Clinical Psychology Review
February 1, 2024
Jake Linardon, Mariel Messer, Simon B. Goldberg et al.
61 citations
Mindfulness apps produce small but significant reductions in symptoms of depression and anxiety compared to control groups. A meta-analysis of 45 randomized controlled trials found effect sizes of g = 0.24 for depression (46 comparisons, 5,852 participants) and g = 0.28 for anxiety (48 comparisons, 6,082 participants). These benefits were not due to symptom worsening in control groups and remained when restricting to higher-quality trials. No significant moderators were identified, except that studies offering monetary compensation showed larger effects on depression. When compared to active therapeutic interventions, mindfulness apps showed non-significant effects, though few studies were available. The evidence suggests mindfulness apps can help reduce depression and anxiety symptoms, but more rigorous studies with longer follow-up are needed.
Clinical Psychology Review
June 1, 2025
Siobhan M O'Dean, Elizabeth Summerell, Eddie Harmon-Jones et al.
10 citations
People who are more mindful tend to report less anger and aggression, and mindfulness training can reduce these responses. Four meta-analyses of 118 studies found small-to-medium inverse correlations between dispositional mindfulness and both anger (r = -0.23) and aggression (r = -0.19). In experimental studies, mindfulness-based interventions produced medium reductions in anger (d = -0.48) and aggression (d = -0.61) compared to control groups. Effects were largest in Asia and with passive control groups, and were similar across clinical, forensic, healthy, medical, and student populations. The findings suggest mindfulness training can help regulate anger and aggression in diverse groups, though more rigorous control groups are needed.
Clinical Psychology Review
February 26, 2025
Eirini Aikaterini Melegkovits, Rui Tang, Olivia Pounds et al.
8 citations
A systematic review of 40 studies with 6941 participants found a moderate association between developmental trauma (abuse or neglect before age 18) and dissociation in people with psychosis. Sexual and emotional abuse showed the strongest links to dissociation. Dissociation partially explained the connection between developmental trauma and positive psychotic symptoms, especially hallucinations, and also contributed to paranoia and delusional ideas. Individuals with psychosis and developmental trauma reported more dissociation than those without trauma. The review recommends screening for psychotic and dissociative symptoms in trauma survivors and managing dissociation, while calling for more longitudinal, qualitative, and experimental research.
Clinical Psychology Review
February 2, 2026
J K E Veraart, N Schimmers, J J Breeksema et al.
4 citations
Ketamine-assisted psychotherapy (KAP) combines psychotherapeutic interventions with the rapid-acting effects of ketamine to treat psychiatric disorders. This systematic review of 64 articles (72 studies) up to 2025 found only 11 were randomized controlled trials (RCTs), highlighting limited evidence. Therapeutic approaches varied, with most classified as 'other.' Results suggest transdiagnostic effectiveness for major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, substance use disorders, and eating disorders. Compared to psychotherapy alone, KAP enhanced treatment engagement, symptom reduction, and duration of response. However, only two studies randomized psychotherapy alongside ketamine, neither reporting added effects; one also randomized ketamine and found no significant interaction. This limited evidence does not support added benefit or synergy from combining psychotherapy with ketamine.
Clinical Psychology Review
February 1, 2026
Liucan Xu, Simon B. Goldberg, Lin Zhang et al.
1 citation
Second-generation mindfulness-based interventions (SG-MBIs), which incorporate ethical and moral practices, effectively reduce depression and anxiety in adults. A meta-analysis of 43 randomized controlled trials on depression (3,756 participants) and 37 on anxiety (3,199 participants) found moderate to large effects: depression improved by a standardized mean difference of 0.59 and anxiety by 0.61. Effects remained significant after removing outlier studies (depression: 0.44; anxiety: 0.40). Clinical populations benefited more than healthy or mixed samples. Follow-up data from 20 trials showed sustained depression reductions (0.70). Most trials had some methodological concerns, but excluding high-risk studies did not change the results. SG-MBIs appear especially valuable for clinical groups and self-compassion-focused interventions.
Clinical Psychology Review
December 1, 2022
Kristine Trettø Sverre, E. Nissen, I. Farver-Vestergaard et al.
A meta-analysis of 30 randomized controlled trials with 2,750 participants found that mindfulness-based therapies (MBT) and cognitive behavioral therapy (CBT) are equally effective for treating current depression in adults. At both post-intervention and follow-up, the difference in outcomes was statistically negligible, and Bayesian analyses supported equivalence. Subgroup analysis suggested that at follow-up, mindfulness-based cognitive therapy (MBCT) was more similar to CBT than was mindfulness-based stress reduction (MBSR). The authors conclude that MBT and CBT are equally efficacious, but it remains unclear whether they work through different mechanisms or shared factors.
Clinical Psychology Review
April 1, 2022
M. Johannsen, E. Nissen, M. Lundorff et al.
Acceptance and mindfulness-based therapies appear to work partly by increasing mindful attention, decentering, and acceptance, which in turn reduce anxiety and depression. A meta-analysis of 33 randomized controlled trials (30 independent trials) found that these three processes together had a small-to-medium mediating effect on treatment outcomes. However, the type of mediation analysis mattered: studies using correlation-based methods found significant mediating effects, while those using causal time-lag analyses did not. The specific role of each mediator could not be determined. Limitations in the number and design of available studies prevent firm conclusions about whether these processes are unique or causal.
Clinical Psychology Review
November 11, 2019
Joseph K. Carpenter, Kristina Conroy, Angelina F Gómez et al.
Trait mindfulness is linked to lower negative affective symptoms, with the facets Nonjudge and Act with Awareness showing the strongest negative correlations. A meta-analysis of 148 studies (44,075 participants) found a weighted mean correlation of r = −0.53 between overall trait mindfulness and affective symptoms. Nonjudge (r = −0.48) and Act with Awareness (r = −0.47) had the largest associations, followed by Nonreact (r = −0.33) and Describe (r = −0.29). Observe was not significantly correlated. Correlations did not differ significantly across anxiety, depression, or PTSD symptoms, though generalized anxiety showed a weaker link with Describe. Cultural differences emerged: Describe correlated more strongly with affective symptoms in Eastern samples, while Nonjudge did so in Western samples.
Clinical Psychology Review
February 1, 2018
Simon B. Goldberg, Raymond P. Tucker, Preston A. Greene et al.
Mindfulness-based interventions are superior to no treatment, minimal treatment, non-specific active controls, and specific active controls for reducing disorder-specific symptoms in clinical populations at post-treatment, with effect sizes ranging from d=0.23 to d=0.55. At follow-up, mindfulness-based interventions remain superior to no treatment, non-specific active controls, and specific active controls (d=0.29 to d=0.52). They do not differ from evidence-based treatments at either post-treatment or follow-up. The most consistent evidence supports mindfulness for depression, pain conditions, smoking, and addictive disorders. These findings suggest mindfulness-based interventions are effective evidence-based treatments.
Clinical Psychology Review
November 5, 2016
Emily K. Lindsay, J. D. Creswell
Monitor and Acceptance Theory (MAT) proposes that mindfulness works through two distinct skills: attention monitoring (noticing present-moment experiences) and acceptance (a non-judgmental orientation toward those experiences). Attention monitoring alone can improve cognitive functioning but may increase emotional reactivity. Acceptance is necessary to reduce that reactivity, so the combination of both skills explains how mindfulness reduces negative affect, stress, and stress-related health problems. The theory integrates conceptual, clinical, and empirical work to offer testable predictions for future research on mindfulness mechanisms.
Clinical Psychology Review
April 1, 2016
M.P.J. Spijkerman, Wendy T. M. Pots, E. Bohlmeijer
Online mindfulness-based interventions have a small but significant beneficial impact on depression, anxiety, well-being, and mindfulness, with the largest effect on stress (moderate effect size). Guided online MBIs showed significantly higher effect sizes for stress and mindfulness than unguided ones. The number of intervention sessions significantly moderated stress outcomes. These findings suggest that online MBIs can improve mental health, particularly stress.
Clinical Psychology Review
April 1, 2015
Jenny Gu, C. Strauss, R. Bond et al.
Mindfulness, rumination, and worry are significant mediators of the effects of mindfulness-based interventions (MBIs) on mental health outcomes. A systematic review and meta-analysis of mediation studies found strong, consistent evidence for cognitive and emotional reactivity, moderate and consistent evidence for mindfulness, rumination, and worry, and preliminary but insufficient evidence for self-compassion and psychological flexibility as mechanisms underlying MBIs. The review used two-stage meta-analytic structural equation modelling to quantitatively synthesize evidence for mechanisms with sufficient data. Most reviewed studies had key methodological shortcomings that preclude robust conclusions, but they provide important groundwork for future research.
Clinical Psychology Review
April 1, 2015
A. M. van der Velden, W. Kuyken, U. Wattar et al.
This systematic review examines how mindfulness-based cognitive therapy (MBCT) alleviates recurrent major depressive disorder. Of 476 articles identified, 23 met inclusion criteria. Twelve studies found that changes in mindfulness, rumination, worry, compassion, or meta-awareness were associated with, predicted, or mediated MBCT's effect on treatment outcomes. Preliminary evidence also suggests alterations in attention, memory specificity, self-discrepancy, emotional reactivity, and momentary affect may play a role. The authors conclude that MBCT may work through some theoretically predicted mechanisms but call for more rigorous designs to establish causal specificity.
Clinical Psychology Review
June 30, 2012
M. Casement, L. Swanson
A meta-analysis of 13 clinical trials found that imagery rehearsal therapy produces large reductions in nightmare frequency, sleep disturbance, and PTSD symptoms, with benefits lasting 6 to 12 months. Adding cognitive behavioral therapy for insomnia to imagery rehearsal further improved sleep quality but did not enhance PTSD or nightmare outcomes. Effect sizes were small in the only study that used an active-treatment control group.
Clinical Psychology Review
May 13, 2011
S. Keng, M. Smoski, C. Robins
Mindfulness, both as a psychological construct and a clinical intervention, has drawn considerable research interest. This review examines three empirical areas: cross-sectional studies linking mindfulness to psychological health, intervention research on mindfulness-oriented programs, and laboratory experiments on immediate effects of mindfulness inductions. The evidence indicates that mindfulness is associated with increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation. The authors discuss mechanisms of change and suggest directions for future research, concluding that mindfulness brings about various positive psychological effects.
Clinical Psychology Review
November 1, 2010
Eric L Garland, Barbara Fredrickson, Ann M Kring et al.
Positive emotions broaden cognition and build durable resources that support coping and flourishing mental health. Momentary emotional experiences can accrue into self-perpetuating systems, producing lasting affective dispositions. This framework explains cognitive-emotional mechanisms in depression, anxiety, and schizophrenia. Mindfulness and loving-kindness meditation are highlighted as interventions that generate positive emotions to counter negative affective processes in these disorders. The review proposes that positive emotions may counteract dysphoric, fearful, or anhedonic states characteristic of psychopathologies with emotional dysfunctions.