Mechanisms of action in mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in people with physical and/or psychological conditions: A systematic review.
Modi Alsubaie, Rebecca Abbott, Barnaby D. Dunn, Chris M Dickens, Tina Frieda Keil, William Henley, Willem Kuyken
Clinical Psychology Review July 2017 DOI: 10.1016/j.cpr.2017.04.008 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | People with psychological and/or physical health conditions |
| Interventions | Mindfulness-based cognitive therapy (MBCT) Mindfulness-based stress reduction (MBSR) |
| Topics | Meditation |
| Keywords | Mechanisms Physical conditions Psychological conditions Systematic review |
| Key findings | The most consistent finding across the reviewed trials was that greater self-reported change in mindfulness mediated superior clinical outcomes, with this evidence pertaining more to interventions targeting psychological rather than physical health conditions. The authors conclude that few studies fully met Kazdin's criteria for examining treatment mechanisms, and that a lack of methodological rigor precludes definitive conclusions about the mechanisms of MBCT and MBSR. |
Abstract
Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.
Comparable studies
Other systematic reviews and meta-analyses on meditation, 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 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 139
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- Mindfulness Meditation and Psychopathology Annual Review of Clinical Psychology December 11, 2018
- Mindfulness-Based Interventions in Psychiatry. FOCUS: The Journal of Lifelong Learning in Psychiatry January 24, 2018
- The Way Forward in Mindfulness and Sustainability: a Critical Review and Research Agenda Journal of Cognitive Enhancement July 2, 2020
- Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review. Biomedicines November 15, 2024
and 134 more in the library
Cites 32
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- Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples Assessment February 29, 2008
- Assessment of Mindfulness by Self-Report Assessment September 1, 2004
- Mindfulness-based cognitive therapy for depression August 21, 2006
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
and 27 more in the library