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.
Both a standard mindfulness-based intervention (MBI) alone and the same MBI plus 10 minutes of Virtual Reality DBT® Mindfulness Skills training significantly reduced symptoms of Generalized Anxiety Disorder in primary care patients, with large effect sizes. The combined treatment led to higher treatment completion: 100% of patients in the MBI+VR group finished the program versus 70% in the MBI-only group. Both groups also improved in depression, emotion regulation, mindfulness, and interoceptive awareness. The findings suggest that adding a brief VR component to MBI may improve adherence, though larger randomized controlled trials are needed.