Perceived Stress Change During a Mindfulness-Based Intervention for Emotional Distress: Integrated Evidence From Two Randomized Trials.
Jialu Jin, Dongyang Chen, Mengyao He, Amy Hu, Stefan G Hofmann, Xinghua Liu
Clinical Psychology & Psychotherapy July 1, 2026 DOI: 10.1002/cpp.70304 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 1,243 |
| Population | Adults with high psychological distress; Study 1 mean age 31.06 years, 83.18% female; Study 2 mean age 30.13 years, 82.08% female |
| Intervention | Mindfulness-based intervention |
| Duration | Study 1: baseline and postintervention; Study 2: baseline, Week 3, Week 5, and postintervention |
| Topics | Meditation |
| Keywords | Humans Treatment outcome Stress, psychological Adult Female Psychological distress Subjective stress Perceived stress Emotional distress Early process Mindfulness‐based intervention |
| Registration | NCT06035003 |
| Key findings | Across two randomized trials, mindfulness-based interventions produced greater reductions in perceived stress, anxiety, and depression than waitlist controls. Changes in perceived stress accounted for part of the intervention-related reductions in anxiety and depression, with a substantial proportion of the effect in Study 2. Perceived stress appeared to function as a temporally prior process for later depression, while its association with anxiety was more bidirectional. |
Abstract
This study examined the role of perceived stress in intervention-related change during a mindfulness-based intervention (MBI) for emotional distress across two randomized controlled trials. In Study 1, 636 participants (Mage = 31.06, SDage = 9.54; 83.18% female) with high psychological distress were randomized to an MBI group (N = 318) or a Waitlist control group (N = 318), measuring perceived stress, anxiety and depression at baseline and postintervention. Study 2 randomized 607 participants (Mage = 30.13, SDage = 8.15; 82.08% female) with high psychological distress to an MBI group (N = 304) or a Waitlist control group (N = 303), with the same measurements at baseline, Week 3, Week 5 and postintervention. In both studies, linear mixed-effects models showed greater reductions in all variables in the intervention group than in the Waitlist control group. In Study 1, simple mediation analyses showed changes in perceived stress accounted for part of the intervention-related reductions in anxiety and depression. In Study 2, parallel process latent growth curve models indicated that changes in perceived stress accounted for substantial proportions of the intervention effects on anxiety and depression. Random intercept cross-lagged panel models further suggested that perceived stress functioned as a temporally prior process particularly for subsequent depression, whereas the temporal association with anxiety was more bidirectional. Perceived stress may represent an important process underlying the MBI effects on emotional distress, especially in reducing depression. Early reductions in perceived stress may help identify subsequent improvement in anxiety and depression. Trial Registration: Study1: Chinese Clinical Trial Registry number: ChiCTR2200057398. Study2: Clinical Trials number: NCT06035003.
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 12
- How Does Mindfulness Training Affect Health? A Mindfulness Stress Buffering Account Current Directions in Psychological Science December 1, 2014
- Mindfulness-Based Cognitive Therapy in Clinical Practice: A Systematic Review of Neurocognitive Outcomes and Applications for Mental Health and Well-Being. Journal of Clinical Medicine March 3, 2025
- Distress tolerance as a mediator of mindfulness-based intervention for anxiety and depression: Evidence from two randomized controlled trials. International journal of clinical and health psychology : IJCHP 2024
- Supported Mindfulness-Based Self-Help Intervention as an Adjunctive Treatment for Rapid Symptom Change in Emotional Disorders: A Practice-Oriented Multicenter Randomized Controlled Trial. Psychotherapy and Psychosomatics 2025
- Effect of cognitive flexibility in mindfulness intervention for emotional distress: Two randomized controlled trials. Journal of Counseling Psychology July 14, 2025
and 7 more in the library