The effect of four Immeasurables meditations on depressive symptoms: A systematic review and meta-analysis

Jing Lv; Qiuling Liu; Xianglong Zeng; Tian P S Oei; Yidan Liu; Kexin Xu; Wenxiang Sun; Hanchao Hou; Jing Liu

doi:10.1016/j.cpr.2020.101814

The effect of four Immeasurables meditations on depressive symptoms: A systematic review and meta-analysis

Clin Psychol Rev. 2020 Mar:76:101814. doi: 10.1016/j.cpr.2020.101814. Epub 2020 Jan 8.

Authors

Jing Lv¹, Qiuling Liu², Xianglong Zeng³, Tian P S Oei⁴, Yidan Liu², Kexin Xu², Wenxiang Sun⁵, Hanchao Hou⁶, Jing Liu⁷

Affiliations

¹ Faculty of Education, East China Normal University, Shanghai, PR China.
² Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, PR China.
³ Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, PR China. Electronic address: xzeng@bnu.edu.cn.
⁴ School of Psychology, The University of Queensland, Australia.
⁵ Faculty of Education, Beijing Normal University, PR China.
⁶ Centre for Positive Psychology, Melbourne Graduate School of Education, The University of Melbourne, Australia.
⁷ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.

PMID: 31945711
DOI: 10.1016/j.cpr.2020.101814

Abstract

The Four Immeasurables Meditations (FIM) intervention have been shown as a promising intervention for reducing depressive symptoms. The current study is a systematic review of FIM intervention effects on depressive symptoms. Among 192 empirical research articles on FIM published before May 2019, 40 independent trials from 35 records measured depressive symptoms. The meta-analysis included 21 randomized controlled trials (RCT; n = 1468) and 16 uncontrolled trials (n = 376). The results supported overall effectiveness of FIM on depressive symptoms (d = 0.38 for RCT and d = 0.87 for uncontrolled trials). Moderator analysis indicated the effects differed across protocols, and effects were smaller in RCT using active control groups. No significant differences were observed for participant type, measures, intervention length, or intervention components. Individual studies found no direct association between meditation practice time and effects, and mindfulness and self-compassion were widely supported as mechanisms of change. Current evidence supports FIM as an effective intervention for reducing depressive symptoms, but additional studies with more rigorous designs using active control groups are needed. Further investigation should be encouraged regarding specific protocols and participants, the contribution of meditation practice, and other mechanisms such as positive emotions.

Keywords: Buddhist; Compassion; Depression; Dose-effect; Loving-kindness; Mindfulness.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Depression / therapy*
Empathy
Humans
Meditation / psychology*
Mindfulness