Nicholas Ian Bowles

Background/Objectives: Psychological benefits have been demonstrated across a variety of different meditation offerings. There remains, however, limited evidence clarifying how different ‘doses’ of meditation relate to benefits, highlighting fundamental limitations for clinical best practice. The present study aimed to examine dose–response effects across a range of daily mindfulness meditation durations in a well-powered randomized controlled experiment, while also investigating whether actual practice behaviour predicts improved outcomes, independent of assigned dose.Method: A total of 716 meditation-naïve, healthy adults were randomized to one of four daily mindfulness practice conditions (4-, 10-, 20-, or 30-minutes) over a 28-day online intervention. The primary outcome was wellbeing, and secondary outcomes included mindfulness-related constructs and mental health symptoms. Primary analyses used a constrained longitudinal design within an intention-to-treat approach to test for differences between assigned dose groups. Secondary per-protocol analyses were conducted to reduce effects of nonadherence. Exploratory analyses examined five measures of practice dose, alongside motivation and expectancy variables, as predictors of outcomes.Results: Significant improvements were observed across all outcomes and arms from baseline to post-intervention (|SMD| = 0.29–0.56, FDR-adjusted p < .05). We found no evidence of a dose–response effect based on assigned practice dose in either intention-to-treat or per-protocol analyses for any outcome (all p’s > .05). While 70.9% of those in the 10-minute group completed 2/3 of sessions, only 65.3% and 48.5% of participants did the same in the 20- and 30-minute groups, respectively. In exploratory analyses, practice engagement was significantly related to 8/10 outcomes ([β] = 0.05-0.14), while goal confidence was significantly related to 9/10 outcomes ([β] = 0.08-0.21), and time was significantly related to changes on all outcomes ([β] = 0.26-0.54; FDR-adjusted p < .05). Conclusions: These findings suggest that within the first 30 days of practice among non-clinical, beginner populations there is no evidence that longer doses (up to 30 min) are more beneficial than shorter doses (down to 5 min) of daily meditation, while practice engagement and confidence in the efficacy of meditation may impact effects.

Mindfulness meditation is now practiced broadly in both religious and secular contexts, with numerous studies indicating potential benefits across a range of psychosocial domains. However, despite significant research effort, we still know little about dose-response effects—how frequently or for how long individuals might need to practice mindfulness meditation to achieve certain practice goals. Increasingly, recommended amounts of practice are becoming shorter, with unclear effects on outcomes. We review and critically appraise the state of knowledge about dose-response effects drawn from empirical investigations, traditional sources, and trends in contemporary teaching and practice. We argue that limitations inherent to the range of doses and analytic approaches used in previous studies reduce our ability to inform the dose-response question. We propose a practical research agenda that prioritizes the question of dose response, incorporating design features optimized specifically to understand the dose-response relationship and how it might vary between outcomes and individuals. Prioritizing the dose-response agenda will allow us to reconcile differences between knowledge sources and enable us to optimize mindfulness programs based on individuals, their goals, and the context in which they practice. Mindfulness meditation is now practiced broadly in both religious and secular contexts, with numerous studies indicating potential benefits across a range of psychosocial domains. However, despite significant research effort, we still know little about dose-response effects—how frequently or for how long individuals might need to practice mindfulness meditation to achieve certain practice goals. Increasingly, recommended amounts of practice are becoming shorter, with unclear effects on outcomes. We review and critically appraise the state of knowledge about dose-response effects drawn from empirical investigations, traditional sources, and trends in contemporary teaching and practice. We argue that limitations inherent to the range of doses and analytic approaches used in previous studies reduce our ability to inform the dose-response question. We propose a practical research agenda that prioritizes the question of dose response, incorporating design features optimized specifically to understand the dose-response relationship and how it might vary between outcomes and individuals. Prioritizing the dose-response agenda will allow us to reconcile differences between knowledge sources and enable us to optimize mindfulness programs based on individuals, their goals, and the context in which they practice.

The popularity of meditation has surged in recent years, driven by the accessibility of digital platforms. In this context, shorter sessions have become common, often accompanied by claims of substantial benefits. The vast differences in practice intensity—from traditional monastic training and residential retreats to multi‐week Mindfulness‐Based Programs and infrequent digital home practice—raise the question of how much practice is necessary to see meaningful benefits. Our previous analysis of lifetime practice history suggested that 160 hours were required for clinically meaningful improvements in psychological distress and life satisfaction, with more needed for stable changes in affect. However, those findings could not address the effects of newly undertaken practice, the best ways to accumulate experience, or how these effects vary by practice history. This study fills these gaps by examining dose–response relationships in a diverse sample of meditators engaging in self‐directed practice in ecologically valid settings, while testing the moderating effects of practice history, personality traits, and meditation goals. One thousand fifty‐three participants provided data across nine surveys over a two‐month period of prospectively monitored, self‐directed meditation practice, followed by a 2‐ to 4‐year follow‐up. Using a longitudinal design, we examined associations between meditation practice dose and outcomes including positive and negative affect, psychological distress, and life satisfaction. Meditation practice dose was significantly associated with improvements in well‐being, affect, and distress, with practice frequency being a stronger predictor of beneficial outcomes than session duration. During the 2‐month prospective period, after controlling for prior lifetime practice, 35 to 65 minutes daily practice was required for meaningful improvements in well‐being, and 50 to 80 minutes daily was needed for meaningful improvements in mental health outcomes. Dose–response effects were moderated by lifetime practice experience across all outcomes, while negative emotionality moderated the relationship for mental health‐related outcomes. Additionally, valuing mental health as a practice goal moderated dose–response effects for mental health outcomes, and cumulative practice from baseline to follow‐up predicted increased valuation of spiritual growth as a practice goal. Our findings indicate that practitioners with varied practice histories, personality traits, and practice goals/motivations benefit from meditation on outcomes measuring mental health and well‐being, with such benefits maintained over a 2–4 year follow‐up period.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Mindfulness meditation has demonstrated modest benefits for mental health and wellbeing, although the relationship between practice dose and outcomes is unclear. Meta-analyses and randomized controlled trials have shown mixed results so far, although such results may stem from methodological issues rather than reflecting the absence of an underlying effect. Research outside structured programs suggests that long-term practice time is linked to positive outcomes, but bias due to self-selection over time may explain these results. The proposed trial aims to test dose-response effects for an online mindfulness meditation course, examining outcomes and participant engagement across different practice doses. Objective: In this pragmatic randomized controlled trial, we hypothesize that larger doses of mindfulness training will yield significantly larger effects, and different doses will be significantly associated with variation in participant engagement, with lower engagement evident for higher doses. Methods: At least 688 healthy adults aged between 18-65 years will be randomised to join one of three 4-week online mindfulness courses with daily practices of varying lengths (i.e. 10-mins, 20-mins, or 30-mins) against a minimally active control condition (3-4 mins). Psychological wellbeing will be measured using the Warwick-Edinburgh Mental Well-being Scale at baseline, mid-intervention, post-intervention, and 1-month follow-up. Secondary outcomes are psychological distress, anxiety, depression, social anxiety, nonattachment, trait mindfulness, decentering, equanimity, repetitive negative thoughts, emotion regulation, attention control, and emotional reactivity. Other outcomes will be collected weekly and daily during the intervention period. The primary analysis will be undertaken following the intention-to-treat approach. We will also conduct per-protocol secondary analyses on all outcomes (i.e. primary and secondary). We will also systematically monitor for possible adverse experiences. Results: This study began screening and recruitment in May 2024. Recruitment was paused approximately 6 weeks later after a significant number of participants were identified as being fraudulent and not meeting the eligiblity criteria. Recruitment re-opened in October 2024 and by the end of 2024, a total of 70 eligible participants were enrolled. Recruitment recommenced in early 2025, and will continue until 31st March 2025 or until the target sample is reached. We estimate that results will be published by March 2026. Conclusions: The study will contribute to the evidence-based for mindfulness meditation, and the question of how much practice people need to engage in to improve wellbeing and other psychological outcomes. Clinical Trial: The study has been prospectively registered at ClinicalTrials.gov with the identifier NCT06378450.

BACKGROUND Mindfulness meditation has demonstrated modest benefits for mental health and well-being, although the relationship between practice dose and outcomes is unclear. Meta-analyses and randomized controlled trials have shown mixed results so far, although such results may stem from methodological issues rather than reflecting the absence of an underlying effect. Research outside structured programs suggests that long-term practice time is linked to positive outcomes, but bias due to self-selection over time may explain these results. OBJECTIVE The proposed trial aims to test dose-response effects for an online mindfulness meditation course, examining outcomes and participant engagement across different practice doses. In this pragmatic randomized controlled trial, we hypothesize that larger doses of mindfulness training will yield significantly larger effects and different doses will be significantly associated with variation in participant engagement, with lower engagement evident for higher doses. METHODS At least 688 healthy adults aged between 18 and 65 years will be randomized to join one of three 4-week online mindfulness courses with daily practices of varying lengths (ie, 10, 20, or 30 min) against a minimally active control condition (4 min). Psychological well-being will be measured using the Warwick-Edinburgh Mental Wellbeing Scale at the baseline, midintervention, and postintervention time points and at 1-month follow-up. Secondary outcomes are psychological distress, anxiety, depression, social anxiety, nonattachment, trait mindfulness, decentering, equanimity, repetitive negative thoughts, emotion regulation, attention control, and emotional reactivity. Other outcomes will be collected weekly and daily during the intervention period. The primary analysis will be undertaken following the intention-to-treat approach. We will also conduct per-protocol secondary analyses on all outcomes (ie, primary and secondary). In addition, we will systematically monitor for possible adverse experiences. RESULTS This study began screening and recruitment in May 2024. Recruitment was paused approximately 6 weeks later after a substantial number of participants were identified as being fraudulent and not meeting the eligibility criteria. Recruitment reopened in October 2024, and by the end of 2024, a total of 70 eligible participants were enrolled. Recruitment recommenced in early 2025 and will continue until the end of March 2025 or until the target sample is reached. We estimate that the results will be published by March 2026. CONCLUSIONS This study will contribute to the evidence base for mindfulness meditation and the question of how much practice people need to engage in to improve well-being and other psychological outcomes. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/72786

Mindfulness meditation is now practiced broadly in both religious and secular contexts, with numerous studies indicating potential benefits across a range of psychosocial domains. However, despite significant research effort, we still know little about dose-response effects – how frequently or for how longindividuals might need to practice mindfulness meditation to achieve certain practice goals. Increasingly, recommended amounts of practice are becoming shorter while the impact of this reduction on outcomes in unclear. We review and critically appraise the state of knowledge about dose-response effects drawn from empirical investigations, traditional sources, and trends in contemporary teachingand practice. We argue that limitations inherent to the range of doses and analytic approaches used in previous studies reduce our ability to inform the dose-response question. We propose a practical research agenda that prioritizes the question of dose-response, incorporating design features that are optimizedspecifically to understanding the dose-response relationship and how it might vary between outcomes and individuals. Prioritizing the dose-response agenda will allow us to reconcile differences between knowledge sources and enable us to optimize mindfulness offerings based on the individual, their goals, and the context in which they practice.

Objectives: Meta-analyses of meditation studies have revealed mixed modest evidence of benefits across a range of outcomes. However, because this evidence-base is predominantly from brief interventions, it is unclear whether it accurately reflects how contemporary meditators practice or the dose–response relationship between amount of practice and outcome. This study sought to characterize how contemporary meditators practice, examine any possible dose–response relationships between historical practice and measures of psychological wellbeing, and explore which characteristics of practice most strongly predict favorable psychological outcomes. Methods: One thousand six hundred and sixty-eight meditators (M = 1095 h practice, SD = 2365) responded to advertisements in meditation practice communities and social media. We explored associations between demographics, meditation practice characteristics, and outcomes including positive and negative affect, psychological distress, and life satisfaction in a cross-sectional study design. Results: Historical meditation practice (accumulated lifetime hours) was significantly associated with favorable psychological outcomes (|r| ranging from .18 to .28). Model fit was optimized with a generalized additive model (average increase in R² = 2.22), indicating non-linear effects. The strength of association between practice time and outcomes was generally strongest for approximately the first 500 h, before plateauing. Several practice types including Vipassana (as taught by S.N. Goenka) and cultivating practices (e.g. compassion, lovingkindness) were more strongly predictive of favorable psychological outcomes. Conclusions: Benefits of meditation accrue over time in a non-linear manner, and show variation based on practice context. These results highlight the importance of understanding how the benefits of meditation accrue over longer time durations than typical standardized programs.

Objectives: Meta-analyses of meditation studies have revealed mixed modest evidence of benefits across a range of outcomes. However, because this evidence-base is predominantly from brief interventions, it is unclear whether it accurately reflects how contemporary meditators practice or the dose-response relationship between amount of practice and outcome. This study sought to characterize how contemporary meditators practice, examine any possible dose-response relationships between historical practice and measures of psychological wellbeing, and explore which characteristics of practice most strongly predict favorable psychological outcomes.Methods: One thousand six hundred and sixty-eight meditators (M=1,095 hours practice, SD=2,365) responded to advertisements in meditation practice communities and social media. We explored associations between demographics, meditation practice characteristics, and outcomes including positive and negative affect, psychological distress, and life satisfaction in a cross-sectional study design. Results: Historical meditation practice (accumulated lifetime hours) was significantly associated with favorable psychological outcomes (|r| ranging from .18 - .28). Model fit was optimized with a generalized additive model (average increase in R2=2.22), indicating non-linear effects. The strength of association between practice time and outcomes was generally strongest for approximately the first 500 hours, before plateauing. Several practice types, including Vipassana (as taught by S.N. Goenka) and cultivating practices (e.g., compassion, lovingkindness) were more strongly predictive of favorable psychological outcomes.Conclusions: Benefits of meditation accrue over time in a non-linear manner, and show variation based on practice context. These results highlight the importance of understanding how the benefits of meditation accrue over longer time durations than typical standardized programs.