Mindfulness

Mindfulness meditation training may cultivate interoceptive awareness and provide therapeutic benefit when implemented within mental and physical health interventions. This pre-registered meta-analysis evaluated the impact of mindfulness interventions on self-reported interoception measures and associated relationships with psychological outcomes. Twenty-nine randomized controlled trials with 2,191 participants (77.8% female, mean age 32.8 years) were meta-analyzed using correlated and hierarchical effects models. Interventions included mindfulness-based programs (k = 15), body-based approaches (incorporating elements like massage, k = 8), and other variations (k = 6). Five SIMs were tested; the Multidimensional Assessment of Interoceptive Awareness was the most common (22 studies). Results showed a small-to-medium positive effect on interoception measures across all studies (g = 0.31, p < 0.001, 95% CI [0.21, 0.42]) with low-to-moderate heterogeneity (τ = 0.16). Mindfulness-based programs demonstrated the largest effects (g = 0.41). No evidence of publication bias was found. No other moderators, such as practice dosage or clinical sample, were significant. Improvements in self-reported interoception were similar in size to improvements in self-reported mindfulness and were related to improvements in psychological distress. These meta-analytic findings provide evidence that mindfulness-based interventions lead to adaptive changes in the subjective experience of interoception, perhaps contributing to improved mental wellbeing.

Employers and universities globally subsidise access to mindfulness-based programmes (MBPs) for their employees and students to improve work performance, despite unclear evidence. This paper offers the highest quality synthesis of MBPs' impact on work performance in academic and occupational settings to date (PROSPERO #191756). On 2nd August 2024, we searched eight databases. The primary outcome was task performance-the quantity and quality of completed tasks assigned to the individual. Secondary outcomes were contextual performance, adaptive performance, and counter-productive behaviour. Two independent reviewers selected studies, extracted data, and appraised risks of bias. We conducted pairwise random-effects meta-analyses of 99 studies (N = 16,054). MBPs were found to improve task performance at post-intervention compared to passive control groups (k = 22, Hedges' g = 0.25, 95% CI 0.06-0.44, p = 0.01, I2 = 81.48%) but not compared to active control groups (k = 4, Hedges' g = 0.12, 95% CI -0.3-0.55, p = 0.43, I2 = 62.87%). MBPs improved adaptive performance and contextual performance. Effects may last several months. Confidence in the review results, per Grading of Recommendations Assessment, Development and Evaluation (GRADE), is very low.

BackgroundIn recent years, virtual reality (VR) has been increasingly applied in mindfulness training. Although the number of studies in this area has grown rapidly, their quality remains inconsistent. Substantial variations exist across studies in terms of participant populations, modes of VR application, experimental designs, intervention durations, and measurement instruments, which in turn have led to divergent findings. Therefore, a systematic review and meta-analysis is warranted to synthesize the existing evidence, evaluate the robustness of current findings, and provide guidance for future research and clinical applications.MethodsA meta-analytic approach was employed, incorporating 25 studies published in both Chinese and English with a total sample of 1,485 participants. A random-effects model was applied, and Hedges' g was used as the effect size metric to evaluate the effectiveness of VR in enhancing mindfulness. The study also examined the potential moderating effects of participant characteristics, modes of VR implementation, experimental designs, intervention durations, and measurement instruments.Results(1) VR interventions significantly enhanced mindfulness, with a large effect size (Hedges' g = 0.975). (2) The effectiveness of VR-based mindfulness training was moderated by usage mode and participants' health status. Fully immersive VR demonstrated greater benefits than active-interaction VR. Participants with mental health disorders experienced greater improvements compared to healthy individuals, whereas those with chronic physical conditions showed no significant effects. (3) No significant moderating effects were observed for experimental design, intervention duration, or measurement instruments.DiscussionThe findings of this study contribute to the theoretical foundation of mindfulness training and offer practical implications for the design of future VR-based interventions. Specifically, the results suggest that prioritizing the development of highly immersive, low-interaction, and nature-friendly virtual environments may enhance the effectiveness of VR interventions.

ImportanceLate-life loneliness is a serious public health concern, yet the long-term efficacy and mechanisms of interventions to alleviate it remain underexplored.ObjectiveTo evaluate the 12-month effectiveness of lay counselor-delivered, telephone-based behavioral activation and mindfulness interventions in reducing loneliness and enhancing well-being among at-risk older adults and to examine whether social isolation mediates these effects.Design, setting, and participantsThe Helping Alleviate Loneliness in Hong Kong Older Adults (HEAL-HOA) was a 3-arm, assessor-blinded randomized clinical trial conducted from April 1, 2021, to April 28, 2024. Eligible participants 65 years or older who were living alone, digitally excluded, lonely, and experiencing financial hardship were recruited from public housing estates, community centers, academies for older adults, and word of mouth. Participants were randomized 1:1:1 to receive telephone-delivered behavioral activation (Tele-BA), telephone-delivered mindfulness (Tele-MF), or telephone-delivered befriending (Tele-BF [attention control]).InterventionsParticipants received eight 30-minute sessions delivered by trained lay counselors via telephone for 4 weeks.Main outcomes and measuresThe primary outcome was loneliness, measured using the UCLA Loneliness Scale (UCLA-LS) and the De Jong Gierveld Loneliness Scale (DJGL). Secondary outcomes included perceived stress, social support, sleep quality, life satisfaction, anxiety, depressive symptoms, and psychological well-being. Social isolation was examined as a mediator. Outcomes were assessed at baseline and at 1, 3, 6, and 12 months of follow-up.ResultsOf 4152 individuals screened, 1151 participants (mean [SD] age, 76.6 [7.8] years; 843 [73.2%] female; 965 [83.8%] with ≥1 chronic illness) were randomized (Tele-BA, 335 [29.1%]; Tele-MF, 460 [40.0%]; Tele-BF, 356 [30.9%]). Intention-to-treat analyses using linear mixed-effects models showed significant between-group changes in loneliness at 12 months for Tele-BA (UCLA-LS: mean difference [MD], -0.73; 95% CI, -1.29 to -0.16; P = .01; DJGL: MD, -0.13; 95% CI, -0.23 to -0.03; P = .01) and Tele-MF (UCLA-LS: MD, -0.72; 95% CI, -1.24 to -0.20; P = .003) compared with Tele-BF. Secondary outcomes, including sleep quality, psychological well-being, and life satisfaction, also improved significantly. Social isolation at 6 months partially mediated the effect on loneliness (UCLA-LS) for both interventions at 12 months (accounting for 0.13 [13.5%] and 0.18 [18.0%] of the total effects for Tele-BA and Tele-MF, respectively).Conclusions and relevanceIn this randomized clinical trial, brief telephone-delivered behavioral activation and mindfulness interventions by lay counselors sustainably reduced loneliness and enhanced well-being during 12 months in at-risk older adults, with social isolation as a partial mediator. These scalable interventions offered effective solutions for combating late-life loneliness. Future research should investigate the applicability of these interventions outside the Hong Kong context as well as their cost-effectiveness.Trial registrationIdentifier: ChiCTR2300072909.