Cited by 287Mindfulness and Compassion InterventionsStress Responses and CortisolPhysical Activity and Health

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How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry

Riley, Kristen E., Park, Crystal L.·2015·Health Psychology Review

DOI 10.1080/17437199.2014.981778

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Abstract

Yoga is increasingly used in clinical settings for a variety of mental and physical health issues, particularly stress-related illnesses and concerns, and has demonstrated promising efficacy. Yet the ways in which yoga reduces stress remain poorly understood. To examine the empirical evidence regarding the mechanisms through which yoga reduces stress, we conducted a systematic review of the literature, including any yoga intervention that measured stress as a primary dependent variable and tested a mechanism of the relationship with mediation. Our electronic database search yielded 926 abstracts, of which 71 were chosen for further inspection and 5 were selected for the final systematic review. These five studies examined three psychological mechanisms (positive affect, mindfulness and self-compassion) and four biological mechanisms (posterior hypothalamus, interleukin-6, C-reactive protein and cortisol). Positive affect, self-compassion, inhibition of the posterior hypothalamus and salivary cortisol were all shown to mediate the relationship between yoga and stress. It is striking that the literature describing potential mechanisms is growing rapidly, yet only seven mechanisms have been empirically examined; more research is necessary. Also, future research ought to include more rigorous methodology, including sufficient power, study randomisation and appropriate control groups.

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Background
Creating joy in the workplace
Jalilianhasanpour, R., Asadollahi, S., & Yousem, D. M. (2021) · European Journal of Radiology · doi:10.1016/j.ejrad.2021.110019 · Cited by 28
Āsana for Neck, Shoulders, and Wrists to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol
Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk8010026 · Cited by 33
“Many clinical studies on yoga as medical science have been published in the topranking journals of various medical fields, such as cardiology for cardiovascular diseases [8–10], coronary heart disease [11], hypertension [12], atrial fibrillation and arrhythmia [13] and vasovagal syncope [14]; internal medicine for met…”
Background
Five-week yin yoga-based interventions decreased plasma adrenomedullin and increased psychological health in stressed adults: A randomized controlled trial
Daukantaité, D., Tellhed, U., Maddux, R. E., Svensson, T., & Melander, O. (2018) · PLoS ONE · doi:10.1371/journal.pone.0200518 · Cited by 33
Yin yoga and mindfulness: a five week randomized controlled study evaluating the effects of the YOMI program on stress and worry
Hylander, F., Johansson, M., Daukantaitė, D., & Ruggeri, K. (2017) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2017.1301189 · Cited by 33
“Increased levels of mindfulness through yoga practice have previously been shown to be beneficial in stress reduction (Riley & Park, 2015) and practitioners can strengthen key features of mindfulness through continuous yoga practice (Gordon, 2013).”
Background
Stress, mindfulness, and the allergic patient
Marshall, G. D., & Tull, M. T. (2018) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2018.1536547 · Cited by 26
“more physical components of yoga can have their own stress management capabilities [86].”
Background
Integrative Approaches to Stress Management
Carlson, L. E., Toivonen, K., & Subnis, U. B. (2019) · The Cancer Journal · doi:10.1097/ppo.0000000000000395 · Cited by 32
The Effects of Tele-Yoga in Ankylosing Spondylitis Patients: A Randomized Controlled Trial
Acar, Y., İlçin, N., & Sarı, İ. (2023) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2023.0022 · Cited by 26
“47 There is increasing interest in the potential role of yoga as an intervention for mental health concerns.”
Taking a Stand for Office-Based Workers' Mental Health: The Return of the Microbreak
Mainsbridge, C. P., Cooley, D., Dawkins, S., de Salas, K., Tong, J. S., Schmidt, M. W., & Pedersen, S. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.00215 · Cited by 29
“Conversely, an inability to maintain the ideal mood state has been associated with stress (22, 23) and adverse health symptomology (24, 25).”
Background
A Comparison of the Acute Effects of Different Forms of Yoga on Physiological and Psychological Stress: A Pilot Study
Marshall, M. R., McClanahan, M., Warren, S. M., Rogers, R. R., & Ballmann, C. G. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17176090 · Cited by 26
“Mindfulness, or the state of being keenly aware of the present, has been shown to increase following yoga practice and leads to decreased perceived stress [7].”
BackgroundInfluential
The Effect of Yoga on Cardiovascular Disease Risk Factors: A Meta-Analysis
Isath, A. M., Kanwal, A. S., Virk, H. U. H., Bandyopadhyay, D., Wang, Z., Kumar, A., Kalra, A., Naidu, S. S., Lavie, C. J., Virani, S. S., et al. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.101593 · Cited by 26
Effect of six months pranayama training on stress-induced salivary cortisol response among adolescents-Randomized controlled study
Kuppusamy, M., Dilara, K., Ravishankar, P., Julius, A., Padmavathi, R., Poonguzhali, S., & Vijayakumar, V. (2021) · EXPLORE · doi:10.1016/j.explore.2021.07.005 · Cited by 25
Self-Report Stress Measures to Assess Stress in Adults With Mild Intellectual Disabilities—A Scoping Review
de Witte, M., Kooijmans, R., Hermanns, M., van Hooren, S., Biesmans, K., Hermsen, M. A., Stams, G. J. J. M., & Moonen, X. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.742566 · Cited by 31
“Stress is defined by Aldwin (2007) as the quality of an experience produced by a person-environment transaction that, through either overarousal or underarousal, results in psychological or physiological distress (Aldwin, 2007; Riley and Park, 2015).”
Background
Effect of online Kundalini Yoga mental health of university students during Covid-19 pandemic: A randomized controlled trial
Brandão, T., Martins, I., Torres, A., & Remondes‐Costa, S. (2024) · Journal of Health Psychology · doi:10.1177/13591053231220710 · Cited by 24
“Indeed, self-compassion has been found to be a mechanism of change in Yoga interventions since it is a quality that results from contemplative practices (Riley and Park, 2015).”
Background
Long-term effects of yoga-based practices on neural, cognitive, psychological, and physiological outcomes in adults: a scoping review and evidence map
Campelo, G., de Araújo, J. R., Aristizabal, J. P., de Souza, W. C., & de Castilho, G. M. (2025) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-025-04825-x · Cited by 28
Effect of a single session of yoga and meditation on stress reactivity: A systematic review
Mandlik, G. V., Siopis, G., Nguyen, B., Ding, D., & Edwards, K. M. (2023) · Stress and Health · doi:10.1002/smi.3324 · Cited by 23
Mindfulness and self-compassion as mediators of the Mindful2Work Training on perceived stress and chronic fatigue
van der Meulen, R. T., Valentin, S., Bögels, S. M., & de Bruin, E. I. (2020) · Mindfulness · doi:10.1007/s12671-020-01557-6 · Cited by 29
Comparing the Psychological Effects of Meditation- and Breathing-Focused Yoga Practice in Undergraduate Students
Qi, X., Tong, J. S., Chen, S., He, Z., & Zhu, X. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.560152 · Cited by 22
“Participants performed 80 min of Hatha yoga exercise (Riley and Park, 2015) in a morning yoga class per week for 12 weeks.”
Method
Effects of Suryanamaskar, an Intensive Yoga Exercise Routine, on the Stress Levels and Emotional Intelligence of Indian Students
Stec, K., Kruszewski, M., & Ciechanowski, L. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20042845 · Cited by 22
“The system of yoga, itself over five thousand years old [2–5], forms an important part of such a holistic and integrated approach to human health, stress reduction [6], and physical culture.”
BackgroundResult
Yoga Research a Scientometric Assessment of Global Publications Output during 2007-16
Gupta, B., Ahmed, K. M., Dhawan, S., & Gupta, R. (2018) · Pharmacognosy Journal · doi:10.5530/pj.2018.3.65 · Cited by 23
Perceived benefits and barriers to yoga participation after stroke: A focus group approach
Harris, A., Austin, M., Blake, T. M., & Bird, M. (2018) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2018.11.015 · Cited by 22
Personality Traits, Technology-Related Teaching Skills, and Coping Mechanisms as Antecedents of Teachers’ Job-Related Affective Well-Being and Burnout in Compulsory and Higher Education Online Teaching Settings
Stan, R. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.792642 · Cited by 34
“A mindfulness approach combined with releasing eye strain has proven to provide an adaptive response to stressors (Riley and Park, 2015).”
Background
Feasibility of Mindfulness-Based Stress Reduction for older adolescents and young adults with poorly controlled type 1 diabetes
Ellis, D. A., Carcone, A. I., Slatcher, R. B., & Sibinga, E. M. S. (2017) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2017.1415810 · Cited by 21
“Recent reviews (Baer, 2010; Riley & Park, 2015; Tang, Hölzel, & Posner, 2015; Witkiewitz et al., 2014) suggest that mindfulness practices may not only improve stress tolerance and emotion regulation but that they may also improve focus and attention regulation, resulting in fewer overlearned (and…”
Background
Efficacy of yoga for posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials
Nejadghaderi, S. A., Mousavi, S. E., Fazlollahi, A., Asghari, K. M., & Garfin, D. R. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.116098 · Cited by 27
“Yoga may help address PTSD symptoms by improving emotion and sympathetic nervous system regulation, reducing hyperarousal and enhancing vagal activity, a key component of the parasympathetic nervous system (Kamraju, 2023; Riley and Park, 2015).”
For Body and Mind: Practicing Yoga and Emotion Regulation
Kobylińska, D., Lewczuk, K., Marchlewska, M., & Pietraszek, A. (2018) · Social Psychological Bulletin · doi:10.5964/spb.v13i1.25502 · Cited by 23
“Similarly, in a review by Riley and Park (2015), yoga interventions were also described as effective in reducing stress.”
Background
Impact of workplace yoga on pain measures, mental health, sleep quality, and quality of life in female teachers with chronic musculoskeletal pain: A randomized controlled study
Metri, K., Raghuram, N., Narayan, M., Sravan, K., Sekar, S., Bhargav, H., Babu, N., Mohanty, S., & Revankar, R. R. (2023) · Work · doi:10.3233/wor-210269 · Cited by 20
Verbal Cuing Is Not the Path to Enlightenment. Psychological Effects of a 10-Session Hatha Yoga Practice
Csala, B., Ferentzi, E., Tihanyi, B. T., Drew, R., & Köteles, F. G. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01375 · Cited by 20
Embodied Cognition in Meditation, Yoga, and Ethics—An Experimental Single-Case Study on the Differential Effects of Four Mind–Body Treatments
Matko, K., Sedlmeier, P., & Bringmann, H. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811734 · Cited by 21
Stress management interventions for adults with heart failure: Systematic review and meta-analysis.
Gathright, E. C., Salmoirago‐Blotcher, E., DeCosta, J., Donahue, M. L., Feulner, M. M., Cruess, D. G., Wing, R. R., Carey, M. P., & Scott‐Sheldon, L. A. J. (2021) · Health Psychology · doi:10.1037/hea0001084 · Cited by 21
A Pragmatic Controlled Trial of a Brief Yoga and Mindfulness-Based Program for Psychological and Occupational Health in Education Professionals
Dyer, N. L., Borden, S., Dusek, J. A., & Khalsa, S. B. S. (2020) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2020.102470 · Cited by 21
Yoga and nonsuicidal self-injury: Mediational effects of self-compassion and body appreciation
Muehlenkamp, J. J., & Wagner, E. M. (2022) · Body Image · doi:10.1016/j.bodyim.2022.08.001 · Cited by 18
Physical exercise and ergonomic workplace interventions for nursing personnel—effects on physical and mental health: a systematic review
Heuel, L., Otto, A.-K., & Wollesen, B. (2023) · German Journal of Exercise and Sport Research · doi:10.1007/s12662-023-00922-6 · Cited by 24
“One might argue that yoga has the potential to improve biochemical markers of stress (Riley & Park, 2015); however, Mandal et al. (2021) did not ﬁnd improvements in biochemical outcomes after a 20-h yoga intervention.”
Effects of Yogic Interventions on Patients Diagnosed With Cardiac Diseases. A Systematic Review and Meta-Analysis
Kalra, S., Miraj, M., Ajmera, P., Shaik, R. A., Seyam, M. K., Shawky, G. M., Alasiry, S. M., Mohamed, E. S. H., Alasiri, H., Alzhrani, M., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.942740 · Cited by 17
“Various reported benefits of yoga include reduction in blood pressure, enhanced dominance of the parasympathetic nervous system over the sympathetic nervous system, normalization of endocrinal function and gastrointestinal function, improved musculoskeletal fitness and posture, enhanced energy levels, normalization of…”
Background
Holistic frailty prevention: The promise of movement‐based mind–body therapies
Loewenthal, J., Berning, M. J., Wayne, P. M., Eckstrom, E., & Orkaby, A. R. (2023) · Aging Cell · doi:10.1111/acel.13986 · Cited by 19
“In addition, yoga modulates the hypothalamic– pituitary– adrenal axis (HPA), reducing markers such as cortisol, catecholamines, and renin– angiotensin (Purdy, 2013; Riley & Park, 2015).”
Background
Yoga as an Adjunctive Intervention to Medication-Assisted Treatment with Buprenorphine+Naloxone
Lander, L. R., Chiasson-Downs, K., Andrew, M. E., Rader, G., Dohar, S., & Waibogha, K. (2017) · Journal of Addiction Research & Therapy · doi:10.4172/2155-6105.1000354 · Cited by 17
Yoga as a Mind-Body Practice
Brems, C. (2020) · Springer eBooks · doi:10.1007/978-3-030-30892-6_10 · Cited by 17
A mixed methods evaluation of an individualised yoga therapy intervention for rheumatoid arthritis: Pilot study
Cartwright, T., Cahill, M., & Sadana, V. (2020) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2020.102339 · Cited by 17
The long-term mental health benefits of exercise training for physical education students: a comprehensive review of neurobiological, psychological, and social effects
Ma, Y., & Mumtaz, S. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1678367 · Cited by 48
“A 9-month study of yoga practitioners showed a 40% decrease in emotional reactivity to stressors, compared to only 15% in conventional exercisers (66).”
Acute Cortisol Profile Associations With Cognitive Impairment After Severe Traumatic Brain Injury
Barton, D. J., Kumar, R. G., Schuster, A. A., Juengst, S. B., Oh, B., & Wagner, A. K. (2021) · Neurorehabilitation and neural repair · doi:10.1177/15459683211048771 · Cited by 16
Āsana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol
Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk9010006 · Cited by 18
“…[31,32], irritable bowel [33], inflammatory markers [34,35] and immune system [36]; in neurology/psychology for stress, anxiety and burnout [37,38]; in pneumology [39,40]; in orthopedics/physiatry for chronic pain and pain-associated disorders [41–52] and disc herniation [45–47]; in…”
Background
Improvements in Psychological and Occupational Well-being Following a Brief Yoga-Based Program for Education Professionals
Trent, N. L., Borden, S., Miraglia, M., Pasalis, E., Dusek, J. A., & Khalsa, S. B. S. (2019) · Global Advances in Health and Medicine · doi:10.1177/2164956119856856 · Cited by 19
Improvement in resilience and stress-related blood markers following ten months yoga practice in Antarctica
Nirwan, M., Halder, K., Saha, M., Pathak, A., Balakrishnan, R., & Ganju, L. (2020) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2019-0240 · Cited by 17

Authors: Riley, K. E., & Park, C. L.
Affiliations: University of Connecticut (US)
Corresponding author: Riley, Kristen E.
ORCID: Riley, Kristen E.
Park, Crystal L.
Venue: Health Psychology Review
Publisher: Informa UK Limited
Published: 2015-04-15
Volume: 9
Issue: 3
Pages: 379-396
ISSN: 1743-7199 (ISSN-L)
1743-7202
DOI: 10.1080/17437199.2014.981778
OpenAlex: W1971363556
Cited by: 287
References: 65
Citations by year: 2026: 26 · 2025: 36 · 2024: 38 · 2023: 31 · 2022: 24 · 2021: 39 · 2020: 31 · 2019: 15 · 2018: 18 · 2017: 18 · 2016: 8 · 2015: 3
FWCI: 2.25
Type: journal article
Language: en
Open access: closed
Locations: Health Psychology Review (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Keywords: yoga, stress reduction, mechanisms of change, mediation, positive affect, mindfulness, self-compassion, posterior hypothalamus, interleukin-6, C-reactive protein, salivary cortisol, stress-related disorders
MeSH terms: C-Reactive Protein, Humans, Hydrocortisone, Stress, Psychological, Yoga, Interleukin-6, Treatment Outcome, Meditation

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How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry

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