Educational Research Review 18 (2016) 1e32

Contents lists available at ScienceDirect

Educational Research Review

journal homepage: www.elsevier.com/locate/edurev

Review

Mindfulness-based meditation to decrease stress and anxiety

in college students: A narrative synthesis of the research
Mandy D. Bamber*, Joanne Kraenzle Schneider
School of Nursing, Saint Louis University, 3525 Caroline Street, St. Louis, MO 63104-1099, USA

a r t i c l e i n f o a b s t r a c t

Article history: Objective: The primary purpose of this paper was to narratively review the research testing
Received 20 March 2015
the effects of mindfulness meditation on stress and anxiety in the college students;
Received in revised form 13 December 2015
reviewing the inclusion of mindfulness was a secondary purpose.
Accepted 15 December 2015
Available online 23 December 2015 Methods: A literature search resulted in 57 studies on the effectiveness of mindfulness
meditation in reducing stress and anxiety in college students.
Keywords: Conclusions: Researchers examined anxiety in 40 studies, self-reported stress in 34,
Mindfulness physiological stress in 11, and mindfulness in 24. Thirty-three of 40 and 25 of 34 studies
Mindfulness-based stress reduction showed significant decreases in anxiety and stress respectively; 22 of 24 showed an in-
Stress crease in mindfulness. Physiological stress had inconsistent results indicating a need for
Anxiety further research. Overall, mindfulness meditation shows promise in reducing stress and
College students
anxiety in college students. Additionally, there are a number of differences in mindfulness
interventions including frequency, duration, instructional method, and inclusion of yoga,
that need quantitative examination (meta-analysis) to determine which is most effective.
© 2015 Published by Elsevier Ltd.

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1. Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2. Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.3. Mindfulness-based interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.4. Mindfulness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.5. Mindfulness as a mediator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.6. Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
3. Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3.1. Search strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3.2. Inclusion/Exclusion criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
4. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
4.1. Theory and research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
4.2. MBSR and stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
4.3. MBSR and anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
4.4. MBSR and mindfulness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

* Corresponding author. Permanent Address: Florida State University, 439 Duxbury Hall, 98 Varsity Way, Tallahassee, FL 32308, USA.
E-mail addresses: MBamber@slu.edu (M.D. Bamber), schneijk@slu.edu (J. Kraenzle Schneider).

http://dx.doi.org/10.1016/j.edurev.2015.12.004
1747-938X/© 2015 Published by Elsevier Ltd.
2 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

4.5. MM and stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

4.6. MM and anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
4.7. MM and mindfulness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
5. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
5.1. Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
6. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Acknowledgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

1. Introduction

Transition to college requires emerging adults to adapt to new environments, social situations, academic workload, and
much more. As students attempt to acclimate to new environments and situations, stress and anxiety often occur. Mind-
fulness meditation (MM) is a meditative practice that encourages focus and attention. Recently mindfulness-based in-
terventions have been widely applied in research and integrated into college programs with the expectancy that they provide
effective coping strategies for students who are under considerable stress to be successful.
Currently there are no narrative reviews on MM in college students. Therefore, we conducted a narrative review of MM
interventions used to reduce college student stress and anxiety.

2. Background

2.1. Stress

Stress is the perception that a situation or event exceeds coping resources (Lazarus & Folkman, 1984). Students can
experience stress from living away from their caregivers for the first time, changing social lives, and challenging experiences
of higher learning. Stress at low levels can be beneficial, motivating students to perform well and preserve their mental and
physical well-being. However, a majority of college students (53.5%) reported that their stress was above average or extreme.
High level stress can have negative psychological, social, and academic impacts (American College Health Association
[ACHA], 2015a, b; Hughes, 2005; Kang, Choi, & Ryu, 2009). Stress can affect students' timeliness of assignments, ab-
sences, and attrition (Ratanasiripong, Sverduk, Hayashino, & Prince, 2010). Stress was reported as the primary reason
students performed poorly in a course, exam, or project (30%); 45.1% reported that academics were ‘very difficult’ to handle
(ACHA, 2015a, b).
Stress in college students is not a new topic. Research on stress in college student's dates back more than 50 years, with the
first study focusing on graduate student stress (Reifnam, 2011). Since then there have been a myriad of interventions created
and intervention studies conducted with students to find a method of decreasing stress or improving the ability to cope with
stress. Researchers have examined guided imagery, journaling, exercise, music therapy, and most recently meditation. Yet,
stress continues to be a debilitating problem for college students. In 2015, 30% of students reported that stress interfered with
their academic performance within the last year (ACHA, 2015a, b). This is a 2.2% increase since 2000. While this is only a small
increase; stress is still on the rise in college students. .

2.2. Anxiety

Stress, when not dealt with effectively, can cause anxiety (Hughes, 2005; Kang et al., 2009). Anxiety is an ambiguous
feeling that is worsened when a person experiences extended, unresolved stress or multiple stressors (Lazarus & Folkman,
1984). Like stress, mild anxiety can have a positive influence on academic outcomes. Mild levels of anxiety can increase
efficiency and intellectual functioning. However, high levels of anxiety are detrimental to academic outcomes. In fact, while
56.9% of students experienced ‘overwhelming anxiety’ in the previous twelve months, 21.9% of college students reported that
anxiety negatively impacted their academics (ACHA, 2015a, b; Godbey & Courage, 1994). Students with both decreased
aptitude for academics and high levels of anxiety are more likely to have poor study skills and academic outcomes, placing
them at an increased risk of failure.
Testing is reported as one of the most anxiety provoking events among college students, and poor test scores are often a
result of high anxiety (Godbey & Courage, 1994). Excessive levels of anxiety may impede intellectual functioning and those
with high anxiety were more likely to report low grades (Godbey & Courage, 1994). Stress and anxiety negatively affect
memory, concentration, problem-solving, and academic performance and insalubrious elevations can lead to illness,
rumination, avoidance, depression, and any number of other psychosomatic or physical problems. (Beddoe & Murphy, 2004;
Kang et al., 2009). In fact, anxiety has been the foremost diagnosed or treated mental health condition in college students
(15.8%; ACHA, 2015a, b). Student reports of anxiety have almost doubled in the last 15 years. In 2000, 11.3% of students
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 3

reported that anxiety impacted their academics in the last 12 months. In 2015, that rate was 21.9% (ACHA, 2000a, b; 2015a,
b).
Research on college student anxiety dates back to the late 1950's when the first anxiety measure was introduced. These
early studies found that overly anxious college students did not perform as well as their less anxious peers, had greater
difficulty completing tasks, and had lower grade point averages. They also found that overall female students had more
anxiety than their male peers (Head & Lindsey, 1983). Head and Lindsey reported that, at the time (1983) the most successful
interventions were those that used behavior modifications and they suggested that universities should develop programs to
reduce college students' anxiety levels. More than 30 years later, anxiety in college students remains an issue. Considering the
length of time college student anxiety has been studied and the number of MM interventions available, a review of these
interventions is necessary.

2.3. Mindfulness-based interventions

Mindfulness meditation (MM) originated from Buddhist Vipassana meditation and was introduced to western society
by Thich Nhat Hanh (Kang et al., 2009). In 1979, Jon Kabat-Zinn developed the first mindfulness-based stress inter-
vention called mindfulness-based stress reduction (Center for Mindfulness in Medicine, Health Care, and Society, 2014).
Mindfulness-based interventions focus on awareness of the present moment, mind-body connection, control of atten-
tion, non-judgmental thoughts, and bodily sensations. These interventions use mindfulness meditation (MM) tech-
niques, such as body scan and diaphragmatic breathing, to bring awareness to unconscious thoughts, feelings, and
behaviors.
Over the past 30 years, mindfulness interventions have grown in popularity. One of the most popular mindfulness in-
terventions is MBSR; which is available in over 200 medical centers, hospitals, and clinics (Flowers, 2014). MBSR is a
structured, instructor-led program that combines MM with Hatha Yoga, is taught over eight weeks with one 8-h silent
meditation session at the halfway point (Flowers, 2014). Other commonly used mindfulness-based interventions are
mindfulness-based cognitive therapy (MBCT) and acceptance-based behavioral therapy (ABBT). MBCT, developed from MBSR
by Segal and colleagues, includes cognitive therapy commonly used for individuals who suffer from chronic depression (Your
Guide to Mindfulness-Based Cognitive Therapy, 2014). Acceptance-based behavioral therapy (ABBT), was developed by Susan
Orsillo and is commonly used for the treatment of generalized anxiety disorder. ABBT uses mindfulness and acceptance to
retrain the user from traditional inflexible and avoidant behaviors to more flexible and accepting behaviors (Hayes-Skelton,
Orsillo, & Roemer, 2013). Through this review we found that researchers most commonly use MBSR, revised MBSR, MBCT,
revised MBCT, ABBT, or developed their own MM intervention. Thus, in this paper, we refer to all of these methods under the
generic label of mindfulness meditation (MM). In addition, we reviewed studies of pure MBSR and studies of generic MM
separately because pure MBSR is structured and is therefore relatively uniform across studies whereas MM interventions can
vary across studies.

2.4. Mindfulness

There are several core constructs of mindfulness. These constructs are control of attention, awareness, non-
reactivity, and non-judgmental thoughts. Mindfulness training is thought to begin with attention or “paying atten-
tion on purpose” and is the foundation of mindfulness (Kabat-Zinn, 2003, p. 145; Malinowski, 2013a, b). This is the
deliberate act of focusing our minds on passing thoughts, feelings, emotions, and actions (Kabat-Zinn, 2003). Kabat-
Zinn (2003) stated that mindfulness was not only “paying attention on purpose” but also paying attention to the
present moment and paying attention non-judgmentally. Mindfulness training in attention is thought to increase both
emotional and cognitive flexibility, allowing practitioners to develop a non-judgmental awareness. Non-judgmental
awareness refers to the attention that is payed to a current moment experience and not forming an opinion of it.
Non-judgmental awareness leads to non-reactivity, or not reacting to that current moment experience, but
acknowledging that it has occurred and letting it go. An example of this would be a student who received a poor
grade and was not consumed by negative emotions of that poor grade, but acknowledged it happened, and moved on.
Non-judgmental awareness and non-reactivity reflect the manner in which practitioners react to physical or emotional
stimuli; they act with awareness, tractability, and emotional stability. The MM constructs, when achieved, are thought
to improve physical, mental, and emotional well-being, and give practitioners control over their behaviors
(Malinowski, 2013a, b).
During our review, it became apparent to us, that the purpose of MM was to improve students’ mindfulness and that the
most immediate outcome, mindfulness was a mechanism through which MM influenced stress and anxiety. Therefore, we
reviewed mindfulness as a secondary outcome of this review.

2.5. Mindfulness as a mediator

Mindfulness has recently been categorized as either, state or trait. Brown & Cordon (2009) posited that trait mindfulness is
the nature of a person's everyday experiences and that state mindfulness is the stimulated state of mind that occurs during
and immediately after meditation. Treadway & Lazar (2010) described trait mindfulness as a change that occurs slowly over a
4 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

period of time with continued MM practice. They also concluded that trait mindfulness is a result of changes in the brains'
activity and structure. Repeated meditative practices increased trait mindfulness and those who had greater increases in state
mindfulness had greater increases in trait mindfulness (Kiken, Garland, Bluth, Palsson, & Gaylord, 2015). Kiken et al. (2015)
also reported that changes in both state and trait mindfulness were associated with changes in distress and that state
mindfulness was negatively associated with distress when tested independently of trait mindfulness. It has also been re-
ported that after brief MM sessions, one 20 min session and three 20 min sessions, that anxiety and negative mood were
decreased and that state mindfulness was increased (Zeidan, Johnson, Gordon, & Goolkasian, 2010; McClintock & Anderson,
2013).
Weinstein, Brown, and Ryan (2009) found a negative relationship between trait mindfulness and perceived stress and its
subsequent anxiety. Those with higher trait mindfulness perceived lower stress, than those with lower trait mindfulness. In
addition, trait mindfulness was associated with well-being, as well as a decrease in anxiety (Weinstein et al., 2009). Those
with higher trait mindfulness were more stress resistant, possessed greater psychological flexibility, and showed reduced
levels of psychological distress and anxiety (Ghorbani, Cunningham, & Watson, 2010; Masuda & Tully, 2012). Thus, there is
likely a moderating relationship between trait mindfulness and stress once trait mindfulness is added as a covariate (Shapiro,
Brown, Thoresen, & Plante, 2011).
In conclusion, the relationship between MM, state and trait mindfulness, stress, and anxiety is quite complex. MM
immediately increases state mindfulness which can decrease both stress and anxiety. With repetitive practice, state mind-
fulness increases trait mindfulness, and higher levels of trait mindfulness reduces stress and anxiety. Additionally, the higher
the trait mindfulness the greater increases in state mindfulness as a result of MM practice. Thus, a hypothesized model is
depicted in Fig. 1. To begin our exploration of this model we found no review of MM interventions used to treat stress and
anxiety in the long-run and mindfulness as a mediator.

2.6. Objectives

Therefore, the purpose of this paper was to narratively review the mindfulness-based interventions, MBSR specifically and
MM generically, used to reduce stress and anxiety in college students. Our secondary purpose was to review mindfulness as a
mediator in those studies focused on college student stress and/or anxiety.
Zoogman, Goldberg, Hoyt and Miller (2014) conducted a meta-analysis on the effects of MM with youth. They found
that there was an overall small effect size in the youth population (del ¼ .227). Additionally, they examined several
moderators to determine which affected the outcomes of MM. Only one moderator was found to have a moderate effect
size and that was in clinical samples (del ¼ .5). The other moderators examined; outside practice, instructor training/
experience, and intervention type all resulted in small effect sizes. This study and the researchers’ outcomes are important
to acknowledge because it is similar to the outcomes we are examining; however, our review differs in few key ways. First
Zoogman et al. (2014) examined an adolescent population, ages 14e18. Our review focuses on the college population.
Therefore, participants in this review were typically 18 and older. We are specifically interested on the stress and anxiety
that is perceived in this particular population. The second important difference is this review is narrative in nature.
Zoogman et al. (2014) examined the literature using meta-analytic techniques. Our intent was to narratively review the

Trait Mindfulness

Stress

Mindfulness
State Mindfulness
Meditation

Anxiety

Fig. 1. Hypothesized model of the relationship between MM, mindfulness, and stress and anxiety.
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 5

MM studies conducted with college student anxiety and stress and compliment a future meta-analysis using the college
student population.

3. Methods

3.1. Search strategies

We searched several databases through 2014, including PsychINFO (1967þ), PsychARTICLES (1894þ), MEDLINE (1946þ),
CINAHL (1981þ), Scopus (1832þ), PubMed (1946þ), Cochrane (1993þ), Proquest Dissertation and Theses, Campbell Library
(2000þ), ERIC (1966þ), Education Source (1929þ), Academic Search Complete (1887þ), Educators Reference Complete
(1932þ). Structured language search terms were used to gather as many potential articles as possible, which included;
“mindful*” AND “college OR universit*” AND “anxiety OR stress*”. Search terms with asterisks allowed the inclusion of any
ending on the term. Subject headings were exploded. Grey literature was searched including dissertations and theses and
conference proceedings. Hand searching, ancestry, and index searches were also completed. The database search resulted in
325 studies, including seven dissertations. Hand searching and index searching resulted in four additional studies. After
duplicates were removed, 176 studies remained. We screened the abstracts for these 176 studies for initial eligibility, 108
remained. After the full-text versions of the 108 articles were screened for inclusion criteria, 44 studies remained. New
searches were conducted to update included literature. Searches resulted in 213 studies, after duplicated were removed 38
remained. These articles were screened for inclusion criteria, 13 studies remained. There are 57 total articles included in this
review (See Fig. 2)

3.2. Inclusion/Exclusion criteria

To be included, researchers had to have measured stress or anxiety as outcomes. Researchers typically used psychological
self-report measures such as the State-trait Anxiety Inventory (STAI) and Perceived Stress Scale (PSS). Studies where re-
searchers used instruments with subscales for both anxiety and stress, such as the Depression, Anxiety, and Stress Scale
(DASS) were included if the subscale scores were presented separately.
We included studies with interventions that contained the mindfulness core constructs, that is (attention, awareness, non-
reactivity, and non-judgmental thoughts discussed above), because these are fundamental components of MBSR and MM. We
excluded studies that did not include meditation. We also excluded studies that did not test a mindfulness intervention (e.g.,
cross-sectional, qualitative studies, and reviews) because we were interested in the mindfulness interventions that were

Records identified through Additional records identified

Second screening of the
database searching (n=325) through other sources (n=4)
literature (n=213)

Records after duplicates removed Records after duplicated Records excluded (n=18)
(n =176) removed/Abstracts Screened Wrong populations and/or
(n=38) outcome variables

Records excluded (n=108)

Abstracts screened (n=176) Wrong populations and/or
Articles read for eligibility Articles excluded, (n=9)
outcome variables
(n=22) Correlational or Qualitative
studies
Articles screened for
Articles excluded, (n=24)
eligibility (n=68)
Correlational or Qualitative
studies
Articles added to review
Initial articles included in (n=13)
review (n=44)

Total articles included in

review (n=57)

Fig. 2. Search outcomes

6 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

tested. We included studies of college students of any age, major, and gender, including graduates and undergraduates.
Studies had to be in English.

4. Results

4.1. Theory and research

Theory serves to characterize and articulate central concepts (Walker & Avant, 2005) and to guide research and generate
new knowledge. While theory is critical, often researchers do not mention a theoretical framework in their published studies.
Likewise in this review, few researchers mentioned using a theoretical framework. Of the 57 studies included in this review, in
a mere 12 studies researchers reported a theoretical framework. The most common of these was the Transactional Model of
Stress and Coping (Kang et al., 2009; Lynch, Gander, Kohls, Kudielka, & Walach, 2011; Oman, Shapiro, Thoresen, Plante, &
Flinders, 2008; Sears & Kraus, 2009). Other theories used were Borkovec's Model of Chronic Worry, Hexa-flex Model,
Health Belief Model, The Rumination Arousal Model, Borenstein's Dependency Model, Barlow's Triple Vulnerability Frame-
work, and Dorjee's Five Dimensional Model of Mindfulness (Delgado-Pastor et al., 2015; Hoffmann Gurka, 2006; Key, 2010;
Leggett, 2011; Lynch et al., 2011; McClintock & Anderson, 2013; O'Brien, 2013; Van Gordon et al., 2013). However, researchers
theorized that awareness, attention, and self-reflection increased the ability to regulate emotional response and increased
learning capacity (Byrne, Bond, & London, 2013; Yamada & Victor, 2012), thus suggesting connections between the constructs
of mindfulness and emotions and learning capacity. Some stated that MM enabled the practitioner to experience
“nonjudgmental awareness” and that emotional regulation was increased (Byrne et al., 2013; Rosenzweig, Reibel, Greeson,
Brainard, & Hojat, 2003). They also viewed MM practice as engaging the practitioner in self-reflection and awareness of
sensation, enabling them to have enhanced engagement in life and increased learning capacity (Danitz & Orsillo, 2014;
Yamada & Victor, 2012).

4.2. MBSR and stress

MBSR was used in 15 studies, eleven of which focused on perceived stress in college students (See Table 1). Significant
reductions in stress were reported in seven studies (Demarzo et al., 2014; Newsome, 2010; Newsome, Waldo, & Gruszka,
2012; Oman et al., 2008; Shapiro, Brown, & Biegel, 2007; Shapiro, Jazaieri, & Goldin, 2012; Song & Lindquist, 2015) two
reported reductions after controlling for gender and mindfulness and one reported no significant effect. de Vibe et al. (2013)
found that overall stress scores were not significantly decreased with MBSR. Women (not men) in the treatment group had
significant reductions suggesting that men and women experience stress differently (de Vibe et al., 2013). Shapiro et al. (2011)
reported that students with higher trait mindfulness, when used as a covariate, reported significant reduction in stress
immediately post intervention and at one-year follow-up. This suggests that those who are inherently more mindful expe-
rience greater benefit than those less so. Finally, researchers of one MBSR study reported a downward trend in stress scores
over an 8-week period that did not reach significance (Beddoe & Murphy, 2004) likely due to low power (N ¼ 16). Overall,
when MBSR was used, 73% of the studies showed significant reductions in overall stress scores supporting potential effec-
tiveness for MBSR in reducing perceived stress in college students, but due to the limitations of these studies, these findings
should be interpreted with caution.

4.3. MBSR and anxiety

Researchers used anxiety as an outcome in nine studies. MBSR significantly reduced anxiety in all studies (See Table 2). Six
research teams reported significant reductions in total anxiety (Astin, 1997; Barbosa, Raymond, Zlotnick, Wilk, &
ToomeyMitchell, 2013; Beddoe & Murphy, 2004; Rosenzweig et al., 2003; Shapiro et al., 2007; Song & Lindquist, 2015);
while three reported reductions in state and/or trait anxiety (Blevins, 2009; Shapiro, Schwartz, & Bonner, 1998; Shapiro et al.,
2012). Five out of seven of these studies lacked either a control group or randomization (Barbosa et al., 2013; Beddoe &
Murphy, 2004; Rosenzweig et al., 2003; Shapiro et al., 2007; Shapiro et al., 2012). All studies lacked generalizability due to
a disproportionate number of women and participants from a single major. Finally, Beddoe and Murphy (2004) reported a 22%
attrition rate and did not provide an explanation, while Song and Lindquist (2015) stated that there was possible contami-
nation between groups. Despite threats to internal and external validity, in each of these studies researchers reported that
MBSR was effective in reducing college student anxiety. More rigorous research must be conducted, specifically to examine
differences across genders and disciplines.

4.4. MBSR and mindfulness

Mindfulness has been reported as a mediator between MBSR and stress and anxiety (Lundwall, 2012; Shapiro et al., 2011);
researchers examined mindfulness in seven of the 15 MBSR studies (See Table 3; Newsome, 2010; Newsome et al., 2012;
Shapiro et al., 2007; Shapiro et al., 2011; Shapiro et al., 2012; de Vibe et al., 2013).
In the six studies that researchers reported increases in mindfulness, five reported significant decreases in stress and/or
anxiety (Newsome, 2010; Newsome et al., 2012; Shapiro et al., 2007; Shapiro et al., 2012; Song & Lindquist, 2015). Shapiro
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 7

Table 1
MBSR and stress.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Shapiro, Examine effects of MBSR on RCT- Matched, MBSR Significant decreases in state Homogenous population,
Schwartz & psychological well-being, waitlist-control anxiety [F(1, 69) ¼ 4.11, possible experimenter or
Bonner empathy and spiritual (N ¼ 78) p < .05], trait anxiety [F(1, 69),placebo effects, no assessment
(1998) a experience p < .002], and GSI [F(1, of long term effects,
69) ¼ 6.62, p < .02], mindfulness, no comparison
group.
Beddoe, & Examine effects of MBSR on Quasi- MBSR Significant changes in Anxiety Small self-selected
Murp hy stress and empathy. experimental (p < .05). Downward, not homogenous sample, no
(2004) a pretest/posttest significant, trends in stress control group, assessment of
(N ¼ 16) mindfulness, or physiological
stress markers, high attrition
Shapiro et al. Examine effects of MBSR on Non-randomized MBSR Significant decreases in STAI No randomization, small,
(2007) c psychological distress cohort-controlled anxiety, present moment homogenous self-selected
(N ¼ 54) (p ¼ .0005) STAI anxiety, past sample, possible motivational
month (p ¼ .0002) PSS differences, no physiological
perceived stress (p ¼ .0001) and stress markers.
increases in MAAS (p ¼ .006)
Oman et al. Examine effects of and 3 arm RCT (N ¼ 44) MBSR and EPP No significant differences Small, homogenous sample, no
(2008) comparison to MBSR and between MBSR and EPP. assessment of mindfulness or
EPP on the management of Intervention groups had a physiological stress markers.
stress significant decrease in stress
(p < .05) at follow up but not
immediately posttest.
Newsome Examine effects of a A quasi- MBSR Significant decrease in stress No physiological stress
(2010) b mindfulness course on experimental [F(3,90) ¼ 26.14, p < .001, measures or control group,
stress, mindfulness and repeated measures h ¼ .47], and increase in possible adherence problems,
self-compassion (N ¼ 31) mindfulness [F(3,90) ¼ 19.57, small homogenous, self-
p < .001, h ¼ .40] selected sample.
Shapiro et al. Examine for whom (MBSR) RCT (N ¼ 30) MBSR Significant increases in Small homogenous sample, no
(2011) b is most effective between mindfulness (p < .05) No physiological measures of
high levels of pre- significant changes in stress. stress.
treatment trait mindfulness Those with higher levels of trait
and low levels of trait mindfulness had significant
mindfulness. decreases in stress (p < .04) and
increases in mindfulness
(p < .01), at one year follow-up
had significant increases in
mindfulness (p < .01) and stress
(p < .04)
Newsome et al. Examine effects of MBSR on Quasi- MBSR Significant reductions in stress Small, homogeneous sample,
(2012) b students entering the experimental, [F ¼ 26.14, df ¼ 3, p < .0001] No no measure of physiological
helping professions. single group significant changes between stress markers. No control
pretest/posttest posttest and follow-up. group or randomization.
(N ¼ 31) Significant increases in
mindfulness [F ¼ 19.57, df ¼ 3,
p < .0001], and between
posttest and follow-up
(p < .016).
Shapiro et al. Examine effects of MBSR on Quasi- MBSR Significant changes in Small homogenous sample, no
(2012) c moral reasoning and experimental, mindfulness, anxiety, and randomization or control
decision making single group stress: FFMQ (p < .001), MAAS group. No physiological
pretest/post-test (p < .05), STAI-S (p < .001), measures.
(N ¼ 25) STAI-T (p < .005), and PSS
(p < .001). Significant changes
at follow-up in mindfulness
(p < .03) and stress (p < .001),
not anxiety (p > .06).
de Vibe et al. Examines MBSR on distress, RCT (N ¼ 228) MBSR Stress was not significant Possible placebo effect, no
(2013) b stress, burnout, well-being, (p ¼ .021), gender (women) physiological stress markers
and mindfulness added as a covariate MM group
had significant decreases in
stress (<.001). Attendance and
practice did not predict changes
in mindfulness.
Demarzo et al. Examine the effects of Quasi- MBSR Significant decrease in stress Small sample size, no control
(2014) MBSR on a healthy college experimental (p < .001) group, did not examine
population. pretest/posttest mindfulness.
(N ¼ 23)
(continued on next page)
8 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 1 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Song & Examine effects of MBSR on RCT (N ¼ 44) MBSR Significant differences found Small homogeneous sample
Lindquist, Korean Nursing students between groups in stress NO f/u on MBSR HW
(2015) c (F ¼ 15.31, p < .001), anxiety Possible contamination b/n
(F ¼ 5.61, p ¼ .023) and groups
mindfulness (F ¼ 5.03, p ¼ .01)
a
Outcomes stress and anxiety.
b
Outcomes stress and mindfulness.
c
Outcomes stress, anxiety, and mindfulness.

et al. (2011) reported significant increases in mindfulness scores (p < .05), and nonsignificant decreases in stress scores
compared to controls (p < .10). Once trait mindfulness was added as a covariate, they found greater increases in mindfulness
(p < .01) and significant decreases in stress scores (p < .04) in those with higher levels of trait mindfulness suggesting a
moderating relationship between trait mindfulness and stress (Shapiro et al., 2011). de Vibe et al. (2013) reported no changes
in mindfulness scores pre-to post-intervention overall except in the subscale that reflected non-reactivity. Men and women
reported being significantly less reactive after the intervention. Then, when gender was controlled, only women reported a
significant reduction in non-judgmental thoughts and reported a significant decrease in stress scores. It is important to note
that only 46.7% of MBSR studies examined mindfulness.

4.5. MM and stress

MM was used in 42 studies and stress (self-reported and physiological measures) was an outcome in 29. In 23 studies
where self-reported stress was the outcome, 18 research teams reported significant reductions in stress (See Table 4). Five
studies with nonsignificant results had notable limitations; single group pretest/posttest designs and dose concerns (Bond
et al., 2013; Bonifas & Napoli, 2014; Danitz & Orsillo, 2014; Key, 2010; Yamada & Victor, 2012). Researchers reported using
abbreviated (one-time, 10 min sessions, lasting four weeks, etc.) MM interventions (Bond et al. 2013; Danitz & Orsillo, 2014;
Yamada & Victor, 2012), or data collection occurred before intervention completion (Bonifas & Napoli, 2014) which may have
affected dose and the ability to significantly decrease stress. In addition, researchers of these studies embedded MM into
didactic material, such as neuroscience, which may have detracted from the MM intervention, raising further questions about
dose (Bond et al., 2013; Bonifas & Napoli, 2014). To lend credence to the importance of intervention characteristics, Delgado-
Pastor et al. (2015) compared two facets of MM, awareness (MIT) and attention (MCT) and found that stress was decreased in
the MIT group but not the MCT.
Furthermore, these researchers included specific college majors and first year college students, masters of social work,
medical students, and law students, which affects generalizability; these students may have heightened stress and anxiety
related to patient care, new experiences, and intense academic demands. Finally, small and homogenous participant samples
were often described as limitations in the research (Bond et al., 2013; Bonifas & Napoli, 2014; Danitz & Orsillo, 2014; Yamada
& Victor, 2012).
The fifth study with nonsignificant results was one by Key (2010) who used the Calgary Symptoms of Stress Inventory
(CSOSI) which was relatively new at the time and normative scores had not been established. Thus, it was not possible to
determine if participants had lower or higher than average stress scores before the intervention. Key (2010) also reported
participants were mostly female, limiting generalizability. The limitations of the studies make it difficult to conclude if MM, is
in fact, effective in reducing stress. Clearly more rigorous research is needed.
Researchers used physiological markers of stress in eleven studies (See Table 5). In four studies, salivary or serum cortisol
levels were used (Lynch et al., 2011; Myint, Choy, Su, & Lam, 2011; Tang et al., 2007; Turakitwanakan, Mekseepralard, &
Busarakumtragul, 2013). Researchers of two studies reported significant improvement in cortisol levels after MM in-
terventions; one in medical students who received an intensive four hours for four days MM intervention (Turakitwanakan
et al., 2013), the other in undergraduate Chinese students after a stress task (Tang et al., 2007). Lynch et al. (2011) and Myint
et al. (2011) reported that cortisol did not decrease; however, both had small sample sizes (16 and 18 respectively). Lynch et al.
(2011) collected daily waking salivary cortisol levels, while Myint et al. (2011) collected serum cortisol levels throughout the
course of a 5-day MM intervention. Thus, researchers have shown ambiguous results with regards to the effects of MM in-
terventions on cortisol levels.
Seven research teams examined heart rate (HR) in response to MM (Chen, Yang, Wang, & Zhang, 2012; Delgado et al.,
2010; Delgado-Pastor et al., 2015; Key, 2010; Myint et al., 2011; Shenesey, 2013; Zeidan et al., 2010). In two different
studies, researchers reported significant reductions in HR after MM. They reported that MM, sham meditation, and
control groups all had significant reductions in HR, but those in the MM intervention had a greater reduction (Zeidan
et al., 2010), or no differences between groups (Shenesey, 2013). Delgado-Pastor et al. (2015) reported that MIT had
significant reductions in both heart rate variability (HRV) and HR, but MCT had borderline significance (p < .07) in HRV
and non-significant results in HR. Thus more work is needed to determine the effects of MM and its characteristics, if any,
on HR.
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 9

Table 2
MBSR and anxiety.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Astin (1997) Examine effects of RCT (N ¼ 28) MBSR Significant decreases in Small homogenous sample,
mindfulness meditation on anxiety, [F(2,16) ¼ 7.05, no assessment of
stress p < .02] mindfulness, possible
experimenter or placebo
effects.
Shapiro, Schwartz, Examine effects of MBSR on RCT- Matched, MBSR Significant decreases in Homogenous population,
& Bonner (1998) psychological well-being, waitlist-control state anxiety [F(1, possible experimenter or
a
empathy and spiritual (N ¼ 78) 69) ¼ 4.11, p < .05], trait placebo effects, no
experience anxiety [F(1, 69), p < .002], assessment of long term
and GSI [F(1, 69) ¼ 6.62, effects, mindfulness, no
p < .02], comparison group.
Rosenzweig et al. Examine effects of MBSR on Quasi- MBSR Significant decreases in No randomization,
(2003) psychological wellbeing experimental tension-anxiety (p < .009) homogenous sample, no
nonrandomized and vigor-anxiety (p < .006) assessment of mindfulness,
cohort-controlled single instrumentation.
(N ¼ 302)
Beddoe & Murphy Examine effects of MBSR on Quasi- MBSR Significant changes in Small self-selected
(2004) a stress and empathy. experimental Anxiety (p < .05). homogenous sample, no
pretest/posttest Downward, not significant, control group, assessment
(N ¼ 16) trends in stress of mindfulness, or
physiological stress
markers, high attrition
Shapiro et al. Examine effects of MBSR on Non-randomized MBSR Significant decreases in No randomization, small,
(2007) b psychological distress cohort-controlled STAI anxiety, present homogenous self-selected
(N ¼ 54) moment (p ¼ .0005) STAI sample, possible
anxiety, past month motivational differences, no
(p ¼ .0002) PSS perceived physiological stress
stress (p ¼ .0001) and markers.
increases in MAAS
(p ¼ .006)
Blevins (2009) Examine effects of a MM on RCT (N ¼ 41) MBSR and Significant changes state [F Small, homogenous sample.
body image satisfaction, traditional (2, 20) ¼ 21.59, p < .001, High attrition, adherence,
self-esteem, depressive strategies for h2 ¼ .68] and trait anxiety, single mindfulness
symptoms, anxiety, binge weight loss [F (2, 20) ¼ 6.75, p ¼ .006, questionnaire, limited
eating, and weight. h2 ¼ .40], and total anxiety number of meditation
at follow-up (p < .008). sessions.
Shapiro et al. Examine effects of MBSR on Quasi- MBSR Significant changes in Small homogenous sample,
(2012) b moral reasoning and experimental, mindfulness, anxiety, and no randomization or
decision making single group stress: FFMQ (p < .001), control group. No
pretest/post-test MAAS (p < .05), STAI-S physiological measures.
(N ¼ 25) (p < .001), STAI-T (p < .005),
and PSS (p < .001).
Significant changes at
follow-up in mindfulness
(p < .03) and stress
(p < .001), not anxiety
(p > .06).
Barbosa et al. Examine effects of MBSR on Quasi- MBSR Significant decreases in Small, homogenous sample,
(2013) anxiety and empathy experimental with anxiety post-intervention no randomization or
matched control (p < .001) and at follow-up mindfulness measures,
(N ¼ 28) (p < .01) potential placebo effect,
limited measures.
Song & Lindquist, Examine effects of MBSR on RCT (N ¼ 44) MBSR Significant differences Small homogeneous
(2015) b Korean Nursing students found between groups in sample
stress (F ¼ 15.31, p < .001), NO f/u on MBSR HW
anxiety (F ¼ 5.61, p ¼ .023) Possible contamination b/n
and mindfulness (F ¼ 5.03, groups
p ¼ .01)
a
Outcomes stress and anxiety.
b
Outcomes stress, anxiety, and mindfulness.

Respiratory rate (RR) was reported in two studies; both reported significant reductions in RR after MM (Delgado et al.,
2010; Shenesey, 2013). As stated above, Shenesey (2013) compared the effects of MM, sham meditation, and relaxation
control, all of which had significant reductions in RR; however, there were no significance between groups. As with HR, more
research is needed before conclusions are made.
Researchers of five studies included blood pressure (BP) measures as an outcome (Chen et al., 2012; Key, 2010; Leggett,
2011; Myint et al., 2011; Zeidan et al., 2010). Leggett (2011) reported a significant reduction in both systolic (SBP) and
10 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 3
MBSR and mindfulness.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Shapiro et al. Examine effects of MBSR on
(2007) b psychological distress
Newsome Examine effects of a
(2010) a mindfulness course on
stress, mindfulness and
self-compassion
Shapiro et al. Examine for whom (MBSR)
(2011) a is most effective between
high levels of pre-
treatment trait mindfulness
and low levels of trait
mindfulness.
Newsome et al. Examine effects of MBSR on
(2012) a students entering the
helping professions.
Shapiro et al. Examine effects of MBSR on
(2012) b moral reasoning and
decision making
de Vibe et al. Examines MBSR on distress,
(2013) a stress, burnout, well-being,
and mindfulness
Song & Examine effects of MBSR on
Lindquist, Korean Nursing students
(2015) b
a
Outcomes stress and mindfulness.
b
Outcomes stress, anxiety, and mindfulness.
Non-randomized MBSR Significant decreases in STAI
cohort-controlled anxiety, present moment
(N ¼ 54) (p ¼ .0005) STAI anxiety, past
month (p ¼ .0002) PSS
perceived stress (p ¼ .0001) and
increases in MAAS (p ¼ .006)
A quasi- MBSR Significant decrease in stress
experimental [F(3,90) ¼ 26.14, p < .001,
repeated measures h ¼ .47], and increase in
(N ¼ 31) mindfulness [F(3,90) ¼ 19.57,
p < .001, h ¼ .40]
RCT (N ¼ 30) MBSR Significant increases in
mindfulness (p < .05) No
significant changes in stress.
Those with higher levels of trait
mindfulness had significant
decreases in stress (p < .04) and
increases in mindfulness
(p < .01), at one year follow-up
had significant increases in
mindfulness (p < .01) and stress
(p < .04)
Quasi- MBSR Significant reductions in stress
experimental, [F ¼ 26.14, df ¼ 3, p < .0001] No
single group significant changes between
pretest/posttest posttest and follow-up.
(N ¼ 31) Significant increases in
mindfulness [F ¼ 19.57, df ¼ 3,
p < .0001], and between
posttest and follow-up
(p < .016).
Quasi- MBSR Significant changes in
experimental, mindfulness, anxiety, and
single group stress: FFMQ (p < .001), MAAS
pretest/post-test (p < .05), STAI-S (p < .001),
(N ¼ 25) STAI-T (p < .005), and PSS
(p < .001). Significant changes
at follow-up in mindfulness
(p < .03) and stress (p < .001),
not anxiety (p > .06).
RCT (N ¼ 228) MBSR Stress was not significant
(p ¼ .021), gender (women)
added as a covariate MM group
had significant decreases in
stress (<.001). Attendance and
practice did not predict changes
in mindfulness.
RCT (N ¼ 44) MBSR Significant differences found
between groups in stress
(F ¼ 15.31, p < .001), anxiety
(F ¼ 5.61, p ¼ .023) and
mindfulness (F ¼ 5.03, p ¼ .01)
No randomization, small,
homogenous self-selected
sample, possible
motivational differences, no
physiological stress
markers.
No physiological stress
measures or control group,
possible adherence
problems, small
homogenous, self-selected
sample.
Small homogenous sample,
no physiological measures
of stress.
Small, homogeneous
sample, no measure of
physiological stress
markers. No control group
or randomization.
Small homogenous sample,
no randomization or
control group. No
physiological measures.
Possible placebo effect, no
physiological stress
markers
Small homogeneous
sample
NO f/u on MBSR HW
Possible contamination b/n
groups

diastolic blood pressure (DBP), while Chen et al. (2012) reported significant reductions in SBP only. Researchers of three
studies reported no significant improvements in BP (Key, 2010; Myint et al., 2011; Zeidan et al., 2010). As with HR and RR, it is
premature for us to draw conclusions about the effects of MM on BP.

4.6. MM and anxiety

Anxiety was the most commonly assessed outcome in MM research; 31 researchers studied anxiety (See Table 6). In 24
studies, researchers found that either state, trait, or overall anxiety decreased after MM. Seven research teams reported no
significant improvement in anxiety scores (Bergen-Cico, Possemato, & Cheon, 2013; Danitz & Orsillo, 2014; Gockel, Burton,
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32
Table 4
Self-reported stress and MM.
Citation Purpose
Deckro et al. Examine effects of a mind/
(2002) a body intervention on
psychological distress
Hoffmann Examine effects of MM on RCT waitlist-
Gurka (2006) stress and if cue reminders control (N ¼ 123)
result in higher rates of
practice.
Jain et al. Compare effects MM and
(2007) somatic relaxation training
(SR).
Kang et al. Examine effects of a
(2009) a mindful-based coping
intervention on stress,
anxiety and depression.
Cohen & Miller Examine effects of MM with
(2009) c at risk for occupational
stress and examine the
feasibility of MBSR in
relational awareness
b
Key (2010) Examine effects of
mindfulness and distraction (N ¼ 101)
on rumination and
cardiovascular recovery
after a stressor induction,
Examine MM effects on
psychological distress.
Warnecke, Examine effects of MM on
Quinn, stress
Ogden,
Towle &
Nelson
(2011) a
Myint et al. Examine effects of a brief
(2011) MM intervention on
physiological well-being of
students preparing to take
an exam.
Lynch et al. Examine feasibility of
(2011) c implementing MM into
college life
Design/Sample Intervention Outcomes
RCT- waitlist- Mind/Body with Significant decreases in state
control (N ¼ 128) MM, cognitive anxiety (p ¼ .001), trait anxiety
behavioral and (p ¼ 0017), and stress (p ¼ .008)
relaxation response
skills
MM Significant decreases in stress
[F(2,68) ¼ 5.70, p < .01,
h ¼ .04]
2
Three-armed RCT MM SR and MM both had significant Self-selected samples, short
(N ¼ 83) Somatic relaxation decreases in BSI compared
(SR) (p ¼ .01; p ¼ .002) no
differences between the MM
and SR groups (p ¼ .93)
RCT (N ¼ 41) MM Significant decreases in stress
(F ¼ 6.145, p ¼ .02), and anxiety Groups were not equal
(F ¼ 6.985, p ¼ .013)
Quasi- Interpersonal Significant increases in
experimental Mindfulness Mindfulness (F ¼ 10.037,
pretest/posttest Training (IMT) p ¼ .005), decreases in stress
(N ¼ 21) and anxiety
(F ¼ 14.957, p ¼ .001; F ¼ 5.733, stress.
P ¼ .0127)
Three-armed RCT MM MM increases in trait
mindfulness [F(1,98) ¼ 8.47
p ¼ .004], no significant effects
on stress [F(1,98) ¼ .33,
p ¼ .569] or cardiovascular
recovery; HR [F(1,98) ¼ .16,
p ¼ .692], SBP [F(1,98) ¼ 1.48,
p ¼ .227], DBP [F(1,98) ¼ .001,
p ¼ .977]
Single-blinded RCT, Guided MM Significant decreases in stress
with intention to on PSS and subscale of DASS
treat. (N ¼ 66) (p < .05; p ¼ .05) and anxiety
(p < .05). 16 week follow-up
showed no significant changes adherence, short follow-up
in stress or anxiety
Three-armed non- MM Significant decreases in DASS- Small homogenous sample,
randomized Stress in meditating, no exam
controlled group (p < .05), Meditating-
(N ¼ 18) Exam group and no meditation meditation experience.
exam group had no significant
changes in the DASS-Stress. No
significant outcomes for the
physiological measures in any
group.
A non-randomized Mindfulness-Based Salivary cortisol and alpha-
wait-list-controlled Coping with amylase levels were not
(N ¼ 16) University Life significant
(MBCUL) Significant decreases in stress
(d ¼ 1.06; z ¼ 2.25, p ¼ .03), groups. High attrition.
anxiety (d ¼ 1.04; z ¼ 2.14,
p ¼ .03), and increases in
mindfulness (d ¼ 1.06;
z ¼ 1.89, p ¼ .06). Negative
correlations between change in
11
Limitations
Homogenous self-selected
sample, high attrition, low
adherence, wide age range,
no control of health
conditions/stress level, no
assessment of mindfulness
or physiological stress
markers
Homogenous sample,
possible experimenter
effects, use of self-report
measures, high attrition
and low adherence. No
assessment of mindfulness
or physiological stress
markers.
intervention period, group
effects present in both
interventions. Post-test
collection timing,
homogenous sample, no
assessment of mindfulness.
Small, homogenous sample.
prior to intervention. No
assessment of mindfulness
or physiological markers of
stress.
No control group, small
sample size, possible effects
of group membership. No
physiological measures of
Homogenous sample, with
possible intervention bias.
Small homogenous sample,
no measures of mindfulness
or physiological stress,
possible issues with
no measures of
mindfulness, short
Small, homogenous sample.
No randomization. Erratic
sleep patterns. Possible
differences between
(continued on next page)
12 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 4 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

mindfulness and anxiety
(rho ¼ .81, p ¼ .01), and
perceived stress (rho ¼ .74,
p ¼ .01).
Schwarze, M. J. Examine effectiveness of a AB single-subject, MBCT Reductions in PSS scores in all Small, single-subject
(2012) modified MBCT on stress repeated 5 times. five participants. Greater design. Possible motivated
and mindfulness (N ¼ 5) reductions in some volunteers, shorted
participants, but more stable sessions, and one measure
results with only minimal for each variable.
reductions in others.
Yamada & Examine viability/effects of Quasi- MM adapted from Significant changes in state Abbreviated intervention,
Victor (2012) brief MM in academics and experimental, MBSR anxiety [F(1,55) ¼ 5.61, p < .05] small sample, no
c
psychological well-being controlled (N ¼ 60) and FMI [F(1,36) ¼ 9.445, randomization, more males
p < .01]. Not significant for in the MM group
stress (p ¼ .287), trait anxiety
(p ¼ .157), or MAAs
mindfulness (p ¼ .503)
Bond et al. Examine effects of a Quasi experimental Integrated MM, Stress (p ¼ .7) decreased but not Small, homogenous sample,
(2013) mindfulness-based elective pretest/post-test yoga, and significant no measures of mindfulness
course on psychological (N ¼ 27) neuroscience or physiological stress
well-being didactic lecture. markers, no control group,
possible placebo effects.
Van Gordon Examine the benefits and Quasi- MAT. Significant decreases in both Small sample, no
et al. (2013) c feasibility of MAT experimental case anxiety and stress subscales of randomization, possible
controlled (N ¼ 25) the DASS F(1,20) ¼ 17.53, placebo effects, no
p < .001, h2 ¼ .47) and physiological stress
significant increases in markers
mindfulness(F(1,20) ¼ 23.83,
p < .001)
Call et al. Examine effects of aspects 3 arm RCT waitlist- MBSR-based hatha Hatha yoga group and body Homogeneous sample, no
a
(2013) of MBSR on stress and control (N ¼ 91) yoga scan groups had significant physiological stress
anxiety MBSR-based body decreases in anxiety markers, no control of
scan [F(1,87) ¼ 12.15, p < .001; physical activity, significant
F(1,87) ¼ 6.86, p < .01] and pre-intervention group
stress [F(1,87) ¼ 5.30, p < .05; differences, limited
F(1,87) ¼ 5.72, p < .05]. No mindfulness education and
significant differences between intervention.
experimental conditions.
Gallego, Compare effects of MM and 3-arm randomized MBCT Stress was significantly Small sample size, no
Aguilar- exercise on depression, comparison- decreased (t ¼ 2.953, mindfulness measure
Parra, stress, and anxiety control p ¼ .006 d ¼ .667), no
Cangas, significance, downward trend
Langer & for anxiety t ¼ (.715,p ¼ .480,
Man ~ as d ¼ .318), significance between
(2014) a MM and control in both stress
(F ¼ 3.519, p ¼ .033, h2 ¼ .066)
and anxiety (F ¼ 5,402, p ¼ .006,
h2 ¼ .098)
Hindman, Compare the effects of 3-arm Quasi- Mindful Stress Both MSM-formal and MSM- Partial randomization
(2013) c formal MM, brief informal experimental with Management Informal had significant Self-report measures
MM, and control on waitlist control (MSM)-Formal and decrease in stress (p < .01, Small homogenous sample
mindfulness, stress, and (N ¼ 34) MSM-Informal P < .05) and increases in FFMQ
anxiety mindfulness measure (p < .001,
p < .05), the MSM-formal had
significant decreases in anxiety
(p < .01) and increase in MAAS
mindfulness measure (p < .01),
the MSM-informal were not
significant in MAAS and anxiety
measures. Moderate effect size
between MSM-formal and
MSM-informal, and large effect
sizes between MSM-Formal and
control.
Bonifas & Examine effectiveness of a Course evaluation, MM No change in stress scores pre- Stress scores collected
Napoli mindfulness course on Single group to post intervention (t ¼ .225, before intervention
(2014) quality of life and stress Pretest/posttest p > .10) completion, no control
coping (N ¼ 77, over 5 group, mindfulness
years) measures, randomization,
or physiological stress
markers.
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 13

Table 4 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Danitz & Examine the effects of a RCT- waitlist ABBT No significant differences Small homogenous sample,
Orsillo, one-time acceptance-based control (N ¼ 90) between groups on anxiety self-select (1st come
(2014) behavior therapy on [F(1, 43) ¼ .27, p ¼ .61, d ¼ .12] assigned to intervention),
psychological well-being in or stress [F(1, 43) ¼ .72, p ¼ .40, one-time MM instruction.
first year college and law d ¼ .22], those in the ABBT
students group reported mild levels of
stress pre-intervention and
normative at 3 month f/u and
moderate anxiety pre-
intervention and mild at 3
month f/u.
Goodman et al. Examine effects and Quasi- MM Significant increase in Both groups physically
(2014) c feasibility of a mindfulness experimental, non- mindfulness over time active, small sample size, no
intervention for student randomized control [t(8) ¼ 2.88, p < .05, d ¼ .48] randomization, can't
athletes (N ¼ 26) and between groups [F(1, determine which
19) ¼ 4.55, p < .05] decrease in component most effective.
stress over time [t(8) ¼ 2.57,
p < .05, d ¼ .26], not significant
in anxiety with-in groups or
between groups.
Greeson et al. Examine effects of Koru in RCT (N ¼ 99) Koru Significant decrease in stress Self-report measures,
(2014) b college students on stress (group x time) [F[1, Homogenous sample
76.40] ¼ 4.50,p ¼ .037, d ¼ .45) no midpoint assessment
and increase in mindfulness [F
[1,79.09 ¼ 26.80, p < .001,
d ¼ .95]
Taylor, Strauss, Examine effects of MBCT Single blinded RCT MBCT-SH Significant differences between Healthy homogenous
Cavanagh & self-help on anxiety and (N ¼ 79) groups in anxiety (F ¼ 4.01, sample, waitlist control, no
Jones (2014) stress. p < .05), Stress (F ¼ 9.89, face-to-face interaction
c
p < .001), and mindfulness
(F ¼ 23.22, p < .001)
Delgado-Pastor Compare two facets of MM; 3-arm RCT (N ¼ 41) MM MIT had a significant in Small sample size, brief
et al. (2015) awareness (MIT) and decreases in stress (F ¼ 7.843, intervention period,
b
attention (MCT) p ¼ .009), HR (p < .001), and homogenous, sample.
HRV (P < .009), and significant
increase in FMI mindfulness
measure F(2, 37) ¼ 4.16,
p < .024, h2p ¼ .183, not MAAS
mindfulness measure F(2, 37) ¼
3.32, p < .152, h2p ¼ .09].
Significant differences between
MIT and control on both
mindfulness measures (p < .01;
p < .03). MCT no significant
change in stress (p ¼ .1),
mindfulness, or HR, and
marginally significant in HRV
(p < .07). A significant
difference between MCT and
control on FMI (p < .03)
a
Outcomes stress and anxiety.
b
Outcomes stress and mindfulness.
c
Outcomes stress, anxiety, and mindfulness.

James, & Bryer, 2013; Goodman, Kashdan, Mallard, & Schumannet, 2014; Hassed, de Lisle, Sullivan, & Pier, 2009; Paholpak
et al., 2012; Roberts-Wolfe, Sacchet, Hastings, Roth, & Britton, 2012).
The State-Trait Anxiety Inventory (STAI) was a commonly used anxiety measure; twelve research teams used the State-
Trait Anxiety Inventory (STAI), state, trait, or both state and trait anxiety subscales (Blevins, 2009; Deckro et al., 2002;
Delgado et al., 2010; Gockel et al., 2013; Kang et al., 2009; Kim, Yang, & Schroeppel, 2012; McClintock & Anderson, 2013;
O'Brien, 2013; Shenesey, 2013; Glick & Orsillo, 2015; Yamada & Victor, 2012; Zeidan et al., 2010). Deckro et al., (2002) and
Yamada and Victor (2012) reported significant decreases in state anxiety and downward trends in trait anxiety in the MM
groups. Deckro et al., (2002) reported high attrition rates (30%) and inconsistent attendance, with only 43% of participants
attending all six meditation sessions; while Yamada and Victor (2012) reported short 10-min MM sessions, twice per week
and small sample size.
Six research teams reported nonsignificant downward trends in anxiety (Bergen-Cico et al., 2013; Danitz & Orsillo, 2014;
Goodman et al., 2014; Hassed et al., 2009; Paholpak et al., 2012; Roberts-Wolfe et al., 2012). Gockel et al. (2013) conveyed they
used the STAI-state measure, but did not report scores and instead stated “no other significant between-group differences”
14 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 5
Physiological Stress outcomes and MM.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Tang et al. (2007) Examine short term RCT (N ¼ 80) Integrative mind- Significant differences in Homogenous sample, possible
a
effects of MM on body training tensioneanxiety placebo effects. Cultural
attention and self- (IMBT) [F(1,78) ¼ 11.920; P < .01], differences, no assessment of
regulation and salivary cortisol after a mindfulness
math stress task
[F(1,38) ¼ 6.281; P < .01]
Zeidan et al. Examine differences on 3 Armed RCT MM STAI-State showed 3-way Homogenous healthy sample,
(2010) a mood and (N ¼ 82) Sham MM effect was significant [F brief mindfulness intervention,
cardiovascular Control (4,150) ¼ 2.98, p ¼ .02, possible experimenter bias,
measures between MM h2 ¼ .07]; no change in baseline group differences in
and sham MM. control group, Significant BP, anxiety, and HR.
decreases in anxiety in
sham and MM groups. All
groups had significant
decreases in HR with the
strongest effect for MM
[F(1,28) ¼ 29.87, p < .01,
h2 ¼ .52], sham
mindfulness,
[F(1,26) ¼ 14.87, p < .01,
h2 ¼ .36], and controls,
[F(1,25) ¼ 7.64, p ¼ .01,
h2 ¼ .23]. There were no
significant differences
between groups on blood
pressure.
Delgado et al. Examine response to RCT active-control MM and Relaxation Significant decreases in No non-treatment control
(2010) a psychological and (N ¼ 32) Training both groups in trait anxiety group, small homogenous
physiological measures [F(1,26) ¼ 8.72, p < .008], sample, no follow-up, possible
to mindfulness-based MM had lower RR experimenter bias.
program on high levels compared to relaxation
of worry group [F(1, 27) ¼ 4.59,
p < .04] and significantly
longer expiratory
[F(1,27) ¼ 4.63, p < .04] and
inspiratory periods
[F(2,26) ¼ 3.87, p < .03], no
group differences in HRV or
HR
b
Key (2010) Examine effects of Three-armed RCT MM MM increases in trait Homogenous sample, with
mindfulness and (N ¼ 101) mindfulness [F(1,98) ¼ 8.47 possible intervention bias.
distraction on p ¼ .004], no significant
rumination and effects on stress
cardiovascular recovery [F(1,98) ¼ .33, p ¼ .569] or
after a stressor cardiovascular recovery;
induction, Examine MM HR [F(1,98) ¼ .16, p ¼ .692],
effects on psychological SBP [F(1,98) ¼ 1.48,
distress. p ¼ .227], DBP
[F(1,98) ¼ .001, p ¼ .977]
b
Leggett (2011) Examine effectiveness RCT repeated Mindful breathing Significant decreases in Potential for cross
of MM to decrease measures (N ¼ 85) blood pressure, systolic and contamination among
stress and depression, diastolic [F (1, 81) ¼ 6.557, intervention and control group.
while improving self- p ¼ .012; F (1, 81) ¼ 6.078, No physiological measures of
efficacy in clinical skills p ¼ .016] Increased trend in stress.
performance. mindfulness that did not
reach significance.
Lynch et al. Examine feasibility of A non-randomized Mindfulness-Based Salivary cortisol and alpha- Small, homogenous sample. No
(2011) c implementing MM into wait-list-controlled Coping with amylase levels were not randomization. Erratic sleep
college life (N ¼ 16) University Life significant patterns. Possible differences
(MBCUL) Significant decreases in between groups. High attrition.
stress (d ¼ 1.06; z ¼ 2.25,
p ¼ .03), anxiety (d ¼ 1.04;
z ¼ 2.14, p ¼ .03), and
increases in mindfulness
(d ¼ 1.06; z ¼ 1.89,
p ¼ .06). Negative
correlations between
change in mindfulness and
anxiety (rho ¼ .81,
p ¼ .01), and perceived
stress (rho ¼ .74, p ¼ .01).
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 15

Table 5 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Chen et al. (2012) Examine effects of MM RCT (N ¼ 60) MM Significant decrease in Small, homogeneous sample,
a
on stress, anxiety, and anxiety [F (1, influenced by Buddhism, no
systolic blood pressure 58) ¼ 25.42,P < .001, measures of mindfulness, no
h2 ¼ .31] HR was not social support in control group,
significant [F (1, 58) ¼ 1.49, short intervention period
p ¼ .228, h2 ¼ .03]
significant change in SBP [F
(1, 58) ¼ 4.73, p ¼ .034,
h2 ¼ .08], but not DBP [F (1,
58) ¼ 1.19, p ¼ .280,
h2 ¼ .02]
Shenesey (2013) Compare the effects of 3-arm randomized MM-Body Scan Significant decrease in state One time, one facet MM
a
MM, sham MM, and experimental [F (1, 107) 79.85, p < .000, intervention, PMR and Body
relaxation on condition (N ¼ 112) partial h2 ¼ .43] and trait [F scan are similar, no control
physiological stress and (1, 103) ¼ 24.35, p < .000, group, or mindfulness measure
anxiety partial h2 ¼ .1] anxiety in all
groups but no differences
between groups s [F (1,
59) ¼ .05, p ¼ .95, partial
h2 ¼ .00; F (2, 103) ¼ .03,
p ¼ .97, partial h2 ¼ .00], HR
[F (1, 107) ¼ 10.62, p ¼ .001,
partial h2 ¼ .09] and RR [F
(1, 98) ¼ 47.15, p < .000,
partial h2 ¼ .3] decreased in
all groups, no difference
between groups [F (2,
107) ¼ .52, p ¼ .598, partial
h2 ¼ .01; F(2, 98) ¼ 5.89,
p ¼ .799, partial h2 ¼ .01]
Turakitwanakan Examine effects MM on Single group, MM Significant decrease in Small, homogenous sample, no
et al. (2013) mental health and pretest/posttest serum cortisol levels randomization, control group,
serum cortisol (N ¼ 30) (p < .05) or mindfulness measures,
possible placebo effect.
Delgado-Pastor Compare two facets of 3-arm RCT (N ¼ 41) MM MIT had a significant in Small sample size, brief
et al. (2015) b MM; awareness (MIT) decreases in stress intervention period,
and attention (MCT) (F ¼ 7.843, p ¼ .009), HR homogenous, sample.
(p < .001), and HRV
(P < .009), and significant
increase in FMI mindfulness
measure F(2, 37) ¼ 4.16,
p < .024, h2p ¼ .183, not
MAAS mindfulness
measure F(2, 37) ¼ 3.32,
p < .152, h2p ¼ .09].
Significant differences
between MIT and control
on both mindfulness
measures (p < .01; p < .03).
MCT no significant change
in stress (p ¼ .1),
mindfulness, or HR, and
marginally significant in
HRV (p < .07). A significant
difference between MCT
and control on FMI (p < .03)
a
Outcomes stress and anxiety.
b
Outcomes stress and mindfulness.
c
Outcomes stress, anxiety, and mindfulness.

(p.348) were found in psychological well-being measures. This could be the result of: posttest anxiety scores collected during
midterms and finals (Bergen-Cico et al., 2013; Hassed et al., 2009), low pre-intervention anxiety scores (Paholpak at al., 2012),
or self-selection (Roberts-Wolfe et al., 2012). Roberts-Wolfe et al. (2012) reported that participants self-selected into the MM
group, which could have attracted those with higher levels of distress motivated to seek treatment. The intervention was
embedded in a 12-week didactic course, which may have affected the delivery or dose and resulted in marginal decreases in
anxiety (Roberts-Wolfe et al., 2012). Goodman et al. (2014) examined the effects of MM on collegiate athletes and as a control
16 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 6
MM and anxiety.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Greene & Compare effects of MM and
Hiebert cognitive training on self-
(1988) observation and psychological
wellbeing
Deckro et al. Examine effects of a mind/body
a
(2002) intervention on psychological
distress
Tang et al. Examine short term effects of
(2007) a MM on attention and self-
regulation
Kang et al. Examine effects of a mindful-
(2009) a based coping intervention on
stress, anxiety and depression.
Hassed et al. Examine effects of a
(2009) mindfulness-based program on
the psychological distress and
quality of life
Sears & Examine relationships between
Kraus MM and cognitive distortions,
(2009) coping styles, anxiety, negative
affect, positive affect, and hope
Cohen & Examine effects of MM with at
Miller risk for occupational stress and
c
(2009) examine the feasibility of MBSR
in relational awareness
Zeidan et al. Examine differences on mood
(2010) a and cardiovascular measures
between MM and sham MM.
Delgado et al. Examine response to
(2010) a psychological and physiological
measures to mindfulness-based
program on high levels of worry
Randomized Cognitive Significant decreases in anxiety Small sample size, no assessment
comparison Restructuring in both groups (p < .01), which of mindfulness or physiological
(N ¼ 24) MM were equally effective. stress markers, possible placebo
effects, no control group
RCT- waitlist- Mind/Body with Significant decreases in state Homogenous self-selected
control MM, cognitive anxiety (p ¼ .001), trait anxiety sample, high attrition, low
(N ¼ 128) behavioral and (p ¼ 0017), and stress (p ¼ .008) adherence, wide age range, no
relaxation control of health conditions/
response skills stress level, no assessment of
mindfulness or physiological
stress markers
RCT (N ¼ 80) Integrative Significant differences in tension Homogenous sample, possible
mind-body eanxiety [F(1,78) ¼ 11.920; placebo effects. Cultural
training (IMBT) P < .01], and salivary cortisol differences, no assessment of
after a math stress task mindfulness
[F(1,38) ¼ 6.281; P < .01]
RCT (N ¼ 41) MM Significant decreases in stress Small, homogenous sample.
(F ¼ 6.145, p ¼ .02), and anxiety Groups were not equal prior to
(F ¼ 6.985, p ¼ .013) intervention. No assessment of
mindfulness or physiological
markers of stress.
Quasi Mindfulness- Significant decreases in GSI No control group, low T2 report
experimental, based stress [F(1,147) ¼ 9.98, p ¼ .00, rates, no measures of
pretest/post-test management, h2 ¼ .06, b - 1 ¼ .88] anxiety mindfulness, adherence,
(N ¼ 148) cognitive subscale was not significant
therapy, and (p ¼ .11) but had a downward
self- trend
examination.
42 Brief Meditation- The longer meditation group had Small, non-randomized, self-
nonrandomized Attention, greater decreases in anxiety selected sample, different length
cohort- Brief Meditation- [F(3,52) ¼ 3.35, p ¼ .03, intervention sessions across
controlled Loving Kindness, h2 ¼ .162, shorter meditation groups, no measures of
(N ¼ 57) Longer sessions had downward non- mindfulness
Meditation- significant trends
Attentional and
Loving Kindness
Quasi- Interpersonal Significant increases in No control group, small sample
experimental Mindfulness Mindfulness (F ¼ 10.037, size, possible effects of group
pretest/posttest Training (IMT) p ¼ .005), decreases in stress and membership. No physiological
(N ¼ 21) anxiety measures of stress.
(F ¼ 14.957, p ¼ .001; F ¼ 5.733,
P ¼ .0127)
3 Armed RCT MM STAI-State showed 3-way effect Homogenous healthy sample,
(N ¼ 82) Sham MM was significant [F (4,150) ¼ 2.98, brief mindfulness intervention,
Control p ¼ .02, h2 ¼ .07]; no change in possible experimenter bias,
control group, Significant baseline group differences in BP,
decreases in anxiety in sham and anxiety, and HR.
MM groups. All groups had
significant decreases in HR with
the strongest effect for MM
[F(1,28) ¼ 29.87, p < .01,
h2 ¼ .52], sham mindfulness,
[F(1,26) ¼ 14.87, p < .01,
h2 ¼ .36], and controls,
[F(1,25) ¼ 7.64, p ¼ .01,
h2 ¼ .23]. There were no
significant differences between
groups on blood pressure.
RCT active- MM and Significant decreases in both No non-treatment control group,
control (N ¼ 32) Relaxation groups in trait anxiety small homogenous sample, no
Training [F(1,26) ¼ 8.72, p < .008], MM follow-up, possible
had lower RR compared to experimenter bias.
relaxation group [F(1, 27) ¼ 4.59,
p < .04] and significantly longer
expiratory [F(1,27) ¼ 4.63,
p < .04] and inspiratory periods
[F(2,26) ¼ 3.87, p < .03], no
group differences in HRV or HR
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 17

Table 6 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Warnecke Examine effects of MM on stress Single-blinded Guided MM Significant decreases in stress on Small homogenous sample, no
et al. RCT, with PSS and subscale of DASS measures of mindfulness or
(2011) a intention to (p < .05; p ¼ .05) and anxiety physiological stress, possible
treat. (N ¼ 66) (p < .05). 16 week follow-up issues with adherence, short
showed no significant changes in follow-up
stress or anxiety
Silverstein Examine effects of MM on Nonrandomized MM Significant improvement in Small homogenous, self-
et al. barriers to healthy sexual controlled mindfulness (t ¼ 3.00, df ¼ 11, selected, sample. Anxiety not
(2011) b functioning, attention, self- pretest/post-test p ¼ .01), and FFMQ-total score primary research question.
judgment, and clinical (N ¼ 44) (t ¼ 4.42, df ¼ 11, p ¼ .001),
symptoms. Significant decrease in anxiety
(t ¼ -03.17, df ¼ 11, p ¼ .009)
Lynch et al. Examine feasibility of A non- Mindfulness- Salivary cortisol and alpha- Small, homogenous sample. No
(2011) c implementing MM into college randomized Based Coping amylase levels were not randomization. Erratic sleep
life wait-list- with University significant patterns. Possible differences
controlled Life (MBCUL) Significant decreases in stress between groups. High attrition.
(N ¼ 16) (d ¼ 1.06; z ¼ 2.25, p ¼ .03),
anxiety (d ¼ 1.04; z ¼ 2.14,
p ¼ .03), and increases in
mindfulness (d ¼ 1.06;
z ¼ 1.89, p ¼ .06). Negative
correlations between change in
mindfulness and anxiety
(rho ¼ .81, p ¼ .01), and
perceived stress (rho ¼ .74,
p ¼ .01).
Paholpak Examine effects of a short-term RCT (N ¼ 58) MM Reductions in anxiety (t ¼ .09, Short intervention period,
et al. mindful awareness breathing p ¼ .929) but did not reach significant pre-intervention
(2012) meditation on stress, memory significance. between group differences,
function, intelligence and shorted intervention.
academic achievement. Homogenous Buddhist sample,
no measure of mindfulness.
Roberts- Examine effects of mindfulness Quasi- MM Non-significant trends in Small homogenous sample. No
Wolfe training on memory, physical experimental, Controls (increase) [t (22) ¼ .142, randomization or mindfulness
et al. and psychological well-being. pretest/posttest p ¼ .17] and MM (decrease) measure, possible selection
(2012) with active [t(34) ¼ 1.019, p ¼ .315] in MASQ placebo effect.
control (N ¼ 58) scores
Yamada & Examine viability/effects of brief Quasi- MM adapted Significant changes in state Abbreviated intervention, small
Victor MM in academics and experimental, from MBSR anxiety [F(1,55) ¼ 5.61, p < .05] sample, no randomization, more
(2012) c psychological well-being controlled and FMI [F(1,36) ¼ 9.445, males in the MM group
(N ¼ 60) p < .01]. Not significant for stress
(p ¼ .287), trait anxiety
(p ¼ .157), or MAAs mindfulness
(p ¼ .503)
Gockel et al. Examine a brief MM training on Mixed-methods. MM adapted Significant between group No randomization, possible
(2013) b anxiety, rumination self- Nonrandomized from MBSR differences in mindfulness on trainer bias, abbreviated
compassion, empathy, cohort control FMI at follow up (t ¼ 2.16, intervention.
mindfulness, counseling, and (N ¼ 132) p ¼ .034) but not the MAAS. No
self-efficacy, developing significant between group
counseling skills, classroom differences in state anxiety, no
outcomes and learning. statistics reported.
Kim et al. Examine effects of Kouk Sun Do Mixed Methods; Kouk Sun Do Significant decreases in trait Small, homogenous sample, high
(2012) on anxiety. RCT waitlist- anxiety [F(1, 16) ¼ 7.86, p < .013, attrition, self-report measures,
control (N ¼ 30) hp ¼ .33, G ¼ .70] and decreased no mindfulness measures.
2

and grounded over time [F(1, 16) ¼ 11.24,

theory p < .01, h2p ¼ .41].
Chen et al. Examine effects of MM on stress, RCT (N ¼ 60) MM Significant decrease in anxiety [F Small, homogeneous sample,
(2012) b anxiety, and systolic blood (1, 58) ¼ 25.42,P < .001, h2 ¼ .31] influenced by Buddhism, no
pressure HR was not significant [F (1, measures of mindfulness, no
58) ¼ 1.49, p ¼ .228, h2 ¼ .03] social support in control group,
significant change in SBP [F (1, short intervention period
58) ¼ 4.73, p ¼ .034, h2 ¼ .08],
but not DBP [F (1, 58) ¼ 1.19,
p ¼ .280, h2 ¼ .02]
Bergen-Cico Examine psychological benefits Quasi- 5 week MBSR. Significant increases in No randomization, abbreviated
et al. of a brief MBSR. experimental mindfulness on the KIMS intervention, possible placebo
(2013) b pretest/post-test (p < .001) and the PHLM effects.
(N ¼ 119) (p¼<.001). Trait anxiety trended
downward but not significant
(p ¼ .10)
(continued on next page)
18 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 6 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Byrne, Bond Compare MM with interpersonal 3 arm quasi- MM Significant decrease in anxiety [ No randomization, self-report
& London process and control with effects experimental t(45) ¼ 9.29, p < .001] and measures, HW required of MM
(2013) b on anxiety (N ¼ 112) increase in mindfulness [t(45) ¼ group.
5.21, p < .001], remained
significant at 6 months: anxiety
[t(45) ¼ 8.75, p
<.001], mindfulness
[t(45) ¼ 3.01, p < .003. Greater
increases in mindfulness was
associated with greater
decreases in anxiety [R ¼ .06, F(1,
112) ¼ 4.25, p < .05]
Van Gordon Examine the benefits and Quasi- MAT. Significant decreases in both Small sample, no randomization,
et al. feasibility of MAT experimental anxiety and stress subscales of possible placebo effects, no
(2013) c case controlled the DASS F(1,20) ¼ 17.53, physiological stress markers
(N ¼ 25) p < .001, h2 ¼ .47) and
significant increases in
mindfulness(F(1,20) ¼ 23.83,
p < .001)
Call et al. Examine effects of aspects of 3 arm RCT MBSR-based Hatha yoga group and body scan Homogeneous sample, no
a
(2013) MBSR on stress and anxiety waitlist-control hatha yoga groups had significant decreases physiological stress markers, no
(N ¼ 91) MBSR-based in anxiety [F(1,87) ¼ 12.15, control of physical activity,
body scan p < .001; F(1,87) ¼ 6.86, p < .01] significant pre-intervention
and stress [F(1,87) ¼ 5.30, group differences, limited
p < .05; F(1,87) ¼ 5.72, p < .05]. mindfulness education and
No significant differences intervention.
between experimental
conditions.
Gallego et al. Compare effects of MM and 3-arm MBCT Stress was significantly Small sample size, no
(2014) a exercise on depression, stress, randomized decreased (t ¼ 2.953, mindfulness measure
and anxiety comparison- p ¼ .006 d ¼ .667), no
control significance, downward trend for
anxiety t ¼ (.715,p ¼ .480,
d ¼ .318), significance between
MM and control in both stress
(F ¼ 3.519, p ¼ .033, h2 ¼ .066)
and anxiety (F ¼ 5,402, p ¼ .006,
h2 ¼ .098)
Hindman, Compare the effects of formal 3-arm Quasi- Mindful Stress Both MSM-formal and MSM- Partial randomization
(2013) c MM, brief informal MM, and experimental Management Informal had significant decrease Self-report measures
control on mindfulness, stress, with waitlist (MSM)-Formal in stress (p < .01, P < .05) and Small homogenous sample
and anxiety control (N ¼ 34) and MSM- increases in FFMQ mindfulness
Informal measure (p < .001, p < .05), the
MSM-formal had significant
decreases in anxiety (p < .01)
and increase in MAAS
mindfulness measure (p < .01),
the MSM-informal were not
significant in MAAS and anxiety
measures. Moderate effect size
between MSM-formal and MSM-
informal, and large effect sizes
between MSM-Formal and
control.
McClintock & Examine the efficacy of brief MM RCT (N ¼ 70) Brief MM MM had significant decreases in Homogeneous sample, brief
Anderson on affect and interpersonal state anxiety after MM [b ¼ .24, intervention, all self-report
(2013) dependency t(67) ¼ 2.63, p < .05] than the measures
distraction group.
O'Brien Examine effects of MM mixed Quasi- MM with humor Significant decreases in state No randomization, possible
(2013) b with humor on anxiety in a experimental, (F ¼ 31.18, p < .0001) and trait placebo effect. Homogenous
clinical setting non-randomized (F20.477, p,.0001) anxiety and sample, self-report measures.
control (N ¼ 73) increases in mindfulness
(F ¼ 29.667, p < .001)
Shenesey, Compare the effects of MM, 3-arm MM-Body Scan Significant decrease in state[F (1, One time, one facet MM
(2013) a sham MM, and relaxation on randomized 107) 79.85, p < .000, partial intervention, PMR and Body scan
physiological stress and anxiety experimental h2 ¼ .43] and trait [F (1, are similar, no control group
condition 103) ¼ 24.35, p < .000, partial
(N ¼ 112) h2 ¼ .1] anxiety in all groups but
no differences between groups s
[F (1, 59) ¼ .05, p ¼ .95, partial
h2 ¼ .00; F (2, 103) ¼ .03, p ¼ .97,
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 19

Table 6 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

partial h2 ¼ .00], HR [F (1,
107) ¼ 10.62, p ¼ .001, partial
h2 ¼ .09] and RR [F (1,
98) ¼ 47.15, p < .000, partial
h2 ¼ .3] decreased in all groups,
no difference between groups [F
(2, 107) ¼ .52, p ¼ .598, partial
h2 ¼ .01; F(2, 98) ¼ 5.89,
p ¼ .799, partial h2 ¼ .01]
Danitz & Examine the effects of a one- RCT- waitlist ABBT No significant differences Small homogenous sample, self-
Orsillo, time acceptance-based behavior control (N ¼ 90) between groups on anxiety [F(1, select (1st come assigned to
(2014) a therapy on psychological well- 43) ¼ .27, p ¼ .61, d ¼ .12] or intervention), one-time MM
being in first year college and stress [F(1, 43) ¼ .72, p ¼ .40, instruction.
law students d ¼ .22], those in the ABBT group
reported mild levels of stress
pre-intervention and normative
at 3 month f/u and moderate
anxiety pre-intervention and
mild at 3 month f/u.
Goodman Examine effects and feasibility of Quasi- MM Significant increase in Both groups physically active,
et al. a mindfulness intervention for experimental, mindfulness over time small sample size, no
(2014) c student athletes non-randomized [t(8) ¼ 2.88, p < .05, d ¼ .48] randomization, can't determine
control (N ¼ 26) and between groups [F(1, which component most
19) ¼ 4.55, p < .05] decrease in effective.
stress over time [t(8) ¼ 2.57,
p < .05, d ¼ .26], not significant in
anxiety with-in groups or
between groups.
Taylor, Examine effects of MBCT self- Single blinded MBCT-SH Significant differences between Healthy homogenous sample,
Strauss, help on anxiety and stress. RCT (N ¼ 79) groups in anxiety (F ¼ 4.01, waitlist control, no face-to-face
Cavanagh, p < .05), Stress (F ¼ 9.89, interaction
& Jones p < .001), and mindfulness
(2014) c (F ¼ 23.22, p < .001)
Glick & Compare effects acceptance- Randomized ABBT No significant decrease in trait One-time online MM
Orsillo based behavior therapies and comparison- anxiety (F ¼ .09, p ¼ .77) intervention
(2015) b time-management control Convenience sample, self-report
(N ¼ 118) measures, not delivered by a
trained individual
a
Outcomes stress and anxiety.
b
Outcomes anxiety and mindfulness.
c
Outcomes stress, anxiety, and mindfulness.

used students in intramural sports. Collegiate athletes have far greater demands on their schedules and performance; which
may have influenced the outcomes. Danitz and Orsillo (2014) stated that at follow-up those in the one-time MM intervention
group reported mild levels of anxiety, when pre-intervention they reported moderate levels of anxiety. Hindman (2013)
examined formal meditation with informal meditation and found that anxiety was significantly reduced with formal
meditation, but not informal. This may give some insight to the importance of dose and practice required to reduce anxiety.
Despite these limitations and nonsignificant findings, MM interventions decreased anxiety in 80% of the studies examined.
MM shows promise in decreasing anxiety in college students, but study limitations dampen confidence in this effect.

4.7. MM and mindfulness

Mindfulness was examined in only 16 studies. Twelve research teams reported significant increases in mindfulness scores
(See Table 7). Four research teams each used two of the three mindfulness measures: the Freiburg Mindfulness Inventory
(FMI) and the Mindful Attention Awareness Scale (MAAS), or the Five Facets Mindfulness Questionnaire (FFMQ). All four
research teams reported significant increases in either FMI or FFMQ and but not the MAAS (Delgado-Pastor et al., 2015; Gockel
et al., 2013; Hindman, 2013; Yamada & Victor, 2012). Hindman (2013) compared formal vs informal meditation and reported
that the formal meditation, which required more in-depth meditative practice and homework than the informal meditation,
had increased mindfulness score on both the MAAS and the FFMQ. He reported that informal meditation intervention had
significant increases in the FFMQ but not the MAAS. Delagdo-Pastor et al. (2015) examined and compared two facets of
mindfulness, awareness and attention, and reported that awareness had significant increases in the FMI, but not the MAAS
and the attention was not significant in either measure. The MAAS was developed for use with both trait and state
20 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 7
MM and mindfulness.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Cohen & Examine effects of MM with at risk Quasi- Interpersonal Significant increases in Mindfulness No control group, small
Miller for occupational stress and examine experimental Mindfulness (F ¼ 10.037, p ¼ .005), decreases in sample size, possible effects
c
(2009) the feasibility of MBSR in relational pretest/posttest Training (IMT) stress and anxiety of group membership. No
awareness (N ¼ 21) (F ¼ 14.957, p ¼ .001; F ¼ 5.733, physiological measures of
P ¼ .0127) stress.
a
Key (2010) Examine effects of mindfulness and Three-armed MM MM increases in trait mindfulness Homogenous sample, with
distraction on rumination and RCT (N ¼ 101) [F(1,98) ¼ 8.47 p ¼ .004], no possible intervention bias.
cardiovascular recovery after a significant effects on stress
stressor induction, Examine MM [F(1,98) ¼ .33, p ¼ .569] or
effects on psychological distress. cardiovascular recovery; HR
[F(1,98) ¼ .16, p ¼ .692], SBP
[F(1,98) ¼ 1.48, p ¼ .227], DBP
[F(1,98) ¼ .001, p ¼ .977]
Leggett Examine effectiveness of MM to RCT repeated Mindful Significant decreases in blood Potential for cross
a
(2011) decrease stress and depression, measures breathing pressure, systolic and diastolic [F (1, contamination among
while improving self-efficacy in (N ¼ 85) 81) ¼ 6.557, p ¼ .012; F (1, intervention and control
clinical skills performance. 81) ¼ 6.078, p ¼ .016] Increased group. No physiological
trend in mindfulness that did not measures of stress.
reach significance.
Silverstein Examine effects of MM on barriers to Nonrandomized MM Significant improvement in Small homogenous, self-
et al. healthy sexual functioning, controlled mindfulness (t ¼ 3.00, df ¼ 11, selected, sample. Anxiety
(2011) b attention, self-judgment, and pretest/post-test p ¼ .01), and FFMQ-total score not primary research
clinical symptoms. (N ¼ 44) (t ¼ 4.42, df ¼ 11, p ¼ .001), question.
Significant decrease in anxiety (t ¼ -
03.17, df ¼ 11, p ¼ .009)
Lynch et al. Examine feasibility of implementing A non- Mindfulness- Salivary cortisol and alpha-amylase Small, homogenous sample.
(2011) c MM into college life randomized Based Coping levels were not significant No randomization. Erratic
wait-list- with Significant decreases in stress sleep patterns. Possible
controlled University Life (d ¼ 1.06; z ¼ 2.25, p ¼ .03), differences between groups.
(N ¼ 16) (MBCUL) anxiety (d ¼ 1.04; z ¼ 2.14, High attrition.
p ¼ .03), and increases in
mindfulness (d ¼ 1.06; z ¼ 1.89,
p ¼ .06). Negative correlations
between change in mindfulness and
anxiety (rho ¼ .81, p ¼ .01), and
perceived stress (rho ¼ .74,
p ¼ .01).
Yamada, Examine viability/effects of brief Quasi- MM adapted Significant changes in state anxiety Abbreviated intervention,
Victor MM in academics and psychological experimental, from MBSR [F(1,55) ¼ 5.61, p < .05] and FMI small sample, no
c
(2012) well-being controlled [F(1,36) ¼ 9.445, p < .01]. Not randomization, more males
(N ¼ 60) significant for stress (p ¼ .287), trait in the MM group
anxiety (p ¼ .157), or MAAs
mindfulness (p ¼ .503)
Gockel et al. Examine a brief MM training on Mixed-methods. MM adapted Significant between group No randomization, possible
(2013) b anxiety, rumination self- Nonrandomized from MBSR differences in mindfulness on FMI at trainer bias, abbreviated
compassion, empathy, mindfulness, cohort control follow up (t ¼ 2.16, p ¼ .034) but not intervention.
counseling, and self-efficacy, (N ¼ 132) the MAAS. No significant between
developing counseling skills, group differences in state anxiety,
classroom outcomes and learning. no statistics reported.
Bergen-Cico Examine psychological benefits of a Quasi- 5 week MBSR. Significant increases in mindfulness No randomization,
et al. brief MBSR. experimental on the KIMS (p < .001) and the abbreviated intervention,
(2013) b pretest/post-test PHLM (p¼<.001). Trait anxiety possible placebo effects.
(N ¼ 119) trended downward but not
significant (p ¼ .10)
Byrne, Bond Compare MM with interpersonal 3 arm quasi- MM Significant decrease in anxiety [ No randomization, self-
& London process and control with effects on experimental t(45) ¼ 9.29, p < .001] and increase report measures, HW
(2013) b anxiety (N ¼ 112) in mindfulness [t(45) ¼ required of MM group.
5.21, p < .001], remained significant
at 6 months: anxiety [t(45) ¼ 8.75, p
<.001], mindfulness [t(45) ¼ 3.01,
p < .003. Greater increases in
mindfulness was associated with
greater decreases in anxiety [R ¼ .06,
F(1, 112) ¼ 4.25, p < .05]
Van Gordon Examine the benefits and feasibility Quasi- MAT. Significant decreases in both anxiety Small sample, no
et al. of MAT experimental and stress subscales of the DASS randomization, possible
(2013) c case controlled F(1,20) ¼ 17.53, p < .001, h2 ¼ .47) placebo effects, no
(N ¼ 25) and significant increases in physiological stress markers
mindfulness(F(1,20) ¼ 23.83,
p < .001)
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 21

Table 7 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Hindman, Compare the effects of formal MM, 3-arm Quasi- Mindful Stress Both MSM-formal and MSM- Partial randomization
(2013) c brief informal MM, and control on experimental Management Informal had significant decrease in Self-report measures
mindfulness, stress, and anxiety with waitlist (MSM)-Formal stress (p < .01, P < .05) and increases Small homogenous sample
control (N ¼ 34) and MSM- in FFMQ mindfulness measure
Informal (p < .001, p < .05), the MSM-formal
had significant decreases in anxiety
(p < .01) and increase in MAAS
mindfulness measure (p < .01), the
MSM-informal were not significant
in MAAS and anxiety measures.
Moderate effect size between MSM-
formal and MSM-informal, and large
effect sizes between MSM-Formal
and control.
O'Brien Examine effects of MM mixed with Quasi- MM with Significant decreases in state No randomization, possible
b
(2013) humor on anxiety in a clinical experimental, humor (F ¼ 31.18, p < .0001) and trait placebo effect. Homogenous
setting non-randomized (F20.477, p,.0001) anxiety and sample, self-report
control (N ¼ 73) increases in mindfulness measures.
(F ¼ 29.667, p < .001)
Goodman Examine effects and feasibility of a Quasi- MM Significant increase in mindfulness Both groups physically
et al. mindfulness intervention for experimental, over time [t(8) ¼ 2.88, p < .05, active, small sample size, no
(2014) c student athletes non-randomized d ¼ .48] and between groups [F(1, randomization, can't
control (N ¼ 26) 19) ¼ 4.55, p < .05] decrease in determine which
stress over time [t(8) ¼ 2.57, p < .05, component most effective.
d ¼ .26], not significant in anxiety
with-in groups or between groups.
Greeson et al. Examine effects of Koru in college RCT (N ¼ 99) Koru Significant decrease in stress (group Self-report measures,
(2014) a students on stress x time) [F[1, 76.40] ¼ 4.50,p ¼ .037, Homogenous sample
d ¼ .45) and increase in mindfulness no midpoint assessment
[F [1,79.09 ¼ 26.80, p < .001, d ¼ .95]
Taylor, Examine effects of MBCT self-help Single blinded MBCT-SH Significant differences between Healthy homogenous
Strauss, on anxiety and stress. RCT (N ¼ 79) groups in anxiety (F ¼ 4.01, p < .05), sample, waitlist control, no
Cavanagh, Stress (F ¼ 9.89, p < .001), and face-to-face interaction
& Jones, mindfulness (F ¼ 23.22, p < .001)
(2014) c
Delgado- Compare two facets of MM; 3-arm RCT MM MIT had a significant in decreases in Small sample size, brief
Pastor awareness (MIT) and attention (N ¼ 41) stress (F ¼ 7.843, p ¼ .009), HR intervention period,
et al. (MCT) (p < .001), and HRV (P < .009), and homogenous, sample.
(2015) a significant increase in FMI
mindfulness measure F(2,
37) ¼ 4.16, p < .024, h2p ¼ .183, not
MAAS mindfulness measure F(2, 37)
¼ 3.32, p < .152, h2p ¼ .09].
Significant differences between MIT
and control on both mindfulness
measures (p < .01; p < .03). MCT no
significant change in stress (p ¼ .1),
mindfulness, or HR, and marginally
significant in HRV (p < .07). A
significant difference between MCT
and control on FMI (p < .03)
a
Outcomes stress and mindfulness.
b
Outcomes anxiety, and mindfulness.
c
Outcomes anxiety, stress, and mindfulness.

mindfulness (Brown & Ryan, 2003). However, it has gained popularity in measuring trait mindfulness. Future researchers
should assess both state and trait mindfulness to determine the effects of MM (see Table 7).
Leggett (2011) also reported a nonsignificant increase in MAAS scores after a 3-session MM intervention. While MAAS
sensitivity might be an issue, three session of MM may be too small of a dose to improve overall mindfulness.
In the 15 studies that researchers reported improved mindfulness scores, twelve had significant decreases in stress and/or
anxiety in at least one measure (Byrne et al., 2013; Cohen & Miller, 2009; Delgado-Pastor et al., 2015; Goodman et al., 2014;
Greeson, Juberg, Maytan, James, & Rogers, 2014; Hindman, 2013; Lynch et al., 2011; O'Brien, 2013; Silverstein, Brown, Roth, &
Britton, 2011; Taylor, Strauss, & Cavanagh, 2014; Van Gordon, Shonin, Sumich, Sundin, & Griffiths, 2013; Yamada & Victor,
2012). One had a downward trend in anxiety (Bergen-Cico et al., 2013), and the remaining two showed no significant ef-
fects (Gockel et al., 2013; Key, 2010). Further research is needed to examine MM effects on mindfulness and specifically, the
differing effects on state versus trait mindfulness and how these constructs relate to decreasing stress and anxiety.
22 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 8
All included studies.

Citation Purpose Design/Sample Intervention Outcomes Limitations

Greene & Compare effects of MM and
Hiebert cognitive training on self-
(1988) observation and psychological
wellbeing
Astin (1997) Examine effects of mindfulness
meditation on stress
Shapiro, Examine effects of MBSR on
Schwartz & psychological well-being,
Bonner (1998) empathy and spiritual
experience
Deckro et al. Examine effects of a mind/body
(2002) intervention on psychological
distress
Rosenzweig Examine effects of MBSR on
et al. (2003) psychological wellbeing
Beddoe & Examine effects of MBSR on
Murphy stress and empathy.
(2004)
Hoffmann Gurka Examine effects of MM on stress
(2006) and if cue reminders result in
higher rates of practice.
Tang et al. Examine short term effects of
(2007) MM on attention and self-
regulation
Jain et al. (2007) Compare effects MM and
somatic relaxation training
(SR).
Shapiro et al. Examine effects of MBSR on
(2007) psychological distress
Oman et al. Examine effects of and
(2008) comparison to MBSR and EPP
on the management of stress
Kang et al. Examine effects of a mindful-
(2009) based coping intervention on
stress, anxiety and depression.
Randomized Cognitive Significant decreases in anxiety Small sample size, no
comparison Restructuring in both groups (p < .01), which assessment of mindfulness or
(N ¼ 24) MM were equally effective. physiological stress markers,
possible placebo effects, no
control group
RCT (N ¼ 28) MBSR Significant decreases in anxiety, Small homogenous sample, no
[F(2,16) ¼ 7.05, p < .02] assessment of mindfulness,
possible experimenter or
placebo effects.
RCT- Matched, MBSR Significant decreases in state Homogenous population,
waitlist-control anxiety [F(1, 69) ¼ 4.11, possible experimenter or
(N ¼ 78) p < .05], trait anxiety [F(1, 69), placebo effects, no assessment
p < .002], and GSI [F(1, of long term effects,
69) ¼ 6.62, p < .02], mindfulness, no comparison
group.
RCT- waitlist- Mind/Body with Significant decreases in state Homogenous self-selected
control MM, cognitive anxiety (p ¼ .001), trait anxiety sample, high attrition, low
(N ¼ 128) behavioral and (p ¼ 0017), and stress (p ¼ .008) adherence, wide age range, no
relaxation control of health conditions/
response skills stress level, no assessment of
mindfulness or physiological
stress markers
Quasi- MBSR Significant decreases in No randomization,
experimental tension-anxiety (p < .009) and homogenous sample, no
nonrandomized vigor-anxiety (p < .006) assessment of mindfulness,
cohort- single instrumentation.
controlled
(N ¼ 302)
Quasi- MBSR Significant changes in Anxiety Small self-selected
experimental (p < .05). Downward, not homogenous sample, no control
pretest/posttest significant, trends in stress group, assessment of
(N ¼ 16) mindfulness, or physiological
stress markers, high attrition
RCT waitlist- MM Significant decreases in stress Homogenous sample, possible
control [F(2,68) ¼ 5.70, p < .01, experimenter effects, use of
(N ¼ 123) h2 ¼ .04] self-report measures, high
attrition and low adherence. No
assessment of mindfulness or
physiological stress markers.
RCT (N ¼ 80) Integrative Significant differences in Homogenous sample, possible
mind-body tensioneanxiety placebo effects. Cultural
training (IMBT) [F(1,78) ¼ 11.920; P < .01], and differences, no assessment of
salivary cortisol after a math mindfulness
stress task [F(1,38) ¼ 6.281;
P < .01]
Three-armed MM SR and MM both had significant Self-selected samples, short
RCT (N ¼ 83) Somatic decreases in BSI compared intervention period, group
relaxation (SR) (p ¼ .01; p ¼ .002) no effects present in both
differences between the MM interventions. Post-test
and SR groups (p ¼ .93) collection timing, homogenous
sample, no assessment of
mindfulness.
Non- MBSR Significant decreases in STAI No randomization, small,
randomized anxiety, present moment homogenous self-selected
cohort- (p ¼ .0005) STAI anxiety, past sample, possible motivational
controlled month (p ¼ .0002) PSS differences, no physiological
(N ¼ 54) perceived stress (p ¼ .0001) and stress markers.
increases in MAAS (p ¼ .006)
3 arm RCT MBSR and No significant differences Small, homogenous sample, no
(N ¼ 44) EPP between MBSR and EPP. assessment of mindfulness or
Intervention groups had a physiological stress markers.
significant decrease in stress
(p < .05) at follow up but not
immediately posttest.
RCT (N ¼ 41) MM Significant decreases in stress Small, homogenous sample.
(F ¼ 6.145, p ¼ .02), and anxiety Groups were not equal prior to
(F ¼ 6.985, p ¼ .013) intervention. No assessment of
mindfulness or physiological
markers of stress.
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 23

Table 8 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Blevins (2009) Examine effects of a MM on RCT (N ¼ 41) MBSR and Significant changes state [F (2, Small, homogenous sample.
body image satisfaction, self- traditional 20) ¼ 21.59, p < .001, h2 ¼ .68] High attrition, adherence, single
esteem, depressive symptoms, strategies for and trait anxiety, [F (2, mindfulness questionnaire,
anxiety, binge eating, and weight loss 20) ¼ 6.75, p ¼ .006, h2 ¼ .40], limited number of meditation
weight. and total anxiety at follow-up sessions.
(p < .008).
Hassed et al. Examine effects of a Quasi Mindfulness- Significant decreases in GSI No control group, low T2 report
(2009) mindfulness-based program on experimental, based stress [F(1,147) ¼ 9.98, p ¼ .00, rates, no measures of
the psychological distress and management,
pretest/post-test h2 ¼ .06, b - 1 ¼ .88] anxiety mindfulness, adherence,
quality of life (N ¼ 148) cognitive subscale was not significant
therapy, and (p ¼ .11) but had a downward
self- trend
examination.
Sears & Kraus Examine relationships between 4  2 Brief The longer meditation group Small, non-randomized, self-
(2009) MM and cognitive distortions, nonrandomized Meditation- had greater decreases in selected sample, different
coping styles, anxiety, negative cohort- Attention, anxiety [F(3,52) ¼ 3.35, p ¼ .03, length intervention sessions
affect, positive affect, and hope controlled Brief h2 ¼ .162, shorter meditation across groups, no measures of
(N ¼ 57) Meditation- sessions had downward non- mindfulness
Loving significant trends
Kindness,
Longer
Meditation-
Attentional and
Loving Kindness
Cohen & Miller Examine effects of MM with at Quasi- Interpersonal Significant increases in No control group, small sample
(2009) risk for occupational stress and experimental Mindfulness Mindfulness (F ¼ 10.037, size, possible effects of group
examine the feasibility of MBSR pretest/posttest Training (IMT) p ¼ .005), decreases in stress membership. No physiological
in relational awareness (N ¼ 21) and anxiety measures of stress.
(F ¼ 14.957, p ¼ .001; F ¼ 5.733,
P ¼ .0127)
Zeidan et al. Examine differences on mood 3 Armed RCT MM STAI-State showed 3-way effect Homogenous healthy sample,
(2010) and cardiovascular measures (N ¼ 82) Sham MM was significant [F brief mindfulness intervention,
between MM and sham MM. Control (4,150) ¼ 2.98, p ¼ .02, possible experimenter bias,
h2 ¼ .07]; no change in control baseline group differences in
group, Significant decreases in BP, anxiety, and HR.
anxiety in sham and MM
groups. All groups had
significant decreases in HR with
the strongest effect for MM
[F(1,28) ¼ 29.87, p < .01,
h2 ¼ .52], sham mindfulness,
[F(1,26) ¼ 14.87, p < .01,
h2 ¼ .36], and controls,
[F(1,25) ¼ 7.64, p ¼ .01,
h2 ¼ .23]. There were no
significant differences between
groups on blood pressure.
Newsome Examine effects of a A quasi- MBSR Significant decrease in stress No physiological stress
(2010) mindfulness course on stress, experimental [F(3,90) ¼ 26.14, p < .001, measures or control group,
mindfulness and self- repeated h ¼ .47], and increase in possible adherence problems,
compassion measures mindfulness [F(3,90) ¼ 19.57, small homogenous, self-
(N ¼ 31) p < .001, h ¼ .40] selected sample.
Delgado et al. Examine response to RCT active- MM and Significant decreases in both No non-treatment control
(2010) psychological and physiological control (N ¼ 32) Relaxation groups in trait anxiety group, small homogenous
measures to mindfulness-based Training [F(1,26) ¼ 8.72, p < .008], MM sample, no follow-up, possible
program on high levels of worry had lower RR compared to experimenter bias.
relaxation group [F(1,
27) ¼ 4.59, p < .04] and
significantly longer expiratory
[F(1,27) ¼ 4.63, p < .04] and
inspiratory periods
[F(2,26) ¼ 3.87, p < .03], no
group differences in HRV or HR
Key (2010) Examine effects of mindfulness Three-armed MM MM increases in trait Homogenous sample, with
and distraction on rumination RCT (N ¼ 101) mindfulness [F(1,98) ¼ 8.47 possible intervention bias.
and cardiovascular recovery p ¼ .004], no significant effects
after a stressor induction, on stress [F(1,98) ¼ .33,
Examine MM effects on p ¼ .569] or cardiovascular
psychological distress. recovery; HR [F(1,98) ¼ .16,
p ¼ .692], SBP [F(1,98) ¼ 1.48,
(continued on next page)
24 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 8 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

p ¼ .227], DBP [F(1,98) ¼ .001,
p ¼ .977]
Shapiro et al. Examine for whom (MBSR) is RCT (N ¼ 30) MBSR Significant increases in Small homogenous sample, no
(2011) most effective between high mindfulness (p < .05) No physiological measures of
levels of pre-treatment trait significant changes in stress. stress.
mindfulness and low levels of Those with higher levels of trait
trait mindfulness. mindfulness had significant
decreases in stress (p < .04) and
increases in mindfulness
(p < .01), at one year follow-up
had significant increases in
mindfulness (p < .01) and stress
(p < .04)
Leggett (2011) Examine effectiveness of MM to RCT repeated Mindful Significant decreases in blood Potential for cross
decrease stress and depression, measures breathing pressure, systolic and diastolic contamination among
while improving self-efficacy in (N ¼ 85) [F (1, 81) ¼ 6.557, p ¼ .012; F (1, intervention and control group.
clinical skills performance. 81) ¼ 6.078, p ¼ .016] Increased No physiological measures of
trend in mindfulness that did stress.
not reach significance.
Warnecke et al. Examine effects of MM on stress Single-blinded Guided MM Significant decreases in stress Small homogenous sample, no
(2011) RCT, with on PSS and subscale of DASS measures of mindfulness or
intention to (p < .05; p ¼ .05) and anxiety physiological stress, possible
treat. (N ¼ 66) (p < .05). 16 week follow-up issues with adherence, short
showed no significant changes follow-up
in stress or anxiety
Myint et al. Examine effects of a brief MM Three-armed MM Significant decreases in DASS- Small homogenous sample, no
(2011) intervention on physiological non-randomized Stress in meditating, no exam measures of mindfulness, short
well-being of students controlled group (p < .05), Meditating- meditation experience.
preparing to take an exam. (N ¼ 18) Exam group and no meditation
exam group had no significant
changes in the DASS-Stress. No
significant outcomes for the
physiological measures in any
group.
Silverstein et al. Examine effects of MM on Nonrandomized MM Significant improvement in Small homogenous, self-
(2011) barriers to healthy sexual controlled mindfulness (t ¼ 3.00, df ¼ 11, selected, sample. Anxiety not
functioning, attention, self- pretest/post-test p ¼ .01), and FFMQ-total score primary research question.
judgment, and clinical (N ¼ 44) (t ¼ 4.42, df ¼ 11, p ¼ .001),
symptoms. Significant decrease in anxiety
(t ¼ -03.17, df ¼ 11, p ¼ .009)
Lynch et al. Examine feasibility of A non- Mindfulness- Salivary cortisol and alpha- Small, homogenous sample. No
(2011) implementing MM into college randomized Based Coping amylase levels were not randomization. Erratic sleep
life wait-list- with University significant patterns. Possible differences
controlled Life (MBCUL) Significant decreases in stress between groups. High attrition.
(N ¼ 16) (d ¼ 1.06; z ¼ 2.25, p ¼ .03),
anxiety (d ¼ 1.04; z ¼ 2.14,
p ¼ .03), and increases in
mindfulness (d ¼ 1.06;
z ¼ 1.89, p ¼ .06). Negative
correlations between change in
mindfulness and anxiety
(rho ¼ .81, p ¼ .01), and
perceived stress (rho ¼ .74,
p ¼ .01).
Schwarze (2012) Examine effectiveness of a AB single- MBCT Reductions in PSS scores in all Small, single-subject design.
modified MBCT on stress and subject, five participants. Greater Possible motivated volunteers,
mindfulness repeated 5 reductions in some participants, shorted sessions, and one
times. (N ¼ 5) but more stable results with measure for each variable.
only minimal reductions in
others.
Paholpak et al. Examine effects of a short-term RCT (N ¼ 58) MM Reductions in anxiety (t ¼ .09, Short intervention period,
(2012) mindful awareness breathing p ¼ .929) but did not reach significant pre-intervention
meditation on stress, memory significance. between group differences,
function, intelligence and shorted intervention.
academic achievement. Homogenous Buddhist sample,
no measure of mindfulness.
Newsome et al. Examine effects of MBSR on Quasi- MBSR Significant reductions in stress Small, homogeneous sample, no
(2012) students entering the helping experimental, [F ¼ 26.14, df ¼ 3, p < .0001] No measure of physiological stress
professions. single group significant changes between markers. No control group or
pretest/posttest posttest and follow-up. randomization.
(N ¼ 31) Significant increases in
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 25

Table 8 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

mindfulness [F ¼ 19.57, df ¼ 3,
p < .0001], and between
posttest and follow-up
(p < .016).
Roberts-Wolfe Examine effects of mindfulness Quasi- MM Non-significant trends in Small homogenous sample. No
et al. (2012) training on memory, physical experimental, Controls (increase) [t randomization or mindfulness
and psychological well-being. pretest/posttest (22) ¼ .142, p ¼ .17] and MM measure, possible selection
with active (decrease) [t(34) ¼ 1.019, placebo effect.
control (N ¼ 58) p ¼ .315] in MASQ scores
Shapiro et al. Examine effects of MBSR on Quasi- MBSR Significant changes in Small homogenous sample, no
(2012) moral reasoning and decision experimental, mindfulness, anxiety, and randomization or control group.
making single group stress: FFMQ (p < .001), MAAS No physiological measures.
pretest/post-test (p < .05), STAI-S (p < .001),
(N ¼ 25) STAI-T (p < .005), and PSS
(p < .001). Significant changes
at follow-up in mindfulness
(p < .03) and stress (p < .001),
not anxiety (p > .06).
Yamada & Victor Examine viability/effects of Quasi- MM adapted Significant changes in state Abbreviated intervention, small
(2012) brief MM in academics and experimental, from MBSR anxiety [F(1,55) ¼ 5.61, p < .05] sample, no randomization,
psychological well-being controlled and FMI [F(1,36) ¼ 9.445, more males in the MM group
(N ¼ 60) p < .01]. Not significant for
stress (p ¼ .287), trait anxiety
(p ¼ .157), or MAAs
mindfulness (p ¼ .503)
Gockel et al. Examine a brief MM training on Mixed-methods. MM adapted Significant between group No randomization, possible
(2013) anxiety, rumination self- Nonrandomized from MBSR differences in mindfulness on trainer bias, abbreviated
compassion, empathy, cohort control FMI at follow up (t ¼ 2.16, intervention.
mindfulness, counseling, and (N ¼ 132) p ¼ .034) but not the MAAS. No
self-efficacy, developing significant between group
counseling skills, classroom differences in state anxiety, no
outcomes and learning. statistics reported.
Kim et al. (2012) Examine effects of Kouk Sun Do Mixed Methods; Kouk Sun Do Significant decreases in trait Small, homogenous sample,
on anxiety. RCT waitlist- anxiety [F(1, 16) ¼ 7.86, high attrition, self-report
control (N ¼ 30) p < .013, h2p ¼ .33, G ¼ .70] and measures, no mindfulness
and grounded decreased over time [F(1, measures.
theory 16) ¼ 11.24, p < .01, h2p ¼ .41].
Chen et al. Examine effects of MM on RCT (N ¼ 60) MM Significant decrease in anxiety Small, homogeneous sample,
(2012) stress, anxiety, and systolic [F (1, 58) ¼ 25.42,P < .001, influenced by Buddhism, no
blood pressure h2 ¼ .31] HR was not significant measures of mindfulness, no
[F (1, 58) ¼ 1.49, p ¼ .228, social support in control group,
h2 ¼ .03] significant change in short intervention period
SBP [F (1, 58) ¼ 4.73, p ¼ .034,
h2 ¼ .08], but not DBP [F (1,
58) ¼ 1.19, p ¼ .280, h2 ¼ .02]
Bond et al. Examine effects of a Quasi Integrated MM, Stress (p ¼ .7) decreased but not Small, homogenous sample, no
(2013) mindfulness-based elective experimental yoga, and significant measures of mindfulness or
course on psychological well- pretest/post-test neuroscience physiological stress markers, no
being (N ¼ 27) didactic lecture. control group, possible placebo
effects.
Bergen-Cico Examine psychological benefits Quasi- 5 week MBSR. Significant increases in No randomization, abbreviated
et al. (2013) of a brief MBSR. experimental mindfulness on the KIMS intervention, possible placebo
pretest/post-test (p < .001) and the PHLM effects.
(N ¼ 119) (p¼<.001). Trait anxiety
trended downward but not
significant (p ¼ .10)
Byrne, Bond & Compare MM with 3 arm quasi- MM Significant decrease in anxiety [ No randomization, self-report
London interpersonal process and experimental t(45) ¼ 9.29, p < .001] and measures, HW required of MM
(2013) control with effects on anxiety (N ¼ 112) increase in mindfulness group.
[t(45) ¼
5.21, p < .001], remained
significant at 6 months: anxiety
[t(45) ¼ 8.75, p
<.001], mindfulness
[t(45) ¼ 3.01, p < .003. Greater
increases in mindfulness was
associated with greater
decreases in anxiety [R ¼ .06,
F(1, 112) ¼ 4.25, p < .05]
(continued on next page)
26 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 8 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

Van Gordon et al. Examine the benefits and Quasi- MAT. Significant decreases in both Small sample, no
(2013) feasibility of MAT experimental anxiety and stress subscales of randomization, possible
case controlled the DASS F(1,20) ¼ 17.53, placebo effects, no physiological
(N ¼ 25) p < .001, h2 ¼ .47) and stress markers
significant increases in
mindfulness(F(1,20) ¼ 23.83,
p < .001)
Call, Miron & Examine effects of aspects of 3 arm RCT MBSR-based Hatha yoga group and body Homogeneous sample, no
Orcutt (2013) MBSR on stress and anxiety waitlist-control hatha yoga scan groups had significant physiological stress markers, no
(N ¼ 91) MBSR-based decreases in anxiety control of physical activity,
body scan [F(1,87) ¼ 12.15, p < .001; significant pre-intervention
F(1,87) ¼ 6.86, p < .01] and group differences, limited
stress [F(1,87) ¼ 5.30, p < .05; mindfulness education and
F(1,87) ¼ 5.72, p < .05]. No intervention.
significant differences between
experimental conditions.
de Vibe et al. Examines MBSR on distress, RCT (N ¼ 228) MBSR Stress was not significant Possible placebo effect, no
(2013) stress, burnout, well-being, and (p ¼ .021), gender (women) physiological stress markers
mindfulness added as a covariate MM group
had significant decreases in
stress (<.001). Attendance and
practice did not predict changes
in mindfulness.
Barbosa et al. Examine effects of MBSR on Quasi- MBSR Significant decreases in anxiety Small, homogenous sample, no
(2013) anxiety and empathy experimental post-intervention (p < .001) randomization or mindfulness
with matched and at follow-up (p < .01) measures, potential placebo
control (N ¼ 28) effect, limited measures.
Gallego et al. Compare effects of MM and 3-arm MBCT Stress was significantly Small sample size, no
(2014) exercise on depression, stress, randomized decreased (t ¼ 2.953, mindfulness measure
and anxiety comparison- p ¼ .006 d ¼ .667), no
control significance, downward trend
for anxiety t ¼ (.715,p ¼ .480,
d ¼ .318), significance between
MM and control in both stress
(F ¼ 3.519, p ¼ .033, h2 ¼ .066)
and anxiety (F ¼ 5,402, p ¼ .006,
h2 ¼ .098)
Hindman (2013) Compare the effects of formal 3-arm Quasi- Mindful Stress Both MSM-formal and MSM- Partial randomization
MM, brief informal MM, and experimental Management Informal had significant Self-report measures
control on mindfulness, stress, with waitlist (MSM)-Formal decrease in stress (p < .01, Small homogenous sample
and anxiety control (N ¼ 34) and MSM- P < .05) and increases in FFMQ
Informal mindfulness measure (p < .001,
p < .05), the MSM-formal had
significant decreases in anxiety
(p < .01) and increase in MAAS
mindfulness measure (p < .01),
the MSM-informal were not
significant in MAAS and anxiety
measures. Moderate effect size
between MSM-formal and
MSM-informal, and large effect
sizes between MSM-Formal and
control.
McClintock & Examine the efficacy of brief RCT (N ¼ 70) Brief MM MM had significant decreases in Homogeneous sample, brief
Anderson MM on affect and interpersonal state anxiety after MM intervention, all self-report
(2013) dependency [b ¼ .24, t(67) ¼ 2.63, measures
p < .05] than the distraction
group.
O'Brien (2013) Examine effects of MM mixed Quasi- MM with humor Significant decreases in state No randomization, possible
with humor on anxiety in a experimental, (F ¼ 31.18, p < .0001) and trait placebo effect. Homogenous
clinical setting non-randomized (F20.477, p,.0001) anxiety and sample, self-report measures.
control (N ¼ 73) increases in mindfulness
(F ¼ 29.667, p < .001)
Shenesey (2013) Compare the effects of MM, 3-arm MM-Body Scan Significant decrease in state[F One time, one facet MM
sham MM, and relaxation on randomized (1, 107) 79.85, p < .000, partial intervention, PMR and Body
physiological stress and anxiety experimental h2 ¼ .43] and trait [F (1, scan are similar, no control
condition 103) ¼ 24.35, p < .000, partial group, or mindfulness measure
(N ¼ 112) h2 ¼ .1] anxiety in all groups but
no differences between groups
s [F (1, 59) ¼ .05, p ¼ .95, partial
h2 ¼ .00; F (2, 103) ¼ .03,
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 27

Table 8 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

p ¼ .97, partial h2 ¼ .00], HR [F
(1, 107) ¼ 10.62, p ¼ .001,
partial h2 ¼ .09] and RR [F (1,
98) ¼ 47.15, p < .000, partial
h2 ¼ .3] decreased in all groups,
no difference between groups
[F (2, 107) ¼ .52, p ¼ .598,
partial h2 ¼ .01; F(2, 98) ¼ 5.89,
p ¼ .799, partial h2 ¼ .01]
Turakitwanakan Examine effects MM on mental Single group, MM Significant decrease in serum Small, homogenous sample, no
et al. (2013) health and serum cortisol pretest/posttest cortisol levels (p < .05) randomization, control group,
(N ¼ 30) or mindfulness measures,
possible placebo effect.
Bonifas & Napoli Examine effectiveness of a Course MM No change in stress scores pre- Stress scores collected before
(2014) mindfulness course on quality evaluation, to post intervention (t ¼ .225, intervention completion, no
of life and stress coping Single group p > .10) control group, mindfulness
Pretest/posttest measures, randomization, or
(N ¼ 77, over 5 physiological stress markers.
years)
Danitz & Orsillo Examine the effects of a one- RCT- waitlist ABBT No significant differences Small homogenous sample,
(2014) time acceptance-based control (N ¼ 90) between groups on anxiety [F(1, self-select (1st come assigned to
behavior therapy on 43) ¼ .27, p ¼ .61, d ¼ .12] or intervention), one-time MM
psychological well-being in first stress [F(1, 43) ¼ .72, p ¼ .40, instruction.
year college and law students d ¼ .22], those in the ABBT
group reported mild levels of
stress pre-intervention and
normative at 3 month f/u and
moderate anxiety pre-
intervention and mild at 3
month f/u.
Demarzo et al. Examine the effects of MBSR on Quasi- MBSR Significant decrease in stress Small sample size, no control
(2014) a healthy college population. experimental (p < .001) group, or mindfulness measure
pretest/posttest
(N ¼ 23)
Goodman et al. Examine effects and feasibility Quasi- MM Significant increase in Both groups physically active,
(2014) of a mindfulness intervention experimental, mindfulness over time small sample size, no
for student athletes non-randomized [t(8) ¼ 2.88, p < .05, d ¼ .48] randomization, can't determine
control (N ¼ 26) and between groups [F(1, which component most
19) ¼ 4.55, p < .05] decrease in effective.
stress over time [t(8) ¼ 2.57,
p < .05, d ¼ .26], not significant
in anxiety with-in groups or
between groups.
Greeson et al. Examine effects of Koru in RCT (N ¼ 99) Koru Significant decrease in stress Self-report measures,
(2014) college students on stress (group x time) [F[1, Homogenous sample
76.40] ¼ 4.50,p ¼ .037, d ¼ .45) no midpoint assessment
and increase in mindfulness [F
[1,79.09 ¼ 26.80, p < .001,
d ¼ .95]
Taylor, Strauss Examine effects of MBCT self- Single blinded MBCT-SH Significant differences between Healthy homogenous sample,
Cavanagh & help on anxiety and stress. RCT (N ¼ 79) groups in anxiety (F ¼ 4.01, waitlist control, no face-to-face
Jones (2014) p < .05), Stress (F ¼ 9.89, interaction
p < .001), and mindfulness
(F ¼ 23.22, p < .001)
Delgado-Pastor Compare two facets of MM; 3-arm RCT MM MIT had a significant in Small sample size, brief
et al. (2015) awareness (MIT) and attention (N ¼ 41) decreases in stress (F ¼ 7.843, intervention period,
(MCT) p ¼ .009), HR (p < .001), and homogenous, sample.
HRV (P < .009), and significant
increase in FMI mindfulness
measure F(2, 37) ¼ 4.16,
p < .024, h2p ¼ .183, not MAAS
mindfulness measure F(2, 37) ¼
3.32, p < .152, h2p ¼ .09].
Significant differences between
MIT and control on both
mindfulness measures (p < .01;
p < .03). MCT no significant
change in stress (p ¼ .1),
mindfulness, or HR, and
marginally significant in HRV
(continued on next page)
28 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32

Table 8 (continued )

Citation Purpose Design/Sample Intervention Outcomes Limitations

(p < .07). A significant
difference between MCT and
control on FMI (p < .03)
Glick & Orsillo Compare effects acceptance- Randomized ABBT No significant decrease in trait One-time online MM
(2015) based behavior therapies and comparison- anxiety (F ¼ .09, p ¼ .77) intervention
time-management control Convenience sample, self-
(N ¼ 118) report measures, not delivered
by a trained individual
Song & Lindquist Examine effects of MBSR on RCT (N ¼ 44) MBSR Significant differences found Small homogeneous sample
(2015) Korean Nursing students between groups in stress NO f/u on MBSR HW
(F ¼ 15.31, p < .001), anxiety Possible contamination b/n
(F ¼ 5.61, p ¼ .023) and groups
mindfulness (F ¼ 5.03, p ¼ .01)

5. Discussion

Although mindfulness interventions look promising, much more must be known before conclusions can be made. Most
researchers reported significant decreases in stress and anxiety suggesting that MBSR and MM were successful in reducing
college students’ perceived stress and anxiety. MBSR was reported as effective in decreasing stress in 73% and anxiety in 100%
of the studies reviewed. Mindfulness was increased in 85% of the 7 studies where it was included as an outcome. MM was
reported as effective in decreasing stress (self-reported) in 78% and anxiety in 77% of the studies reviewed, and in the 16
studies where mindfulness was an outcome it was increased in 94% of those studies. More researchers must include
mindfulness as a measure. It is likely that an increase in mindfulness occurs to improve overall intervention effectiveness. A
limited number (s ¼ 24) of research teams evaluated changes in mindfulness. In the 24 studies reviewed with outcomes of
stress and/or anxiety and mindfulness, 77% of these studies had both increases in mindfulness and decreases in stress and/or
anxiety. Nevertheless, further research is needed to determine which, the structured MBSR intervention or other MM in-
terventions, are more effective and what intervention characteristics are most essential to intervention success.
Future researchers should address several gaps in the MM/MBSR research. First, examination of the literature has led us to
hypothesize a model depicting relationships between MM, state mindfulness, trait mindfulness, stress, and anxiety (See
Fig. 1). These relationships require further exploration and researchers might consider examining the association between
state and trait mindfulness and stress and anxiety. For example, just how much of an increase in state and/or trait mindfulness
is needed to receive reductions is stress and anxiety? What is an effective dose of MM and what intervention characteristics
are most effective? Finally, are there any participants for whom MM is most effective?
Researchers might also examine the mediating and moderating role of state and trait mindfulness. A limited number of
research teams (42%) evaluated changes in mindfulness, and fewer evaluated the differences between state and trait
mindfulness. Future researchers should examine participant changes in both state and trait mindfulness to determine the
direct effect of mindfulness-based interventions. Researchers should determine the number of sessions needed to increase
state mindfulness, and the number of sessions needed to increase trait mindfulness. The research suggests that those with
higher trait mindfulness naturally perceive less stress and anxiety; therefore, it is important to determine what is required to
increase trait mindfulness. Of the thirteen research teams who found that stress and/or anxiety was not affected by the
intervention, almost half of these did not assess changes in state or trait mindfulness (Bond et al., 2013; Bonifas & Napoli,
2014; Danitz & Orsillo, 2014; Hassed et al., 2009; Oman et al., 2008; Paholpak et al., 2012; Roberts-Wolfe et al., 2012). It is
possible these interventions did not increase state and/or trait mindfulness, and therefore, did not reduce stress and/or
anxiety.
Mindfulness is multifaceted and includes meditative techniques to attain the four constructs; attentional control,
awareness, non-judgmental thought, and non-reactivity. The Liverpool Mindfulness Model describes five tiers or levels of the
mindfulness process that a practitioner must achieve to benefit from MM. Future researchers might use these tiers to better
understand the effects of MM. The first tier, motivational influences are described as the person's motivation, intention,
expectations, and attitudes towards MM (Malinowski, 2013a, b). Researchers might determine what motivations participants
had to volunteer for or begin to practice MM. The second tier is the actual MM training; the amount delivered and in what
manner participants engage themselves in the training (Malinowski, 2013a, b). Along with assessing motivation, researchers
should examine participant engagement in the MM intervention. As for training delivered, doses differed across studies and it
is critical to determine which dose (frequency and duration) was most effective. Doses ranged from one session to eight weeks
of sessions. Researchers should compare different frequencies and durations of interventions to determine which are most
effective. There was some evidence of the effects of dose in the study conducted by Hindman (2013) who reported that the
formal, more in-depth, meditation had better outcomes than the informal meditation.
When the practitioner has had sufficient training and is engaged in that training, control of attention develops. Attentional
control assists in the development of emotional and cognitive flexibility, which in turn interacts with attention. Malinowski
(2013a, b) describes attentional control and emotional and cognitive flexibility as the three core mental processes. Once these
 M.D. Bamber, J. Kraenzle Schneider / Educational Research Review 18 (2016) 1e32 29

core processes are achieved the practitioner can then exhibit the fourth tier, described as non-judging awareness with an
equalized mental state. Improved physical, behavioral, and mental well-being (tier 5) are a result of the equalized mental state
and embodiment of non-judging awareness (Malinowski, 2013a, b).
There was some evidence of these processes reported by Delgado-Pastor et al. (2015), who examined two facets of
mindfulness, awareness and attention, and found that meditation training in awareness had better outcomes than meditation
training in attention. This may suggest that those in the awareness training incidentally and concurrently received attention
training or that awareness training is not dependent on attention training as the Liverpool Mindfulness Model suggests.
Different components of mindfulness should be evaluated to determine which are most sensitive to change and are related to
stress and anxiety. They should also examine awareness and attention to see if one of these constructs is needed to obtain
physical, behavioral, and mental well-being. Researchers continue to use mindfulness-based interventions without dis-
tinguishing which of these components or stages are responsible for reducing stress and anxiety.
Participant characteristics, such as major, gender, age, and level of study is another opportunity for research. Researchers
should compare students in various professions including general student populations, for example; students in their first
two years of general study, students in high stress majors like; engineering, health sciences, and other science, technology and
math (STEM) majors, and students in non-helping majors such as; business and computer sciences. It is possible that different
doses of mindfulness-based interventions will be effective for different professions.

5.1. Limitations

There are several limitations across the studies including quasi-experimental or single group research designs, small
sample sizes, and reliance on self-report measures. The studies with small sample sizes and insignificant effects could
potentially have resulted in type II errors. Quasi-experimental and single group designs may have had confounding variables
researchers were unable to control. Self-reported measures may include response bias. Physiological stress markers were
present in eleven studies with MM and none that used MBSR. Physiological markers, such as cortisol, BP, and HR, should be
included in future research. As a result it is premature to draw conclusions from physiological markers of stress.

6. Conclusion

This is the first large narrative review of 57 articles that were solely focused on the college student population. Both MBSR
and MM intervention outcomes indicate encouraging results in reducing stress and anxiety in college students. Out of the 40
studies that examined anxiety; researchers reported significant reductions in 33 of those. Research teams in the remaining
seven studies reported downward trends. Self-reported stress was an outcome in 38 studies and researchers reported sig-
nificant decreases in 29 of the studies. Of the nine remaining studies, several reported downward trends or decreases in
women but not men. Finally, mindfulness was reported in 24 studies; 22 research teams reported increases in mindfulness.
While there is encouraging evidence that mindfulness-based interventions are effective in reducing stress and anxiety while
improving mindfulness in the college student population; more rigorous research must be done before a definite conclusion
can be drawn.
College students face undue stress and anxiety. Mindfulness-based interventions offer a coping strategy to combat
stressors and reduce their anxiety. Once more evidence is presented to support these preliminary results mindfulness-based
interventions could potentially be used on a large scale across colleges and universities that are often concerned with attrition
and graduation rates, often a problem in the first year. Attrition is frequently related to academic difficulties enhanced by high
levels of stress and/or anxiety that impact concentration, physical well-being, and motivation. Mindfulness-based in-
terventions could be used to facilitate the first-year transition and aid in learning.
MM and MBSR interventions could be targeted to fit into college/program orientations, courses, and extra-curricular
activities. MM has recently been integrated, with success, in medical schools to provide students with an effective coping
strategy (Phillips, 2015). MM could be used in college or program orientations to introduce concepts of mindfulness and
services available to students on campus. Mindfulness-based interventions could easily be incorporated into courses with a
brief meditation session before the start of every didactic course. While these seem like lofty goals, it could potentially in-
crease success, decrease attrition, and improve academic achievement through reduction of stress and anxiety (Table 8).

Acknowledgment

The authors wish to thank Drs. Helen Lach and Rebecca Lorenz who reviewed earlier drafts of this manuscript.

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