An exploratory mechanistic study of the effects of a body scan meditation in adults presenting with mild to moderate depression

Research to date has focused largely on mindfulness-based interventions as whole treatment packages, with relatively little exploration of the specific mindfulness practices that comprise them. Understanding the effects of individual practices could offer insight into why mindfulness-based interventions work for some but not others and help identify and mitigate any adverse effects. This is in line with wider developments in psychotherapy research that are based on the assumptions that knowledge about active ingredients, mechanisms engagement, and differential outcomes can provide important information for tailoring interventions more precisely to individual needs and potentially improve effectiveness and safety of delivery. The current study will focus on the body scan meditation, a foundational component of mindfulness-based interventions that represents the main home practice for the first weeks of these programmes. The body scan involves systematically moving attention across different areas of the body, cultivating awareness of bodily sensations with a non-judgmental and accepting attitude. Within mindfulness based interventions, the intention of the practice is to help patients become more fluent in shifting to a sensory-perceptual mode of processing, which is assumed to naturally counter tendencies towards unhelpful thinking patterns (rumination), and to increase participants’ bodily awareness, a skill that is thought to be critical for effective emotion-regulation. Although mainly introduced as a means of building foundational skills, preliminary reports suggest that it may have wider beneficial effects on sleep and depressive symptoms. However, research specifically examining its impact on individuals with depression is sparse (Gan et al., 2022). Furthermore, the quality of existing studies exploring the effects of mindfulness-based interventions has been questioned, with systematic reviews highlighting issues such as high attrition rates and inconsistent reporting (Gan et al., 2022). Based on this reasoning, the current study will investigate effects of the body scan on potential activating (increased bodily awareness, reduced rumination) and downstream (sleep quality) mechanisms as well as on depressive symptoms as a primary clinical outcome, both with a view to understanding improvement and potential deteriorations. MRC guidance for the evaluation of complex interventions and the NIHR Experimental Medicine Framework consider the use of control groups in exploratory mechanisms studies as helpful but not essential. Given its focus on mechanisms engagement, the current study will therefore use a single group design with assessments before and after a brief body scan intervention. Alongside investigation of mechanisms engagement, previous research has called for more detailed investigations into the fine-grained, lived experience of mindfulness practices (Rao et al., 2018; Lindayani et al., 2020). To achieve this, qualitative assessments in a subset of participants will use micro-phenomenology (Petitmengin, 2019) to elicit rich, detailed accounts of participants’ moment-to-moment experience during the body scan meditation. This mixed-methods approach aims to provide a deeper mechanistic understanding of the body scan practice, potentially contributing to a more effective use of this important ingredient of MBIs.