Long-term Mental Health Effects of Mindfulness Training: a 4-Year Follow-up Study
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Mindfulness-based stress reduction (MBSR) enhances short-term psychological health in clinical and non-clinical samples, whereas studies examining long-term effects are scarce. This study examined whether the effects of a 7-week MBSR programme on mental health persisted at 2- and 4-year follow-up and explored possible mechanisms of effect.
In a two-site randomised controlled trial, 288 medical and psychology students were allocated to an MBSR intervention (n = 144) or a no-treatment control group (n = 144). During the 4-year follow-up period, the MBSR group was offered 90-min booster sessions semi-annually. The primary outcome measures were mental distress (General Health Questionnaire (GHQ)) and subjective well-being (SWB); these were measured at baseline (T0) and post-intervention follow-up at 1 month (T1), 2 years (T1) and again at 4 years (T3). Secondary outcomes included coping, mindfulness and meditation practice.
At 4-year follow-up, the MBSR group showed significantly better scores on mental distress, mindfulness, avoidance coping and problem-focused coping (Cohen’s d = 0.23–0.42). Meditation practice positively predicted long-term mindfulness scores. Short-term effects in mindfulness scores mediated long-term intervention effects in mental distress and coping. However, reversed mediation was also observed (i.e. changes in outcome mediating long-term mindfulness scores), and this indicates that initial changes in outcome and mindfulness are intrinsically intertwined and may both influence long-term effects. Small post-intervention effects on well-being and seeking social support did not persist at follow-up.
MBSR fostered enduring effects on mental distress and coping in medical and psychology students 4 years post-intervention.
KeywordsMindfulness Stress reduction Coping Long-term follow-up
We warmly thank all of the students who participated in this study.
IS designed and executed the study, analysed the data and wrote the paper. MdV designed and executed the study and assisted with the data analyses and the writing. OF analysed the data and wrote part of the methods and results. RT, TS and AB collaborated in the design and the writing of the study. JHR collaborated in the design and writing and editing of the final manuscript. All authors approved the final version of the manuscript for submission.
We would like to thank the Norwegian Medical Association, the Northern Norway Regional Health Authority and the Norwegian Knowledge Centre for the Health Services for funding this research project. These funding sources had no role in conducting the study.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interests.
The study was approved by the Regional Committee for Medical and Health Research Ethics in Norway and the Norwegian Data Inspectorate. All participants provided informed consent.
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