Perspectives on Psychological Science
October 10, 2017
Nicholas T. van Dam, Marieke K. van Vugt, David R. Vago et al.
1,500 citations
Mindfulness meditation has become widely used in therapy, corporate wellness, education, and the military, but the research backing it has faced criticism for poor methodology and misinformation. This article reviews the current state of mindfulness research, discussing difficulties in defining mindfulness, the proper scope of studies, and key methodological issues. The authors summarize what is known and unknown, offering a prescriptive agenda for contemplative science that focuses on assessment, training, possible adverse effects, and brain imaging. The goal is to inform scientists, media, and the public, minimize harm, curb poor research practices, and stop the spread of misinformation about mindfulness's benefits, costs, and future.
Contemporary Buddhism
May 1, 2011
Paul Grossman, Nicholas T. van Dam
540 citations
The Buddhist concept of mindfulness, central to many Western psychological interventions, originates from a centuries-old systematic investigation of subjective experience. Current enthusiasm for mindfulness in Western science has led to many different definitions, measurements, and self-report questionnaires that treat it as a stable personality trait. This paper identifies persistent problems with these attempts and warns that they risk distorting, diluting, or reifying the original Buddhist ideas. To properly understand and measure mindfulness, psychologists and scientists may need to study Buddhist phenomenology more deeply and engage in long-term direct practice of insight meditation, a step that seems necessary before any valid characterization or quantification can occur.
Translational Psychiatry
March 21, 2017
Drew D. Kiraly, Sarah R. Horn, Nicholas T. van Dam et al.
182 citations
Patients with treatment-resistant depression (TRD) show elevated levels of the pro-inflammatory cytokine interleukin-6 compared to healthy controls, supporting the immune hypothesis of depression. Analysis of 41 cytokines, chemokines, and growth factors in blood samples from 26 healthy controls and 33 unmedicated TRD patients revealed a unique pattern of increased inflammatory mediators, chemokines, and colony-stimulating factors. Following a single intravenous infusion of ketamine (0.5 mg/kg), several cytokines showed transient changes, but none correlated with treatment response. Low pretreatment levels of fibroblast growth factor 2 were associated with ketamine treatment response, suggesting novel treatment targets for TRD patients with dysregulated immune functioning.
Mindfulness
April 13, 2023
Julieta Galante, Andrea Grabovac, Malcolm Wright et al.
82 citations
About half of the millions of people who learn mindfulness meditation continue regular practice after initial instruction, but it is unclear whether benefits increase with ongoing practice or whether harm can occur. Evidence shows a wide range of experiences from positive to challenging and potentially harmful. Complex interactions and temporal sequences may explain these experiences and their links to health and well-being. Effects may vary systematically due to factors like initial dosage, accumulated practice, developing skill, and interactions with past experiences and environment. The authors call for interdisciplinary, ontologically agnostic research using longitudinal models and insights from contemplative traditions to develop safer, more effective applications.
Mindfulness
January 1, 2022
Nicholas Bowles, Jonathan N. Davies, Nicholas T. van Dam
54 citations
Benefits of meditation accumulate over time in a non-linear fashion, with the strongest gains occurring in roughly the first 500 hours of practice before leveling off. In a cross-sectional survey of 1,668 meditators averaging 1,095 lifetime hours, greater historical practice was associated with better psychological outcomes, including higher positive affect and life satisfaction and lower psychological distress and negative affect. The type of practice mattered: Vipassana (as taught by S.N. Goenka) and cultivating practices like compassion and lovingkindness were more strongly linked to favorable outcomes. The results suggest that the dose-response relationship between meditation practice and wellbeing is not linear and depends on practice context.
Scientific Reports
July 1, 2024
Jonathan N. Davies, Anna Faschinger, Julieta Galante et al.
45 citations
Between 2002 and 2022, the use of meditation, yoga, and guided imagery or progressive relaxation among US adults rose significantly. By 2022, 18.3% (60.53 million) practiced meditation, 16.8% (55.78 million) practiced yoga, and 6.7% (22.22 million) used guided imagery or progressive relaxation. Growth was widespread across sociodemographic groups, but people of 'Other' race (54% Indigenous Americans) and those with moderate psychological distress were overrepresented across all practices. Individuals with severe distress were more likely to use meditation and guided imagery or progressive relaxation. Meditation use accelerated among adults aged 65 and older, those not accessing mental health care, and less educated groups, suggesting unmet health needs.
Psychological Medicine
December 7, 2020
Nicholas T. van Dam, Julieta Galante
19 citations
A critique of a recent study on harm after mindfulness-based stress reduction (MBSR) programs points out serious methodological limitations that undermine confidence in the authors' conclusion that MBSR is no more harmful than no treatment. The original study used a large observational dataset of 2,155 participants alongside active and wait-list arms of randomized controlled trials (156 and 118 participants respectively). The critique argues that despite the seemingly conclusive finding, the methods employed have potentially serious flaws.
Frontiers in Psychology
January 1, 2024
Anya Daly, Rosa Ritunnano, Shaun Gallagher et al.
17 citations
Mental disorders involve complex alterations of the self that arise from interactions among cognitive, bodily, affective, social, narrative, cultural, and normative elements. The pattern theory of self (PTS) provides a non-reductive account consistent with embodied-enactive cognition and phenomenological psychopathology, emphasizing the multi-dimensionality of subjects and situated embodiment. This article develops the Examination of Self Patterns (ESP), a flexible methodological framework that front-loads the self-pattern into a minimally structured phenomenological interview. The ESP avoids internalist or externalist assumptions about mind and is guided by person-specific interpretations rather than diagnostic categories, offering advantages for tackling the complexity of mental health research and clinical protocols.
Mindfulness
June 1, 2023
Toby J. Woods, Jennifer Windt, Lydia Brown et al.
15 citations
People who practice Shamatha, Thai Forest, or Stillness Meditation typically report a highly positive experience of stillness or silence with little awareness of thoughts and perceptions, but with a high degree of abstract content such as calm and mental relaxation. Across the three traditions, robust differences emerged in reports of bliss/joy, wakefulness, absorptiveness, and depth. The experiences are contentless only in the sense of lacking obvious mental content like thoughts, not in being devoid of all content, challenging the classical view that such states are identical across traditions.
Clinical Psychological Science
January 6, 2025
Nicholas T. van Dam, Jessica Targett, Jonathan N. Davies et al.
14 citations
Meditation use in the United States is about as common as accessing mental health services, making it important to understand its potential harms. In a survey of 886 U.S. adults, nearly all (96.6%) reported an unusual experience related to meditation, 58.4% reported an adverse effect on a standard inventory, 78.3% endorsed at least one item on a scale of meditation-related adverse effects, 31.4% said they had a challenging, difficult, or distressing experience, and 9.1% reported functional impairment due to such effects. Psychological distress, psychoticism, unusual beliefs, and attending a meditation retreat were each linked to more unusual experiences and adverse effects. The authors recommend informing potential meditators about possible experiences, considering risk factors, and routinely monitoring for adverse effects.
Brain Research Bulletin
October 15, 2023
Saampras Ganesan, Bradford A. Moffat, Nicholas T. van Dam et al.
13 citations
Using 7 Tesla functional MRI, a pilot study scanned 10 beginner meditators during focused attention meditation (attending to breathing) and non-focused rest. After adjusting for physiological differences, meditation reduced activity in default-mode network hubs (antero-medial prefrontal and posterior cingulate cortices, precuneus) and visual and thalamic regions compared to rest. These reductions survived stringent corrections for physiological fluctuations. State mindfulness scores rose significantly after the session and remained elevated at a 2-week follow-up. The findings support evidence that focused attention meditation dampens default-mode activity tied to self-referential processing and demonstrate the feasibility of ultra-high field fMRI for meditation research.
June 23, 2023
Nicholas Bowles, Jonathan N. Davies, Sarah Strohmaier et al.
10 citations
preprint
Mindfulness meditation is widely practiced in religious and secular settings, with many studies suggesting benefits for psychosocial well-being. Yet little is known about dose-response effects—how often or how long one must practice to achieve specific goals. Recommended practice durations are becoming shorter, but the impact of this reduction on outcomes is unclear. This review critically appraises evidence from empirical studies, traditional sources, and contemporary teaching trends. It argues that previous studies' limited dose ranges and analytic approaches hinder understanding of dose-response. The authors propose a research agenda prioritizing dose-response questions, using designs optimized to examine how the relationship varies by outcome and individual, which could reconcile conflicting knowledge and tailor mindfulness offerings.
Applied Psychology Health and Well-Being
August 1, 2025
Nicholas Bowles, Nicholas T. van Dam
6 citations
Meditation practice dose is significantly associated with improvements in well-being, affect, and distress, with practice frequency being a stronger predictor of beneficial outcomes than session duration. During a two-month prospective period, 35 to 65 minutes of daily practice was required for meaningful improvements in well-being, and 50 to 80 minutes daily for meaningful improvements in mental health outcomes. Dose-response effects were moderated by lifetime practice experience, negative emotionality, and valuing mental health as a practice goal. Benefits were maintained over a two- to four-year follow-up period.
Mindfulness
March 1, 2025
Julieta Galante, Nicholas T. van Dam
6 citations
The authors critique a proposal to broaden the definition of mindfulness to include diverse contemplative practices, arguing instead to move the term away from the spotlight and study contemplative practices with more precise academic terms. They contend that comparing mindfulness and public health is a category error: mindfulness is a set of practices, while public health is a field defined by application. Reframing mindfulness as an aid to public health, rather than a replacement, clarifies its potential as an individual-level component of multi-level interventions addressing social determinants of health. Realizing this requires collaborative partnerships between mindfulness developers and independent public health researchers, using participatory methods to assess community needs.
International review of psychiatry (Abingdon, England)
December 1, 2024
Roman Palitsky, Nicholas K. Canby, Nicholas T. van Dam et al.
6 citations
Research on adverse effects (AEs) of psychedelics has been limited, leading to underspecified profiles and potential undercounting. This article argues that meditation-related AE research, which shares phenomenological and contextual features with psychedelic AEs, offers valuable insights. An integrative review of both fields is presented, recommending that meditation AEs serve as a comparator condition. The authors propose adopting detailed, comprehensive, user-informed, impact-based, standardized, unbiased, and representative measures of AEs, along with examining factors that influence their impacts and trajectories, to advance psychedelic AE research.
bioRxiv (Cold Spring Harbor Laboratory)
April 14, 2019
J.R. Payne, Oliver Baell, Harry Geddes et al.
6 citations
preprint
Long-term meditation practice may not produce lasting changes in certain brain markers of attention. Experienced mindfulness meditators and non-meditators showed no differences in behavioral performance or in neural markers such as theta phase synchronisation, P200, and P300 during a dichotic oddball listening task when neither group meditated before or during the session. Bayes Factor analysis found evidence against group differences for P200 and P300. The findings suggest that increased activity in these attention-related neural markers does not reflect stable, trait-like changes in a community sample of mindfulness meditators, adding nuance to understanding how much meditation is needed to alter specific brain processes.
Current Opinion in Psychology
February 1, 2026
Karin Matko, Nicholas T. van Dam
4 citations
Mindfulness and meditation can cause adverse effects, including anxiety, depression, and traumatic re-experiencing, with 25-87% of practitioners reporting such effects and 3-37% experiencing functional impairment like inability to work. It is unclear whether these effects are temporary or lasting. Retreat attendance and pre-existing mental health conditions may increase risk, though causality is not established. The review recommends thorough screening, informed consent, and ongoing monitoring in clinical practice, along with setting clear expectations, offering psychoeducational support, and adapting interventions when appropriate to balance benefits and risks.
Mindfulness (N Y)
September 26, 2025
Saampras Ganesan, Nicholas T. van Dam, Sunjeev K. Kamboj et al.
3 citations
A 7-Tesla MRI study found that neurofeedback training (NFT) helps people become more aware of their mental states and boosts emotional well-being during real-world meditation. Participants who received NFT showed improved self-awareness and greater emotional benefits from meditation compared to those who did not receive NFT. The results suggest that NFT can enhance the positive effects of meditation practice.
bioRxiv (Cold Spring Harbor Laboratory)
October 26, 2024
Saampras Ganesan, Nicholas T. van Dam, Sunjeev K. Kamboj et al.
3 citations
preprint
Personalized high-precision neurofeedback (NF) can help novice meditators better disengage from mental activity during meditation, improving emotional well-being and mindful awareness. In a single-blind, controlled study, 40 novices received two days of meditation training with feedback from either their own or a matched participant's posterior cingulate cortex (PCC) activity, measured using 7 Tesla fMRI. The experimental group showed stronger functional decoupling of PCC from dorsolateral prefrontal cortex, indicating improved control over disengagement. This led to greater improvements in emotional well-being and mindful awareness during a week of real-world self-guided meditation, supporting the utility of NF-guided meditation training.
Mindfulness
February 1, 2025
Yana Ryakhovskaya, Nicholas T. van Dam, Luke D. Smillie
2 citations
People higher in openness and agreeableness are more likely to have tried meditation, while those higher in openness, agreeableness, and curiosity hold more positive expectations about it. Neuroticism predicts greater perceived barriers to meditation. Personality traits do not strongly predict whether someone chooses to join a study advertised as being about meditation versus one described more generally. These findings help explain which personality characteristics draw individuals to meditation and may guide the design of tailored meditation programs.
May 13, 2024
Nicholas T. van Dam, Jessica Targett, Jonathan N. Davies et al.
2 citations
preprint
Meditation use is now as common as mental health service access. In a cross-sectional, population-based survey of 886 US adults, 96.6% reported an unusual experience related to meditation, 58.4% reported an adverse effect (AE), 78.3% endorsed at least one item on the Meditation-related AEs Scale, 31.4% reported a challenging, difficult, or distressing experience, and 9.1% reported functional impairment due to AEs. Psychological distress, psychoticism, unusual beliefs, and meditation retreat participation were positively associated with unusual experiences and AEs. The findings suggest that potential meditators should be informed about possible experiences, providers should consider risk factors, and AEs should be routinely and actively monitored.
BMC Complementary Medicine and Therapies
December 4, 2025
Jonathan N. Davies, Cate Bailey, Julieta Galante et al.
1 citation
About 41.5% of Australian and 35.7% of New Zealand adults have ever used meditation, with 32.8% and 24.9% using it in the past year. Younger age and higher education consistently predicted past-year use in both countries. In Australia, additional predictors included female gender, Aboriginal or Torres Strait Islander ancestry, unmet mental health care needs, and receipt of complementary care. In New Zealand, identifying as LGBTQIA+ was a strong positive predictor, while not receiving medical care was linked to lower odds. Over 21.7% of Australian and 17.6% of New Zealand meditators reported a meditation-related adverse effect.
bioRxiv (Cold Spring Harbor Laboratory)
January 3, 2023
Saampras Ganesan, Bradford A. Moffat, Nicholas T. van Dam et al.
1 citation
preprint
Using ultra-high strength 7 Tesla fMRI, a pilot study scanned 10 beginner meditators during focused attention meditation and rest. Meditation significantly reduced activity in Default-mode network hubs—antero-medial prefrontal cortex, posterior cingulate cortex, precuneus—and in visual and thalamic regions, even after adjusting for physiological differences between conditions. State Mindfulness Scale scores significantly increased after the meditation session and remained elevated at a two-week follow-up. The findings support that focused attention meditation attenuates default-mode activity linked to self-referential processing, establishing the feasibility of 7 Tesla fMRI for meditation research.
June 25, 2026
Nicholas Bowles, Nicholas T. van Dam, Jonathan N. Davies et al.
preprint
Among 716 meditation-naïve healthy adults randomly assigned to 4, 10, 20, or 30 minutes of daily mindfulness meditation over 28 days, all groups showed significant improvements in wellbeing and mental health symptoms from baseline to post-intervention. No evidence of a dose–response effect emerged: longer assigned practice durations were not more beneficial than shorter ones. Adherence declined with longer assignments; 70.9% of the 10-minute group completed at least two-thirds of sessions versus 48.5% of the 30-minute group. Exploratory analyses indicated that actual practice engagement and confidence in meditation's efficacy predicted better outcomes, suggesting that adherence and expectancy may matter more than prescribed length.
JMIR mHealth and uHealth
June 8, 2026
Julia Adams, Jonathan N. Davies, Prai Wattanatakulchat et al.
Meditation app use is generally low: half of users engage for 16 minutes or less in the first month after download, and fewer than 20% continue past 14 days. Intended use far exceeds actual use. Higher engagement is associated with expectation match, expectations for anxiety and attention, conscientiousness, satisfaction with life, and well-being, while neuroticism, perceived stress, psychological distress, and lower quality of life are linked to lower engagement. Readiness to change uniquely predicts higher engagement. Acute stress motivates use, but chronic stress disrupts it. Engagement is best when experiences match expectations and users are prepared to change.