We present the results of a pre-registered randomised controlled trial (RCT) that tested whether two smartphone-based mindfulness meditation applications (apps) lead to improvements in mental health. University students (n = 208, aged 18 to 49) were randomly assigned to use one of the three apps: Headspace, Smiling Mind, or Evernote (control group). Participants were instructed to use their assigned app for 10 min each day for 10 days, after which they received an extended 30 days’ access to continue practicing at their discretion. Participants completed measures of depressive symptoms, anxiety, stress, college adjustment, flourishing, resilience, and mindfulness at baseline, after the 10-day intervention, and after the 30-day continued access period. App usage was measured by self-report. Mindfulness app usage was high during the 10-day period (used on 8 of 10 days), but low during the 30-day extended use period (less than 20% used the app 2+ times per week). Mindfulness app users showed significant improvements in depressive symptoms, college adjustment, resilience (Smiling Mind only), and mindfulness (Headspace only) from baseline to the end of 10 days relative to control participants. Participants who continued to use the app frequently were more likely to maintain improvements in mental health, e.g. in depressive symptoms and resilience (Headspace only), until the end of the 30-day period. Thus, brief mobile mindfulness meditation practice can improve some aspects of negative mental health in the short term and may strengthen positive mental health when used regularly. Further research is required to examine the long-term effects of these apps.
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Ahtinen, A., Mattila, E., Välkkynen, P., Kaipainen, K., Vanhala, T., Ermes, M., et al. (2013). Mobile mental wellness training for stress management: Feasibility and design implications based on a one-month field study. JMIR mHealth and uHealth, 1(2), e11. https://doi.org/10.2196/mhealth.2596.
Aiken, L. & West, S. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
Aitken, M., & Lyle, J. (2015). Patient adoption of mHealth: Use, evidence and remaining barriers to mainstream acceptance. Parsippany: IMS Institute for Healthcare Informatics.
Anderson, M., & Horrigan, J. B. (2016, October 3). Smartphones help those without broadband get online, but don’t necessarily bridge the digital divide. PEW Research Report. Retrieved from pewresearch.org/fact-tank/2016/10/03/smartphones-help-those-without-broadband-get-online-but-dont-necessarily-bridge-the-digital-divide/
Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2016). Mental health smartphone apps: Review and evidence-based recommendations for future developments. JMIR mental health, 3(1), e7. https://doi.org/10.2196/mental.4984.
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale: An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77. https://doi.org/10.1016/s0022-3999(01)00296-3.
Bergomi, C., Tschacher, W., & Kupper, Z. (2015). Meditation practice and self-reported mindfulness: A cross-sectional investigation of meditators and non-meditators using the comprehensive inventory of mindfulness experiences (CHIME). Mindfulness, 6(6), 1411–1421. https://doi.org/10.1007/s12671-015-0415-6.
Bostock, S., Crosswell, A. D., Prather, A. A., & Steptoe, A. (2018). Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being. Journal of Occupational Health Psychology. Advanced online publication. https://doi.org/10.1037/ocp0000118.
Bostock, S. K., & Steptoe, A. (2013, April). Can finding headspace reduce work stress? A randomised controlled workplace trial of a mindfulness meditation app. Psychosomatic Medicine, 75(3), A36–A37.
Brody, J. L., Scherer, D. G., Turner, C. W., Annett, R. D., & Dalen, J. (2017). A conceptual model and clinical framework for integrating mindfulness into family therapy with adolescents. Family Process. Advanced online. https://doi.org/10.1111/famp.12298.
Carissoli, C., Villani, D., & Riva, G. (2015). Does a meditation protocol supported by a mobile application help people reduce stress? Suggestions from a controlled pragmatic trial. Cyberpsychology, Behavior, and Social Networking, 18(1), 46–53. https://doi.org/10.1089/cyber.2014.0062.
Carmody, J., & Baer, R. A. (2009). How long does a mindfulness-based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65(6), 627–638. https://doi.org/10.1002/jclp.20555.
Cavanagh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., & Jones, F. (2013). A randomised controlled trial of a brief online mindfulness-based intervention. Behaviour Research and Therapy, 51(9), 573–578. https://doi.org/10.1016/j.brat.2013.06.003.
Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34(2), 118–129. https://doi.org/10.1016/j.cpr.2014.01.001.
Clayton, R. B., Leshner, G., & Almond, A. (2015). The extended iSelf: The impact of iPhone separation on cognition, emotion, and physiology. Journal of Computer-Mediated Communication, 20(2), 119–135. https://doi.org/10.1111/jcc4.12109.
Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health: Claremont symposium on applied social psychology. Newbury Park, CA: Sage.
Creswell, J. D. (2017). Mindfulness interventions. Annual Review of Psychology, 68, 491–516. https://doi.org/10.1146/annurev-psych-042716-051139.
Cyr, D., Head, M., & Ivanov, A. (2006). Design aesthetics leading to m-loyalty in mobile commerce. Information & Management, 43(8), 950–963. https://doi.org/10.1016/j.im.2006.08.009.
Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D. W., Oishi, S., & Biswas-Diener, R. (2010). New well-being measures: Short scales to assess flourishing and positive and negative feelings. Social Indicators Research, 97(2), 143–156. https://doi.org/10.1007/s11205-009-9493-y.
Donker, T., Petrie, K., Proudfoot, J., Clarke, J., Birch, M. R., & Christensen, H. (2013). Smartphones for smarter delivery of mental health programs: A systematic review. Journal of Medical Internet Research, 15(11), e247. https://doi.org/10.2196/jmir.2791.
Economides, M., Martman, J., Bell, M. J., & Sanderson, B. (2018). Improvements in stress, affect, and irritability following brief use of a mindfulness-based smartphone app: A randomized controlled trial. Mindfulness. https://doi.org/10.1007/s12671-018-0905-4.
Farago, P. (2012, October 22). App engagement: The matrix reloaded. Flurry Analytics Blog. Retrieved from http://flurrymobile.tumblr.com/post/113379517625/app-engagement-the-matrix-reloaded
Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J. P. (2007). Mindfulness and emotion regulation: The development and initial validation of the cognitive and affective mindfulness scale revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29(3), 177–190. https://doi.org/10.1007/s10862-006-9035-8.
Fisher, S., & Hood, B. (1987). The stress of the transition to university: A longitudinal study of psychological disturbance, absent-mindedness and vulnerability to homesickness. British Journal of Psychology, 78, 425–441. https://doi.org/10.1111/j.2044-8295.1987.tb02260.x.
Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., et al. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357–368. https://doi.org/10.1001/jamainternmed.2013.13018.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183. https://doi.org/10.1037/a0018555.
Hone, L., Jarden, A., & Schofield, G. (2014). Psychometric properties of the flourishing scale in a New Zealand sample. Social Indicators Research, 119(2), 1031–1045. https://doi.org/10.1007/s11205-013-0501-x.
Howells, A., Ivtzan, I., & Eiroa-Orosa, F. J. (2016). Putting the ‘app’ in happiness: A randomised controlled trial of a smartphone-based mindfulness intervention to enhance wellbeing. Journal of Happiness Studies, 17(1), 163–185. https://doi.org/10.1007/s10902-014-9589-1.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47. https://doi.org/10.1016/0163-8343(82)90026-3.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy/bpg016.
Kabat-Zinn, J. (2013). Full catastrophe living, revised edition: How to cope with stress, pain and illness using mindfulness meditation. Hachette UK.
Kladnitski, N., Smith, J., Allen, A., Andrews, G., & Newby, J. M. (2018). Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial. Internet Interventions. Advanced online publication. https://doi.org/10.1016/j.invent.2018.06.003.
Larsen, M. E., Nicholas, J., & Christensen, H. (2016). Quantifying app store dynamics: Longitudinal tracking of mental health apps. JMIR mHealth and uHealth, 4(3), e96. https://doi.org/10.2196/mhealth.6020.
Levinson, D. B., Stoll, E. L., Kindy, S. D., Merry, H. L., & Davidson, R. J. (2014). A mind you can count on: Validating breath counting as a behavioral measure of mindfulness. Frontiers in Psychology, 5, e1202. https://doi.org/10.3389/fpsyg.2014.01202.
Lewinsohn, P. M., Seeley, J. R., Roberts, R. E., & Allen, N. B. (1997). Center for Epidemiological Studies-Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12, 277–287. https://doi.org/10.1037//0882-79220.127.116.117.
Lim, D., Condon, P., & DeSteno, D. (2015). Mindfulness and compassion: An examination of mechanism and scalability. PLoS One, 10(2), e0118221. https://doi.org/10.1371/journal.pone.0118221.
Lyubomirsky, S., Dickerhoof, R., Boehm, J. K., & Sheldon, K. M. (2011). Becoming happier takes both a will and a proper way: An experimental longitudinal intervention to boost well-being. Emotion, 11, 391–402. https://doi.org/10.1037/a0022575.
Mani, M., Kavanagh, D. J., Hides, L., & Stoyanov, S. R. (2015). Review and evaluation of mindfulness-based iPhone apps. JMIR mHealth and uHealth, 3(3), e82. https://doi.org/10.2196/mhealth.4328.
Meinlschmidt, G., Lee, J. H., Stalujanis, E., Belardi, A., Oh, M., Jung, E. K., et al. (2016). Smartphone-based psychotherapeutic micro-interventions to improve mood in a real-world setting. Frontiers in Psychology, 7, e1112. https://doi.org/10.3389/fpsyg.2016.01112.
Oliver, M. I., Pearson, N., Coe, N., & Gunnell, D. (2005). Help-seeking behaviour in men and women with common mental health problems: Cross-sectional study. British Journal Psychiatry, 186, 297–301. https://doi.org/10.1192/bjp.186.4.297.
Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58, 528–537. https://doi.org/10.1037//0022-3518.104.22.1688.
Plaza, I., Demarzo, M. M. P., Herrera-Mercadal, P., & García-Campayo, J. (2013). Mindfulness-based mobile applications: Literature review and analysis of current features. JMIR mHealth and uHealth, 1(2), e24. https://doi.org/10.2196/mhealth.2733.
Price, M., Yuen, E. K., Goetter, E. M., Herbert, J. D., Forman, E. M., Acierno, R., & Ruggiero, K. J. (2014). mHealth: A mechanism to deliver more accessible, more effective mental health care. Clinical Psychology & Psychotherapy, 21(5), 427–436. https://doi.org/10.1002/cpp.1855.
Prins, M. A., Verhaak, P. F., Bensing, J. M., & van der Meer, K. (2008). Health beliefs and perceived need for mental health care of anxiety and depression—The patients’ perspective explored. Clinical Psychology Review, 28(6), 1038–1058. https://doi.org/10.1016/j.cpr.2008.02.009.
Puddicombe, A. (2017). User profile, LinkedIn. 31 October 2017, linkedin.com/in/andypuddicombe/.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurements, 1, 385–401. https://doi.org/10.1177/014662167700100306.
Roberti, J. W., Harrington, L. N., & Storch, E. A. (2006). Further psychometric support for the 10-item version of the perceived stress scale. Journal of College Counseling, 9(2), 135–147. https://doi.org/10.1002/j.2161-1882.2006.tb00100.x.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. (2nd edition). New York: Guilford Press.
Smiling Mind (2017). Smiling mind. Retrieved from smilingmind.com.au/
Smith, A. (2017). Record shares of Americans now own smartphones, have home broadband. PEW Research Report. Retrieved from pewresearch.org/fact-tank/2017/01/12/evolution-of-technology/
Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15(3), 194–200. https://doi.org/10.1080/10705500802222972.
Smith, B.W., Epstein, E.E., Oritz, J.A., Christopher, P.K., & Tooley, E.M. (2013). The foundations of resilience: What are the critical resources for bouncing back from stress? In Prince-Embury, S. & Saklofske, D.H. (Eds.), Resilience in children, adolescents, and adults: Translating research into practice, The Springer series on human exceptionality (pp. 167–187). New York: Springer.
Snaith, R. P. (2003). The hospital anxiety and depression scale. Health and Quality of Life Outcomes, 1, 29. https://doi.org/10.1186/1477-7525-1-29.
Spijkerman, M. P. J., Pots, W. T. M., & Bohlmeijer, E. T. (2016). Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical Psychology Review, 45, 102–114. https://doi.org/10.1016/j.cpr.2016.03.009.
Stoyanov, S. R., Hides, L., Kavanagh, D. J., Zelenko, O., Tjondronegoro, D., & Mani, M. (2015). Mobile app rating scale: A new tool for assessing the quality of health-related mobile apps. JMIR mhealth and uhealth, 3(1), e27. https://doi.org/10.2196/mhealth.3422.
Swain, H. (2016) Mindfulness: The craze sweeping through schools is now at a university near you. The Guardian. Retrieved from http://www.theguardian.com/education/2016/jan/26/mindfulness-craze-schools-university-near-you-cambridge
Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623. https://doi.org/10.1037//0022-006X.68.4.615.
Torous, J., & Firth, J. (2016). The digital placebo effect: Mobile mental health meets clinical psychiatry. The Lancet Psychiatry, 3(2), 100–102. https://doi.org/10.1016/s2215-0366(15)00565-9.
Van Dam, N. T., van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., et al. (2017). Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on Psychological Science. https://doi.org/10.1177/1745691617709589.
Wen, L., Sweeney, T. E., Welton, L., Trockel, M., & Katznelson, L. (2017). Encouraging mindfulness in medical house staff via smartphone app: A pilot study. Academic Psychiatry, 41(5), 646–650. https://doi.org/10.1007/s40596-017-0768-3.
Weinstein, N., Brown, K. W., & Ryan, R. M. (2009). A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. Journal of Research in Personality, 43(3), 374–385. https://doi.org/10.1016/j.jrp.2008.12.008.
Weiss, L. A., Westerhof, G. J., & Bohlmeijer, E. T. (2016). Can we increase psychological well-being? The effects of interventions on psychological well-being: A meta-analysis of randomized controlled trials. PLoS One, 11(6), e0158092. https://doi.org/10.1371/journal.pone.0158092.
Yang, E., Schamber, E., Meyer, R. M., & Gold, J. I. (2018). Happier healers: Randomized controlled trial of mobile mindfulness for stress management. The Journal of Alternative and Complementary Medicine, 24(5), 505–503. https://doi.org/10.1089/acm.2015.0301.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x.
This research was funded by the Office of the Vice-Chancellor, University of Otago. The authors thank research assistants Tayla Boock, Todd Johnston, and Samantha McDiarmid for their assistance in collecting data.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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The authors declare that they have no conflict of interest.
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Flett, J.A.M., Hayne, H., Riordan, B.C. et al. Mobile Mindfulness Meditation: a Randomised Controlled Trial of the Effect of Two Popular Apps on Mental Health. Mindfulness 10, 863–876 (2019). https://doi.org/10.1007/s12671-018-1050-9
- Mobile phones
- Mental health