{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:28:37Z","timestamp":1788280117057,"version":"build-2803163510"},"reference-count":149,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005632","name":"National Centre for Research and Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005632","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec>\n<jats:title>\nIntroduction\n<\/jats:title>\n<jats:p>Mindfulness-Based Stress Reduction (MBSR) helps counteract the negative consequences of stress. An essential aspect of mind-body therapies is learning to be mindful of emotional reactions and bodily sensations, a process defined as interoceptive awareness. This awareness can also be enhanced by providing physiological feedback from a smartwatch. However, the impact of using smartwatch-generated physiological signals during mindfulness training has not been studied yet. The study aims at verifying, whether physiological signals from a smartwatch would support the MBSR.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>\nMethods\n<\/jats:title>\n<jats:p>We conducted a mixed-design randomized controlled trial to investigate the effects of MBSR training, with and without monitoring physiological signals via a smartwatch, on mental functioning parameters, with measurements taken at baseline and after 8 weeks. Participants were classified into three groups (N = 72): the MBSR group, the MBSR + smartwatch group, and the control group. Between measurement sessions, two groups of participants were engaged in MBSR training, while the third group did not participate in any training.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>Results showed a significant reduction in subjectively perceived stress levels, eating disorder symptoms, and intrusive ruminations in both groups participating in MBSR, compared to the control group. However, a notable difference emerged between the two MBSR groups: in the group with smartwatches, a significant increase in mindfulness was observed. In contrast, in the MBSR group without smartwatches, there was a significant decrease across multiple stress-related components, including: anxiety, cognitive impairment, addictions, sleep disorders symptoms, behaviors indicating lack of entertainment, and poor functioning.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>\nConclusions\n<\/jats:title>\n<jats:p>The results suggest that supplementing MBSR with monitoring interoceptive signals by a smartwatch enhances mindfulness, and maintains the effect of stress and eating disorders symptoms reduction but does not decrease anxiety nor improve general mental functioning. This imposes the need for further research to investigate mechanisms involved when observing interoceptive signals by a smartwatch.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0322413","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T22:49:48Z","timestamp":1745448588000},"page":"e0322413","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Mindfulness-based stress reduction training supplemented with physiological signals from smartwatch improves mindfulness and reduces stress, but not anxiety and depression"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1335-3385","authenticated-orcid":true,"given":"Sylwia","family":"Sumi\u0144ska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Rynkiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"pone.0322413.ref001","volume-title":"The wisdom of the body","author":"Cannon WB","year":"1932"},{"key":"pone.0322413.ref002","volume-title":"The stress of life","author":"H. 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