Mindfulness
DOI 10.1007/s12671-014-0320-4
ORIGINAL PAPER
A Brief Mindfulness Exercise Reduces Cardiovascular Reactivity
During a Laboratory Stressor Paradigm
Patrick R. Steffen & Michael J. Larson
# Springer Science+Business Media New York 2014
Abstract Mindfulness meditation is increasingly used in
health interventions and may reduce stress and blood pressure.
We aimed to investigate the effectiveness of brief mindfulness
meditation in reducing cardiovascular reactivity and recovery
during a laboratory stressor. We randomly assigned 62
meditation-naïve participants to a mindfulness meditation
group or a matched non-mindful listening exercise control
group. There were no differences between groups in blood
pressure, demographic, or mood variables at baseline. Mind-
fulness participants showed lower systolic blood pressure
following the mindfulness exercise and decreased systolic
and diastolic blood pressure reactivity during a speeded math
stressor. Specifically, as the stressor progressed, blood pres-
sure in the mindfulness group began to decrease, whereas in
the control group, it continued to increase. There were no
group differences during recovery. Overall, brief mindfulness
meditation reduced cardiovascular reactivity to stress and may
be an effective intervention for reducing stress-related blood
pressure reactivity.
Keywords Stress . Mindfulness . Meditation . Blood
pressure . Cardiovascular reactivity
Introduction
One third of Americans report experiencing high levels of
chronic stress with which they feel they cannot adequately
P. R. Steffen (*)
Department of Psychology, Brigham Young University, Provo, UT,
USA
e-mail: steffen@byu.edu
M. J. Larson
Department of Psychology and Neuroscience Center, Brigham
Young University, Provo, UT, USA
cope (Keller et al. 2012; American Psychological Association
2008). Stress negatively impacts health and plays a significant
role in the development and progression of cardiovascular
disorders such as hypertension (Cohen et al. 2007; Keller
et al. 2012; American Psychological Association 2008) and
predicts the development of heart disease (Carroll et al. 2012),
the leading cause of death in all developed countries (Mathers
et al. 2009). In spite of the existence of effective interventions
for chronic disorders such as hypertension and heart disease,
approximately one half of persons receiving medical treatment
fail to fully adhere to treatment recommendations (Centers for
Disease Control 2010; Haynes et al. 2008). For example, only
50 % of those with diagnosed hypertension have their blood
pressure within desirable limits, often because they do not
follow their treatment recommendations as prescribed due to
negative side effects (Egan et al. 2010; Ockene et al. 2002).
According to the World Health Organization, it is more cost
effective to improve adherence than it is to try to improve
treatments (World Health Organization 2003). Utilizing treat-
ments with less negative side effects is one possible way to
increase treatment adherence and success.
Mindfulness meditation is increasingly used as a method to
decrease stress and improve health (Chiesa and Serretti 2009,
2010; Grossman et al. 2004; Hofmann et al. 2010). Mindful-
ness meditation interventions typically last between 8 and
12 weeks, have documented small yet meaningful reductions
in stress and blood pressure in clinical populations (i.e., breast
cancer) and in healthy populations, and do not have negative
side effects (Chiesa and Serretti 2009, 2010; Goldstein et al.
2012; Goyal et al. 2014). Brief mindfulness interventions
lasting three to four sessions have also demonstrated reduc-
tions in stress, negative mood, and heart rate (Zeidan et al.
2010). Given the difficulties associated with adherence to
standard interventions, and research showing that both psy-
chotherapy and medication treatments for mental health diffi-
culties only have a mode of one session to convey information

and enact change (e.g., Gibbons et al. 2011), brief effective
interventions are desirable.
Cardiovascular reactivity to stress during brief laboratory
stressors is related to health outcomes over time (Chida and
Steptoe 2010 for a review). High cardiovascular reactivity to
stress and less recovery post-stress predict increased cardio-
vascular disease risk, including increased carotid intima-
media thickness and increased risk for developing hyperten-
sion. The Paced Auditory Serial Addition Task (PASAT;
Gronwall et al. 1977), a speeded math task, is a good potential
laboratory stressor as it increases perceived stress (Hirvikoski
et al. 2011) and blood pressure levels (Carroll et al. 2003,
2011). In the Carroll studies, less blood pressure recovery
following completion of the PASAT predicted increased risk
of hypertension at subsequent 5- and 12-year follow-up ex-
aminations, and predicted mortality over a 16-year period.
Therefore, the PASAT provides a good laboratory-based
stressor to examine cardiovascular reactivity, the effects of
stress on health, as well as for examining potential treatment
options, such as mindfulness meditation.
Mindfulness meditation involves focusing on the present
moment in an open and nonjudgmental way. Although mind-
fulness meditation derives from Buddhist traditions, it has
been adapted for use in Western therapeutic modalities with
less emphasis on spiritual concerns and more on achieving a
mindful point of view. A number of studies show mindfulness
meditation practice related to decreased stress and improved
health (see Goldstein et al. 2012; Goyal et al. 2014; Grossman
et al. 2004; Hofmann et al. 2010 for reviews). Mindfulness-
based cognitive therapy (MBCT) and mindfulness-based
stress reduction (MBSR) are two widely used therapeutic
approaches that have incorporated mindfulness meditation.
Both of these approaches are associated with significant re-
ductions in self-reported stress relative to controls (Bohlmeijer
et al. 2010). Chiesa and Serretti (2009, 2010) hypothesize that
mindfulness reduces emotional reactivity and ruminative
tendencies and thereby reduces stress responsiveness.
Mindfulness meditation significantly reduces perceived
stress. Britton et al. (2012) studied the impact of MBCT on
stress response. They administered the Trier Social Stress Test
(TSST) pre- and post-participation in MBCT to examine
changes in stress over an 8-week period compared to a wait
list control group. Mindfulness meditation significantly re-
duced emotional reactivity to social stress. A neuroimaging
study, using an 8-week mindfulness stress reduction program,
found that decreases in perceived stress were related to de-
creased amygdala gray matter density (Holzel et al. 2010). In
these studies, it appears that mindfulness contributes to stress
reduction through improved emotion regulation, which may
be the pathway through which mindfulness impacts cardio-
vascular reactivity (Britton et al. 2012; Nyklicek et al. 2013).
Mindfulness meditation reduces blood pressure and
cardiovascular reactivity. For example, Nyklicek et al.
Mindfulness
(2013) administered a brief laboratory stressor to a community
sample before and after 8 weeks of MBSR training using an
experimental design. Relative to a waitlist control group,
mindfulness meditation reduced overall blood pressure (BP)
as well as reduced BP reactivity during the second adminis-
tration of the laboratory stressor. Campbell et al. (2012) used
MBSR to show that those higher in BP at baseline had
significant decreases in BP relative to a control group; how-
ever, there were no effects for those with low BP at baseline.
Carlson et al. (2007) used MBSR to show decreased blood
pressure response over time, as well as decreased psycholog-
ical stress. Reviews of the effects of mindfulness on health
conducted by Goldstein et al. (2012), Goyal et al. (2014),
Grossman et al. (2004), and Chiesa and Serretti (2009,
2010) indicate that MBSR predicted decreased BP and better
health outcomes, particularly in younger and healthy popula-
tions suggesting that it may be useful in the prevention of
disease. Overall, the research indicates that mindfulness med-
itation exerts a small but meaningful reductions in stress and
cardiovascular reactivity. It is not known, however, the
amount of mindfulness meditation that is required for positive
health benefits and whether or not brief mindfulness medita-
tion can influence cardiovascular reactivity to a stressor.
Given that cardiovascular reactivity to stress is a significant
predictor of hypertension and heart disease (Carroll et al.
2003, 2011, 2012; Chida and Steptoe 2010) and over one
third of the American population reports experiencing high
levels of stress associated with concomitant declines in im-
mune functioning and mental health (American Psychological
Association 2008; Keller et al. 2012), effective interventions
are sorely needed. A significant benefit of mindfulness is that
it is relatively simple to practice (although difficult to master),
potentially leading to increased treatment adherence even in
novices. The purpose of this study was to examine whether a
brief mindfulness exercise could be used to reduce the phys-
iological effects of the stress response. Using a randomized
experimental design, we specifically addressed three research
questions. First, will engaging in a single-session, brief mind-
fulness exercise result in reduced blood pressure and heart rate
relative to a control group? Second, will a brief mindfulness
exercise reduce cardiovascular reactivity to the PASAT labo-
ratory stressor? Third, will a brief mindfulness exercise in-
crease cardiovascular recovery post-stressor?
Method
Participants
Participants were recruited from undergraduate psychology
courses. Upon expressing interest in the study, participants
were randomly assigned to either a mindfulness group (n=30;
14 females) or a control group (n=32; 17 females). Sample
Mindfulness
characteristics are presented as a function of experimental
group in Table 1. We measured baseline anxiety and depres-
sive symptoms due to previous research that shows depressive
and anxiety symptoms can alter cardiovascular stress reactiv-
ity (e.g., Carroll et al. 2007). Importantly, the groups did not
differ in regard to age, gender distribution, ethnicity, years of
education, baseline depression symptoms measured by the
Beck Depression Inventory-Second Edition (BDI-II; Beck
1996), or baseline trait anxiety, or state anxiety symptoms as
measured by the State-Trait Anxiety Inventory (STAI;
Spielberger et al. 1983). No participants had ever engaged in
mindfulness meditation practices. The study received Institu-
tional Review Board approval before beginning.
Procedure
The experimental and control groups completed the same
procedures, with the exception of the mindfulness exercise.
Upon arrival for the study participants completed written
informed consent followed by a demographic questionnaire
and measures of mood (BDI-II; STAI). Following completion
of the questionnaires, three baseline blood pressure and heart
rate values were collected followed by the mindfulness or
control exercise (with the total baseline period lasting approx-
imately 15 min), PASAT stressor task (approximately 8 min),
and subsequent recovery period (recovery period was 20 min
of sitting in a quiet room). The STAI post-measure was
administered immediately after the PASAT was completed.
Blood pressure and heart rate readings were taken 2 min apart
and averaged together for increased reliability at baseline,
minutes 6 and 8 of the mindfulness or control exercise (Early
Mindfulness), minutes 12 and 14 of the mindfulness or control
exercise (Late Mindfulness), minutes 2 and 4 of the PASAT
stressor (Early PASAT), minutes 6 and 8 of the PASAT stress-
or (Late PASAT), minutes 8 and 10 of the recovery period
(Early Recovery), and minutes 18 and 20 of the recovery
period (Late Recovery). The experiment took about an hour
to complete. Following completion of the study participants
were debriefed regarding the purposes of the research and
provided either $10 per hour or course credit.
To compare brief mindfulness meditation with non-
mindfulness in an experimental setting, participants engaged
in either passive listening or mindfulness exercises from Jon
Kabat-Zinn’s Mindfulness for Beginners two-disk CD set
(Kabat-Zinn 2006). Participants in the mindfulness group
were provided basic standardized instruction on mindfulness
and the importance of focusing on the present moment in an
open and nonjudgmental way. They completed the Mindful-
ness of Breathing exercise from the second CD of Kabat-
Zinn’s Mindfulness for Beginners (total time in the exercise
was 14:33). Participants in the control group also passively
listened to two tracks from the same CD focusing on aware-
ness of the environment and the importance of ethical
behaviors. The specific tracks were Awareness, A Sixth Sense
(time=7:41), and An Ethical Foundation (time=6:30; total
passive listening time=14:19). Notably, the mindfulness and
control tasks included listening to the same voice (Kabat-
Zinn) from the same CDs for approximately the same amount
of time. Thus, the primary difference that was manipulated
was the participation in a mindfulness task versus passive
listening about ethical behaviors and awareness.
Measures
Paced Auditory Serial Addition Task
The PASAT is a speeded mathematics task originally designed
to identify individuals with a head injury and track their recov-
ery (Gronwall 1977). The PASAT is thought to measure speed
of information processing, auditory attention, and working
memory (Tombaugh 2006). Studies indicate that, due to the
speed and complexity of the task, the PASAT can be a stressful
experience and it has been used as a laboratory stressor in
previous research (e.g., Lejuez et al. 2003; Tanosoto et al.
2012). Participants were presented with a random series of
digits from 1 to 9 via recorded voice (ours were presented using
an MP3 player on a personal computer). Participants were
subsequently instructed to consecutively add the digits such
that the current digit is added to the previous digit, not to the
sum of the previous two digits. Participants typically complete
four blocks of fifty digits each block. To increase difficulty and
monotonically manipulate attention load, the interstimulus in-
terval (ISI) decreases across the four blocks from 2.4 s, to 2.2 s,
to 1.6 s, and finally 1.2 s. To be efficient with the laboratory
stressor, we utilized the fastest 1.6-s and 1.2-s ISI blocks that
should be related to the highest stress levels (50 trials for each
block for a total of 100 trials).
Blood Pressure and Heart Rate Data Acquisition
Heart rate, diastolic, and systolic blood pressure data were
collected using a Dinamap Model 8100 automated blood
pressure monitor (Critikon Corporation, Tampa, FL, USA)
that capitalizes on the oscillometric method. Readings were
obtained following the specifications of the manufacturer
using a cuff that was measured and properly sized to fit on
the upper nondominant arm of the participant.
Data Analysis
Before analyzing the research questions, experimental groups
were first compared to examine whether groups were not
significantly different at baseline for demographic, blood
pressure, and mood variables using independent sample t tests
 Mindfulness

Table 1 Sample characteristics by experimental group

Mindfulness (n=30) Control (n=32) Analysis

Mean (SD) or % Mean (SD) or % t or χ2 p

Age 19.9 (2.0) 20.6 (2.3) −1.32 0.18
Gender (% female) 47 % 53 % 0.26 0.61
Ethnicity (% white) 94 % 94 % 0.04 0.95
Education (years) 13.5 (1.4) 14.1 (1.5) −1.70 0.09
BDI-II 6.7 (5.5) 8.0 (8.6) −0.64 0.53
STAI-trait 33.1 (9.3) 35.3 (9.4) −0.93 0.35
STAI-state pre 30.5 (8.1) 30.7 (8.2) −0.08 0.94
STAI-state post 28.1 (10.0) 30.7 (8.7) −1.06 0.30
PASAT % correct first trial 0.60 (0.20) 0.63 (0.25) −0.46 0.65
PASAT % correct last trial 0.53 (0.18) 0.50 (0.23) 0.55 0.59
Baseline SBP (mm/Hg) 116 (10) 116 (12) 0.08 0.93
Baseline DBP (mm/Hg) 68 (7) 69 (10) −0.84 0.41
Baseline heart rate (BPM) 77 (13) 71 (13) 1.89 0.06

BDI-II Beck Depression Inventory-2nd edition, STAI State Trait Anxiety Inventory, SBP systolic blood pressure, DBP diastolic blood pressure, BPM
beats per minute

and chi-square analyses. 2-Group × 7-Time repeated measures
analyses of variance (ANOVAs) were used to analyze the
research questions. We report partial-eta2 (n2a) for ANOVA
effect sizes, and significant main effects and interactions were
decomposed using follow-up contrasts. Main effects for time
were calculated to examine the impact of the experiment on
blood pressure and heart rate from baseline to recovery, in-
cluding the stressor. Time main effects were followed up by
analyses of group × time interactions and tests of group
differences. For the first research question on the effects of
brief mindfulness training on blood pressure and heart rate,
follow-up contrasts were conducted to examine differences
immediately post-manipulation controlling for baseline. For
the second research question on the effects brief mindfulness
training on differences in cardiovascular reactivity to the
PASAT, follow-up contrasts were conducted to examine dif-
ferences from baseline to the beginning of the PASAT and
from the beginning of the PASAT to the end of the PASAT.
For the third research question on the effects of brief mind-
fulness training on cardiovascular recovery after the end of the
stressor, follow-up contrasts were conducted to examine dif-
ferences from baseline to the first recovery period (10 min)
and to the second recovery period (20 min).
Results
We examined whether brief mindfulness training would im-
prove performance on the PASAT and if state anxiety would
be related to worse performance on the PASAT. There were no
between-group differences on state anxiety post-stressor or
PASAT performance (see Table 1). There was a significant
main effect of time for PASAT performance with the average
score decreasing from the first trial to the last trial, F(1,59)=
38.40, p<0.001, ηp2 =0.39. Additionally, the mindfulness
group displayed a nonsignificant trend towards improved
performance on the PASAT over time relative to the control
group, with the group × time interaction approaching signif-
icance F(1,59)=3.20, p=0.08, ηp2 =0.05.
In regards to baseline cardiovascular functioning, the mind-
fulness and control groups did not significantly differ on
systolic and diastolic blood pressure at baseline. There was,
however, a nonsignificant trend for heart rate to be higher in
the mindfulness group at baseline compared to the control
group (t=1.89, p=0.06).
Mindfulness Meditation, Blood Pressure, and Heart Rate
Our first research question addressed the impact of mindful-
ness on cardiovascular functioning immediately following the
brief mindfulness exercise. Age and gender were included as
covariates in all analyses because they were related to the
outcomes of interest with those older and men having higher
BP. Overall, systolic blood pressure (SBP), diastolic blood
pressure (DBP), and heart rate (HR), all changed significantly
over the course of the experiment (see Figs. 1 and 2) regard-
less of experimental group as evidenced by significant main
effects of time in the ANOVAs for SBP, F(6, 342)=51.77,
p<0.001, ηp2 =0.48, DBP, F(6,342)=47.70, p<0.001, ηp2 =
0.46, and HR, F(6,294)=19.65, p<0.001, =0.29. These main
effects were qualified by significant group × time interactions
for SBP, F(6,342)=3.59, p<0.001, ηp2 =0.059, and DBP,
F(6,342)=3.41, p<0.01, ηp2 =0.06, but not HR, F(6,294)=
Mindfulness

Fig. 1 Effects of brief

mindfulness training on systolic
blood pressure reactivity across
tasks

1.49, p=0.19, ηp2 =0.03. Follow-up contrasts examining the 57)=8.12, p=0.006, ηp2 =0.13, but not lower DBP, F(1,57)=
changes from baseline to the end of the mindfulness manipu- 0.37, p=0.31, ηp2 =0.01. Tables 2 and 3 present the means and
lation revealed that mindfulness resulted in lower SBP, F(1, standard deviations for SBP and DBP by experimental group

Fig. 2 Effects of brief

mindfulness training on diastolic
blood pressure reactivity across
tasks
 Mindfulness

Table 2 Means (and standard deviations) of systolic blood pressures by experimental group controlling for age and gender (for the early mindfulness
meditation through late recovery periods; baseline systolic blood pressure is controlled)

Baseline Early mind Late mind Early PASAT Late PASAT Early recovery Late recovery

Mindfulness 116.1 (10.3) 110.1 (9.5) 107.9 (9.4) 119.9 (12.1) 116.9 (11.0) 107.5 (7.0) 109.4 (8.4)
Control 115.9 (12.3) 114.1 (10.5) 112.7 (11.1) 124.7 (16.1) 125.7 (15.8) 112.1 (12.1) 111.2 (11.8)
F (p value) 0.019 (0.89) 6.498 (0.014) 8.893 (0.004) 5.618 (0.021) 15.198 (0.001) 5.714 (0.020) 0.455 (0.503)

at each time point, with the corresponding F and p values
representing the mean group differences controlling for age,
gender, and baseline blood pressure. Overall, at the end of the
brief mindfulness exercise, SBP was significantly reduced in
the mindfulness meditation group relative to the controls, but
DBP was not, in spite of the overall group by time interaction
effect for DBP. The main effects of group were not significant
for SBP, F(1,57)=2.99, p=0.09, DBP, F(1,57)=1.93, p=0.17,
or HR, F(1,57)=2.75, p=0.10.
Mindfulness Meditation and Cardiovascular Reactivity
During the PASAT
Our second research question addressed the impact of mind-
fulness in response to the PASAT laboratory stressor. Con-
trasts examining changes from baseline to the end of the
PASAT stressor revealed that SBP and DBP were lower in
the mindfulness meditation group compared to the controls,
SBP F(1,57)=16.82, p<0.001, ηp2 =0.23 and DBP F(1,57)=
4.64, p < 0.05, ηp2 = 0.08. Interestingly, when examining
follow-up contrasts comparing the beginning to the end of
the PASAT stressor, the mindfulness group decreased 3 mm/
Hg in SBP and 5 mm/Hg in DBP, whereas the control group
increased 1 mm/Hg in SBP and 0.1 mm/Hg in DBP, SBP
F(1,57)=4.26, p<0.05, ηp2 =0.07, and DBP F(1,57)=6.54,
p<0.05, ηp2 =0.10. Heart rate did not differ by group in
response to the PASAT, F(1,57)=1.08, p<0.31, ηp2 =0.02. It
appears that as the stressor continued, the mindfulness group
was less physiologically distressed relative to the control
group. This was true when controlling for baseline BP as well
as controlling for BP at the beginning of the stress task.
Mindfulness Meditation and Cardiovascular Recovery
Our third research question addressed the impact of brief
mindfulness meditation on cardiovascular recovery (i.e.,
return to baseline post-stressor). Contrasts comparing the
baseline period to the 10- and 20-min recovery periods were
examined. For SBP, there was a nonsignificant trend for
mindfulness meditation participants to have lower SBP at
the 10-min recovery, F(1,57)=3.65, p=0.06, ηp2 =0.06, but
there were no significant differences between groups at the 20-
min recovery period, F(1,57)=0.39, p=0.54, ηp2 =0.01. For
DBP, there were no significant between-groups differences at
either the 10-min recovery, F(1,57)=1.45, p=0.23, =0.03, or
the 20 min recovery, F(1,57)=1.71, p=0.20. Heart rate did not
differ by group during the recovery phase of the experiment,
F(1,57)=0.29, p=0.59, ηp2 =0.01 and F(1,57)=0.81, p<0.37,
ηp2 =0.02, respectively.
Discussion
We examined the effects of a single-session, brief mindfulness
exercise on cardiovascular reactivity during a laboratory
stressor. First, we examined whether engaging in a brief
mindfulness exercise would result in reduced blood pressure
and heart rate relative to a control group. The brief mindful-
ness group and the control group did not differ on blood
pressure or heart rate at baseline. We found that SBP was
significantly lower in the brief mindfulness group at the end of
the mindfulness exercise, with no differences in DBP or heart
rate. Second, we examined whether engaging in a brief mind-
fulness exercise would reduce cardiovascular reactivity to the
PASAT laboratory stressor. Those in the brief mindfulness
group displayed lowered SBP and DBP during the stressor.
Third, we examined whether engaging in a brief mindfulness
exercise would increase cardiovascular recovery after the
stressor. The experimental groups did not significantly differ
during the recovery period.

Table 3 Means (and standard deviations) of diastolic blood pressures by experimental group controlling for age and gender (for the early mindfulness
meditation through late recovery periods; baseline diastolic blood pressure is controlled)

Baseline Early mind Late mind Early PASAT Late PASAT Early recovery Late recovery

Mindfulness 67.4 (7.4) 64.7 (7.4) 64.7 (7.0) 76.0 (9.5) 71.5 (7.6) 65.9 (6.3) 66.5 (6.9)
Control 69.5 (9.6) 67.2 (8.6) 65.7 (9.2) 76.3 (11.6) 76.4 (13.7) 65.4 (8.2) 65.7 (7.5)
F (p value) 0.984 (0.325) 2.849 (0.097) 0.404 (0.527) 0.362 (0.550) 5.411 (0.024) 0.053 (0.819) 0.428 (0.516)
Mindfulness

Overall, relative to a control group, brief mindfulness med- pathway through which mindfulness impacts cardiovascular
itation resulted in lowered SBP and DBP reactivity during the functioning is through changes in cognitive functioning
stressor. The brief mindfulness meditation and control groups (Garland 2011). Interestingly, meditation did not impact self-
did not significantly differ at baseline or during recovery reported mood or level of relaxation; similar results were
periods, but the brief mindfulness meditation group displayed found in this study.
lower SBP after the meditation practice and lower SBP and
DBP during the stressor. This was true whether we controlled
Limitations and Future Directions
for baseline BP or BP immediately before the stressor. Spe-
cifically, we found that as the stressor continued, the brief
There are several limitations to keep in mind when
mindfulness meditation group began to decrease in BP, where-
interpreting the findings. First, only a relatively small sample
as the control group continued to increase. Therefore, the brief
of self-selected healthy college students was assessed so it is
mindfulness meditation exercise exerted its effects through
not clear how these results may apply to other groups. Repli-
decreasing cardiovascular reactivity during the stressor itself.
cation in a larger and more diverse sample is needed. Second,
A key implication of this finding is that mindfulness medita-
participants were assessed in one lab session so it is not known
tion can have immediate positive effects for novice meditators
how the brief mindfulness meditation intervention affected
with potential benefits for health and stress reduction and that
participants in the following hours or days. Third, we only
only session may be enough to show some preliminary chang-
measured state anxiety at baseline and during recovery. Ideal-
es. This is important in today’s world of single-session en-
ly, we should have measured anxiety or mood after the mind-
counters with clients, particularly in community mental health
fulness manipulation to assess psychological changes more
settings (e.g., Gibbons et al. 2011).
carefully. Fourth, we did not observe changes in state anxiety
As noted above, several studies show that mindful-
as might be expected. It is possible that a longer laboratory
ness meditation training reduces blood pressure levels
stressor, such as the Trier Social Stress Test, would allow more
over time and cardiovascular reactivity (Campbell et al.
careful assessment of change over time. Future studies can
2012; Carlson et al. 2007; Nyklicek et al. 2013). Our
build upon these findings by assessing anxiety or mood im-
study is the first to show reduced cardiovascular reac-
mediately following the mindfulness meditation intervention
tivity immediately following one session of brief mind-
as well as at baseline and during recovery and employ a longer
fulness meditation practice in novice meditators. This
experimental stressor. Additionally, it would be interesting to
study builds upon the previous studies by showing that
measure how long the effects of the brief mindfulness inter-
cardiovascular effects can occur as early as the first
vention last by studying participants later that same day and
session of training. Focusing on the immediate benefits
during the following days. Manipulating the length of the
of mindfulness practice may help encourage participants
mindfulness exercise (comparing shorter versus longer pe-
to continue practicing and may adherence through sim-
riods) would also help determine the ideal amount of brief
plicity and immediate positive effect. Brief mindfulness
mindfulness practice needed to achieve desired results.
meditation exercises are simple to learn and perform.
This study was approved by the local Institutional Review
Indeed, successful mindfulness meditation practice is
Board before beginning the study, and all participants read and
associated with decreased stress and an increased sense
signed an informed consent form before participating in the
of self-efficacy, which could possibly encourage adher-
study.
ence (Chiesa and Serretti 2009, 2010; Haynes et al.
2008). Future research replicating the current findings
and relating them to adherence is needed to confirm this
possibility. Acknowledgments We gratefully acknowledge the assistance of Justin
Hoskin, Kevin Voisin, and Christina Catron in data collection. Funding
In addition to cardiovascular benefits, brief mindfulness for this study was provided by a Brigham Young University Mentored
interventions can possibly improve cognitive performance Environment Grant and an Office of Research and Creative Activities
(Ramsburg and Youmans 2013). In our study, the effects of Grant to Patrick R. Steffen and Michael J. Larson.
the brief mindfulness exercise on PASAT performance
approached significance, which appeared to be affected by Conflict of Interest The authors have no conflict of interest to disclose.
the control group performing better at baseline. A follow-up
study with a larger sample size may help to reduce baseline
differences in PASAT ability. Ramsburg and Youmans (2013) References
used a brief mindfulness meditation intervention with students
before giving a lecture. Relative to a resting control group, American Psychological Association (2008). 2008 Stress in America
those in the mindfulness meditation group performed better on report. Retrieved from http://www.apa.org/news/press/releases/
a post-lecture quiz. It is important to note that one plausible 2008/10/stress-in-america.pdf.

Beck, A. T. (1996). Beck depression inventory-second edition (BDI-II).
USA: The Psychological Corporation.
Bohlmeijer, E., Prenger, R., Taal, E., & Cuijpers, P. (2010). The effects of
mindfulness-based stress reduction therapy on mental health of
adults with a chronic medical disease: a meta-analysis. Journal of
Psychosomatic Research, 68, 539–544. doi:10.1016/j.jpsychores.
2009.10.005.
Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012).
Mindfulness-based cognitive therapy improves emotional reactivity
to social stress: results from a randomized controlled trial. Behavior
Therapy, 43, 365–380. doi:10.1016/j.beth.2011.08.006.
Campbell, T. S., Labelle, L. E., Bacon, S. L., Faris, P., & Carlson, L. E.
(2012). Impact of mindfulness-based stress reduction (MBSR) on
attention, rumination and resting blood pressure in women with
cancer: a waitlist-controlled study. Journal of Behavioral
Medicine, 35, 262–271. doi:10.1007/s10865-011-9357-1.
Carlson, L. E., Speca, M., Faris, P., & Patel, K. D. (2007). One year pre-
post intervention follow-up of psychological, immune, endocrine,
and blood pressure outcomes of mindfulness-based stress reduction
(MBSR) in breast and prostate cancer outpatients. Brain, Behavior,
and Immunity, 21, 1038–1049. doi:10.1016/j.bbi.2007.04.002.
Carroll, D., Ring, C., Hunt, K., Ford, G., & MacIntyre, S. (2003). Blood
pressure reactions to stress and the prediction of future blood pres-
sure: effects of sex, age, and socioeconomic status. Psychosomatic
Medicine, 65, 1058–1064. doi:10.1097/01.PSY.0000097330.58739.
26.
Carroll, D., Phillips, A. C., Hunt, K., & Der, K. (2007). Symptoms of
depression and cardiovascular reactions to acute psychological
stress: evidence from a population study. Biological Psychology,
75, 68–74.
Carroll, D., Phillips, A. C., Der, G., Hunt, K., & Benzeval, M. (2011).
Blood pressure reactions to acute mental stress and future blood
pressure status: data from the 12-year follow-up of the west of
Scotland study. Psychosomatic Medicine, 73, 737–741. doi:10.
1097/PSY.0b013e3182359808.
Carroll, D., Ginty, A. T., Der, G., Hunt, K., Benzeval, M., & Phillips, A.
C. (2012). Increased blood pressure reactions to acute mental stress
are associated with 16-year cardiovascular disease mortality.
Psychophysiology, 49, 1444–1448. doi:10.1111/j.1469-8986.2012.
01463.x.
Centers for Disease Control and Prevention. (2010). Chronic diseases
and health promotion. Retrieved from http://www.cdc.gov/
chronicdisease/overview/index.htm.
Chida, Y., & Steptoe, A. (2010). Greater cardiovascular responses to
laboratory mental stress are associated with poor subsequent cardio-
vascular risk status. Hypertension, 55, 1026–1032. doi:10.1161/
HYPERTENSIONAHA.109.146621.
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for
stress management in healthy people: a review and meta-analysis.
Journal of Alternative and Complementary Medicine, 15, 593–600.
doi:10.1089/acm.2008.0495.
Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological
and clinical features of mindfulness meditations. Psychological
Medicine, 40, 1239–1252. doi:10.1017/S0033291709991747.
Cohen, S., Janicki-Davis, D., & Miller, G. E. (2007). Psychological stress
and disease. JAMA: Journal of the American Medical Association,
298, 1685–1687. doi:10.1001/jama.298.14.1685.
Egan, B. M., Zhao, Y., & Axon, R. N. (2010). US trends in prevalence,
awareness, treatment, and control of hypertension, 1988–2008.
JAMA: Journal of the American Medical Association, 303, 2043–
2050. doi:10.1001/jama.2010.650.
Garland, E. L. (2011). Trait mindfulness predicts attentional and autonom-
ic regulation of alcohol cue-reactivity. Journal of Psychophysiology,
25, 180–189.
Gibbons, M. B. C., Rothbard, A., Farris, K. D., Stirman, S. W.,
Thompson, S. M., Scott, K., Heintz, L. E., Gallop, R., & Crits-
Mindfulness
Christoph, P. (2011). Changes in psychotherapy utilization among
consumers of services for major depressive disorder in the commu-
nity mental health system. Administration and Policy in Mental
Health, 38, 495–503.
Goldstein, C. M., Josephson, R., Xie, S., & Hughes, J. W. (2012).
Current perspectives on the use of meditation to reduce blood
pressure. International Journal of Hypertension. doi:10.1155/
2012/578397.
Goyal, M., Singh, S., Sibinga, E. M. S., Gould, N. F., Rowland-Seymour,
A., Sharma, R., et al. (2014). Meditation programs for psychological
stress and well-being: a systematic review and meta-analysis. JAMA
Internal Medicine, 174, 357–368. doi:10.1001/jamainternmed.
2013.13018.
Gronwall, D. M. A. (1977). Paced auditory serial addition task: a measure of
recovery from concussion. Perceptual and Motor Skills, 44, 367–373.
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004).
Mindfulness-based stress reduction and health benefits: a meta-
analysis. Journal of Psychosomatic Research, 57, 35–43. doi:10.
1016/S0022-3999(03)00573-7.
Haynes, R. B., Ackloo, E., Sahota, N., McDonald, H. P., & Yao, X.
(2008). Interventions for enhancing adherence to prescribed medi-
cations. Cochrane Database of Systematic Reviews, 16, CD000011.
doi: 0.1002/14651858.CD000011.pub3.
Hirvikoski, T., Olsson, E. M. G., Nordenstrom, A., Lindholm, T.,
Nordstrom, A. L., & Lajic, S. (2011). Deficient cardiovascular stress
reactivity predicts poor executive functions in adults with attention-
deficit/hyperactivity disorder. Journal of Clinical and Experimental
Neuropsychology, 33, 63–73. doi:10.1080/13803395.2010.493145.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect
of mindfulness-based therapy on anxiety and depression: a meta-
analytic review. Journal of Consulting and Clinical Psychology, 78,
169–183. doi:10.1037/a0018555.
Holzel, B. K., Carmody, J., Evans, K., Hoge, E. A., Dusek, J. A., Morgan,
L., & Lazar, S. W. (2010). Stress reduction correlates with structural
changes in the amygdala. SCAN: Social, Cognitive, and Affective
Neuroscience, 5, 11–17. doi:10.1093/scan/nsp034.
Kabat-Zinn, J. (2006). Mindfulness for beginners. Boulder, CO: Sounds
True.
Keller, A., Litzelman, K., Wisk, L. E., Maddox, T., Cheng, E. R.,
Creswell, P. D., & Witt, W. P. (2012). Does the perception that stress
affects health matter? the association with health and mortality.
Health Psychology, 31, 677–684. doi:10.1037/a0026743.
Lejuez, C. W., Kahler, C. W., & Brown, R. A. (2003). A modified
computer version of the paced auditory serial addition task
(PASAT) as a laboratory-based stressor. The Behavior Therapist,
26, 290–293.
Mathers, C. D., Boerma, T., & Fat, D. M. (2009). Global and regional
causes of death. British Medical Bulletin, 92, 7–32. doi:10.1093/
bmb/ldp028.
Nyklicek, I., Mommersteeg, P. M. C., Van Beugen, S., Ramakers, C., &
Van Boxtel, G. J. (2013). Mindfulness-based stress reduction and
physiological activity during acute stress: a randomized controlled
trial. Health Psychology, Advance online publication. doi:10.1037/
a0032200.
Ockene, I. S., Hayman, L. L., Pasternak, R. C., Schron, E., & Dunbar-
Jacob, J. (2002). Task Force #4—Adherence issues and behavior
changes: achieving a long-term solution. Journal of the American
College of Cardiology, 40, 630–651. doi:10.1016/S0735-1097(02)
02077-6.
Ramsburg, J. T., & Youmans, R. J. (2013). Meditation in the higher
education classroom: meditation training improves student knowl-
edge retention during lectures. Mindfulness. Advance online
publication. doi:10.1007/s12671-013-0199-5.
Spielberger, C. D., Gorusch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G.
A. (1983). Manual for the state-trait anxiety inventory. Palo Alto,
CA: Consulting Psychologists Press.
Mindfulness
Tanosoto, T., Arima, T., Tomonaga, A., Ohata, N., & Svensson, P. (2012).
A paced auditory serial addition task evokes stress and differential
effects on masseter-muscle activity and haemodynamics. European
Journal of Oral Science, 120, 363–367. doi:10.1111/j.1600-0722.
2012.00973.x.
Tombaugh, T. N. (2006). A comprehensive review of the paced
autidoty serial addition test (PASAT). Archives of Clinical
Neuropsychology, 21, 53–76. doi:10.1016/j.acn.2005.07.
006.
World Health Organization (2003). Adherence to long-term therapies:
Evidence for action. Geneva, Switzerland: World Health
Organization. Retrieved from http://www.who.int/chp/knowledge/
publications/adherence_full_report.pdf.
Zeidan, F., Johnson, S. K., Gordon, N. S., & Goolkasian, P. (2010).
Effects of brief and sham mindfulness meditation on mood
and cardiovascular variables. Journal of Alternative and
Complementary Medicine, 16, 867–873. doi:10.1089/acm.
2009.0321.