Posted 01.16.2018 | by AMRA

College life is accompanied by many stresses, but few exceed the stress of final exams week—a period of intensive “cramming,” all night study sessions, and fearful anticipation of final grades. It comes as no surprise that approximately half of all college students report a significant degree of test anxiety.

Galante et al. [Lancet Public Health] studied whether an eight-week mindfulness skills program might reduce students’ acute exam-related distress levels during final exams week.

The researchers randomly assigned 616 undergraduate and graduate students at Cambridge College, UK (62% female; 66% White; 92% age 17-30 years) to either an 8-week Mindfulness Skills for Students (MSS) program, or mental health support-as-usual group. Participants were prescreened to rule out severe mental health symptoms.

The MSS program consisted of eight 75-90 minute group sessions that included mindfulness meditation, periods of reflection and inquiry, and interactive exercises. MSS participants were encouraged to engage in 8-25 minutes of home practice daily.

Mental health support-as-usual consisted of access-as-needed to university counseling services and the National Health Service. No mental health services were offered to the support-as-usual group participants unless they actively sought help from these services on their own.

All participants were asked to complete a self-report distress measure and a wellness measure at post-intervention and again during final exams week. Following the completion of outcome measures, participants were offered monetary vouchers ($4.50 at post-intervention and $7.50 during exams week) that they could either pocket or contribute to charity. If MSS participants missed a session, they were contacted to discover whether they experienced any adverse consequences from participation in the intervention.

Fifty-one percent (51%) of MSS participants attended at least half of the MSS sessions, and 74% of study participants completed their exam period questionnaires. Results were analyzed for all participants, whether or not they attended all the MSS sessions.

The results showed that MSS participants had significantly lower distress levels (moderate effect size) at post-intervention and during exams week. More support-as-usual group participants (57%) reported distress levels within the clinically significant range than did MSS participants (37%)—a one-third relative reduction in risk for MSS participants.

MSS participants were significantly less likely to report problems affecting their academic study or university experience than control participants. MSS participants also reported significantly higher well-being levels at both post-intervention and during exam week. Finally, MSS participants were significantly more likely to donate their monetary vouchers to charity. Only one participant reported an adverse effect, feeling that MSS brought unwanted matters to the fore. The report omitted whether the adverse effect was mild or severe.

This is the largest randomized controlled study of mindfulness in a college population to date. It demonstrates that a mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.

As the support-as-usual group was neither an active treatment nor a placebo control, the study cannot prove the superiority of mindfulness over other stress reduction programs. For the same reasons, the positive outcomes experienced by MSS participants cannot be specifically linked to mindfulness training, as they may be due to other factors such as group support or raised expectancies.


Galante, J., Dufour, G., Vainre, M., Wagner, A. P., Stochl, J., Benton, A., . . . Jones, P. B. (2017). A mindfulness-based intervention to increase resilience to stress in university students (the mindful student study): A pragmatic randomised controlled trial. Lancet Public Health.

[Link to abstract]