Mindfulness and psychotic-like experiences in nonclinical populations: a systematic review and two meta-analyses

This systematic review and meta-analyses provide the first synthesis of the literature on trait mindfulness and psychotic-like experiences (PLEs). Theoretical models suggest a protective function of mindfulness and it is important to understand any potential role of mindfulness in the prevention and treatment of PLEs. We examined the following: (1) What is the relationship between trait mindfulness and PLEs in nonclinical populations?; and (2) What is the effect of mindfulness-based interventions (MBIs) on PLEs in nonclinical populations? Five databases were searched, and effect sizes were extracted for each study. Seventeen papers were included in the review. Eleven papers explored the relationship between mindfulness and PLEs, and the meta-regression found a small negative association between PLEs and mindfulness (k = 8; pooled correlation r = -0.25; 95% confidence interval [CI]: -0.37, -0.13, p < .001). Eight studies investigated the effect of MBIs on PLEs and the summary effect was not significant in the meta-analysis (k = 5; pooled standard mean difference = .09; 95% CI: -0.61, 0.79, p = 0.80). Overall, the findings suggest that higher levels of mindfulness are associated with reduced PLEs, with no evidence for the effectiveness of MBIs in reducing PLEs. Findings should be interpreted cautiously given the small number of studies and high heterogeneity in the meta-analyses. Future studies are needed to determine whether MBIs might prevent the transition to psychosis or an at-risk mental state and might usefully measure a broader range of clinically relevant outcomes.