Bi-Directional and Time-Lagged Associations between Engagement and Mental Health Symptoms in a Group Mindfulness-Based Mental Health Intervention.
Brock A Rigsby, Reagan L Miller, Megan J Moran, Addie Rzonca, Jonathan I Najman, Melanie S Adams, Mark A. Prince, Rachel G. Lucas‐Thompson
International Journal of Environmental Research and Public Health August 5, 2024 DOI: 10.3390/ijerph21081030 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational daily diary study nested within a six-week mindfulness intervention Peer reviewed |
|---|---|
| Sample size | 62 |
| Population | Adults recruited to participate in a six-week mindfulness intervention |
| Intervention | Mindfulness-based intervention |
| Duration | Six-week mindfulness intervention |
| Topics | Meditation |
| Keywords | Humans Mental health Adolescent Female Young adult Psychological distress University students Within-person variability Daily diary Group intervention Mindfulness-based intervention Location scale model Erraticism |
| Key findings | The authors report bidirectional, time-lagged associations between mindfulness engagement and mental health symptoms. Daily within-person increases in engagement were associated with concurrent mental health improvements but prospective increases in symptoms. Higher engagement relative to personal averages was not consistently associated with better mental health and was associated with greater heterogeneity in outcomes. Higher average and daily symptom levels were associated with lower engagement in the mindfulness protocol. |
Abstract
There is a high need for accessible avenues for improving mental health among emerging adults, particularly on college campuses. Mindfulness-based intervention (MBI) is a promising avenue for reducing mental health symptoms, but initial discomforts associated with MBI may cause symptoms to fluctuate before decreasing, which presents a barrier to engagement with mindfulness on a daily basis. Consistent mindfulness practice is key for forming habits related to MBI, and engagement with mindfulness at home, including between intervention sessions, is an important predictor of mental health outcomes. Research suggests that mental health symptoms may serve as barriers to their own treatment. Thus, it is important to understand how mental health symptom levels impact adherence to treatment protocols. To improve understanding of symptom-specific barriers to treatment and engagement with mindfulness, the present study collected daily diary surveys about engagement with mindfulness and mental health symptoms from a sample of 62 adults recruited to participate in a six-week mindfulness intervention. We explored mental health symptoms as a predictor of engagement with MBI at the mean level and whether within-person variability in symptoms predicted same-day or time-lagged changes in engagement via mixed-effects associations. Using heterogeneous location scale models, we further explored whether erraticism in either mental health symptoms or engagement with mindfulness predicted the other and if outcomes of the mindfulness intervention were homogeneous among subjects. Results showed that bi-directional and time-lagged associations exist between symptoms and engagement, indicating that there is a nuanced temporal and reciprocal relationship between engagement with mindfulness and mental health symptoms. Daily within-person elevations in engagement with mindfulness were associated with concurrent improvements in mental health but prospective increases in mental health symptoms. We also found that higher engagement (over personal averages) was not consistently associated with improvements in mental health across the sample but was instead associated with greater heterogeneity in outcomes. We also found that increases in mental health symptoms (over personal averages), as well as higher average levels of mental health symptoms, were both associated with lower levels of engagement in the mindfulness treatment protocol.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cited by 2
- A comparative study between mindfulness‐enhanced exercise training with tai chi and resistance training for college students' mental health: Efficacy, trajectories, and mechanisms Applied Psychology: Health and Well-Being December 1, 2025
- Associations of Mindful Partnering With Mental and Relational Health. Journal of Marital and Family Therapy July 1, 2026
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and 13 more in the library