A systematic review of 27 randomized controlled trials found that mindfulness skills, decentering, and attitudes such as self-compassion are significant indirect pathways through which mindfulness-based programs improve mental health and well-being. Only four studies examined mechanisms within specific mindfulness practices. The evidence for alternative mechanisms like attention and awareness remains limited, especially regarding well-being outcomes, mental health promotion, and comparisons with active controls. The authors call for high-quality trials with powered multivariate mediation analyses to address these knowledge gaps and guide future interventions.
Universal school-based mindfulness training can benefit young people, but it is unclear who benefits most, how it works, and how implementation affects outcomes. A scoping review of 31 studies found mixed evidence on moderators such as age or gender. Five studies showed that increased mindfulness skills and reduced cognitive reactivity and self-criticism after training predicted better outcomes later. Twenty-five studies examined implementation factors, but methodological shortcomings limit conclusions. The authors propose a conceptual model to guide future research and theory development.
A new 8-week follow-on mindfulness course focused on awareness of feeling tone (vedanā) was tested in an open trial with 83 participants, 78 of whom had previously completed a mindfulness-based program. After the course, participants showed reduced depression, stress, and anxiety and increased well-being and mindfulness, with 38% meeting criteria for reliable change in anxiety and depression. About three-quarters reported unpleasant experiences related to mindfulness practice, but none reported harm. Five participants showed reliable deterioration in depression or anxiety, though most of them described benefits in anonymous feedback. The findings suggest added value from a follow-on course exploring feeling tone for people with prior mindfulness experience.