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RUNNING HEAD: BRIEF MINDFULNESS META-ANALYSIS
*In press at the Journal of Consulting and Clinical Psychology*
Brief Mindfulness Training for Negative Affectivity: A Systematic Review and Meta-
Analysis
Maya C. Schumer1ξ, Emily K. Lindsay2, J. David Creswell3ξ
1 Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095
2 Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15213
3 Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, 15213
ξ Corresponding Author 1: Maya C. Schumer, Department of Psychology, 502 Portola Plaza, Los
Angeles, CA, 90095, United States. Email: mayaschumer@g.ucla.edu.
ξ Corresponding Author 2: J. David Creswell, Department of Psychology, 5000 Forbes Ave,
Pittsburgh, PA, 15213, United States. Email: creswell@cmu.edu. (Phone #: 412-268-9182)
Word Count: 6,013
Abstract Word Count: 241
References: 123
© 2018, American Psychological Association. This paper is not the copy of record and may not exactly
replicate the final, authoritative version of the article. Please do not copy or cite without authors
permission. The final article will be available, upon publication, via its DOI: 10.1037/ccp0000324
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Abstract
Objective: Over the last ten years, there has been a dramatic increase in published randomized
controlled trials (RCTs) of brief mindfulness training (from single-session inductions to multi-
session interventions lasting up to two weeks), with some preliminary indications that these
training programs may improve mental health outcomes, such as negative affectivity. This meta-
analysis aimed to evaluate whether brief mindfulness training reliably reduces negative
affectivity.
Method: PubMed, PsycINFO, and the Mindfulness Research Monthly Newsletter were
systematically searched for brief mindfulness intervention RCTs assessing negative affectivity
outcomes (e.g., depression, rumination, anxiety, stress). 65 RCTs, including 5,489 participants
predominantly without experience in meditation (64.64% female, mean age = 24.62), qualified
for the meta-analytic review.
Results: The meta-analysis revealed a small but significant effect of brief mindfulness training
on reducing negative affectivity compared to control programs (g=.21, p<.001). The overall
effect size was significantly moderated by participant characteristics: community samples (g=.41,
p<.001) produced larger training effects compared to student samples (g=.14, p=.001) (Qbetween
p=.03). No significant effect size differences were found between clinical and non-clinical
samples. However, when accounting for publication bias, the overall effect size of brief
mindfulness training programs on negative affectivity was significantly reduced (g=.04).
Conclusions: Brief mindfulness training programs are increasingly popular approaches for
reducing negative affectivity. This meta-analysis indicates that brief mindfulness training
modestly reduces negative affectivity. Quantitative analyses indicated the presence of
publication bias (i.e., unpublished null effect studies), highlighting the need to continue rigorous
evaluation of brief mindfulness interventions.
Keywords: mindfulness interventions; negative affectivity; anxiety; depression; meta-analysis
Public Health Significance
This meta-analysis shows that brief mindfulness interventions lasting up to two weeks are
potentially effective for reducing negative affectivity among people with no prior meditation
experience. The presence of publication bias in this literature indicates that more published
studies are needed to evaluate whether this effect is reliable and robust.
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Brief Mindfulness Training for Negative Affectivity: A Systematic Review and Meta-
Analysis
There has been an exponential increase in randomized controlled trials (RCTs) of
mindfulness interventions in recent years (Creswell, 2017). INSERT FIGURE 1. While all
mindfulness interventions train participants to bring nonjudgmental awareness to the present
moment (Bishop et al., 2004), they vary widely in training duration. Many mindfulness RCTs
have utilized 8-10 week interventions, such as the 8-week Mindfulness-Based Stress Reduction
(MBSR) program, but there has also been a surge of published studies describing brief
mindfulness interventions, from single-session inductions to multi-session training programs
lasting two weeks or less (e.g., Zeidan et al., 2010a, b; Creswell et al., 2014; see Figure 1). While
there have been numerous meta-analytic reviews of longer-term mindfulness training programs
(e.g., MBSR) showing that these programs reliably reduce negative affectivity compared to
control groups (see Khoury et al., 2015), there are no meta-analytic reviews evaluating the
effects of brief mindfulness interventions. This meta-analysis evaluates whether brief
mindfulness training decreases negative affectivity in populations new to meditation.
Brief mindfulness training interventions have taken a number of forms, ranging from
two-week programs (e.g., 10 minutes of guided at-home practice for 14 days: Cavanagh et al.,
2013) to shorter, one-week interventions (e.g., two focused breathing inductions separated by
seven days of at-home daily practice: Banks et al., 2015) to single-session inductions that are
often lab-based (e.g., five minutes of guided mindfulness practice: Wells & Roussis, 2014). This
meta-analysis examines the full range of brief mindfulness interventions and tests whether length
of training moderates their efficacy.
Understanding the effects of brief mindfulness interventions is important and timely
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because brief training approaches (via downloadable Smartphone mindfulness applications or
internet streamed audios, for example) are increasingly popular worldwide (Creswell, 2017;
Wahbeh, Svalina, & Oken, 2014). And indeed, initial well-controlled RCTs of brief mindfulness
training suggest immediate benefits of these programs. For example, in a non-clinical sample
exposed to a negative mood induction, Broderick (2005) found that an 8-minute guided
mindfulness exercise reduced negative affectivity compared to control exercises. In another non-
clinical sample, Zeidan and colleagues (2010b) found that a 3-day intervention (20 minutes of
guided practice per day) lowered negative affectivity at post-treatment compared to sham
meditation or no training. Despite these promising indications, it is unclear how reliable these
effects are across studies and time.
This meta-analysis focuses on the effects of brief mindfulness training programs on
reducing measures of negative affectivity, a dimension of subjective distress (Watson & Clark,
1984) that encompasses the experience of negative emotions (e.g., fear, anxiety, disgust) and
mood states related to depression (e.g., sadness) (Eysenck, 1970; Gotlib, 1984; Watson, Clark, &
Carey, 1988; Zurawski & Smith, 1987). Specifically, negative affectivity is operationalized as
any emotional state that is aversive, negative, uncomfortable, or unpleasant, such as anxiety,
worry, depression, fear, or anger (Carmody & Baer, 2009; Drapeau, Marchand, & Beaulieu-
Pre’vost, 2011; Keng, Smoski, & Robins, 2011; Ridner, 2004). We selected negative affectivity
as the outcome of interest in this meta-analysis for several reasons. First, measures of negative
affectivity are clinically important; they have been shown to robustly predict clinical
symptomatology (Coyne, Thompson, & Racioppo, 2001; Kvaal, Ulstein, Nordhus, & Engedal,
2005, Rush, Carmody, & Reimitz, 2000), including anxiety and depressive symptoms (Headey,
Kelley, & Wearing, 1993, Watson, Clark, & Carey, 1988). Second, negative affectivity is one of
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the most commonly measured outcomes in the mindfulness training literature, with longer-term
mindfulness interventions (e.g., MBSR) showing reliable and large effects on reducing negative
affectivity compared to control groups (g’s=.62-.80: Baer, 2003; Khoury, Sharma, Rush, &
Fournier, 2015). It is also the most commonly measured outcome variable (to our knowledge) in
the brief mindfulness interventions literature. In this review, negative affectivity was measured
most often via self-report (91 measures) and less often via performance-based measures (2
measures), with the majority of outcomes assessing state-level negative affectivity changes (68
outcomes) (for a full list of negative affectivity outcome measures used in this meta-analysis, see
Supplementary Table 1). Finally, negative affectivity is a theoretically relevant outcome in the
mindfulness literature. By fostering awareness and nonreactivity toward momentary affective
experiences, mindfulness alters how one relates to negative affect; unpleasant and stressful
experiences are allowed to arise and pass without interference (Brown, Ryan, & Creswell, 2007;
Lindsay & Creswell, 2017).
To examine whether brief mindfulness training reduces negative affectivity, we reviewed
published RCTs that assessed the efficacy of brief mindfulness training against a control
condition (active or no training) in adults predominantly without prior meditation experience (in
a small number of studies, fewer than 5% of participants reported meditation experience). This
meta-analysis first presents overall results across all eligible RCTs (N=65). It was predicted that
brief mindfulness interventions, relative to control groups, would significantly reduce negative
affectivity at post-treatment.
A second aim of this meta-analysis was to empirically evaluate whether study factors or
participant characteristics moderated the strength of mindfulness intervention effects on negative
affectivity. Previous meta-analyses of longer-term mindfulness training RCTs indicate that
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intervention duration can moderate the effects of mindfulness training programs, with longer
durations of training producing larger mindfulness effects (Khoury et al., 2015; Spijkerman, Pots,
& Bohlmeijer, 2016). Given the range of training durations in brief mindfulness interventions
(from 5-minute inductions to 2 week programs), this meta-analysis evaluates intervention
duration as a moderator. It was hypothesized that there would be a moderating role of
intervention duration, such that longer interventions would show larger effects on reducing
negative affectivity compared to very brief (e.g., induction) interventions. Regarding participant
characteristics, although previous meta-analyses suggest that 8-week mindfulness-based
interventions are equally effective for clinical (e.g., physical disease or mental disorder) and
nonclinical populations (i.e., students or community volunteers with no clinical diagnoses), some
have hypothesized that nonclinical samples are generally likely to show smaller mindfulness
training effects due to floor effects. Specifically, with fewer clinical symptoms (e.g., depression
and anxiety) at baseline, nonclinical samples have a smaller window for improvement in
negative affectivity compared to clinical samples (Carmody & Baer, 2009; Spijkerman et al.,
2016). Thus, we explored the hypotheses that clinical status and population type would moderate
mindfulness training effects on negative affectivity. Specifically, nonclinical samples were
expected to show smaller mindfulness training effects than clinical samples. Community
populations were expected to show larger mindfulness training effects than college students,
given that community participants are likely more motivated to participate (and to be adherent)
to mindfulness intervention programs. Finally, although we had no formal predictions that other
participant and study factors would moderate brief mindfulness training effects (age, type of
control program, study quality, type of mindfulness exercises, and outcome assessment type and
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timing)1, these moderators were nonetheless tested in this meta-analysis.
Finally, results are presented from a subsample of RCTs (N=46) that measure negative
affectivity in response to a distress paradigm (i.e., tasks designed to trigger a negative affective
response). We contrast these “negative affect reactivity studies” with studies measuring changes
in negative affectivity from pre- to post-intervention (in the absence of a distress paradigm). We
expected brief mindfulness training effects to be more pronounced in these negative affect
reactivity studies compared to studies that measure negative affectivity without inducing distress.
This expectation borrows logic from the stress-buffering theory; mindfulness may be more
effective for lowering negative affectivity in high stress contexts where there is more room for
intervention-related improvement (Arch & Craske, 2006; Creswell & Lindsay, 2014).
Methods
This meta-analysis was conducted using the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines (Moher, Liberati, Tetzlaff, Altman, & Group,
2009). Methods and inclusion criteria were specified in advance and documented in a study
protocol by the authors of this review.
Search and Selection
The following databases were searched for primary studies between February and May of
2015: PubMed, PsycINFO, and the Mindfulness Research Monthly Newsletter (Black, 2010).
Specifically, the following were used as search terms in the PubMed and PsycINFO databases:
‘mindfulness’ AND ‘brief,’ ‘induction,’ OR ‘short term’. Additional studies were identified from
references of relevant studies and review articles retrieved from the database searches.
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1!We did not pursue other demographic factors such as sex, ethnicity, and socioeconomic status (SES) as moderators
because there is little indication in the literature for sex differences in mindfulness training effects (Khoury et al.,
2013; Zoogman et al., 2015) and limited information was available for determining SES and ethnicity from the
included studies.!
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INSERT FIGURE 2 (FLOWCHART OF STUDY SELECTION)
Figure 2 depicts the study selection process for this meta-analysis. Studies were included
if they met the following criteria:
(1) offered a primarily mindfulness meditation-based induction or intervention that aimed
to promote nonjudgmental awareness of the present moment (Creswell, 2017) and lasted
no longer than 2 weeks2. Studies described as mindfulness-related interventions involving
compassion, lovingkindness, Zen, or Buddhist meditation, or those that included
mindfulness as part of a multi-component intervention (e.g., Acceptance and
Commitment Therapy, Cognitive Behavioral Stress Management, Integrative Body-Mind
Therapy) were excluded in order to directly evaluate the impact of mindfulness training
without the confounding effects of other intervention elements;
(2) included no more than 5% of participants who reported meditation experience (to
assess the effects of brief mindfulness training in a primarily mindfulness-naïve
population);
(3) randomly assigned participants to a mindfulness or control condition and used a
between-subjects design;
(4) had more than one participant enrolled in the intervention or induction;
(5) included at least one outcome directly measuring negative affectivity. Eligible
outcomes measured state or trait negative emotional distress or reactivity (e.g., anger,
anxiety, depression, distress, irritability, sadness, shame, stress). Measures that assessed
distress or reactivity in response to negative cognitions were included, but cognitive
outcomes and tasks without an affective element were not included.
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2 Studies that did not explicitly refer to the intervention or induction as “mindfulness” but were primarily focused on
training or inducing the two key components of mindfulness (awareness and acceptance; Bishop et al., 2004) were
included.!
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In total, 63 published papers (describing 65 RCTs) met the criteria for inclusion in this
meta-analysis. Studies were not excluded based on the clinical status of participants.
Data Abstraction
Information was extracted from each selected study on: (1) characteristics of the study
participants (including age, percentage of female participants, ethnicity, whether the sample
comprised college students or community adults, and clinical status); (2) type of mindfulness
intervention (whether the intervention was an induction or a training program, its duration, and
program details); (3) type of control (active or no training); (4) the particular outcome measure
assessing negative affectivity and its type (state or trait).
In an effort to reduce reporting bias, all negative affectivity outcomes mentioned in the
study’s methods section were included in the database, even if statistical results were not
reported for that outcome. When no numerical data was reported on the outcome of interest but
figures were included (e.g., bar graphs), group means and SD/SEs were estimated from ruler
measurements. When sufficient data was not reported to enable the calculation of an effect size,
we contacted the study authors for data. In cases where we were not able to reach authors for
data, we coded an F statistic of 0.01 for non-significant effects and missing outcomes, and when
Ns per study condition were not obtained, we split Ns evenly between groups (or favored the
control group when total Ns were odd).
The coding verification procedure went as follows: A detailed coding manual was
developed (and available by request from the authors), and coding reliability was established by
two independent coders on several studies (coding agreement was 92.86%). All studies were
coded by M.C.S., and a second judge (E.K.L) resolved uncertain coding decisions.
Numerical data were extracted for pre- and post-intervention time points and the coded
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moderator variables. All data were entered and analyzed using the software program,
Comprehensive Meta Analysis Version 3 (CMA; Borenstein, Hedges, Higgins, & Rothstein,
2014). This program allows data entry in various formats based on how the authors reported
them. Our preference was to use descriptive statistics (e.g., means and SDs) whenever possible,
as opposed to using inferential statistics. The CMA database is available for research purposes
by request.
Validity Assessment
Publication bias was evaluated first with a rank correlation test (to test for publication
bias in general), then by investigating the extent of publication bias with trim-and-fill methods,
and finally by creating funnel plots to visualize the bias. Specifically, Begg’s rank correlation
test (Begg and Mazumdar, 1994) is a statistical analogue to the funnel plot and provides a
quantitative estimate (using Kendall’s τ) of the relative skewness of the distribution of studies
observed in the funnel plot by relating study sample size with each study’s observed effect size
(a significant correlation indicates greater publication bias). The trim-and-fill technique
described by Duval and Tweedie (2000) evaluated the presence and impact of missing studies
shown in the funnel plot, whether they were to the left or to the right of the mean overall effect
size (i.e., missing studies with smaller or larger than average effect sizes) using fixed effect
models. Specifically, the funnel plot visually assesses publication bias by graphing the effect size
estimate of each study against its standard error (with less symmetrical funnel plots indicating
greater risk of publication bias).
Study quality was assessed using the Delphi list criteria (Verhagen et al., 1998). This list
contains 9 criteria that assess the quality of an RCT: 1) randomization performed, 2) treatment
allocation concealed, 3) groups similar at baseline, 4) eligibility criteria specified, 5) outcome
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assessor blinded3, 6) care provider blinded4, 7) participant blinded, 8) descriptive statistics
reported, and 9) intent-to-treat analyses. For each criterion clearly mentioned by a study in the
published report, the study receives one point, and if not mentioned, the criterion category
receives 0 points, resulting in a Delphi score from 0-9.
Study Characteristics (Moderators)
Length of training: Length of the mindfulness intervention was coded in two ways. First,
an intervention was categorized as either a mindfulness induction (one practice session; e.g., 10
minutes of mindful breathing) or mindfulness training (more than one practice session; e.g., 2
weeks of daily practice). Second, meta-regressions were conducted to look at the moderating role
of intervention duration, as measured in minutes, number of sessions, and number of days the
training spanned.
Study Population: The moderating effects of three sample characteristics were tested.
First, study population was categorized as comprising either a student or community sample (and
if the sample was recruited from both types of populations, the dominant type was favored based
on the mean age of the sample, with the cut-off for students at less than 22 years). The average
age of the study sample was analyzed with a meta-regression analysis. Clinical status was coded
as either nonclinical (i.e., lacking a mental or physical health diagnosis) or clinical (i.e.,
diagnosed with a disorder or medical condition like Generalized Anxiety Disorder or chronic
pain). Additionally, clinical status was analyzed as a moderator separately in student vs.
community samples.
Study Quality: Study quality (i.e., Delphi score) was analyzed continuously in a meta-
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3By “outcome assessor” we are referring to the experimenter.
4Since we were not examining a medical intervention that required a doctor or care provider, by “care
provider” we are referring to the person who delivered the mindfulness intervention program (in most
cases, mindfulness instructions were pre-recorded) and whether they were blind to condition.
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regression analysis, consistent with previous meta-analyses (Khoury et al., 2013; Spijkerman et
al., 2016). Study quality was also analyzed individually in student vs. community samples to
explore whether it differed in these two study types and whether it explained potential effect size
differences between populations.
Control Type: Consistent with other mindfulness intervention meta-analyses that tested
control condition type as a moderator (Grossman, Niemann, Schmidt, & Walach, 2004;
Zoogman, Goldberg, Hoyt, & Miller, 2015), control type was categorized as either “active” or
“no training” and evaluated as a moderator. “Active” control conditions included both well-
matched (i.e., the control group closely resembled the intervention in duration and amount of
required activity; e.g., sham meditation, muscle relaxation) and not well-matched (i.e., the
control group participated in some kind of activity that did not match the experimental
intervention in terms of duration or rigor; e.g., using usual coping skills) types. In “no training”
control conditions, participants did not engage in activity during the time the experimental group
received treatment. Larger mindfulness training effects in relation to no training versus active
control programs may indicate that active comparisons more accurately account for general or
non-specific intervention effects.
Mindfulness Exercise Type: To compare efficacy among the different mindfulness
training exercises used in the selected studies, we coded interventions as instructing: focused
breathing, body scan, multiple mindfulness exercises in a single intervention, or “other,” a
category that collapses studies where mindfulness instructions were applied to a task (e.g., the
raisin-eating exercise: Heppner et al., 2008, Hong et al., 2012; alcohol and smoking cue
inductions: Murphy & MacKillop, 2014, Bowen & Marlatt, 2009, Rogojanski et al., 2011) and
studies of mindfulness interventions that could not be placed in any of the other three categories
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(e.g., reading statements mindfully: Huffziger & Kuehner, 2009, Sauer & Baer, 2012, Wahl et al.,
2012; learning mindfulness strategies: Chen et al., 2013, Cruess et al., 2015, Singer & Dobson,
2007).
Negative Affectivity Assessment: Aspects of negative affectivity related to study design
and assessment were analyzed in two moderator analyses. To test for the stability of mindfulness
training effects, we coded the timing of negative affectivity outcome assessment (whether the
outcome was measured immediately post-intervention, within 1 day of the intervention, or 1 day
or longer post-intervention). Second, negative affectivity outcomes were categorized as
measuring state- or trait-level effects, with the expectation that state negative affectivity would
be more malleable in brief mindfulness training studies.
Negative Affect Reactivity Studies: Within the subsample of negative affect reactivity
studies, we assessed whether the timing of the distress paradigm (before, during, after, or both
before and after the mindfulness intervention) moderated the brief training effect within these
studies so as to compare efficacy across different study designs.
Quantitative Data Synthesis
Due to the heterogeneity across studies from different study designs, such as the differing
number of comparison or control groups (1-3) and type of outcome measures (see
Supplementary Table 1), we used a random effects model (and in the case of multiple control
comparisons to the intervention, a summary effect was computed; Raudenbush, 1994; Shadish &
Keith, 1994). Effect directions (see Supplementary Table 1) were typically determined by the
measure’s original citation, but when the scale was created specifically for the study, we relied
on the author’s interpretation of the effect. Reductions in negative affectivity from pre- to post-
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training were coded as positive effect directions5.
Effect sizes were calculated in one of two ways: 1) based on pre- and post-intervention
values in both the mindfulness and control groups or 2) using only post-intervention data if no
pre-intervention data was collected and only post-intervention data was reported. Hedges’ g, the
unit for effect size, and its 95% confidence interval (Hedges & Olkin, 1985) were calculated with
random-effects models using pre-to-post mean changes and post-only mean differences between
groups using the following formula:
Effect sizes (g) were interpreted such that ~0.2 was a small effect, ~0.5 was a medium effect, and
~0.8 was a large effect (Cohen, 1988). A pre-post correlation of 0.6 was used, which is a
conservative estimate consistent with previous meta-analyses (Segerstrom & Miller, 2004). Each
individual RCT functioned as the unit of analysis, such that each study contributed one effect
size in each analysis, and in cases where multiple negative affectivity outcomes were reported in
a single RCT, an aggregate effect size was automatically computed; exceptions are noted in the
tables. These exceptions consist of studies that included multiple intervention and/or control
groups in a single RCT, although the most common study design included one intervention and
one control group. In studies where there were multiple mindfulness intervention conditions, an
aggregate effect was calculated for all intervention conditions compared to the control condition
for each negative affectivity outcome. In studies where there were multiple control conditions, a
summary effect for the mindfulness intervention versus all control conditions was calculated.
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5Two outcomes measured distress tolerance (Sauer & Baer, 2012) and psychological detachment (Hülsheger et al.,
2015); in these cases, an increase in these outcomes from pre- to post-training was coded as a positive effect
direction.
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After the overall negative affectivity effect size was computed (which includes all
negative affectivity outcomes), Cochran’s Q was used to evaluate heterogeneity between studies
(i.e., whether the observed effect size was influenced by characteristics that vary among studies,
such as study design quality and sample characteristics). Given a statistically significant Q, we
planned to run moderator analyses and meta-regressions under the assumption that they would
explain the heterogeneity across studies.
Results
Primary meta-analytic findings are listed in Table 1. First, we describe the overall
negative affectivity effect (Table 1), followed by additional moderator analyses and meta-
regressions (Tables 1a-1d) to explore whether the coded moderators explained heterogeneity of
the overall effect size. Second, results from the subgroup analysis of studies that included a
distress paradigm are presented (Tables 2-2a).
Sample Characteristics
5,489 individuals participated in the N=65 independent RCT studies (3,548 were
female6,7), and these participants had an average age of 24.62 years (SD=7.77)8. Of the 35 RCTs
reporting ethnicity (3,697 participants), 68.97% were Caucasian. Most participants in these
studies were categorized as nonclinical (N=4,757) and fewer had clinical diagnoses (N=732).
Sample sizes ranged from 17 to 411 participants, and the average sample size was 84 participants.
Studies were drawn from 14 countries, with the United States as the most common setting
(N=33).
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64 studies did not report the number of female participants (Cavanagh et al., 2013; Droit Volet et al. 2014; Ortner &
Zelazo, 2014; Wells & Roussis, 2014).
7N female and mean age should be interpreted cautiously, as several studies only reported these statistics prior to
dropouts and exclusions.
83 studies either a) did not report mean or median age (Heppner et al. 2008, Ortner & Zelazo, 2014) or b) described
age more broadly (Arch & Craske, 2006).
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Overall Effects on Negative Affectivity
As predicted, there was a small, positive effect of brief mindfulness interventions on
reducing negative affectivity in the 65 RCTs (Hedges’ g=.21 [.12,.29], p<.001). There was
significant heterogeneity in the overall effect size estimate among these 65 studies
(Qwithin=136.230, p<.001), so subsequent analyses were conducted with the coded moderator
variables to help explain this heterogeneity (Tables 1a-d).
Moderator Effects and Meta-Regressions
Length of Training: Contrary to predictions, length of training (i.e., whether the
mindfulness intervention was one session (g=.22) or longer (g=.12)) did not significantly
moderate brief mindfulness intervention effects (see Table 1a). Similarly, meta-regressions
showed that the duration of the mindfulness program (in minutes, sessions, or days) did not
significantly moderate the overall negative affectivity effect (see Table 1b).
Study Population: Consistent with predictions, the study population type significantly
moderated the overall negative affectivity effect (Qbetween p=.03). Specifically, community
samples (g=.40) had larger mindfulness intervention effects on reducing negative affectivity
relative to student samples (g=.14) (see Table 1a). While clinical status did not significantly
moderate the overall effect of mindfulness interventions on negative affectivity, clinical
populations showed modestly larger effect sizes (g=.33) than nonclinical populations (g=.19)
(see Table 1a). Within community versus student samples alone, clinical status did not
significantly moderate the brief mindfulness training effect for these subgroups (see Table 1c).
Study sample age did not significantly moderate the overall negative affectivity effect (see Table
1b).
Study Quality: When evaluated in a meta-regression analysis, study quality did not
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significantly moderate the overall negative affectivity effect (see Table 1b). However, within
studies using community samples, study quality did moderate the mindfulness training effect (
=.26, p=.03), such that higher quality studies produced larger mindfulness training effects on
negative affectivity (see Table 1d); in studies using student samples, study quality was not a
significant moderator.
Control Type: The type of control program (active comparison programs: g=.17; no-
training: g=.42) did not significantly moderate the overall effect of mindfulness interventions on
negative affectivity, although these effect sizes suggest a smaller overall effect of mindfulness
training when compared to other active programs (see Table 1a).
Mindfulness Exercise Type: The type of mindfulness training exercise (Table 1a)
significantly moderated the overall training effect (Qbetween p=.006), with studies instructing
multiple types of mindfulness exercises in a single intervention (g=.26) and other types of
mindfulness exercises (e.g., mindfulness applied to a task) (g=.30) producing stronger effects
compared to studies instructing focused breathing (g=.16) or a body scan (g=-.09), suggesting
that instructing mindfulness exercises beyond body scans and focused breathing might be
maximally effective.
Negative Affectivity Assessment: The timing of outcome assessment did not significantly
moderate the overall effect (see Table 1a), although effect sizes tended to decrease over time.
Outcomes assessed immediately post-intervention showed the largest effect (g=.29), followed by
those assessed later that same day (g=.18), and outcomes assessed 1 day or longer post-
intervention showed very small effects (g=.08), suggesting that brief mindfulness training effects
on negative affectivity may fade with time. Second, whether an outcome measured state or trait
negative affectivity did not significantly moderate the overall brief mindfulness training effect
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(see Table 1a), although state measures (g=.23) produced somewhat larger training effects than
trait measures (g=.14).
Negative Affect Reactivity Studies
In the subsample of 46 RCTs that used a distress paradigm to measure negative affect
reactivity, a small significant effect of brief mindfulness training was present (Hedges’ g=.27
[.14,.35], p<.001), which, consistent with predictions, was larger than the effect observed in
studies that did not use a distress paradigm (Hedges’ g=.10 [-.01, .22], p=.08). There was
significant heterogeneity within this reactivity study effect (Table 2). Although the timing of the
distress paradigm did not significantly moderate the overall effect within these studies (Table 2a),
studies that administered distress paradigms before (g=.26), after (g=.26), as well as both before
and after mindfulness training (g=.29) had comparable negative reactivity effects, whereas
studies that administered a distress paradigm during the intervention produced a smaller effect
(g=.15).
Publication Bias Assessment
To evaluate the potential of publication bias in this brief mindfulness training literature,
funnel plots visually depict the distribution of study effect sizes against their standard errors
(open circles in Figure 3). Begg’s rank correlation test (Begg & Mazumdar, 1994) indicated a
significant association between sample size and observed effect size for studies with negative
affectivity outcomes (Kendall’s = .40, p <.001), indicating a risk for publication bias in this
brief mindfulness training literature. To explore the nature of publication bias, trim-and-fill
analyses (Duval & Tweedie, 2000) estimated the potential for missing studies to the left and right
of the mean effect size and then filled these studies on the funnel plots (filled-in circles in Figure
3). The trim-and-fill analysis indicated no studies to be missing on the right side (positive
Brief Mindfulness Meta-Analysis
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mindfulness training effects) whereas 18 study effect sizes were estimated to be missing on the
left side (negative or null mindfulness training effects) (Figure 3). By filling in these missing
negative effect studies, the trim-and-fill analysis estimates the brief mindfulness training effect
size on negative affectivity outcomes to be much more modest and not significantly different
from zero (adjusted effect size of training on negative affectivity for potentially missing studies:
Hedges’ g=.04 [-.01, .09]).
Discussion
This is the first meta-analysis to examine the effects of brief mindfulness meditation
training on negative affectivity outcomes, with the aim of assessing the overall magnitude of the
effect of brief mindfulness interventions across studies. The results show that brief mindfulness
training programs have an immediate and significant (albeit small) effect on decreasing negative
affectivity in both nonclinical and clinical samples. However, since the majority of studies in this
meta-analysis sampled from nonclinical populations, the efficacy of brief mindfulness training
on reducing negative affectivity in clinical populations requires further evaluation. Overall, brief
mindfulness interventions may be effective for reducing negative affectivity by activating
attention regulation (Ainsworth et al., 2013; Dickenson et al., 2013) and emotion regulation
skills (e.g., decreasing mind-wandering and rumination: Rahl et al., 2016, Chiesa & Serretti,
2009; increasing the tolerance for negative emotional content and arousal: Lutz et al., 2013).
Importantly, analyses also reveal the potential for publication bias in this meta-analysis
(i.e., null results might not have been published), suggesting caution in inferring that brief
mindfulness training programs reliably reduce negative affectivity. Specifically, trim-and-fill
analyses estimated that some studies with negative effects may have been conducted but not
published (Figure 3), and including these hypothetical studies reduces the overall effect size to
Brief Mindfulness Meta-Analysis
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nearly zero.
The possible existence of numerous unpublished brief mindfulness training studies
combined with the significant heterogeneity among published studies included in this meta-
analysis suggests the likelihood of important boundary conditions on the putative benefits of
brief mindfulness training programs on reducing negative affectivity. To this end, this meta-
analysis explored several moderating factors that begin to identify contexts when brief
mindfulness training effects may be present (e.g., in community samples; immediately post-
intervention; in interventions that include multiple mindfulness exercises), but these factors need
to be carefully evaluated in future RCTs. Specifically, this meta-analysis indicates that brief
mindfulness training programs had significantly larger negative affectivity reduction effects
among community adult populations compared to college students. One potential explanation is
that there may be higher motivation among community members to seek out and engage with
brief mindfulness training programs. For example, older community adults exhibit more positive
help-seeking attitudes than younger adults (Mackenzie et al., 2008). This finding supports the
notion that particular populations may benefit more from brief mindfulness interventions than
others (Creswell & Lindsay, 2014).
The literature on brief mindfulness training shows that studies thus far have mainly
sampled from nonclinical populations (approximately 87% of the participants included in this
meta-analysis were drawn from nonclinical populations). Although the few studies drawn from
clinical populations (k=11; N=732) showed a significant effect of brief mindfulness interventions
on reducing negative affectivity in this meta-analysis (g=.33), it is important for future research
to further evaluate the efficacy of brief mindfulness interventions in clinical populations,
particularly in light of evidence suggesting that individuals with clinical diagnoses have more
Brief Mindfulness Meta-Analysis
21!
difficulty practicing mindfulness effectively for the first time compared to nonclinical
individuals (Vitalia & Răban-Motounu, 2014). Moreover, the studies included in this meta-
analysis did not assess clinical outcomes. Still, brief mindfulness practices are widely used for
managing negative affect (Arch & Craske, 2006; Sears & Kraus, 2009; Vinci et al., 2014), an
important outcome for mental health professionals (Sauer-Zavala et al., 2012). More research is
needed to test whether brief mindfulness interventions may have clinically meaningful effects,
and to address the problem of publication bias that limits support for recommending brief
mindfulness interventions as an evidence-based treatment for negative affectivity.
Surprisingly, this meta-analysis did not indicate that training duration (which ranged from
one session to two weeks of mindfulness training) moderated the overall effect; instead, very
brief mindfulness interventions had comparable effects to multi-day brief mindfulness
interventions. Moreover, moderator analyses suggest that brief mindfulness training effects on
negative affectivity tend to fade with time (see Table 1a) across all lengths of training. Thus, in
contrast to more intensive 8-week mindfulness interventions that promote more stable benefits
over time (e.g., Bowen et al., 2014; Kuyken et al., 2015), it’s likely that brief mindfulness
interventions of up to two weeks have acute, but not long-term, benefits for reducing negative
affectivity. Future research directly comparing the effects of inductions, brief trainings, and
standard 8-week interventions with multiple post-intervention assessments would inform this
question.
Within the 46 negative affect reactivity studies, the timing of the distress paradigm in
relation to mindfulness training did not significantly moderate the overall effect. The effects of
mindfulness were equally strong when practiced before or after a distress task, as well as when
there were multiple distress tasks with mindfulness practice in between, potentially serving two
Brief Mindfulness Meta-Analysis
22!
roles: reducing negative affect in response to distress (acting as a distress inoculation) and
promoting recovery from distress (with distress potentially increasing participants' motivation to
engage in mindfulness). A recent review of acceptance and mindfulness-based interventions
(Levin, Luoma, & Haeger, 2015) concluded that these interventions may reduce the relationship
between initial negative affect (e.g., depression) and further reactivity. The present meta-
analysis supports and extends these findings, suggesting that mindfulness practice may reduce
both the magnitude of initial negative reactivity and the ongoing reactivity toward that primary
negative emotional experience (thus facilitating recovery). For example, Arch and Craske (2006)
showed that practicing mindfulness between aversive task blocks increased the willingness to be
exposed to aversive stimuli, and noted that mindfulness seemed to reduce reactivity and facilitate
recovery. Similarly, Erisman and Roemer (2010) measured negative affectivity in response to
negative film clips before and twice after a mindfulness induction and found that mindfulness
lowered self-reported negative affectivity directly following the film clips (but had no effect
when negative affectivity was assessed at a more distal post-induction time point). These results
suggest that mindfulness may facilitate emotion regulation by reducing initial reactivity to
emotionally threatening stimuli, which reduces the later need for recovery. More research is
needed to understand when brief mindfulness training is most effective and the mechanisms
through which it impacts affective reactivity and recovery processes over time.
This review is the first systematic meta-analysis of brief mindfulness meditation training,
addressing an important gap in the mindfulness intervention literature. Nonetheless, this review
has several limitations. First, given the potential for unpublished brief mindfulness training
studies with null results, our decision not to seek out and include unpublished studies could be
viewed as a limitation. On the other hand, while including unpublished studies may reduce the
Brief Mindfulness Meta-Analysis
23!
risk of publication bias, their inclusion can introduce other sources of bias (Higgins & Green,
2011), including the possibility of critical methodological mistakes and unreliable results not
addressed through peer-review (Chalmers et al., 1987).
Second, most outcomes were self-reported (except two that were performance-based), a
method of data collection that is biased by many factors as it is difficult to introspect about
higher-order cognitive processes (Nisbett & Wilson, 1977). To improve reporting on negative
affectivity, future studies might implement validated behavioral measures of negative affectivity
in addition to self-report measures (e.g., Paced Auditory Serial Addition Task, a behavioral
measure of distress tolerance: Lejuez, Kahler, & Brown, 2003). Additionally, Ecological
Momentary Assessment (EMA) methods (Shiffman et al., 2008), which collect real-time data in
daily life, are an increasing popular way to reduce memory bias by measuring affective
experiences in response to daily life events (for recent mindfulness training studies using EMA
methods, see Huffziger et al., 2013; Mrazek et al., 2013; Ruscio, Muench, Brede, MacIntyre, &
Waters, 2016; Ruscio, Muench, Brede, & Waters, 2016).
Third, the immediacy of post-training outcome assessments in most studies is not
informative about the lasting effects – if any – of brief mindfulness training on negative
affectivity and its impact on daily life functioning; thus, negative affectivity should be measured
at more distal time points and in daily life in future research.
Finally, the studies in this meta-analysis were categorized as having relatively low
(Buffart et al., 2012) methodological quality overall (mean Delphi score = 3.23, SD = 1.09),
which may be attributed to a lack of clarity in reporting study design characteristics. To improve
study quality, future reports should not only explicitly describe their study designs (e.g.,
participant blinding is particularly important; Bergeron, Almgren-Doré, & Dandeneau, 2016),
Brief Mindfulness Meta-Analysis
24!
but also adhere to guidelines for conducting high quality RCTs (e.g., CONSORT; Rennie, 2001).
Several more directions for future research emerge from the findings presented in this
meta-analysis. In light of the finding that community adults show larger mindfulness effects than
college students, future studies might assess subjects’ baseline motivation for participating.
Perhaps mindfulness is less effective for those driven by external motivation (e.g., monetary
compensation or, for college students specifically, course credit); thus, researchers might study
the moderating role of motivation. In line with general recommendations in the field (Davidson,
2010; MacCoon et al., 2012) and in light of the finding that mindfulness training showed smaller
effects when compared to active rather than no training controls (see Table 1a), it is important
for future studies to use well-matched active control programs (e.g., sham meditation, used in
Zeidan et al., 2010b). Active control programs more effectively control for non-specific
treatment factors, an approach that enables studies to test the unique effects of the “active
ingredients” of mindfulness training (Chiesa & Serretti, 2009). Otherwise, mindfulness-specific
factors are mixed with non-specific effects of undergoing an intervention (Karlsson & Bergmark,
2015). Another direction for future research is the opportunity to conduct a meta-analytic review
assessing brief mindfulness training effects on cognitive outcomes (e.g., working memory,
attention), a growing area of literature. In this review alone, 14 out of 66 RCTs measured
cognitive outcomes in addition to negative affectivity (e.g., N-back performance; Johnson et al.,
2015). This type of review might also inform mindfulness mechanisms (e.g., meditation training
may first evoke attentional and meta-cognitive skills or states (Bishop et al., 2004) which then
affect emotional health over time (Wells, 2002).
Overall, this meta-analytic review suggests caution in implementing brief mindfulness
training programs for reducing negative affectivity, given the potential presence of publication
Brief Mindfulness Meta-Analysis
25!
bias. While brief mindfulness programs are rapidly growing in popularity, more rigorous
research is needed to evaluate their presumed benefits. This meta-analysis provides some initial
clues about populations that may particularly benefit (e.g., community adults), formats for brief
mindfulness training (e.g., multiple types of mindfulness exercises in a single program), and
study design approaches (e.g., measuring negative affectivity using state measures) that may be
important for determining when we are likely to see benefits, evidence that we think will help the
field advance in understanding brief mindfulness intervention effects in the coming years.
Acknowledgements: This work was conducted at Carnegie Mellon University.
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26!
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Table 1.
Overall Effects on Negative Affectivity Outcomes.
Negative Affectivity Outcome k N Effect Size (Hedges’ g) 95% CI Q I2
All outcomes 65 5489 0.208* 0.124-0.292 136.23* 53.02
Note. *p<.001; k=number of studies; N=total participants; 95% CI=95% confidence interval around mean
estimate; Q=a standardized metric for heterogeneity of effect sizes around the mean effect size; I2=an estimate of the
proportion of observed variability that reflects real effect size variability. N=6 studies had outcomes coded for no
effect: Cropley et al., 2007; Ellett et al., 2008; Nosen & Woody, 2013; Ramsey & Jones, 2015; Zabelina, 2011;
Zeidan et al., 2010a.
Table 1a.
Moderator Results.
Moderator Variable k N Effect Size (Hedges’ g) 95% CI QWithin QBetween
Mindfulness Intervention Type 1.365
Induction 54+ 4607 0.220*** 0.122-0.317 128.389***
Training 14 961 0.122 -0.009-0.253 13.456
Population Type 4.789*
Community 19 1160 0.402*** 0.177-0.628 58.296***
Student 46 4329 0.136** 0.057-0.214 67.457*
Clinical Status 1.183
Clinical 11 732 0.329** 0.091-0.567 21.198*
Non-Clinical 54 4757 0.188*** 0.098-0.278 113.312***
Control Type 2.494
Active 78+ 5198 0.173*** 0.103-0.243 114.574**
No Training 17+ 1285 0.422** 0.121-0.722 99.020***
Mindfulness Training Exercise 12.487**
Focused Breathing 21+ 1899 0.159** 0.055-0.264 24.626
Multiple Exercises 12 1053 0.255* 0.031-0.479 31.512**
Body Scan 8+ 588 -0.089 -0.256-0.077 7.251
Other 27 2028 0.304*** 0.147-0.461 68.139***
Negative Affectivity Outcome 1.661
State 59+ 4811 0.233*** 0.138-0.327 134.062***
Trait 18+ 1296 0.136* 0.022-0.249 16.055
Time Point 2.746
Immediately Post-Intervention 77+ 6218 0.286*** 0.191-0.381 238.164***
Within 1 Day Post-Intervention 23+ 1483 0.175* 0.023-0.328 40.814**
1 Day+ Post-Intervention 5+ 439 0.077 -0.219-0.374 9.304
Note. *p<.05; **p<.01; ***p<.001; k=number of studies; N=total participants; 95% CI=95% confidence interval
around mean estimate. k+ refers to the analyses where independence was violated by one or more studies being split
into multiple studies based on having multiple conditions. These studies were split into multiple studies: Control
Type (Arch & Craske, 2006; Broderick, 2005; Cassin et al., 2011; Cruess et al., 2015; Heppner et al., 2008; Hilt &
Pollack, 2012; Hong et al., 2012; Hooper et al., 2011; Huffziger & Kuehner, 2009; Johnson et al., 2015; Keng et al.,
2013; Kuehner et al., 2009; Laurent et al., 2014; Lee & Orsillo, 2014; Liu et al., 2012; Luethcke et al., 2011;
Murphy & MacKillop, 2014; Nosen & Woody, 2013; Ortner & Zelazo, 2014; Ramos Diaz et al., 2014; Shikatani et
al., 2014; Singer & Dobson, 2007; Ussher et al., 2009; Villa & Hilt, 2014; Vinci et al., 2014; Wells & Roussis,
2014; Zeidan et al., 2010b), Intervention Type (Ainsworth et al., 2013, 2015; Bonamo et al., 2014), Type of
Mindfulness Training Exercise (Ainsworth et al., 2013, 2015; Bonamo et al., 2014), Time Point (Ainsworth et al.,
2015; Alberts & Thewissen, 2011; Arch & Craske, 2006; Atkinson & Wade, 2012; Banks et al., 2015; Bowen &
Marlatt, 2009; Broderick, 2005; Cropley et al., 2007; Cruess et al., 2015; Erisman & Roemer, 2010; Hilt & Pollak,
2012; Huffziger & Kuehner, 2009; Keng et al., 2013; Kuehner, 2009; Laurent et al., 2014; Marchiori & Papies,
2013; McClintock & Anderson, 2013; Ramos Diaz et al., 2014; Sauer & Baer, 2012; Shikatani et al., 2014; Ussher
et al., 2009; Villa & Hilt, 2014; Vinci et al., 2014; Wahl et al., 2012).
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Table 1b.
Meta-Regression Results.
Regression Variable k N β 95% CI Qmodel Qresidual
Mean Age 62 5320 0.0091 -0.002-0.020 2.55 128.69***
Duration (minutes)!61 4679 -0.0006 -0.003-0.001 0.36 120.94***
Duration (sessions) 65 5489 -0.0003 -0.035-0.034 0 136.22***
Duration (days) 65 5489 -0.0087 -0.036-0.019 0.39 135.68***
Delphi Score 65 5489 0.0674 -0.008-0.142 3.07 132.78***
Community 62 5320 0.0091 -0.002-0.020 2.55 128.69***
Student 46 4329 0.0202 -0.050-0.090 0.32 67.34*
Note. *p<.05; **p<.01; ***p<.001; k=number of studies; N=total participants; 95% CI=95% confidence interval
around mean estimate; β = slope coefficient. N=3 studies did not report the mean age of their samples or described
age more broadly, and were excluded from these analyses (Arch & Craske, 2006; Heppner et al., 2008; Ortner &
Zelazo, 2014). N=4 studies did not report the length of the mindfulness induction in minutes, and were excluded
from these analyses (Bonamo et al., 2014, Luethcke et al., 2011, Hong et al., 2012, Hulsheger et al., 2013).
Table 1c.
Subgroup Moderator Results.
Subgroup k N Effect Size (Hedges’ g) 95% CI QWithin QBetween
Community 0.037
Clinical 10 525 0.390** 0.128-0.652 17.356*
Non-Clinical 9 635 0.425* 0.036-0.814 41.010***
Student 0.818
Clinical 1 207 0.002 -0.293-0.296 0
Non-Clinical 45 4122 0.143** 0.061-0.225 67.017*
Note. *p<.05; **p<.01; ***p<.001; k=number of studies; N=total participants; 95% CI=95% confidence interval
around mean estimate
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Table 2.
Overall Effects on Negative Affect Reactivity Studies.
Negative Affectivity Outcome k N Effect Size (Hedges’ g) 95% CI Q I2
All outcomes 65 3810 0.245*** 0.138-0.352 109.615*** 58.947
Note. *p<.001; k=number of studies; N=total participants; 95% CI=95% confidence interval around mean
estimate; Q=a standardized metric for heterogeneity of effect sizes around the mean effect size; I2=an estimate of the
proportion of observed variability that reflects real effect size variability.
Table 2a.
Timing of Distress Paradigm Moderator Analysis.
Moderator Variable k N Effect Size (Hedges’ g) 95% CI QWithin QBetween
Timing of Distress Paradigm 0.762
Before Intervention 10 863 0.257*** 0.116-0.397 5.820
After Intervention 19 1832 0.262** 0.077-0.447 58.337***
During Intervention 7 484 0.148 -0.098-0.394 10.507
Before & After Intervention 11 631 0.294 -0.007-0.596 32.933***
Note. *p<.05; **p<.01; ***p<.001; k=number of studies; N=total participants; 95% CI=95% confidence interval
around mean estimate.
Figure Captions
Figure 1. Number of brief mindfulness training RCTs published per year.
Number of brief mindfulness training studies published per year, beginning with the first brief
mindfulness training study published in 2005.
Figure 2. Flowchart of study selection.
Study selection process for this meta-analysis.
Figure 3. Funnel plot evaluating publication bias among negative affectivity outcome studies.
Each funnel plot displays a scatterplot of studies (with open circles) as a function of the study
effect size (Hedges’ g) by its standard error. Filled circles are estimates of potentially missing
studies from the trim-and-fill analysis, with the filled diamond and vertical line indicating the
estimated population effect size after the trim-and-fill procedure.
!
Figure 1. Number of brief mindfulness training RCTs published per year.
Number of brief mindfulness training studies published per year, beginning with the first brief
mindfulness training study published in 2005.
!
!
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Number of Studies (k)
Year
Number of Brief Mindfulness Training RCTs
Published Per Year
Potentially relevant publications identified and
screened for retrieval (n=1926)
Potentially appropriate RCT studies to be included in
the meta-analysis (n=122)
Publications retrieved for detailed evaluation (n=145)
Publications excluded: n=1781
Not a mindfulness intervention (n=895)
Not mindfulness-naïve at baseline (n=32)
Single-subject design (n=32)
Review article (n=124)
>2 weeks (n=698)
Publications excluded: n=23
Not an RCT (n=23)
Publications excluded: n=59
No outcome assessing negative affectivity (n=59)
RCTs included in meta-analysis (n=65 studies
reported in 63 papers)
! 2 papers included
subgroups and were broken
down into 2 studies during
analysis (Nosen & Woody
2013; Sanders & Lam,
2010)
Figure 2. Flowchart of study selection.
Study selection process for this meta-analysis.
Figure 3. Funnel plot evaluating publication bias among negative affectivity outcome studies.
Each funnel plot displays a scatterplot of studies (with open circles) as a function of the study effect size (Hedges’ g) by its standard error. Filled circles are
estimates of potentially missing studies from the trim-and-fill analysis, with the filled diamond and vertical line indicating the estimated population effect size
after the trim-and-fill procedure.
Supplementary Table 1.
Coded Effect Size Direction by Negative Affectivity Outcome.
Negative Affectivity Outcome
Positive
Effect
Direction
k
Study
Affect Scale Negative
–
1
(Arch & Craske, 2006)
Aggression (Computerized Task)
–
1
(Heppner et al., 2008)
Anger
–
1
(Ortner & Zelazo, 2014)
Anger Rumination Scale
–
1
(Long & Christian, 2015)
Attitude Towards Negative Experiences Scale –
Negative Attitudes Towards Negative Experiences
–
1
(Singer & Dobson, 2007)
Average Post Event Processing Degree
–
1
(Shikatani, Antony, Kuo, & Cassin, 2014)
Average Post Event Processing Distress
–
1
(Shikatani et al., 2014)
BDI-II
–
1
(Luethcke et al., 2011)
Body Image Avoidance Questionnaire
–
1
(Luethcke et al., 2011)
Brief Core Schema Scale (BCSS) – Negative
Other
–
1
(Ellett, Freeman, & Garety, 2008)
Brief Core Schema Scale (BCSS) – Negative Self
–
1
(Ellett et al., 2008)
Brief Fear of Negative Evaluation Scale
–
1
(Ellett et al., 2008)
Brief Mood Inspection Scale
–
1
(Alberts & Thewissen, 2011)
Center for Epidemiologic Studies Depression
Scale
–
1
(Zeidan, Johnson, Diamond, David, &
Goolkasian, 2010a1)
DASS-21
–
3
(Nosen & Woody, 20132; Rogojanski,
Vettese, & Antony, 2010)
DES – Anger
–
1
(Reynolds, Lin, Zhou, & Consedine, 2015)
DES - Contempt
–
1
(Reynolds et al., 2015)
DES - Disgust
–
1
(Reynolds et al., 2015)
DES - Fear
–
1
(Reynolds et al., 2015)
DES – Guilt
–
1
(Reynolds et al., 2015)
DES - Sad
–
1
(Reynolds et al., 2015)
DES - Shame
–
1
(Reynolds et al., 2015)
Difficulties in Emotion Regulation Scale
–
1
(Watford & Stafford, 2015)
DERS – Aware
–
1
(Erisman & Roemer, 2010)
DERS – Clarity
–
1
(Erisman & Roemer, 2010)
DERS - State
–
2
(Erisman & Roemer, 2010; Watford &
Stafford, 2015)
Distress Tolerance (Paced Auditory Serial
Addition Task – Computerized Version)
+
1
(Sauer & Baer, 2012)
########################################################
1No data reported; an F statistic of 0.01 was assumed, which coded for no effect in our database.#
2No data reported; an F statistic of 0.01 was assumed, which coded for no effect in our database.#
DDSQ – Thinking Content
–
1
(Banks et al., 2015)
DDSQ – Thinking Style - Concentration
–
1
(Banks et al., 2015)
DDSQ – Thinking Style – Control and Confidence
–
1
(Banks et al., 2015)
DDSQ – Thinking Style – Self-Esteem
–
1
(Banks et al., 2015)
DDSQ – Thinking Style – Self-Focused
–
1
(Banks et al., 2015)
Dysfunctional Attitudes Scale
–
1
(Kuehner, Huffziger, & Liebsch, 2009)
EDE-Q Shape and Weight Concern Subscale
–
1
(Luethcke et al., 2011)
Emotional Exhaustion (Maslach Burnout
Inventory)
–
1
(Hülsheger, Alberts, Feinholdt, & Lang,
2013)
Future Events Scale – Pessimism
–
1
(Kiken & Shook, 2011)
Goldberg Scale for Neuroticism
–
1
(Zabelina, 20113)
Impact of Events Scale
–
1
(Ramos Díaz, Jiménez Jiménez, & Lopes,
2014)
Intrusive Thoughts
–
1
(Wells & Roussis, 2014)
Irritability
–
1
(Marchiori & Papies, 2014)
Linguistic Inquiry and Word Count – Anger
–
1
(Ortner & Zelazo, 2014)
Linguistic Inquiry and Word Count – Negative
Emotion
–
1
(Ortner & Zelazo, 2014)
MPSS – Depression
–
1
( Cropley et al., 20074)
MPSS – Irritability
–
2
(Cropley et al., 2007; Ussher et al., 2009)
MPSS – Stress
–
2
(Cropley et al., 2007; Ussher et al., 2009)
MPSS – Tension
–
2
(Cropley et al., 2007; Ussher et al., 2009)
Negative Affect (Affect Circumplex)
–
1
(Murphy & MacKillop, 2014)
Negative Memory Recall
–
1
(Alberts & Thewissen, 2011)
Negative Thoughts
–
1
(Broderick, 2005)
Pain Distress
–
1
(Liu, Wang, Chang, Chen, & Si, 2013)
Pain Experience Questionnaire: Affective Pain
–
1
(Prins, Decuypere, & Van Damme, 2014)
Pain Experience Questionnaire: General Anxiety
–
1
(Prins et al., 2014)
PANAS – NA (State Version)
–
285
(Adams et al., 2013; Ainsworth et al., 2015;
Arch & Craske, 2006; Atkinson & Wade,
2012; Banks, Welhaf, & Srour, 2015;
Bowen & Marlatt, 2009; Broderick, 2005;
Cassin & Rector, 2011; Creswell, Pacilio,
Lindsay, & Brown, 2014; Erisman &
Roemer, 2010; Hong, Lishner, & Han,
2012; Huffziger & Kuehner, 2009; Kiken &
Shook, 2011; Kuehner et al., 2009; Laurent,
Laurent, Nelson, Wright, & Sanchez, 2014;
McClintock & Anderson, 2013; Ramos
Díaz et al., 2014; Ramsey & Jones, 2015;
Rogojanski et al., 2010; Shikatani et al.,
2014; Verplanken & Fisher, 2013; Villa &
########################################################
3No data reported; an F statistic of 0.01 was assumed, which coded for no effect in our database.#
4No data reported for this study for any MPSS measures; an F statistic of 0.01 was assumed, which coded for no
effect in our database.#
Hilt, 2014; Vinci et al., 2014; Watford &
Stafford, 2015; Yusainy & Lawrence, 2015)
PANAS – NA (Trait Version)
–
1
(Ortner & Zelazo, 2014)
PANAS-X – Anger
–
1
(Sauer & Baer, 2012)
Patient Health Questionnaire for Depression and
Anxiety (PHQ-4)
–
1
(Cavanagh et al., 2013)
Patient Health Questionnaire (PHQ-15)
–
1
(Mirams, Poliakoff, Brown, & Lloyd, 2013)
Perceived Stress Scale
–
1
(Cavanagh et al., 2013)
Post Event Processing – Degree
–
1
(Shikatani et al., 2014)
Post Event Processing – Distress
–
1
(Shikatani et al., 2014)
POMS
–
3
(Johnson, Gur, David, & Currier, 2013;
Zeidan, Johnson, Diamond, et al., 2010a;
Zeidan, Johnson, Gordon, et al., 2010b)
POMS – Anger
–
3
(Johnson et al., 2013; Zeidan, Johnson,
Diamond, et al., 2010a; Zeidan, Johnson,
Gordon, et al., 2010b)
POMS – Depression
–
3
(Johnson et al., 2013; Zeidan, Johnson,
Diamond, et al., 2010a; Zeidan, Johnson,
Gordon, et al., 2010b)
POMS – Tension
–
3
(Johnson et al., 2013; Zeidan, Johnson,
Diamond, et al., 2010a; Zeidan, Johnson,
Gordon, et al., 2010b)
Psychological Detachment
+
1
(Hülsheger, Feinholdt, & Nübold, 2015)
Questionnaire of Smoking Urges – Negative
Affect
–
1
(Adams et al., 2013)
Repetitive Thoughts Questionnaire – Negative
Affect
–
1
(Johnson et al., 2013)
Self-Beliefs Related to Social Anxiety Scale
–
1
(Shikatani et al., 2014)
Self-Rating Anxiety Scale
–
1
(Chen, Yang, Wang, & Zhang, 2013)
Self-Rating Depression Scale
–
1
(Chen et al., 2013)
Short Mood and Feelings Questionnaire
–
1
(Liehr & Diaz, 2010)
STAI – State
–
12
(Ainsworth et al., 2015; Ainsworth et al.,
2013; Bonamo, Legerski, & Thomas, 2014;
Cruess et al., 2015; Droit-Volet, Fanget, &
Dambrun, 2015; Hooper, Davies, Davies, &
McHugh, 2011; Johnson et al., 2013; Lee &
Orsillo, 2014; Mirams, Poliakoff, Brown, &
Lloyd, 2013; McClintock & Anderson,
2013; Zeidan, Johnson, Diamond, et al.,
2010a; Zeidan, Johnson, Gordon, et al.,
2010b)
STAI – Trait
–
1
(Ainsworth et al., 2013)
State Adult Attachment Measure – Anxiety
–
1
(Pepping et al., 2015)
State Adult Attachment Measure – Avoidance
–
1
(Pepping et al., 2015)
State Adult Attachment Measure – Security
–
1
(Pepping et al., 2015)
State Anxiety Inventory for Children
–
1
(Liehr & Diaz, 2010)
########################################################
53 studies used modified versions of the PANAS, such as the “International PANAS Short Form” and the “Short
PANAS”: Arch & Craske, 2006; Ramsey & Jones, 2015; and Villa & Hilt, 2014.
State Rumination
–
2
(Hilt & Pollak, 2012; Villa & Hilt, 2014)
State Social Paranoia Scale
–
1
(Ellett et al., 20086)
Stress Arousal Adjective Checklist
–
1
(Ramsey & Jones, 20157)
Subjective Units of Distress – Anxiety
–
1
(Ellett et al., 2008)
Subjective Units of Distress – Paranoia
–
1
(Ellett et al., 2008)
Susceptibility of Embarrassment Scale
–
1
(Reynolds et al., 2015)
Urge Distress
–
1
(Murphy & MacKillop, 2014)
VAS – Affect
–
1
(Adams et al., 2013)
VAS – Anxiety
–
3
(Ainsworth et al., 2015; Shikatani et al.,
2014; Wahl et al., 2012)
VAS – Body Dissatisfaction
1
(Adams et al., 2013)
VAS – Distress
–
1
(Cassin & Rector, 2011)
VAS – Negative Mood
–
1
(Singer & Dobson, 2007)
VAS – Sadness
–
3
(Keng, Robins, Smoski, Dagenbach, &
Leary, 2013; Sanders & Lam, 2010)
VAS – Stress
–
2
(Banks et al., 2015; Creswell et al., 2014)
VAS – Urge to Neutralize
–
1
(Wahl et al., 2012)
Weight- and Body-Related Shame and Guilt Scale
– Dutch Version
–
1
(Marchiori & Papies, 2014)
Note. k=number of studies; BDI = Beck Depression Inventory; DASS = Depression Anxiety Stress Scale; DDSQ
= Dundee Stress State Questionnaire; DES = Differential Emotions Scale; DERS = Difficulties in Emotion
Regulation; MPSS = Mood and Physical Symptoms Scale; PANAS-NA = Positive and Negative Affect Scale –
Negative Affect Subscale; POMS = Profile of Mood States; STAI = State-Trait Anxiety Inventory; VAS = Visual
Analogue Scale
#
########################################################
6No data reported; an F statistic of 0.01 was assumed, which coded for no effect in our database.
7No data reported; an F statistic of 0.01 was assumed, which coded for no effect in our database.#
Supplementary Table 2.
Description of Randomized Controlled Trials Included in the Meta-Analysis.
Author!
Study Aims!
N!
Participant
Population!
Mindfulness Intervention
Description!
Control Group
Description!
Negative
Affectivity
Outcome !
Effect Estimates
(Hedges' g, 95% CI)!
Adams et
al., 2013!
To test whether
mindfulness decreases the
influence of body
dissatisfaction on
negative affect and
smoking outcomes!
64!
Non-clinical
female college
student
smokers!
10-min audio-recorded
focused breathing
induction followed by 10
min of applying
mindfulness while trying
on bathing suit (INT 1a) or
looking at purse (INT 1b)
No training- trying
on bathing suit in
silence (CT 1a) or
looking at purse in
silence (CT 1b)
PANAS-NA
State;
Questionnaire
of Smoking
Urges -
Negative
Affect; VAS -
Affect, Body
Dissatisfaction !
0.141 [-0.35, 0.63]!
Ainsworth
et al., 2013!
To compare the effects of
2 types of mindfulness
meditation - Focused
Attention (FA) and Open-
Monitoring (OM) - on
alerting, orienting, and
executive attention
network function !
73!
Non-clinical
college
students!
INT 1: 3 1-hour group
training sessions of guided
FA practice and daily at-
home 10-min FA practice
over 8 days
INT 2: 3 1-hour group
training sessions of guided
OM practice and daily at-
home 10-min OM practice
over 8 days!
Active but not
well-matched - 10
min of relaxation at
the follow-up
session!
STAI - State,
Trait!
0.021 [-0.46, 0.50]!
Ainsworth
et al., 2015!
To compare the effects of
2 types of mindfulness
meditation (FA and OM)
on subjective, autonomic
and neuropsychological
outcomes !
32!
Non-clinical
community
adults!
INT 1:10-min audio-
recorded FA induction
INT 2: 10-min audio-
recorded OM induction!
Active - 10 min of
relaxation!
PANAS-NA
State; STAI -
State; VAS -
Anxiety!
0.905 [0.14, 1.67]!
Alberts &
Thewissen,
2011!
To test the effects of
mindfulness on memory
for emotional stimuli!
37!
Non-clinical
college
students!
15-min audio-recorded
focused breathing
induction!
No training !
Brief Mood
Inspection
Scale, Negative
Memory Recall!
.253 [-0.39, 0.89]!
Arch &
Craske,
2006!
To test whether
mindfulness decreases the
intensity and negativity of
affectively valenced
stimuli and increases
60!
Non-clinical
college
students!
15-min audio-recorded
focused breathing
induction!
CN 1: Active -15
min of instructed
mind-wandering
CN 2: Active – 15
min worry
Affect Scale
Negative;
PANAS-NA
State!
0.366 [-0.16, 0.90]!
willingness to remain in
contact with aversive
stimuli!
induction !
Atkinson &
Wade,
2012!
To test whether
mindfulness decreases
body dissatisfaction and
negative affect!
79!
Non-clinical
college
students!
10-min video composed of
three parts: an educational
component, a 3-min guided
experiential exercise
encouraging acceptance
and awareness, and
instructions for using the
technique in response to
media pressures regarding
body image
INT 1a: + engagement
INT 1b: + non-engagement!
No training!
PANAS-NA
State!
1.374 [0.84, 1.91]!
Banks et
al., 2015!
To test the effects of
mindfulness on working
memory and mind
wandering!
62!
Non-clinical
college
students!
2 15-min audio-recorded
focused breathing
inductions pre/post 7 days
of at-home practice (15
min/day at least 4
times/week) !
Active - 15-min
audio-recorded
relaxation training
sessions
(progressive
muscle relaxation
and body scan
exercise) pre/post 7
days of at-home
training (15
min/day at least 4
times/week)!
Dundee Stress
State
Questionnaire –
Thinking
Content, TS
(Thinking
Style)
concentration,
TS control/
confidence, TS
self-focused;
PANAS-NA
State; VAS -
Stress!
-0.147 [-0.64, 0.35]
Bonamo et
al., 2014!
To test the effects of
mindfulness on encoding
and long-term recall!
167!
Non-clinical
female college
students!
INT 1: 45-min audio-
recorded body scan
INT 2: 20-min audio-
recorded body scan!
No training !
STAI - State!
-0.307 [-0.65, 0.04]
Bowen &
Marlatt,
2009!
To test the effects of
mindfulness on smoking
outcomes!
123!
Non-clinical
college student
smokers!
11-min mindfulness
induction during a smoking
cue!
Active- 11-min
induction with
usual coping
strategies during a
smoking cue!
PANAS-NA
State!
0.142 [-0.21, 0.49]!
Broderick,
2005!
To test whether
mindfulness reduces
dysphoric mood!
177!
Non-clinical
college
students!
8-min audio-recorded
focused breathing
induction!
CN 1: Active – 8-
min reflection on
distracting
statements
CN 2: Active – 8-
min reflection on
ruminating
statements!
PANAS-NA
State!
0.343 [0.03, 0.66]!
Cassin &
Rector,
2011!
To test whether
mindfulness reduces
distress associated with
post-event processing
(PEP)!
57!
Community
adults
diagnosed with
social phobia!
10-min audio-recorded
focused breathing
induction, followed by a 2-
min practice period, then
by a 5-min application of
mindfulness to a PEP
induction!
CN 1: No training
CN 2: Active - 10-
min distraction
training followed
by a 5-min
application of
distraction to a PEP
induction!
PANAS-NA
State; VAS -
Distress!
0.537 [-0.02, 1.09]!
Cavanagh
et al., 2013!
To test whether
mindfulness increases
trait mindfulness and
reduces perceived stress
and anxiety/depression
symptoms !
58!
Non-clinical
college
students!
14 days of at-home online
mindfulness training:
audio-recorded 10-min
mindfulness exercises to be
practiced at least once a
day!
No training !
Patient Health
Questionnaire
for Depression
and Anxiety
(PHQ-4);
Perceived
Stress Scale!
0.319 [-0.20, 0.84]!
Chen et al.,
2013!
To test the effects of
mindfulness on anxiety
and depression symptoms
and autonomic nervous
system activity !
60!
Non-clinical
nursing
students!
30-min daily sessions of
mindfulness training for 7
days!
No training !
Self-Rating
Anxiety Scale;
Self-Rating
Depression
Scale!
0.330 [-0.17, 0.83]!
Creswell et
al., 2014!
To test whether
mindfulness buffers stress
reactivity!
66!
Non-clinical
college
students!
3 consecutive 25-min
sessions of audio-recorded
mindfulness training
(focused breathing) across
3 days!
Active - 3
consecutive 25-min
sessions of audio-
recorded poetry
passages and
analysis prompts
across 3 days!
PANAS-NA
State; VAS -
Stress!
-0.004 [-0.48, 0.47]!
Cropley et
al., 2007!
To test the effects of
mindfulness on smoking
outcomes!
30!
Non-clinical
college student
smokers!
10-min audio-recorded
body scan!
Active - 10-min
audio-recorded
information about
natural history!
MPSS -
Depression,
Irritability,
Stress, Tension!
0.036 [-0.66, 0.73]!
Cruess et
To test whether
120!
Non-clinical
15-20 min audio-recorded
CN 1: Active - 15-
STAI - State!
0.293 [-0.09, 0.67]!
al., 2015!
mindfulness reduces
subjective distress and
buffers physiological
stress reactivity!
college
students!
mindfulness instructions!
20 min of being
read to by the
experimenter
CN 2: Active – 15-
20 min of
relaxation!
Droit-Volet
et al., 2014!
To test the effects of
mindfulness on time
perception !
42!
Non-clinical
college
students!
20 min of audio-recorded
mindfulness training: 10-
min body-scan and 10-min
sitting meditation !
Active - 20 min of
relaxation!
STAI - State!
0.389 [-0.21, 0.99]!
Ellet et al.,
2008!
To test the effects of
mindfulness on psychotic
processes and symptoms!
30!
Community
adults
diagnosed with
persecutory
delusions
(psychosis)!
10-min audio-recorded
focused breathing exercise!
Active – 10 min of
shopping on a busy
street accompanied
by research
assistant!
Brief Core
Schema Scale -
Negative Other,
Negative Self,
Brief Fear of
Negative
Evaluation
Scale; State
Social Paranoia
Scale;
Subjective
Units of
Distress -
Anxiety,
Paranoia!
0.672 [-0.05, 1.40]!
Erisman &
Roemer,
2010!
To test the effects of
mindfulness on emotional
responses to affectively
valenced stimuli!
30!
Non-clinical
college
students with
high levels of
difficulties in
emotional
regulation!
10-min audio-recorded
mindfulness intervention
consisting of information
about mindfulness, focused
breathing, and how to
apply mindfulness to
emotional experiences !
Active - 10 min of
listening to
educational
information!
DERS - aware,
clarity; DERS –
state; PANAS-
NA State!
0.223 [-0.48, 0.93]!
Heppner et
al., 2008!
To test the effects of
mindfulness on social
rejection!
57!
Non-clinical
college
students!
5-min audio-recorded
mindful raisin-eating task!
CN 1: No training
(rejection
condition)
CN 2: No training
(acceptance
condition)!
Aggression
(Behavioral
Measure)!
0.140 [-0.41, 0.69]!
Hilt &
Pollak,
To test the effects of
mindfulness on
96!
Non-clinical
young students !
8-min audio-recorded
focused breathing
CN 1: Active - 8
min of problem-
State
Rumination!
0.143 [-0.28, 0.57]!
2012!
rumination!
induction!
solving
CN 2: Active – 8-
min audio-recorded
distraction
induction!
Hong et al.,
2012!
To test the effects of
mindfulness on
willingness to sample and
enjoyment of food !
411!
Non-clinical
college
students!
Audio-recorded mindful
raisin-eating task!
CN 1: Active -
Audio-recorded
information about
food storage
followed by eating
raisins non-
mindfully
CN 2: No training
PANAS-NA
State!
-0.062 [-0.27, 0.14]
Hooper et
al., 2011!
To test whether
mindfulness reduces
spider fear and avoidance!
60!
Non-clinical
college
students with
fear of spiders!
9-min audio-recorded
focused breathing
induction!
CN 1: Active- 9
min audio-recorded
instructions to
suppress thoughts
CN 2: Active- 9
min of instructed
mind-wandering!
STAI - State!
0.614 [0.07, 1.16]!
Huffziger
& Kuehner,
2009!
To test the effects of
mindfulness on sad mood !
76!
Clinically
depressed
community
adults!
8 min of reading and
focusing on mindfulness
statements (i.e., prompts to
a mindful approach, often
incorporating present-
moment awareness)!
CN 1: Active - 8
min of reflecting
on distracting
statements
CN 2: Active – 8
min of reflecting
on ruminating
statements!
PANAS-NA
State!
0.272 [-0.21, 0.75]!
Hülsheger
et al., 2013!
To test whether
mindfulness reduces
emotional exhaustion and
increases job satisfaction
in a field setting!
64!
Non-clinical
employed
community
adults!
10-day self-training
intervention consisting of
daily guided mindfulness
meditations and informal
mindfulness exercises!
No training !
Emotional
Exhaustion
(Maslach
Burnout
Inventory)!
0.179 [-0.33, 0.69]!
Hülsheger
et al., 2015
To test the effects of
mindfulness on work
recovery and sleep
128
Non-clinical
employed
community
adults
10-day self-training
intervention consisting of
daily guided mindfulness
meditations and informal
mindfulness exercises
No training
Psychological
Detachment
-0.030 [-0.38, 0.32]
Johnson et
al., 2015!
To test the effects of
mindfulness on mood
92!
Non-clinical
college
25-min audio-recorded
focused breathing
CN 1: Active – 25
min of listening to
POMS - Total
Score, Anger,
0.054 [-0.36, 0.47]!
(depression, anxiety) and
cognition (attention,
working memory) !
students!
induction!
a book on tape
CN 2: Active – 25
min audio-recorded
instructed unguided
breathing!
Depression,
Tension;
Repetitive
Thoughts
Questionnaire -
Negative
Affect; STAI -
State!
Keng et al.,
2013!
To test the effects of
mindfulness on sad mood
and cognition !
100!
Predominantly
community
adults with
non-clinical
depression
symptoms!
10 min of instructed
mindfulness training later
followed by 5-min
mindfulness induction
while making VAS ratings
every 30 seconds!
CN 1: No training
CN 2: Active - 10
min of reappraisal
followed by 5-min
reappraisal
induction while
making VAS
ratings every 30
seconds!
VAS - Sadness!
1.800 [1.26, 2.34]!
Kiken &
Shook,
2011
!
To test whether
mindfulness reduces
negativity bias!
175!
Non-clinical
college
students!
15-min audio-recorded
focused breathing
induction!
Active -15 min of
instructed mind
wandering !
Future Events
Scale -
Pessimism;
PANAS-NA
State!
0.015 [-0.28, 0.31]!
Kuehner et
al., 2009!
To test the effects of
mindfulness on mood and
dysfunctional attitudes !
60!
Non-clinical
college
students!
8 min of reading and
focusing on mindfulness
statements (i.e., prompts to
a mindful approach, often
incorporating present-
moment awareness)!
CN 1: Active - 8
min of rumination
CN 2: Active – 8
min of focusing
attention on
external thoughts!
Dysfunctional
Attitudes Scale;
PANAS-NA
State!
0.267 [-0.27, 0.80]!
Laurent et
al., 2014!
To test the effects of
mindfulness on romantic
couples’ physiological
responses to conflict-
induced stress!
204!
Non-clinical
college student
heterosexual
couples!
10-min audio-recorded
mindfulness intervention
consisting of information
about mindfulness and how
to apply it to emotional
experiences !
CN 1: Active - 10-
min audio-recorded
perspective-taking
exercise
CN 2: Active -10
min of thinking
about a stressful
situation!
PANAS-NA
State!
-0.117 [-0.41, 0.18]
Lee &
Orsillo,
2014!
To test the effects of
mindfulness on cognitive
flexibility !
42!
Predominantly
community
adults
diagnosed with
20-min audio-recorded
focused breathing
induction later followed by
a 3-min re-induction prior
CN 1: Active - 20
min of music
CN 2: Active - 20
min of instructed
STAI - State!
0.563 [-0.08, 1.20]!
Generalized
Anxiety
Disorder!
to the cognitive task!
mind-wandering!
Liehr &
Diaz, 2010!
To test the effects of
mindfulness on
depression and anxiety !
17!
Non-clinical
children that
are minorities !
10 15-min mindfulness
sessions over 14 days
taught by experienced
meditation instructor in
school setting!
Active - 10 15-min
health education
classes over 14
days taught by
health teacher in
school setting!
Short Mood and
Feelings
Questionnaire;
State Anxiety
Inventory for
Children!
0.697 [-0.24, 1.63]!
Liu et al.,
2012!
To test the effects of
mindfulness on pain
outcomes!
60!
Non-clinical
female college
students!
5 min of psycho-education
on mindfulness followed
by 10 min of mindfulness
training!
CN 1: Active - 5
min psycho-
education followed
by 10-min
distraction exercise
CN 2: Active -15
min of music!
Pain Distress!
0.524 [-0.02, 1.07]!
Long &
Christian,
2015!
To test the effects of
mindfulness on
relationship between
injustice and retaliation !
109!
Non-clinical
college
students!
12-min audio-recorded
focused breathing
induction
INT 1a: + fairness
INT 1b: + injustice !
Active -12 min of
instructed mind-
wandering
CT 1a: fairness
CT 1b: injustice !
Anger
Rumination
Scale!
0.305 [-0.08, 0.69]!
Luethcke et
al., 2011!
To test the effects of
mindfulness on mirror
exposure (ME) and eating
disorder risk factors!
168!
Non-clinical
female college
students!
2 sessions over 7 days: 1)
Focused breathing
induction prior to baseline
ME task on day 1; 2)
focused breathing
induction before the
second ME on day 7
In between the 2 sessions
was homework to practice
mindfulness during an
everyday activity!
CN 1: Active but
not well-matched -
instructions for ME
task were specific
to the cognitive
dissonance strategy
CN 2: Active but
not well-matched -
instructions for ME
task were specific
to the non-
judgment strategy
Neither CN
included pre-ME
practice time!
BDI II; Body
Image
Avoidance
Questionnaire;
EDE-Q Shape
and Weight
Concern
Subscale!
-0.055 [-0.37, 0.26]
Marchiori
& Papies,
2013!
To test the effects of
mindfulness on eating
habits (portion size,
110!
Non-clinical
college
students!
14-min audio-recorded
body scan!
Active - 14 min of
listening to a book
on tape!
Irritability;
Weight- and
Body-Related
0.032 [-0.34, 0.40]!
overeating when hungry)!
Shame and
Guilt Scale
(Dutch Version)!
McClintock
&
Anderson,
2013!
To test the effects of
mindfulness on
interpersonal dependency
and dependency-
associated distress !
70!
Non-clinical
college
students with
high-trait
interpersonal
dependency !
20 min audio-recorded
focused breathing
induction!
Active - 20 min
audio-recorded
instructions to
focus on specific
ideas!
PANAS-NA
State; STAI -
State!
0.561 [0.09, 1.04]!
Mirams et
al., 2013!
To test the effects of
mindfulness on somatic
perception !
62!
Non-clinical
college
students!
2 in-lab sessions separated
by 8 15-min audio-
recorded body scan
exercises over the course
of 7 days practiced at home
daily !
Active - 8 15-min
audio-recorded
consecutive clips
of a book on tape
over the course of
7 days!
Patient Health
Questionnaire
(PHQ-15);
STAI - State!
0 [-0.49, 0.49]!
Murphy &
MacKillop,
2014!
To test the effects of
mindfulness on alcohol
cravings!
84!
Community
adults that are
clinically at-
risk heavy
drinkers!
10-min audio-recorded
body scan followed by a
45-min alcohol cue
induction to which
mindfulness was applied!
CN 1: Active- 10-
min distraction
induction
CN 2: Active but
not well-matched -
10 min of usual
coping skills
Both followed by
applying strategy
to a 45-min alcohol
cue exposure !
Negative Affect
(Affect
Circumplex);
Urge Distress!
-0.252 [-0.71, 0.20]
Nosen &
Woody,
2013a!
84!
Non-clinical
community
adult smokers
tested 1 day
prior to
quitting !
0.023 [-0.42, 0.47]!
Nosen &
Woody,
2013b!
To test the effects of
mindfulness on smoking
cravings!
88!
Non-clinical
community
adult smokers
tested 8 days
prior to
quitting!
60-90 min mindfulness
psycho-education tailored
to smoking cravings!
CN 1: Active - 60-
90 min of filler
questionnaires
CN 2: Active -
psycho-education !
DASS-21!
0.022 [-0.41, 0.45]!
Ortner &
Zelazo,
To test whether
mindfulness reduces
52!
Non-clinical
college
10-min audio-recorded
focused breathing
CN 1: Active- 10
min audio-recorded
Anger;
Linguistic
0.005 [-0.56, 0.57]!
2014!
conflict-related negative
affect and anger !
students!
induction!
guided imagery
exercise
CN 2: No training
Inquiry and
Word Count -
anger, negative
emotion;
PANAS-NA
Trait!
Pepping et
al., 2015!
To test the effects of
mindfulness on
attachment security!
86!
Non-clinical
college
students!
15-min mindfulness
induction read aloud to
participant by
experimenter; participants
completed 1 of 4 types:
mindfulness of breath,
thoughts, emotions, or
body!
Active - 15 min of
either reading a
story about nature,
reflecting on
listening skills,
assertion, or use of
questions in a
conversation
(collapsed as one
condition for
analysis)!
State Adult
Attachment
Measure -
Anxiety,
Avoidance,
Security!
0.014 [-0.41, 0.43]!
Prins et al.,
2014!
To test the effects of
mindfulness on pain
perception!
46!
Non-clinical
college
students!
10-min mindfulness
induction during a pain
induction!
Active - 10 min of
listening to stories
during a pain
induction!
Pain Experience
Questionnaire -
Affective Pain,
General
Anxiety!
-0.088 [-0.66, 0.48]
Ramos
Diaz et al.,
2014!
To test the effects of
mindfulness on coping
with memory of acute
stressors!
76!
Non-clinical
female college
students!
10-min interview with
experimenter who
administered mindful
instructions while
participant describes
feelings about acute
stressor!
CN 1: Active - 10
min of talking
about stressful
feelings with
experimenter
CN 2: Active – 10
min of thinking
about a stressful
situation!
Impact of
Events Scale;
PANAS-NA
State!
-0.032 [-0.50, 0.44]
Ramsey &
Jones, 2015!
To test whether
mindfulness reduces
behavioral engagement in
ostracism !
100!
Non-clinical
college
students!
5 min audio-recorded
mindful raisin-eating
exercise!
Active - 5 min of
reading and typing!
PANAS-NA
State; Stress
Arousal
Adjective
Checklist!
0.020 [-0.37, 0.41]!
Reynolds et
al., 2015!
To test whether
mindfulness affects the
relationship between
disgust and avoidance!
101!
Predominantly
non-clinical
college
students!
10-min audio-recorded
mindfulness induction
consisting of information
about mindfulness and
Active -10-min
public service
audio-recording
from national radio!
Differential
Emotions Scale
- anger,
contempt,
0.050 [-0.34, 0.44]!
emotion management, a
focused breathing exercise,
and another mindfulness
exercise!
disgust, fear,
guilt, sad,
shame;
Susceptibility
of
Embarrassment
Scale!
Rogojanski
et al., 2011!
To test the effects of
mindfulness on coping
with smoking cravings!
61!
Non-clinical
community
adult smokers!
20 min of audio-recorded
mindfulness instructions
during a smoking cue
exposure !
Active - 20 min of
audio-recorded
instructions to
suppress thoughts
during a smoking
cue exposure!
DASS-21;
PANAS-NA
State!
0.638 [0.13, 1.15]!
Sanders &
Lam, 2010a!
30!
Community
adults
recovering
from clinical
depression!
-0.205 [-0.90, 0.49]
Sanders &
Lam,
2010b!
To test the effects of
mindfulness on affect and
problem solving in social
settings!
30!
Non-clinical
never-
depressed
community
adults!
8-min PowerPoint
presentation in which
mindfulness is applied via
focusing attention on each
item from a list of 28
symptom-focused items
related to rumination!
Active - 8-min
PowerPoint
presentation in
which participants
thought about each
item from a list of
28 symptom-
focused items
related to
rumination!
VAS - Sadness!
0.205 [-0.49, 0.90]!
Sauer &
Baer, 2012!
To test the effects of
mindfulness on
behavioral distress
tolerance !
40!
Predominantly
community
adults with
Borderline
Personality
Disorder!
8 min of mindful self-focus
on mindful statements!
Active - 8 min of
reading ruminative
statements!
Distress
Tolerance
(Behavioral
Measure);
PANAS-X
Anger!
0.99 [0.34, 1.64]!
Shikatani et
al., 2014!
To test the effects of
mindfulness on post-
event processing (PEP)
and recruitment of
cognitive processes!
56!
Community
adults
diagnosed with
social anxiety!
40-min session consisting
of 1) learning about the
acceptance and awareness
components of mindfulness
and 2) an audio-recorded
mindfulness induction: 3-
min focused breathing
exercise followed by 3 7-
min mindfulness exercises
about noticing thoughts
and emotions about speech!
CN 1: Active - 40-
min of anxiety
psycho-education
CN 2: Active but
not well-matched -
20 min spent
thinking about pre-
induction speech
performance !
Average PEP-
Degree,
Distress;
PANAS-NA
State; PEP-
Degree,
Distress; Self-
Beliefs Related
to Social
Anxiety Scale;
VAS - Anxiety!
0.171 [-0.38, 0.72]!
Singer &
Dobson,
2007!
To test the effects of
mindfulness on
depression relapse
prevention!
80!
Clinically
depressed
community
adults!
10-min mindfulness
induction with verbally
read instructions
encouraging present-
moment awareness and
acceptance of thoughts and
feelings
!
CN 1: No training
CN 2: Active- 10
min of rumination
CN 3: Active -10
min of focusing on
and visualizing
unrelated mental
images !
Attitude
Towards
Negative
Experiences
Scale -
Negative
Attitudes
Towards
Negative
Experiences;
VAS - Negative
Mood!
0.616 [0.10, 1.14]!
Ussher et
al., 2009!
To test the effects of
mindfulness on smoking
cravings and withdrawal
symptoms!
48!
Non-clinical
community
adult smokers!
2 sessions of a 10-min
audio-recorded body scan
(in-lab and outside-lab
within same day)!
CN 1: Active –2
sessions (in-lab and
outside-lab within
same day) of a 10-
min audio-
recording of
natural history
readings
CN 2: Active – 2
sessions (in-lab and
outside-lab within
same day) of 10-
min audio-recorded
instructions for
isometric exercises!
Mood and
Physical
Symptoms
Scale (MPSS) -
Irritability,
Stress, Tension!
0.216 [-0.37, 0.80]!
Verplanken
& Fisher,
2014!
To test whether
mindfulness reduces
worrying!
103!
Non-clinical
college
students!
20-min audio-recorded
focused breathing
induction!
Active - 20-min
audio-recording of
a travel
documentary!
PANAS-NA
State!
0.149 [-0.24, 0.53]!
Villa &
Hilt, 2014!
To test whether
mindfulness reduces
rumination and negative
affect !
111!
Non-clinical
college
students!
8-min audio-recorded
focused breathing
induction!
CN 1: No training
CN 2: Active - 8
min of relaxation!
PANAS-NA
State; State
Rumination!
-0.020 [-0.42, 0.38]
Vinci et al.,
2014!
To test the effects of
mindfulness on negative
affect and alcohol
cravings !
207!
College
students
clinically at-
risk for heavy
drinking!
10-min audio-recorded
focused breathing
induction INT 1a: +
negative stimuli
INT 1b: + neutral stimuli
CN 1: Active - 10
min of relaxation
CN 2: Active – 10
min of word
puzzles!
PANAS-NA
State!
0.002 [-0.29, 0.30]
Wahl et al.,
2012!
To test the effects of
mindfulness on obsessive/
intrusive thoughts!
30!
Community
adults
diagnosed with
Obsessive-
Compulsive
Disorder!
6-min mindfulness
induction adapted from the
module ‘Thoughts are not
facts’ used in MBCT
(Segal et al. 2002) while
experiencing intrusive
thoughts!
Active - 6-min
distraction
induction while
experiencing
intrusive thoughts!
VAS - Anxiety,
VAS - Urge to
Neutralize !
0.764 [0.04, 1.49]!
Watford &
Stafford,
2015!
To test whether
mindfulness improves
emotion regulation
outcomes !
70!
Non-clinical
college
students!
15-min audio-guided
focused breathing
induction!
Active - 15 min of
listening to the
radio!
DERS - aware,
clarity; DERS-
state; PANAS-
NA State!
0.003 [-0.46, 0.47]!
Wells &
Roussis,
2014!
To test the effects of
mindfulness on intrusive
thoughts and images!
56!
Non-clinical
college
students!
5-min mindfulness exercise
encouraging detachment,
awareness, and acceptance
of any intrusive
images/thoughts!
CN 1: Active and
well-matched – 5
min of accepting
intrusive thoughts
CN 2: Active and
well-matched – 5
min of imagining
and visualizing
intrusive thoughts
CN 3: No training
Intrusive
Thoughts!
0.545 [-0.06, 1.15]!
Yusainy &
Lawrence,
2015!
To test the effects of
mindfulness on
aggression !
110!
Non-clinical
college
students!
15-min audio-recorded
focused breathing
induction!
Active - 15 min of
listening to
educational
information and
playing scrabble!
PANAS-NA
State!
-0.163 [-0.54, 0.21]
Zabelina et
To test the effects of
81!
Non-clinical
10-min audio-recorded
Active - 10 min of
Goldberg Scale
0.022 [-0.41, 0.45]!
al., 2011!
mindfulness on trait
variables (creativity,
neuroticism, and
mindfulness)!
college
students!
focused breathing
induction!
listening to
educational
information!
for Neuroticism !
Zeidan,
Johnson,
Diamond,
David, &
Goolkasian,
2010!
To test the effects of
mindfulness on mood and
cognitive variables
(sustained attention,
verbal fluency, visual
coding, and working
memory) !
49!
Non-clinical
college
students!
4 20-min sessions of
mindfulness training
(focused breathing) taught
by an instructor over 4
days!
Active - 4 20-min
sessions of
listening to a book
on tape while being
monitored by an
experimenter over
4 days!
Center for
Epidemiologic
Studies
Depression
Scale; POMS -
Total Score,
Anger,
Depression,
Tension; STAI -
State!
0.183 [-0.37, 0.74]!
Zeidan,
Johnson,
Gordon, &
Goolkasian,
2010!
To test the effects of
mindfulness on mood and
cardiovascular variables!
82!
Non-clinical
college
students!
3 20-min focused breathing
inductions over 3 days!
CN 1: Active - 3
20-min sham
meditation sessions
over 3 days
CN 2: Active – 3
20-min sessions
over 3 days of
talking with other
participants!
POMS - Total
Score, Anger,
Depression,
Tension; STAI -
State!
0.727 [0.26, 1.19]!
Note. N=total participants; 95% CI=95% confidence interval around mean estimate; INT=Intervention; CN=Control; min=minutes; BDI = Beck Depression
Inventory; CI = Confidence Interval; DASS = Depression Anxiety Stress Scale; DERS = Difficulties in Emotion Regulation; MPSS = Mood and Physical
Symptoms Scale; PANAS-NA = Positive and Negative Affect Scale – Negative Affect Subscale; POMS = Profile of Mood States; STAI = State-Trait Anxiety
Inventory; VAS = Visual Analogue Scale.
!
!
