What is Mindfulness: Benefits, How to Practice, and More - Healthline
It often involves focusing on sensations to root yourself in your body in the here and now. It can be practiced during formal meditation or ...
2018 review
A <anchor>2018 review</anchor> noted that it was the first meta-analysis to show that regular mindfulness practice is beneficial for anxiety and depression, even without being integrated into a larger therapeutic framework.
Effects of mindfulness exercises as stand-alone intervention on symptoms of anxiety and depression: Systematic review and meta-analysis - ScienceDirect
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## Behaviour Research and Therapy

# Effects of mindfulness exercises as stand-alone intervention on symptoms of anxiety and depression: Systematic review and meta-analysis

Author links open overlay panelPaulBlancka, SarahPerletha, ThomasHeidenreichb, PaulaKrögera, BeateDitzenc, HinrichBentsa, JohannesMandera

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## Highlights

- •
  We investigated mindfulness exercises as a stand-alone intervention.

- •
  Stand-alone mindfulness exercises exhibit positive effects on anxiety and depression.

- •
  Future studies should investigate effects in clinical samples.

## Abstract

Mindfulness-based interventions (MBIs) are currently well established in psychotherapy with meta-analyses demonstrating their efficacy. In these multifaceted interventions, the concrete performance of mindfulness exercises is typically integrated in a larger therapeutic framework. Thus, it is unclear whether stand-alone mindfulness exercises (SAMs) without such a framework are beneficial, as well. Therefore, we conducted a systematic review and meta-analysis regarding the effects of SAMs on symptoms of anxiety and depression. Systematic searching of electronic databases resulted in 18 eligible studies (n = 1150) for meta-analyses. After exclusion of one outlier SAMs had small to medium effects on anxiety ( SMD = 0.39; CI: 0.22, 0.56; PI: 0.07, 0.70; p < .001, I 2 = 18.90%) and on depression ( SMD = 0.41; CI: 0.19, 0.64; PI: −0.05, 0.88; p < .001; I 2 = 33.43%), when compared with controls. Summary effect estimates decreased, but remained significant when corrected for potential publication bias. This is the first meta-analysis to show that the mere, regular performance of mindfulness exercises is beneficial, even without being integrated in larger therapeutic frameworks.

## Section snippets

## Eligibility criteria

The systematic review and meta-analysis were designed and conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRSIMA; Moher, Liberati, Tetzlaff, & Altman, 2009) statement. Inclusion criteria were specified in advance and documented in a protocol at PROSPERO ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=33441).

## Study selection

The initial database search yielded 8181 results, 2405 new records were found after updating the search. 52 additional records were identified through reference lists of eligible studies (Fig. 1). After removal of duplicates, the initial abstract screening led to an exclusion of 8524 studies. The independent full-text screening of 578 articles found that 21 studies met inclusion criteria. Agreement between raters was high with only three studies being rated differently (κ = 0.93, z = 22.4,

## Discussion

A core element of mindfulness as taught in MBIs refers to the regular performance of formal mindfulness exercises. Yet, the efficacy of these exercises as a stand-alone intervention is seldom explored, since most studies investigate fully-fletched MBIs, which are composed of several components (Dimidjian and Segal, 2015, Mander et al., 2017). Therefore, the aim of the present systematic review and meta-analysis was to isolate one specific component and sight the existing evidence concerning the

## Funding

This research was supported by a grant from the German Research Foundation (DFG) to Dr. Johannes Mander (MA6526/2-1).

## Contributors

PB and JM designed the study and wrote the protocol. Independent screening and data extraction of eligible studies was conducted by PB and SP. PB conducted the statistical analysis and wrote the first draft of the manuscript. TH, PK, BD, HB and JM critically revised the manuscript for important intellectual content. All authors contributed to and have approved the final manuscript.

## Acknowledgements

We would like to thank Jana Nusskern, Luise Prüssner, Ivo Ritter, Kamala Grothe, Hanna Deflorin, Elena Gruber and Clara Janinhoff for their intensive support in realizing this study.

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Dental anxiety and dental neglect are interconnected constructs with profound consequences for oral health and corresponding challenges for dental professionals. Meanwhile, other literature has indicated that mindfulness and self-compassion relate negatively to different forms of anxiety, and propose elements of potential interventions. This study aimed to explore the potential impact of dental anxiety as a mediator on the relationships between mindfulness or self-compassion and dental neglect. The results showed significant negative associations between mindfulness and self-compassion with dental anxiety and dental neglect. Mediation analyses supported the hypothesis that dental anxiety mediates the positive associations between mindfulness or self-compassion and dental neglect, providing preliminary evidence for the potential effectiveness of mindfulness and self-compassion interventions in addressing dental anxiety and dental neglect. Future research and potential clinical implications are discussed.

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Training outcomes of mindfulness interventions for anxiety have been extensively researched. Less is known about the acute effects of mindfulness induction and associated mechanisms. This systematic review aimed to identify 1) the effect of mindfulness induction on pre-post measures of state anxiety and attention among adults experiencing high levels of anxiety; and 2) the impact of predictors, mediators and moderators on post-induction changes in anxiety and attention. State distress and mindfulness were included as secondary outcomes.

A systematic search was conducted in November 2021 in electronic databases using relevant search terms. Five studies (four randomised controlled trials and one non-randomised controlled trial) were included, comprising a total of 277 participants with elevated trait/generalised anxiety. Each study used a brief audio-based mindfulness induction exercise.

The meta-analysis indicated mindfulness induction had medium and large effects on state anxiety ( k = 3, n = 100, g = −0.60, 95% CI [-1.04, −0.16]; p = .008) and state mindfulness ( k = 2, n = 110, g = 0.91, 95% CI [0.52, 1.30], p < .001), respectively, when compared with non-therapeutic control conditions. Furthermore, two studies showed small and moderate effects of mindfulness on state anxiety when compared to therapeutic active controls, but were not pooled in a meta-analysis. While results could not be pooled for attention, there was limited evidence of behavioural improvements on tasks measuring aspects of attention following mindfulness induction. However, one study found an increase in Low Beta to High Beta ratio and a reduction in Beta activity in the Anterior Cingulate Cortex following mindfulness induction. Moreover, another study found aspects of state mindfulness mediated reductions in state anxiety.

A small number of studies were included in the review, with high risk of bias and low certainty of evidence present.

The findings support the use of mindfulness induction to reduce state anxiety in anxious individuals but suggest gains in state mindfulness may be a more realistic expected outcome. Further controlled trials are needed to delineate the relative effects of objectively assessed anxiety outcomes from mindfulness induction in clinically defined samples.

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© 2017 Elsevier Ltd. All rights reserved.

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