Perspectives on Psychological Science
October 14, 2011
Britta K. Hölzel, Sara W. Lazar, Tim Gard et al.
2,997 citations
Mindfulness meditation, the nonjudgmental awareness of present-moment experiences, improves well-being and reduces psychiatric and stress-related symptoms, leading to its integration into psychotherapeutic interventions. Despite a surge in publications, few theoretical reviews synthesize the literature into a comprehensive framework. This article explores four components through which mindfulness exerts its effects: attention regulation, body awareness, emotion regulation (including reappraisal, exposure, extinction, and reconsolidation), and a change in perspective on the self. Empirical research, including self-reports and experimental data, supports these mechanisms. Neuroimaging studies show mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network. The authors suggest these components work synergistically to enhance self-regulation, guiding future research and treatment development.
Frontiers in Psychology
November 22, 2021
Willoughby B. Britton, Gaelle Desbordes, Rebecca L. Acabchuk et al.
77 citations
Self-related processes (SRPs) such as rumination, self-compassion, self-efficacy, and self-esteem are theorized to be key mechanisms of mindfulness-based interventions (MBIs). This evidence map introduces a framework for categorizing SRPs and assesses how well mindfulness training engages these targets and whether engagement relates to improved outcomes. Rumination shows the strongest evidence as a mechanism for depression, with support for other health outcomes as well. Self-compassion consistently engages with mindfulness training but inconsistently links to better outcomes. Decentering and interoception are emerging potential mechanisms, though their construct validity remains under development. Few SRPs have been measured in MBIs, and more research with well-validated measures is needed.
Journal of Clinical Psychology
September 7, 2007
Arthur Margolin, Zev Schuman-Olivier, Mark Beitel et al.
75 citations
Impulsivity is linked to heavier intoxicant use and HIV risk behavior, and lower spiritual practices and motivation for recovery, among HIV-positive drug users. A manual-guided therapy integrating cognitive and Buddhist psychologies, spiritual self-schema (3-S(+)) therapy, was tested in a preliminary study. Compared with standard care, patients who completed 3-S(+) therapy showed greater reductions in impulsivity and intoxicant use, and greater increases in spiritual practices and motivation for abstinence, HIV prevention, and medication adherence.
Expert Review of Neurotherapeutics
January 14, 2020
Rebecca Erwin Wells, Elizabeth K. Seng, Robert R Edwards et al.
74 citations
Migraine is a leading cause of disability, and many patients cannot use or afford medications. Mindfulness-based interventions (MBI), such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), offer a potential non-pharmacological treatment. Most research to date consists of small pilot trials with limited rigor, but initial evidence suggests improvements in headache-related disability and psychological well-being. Many questions remain about optimal dosage, duration, delivery, and which patients benefit most. Mindfulness will not cure migraine but may help patients engage in valued activities as part of a comprehensive treatment approach.
Health Psychology
July 6, 2023
Richa Gawande, Lydia Smith, Alexandra Comeau et al.
21 citations
An 8-week warm mindfulness training program for primary care patients with anxiety, depression, or stress-related disorders improved emotion regulation and helped patients initiate health behavior changes more than a low-dose mindfulness comparator. Emotion regulation difficulties decreased significantly at 8 weeks and at 24 weeks. 63% of those in the full program started their action plan within three weeks, compared to 38% in the comparator group.
Frontiers in Psychiatry
September 9, 2021
Marcelo Trombka, Timothy B. Creedon, Marcelo Demarzo et al.
14 citations
Portuguese-speaking immigrants in the Boston area who completed an 8-week mindfulness program adapted for their language and culture attended an average of 6.1 sessions and practiced 213.7 minutes per week. Nearly all participants rated the program as very good or excellent, would recommend it, and would participate again. Depression symptoms decreased substantially and anxiety symptoms decreased moderately, while emotional regulation improved. Half of those who completed surveys initiated a health behavior change. The program appears feasible, acceptable, and culturally appropriate for this underserved population, though larger controlled studies are needed.
Psychiatry Research
December 1, 2024
Zev Schuman-Olivier, Richa Gawande, Timothy B. Creedon et al.
10 citations
Mindfulness training helps people change health behaviors partly by improving how they listen to and trust internal bodily signals, a process called interoceptive appreciation. In a randomized trial with 274 primary care patients who had depression, anxiety, or stress disorders related to chronic illness, those who received Mindfulness Training for Primary Care showed greater initiation of a chosen health behavior action plan compared to a low-dose mindfulness group. The effect was mediated by interoceptive appreciation: among patients without depression, listening to bodily signals played a key role; among those with moderate-to-severe depression, trusting bodily signals was more important. Regaining body trust may be a crucial step for behavior change in depression.
Scientific Reports
November 6, 2025
Isaac N Treves, Ya-Yun Chen, Caitlyn L Wilson et al.
5 citations
A meta-analysis of 29 randomized controlled trials with 2,191 participants found that mindfulness-based interventions produce a small-to-medium improvement in self-reported interoceptive awareness (g = 0.31). Mindfulness-based programs showed the largest effects (g = 0.41). Improvements in interoception were similar in size to improvements in self-reported mindfulness and were linked to reductions in psychological distress. No evidence of publication bias was detected, and no other factors such as practice dosage or clinical sample significantly moderated the results. These findings suggest mindfulness interventions can positively alter how people subjectively experience bodily sensations, which may contribute to better mental health.
Psychophysiology
May 1, 2025
Isaac N Treves, Anna O Tierney, Simon B. Goldberg et al.
5 citations
A breath-counting task designed to measure mindfulness in adults was tested in 78 adolescents with high rumination. The task showed fair reliability but did not correlate positively with self-reported mindfulness, either as a trait or in daily life. Unexpectedly, more mindful adolescents performed worse on breath counting, and the task showed negative correlations with observing emotions and body sensations and with nonreactivity. Breath-counting performance was also unrelated to clinical, personality, and executive functioning measures. The findings indicate that, in this population, breath counting may measure only a narrow form of sustained attention and may not capture broader mindfulness qualities or have predictive validity.
Journal of Mood and Anxiety Disorders
March 1, 2025
Diane Joss, Michael Datko, Charisma I Washington et al.
5 citations
Self-judgment, a symptom common to many psychological disorders, often follows childhood maltreatment and can make standard treatments less effective. In a pilot study of 24 adults with anxiety or depressive disorders (83% had multiple diagnoses), an eight-week mindful self-compassion program significantly reduced self-judgment and increased self-compassion. Participants who reported more childhood trauma improved more than those with less trauma. Brain scans showed that reduced self-judgment was linked to stronger connections between the posterior cingulate cortex and frontal regions involved in regulation and language, and weaker connections with the amygdala-hippocampal complex, suggesting the training lessens fear-related influences on self-referential thinking while boosting executive control.
JAMA Psychiatry
October 26, 2016
David Lovas, J. Gary Lutz, Zev Schuman-Olivier
3 citations
No Summary
Psychiatry Research Case Reports
March 8, 2024
My Ngoc To, Zev Schuman-Olivier
2 citations
About 15-30% of people with PTSD also have high dissociation, a dissociative subtype (PTSD-D). Best practices for offering mindfulness-based interventions (MBIs) to these patients are unclear. This case study from a larger randomized controlled trial describes a patient with PTSD-D who completed an 8-week MBI while actively dissociating. Follow-up interviews and pre/post assessments showed the patient had a positive experience and improved self-regulation. The training may have been safe and effective because it integrated choice points and promoted structural safety. Six influencing factors that contributed to the outcome are discussed to guide clinicians and researchers.
Psychiatry research. Neuroimaging
March 1, 2025
Michael Datko, Jacqueline Lutz, Richa Gawande et al.
1 citation
Mindfulness training for primary care patients with anxiety or depression increased activity in the dorsal medial prefrontal cortex when anticipating pain, and this brain change was strongly linked to initiating health behavior changes. Greater increases in this brain response correlated with higher levels of action plan initiation, suggesting that mindfulness strengthens emotion regulation and goal-directed behavior in the face of discomfort.
Cerebral cortex (New York, N.Y. : 1991)
February 5, 2025
Isaac N Treves, Aaron Kucyi, Anna O Tierney et al.
1 citation
During a breath-counting task, 72 adolescents showed increased static connectivity within attention-direction and orienting networks and anticorrelations between attention networks and the default mode network compared to rest. Dynamic connectivity analysis revealed four distinct brain states, including one anticorrelated with the default mode network that was proportionally more present during the task. Brain state markers distinguished breathing tasks from rest and momentary on-task from off-task attention, but no brain states reflected between-individual behavioral variability.
Frontiers in Public Health
January 1, 2025
Richa Gawande, Felipe Kalatauma Rosario, Carlos Santiago et al.
1 citation
A community-based peer-led mindfulness intervention called Mandela Yoga, co-developed by Black and Brown yoga teachers, therapists, and community leaders with lived experience of recovery, incarceration, chronic illness, and racism, was implemented as part of a Federally Qualified Health Center reentry program for men of color recently released from incarceration. A qualitative analysis of a 12-week implementation documented attendance and conducted interviews with the peer facilitator and one participant. Four key themes emerged: breath and mind-body connection leading to presence; consistency; peer connection; and agency and positive action. Mandela Yoga shows promise as a mind-body-community intervention for communities of color in recovery and post-incarceration.
Frontiers in Psychology
January 1, 2025
Diane Joss, Joseph Rosansky, Paula Gardiner et al.
1 citation
Among people with opioid use disorder receiving buprenorphine, those who also took part in a 24-week online mindfulness-based intervention showed a specific chain of symptom improvement linked to their history of adverse childhood experiences (ACE). Higher ACE severity was associated with greater reductions in self-critical rumination by week 8, which then predicted reduced pain catastrophizing by week 16, and less pain interference by week 24. This pathway was not seen in a matched recovery support control group. Both groups experienced significant reductions in depression, anxiety, and other symptoms, but only in the mindfulness group did ACE severity predict changes in self-critical rumination, suggesting this may be a key target for treatment.
Global advances in integrative medicine and health
January 1, 2024
Eunmi Kim, Diane Joss, Frannie Marin et al.
1 citation
This registered clinical trial protocol describes a planned study of Heart-Smile Training (HST), a compassion-based meditation program that cultivates awareness of heart-area bodily signals (interoception), for people with depression. The study aims to test the feasibility of the intervention and research procedures and to investigate neurocardiac mechanisms, specifically changes in the Heartbeat Evoked Potential measured by EEG. Fifty participants will be randomly assigned to a 4-week HST group or a waitlist control. Outcomes include depression severity, EEG gamma activity, heart rate variability, and psychological measures of self-compassion, mindfulness, and social connectedness. Results are not yet available.
Research Square
June 4, 2025
Isaac N Treves, Ya-Yun Chen, Caitlyn L Wilson et al.
Mindfulness-based interventions produce small-to-medium improvements in self-reported interoceptive awareness, according to a meta-analysis of 29 randomized controlled trials involving 2,191 participants (77.8% female, mean age 32.8 years). The overall effect size was g = 0.31, with mindfulness-based programs showing the largest effects (g = 0.41). Improvements in interoception were similar in size to improvements in self-reported mindfulness and were linked to reductions in psychological distress. No evidence of publication bias was found, and no other moderators—such as practice dosage or clinical sample—were significant. The findings suggest that mindfulness training leads to adaptive changes in how people subjectively experience bodily signals, which may contribute to better mental wellbeing.
Psychiatry research. Neuroimaging
December 1, 2022
Michael Datko, Jacqueline Lutz, Richa Gawande et al.
An 8-week Mindfulness Training for Primary Care (MTPC) program altered brain activity during interoceptive attention in adults with anxiety and/or depression. After training, fMRI scans showed increased response in the left anterior insula when participants focused on their heartbeat compared to a visual task. Among patients with moderate-to-severe depression, this increased insula response was linked to greater Body Trusting—a sense of trusting one's own body sensations and viewing the body as a safe place to attend to. The findings suggest that depression severity influences how patients respond to mindfulness-based treatment, and that cultivating body trust may be a key component for those with more severe depression.
Frontiers in Psychiatry
February 26, 2021
Marcelo Trombka, M. Demarzo, Daniel Fernando Campos et al.
A randomized controlled trial assigned Brazilian police officers to either a mindfulness-based health promotion program or a waiting list. At both post-intervention and 6-month follow-up, the mindfulness group showed greater improvements in quality of life and reductions in depression and anxiety symptoms compared to the waiting list. The program also increased non-organizational religiosity at post-intervention, but this effect was not sustained at 6 months. Changes in self-compassion mediated improvements in quality of life. The authors conclude that the mindfulness program is feasible and efficacious for this population.
Harvard Review of Psychiatry
November 1, 2020
Zev Schuman-Olivier, Marcelo Trombka, D. Lovas et al.
Mindfulness, defined as nonjudgmental present-moment awareness, can help initiate and maintain behavior change, which is crucial for preventing and treating chronic medical and psychiatric illnesses. This integrative review synthesizes the neuroscience of mindfulness, integrating motivation and learning mechanisms into a mindful self-regulation model that explains how mindfulness affects behavior change. It also reviews clinical research on mindfulness-based interventions for health behaviors relevant to psychiatric care. The authors highlight current research limitations and propose mechanisms for future study to enhance mindfulness's impact on behavior change.
Pain medicine (Malden, Mass.)
October 1, 2020
Michael P Berry, Jacqueline Lutz, Zev Schuman-Olivier et al.
A brief self-compassion training (eight contact hours plus two weeks of home practice) reduced clinical pain intensity and disability and increased trait self-compassion and interoceptive awareness in people with chronic low back pain. Brain imaging showed that after training, evoked pressure pain response decreased in the right temporo-parietal junction, and pain anticipation responses increased in the right dorsolateral prefrontal cortex and ventral posterior cingulate cortex. These brain changes were associated with improvements in self-compassion and body awareness. The authors argue that self-compassion may help regulate pain through self-referential, salience-processing, and emotion regulatory brain areas, but note that controlled studies are needed to confirm specificity.
Journal of Affective Disorders
July 6, 2018
D. Lovas, Zev Schuman-Olivier
Mindfulness-based cognitive therapy (MBCT) shows promise as an adjunctive treatment for bipolar disorder, with preliminary evidence suggesting it may improve anxiety, residual depression, mood regulation, and attentional and frontal-executive control without precipitating mania. A systematic review of 13 studies found wide variation in methodological quality, with most studies underpowered or lacking power calculations. Due to study heterogeneity and quality issues, meta-analysis was not possible, so net effects cannot be estimated. More high-quality research is needed to confirm clinical efficacy.