Childhood trauma and PTSD symptoms are linked to worse depression outcomes and more meditation-related adverse effects in mindfulness-based programs. Across two clinical trials, total childhood trauma and childhood sexual abuse consistently predicted poorer depression outcomes. Childhood sexual abuse also predicted dropout in one study. Multiple forms of trauma and PTSD symptoms predicted meditation-related side effects, while total trauma, emotional abuse, and subclinical PTSD predicted lasting adverse effects. These findings suggest that trauma-sensitive modifications, safety monitoring, screening, and provider education are needed when implementing mindfulness programs for depression.
Worldviews can both increase the risk of meditation-related challenges and serve as a remedy for them, depending on the individual. Buddhist practitioners and teachers in the contemporary West navigate both religious and scientific explanatory frameworks, a context shaped by "Buddhist modernism" which presents Buddhism as compatible with science. Interview data from the Varieties of Contemplative Experience project show that for some, having, applying, or changing a worldview helped mitigate challenging experiences or distress, while for others, worldviews acted as a risk factor influencing the onset and course of difficulties.