Posted 05.17.2018 | by AMRA

Most mindfulness research studies do not follow participants long after the intervention ends. At best, a few studies have followed their participants for up to two years. As a result, little is known about whether the effects of mindfulness-based interventions persist, strengthen, or fade over time. To address this limitation, de Vibe et al. [PLOS One] followed participants for six years after completing a Mindfulness-Based Stress Reduction (MBSR) program.

The researchers randomly assigned 288 Norwegian medical and psychology graduate students (76% female, average age = 24 years) to a slightly abridged form of MBSR or a no-intervention control. The MBSR program consisted of seven 1.5-hour weekly group sessions and required 20 minutes of daily home practice.

Participants were assessed on dispositional mindfulness (using the Five Facet Mindfulness Questionnaire), subjective wellbeing, problem-focused coping and avoidance-focused coping at baseline, one month post-intervention, and at 1, 2, 4, and 6-year follow-up. Problem-focused coping involves facing one’s problems head-on by actively addressing them, while avoidance-focused coping consists of avoiding one’s problems or suppressing thoughts and emotions about them.

Participants also had the opportunity to enroll in a 1.5-hour mindfulness “booster” class each semester. While most attended at least one booster class, 46% never attended any. There were dropouts at each assessment time-point, with 61% of the participants having dropped out of the study by year six. There was no difference between MBSR and control group dropout rates, but participants with higher baseline avoidance-focused coping were significantly more likely to drop out.

Six-year longitudinal growth curves revealed that the MBSR participants showed significant continuing increases in mindfulness and problem–focused coping, with significant continuing decreases in avoidance-focused coping over time. MBSR rates of increase in mindfulness and problem-focused coping significantly exceeded those of the controls. For example, MBSR mindfulness scores increased by an average of 15 points, while control scores increased by an average of 7 points.

Outcome differences were observed even though half of the MBSR participants no longer practiced formal meditation by year six, and those who did only practiced for an average of 15 minutes weekly. Additionally, about one third of the controls subsequently attended courses in qigong, tai chi, yoga, or meditation that they also practiced for an average of 15 minutes weekly.

Increases in mindfulness were moderately correlated with increases in problem-focused coping (r=.67) and decreases in avoidance-focused coping (r=-.72). Increases in problem-focused coping were in turn correlated (r=.67) with increases in subjective well-being, making it the best predictor of wellbeing.

The study shows that the psychological benefits of MBSR persist and increase over a six-year interval in a young, educated, non-clinical sample. It also demonstrates that most subjective improvements in wellbeing come from increased reliance on problem-focused coping, which is correlated with increased mindfulness. Generalizations from this sample are limited by the relatively high long-term follow-up dropout rate, and by the lack of an active control.

Reference:

de Vibe, M., Solhaug, I., Rosenvinge, J. H., Tyssen, R., Hanley, A., & Garland, E. (2018). Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; results from a randomized controlled trial. PLoS ONE.

[Link to abstract]