Evidence Map of Mindfulness

This evidence map provides an overview of “mindfulness” intervention research and describes its volume and focus. It summarizes patient outcomes as reported in systematic reviews of randomized controlled trial evidence. We searched 10 electronic databases to February 2014, screened reviews of reviews, and consulted topic experts. We used a bubble plot as a visual overview of the distribution of evidence and synthesized results narratively in an executive summary. In total, 81 systematic reviews met inclusion criteria and the largest review included 109 mindfulness RCTs. Most research is available for general overviews on health benefits or psychological wellbeing. Reviews on chronic illness, depression, substance use, somatization, distress, and mental illness included 10 or more RCTs. Reviews suggest differential effects of mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and other mindfulness-based interventions, and definitions of “mindfulness-based” varied. The most consistent effect was reported for depression but published meta-analyses also indicated effects compared to passive control of MBSR on overall health, chronic illness, and psychological variables; MBCT for mental illness; and mindfulness interventions for somatization disorders. Limited evidence is also available for mindfulness interventions for pain, anxiety, and psychosis compared to passive control groups. More detail is provided for priority areas post-traumatic stress disorder, stress, depression, and wellness. The evidence map provides a broad overview (not detailed or definitive effectiveness evidence) over the existing research to help interpret the state of the evidence to inform policy and clinical decision making.

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[45]  N. Uldbjerg,et al.  Self‐hypnosis for coping with labour pain: a randomised controlled trial , 2013, BJOG : an international journal of obstetrics and gynaecology.

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[51]  Jia Yi Chow,et al.  Mindfulness, movement control, and attentional focus strategies: effects of mindfulness on a postural balance task. , 2012, Journal of sport & exercise psychology.

[52]  B. Leiby,et al.  Psychosocial benefits of a novel mindfulness intervention versus standard support in distressed women with breast cancer , 2013, Psycho-oncology.

[53]  Mark R. Burge,et al.  PTSD symptom reduction with mindfulness-based stretching and deep breathing exercise: randomized controlled clinical trial of efficacy. , 2013, The Journal of clinical endocrinology and metabolism.

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[55]  Geraint Rees,et al.  Cognitive-Affective Neural Plasticity following Active-Controlled Mindfulness Intervention , 2012, The Journal of Neuroscience.

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[59]  I. Nyklíček,et al.  Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. , 2013, Research in developmental disabilities.

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[62]  T. Åkerstedt,et al.  Effects of mindfulness training on levels of cortisol in cancer patients. , 2013, Psychosomatics.

[63]  J. Lipsitz,et al.  Do mindfulness-based interventions reduce pain intensity? A critical review of the literature. , 2013, Pain medicine.

[64]  M. Smoski,et al.  Reappraisal and mindfulness: a comparison of subjective effects and cognitive costs. , 2013, Behaviour research and therapy.

[65]  Joanna J. Arch,et al.  Which treatment worked better for whom? Moderators of group cognitive behavioral therapy versus adapted mindfulness based stress reduction for anxiety disorders. , 2013, Behaviour research and therapy.

[66]  E. Garland,et al.  Mindfulness-Oriented Recovery Enhancement Reduces Pain Attentional Bias in Chronic Pain Patients , 2013, Psychotherapy and Psychosomatics.

[67]  B. Lau,et al.  The Chinese medicine construct "stagnation" in mind-body connection mediates the effects of mindfulness training on depression and anxiety. , 2013, Complementary therapies in medicine.

[68]  G. Dobos,et al.  Mindfulness-based stress reduction for breast cancer-a systematic review and meta-analysis. , 2012, Current oncology.

[69]  Guillaume Fortin,et al.  Mindfulness-based therapy: a comprehensive meta-analysis. , 2013, Clinical psychology review.

[70]  R. Dunn,et al.  Effects of pre-session centering for therapists on session presence and effectiveness , 2013, Psychotherapy research : journal of the Society for Psychotherapy Research.

[71]  C. Becker,et al.  A comparison of mindfulness, nonjudgmental, and cognitive dissonance-based approaches to mirror exposure. , 2011, Body image.

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[74]  P. Duberstein,et al.  Emotional benefits of mindfulness-based stress reduction in older adults: the moderating roles of age and depressive symptom severity , 2013, Aging & mental health.

[75]  Kerry L. Schofield,et al.  Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis , 2013, PloS one.

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[77]  A. Schröder,et al.  Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up. , 2013, Journal of psychosomatic research.

[78]  Elizabeth Tipton,et al.  Mindfulness Based Stress Reduction (MBSR) for Improving Health, Quality of Life, and Social Functioning in Adults , 2012 .

[79]  F. Mair,et al.  Mindfulness based interventions in multiple sclerosis - a systematic review , 2014, BMC Neurology.

[80]  A. Zautra,et al.  An Online Mindfulness Intervention Targeting Socioemotional Regulation in Fibromyalgia: Results of a Randomized Controlled Trial , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[81]  S. Payne,et al.  What is the evidence for the use of mindfulness‐based interventions in cancer care? A review , 2011, Psycho-oncology.

[82]  D. Kivlahan,et al.  Mindful awareness in body-oriented therapy for female veterans with post-traumatic stress disorder taking prescription analgesics for chronic pain: a feasibility study. , 2007, Alternative therapies in health and medicine.

[83]  T. Toneatto,et al.  Does Mindfulness Meditation Improve Anxiety and Mood Symptoms? A Review of the Controlled Research , 2007, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[84]  P. Perakakis,et al.  Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness. , 2010, Behaviour research and therapy.

[85]  Tessa Hart,et al.  Treatment for depression after traumatic brain injury: a systematic review. , 2009, Journal of neurotrauma.

[86]  Alessandro Serretti,et al.  Mindfulness-based interventions for chronic pain: a systematic review of the evidence. , 2011, Journal of alternative and complementary medicine.

[87]  B. Oken,et al.  Pilot controlled trial of mindfulness meditation and education for dementia caregivers. , 2010, Journal of alternative and complementary medicine.

[88]  M. Mantzios,et al.  Making concrete construals mindful: A novel approach for developing mindfulness and self-compassion to assist weight loss , 2014, Psychology & health.

[89]  S. Bauer-Wu,et al.  Mindfulness Meditation for Oncology Patients: A Discussion and Critical Review , 2006, Integrative cancer therapies.

[90]  A. Lang,et al.  Meditation-Based Mantram Intervention for Veterans With Posttraumatic Stress Disorder: A Randomized Trial , 2013 .

[91]  K. Refshauge,et al.  A comparison of the effect of mindfulness and relaxation on responses to acute experimental pain , 2013, European journal of pain.

[92]  Alessandro Serretti,et al.  Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis , 2011, Psychiatry Research.

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[94]  G. Dobos,et al.  Mindfulness-based stress reduction for low back pain. A systematic review , 2012, BMC Complementary and Alternative Medicine.

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[96]  Matthew J. Goodman,et al.  Lymphocyte Recovery After Breast Cancer Treatment and Mindfulness-Based Stress Reduction (MBSR) Therapy , 2013, Biological research for nursing.

[97]  P. Fink,et al.  Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials , 2011, Acta psychiatrica Scandinavica.

[98]  Dawa T. Phillips,et al.  Mindfulness Training Improves Working Memory Capacity and GRE Performance While Reducing Mind Wandering , 2013, Psychological science.

[99]  F. Huppert,et al.  The efficacy of mindfulness‐based stress reduction on mental health of breast cancer patients: a meta‐analysis , 2013, Psycho-oncology.

[100]  Elizabeth A. Hoge,et al.  Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. , 2013, The Journal of clinical psychiatry.

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[103]  J. Greeson,et al.  Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts. , 2010, Behaviour research and therapy.

[104]  E. Hougaard,et al.  The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. , 2011, Clinical psychology review.

[105]  M. Burge,et al.  Mind-Body Practices for Posttraumatic Stress Disorder , 2013, Journal of Investigative Medicine.

[106]  Cardiovascular reactivity to and recovery from stressful tasks following a mindfulness analog in college students with a family history of hypertension. , 2013, Journal of alternative and complementary medicine.

[107]  Patricia F. Pearce,et al.  Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials , 2012, Journal of research in nursing : JRN.

[108]  L. Carlson,et al.  Mindfulness-Based Stress Reduction for the Treatment of Irritable Bowel Syndrome Symptoms: A Randomized Wait-list Controlled Trial , 2013, International Journal of Behavioral Medicine.

[109]  A. Serretti,et al.  Are Mindfulness-Based Interventions Effective for Substance Use Disorders? A Systematic Review of the Evidence , 2014, Substance use & misuse.

[110]  Gerhard Andersson,et al.  Guided internet-delivered acceptance and commitment therapy for chronic pain patients: a randomized controlled trial. , 2013, Behaviour research and therapy.

[111]  A. Serretti,et al.  Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. , 2009, Journal of alternative and complementary medicine.

[112]  J. Langhorst,et al.  A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. , 2013, Journal of psychosomatic research.

[113]  R. Piferi,et al.  Evaluation of a Mindfulness-Based Intervention Program to Decrease Blood Pressure in Low-Income African-American Older Adults , 2012, Journal of Urban Health.

[114]  Erik Taal,et al.  The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. , 2010, Journal of psychosomatic research.

[115]  Z. Segal,et al.  Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. II. Psychotherapy alone or in combination with antidepressant medication. , 2009, Journal of affective disorders.

[116]  B. Oken,et al.  Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature. , 2013, Drug and alcohol dependence.

[117]  M. Cropley,et al.  Assessing treatments used to reduce rumination and/or worry: a systematic review. , 2013, Clinical psychology review.

[118]  Thomas Llewelyn Webb,et al.  The Effectiveness of Mindfulness-Based Interventions for Supporting People With Intellectual Disabilities , 2013, Behavior modification.

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[120]  N. Kalin,et al.  A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation , 2013, Brain, Behavior, and Immunity.

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[123]  É. Labbé,et al.  Health Care Providers’ Mindfulness and Treatment Outcomes: A Critical Review of the Research Literature , 2011 .

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[128]  J. Moskowitz,et al.  A Randomized Study of the Effects of Mindfulness Training on Psychological Well-being and Symptoms of Stress in Patients Treated for Cancer at 6-month Follow-up , 2012, International Journal of Behavioral Medicine.

[129]  M. Berk,et al.  Complementary medicine, self-help, and lifestyle interventions for obsessive compulsive disorder (OCD) and the OCD spectrum: a systematic review. , 2012, Journal of affective disorders.

[130]  A. Serretti,et al.  Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. , 2011, Clinical psychology review.

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[132]  N. Morone,et al.  Mind-body interventions for chronic pain in older adults: a structured review. , 2007, Pain medicine.

[133]  C. Regehr,et al.  Interventions to reduce stress in university students: a review and meta-analysis. , 2013, Journal of affective disorders.

[134]  C. Johansen,et al.  Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. , 2013, European journal of cancer.

[135]  N. Cuellar,et al.  Mindfulness Meditation for Veterans—Implications for Occupational Health Providers , 2008 .

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[140]  Hiroaki Kumano,et al.  Mindfulness‐based stress reduction and cancer: a meta‐analysis , 2009, Psycho-oncology.

[141]  S. Greenfield,et al.  The effect of complementary and alternative medicine on the quality of life of cancer survivors: a systematic review and meta-analyses. , 2013, Complementary therapies in medicine.

[142]  Matthew D. Lieberman,et al.  Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: A small randomized controlled trial , 2012, Brain, Behavior, and Immunity.

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[144]  A. Crain,et al.  Mindfulness-based stress reduction for family caregivers: a randomized controlled trial. , 2013, The Gerontologist.

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[146]  Brandon G. King,et al.  Intensive meditation training, immune cell telomerase activity, and psychological mediators , 2011, Psychoneuroendocrinology.

[147]  J. Gross,et al.  MBSR vs aerobic exercise in social anxiety: fMRI of emotion regulation of negative self-beliefs. , 2013, Social cognitive and affective neuroscience.

[148]  E. Ernst,et al.  Mindfulness-based cognitive therapy: evaluating current evidence and informing future research. , 2007, Journal of consulting and clinical psychology.

[149]  Robert Koehler,et al.  Mindfulness Meditation for Substance Use Disorders: A Systematic Review , 2009, Substance abuse.

[150]  L. Carlson,et al.  Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[151]  P. Mitchell,et al.  A randomized controlled trial of mindfulness‐based cognitive therapy for bipolar disorder , 2013, Acta psychiatrica Scandinavica.

[152]  M. Baime,et al.  Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial. , 2012, Journal of occupational health psychology.

[153]  T. Simpson,et al.  Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder: a randomized controlled pilot study. , 2013, Journal of clinical psychology.

[154]  Lei Zhang,et al.  Improving spatial abilities through mindfulness: Effects on the mental rotation task , 2011, Consciousness and Cognition.

[155]  E. Friedmann,et al.  Effects of interventions on depression in heart failure: a systematic review. , 2012, Heart & lung : the journal of critical care.

[156]  J. Schulz,et al.  Effectiveness of mindfulness-based therapies in reducing symptoms of depression: A meta-analysis , 2012 .

[157]  S. Vangkilde,et al.  Mindfulness training affects attention--or is it attentional effort? , 2012, Journal of experimental psychology. General.

[158]  Debra Creedy,et al.  Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. , 2012, International journal of nursing studies.

[159]  Monika Merkes Mindfulness-based stress reduction for people with chronic diseases. , 2010, Australian journal of primary health.

[160]  M. Lawrence,et al.  A Systematic Review of the Benefits of Mindfulness-Based Interventions following Transient Ischemic Attack and Stroke , 2013, International journal of stroke : official journal of the International Stroke Society.

[161]  Roger L. Brown,et al.  Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial , 2012, The Annals of Family Medicine.

[162]  F. Musial,et al.  Mindfulness-Based Stress Reduction for Integrative Cancer Care – a Summary of Evidence , 2011, Complementary Medicine Research.

[163]  W. Malarkey,et al.  Workplace based mindfulness practice and inflammation: A randomized trial , 2013, Brain, Behavior, and Immunity.

[164]  Yi-Yuan Tang,et al.  Brief meditation training induces smoking reduction , 2013, Proceedings of the National Academy of Sciences.

[165]  M. Katz,et al.  A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder. , 2013, Journal of affective disorders.

[166]  H. Küchenhoff,et al.  Existential behavioural therapy for informal caregivers of palliative patients: a randomised controlled trial , 2013, Psycho-oncology.

[167]  S. Smalley,et al.  Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy , 2014, Psychology & health.

[168]  Xinghua Liu,et al.  Effect of brief mindfulness intervention on tolerance and distress of pain induced by cold-pressor task. , 2013, Stress and health : journal of the International Society for the Investigation of Stress.