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Emotion-Related Constructs Engaged by Mindfulness-Based Interventions: a Systematic Review and Meta-analysis

Abstract

Objectives

Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotion-related constructs has not been systematically examined.

Methods

Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria.

Results

Seventy-two studies (N = 7,378) were included (MBSR k = 47, MBCT k = 21, modified k = 4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d = 0.58; k = 36), and in all constructs assessed: depression (d = 0.66; k = 26), anxiety (d = 0.63; k = 19), combined mental health (d = 0.75; k = 7), and stress (d = 0.44; k = 11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population type did not moderate results, but MBI type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies.

Conclusions

This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools.

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References

*Denotes study included in the systematic review and meta-analyses.

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Acknowledgments

We thank Blair T. Johnson and Emily A. Hennessy for their methodological advice. We also would like to thank Ana Alejandre-Lara for her work on the figures and manuscript preparation.

Funding

This work was supported by the National Institutes of Health (NIH) Science of Behavior Change Common Fund Program through an award administered by the National Center for Complementary and Integrative Health (grant UH2AT009145). W.B.B. received funding from NIH grant K23AT006328-01A1. The views presented here are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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Correspondence to Ethan Moitra.

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Conflict of Interest

E.B.L. is Director of the Mindfulness Center at Brown University. The Mindfulness Center, a non-profit entity, has an Education Unit that provides mindfulness-based program delivery to the general public for fees. However, E.B.L.’s salary is not tied to quantity or content of programs offered through the Mindfulness Center. W.B.B. is a MBSR and MBCT teacher and has received financial compensation for this role. W.B.B. receives payments for providing trainings and education in scientific literacy, meditation safety, and trauma-informed mindfulness. W.B.B. is nominally affiliated with the Mindfulness Center at Brown University which generates income by offering mindfulness classes to the public; W.B.B. does not receive any financial compensation from the Mindfulness Center. The other authors have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Hoge, E.A., Acabchuk, R.L., Kimmel, H. et al. Emotion-Related Constructs Engaged by Mindfulness-Based Interventions: a Systematic Review and Meta-analysis. Mindfulness 12, 1041–1062 (2021). https://doi.org/10.1007/s12671-020-01561-w

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  • DOI: https://doi.org/10.1007/s12671-020-01561-w

Keywords

  • Mindfulness
  • Affect regulation
  • Emotion
  • Measurement tools