Journal of affective disorders
April 1, 2023
Otto Simonsson, Peter S Hendricks, Richard Chambers et al.
124 citations
Using nationally representative US adult data (N = 2822), most people who have used classic psychedelics (59.1%) never had a challenging, difficult, or distressing experience. However, 8.9% reported functional impairment lasting more than one day from such an experience, and 2.6% sought medical, psychiatric, or psychological help afterward. Co-use of lithium or other mood stabilizers, and certain set and setting factors—including no preparation, disagreeable physical environment, negative mindset, no psychological support, a dose perceived as too large, and a major life event prior—were associated with greater difficulty. Negative mindset, no psychological support, and a major life event prior were also linked to overall risk of harm.
Clinical psychology review
February 1, 2024
Jake Linardon, Mariel Messer, Simon B Goldberg et al.
61 citations
Mindfulness apps produce small but significant reductions in symptoms of depression and anxiety compared to control groups. A meta-analysis of 45 randomized controlled trials found effect sizes of g = 0.24 for depression (46 comparisons, 5,852 participants) and g = 0.28 for anxiety (48 comparisons, 6,082 participants). These benefits were not due to symptom worsening in control groups and remained when restricting to higher-quality trials. No significant moderators were identified, except that studies offering monetary compensation showed larger effects on depression. When compared to active therapeutic interventions, mindfulness apps showed non-significant effects, though few studies were available. The evidence suggests mindfulness apps can help reduce depression and anxiety symptoms, but more rigorous studies with longer follow-up are needed.
Journal of psychoactive drugs
January 1, 2023
Otto Simonsson, Simon B Goldberg
37 citations
In a representative sample of 953 American adults, those who had used classic psychedelics in their lifetime or reported greater ego dissolution during their most intense psychedelic experience were more likely to also have experience with meditation. Among meditators, higher ego dissolution was linked to more frequent meditation practice. Both lifetime psychedelic use and ego dissolution were associated with enlightenment as a motivation to meditate and with fewer perceived barriers to meditation. Ego dissolution was also tied to finding meditation more effective. Neither psychedelic use nor ego dissolution was associated with a higher likelihood of meditation-related adverse effects. These findings suggest a potential synergy between psychedelics and meditation, but randomized controlled trials are needed to confirm causality.
Psychopharmacology
July 1, 2025
Otto Simonsson, Simon B Goldberg, Richard Chambers et al.
33 citations
In a US-representative sample of 2,822 adults, lifetime naturalistic psychedelic use was associated with more unusual visual experiences but not with psychotic symptoms in the past two weeks. Among those who had used psychedelics, 1.3% reported a diagnosis of hallucinogen persisting perception disorder. An interaction emerged: individuals with a family history of psychotic or bipolar disorders who used psychedelics reported more psychotic symptoms, while those without such a family history reported fewer. The findings suggest that family history may modify the association between psychedelic use and psychotic symptoms.
JMIR mental health
April 28, 2023
Sin U Lam, Qiang Xie, Simon B Goldberg
29 citations
Among US adults who have ever meditated, more than half (58.8%) have used a meditation app at least once, and 21.7% use one weekly or daily. Younger age, higher anxiety, and a mental health motivation for meditating were linked to having used a meditation app. Active users were younger, less likely to be men or non-Latinx White, had lower income, and were more likely to have started meditating for spiritual reasons. Concerns about cost, effectiveness, time, technical issues, and user-friendliness were more common among app users. Desired features include practice tips, reminders, mini-practices, and mental health content, while social features were less popular. Headspace and Calm were the most used apps.
Therapeutic advances in psychopharmacology
January 1, 2022
Otto Simonsson, Peter S Hendricks, Richard Chambers et al.
26 citations
In a US-representative sample of 2822 adults, lifetime use of classic psychedelics was linked to healthier tobacco-related and diet-related behaviors. Among the 613 who had used psychedelics, greater psychological insight during their most insightful experience was associated with healthier exercise habits, a healthy body mass index, and diet improvements. Psychological insight was also tied to self-reported health behavior improvements attributed to the psychedelic experience, including alcohol-related changes. The findings suggest that psychological insight during a classic psychedelic experience may promote positive health behavior change and better physical health, especially in weight management, though causality cannot be established.
Psychiatry Research
July 23, 2023
Otto Simonsson, Per Carlbring, Robin Carhart-Harris et al.
24 citations
In a meta-analysis of three psilocybin trials for depression involving 102 participants, clinically significant symptom worsening occurred for a minority of those receiving psilocybin or escitalopram (about 10%) and for a majority of those in the waitlist condition (63.6%). The psilocybin arm showed a lower likelihood of symptom worsening compared to waitlist and no difference compared to escitalopram. The authors note the limitation of a relatively small sample size.
Drug and alcohol dependence
October 1, 2022
Otto Simonsson, Simon B Goldberg, Richard Chambers et al.
16 citations
Among a US-representative sample of 2,822 adults, 613 reported lifetime classic psychedelic use, and 1.5% of those users reported having a seizure while using a classic psychedelic—a rate similar to epilepsy prevalence in the general population. Nearly half of those who had a seizure were also taking antidepressants, mood stabilizers, or opioid replacement therapies at the time. Seizures were more common among respondents with a personal or family history of epilepsy. The findings suggest that classic psychedelic use may elevate seizure risk in certain people, especially those with a personal or family history of epilepsy.
Clinical psychological science : a journal of the Association for Psychological Science
March 1, 2025
Simon B Goldberg, Ashley D Kendall, Matthew J Hirshberg et al.
15 citations
In a randomized controlled trial of a meditation app with 662 participants (80.4% had elevated depression or anxiety), the relationship between how much people used the app (dosage) and changes in psychological distress was inconsistent. Across 41 different statistical models, some showed that more use—measured in minutes, days, or activities completed—was linked to greater reductions in distress, but many models found no such link, and a few even suggested the opposite pattern. This variability highlights the challenge of defining and studying dosage in meditation app interventions and points to the need for careful, transparent methods in this area.
Psychological medicine
April 1, 2024
Otto Simonsson, Walter Osika, Cecilia U D Stenfors et al.
15 citations
People who used psychedelics during a two-month period reported a greater increase in days of mindfulness meditation per week than those who did not. Among psychedelic users, experiencing personal insight during the most intense psychedelic session was linked to larger increases in both mindfulness and loving-kindness or compassion meditation practice. Conversely, more frequent loving-kindness or compassion meditation at the start of the study was associated with less severe feelings of death or dying during the subsequent psychedelic experience. These findings suggest a bidirectional relationship: psychedelics may boost meditation engagement, while meditation may reduce challenging psychedelic experiences.
Mindfulness
November 1, 2023
Isaac N Treves, Halie A Olson, Ola Ozernov-Palchik et al.
15 citations
An 8-week randomized controlled trial with 279 U.S. children ages 8-10 tested a remote, app-based mindfulness intervention (Inner Explorer) against two audiobook control groups. Over 80% of children completed the intervention. Children who used the mindfulness app reported reduced self-perceived stress, and parents reported reduced negative affect in their children. However, no significant reductions in anxiety or depression symptoms were found. Between-group effect sizes were small. Regular use—at least 30 days of practice within the study period—was linked to lower child negative affect (by parental report), lower parental stress, and lower child self-perceived stress. The findings suggest that home use of a mindfulness app can benefit children's emotional well-being if used regularly.
Mindfulness
April 1, 2023
Charlotta Simonsson, Richard Chambers, Peter S Hendricks et al.
15 citations
People who have used classic psychedelics report meditating more often, specifically mindfulness meditation, but not loving-kindness or compassion meditation. Among those who had a psychedelic experience, both psychological insight and ego dissolution were linked to more frequent practice of both types of meditation. However, when both factors were considered together, only psychological insight predicted higher meditation frequency. These findings, from a survey of 2,822 U.S. adults, suggest that psychedelic experiences—especially those that produce psychological insight—may encourage regular meditation, though causality cannot be established.
Current psychology (New Brunswick, N.J.)
May 1, 2024
Sarah Strohmaier, Simon B Goldberg
13 citations
Improvements in the quality of mindfulness meditation practice over time are linked to reductions in anxiety and stress and increases in mindfulness, but not the reverse. Data from a randomized controlled trial with 48 novice practitioners from the general population who used low-dose mindfulness practices suggests that practice quality drives better psychological outcomes, supporting its importance even in low-dose and self-help programs.
Frontiers in psychology
January 1, 2024
Brian Galla, Aishwarya Karanam, Avital Pelakh et al.
13 citations
A reanalysis of 22 randomized controlled trials (16,558 adolescents) found that universal school-based mindfulness interventions do not reliably improve adolescent mental health. Compared to passive controls, mindfulness training actually reduced trait mindfulness slightly (d = -0.10). Compared to active controls, it improved anxiety/stress (d = 0.17) and wellbeing (d = 0.10), but against all controls combined, no outcomes—including anxiety, depression, attention, or social behavior—showed significant benefit (effect sizes ranged from 0.01 to 0.26). No effects persisted at follow-up. These results question the value of existing school-based mindfulness programs as a universal prevention strategy for adolescents.
Journal of counseling psychology
March 1, 2024
Kevin M Riordan, Otto Simonsson, Corrina Frye et al.
12 citations
A two-week compassion-based meditation program delivered via the Healthy Minds Program app was tested in undergraduates with elevated depression or anxiety (N=351). Participants were randomly assigned to either one 20-minute meditation per day or two 10-minute meditations per day. Both groups showed improvements in psychological distress, experiential avoidance, fear of missing out, loneliness, and self-compassion from before to after the intervention, and daily distress and loneliness also improved over time. No significant differences were found between the two dosing schedules on any measure. When total daily meditation time is equal, distributing practice into shorter sessions does not affect outcomes for distressed beginners.
Clinical psychological science : a journal of the Association for Psychological Science
January 1, 2025
Matthew J Hirshberg, Cortland J Dahl, Daniel Bolt et al.
9 citations
A four-week smartphone-based meditation intervention reduced psychological distress in adults, most of whom had clinical anxiety or depressive symptoms during the early COVID-19 pandemic. The intervention improved four proposed mediators—mindful action, loneliness, cognitive defusion, and purpose—which together accounted for 21.9% to 62.5% of the effect on distress at three-month follow-up. In a multiple mediator analysis, reduced loneliness alone explained 61.7% of the combined indirect effect. The findings suggest multiple psychological pathways may mediate distress reduction in digital meditation-based interventions.
Journal of affective disorders
July 9, 2025
Otto Simonsson, Peter S Hendricks, Caroline M Swords et al.
8 citations
In a large observational study of US adults aged 18–50, naturalistic psychedelic use was modestly linked to increased depressive symptoms over time. Among 12,345 participants followed longitudinally, 505 reported psychedelic use. Those who used psychedelics in a 'risk context'—such as a negative mindset or lack of psychological support—showed a moderate increase in depressive symptoms compared to non-users and to users without such risks. This association was explained by more challenging psychedelic experiences in that context. The findings indicate that psychedelic use outside controlled therapeutic settings may not be generally beneficial and could worsen depressive symptoms under certain conditions.
Journal of medical Internet research
April 17, 2025
Isaac Treves, Zia Bajwa, Keara D Greene et al.
8 citations
Consumer-grade neurofeedback devices used during meditation produce a modest reduction in psychological distress compared to control conditions, but no improvements in cognition, mindfulness, or physiological health. A systematic review and meta-analysis of 21 randomized studies (763 participants in training trials, 167 in within-participant designs) found a small effect for distress reduction (g=-0.16) but no evidence that the devices help users modulate brain targets or deepen meditation. Most studies used the Muse device and mindfulness apps as controls. The authors suggest observed benefits may stem from placebo effects (neurosuggestion) rather than genuine neurofeedback. Adverse effects were rarely assessed.
Human brain mapping
January 1, 2025
Isaac N Treves, Aaron Kucyi, Madelynn Park et al.
8 citations
Trait mindfulness—the tendency to attend to present experience non-judgmentally—is linked to better mental health, but its neural basis remains unclear. In the largest resting-state fMRI study of trait mindfulness to date, involving 367 meditation-naïve adults across three sites, no connections predicted overall trait mindfulness. However, neural models for two subscales, Acting with Awareness and Non-judging, were identified. Positive networks for these subscales involved distinct fronto-parietal and default-mode networks, while negative networks overlapped across subscales and included somatomotor, visual, and default-mode regions. Only negative networks generalized to predict subscale scores in some out-of-sample tests. Predictions negatively correlated with a mind-wandering model. The findings provide preliminary evidence for generalizable connectivity models of mindfulness facets, but incomplete generalization across sites and model overlap highlight the challenge of identifying robust brain markers.
Psychophysiology
May 1, 2025
Isaac N Treves, Anna O Tierney, Simon B Goldberg et al.
5 citations
A breath-counting task designed to measure mindfulness in adults was tested in 78 adolescents with high rumination. The task showed fair reliability but did not correlate positively with self-reported mindfulness, either as a trait or in daily life. Unexpectedly, more mindful adolescents performed worse on breath counting, and the task showed negative correlations with observing emotions and body sensations and with nonreactivity. Breath-counting performance was also unrelated to clinical, personality, and executive functioning measures. The findings indicate that, in this population, breath counting may measure only a narrow form of sustained attention and may not capture broader mindfulness qualities or have predictive validity.
Journal of consulting and clinical psychology
August 1, 2024
Simon B Goldberg, Daniel M Bolt, Cortland J Dahl et al.
5 citations
Meditation app users who reported increased positive feelings and decreased negative feelings during practice showed greater reductions in psychological distress, both immediately after the program and three months later. In a randomized trial with 243 distressed public school employees, most of whom had clinically elevated depression or anxiety, negative affect during meditation declined over time while positive affect remained stable. Changes in positive affect predicted later distress more strongly than changes in negative affect. The findings challenge the common mindfulness emphasis on nonjudgmental awareness regardless of emotional tone, suggesting that the affective quality of meditation experience matters for outcomes and could guide personalized intervention.
Frontiers in psychology
January 1, 2023
Otto Simonsson, Cecilia U D Stenfors, Simon B Goldberg et al.
4 citations
Mindfulness meditation and psychedelic use are both associated with positive impacts on leadership, though through different mechanisms. In a representative sample of 3,150 managers in the US and UK, more lifetime hours of mindfulness meditation and greater psychological insight during the most intense psychedelic experience each independently predicted a positive leadership impact (odds ratios 2.33 and 3.49, respectively). Both practices shared subthemes such as improved focus, creativity, patience, empathy, and compassion. Unique to mindfulness were better sleep, stress reduction, and calming effects; unique to psychedelics were greater self-understanding, less hierarchical attitudes, and positive interpersonal changes. The cross-sectional design precludes causal conclusions, but the findings suggest complementary benefits for leadership development.
Psychological services
July 10, 2025
Rachel L Dyer, Katherine M Zimmerman, Xinxuyang Zhao et al.
2 citations
Depression and anxiety have worsened among American adults in recent decades. Meditation apps could help reduce these symptoms, but many users struggle to keep using them. This study interviewed 20 adults with elevated depressive or anxiety symptoms who were part of a clinical trial testing a meditation app called the Healthy Minds Program. Using an implementation science framework called the Consolidated Framework for Implementation Research, the researchers identified four categories: practical factors that helped users build a meditation habit, motivations for starting and sticking with practice, obstacles to developing a practice, and suggestions for improving the app. Most participants reported positive outcomes, which for some motivated continued use. Future work should examine how barriers and facilitators shift as users gain more experience.
Clinical psychology review
February 1, 2026
Liucan Xu, Simon B Goldberg, Lin Zhang et al.
1 citation
Second-generation mindfulness-based interventions (SG-MBIs), which incorporate ethical and moral practices, effectively reduce depression and anxiety in adults. A meta-analysis of 43 randomized controlled trials on depression (3,756 participants) and 37 on anxiety (3,199 participants) found moderate to large effects: depression improved by a standardized mean difference of 0.59 and anxiety by 0.61. Effects remained significant after removing outlier studies (depression: 0.44; anxiety: 0.40). Clinical populations benefited more than healthy or mixed samples. Follow-up data from 20 trials showed sustained depression reductions (0.70). Most trials had some methodological concerns, but excluding high-risk studies did not change the results. SG-MBIs appear especially valuable for clinical groups and self-compassion-focused interventions.
Research square
May 19, 2026
Sunjuri Sun, Claudia Hanson, Peter S Hendricks et al.
The evidence on child and maternal outcomes after exposure to classic psychedelics during pregnancy is very sparse and of very low certainty. A systematic review of 42 studies, mostly case reports from high-income countries, found that LSD was the most commonly reported substance. Outcomes reported included spontaneous abortions (2 studies), stillbirth (1 study), neonatal mortality (16 studies), preterm birth (17 studies), birthweight (15 studies), and congenital malformations (26 studies). No maternal deaths were reported. Because of small sample sizes and varied study designs, no meta-analysis was possible. The authors conclude that methodologically rigorous research on psychedelic use during pregnancy is urgently needed.