Prevalence of harm in Mindfulness-Based Stress Reduction

Background: Globally, mindfulness meditation has become a common method for reducing stress and stress-related psychopathology. As mindfulness programs become ubiquitous, concerns have been raised about the unknown potential for harm. This study estimates four indices of harm following Mindfulness-based Stress Reduction (MBSR): mean change in symptoms, proportion of participants reporting increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms and clinically significant harm.

Methods: Intent-to-treat analyses with multiple imputation for missing data were used on pre- and post-test data from a large, population observational dataset (n = 1914) spanning 12-years (2002-2013) of community health clinic MBSR classes. We estimated prevalence of harm on global psychological symptoms. Pre- and post-test MBSR (n = 150) and waitlist control (n = 118) data from three randomized controlled trials (2004 – 2018) conducted in the same city by the same health clinic MBSR teachers contemporaneous to the community data were included to anchor community estimates and allow Absolute Risk Reductions estimates.

Results: We find no evidence that MBSR leads to significantly higher rates of harm relative to waitlist control. On several metrics of harm, community MBSR was significantly preventative of developing psychological symptoms compared to no treatment.

Conclusions: MBSR does not produce significantly increased rates of harm relative to no treatment. To the contrary, MBSR may be protective against the metrics of harm estimated. More research is required to characterize the relatively small proportion of MBSR participants that experience harm.

Matthew J. Hirshberg, Ph.D., Simon B. Goldberg, Ph.D., Melissa Rosenkranz, Ph.D., &

Richard J. Davidson Ph.D.