Cited by 62Mindfulness and Compassion InterventionsPsychotherapy Techniques and ApplicationsReligion, Spirituality, and Psychology

Prevalence of harm in mindfulness-based stress reduction

Open access
Hirshberg, Matthew J., Goldberg, Simon B., Rosenkranz, Melissa, Davidson, Richard J.·2022·Psychological Medicine

Published version of a preprint

Abstract

Background: Mindfulness meditation has become a common method for reducing stress, stress-related psychopathology and some physical symptoms. As mindfulness programs become ubiquitous, concerns have been raised about their unknown potential for harm. We estimate multiple indices of harm following Mindfulness-Based Stress Reduction (MBSR) on two primary outcomes: global psychological and physical symptoms. In secondary analyses, we estimate multiple indices of harm on anxiety and depressive symptoms, discomfort in interpersonal relations, paranoid ideation and psychoticism. Methods: Intent-to-treat analyses with multiple imputations for missing data were used on pre- and post-test data from a large, observational dataset ( n = 2155) of community health clinic MBSR classes and from MBSR ( n = 156) and waitlist control ( n = 118) participants from three randomized controlled trials conducted contemporaneous to community classes in the same city by the same health clinic MBSR teachers. We estimate the change in symptoms, proportion of participants with increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms, and for global psychological symptoms, clinically significant harm. Results: We find no evidence that MBSR leads to higher rates of harm relative to waitlist control on any primary or secondary outcome. On many indices of harm across multiple outcomes, community MBSR was significantly preventative of harm. Conclusions: Engagement in MBSR is not predictive of increased rates of harm relative to no treatment. Rather, MBSR may be protective against multiple indices of harm. Research characterizing the relatively small proportion of MBSR participants that experience harm remains important.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1017/s0033291720002834

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 29 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Clarke TC, & Stussman BJ (2018). Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Over. 325, 8. 30475686
  2. Clarke TC, Stussman BJ, & Nahin RL (2015). Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002–2012. 79, 16. PMC4573565 25671660
  3. Freiman JA, Chalmers TC, Smith H, & Kuebler RR (1992). The importance of beta, the type II error, and sample size in the design and interpretation of the randomized controlled trial. Medical Uses of Statistics, 357– 373. 355881
  4. Kabat-Zinn J (2013). Full catastrophe living, revised edition: How to cope with stress, pain and illness using mindfulness meditation. Hachette UK.
  5. Rubin DB (2004). Multiple imputation for nonresponse in surveys (Vol. 81). John Wiley & Sons.

Cited by

Sorted by citations

Authors
Hirshberg, M. J., Goldberg, S. B., Rosenkranz, M., & Davidson, R. J.
Affiliations
University of Wisconsin–Madison (US)
Corresponding author
Hirshberg, Matthew J.
Venue
Psychological Medicine
Published
2020-08-18
Volume
52
Issue
6
Pages
1080-1088
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
OpenAlex
W3068462010
Cited by
62
References
29
Citations by year
2026: 8 · 2025: 10 · 2024: 9 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 3
FWCI
3.50
Type
journal article
Language
en
Open access
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • PsyArXiv (OSF Preprints) (submittedVersion)
  • PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (5u01at002114-03)
  • National Center for Complementary and Integrative Health (U01-AT002114, K23AT010879, P01AT004952)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Health › Religion, Spirituality, and Psychology
Keywords
mindfulness-based stress reduction, mindfulness meditation, adverse effects, anxiety symptoms, depressive symptoms, paranoid ideation, psychoticism, psychological symptoms, somatic symptoms, waitlist control
MeSH terms
Anxiety, Depression, Humans, Stress, Psychological, Prevalence, Treatment Outcome, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review