Rev Cuid. 2026; 17(3): 5159

https://doi.org/10.15649/cuidarte.5159

Review Article

Mindfulness for reducing stress, anxiety, and depression in incarcerated individuals: a scoping review

Mindfulness en la reducción del estrés, ansiedad y depresión en personas privadas de la libertad: revisión de alcance

Mindfulness na redução do estresse, ansiedade e depressão em indivíduos encarcerados: uma revisão de escopo

Universidad de Guanajuato, Celaya, Mexico. Universidad Juárez Autónoma de Tabasco. Villahermosa, Mexico. E-mail: y.mateocrisostomo@ugto.mx Yadira Mateo-Crisóstomo   
Universidad Cooperativa de Colombia, Santa Marta, Colombia. E-mail: doriam.camacho@ucc.edu.co Doriam Esperanza Camacho Rodríguez   
Universidad de Guanajuato, Celaya, Mexico. E-mail: h.aguilar@ugto.mx
Corresponding Author Herlinda Aguilar Zavala   
Universidad de Guanajuato. Celaya, Mexico. E-mail: mherrera@ugto.mx José Manuel Herrera Paredes   
Universidad de Guanajuato. Celaya, Mexico. E-mail: ja.zamoranoespero@ugto.mx Jesús Antonio Zamorano Espero   

 

Highlights

 

How to cite this article: Mateo-Crisóstomo Yadira, Camacho Rodríguez Doriam Esperanza, Aguilar Zavala Herlinda, Herrera Paredes José Manuel, Zamorano Espero Jesús Antonio. Mindfulness for reducing stress, anxiety, and depression in incarcerated individuals: a scoping review. Revista Cuidarte. 2026;17(3):e5159. https://doi.org/10.15649/cuidarte.5159

Received: April 10th, 2025
Accepted: December 3rd, 2025
Published: October 22nd, 2026

CreativeCommons 

E-ISSN: 2346-3414

Abstract

Introduction: Mental disorders affect one in eight people worldwide and cause significant disturbances in thinking, emotional regulation, and behavior. Objective: To map the effect of mindfulness intervention in reducing stress, anxiety, and depression levels in people deprived of their liberty. Materials and Methods: The five-stage methodological framework proposed by Arksey and O’Malley was used. A systematic literature search was conducted in the PubMed, SAGE Journals, ScienceDirect, Springer, and Web of Science databases. Results: A total of 10 articles were included, which analyzed 10 different interventions. Regarding participant sex, most studies focused on male populations, except for three studies that evaluated women and one that included a mixedsex sample. Six of the seven interventions reviewed showed a significant reduction in at least one of these variables, with the Path of Freedom intervention standing out. Discussion: The adapted Path of Freedom program stood out as the most effective intervention for reducing stress, anxiety, and depression. This result suggests that its impact goes beyond traditional mindfulness practices by integrating key components of emotional regulation in a more structured way. Conclusion: Mindfulness-based interventions have proven to be effective in reducing stress, anxiety, and depression among incarcerated individuals. However, their impact varies depending on the methodological approach, program duration, and the components incorporated.

Keywords: Mindfulness; Stress; Anxiety; Depression; Prisoners.

Resumen

Introducción: Los trastornos mentales afectan a una de cada ocho personas en el mundo y provocan alteraciones significativas en el pensamiento, la regulación emocional y la conducta. Objetivo: Mapear el efecto de la intervención de mindfulness en la reducción de los niveles de estrés, ansiedad y depresión en personas privadas de la libertad. Materiales y Métodos: Se utilizó el marco metodológico de cinco etapas de Arksey y O´Malley. Se realizó una búsqueda sistematizada en las bases de datos PubMed, SAGE Journals, Science, Springer y Web of Science. Resultados: En total, se incluyeron 10 artículos, los cuales analizaron 10 intervenciones distintas. En cuanto a la distribución por género, la mayoría de los estudios se enfocan en poblaciones masculinas, con excepción de tres estudios que evaluaron a mujeres y uno que incluyó una muestra mixta. Seis de las siete intervenciones revisadas mostraron una disminución significativa en al menos una de estas variables, destacando la intervención Path of Freedom. Discusión: La adaptación del programa Path of Freedom destacó como la más efectiva en la reducción del estrés, la ansiedad y la depresión. Este resultado sugiere que su impacto va más allá de las prácticas tradicionales de Mindfulness, integrando de manera más estructurada componentes clave de la regulación emocional. Conclusión: Las intervenciones basadas en Mindfulness han demostrado ser efectivas para reducir el estrés, la ansiedad y la depresión en personas privadas de la libertad. Sin embargo, su impacto varía según el enfoque metodológico, la duración del programa y los componentes incorporados.

Palabras Clave: Atención Plena; Estrés; Ansiedad; Depresión; Prisioneros.

Resumo

Introdução: Transtornos mentais afetam uma em cada oito pessoas no mundo e causam alterações significativas no pensamento, na regulação emocional e no comportamento. Objetivo: Mapear o efeito da intervenção de mindfulness na redução dos níveis de estresse, ansiedade e depressão em indivíduos encarcerados. Materiais e Métodos: Foi utilizado o modelo metodológico de cinco etapas de Arksey e O'Malley. Uma busca sistemática foi realizada nas bases de dados PubMed, SAGE Journals, Science, Springer e Web of Science. Resultados: Um total de 10 artigos foram incluídos, analisando 10 intervenções diferentes. Em relação à distribuição por gênero, a maioria dos estudos focou em populações masculinas, com exceção de três estudos que avaliaram mulheres e um que incluiu uma amostra mista. Seis das sete intervenções revisadas mostraram uma diminuição significativa em pelo menos uma dessas variáveis, com a intervenção Caminho da Liberdade se destacando. Discussão: O programa Caminho da Liberdade adaptado se destacou como o mais eficaz na redução do estresse, da ansiedade e da depressão. Este resultado sugere que seu impacto vai além das práticas tradicionais de mindfulness, integrando componentes-chave da regulação emocional de forma mais estruturada. Conclusão: Intervenções baseadas em mindfulness têm se mostrado eficazes na redução do estresse, da ansiedade e da depressão em indivíduos encarcerados. No entanto, seu impacto varia dependendo da abordagem metodológica, da duração do programa e dos componentes incorporados.

Palavras-Chave: Atenção Plena; Estresse; Ansiedade; Depressão; Prisioneiros.

 

Introduction

Mental health has become the leading global health concern since 20211,2. Conditions such as depression and anxiety disorders affect 3.8% and 4.0% of the global population, respectively3,4. In Latin America and the Caribbean, anxiety disorders have the highest prevalence worldwide, while depressive disorders rank second5.

Mental health problems have a greater impact on vulnerable populations, such as incarcerated individuals6, because they are exposed to a highly stressful environment7 characterized by loss of autonomy, judicial uncertainty, the need to adapt to strict institutional rules8, overcrowding9, violence, lack of privacy, and interpersonal conflicts10, as well as disconnection from the family environment and the absence of a sense of purpose11.

Stress, anxiety, and depression are interconnected and may reinforce one another over time12. Aunque Although negative emotions serve an adaptive function by helping individuals identify threats, their persistence may trigger maladaptive responses and increase the risk of mood disorders13. Perceived stress arises from the appraisal of a situation as threatening and the perception that one lacks sufficient resources to cope with it14. Its persistent presence may lead to anxiety, characterized by a state of heightened alertness and recurrent negative thoughts, which, in turn, further amplifies the perception of stress through a feedback loop15.

Stress is a key factor in the development of depression, particularly among vulnerable populations exposed to overcrowding, violence, and uncertainty16. The diathesis-stress model posits that certain stressful situations may trigger depressive episodes, while persistent depression may deplete cognitive resources, further impairing the ability to cope with stress17. This process creates a downward spiral in which stress accumulates and exacerbates emotional disorders18.

One strategy for interrupting this cycle is mindfulness19, for which evidence supports its effectiveness in reducing stress, anxiety, and depression by promoting adaptive coping strategies20. In correctional settings, its implementation has demonstrated benefits such as enhanced resilience, improved impulse control, and reduced aggressive behavior21,22.

Evidence regarding the effectiveness of mindfulness in correctional settings remains limited and fragmented23, although studies have examined its effects on emotional regulation and the reduction of aggressive behavior24. The objective of this scoping review was to map the effects of mindfulness interventions on reducing levels of stress, anxiety, and depression among incarcerated individuals.

 

Materials and Methods

This scoping review25 was conducted using the five-stage methodological framework developed by Arksey and O’Malley26. The study findings are reported in accordance with the PRISMA-ScR 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines25.

Research question
The research question that guided the search strategy was developed using the PICO framework (P = Patient or Problem, I = Intervention, C = Comparison, and O = Outcome)27. The population of interest consisted of incarcerated individuals, the primary intervention was mindfulness, and the outcome variables included stress, anxiety, and depression. The following key questions guided the review:
What is the scope of the evidence on the effects of mindfulness interventions in reducing stress, anxiety, and depression among incarcerated individuals?
What characteristics of mindfulness interventions have been shown to be effective in reducing stress, anxiety, and depression in this population?

Relevant studies
A systematized literature search was conducted in the PubMed, SAGE Journals, ScienceDirect, Springer, and Web of Science databases between January and March 2025. The search strategy included MeSH and DeCS terms in Spanish, English, and Portuguese: “Mindfulness,” “Prisoners,” “Stress, Psychological,” “Anxiety,” “Depression,” “atención plena,” “prisioneros,” “estrés psicológico,” “ansiedad,” “depresión,” “Atenção Plena,” “Prisioneiros,” “Estresse Psicológico,” “Ansiedade,” and “Depressão.” These terms were combined using the Boolean operator AND. The search strategy was adapted to the specific requirements of each database and tested in all three languages before the final search was conducted.

Study selection
Original articles reporting randomized controlled trials, as well as studies reporting a single randomized or quasi-experimental clinical trial, published between January 1, 2015, and January 1, 2025, were included. Eligible studies had to evaluate mindfulness interventions in relation to stress, anxiety, and depression, be available through open access, and be published in Spanish, English, or Portuguese. Studies that did not report outcome measures for any of these dimensions were excluded, as were non-systematic literature reviews, study protocols, gray literature (e.g., conference abstracts and theses), and descriptive or correlational studies.

Data charting
The study selection process was conducted sequentially, from identification through inclusion, following the PRISMA-ScR flow diagram25. Initially, studies were identified through searches of the PubMed, SAGE Journals, ScienceDirect, Springer, and Web of Science databases, as well as through manual searches. Duplicate records were then removed using reference management software. Subsequently, the records were organized in a Microsoft Excel spreadsheet to assess their eligibility.

Two reviewers independently screened the titles and abstracts by applying the eligibility criteria. Studies considered potentially relevant were retrieved in full text for further assessment. Reasons for exclusion were documented for subsequent review by a third reviewer. Finally, any disagreements arising during the final stage of the selection process were resolved by the third reviewer, leaving no unresolved discrepancies.

Collating, summarizing, and reporting the results
Using a standardized data extraction form, two reviewers independently extracted the data and organized them in a Microsoft Excel spreadsheet. The extracted information included the year of publication, the country where the study was conducted, the sample size, and specific data on the characteristics of the mindfulness intervention.

The 12 checklist items were independently assessed by two reviewers, who evaluated aspects such as the intervention name, theoretical foundation, materials, procedures, facilitator qualifications, mode of delivery, setting, duration, adaptations, and intervention fidelity. The results were organized into an Excel matrix to facilitate comparative analysis. All extracted data are publicly available through Mendeley Data28.

Ethical considerations
Review studies do not require approval from a research ethics committee because they do not involve the direct collection of data from participants. However, they must adhere to a rigorous methodological approach to ensure the validity and reliability of the findings.

 

Results

A total of 628 records reporting interventions described in original articles were identified. After duplicate records were removed, an initial screening based on titles and abstracts was conducted, resulting in the exclusion of 545 records that did not meet the eligibility criteria. As a result, 80 articles were selected for full-text review.

In addition, a complementary search was conducted to identify randomized controlled trials or quasiexperimental studies that specifically evaluated mindfulness interventions. Of the studies retrieved, 60 were excluded because they did not meet the predefined eligibility criteria. The main reasons for exclusion included the absence of a focus on mindfulness-based interventions, theoretical papers or review articles without empirical findings, inclusion of populations other than the target population, insufficient methodological information, and unavailability of the full text. Ultimately, 20 articles were identified as potentially relevant, of which 10 met all the established eligibility criteria and addressed a range of mindfulness interventions Figure 1.

Figure 1. PRISMA ScR flow diagram for the identification of studies via databases and registers


To address the research questions, the selected studies were analyzed systematically, and their findings were classified into three main domains: (1) characteristics of the participant population, (2) study design and intervention components, and (3) study results and the effects of the intervention on stress, anxiety, and depression.

Characteristics of the study population
Table 1 summarizes the characteristics of the study populations included in the selected studies published between 2015 and 2025. These studies were conducted across diverse regions of the world, including the United States29,30, China31-33, the Netherlands34, the United Kingdom35,36, Spain37, and Portugal38, providing a global perspective on the use of mindfulness interventions in correctional settings.

Regarding participant sex, most studies focused on male populations, with the exception of three studies that evaluated women and one that included a mixed-sex sample. Participants’ ages varied widely, ranging from adolescents aged 14 years to adults aged 60 years, with study-specific differences according to the geographic setting and study design. Marital status was reported in only a few studies, indicating that participants were either single or married.

With respect to educational level, few studies reported this information. Among those that did, most participants had completed secondary education. Finally, the duration of incarceration was reported inconsistently across studies, ranging from relatively short periods of 8 months to as long as 23 years Table 1.

Table 1. Characteristics of the study population (2015-2025)

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Table 1. Characteristics of the study population (2015-2025)

Author/year Country Sex Age Marital
status 		Educational
level 		Mean duration of
incarceration 		Study
design
Ferstz et al.29 , 2015 United States Women 20-53 years Single Not applicable Not applicable QE
Himelstein et al.30 , 2015 United States Men 14-18 years Not applicable Not applicable 8 months RCT
Xu et al.31 , 2016 China Men 22-57 years Married Secondary Not applicable QE
An et al.32 , 2019 China Men 19-57 years Not applicable Not applicable 3 years QE
Song et al.33 , 2021 China Women 40 years Not applicable Secondary 15 years QE
Bouw et al.34 , 2019 Netherlands Men 23-55 years Not applicable Not applicable 15 -
209 months		 QE
Simpson et al.35 , 2019 United
Kingdom		 Men 16-21 years Not applicable Secondary 52 months QE
Davies et al.36 , 2021 United
Kingdom 		Men and
women 		26-35 years Not applicable Not applicable 23 years QE
Gallego et al.37 , 2023 Spain Men 23-58 years Not applicable Not applicable Not applicable RCT
Carmo et al.38 , 2024 Portugal Men 23-60 years Single Secondary Not applicable QE

     QE=Quasi-experimental study, RCT = Randomized controlled trial

The selected studies were analyzed systematically, and their findings were classified into two main domains: (1) study design and intervention components, and (2) study results and the effects of the intervention on stress, anxiety, and depression.

Characteristics of the identified intervention designs
Quasi-experimental studies: Eight quasi-experimental studies29,31-36,38 and two randomized controlled trials30,37 were identified that evaluated mindfulness interventions for reducing stress, anxiety, and depression among incarcerated individuals.

Among the quasi-experimental studies, interventions were delivered in person and included between 18 and 44 participants per study group. Intervention duration ranged from 6 to 12 weeks. Most interventions comprised 6 to 12 sessions, with each session lasting approximately 1 to 3 hours. Activities implemented in the intervention groups included meditation, relaxation exercises, body scan, seated meditation, yoga, mindful movement, and group discussions29-38. Regarding the care provided to the control groups, several studies did not describe the comparator intervention29,31-33,35,38. Others used alternative interventions, such as substance use treatment programs30, individual psychotherapy33, or sports programs or training provided after the study period32,37. The findings showed significant reductions in stress29,33, anxiety, and depression following the intervention29,31,34-36,38, as well as improvements in self-esteem30,32 and sleep quality29.

Randomized controlled trials
In contrast, the randomized controlled trials included between 33 and 44 participants per study group. The interventions lasted 8 and 10 months, respectively, and consisted of 8 to 11 sessions of approximately 2 hours each. The interventions comprised meditation practices, psychoeducation, practical exercises, guided meditation, and informal practice, together with the use of workbooks. Regarding the control groups, mindfulness-based interventions were provided after the trial period30,37. The findings indicated that mindfulness-based interventions produced significant reductions in stress, anxiety, and depression, with effect sizes ranging from moderate to large30,37 Table 2.

Table 2. Overall characteristics of the intervention designs identified between 2015 and 2025

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Table 2. Overall characteristics of the intervention designs identified between 2015 and 2025

Author/year Sample Mode of
delivery 		Duration Number of
sessions and
length 		Intervention
group care 		Control group
care 		Primary outcomes Findings
Ferstz et
al.29 , 2015		 Intervention group
(IG): 18
participants;
Control group (CG):
15 participants 		Face-toface 12 weeks 12 sessions;
1 hour per
session		 Meditation,
relaxation
exercises, and
mindful breathing		 Treatment not
reported		 Perceived stress decreased from 24.61 to 20.83 (t (17) = 2.805, p = 0.012); anxiety, measured with the State-Trait Anxiety Inventory (STAI), decreased from 55.44 to 43.11 (t (17) = 4.079, p = 0.001); and depression, assessed using the Center for Epidemiologic Studies Depression Scale-10 (CES-D-10), decreased from 17.78 to 13.56 (t (17) = 4.228, p = 0.001). . The mindfulness intervention significantly improved sleep quality, as reflected by a reduction in the mean Pittsburgh Sleep Quality Index (PSQI) score from 12.80 to 9.80 (t (14) = 3.574, p = 0.003).
Himelstein et
al.30 , 2015		 IG: 27 participants;
CG: 27 participants
 Face-toface 12 weeks 12 sessions;
15-25 minutes
per session 		Mindfulness program (mindfulness meditation and individual counseling) Substance use treatment program and individual psychotherapy The mindfulness intervention significantly improved decision-making skills from 8.8 (SD = 2.0) to 10.1 (SD = 1.8), t = −3.44, p < 0.01. Attitudes toward drugs (pre-intervention M=38.7, SD =5.4; post-intervention M =40.7, SD =7.2; t =−1.60) and mindfulness (Mindful Attention Awareness Scale [MAAS]: preintervention M =58.8, SD =10.9; postintervention M =60.5, SD =11.1; t =−0.90) changed in the expected direction toward greater well-being. Participants who received mindfulness training experienced a significant increase in self-esteem, from 21.6 (SD = 3.7) to 22.8 (SD = 3.8), t = −2.07, p < 0.05.
Xu et al. 31 ,
2016 		IG: 19
participants;
CG: 21
participants
 Face-toface 6 weeks 6 sessions;
2.5-3 hours
per session		 Body scan, seated meditation, walking meditation,
yoga, and group discussions		 Treatment not
reported		 Significant group-by-time interactions were observed for anxiety, depression, tensionanxiety, depression-dejection, angerhostility, confusion-bewilderment, and total mood disturbance, with significant improvements from pre- to post-intervention in the mindfulness training group, whereas the control group showed no meaningful changes. For example, significant reductions were observed for tension-anxiety (F (1.38) = 24.79, p < 0.001) and anger-hostility (F (1.38)=22.02, p < 0.001) . Simple-effects analyses showed that the mindfulness group had significantly higher mindfulness scores at posttest than the control group (F (1.38) = 12.91, p < 0.001), whereas no significant changes were observed in the control group (F (1.38)=0.25, p =0.62).
An et
al. 32 , 2019 		IG: 39
participants;
CG: 44
participants 		Face-toface 6 weeks 6 sessions;
2.5-3 hours
per session		 PMeditation practices and
mindfulness
yoga		 Received the same mindfulness training after the posttrial period Compared with the waitlist control group, participants who received mindfulness training showed significant improvements in several psychological indicators. These included increased mindfulness (p < 0.01), significant reductions in Symptom Checklist-90 (SCL-90) scores (p < 0.001) and aggression (p < 0.05), as well as improvements in sleep quality (p < 0.05) and reductions in total mood disturbance (p < 0.01). In addition, when participants were compared according to sentence length, mindfulness training was more effective among individuals serving longer prison sentences, who showed significant improvements in mindfulness (p < 0.05) and SCL-90 scores (p < 0.001), along with reductions in anxiety, depression, aggression, perceived stress, and total mood disturbance (all p < 0.05).
Song et
al. 33 , 2021 		IG: 25
participants;
CG: 30
participants 		Face-toface 8 weeks 8 sessions;
2 hours
of theory
and 30-40
minutes
of practice
per session 		Body scan, seated meditation and other audio-guided meditations, together with informal practice (purposefully paying attention to routine daily activities) Mindfulnessbased cognitive therapy theory without practice The results showed that standard Mindfulness-Based Cognitive Therapy (MBCT) significantly reduced perceived stress (p = 0.01, d = 0.65, moderate effect), depression (p = 0.002, d = 0.82, large effect), and state anxiety (p = 0.02, d = 0.59, moderate effect). However, the reduction in trait anxiety was not significant (p = 0.02, d = 0.48, small effect). Standard MBCT was more effective than theoretical instruction alone in reducing stress, state anxiety, and depression, although its impact on trait anxiety was limited.
Bouw et al.34 ,
2019		 IG: 22
participants;
CG:
10 participants 		Face-toface 8 weeks 8 sessions;
2 hours
per session		 Mindfulness exercises (body scan, object-focused meditation, breathing exercises, and slow-movement yoga) Treatment not
reported		 During the mindfulness intervention, participants experienced positive changes in several emotional domains. Anger decreased significantly, with the median score declining from 3.0 before the intervention to 2.0 afterward (z = −2.151, p = 0.031), and mean anger intensity decreased from 6.6 (SD = 1.7) to 5.4 (SD = 1.9; t (15) = 2.30, p = 0.036, d = 0.69). Regarding stress, no significant changes were observed in its frequency (pre-intervention median = 4.0 vs. post-intervention median = 3.0; z = −1.458, p = 0.145), although mean stress intensity decreased from 7.5 (SD = 2.3) to 5.4 (SD = 2.7; t (18) = 4.16, p = 0.001, d = 0.82). Participants' self-esteem increased significantly, from a mean of 7.4 (SD = 2.3) to 8.3 (SD = 1.2; t (21) = 2.82, p = 0.010, d = 0.53), indicating an enhanced positive selfperception.
Simpson et
al.35 , 2019		 IG: 23
participants; CG:
23 participants 		Face-toface 10 weeks 10 sessions;
30–45
minutes
per session		 Breath awareness,
body
scan, and
mindful
movement		 Treatment not
reported		 In terms of quantitative outcomes, the intervention produced positive effects on several measures. Impulsivity scores decreased significantly on both the Teen Conflict Survey TCS (d = 0.72; 95% CI: 0.32–1.11; p = 0.001) and the Barret Impulsivity Scale BIS-11 (d = 0.50; 95% CI: 0.21–0.76; p = 0.01). The BIS-11 subscales showed reductions in attentional impulsiveness (d = 0.44; p = 0.005), motor impulsiveness (d = 0.39; p = 0.04), and non-planning impulsiveness (d = 0.36; p = 0.01). Improvements were also observed in attention (d = 0.33; p = 0.01), cognitive instability (d = 0.46; p = 0.01), and selfcontrol (d = 0.37; p = 0.02). Mental distress decreased, with a small effect size (d = 0.32; 95% CI: 0.03–0.60; p = 0.26).
Davies et
al.36 , 2021		 IG: 17
participants;
CG: 16
participants 		Face-toface 10 months 8 sessions;
2 hours
per session		 Psychoeducation, group sharing of experiences, and practical exercises; sessions were supplemented with a workbook and between-session practice Treatment
not reported		 Regarding perceived stress, participants showed a significant reduction in Perceived Stress Scale (PSS) scores (t (30) = 4.12, p = 0.001, d = 0.80), indicating a substantial decrease in psychological distress. Depression and anxiety symptoms also decreased significantly, as measured by the Self-Rating Depression Scale (SDS) (t (27) = 3.48, p = 0.002, d = 0.67) and the Self-Rating Anxiety Scale (SAS) (t (27) = 3.21, p = 0.003, d = 0.61), demonstrating a moderate effect of the intervention on psychological well-being. Improvements were also observed in impulse control and sustained attention, as evidenced by a significant reduction in Stop-Signal Reaction Time (SSRT) (t (29) = −2.64, p = 0.013, d = 0.68), indicating greater cognitive control and lower impulsivity. Mindfulness levels also increased significantly following the intervention.
Gallego et
al.37 , 2023		 IG: 22
participants;
CG: 22
participants 		Face-toface 8 weeks 11 sessions;
2 hours
per session		 Formal meditation was practiced for 10 minutes during the first session, 15 minutes during the second session, and 20 minutes during subsequent sessions Sports program Regarding depression, the Wilcoxon signedrank test showed a significant reduction in the mindfulness group between baseline and the 2-month follow-up (Z = −2.383; p = 0.017; r = −0.53). Anxiety scores decreased from moderate to mild levels at the 2-month follow-up, although the overall change did not reach statistical significance (χ² = 10.73; p = 0.067). The most pronounced changes were observed for stress. In the mindfulness group, stress levels decreased significantly from moderate to normal (χ² = 16.44; p = 0.032), with significant differences between baseline and post-intervention (Z = −2.609; p = 0.009; r = −0.56) and between baseline and the 2-month follow-up (Z = −2.533; p = 0.011; r = −0.57), indicating a large and sustained effect.
Carmo et
al.38 , 2024		 IG: 22
participants;
CG:
22 participants 		Face-toface 5 months 18 sessions;
90 minutes
per session		 Mindfulness meditation exercises (mindful yoga, body scan, seated meditation, and mindful walking) Treatment not
reported		 Following the intervention, although no statistically significant between-group differences were observed in stress, anxiety, or depression, mean scores were consistently lower in the mindfulness group. Selfesteem remained significantly higher in the mindfulness group (M = 32.42, SD = 5.96) than in the control group (M = 28.55, SD = 4.47; U = 140, p = 0.016, d = 0.35), with a small but consistent effect. At baseline, the control group had higher levels of anxiety (U = 152.5, p = 0.034, d = 0.25) and negative affect (U = 130.5, p = .009, d = 0.35), whereas the mindfulness group demonstrated higher self-esteem (U = 158, p = 0.048, d = 0.31).

                                 Face-to-face = in person. IG: Intervention Group; CG: Control Group; SD: Standard Deviation, M: Mean; CI: Confidence

Effective mindfulness interventions for reducing stress, anxiety, and depression
The overall analysis of mindfulness interventions identified a total of eight studies that evaluated the effectiveness of different programs for reducing stress, anxiety, and depression among incarcerated individuals29,31-38. The interventions included Path of Freedom29,36. Mindfulness- Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR)31-34,36-38.

Regarding the number of sessions, most interventions were delivered in a group format and ranged from 2 to 18 sessions. Session duration ranged from 1 to 3 hours. All interventions were delivered by certified mindfulness instructors with experience in mindfulness, underscoring the importance of qualified personnel to ensure intervention effectiveness.

The most important results showed that all eight interventions achieved significant reductions in stress, anxiety, or depression29,31,32,34-38. The most effective interventions were the adapted Path of Freedom program29,36 and MBCT31,32,34,36. These interventions produced significant reductions in anxiety, depression, and perceived stress (p < 0.01), with moderate-to-large effect sizes (d =0.82 to 0.84) (d =0,82 a d = 0,84)32,36.

The 12-session Path of Freedom intervention29 achieved significant reductions in stress (p = 0.012), anxiety (p = 0.001), and depression (p = 0.001). The 6-session MBCT intervention31 produced significant reductions in anxiety (p = 0.001) and depression (p = 0.024). MBCT protocols34,36 also demonstrated reductions in anxiety, depression, and total mood disturbance (p < 0.001). The 18-session intervention combining MBSR and MBCT38 showed a positive effect in reducing anxiety (p = 0.034), although the effect size was small (d = 0.25) (d = 0,25). Table 3

Table 3. Effective mindfulness interventions for reducing stress, anxiety, and depression

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Table 3. Effective mindfulness interventions for reducing stress, anxiety, and depression

Author / year Intervention
name 		Delivery/
components 		Setting/sessions Intervention vs. Control
Outcome
Ferstz, et
al.29, , 2015 		Adapted Path
of Freedom intervention 		Certified mindfulness instructor accredited by the Prison Mindfulness Institute Correctional facility;
12 group sessions; 1 hour
per session 		A significant reduction in perceived stress was observed following the intervention (post-intervention M = 20.83, d = 1.48) compared with baseline (pre-intervention M = 24.61, d = 0.95), t (17) = 2.805, p = 0.012. Anxiety also decreased significantly, with post-intervention scores (M = 43.11, d = 1.46) being lower than baseline scores (M = 55.44, d = 2.45), t (17) = 4.079, p = 0.001. Likewise, participants showed a significant improvement in depression, with mean scores decreasing from M = 17.78 (d = 1.20) preintervention to M = 13.56 (d = 1.17) post-intervention, t (17) = 4.228, p = 0.001.
Xu et
al.31, , 2016 		Mindfulness-
Based Cognitive Therapy (MBCT) protocol 		Mindfulness
instructor with experience 		Correctional
facility; 6 group
sessions;
2.5–3 hours
per session 		Significant time-by-treatment interactions were observed for anxiety and depression (p < 0.05). Simple-effects analyses showed that the mindfulness group experienced significant reductions in anxiety (SAS: F (1.38)=13.75, p =0.001) and depression (SDS: F (1.38)=5.63, p =0.024) at posttest compared with pretest. Significant reductions were also observed in tension-anxiety (F (1.38)=19.42, p < 0.001), depression-dejection (F (1.38)=7.42, p =0.01), anger–hostility (F (1.38)=13.59, p < 0.001), confusionbewilderment (F (1.38)=8.92, p =0.005), and total mood disturbance (TMD: F (1.38)=12.42, p < 0.001).
An et
al.32, , 2019 		Mindfulness- Based Stress Reduction (MBSR) and Mindfulness- Based Cognitive Therapy (MBCT) Mindfulness
instructor with
experience 		Correctional
facility; 6 group
sessions; 2.5–3 hours
per session 		The mindfulness group showed significant reductions in overall psychological distress (p = 0.000), particularly in symptoms of somatization (p = 0.002), obsessive– compulsive symptoms (p = 0.000), interpersonal sensitivity (p = 0.000), depression (p = .000), anxiety (p = 0.001), hostility (p = 0.000), phobic anxiety (p = 0.006), paranoid ideation (p = 0.001), and psychoticism (p = 0.002).
Song et
al.33, , 2021 		Mindfulness- Based Cognitive Therapy (MBCT) protocol Mindfulness instructors certified by the Oxford Mindfulness Center Correctional facility; 8 group sessions; 2 hours plus 30–40 minutes of practice per session An analysis of covariance (ANCOVA) was performed to control for pretest values and evaluate the effects of the intervention. Significant between-group differences were found for state anxiety (F (2.63) = 3.28, p = 0.04) and depression (F (2.63) = 6.37, p < 0.001). Post hoc analyses showed that the standard MBCT group had significantly lower levels of state anxiety than the theoretical learning group (t =2.55, p =0.04, d =0.67). Likewise, depression levels in the standard MBCT group were significantly lower than those in the waitlist control group (t =3.57, p =0.002, d =0.84).
Bouw et
al.34, , 2019 		Mindfulness- Based Cognitive Therapy (MBCT) protocol Mindfulness instructor with experience Correctional
facility; 2 group
sessions; 2 hours
per session 		The reduction in stress intensity (from 7.5 to 5.4) was statistically significant, with a moderate-to-large effect size (d = 0.82).
Davies et
al.36, , 2021 		Adapted 12-session Path of Freedom intervention Mindfulness instructor Correctional
facility;
2 group
sessions; 2 hours
per session 		A significant increase in mindfulness was observed following the intervention, as reflected by Five Facet Mindfulness Questionnaire (FFMQ) scores (F = 8.86, p = 0.006) and Child and Adolescent Mindfulness Measure– Short Form (CAMSR) scores (F = 5.69, p = 0.024). Perceived stress also decreased significantly over time (F= 19.177, p < 0.001; ηp2 = .398).
Gallego et
al.37, , 2023 		Mindfulness- Based Cognitive Therapy (MBCT) protocol Mindfulness instructor with experience Correctional
facility; 11 group sessions;
2 hours
per session 		For stress, significant differences were observed across assessment time points (χ²(3) = 8.793, p = 0.032), with a marked reduction following the intervention (p = 0.009, r = −0.556), which was maintained at the 2-month follow-up (p = 0.011, r = −0.567). For anxiety, no overall significant differences were found (χ²(3) = 4.310, p = 0.230), although a moderate reduction was observed at the 2-month follow-up (p = 0.036, r = −0.468). Likewise, no overall significant changes were found for depression (χ²(3) = 6.241, p = 0.100); however, depression scores were significantly lower at the 2-month follow-up (p = 0.017, r = −0.533). Although a downward trend was observed immediately after the intervention, it did not reach statistical significance (p = 0.080, r = −0.392).
Carmo et
al.38, , 2024 		Mindfulness- Based Stress Reduction (MBSR) and Mindfulness- Based Cognitive Therapy (MBCT) Mindfulness instructor certified in MBCT Correctional facility; 18 group sessions; 90 minutes per session (60 minutes of meditation practice and 30 minutes of feedback) The mindfulness intervention showed positive effects in reducing anxiety, with participants in the mindfulness group demonstrating significantly lower anxiety levels than those in the control group (M = 2.82, SD = 3.81 vs. M = 4.95, SD = 4.69; U = 152.50, p = 0.034). However, the effect size was small (d = 0.25).

     M: Mean; SD: Standard Deviation; SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale

 

Discussion

The studies included in this review provide evidence supporting the effectiveness of mindfulness in correctional settings, although they predominantly involved samples of incarcerated men. This limits the understanding of its impact among incarcerated women, who may respond differently to the intervention38. These differences may be attributable to variations in emotional regulation and in the prevalence of psychological disorders such as depression and anxiety. Additional studies involving female or mixed-sex samples are needed to evaluate potential sex differences in the effectiveness of mindfulness interventions39.

Another relevant aspect is the variability in participants' age. Some studies suggest that younger adults may show greater initial resistance to mindfulness practice, whereas older adults tend to engage more readily and derive greater benefits because of a greater willingness to engage in emotional learning40. These findings suggest that the effects of mindfulness interventions may vary according to age, highlighting the need to tailor intervention strategies to the age-related characteristics of the incarcerated population.

In addition, the length of incarceration appears to play a key role in incarcerated individuals' willingness to participate in mindfulness programs. Studies have suggested that individuals in the early years of their sentence tend to experience higher levels of stress and anxiety, which may make them more receptive to this type of intervention. In contrast, those who have spent longer periods in prison may be more resistant to change or less motivated to engage in emotional regulation programs41.

A central issue emerging from this review is the differential effectiveness of the interventions evaluated. Among them, the adapted Path of Freedom program demonstrated the greatest effectiveness in reducing stress, anxiety, and depression. This result suggests that its impact extends beyond traditional mindfulness practices by more systematically integrating key components of emotional regulation40. Unlike other protocols that focus exclusively on meditation and mindfulness practice, Path of Freedom incorporates emotional intelligence strategies, interpersonal skills development, and behavioral management, which may enhance its therapeutic effects in correctional populations42.

From a theoretical perspective, combining mindfulness with elements of emotional intelligence may explain the greater effectiveness of this intervention. Mindfulness alone reduces stress and anxiety by fostering greater present-moment awareness and improving the regulation of automatic responses to adverse situations43. However, the inclusion of skills such as emotion identification and regulation, enhanced decision-making, and strengthened self-control may represent a key differentiating factor in reducing depression. In correctional settings, where individuals are exposed to high levels of emotional distress and interpersonal conflict, the ability to regulate emotions effectively becomes essential for psychological well-being44.

Likewise, the structured design of Path of Freedom, which includes group sessions led by certified instructors and an interactive methodology combining meditation practice, psychoeducation, and self-reflection activities, may promote greater adherence to the intervention45. This holistic approach may explain why its effects were more consistent across all psychological variables evaluated than those of shorter programs or interventions with less methodological diversity46.

Among the strategies evaluated, MBSR and MBCT were used in five studies and demonstrated variable effectiveness in reducing stress, anxiety, and depression, with effect sizes ranging from low to moderate47. MBSR focuses on stress reduction and the promotion of overall well-being through practices such as meditation, body scan, and yoga, making it a useful approach for enhancing emotional regulation across diverse populations, including incarcerated individuals48.

In contrast, MBCT combines mindfulness with principles of CBT, focusing on modifying negative thought patterns to prevent depressive relapse, making it more suitable for individuals with a history of depression48. Whereas MBSR aims to strengthen resilience to stress49, MBCT emphasizes cognitive restructuring. In correctional settings, the choice between these interventions should be guided by participants' psychological profiles, and combining both interventions may optimize their benefits by providing a more comprehensive approach49.

Conclusion

Mindfulness-based interventions have been shown to be effective in reducing stress, anxiety, and depression among incarcerated individuals. However, their effectiveness varies according to the intervention approach, program duration, and the components incorporated. The Path of Freedom intervention demonstrated the greatest effectiveness, possibly because of its structured integration of mindfulness with emotional intelligence and interpersonal skills.

Factors such as sex, age, educational level, and length of incarceration may influence adherence to and the effectiveness of these interventions, underscoring the need for more targeted research. Among the interventions evaluated, both MBSR and MBCT have demonstrated benefits, although through different approaches. MBSR focuses on stress regulation and the promotion of overall wellbeing, whereas MBCT emphasizes cognitive restructuring to prevent depressive relapse. Combining these strategies may enhance their therapeutic effects by providing a more comprehensive approach in correctional settings.

Conflict of Interest: The authors declare no conflicts of interest.

Funding: This research received no external funding.

Acknowledgments: The authors thank the Universidad Cooperativa de Colombia, Santa Marta Campus, for serving as the host institution for the research internship.

Author Contributions: YM-C: Conceptualization; Methodology; Supervision; Writing-Review & Editing. DECR: Investigation; Data Curation; Formal Analysis; Writing-Original Draft Preparation. HAZ: Validation; Visualization; Resources; Writing-Review & Editing. JMHP: Investigation; Formal Analysis; Validation; Writing-Review & Editing. JAZE: Data Curation; Writing-Original Draft Preparation; Writing-Review & Editing.

 

References

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References

  1. Stinson J, Ipsos Knowledge Centre. Ipsos Health Service Report 2024: Mental Health seen as the biggest Health issue. [Internet] 2024 [cited 2025 Mar 22]. Available from: https://www.ipsos.com/en/ipsos-health-service-report

  2. World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October, 2021. [Internet] 2021 [cited 2025 Feb 25]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1

  3. Organización Panamericana de la Salud y Organización Mundial de la Salud. La carga de los trastornos mentales en la región de las Américas 2018. Consulta: Febrero 25, 2025. Disponible en: https://iris.paho.org/bitstream/handle/10665.2/49578/9789275320280_spa.pdf

  4. Organización Mundial de la Salud. Trastornos de ansiedad [Internet]. [consulta el 25 de Febrero de 2025]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/anxiety-disorders

  5. Santomauro DF, Mantilla Herrera AM, Shadid J, Zheng P, Ashbaugh C, Pigott DM, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700-1712. https://doi.org/10.1016/S0140-6736(21)02143-7

  6. Organización Mundial de la Salud. Estrés [Internet]. 2023 [consulta el 18 de febrero de 2025]. Disponible en: https://www.who.int/es/news-room/questions-and-answers/item/stress

  7. Porter LC, Kozlowski-Serra M, Lee H. Proliferation or adaptation? Differences across race and sex in the relationship between time served in prison and mental health symptoms. Social Science & Medicine. 2021;276:113815. https://doi.org/10.1016/j.socscimed.2021.113815

  8. Antoni MH, Dhabhar FS. The impact of psychosocial stress and stress management on immune responses in patients with cancer. Cancer. 2019;125(9):1417–1431. https://doi.org/10.1002/cncr.31943

  9. Moore KE, Siebert S, Brown G, Felton J, Johnson JE. Stressful life events among incarcerated women and men: Association with depression, loneliness, hopelessness, and suicidality. Health & Justice. 2021;9:22. https://doi.org/10.1186/s40352-021-00140-y

  10. United Nations Office on Drugs and Crime. World Drug Report. [cited 2025 Feb 11]; Available from: https://www.unodc.org/wdr2018

  11. Morley RH. The Impact of Mindfulness Meditation and Self-Compassion on Criminal Impulsivity in a Prisoner Sample. Article in Journal of Police and Criminal Psychology. 2017;33:118-122. https://doi.org/10.1007/s11896-017-9239-8

  12. Monzonís-Carda I, Adelantado-Renau M, Beltran-Valls MR, Moliner-Urdiales D. An examination of the association between risk of depression and academic performance according to weight status in adolescents: DADOS study. Journal of Affective Disorders. 2021; 290:157–163. https://doi.org/10.1016/j.jad.2021.04.086

  13. Feng G, Xu X, Lei J. Tracking perceived stress, anxiety, and depression in daily life: a double-downward spiral process. Front. Psychol. 2023;14:1114332. https://doi.org/10.3389/fpsyg.2023.1114332

  14. Liu Z, Liu R, Zhang Y, Zhang R, Liang L, Wang Y, et al. Association between perceived stress and depression among medical students during the outbreak of COVID-19: The mediating role of insomnia. Journal of Affection Disorders. 2021;292:89-94. https://doi.org/10.1016/j.jad.2021.05.028

  15. Pereira-Morales AJ, Adan A, Forero DA. Perceived Stress as a Mediator of the Relationship between Neuroticism and Depression and Anxiety Symptoms. Current Psychology. 2019;38(1):66– 74. https://doi.org/10.1007/s12144-017-9587-7

  16. Rodríguez-Naranjo C, Caño A. Daily stress and coping styles in adolescent hopelessness depression: Moderating effects of gender. Personality and Individual Differences. 2016;97:109-114. https://doi.org/10.1016/j.paid.2016.03.027

  17. Monroe SM, Simons AD. Diathesis-stress theories in the context of life stress research: implications for the depressive disorders. Psychological Bulletin. 1991;110(3):406-425 https://doi.org/10.1037/0033-2909.110.3.406

  18. Lu F, Xu Y, Yu Y, Peng L, Wu T, Wang T, et al. Moderating effect of mindfulness on the relationships between perceived stress and mental health outcomes among Chinese intensive care nurses. Front. Psychiatry. 2019;10. https://doi.org/10.3389/fpsyt.2019.00260

  19. Davies J, Ugwudike P, Young H, Hurrell C, Raynor P. A Pragmatic Study of the Impact of a Brief Mindfulness Intervention on Prisoners and Staff in a Category B Prison and Men Subject to Community-Based Probation Supervision. International Journal of Offender Therapy and Comparative Criminology. 2021;65(1):136-156. https://doi.org/10.1177/0306624X20944664

  20. Martín-Asuero A, García-Banda G. The Mindfulness-based Stress Reduction program (MBSR) reduces stress-related psychological distress in healthcare professionals. The Spanish Journal of Psychology. 2010;13(2):897-905. https://doi.org/10.1017/s1138741600002547

  21. Bouw N, Huijbregts SCJ, Scholte E, Swaab H. Mindfulness-Based Stress Reduction in Prison: Experiences of Inmates, Instructors, and Prison Staff. International Journal of Offender Therapy and Comparative Criminology. 2019;63(15-16):2550-2571. https://doi.org/10.1177/0306624X19856232

  22. Carmo C, Iacob V, Brás M, Fernandes J. Effects of a Mindfulness-Based Intervention on Male Portuguese Prisoners. International Journal of Offender Therapy and Comparative Criminology. 2024;68(6-7):677–692. https://doi.org/10.1177/0306624X221106333

  23. Abdul Manan H, Mir IA, Humayra S, Tee RY, Vasu DT. Effect of mindfulness-based interventions on anxiety, depression, and stress in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Front. Psychol. 2024; 15:1435243. https://doi.org/10.3389/fpsyg.2024.1435243

  24. Per M, Spinelli C, Sadowski I, Schmelefske E, Anand L, Khoury B. Evaluating the effectiveness of mindfulness-based interventions in incarcerated populations: a meta-analysis. Criminal Justice and Behavior. 2020;47(3):310–330. https://doi.org/10.1177/0093854819891457

  25. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine. 2018;169(7):467-473. https://doi.org/10.7326/M18-0850

  26. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005;8(1):19-32. https://doi.org/10.1080/1364557032000119616

  27. Martínez Díaz JD, Ortega Chacón V, Muñoz Ronda FJ. El diseño de preguntas clínicas en la práctica basada en la evidencia: modelos de formulación. Enfermería Global. 2016;15(43):431-438. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412016000300016&lng=es

  28. Mateo Crisóstomo Y. Mindfulness en la reducción del estrés, ansiedad y depresión: revisión de alcance. Mendeley Data. 2025 V1: https://doi.org/10.17632/7fcr395nc9.1

  29. Ferszt GG, Miller RJ, Hickey JE, Crisp K. The Impact of a Mindfulness Based Program on Perceived Stress, Anxiety, Depression and Sleep of Incarcerated Women. Int J Environ Res Public Health. 2015;12(9). https://doi.org/10.3390/ijerph120911594

  30. Himelstein S, Saul S, Garcia-Romeu A. Does Mindfulness Meditation Increase Effectiveness of Substance Abuse Treatment with Incarcerated Youth? A Pilot Randomized Controlled Trial. Mindfulness. 2015;6:1472-1480. https://doi.org/10.1007/s12671-015-0431-6

  31. Xu W, Jia K, Liu X, Hofmann SG. Effects of Mindfulness Training on Emotional Health in Chinese Long-Term Male Prison Inmates. Mindfulness. 2016;7:1044-1051. https://doi.org/10.1007/s12671-016-0540-x

  32. An Y, Huang Q, Zhou Y, Zhou Y, Xu W. Who can get more benefits? Effects of mindfulness training in long-term and short-term male prisoners. International Journal of Offender Therapy and Comparative Criminology. 2019;63(13):2318-2337. https://doi.org/10.1177/0306624X19846771

  33. Song X, Zhao H, Lou T, Wang Y, Zheng M. Corrigendum to Comparison of mindfulness with and without practice among women in custody. Criminal Justice and Behavior. 2020;48(7):1025. https://doi.org/10.1177/0093854820986315

  34. Bouw N, Huijbregts SCJ, Scholte E, Swaab H. Mindfulness-Based Stress Reduction in Prison: Experiences of Inmates, Instructors, and Prison Staff. International Journal of Offender Therapy and Comparative Criminology. 2019;63(15-16):2550-2571. https://doi.org/10.1177/0306624X19856232

  35. Simpson S, Wyke S, Mercer SW. Adaptation of a Mindfulness-Based Intervention for Incarcerated Young Men: a Feasibility Study. Mindfulness (NY). 2019;10:1568–78. https://doi.org/10.1007/s12671-018-1076-z

  36. Davies J, Ugwudike P, Young H, Hurrell C, Raynor P. Pragmatic Study of the Impact of a Brief Mindfulness Intervention on Prisoners and Staff in a Category B Prison and Men Subject to Community-Based Probation Supervision. International Journal of Offender Therapy and Comparative Criminology. 2020;65(1):136-156. https://doi.org/10.1177/0306624X20944664

  37. Gallego J, Cangas AJ, Mañas I, Aguilar-Parra JM, Langer ÁI, Navarro N, et al. Effects of a mindfulness and physical activity programme on anxiety, depression and stress levels in people with mental health problems in a prison: a controlled study. Healthcare (Basel). 2023;11(4):555. https://doi.org/10.3390/healthcare11040555

  38. Carmo C, Iacob V, Brás M, Fernandes J. Effects of a Mindfulness-Based Intervention on Male Portuguese Prisoners. Int J Offender Ther Comp Criminol. 2022;68(7):677-692. https://doi.org/10.1177/0306624X221106333

  39. Zhang D, Shen J. Dispositional mindfulness and mental health among Chinese college students during the COVID-19 lockdown: the mediating role of self-compassion and the moderating role of gender. Front Psychol. 2023;13:1072548. https://doi.org/10.3389/fpsyg.2022.1072548

  40. Creswell JD. Mindfulness interventions. Annual Review of Psychology. 2017;68:491-516. https://doi.org/10.1146/annurev-psych-042716-051139

  41. Dugan JW, Weatherly RA, Girod DA, Barber CE, Tsue TT. Longitudinal Study of Emotional Intelligence Training for Otolaryngology Residents and Faculty. JAMA Otolaryngology–Head & Neck Surgery. 2014;140(8):720-726. https://doi.org/10.1001/jamaoto.2014.1169

  42. Crowne KA, Young TM, Goldman B, Patterson B, Krouse AM, Proenca J. Leading nurses: emotional intelligence and leadership development effectiveness. Leadersh Health Serv (Bradf Engl). 2017;30(3):217-232. https://doi.org/10.1108/LHS-12-2015-0055

  43. Codier E, Freitas B, Muneno L. Developing emotional intelligence ability in oncology nurses: A clinical rounds approach. Oncology Nursing Forum. 2013;40(1):22-29. https://doi.org/10.1188/13.onf.22-29

  44. Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The Impact of Enhancing Students’ Social and Emotional Learning: A Meta-Analysis of School-Based Universal Interventions. Child Development. 2011;82(1):405-432. https://doi.org/10.1111/j.1467-8624.2010.01564.x

  45. Salvarani V, Rampoldi G, Ardenghi S, Bani M, Blasi P, Ausili D, et al. Protecting emergency room nurses from burnout: The role of dispositional mindfulness, emotion regulation and empathy. Journal of Nursing Management. 2019;27(4):765-774. https://doi.org/10.1111/jonm.12771

  46. Jiménez-Picón N, Romero-Martín M, Ponce-Blandón JA, Ramirez-Baena L, Palomo-Lara JC, Gómez-Salgado J. The Relationship between Mindfulness and Emotional Intelligence as a Protective Factor for Healthcare Professionals: Systematic Review. Int. J. Environ. Res. Public Health. 2021;18(10):5491. https://doi.org/10.3390/ijerph18105491

  47. Eisendrath SJ, Gillung E, Delucchi KL, Segal ZV, Nelson JC, McInnes LA, et al. Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression. Psychother Psychosom. 2016;85(2):99-110. https://doi.org/10.1159/000442260

  48. Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review. 2015;37:1-12. https://doi.org/10.1016/j.cpr.2015.01.006

  49. Hofmann SG, Gómez AF. Mindfulness-Based Interventions for Anxiety and Depression. Psychiatric Clinics of North America. 2017;40(4):739-749. https://doi.org/10.1016/j.psc.2017.08.008