The differences between immersive audio and video scenarios to mediate digital mindfulness interventions: a RCT study

Objective: Digital mindfulness-based interventions (MBIs) have gained increasing attention due to their scalability and accessibility. Among digital formats, immersive virtual reality (VR) systems appear particularly promising, yet direct comparisons with traditional audio-guided mindfulness remain scarce. This randomized controlled trial (RCT) aimed to directly compare the effectiveness of immersive VR-based mindfulness interventions (VR-MBI) versus immersive audio-based mindfulness interventions (audio-MBI), in order to better disentangle the role of immersive visual stimulation. Methods: Sixty healthy participants were randomly assigned to either a VR-MBI group or an audio-MBI control group. Both groups completed four weekly 10-minute mindfulness sessions over one month, delivered in controlled laboratory conditions. Psychological outcomes were assessed at baseline and post-intervention using validated self-report measures of well-being (WHO-5, MHC-SF), positive and negative affect (SPANE), anxiety (STAI), depression (BDI-II), perceived stress (PSS-10), and mindfulness awareness (MAAS). Between-group differences were examined using change scores (post–pre), with non-parametric analyses applied where appropriate. Results: Both VR-MBI and audio-MBI groups showed significant reductions in anxiety and depressive symptoms over time. However, between-group comparisons revealed significantly greater improvements in positive affect (SPANE) and emotional well-being (MHC-SF) in the VR-MBI group compared to the audio-MBI group. Specifically, VR-MBI induced a 25.6% increase in positive emotions and a 14.4% increase in well-being relative to audio-MBI. No significant between-group differences were observed for mindfulness awareness or perceived stress. Conclusions: These findings provide direct evidence that immersive VR-based mindfulness interventions offer specific advantages over traditional audio-guided mindfulness in enhancing positive emotions and well-being in mindfulness-naïve individuals.