Emotion-Related Constructs Engaged by Mindfulness-Based Interventions: a Systematic Review and Meta-analysis
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REVIEW
Emotion-Related Constructs Engaged by Mindfulness-Based Interventions: a Systematic Review and Meta-analysis Elizabeth A. Hoge 1 & Rebecca L. Acabchuk 2 & Hannah Kimmel 3 & Ethan Moitra 4,5 & Willoughby B. Britton 3,4 & Travis Dumais 3 & Rebecca A. Ferrer 6 & Sara W. Lazar 7 & David Vago 8 & Jonah Lipsky 3 & Zev Schuman-Olivier 9 & Aya Cheaito 3,4 & Lauren Sager 3 & Sarah Peters 3 & Hadley Rahrig 3 & Pamela Acero 3 & Jodi Scharf 3 & Eric B. Loucks 3 & Carl Fulwiler 9,10 Accepted: 12 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives Mindfulness-based interventions (MBIs) have been widely implemented to improve self-regulation behaviors, often by targeting emotion-related constructs to facilitate change. Yet the degree to which MBIs engage specific measures of emotionrelated constructs has not been systematically examined. Methods Using advanced meta-analytic techniques, this review examines construct and measurement engagement in trials of adults that used standardized applications of the two most established MBIs: Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), or modified variations of these interventions that met defined criteria. Results Seventy-two studies (N = 7,378) were included (MBSR k = 47, MBCT k = 21, modified k = 4). MBIs led to significant improvement in emotion-related processing overall, compared to inactive controls (d = 0.58; k = 36), and in all constructs assessed: depression (d = 0.66; k = 26), anxiety (d = 0.63; k = 19), combined mental health (d = 0.75; k = 7), and stress (d = 0.44; k = 11). Reactions to pain, mood states, emotion regulation, and biological measures lacked sufficient data for analysis. MBIs did not outperform active controls in any analyses. Measurement tool and population type did not moderate results, but MBI type did, in that MBCT showed stronger effects than MBSR, although these effects were driven by a small number of studies. Conclusions This review is the first to examine the full scope of emotion-related measures relevant to self-regulation, to determine which measures are most influenced by MBCT/MBSR. Compared to extant reviews, which typically focused on MBI outcomes, this work examined mechanistic processes based on measurement domains and tools. While effect sizes were similar among measurement tools, this review also includes a descriptive evaluation of measures and points of caution, providing guidance to MBI researchers and clinicians for selection of emotion-related measurement tools. Keywords Mindfulness . Affect regulation . Emotion . Measurement tools * Ethan Moitra [email protected] 1
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Department of Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Ave NW Suite 200, Washington, DC 20007, USA Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, USA Department of Psychiatry and Human Behavior, Warren Alper
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