Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction

“The following recommended values were used as criteria for good model fit: (1) non-significant v2 value; (2) comparative fit index (CFI) [ .95; (3) root mean square error of approximation (RMSEA) \ .06; and (4) standardized root mean squared residual (SRMR) \ .08 (Hu and Bentler 1999; Kline 2004).”

“Meditation and mindfulness have roots in various religious traditions (Kabat-Zinn 2003; Walsh and Shapiro 2006), and this study found that over 50% of survey respondents said that taking Mindfulness-Based Stress Reduction deepened their sense of spirituality.”

“Effect sizes for prepost change scores were determined using the formula for paired samples (d = t/Hdf) ( Rosenthal 1991 ).”

“Recent reviews of clinical and non-clinical populations report that Mindfulness-Based Stress Reduction training enhances mental health and quality of life (Baer 2003; Bohlmeijer et al. 2010; Chiesa and Serretti 2009; Greeson 2009; Grossman et al. 2004; Hofmann et al. 2010).”

“Recent reviews of clinical and non-clinical populations report that Mindfulness-Based Stress Reduction training enhances mental health and quality of life (Baer 2003; Bohlmeijer et al. 2010; Chiesa and Serretti 2009; Greeson 2009; Grossman et al. 2004; Hofmann et al. 2010).”

“While there is some controversy over the precise usage of the term spirituality, a functional definition includes ‘‘the personal quest for understanding answers to ultimate questions about life, about meaning, and about relationship to the sacred or transcendent’’ (Koenig et al. 2001).”

“…meditation can foster an increased sense of spirituality by disengaging from a narrow self-focus, and engaging a much broader view of interconnectedness in which oneself is not seen as separate from everyday activities, other people, or the world (Kabat-Zinn 1994; Kristeller and Johnson 2005).”

“least two previous outcome studies (Carmody and Baer 2008; Carmody et al. 2008) documented a significant association between increased mindfulness following Mindfulness-Based Stress Reduction and reduced selfreported medical symptoms, the current study did not find a significant relationship between increased mindfuln…”

“Recent reviews of clinical and non-clinical populations report that Mindfulness-Based Stress Reduction training enhances mental health and quality of life (Baer 2003; Bohlmeijer et al. 2010; Chiesa and Serretti 2009; Greeson 2009; Grossman et al. 2004; Hofmann et al. 2010).”

“6) was nearly one standard deviation below the validation sample mean (Feldman et al. 2007).”

“The present findings are consistent with previous reports that mindfulness meditation training can enhance certain aspects of spirituality (Astin 1997; Shapiro et al. 1998), and that increases in spirituality following Mindfulness-Based Stress Reduction are associated with greater levels of mindfulness and mental heal…”

“While expectancy may be considered a component of the placebo response, it is also closely related to motivation and may direct intentions and behavior (Delsignore and Schnyder 2007; Maddux et al. 1986; Wigfield 1994).”

“There is consistent evidence that spirituality can contribute to emotional well-being and can provide resilience to stress (Southwick et al. 2005).”

“Recent reviews of clinical and non-clinical populations report that Mindfulness-Based Stress Reduction training enhances mental health and quality of life (Baer 2003; Bohlmeijer et al. 2010; Chiesa and Serretti 2009; Greeson 2009; Grossman et al. 2004; Hofmann et al. 2010).”

“Self-report of spirituality using the Daily Spiritual Experiences Scale may have been confounded by items such as gratitude, peace, and harmony, which can contribute to both spirituality and positive mental health (Koenig 2008).”

“These positive outcomes have been related in part to enhanced mindfulness (Carmody and Baer 2008; Carmody et al. 2008; Nyklı́ček and Kuijpers 2008; Shapiro et al. 2008).”

“Meditation and mindfulness have roots in various religious traditions (Kabat-Zinn 2003; Walsh and Shapiro 2006), and this study found that over 50% of survey respondents said that taking Mindfulness-Based Stress Reduction deepened their sense of spirituality.”

“These findings are consistent with a wealth of medical literature, which reports an association between positive expectancy and non-specific treatment effects (Harrington 1999; Stewart-Williams and Podd 2004).”

“The present findings are consistent with previous reports that mindfulness meditation training can enhance certain aspects of spirituality (Astin 1997; Shapiro et al. 1998), and that increases in spirituality following Mindfulness-Based Stress Reduction are associated with greater levels of…”

“The possibility that enhanced attention to and awareness of the divine, the transcendent, and the interconnectedness of all things engenders greater mindfulness and mental health is consistent with both Eastern contemplative traditions and Western psychological theory ( Wallace and Shapiro 2006 ).”

“A small number of clinical studies have shown that Mindfulness-Based Stress Reduction is associated with increased aspects of spirituality, including personal faith, meaning and peace, and a sense of engagement and closeness with some form of higher power or God (Astin 1997; Birnie et al. 2010; Carmody et al. 2008; Sh…”

“These characteristics were consistent with the general demographics of the Duke Mindfulness-Based Stress Reduction program and were similar to those reported in previous outcome studies at large academic medical centers (Carmody and Baer 2008; Carmody et al. 2009; Reibel et al. 2001).”

“Several previous studies of self-selected community Mindfulness-Based Stress Reduction program participants with lower levels of self-rated physical health at study entry reported significant improvement in physical health-related quality of life following mindfulness meditation training (Reibel et al. 2001; Rosenzwei…”

“Self-report of mindfulness may not provide accurate assessment, particularly for individuals with little to no meditation experience (Grossman 2008).”

“Future studies are needed to formally assess this possibility, since religious and spiritual beliefs and their associated behaviors and biology may represent an important mechanism linking contemplative practices to improved mental and physical health (Park 2007; Wachholtz et al. 2007).”

“These characteristics were consistent with the general demographics of the Duke Mindfulness-Based Stress Reduction program and were similar to those reported in previous outcome studies at large academic medical centers (Carmody and Baer 2008; Carmody et al. 2009; Reibel et al. 2001).”

“least two previous outcome studies (Carmody and Baer 2008; Carmody et al. 2008) documented a significant association between increased mindfulness following Mindfulness-Based Stress Reduction and reduced selfreported medical symptoms, the current study did not find a significant relationship between increased mindfuln…”

“…training can enhance certain aspects of spirituality (Astin 1997; Shapiro et al. 1998), and that increases in spirituality following Mindfulness-Based Stress Reduction are associated with greater levels of mindfulness and mental health (Birnie et al. 2010; Carmody et al. 2008; Garland et al. 2007).”

“Items were reverse scored so that higher total scores indicated increased perceptions of self-transcendence and daily spiritual experiences (Underwood 2006).”

“12-item Short-Form Health Survey (SF-12)—The SF-12 is a valid and reliable means of assessing health-related quality of life in both normative and clinical samples (Gandhi et al. 2001).”

“While expectancy may be considered a component of the placebo response, it is also closely related to motivation and may direct intentions and behavior (Delsignore and Schnyder 2007; Maddux et al. 1986; Wigfield 1994).”

“Several previous studies of self-selected community Mindfulness-Based Stress Reduction program participants with lower levels of self-rated physical health at study entry reported significant improvement in physical health-related quality of life following mindfulness meditation training (Reibel et al. 2001; Rosenzwei…”

“In theory, mindfulness meditation can foster an increased sense of spirituality by disengaging from a narrow selffocus, and engaging a much broader view of interconnectedness in which oneself is not seen as separate from everyday activities, other people, or the world (Kabat-Zinn 1994; Kristeller and Johnson 2005).”

“Alternatively, Mindfulness-Based Stress Reduction as an intervention may not have a strong effect on the physical component of the Short Form Health Survey (Plews-Ogan et al. 2005).”

“closely related to motivation and may direct intentions and behavior (Delsignore and Schnyder 2007; Maddux et al. 1986; Wigfield 1994).”

“Scores on this well-validated scale have previously been related to quality of life and positive psychosocial status in normative samples (McCauley et al. 2007; Underwood and Teresi 2002).”

“As such, the experience of mindfulness has been described as a method of self-transcendence (Phelan 2010; Singh 2010).”

“As such, the experience of mindfulness has been described as a method of self-transcendence (Phelan 2010; Singh 2010).”

“It is assumed that mindfulness is a central mechanism of MBT (e.g., Bränström, Kvillemo, Brandberg, & Moskowitz, 2010; Greeson et al., 2011; Kuyken et al., 2010; Shahar, Britton, Sbarra, Figueredo, & Bootzin, 2010) that might enhance positive affect, decrease negative affect, and reduce maladaptive…”

“Total sample sizes (n) were typically between 30 and 155, with 3 studies having sample sizes less than 30(60,67) and 3 studies with sample sizes more than 155.(69,75,78) The samples with which the mindfulness-based stress reduction interventions for stress management were conducted were in undergraduate students (n 1⁄…”

“Increases in spirituality have been linked to both yoga practice (Bussing, Hedtstuck, Khalsa, Ostermann, & Heusser, 2012) and decreases in stress (Greeson et al., 2011).”

“Mindfulness scores fell approximately one standard deviation below a published norm for college students(31), and was comparable to a sample of adults who participated in an 8-week, self-pay MindfulnessBased Stress Reduction (MBSR) program.(32) Self-compassion fell nearly one standard deviation below the college stude…”

“, 2004), spirituality (S. L. Shapiro et al., 1998; Astin, 1997; Greeson et al., 2011), self-compassion (Lykins & Baer, 2009; S.”

“16 It remains to be determined, however, whether having a religious affiliation, engaging in MBSR for spiritual growth, or being more or less attuned to daily spiritual experiences might predict decreased depression symptoms following MBSR. Similarly, relatively little is known regarding potential sex or age difference…”

“For example, individuals participating in an eight-week Mindfulness-Based Stress Reduction course evidenced increases in trait mindfulness which mediate the effects of training on clinical outcomes (Carmody and Baer, 2008; Greeson et al., 2011).”

“…the effects in the present study were generally small to medium (with the exception of a large effect for rumination), while effects sizes found in previous MBSR studies have typically been medium to large (see Carmody and Baer, 2008; Carmody, Baer, Lykins, & Olendzi, 2009; Greeson et al., 2011).”

“ward the mean and has precedent in past MBSR research (Greeson et al. 2011).”

“Trait mindfulness can be promoted by repeated practice of mindfulness meditation [7, 8].”

“For example, individuals participating in an eightweek Mindfulness-Based Stress Reduction course evidenced increases in trait mindfulness which mediate the effects of training on clinical outcomes [19, 20].”

“Previous psychometric evaluation of the CAMS-R in students found the instrument to be reliable and valid,(29) and sensitive to change following MBSR.(30) Cronbach's α was 0.”

“Although mindfulness practice is often described as secular and non-conceptual (e.g. Gunaratana, 1990; Thera, 1973), others conceptualize mindfulness training as compatible with spiritual concepts (e.g. Bergemann et al., 2013; Greeson et al., 2011; Kristeller, 2010).”

“Questionnaire to measure meditation depth The questionnaire was a modified version of the ‘Cognitive and Affective mindfulness Scale-Revised (CAMS-R)’ (Feldman, Hayes, Kumar, greeson, & Laurenceau, 2007), which has demonstrated good internal reliability in greeson et al. (2011) with a Cronbach α of .”

“Many elements and exercises of MBRT are drawn from MBSR (Kabat-Zin 1990), with adaptations made to engage and respond to the specific culture and needs of LEOs (see Christopher et al. 2015 for full description of the intervention).”

“Increase in one’s spiritual experience (awareness of and relationship with the transcendent), which may assist in recovery, may be partially mediated by practice of mindfulness and related neurobiological changes (attention, present-moment focus, awareness, and nonjudgment (Carmody et al., 2008; Greeson et al., 2011).”

“Mindfulness training can affect and improve health-related quality of life by enhancing spirituality [40], and mindfulness can improve the spirituality of healthy adults [39,41].”

“…have evidence of internal consistency and convergent and discriminant validity (Baer et al. 2006; Feldman et al. 2007) and clinical utility in terms of sensitivity to change and association with symptom improvement in mindfulness-based interventions (Carmody et al. 2009; Greeson et al. 2011).”

“Other studies suggest that mindfulness may work via intermediate factors (Carmody et al. 2009; Greeson et al. 2011), suggesting an indirect effect.”

“Among other psychosocial variables, the questionnaires assessed dispositional (trait) mindfulness, along with symptoms of stress, cognitive perseveration, emotion regulation, and sleep quality [24, 25].”

“A number of psychological mechanisms by which mindfulness-based interventions might positively affect health in cancer patients have been proposed, including changes in mindfulness [30, 31], coping strategies [20, 31], and perhaps spirituality [32, 33].”

“Second, in the light of evidence suggesting that spirituality may be a possible mechanism by which mindfulness training leads to beneficial outcomes such as improvements in medical and psychological symptoms (Carmody et al., 2008; Greeson et al., 2011),”

“There is natural variation in trait mindfulness in the population in the absence of mindfulness training (Brown and Ryan, 2003), and training in mindfulness has been demonstrated to increase trait mindfulness (Brown and Ryan, 2003; Shapiro et al. , 2007; Greeson et al. , 2011; Robins et al. , 2012).”

“6 7–9 In Hong Kong, around 14% of people follow Bud-dhism and > 14% follow Daoism.”

“26 Another intervention study compared a secular mindfulness training (n=49) with a modified Christian MBI (n=42) in college students, and found that while both groups reported decreases in depressive, anxiety, and stress scores, those in the modified Christian group reported greater reductions of…”

“The CAMS-R has been shown to possess acceptable levels of internal consistency (α = .81, n = 279, Greeson et al., 2011, α = .77, n = 298, Feldman et al., 2007).”

“05), according to the design proposed by Guilford (1973). Moreover, the explanatory power of mindfulness in predicting students’ cumulative averages, which accounted for only 1% of the total variance, was low, as indicated by Cohen’s (1988) standard.”

“…by nutritional or exercise habits or sustainable living, indicated by different sustainable consumption scales (S. M. Geiger et al., 2019; Lentz et al., 2019; Soriano-Ayala et al., 2020); relationship quality (McGill et al., 2016); and spirituality (Carmody et al., 2008; Greeson et al., 2011).”

“81 (Greeson et al. 2011) and α=.”

“[7] There is a growing body of research supporting the potential of art therapy in reducing emotional distress, depression, anxiety, and pain in cancer patients undergoing chemotherapy.”

“…of coherence, an altered perception of stressors, development of an observing attitude, changes in spirituality, improved attention-related functions, and cognitive flexibility (Dobkin, 2008; Dobkin & Zhao, 2011; Greeson et al., 2011; Kerr, Josyula, & Littenberg, 2011; Moore & Malinowski, 2009).”

“…practice display similar outcomes, both employ comparable methods, and have been shown through self-report measures to have a relationship (Greeson et al., 2011), we feel it is valuable to analyse what the similarities and differences are in terms of neural activation patterns and changes…”

“…healing techniques because of growing consumer demands (Crammer et al. 2011; Wu et al. 2009; Fabian et al. 2005; Menniti-Ippolito and De Mei 1999); some leading medical journals are dedicating space for alternative treatments that are evidence based (Lake et al. 2012; Greeson et al. 2011).”

“Another study also recruited study participants from a self-paid, community-based MBSR program and showed statistically significant pre-post improvement in mental health, as measured by the Short-Form Health Survey, Mental Component Score (Greeson et al. 2011).”

“Findings of a study by Greeson et al. (2011), according to exploratory mediation model have been suggested a novel mechanism by which increased spirituality following Mindfulness-Based Stress Reduction accounted for improved mental health-related quality of life both directly and indirectly, as a…”

“The methods and participants for this study have been described in detail elsewhere (Greeson et al., 2011).”

“In fact, some studies have also suggested that gains in spirituality may in fact mediate the positive effects of mindfulness training in predicting symptom reduction and well-being (Greeson et al., 2011).”

“Meditation involves cultivating spirituality by helping an individual to broaden their self-perception and adopt a wider view of interconnectedness with activities, people, and the world around them (Greeson et al., 2011).”

“An 8‐week Mindfulness‐Based Stress Reduction (MBSR) program showed increase in the trait mindfulness of the participants, which mediate the effects of training on clinical outcomes.[24,25] In a similar study, 8 weeks of yoga training resulted in significant increases in trait happening in the present”).”

“…Koru, developed specifically for college students by psychiatrists at Duke University (Rogers & Maytan, 2012) and found significant increases in both self-compassion and mindfulness, as well as improved sleep (Greeson et al., 2011) after participating in the mindfulness meditation intervention.”

“However, although many mindfulness-based interventions have adopted a secular context (Kabat-Zinn, 1990), they still demonstrate mindfulness-based programs with enhanced levels of spirituality (Carmody, Reed, Kristeller, & Merriam, 2008; Greeson et al., 2011).”

“There is also initial evidence that mindfulness-based programs may promote spiritual well-being (e.g., Carmody et al., 2008; Greeson et al., 2011).”

“CAMS-R showed convergent validity with alternative measures of mindfulness, an acceptable level of internal consistency (Feldman et al., 2007) and appeared sensitive to intervention-related changes (Greeson et al., 2011).”

“This method for measuring change has been used in previous research of MBIs 38 and corrects for statistical regression toward the mean.”

“Empirically, mindfulness meditation training promoted daily spirituality in healthy, but mentally stressed adults (Greeson et al., 2011).”

“[15],theassessmentofoverallqualityoflifeamong peoplewithlowincomesissignificantlyhigherthan inpeoplewithverylowincomes.”

“…Kaynakçı & yerin güneri, 2023). caMS-R’s clinical value is reinforced by its sensitivity to change following mindfulness-based therapies and training (greeson et al., 2011). the caMS-R’s shortness and conceptual breadth make it a useful stand-alone measure of dispositional mindfulness for…”

“The influence of mindfulness-based stress reduction on positive mental health may be mediated by an increase in day-to-day spiritual experiences (Greeson et al, 2011).”