Abstract
Objectives
Conventional 8-week mindfulness-based interventions (MBIs) require substantial time and in-person attendance. Single-workshop MBIs provide an accessible training alternative but offer little opportunity to integrate teaching and daily practice. The present study investigated whether online mindfulness booster sessions, following a single MBI workshop, promote well-being through improved acquisition of mindfulness skills in undergraduate students.
Methods
Following workshop attendance, participants (n = 101) were randomized to either a booster session condition or active control condition. Mood and stress were assessed daily in both groups for 1 month, with an additional 3 min of mindfulness prompts in the booster condition. Scale-based assessments were completed pre-workshop, post-workshop, and post-intervention. Data were reduced via planned factor analysis to form Decentering, Reactivity, and Symptom Burden scores. Mindfulness-related skills were assessed post-intervention via the Applied Mindfulness Process Scale (AMPS).
Results
Booster sessions promoted significantly greater increases in Decentering over the intervention period, β = 0.26, 95% CI [0.09, 0.44]; independent of baseline Decentering. Change in Decentering was significantly positively associated with AMPS positive emotion regulation, β = 0.09, 95% CI [0.01, 0.18]. No changes were observed for Reactivity or Symptom Burden.
Conclusions
Continued mindfulness practice following completion of a single MBI workshop may aid in the cultivation of Decentering. Future research should investigate the efficacy of booster sessions in clinical and community samples to determine whether growth in Decentering promotes additional mental health benefits over longitudinal follow-up.
Pre-registration
Study hypotheses and the data analyses plan were pre-registered with the Open Science Framework, which can be accessed via https://doi.org/10.17605/OSF.IO/3KWSX.
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Data Availability
The online version contains de-identified data for this study in Supplementary File: Online Resource 11.
References
Akgun, S., & Ciarrochi, J. (2003). Learned resourcefulness moderates the relationship between academic stress and academic performance. Educational Psychology, 23(3), 287–294. https://doi.org/10.1080/0144341032000060129
Assumpcao, A. A., Pena, C. S., Neufeld, C. B., & Teodoro, M. M. (2019). Mindfulness-based cognitive therapy for university students with depression, anxiety, and stress symptoms: A randomized controlled trial. Asia Pacific Journal of Clinical Trials: Nervous System Diseases, 4(3), 51. https://doi.org/10.4103/2542-3932.263668
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/10731911052835
Beevers, C. G., Strong, D. R., Meyer, B., Pilkonis, P. A., & Miller, I. W. (2007). Efficiently assessing negative cognition in depression: An item response theory analysis of the dysfunctional attitude scale. Psychological Assessment, 19(2), 199–209. https://doi.org/10.1037/1040-3590.19.2.199
Benzo, R. P., Anderson, P. M., Bronars, C., & Clark, M. (2018). Mindfulness for healthcare providers: The role of non-reactivity in reducing stress. EXPLORE, 14(6), 453–456. https://doi.org/10.1016/j.explore.2018.03.008
Bergen-Cico, D., Possemato, K., & Cheon, S. (2013). Examining the efficacy of a brief mindfulness-based stress reduction (brief MBSR) program on psychological health. Journal of American College Health, 61(6), 348–360. https://doi.org/10.1080/07448481.2013.813853
Bernstein, A., Hadash, Y., Lichtash, Y., Tanay, G., Shepherd, K., & Fresco, D. M. (2015). Decentering and related constructs: A critical review and metacognitive processes model. Perspectives on Psychological Science, 10(5), 599–617. https://doi.org/10.1177/1745691615594577
Bishop, S., Lau, M., Shapiro, S., Carlson, L., Anderson, N., Carmody, J., Segal, Z., Abbey, S., Speca, M., Velting, D., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241. https://doi.org/10.1093/clipsy.bph077
Bohlmeijer, E., Prenger, R., Taal, E., & Cuijpers, P. (2010). The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis. Journal of Psychosomatic Research, 68(6), 539–544. https://doi.org/10.1016/j.jpsychores.2009.10.005
Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18(4), 211–237. https://doi.org/10.1080/10478400701598298
Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15(5), 593–600. https://doi.org/10.1089/acm.2008.0495
Davidson, R. J., & Kaszniak, A. W. (2015). Conceptual and methodological issues in research on mindfulness and meditation. American Psychologist, 70(7), 581–592. https://doi.org/10.1037/a0039512
De Jonge, E., & Van Der Loo, M. (2013). An introduction to data cleaning with R. Statistics Netherlands.
de Vibe, M., Solhaug, I., Rosenvinge, J. H., Tyssen, R., Hanley, A., & Garland, E. (2018). Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; results from a randomized controlled trial. PLoS ONE, 13(4), e0196053. https://doi.org/10.1371/journal.pone.0196053
Desbordes, G., Gard, T., Hoge, E. A., Hölzel, B. K., Kerr, C., Lazar, S. W., Olendzki, A., & Vago, D. R. (2014). Moving beyond mindfulness: Defining equanimity as an outcome measure in meditation and contemplative research. Mindfulness, 6(2), 356–372. https://doi.org/10.1007/s12671-013-0269-8
Dimidjian, S., & Segal, Z. V. (2015). Prospects for a clinical science of mindfulness-based intervention. American Psychologist, 70(7), 593–620. https://doi.org/10.1037/a0039589
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–60. https://doi.org/10.3758/BRM.41.4.1149
Fiodorova, A., & Farb, N. A. S. (2021). Brief daily self-care reflection for undergraduate well-being: A randomized control trial of an online intervention. Anxiety, Stress, & Coping, 35(2), 158–170. https://doi.org/10.1080/10615806.2021.1949000
Fresco, D. M., Moore, M. T., van Dulmen, M. H., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: Validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–246. https://doi.org/10.1016/j.beth.2006.08.003
Gao, L., Curtiss, J., Liu, X., & Hofmann, S. G. (2018). Differential treatment mechanisms in mindfulness meditation and progressive muscle relaxation. Mindfulness, 9(4), 1268–1279. https://doi.org/10.1007/s12671-017-0869-9
Garland, E. L., Farb, N. A., Goldin, P., & Fredrickson, B. L. (2015). Mindfulness broadens awareness and builds eudaimonic meaning: A process model of mindful positive emotion regulation. Psychological Inquiry, 26(4), 293–314. https://doi.org/10.1080/1047840X.2015.1064294
Garland, E. L., Hanley, A. W., Goldin, P. R., & Gross, J. J. (2017). Testing the mindfulness-to-meaning theory: evidence for mindful positive emotion regulation from a reanalysis of longitudinal data. PLoS ONE, 12(12), e0187727. https://doi.org/10.1371/journal.pone.0187727
Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation, and emotional problems. Personality and Individual Differences, 30(8), 1311–1327. https://doi.org/10.1016/S0191-8869(00)00113-6
Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., & Wolever, R. Q. (2015). Decreased symptoms of depression after mindfulness-based stress reduction: Potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age. Journal of Alternative and Complementary Medicine, 21(3), 166–174. https://doi.org/10.1089/acm.2014.0285
Hindman, R. K., Glass, C. R., Arnkoff, D. B., & Maron, D. D. (2015). A comparison of formal and informal mindfulness programs for stress reduction in university students. Mindfulness, 6(4), 873–884. https://doi.org/10.1007/s12671-014-0331-1
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
Hoge, E. A., Bui, E., Goetter, E., Robinaugh, D. J., Ojserkis, R. A., Fresco, D. M., & Simon, N. M. (2015). Change in decentering mediates improvement in anxiety in mindfulness-based stress reduction for generalized anxiety disorder. Cognitive Therapy and Research, 39(2), 228–235. https://doi.org/10.1007/s10608-014-9646-4
Jha, A. P., Krompinger, J., & Baime, M. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective, & Behavioral Neuroscience, 7(2), 109–119. https://doi.org/10.3758/cabn.7.2.109
Josefsson, T., Lindwall, M., & Broberg, A. G. (2014). The effects of a short-term mindfulness based intervention on self-reported mindfulness, decentering, executive attention, psychological health, and coping style: Examining unique mindfulness effects and mediators. Mindfulness, 5(1), 18–35. https://doi.org/10.1007/s12671-012-0142-1
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. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. Delacorte.
Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041–1056. https://doi.org/10.1016/j.cpr.2011.04.006
Kessel, R., Gecht, J., Forkmann, T., Drueke, B., Gauggel, S., & Mainz, V. (2016). Exploring the relationship of decentering to health related concepts and cognitive and metacognitive processes in a student sample. BMC Psychology, 4, 11. https://doi.org/10.1186/s40359-016-0115-6
Klatt, M. D., Buckworth, J., & Malarkey, W. B. (2009). Effects of low-dose mindfulness-based stress reduction (MBSR-ld) on working adults. Health Education & Behavior, 36(3), 601–614. https://doi.org/10.1177/1090198108317627
Kroenke, K., Spitzer, R., Williams, J., & Lowe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359. https://doi.org/10.1016/j.genhosppsych.2010.03.006
Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. Psychological Bulletin, 136(4), 576–600. https://doi.org/10.1037/a0019712
Li, M. J., Black, D. S., & Garland, E. L. (2016). The applied mindfulness process scale (AMPS): A process measure for evaluating mindfulness-based interventions. Personality and Individual Differences, 93, 6–15. https://doi.org/10.1037/a0019712
Lindsay, E. K., & Creswell, J. D. (2017). Mechanisms of mindfulness training: Monitor and acceptance theory (MAT). Clinical Psychology Review, 51, 48–59. https://doi.org/10.1016/j.cpr.2016.10.011
Luberto, C. M., Hall, D. L., Park, E. R., Haramati, A., & Cotton, S. (2020). A perspective on the similarities and differences between mindfulness and relaxation. Global Advances in Health and Medicine, 9, 1–13. https://doi.org/10.1177/2164956120905597
Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Sciences, 12(4), 163–169. https://doi.org/10.1016/j.tics.2008.01.005
Matthew, T., Sherwin, R. S., Murphy, J., & Kerr, D. (1997). Importance of cerebral blood flow to the recognition of and physiological responses to hypoglycemia. Diabetes, 46(5), 829–833. https://doi.org/10.2337/diab.46.5.829
Mellick, W., Vanwoerden, S., & Sharp, C. (2017). Experiential avoidance in the vulnerability to depression among adolescent females. Journal of Affective Disorders, 208, 497–502. https://doi.org/10.1016/j.jad.2016.10.034
Moore, A., & Malinowski, P. (2009). Meditation, mindfulness and cognitive flexibility. Consciousness and Cognition, 18(1), 176–186. https://doi.org/10.1016/j.concog.2008.12.008
Morgan, L. P., Graham, J. R., Hayes-Skelton, S. A., Orsillo, S. M., & Roemer, L. (2014). Relationships between amount of post-intervention of mindfulness practice and follow-up outcome variables in an acceptance-based behavior therapy for generalized anxiety disorder: The importance of informal practice. Journal of Contextual Behavioral Science, 3(3), 173–176. https://doi.org/10.1016/j.jcbs.2014.05.001
Neff, K. D. (2003). Development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027
Neimeyer, R. A., Kazantzis, N., Kassler, D. M., Baker, K. D., & Fletcher, R. (2008). Group cognitive behavioural therapy for depression outcomes predicted by willingness to engage in homework, compliance with homework, and cognitive restructuring skill acquisition. Cognitive Behaviour Therapy, 37(4), 199–215. https://doi.org/10.1080/16506070801981240
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61(1), 115–121. https://doi.org/10.1037/0022-3514.61.1.115
Oswalt, S. B., Lederer, A. M., Chestnut-Steich, K., Day, C., Halbritter, A., & Ortiz, D. (2020). Trends in college students’ mental health diagnoses and utilization of services, 2009–2015. Journal of American College Health, 68(1), 41–51. https://doi.org/10.1080/07448481.2018.1515748
Pinheiro, J., Bates, D., DebRoy, S., & Sarkar, D. (2020). R Core Team (2020) nlme: Linear and nonlinear mixed effects models. R Package Version, 3, 1–148.
Ribeiro, L., Atchley, R. M., & Oken, B. S. (2018). Adherence to practice of mindfulness in novice meditators: Practices chosen, amount of time practiced, and long-term effects following a mindfulness-based intervention. Mindfulness, 9(2), 401–411. https://doi.org/10.1007/s12671-017-0781-3
Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. Retrieved April 14, 2020 from http://www.jstatsoft.org/v48/i02/
RStudio Team. (2015). RStudio: Integrated Development for R. RStudio, Inc. Retrieved November 22, 2019 from http://www.rstudio.com/
Schneiderman, N., Ironson, G., & Siegel, S. D. (2005). Stress and health: Psychological, behavioral, and biological determinants. Annual Review of Clinical Psychology, 1(1), 607–628. https://doi.org/10.1146/annurev.clinpsy.1.102803.144141
Schulz, K. F., Altman, D. G., Moher, D., et al. (2010). CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. BMC Medicine, 8, 18. https://doi.org/10.1186/1741-7015-8-18
Sedlmeier, P., Eberth, J., Schwarz, M., Zimmermann, D., Haarig, F., Jaeger, S., & Kunze, S. (2012). The psychological effects of meditation: A meta-analysis. Psychological Bulletin, 138(6), 1139–1171. https://doi.org/10.1037/a0028168
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2012). Mindfulness-based cognitive therapy for depression. Guilford Press.
Segal, Z. V., Anderson, A. K., Gulamani, T., Dinh Williams, L. A., Desormeau, P., Ferguson, A., Walsh, K., & Farb, N. A. S. (2019). Practice of therapy acquired regulatory skills and depressive relapse/recurrence prophylaxis following cognitive therapy or mindfulness based cognitive therapy. Journal of Consulting and Clinical Psychology, 87(2), 161–170. https://doi.org/10.1037/ccp0000351
Solhaug, I., de Vibe, M., Friborg, O., Sørlie, T., Tyssen, R., Bjørndal, A., & Rosenvinge, J. H. (2019). Long-term mental health effects of mindfulness training: A 4-year follow-up study. Mindfulness, 10(8), 1661–1672. https://doi.org/10.1007/s12671-019-01100-2
Steinert, C., Hofmann, M., Kruse, J., & Leichsenring, F. (2014). Relapse rates after psychotherapy for depression – stable long-term effects? A meta-analysis. Journal of Affective Disorders, 168, 107–118. https://doi.org/10.1016/j.jad.2014.06.043
Strohmaier, S., Jones, F. W., & Cane, J. E. (2021). Effects of length of mindfulness practice on mindfulness, depression, anxiety, and stress: A randomized controlled experiment. Mindfulness, 12(1), 198–214. https://doi.org/10.1007/s12671-020-01512-5
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27(3), 247–259. https://doi.org/10.1023/A:1023910315561
Waite, T. A., & Campbell, L. G. (2006). Controlling the false discovery rate and increasing statistical power in ecological studies. Ecoscience, 13(4), 439–442. https://doi.org/10.2980/1195-6860(2006)13[439:CTFDRA]2.0.CO;2
Walsh, K. M., Saab, B. J., & Farb, N. A. (2019). Effects of a mindfulness meditation app on subjective well-being: active randomized controlled trial and experience sampling study. Journal of Medical Internet Research Mental Health, 6(1), e10844. https://doi.org/10.2196/10844
Weidner, G., Kohlmann, C., Dotzauer, E., & Burns, L. R. (1996). The effects of academic stress on health behaviors in young adults. Anxiety, Stress & Coping, 9(2), 123–133. https://doi.org/10.1080/10615809608249396
Weissman, M. M. (1994). Psychotherapy in the maintenance treatment of depression. British Journal of Psychiatry, 165(S26), 42–50. https://doi.org/10.1192/S0007125000293288
Whisman, M. A. (1990). The efficacy of booster maintenance sessions in behaviour therapy: Review and methodological critique. Clinical Psychology Review, 10(2), 155–170. https://doi.org/10.1016/0272-7358(90)90055-F
Zajecka, J., Kornstein, S. G., & Blier, P. (2013). Residual symptoms in major depressive disorder: Prevalence, effects, and management. Journal of Clinical Psychiatry, 74(4), 407–414. https://doi.org/10.4088/JCP.12059ah1
Zhang, N., Fan, F., Huang, S., & Rodriguez, M. A. (2016). Mindfulness training for loneliness among Chinese college students: A pilot randomized controlled trial. International Journal of Psychology, 53(5), 373–378. https://doi.org/10.1002/ijop.12394
Zhang, J. Y., Ji, X. Z., Meng, L. N., & Cai, Y. J. (2019). Effects of modified mindfulness-based stress reduction (MBSR) on the psychological health of adolescents with subthreshold depression: A randomized controlled trial. Neuropsychiatric Disease and Treatment, 15, 2695–2704. https://doi.org/10.2147/NDT.S216401
Acknowledgements
We thank Dr. Jeffrey Graham for allowing us to use and build upon his 5-step meditation technique for the introductory mindfulness workshops of the present study.
Funding
This research was funded by the University of Toronto Mississauga Undergraduate Research Grant, and the Oxford Mindfulness Trust.
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Jana Radosavljevic: conceptualization (equal), methodology (equal), formal analysis (supporting), investigation (lead), writing–original draft, writing–review and editing (equal), visualization (equal), project administration (lead), funding acquisition (supporting).
Norman Farb: conceptualization (equal), methodology (equal), software, validation, formal analysis (lead), investigation (supporting), resources, data curation, writing–review and editing (equal), visualization (equal), supervision, project administration (supporting), funding acquisition (lead).
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Radosavljevic, J., Farb, N.A.S. Walking the Talk: a Randomized Trial Exploring the Role of Mindfulness Booster Sessions on Skill Acquisition Following Workshop Attendance. Mindfulness 14, 891–907 (2023). https://doi.org/10.1007/s12671-023-02091-x
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DOI: https://doi.org/10.1007/s12671-023-02091-x