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Meditation, Mindfulness, and Attention: a Meta-analysis

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David Sumantry at Toronto Metropolitan University
David Sumantry
  • Toronto Metropolitan University
Kathleen Stewart at Toronto Metropolitan University
Kathleen Stewart
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Objectives Despite being an ancient tradition, meditation has only become a popular inquiry of research over the past few decades. This resurgence can partially be attributed to the popularization of Eastern meditative practices, such as mindfulness, into Western culture. Though the mechanisms of meditation are not yet scientifically well-understood, systems of attention and executive control may play an important role. The present study aimed to examine potential attentional mechanisms of attention-based meditations across studies.Methods This paper examines behavioral measures of attention across literature. Studies (K = 87) that assigned participants to or recruited participants who use techniques common in mindfulness practices (focused attention, open monitoring, or both) were meta-analyzed. Outcomes were coded according to attentional network (alerting, orienting, executive control) or facet of executive control (inhibition, shifting, updating).ResultsMeta-analytic results suggest that generalized attention (g = 0.171, 95% CI [0.119, 0.224]), its alerting (g = 0.158, 95% CI [0.059, 0.256]) and executive control (g = 0.203, 95% CI [0.143, 0.264]) networks, and the inhibition (g = 0.159, 95% CI [0.064, 0.253]) and updating (g = 0.256 [0.176, 0.337]) facets of executive control are improved by meditation. There was significant heterogeneity in attention, the alerting and executive control networks, and the inhibition facet. Studies that taught both FA and OM techniques did not show attentional improvements over those that taught the techniques in isolation. Meditation led to greater improvements in accuracy-based tasks than reaction time tasks.Conclusions This meta-analysis suggests that attention is likely implicated in meditation, and meditation may improve some, but not all, attentional processes. Implications for understanding meditational mechanisms and moderator-related differences are discussed.
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REVIEW
Meditation, Mindfulness, and Attention: a Meta-analysis
David Sumantry
1
&Kathleen E. Stewart
1
Accepted: 15 January 2021
#The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021
Abstract
Objectives Despite being an ancient tradition, meditation has only become a popular inquiry of research over the past few
decades. This resurgence can partially be attributed to the popularization of Eastern meditative practices, such as mindfulness,
into Western culture. Though the mechanisms of meditation are not yet scientifically well-understood, systems of attention and
executive control may play an important role. The present study aimed to examine potential attentional mechanisms of attention-
based meditations across studies.
Methods This paper examines behavioral measures of attention across literature. Studies (K= 87) that assigned participants to or
recruited participants who use techniques common in mindfulness practices (focused attention, open monitoring, or both) were
meta-analyzed. Outcomes were coded according to attentional network (alerting, orienting, executive control) or facet of exec-
utive control (inhibition, shifting, updating).
Results Meta-analytic results suggest that generalized attention (g= 0.171, 95% CI [0.119, 0.224]), its alerting (g=0.158,95%
CI [0.059, 0.256]) and executive control (g= 0.203, 95% CI [0.143, 0.264]) networks, and the inhibition (g=0.159,95%CI
[0.064, 0.253]) and updating (g= 0.256 [0.176, 0.337]) facets of executive control are improved by meditation. There was
significant heterogeneity in attention, the alerting and executive control networks, and the inhibition facet. Studies that taught
both FA and OM techniques did not show attentional improvements over those that taught the techniques in isolation. Meditation
led to greater improvements in accuracy-based tasks than reaction time tasks.
Conclusions This meta-analysis suggests that attention is likely implicated in meditation, and meditation may improve some, but
not all, attentional processes. Implications for understanding meditational mechanisms and moderator-related differences are
discussed.
Keywords Meditation .Meta-analysis .Attention .Executive control
Meditation—particularly mindfulness meditation—has dra-
matically risen in popularity in western cultures over the last
several decades (see Van Dam et al. 2018). Despite empirical
support that meditation may be beneficial for a variety of
populations and may both improve quality of life (e.g.,
Reibel et al. 2001) and reduce negative mental health out-
comes (e.g., Tickell et al. 2019), understanding the mecha-
nisms through which meditative practices work is crucial for
further refinement. Exploring mechanisms will help to high-
light the potentially crucial components of meditation, which
in turn can help to maximize the benefits of practice. One of
the key components of various meditations is a trained ability
to focus on the present moment (Hölzel et al. 2011; Wallace
2007). As such, improved attentional ability may be one
mechanism that drives the outcomes of meditative practices
(Kok et al. 2013).
Understanding the mechanisms behind meditation are only
possible after answering the question, “which meditation?”as
meditative traditions and techniques can be drastically differ-
ent from one another. Moreover, Western versions of mind-
fulness and other meditative practices tend to prioritize quan-
tifiable outcomes that can be readily studied (e.g., symptom
relief or productive gains) rather than embrace the holistic
Eastern perspectives from which they came (see Monteiro
et al. 2015, for a review). Dahl et al. (2015) described three
families of meditative practices into which many can be clas-
sified. The attentional family includes focused attention (FA)
and open monitoring (OM; alternatively, open presence) prac-
tices, which are centered around attention regulation (see also
*David Sumantry
David.Sumantry@ryerson.ca
1
Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2L3,
Canada
https://doi.org/10.1007/s12671-021-01593-w
/ Published online: 2 February 2021
Mindfulness (2021) 12:1332–1349
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Mindfulness meditation is a mental training technique that typically involves the deliberate selection of an attentional focus, often to the breath or bodily sensations, and the constant direction and re-direction of attention to this focus with an attitude of nonjudgemental awareness (Crane et al., 2017;Van Dam et al., 2018). This practice has been associated with enhanced psychological well-being (Goyal et al., 2014;McClintock et al., 2019;Querstret et al., 2020) as well as improved cognitive performance across specific domains (Im et al., 2021;Sumantry & Stewart, 2021;Yakobi et al., 2021). ...
... Two cognitive processes are commonly reported to be improved by mindfulness meditation: attention and executive control (a function which prioritises the processing of stimuli, cognitive processes and responses related to internal goals). Significant mindfulness-related improvements in accuracy (but not reaction time) are commonly reported from tasks that measure these constructs (Im et al., 2021;Sumantry & Stewart, 2021;Verhaeghen, 2021;Yakobi et al., 2021). Theoretical perspectives, supported by some empirical evidence, suggest that enhanced mindful attention may serve as a core mechanism underlying meditation's positive effects on well-being. ...
... Given this possibility, incorporation of a sustained attention task in future research could be useful to better disentangle any such effects. Current research has shown mixed results for the effects of meditation on cognition, with overall small effect sizes reported in meta-analyses (Sumantry & Stewart, 2021;Yakobi et al., 2021). It may be that any cognitive effects related to meditation are dependent on specific circumstances. ...
Neural differences in conflict monitoring and stimulus expectancy processes in experienced meditators are likely driven by enhanced attention
Preprint
Full-text available
  • Dec 2024
Objectives Mindfulness meditation has been linked to enhanced attention and executive function, likely resulting from practice-related effects on neural activity patterns. In this study, we used an event-related potential (ERP) paradigm to examine brain responses related to conflict monitoring and attention in experienced mindfulness meditators to better understand key factors driving meditation-related effects. Methods We measured electroencephalography-derived N2 and P3 ERPs reflecting conflict monitoring and attention processes from 35 meditators and 29 non-meditators across both an easy and a hard Go/Nogo task (50% Nogo and 25% Nogo stimuli, respectively). Results Meditators displayed distinct neural activity patterns compared to non-meditators, with enhanced N2 responses in fronto-midline electrodes following hard Nogo trials ( p FDR = 0.011, np ² = 0.111). The fronto-midline N2 ERP was also larger following Nogo trials than Go trials, in the harder task condition, and was related to correct responses. Meditators also exhibited a more frontally distributed P3 ERP in the easy task compared to the hard task, while non-meditators showed a more frontally distributed P3 ERP in the hard task ( p FDR = 0.015, np ² = 0.079). Conclusions Mindfulness meditation was associated with distinct topographical patterns of neural activity in the attention task, without corresponding increases in global neural activity amplitudes. These meditation-related effects appear to be driven by attention-specific mechanisms, despite the examined neural activity being associated with conflict monitoring and stimulus expectancy. Our findings suggest that the cognitive benefits of meditation may only emerge in tasks that actively engage targeted cognitive processes, such as sustained attention.
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... [3,4,5] Besides this, a meta-analysis has suggested that mindfulness brings positive changes in the brain networks involved in attentional control which is beneficial for a wide range of cognitive functions. [6] Self-reporting questionnaires are the most common tools currently in use to measure mindfulness whereas, some objective behavioral task-based measurements are also emerging. [7,8] Meditation breath attention scores task, Breath counting task and Mindful awareness task are some proposed behavioral task-based measures to assess mindfulness. ...
... Published literatures suggest that increase in mindfulness is associated with better control of attention and non-reactive awareness. [6,7,9] Based on this understanding, we expected that self-reported time span of focused attention (TSFA) defined as the duration of uninterrupted attention to breath during the BFTT would reflect the mindfulness of the person. Hence, this study aimed to perform the preliminary assessment of the BFTT and to assess the correlation of TSFA with the score obtained from self-reporting questionnaire-based Mindful Attention Awareness Scale (MAAS). ...
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Introduction: An easy task-based measure of mindfulness that can be self-administered in a daily life setting is still not available. We aimed to perform a preliminary evaluation of the Breath Focus Test Task to measure mindfulness. Methods: A quantitative observational study was performed among medical students. Each participant was instructed to focus attention to the participant’s own breath and count each breath with awareness until the participant noticed mind wandering. The last breath count attended before losing awareness of the task (breath count with awareness) was recalled and self-reported by each participant. Three such breath focus sessions were planned for each participant. The mean ‘breath count with awareness’ of each participant was then converted to time span of focused attention using the rate of breathing. This time span of focused attention was reported as the proposed measure of mindfulness. Each participant also completed the 'Mindful Attention Awareness Scale questionnaire'. Results: Out of 101 participants, 76 completed at least one breath focus session satisfactorily. The median time span of focused attention was three minutes (first quartile = 1.9 minutes and third quartile = 4.5 minutes). The Mindful Attention Awareness Score was 3.9 (SD = 0.6). The results did not show a significant correlation between the time span of focused attention and the Mindful Attention Awareness Score (r s = 0.04, p = 0.74). Conclusion: This study shows the feasibility of the proposed test task. However, the measure obtained from the current form did not correlate with the Mindful Attention Awareness Score.
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... Recent research highlights diverse psychological benefits from mindfulness practice. Mindfulness is believed to enhance emotional regulation, attentional control, and selfawareness (Sumantry & Stewart, 2021;Wheeler et al., 2017). The positive impact on emotional regulation specifically from mindfulness practice such as meditation is thought to occur via the promotion of positive emotions while reducing negative affect and rumination (Davis & Hayes, 2011). ...
Mindful young brains and minds: a systematic review of the neural correlates of mindfulness-based interventions in youth
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This systematic narrative review examines neuroimaging studies that investigated the neural correlates of mindfulness-based interventions in youth (ages 0–18). We extracted 13 studies with a total of 467 participants aged 5–18 years from the MEDLINE database on February 21st, 2024. These studies included both typically developing youth and those at risk of developing or recovering from neuropsychiatric disorders. Most studies (76.9%) utilized a pre-post intervention design, with resting-state functional magnetic resonance imaging (fMRI) being the most common imaging modality (46.1%), followed by task-based fMRI (38.4%), diffusion-weighted imaging (15.4%), and structural MRI (7.7%). Despite substantial heterogeneity across study designs and findings, several consistent patterns emerged. Resting-state fMRI studies generally reported increased functional connectivity within and between networks, notably involving the salience network, frontoparietal network, and default mode network. Studies using diffusion-weighted imaging indicated enhancements in white matter microstructural properties, supporting overall connectivity improvements. Several task-based fMRI studies identified decreased activation of the default mode network and heightened reactivity of the salience network during or after mindfulness practice, with real-time neurofeedback further amplifying these effects. While preliminary, the reviewed studies suggest that mindfulness interventions may alter both functional and structural connectivity and activity in youth, potentially bolstering self-regulation and cognitive control. Nonetheless, the variability in methodologies and small sample sizes restricts the generalizability of these results. Future research should prioritize larger and more diverse samples, and standardized mindfulness-based interventions to deepen our understanding of the neural mechanisms underlying mindfulness-based interventions in youth and to optimize their efficacy.
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... Long-term training typically follows structured programs like Mindfulness-Based Cognitive Therapy (MBCT) or Mindfulness-Based Stress Reduction (MBSR), lasting several weeks to months (Alsubaie et al., 2017). Although debates continue in academia concerning the precise definition of mindfulness, most researchers concur that mindfulness training can improve present-moment interoception (Grant & Zeidan, 2019) and improve individuals' attentional control (Sumantry & Stewart, 2021) and emotional regulation skills (Grecucci et al., 2015;Howarth et al., 2019). This helps individuals avoid avoidance behaviors and internal reactions, fostering greater acceptance of bodily and emotional responses (Lindsay & Creswell, 2019). ...
Breath-Counting Task Enhances the Sensitivity of Fear Acquisition
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Fear acquisition is an essential survival mechanism for humans; however, the role and mechanisms of mindfulness training in this process remain unclear. This study employed a discriminative fear conditioning paradigm to investigate the effects and mechanisms of short-term mindfulness training, exemplified by the breath-counting task, on fear acquisition. The experiment consisted of three consecutive phases: intervention, ha-bituation, and acquisition. During the intervention phase, each participant was assigned to one of two conditions: the breath-counting task group (experimental group) or the free reading group (control group). The results indicated that the mindfulness group exhibited significantly lower expectancy ratings for shocks to the CS− compared to the control group, while no significant difference was found in the shock ratings for CS+. Regarding skin conductance responses, although the mindfulness group showed a significantly reduced fear response to CS relative to the free reading group, there was no significant difference in overall fear acquisition effects between the two groups. The above findings indicate that breath-counting tasks enhance sensitivity to the acquisition of conditioned fear by reducing exaggerated fear responses to safety signals. The conclusions of this study further elucidate the conflicting results regarding the effects of mindfulness training on fear acquisition and provide novel perspectives for the prevention of anxiety spectrum disorders.
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... It may thus be reasonably constructed as the core antidote to the root cognitive problem of the information age: distractibility. MBPs, as we shall see below with special reference to MBCT, offer a systematic training to re-balance top-down and bottom-up attentional systems, cultivating both a stabilized attention and a broadened awareness (and therefore meta-awareness; Sumantry & Stewart, 2021;van den Hurk et al., 2010). Such mindfulness-based re-equilibration forms the foundation for all learning purposes. ...
The Mindful Way From Information to Knowledge, to Wisdom, and to Life: Perspectives on Mindfulness (-Based Cognitive Therapy) for Higher Education
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This article explores the potential relevance of Mindfulness-Based Programs, particularly Mindfulness-Based Cognitive Therapy (MBCT), to support the mission of higher education by facilitating the journey from information to knowledge, and from knowledge to wisdom. It thus addresses the problems of distractibility and superficial engagement caused by information overload and aims to prepare students for a fulfilling life. Based upon an in-depth dialogue among authors belonging to different disciplines, this conceptual synthesis integrates the various perspectives of Buddhist studies, philosophy of education, anthropology of education, clinical psychology, and psychiatry, to construct a comprehensive view of mindfulness for higher education. The structure of its argument progresses from the languishing to the flourishing of students, and from mindfulness taught in the form of interventions, to mindfulness cultivated as the very thread of learning. The article starts by reviewing the evidence regarding students’ mental health and vulnerabilities, and moves to directly listening to their voices, larger aspirations, and more existential concerns. It next elaborates an epistemic and developmental model of mindful education, making creative use of T. S. Eliot’s questions regarding information, knowledge, wisdom, and Life, to capture some ongoing, complex issues. MBCT’s principles, formats, practices, and adaptations are then examined to envision skillful responses to these perceived challenges, with a proposal to further weave mindfulness into the constitution of higher education. Ultimately, in reference to Simone Weil, mindfulness training is conceived as guiding the “formation of attention,” along the “joy of learning,” to accomplish two interrelated humanistic ideals: academic excellence and human flourishing.
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... Since mindfulness is a key element in most modern Buddhist meditation practices and some modern Christian contemplative practices, this research sheds some light on the effects of spiritual training regimens in the two traditions. Meta-analyses have shown that mindfulness training improves attentional processes (Sumantry & Stewart, 2021), reduces both state and trait anxiety , and leads to a general sense of well-being . It has also been shown to lead to prosocial behaviors (Donald et al., 2018), and this is so even when the training does not contain any explicit ethics-based instruction (Berry et al., 2020). ...
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... In contrast, meditation allows for monitoring one's mind and acknowledging thoughts and feelings nonjudgmentally (Dorjee, 2016;Teper & Inzlicht, 2013). Meditation increases self-control (Miyake et al., 2000;Sumantry & Stewart, 2021), impression management (Vohs et al., 2005), and emotional regulation (Basso et al., 2019;Sedlmeier et al., 2012). It provides a vehicle for the researcher to open their focus and orient their attention to their participants, accept self and others without judgment and increase present moment awareness (Cardacitto et al., 2008;Kabat-Zinn, 1994;Smalley & Winston, 2022). ...
Meditation in Qualitative Research for Bracketing and Beyond
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In this study, I recounted my experience using mantra meditation during a phenomenological study for the purposes of bracketing. The efficacy and purpose of bracketing have been debated from Husserl (1931), whose aimed was to achieve objectivity, to Heidegger (1962) who advocated for immersion of the researcher, through the French school (Merleau-Ponty, 1964) of middle ground, by whom bracketing was seen as the process to unearth and suspend biases for the better understanding of participants’ experiences (Arsel, 2017; Creswell & Creswell, 2017; Creswell & Poth, 2016; Fischer & Guzel, 2023). In this study, however, I propose another approach to bracketing that expands beyond phenomenology and the duality of objectivity or immersion. I propose that bracketing, with the aim of meditation is inseparable from qualitative research. Meditation, as a form of bracketing, provokes the researcher to be fully present ensuring that participants’ experiences are heard and interpreted in a faithful manner. In this orientation, the goal of bracketing is not to rid one’s subjectivity but to allow subjectivity to be diminished and the researcher to be fully present to the other.
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... It draws its roots from eastern practices and philosophies, especially Theravada Buddhism (Olendzki, 2010). Mindfulness-based interventions (MBIs) have been found to improve a wide range of cognitive functions, including emotion regulation (Kral et al., 2018;Zhang et al., 2019), attentional control (Prakash, 2021;Sumantry and Stewart, 2021), sleep quality (Rusch et al., 2019), and wellbeing (Querstret et al., 2020;Zhang et al., 2021;Zollars et al., 2019). Implementation of MBIs have also shown promising results in alleviating various mental conditions, including anxiety (Crowley et al., 2022;Zhihong et al., 2017), depression (Parmentier et al., 2019;Reangsing et al., 2021), PTSD (Haider et al., 2021;Sun et al., 2021), ADHD (Gu et al., 2021;Geurts et al., 2021), and schizophrenia (Chai et al., 2022;Özdemir and Budak, 2022). ...
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Full-text available
  • May 2019
Importance Mindfulness meditation training has been shown to be feasible in surgical trainees, but affective, cognitive, and performance benefits seen in other high-stress populations have yet to be evaluated. Objective To explore potential benefits to stress, cognition, and performance in postgraduate year 1 (PGY-1) surgery residents receiving modified mindfulness-based stress reduction (modMBSR). Design, Setting, and Participants This follow-up study is an analysis of the Mindful Surgeon pilot randomized clinical trial of modMBSR (n = 12) vs an active control (n = 9), evaluated at baseline (T1), postintervention (T2), and 1 year (T3), took place at an academic medical center residency training program among PGY-1 surgery residents. Data were collected between June 2016 and June 2017 and analyzed from June 2017 to December 2017. Interventions Weekly 2-hour modMBSR classes and 20 minutes of daily home practice during an 8-week period vs an active control (different content, same structure). Main Outcomes and Measures Preliminary evidence of efficacy was explored, primarily focusing on perceived stress and executive function and secondarily on burnout, depression, motor skill performance, and changes in blood oxygen level–dependent functional neuroimaging during an emotion regulation task. Group mean scores were calculated at T1, T2, and T3 and in linear mixed-effects multivariate analysis. Effect size for analysis of covariance is presented as partial η² with the following cutoff points: small, less than 0.06; medium, 0.06 to 0.14; large, greater than 0.14. Results Postgraduate year 1 surgery residents (N = 21; 8 [38%] women) were randomized to a modMBSR arm (n = 12) or an active control arm (n = 9). Linear mixed-effects modeling revealed differences at T2 and T3 in perceived stress (mean [SD] difference at T2: modMBSR, 1.42 [5.74]; control, 3.44 [6.71]; η² = 0.07; mean [SD] difference at T3: modMBSR, 1.00 [4.18]; control, 1.33 [4.69]; η² = 0.09) and in mindfulness (mean [SD] difference at T2: modMBSR, 3.08 [3.63]; control, 1.56 [4.28]; η² = 0.13; mean [SD] difference at T3: modMBSR, 2.17 [3.66]; control, −0.11 [6.19]; η² = 0.15). Burnout at T2 (mean [SD] difference: modMBSR, 4.50 [9.08]; control, 3.44 [6.71]; η² = 0.01) and T3 (mean [SD] difference: modMBSR, 5.50 [9.96]; control, 5.56 [9.69]; η² = 0.01) showed similar increase in both groups. Working memory increased more at T2 in the modMBSR arm (mean [SD] difference, 0.35 [0.60]) than in the control arm (mean [SD] difference, 0.21 [0.74]; η² = 0.02) and at T3 (modMBSR, 0.68 [0.69]; control, 0.26 [0.58]; η² = 0.20). Cognitive control decreased more in the control arm at T2 (mean [SD] difference at T2: modMBSR, 0.15 [0.40]; control, −0.07 [0.32]; η² = 0.13) and at T3 (mean [SD] difference: modMBSR, 0.07 [0.59]; control, −0.26 [0.53]; η² = 0.16). Mean (SD) circle-cutting time improved more at T2 in the modMBSR arm (−24.08 [63.00] seconds) than in the control arm (−4.22 [112.94] seconds; η² = 0.23) and at T3 in the modMBSR arm (−4.83 [77.94] seconds) than in the control arm (11.67 [145.17] seconds; η2 = 0.13). Blood oxygen level–dependent functional neuroimaging during an emotional regulation task showed unique postintervention activity in the modMBSR arm in areas associated with executive function control (dorsolateral prefrontal cortex) and self-awareness (precuneus). Conclusions and Relevance In this pilot randomized clinical trial, modMBSR in PGY-1 surgery residents showed potential benefits to well-being and executive function, suggesting a powerful role for mindfulness-based cognitive training to support resident well-being and performance, as mandated by the Accreditation Council for Graduate Medical Education. Trial Registration ClinicalTrials.gov identifier: NCT03141190
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The Effects of Mindfulness Training on Cognitive and Psychosocial Well-Being Among Family Caregivers of Persons with Neurodegenerative Disease
Article
Full-text available
  • Oct 2019
  • Mindfulness
Objectives The objective of this study was to assess the effect of a mindfulness-based stress reduction (MBSR) intervention on cognitive function and well-being in family caregivers. Methods Family caregivers (N = 57) of a person with a neurodegenerative disease were recruited and assigned to an 8-week MBSR program (n = 33) or a psychoeducation-social support group (n = 24). All participants completed pre- and post-intervention assessment of cognitive and psychosocial functioning. Results Results suggested that MBSR was associated with a significantly larger reduction in self-reported depressive symptoms and perceived stress relative to the control group; however, no between-group differences were found for executive function or other cognitive outcomes. Conclusions This study contributes to the growing body of literature highlighting the potential use of contemplative practices for improving psychosocial well-being among family caregivers.
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A Longitudinal Training Study to Delineate the Specific Causal Effects of Open Monitoring Versus Focused Attention Techniques on Emotional Health
Article
  • Jul 2020
  • COMPLEMENT THER MED
Background Emotional dysregulation is a core mechanism of mood disorders. Meditation-based interventions can ameliorate a wide range of psychological problems. However, in order to develop structured treatment and preventative protocols for emotional disorders, it is crucial to understand how different types of specific meditation practices improve emotion regulation abilities. Mindfulness-based techniques are broadly separated into two practices – open monitoring (OM) and focused attention (FA). This study directly investigated the potential practice-specific benefits of OM versus FA techniques as tools for improving emotion regulation skills from pre-to-post training. Method Novice participants were randomized into an 8-week long OM or FA intervention that was previously developed through a science of behavior change approach. Healthy emotional skills were assessed using experience sampling methodology and inventories. Participants were assessed before, during, and after the interventions to investigate if the type of training may explain longitudinal changes in emotional skills. Results Both OM and FA attentional training practices improved acceptance of stressors and reduced distress and rumination. We also found divergent effects of OM versus FA training: Compared to OM, FA training improved abilities to use reappraisal strategy to regulate emotions in naturalistic settings at the end of 8-weeks training. FA training (versus OM) also led to greater self-regulation abilities. Conclusion Our findings suggest that a FA training has specific causal impacts on emotion regulatory skills, and it can be selectively implemented in interventions to target emotional disorders.
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RoB 2: A revised tool for assessing risk of bias in randomised trials
Article
  • Aug 2019
Assessment of risk of bias is regarded as an essential component of a systematic review on the effects of an intervention. The most commonly used tool for randomised trials is the Cochrane risk-of-bias tool. We updated the tool to respond to developments in understanding how bias arises in randomised trials, and to address user feedback on and limitations of the original tool.
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