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How do mindfulness-based programmes improve anxiety, depression and psychological distress? A systematic review

Alan Maddock, Carolyn Blair

Current Psychology April 1, 2023 DOI: 10.1007/s12144-021-02082-y (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Peer reviewed
Topics Anxiety Depression Meditation
Key findings The review reports preliminary evidence that mindfulness-based programme effects on anxiety and depression may be mediated by mechanisms including mindfulness, rumination, worry, self-compassion, cognitive reactivity, aversion, attention regulation skills, and positive affect. The authors state that an overall lack of methodological rigour precludes definitive conclusions about causality.

Abstract

Abstract: This study aimed to systematically review studies which conducted a controlled mediation analysis in order to examine the potential mechanisms which underlie mindfulness-based programme’s (MBPs) effects on anxiety, depression and psychological distress in any health or mental health population. Searches of six databases (Medline (Ovid), PsycINFO, Cochrane Central Register of Controlled Trials, EMBASE, Cinahal Plus and Cochrane Reviews) were undertaken in September 2020. After removing duplicates, 2052 records were screened, of these 1822 were excluded based on the abstract and 230 were further assessed for eligibility against the full study inclusion criteria. Full texts were acquired for the 11 studies which met the inclusion criteria. The quality of the methodologies of each of these 11 studies were assessed using the Cochrane risk of bias tool (Higgins et al., 2011). The quality of the findings from each study relating to the hypothesised mechanisms of action of the MBP reviewed were evaluated using Alsubaie et al. (2017)’s framework for abstracting and interpreting mechanistic study quality, derived from recommendations made by Kazdin (2007, 2009). We found preliminary evidence that MBCT/MBSR treatment effects on anxiety and depression may be mediated by hypothesised mechanisms, such as mindfulness, rumination, worry, self-compassion, cognitive reactivity, aversion, attention regulation skills and positive affect. An overall lack of methodological rigour does preclude us from making any definitive conclusions on causality. The results from this study do however provide some insights into what the potential causal pathways connecting MBPs with improved anxiety and depression might be.

Comparable studies

Other systematic reviews and meta-analyses on anxiety, most cited first.

Study Year Design Participants
Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations 2014 Meta-analysis n = 3,515
Research Review: The effects of mindfulness‐based interventions on cognition and mental health in children and adolescents – a meta‐analysis of randomized controlled trials Children and adolescents 2018 Systematic review and meta-analysis n = 3,666
Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... 2020 Systematic review n = 188
Does Mindfulness Meditation Improve Anxiety and Mood Symptoms? A Review of the Controlled Research Clinical populations with medical and emotional disorders 2007 Systematic review n = 15
Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years Patients from included clinical trials 2016 Systematic review

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Anxiety Depression Meditation