Mindfulness and sustainability at the crossroads: towards mindfulness curricula for human and planetary wellbeing and transformation

Secular Mindfulness-Based Interventions: Efficacy and Neurobiology.

An Introduction to the Buddhist Underpinnings of Mindfulness-Based Interventions: Buddha-Nature and Intrinsic Goodness

Mindfulness-based interventions for women victims of interpersonal violence: A systematic review

The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). Fifty (50) subjects were recruited from the community and took part in MBSR (n = 36) and CBSR (n = 14) courses. Participants self-selected into MBSR or CBSR courses taught at different times. There were no initial differences between the MBSR and CBSR subjects on demographics, including age, gender, education, and income. MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. Perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain, and mindfulness were assessed before and after each course. Pre-post scores for each intervention were compared by using paired t tests. Pre-post scores across interventions were compared by using a general linear model with repeated measures. SETTINGS/LOCATIONS: Weekly meetings for both courses were held in a large room on a university medical center campus. MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain. Future studies should continue to examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.

Tensions between the well-being of present humans, future humans, and nonhuman nature manifest in social protests and political and academic debates over the future of Earth. The increasing consumption of natural resources no longer increases, let alone equalises, human well-being, but has led to the current ecological crisis and harms both human and nonhuman well-being. While the crisis has been acknowledged, the existing conceptual frameworks are in some respects ill-equipped to address the crisis in a way that would link the resolving of the crisis with the pivotal aim of promoting equal well-being. The shortcomings of the existing concepts in this respect relate to anthropocentric normative orientation, methodological individualism that disregards process dynamics and precludes integrating the considerations of human and nonhuman well-being, and the lack of multiscalar considerations of well-being. This work derives and proposes the concept of planetary well-being to address the aforementioned conceptual issues, to recognise the moral considerability of both human and nonhuman well-being, and to promote transdisciplinary, cross-cultural discourse for addressing the crisis and for promoting societal and cultural transformation. Conceptually, planetary well-being shifts focus on well-being from individuals to processes, Earth system and ecosystem processes, that underlie all well-being. Planetary well-being is a state where the integrity of Earth system and ecosystem processes remains unimpaired to a degree that species and populations can persist to the future and organisms have the opportunity to achieve well-being. After grounding and introducing planetary well-being, this work shortly discusses how the concept can be operationalised and reflects upon its potential as a bridging concept between different worldviews.

Introduction:Mindfulness-based interventions train participants to pay attention to their own emotions in the current moment without judging themselves. This study aims to assess the attitudes toward a mindfulness-based stress reduction intervention among African American women living with HIV.Methods:We collected qualitative data from three focus group discussions with 18 African American women living with HIV who were purposely recruited from the Palmetto Health-USC Immunology Center in South Carolina, United States. The participants discussed how they coped with stress, and then were given a presentation on mindfulness-based stress reduction and a sample mindfulness-based stress reduction mini workshop with follow-up discussion about their thoughts and opinions on the information presented to them.Results:Participants said that mindfulness could be a useful technique and they were interested in participating in a mindfulness-based stress reduction program. Their main concerns included physical ability to perform some of the mindfulness techniques (e.g. yoga) and logistic barriers, such as schedule constraints. They also provided some suggestions to further tailor the mindfulness-based stress reduction, such as modifying yoga, using familiar terms, and combining both in-person and online components. These results suggest that African American women living with HIV showed strong interest in mindfulness-based stress reduction and a high level of willingness to participate in mindfulness-based stress reduction, but the existing mindfulness-based stress reduction program needs to be tailored to address challenges and barriers these women may face for attendance and completion.Conclusion:The next step is to further test the feasibility, acceptability, and efficacy through a pilot study for African American women living with HIV to practice a tailored mindfulness-based stress reduction for this group.

The aims of this study were two-fold: (1) to investigate the effectiveness of a 6-week mindfulness-based stress reduction (MBSR) program in a sample of college students at risk for social anxiety and (2) to investigate whether emotion regulation strategies and self-compassion act as mechanisms of MBSR effectiveness. Participants in this study were predominantly female college students identified as at risk for social anxiety, who were randomly assigned to either the MBSR intervention or to the wait list control group. The final sample included 22 participants in the MBSR group and 24 in the wait list control group for whom pre-intervention and post-intervention (1 week after the MBSR intervention was finalized) data were gathered on self-report measures. The results showed that MBSR participation lead to significant reductions in social anxiety and perceived stress. Also, significant post-intervention differences in favor of the MBSR group compared to the wait list control group were found for self-compassion and acceptance, but not for positive reinterpretation. Mediation analyses employing a bootstrap procedure with 95% confidence intervals were conducted to test the potential MBSR intervention mechanisms. The results revealed that acceptance and self-compassion mediated the relationship between MBSR participation and social anxiety, as well as MBSR participation and perceived stress. The current findings indicated that mindfulness-based interventions might work by: (1) reducing self-identification with successes and failures in social and stressful situations and (2) deactivating appraisals concerning anxiety provoking situations.

Can mindfulness-based interventions improve the quality of life of patients with moderate/severe alopecia areata? A prospective pilot study

Issue/problem Dominant economic paradigms, particularly neoliberal frameworks prioritizing market growth, have inadequately addressed the fundamental socioeconomic determinants of health, mental health, and sustainability. Health outcomes are deeply shaped by patterns of resource distribution and relational power, yet economic and health policies are often developed in isolation. A new systems approach is needed to bridge this divide and realign public health investment with human and planetary well-being. Description of the problem Human Economics Systems Theory (HEST) proposes a new conceptual framework that places the economy at the center of a dynamic system linking governance, social determinants of health, environmental sustainability, and cultural context. Grounded in systems thinking, resilience theory, and anthropological insights, HEST models how economic structures fundamentally shape human survival, flourishing, and community formation. The objective was to provide a systems-based tool to guide transformative policy development for sustainable, equitable health outcomes. Results HEST identifies leverage points where economic policy interventions can create positive feedback loops for health equity, mental health, social cohesion, and environmental resilience. It reframes ‘investment’ as strengthening adaptive, equitable systems rather than treating health and economy as separate domains. The conceptual model offers policymakers new insights into structuring societies that align economic design with human well-being. Lessons HEST highlights the inseparability of economic systems and public health. By realigning investment strategies to respect human relational dynamics, survival needs, and social determinants, policymakers can cultivate sustainable, equitable, and resilient communities. Human Economics Systems Theory offers a new lens for reimagining health policy, economic policy, and the social contract across diverse countries and settings. Key messages • Public health investment must realign economic systems with human well-being, survival needs, and social equity. • Human Economics Systems Theory offers a systems-based framework for sustainable, equitable health, and economic policy.

Anxiety disorders are common, highly distressing, and impairing conditions. Effective treatments exist, but many patients do not access or respond to them. Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) are popular and can decrease anxiety, but it is unknown how they compare to standard first-line treatments. To determine whether MBSR is noninferior to escitalopram, a commonly used first-line psychopharmacological treatment for anxiety disorders. This randomized clinical trial (Treatments for Anxiety: Meditation and Escitalopram [TAME]) included a noninferiority design with a prespecified noninferiority margin. Patients were recruited between June 2018 and February 2020. The outcome assessments were performed by blinded clinical interviewer at baseline, week 8 end point, and follow-up visits at 12 and 24 weeks. Of 430 individuals assessed for inclusion, 276 adults with a diagnosed anxiety disorder from 3 urban academic medical centers in the US were recruited for the trial, and 208 completed the trial. Participants were 1:1 randomized to 8 weeks of the weekly MBSR course or the antidepressant escitalopram, flexibly dosed from 10 to 20 mg. The primary outcome measure was anxiety levels as assessed with the Clinical Global Impression of Severity scale (CGI-S), with a predetermined noninferiority margin of -0.495 points. The primary noninferiority sample consisted of 208 patients (102 in MBSR and 106 in escitalopram), with a mean (SD) age of 33 (13) years; 156 participants (75%) were female; 32 participants (15%) were African American, 41 (20%) were Asian, 18 (9%) were Hispanic/Latino, 122 (59%) were White, and 13 (6%) were of another race or ethnicity (including Native American or Alaska Native, more than one race, or other, consolidated owing to low numbers). Baseline mean (SD) CGI-S score was 4.44 (0.79) for the MBSR group and 4.51 (0.78) for the escitalopram group in the per-protocol sample and 4.49 (0.77) vs 4.54 (0.83), respectively, in the randomized sample. At end point, the mean (SD) CGI-S score was reduced by 1.35 (1.06) for MBSR and 1.43 (1.17) for escitalopram. The difference between groups was -0.07 (0.16; 95% CI, -0.38 to 0.23; P = .65), where the lower bound of the interval fell within the predefined noninferiority margin of -0.495, indicating noninferiority of MBSR compared with escitalopram. Secondary intent-to-treat analyses using imputed data also showed the noninferiority of MBSR compared with escitalopram based on the improvement in CGI-S score. Of patients who started treatment, 10 (8%) dropped out of the escitalopram group and none from the MBSR group due to adverse events. At least 1 study-related adverse event occurred for 110 participants randomized to escitalopram (78.6%) and 21 participants randomized to MBSR (15.4%). The results from this randomized clinical trial comparing a standardized evidence-based mindfulness-based intervention with pharmacotherapy for the treatment of anxiety disorders found that MBSR was noninferior to escitalopram. ClinicalTrials.gov Identifier: NCT03522844.

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 emotion-related constructs has not been systematically examined. 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. 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. 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.

Women experiencing homelessness (WEH) report exceedingly high rates of trauma exposure, posttraumatic stress disorder (PTSD), and substance use disorder (SUD). Mindfulness-based interventions including Mindfulness-based Stress Reduction (MBSR) may help lower traumatic stress-related symptoms and reduce SUD, but have been underexplored in community-based settings serving WEH with symptoms of PTSD and SUD. We used a mixed-method, community-engaged approach that implemented a Community Advisory Board and the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework, including intervention demonstrations, to adapt and refine MBSR for WEH experiencing symptoms of PTSD/SUD. Trauma-exposed WEH (N = 28) living at a drug treatment site provided perspectives and feedback on an MBSR demonstration via quantitative questionnaires and four focus groups. Quantitative measures indicated high perceived acceptability and feasibility: Nearly all WEH reported MBSR activities (including yoga, meditation, body scans, class discussion, and home practice) would be at least "somewhat helpful"; between 71.43% to 89.29% reported each activity would be "a great deal helpful." Most reported the focus group sessions were useful for providing feedback relevant for improving program design and administration. Qualitative findings revealed four themes aligning with quantitative findings that provided useful suggestions to guide MBSR implementation with trauma-exposed WEH: (a) perception of feasibility and effectiveness of MBSR, (b) strategies for successful recruitment, (c) strategies for successful retention, and (d) characteristics of the MBSR trainer. Focus group recommendations could bolster intervention compliance, engagement, and completion for MBSR and community-based programs for WEH more generally. Results provide suggestions for implementing a trauma-sensitive approach when administering MBSR to trauma-exposed WEH. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

BackgroundStress among students is on the rise during early medical school and has been implicated in poor academic performance. Several methods are being discussed to efficiently reduce stress, among them mindfulness-based interventions. We therefore set out to assess how stress, mindfulness, and academic performance are connected and if an intervention on mindfulness based stress reduction could alleviate stress among medical students and improve their academic achievements.MethodsA non-randomized controlled trial including 143 medical students in their preclinical years was performed in 2019. The students completed two surveys - one in the first, the other in the third term - recording perceived stress and mindfulness via validated scales (PSS-10 and MAAS). In between both, 41 students participated in a voluntary mindfulness-based intervention including six two-hours courses. 86 students served as controls. Scholarly success was assessed via the scores achieved in six exams written during the observation period.ResultsStress was inversely related with mindfulness and with the results of the most challenging exam. The intervention on mindfulness based stress reduction helped to contain stress and maintain mindfulness during the observation period and this effect lasted for at least six months beyond completion of the intervention. In contrast, beneficial effects on scholarly success were transient and only detectable at completion of the intervention.ConclusionOur observation of short- and intermediate term effects resulting from six individual interventions on mindfulness based stress reduction is encouraging and calls for alternative strategies to induce long-lasting impacts.

BackgroundA large body of randomized controlled trials (RCTs) has shown that mindfulness-based interventions are effective for improving mental health, but research is lacking in regards to the mechanisms of change. We aimed to investigate the mediating effects of self-reported altered resting state of Mindfulness-Based Stress Reduction (MBSR) on mental health, when provided as a universal intervention in a real-life context.MethodsAutoregressive path models with three time points of measurement, and contemporaneous and constant b paths were used in an RCT. The RCT took place in all five geographical regions of Denmark and included 110 schools and 191 schoolteachers. The schools were randomized 1:1 in each geographical region to intervention or a wait-list control group. The intervention was the standardized MBSR. Data were collected at baseline and after 3 and 6 months. The outcomes were perceived stress, measured by Cohen’s Perceived Stress Scale (PSS), symptoms of anxiety and depression, measured by Hopkins Symptom Check List-5 (SCL-5), and well-being measured by WHO-5 Well-being Index (WHO-5). The mediator was resting state measured by the Amsterdam Resting State Questionnaire (ARSQ).ResultsStatistically significant mediated effects of altered ARSQ-subscales scores for Discontinuity of Mind, Planning, and Comfort were found for the MBSR effect on all outcomes; PSS, SCL-5 and WHO-5. Furthermore, statistically significant mediated effects of altered sleepiness subscale score of the effects on PSS and SCL-5 of MBSR were found. No statistically significant mediating effects of the subscales Theory of Mind, Self and Somatic Awareness for the MBSR intervention effect were found.ConclusionThe results support that the MBSR program can alter self-reported resting state, towards less mind wandering and more comfort, measured by the ARSQ, and that this may explain some of the mechanisms regarding the effectiveness of MBSR on mental health at 6 months, when provided as a universal intervention. The study provides insight into an active ingredient of how MBSR may improve mental health and well-being. It supports the suggestions that mindfulness meditation may be a sustainable way of training the mental health.Clinical trial registration:ClinicalTrials.gov, identifier NCT03886363.

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.