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October 23, 2017

'Mindfulness' is everywhere. How does the evidence stack up?

Daily Briefing

    Mindfulness meditation is a booming trend, but the much-touted benefits of the practice—such as decreased anxiety and increased focus—may be overhyped, according to a review in Perspectives on Psychological Science, Bret Stetka reports for Scientific American.

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    What is mindfulness?

    Mindfulness is a practice based on Buddhist thought and theory, Stetka reports, that involves focusing on your present surroundings and state of mind.

    The practice gained popularity in the West in the 1970s after University of Massachusetts professor and a cognitive scientist Jon Kabat-Zinn developed what he termed "mindfulness-based stress reduction" as an alternative therapy for several difficult-to-treat conditions, Stetka reports.

    Over the years, several studies have suggested mindfulness affords "a staggering collection of possible health benefits," ranging from improved cognition to possibly preserving the tips of chromosomes, which erode as we get older. According to Stetka, mindfulness meditation and practice today comprise a $1.1 billion industry in the United States.

    Lacking evidence

    However, in a paper published last week in Perspectives on Psychological Science, a group of 15 prominent psychologists and cognitive scientists argued that the scientific data on mindfulness in some areas is lacking—despite the growth in popularity.

    The paper cited meta-analyses that found mindfulness practices often yield "unimpressive results," Stetka writes. For instance, one 2014 review found there was practically no evidence of benefits in terms of attention, improved sleeping, reduction in substance misuse, , or weight control. And another review, published in 2015, found that only about 9 percent of research on mindfulness-based interventions have been tested in clinical trials involving a control group.

    The authors also expressed concern that less than one-quarter of meditation trials included monitoring for potential negative effects.

    Ultimately, Nicholas Van Dam—lead author of the study and a clinical psychologist and research fellow in psychological sciences at the University of Melbourne, cautioned that the potential benefits of mindfulness are being exaggerated for financial gain. "Overall, I suspect that a large number of the health promises will not be fulfilled, mostly because therapies, phone apps, and other interventions are being rushed to market without sufficiently rigorous testing and appropriate implementation," Van Dam said.

    But Van Dam acknowledged that the paper "does not mean that mindfulness meditation is not helpful for some things." For instance, the 2014 review found meditation and mindfulness can yield some benefit when it comes to anxiety, depression, and pain, he said. In addition, a trial published earlier this month in Science Advances found that mindfulness-like attention training helps reduce self-perceived stress—but not cortisol, the hormone that serves as a biological gauge of stress.

    Obstacles for research

    An underlying challenge when it comes to mindfulness research is the lack of standardization about the term's definition, according to lead author Van Dam. In the paper, the authors wrote that there is "neither one universally accepted technical definition of 'mindfulness' nor any broad agreement about detailed aspects of the underlying concept to which it refers."

    Further, Van Dam said the wide variety of approaches toward mindfulness can undercut the usefulness of better developed studies on the topic, including the recent study in Perspectives on Psychological Science. "We specifically commented in our article on the fact that many continue to develop novel interventions without fully evaluating those that are already being implemented," he said.

    Separately, Willem Kuyken—a psychiatry professor at the University of Oxford in England, who was not involved in the paper—said, "The intention and scope of this review is welcome—it is looking to introduce rigor and balance into this emerging new field." He added, "There are many areas where mindfulness-based programs seem to be acceptable and promising, but larger scale randomized, rigorous trials are needed" (Stetka, Scientific American, 10/11).

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