Mindfulness Meditation According to the Satipatthana Sutta: A Single-Case Study With Participants as Collaborators.

Objectives: We explored the effects of a mindfulness program based on the satipatthana sutta (instead of a contemporary Western program), with participants as collaborators, using a single-case experimental design. The main question was whether such a training has positive effects and, if so, whether and how the effects vary across participants and measures. Method: Participants chose the design (multiple baseline) and the measures to be repeatedly collected. Then they took part in a 6-week mindfulness training based on the satipatthana sutta; finally, they performed a preliminary data analysis of their own results. Reported are a selection of the visual analyses, intraindividual effect sizes (Tau-U), and the results of single-case meta-analyses over participants, as well as a multivariate graphical analysis of interindividual differences. Results: Substantial training effects were found on average and for the majority of participants for concentration, mind wandering, decentering, positive affect, and well-being. Effects were small for negative affect, and no effects were found for emotion regulation. However, interindividual variation was high, both in respect to specific measures and concerning the overall effect of the training program. Participants' motivation was found to be very high throughout the study. Conclusion: Our findings indicate that a traditional mindfulness program yields effects that are roughly comparable to the effects of secular mindfulness training regimens. Regarding participants as collaborators appears to have a strong motivating effect. And finally, the study demonstrates that using single-case experimental designs (instead of group designs) allows for a more fine-grained analysis of meditation effects. The high interindividual variation points to the possibility that the amount of unexplained variance in group studies is severely underestimated. Results from studies like the current one could have benefits for both theoretical advancement and custom-tailored assignment of specific forms of meditation to specific people with specific aims. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02160-1.

Embodied Cognition in Meditation, Yoga, and Ethics-An Experimental Single-Case Study on the Differential Effects of Four Mind-Body Treatments.

Yoga is an embodied contemplative practice considered as a path toward long-term well-being, which fosters an integrated processing of bodily and emotional stimuli. However, little is known about how the different components of yoga contribute to these processes. This was the aim of this single-case multiple-baseline study. Herein, we explored how different yoga components affect body awareness, emotion regulation, affectivity, self-compassion, and distress tolerance. Forty-two randomly assigned participants (from initially fifty-seven) completed one of four 8-week treatments: Mantra meditation alone (MA), meditation plus physical yoga (MY), meditation plus ethical education (ME), and meditation plus yoga and ethical education (MYE). Participants had no prior regular yoga or meditation practice. Data were analyzed using visual inspection, effect size estimation, and multilevel modeling. Surprisingly, all four treatments similarly improved body awareness (Tau-UMA = 0.21 to Tau-UMY = 0.49), emotion regulation (Tau-UMYE = -0.43 to Tau-UME = -0.52), self-compassion (η2 = 0.08), and distress tolerance (η2 = 0.13). These effects were maintained until follow-up at 2 and 12 months after the study, even though home practice declined. The MA condition had the least favorable effect on affective experience (Tau-UMA = -0.14 and 0.07), while the ME condition enhanced valence the most (Tau-UME = 0.10) and the MY condition was the most effective in preventing negative affective responses. Although mantra meditation on its own negatively influenced daily affect, it can be assumed as the driving force behind the improvement in the other variables. This points to the central role of meditation in increasing interoception, self-awareness, and embodied processing.

Who Benefits Most? Interactions between Personality Traits and Outcomes of Four Incremental Meditation and Yoga Treatments.

Mind-Body Medicine (MBM) includes a broad range of interventions with proven preventive and clinical value, such as yoga and meditation. However, people differ in their preferences and response to different MBM treatments and it remains unclear who benefits most from what type of practice. Thus, finding moderators of treatment outcome seems to be a promising approach. This was the aim of the present study. We conducted a single-case multiple-baseline study investigating the outcomes and moderators of four different MBM treatments. Fifty-seven healthy participants with no prior experience were randomly assigned to three baselines (7, 14, and 21 days) and four eight-week treatments: mantra meditation alone, meditation plus physical yoga, meditation plus ethical education and meditation plus yoga and ethical education. We analysed the data using effect size estimation, multiple regression and cluster analyses. High anxiety, high absorption, low spirituality, low openness and younger age were associated with a range of positive outcomes, such as increased wellbeing or decentering and decreased mind wandering. Receiving ethical education consistently improved wellbeing, while engaging in physical yoga reduced mind wandering. In the cluster analysis, we found that participants with a more maladaptive personality structure enhanced their emotion regulation skills more. Consequently, people do differ in their response to MBM interventions and more vulnerable people, or those high in absorption, seem to benefit more. These findings could support the development of custom-tailored MBM interventions and help clinicians to make scientifically sound recommendations for their patients.

Meditation-based lifestyle modification in mild to moderate depression-A randomized controlled trial.

OBJECTIVE: Depression is a global key challenge in mental health care. The implementation of effective, low-risk and cost-effective interventions to reduce its disease burden is a necessity. The aim of this study was to investigate the efficacy of the new Meditation-Based Lifestyle Modification (MBLM) program, a "second-generation" mindfulness-based intervention, in depressive outpatients. METHODS: Eighty-one patients with mild to moderate depression were randomized into three groups: intervention group (MBLM), control group (CONTROL), and treatment as usual group (TAU). The primary outcome was the change of depressive symptoms as administered by the Beck Depression Inventory-II (BDI-II) after 4 and 8 weeks. Secondary outcome variables included the Brief Symptom Checklist-18 and the Perceived Stress Scale-10. A 6-month follow-up was conducted. RESULTS: A greater reduction of depressive symptoms was found in MBLM participants compared to CONTROL (p < .001, ηp2 = 0.11, d = 0.70) and TAU ( p<.001,ηp2=0.10,d=0.67$p\lt .001,{\eta }_{{\rm{p}}}^{2}=0.10,d=0.67$ ) with a 13.15 points reduction of BDI-II score versus 1.71 points (CONTROL) and 3.34 points (TAU) after 8 weeks. Between-group post hoc tests for all secondary outcomes and at follow-up also yielded significant between-group differences with medium to large effect sizes in favor of MBLM. CONCLUSIONS: Study results showed beneficial effects of MBLM in depressed outpatients. Further high-quality controlled clinical studies including qualitative research are needed to investigate the specific and unspecific effects of the MBLM program in depression and other medical conditions.

Differential Effects of Ethical Education, Physical Hatha Yoga, and Mantra Meditation on Well-Being and Stress in Healthy Participants-An Experimental Single-Case Study.

Traditionally, yoga is a multicomponent practice consisting of postures, breathing techniques, meditation, mantras, and ethics. To date, only a few studies have tried to dismantle the effects of each of these components and their combinations. To fill this gap, we examined the incremental effects of ethical education and physical Hatha yoga on mantra meditation using a single-case multiple-baseline design. This study was part of a project evaluating the new mind-body program Meditation-Based Lifestyle Modification. Fifty-seven healthy participants with no regular yoga or meditation practice were randomly assigned to three baselines (7, 14, and 21 days) and four conditions using a random number generator. The conditions were mantra meditation alone (MA), meditation plus physical yoga (MY), meditation plus ethical education (ME), and meditation plus yoga and ethical education (MYE). All the interventions lasted for 8 weeks and were run consecutively according to baseline length. During the baseline and treatment phases, participants received daily questionnaires measuring their well-being (WHO-5 Well-Being Index), stress (Perceived Stress Scale), and subjective experiences. Forty-two participants completed the treatment and were entered in the analyses. We analyzed our data using visual inspection, effect size estimation (Tau-U), and multilevel modeling. Almost all participants showed a longitudinal increase in well-being. Regarding between-group differences, participants who received ethical education exhibited the largest increases in well-being (Tau-U = 0.30/0.23 for ME/MYE), followed by participants in the MY condition (Tau-U = 0.12). Conversely, participants in the MA condition showed no change (Tau-U = 0.07). There was a tendency for the combined treatments to decrease stress. This tendency was strongest in the MY condition (Tau-U = -0.40) and reversed in the MA condition (Tau-U = 0.17). These results emphasize the incremental and differential effects of practicing meditation in combination with other practices from the eight-fold yoga path. This approach is valuable for better understanding the multifaceted practice of yoga. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04252976.

"To Be Finally at Peace with Myself": A Qualitative Study Reflecting Experiences of the Meditation-Based Lifestyle Modification Program in Mild-to-Moderate Depression.

Background: Meditation-Based Lifestyle Modification (MBLM) is a new mind-body intervention that is based on classical yoga; it implements virtue-based ethical living, physical yoga, and meditation in a therapeutic context. This qualitative study aimed at understanding better how depressive patients who received MBLM as a treatment experience intra- and interpersonal outcomes of their practice. Methods: In a larger randomized controlled trial of MBLM in depressive outpatients, a subsample (n = 12) completed in-depth interviews. To determine short-term and long-term effects, cohorts were interviewed at two different times after intervention onset (T1 = 8 weeks; T2 = 6 months). Verbatim interview transcripts were analyzed by using thematic analysis. Results: Three themes emerged in the interviews: (1) Reappraisal of past and present life patterns, leading to a reflection on one's own values; (2) Serenity, attained by states of calm, growing acceptance, and the ability to set boundaries; and (3) Mindful living as expressed by increased self-awareness, being more present, and conscious interactions. The ethical component of MBLM was identified as a key factor in individual empowerment and appreciation of one's own strengths. Systematic changes in the importance of reported themes after 6 months (T2) reflected the sustained effects of the intervention. Conclusions: The findings speak clearly for the benefits of MBLM in the treatment of depression. In particular, the explicit therapeutic implementation of virtue-based ethics offers a valuable addition to previous yoga and meditation programs. Clinical Trials.gov ID: Clinical Trial Registration number: NCT03652220.

Meditation-Based Lifestyle Modification: Development of an Integrative Mind-Body Program for Mental Health and Human Flourishing.

Mental disorders are a core health challenge in the 21st century. Integrative mental health care takes an individual, lifestyle-modifying, salutogenic approach, combining somatic, psychosocial, and spiritual perspectives from evidence-based conventional and complementary medicine. In particular, meditation and mindfulness have received growing research interest in the last decade. In this article, we present Meditation-Based Lifestyle Modification (MBLM), a new, complex mind-body intervention for mental health care. It is the first program to intensify meditation practice using classical yoga. The program (a) covers all areas of classical yoga, (b) considers ethical and spiritual aspects of daily life, (c) orients participants toward sustained lifestyle modification, and (d) is applicable in a clinical context. The scientific rationale of the program is outlined in this article, based on the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare. Further research is planned to show the clinical feasibility of MBLM and evaluate its efficacy, processes of change, and cost-effectiveness.

Meditation Based Lifestyle Modification (MBLM) in outpatients with mild to moderate depression: A mixed-methods feasibility study.

BACKGROUND: Integrative mental health care can be applied to treat depression with a person-centered, lifestyle-modifying, and more salutogenic approach to mental health and human flourishing. In this article, we report on the feasibility and acceptability of a new mind-body program, Meditation Based Lifestyle Modification (MBLM), in outpatients with mild or moderate depression. METHODS: This is a single-arm mixed-methods feasibility study of n = 25 outpatients in psychiatric care. Depressive symptoms, scores for mindfulness, aspects of spirituality, and eudaemonic well-being based on yoga philosophy were assessed at baseline and at the end of the intervention. Adherence was monitored and face-to-face interviews were held after the program to explore the acceptability and feasibility of MBLM. RESULTS: Twenty patients (75 %) completed at least six sessions of the course. Adherence was 87.5 % of allocated sessions. In qualitative analysis, more than half of the participants experienced novelty and inspiration through practicing the ethical aspects of yoga (e.g., nonviolence, truthfulness, etc.). Almost all participants experienced a decrease in emotional distress. Virtually all participants reported more self-confidence and self-acceptance. In quantitative analysis, participants reported a clinically important decrease in depressive symptoms of 39.23 % (p = .002), eudaemonic well-being increased significantly in a range of related scales and scores for mindfulness increased (p < .001). CONCLUSION: MBLM is a highly acceptable and feasible program for outpatients with mild to moderate depression. This comprehensive, lifestyle-modifying approach is highly relevant to preventing and treating mental illness, and treating psychic comorbidities in patients with chronic somatic illness.

How General Is the Semantic Structure of Time? A Comparison of Indians and Germans.

People in different cultures differ in their time-related behaviors and judgments. But do they also differ in how time is represented in their minds, that is, in their semantic structures of time, and if so, how and why? Two studies addressed these questions using participants' time-related associative responses to compare the semantic structures of time across Indian and German university students. Study 1 compared time-related associations and found only low intercultural agreement, which increased somewhat if associations were grouped into categories. In Study 2, a comparison of the results of multidimensional scaling analyses on a cross-culturally representative selection of stimuli was consistent with the conclusion that differences across cultures are much more pronounced than commonalities. Two cultural aspects in particular might be responsible for the diversity in the semantic structures of time: the monochronic-polychronic distinction and the distinction between linear and cyclical time. Moreover, intercultural differences may be strongly intensified by language effects, especially if the languages in question greatly differ. It is concluded that behavioral and judgmental differences in dealing with time may be grounded in how people intuitively think about it and the language used to do so.

PROMISE: A Model of Insight and Equanimity as the Key Effects of Mindfulness Meditation.

In a comprehensive meta-analysis on the effects of mindfulness meditation, Eberth and Sedlmeier (2012) identified a multitude of positive effects that covered a wide range of psychological variables, such as heightened mindfulness as measured through contemporary mindfulness scales, reduced negative emotions, increased positive emotions, changes in self-concept, enhanced attention, perception, and wellbeing, improved interpersonal abilities, and a reduction of negative personality traits. The present research aimed at developing and testing a comprehensive model explaining the wide range of mindfulness meditation effects and their temporal and causal relationships. In Study 1, interviews with meditators at different levels of experience were analyzed using a grounded theory procedure. The resulting model was triangulated and refined by concepts from both Western research and ancient Buddhist scriptures. The model developed highlights equanimity (reduction in emotional reactivity) and insight (alteration of cognitions) as the two key effects of mindfulness meditation that eventually lead to increased wellbeing. The model was pilot-tested with a large sample of meditators and non-meditators in Study 2. Data showed an acceptable fit with the model and indicated that meditators and non-meditators score significantly differently on the model's core categories.

What Is Meditation? Proposing an Empirically Derived Classification System.

Meditation is an umbrella term, which subsumes a huge number of diverse practices. It is still unclear how these practices can be classified in a reasonable way. Earlier proposals have struggled to do justice to the diversity of meditation techniques. To help in solving this issue, we used a novel bottom-up procedure to develop a comprehensive classification system for meditation techniques. In previous studies, we reduced 309 initially identified techniques to the 20 most popular ones. In the present study, 100 experienced meditators were asked to rate the similarity of the selected 20 techniques. Using multidimensional scaling, we found two orthogonal dimensions along which meditation techniques could be classified: activation and amount of body orientation. These dimensions emphasize the role of embodied cognition in meditation. Within these two dimensions, seven main clusters emerged: mindful observation, body-centered meditation, visual concentration, contemplation, affect-centered meditation, mantra meditation, and meditation with movement. We conclude there is no "meditation" as such, but there are rather different groups of techniques that might exert diverse effects. These groups call into question the common division into "focused attention" and "open-monitoring" practices. We propose a new embodied classification system and encourage researchers to evaluate this classification system through comparative studies.

Can gender priming eliminate the effects of stereotype threat? The case of simple dynamic systems.

Mathematics and mental rotation are classic fields where it has been shown that priming women with their gender identity impedes performance. Whereas past research focused mainly on stereotype threat effects in women in a narrowly defined context, this study broadened the research focus: We primed 264 women and men equally with a male, a neutral, or a female prime before they had to solve a simple dynamic system task. As expected, female-primed women subsequently performed worst of all six groups. Solution rates were almost 14% higher for the women in the male-primed condition. Men performed better than women in all three priming conditions. However, this difference was reduced in the male-primed condition as women's performance had increased as anticipated. Unexpected was a decline in the male performance in the same condition. The study showed that gender priming had a significant effect on women in tasks involving simple dynamic systems. However, mathematical knowledge and area of occupation clearly were stronger predictors for both men and women. Priming alone cannot eliminate the effects of stereotype threat.

Comparing eye trackers by correlating their eye-metric data.

Up to now, the potential of eye tracking in science as well as in everyday life has not been fully realized because of the high acquisition cost of trackers. Recently, manufacturers have introduced low-cost devices, preparing the way for wider use of this underutilized technology. As soon as scientists show independently of the manufacturers that low-cost devices are accurate enough for application and research, the real advent of eye trackers will have arrived. To facilitate this development, we propose a simple approach for comparing two eye trackers by adopting a method that psychologists have been practicing in diagnostics for decades: correlating constructs to show reliability and validity. In a laboratory study, we ran the newer, low-cost EyeTribe eye tracker and an established SensoMotoric Instruments eye tracker at the same time, positioning one above the other. This design allowed us to directly correlate the eye-tracking metrics of the two devices over time. The experiment was embedded in a research project on memory where 26 participants viewed pictures or words and had to make cognitive judgments afterwards. The outputs of both trackers, that is, the pupil size and point of regard, were highly correlated, as estimated in a mixed effects model. Furthermore, calibration quality explained a substantial amount of individual differences for gaze, but not pupil size. Since data quality is not compromised, we conclude that low-cost eye trackers, in many cases, may be reliable alternatives to established devices.

Functional neuroanatomy of meditation: A review and meta-analysis of 78 functional neuroimaging investigations.

Meditation is a family of mental practices that encompasses a wide array of techniques employing distinctive mental strategies. We systematically reviewed 78 functional neuroimaging (fMRI and PET) studies of meditation, and used activation likelihood estimation to meta-analyze 257 peak foci from 31 experiments involving 527 participants. We found reliably dissociable patterns of brain activation and deactivation for four common styles of meditation (focused attention, mantra recitation, open monitoring, and compassion/loving-kindness), and suggestive differences for three others (visualization, sense-withdrawal, and non-dual awareness practices). Overall, dissociable activation patterns are congruent with the psychological and behavioral aims of each practice. Some brain areas are recruited consistently across multiple techniques-including insula, pre/supplementary motor cortices, dorsal anterior cingulate cortex, and frontopolar cortex-but convergence is the exception rather than the rule. A preliminary effect-size meta-analysis found medium effects for both activations (d=0.59) and deactivations (d=-0.74), suggesting potential practical significance. Our meta-analysis supports the neurophysiological dissociability of meditation practices, but also raises many methodological concerns and suggests avenues for future research.

How Do Theories of Cognition and Consciousness in Ancient Indian Thought Systems Relate to Current Western Theorizing and Research?

Unknown to most Western psychologists, ancient Indian scriptures contain very rich, empirically derived psychological theories that are, however, intertwined with religious and philosophical content. This article represents our attempt to extract the psychological theory of cognition and consciousness from a prominent ancient Indian thought system: Samkhya-Yoga. We derive rather broad hypotheses from this approach that may complement and extend Western mainstream theorizing. These hypotheses address an ancient personality theory, the effects of practicing the applied part of Samkhya-Yoga on normal and extraordinary cognition, as well as different ways of perceiving reality. We summarize empirical evidence collected (mostly without reference to the Indian thought system) in diverse fields of research that allows for making judgments about the hypotheses, and suggest more specific hypotheses to be examined in future research. We conclude that the existing evidence for the (broad) hypotheses is substantial but that there are still considerable gaps in theory and research to be filled. Theories of cognition contained in the ancient Indian systems have the potential to modify and complement existing Western mainstream accounts of cognition. In particular, they might serve as a basis for arriving at more comprehensive theories for several research areas that, so far, lack strong theoretical grounding, such as meditation research or research on aspects of consciousness.

How Persistent are Grammatical Gender Effects? The Case of German and Tamil.

Does the language we speak shape the way we think? The present research concentrated on the impact of grammatical gender on cognition and examined the persistence of the grammatical gender effect by (a) concentrating on German, a three-gendered language, for which previous results have been inconsistent, (b) statistically controlling for common alternative explanations, (c) employing three tasks that differed in how closely they are associated with grammatical gender, and (d) using Tamil, a nongendered language, as a baseline for comparison. We found a substantial grammatical gender effect for two commonly used tasks, even when alternative explanations were statistically controlled for. However, there was basically no effect for a task that was only very loosely connected to grammatical gender (similarity rating of word pairs). In contrast to previous studies that found effects of the German and Spanish grammatical gender in English (a nongendered language), our study did not produce such effects for Tamil, again after controlling for alternative explanations, which can be taken as additional evidence for the existence of a purely linguistic grammatical gender effect. These results indicate that general grammatical gender effects exist but that the size of these effects may be limited and their range restricted.

The sounds of safety: stress and danger in music perception.

As with any sensory input, music might be expected to incorporate the processing of information about the safety of the environment. Little research has been done on how such processing has evolved and how different kinds of sounds may affect the experience of certain environments. In this article, we investigate if music, as a form of auditory information, can trigger the experience of safety. We hypothesized that (1) there should be an optimal, subjectively preferred degree of information density of musical sounds, at which safety-related information can be processed optimally; (2) any deviation from the optimum, that is, both higher and lower levels of information density, should elicit experiences of higher stress and danger; and (3) in general, sonic scenarios with music should reduce experiences of stress and danger more than other scenarios. In Experiment 1, the information density of short music-like rhythmic stimuli was manipulated via their tempo. In an initial session, listeners adjusted the tempo of the stimuli to what they deemed an appropriate tempo. In an ensuing session, the same listeners judged their experienced stress and danger in response to the same stimuli, as well as stimuli exhibiting tempo variants. Results are consistent with the existence of an optimum information density for a given rhythm; the preferred tempo decreased for increasingly complex rhythms. The hypothesis that any deviation from the optimum would lead to experiences of higher stress and danger was only partly fit by the data. In Experiment 2, listeners should indicate their experience of stress and danger in response to different sonic scenarios: music, natural sounds, and silence. As expected, the music scenarios were associated with lowest stress and danger whereas both natural sounds and silence resulted in higher stress and danger. Overall, the results largely fit the hypothesis that music seemingly carries safety-related information about the environment.

The impact of attention on judgments of frequency and duration.

Previous studies that examined human judgments of frequency and duration found an asymmetrical relationship: While frequency judgments were quite accurate and independent of stimulus duration, duration judgments were highly dependent upon stimulus frequency. A potential explanation for these findings is that the asymmetry is moderated by the amount of attention directed to the stimuli. In the current experiment, participants' attention was manipulated in two ways: (a) intrinsically, by varying the type and arousal potential of the stimuli (names, low-arousal and high-arousal pictures), and (b) extrinsically, by varying the physical effort participants expended during the stimulus presentation (by lifting a dumbbell vs. relaxing the arm). Participants processed stimuli with varying presentation frequencies and durations and were subsequently asked to estimate the frequency and duration of each stimulus. Sensitivity to duration increased for pictures in general, especially when processed under physical effort. A large effect of stimulus frequency on duration judgments was obtained for all experimental conditions, but a similar large effect of presentation duration on frequency judgments emerged only in the conditions that could be expected to draw high amounts of attention to the stimuli: when pictures were judged under high physical effort. Almost no difference in the mutual impact of frequency and duration was obtained for low-arousal or high-arousal pictures. The mechanisms underlying the simultaneous processing of frequency and duration are discussed with respect to existing models derived from animal research. Options for the extension of such models to human processing of frequency and duration are suggested.

How we remember the emotional intensity of past musical experiences.

Listening to music usually elicits emotions that can vary considerably in their intensity over the course of listening. Yet, after listening to a piece of music, people are easily able to evaluate the music's overall emotional intensity. There are two different hypotheses about how affective experiences are temporally processed and integrated: (1) all moments' intensities are integrated, resulting in an averaged value; (2) the overall evaluation is built from specific single moments, such as the moments of highest emotional intensity (peaks), the end, or a combination of these. Here we investigated what listeners do when building an overall evaluation of a musical experience. Participants listened to unknown songs and provided moment-to-moment ratings of experienced intensity of emotions. Subsequently, they evaluated the overall emotional intensity of each song. Results indicate that participants' evaluations were predominantly influenced by their average impression but that, in addition, the peaks and end emotional intensities contributed substantially. These results indicate that both types of processes play a role: All moments are integrated into an averaged value but single moments might be assigned a higher value in the calculation of this average.

Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners.

Numerous studies have begun to address how the brain's gray and white matter may be shaped by meditation. This research is yet to be integrated, however, and two fundamental questions remain: Is meditation associated with altered brain structure? If so, what is the magnitude of these differences? To address these questions, we reviewed and meta-analyzed 123 brain morphology differences from 21 neuroimaging studies examining ∼300 meditation practitioners. Anatomical likelihood estimation (ALE) meta-analysis found eight brain regions consistently altered in meditators, including areas key to meta-awareness (frontopolar cortex/BA 10), exteroceptive and interoceptive body awareness (sensory cortices and insula), memory consolidation and reconsolidation (hippocampus), self and emotion regulation (anterior and mid cingulate; orbitofrontal cortex), and intra- and interhemispheric communication (superior longitudinal fasciculus; corpus callosum). Effect size meta-analysis (calculating 132 effect sizes from 16 studies) suggests a global 'medium' effect size (Cohen's d¯=0.46; r¯=.19). Publication bias and methodological limitations are strong concerns, however. Further research using rigorous methods is required to definitively link meditation practice to altered brain morphology.