GelGreen br sessions included presentation of theoretical ma
sessions included presentation of theoretical materials on mindfulness, relaxation, and the mind-body connection and experiential practice of meditation and gentle movement exercises (e.g., mindful walking). The intervention addresses key aspects of eudaimonic well-being, including self-acceptance, positive relations with others, personal growth, and purpose in life. Specifically, cultivating an attitude of self-acceptance was addressed throughout the intervention through reminders by the instructor to be kind to oneself, or “gently” return attention to the present moment during meditative exercises. Weeks 3 and 4 included practice of loving kindness meditation, in which participants were asked to generate caring, warm, and positive feelings toward the self and others. Weeks 4 and 5 focused on practicing GelGreen mindful approach to working with difficult emotions, which involves recognizing emotions, accepting them as part of the human experience, and learning to shift one’s relationship with difficult thoughts by “disidentifying,” or creating a sense of space or relief from difficult thoughts. Disidentifying has been theorized to increase the ability to positively reappraise the environment and allow for personal growth and meaning making (Garland et al., 2015).
2.3.1. Demographic and health history variables
Information on participant age, ethnicity, income, marital status, and type of treatment received was collected via self-report ques-tionnaire. Time since diagnosis and disease stage was collected via tumor registry records.
2.3.2. Eudaimonic well-being, hedonic well-being, and depressive symptoms Eudaimonic and hedonic well-being were assessed with the Mental Health Continuum-Short Form (MHC-SF; Keyes, 2002), which has high reliability and validity (Lamers et al., 2010). Eudaimonic well-being was assessed with two subscales capturing psychological and social well-being. The 6-item psychological well-being subscale addresses each of six theorized components of eudaimonic well-being as articulated by Ryff (2018): purpose in life, personal growth, positive relations, self-acceptance, autonomy and environmental mastery. The 5-item social well-being subscale assesses constructs like social integration, social acceptance, and social coherence (e.g., “that the way our society works makes sense to you”). Hedonic well-being was assessed with the 3-item hedonic well-being subscale, which consists of the following items: happy, interested, satisfied. For each scale item on the MHC-SF, parti-cipants indicate the frequency of feelings of well-being over the past month (0 = never; 1 = once or twice a month; 2 = about once a week; 3 = two or three times a week; 4 = almost every day; 5 = every day). In the current study, one participant did not complete the MHC-SF, leaving a final sample of 21 participants. Internal consistency was high
at the pre- and post-intervention assessment (α’s > 0.80). Depressive symptoms were assessed with the 20-item Center for
Epidemiologic Studies-Depression scale (CES-D; Radloff, 1977). Parti-cipants rated how often they had experienced symptoms of depression during the past week (0 = none of the time or rarely; 3 = most of the time). Internal consistency was high at the pre- and post-intervention assessment (α > 0.84).
2.3.3. Transcriptome profiling
At each time point morning blood samples (7:30-11:00AM) were collected by venipuncture, peripheral blood mononuclear cells (PBMC) were isolated by standard ficol gradient centrifugation, and CD14+ cells were isolated from PBMC by immunomagnetic positive selection (MACS, Miltenyi Biotec). CD14+ cells were selected because they are a primary source of pro-inflammatory cytokines and pro-inflammatory gene expression in the context of chronic stress (Miller et al., 2008b, 2014; Powell et al., 2013). RNA was extracted (Qiagen RNeasy), tested for suitable mass (Nanodrop ND1000) and integrity (Agilent TapeSta-tion), converted to fluorescent cRNA (Ambion TotalPrep) and Psychoneuroendocrinology 103 (2019) 173–179
hybridized to Illumina Human HT-12 v4 BeadArrays following the manufacturer’s standard protocol in the UCLA Neuroscience Genomics Core Laboratory. All samples were assayed in a single batch, quantile normalized, and log2-transformed for statistical analysis as described below. All but one sample yielded technically valid results according to study-specific probe signal distribution metrics (median intensity > 100 units). The paired (baseline) sample for the single invalid ob-servation was removed prior to analysis, as was the baseline sample from a second participant who provided no follow-up sample, leaving a final set of 20 paired baseline and follow-up samples available for analysis of change in gene expression.