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Cited by 25Mindfulness and Compassion InterventionsReligion, Spirituality, and PsychologyPsychotherapy Techniques and Applications

Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study

Open access
Pauly, Luca, Bergmann, Niklas, Hahne, Inge, Pux, Sarah, Hahn, Eric, Ta, Thi Minh Tam, Rapp, Michael, Böge, Kerem·2022·BJPsych Open
DOI 10.1192/bjo.2021.1066PMC PMC8693904
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Abstract

Background: Meditation is commonly implemented in psychological therapies since the ‘third wave’ of cognitive–behavioural therapy has increased the focus on mindfulness-based interventions. Although extensive research literature demonstrates its benefits, little is known about potential adverse effects. Aims: The aim of this study is to report the prevalence, type and severity of particularly unpleasant meditation-related experiences in the largest cross-sectional study on this topic to date, with 1370 regular meditators. Method: The participants were asked whether they ever encountered particularly unpleasant experiences as a result of their meditation experience. For the first time, the type and severity of those experiences were assessed and the association with several predictors, such as pre-existing mental disorders, were explored via logistic and linear regression. Results: Similar to previous studies, 22% of participants (95% CI 20–24) reported having encountered unpleasant meditation-related experiences, and 13% of participants (95% CI 3–5) reported experiences that were categorised as adverse. Those were mostly of affective, somatic and cognitive nature. Unpleasant meditation-related experiences were more likely to occur in participants with pre-existing mental illnesses (P= 0.000, 95% CI 1.25–2.12). Conclusions: This study demonstrates that unpleasant meditation-related experiences are prevalent among meditators and, to a relevant extent, severe enough to warrant further scientific inquiry. Longitudinal studies are needed to examine whether the unpleasant meditation-related experiences are merely negative and thus should be avoided, or are an inherent part of the contemplative path.

AI snapshot

Written from the paper’s full text.

TL;DR

In an international cross-sectional survey of 1,370 regular meditators, 22% reported particularly unpleasant meditation-related experiences and 13% reported experiences categorised as adverse. Pre-existing mental disorders, retreat experience, repetitive negative thinking, and neuroticism were associated with higher odds of unpleasant experiences, while deconstructive meditation type was not.

Key findings

  • 22% (n = 301) reported unpleasant meditation-related experiences; severity breakdown was 8.9% mild, 8.8% moderate, 3.1% severe, 0.9% very severe, and 0.2% extremely severe, with 13% total categorised as adverse.
  • Unpleasant experiences were mostly affective (16.3%), somatic (13.4%), and cognitive (11.5%).
  • Pre-existing mental disorders were associated with higher odds of unpleasant experiences (OR 1.63, 95% CI 1.25–2.12, P = 0.000) and higher severity (ß = 0.38, s.e. = 0.10, 95% CI 0.18–0.58, P = 0.000).
  • Retreat experience (OR 1.89, 95% CI 1.43–2.48, P = 0.000), repetitive negative thinking (OR 1.34, 95% CI 1.12–1.60, P = 0.002), and neuroticism (OR 1.29, 95% CI 1.13–1.48, P = 0.000) were also associated with occurrence; deconstructive meditation type was not significant (OR 1.63, 95% CI 0.67–3.94, P = 0.279).

Methods

  • Cross-sectional online survey conducted June 2020–May 2021; 11,143 started, 1,760 completed, and 1,370 regular meditators were analysed after exclusions.
  • Participants reported meditation experience, type, retreat attendance, pre-existing mental disorders, and unpleasant/adverse effects; mindfulness (MAAS), repetitive negative thinking (PTQ), and neuroticism (BFI) were measured.
  • Logistic regression modelled occurrence of unpleasant experiences and linear regression modelled severity, including predictors such as meditation type, retreat, mindfulness, repetitive negative thinking, neuroticism, and pre-existing mental disorders.

Limitations

  • The paper states that the cross-sectional design prevents causal conclusions; timing/context of experiences was not assessed, and mindfulness/repetitive thinking captured current status.
  • Occurrence, type, and severity were each assessed by only one question, self-reports were not previously validated, attribution to meditation was subjective, and memory bias/underreporting are possible.
  • The paper also notes only 15.8% of starters completed the survey, risking selection bias; positive effects were not assessed; and the deconstructive-only subgroup was small (2.2%, n = 30), limiting conclusions about meditation type.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1192/bjo.2021.1066

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 38 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    3.1% of participants reported severe effects in need of countermeasures.

    “3.1% (n = 43) reported severe effects in need of countermeasures”
    Quote in the paperSubstantial claim
  • Findingown data

    8.9% of participants reported mild unpleasant experiences without consequences.

    “8.9% of all participants (n = 122) indicated mild experiences without consequences, which were categorised as unpleasant but temporary meditation-related effects.”
    Quote in the paperNot a substantial claim
  • Findingown data

    8.8% of participants reported moderate adverse effects.

    “8.8% (n = 120) reported moderate adverse effects”
    Quote in the paperNot a substantial claim
  • Findingown data

    13% of participants reported experiences that were categorised as adverse.

    “13% of participants (95% CI 3–5) reported experiences that were categorised as adverse”
    • Also stated in: § Results · plain
      “Moderate to extremely severe experiences were categorised as adverse effects, which were reported by 13% in total.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The unpleasant experiences reported by participants were caused by their meditation practice.
  • Findingown data

    Unpleasant meditation-related experiences were more likely to occur in participants with pre-existing mental illnesses (OR 1.63, 95% CI 1.25-2.12, P = 0.000).

    “Unpleasant meditation-related experiences were more likely to occur in participants with pre-existing mental illnesses (P = 0.000, 95% CI 1.25–2.12).”
    • Also stated in: § Results · boosted
      “Strong evidence was found that people with a mental disorder before they started meditating had higher odds of having particularly unpleasant meditation-related experiences (odds ratio 1.63, 95% CI 1.25–2.12, P = 0.000).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Participants accurately reported whether they had a pre-existing mental disorder before starting meditation.
  • May combine two claims. 16
  • Classified as probably not a substantial claim. 27

  • May combine two claims.

    Findingown data

    The percentage of participants only practising deconstructive meditation types was relatively small (2.2%, n = 30), while the majority indicated deconstructive as well as non-deconstructive meditation types (64.9%, n = 889).

    “It is crucial to mention that the percentage of participants only practising deconstructive meditation types was relatively small (2.2%, n = 30), as the majority indicated deconstructive as well as non-deconstructive meditation types (64.9%, n = 889).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    A sample of at least N = 717 was required to reach sufficient power of 0.80.

    “To test the hypotheses, a sample of at least N = 717 people who completed the study was required to reach sufficient power of 0.80.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The BFI items displayed high internal reliability across samples, with a Cronbach's alpha of 0.86 for the neuroticism factor.

    “The BFI items displayed high internal reliability across samples, with a Cronbach's alpha of 0.86 for the neuroticism factor.24”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Waddell J, Nissen L, Hale A, Kyle G. Using the Big Five inventory to evaluate the personality traits of Australian pharmacists. Int J Pharm Pract 2019; 28(3): 275–81. 31828855 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Less than a quarter of studies on meditation assessed possible adverse effects, which leads to a probable underestimation.

    “Less than a quarter of studies on meditation assessed possible adverse effects, which leads to a probable underestimation.4,5”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [4] Goyal M, Singh S, Sibinga E, Gould N, Rowland-Seymour A, Sharma R, Meditation programs for psychological stress and well-being. JAMA Intern Med 2014; 174(3): 357. 24395196 PMC4142584 source

      Not checked in the free run.

    • cites [5] Jonsson U, Alaie I, Parling T, Arnberg F. Reporting of harms in randomized controlled trials of psychological interventions for mental and behavioral disorders: a review of current practice. Contemp Clin Trials 2014; 38(1): 1– 8. 24607768 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The MAAS has displayed good psychometric properties, with a Cronbach's alpha of 0.89-0.93.

    “The MAAS has displayed good psychometric properties, with a Cronbach's alpha of 0.89–0.93.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Black D, Sussman S, Johnson C, Milam J. Psychometric assessment of the Mindful Attention Awareness Scale (MAAS) among Chinese adolescents. Assessment 2011; 19(1): 42– 52. 21816857 PMC3705937 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Mindfulness was measured with the validated MAAS.

    “Mindfulness was measured with the validated MAAS.21”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Brown K, Ryan R. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 2003; 84(4): 822–48. 12703651 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Pre-existing mental disorders were included as covariates in subsequent analysis to control for possible confounding.

    “To control for possible confounding, pre-existing mental disorders were included as covariates in the subsequent analysis.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Schlosser et al. indicated that repetitive thinking is positively associated with the occurrence of unpleasant meditation-related experiences.

    “Schlosser et al6,14 indicated that repetitive thinking is positively associated with the occurrence of unpleasant meditation-related experiences.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [6] Schlosser M, Jones R, Demnitz-King H, Marchant N. Meditation experience is associated with lower levels of repetitive negative thinking: the key role of self-compassion. Curr Psychol [Epub ahead of print] 9 Jun 2020. Available from: 10.1007/s12144-020-00839-5. source

      Not checked in the free run.

    • cites [14] Schlosser M, Sparby T, Vörös S, Jones R, Marchant N. Unpleasant meditation-related experiences in regular meditators: prevalence, predictors, and conceptual considerations. PLoS One 2019; 14(5): e0216643. 31071152 PMC6508707 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Because of the cross-sectional design, it cannot be assessed whether the meditation practice was applied correctly.

    “Because of the cross-sectional design of the study, it cannot be assessed whether the meditation practice was applied correctly.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Schlosser et al. found that 25.6% of regular meditators reported having had particular unpleasant meditation-related experiences.

    “A recent larger-scale, cross-sectional online study by Schlosser et al, on unpleasant meditation-related experiences, indicated that 25.6% of regular meditators reported having had particular unpleasant meditation-related experiences.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Schlosser M, Jones R, Demnitz-King H, Marchant N. Meditation experience is associated with lower levels of repetitive negative thinking: the key role of self-compassion. Curr Psychol [Epub ahead of print] 9 Jun 2020. Available from: 10.1007/s12144-020-00839-5. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The PTQ has displayed excellent psychometric properties across samples, with Cronbach's alpha ranging from 0.94 to 0.95.

    “The PTQ has displayed excellent psychometric properties across samples: Cronbach's alpha ranged from 0.94 to 0.95.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Ehring T, Zetsche U, Weidacker K, Wahl K, Schönfeld S, Ehlers A. The Perseverative Thinking Questionnaire (PTQ): validation of a content-independent measure of repetitive negative thinking. J Behav Ther Exp Psychiatry 2011; 42(2): 225–32. 21315886 PMC3042595 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Other recent studies found that between 50 and 53% of meditators reported at least one meditation-related adverse effect, and 6-14% reported enduring negative adverse effects.

    “Other recent studies found that between 50 and 53% of meditators reported at least one meditation-related adverse effect,7,8 and 6–14% reported enduring negative adverse effects.7”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] Britton WB, Lindahl JR, Cooper DJ, Canby NK, Palitsky R. Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clin Psychol Sci 2021; 9(6): 1185–204. PMC8845498 35174010 source

      Not checked in the free run.

    • cites [8] Goldberg SB, Lam SU, Britton WB, Davidson RJ. Prevalence of meditation-related adverse effects in a population-based sample in the United States. Psychother Res [Epub ahead of print] 2 Jun 2021. Available from: 10.1080/10503307.2021.1933646. PMC8636531 34074221 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Positive correlations of neuroticism with negative affect, anxiety and stress, as well as negative correlations with well-being and mindfulness, have been found.

    “Positive correlations of neuroticism with negative affect, anxiety and stress, as well as negative correlations with well-being and mindfulness, have been found.15–17”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [15] Baer R, Smith G, Allen K. Assessment of mindfulness by self-report. Assessment 2004; 11(3): 191– 206. 15358875 source

      Not checked in the free run.

    • cites [16] Costa P, McCrae R. The five-factor model, five-factor theory, and interpersonal psychology. In Handbook of Interpersonal Psychology: Theory, Research, Assessment, and Therapeutic Interventions (eds LM Horowitz, S Strack): 91– 104. Wiley, 2010. source

      Not checked in the free run.

    • cites [17] Crescentini C, Capurso V. Mindfulness meditation and explicit and implicit indicators of personality and self-concept changes. Front Psychol 2015; 6: 44. PMC4310269 25688222 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was preregistered at aspredicted.org (no. 42195).

    “This study was preregistered at https://aspredicted.org/pm34k.pdf (no. 42195).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Repetitive negative thinking is associated with symptoms of depression and anxiety.

    “It has been shown that repetitive negative thinking is associated with symptoms of depression and anxiety.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Ehring T, Zetsche U, Weidacker K, Wahl K, Schönfeld S, Ehlers A. The Perseverative Thinking Questionnaire (PTQ): validation of a content-independent measure of repetitive negative thinking. J Behav Ther Exp Psychiatry 2011; 42(2): 225–32. 21315886 PMC3042595 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Repetitive negative thinking is a transdiagnostic process that manifests across a wide spectrum of mental health disorders, including depression, obsessive-compulsive disorder, panic disorder and psychosis.

    “Preservative negative thinking is a transdiagnostic process that manifests across a wide spectrum of mental health disorders, including depression, obsessive–compulsive disorder, panic disorder and psychosis.13,30”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13] Ehring T, Zetsche U, Weidacker K, Wahl K, Schönfeld S, Ehlers A. The Perseverative Thinking Questionnaire (PTQ): validation of a content-independent measure of repetitive negative thinking. J Behav Ther Exp Psychiatry 2011; 42(2): 225–32. 21315886 PMC3042595 source

      Not checked in the free run.

    • cites [30] McEvoy PM, Brans S. Common versus unique variance across measures of worry and rumination: predictive utility and mediational models for anxiety and depression. Cognit Ther Res 2013; 37(1): 183–96. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    People with mental disorders could tend to overidentify with unpleasant emotions, being unable to let go of them, and thus enhance the severity and resulting distress of unpleasant meditation-related experiences.

    “People with mental disorders could tend to overidentify with unpleasant emotions, being unable to let go of them, and thus enhancing the severity and resulting distress of unpleasant meditation-related experiences.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Because there was no evidence for higher severity of unpleasant experiences in people who had attended a retreat, definite conclusions about the effects of retreats cannot be drawn.

    “As there was no evidence found for higher severity of unpleasant experiences in people who had attended a retreat, definite conclusions about the effects of retreats cannot be drawn.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many studies examining the relationship between negative affectivity and adverse outcomes focus on traits that might be considered facets of neuroticism, such as trait hostility and anger.

    “Indeed, many studies examining the relationship between negative affectivity and adverse outcomes focus on traits that might be considered facets of neuroticism, such as trait hostility and anger.18”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Smith T, Glazer K, Ruiz J, Gallo L. Hostility, anger, aggressiveness, and coronary heart disease: an interpersonal perspective on personality, emotion, and health. J Pers 2004; 72(6): 1217–70. 15509282 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Practising meditation may cause vulnerable individuals to be more aware of their sensations, emotions and thoughts, resulting in increased reporting of unpleasant experiences.

    “Practising meditation may cause vulnerable individuals to be more aware of their sensations, emotions and thoughts,29 resulting in the increased reporting of unpleasant experiences seen in the current study.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] Morone N, Moore C, Greco C. Characteristics of adults who used mindfulness meditation: United States, 2012. J Altern Complement Med 2017; 23(7): 545–50. 28084788 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Meditators who encounter unpleasant experiences may participate in retreats to receive further guidance and supervision in their meditation practice.

    “Another explanation could be that meditators who encounter unpleasant experiences participate in retreats to receive further guidance and supervision in their meditation practice.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Retreat-specific characteristics presumably represent a context that makes unpleasant experiences more likely.

    “Retreat-specific characteristics presumably represent a context that makes unpleasant experiences more likely.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Participants with heightened levels of repetitive negative thinking possibly find it harder to disengage from unpleasant thoughts that can arise during meditation.

    “Participants with heightened levels of repetitive negative thinking possibly find it harder to disengage from unpleasant thoughts that can arise during meditation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The prevalence of unpleasant meditation-related experiences found in this study is in line with rates found in previous studies using a similar open-ended question format, whereas studies using systematic monitoring found higher rates.

    “Those numbers are in line with rates found in previous studies that used a similar open-ended question format,6,25–28 whereas studies using systematic monitoring of unpleasant experiences found higher rates.7,8”
    Quote in the paperNot a substantial claim0 of 7 sources checked
    • cites [6] Schlosser M, Jones R, Demnitz-King H, Marchant N. Meditation experience is associated with lower levels of repetitive negative thinking: the key role of self-compassion. Curr Psychol [Epub ahead of print] 9 Jun 2020. Available from: 10.1007/s12144-020-00839-5. source

      Not checked in the free run.

    • cites [25] Anderson T, Suresh M, Farb NAS. Meditation benefits and drawbacks: empirical codebook and implications for teaching. J Cogn Enhanc 2019; 3(2): 207–20. source

      Not checked in the free run.

    • cites [26] Cebolla A, Demarzo M, Martins P, Soler J, Garcia-Campayo J. Unwanted effects: is there a negative side of meditation? A multicentre survey. PLoS One 2017; 12(9): e0183137. 28873417 PMC5584749 source

      Not checked in the free run.

    • cites [27] Lomas T, Cartwright T, Edginton T, Ridge D. A qualitative analysis of experiential challenges associated with meditation practice. Mindfulness 2014; 6(4): 848–60. source

      Not checked in the free run.

    • cites [28] Vieten C, Wahbeh H, Cahn B, MacLean K, Estrada M, Mills P, Future directions in meditation research: recommendations for expanding the field of contemplative science. PLoS One 2018; 13(11): e0205740. 30403693 PMC6221271 source

      Not checked in the free run.

    • cites [7] Britton WB, Lindahl JR, Cooper DJ, Canby NK, Palitsky R. Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clin Psychol Sci 2021; 9(6): 1185–204. PMC8845498 35174010 source

      Not checked in the free run.

    • cites [8] Goldberg SB, Lam SU, Britton WB, Davidson RJ. Prevalence of meditation-related adverse effects in a population-based sample in the United States. Psychother Res [Epub ahead of print] 2 Jun 2021. Available from: 10.1080/10503307.2021.1933646. PMC8636531 34074221 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    Participants with pre-existing mental disorders could seek to meditate to manage their symptoms better and consolidate a more productive way of handling unpleasant emotions.

    “Participants with pre-existing mental disorders could also seek to meditate to manage their symptoms better and consolidate a more productive way of handling unpleasant emotions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat or frustration.

    “The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat or frustration.16”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Costa P, McCrae R. The five-factor model, five-factor theory, and interpersonal psychology. In Handbook of Interpersonal Psychology: Theory, Research, Assessment, and Therapeutic Interventions (eds LM Horowitz, S Strack): 91– 104. Wiley, 2010. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    A total of 390 participants were excluded from the analyses for reasons including age under 18, no meditation experience, only yoga practices, no demonstrated meditation practices, less than 2 months of meditation experience, and practising less than once a week.

    “In the next step, a total of 390 participants were excluded from the analyses: 29 indicated an age <18 years, 148 had no meditation experience, 52 indicated only yoga practices, 11 did not demonstrate meditation practices, 140 had <2 months of meditation experience and 10 practised less than once a week.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    A total of 11,143 individuals started the survey, of which 1760 completed it.

    “A total of 11 143 individuals started the survey, of which 1760 completed it.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The questionnaire involved self-reports that were not previously validated.

    “The questionnaire involved self-reports that were not previously validated.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Because of the cross-sectional nature of the study, no conclusions about causality can be drawn.

    “Because of the cross-sectional nature of the study, no conclusions about causality can be drawn.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Participants self-attributed the unpleasant experiences to their meditation practise; however, this attribution is subjective, and it is not entirely clear whether the unpleasant experience might have also arisen without the meditation practice.

    “Participants self-attributed the unpleasant experiences to their meditation practise; however, this attribution is subjective, and it is not entirely clear whether the unpleasant experience might have also arisen without the meditation practice.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The positive effects of meditation were not assessed; therefore, no conclusion can be drawn from the data about the relation of cost and benefits of meditation practices.

    “Furthermore, the positive effects of meditation were not assessed; therefore, no conclusion can be drawn from the data about the relation of cost and benefits of meditation practices.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The exact time and context in which the unpleasant experiences occurred were not assessed; thus, they could have taken place a long time ago, whereas variables such as mindfulness and repetitive negative thinking captured the status quo.

    “The exact time and context in which the unpleasant experiences occurred were not assessed; thus, they could have taken place a long time ago, whereas variables such as mindfulness and repetitive negative thinking captured the status quo.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Open-ended question formats seem to underestimate the prevalence of adverse effects by nearly 70%, which could have led to an underreporting of adverse effects.

    “Open-ended question formats seem to underestimate the prevalence of adverse effects by nearly 70%, which could have led to an underreporting of adverse effects.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Britton WB, Lindahl JR, Cooper DJ, Canby NK, Palitsky R. Defining and measuring meditation-related adverse effects in mindfulness-based programs. Clin Psychol Sci 2021; 9(6): 1185–204. PMC8845498 35174010 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The data is suggestive of an interaction-based model where meditation practice on its own may lead to unpleasant experiences, but the specific type of effect and associated impairment is influenced by a number of factors.

    “The data is suggestive of an interaction-based model where meditation practice on its own may lead to unpleasant experiences, but the specific type of effect and associated impairment is influenced by a number of factors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The findings suggest that there is no specific personality type that is prone to adverse effects of meditation, but that other factors such as mental illness are more decisive.

    “The findings suggest that there is no specific personality type that is prone to adverse effects of meditation, but that other factors such as mental illness are more decisive.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    There may be a memory bias as most of the effects might have occurred some time ago, and may be forgotten and thus underreported.

    “Also, there may be a memory bias as most of the effects might have occurred some time ago, and may be forgotten and thus underreported.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Only 15.8% of participants who started the survey completed it, which could have led to selection bias.

    “Another limitation of our sample is that only 15.8% of participants who started the survey completed it. This presumably can be assigned to the rather long protocol and could have led to selection bias.”
    Quote in the paperNot a substantial claim
38 of 38

  • The paper relies on this without support.

    The unpleasant experiences reported by participants were caused by their meditation practice.

    “Have you ever had any particularly unpleasant experiences which you think may have been caused by your meditation practice?”

  • The paper relies on this without support.

    The sample of 1370 regular meditators is representative of regular meditators in general.

    “The link to the questionnaire was sent to international meditation and Buddhist centres, meditation teachers, therapists that teach Mindfulness-based Stress Reduction and other mindfulness communities. It was shared on Instagram and Facebook, and platforms to recruit participants, such as PollPool and SurveyCircle.”

  • The paper relies on this without support.

    Participants accurately reported whether they had a pre-existing mental disorder before starting meditation.

    “We assessed whether participants had a history of pre-existing mental disorders. To clarify the time of disease onset, participants were directly asked if they ever had a mental disorder before they started to practice meditation.”

  • The authors state this as an assumption.

    The mental disorders preceded the unpleasant experiences and not the other way around.

    “As the onset of the mental illness had been before they started to meditate, it can be assumed that the mental disorders preceded the unpleasant experiences and not the other way around.”

  • The authors state this as an assumption.

    Pre-existing mental illness determines the association of repetitive negative thinking and unpleasant meditation-related experiences.

    “Therefore, it could be assumed that pre-existing mental illness determines the association of repetitive negative thinking and unpleasant meditation-related experiences.”

  • The paper relies on this without support.

    This is the first time the role of neuroticism has been examined regarding unpleasant meditation-related experiences.

    “This is the first time the role of neuroticism has been examined regarding unpleasant meditation-related experiences.”

  • The paper relies on this without support.

    This study is the first to examine those factors in such a large sample.

    “This study is the first to examine those factors in such a large sample, and so the results should not be interpreted as conclusive, but should warrant further investigation.”

  • The paper relies on this without support.

    In previous studies, pre-existing mental disorders were often not assessed.

    “In previous studies, pre-existing mental disorders were often not assessed; thus, this represents an important finding.”
8 of 8

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.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reported number practising both meditation types exceeds the deconstructive total

    Major

    The discussion says 889 participants practised both deconstructive and non-deconstructive types. That cannot be reconciled with Table 1's total of only 636 participants practising deconstructive types.

  • Adverse-effect confidence interval excludes the reported prevalence

    Minor

    The abstract reports 13% adverse effects with a 95% confidence interval of 3-5%. The interval excludes 13%; moreover, the 8.8% reporting moderate adverse effects alone exceeds its upper bound.

  • No-belief percentage uses the full sample rather than the stated group

    Minor

    Table 2 labels 118 cases as 8.6% of the no-belief group, but that group contains 519 people, making the within-group percentage 22.7%. The belief row likewise reports 183 cases as 13.4%, rather than 21.5% of its stated group of 850.

    Reported 8.6 · recomputed 22.736031

  • Table 1 title gives the wrong sample size

    Minor

    The table title says it describes 866 regular meditators, whereas the methods state that 1370 were included in the analyses. The table's percentages also use approximately 1370 as their denominator.

4 of 4

The citation lists haven’t been fetched yet

References 34 · Cited by 25

Research works printed but not linked: 1

  1. 2010, Conceptual Framework for the International Classification for Patient Safety

Authors
Pauly, L., Bergmann, N., Hahne, I., Pux, S., Hahn, E., Ta, T. M. T., Rapp, M., & Böge, K.
Affiliations
  • Psychologische Hochschule Berlin (DE)
  • Charité – Universitätsmedizin Berlin (DE)
  • University of Potsdam (DE)
Corresponding author
Böge, Kerem
ORCID
Venue
BJPsych Open
Publisher
Royal College of Psychiatrists
Published
2021-12-10
Volume
8
Issue
1
ISSN
2056-4724 (ISSN-L)
DOI
10.1192/bjo.2021.1066
PMC
PMC8693904
OpenAlex
W4205621109
Semantic Scholar
997cc1401c5baea6f6f942ac0f2934124e131123
Cited by
25
References
34
Citations by year
2026: 8 · 2025: 8 · 2024: 5 · 2023: 2 · 2022: 2
FWCI
1.54
Type
journal article
Language
en
Open access
Licence
Locations
  • BJPsych Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by)
  • Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver (cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
meditation, mindfulness-based interventions, prevalence, predictive factors, pre-existing mental disorders, emotional experience, somatic experience, cognitive experience, contemplative practice

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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.

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