Cortisol as a marker for improvement in mindfulness-based stress reduction
Section snippets
Cortisol production in relation to stressors and the stress response
The term “homeostasis” was coined to capture an organism's capacity to maintain certain bodily functions (e.g., body temperature, oxygen) within a narrow range via coordinated physiological mechanisms, despite disturbances in its internal and/or external environment.1 The process by which this regulation is achieved is complex and our understanding of it has evolved markedly over the last century. Initially, Selye posited that, when the integrity of an organism is threatened by exposure to a
The Mindfulness-Based Stress Reduction (MBSR) model
The MBSR program, developed by Kabat-Zinn and colleagues at the University of Massachusetts Stress Reduction Clinic three decades ago, was designed to teach patients how to cope effectively with various chronic medical conditions (e.g., irritable bowel syndrome, chronic pain, cancer). Mindfulness is defined as a refined, systematic, attention-based strategy that focuses on the promotion of present moment awareness, in which thoughts, feelings and/or sensations that arise in the attentional
Benefits of practicing mindfulness
From the program's inception, patients enrolled in MBSR programs at the University of Massachusetts Stress Reduction Clinic completed pre- and post-intervention questionnaires to assess efficacy.16, 17, 18, 19 Patient outcomes have been favorable, with self-reported reductions in physical (i.e., pain and other medical symptoms) and psychological symptomatology (e.g., decreases in depression, anxiety, perceived stress) reported following participation in MBSR programs in various centers around
Can salivary cortisol be an objective marker for stress reduction?
Various physiological responses have been studied in relation to the practice of MBSR including cardiovascular, brain, immune, and endocrine functions.20, 21, 23, 45, 46, 47, 48 Given that cortisol is a hormone secreted in response to stress, we have chosen to evaluate the potential role of this hormonal mediator of the stress response as an objective marker for improvement in those who participate in a MBSR program by reviewing the extant literature on the subject. We acknowledge that cortisol
Summary and critique of existing research on cortisol and MBSR
Table 1 summarizes the literature evaluating the effects of participation in a MBSR program on cortisol levels, systematically identifying variations in the sample, in the intervention, and in the methodology of cortisol assessment, along with the main research findings. There is accumulating evidence indicating that cortisol levels decrease following participation in a MBSR program. Carlson et al. related the effects of participation in a MBSR program on mood, quality of life, stress symptoms,
Conclusions
Herein we examined the potential role of cortisol as an objective marker for improvement in those who complete a MBSR program. When collected using rigorous methods, cortisol is a promising candidate to assess the effectiveness of interventions intended to reduce stress, such as MBSR, as this hormone is secreted by the adrenal glands in response to stress, has been found to be a reliable biological marker of adrenocortical activity, and has generally been found to be responsive to interventions
Conflict of interest
None.
Role of the funding source
The authors would like to acknowledge the Jewish General Hospital of Montreal Segal Center and the Weekend to End Breast Cancer for supporting this research. Additionally, Dr. R. Matousek gratefully acknowledges support from the Strategic Training Program in Palliative Care Research of the Canadian Institutes of Health Research (CIHR).
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