Effectiveness of Mindfulness-Based Stress Reduction Groups for Autistic Adults: A Randomized Clinical Trial
T. Hirvikoski, Hanna Agius, Gustaf Wettermark, Carina Eriksdotter, Anne-Kristina Luoto, N. Jayaram-Lindström, S. Bölte
Autism in Adulthood November 26, 2025 DOI: 10.1177/25739581251400582 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Qualitative Peer reviewed |
|---|---|
| Sample size | 77 |
| Population | Autistic adults recruited from outpatient services, mean age 40 years, 52% female, 64.9% unemployed, 87% with at least one co-occurring psychiatric diagnosis |
| Duration | Intervention conducted 2018-2020; outcomes assessed preintervention, postintervention, and at 3-month follow-up |
| Measures | Perceived Stress Scale, Hospital Anxiety and Depression Scale |
| Topics | Meditation |
| Key findings | Adapted MBSR groups reduced perceived stress and mental health symptoms more than treatment as usual in autistic adults, with effects maintained at 3-month follow-up (between-group d = 0.55-0.70), while autism acceptance and general quality of life showed no change. Participants described the groups as inclusive and safe but noted difficulty maintaining practice after the intervention. |
Abstract
Autistic adults often experience high levels of stress and difficulties in coping with stressors in everyday life. The aim of this study was to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) groups, adjusted for autistic adults in an outpatient context. We conducted a two-arm, parallel-group, randomized controlled effectiveness trial during the years 2018–2020. Autistic adults ( N = 77) were recruited from outpatient services and randomized to either MBSR ( n = 39) or treatment as usual, TAU (i.e., continued regular services, n = 38). We used linear mixed models with random intercept to analyze the effects of intervention on self-rated perceived stress (primary outcome), as well as mental health, mindfulness skills, quality of life, and autism acceptance (secondary outcomes). In addition, we collected qualitative data at exit discussions in the MBSR groups and examined the transcription using thematic content analysis. Participants (52% female) had a mean age of 40 years, with a majority being unemployed at the time of inclusion (64.9%) and having at least one co-occurring psychiatric diagnosis (87%). The completion rate in the MBSR group was 81%. A comparison of the slopes of the two groups showed a greater reduction of perceived stress from pre- to postintervention in the MBSR group than in the TAU group (Perceived Stress Scale total score: between-group effect size d = 0.55 [0.20–0.90] at postintervention and d = 0.61 [0.13–1.10] at the 3-month follow-up). Likewise, symptoms of mental health problems decreased more in the MBSR group (Hospital Anxiety and Depression Scale total score: between group d = 0.64 [0.23–1.05] at postintervention and d = 0.70 [0.14–1.26] at the 3-month follow-up). No changes in autism acceptance or general quality of life were observed in this study. Qualitative analysis indicated that participants perceived the MBSR group as inclusive and safe. Moreover, they appreciated both the conveyance of mindfulness techniques and the change in their approach (a “new mindset”) regarding stress. The participants also reflected on the challenges of continued practice after completed intervention. The MBSR groups for autistic adults may be an effective intervention in a clinical context. Future studies should examine the facilitators and barriers for the long-term maintenance of the acquired benefits.
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 11
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness Meditation and Psychopathology Annual Review of Clinical Psychology December 11, 2018
- Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review. Brain Sciences September 30, 2024
- Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context Autism May 16, 2023
- Virtual Group-Based Mindfulness Intervention for Autistic Adults: a Feasibility Study. Mindfulness June 13, 2022
and 6 more in the library