Associations Between Mindfulness and Mental Health Outcomes: a Systematic Review of Ecological Momentary Assessment Research

Objectives Psychological science has taken up investigations of the effectiveness of mindfulness-based programs (MBPs) and mechanisms through which people benefit from mindfulness. Reliable and valid psychometric tools are essential components of psychological science, and efforts have been made to produce tools for the accurate measurement of mindfulness as a construct. However, trait measurement methods, which are commonly used, may not adequately assess mindfulness and mental health outcomes in a way that allows for mechanisms to be adequately tested. Intensive longitudinal assessment methods sample behavior and experience multiple times over a brief period of several days or weeks and may be more appropriate methods for testing mechanisms of action. We provide a systematic review of published, peer-reviewed studies that used intensive longitudinal methods to investigate the effects of mindfulness on mental health outcomes. Methods Articles were included in the systematic review if mindfulness measures and/or mindfulness interventions were a part of the study design and if intensive longitudinal methods were used to assess mindfulness or mental health outcomes. Results Findings consistently demonstrated a positive association between mindfulness and mental health. Only two studies collected both trait and state measurements of either mindfulness or mental health outcomes, and results indicated that EMA produced larger effect sizes between mindfulness and mental health outcomes. Conclusions Theorized associations between mindfulness and mental health are supported by the current EMA literature. Intensive longitudinal methods may produce more consistent and reliable results through increased sensitivity and ecological validity in that they examine the momentary relationships between mindfulness and mental health outcomes. Thus, intensive longitudinal assessment may be a more appropriate method for investigating hypothesized mechanisms of action in MBPs.