Unlocking Flow Through Mindfulness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

Flow, a state of deep absorption in an activity, is linked to enhanced performance and well-being. Mindfulness, emphasizing present-moment awareness and acceptance, may promote flow. This systematic review and meta-analysis examined the impact of mindfulness-based interventions (MBIs) on flow state and trait in randomized controlled trials (RCTs). Following PRISMA guidelines, PubMed, Scopus, ProQuest, and Google Scholar were searched (2022, updated January 2024). Inclusion criteria followed PICOS standards: healthy participants following a MBI or control intervention, using validated flow assessments. Exclusion criteria were non-peer-reviewed, qualitative studies, non-RCT designs, and clinical populations. Risk of bias was assessed with Cochrane's RoB2 tool. Eight RCTs (293 participants, 52% female, median intervention duration 7 weeks) met inclusion criteria. The random-effects meta-analysis showed a positive effect of MBIs on flow outcomes (SMD = 0.777, 95% CI [0.505, 1.049], p < 0.0001), with low heterogeneity (I2 = 22.59%, PI = [0.3230, 1.2314]). Publication bias was minimal, as indicated by Egger's test (p = 0.108) and trim-and-fill analyses. Although 50% of the included studies were rated as having a high risk of bias, sensitivity analyses did not reveal important deviations from mean effect. Studies suggest that MBIs meaningfully enhance flow state and trait. Mechanistic insights suggest that MBIs improve flow by enhancing attention, present-moment awareness, and reducing self-critical thoughts. However, small sample sizes and high risk of bias warrant caution. Future research should investigate dose-response and follow-up effects of interventions on specific dimensions of flow and ensure a rigorous assessment of bias risk and evidence synthesis.