of mean number of practice sessions per week. These findings contrast strikingly with our original study, in which high and low practice time meditators demonstrated marked differences in IL-6 and distress responses to a TSST administered after meditation training. In addition to providing the first published data regarding stress responsivity as a potential predictor of subsequent ability/willingness to practice meditation, the current study strengthens findings from our initial work by supporting the conclusion that in individuals who actively engage in practicing the technique, compassion meditation may represent a viable strategy for reducing potentially deleterious physiological and behavioral responses to psychosocial stress.

The neural mediators of kindness-based meditation: a theoretical model

Although kindness-based contemplative practices are increasingly employed by clinicians and cognitive researchers to enhance prosocial emotions, social cognitive skills, and well-being, and as a tool to understand the basic workings of the social mind, we lack a coherent theoretical model with which to test the mechanisms by which kindness-based meditation may alter the brain and body. Here, we link contemplative accounts of compassion and loving-kindness practices with research from social cognitive neuroscience and social psychology to generate predictions about how diverse practices may alter brain structure and function and related aspects of social cognition. Contingent on the nuances of the practice, kindness-based meditation may enhance the neural systems related to faster and more basic perceptual or motor simulation processes, simulation of another’s affective body state, slower and higher-level perspective-taking, modulatory processes such as emotion regulation and self/other discrimination, and combinations thereof. This theoretical model will be discussed alongside best practices for testing such a model and potential implications and applications of future work.

A new era for mind studies: training investigators in both scientific and contemplative methods of inquiry.

The study of the human mind has evolved over the course of many centuries. While modern neuroscience relies on objective, quantitative methods for measuring how mental events manifest as brain activity, ancient contemplative traditions have used first-person introspective practices to gain a greater understanding of the mind. It is now possible to combine these different approaches, hopefully in a mutually enriching, synergistic way. As proposed by the late Francisco J. Varela, studying the conscious mind could greatly benefit from bringing together the “first-person” perspective of a well-trained experimental subject with the “third-person” perspective of an outside observer (i.e., a scientist measuring brain activity). Varela called this approach neurophenomenology, referring to the combination of neural measurements with the style of inquiry of classic phenomenology (Varela, 1996). In neurophenomenology experiments, the subject is actively involved in describing his moment-by-moment conscious experience and is sometimes asked to generate specific mind states, while the experimenter is guided by these first-person data in the analysis and interpretation of physiological data (Lutz and Thompson, 2003). This methodology can be used to better account for seemingly random fluctuations in brain activity, which are usually discarded as “noise” but may reveal key insights into ongoing variations in the subjects inner experience (Lutz et al., 2002; Lachaux, 2011).

Meditation buffers medical student compassion from the deleterious effects of depression

Abstract Increasing data suggest that for medical school students the stress of academic and psychological demands can impair social emotions that are a core aspect of compassion and ultimately physician competence. Few interventions have proven successful for enhancing physician compassion in ways that persist in the face of suffering and that enable sustained caretaker well-being. To address this issue, the current study was designed to (1) investigate the feasibility of cognitively-based compassion training (CBCT) for second-year medical students, and (2) test whether CBCT decreases depression, enhances compassion, and improves daily functioning in medical students. Compared to the wait-list group, students randomized to CBCT reported increased compassion, and decreased loneliness and depression. Changes in compassion were most robust in individuals reporting high levels of depression at baseline, suggesting that CBCT may benefit those most in need by breaking the link between personal suffering and a concomitant drop in compassion.

P02.119. Cognitively-Based Compassion Training reduces peripheral inflammation in adolescents in foster care with high rates of early life adversity

Purpose Children exposed to early life adversity (ELA) demonstrate elevated circulating concentrations of health-relevant inflammatory biomarkers which persist into adulthood. Increased inflammation in individuals with ELA is believed to contribute to the increased risk for medical and psychiatric illnesses observed in these individuals. The objective of this study was to determine whether Cognitively-Based Compassion Training (CBCT) reduces salivary concentrations of C-reactive protein (CRP) in adolescents with high rates of ELA, and to evaluate the relationship between CBCT practice time and changes in CRP. CBCT is a meditation-based program designed to enhance compassion for self and others and to promote prosocial behavior. Based on prior findings, it was hypothesized that practice time during the study would be more strongly associated with reductions in CRP than would group assignment.

Cognitively-Based Compassion Training (CBCT) in Breast Cancer Survivors: A Randomized Clinical Trial Study

Context. Breast cancer (BC) requires a significant psychological adaptation once treatment is finished. There is growing evidence of how compassion training enhances psychological and physical well-being, however, there are very few studies analyzing the efficacy of compassion-based Interventions on BC survivors. Objective. To study the efficacy of the Cognitively-Based Compassion Training (CBCT) protocol in a BC survivor sample on quality of life, psychological well-being, fear of cancer recurrence, self-compassion, and compassion domains and mindfulness facets. Furthermore, enrollment, adherence, and satisfaction with the intervention were also analyzed. Methods. A randomized clinical trial was designed. Participants (n = 56) were randomly assigned to CBCT (n = 28) or a treatment-as-usual control group (TAU; n = 28). Pre-post intervention and 6-month follow-up measures took place to evaluate health-related quality of life, psychological well-being; psychological stress, coping strategies, and triggering cognitions; self-compassion and compassion; and mindfulness in both intervention and wait-list groups. Results. Accrual of eligible participants was high (77%), and the drop-out rate was 16%. Attendance to CBCT sessions was high and practice off sessions exceeded expectations). CBCT was effective in diminishing stress caused by FCR, fostering self-kindness and common humanity, and increasing overall self-compassion scores, mindful observation, and acting with awareness skillsets. Conclusion. CBCT could be considered a promising and potentially useful intervention to diminish stress caused by FCR and enhance self-kindness, common humanity, overall self-compassion, mindful observation, and acting with awareness skillsets. Nevertheless, future randomized trials are needed and a process of deeper cultural adaptation required.

Enhancing Social Interaction in Depression (SIDE study): protocol of a randomised controlled trial on the effects of a Cognitively Based Compassion Training (CBCT) for couples

Introduction Positive social interactions (PSIs) and stable relationships can exert substantial benefits on health. However, patients suffering from depression benefit less from these health-promoting effects. Moreover, relationship quality and even partners’ health has been found to be negatively affected by depressive symptomatology, which may result in overall impairments in social functioning of a romantic couple. Psychobiological research indicates that these impairments may be accompanied by a maladaptive regulation of the patient’s neuroendocrine response to external stressors. Concerning the improvement of social functioning, first studies showed promising results of “Cognitively Based Compassion Training (CBCT®)”. However, randomised trials are still scarce. Previous programmes did not involve participation of the patient’s romantic partner. Therefore, the present study aims to investigate whether a CBCT® programme adapted for couples (CBCT®-fC) can improve depressive symptoms, distress, social interaction skills and the neurobiological regulation of stress. Methods and analysis Couples with the female partner suffering from depression will be invited to participate in a pre-to-post intervention assessment on two consecutive days, respectively, involving a standardised PSI task, eye-tracking, ECG recordings, saliva-sampling, blood-sampling and questionnaire data. After baseline assessment, participating couples will be randomised to either a 10 week CBCT®-fC or to a treatment as usual control condition. The primary endpoint is the reduction of depressive symptoms measured by the Hamilton Depression Rating Scale. Secondary outcomes encompass self-rated depression (Beck Depression Inventory), attention towards the partners face during PSI (eye tracking), stress-related biomarkers (cortisol, α-amylase, interleukin (IL)-1ß/IL-6, heart rate variability), methylation of oxytocin-receptor-genes and serotonin-transporter-genes and self-ratings of psychological constructs such as relationship quality and empathy. Ethics and dissemination Ethical approval has been obtained by the Ethics Committee of the Medical Faculty Heidelberg. Results will be presented in international, peer-reviewed journals and on conferences in the field of clinical psychology and psychiatry. Trial registration number NCT03080025.