Does it matter how meditation feels? An experience sampling study.

Meditation app users who reported increased positive feelings and decreased negative feelings during practice showed greater reductions in psychological distress, both immediately after the program and three months later. In a randomized trial with 243 distressed public school employees, most of whom had clinically elevated depression or anxiety, negative affect during meditation declined over time while positive affect remained stable. Changes in positive affect predicted later distress more strongly than changes in negative affect. The findings challenge the common mindfulness emphasis on nonjudgmental awareness regardless of emotional tone, suggesting that the affective quality of meditation experience matters for outcomes and could guide personalized intervention.

Study at a glance

Abstract

Meditation apps are the most widely used mental health apps. The precise mechanisms underlying their effects remain unclear. In particular, the degree to which affect experienced during meditation is associated with outcomes has not been established. We used the meditation app arm of a recently completed randomized controlled trial comparing a self-guided meditation app (Healthy Minds Program) to a waitlist control. Predominantly distressed public school employees (n = 243, 80.9% with clinically elevated depression and/or anxiety) reported positive and negative affect during meditation practice. Data were analyzed using two-level multivariate latent growth curve models (observations nested within participants) that simultaneously attended to both positive and negative affect. We examined whether positive and negative affect during meditation changed over time and whether these changes were associated with changes in psychological distress (parent trial's preregistered primary outcome) at posttest or 3-month follow-up. On average, participants reported decreased negative affect but no change in positive affect during meditation over time. Increased positive affect and decreased negative affect during meditation were associated with improvements in distress at posttest and follow-up. Change in positive affect was a stronger predictor of distress at follow-up than change in negative affect. Despite notions embedded within mainstream mindfulness meditation training that deemphasize the importance of the affective experience of practice (i.e., nonjudgmental awareness of present moment experience, regardless of valence), results indicate that these experiences contain signals associated with outcomes. Monitoring affect during meditation may be worthwhile to guide intervention delivery (i.e., measurement-based care, precision medicine). (PsycInfo Database Record (c) 2024 APA, all rights reserved).