PDF(Pubmed)
Abstract：
BACKGROUND: Mindfulness-based programmes (MBPs) have shown beneficial effects on mental health. There is emerging evidence that MBPs may also be associated with marked deviations in the subjective experience of waking consciousness. We aimed to explore whether MBPs can have a causal role in different types of such states.
METHODS: We conducted a pragmatic randomised controlled trial (ACTRN12615001160527). University of Cambridge students without severe mental illness were randomised to an 8-week MBP plus mental health support as usual (SAU), or to SAU alone. We adapted the Altered States of Consciousness Rating Scale (OAV, 0-100-point range) to assess spontaneous experiences in daily life, and included it as a post-hoc secondary outcome at the end of the one-year follow-up questionnaire. Two-part model analyses compared trial arms, and estimated dose-response effects of formal (meditation) and informal (daily activities) mindfulness practice during the year. Sensitivity analyses correcting for multiple comparisons were conducted.
RESULTS: We randomised 670 participants; 205 (33%) completed the OAV. In comparison with SAU, MBP participants experienced unity more frequently and intensively (two-part marginal effect (ME) = 6.26 OAV scale points, 95% confidence interval (CI) = 2.24, 10.27, p = 0.006, Cohen\'s d = 0.33) and disembodiment more frequently (ME = 4.84, 95% CI = 0.86, 8.83, p = 0.019, Cohen\'s d = 0.26). Formal practice predicted spiritual, blissful and unity experiences, insightfulness, disembodiment, and changed meanings. Informal practice predicted unity and blissful experiences. Trial arm comparisons and informal practice effects lost significance after corrections for multiple comparisons, but formal practice dose-response effects remained significant.
CONCLUSIONS: Results provide a novel suggestion of causal links between mindfulness practice and specific altered states of consciousness. To optimise their impact, practitioners and teachers need to anticipate and handle them appropriately. Future studies need to confirm findings and assess mechanisms and clinical implications.
METHODS: We conducted a pragmatic randomised controlled trial (ACTRN12615001160527). University of Cambridge students without severe mental illness were randomised to an 8-week MBP plus mental health support as usual (SAU), or to SAU alone. We adapted the Altered States of Consciousness Rating Scale (OAV, 0-100-point range) to assess spontaneous experiences in daily life, and included it as a post-hoc secondary outcome at the end of the one-year follow-up questionnaire. Two-part model analyses compared trial arms, and estimated dose-response effects of formal (meditation) and informal (daily activities) mindfulness practice during the year. Sensitivity analyses correcting for multiple comparisons were conducted.
RESULTS: We randomised 670 participants; 205 (33%) completed the OAV. In comparison with SAU, MBP participants experienced unity more frequently and intensively (two-part marginal effect (ME) = 6.26 OAV scale points, 95% confidence interval (CI) = 2.24, 10.27, p = 0.006, Cohen\'s d = 0.33) and disembodiment more frequently (ME = 4.84, 95% CI = 0.86, 8.83, p = 0.019, Cohen\'s d = 0.26). Formal practice predicted spiritual, blissful and unity experiences, insightfulness, disembodiment, and changed meanings. Informal practice predicted unity and blissful experiences. Trial arm comparisons and informal practice effects lost significance after corrections for multiple comparisons, but formal practice dose-response effects remained significant.
CONCLUSIONS: Results provide a novel suggestion of causal links between mindfulness practice and specific altered states of consciousness. To optimise their impact, practitioners and teachers need to anticipate and handle them appropriately. Future studies need to confirm findings and assess mechanisms and clinical implications.
摘要：
背景：基于正念的计划（MBP）已显示出对心理健康的有益影响。有新的证据表明，MBP也可能与清醒意识的主观体验中的明显偏差有关。我们旨在探讨MBPs是否在不同类型的此类状态中具有因果作用。
方法：我们进行了一项实用的随机对照试验(ACTRN12615001160527)。剑桥大学没有严重精神疾病的学生被随机接受为期8周的MBP和心理健康支持（SAU）。或者单独去SAU。我们改编了意识状态改变量表(OAV，0-100点范围）以评估日常生活中的自发经历，并在为期一年的随访问卷结束时将其作为事后次要结果。两部分模型分析比较了试验组，以及一年中正式（冥想）和非正式（日常活动）正念练习的剂量反应效应。进行了校正多重比较的敏感性分析。
结果：我们随机分配了670名参与者；205（33％）完成了OAV。与SAU相比，MBP参与者更频繁和更密集地经历团结(两部分边际效应(ME)=6.26OAV量表点，95%置信区间(CI)=2.24,10.27,p=0.006,Cohen\sd=0.33)和反施舍更频繁(ME=4.84,95%CI=0.86,8.83,p=0.019,Cohen\sd=0.26)。正式实践预言了精神，幸福和团结的经历，洞察力,具体化，改变了含义。非正式实践预示着团结和幸福的经历。在对多重比较进行校正后，试验臂比较和非正式练习效果失去了意义，但正式实践剂量反应效应仍然显著。
结论：结果提供了正念练习与特定意识状态改变之间因果关系的新建议。为了优化他们的影响，从业者和教师需要适当地预测和处理它们。未来的研究需要确认发现并评估机制和临床意义。
方法：我们进行了一项实用的随机对照试验(ACTRN12615001160527)。剑桥大学没有严重精神疾病的学生被随机接受为期8周的MBP和心理健康支持（SAU）。或者单独去SAU。我们改编了意识状态改变量表(OAV，0-100点范围）以评估日常生活中的自发经历，并在为期一年的随访问卷结束时将其作为事后次要结果。两部分模型分析比较了试验组，以及一年中正式（冥想）和非正式（日常活动）正念练习的剂量反应效应。进行了校正多重比较的敏感性分析。
结果：我们随机分配了670名参与者；205（33％）完成了OAV。与SAU相比，MBP参与者更频繁和更密集地经历团结(两部分边际效应(ME)=6.26OAV量表点，95%置信区间(CI)=2.24,10.27,p=0.006,Cohen\sd=0.33)和反施舍更频繁(ME=4.84,95%CI=0.86,8.83,p=0.019,Cohen\sd=0.26)。正式实践预言了精神，幸福和团结的经历，洞察力,具体化，改变了含义。非正式实践预示着团结和幸福的经历。在对多重比较进行校正后，试验臂比较和非正式练习效果失去了意义，但正式实践剂量反应效应仍然显著。
结论：结果提供了正念练习与特定意识状态改变之间因果关系的新建议。为了优化他们的影响，从业者和教师需要适当地预测和处理它们。未来的研究需要确认发现并评估机制和临床意义。
