The Effect of Loving-Kindness Meditation on Mood and Anxiety Symptoms, Interpersonal Relationships, and Emotions: An Initial Randomized Controlled Trial With a Non-Clinical Sample of Undergraduate Women

The Effect of Loving-Kindness Meditation on Anhedonic Depressivity, Interpersonal Relationships, and Emotions.

The goal of this clinical trial was to examine the effects of Loving-Kindness Meditation (LKM) on anhedonic depressivity, interpersonal relationships (other inclusive self-concept, willingness to sacrifice, interaction quality) and emotions (positive affect, negative affect).

The second aim was to conduct exploratory analyses investigating potential mediators that help explain changes in anhedonic depressivity over the course of short-term targeted LKM.

Participants were randomly assigned to receive one week of ~5-minute daily audio recordings of Loving-Kindness Meditation or a visualization meditation, both of which were focused on a same-gender close friend. Participants completed baseline and follow-up questionnaires measuring psychological, social, and emotional variables; participants also completed daily questionnaires.

Study Overview

• Status: Completed
• Conditions: Depression and Anxiety Symptoms
• Intervention / Treatment: Behavioral: Loving-Kindness Meditation; Behavioral: Visualization

Detailed Description

Undergraduate women were recruited via the Queen's University psychology department's subject pool (n = 222) and online advertisements (i.e., Facebook; n = 18) in 2021; written informed consent was obtained from all participants prior to any data collection.

We randomly assigned participants-via Microsoft Excel random number generation-to engage in one-week of either a targeted form of Loving-Kindness Meditation or a visualization meditation. Participants identified a specific close friend at the beginning of the study to be the target of their meditation practice. They completed baseline and one-week follow-up measures.

Audio instructions for the LKM and visualization meditation conditions were developed for this study based on those used by Seppala et al. (2014). Recordings were delivered via email. Descriptions of the conditions can be found in the Arms and Interventions sections.

• Study Type: Interventional
• Enrollment (Actual): 240
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Kingston, Ontario, Canada
      • Queen's University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Participants must be enrolled as an undergraduate student
• Each Participant had to self-identify as a woman.
• Participants had to be age 18 or older.
• Participants had to have at least one close female platonic friend.

Exclusion Criteria:

• Participants did not complete at least three of seven daily meditations.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Loving-Kindness Meditation; Participants randomly assigned (via Microsoft Excel) to receive the Loving-Kindness Meditation intervention.	Behavioral: Loving-Kindness Meditation; Participants received a ~5 minute audio recording of Loving-Kindness Meditation Instructions everday for one week. Recordings were delivered via email. Meditators in both conditions were instructed to find a comfortable position, either sitting or lying down, and were then guided through some initial deep breathing. Once relaxed, meditators in the LKM condition were asked to imagine receiving love and wishes of well-being from a close other; they were then asked to direct feelings of love and wishes of wellness to their target close friend. After approximately 5 minutes, meditators were guided back to relaxation.
Active Comparator: Visualization Meditation; Participants randomly assigned (via Microsoft Excel) to receive the Visualization Meditation active comparator condition.	Behavioral: Visualization; Participants received a ~5 minute audio recording of visualization Instructions everday for one week. Recordings were delivered via email. Meditators in both conditions were instructed to find a comfortable position, either sitting or lying down, and were then guided through some initial deep breathing. Meditators in the visualization condition were asked to visualize specific details of their target close friend's appearance. After approximately 5 minutes, meditators were guided back to relaxation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anhedonic Depressivity	The anhedonic depression scale of the Mood and Anxiety Symptom Questionnaire (MASQ; Clark & Watson, 1991) was used to measure anhedonic depressivity. Participants rated items of the MASQ (Clark & Watson, 1991) on a scale from 1-5 (1 = Not at All; 5 = Extremely) based on how they felt over the past week. The anhedonic depression subscale includes 22 items (e.g., "Felt like there wasn't anything interesting or fun to do"). A mean score was calculated, with higher scores indicating more anhedonic depressivity.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Positive Affect	The Positive Affect Negative Affect Schedule (PANAS; Watson et al., 1988) was used to measure positive affect. The PANAS consists of 20 emotion words divided into two subscales (10 positive words and 10 negative words). Participants rate each emotion word on a scale from 1-5 (1 = Very Slightly or Not at All; 5 = Extremely) corresponding to how they have been feeling over the past week. The positive affect subscale contains emotion words such as: "Interested," "Excited," and "Inspired." A mean score was calculated for use in data analyses, with higher scores indicating greater positive affect.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Willingness to Sacrifice	The willingness to sacrifice scale is a two-item measure adapted from the Marburg Attitude Inventory for Styles of Loving (Bierhoff et al., 1993). Participants are asked to respond to the following questions on a scale from 1-10 (1 = Not at all; 10 = Entirely): "To what extent would you be willing to sacrifice your own desires for your close friend's desires?"; and "To what extent would you leave everything else aside for your close friend?". At baseline and follow-up, participants responded to these questions based on the previous week. For each administration, a mean score was calculated for use in data analyses.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Other-Inclusive Self Concept	The Inclusion of the Other in the Self Scale (IOS; Aron et al., 1992) is a one item measure composed of seven images of two increasingly overlapping circles labeled "self" and "other". Other-inclusive self-concept was measured with a modified IOS by asking participants to think about their relationship with their chosen close friend over the past week and to indicate the diagram that best matched their perceived connection. The IOS has convergent validity (Aron et al., 1992; Gächter et al., 2015) and discriminant validity (Aron et al., 1992) in relation to other established interpersonal closeness measures.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Interaction Quality	A modified version of the Rochester Interaction Record (M-RIR; based on Wheeler & Reis, 1991) was used to measure interaction quality. The M-RIR asks participants to rate, from 1-7, the degree to which their interactions with their close other: 1) were intimate (1 = superficial; 7 = meaningful); 2) included self/other disclosure (1 = very little; 7 = a great deal); 3) were satisfying (1 = very unsatisfying; 7 = very satisfying); 4) were loving (1 = not at all loving; 7 = very loving); 5) were supportive (1 = not at all supportive; 7 = very supportive); and 6) were stressful (1 = not at all stressful; 7 = very stressful; reverse coded). At baseline and follow-up, participants completed the M-RIR for the past week. A mean score was calculated for use in data analyses, with higher scores indicating greater interaction quality.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Anxious Arousal	The anxious arousal subscale of the Mood and Anxiety Symptom Questionnaire (MASQ; Clark & Watson, 1991) was used to measure anxious arousal. Participants rated items of the MASQ (Clark & Watson, 1991) on a scale from 1-5 (1 = Not at All; 5 = Extremely) based on how they felt over the past week. The anxious arousal subscale includes 17 items (e.g., "Was trembling or shaking"). For each subscale, a mean score was calculated, with higher scores indicating more anxious arousal.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Negative Affect	The Positive Affect Negative Affect Schedule (PANAS; Watson et al., 1988) was used to measure negative affect. The PANAS consists of 20 emotion words divided into two subscales (10 positive words and 10 negative words). Participants rate each emotion word on a scale from 1-5 (1 = Very Slightly or Not at All; 5 = Extremely) corresponding to how they have been feeling over the past week. The negative affect subscale contains emotion words such as "Hostile", "Irritable", and "Ashamed'". A mean score was calculated for use in data analyses, with higher scores indicating greater negative affect.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Emotional Closeness	Emotional closeness was measured using a modified 10-item version of the Emotional Closeness Questionnaire (ECQ; Flores & Berenbaum, 2012, 2014). The ECQ presents participants with 10 statements that reflect aspects of emotional closeness (e.g., "my friend gave me emotional support", "I shared my personal thoughts or feelings with my friend"). Respondents rate the degree each of these statements happened over the past week on a scale of 1 (not at all) to 5 (extremely). Scores from each question are averaged to create an overall score with higher scores indicating higher levels of emotional closeness (Flores & Berenbaum, 2012, 2014). This questionnaire was modified to ask respondents to specifically consider the close other they chose at the beginning of the study.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Desired Emotional Closeness	Desired emotional closeness was measured using a modified 10-item version of the Emotional Closeness Questionnaire (ECQ; Flores & Berenbaum, 2012, 2014). The D-ECQ presents participants with 5 statements that reflect aspects of emotional closeness (e.g., "my friend gives me emotional support", "I share my personal thoughts or feelings with my friend"). Respondents rate the degree to which they would have liked each of these statements to have happened over the past week on a scale of 1 (not at all) to 5 (extremely). Scores from each question are averaged to create an overall score with higher scores indicating a higher desire for emotional closeness (Flores & Berenbaum, 2012, 2014). This questionnaire was modified to ask respondents to specifically consider the close other they chose at the beginning of the study.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).
Worry	The Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990) was used to measure worry. The PSWQ asks participants to rate the degree to which 16 statements related to worry are typical or characteristic of them (e.g., "My worries overwhelm me", "Once I start worrying, I can't stop"). Respondents rate each item on a scale from 1 (not at all typical) to 5 (very typical; Meyer et al., 1990). A mean score was generated for each participant with higher scores indicating higher levels of worry.	Assessed once at baseline (Day 0) and once at follow-up after the intervention (follow up sent on Day 8).

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Daily Engagement with the Meditation	After completing the meditation, participants were asked: "On a scale from one to ten, how engaged did you feel with the meditation today?" (higher numbers indicating more engagement in the meditation).	Questionnaires with an embedded meditation were sent each day (Day 1 - Day 7). Engagement was measured after listening to the audio recording.
Daily Negative Affect	Prior to the meditation, participants were asked to rate on a scale from 1-10: "how much negative emotion are you feeling right now?" (higher numbers indicating more negative emotion). After completing the meditation, this question was repeated.	Questionnaires with an embedded meditation were sent each day (Day 1 - Day 7). Negative affect was measured before and after listening to the audio recording.
Daily Positive Affect	Prior to the meditation, participants were asked to rate on a scale from 1-10 "how much positive emotion are you feeling right now?" (higher numbers indicating more positive emotion). After completing the meditation, this question was repeated.	Questionnaires with an embedded meditation were sent each day (Day 1 - Day 7). Positive affect was measured before and after listening to the audio recording.
Daily Social Connection	Prior to the meditation, participants were asked to rate on a scale from 1-10 "how socially connected to your friend are you feeling right now?" (higher numbers indicating more feelings of social connection). After completing the meditation, this question was repeated.	Questionnaires with an embedded meditation were sent each day (Day 1 - Day 7). Social connection was measured before and after listening to the audio recording.

Collaborators and Investigators

• Sponsor: Luis Flores
• Collaborators: Social Sciences and Humanities Research Council of Canada
• Investigators: Principal Investigator: Luis Flores, Ph.D., Queen's University and Rutgers University

Publications and helpful links

General Publications

• Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988 Jun;54(6):1063-70. doi: 10.1037//0022-3514.54.6.1063.
• Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State Worry Questionnaire. Behav Res Ther. 1990;28(6):487-95. doi: 10.1016/0005-7967(90)90135-6.
• Clark LA, Watson D. Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. J Abnorm Psychol. 1991 Aug;100(3):316-36. doi: 10.1037//0021-843x.100.3.316.
• Flores Jr, L. E., & Berenbaum, H. (2014). Desired emotional closeness moderates the prospective relations between levels of perceived emotional closeness and psychological distress. Journal of Social and Clinical Psychology, 33(8), 673-700. https://doi.org/10.1521/jscp.2014.33.8.673
• Flores Jr, L. E., & Berenbaum, H. (2012). Desire for emotional closeness moderates the effectiveness of the social regulation of emotion. Personality and Individual Differences, 53(8), 952-957. https://doi.org/10.1016/j.paid.2012.07.009
• Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.) Guilford publications.
• Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf
• Trautwein FM, Naranjo JR, Schmidt S. Decentering the Self? Reduced Bias in Self- vs. Other-Related Processing in Long-Term Practitioners of Loving-Kindness Meditation. Front Psychol. 2016 Nov 21;7:1785. doi: 10.3389/fpsyg.2016.01785. eCollection 2016.
• Bierhoff, H. W., Grau, I., & Ludwig, A. (1993). Marburger Einstellungsinventar zu Liebesstilen (MEIL). Hogrefe.
• Wheeler, L., & Reis, H. T., (1991). Self-recording of everyday life events: Origins, types, and uses. Journal of Personality, 59, 339-354. doi:10.1111/j.1467-6494.1991.tb00252.x
• Aron, A., Aron, E. N., & Smollan, D. (1992). Inclusion of the other in the self scale and the structure of interpersonal closeness. Journal of Personality and Social Psychology, 63(4), 596-612. https://doi.org/10.1037/0022-3514.63.4.596
• Seppala, E.M., Hutcherson, C.A., Nguyen, D.T., Hutcheson, C. A., & Gross, J. J. (2014). Loving-kindness meditation: A tool to improve healthcare provider compassion, resilience, and patient care. Journal of Compassionate Health Care, 1(1), 1-9. https://doi.org/10.1186/s40639-014-0005-9
• Gachter S, Starmer C, Tufano F. Measuring the Closeness of Relationships: A Comprehensive Evaluation of the 'Inclusion of the Other in the Self' Scale. PLoS One. 2015 Jun 12;10(6):e0129478. doi: 10.1371/journal.pone.0129478. eCollection 2015.

Study record dates

Study Major Dates

• Study Start (Actual): January 13, 2021
• Primary Completion (Actual): April 11, 2021
• Study Completion (Actual): April 11, 2021

Study Registration Dates

• First Submitted: May 1, 2026
• First Submitted That Met QC Criteria: May 20, 2026
• First Posted (Actual): May 28, 2026

Study Record Updates

• Last Update Posted (Actual): May 28, 2026
• Last Update Submitted That Met QC Criteria: May 20, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Meditation; Negative Affect; Positive Affect; Social Relationships; Anhedonic Depression; Inclusion of the Other in the Self Scale; Loving-Kindness Meditation; Willingness to Sacrifice; Rochester Interaction Record
• Additional Relevant MeSH Terms: Mental Disorders; Behavioral Symptoms; Behavior; Anxiety Disorders; Depression
• Other Study ID Numbers: rf#1025416

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Deidentified participant data will be shared on Open Science Framework. Only IPD used in the results publication will be shared.
• IPD Sharing Time Frame: Beginning within at publication with no end date.
• IPD Sharing Access Criteria: The data will be publically available. A link to the Open Science Framework page will be included when the results are published.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No