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A significant number (16-69%) of soldiers returning from deployment struggle with the dual challenges of PTSD and alcohol use disorder. However, 50% of affected veterans do not seek treatment, and 57% of those who begin treatment discontinue it early. There is a need for treatment options that are accessible, acceptable, and effective for veterans with dual diagnoses. 

Mindfulness-based interventions have been shown to be of some benefit in reducing PTSD severity and substance use urges, but often present significant barriers to access. Mobile apps are more accessible, yet sustaining motivation to continue their use can be challenging. In a pilot study, Davis et al. [Journal of Clinical and Consulting Psychology] compared their newly developed mindfulness app (Mind Guide) to a stress management control app in veterans with PTSD and alcohol use symptoms. The researchers aimed to compare acceptability, usage, and efficacy across apps.

The researchers randomly assigned 201 military veterans (average age = 23; 84% male; 53% White) who scored high on self-report measures of alcohol use and PTSD symptoms to either the Mind Guide app or a stress management app. Mind Guide is a 16-module, self-guided training program that includes audio-based mindfulness exercises, self-assessments, journaling, goal setting and relapse prevention. Participants were instructed to complete two modules per week over eight weeks, with periodic text and email reminders from a program coordinator.

The stress management control app included an eight-week psychoeducational program focusing on stress, sleep, the immune system, time management, nutrition, and exercise. 

Participants were assessed at baseline, 4 weeks, 8 weeks, and on 1-and 2-month follow-ups on primary outcome measures of PTSD symptoms and alcohol use. Most veterans completed at least half of the Mind Guide modules, with 32% completing at least 75%. On average, veterans spent five hours logged into the app. 

The results showed that the Mind Guide group reported significantly reduced PTSD symptoms compared to the control group at weeks 8 (d=-0.25) and 16 (d=-0.36). Alcohol cravings and alcohol drinking days improved within each group, but without any between-group differences. In a post-hoc analysis of PTSD checklist subscales, hyperarousal and avoidance symptoms improved, but not re-experiencing symptoms.

This pilot study suggests that using Mind Guide can lead to small-to-moderate reductions in the hyperarousal and avoidance symptoms of PTSD for up to 16 weeks. While it also reduces alcohol use and cravings, it does not do so better than the control app. The study revealed that nearly one-third of Mind Guide users completed at least 75% of its modules - a rate higher than that of many similar apps.

The study is limited by its reliance on self-reported PTSD and alcohol use screening measures, the absence of a biochemical measure of abstinence, and the lack of participant ratings on app acceptability and satisfaction.

Reference:

Davis, J. P., Pedersen, E. R., Borsari, B., ... Canning, L. (2025). Effects of a mobile mindfulness smartphone app on posttraumatic stress disorder symptoms and alcohol use problems for veterans: A pilot randomized controlled trial. Journal of Consulting and Clinical Psychology. https://doi.org/10.1037/ccp0000940

Knowledge is lacking regarding who is most likely to benefit from mindfulness-based interventions (MBIs) and who may be at risk of harm. Several studies suggest that patients with recurrent depression in remission are more likely to benefit from Mindfulness-Based Cognitive Therapy (MBCT) if they have histories of childhood trauma.

However, one study on MBCT for active depression found that patients with histories of childhood trauma had poorer treatment outcomes. Additionally, preliminary data suggest that meditators with histories of childhood trauma may be more vulnerable to meditation-related adverse experiences.

Canby et al. [PLOS ONE] conducted two studies to examine whether histories of childhood trauma and PTSD symptoms predict variability in MBCT outcomes in patients with active depression. The first study explored childhood trauma as a predictor of depressive symptom improvement and therapy attrition, while the second, larger replication study also assessed meditation-related adverse experiences and side effects.

In the first study, the researchers randomly assigned 52 patients (average age = 47 years; 79% female) with histories of recurrent depression in partial remission to either an 8-week MBCT program or a waitlist control. At baseline, patients were assessed using the Beck Depression Inventory (BDI), a structured clinical interview, and a self-report measure of childhood trauma (including life-threatening illness or injury, the death of a loved one, physical/sexual abuse, rape, and assault). Post-treatment outcomes were assessed using the BDI.

Results showed that the MBCT group significantly lowered their average BDI scores more than controls. Childhood trauma history and histories of physical and sexual abuse scores were associated with significantly poorer BDI improvement in the MBCT group. In the control group, childhood trauma and sexual abuse scores were associated with significantly poorer improvement over time. Trauma histories did not predict study dropout rates in either condition.

In study 2, part of a larger dismantling study, the researchers randomly assigned 104 patients with mild-to-severe depression or high negative affect (average age = 40 years; 74% female) to MBCT, MBCT with only focused-attention meditation, or MBCT with only open-monitoring meditation. While patients who met the full diagnostic criteria for PTSD were excluded, those with past or sub-clinical PTSD were included.

Participants completed a trauma questionnaire, a self-report measure of depressive symptoms, and a structured clinical interview at baseline. These assessments were repeated at 4 weeks, 8 weeks, and 3-months. At the 3-month assessment, participants also completed a questionnaire assessing meditation-related adverse experiences (MBAEs), meditation-related side effects (MRSEs), and long-lasting adverse effects. 

Results showed that 58% of participants reported unpleasant MRAEs, 37% reported MRAEs that negatively impacted daily functioning,14% reported adverse effects lasting more than a day, 9% reported adverse effects lasting more than a week, and 6% reported adverse effects lasting over a month. Long-lasting adverse effects included executive dysfunction, insomnia, emotional blunting, identity disturbance, anxiety, time-space distortions, traumatic re-experiencing, derealization, and social impairment.

Average depressive symptoms improved significantly in all groups at all time points. Participants with greater total trauma, sexual abuse, or emotional neglect scores improved significantly less on self-reported depression scores. All trauma types predicted a greater likelihood of MSREs, while all trauma variables except physical abuse predicted a greater likelihood of unpleasant MRAEs. MRAEs that interfered with daily functioning were predicted by total trauma, emotional abuse, sexual abuse, and current and past PTSD symptoms.

Persistent adverse effects were predicted by total trauma history, emotional abuse, and current and past PTSD symptoms. Patients with past histories of sexual abuse were more likely to drop out of the study.

Together, the studies show that actively depressed patients with childhood abuse histories and PTSD symptoms are significantly less likely to benefit from MBCT and more likely to experience adverse meditation-related effects. The second study lacked non-meditation and no-treatment controls so one cannot infer whether a different treatment or the simple passage of time might have led to similar, lower, or higher rates of adverse experiences. 

Reference:

Canby NK, Cosby EA, Palitsky R, Kaplan DM, Lee J, Mahdavi G, et al. Childhood trauma and subclinical PTSD symptoms predict adverse effects and worse outcomes across two mindfulness-based programs for active depression. PLOS ONE.

Link to study

Patients with metastatic renal cell carcinoma—a type of kidney cancer that has spread to other organs—often experience distress, functional impairment,  treatment side effects, and reduced quality of life. They may benefit from adjunctive treatments that help reduce distress and support effective coping. Studies have demonstrated the benefits of mindfulness-based programs for cancer patients, but access to these programs is not always easy. Patients may face financial or mobility constraints, lack the time, or live in geographically remote areas. 

Delivering mindfulness training through smartphone apps offers a potential solution to these access barriers. Bergerot et al. [The Oncologist] evaluated the feasibility and acceptability of a mindfulness-based app for cancer patients in Brazil and the United States undergoing immunotherapy for advanced renal cell cancer who were experiencing heightened anxiety.

The researchers recruited 50 Brazilian and U.S. patients receiving immunotherapy for Stage 4 renal cell carcinoma who reported high levels of anxiety (average age = 59 years; 68% Brazilian;  68% male; 64% White). Participants received free access to the Mindfulness-Based Cancer Survivorship Journey (MBCSJ) app. Brazilian patients used the app in Portuguese, while U.S. patients used it in English. They were encouraged to use the app 20-30 minutes daily for a minimum of four days per week across four weeks.

The MBCSJ content included guided body, breath-focused, open awareness, compassion, walking, and mindful movement meditations. It also included suggestions for coping with cancer, mindful imagery exercises, and opportunities for journaling. 

Patients were assessed at baseline and at weeks 2,4, and 12 for anxiety, depression, fatigue, fear of recurrence, quality of life, and mindfulness (using the Mindful Attention Awareness Scale). Feasibility was defined aa at least 50% of patients completing three or more sessions per week for at least two weeks. Acceptability was measured by an open-ended post-intervention survey.  

The results showed that by week 4, 75% of patients reported high  adherence to the app and symptom improvement. The cohort reported significant improvements in anxiety (d = 1.82), depression (d= 0.99), fear of recurrence (d= 1.55), fatigue (d=0.74), mindfulness (d = 1.03) and quality of life (d = 0.91) over time. Patients with high adherence reported liking the app, while those with low adherence cited difficulties using the app, lack of improvement, lack of interest, or interfering life events.

The study observes that a mindfulness-based cancer support digital app is feasible and acceptable for most Brazilian and U.S. metastatic renal cancer patients receiving immunotherapy and experiencing high levels of anxiety. However, as a pilot study, the interpretation is limited by its small sample size and lack of a control condition.

Most studies of mindfulness-based cancer treatments have focused on patient with localized cancers who have competed active treatment. This study suggests a mindfulness app may be helpful for people with metastatic disease who are still undergoing intensive treatment.

Reference:

Bergerot, C. D., Bergerot, P. G., Philip, E. J., ... Pal, S. K. (2025). Feasibility and acceptability of a mindfulness app-based intervention among patients with metastatic renal cell carcinoma: A multinational study. The Oncologist.

Link to study

Buprenorphine is an opioid receptor modulator used in recovery programs for opioid misuse. While it effectively reduces the harm associated with opioid misuse, most patients drop out of buprenorphine treatment within six months. This is often due to persistent cravings triggered after exposure to drug-related cues or stressful events. Research is needed to identify which adjunctive interventions can best enhance treatment effectiveness. 

Previous research has shown that mindfulness training can reduce opioid cravings and use in chronic pain patients on methadone maintenance. Schuman-Olivier et al. [JAMA Network Open] compared the efficacy of buprenorphine plus an adjunctive online mindfulness intervention to buprenorphine plus an online support group in reducing opioid cravings and misuse. 

The researchers randomly assigned 196 patients (mean age = 41 years; 61% female; 92% White) receiving buprenorphine for opioid misuse, who reported high anxiety levels or recent substance misuse, to either an online group-based Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) program or an online recovery support group. M-ROCC included four weeks of fostering group engagement followed by four weeks of a low-dose mindfulness program.

Patients who successfully completed the initial mindfulness program were offered the opportunity to continue with a 16-week intensive mindfulness program focusing on mindfulness, self-compassion, emotional regulation, savoring, and urge surfing. Ninety percent of the participants who completed the initial eight-week program elected to continue with the 16-week program. 

The  support group included an eight-week program to foster group cohesion, followed by 16 weeks incorporating elements of cognitive behavioral therapy, motivational interviewing, community reinforcement, and 12-step programs. Both interventions met once weekly, opening with a 30-minute check-in that included weekly surveys and video-monitored oral toxicology screens, followed by a 60-minute group intervention.

The primary outcome was the number of two-week periods of self-reported and toxicology-confirmed abstinence from opioids during weeks 13 to 24. Secondary outcomes included self-reported anxiety and opioid craving levels, as well as the number of two-week periods free from benzodiazepine and cocaine use.

The results showed no significant differences between groups in terms of opioid, benzodiazepine, or cocaine abstinence during weeks 13 to 24 of the study. For example, opioid use in the M-ROCC group occurred during an average 13.4% of the two-week time periods compared to 12.7% in the support group.

Both groups had significantly reductions in anxiety scores from baseline to post-intervention (M-ROCC Cohen’s d = -1.1; Control Cohen’s d = -1.3), with no significant between-group difference. Opioid cravings significantly decreased in both groups from baseline to postintervention (M-ROCC Cohen’s d = -1.3; Control Cohen’s d = -0.7). The reduction in craving scores was significantly greater in the M-ROCC group  compared to the support group (Cohen’s d = -0.5).

The study found that adding adjunctive online mindfulness training to buprenorphine treatment did not improve the criteria for abstinence from substances compared to a support group involving multiple treatment modalities. While the mindfulness intervention led to greater reductions in craving scores ,this did not correlate with improved abstinence.

The study was limited by the absence of a buprenorphine-only or attention placebo control group. Another limitation was the differential attrition rate: 51% of the M-ROCC group and 31% of the support group did not complete the study, meaning  that more support group members received active treatment and this was likely to impact any between-group effect.

Reference:

Schuman-Olivier, Z., Goodman, H., Rosansky, J., Fredericksen, A. K., Barria, J., Parry, G., Sokol, R., Gardiner, P., Lê Cook, B., & Weiss, R. D. (2025). Mindfulness Training vs Recovery Support for Opioid Use, Craving, and Anxiety During Buprenorphine Treatment: A Randomized Clinical Trial. JAMA Network Open, 8(1), e2454950. 

Link to study

While mindfulness-based interventions (MBIs) appear to have small-to-moderate efficacy in treating chronic pain, the extent to which these effects are mediated by improvements in cognitive functioning remains unclear.

Mohr et al. [Social Science and Humanities Open] conducted two studies to explore this question: (1) a cross-sectional study comparing the cognitive and emotional regulation abilities and interoceptive awareness of patients with chronic pain to those of healthy controls, and (2) an experiment examining the effects of Mindfulness-Based Pain Management (MBPM) compared to treatment-as-usual on the cognitive and emotional regulation abilities and interoceptive awareness of patients with chronic pain.

In the cross-sectional study, researchers compared 24 patients with chronic pain (mean age=43 years; 88% female; 100% White) to 11 healthy controls (mean age = 43 years; 82% female; 82% White) on self-report measures of pain, depression, interoceptive awareness (using the Multidimensional Assessment of Interoceptive Awareness scale, MAIA), and mindfulness (using the Five Facet Mindfulness Questionnaire, FFMQ).

Participants also completed computerized tasks measuring executive functioning (including an emotional Go/No-Go task) and working memory. The emotional Go/No-Go task instructed participants to press a computer key when presented with a specific word and refrain from pressing for other words, which included emotionally neutral, positive, and pain-related words.

Results showed that patients with chronic pain tended to report significantly higher levels of depression and pain, and significantly lower levels of mindfulness and interoceptive awareness, compared to controls. Exploratory analysis suggested that patients with chronic pain and controls differed in terms of how several of their MAIA subscales correlated with various cognitive executive functioning and working memory measures.

In the experiment, the researchers assigned patients with chronic pain who were interested and willing to commit to attending (N=16; mean age=42; 88% female; 100% White) the MBPM program, and those who were uninterested or unwilling to commit (N=14; mean age=38; 86% White) were assigned to treatment-as-usual.

MBPM is an 8-week group program based on Mindfulness-Based Stress Reduction (MBSR) and modified to meet the needs of patients with chronic pain. Due to the COVID pandemic, groups met online for 2-hour weekly group sessions. The pandemic also impacted participation and data collection, with only 47% of the MBPM group attending and completing all evaluations. Participants were assessed pre- and post-intervention using the same measures as in the prior cross-sectional study. 

The preliminary results indicated the MBPM group had significantly greater decreases in depression, pain interference, and pain intensity, and significantly greater improvements on several subscales of the FFMQ and MAIA compared to controls.

While there were some pre-to-post improvements on cognitive and memory tasks, the groups did not significantly differ in their degrees of improvement. For example, while the MBPM group significantly improved its false positive rate on the Go/No-Go task when pain-related stimuli were involved and controls did not, the difference in their improvement rates did not reach statistical significance. 

The experiment suggests that MBPM might improve depression, pain intensity and interference, mindfulness, and interoceptive awareness in chronic pain patients. Decreased depression and increased interoceptive awareness may, in turn, benefit cognitive executive functioning and working memory.

However, the study’s limitations—including a lack of randomization, high attrition rates, small sample size, and lack of adequate correction for multiple comparisons—should be considered carefully when interpreting the findings.

Reference:

Mohr, E., Matthew, S., Narisetti, L., Duff, C., & Schoenberg, P. (2025). Cognitive mechanisms of mindfulness-based pain management in chronic pain. Social Sciences & Humanities Open.

Link to study

Adolescents subjected to chronic stress are at greater risk for developing mental and physical health difficulties. Mindfulness-based interventions (MBIs) may buffer the effects of chronic stress by enhancing cognitive executive function and emotional regulation. Since adolescents are still developing these cognitive and emotional resources, mindfulness training may accelerate their development.

Using ecological momentary assessment, Miller-Chagnon et al. [Journal of Consulting and Clinical Psychology] tested whether an MBI, taught within a community mentoring program, improved mindfulness and emotional regulation in chronically stressed adolescents better than the mentoring program alone. 

The researchers randomly assigned 81 adolescents (mean age = 14 years; 56% male, 37% female, 7% other; 57% White) referred to a community-based mentoring program due to juvenile justice and/or emotional or behavioral problems to either the mentoring program alone or the mentoring program plus an MBI. Half of the adolescents’ families reported annual incomes below $20,000, 55% rated themselves on the bottom rung of a subjective social status scale, and 56% had mental health diagnoses.

The mentoring program met 3 nights per week across 12 weeks. The MBI group received nine weekly 30-minute mindfulness training sessions during weeks 2-10 of the mentoring program, while the control group continued mentored activities as usual. The MBI, adapted from the Learning to Breathe program, emphasized mindfulness of the body, senses, thoughts, emotions, and speech, as well as lovingkindness, gratitude, and compassion.

In the mentoring program, mentors engaged mentees in activities designed to promote positive relationships, academic success, and prosocial interests. A part of the cohort met face-to-face while others participated only online due to the COVID pandemic.  

Participants were assessed using ecological momentary assessment at three time points: one week before the intervention, one week mid-intervention, and one-week post-intervention. During each 7-day assessment period, participants replied to three 13-item questionnaires delivered to their smartphones at semi-random intervals. The questionnaires assessed acute stressors, mindfulness (using the Mindful Attention and Awareness scale), self-judgment, and difficulties with emotional regulation experienced during the past hour. 

The results showed that in the MBI group, the negative association between acute stressors and mindful attention was significantly weaker at postintervention compared to baseline. The presence of an acute stressor was associated with less self-judgment and less emotional regulation difficulty at postintervention than at baseline.

For the control group, acute stressors were associated with lower mindfulness scores and greater emotion regulation difficulty at postintervention than at baseline. All effect sizes were small.

The study demonstrates an MBI can potentially buffer the negative effects of stressor exposure on the ability to stay mindful and regulate emotion among adolescents with social and behavioral problems. A key strength of the study was its use of ecological momentary assessment across three distinct week-long periods, providing a more nuanced understanding of changes over time. The study is limited by the absence of long-term follow-up to assess whether and how long these effects persist.

Reference:

Miller-Chagnon, R. L., Shomaker, L. B., Prince, M. A., Krause, J. T., Rzonca, A., Haddock, S. A., Zimmerman, T. S., Lavender, J. M., Sibinga, E., & Lucas-Thompson, R. G. (2024). The benefits of mindfulness training for momentary mindfulness and emotion regulation: A randomized controlled trial for adolescents exposed to chronic stressors. Journal of Consulting and Clinical Psychology, 92(12), 800–813. 

Link to study

Mindfulness meditation practitioners often report an increased  awareness of body sensations. Some neuroimaging studies support this claim, revealing that meditators, compared to non-meditators, tend to have denser and more active anterior insulas--a brain region involved in body awareness. This enhanced body awareness linked with meditation may play a significant role in improving emotional self-regulation and stress management.

Humans can be sensitive to sensations arising both spontaneously from within the body and those generated externally, such as being touched. Signal detection theory claims that people differ not only in their sensitivity to touch but also in the strictness of the criteria they use to decide whether they have been touched. Sensitive individuals are better at accurately detecting faint touch stimuli, while those with more lax criteria are more likely to incorrectly report being touched when no stimulus is present.

Prior research shows that meditators exhibit reduced EEG alpha power after being cued to begin a signal detection trial, compared to non-meditators. This reduction likely reflects attentional preparation to receive a stimulus. Lower alpha power during this period has been linked to better performance on signal detection tasks. However, it remains unclear whether this improvement is due to increased sensitivity or more lax reporting criteria.

Mylius et al [Psychophysiology] contrasted the ability of meditators and non-meditators to detect very faint tactile sensations during a signal detection task. They also examined whether variations in electroencephalogram (EEG) alpha wave modulation could account for differences in signal detection accuracy between the two groups.

The researchers compared 31 German expert meditators (average age = 35 years; 61% male; average lifetime meditation hours = 2,628 hours) to 33 German non-meditator controls (average age = 32 years; 67% male). Meditators had a history of meditating ≥ 5 hours per week for at least two years, while controls reported reading books for ≥5 hours per week for at least two years. Participants completed on-line self-report survey of mindfulness (Mindful Attention Awareness Scale or MAAS), body sensory awareness (Multidimensional Assessment of Interoceptive Awareness or MAIA-2), and emotion regulation. 

Participants then completed an in-person laboratory task to determine their threshold for mild electrical stimulation--the intensity accurately detected 50% of the time. They subsequently engaged in a signal detection task. At the start of each trial, a gray disc appeared on a computer screen, serving as a cue that the trial was about to begin. Half the time, the cue was followed by threshold level electrical stimulation delivered to the left index finger; the other half, no stimulation occurred. At the end of each trial, participants indicated whether they perceived a tactile stimulation. Throughout the task, EEG recorded participants’ brain alpha power.

Results indicated that the meditator group scored significantly higher than controls on seven of the eight MAIA-2 subscales (Cohen’s d range = 0.90 to 1.52), indicating greater body awareness. The meditator group also reported significantly less expressive suppression (d = 0.94) and less difficulty describing their feelings (d =.64). MAAS scores did not differ by group. The meditator group was not significantly more sensitive to the tactile stimulus but employed significantly laxer criteria when determining whether a stimulus had occurred (η2 = 0.56).

The meditator group also had lower EEG-based alpha power levels at baseline and a greater drop-off of alpha power after task cueing than controls. Lower alpha power after task cueing was associated with a greater likelihood of reporting a stimulus, whether or not it had occurred. 

The investigators found that while meditators self-reported significantly greater body awareness, they were not more sensitive to faint external tactile stimulation compared to non-meditators. However, meditators exhibited significant differences in baseline and post-cueing alpha power during the signal detection task.

Meditators employed laxer criteria in determining whether a tactile stimulus had occurred. What might “laxer criteria” involve? Perhaps the greater attentional readiness associated with lowered alpha power by cueing led to heightened awareness of tiny spontaneous finger sensations, which were misperceived as the touch stimulus.

Reference:

Mylius, M., Guendelman, S., Iliopoulos, F., Gallese, V., & Kaltwasser, L. (2024). Meditation expertise influences response bias and prestimulus alpha activity in the somatosensory signal detection task. Psychophysiology.

Link to study

Mindfulness-Based Stress Reduction (MBSR) integrates various meditation practices, including focused attention on breathing, open-monitoring, body scanning, walking meditation, and mindful yoga. Attention to diaphragmatic breathing is a key element, and some researchers theorize it may be critical to MBSR’s efficacy in alleviating symptoms. Deep breathing has a direct physiological effect on emotions by regulating vagal tone and sympathetic-parasympathetic balance. Perhaps breathing alone can explain much of the effect of meditation.  

Wu et al. [Mindfulness] compared the diaphragmatic and core muscle changes among meditators in a standard MBSR program with those in an alternative form of MBSR that did not instruct on mindful breathing.

The researchers randomly assigned 48 meditation-naïve Chinese college students (average age = 20 years old;  71% female) to either standard MBSR or a MBSR without mindful breathing instruction. Both groups were taught in 8 weekly 2.5 hour sessions with a full-day retreat and daily homework. Both groups were taught by the same instructor, but one group was not directed to observe abdominal movement or concentrate on their breath. For example, during the body scan, control participants were simply told to focus on sensations in their fingers rather than to “maintain awareness of the breath, feeling it move in and out of your nose, concentrate on the breath, and visualize the airflow reaching your fingers.”

Ultrasound measures assessed the range of diaphragmatic movement and the thickness and elasticity of two core muscles: the transversus abdominis involved in abdominal expansion and contraction, and the multifidus involved in aligning the spine. Participants completed a survey before and after the intervention on mindfulness (the Five Facet Mindfulness Questionnaire), depression, anxiety, stress, and perceived self-efficacy in managing emotions. 

Ultrasound results showed the standard MBSR group significantly increased their diaphragmatic range of movement and multifidus thickness in the contracted state compared to controls. Transversus abdominis elasticity during contraction decreased in both groups, while multifidus elasticity increased in both groups, but there were no between-group differences. The researchers suggested such changes represent greater muscle activation, strength, and control.

Both MBSR groups significantly increased their mindfulness and total self-efficacy scores without significant between-group differences  There were no significant between-group differences in depression, anxiety, or stress scores.

The study reveals that instructions to focus attention on abdominal breathing in MBSR can increase ultrasound-assessed physiological changes in breathing anatomy while not necessarily resulting in different psychological outcomes. Interestingly, psychological benefits appear to be roughly equal in both standard MBSR and an alternative version of MBSR without a focus on attention to breath. However, the the study was not powered to test non-equivalence. The study is limited by its small sample size and the lack of detailed procedures regarding the ultrasound assessment.

Reference:

Wu, M., Fan, C., Zhao, X., Zhou, J., Liu, H., Li, H., Zhan, X., & Jiang, Z. (2024). The Effects of Mindfulness-Based Stress Reduction in Mental and Physical Health: Is Mindful Breathing Key? Mindfulness, 15(10), 2582–2594.

Link to study

Brain imaging studies such as those using fMRI typically find that mindfulness meditation training decreases resting-state activity and neural connectivity within the brain’s default mode network (DMN) and increases connectivity between nodes of the DMN and the salience network.

The DMN is associated with mind-wandering and self-referential thinking, with the posterior cingulate cortex (PCC) as a key hub. The salience network is associated with bodily and emotional awareness. This has led to speculation that neurofeedback could facilitate and enhance mindfulness training. 

Neurofeedback Augmented Mindfulness Training (NAMT) is a newer approach that combines neurofeedback to decrease PCC activity with traditional instruction to cultivate non-judgmental awareness. Cosgrove et al. [Frontiers of Neuroscience] conducted a pilot study that explored fMRI resting-state brain functional connectivity before and after NAMT in a group of healthy adolescents.

They hypothesized NAMT would reduce connectivity between the PCC and other regions of the DMN while increasing connectivity between the PCC and regions of the salience network.

The researchers assigned 31 healthy adolescents (average age=15 years; 55% male; 74% White) who were part of a larger neuroimaging study to undergo fMRI while completing a variety of tasks, including an NAMT task. Participants completed pre- and post-fMRI self-report measures of perceived stress, mood, and mindfulness. Before imaging, they received a brief introduction to mindfulness, which included guided breath-focused meditation. 

Participants then underwent fMRI scanning that included 1) an initial resting-state measure , 2) breath-focused mindfulness meditation with and without PCC neurofeedback, and 3) a concluding resting-state measure. In the neurofeedback condition, participants watched a bar on a screen that turned red when PCC activation increased and blue when it decreased. They were instructed that focusing on their breath would turn the bar blue, and mind-wandering would turn it red, and were encouraged to keep the bar blue. The fMRI data analysis compared resting-state connectivity before and after NAMT, rather than during NAMT. 

The results showed significant resting-state increases in PCC connectivity with regions of the hippocampus and amygdala following the NAMT task. These connectivity changes were not associated with score changes on the self-reported psychological measures.

The findings did not support the hypothesis that NAMT training would decrease connectivity between the PCC and other DMN regions, though they did support the hypothesis of increased connectivity between the PCC and salience network regions. Greater PCC-salience network connectivity could theoretically linked to heightened emotional awareness, though this was not reflected in the psychological measures.

The pilot study observes changes in resting-state brain connectivity following brief neurofeedback-augmented mindfulness training but fails to show any associated psychological change scores associated with those connectivity changes.

The results differ somewhat from a previous study that sampled from a clinical adolescent population, found decreased DMN interconnectivity following neurofeedback, and linked connectivity changes to changes in self-report scores. Study limitations include the lack of a sham NAMT treatment to rule out placebo or time-related effects. 

Reference:

Cosgrove, K. T., Tsuchiyagaito, A., Cohen, Z. P., Cochran, G., Yu, X., Misaki, M., Aupperle, R. L., Singh, M. K., Paulus, M. P., & Kirlic, N. (2024). Augmenting mindfulness training through neurofeedback: A pilot study of the pre-post changes on resting-state functional connectivity in typically developing adolescents. Frontiers in Neuroscience, 18.

Link to study

About a third of sexually active women experience either no or very low levels of sexual interest, desire, and arousal which can sometimes be a source of unhappiness and distress. Psychological treatments for low sexual desire include cognitive behavioral approaches (CBT) to challenge negative thoughts that can interfere with sexual arousal, and mindfulness-based approaches (MBI) to help focus on pleasurable sensations without distraction from interfering thoughts.

Both treatments have been shown to be more effective than no-treatment controls. Internet-based CBT and MBI for low sexual desire have the potential to make treatment more affordable and accessible.  

Velten et al. [Journal of Clinical and Consulting Psychology] tested the relative efficacy of internet-based CBT and MBI approaches vs. a waitlist control on symptoms of low sexual desire and sexual distress among women with low sexual desire.

The researchers randomly assigned 266 German women (average age=36 years) who met the diagnostic criteria for both hyposexual desire dysfunction (ICD-11 diagnosis) and sexual interest and arousal disorder (DSM-5 diagnosis) to an internet-based CBT, an internet-based MBI, or a waitlist control. Both active treatments consisted of eight online individual treatment modules, with participants instructed to complete one module per week. CBT and MBI included didactic presentations, guided exercises, and standard elements of sex education and therapy. 

Participants were assessed on sexual desire (primary outcome) and sexual distress (secondary outcome) with online self-report questionnaires at baseline, 5 weeks, and 3-, 6-, and 12-month follow-ups. The intent-to-treat analytic results showed that both treatment groups had significant large-sized increases (d=1.14 and 1.11) in sexual desire at 5 weeks and moderate-sized increases (d=0.75 and 0.74) in sexual desire at 3 months compared to the control group.

There were also significant, large-sized decreases in sexual distress (d=-1.14 and -0.98) at 5 weeks, which were sustained at 3 months (d=-1.18 and -1.00). All shorter-term improvements were maintained at 6- and 12-month follow-up. 

However, not all participants improved in the treatment groups based on a predetermined objective score set by the researchers. At 12-month follow-up, only 20-24% of the women showed clinically meaningful improvement in sexual desire, and only 37-42% had showed clinically meaningful improvement in sexual distress. Indeed, 35-45% of the women showed no improvement in sexual desire, and 12-16% showed no improvement in sexual distress.

The study reveals that internet-based CBT and MBI treatments show equal benefit in increasing sexual desire and decreasing sexual distress among women with low sexual desire, though most participants do not achieve clinically meaningful improvement.

The study is limited by a high dropout rate that was similar across all groups, a common problem in internet-based treatment studies, with only 46% of participants completing the 3-month follow-up and 31% completing the 12-month follow-up.

Reference:

Velten, J., Hirschfeld, G., Meyers, M., & Margraf, J. (2024). Results of a randomized waitlist-controlled trial of online cognitive behavioral sex therapy and online mindfulness-based sex therapy for hypoactive sexual desire dysfunction in women. Journal of Consulting and Clinical Psychology.

Link to study