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Understanding the factors that predict why some individuals perceive to respond more to meditation training than others could impact the development, efficacy, adherence levels, and implementation of meditation-based interventions. We investigated individual-level variables associated with self- and teacher-perceived responsiveness to longer-term meditation training. This study presents a secondary analysis of the Age-Well trial (NCT02977819, 30/11/2016) and includes 90 healthy older adults (65–84 years) that were randomised to an 18-month meditation training or a non-native language (English) training. Responsiveness was measured post-intervention using participants’ and teachers’ ratings of four psychological domains (connection, positive/negative emotions, meta-awareness) in relation to two contexts (during sessions, in daily life), teachers’ perception of overall benefit, and a global composite comprising all self- and teacher-perceived responsiveness measures. Linear regression modelling indicates that, when including baseline variables (sex, education, neuroticism, cognition, expectancy) and engagement (hours of formal practice during intervention), only higher levels of engagement were associated with higher global composite scores (standardised estimate = 0.50, 95% CI: 0.24–0.77, p  < 0.001). Global composite scores were not correlated with pre-post changes in well-being. Findings indicate that more time spent practising meditation was related to greater perceived intervention effects. We suggest that future studies closely monitor levels of engagement and map reasons for disengagement.

Meditation is a mental training approach that can improve mental health and well-being in aging. Yet the underlying mechanisms remain unknown. The Medit-Ageing model stipulates that three mechanisms — attentional, constructive, and deconstructive — upregulate positive psycho-affective factors and downregulate negative ones. To test this hypothesis, we measured brain structural MRI and perfusion, negative and positive psycho-affective composite scores, and meditation mechanisms in 27 older expert meditators and 135 meditation-naive older controls. We identified brain and psycho-affective differences and performed mediation analyses to assess whether and which meditation mechanisms mediate their links. Meditators showed significantly higher volume in fronto-parietal areas and perfusion in temporo-occipito-parietal areas. They also had higher positive and lower negative psycho-affective scores. Attentional and constructive mechanisms both mediated the links between brain differences and the positive psycho-affective score whereas the deconstructive mechanism mediated the links between brain differences and the negative psycho-affective score. Our results corroborate the Medit-Ageing model, indicating that, in aging, meditation leads to brain changes that decrease negative psycho-affective factors and increase positive ones through relatively specific mechanisms. Shedding light on the neurobiological and psycho-affective mechanisms of meditation in aging, these findings provide insights to refine future interventions.

While the COVID-19 pandemic challenged the general public’s health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers’ well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day. Trial registration: ISRCTN ISRCTN61170784 ( https://doi.org/10.1186/ISRCTN61170784 ).

Background Chronic pain patients increasingly seek treatment through mindfulness meditation. Purpose This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults. Method We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use. Results Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life. Conclusions While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.

College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students. We aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention's effect on health behaviors (ie, sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app. This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant. A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up. Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs. ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810.

Key Points It is proposed that the mechanism through which mindfulness meditation exerts its effects is a process of enhanced self-regulation, including attention control, emotion regulation and self-awareness. Research on mindfulness meditation faces a number of important challenges in study design that limit the interpretation of existing studies. A number of changes in brain structure have been related to mindfulness meditation. Mindfulness practice enhances attention. The anterior cingulate cortex is the region associated with attention in which changes in activity and/or structure in response to mindfulness meditation are most consistently reported. Mindfulness practice improves emotion regulation and reduces stress. Fronto-limbic networks involved in these processes show various patterns of engagement by mindfulness meditation. Meditation practice has the potential to affect self-referential processing and improve present-moment awareness. The default mode networks — including the midline prefrontal cortex and posterior cingulate cortex, which support self-awareness — could be altered following mindfulness training. Mindfulness meditation has potential for the treatment of clinical disorders and might facilitate the cultivation of a healthy mind and increased well-being. Future research into mindfulness meditation should use randomized and actively controlled longitudinal studies with large sample sizes to validate previous findings. The effects of mindfulness practice on neural structure and function need to be linked to behavioural performance, such as cognitive, affective and social functioning, in future research. The complex mental state of mindfulness is likely to be supported by the large-scale brain networks; future work should take this into account rather than being restricted to activations in single brain areas. Positive effects of mindfulness-based practices on health and cognitive performance have been reported; however, we know little about the underlying mechanisms. Tang and colleagues outline the challenges of meditation research and consider emerging information about the effects of mindfulness meditation on brain structure and function. Research over the past two decades broadly supports the claim that mindfulness meditation — practiced widely for the reduction of stress and promotion of health — exerts beneficial effects on physical and mental health, and cognitive performance. Recent neuroimaging studies have begun to uncover the brain areas and networks that mediate these positive effects. However, the underlying neural mechanisms remain unclear, and it is apparent that more methodologically rigorous studies are required if we are to gain a full understanding of the neuronal and molecular bases of the changes in the brain that accompany mindfulness meditation.

Compassion is a key motivator of altruistic behavior, but little is known about individuals’ capacity to cultivate compassion through training. We examined whether compassion may be systematically trained by testing whether (a) short-term compassion training increases altruistic behavior and (b) individual differences in altruism are associated with training-induced changes in neural responses to suffering. In healthy adults, we found that compassion training increased altruistic redistribution of funds to a victim encountered outside of the training context. Furthermore, increased altruistic behavior after compassion training was associated with altered activation in brain regions implicated in social cognition and emotion regulation, including the inferior parietal cortex and dorsolateral prefrontal cortex (DLPFC), and in DLPFC connectivity with the nucleus accumbens. These results suggest that compassion can be cultivated with training and that greater altruistic behavior may emerge from increased engagement of neural systems implicated in understanding the suffering of other people, executive and emotional control, and reward processing.

Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety disorders. As an adjunctive treatment, exercise seems most helpful for treatment-resistant depression, unipolar depression, and posttraumatic stress disorder. Yoga as monotherapy or adjunctive therapy shows positive effects, particularly for depression. As an adjunctive therapy, it facilitates treatment of anxiety disorders, particularly panic disorder. Tai chi and qi gong may be helpful as adjunctive therapies for depression, but effects are inconsistent. As monotherapy or an adjunctive therapy, mindfulness-based meditation has positive effects on depression, and its effects can last for six months or more. Although positive findings are less common in people with anxiety disorders, the evidence supports adjunctive use. There are no apparent negative effects of mindfulness-based interventions, and their general health benefits justify their use as adjunctive therapy for patients with depression and anxiety disorders.

The mechanisms underlying the association between positive emotions and physical health remain a mystery. We hypothesize that an upward-spiral dynamic continually reinforces the tie between positive emotions and physical health and that this spiral is mediated by people's perceptions of their positive social connections. We tested this overarching hypothesis in a longitudinal field experiment in which participants were randomly assigned to an intervention group that self-generated positive emotions via loving-kindness meditation or to a waiting-list control group. Participants in the intervention group increased in positive emotions relative to those in the control group, an effect moderated by baseline vagal tone, a proxy index of physical health. Increased positive emotions, in turn, produced increases in vagal tone, an effect mediated by increased perceptions of social connections. This experimental evidence identifies one mechanism—perceptions of social connections—through which positive emotions build physical health, indexed as vagal tone. Results suggest that positive emotions, positive social connections, and physical health influence one another in a self-sustaining upward-spiral dynamic.