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Self-help mindfulness and CBT interventions reduce depression and anxiety in distressed studentsMindfulness Apps Help Students Reduce Depression and Anxiety Symptoms

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Key Takeaway
Consider self-help mindfulness interventions as a scalable option for distressed students, but note unreported effect sizes limit clinical interpretation.

This randomized controlled trial enrolled 335 university students across China who were experiencing moderate to severe emotional distress. Participants were randomized to a self-help mindfulness intervention (sMBI), a combined mindfulness and cognitive behavioral therapy intervention (sMBI + CBT), or a waitlist control group (WL). The primary outcomes were reductions in symptoms of depression and anxiety.

Both sMBI and sMBI + CBT were significantly more effective than WL in reducing depression and anxiety symptoms. However, no significant differences were observed between sMBI and sMBI + CBT. Exact effect sizes, absolute numbers, and p-values were not reported.

Secondary analyses explored mechanisms. For sMBI, effects were sequentially mediated by increases in mindfulness and psychological flexibility. For sMBI + CBT, effects were sequentially mediated by increases in mindfulness and reductions in irrational beliefs.

Safety and tolerability were not reported. Limitations include the lack of reported effect sizes and absolute numbers, which limits the ability to assess clinical significance. The study was conducted entirely online, and generalizability to other populations or settings may be limited.

For clinicians, these findings suggest that scalable, self-help digital interventions may offer benefit for distressed students, but the absence of comparative effect sizes and safety data warrants cautious interpretation. Further research with more detailed reporting is needed.

A randomized controlled trial investigated whether internet-based mindfulness interventions could help university students in China dealing with moderate to severe emotional distress. The study involved 335 students who were assigned to either a waitlist control group or one of two digital programs. One program offered self-help mindfulness training, while the other combined mindfulness with cognitive behavioral therapy techniques.

Both digital programs were significantly more effective than the waitlist control group at reducing symptoms of depression and anxiety. However, the study found no significant difference in effectiveness between the self-help mindfulness program and the combined mindfulness and cognitive behavioral therapy program.

Researchers also looked at how these programs worked. Increases in mindfulness and psychological flexibility explained the benefits of the self-help program. For the combined program, increases in mindfulness and reductions in irrational beliefs were the key mechanisms driving the improvements.

The study tracked participants during treatment and at three-month and six-month follow-ups. No adverse events or safety concerns were reported. While these results are promising, the study was limited to a specific group of students and the long-term effects beyond six months remain to be seen.

What this means for you:
Online mindfulness programs reduced depression and anxiety symptoms in stressed students compared to waiting for treatment.

Study Details

Study typeRct
EvidenceLevel 2
PublishedMay 2026
View Original Abstract ↓
OBJECTIVES: This study evaluated the comparative efficacy of a self-help mindfulness intervention (sMBI) and a combined mindfulness and cognitive behavioral therapy intervention (sMBI + CBT) in reducing symptoms of depression and anxiety. Additionally, it explored the mechanisms underlying these interventions. METHODS: In this randomized controlled trial (RCT), 335 university students from various institutions across China, all experiencing moderate to severe emotional distress, were randomly assigned to one of three groups: sMBI, sMBI + CBT, or a waitlist control group (WL). Interventions were delivered via an internet-based website over a 60-day period, with assessments conducted at baseline, during treatment, post-treatment, and at three-month and six-month follow-ups. An intention-to-treat (ITT) analysis using multilevel mixed-effects models was employed to estimate the effects of the interventions. RESULTS: Both sMBI and sMBI + CBT were significantly more effective than WL in reducing symptoms of depression and anxiety. However, no significant differences were observed between sMBI and sMBI + CBT in their impact on depression and anxiety. The effects of sMBI on depression and anxiety were sequentially mediated by increases in mindfulness and psychological flexibility. In contrast, the effects of sMBI + CBT were sequentially mediated by increases in mindfulness and reductions in irrational beliefs. CONCLUSIONS: This RCT confirms the efficacy of sMBI in reducing depression and anxiety through improvements in mindfulness and psychological flexibility. It also supports the efficacy of sMBI + CBT in alleviating depression by enhancing mindfulness and correcting irrational beliefs. However, the addition of CBT to sMBI does not appear to provide additional benefits in the treatment of depression and anxiety. TRIAL REGISTRATION: Chictr.org Identifier: ChiCTR2300075928.https://www.chictr.org.cn/showproj.html?proj=207327.
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