Clin Psychol Rev
July 26, 2011
Stefan G Hofmann, Paul Grossman, Devon E Hinton
945 citations
Loving-kindness meditation (LKM) and compassion meditation (CM) are practices that aim to foster unconditional kindness and compassion. A review of the literature indicates that these practices are associated with increased positive affect and decreased negative affect. Neuroendocrine studies suggest that CM may reduce stress-induced subjective distress and immune response. Neuroimaging findings suggest that LKM and CM may enhance activity in brain areas involved in emotional processing and empathy. Preliminary intervention studies support their use in clinical populations. When combined with empirically supported treatments like cognitive-behavioral therapy, LKM and CM may help address psychological problems involving interpersonal processes, including depression, social anxiety, marital conflict, anger, and the strains of long-term caregiving.
Evidence-based Complementary and Alternative Medicine
January 1, 2015
Stefan G Hofmann, Nicola Petrocchi, James Steinberg et al.
70 citations
Loving-kindness meditation (LKM), a practice aimed at cultivating unconditional kindness toward oneself and others, was tested as a brief group intervention for people with dysthymia or depression in two small, uncontrolled studies—one in Boston (10 participants) and one in Frankfurt (8 participants). At both centers, LKM was associated with large reductions in self-reported depression symptoms and negative affect, and large increases in positive affect. Clinician ratings also showed large improvements in depression, rumination, and specific positive emotions, with moderate gains in adaptive emotion regulation. Qualitative reports supported the intervention's potential. These proof-of-concept results warrant further controlled investigation.
Mindfulness
May 2, 2020
Christina Totzeck, Tobias Teismann, Stefan G Hofmann et al.
62 citations
Loving-kindness meditation (LKM) improved positive mental health and reduced anxiety in the short term among university students in Germany. Over one year, those who completed LKM showed decreased depression, anxiety, and stress, while the control group showed increases in all three. The findings suggest LKM can enhance mental health in this population.
Clinical Psychology in Europe
September 18, 2019
Simona Stefan, Stefan G Hofmann
24 citations
Loving kindness and compassion meditation, traditional Buddhist practices, have been incorporated into psychotherapy with encouraging outcomes. These practices cultivate metta, a mental state of positive energy and kindness toward oneself and others, countering anger, hostility, and self-loathing common in emotional disorders. A qualitative review of the literature suggests metta meditation is especially useful for treating depression and social anxiety, conditions marked by low positive affect and negative self-views. The practice may enhance therapy by fostering adaptive self-images, social connectedness, and positive emotional experiences, addressing shame and hostility while promoting self-acceptance.
Frontiers in Psychiatry
January 1, 2024
Alexandros Matsingos, Marcel Wilhelm, Laila Noor et al.
18 citations
In double-blind randomized trials of ketamine and esketamine for major depressive disorder, the placebo response accounts for up to 72% of the overall treatment response. Across 14 studies with 1100 participants, the pooled effect size for placebo was -1.85, while the treatment effect was -2.57. Seven days after treatment, the placebo response accounted for 66% of the treatment response. Ketamine and esketamine show large antidepressant effects, but the placebo response plays a significant role and should be leveraged in clinical practice.
International journal of clinical and health psychology : IJCHP
January 1, 2024
Yanjuan Li, Mengyao He, Zhenzhen Wang et al.
18 citations
Across two randomized controlled trials, a mindfulness-based intervention (MBI) improved mindfulness, distress tolerance, anxiety, and depression more than control conditions. In Study 1, 374 adults with moderate emotional distress were assigned to MBI or a waitlist; in Study 2, 170 adults with emotional disorders were assigned to MBI or a control group. Changes in distress tolerance explained the intervention's effects on anxiety and depression. Distress tolerance also preceded improvements in depression over time, but not in anxiety. Distress tolerance appears to be a mechanism through which MBIs reduce emotional distress, suggesting that boosting distress tolerance could strengthen these interventions.
Psychotherapy and Psychosomatics
January 1, 2025
Yanjuan Li, Yi Zhang, Chun Wang et al.
13 citations
Adding facilitator-supported mindfulness-based self-help (MBSH) to usual treatment leads to faster and greater reductions in anxiety and depression for people with emotional disorders. In a randomized trial with 302 patients from four centers, those who received MBSH plus usual care showed significantly more improvement in symptoms, mindfulness, physical symptoms, stress, sleep, and inner peace immediately after the program compared to those receiving usual care alone. Some benefits, including reduced depression and stress and increased mindfulness, appeared as early as three to five weeks and were maintained three months later. The approach is a scalable and effective addition to clinical practice.
Mindfulness
October 8, 2021
Ulrich Stangier, Artjom Frick, Isabel Thinnes et al.
11 citations
Combining Loving Kindness group meditation with individual therapy focused on kindness toward oneself and others (metta-based therapy, MBT) reduced depressive symptoms more than a wait list control in patients with chronic depression. Forty-eight patients with persistent depressive disorder were randomly assigned to MBT or a wait list. After group meditation and at 6-month follow-up, MBT showed greater improvements in clinician-rated and self-reported depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation, with large effect sizes. Most gains occurred during group meditation and were maintained at follow-up. The results provide preliminary support for MBT's effectiveness.
Clinical Psychology & Psychotherapy
January 1, 2024
Zhenzhen Wang, Kaerqika Shalihaer, Stefan G Hofmann et al.
10 citations
A 49-day online mindfulness intervention for emotional distress (MIED) increased attentional control and reduced anxiety and depression in 498 adults with high emotional distress, compared with a waitlist control group. Changes became evident by the third week. Statistical analyses showed that improvements in attentional control mediated the program's effects on later anxiety and depression levels. The findings suggest that mindfulness-based programs may alleviate emotional distress partly by strengthening attentional control.
Psychotherapy research : journal of the Society for Psychotherapy Research
November 17, 2024
Zhenzhen Wang, Xinyi Tang, Amy Hu et al.
5 citations
Decentering—the ability to observe thoughts and feelings as temporary mental events rather than as reflections of reality—may be a key mechanism through which mindfulness-based interventions reduce anxiety and depression. In a cross-sectional study of 998 adults with high emotional distress, decentering significantly mediated the link between mindfulness and lower symptoms. In a longitudinal randomized trial, 688 participants were assigned to a Mindfulness Intervention for Emotional Distress (MIED) or a waitlist control. The MIED group showed greater improvements in decentering, anxiety, and depression over time. Reciprocal influences between decentering and distress were observed, and decentering during the intervention significantly mediated the program's effect on reducing emotional distress.
Journal of Mood and Anxiety Disorders
June 1, 2024
Danielle Moskow Diamond, David Rosenfield, Nikki Kaiser et al.
5 citations
In generalized anxiety disorder, different treatments improve distinct aspects of mindfulness. A clinical trial randomly assigned 226 individuals with GAD to 12 weeks of Kundalini Yoga, cognitive behavioral therapy, or stress education. The Non-judge, Act with Awareness, and Non-react facets of mindfulness increased significantly during treatment, while the Observe and Describe facets did not. Improvement in Acting with Awareness was significantly greater for Kundalini Yoga than for cognitive behavioral therapy. These findings suggest that behavioral treatments can influence specific mindfulness components differently.
BMC Psychiatry
April 1, 2025
Danielle Moskow Diamond, Joshua Curtiss, Joseph K. Carpenter et al.
4 citations
Individuals with panic disorder (PD) and high anxiety sensitivity (AS) may experience increased anxiety when practicing mindfulness. Analyzing data from 1,521 Japanese participants, the study revealed that heightened AS significantly influenced how individuals observed internal sensations, with higher AS linked to greater internal observation but lower external observation. PD also predicted mindfulness observation but was less impactful than AS. These findings underscore the importance of tailoring mindfulness interventions to address specific anxiety sensitivities, enhancing their effectiveness for those struggling with anxiety-related issues.
Journal of Counseling Psychology
July 14, 2025
Zhenzhen Wang, Mo Chen, Amy Hu et al.
2 citations
Two randomized controlled trials tested whether cognitive flexibility—the ability to shift attention—explains how a mindfulness intervention reduces emotional distress. In Study 1, 607 highly distressed adults were assigned to an eight-week mindfulness program or a waitlist. In Study 2, 89 similar participants were assigned to the program or a control group. Both trials showed that the mindfulness program significantly improved anxiety, depression, and general distress. Changes in cognitive flexibility during the intervention statistically mediated later reductions in emotional distress. Specifically, shifting attention away from affective to nonaffective aspects of positive stimuli at week 5, and less shifting from negative to positive affective aspects at week 3, predicted greater distress relief at week 7. The findings indicate cognitive flexibility is a key mechanism of mindfulness-based intervention for emotional distress.
Verhaltenstherapie
April 1, 2024
Elisabeth A. Arens, Lucas Donnerstag, Stefan G Hofmann et al.
1 citation
A pilot test of a Metta-based group program delivered via video showed that teaching loving-kindness meditation to people with depression is feasible and well accepted. Eight patients with depressive disorder participated in the video-based intervention. Measures of therapeutic relationship quality, method implementation, and acceptance indicated that a sustainable therapeutic relationship could be established, meditation techniques could be taught, and a concentrated working atmosphere was possible. Participants accepted the video-based therapy well, and there were preliminary signs of clinical effectiveness. Further research on what moderates acceptance and effectiveness of video-based therapy is needed.
Journal of Anxiety Disorders
July 1, 2026
Paweł Holas, Jan Wardęszkiewicz, Malgorzata Grochowska et al.
A randomized controlled trial with 301 adults diagnosed with Adjustment Disorder tested a brief, internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) against internet-delivered progressive muscle relaxation (iPMR) and a waitlist control over four weeks. iMBCT reduced Adjustment Disorder symptoms more than the waitlist control and produced higher remission rates. Compared with iPMR, iMBCT led to larger decreases in depression and anxiety. Cognitive defusion fully mediated iMBCT's effects on depression and anxiety. Some improvements persisted at one-month follow-up, but the authors caution that findings are mixed due to substantial attrition.
Behavior therapy
May 1, 2026
Yanjuan Li, Amy Hu, Yiran Ding et al.
During a mindfulness-based intervention, daily distress tolerance predicted next-day anxiety and, in later weeks, next-day depression, but the reverse relationships were not significant. Eighty-three adults with high emotional distress completed daily diaries before, during, and after the intervention. Distress tolerance, anxiety, and depression all improved one week after the intervention. In the first three weeks no time-lagged effects appeared; in the last four weeks, higher distress tolerance on one day predicted lower anxiety and depression the next day. The findings support distress tolerance as a temporal precursor to emotional distress, particularly when interventions aim to enhance it.
Expert Review of Neurotherapeutics
August 1, 2024
Andreas Reis, Marlon Westhoff, Hicham Quintarelli et al.
Mindfulness-based interventions show promise as complementary treatments for obsessive-compulsive disorder (OCD), a condition marked by intrusive thoughts and repetitive behaviors. A meta-analysis of ten randomized controlled trials demonstrated the effectiveness of mindfulness techniques. Integrating these strategies into cognitive-behavioral therapy (CBT) may enhance emotional regulation, cognitive flexibility, and acceptance of intrusive thoughts. However, variability in OCD symptoms and treatment responses requires individualized approaches. Further research is needed to refine mindfulness techniques and optimize their effectiveness for patients with persistent symptoms.