A Pilot Study Comparing the Effects of Mindfulness-Based and Cognitive-Behavioral Stress Reduction
Abstract
OBJECTIVES: The objective of this pilot study was to compare the effects of two mind-body interventions: mindfulness-based stress reduction (MBSR) and cognitive-behavioral stress reduction (CBSR). SUBJECTS: Fifty (50) subjects were recruited from the community and took part in MBSR (n = 36) and CBSR (n = 14) courses. Participants self-selected into MBSR or CBSR courses taught at different times. There were no initial differences between the MBSR and CBSR subjects on demographics, including age, gender, education, and income. INTERVENTION: MBSR was an 8-week course using meditation, gentle yoga, and body scanning exercises to increase mindfulness. CBSR was an 8-week course using cognitive and behavioral techniques to change thinking and reduce distress. DESIGN: Perceived stress, depression, psychological well-being, neuroticism, binge eating, energy, pain, and mindfulness were assessed before and after each course. Pre-post scores for each intervention were compared by using paired t tests. Pre-post scores across interventions were compared by using a general linear model with repeated measures. SETTINGS/LOCATIONS: Weekly meetings for both courses were held in a large room on a university medical center campus. RESULTS: MBSR subjects improved on all eight outcomes, with all of the differences being significant. CBSR subjects improved on six of eight outcomes, with significant improvements on well-being, perceived stress, and depression. Multivariate analyses showed that the MBSR subjects had better outcomes across all variables, when compared with the CBSR subjects. Univariate analyses showed that MBSR subjects had better outcomes with regard to mindfulness, energy, pain, and a trend for binge eating. CONCLUSIONS: While MBSR and CBSR may both be effective in reducing perceived stress and depression, MBSR may be more effective in increasing mindfulness and energy and reducing pain. Future studies should continue to examine the differential effects of cognitive behavioral and mindfulness-based interventions and attempt to explain the reasons for the differences.
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A study of Chinese college students during the COVID-19 pandemic showed that stress and anxiety were indirectly linked to overeating.
“A study of Chinese college students during the COVID-19 pandemic showed that stress and anxiety were indirectly linked to overeating.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [93]
Positive emotions such as interest and surprise were linked to low-fat eating, while negative emotions like anger, shyness, and guilt were associated with emotional eating.
“Positive emotions such as interest and surprise were linked to low-fat eating, while negative emotions like anger, shyness, and guilt were associated with emotional eating.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [93]
Research on binge eating disorder highlights a strong link between stress and binge eating, with state-level stress and its negative affects correlating with binge eating episodes in both laboratory and natural settings.
“Research on binge eating disorder highlights the strong link between stress and binge eating, with state-level stress and its negative affects correlating with binge eating episodes in both laboratory and natural settings [93,94,95,96].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [93]
Chronic stress and emotional states significantly impact eating behaviors.
“Chronic stress and emotional states significantly impact eating behaviors.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [93]
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“, 2003), lower self-reported distress (Astin et al., 2003; Smith et al., 2008; Speca, Carlson, Goodey, & Angen, 2000; Tacon, McComb, Caldera, & Randolph, 2003), and reduced depressive and physical symptoms (Dobkin & Zhao, 2011; Gallegos, Hoerger, Talbot, Moynihan, & Duberstein, 2013).”
Vanzhula, I. A., & Levinson, C. A. (2020) · Mindfulness · doi:10.1007/s12671-020-01343-4 · Cited by 30 · see citing works
Kautz‐Turnbull, C., Parr, J., & Petrenko, C. L. M. (2020) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2020.103578 · Cited by 28 · see citing works
“While some interventions have used yoga or other forms of movement for stress reduction in the general population (Michalsen et al., 2005; Granath, Ingvarsson, von Thiele, & Lundberg, 2006; Smith et al., 2008; Berger & Owen, 1988), these interventions could also be studied in parents of children with disabilities.”
BackgroundExamining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being
Abadi, M. H., Barker, A. M., Rao, S. R., Orner, M. B., Rychener, D. L., & Bokhour, B. G. (2021) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2020.0124 · Cited by 28 · see citing works
“27,28 Veterans also reported improvements on the PROMIS-10, suggesting that TCMLH not only prepares patients to engage in their health care but may also have direct impacts on quality of life.”
Hawkes, T. D., Manselle, W., & Woollacott, M. H. (2013) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2013.0266 · Cited by 26 · see citing works
“22 Not surprisingly, during subject recruitment for this study, no sedentary meditators were found.”
Fleischer, N. L., Fernald, L. C. H., & Hubbard, A. (2009) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.085985 · Cited by 27 · see citing works
“For example, in a pilot study comparing mindfulness-based stress reduction (ie meditation and yoga) and cognitive-behavioural stress reduction (ie cognitive and behavioural techniques to reduce stress), both showed reductions in perceived stress and depressive symptoms.(34) Effect sizes were twice as big for the mindf…”
ResultKil, H., & Antonacci, R. (2020) · Journal of Child and Family Studies · doi:10.1007/s10826-020-01714-4 · Cited by 25 · see citing works
Xia, T. C., Hu, H., Seritan, A. L., & Eisendrath, S. (2019) · Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2019.0137 · Cited by 19 · see citing works
Effects of Mindfulness Interventions on Health Outcomes in Older Lesbian/Bisexual Women
Ingraham, N., Eliason, M. J., Garbers, S., Harbatkin, D., Minnis, A. M., McElroy, J. A., & Haynes, S. (2016) · Women s Health Issues · doi:10.1016/j.whi.2016.04.002 · Cited by 25 · see citing works
Garey, L., Reitzel, L. R., Kendzor, D. E., & Businelle, M. S. (2015) · Behavior Modification · doi:10.1177/0145445515612396 · Cited by 23 · see citing works
“MBSR interventions have demonstrated effectiveness at improving health and perceived stress (Grossman, Niemann, Schmidt, & Walach, 2004; Roth & Robbins, 2004; Smith et al., 2008) across several populations, and are promising interventions to reduce, and potentially reverse, health disparities linked to social disadvan…”
BackgroundAbadi, M. H., Richard, B. O., Shamblen, S. R., Drake, C. D., Schweinhart, A. M., Bokhour, B. G., Bauer, R., & Rychener, D. (2021) · Health Education & Behavior · doi:10.1177/10901981211011043 · Cited by 21 · see citing works
“Findings from similar program evaluations suggest that learned skills related to mindful awareness practices may foster this outcome by providing veterans with an effective coping tool (Hull et al., 2019; B. W. Smith et al., 2008).”
BackgroundAdapting Mindfulness to Engage Latinos and Improve Mental Health in Primary Care: a Pilot Study
Ortiz, J. A., Smith, B. W., Shelley, B. M., & Erickson, K. S. (2019) · Mindfulness · doi:10.1007/s12671-019-01229-0 · Cited by 21 · see citing works
Self-citationAslami, E., Alipour, A., Najib, F. S., & Aghayousefi, A. (2017) · PubMed Central · Cited by 20 · see citing works
The Art of Mental Health Practice: The Role of Drama in Developing Empathy
Goodwin, J., & Deady, R. (2012) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12004 · Cited by 19 · see citing works
“Mindfulness encourages the client to become aware of the present moment, using techniques such as the soft drink can exercise detailed above (Smith et al., 2008).”
MethodThe Roles of Exercise and Yoga in Ameliorating Depression as a Risk Factor for Cognitive Decline
Mathersul, D. C., & Rosenbaum, S. (2016) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2016/4612953 · Cited by 20 · see citing works
Højskov, I. E., Moons, P., Hansen, N. V., la Cour, S., Olsen, P. S., Gluud, C. N., Winkel, P., Lindschou, J., Thygesen, L. C., Egerod, I., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013038 · Cited by 19 · see citing works
Effects of Cognitive-Behavioral Therapy on Empathy in Patients with Chronic Pain
Song, M.-K., Choi, S., Lee, D.-H., Lee, K.-J., Lee, W. J., & Kang, D. (2018) · Psychiatry Investigation · doi:10.30773/pi.2017.07.03 · Cited by 19 · see citing works
Jabson, J. M., & Patterson, J. G. (2019) · JMIR Mental Health · doi:10.2196/15048 · Cited by 20 · see citing works
“MBSR interventions produce clinically meaningful reductions in stress in clinical and nonclinical samples and show twice the stress reduction as other behavioral and cognitive interventions [12].”
BackgroundKnowledge, Attitudes and Beliefs of Meditation in College Students: Barriers and Opportunities
Gryffin, P., Chen, W., & Erenguc, N. (2014) · American Journal of Educational Research · doi:10.12691/education-2-4-2 · Cited by 18 · see citing works
“[8,9] If mindfulness is used by itself, it is to differentiate between mindfulness in everyday life, as opposed to its use in meditation.”
BackgroundMindfulness-based interventions for binge eating: an updated systematic review and meta-analysis
Liu, J., Tynan, M., Mouangue, A., Martin, C., Manasse, S. M., & Godfrey, K. M. (2025) · Journal of Behavioral Medicine · doi:10.1007/s10865-025-00550-5 · Cited by 21 · see citing works
“MBSR-based interventions, including meditation practice, breathing exercises, body scans, and gentle yoga, were used by two studies (Smith et al., 2006, 2008).”
Magnusson, G., Ballegaard, S., Karpatschof, B., & Nyboe, J. (2010) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2009.0097 · Cited by 18 · see citing works
“It 29–41 The daily physical exercises included a 20-minute brisk walk without a break, the Royal Canadian Air Force physical fitness program, 42 yoga 43,44 and = or qigong breathing exercises.”
Infusing Mindfulness-Based Interventions in Support Groups for Grieving College Students
Newton, T. L., & Ohrt, J. H. (2018) · The Journal for Specialists in Group Work · doi:10.1080/01933922.2018.1431347 · Cited by 17 · see citing works
Rice, V. J. B., Liu, B., Allison, S. C., & Schroeder, P. J. (2019) · Mindfulness · doi:10.1007/s12671-019-01129-3 · Cited by 17 · see citing works
Terapias cognitivo-conductuales de tercera generación (TTG): la atención plena / mindfulness
Moreno-Coutiño, A. B. (2012) · Revista Internacional de Psicología · doi:10.33670/18181023.v12i01.66 · Cited by 17 · see citing works
Enriching Group Counseling Through Integrating Yoga Concepts and Practices
Rybak, C. J., & Deuskar, M. (2010) · Journal of Creativity in Mental Health · doi:10.1080/15401381003626782 · Cited by 16 · see citing works
“A pilot study conducted a comparison of the effect of an approach called mindfulness-based stress reduction (MBSR) that included yoga, meditation, group discussion, and mindfulness training with the more standard cognitive-behavioral stress reduction ( Smith, B. W, et al, 2008 ).”
MethodBuilding Positive Psychological Resources
Gilbert, E. K., Foulk, T. A., & Bono, J. E. (2017) · doi:10.1002/9781118993811.ch33 · Cited by 14 · see citing works
Daily change patterns in mindfulness and psychological health: A pilot intervention
Kim, S. Y., Suh, H., Oh, W., & Daheim, J. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23043 · Cited by 13 · see citing works
The relationship between neuroticism as a personality trait and mindfulness skills: a scoping review
Angarita‐Osorio, N., Escorihuela, R. M., & Cañete, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1401969 · Cited by 11 · see citing works
Does Well-being Mediate Between Mindfulness and Knowledge Workers’ Work Engagement Relationship?
Goyal, R., & Sharma, H. (2023) · Journal of the Knowledge Economy · doi:10.1007/s13132-023-01313-w · Cited by 11 · see citing works
“Indeed, it would be worthwhile to encourage these initiatives as it will help in improving the degree of mindfulness among knowledge workers as there is scientific evidence that mindfulness can be promoted via a variety of strategies (Smith et al., 2008).”
Mindfulness-Based Programs in School Settings: Current State of the Research
Rawana, J. S., Diplock, B. D., & Chan, S. (2018) · Plenum series on human exceptionality · doi:10.1007/978-3-319-89842-1_18 · Cited by 11 · see citing works
Guillén, J. M. B. (2015) · Revista de la Asociación Española de Neuropsiquiatría · doi:10.4321/s0211-57352015000200005 · Cited by 11 · see citing works
Delaney, C., & Barrere, C. C. P. (2009) · Holistic Nursing Practice · doi:10.1097/hnp.0b013e3181bf381c · Cited by 10 · see citing works
Moody, K. M., Daswani, D., Abrahams, B., & Santizo, R. O. (2010) · Journal of the Society for Integrative Oncology · doi:10.2310/7200.2010.0005 · Cited by 9 · see citing works
Mauduy, M., Mauny, N., & Mange, J. (2022) · Journal of Drug Issues · doi:10.1177/00220426221107560 · Cited by 8 · see citing works
“To this end, mindfulness-based and cognitive-behavioral stress reduction interventions (Smith et al., 2008) are effective for many health-related problems (see Butler et al., 2006 for a review) and thus could be provided to students during individual interviews.”
Contemporary Perspectives on Stress Management: Medication, Meditation or Mitigation
Overholser, J. C., & Fisher, L. B. (2009) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-009-9114-8 · Cited by 8 · see citing works
“Mindfulness training helps to reduce depression (Smith et al. 2008) and emotional exhaustion (Galantino et al. 2005).”
BackgroundJohansson, B., & Bjuhr, H. (2016) · International Journal of Social Science Studies · doi:10.11114/ijsss.v4i3.1389 · Cited by 8 · see citing works
“Several researchers have reported positive effects for chronic conditions including stress, depression, pain, and fatigue connected Lipworth, & Burney, 1985; Smith et al., 2008).”
BackgroundHull, A. E., Holliday, S. B., Eickhoff, C., Sullivan, P., Courtney, R. E., Sossin, K., Adams, A. H., & Reinhard, M. J. (2018) · Psychological Services · doi:10.1037/ser0000192 · Cited by 8 · see citing works
Almenräder, F., Heßmann, G., Voracek, M., & Tran, U. S. (2024) · European Journal of Personality · doi:10.1177/08902070241289160 · Cited by 7 · see citing works
“Thirty-nine studies were designed as RCTs, four were non-randomized cohort studies (Crescentini et al., 2018; Fabbro et al., 2020; Robins et al., 2019; Smith et al., 2008), two studies were single arm trials (Krasner et al., 2009; Ortet et al., 2020).”
- Authors
- Smith, B. W., Shelley, B. M., Dalen, J., Wiggins, K., Tooley, E., & Bernard, J.
- Affiliations
- University of New Mexico (US)
- Venue
- The Journal of Alternative and Complementary Medicine
- Publisher
- SAGE Publications
- Published
- 2008-04
- Volume
- 14
- Issue
- 3
- Pages
- 251-258
- ISSN
- 1075-5535 (ISSN-L)
- 1557-7708
- OpenAlex
- W2009689812
- Semantic Scholar
- e31fcafec5a132bf1eed83b0fcc360ddfb079bff
- Cited by
- 162
- References
- 28
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 1 · 2021: 9 · 2020: 8 · 2019: 14 · 2018: 9 · 2017: 10 · 2016: 8 · 2015: 11 · 2014: 11 · 2013: 18 · 2012: 11
- FWCI
- 12.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Alternative and Complementary Medicine (publishedVersion)
- PubMed (publishedVersion)
- Roger Williams University - Digital Commons (Roger Williams University) (submittedVersion)
- Funders
- McCune Charitable Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- mindfulness-based stress reduction, mindfulness, stress reduction, depression, perceived stress, psychological well-being, neuroticism, binge eating, pain, energy, meditation, body scanning
- MeSH terms
- Adult, Behavior Therapy, Depression, Female, Humans, Male, Middle Aged, Pilot Projects, Quality of Life, Self Care, Stress, Psychological, Yoga, Health Behavior, Exercise, Multivariate Analysis, Treatment Outcome, Meditation, Mind-Body Relations, Metaphysical, Mind-Body Therapies
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