Cultivating inner access: Effects of a wheel of awareness–based mindfulness intervention on psychopathology and awareness of internal states
Limor Raviv, Ricardo Tarrasch, Reuven Dar
Research Square June 22, 2026 preprint DOI: 10.21203/rs.3.rs-9556022/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial |
|---|---|
| Sample size | 99 |
| Population | Adults (87 women, 12 men; mean age 29.01 years, SD 4.05) |
| Intervention | Mindfulness-based intervention based on the Wheel of Awareness practice |
| Duration | Seven weekly two-hour online sessions; measures completed before and after the intervention |
| Measures | Five Facet Mindfulness Questionnaire (FFMQ), Seeking Proxies for Internal States Inventory (SPISI), Depression, Anxiety, and Stress Scale (DASS-21), Obsessive-Compulsive Inventory-Revised (OCI-R) |
| Topics | Meditation |
| Key findings | A seven-week online mindfulness intervention based on the Wheel of Awareness increased mindfulness skills and reduced stress, anxiety, depression, and obsessive-compulsive symptoms relative to a waitlist control. Nonjudgment of internal experiences mediated the reductions in distress and obsessive-compulsive symptoms, while reduced reliance on external proxies for internal states was only near-significant and did not mediate symptom change. |
Abstract
Abstract
Objectives: This study examined the effect of a mindfulness-based intervention based on the Wheel of Awareness practice on psychological distress and access to internal states, within the framework of the Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD). The intervention aimed to enhance mindfulness skills, improve access to internal experiences, and reduce distress, including stress, anxiety, depression, and obsessive-compulsive symptoms.
Methods: Ninety-nine participants (87 women, 12 men; M = 29.01, SD = 4.05) were randomly assigned to either intervention or waitlist control. The intervention included seven weekly, two-hour online sessions. Participants completed self-report measures before and after the intervention, including the Five Facet Mindfulness Questionnaire (FFMQ), the Seeking Proxies for Internal States Inventory (SPISI), the Depression, Anxiety, and Stress Scale (DASS-21), and the Obsessive-Compulsive Inventory-Revised (OCI-R).
Results: Participants in the intervention group displayed significant increases in mindfulness skills and reduced stress, anxiety, depression, and obsessive-compulsive symptoms. The non-judgment of internal experiences component of the practice mediated the association between participation in the program and reductions in distress and obsessive-compulsive symptoms. A near-significant decrease was found in reliance on external proxies for internal states, but it did not mediate changes in obsessive-compulsive tendencies.
Conclusions: The mindfulness-based intervention enhanced mindfulness skills and reduced psychological distress, similar to other mindfulness-based interventions. Results also highlight the central role of nonjudgmental awareness as a mechanism underlying these effects and add to the growing body of evidence of the benefits of online mindfulness practice.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 22
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction Annals of Behavioral Medicine February 1, 2007
- Neural mechanisms of attentional control in mindfulness meditation Frontiers in Neuroscience 2013
- An empirical study of the mechanisms of mindfulness in a mindfulness‐based stress reduction program Journal of Clinical Psychology March 6, 2009
and 17 more in the library