Does Mindfulness Meditation Training Enhance Executive Control? A Systematic Review and Meta-Analysis of Randomized Controlled Trials in Adults

Abstract

Objectives: Over the last years, mindfulness meditation has been claimed to be effective in enhancing several cognitive domains, including executive control. However, these claims have been mostly based on findings pertaining to case-control and cross-sectional studies, which are by nature unable to reveal causal relationships. Aiming to address this issue, we set out to conduct the first quantitative assessment of the literature concerning mindfulness meditation as an enhancer for executive control considering only randomized controlled studies. Methods: We conducted a systematic review and meta-analysis covering experimental studies testing the effect of mindfulness meditation training on at least one executive control function (working memory, inhibitory control, or cognitive flexibility) in adult samples. Four databases were examined, resulting in the identification of 822 candidate references. After a systematic filtering process, a set of 16 studies was retained for evaluation, of which 13 could be included in a subsequent meta-analysis. Results: We found an average effect size of g = 0.34 [0.16, 0.51], indicating a small-to-medium effect of mindfulness meditation training in enhancing executive control. Effect sizes for individual functions were g = 0.42 [0.10, 0.74] for working memory, g = 0.42 [0.20, 0.63] for inhibitory control, and g = 0.09 [-0.13, 0.31] for cognitive flexibility. Funnel plot asymmetry analysis revealed no evidence of publication bias. Conclusions: Taken together, our findings provide preliminary and moderate yet positive evidence supporting the enhancing effects of mindfulness meditation on executive control. Shortcomings of included studies and considerations for future empirical and meta-analytical research are discussed.

Mindfulness training preserves sustained attention and resting state anticorrelation between default‐mode network and dorsolateral prefrontal cortex: A randomized controlled trial

“…Mindfulness training preserved sustained attention on the SART in the mindfulness group relative to the coding group. This finding aligns with prior behavioral studies reporting enhanced cognitive control after mindfulness training in children (Britton et al, 2014; Felver et al, 2017; Flook et al, 2010; Lawler et al, 2019; Leonard et al, 2013; Quach et al, 2016; Salmoirago‐Blotcher et al, 2019; Schonert‐Reichl et al, 2015;Semple et al, 2010; Sidhu, 2012) and adults (Cásedas et al, 2019; Moore & Malinowski, 2009). These RCTs demonstrated improved attentional ability measured by task performance or parent/teacher‐reported questionnaires in typically developing children and adolescents (Felver et al, 2017; Schonert‐Reichl et al, 2015), in children with ADHD (Sidhu, 2012) or reading difficulties (Semple et al, 2010; Sidhu, 2012), and in incarcerated adolescents (Leonard et al, 2013).…”

“…Systematic reviews of mindfulness RCT studies have reported that mindfulness training frequently improves cognitive control in both children and adults (Cásedas, Pirruccio, Vadillo, & Lupiáñez, 2019; Chiesa et al, 2011; Mak et al, 2018). A meta‐analysis of RCTs employing mindfulness‐based interventions in adults found a moderate but significant improvement of cognitive control, specifically in attention and memory (Cásedas et al, 2019). For children and adolescents, 8 out of 10 RCTs reported that mindfulness training improved cognitive control and attentional abilities (with an additional trend in a ninth study) (Britton et al, 2014; Felver, Tipsord, Morris, Racer, & Dishion, 2017; Flook et al, 2010; Lawler, Esposito, Doyle, & Gunnar, 2019; Leonard et al, 2013; Quach, Jastrowski Mano, & Alexander, 2016; Salmoirago‐Blotcher et al, 2019; Schonert‐Reichl et al, 2015; Semple, Lee, Rosa, & Miller, 2010; Sidhu, 2012).…”

“…Systematic reviews of mindfulness RCT studies have reported that mindfulness training frequently improves cognitive control in both children and adults (Cásedas, Pirruccio, Vadillo, & Lupiáñez, 2019; Chiesa et al, 2011; Mak et al, 2018). A meta‐analysis of RCTs employing mindfulness‐based interventions in adults found a moderate but significant improvement of cognitive control, specifically in attention and memory (Cásedas et al, 2019).…”

Mindfulness Enhances Cognitive Functioning: A Meta-Analysis of 111 Randomized Controlled Trials

“…The most recent meta-analysis across 13 RCTs (n = 1,112) observed that MBIs had moderate effects on WM and inhibition, but a negligible effect on shifting among adults (Cásedas, Pirruccio, Vadillo, & Lupiáñez, 2020). In the other meta-analysis, across 17 studies (n = 1,762)…”

The Effects of School-based Mindfulness Intervention on Executive Functioning in a Cluster Randomized Controlled Trial

“…Some studies have, however, suggested more nuanced and selective effects in awareness, e.g., improvement in object detection but not in attention or improvement in the attentional effort instead of ability (Anderson, Lau, Segal, & Bishop, 2007;Jensen, Vangkilde, Frokjaer, & Hasselbaich, 2012). A recent review found a small-to-medium effect (g = 0.34 [0.16, 0.51]) of mindfulness meditation training in enhancing executive control (Cásedas, Pirruccio, Vadillo, & Lupiáñez, 2020), whereas a review on neuropsychological outcomes found no overall support for attention or executive function improvements (Lao, Kissane, & Meadows, 2016). Some independent practice is considered necessary for mindfulness intervention effects to appear among adolescents (Huppert & Johnson, 2010;Zenner, Herrnleben-Kurz, & Walach, 2014) even if the length of the practice can be distinctly shorter than among adults (5-10 min) (Meiklejohn et al, 2012;Zack, Saekow, Kelly, & Radke, 2014).…”