Ecological Momentary Assement During a Remote Mindfulness Intervention Assessing Changes in Lifestyle Factors and Psychological Outcomes

Abstract

Stress and related issues of anxiety disorder and depression pose huge mental and public health risks in the population in general, and on college campuses in particular. Prior research shows that mindfulness interventions help to relieve symptoms of stress, anxiety, and depression, as well as decrease rumination, and increase sleep and exercise behaviors. Yet, the causal mechanisms of these variables and the sequencing of effects are unknown. I utilized a randomized controlled trial, 55 in control arm, and 57 in intervention arm (mean age= 21.39), using a 4-week KORU mindfulness intervention as the intervention arm, with pretest and posttest assessment of the relevant variables, as well as daily ecological momentary assessments (EMA) of formal and informal mindfulness practices, state mindfulness, rumination, sleep, exercise, mood, wellbeing, and stress. In the pre-post analysis, Koru was effective in improving mindfulness, rumination, worry, mood, stress, anxiety, three aspects of psychological wellbeing (Autonomy, Environmental Mastery, and Self-acceptance), and physical activity. In the EMA analysis, Koru was effective in improving mindfulness (i.e., Curiosity and Decentering), rumination, and sleep. Rumination was found to be a significant mediator between both mindfulness subscales and psychological outcomes. Furthermore, the effect of Curiosity on rumination was significant with a lag of up to three days; the effect of Decentering was detectable over two days. The effects of rumination on stressor count, depression, and wellbeing, however, did not extend beyond the same day. Exercise was only a significant mediator in the pathways from Curiosity to depression and well-being and did not extend beyond the same day. Sleep was not a significant mediator for any mindfulness to outcome variable pathway. Lastly, self-reported practice quality, both formal and informal, did not drive changes in mindfulness and did not attribute to changes in the pathway proposed.