Dealing with the COVID-19 pandemic: can self-administered mindfulness help against the stress from lockdown?

The featured image is licensed under a CC BY-SA by Alessandro Sparacio

The coronavirus disease 2019 (COVID-19) outbreak had a massive impact on our lives. The lockdown obliged us to an abrupt change of habits by bringing severe limitations of personal freedoms. The measures taken against COVID-19, such as the lockdown, may well affect people’s mental health. A general population survey in the United Kingdom (with over a thousand people) revealed widespread concerns about the effects of the current situation on their levels of anxiety, depression, and stress (Holmes et al., 2020; Ipsos MORI, 2020).

If the lockdown affects you in a way that puts you at risk for developing mental health issues such as anxiety, depression, or excessive stress, you would probably want to find a strategy to regulate those states. One way to do so that seems especially suited for the current situation, as it does not require large spaces and can be practiced comfortably at home is self-administered mindfulness. Self-administered mindfulness is a type of meditation that consists in increasing the attention to and the awareness of the present moment, with a non-judgmental attitude (Brown, & Ryan 2003). Most awareness exercises like self-administered mindfulness are based on the same idea: each time the mind wanders, the attention is gently brought back to one’s breath or bodily sensations. 

Usually, mindfulness interventions are parts of large programs (which can last 8 weeks) requiring the presence of a qualified instructor. However, self-administered protocols can be engaged in via self-help books, smartphone apps, computer programmes; you don’t always need to be with others to learn and practice mindfulness. These interventions share features such as a non-judgmental attitude and an acceptance of inner experience with other mindfulness protocols. In contrast with other protocols, however, self-administered mindfulness does not require the presence of an instructor, is available 24/7 and is less costly (Spijkerman, Pots, & Bohlmeijer, 2016). Some studies suggest that self-administered mindfulness improved symptoms of perseverative thinking, stress, and depression for a group of students (compared to a passive control group; Cavanagh et al. 2018). 

Despite the study by Cavanagh et al. (2018) yielding a positive result, it is still uncertain whether there is actually evidence supporting self-administered mindfulness. It is no secret that the world of many sciences, including psychology, is affected by some “viruses” that infect the quality of our science in many ways: publication bias (the likelihood that positive results have a higher probability of getting published) and questionable research practices (which is generally used as a term to describe various techniques to obtain significant results that may not actually represent valid evidence). And this can be consequential. Fanelli (2010), for example, estimated that psychology’s and psychiatry’s published findings contain over 90% positive results, a statistical impossibility as the literature is not sufficiently powered to detect findings at that rate. This means that the psychological literature is very likely to contain unreliable findings and that findings that are stable are likely overestimated in their “effect sizes” (a statistical concept that reflects the magnitude of the phenomenon of interest). 

The relative penetration of these viruses into the self-administered mindfulness domain is uncertain. We are far from saying that self-administered awareness interventions are useless, but some caution is needed before we can say that self-administered awareness has demonstrated efficacy in reducing people’s stress levels. A systematic review of literature or a statistical summary of the findings (i.e. a meta-analysis) are necessary to assess the extent to which this strategy is affected by publication bias and to provide an estimate of the true effect behind this type of meditation. We have reasons to believe that existing meta-analyses (e.g., Khoury et al. 2013) did not do this correctly (see e.g., this post by Uri Simonsohn if you are interested in why)1Alternatively, a Registered Report (a type of research protocol in which the manuscript is pre-registered and receives peer-review before data collection) could help identify the efficacy of self-administered mindfulness. A Registered Report is the best “vaccine” against the research problems we outlined before for a twofold reason: 1) The editor commits to publish even non-significant findings (discouraging the use of QRPs) 2) If also negative results are published, it is possible to compute a reliable estimate of the effect size of interest. Even in this case, a registered report that investigates the efficacy of mindfulness in regulating level of stress is missing..

That means that, at the moment, the answer to the title is: we don’t know. As an intervention, self-administered mindfulness currently has a low “Evidence Readiness Level”: we have no way of knowing whether self-administered mindfulness is a reliable intervention against any stress, depression, or anxiety that people may be experiencing as a result of the current situation. And even if we detect that self-administered mindfulness has worked in the populations that were tested, it is also pretty likely that we don’t know how this works across the world: the intervention has not yet been tested across many different populations (and I know of no research that tests it during a global pandemic). 

To investigate this conundrum, part of my PhD project aims to shed light on the potential use of self-administered mindfulness for stress regulation and the affective consequences of stress. We will employ a stringent analysis workflow (including multilevel regression-based models and permutation-based selection models) to test for publication bias in various ways. In other words, I will be able to let you know shortly whether self-administered mindfulness has the benefits for emotion regulation that it currently claims to be having. Although I would have loved to have given you an answer with greater certainty, it is simply too early to tell. As a scientist, I would be remiss to say otherwise. 

This post was written by Alessandro Sparacio & Hans IJzerman

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