The overall goal of this RO1 project is to develop and validate a set "platform" of biological and psychological characteristics (i.e., biopsychomarkers) that predict and indicate patient (Pt) response to mindfulness-based stress reduction (MBSR) and verify that a tailored MBSR approach improves the quality and consistency of MBSR on disease outcomes. Our preliminary data demonstrate that only a subset of ulcerative colitis (UC) Pts respond to MBSR with improved disease outcomes which is in agreement with the literature which reports similar mixed outcomes with mindfulness therapy when it has been applied to other diseases, suggesting that certain biopsychomarkers may impact success. Thus, we hypothesize that the differential responses to MBSR are a consequence of individual variance in biopsychomarkers at the onset of MBSR therapy. The objective of the current proposal is then to identify and verify predictive biopsychomarkers and reliable measurable outcomes as determinants of MBSR success. To achieve this objective we propose two Specific Aims. Aim1: Develop a set of biopsychomarkers, comprised of key psychological and biological characteristics that (a) predict UC Pt response to MBSR and (b) establish an objective set of markers that demonstrate the impact of MBSR on well-being and UC disease state. Aim 2: Verify the impact of Pt and intervention tailoring in order to determine whether (a) tailoring Pt selection based on biopsychomarkers, and whether (b) tailoring of MBSR treatment protocol will impact MBSR's effects on inflammatory pathways and markers of disease and psychological well-being in UC Pts. Accomplishing these Aims will establish an objective set of Pt characteristics that predict effectiveness of MBSR resulting in increased quality and consistency of MBSR as a therapeutic approach. This should open new innovative therapeutic applications for MBSR for the treatment of chronic inflammatory diseases. PUBLIC HEALTH RELEVANCE: The overall objective of this proposal is to modify mindfulness therapy to establish reliable and consistent results for patients with chronic inflammatory diseases using ulcerative colitis (UC) as a model inflammatory disease and mindfulness-based stress reduction (MBSR) as the intervention. We will develop and validate a set "platform" of biological and psychological characteristics (i.e., biopsychomarkers) that predict and indicate patient response to MBSR and a tailored MBSR approach that improves well-being and disease outcomes. Identifying this objective set of criteria would increase the quality and consistency of MBSR and lead to a better understanding of the clinical utility of MBSR as an intervention for chronic inflammatory diseases such as UC. By so doing we would greatly improve our ability to help people with chronic diseases using this CAM approach.