Creswell, J. D. (2017). Mindfulness interventions. Annual review of psychology, 68(1), 491-516.
A lot of the studies quoted in this review are couched in terms of uncertainty, like “may have benefits” or “It could be argued that mindfulness interventions might benefit all types of attention-related outcomes.” Another common phrase used is “initial studies suggest.” The scientific study of mindfulness only started in the mid-90s. The author dutifully points out that many of the mindfulness randomized control trials “used small samples and lack high-quality pretreatment, posttreatment, and follow-up measures,” making it “difficult to draw strong inferences about the validity and reliability of mindfulness intervention.” All of these previously mentioned items make my replicability ears perk up, so when I then get to statements like “was effective in reducing self-reported pain disability posttreatment” or “reduced depressive symptoms posttreatment,” I really just wanted to know “how effective?” or “reduced by how much?” More than anything, this is just a reminder to myself to use effect sizes.
Summary
Mindfulness is a process that “grounds attention and awareness in one’s present moment experience” while also being accepting of one’s present experience. Those two factors, awareness and acceptance, are not “passive resignation” but rather a welcoming of all experience, difficult or otherwise. Mindfulness has been practiced by Buddhists (and other spiritual traditions) for 2500 years, though some current studies show secular mindfulness to be equally effective as spiritual mindfulness. The author evaluates mindfulness interventions across four domains: physical health, mental health, cognitive and affective outcomes, and interpersonal outcomes. In the physical realm, mindfulness interventions have successfully managed chronic pain, provided certain immune system benefits, and help in several different conditions related to stress. In mental health, mindfulness interventions have reduced the risk of depressive episode relapse, improved substance abuse outcomes, and reduced anxiety, depression, and PTSD. In cognitive and affective outcomes, young adults showed improved attention and affective outcomes (though other treatments seemed to work equally as well). Regarding interpersonal outcomes, more randomized controlled trial-based research is needed.
Some final notes… Mindfulness seems to be beneficial “independent of a group context.” “Sham mindfulness meditation” was creatively used to control for expectancy effects (strangely, mindfulness training, a control group, and the shame meditation were all effective in lessening depression, tension and fatigue – but mindfulness training was the most effective). Finally, I always appreciate when papers provide interim summaries.
Application
The authors posit that mindfulness buffers against stress, which seems reasonable. If I were looking for an immediate solution to a problem, I might wait until the mindfulness science firms up a bit more. At the very least, I don’t think mindfulness will hurt (though the author treats that issue as well).
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