Prevalence and Predictors of Self-Reported Adverse Experiences in Digital Meditation Training: 2 Randomized Controlled Trials

Clinical Snapshot

Key Findings

• P Value: Not significant (exact value not provided)

• Effect Size: No significant difference in AEx rates between meditation-exposed and non-exposed groups

• Primary Outcome: Prevalence of adverse experiences: 27.9% (Study 1) and 10.1% (Study 2)

• Nnt Or Sensitivity: Functional impairment rates: 6.7% (Study 1) and 3% (Study 2)

• Confidence Interval: Not reported

Clinical Application

High feasibility given widespread availability of digital meditation platforms Relevant to Australian practice as digital mental health interventions are increasingly integrated into healthcare; aligns with RACGP guidelines supporting evidence-based complementary therapies for mental health Adults with psychological distress considering digital meditation interventions

Abstract

BACKGROUND: Digital meditation-based interventions (MBIs) reach vast global audiences with millions of active users, yet concerns persist about the frequency and nature of adverse experiences (ie, AExs) occurring during meditation training. Some researchers have argued that AExs are substantially underdetected and reflect iatrogenic harm caused by meditation (ie, adverse effects [AEfs]). Others contend that these experiences largely reflect common stressors that would be experienced without meditation. These competing perspectives underscore the need for further research, particularly in the context of digital MBIs, the most widely used form of meditation training. OBJECTIVE: This study examined the prevalence, predictors, and subjective evaluations of AExs during a digital MBI and tested whether reported experiences may be caused by meditation practice via comparisons between meditation-exposed and nonexposed participants. METHODS: Data were drawn from 2 trials of the Healthy Minds Program. Exploratory study 1 (n=315) consisted of a sample of distressed US undergraduate students to estimate the prevalence of AExs and identify baseline predictors. Preregistered confirmatory study 2 (n=594) sampled distressed US adults from all 50 states to replicate findings from study 1 and to examine participants' subjective evaluations of AExs. Study 2 additionally compared AEx rates between participants who did and did not complete guided meditations to assess whether AExs could be caused by meditation exposure. Study 3 (n=87) used qualitative methods to analyze study 1 participants' responses to an open-ended question regarding their strategies for coping with AExs. RESULTS: In studies 1 and 2, 27.9% (88/315) and 10.1% (40/396) of participants, respectively, reported at least one AEx during the study period, with 6.7% (21/315) and 3% (12/396) reporting functional impairment, largely aligning with previous research. Critically, in study 2, rates of AExs did not significantly differ between participants who did and did not complete guided meditations, suggesting that these experiences were not caused by meditation practice. Higher baseline depression, anxiety, loneliness, experiential avoidance, and perceived barriers to meditation predicted more frequent AExs. In studies 1 and 2, 89.8% (79/88) and 90% (36/40) of participants who reported AExs, respectively, indicated that they were glad to have learned to meditate. Qualitative analyses showed that participants used diverse coping strategies, often using skills learned through the Healthy Minds Program. CONCLUSIONS: AExs were relatively common but occurred at comparable rates among participants who did and did not meditate, challenging claims that such experiences were caused by meditation practice in distressed individuals. Although a small subset of participants reported some degree of functional impairment, most evaluated their AExs as tolerable and described their overall MBI experience as positive. Together, these findings highlight the importance of distinguishing AExs that likely reflect epiphenomena of preexisting distress or symptoms from iatrogenic harm attributable to MBIs.

References

1. 1.Beloborodova, P., Smith, L. M., Riordan, K. M., Simonsson, O., Dottori, L. T., Song, H. Q., Shashko, N. S., Tatar, R., Baldwin, S. A., Bernstein, A., Dunne, J. D., Davidson, R. J., Hirshberg, M. J., & Goldberg, S. B. (2026). Prevalence and predictors of self-reported adverse experiences in digital meditation training: 2 randomized controlled trials. JMIR Mental Health. https://doi.org/10.1007/s12671-018-0897-0