Psychological Mediators of Reduced Distress: Preregistered Analyses from a Randomized Controlled Trial of a Smartphone-Based Well-Being Training

A four-week smartphone-based meditation intervention reduced psychological distress during the early COVID-19 pandemic. Among 662 adults, most of whom reported clinical levels of anxiety or depressive symptoms, the intervention improved four proposed mediators—mindful action, loneliness, cognitive defusion, and purpose—measured five times during the program and at three-month follow-up. Each mediator individually accounted for 22.2% to 64.5% of the intervention's effect on later distress. When all mediators were analyzed together, only reduced loneliness remained a significant pathway, explaining 70.0% of the combined indirect effect. Multiple psychological mechanisms likely contribute to the benefits of digital meditation interventions.

Study at a glance

Abstract

Understanding why interventions work is essential to optimizing them. Although mechanistic theories of meditation-based interventions (MBIs) exist, empirical evidence is limited. We randomly assigned 662 adults (79.9% reported clinical levels of anxiety or depressive symptoms) to a four-week smartphone-based MBI or wait-list control condition early in the COVID-19 pandemic. Psychological distress and four theory drive preregistered psychological mediators of well-being (mindful action, loneliness, cognitive defusion and purpose) were assessed five times during the intervention period and at three-month follow-up. Using preregistered latent growth structural equation mediation models, assignment to the intervention predicted significant gains on all mediators which in turn significantly mediated follow-up distress (22.2%–64.5% of intervention effect on distress). No significant mediation pathway was observed in an exploratory multiple mediator analysis, but reduced loneliness accounted for 70.0% of the combined indirect effect. Multiple psychological pathways may mediate reduced distress in a digital MBI.