A Meta-Analysis Examining the Efficacy and Predictors of Change in Mindfulness- and Self-Compassion-Based Interventions (MBSCIs) in Reducing Psychological Distress Among University Students

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Abstract
Introduction: University students are vulnerable to psychological distress due to the academic and social demands of this life stage. Mindfulness and self-compassion are effective and adaptable strategies in an academic environment that promote emotional regulation and psychological well-being. This study aims to conduct a systematic review and meta-analysis to evaluate the combined impact of mindfulness- and self-compassion-based interventions (MBSCIs) on psychological distress. It will also analyze their role as predictors of therapeutic change, as well as the moderating influence of sociodemographic and contextual factors. Method: We systematically searched PubMed, Scopus and Web of Science for randomized controlled trials (RCTs) and single-group pre-post trials investigating the effect of MBSCI on anxiety, depression and stress in college students. Studies were combined using the inverse variance method in a random effects model. Additional subgroup and meta-regression analyses were performed, and risk of bias was assessed. The review was pre-registered (PROSPERO registration number: CRD420251003822). Results: Our review included 49 studies with a total of 5043 participants (3721 in the intervention group, and 1322 in the control group). The results provide relevant evidence on the efficacy of MBSCI in the university population, especially in reducing symptoms of stress, anxiety, and depression. The effect sizes observed were moderate-to-large for stress and small-to-moderate for anxiety and depression, supporting their clinical usefulness in university educational settings. However, these findings should be interpreted with caution, as no included study achieved low risk of bias, and heterogeneity was moderate-to-high across most outcomes. Conclusions: The results suggest that MBSCI could alleviate psychological distress in university students. However, these results are limited by some methodological issues (risk of bias, heterogeneity, lack of follow-ups, poor standardization). It would be advisable to integrate these practices into the university curriculum as workshops or complementary activities. Further studies are needed to confirm their effectiveness and explore sustained effects and differences according to individual characteristics.

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