Breedvelt, J., Y. Amanvermez, M. Harrer, E. Karyotaki, S. Gilbody, C. Bockting, P. Cuijpers, and D. Ebert.“The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis.” Frontiers in Psychiatry 10, no. 193 (2019): 1–15.
CENTRAL TAKEAWAY
Meditation, yoga, and mindfulness may be an inexpensive way to reduce the incidence of moderate to severe mental health concerns like depression, stress, and anxiety in student populations. They may also offer a more welcoming and less stigmatized environment for students who wish to avoid scrutiny over their mental health decisions.
SUMMARY
Due to the rising frequency of mental health issues among postsecondary students and a growing recognition of the negative effects these issues have on important outcomes like physical health, cognitive development, academic performance, productivity, and overall wellbeing, many institutions of higher education have sought to supplement traditional psychological treatments with alternative medicine practices like meditation, yoga, and mindfulness. Indeed, many institutions now offer wellness programs and courses focused on these alternative practices.
However, the degree to which these activities are preventative of or are effective at treating these mental health conditions has been occluded by the generally poor quality of research in this area. The present study seeks to provide clarity on these issues, asking, “What are the effects of mindfulness, meditation, and yoga on depression, anxiety, stress, and academic achievement in tertiary education students vs. control?” (p. 2). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol, the authors identified 24 qualitative studies and 23 quantitative studies examining postsecondary student populations. The qualitative studies were synthesized via a systematic review, while the quantitative articles were analyzed using highly sophisticated meta-analysis methods that included subgroup analyses as well as corrective measures for design bias, researcher allegiance to a particular outcome, and the use of convenience samples. In total, the quantitative studies included 1,373 participants across all conditions (no treatment; standard treatment; meditation, yoga, or mindfulness treatment).
DISCUSSION OF THE FINDINGS
Meditation, yoga, and mindfulness appear to moderately improve the symptoms of depression (g=0.42), anxiety (g=0.46), and stress (g=0.42) when compared to receiving no treatment at all. These effects appear to be somewhat durable, with similar effect sizes evident during long-term follow up examinations that occurred between one and 24 months after formal treatment concluded. Notably, the effect size on depression is similar to that produced by recent meta-analyses of cognitive behavioral therapy on mixed clinical and non-clinical populations and was nearly twice as effective as internet-based interventions.
But is meditation, yoga, or mindfulness better than standard treatments? The meta-analysis concluded that there is “no evidence” that these alternative treatments are “more effective than active control” treatments which here consisted variously of pharmaceuticals, exercise, or cognitive behavioral therapy (p. 12). Therefore, the benefits of meditation, yoga, and mindfulness may in fact be due to third factors, like doing any activity that includes social interaction and peer support, or that requires scheduling activities. Interestingly, the length of treatment with meditation, yoga, or mindfulness did not seem to influence their effectiveness.
IMPLICATIONS FOR ACTION BY CAMPUS LEADERS
Given the state of the evidence, and their rough parity in efficacy compared to standard treatments, there seems to be little downside to instantiating meditation, yoga, and mindfulness experiences on campus. While these practices are not a replacement for standard therapies, their scalability and reduced cost compared to psychotherapy suggest they may have a role to play in preventing mental health issues from arising or from becoming as severe as they otherwise would be.
Furthermore, as for-credit classes or on-campus activities, these practices may present a lower barrier for entry for students who may struggle to navigate complex mental health treatment systems. This, combined with the relative lack of stigma around the alternative practices, may be especially beneficial for students whose families, home cultures, religions, and/or political views continue to stigmatize mental health concerns.
ABOUT THE AUTHORS
Josefien J. F. Breedvelt is a Prudence Trust Research Fellow at King’s College London.
Yagmur Amanvermez is a researcher in the Department of Social and Behavioral Sciences at Tilburg University.
Mathias Harrer is a researcher at the Technische Universität München.
Eirini Karyotaki is an associate professor in the Department of Clinical, Neuro- and Developmental Psychology at Vrije Universiteit Amsterdam.
Simon Gilbody is a professor of psychological medicine and psychiatric epidemiology at the University of York.
Claudi L. H. Bockting is a professor of clinical psychology at the Amsterdam University Medical Center.
Pim Cuijpers is a professor in the Department of Clinical, Neuro-, and Developmental Psychology at Vrije Universiteit Amsterdam.
David D. Ebert is a professor of psychology and digital mental health care at the Technische Universität München.
RECOMMENDED FOLLOW-UP LITERATURE
Huang, J., Y. Nigatu, R. Smail-Crevier, X. Zhang, J. Wang. “Interventions for Common Mental Health Problems among University and College Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Journal of Psychiatric Research 107 (2018): 1–10. https://doi.org/10.1016/j.jpsychires.2018.09.018