Cited by 307Mindfulness and Compassion InterventionsStress Responses and CortisolVagus Nerve Stimulation Research

A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation

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Rosenkranz, Melissa A., Davidson, Richard J., MacCoon, Donal G., Sheridan, John F., Kalin, Ned H., Lutz, Antoine·2013·Brain, Behavior, and Immunity

Abstract

Psychological stress is a major provocative factor of symptoms in chronic inflammatory conditions. In recent years, interest in addressing stress responsivity through meditation training in health-related domains has increased astoundingly, despite a paucity of evidence that reported benefits are specific to meditation practice. We designed the present study to rigorously compare an 8-week Mindfulness-Based Stress Reduction (MBSR) intervention to a well-matched active control intervention, the Health Enhancement Program (HEP) in ability to reduce psychological stress and experimentally-induced inflammation. The Trier Social Stress Test (TSST) was used to induce psychological stress and inflammation was produced using topical application of capsaicin cream to forearm skin. Immune and endocrine measures of inflammation and stress were collected both before and after MBSR training. Results show those randomized to MBSR and HEP training had comparable post-training stress-evoked cortisol responses, as well as equivalent reductions in self-reported psychological distress and physical symptoms. However, MBSR training resulted in a significantly smaller post-stress inflammatory response compared to HEP, despite equivalent levels of stress hormones. These results suggest behavioral interventions designed to reduce emotional reactivity may be of therapeutic benefit in chronic inflammatory conditions. Moreover, mindfulness practice, in particular, may be more efficacious in symptom relief than the well-being promoting activities cultivated in the HEP program.

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Crossref · 10.1016/j.bbi.2012.10.013

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  • Other longitudinal RCTs showed no sustained attention differences between MBSR and HEP, comparable post-training stress-evoked cortisol responses, and equivalent reductions in self-reported psychological distress and physical symptoms.

    “Other longitudinal Rcts also showed no sustained attention differences between MBsR and heP, MBsR and heP had comparable post-training stress-evoked cortisol responses, as well as equivalent reductions in self-reported psychological distress and physical symptoms (Davidson, 2010;Maccoon et al., 2012;2014;Rosenkranz et al., 2013).”

    From Salivary testosterone and cortisol response in acute stress modulated by seven sessions of mindfulness meditation in young males (2024) · cites this paper as Rosenkranz et al., 2013

    The Results (Cortisol) report no significant MBSR–HEP difference in stress-evoked cortisol response, and the Discussion reports comparable reductions in psychological distress and medical symptoms. The Methods (Participants) say attention outcomes belonged to a larger set of experiments whose results would be reported elsewhere; this paper does not establish the claimed absence of sustained-attention differences. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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  • Later rigorous RCT studies using an active control failed to replicate the positive results of meditation versus waitlist control.

    “however, later rigorous Rct studies using an active control failed to replicate these results.”

    From Salivary testosterone and cortisol response in acute stress modulated by seven sessions of mindfulness meditation in young males (2024) · cites this paper as Rosenkranz et al., 2013

    The Methods (Interventions) describe random assignment to MBSR or an active control. The paper reports comparable reductions in psychological distress, consistent with no added benefit for that outcome, but the Results (Primary analyses: Effects of the intervention) find a significantly smaller post-training inflammatory flare in the MBSR group. It therefore does not support the unqualified claim that active-control studies failed to replicate positive results. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • The waitlist control has been intensively investigated in the meditation field.

    “the waitlist control has been intensively investigated in the meditation field (Davidson, 2010;Maccoon, Maclean, Davidson, saron, & lutz, 2014;Maccoon et al., 2012;Rosenkranz et al., 2013;terburg et al., 2009).”
  • For the past 10 years, more and more meditation studies have used longitudinal RCT design with active controls such as relaxation training, health education or enhancement programs, physical exercise, and cognitive tasks.

    “consequently, for the past 10 years, more and more meditation studies have used longitudinal Rct design with active controls such as relaxation training, health education or enhancement programs, physical exercise, and cognitive tasks (Davidson, 2010;Maccoon et al., 2012;2014;Rosenkranz et al., 2013;terburg et al., 2009).”
  • A series of studies used MBSR versus HEP to validate the active control in meditation.

    “For example, a series of studies used MBsR vs. health enhancement Program (heP) to validate the active control in meditation (Davidson, 2010;Maccoon et al., 2012;2014;Rosenkranz et al., 2013).”

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  1. Thompson C Thompson C 1989 Anxiety The instruments of psychiatric research Wiley New York 127 155

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Authors
Rosenkranz, M. A., Davidson, R. J., MacCoon, D. G., Sheridan, J. F., Kalin, N. H., & Lutz, A.
Affiliations
  • University of Wisconsin–Madison (US)
  • The Ohio State University (US)
Venue
Brain, Behavior, and Immunity
Publisher
Elsevier BV
Published
2013-01
Volume
27
Issue
1
Pages
174-184
ISSN
0889-1591 (ISSN-L)
OpenAlex
W2133206720
Cited by
307
References
93
Citations by year
2026: 13 · 2025: 18 · 2024: 12 · 2023: 33 · 2022: 20 · 2021: 30 · 2020: 19 · 2019: 27 · 2018: 23 · 2017: 26 · 2016: 26 · 2015: 27 · 2014: 24 · 2013: 9
FWCI
21.72
Type
journal article
Language
en
Open access
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5u01at002114-03)
  • National Institute of Mental Health (P50MH069315)
  • National Center for Complementary and Alternative Medicine
  • National Center for Complementary and Integrative Health (U01-AT002114, P01AT004952, U01AT002114-01A1)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD003352)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Keywords
mindfulness-based stress reduction, neurogenic inflammation, psychological stress, meditation training, Trier Social Stress Test, cortisol response, psychological distress, chronic inflammatory diseases
MeSH terms
Adult, Analysis of Variance, Blister, Capsaicin, Female, Humans, Hydrocortisone, Male, Middle Aged, Saliva, Stress, Psychological, Tumor Necrosis Factor-alpha, Interleukin-8, Treatment Outcome, Sensory System Agents, Meditation, Neurogenic Inflammation, Mind-Body Therapies, Young Adult, Self Report

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