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. 2021 Feb 8;16(2):e0246038. doi: 10.1371/journal.pone.0246038

Is a meditation retreat the better vacation? effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness

Gerhard Blasche 1,*, Jessica deBloom 2,3, Adrienne Chang 4, Otto Pichlhoefer 5
Editor: Stefan Hoefer6
PMCID: PMC7869997  PMID: 33556137

Abstract

It is well established that leisure vacations markedly improve well-being, but that these effects are only of short duration. The present study aimed to investigate whether vacation effects would be more lasting if individuals practiced meditation during the leisure episode. Meditation is known to improve well-being durably, among others, by enhancing the mental faculty of mindfulness. In this aim, leisure vacations during which individuals practiced meditation to some extent were compared with holidays not including any formal meditation practice as well as with meditation retreats (characterized by intense meditation practice) utilizing a naturalistic observational design. Fatigue, well-being, and mindfulness were assessed ten days before, ten days after, and ten weeks after the stays in a sample of 120 individuals accustomed to meditation practices. To account for differences in the experience of these stays, recovery experiences were additionally assessed. Ten days after the stay, there were no differences except for an increase in mindfulness for those practicing meditation. Ten weeks after the stay, meditation retreats and vacations including meditation were associated with greater increases in mindfulness, lower levels of fatigue, and higher levels of well-being than an "ordinary" vacation during which meditation was not practiced. The finding suggests that the inclusion of meditation practice during vacation could help alleviate vacations’ greatest pitfall, namely the rapid decline of its positive effects.

Introduction

It is well established that vacation, a several day respite from work, leads to a reduction of emotional exhaustion [1] and fatigue [2] both during vacation, as well as in the days thereafter. In addition, vacations can also improve well-being [3, 4], happiness, and life-satisfaction [57] and reduce perceived stress and negative mood [810]. A number of factors explain these effects, including engaging in pleasurable activities [4], traveling to a holiday destination [7], higher ambient temperature and physical activity [11], the absence of negative incidences and negative work-related rumination [4, 12], natural environments [13] and having a respite from work [14]. Unfortunately, the positive effects of vacation on well-being decline rapidly after vacation, generally returning to pre-vacation levels within 1–3 weeks [1, 3, 15]. Returning to everyday life and/or work thus increases fatigue and decreases well-being. However, there are some exceptions to this rule. In a hiking vacation study, beneficial effects on well-being were still apparent seven weeks after the stay [10]. This suggests that activities known to improve health and well-being, such as physical activity, may lead to longer lasting and/or larger vacation effects. In line with this reasoning, recent studies found that both relaxation as well as physical activity conducted during rest-breaks prolonged their effect on well-being beyond usual respites from work [16, 17].

Apart from physical activity and relaxation, another activity known to improve well-being significantly is the practice of meditation [18]. Meditation can be understood as a family of diverse practices that include, but are not limited to, mindfulness meditation. Found within Buddhism and other contemplative traditions, such meditation practices seek to cultivate and regulate specific psychological processes, lastly aimed at increasing well-being. These practices have recently been grouped into three families, the attentional, the constructive, and the deconstructive family [19]. These families not only include different practices but also affect well-being through different avenues. The attentional family, encompassing mindfulness meditation and mindfulness-based stress reduction, improves well-being by a process known as “meta-awareness” or “cognitive distancing”, i.e. “stepping back and observing one’s internal processes of thinking and feeling” [19]. This requires overcoming experiential fusion, i.e. being absorbed in the contents of consciousness, thereby improving our ability to monitor and/or regulate psychological processes. To be able to promote these processes, two cognitive faculties have to be developed: focused attention, i.e. “sustaining selective attention moment by moment on a chosen object,” and open monitoring, i.e. “nonreactively monitoring the content of experience” [20].

An extensively studied form of mindfulness meditation is mindfulness-based stress reduction (MBSR), a standardized meditation program. MBSR has been found to improve various facets of self-reported mindfulness [21] as well as well-being and perceived stress [22, 23], reduce emotional exhaustion [24] and improve mood [25]. For this type of meditation program, the improvement of well-being and mindfulness are correlated, indicating a close relationship between these two variables [23, 26]. Also, a dose-response relationship has been found in some [21, 23] but not all [27] studies, suggesting longer meditation practice to be associated with greater increases in mindfulness.

Meditation is frequently also practiced in the context of meditation retreats. Traditionally, meditation practices were developed within the context of one’s spiritual path, with meditation retreats providing a period of intensive meditative practice for weeks, months, or even years, thus being a vehicle for a lifelong path of personal development and growth. In this way, meditation retreats differ from mindfulness programs, which are usually aimed at a clinical population with little prior meditation experience and characterized by a significantly smaller intensity of daily practice [28]. In a modern context, meditation retreats provide immersive, supportive environments where a practitioner may deepen his or her personal meditation practice in a sustained, continuous manner, removed from the obligations and distractions of daily life [28]. Motivations for participating in meditation retreats include gaining proficiency in particular forms of meditation, continuing one’s ongoing meditative practice, progressing along one’s personal spiritual path, seeking respite or recovery from stressful life events, or even participating in a form of leisure aimed towards personal development and self-improvement [28, 29]. Residential meditation retreat programs, as the ones included in the present study, are often located in remote natural settings, where retreat participants receive instruction in meditation techniques and typically practice for one-week or longer. During such programs, participants may engage in multiple modalities of meditation for 8–9 hours a day, including formal sitting meditation practice, contemplations, and mindful movement exercises. In addition, participants have time for nature walks, writing, napping, reading, and simple kitchen or house chores.

The present study included meditation retreats embedded in a Buddhist tradition. The primary form of meditation taught at these retreats is Shamata (Sanskrit, ‘calm abiding’), where the practitioners learn to focus their attention on an object of meditation, often the breath, as a form of support to stabilize the mind in present awareness. Through sustained practice, the meditator learns to stabilize the mind and develop greater awareness of the mind’s plentiful activity: thoughts, emotions, sensations, perceptions. Shamata meditation encompasses both focused attention and open monitoring [20] and has been ascribed to the attentional family of meditation practices [19]. In its secular form, Shamata meditation can be regarded as a form of mindfulness meditation. However, while mindfulness practice taught during programs primarily aims at calming the mind, the goal of Shamata meditation is to familiarize oneself with one’s inner world: to learn to direct and sustain one’s attention in order to strengthen the capacity to be aware of one’s myriad of mental processes: thinking, feeling, and perceiving and thus developing meta-awareness [19, 30].

Noted psychological benefits of meditation retreats include increases in trait mindfulness [3135], decreased negative affectivity and increased perceived control [31], enhanced adaptive functioning [36], and an improvement of various facets of well-being [3335, 37]. For example, one study compared a one-month Vipassana meditation retreat at a monastery with a control group pursuing life as usual, both groups consisting of experienced meditators [34]. During the retreat, individuals practiced meditation 8–9 hours per day. Variables were assessed directly at the beginning and end of the retreat. Results showed that the retreat led to an increase in self-reported mindfulness as well as several aspects of well-being such as positive and balanced affect. Also, the retreat affected some domains of personality including an increase in cooperativeness and a decrease in reward dependency.

Recently, two meta-analyses were conducted on the effects of meditation retreats. The first documented large improvements on measures of anxiety, depression and stress as well as on self-reported mindfulness and compassion both longitudinally as well as in comparison with a control group [38]. Effects declined but were still apparent at follow-up. Whereas effects were larger for novice meditators, no differences were found for different retreat types or for the duration of the retreat. However, there was a relationship between improvements in mindfulness and improvements in clinical outcomes. The second meta-analysis, focusing solely on mindfulness retreats, found that retreats outperform inactive controls conditions in improving mindfulness and well-being and that these improvements are maintained after the retreat [39]. All in all, the results imply that participants of retreats show improvements in self-rated mindfulness and well-being that persist for some time after the retreat. However, differences to active control conditions (e.g. stress management, vacation) remain inconclusive and warrant further research.

As stated above, meditation retreats are similar to vacations in some respects. Similarities include a respite from work or other obligations of everyday life, traveling to and staying at another place, and engaging in potentially relaxing activities that may provide new perspectives to one’s life. Due to these common facets and keeping in mind the well-documented short term effect of vacation on health and well-being [1, 3], it is reasonable to expect retreats to have similar short-term effects as vacations regarding the improvement of well-being. However, there are obvious differences between retreats and vacations as well. Whereas meditation retreats aim at improving one’s meditation practice and progressing on one’s spiritual path in a supportive environment, thus emphasizing the development of a skill, vacations provide leisure time to pursue preferred activities, including pleasurable and low effort activities [28, 40, 41]. Thus, retreats and vacations presumably differ regarding the extent of mastery and/or challenge that the individual experiences, with long hours of daily meditation undoubtedly being more challenging than, for example, lying on the beach, even though present-day vacations can also involve education, skills development, and self-improvement [29]. A second difference between retreats and vacations is that during vacations, the activities predominantly are under the individual’s control and thus self-determined [42]. In contrast, activities during retreats, including meditation times and practices, mealtimes, and other activities, are generally predetermined. Thus, the extent to which an individual has control over his or her activities will differ.

It is known that the experience of a leisure episode can affect their impact on well-being [43, 44]. For example, mastery is negatively associated with post-leisure fatigue and positively with post-leisure vigor, suggesting that leisure episodes that are challenging lead to a decrease in fatigue and an increase in vigor. Though the experience of control has not been consistently found to affect fatigue, it is positively related to vigor. Two additional established leisure experiences, namely relaxation and detachment from work during leisure time, are associated with improved well-being [43].

The present study aimed to determine whether the rapid decline of well-being following a regular vacation could be attenuated by practicing meditation during the leisure episode as an activity known to improve well-being by various psychological mechanisms, including an increase in mindfulness. In this aim, we compared meditation retreats with individually planned vacations regarding their effect on mindfulness, fatigue, and emotional well-being in experienced meditators using a naturalistic observational design. To be able to account for the effect of meditation practice during the vacations, we distinguished between vacations during which the vacationers practiced meditation (vacations-with-meditation) and vacations during which vacationers did not practice any type of formal meditation (vacations-without-meditation). In this way, we could simultaneously compare the effect of different types of leisure episodes (retreats versus a vacation) while at the same time investigating the effect of meditation (retreats and vacation-with-meditation on the one hand compared to vacations-without-meditation on the other hand). In the present study, “acting with awareness” was chosen as a measure of mindfulness because it represents a core aspect of mindfulness [45, 46]. Therefore, we will use the term “acting with awareness” in the text when referring to the mindfulness measure used in this study.

Based on the reviewed effects of individual meditation and meditation retreats on self-reported mindfulness, we assume that meditation retreats, i.e., the intense, several day practice of meditation, will be associated with a higher level of acting with awareness after the leisure episode than vacation-with-meditation (hypothesis 1a) and that vacations-with-meditation will be associated with a higher level of acting with awareness than vacations-without-meditation (hypothesis 1b). Based on the reviewed effects of individual meditation and meditation retreats on well-being, we assume that meditation retreats also will be associated with a lower level of fatigue upon returning home than vacation-with-meditation (hypothesis 2a) and that vacations-with-meditation will be associated with a lower level of fatigue after the leisure episode than vacation-without-meditation (hypothesis 2b). Likewise, we assume that meditation retreats also will be associated with a higher level of emotional well-being after the episode than vacation-with-meditation (hypothesis 3a) and that vacation-with-meditation will be associated with a higher level of emotional well-being after the episode than vacation-without-meditation (hypothesis 3b). Based on the known effect of meditation on mindfulness and well-being, we assume that the effects of meditation retreats and the effects of vacation-with-meditation, will be partly mediated by an increase in acting with awareness (hypothesis 4). Finally, based on the known effects of positive leisure experiences on well-being, we assume that the effects of both retreats and vacations are partly mediated by the experience of these leisure episodes, i.e., the experience of relaxation, mastery, and control (hypothesis 5).

Material and methods

Design

The study was a naturalistic observational study comparing three groups of individuals attending either one of several meditation retreats or an individually planned vacation during which individuals had or had not practiced meditation. The study was conducted with individuals of a large international Buddhist organization as the organization frequently offered meditation retreats. A convenience sample of five meditation retreats conducted from July to October was studied, three of which were in the US and two in Europe. These retreats were chosen for both size and content. The summer program season often attracts the highest participation of individuals. Additionally, all of these meditation retreats focused on intensive meditation practices, making them a relatively homogenous experimental setting. The type of meditation practice is outlined below. Individuals scheduled for these retreats were contacted via email, asking them to participate in a study on the effects of a meditation retreat on mindfulness and well-being as compared to a vacation (see S1 File). To constitute the vacation group, an email to all affiliates of the organization was sent by the organization asking affiliates whether they were planning a vacation in the specified period, i.e. July to October of the same year as the retreats, and if so, whether they were interested in participating in a study comparing meditations retreats with regular vacations (see S1 File). The provided vacation or retreat times were then used to trigger the invitation mails for the assessments with a link to an online questionnaire (Soscisurvey, Germany). Three assessments were made: assessment T1, the pre-stay assessment 10 days prior to the retreat or vacation, assessment T2, the post-stay assessment 10 days after the end of the retreat/vacation; and assessment T3, the follow-up assessment 10 weeks after the end of the retreat/vacation. The outcome variables fatigue, emotional well-being, and acting with awareness were assessed at all three-time points, individual characteristics at T1 and characteristics of the leisure episodes, including the experience thereof at T2. Individuals received a link to the questionnaire at the specified time and a reminder email two days later. To identify individual assessments, participants were asked to use an individualized but anonymous identification code for each assessment. The questionnaires were available in English and German. The complete text of the recruitment emails is provided in S1 File. The study was approved by the institutional review board of Miami University, Oxford, OH, USA 45056, with the project reference number: 01554e. Study participants gave informed consent by responding to the initial invitation letter. Data were analyzed anonymously.

Study participants

Study participants were members or affiliates of a Buddhist organization scheduled to participate in one of five meditation retreats (retreat group) and members or affiliates of the same Buddhist organization planning a vacation. Specifically, 271 individuals planning to participate in one of the retreats and 181 individuals planning a vacation in the specified time, in sum 452 individuals, stated their willingness to participate in the study. Of these, a total of 321 individuals (71%) responded to the first questionnaire, 201 individuals (44%) also to the second and 129 individuals (28.5%) to all three questionnaires. Of the latter, three individual datasets had to be removed due to missing data and nine due to stays shorter than seven days or longer than 36 days, leaving a total of 120 individuals in the study sample. The final sample did not differ in any of the descriptive or outcome variables from the respondents to the first wave (t-test, p>.17), indicating that dropouts were random. The characteristics of the study participants are presented in Table 1. A total of 76 women and 44 men participated in the study. Their mean age was 51.5 years (SD = 12.7); the youngest was 23 years, the oldest 81 years old. Individuals habitually practiced an average of 5 hours (SD = 5.3) of meditation per week at home, the average number of years since the beginning of meditation practice was 12.1 years (SD = 10.3), varying between 0 and 44 years. The English language questionnaire was used by 94 individuals, the German language questionnaire by 26.

Table 1. Characteristics of individuals and leisure stays.

Meditation retreat Vacation-with-meditation Vacation-without-meditation total
(1) (2) (3)
m sd m sd m sd m sd p group
n 59 37 24 120
Age (years) 49.5 13.8 54.0 11.8 52.5 10.4 51.5 12.7 0.216
Sex (females) 35 (59%) 24 (65%) 17 (71%) 76 (63%) 0.598
Partner (yes) 20 (34%) 25 (68%) 14 (58%) 59 (49%) 0.003 1–2
Paid work (yes) 44 (75%) 29 (78%) 20 (83%) 93 (78%) 0.679
Language (English) 55 (93%) 22 (60%) 17 (71%) 94 (78%) < .001 1–2
Years of meditation practice 10.1 10.2 14.1 11.0 13.9 8.9 12.1 10.3 0.108
Average habitual meditation practice per week (hours) 5.3 7.9 4.9 6.6 4.2 7.1 5.0 7.3 0.801
Duration of the stay (days) 13.8 7.9 15.4 8.1 15.0 6.5 14.5 7.7 0.554
Meditation practice per week during stay (hours) 33.8 12.2 3.4 3.4 0.0 0.0 17.6 18.3 < .001 1–2. 1–3.
2–3
Relaxation (T2) 12.5 4.0 15.9 3.2 15.3 4.1 14.1 4.1 < .001 1–2. 1–3
Mastery (T2) 16.7 2.7 13.5 3.6 12.5 3.9 14.9 3.7 < .001 1–2. 1–3
Control (T2) 10.2 3.8 14.9 3.6 14.6 3.8 12.5 4.3 < .001 1–2. 1–3
Acting with awareness (T1) 29.7 5.7 31.9 5.8 30.4 6.1 30.5 5.9 0.198
Fatigue (T1) 23.0 6.9 22.9 6.8 23.8 6.1 23.1 6.7 0.865
Emotional well-being (T1) 19.1 4.8 18.8 5.0 18.3 4.2 18.8 4.7 0.766

Note: T1: 10 days before the stay, T2: 10 days after the stay, T3: 10 weeks after the stay; significant (p < .05) group differences refer to differences between the 3 stays and are based on the Scheffé-Test indicated in the right hand column.

Description of retreat- and vacation stays

The study encompassed three meditation retreats of 2–5 week duration at meditation centers at three different rural locations (Barnet, Vermont, USA; Red Feather Lakes, Colorado, USA; and Aegina, Greece), including 7–8 hours of daily sitting meditation (n = 46); a 10-day Buddhist teaching program situated in a meditation center in rural France including an average of 5 hours of sitting meditation per day as well as oral teachings (n = 9); and other meditation programs at various locations (France, USA, Canada) including an average of 7 hours of meditation per day (n = 4). A typical retreat day begins at 7 am, with early morning sitting practice, followed by morning exercise and breakfast at 8 am. Teachings and formal sitting practice begin at 9 am and extend to the rest of the morning. Lunch includes silent mindful eating practices from the Japanese Zen tradition. The time from 1 pm-3 pm is reserved for work and study, with formal sitting practice resuming from 3–6 pm, with periodic breaks. Evenings may include additional sitting practice or teachings. All retreats occurred in July to September.

The primary type of formal meditation taught at these retreats is Shamata meditation, belonging to the attentional family of meditation practices and involving focused attention and open monitoring [19]. An additional meditation practice engaged in on some of these meditation retreats was Tonglen, a traditional form of Tibetan Buddhist meditation that emphasizes loving-kindness and compassion. Tonglen can be classified in a family of constructive meditation practices in that it involves “systematically altering the content of thoughts and emotions,” thereby leading to cognitive reappraisal [19]. In addition to formal meditation practice, individuals also were instructed to engage in informal meditation practices, such as cultivating and sustaining awareness while taking walks in nature, mindful eating, or doing household chores mindfully. These practices rely on focused attention and, therefore, can be viewed as belonging to the attentional forms of meditation practices [19].

Regarding the vacations, the most frequented destinations were the USA (16), Canada (8), France (6), Germany (5), and Spain (3). The vacations included in the study were leisure vacations. Vacation activities included spending time in rural or natural vacation locations (n = 32), traveling (n = 13), and visiting family (n = 5). Ten individuals did not specify their vacation activities. All vacations occurred from August to October. Some individuals indicated that they practiced meditation while on vacation on their own accord. Although we did not assess the type of meditation practiced, it is likely that individual meditation encompassed the practices described above, i.e., Shamata and Tonglen, as all individuals were members of the same Buddhist organization.

Variables

Acting with awareness was assessed with one scale of the Kentucky Inventory of Mindfulness Skills (KIMS) (10 items, α = .86) [47, 48]. This facet of mindfulness was chosen as it represents a core component of mindfulness [45] and has a large impact on psychological well-being [26]. Fatigue was assessed with the Fatigue Assessment Scale (10 items, α = .86) [49]. Fatigue is a central variable in recovery from work and other sources of stress and thus potentially responsive for example to vacation [5052]. Emotional well-being was assessed with the WHO-5 Well-being Index (5 items, α = .86) [53, 54]. Emotional well-being is a variable sensitive to stress as well as to recovery from stress and is also widely used in vacation research as well as research on mindfulness training [3, 46]. For the assessment of fatigue and emotional well-being, participants were asked to consider the time since the return from the retreat/vacation (at T2) or the last two weeks (at T1 and T3). All chosen questionnaires are widely used international scales with good scale properties. The experience of vacation was assessed with three scales of the Recovery Experience Questionnaire [44]. Relaxation (four items, e.g., “During retreat/vacation … I did relaxing things”, α = .90), Control, (four items, e.g. “During retreat/vacation … I felt like I could decide for myself what to do”, α = .88) and Mastery (4 items, e.g., “During retreat/vacation … I learned new things”, α = .83). The individuals were asked to “indicate to what extent the following statements describe your experience during the retreat or vacation.”

Data analysis

Data was analysed with Generalized Linear Model (SPSS 25) for three outcome variables at two points in time (T2 & T3) using two (acting with awareness) or three (fatigue and emotional well-being) models with a different number of predictor variables. The three outcome variables were acting with awareness, fatigue and emotional well-being at T2 and T3. In the first model, the following variables were entered: (a) the leisure episode (meditation retreats, vacation-with-meditation, vacation-without-meditation) as categorial predictor variable, with vacation-with-meditation as reference category, (b) the respective dependent variable at T1 to be able to observe changes in outcomes, (c) age, having a partner, being engaged in paid work and language as control variables either because these variables differed significantly between groups (partner, language) or to control for other potential differences (age; paid work as engaging in paid work may increase fatigue and decrease well-being) [55]. In the second model, only calculated for fatigue and well-being, the residual of acting with awareness at T2 was entered to investigate its mediating effects. The residual acting with awareness (corrected for acting with awareness at T1) was used as an estimate of the change in this variable brought about by the leisure episodes. In the third model, relaxation, mastery and control were additionally entered into the model. To determine the differences between the groups (meditation retreats, vacation-with-meditation, vacation-without-meditation), simple analyses of variance or Chi² test were calculated. Effect sizes were calculated according to Cohen [56] using the estimated means plus the standard errors, which were transformed to standard deviations, derived by Generalized Linear Model (GLM) for model 1.

Results

Group and leisure episode differences, and intercorrelations

As expected, the three groups strongly differed regarding the hours of meditation practice during the leisure episodes (Table 1). During the meditation retreats, the average meditation practice was 33.8 hours per week and thus significantly longer than during vacation-with-meditation, where individuals meditated 3.4 hours per week. The group vacation-without-meditation included individuals who did not engage in meditation at all during their vacation. The leisure episodes also differed in regard to the recovery experiences essentially describing the individuals’ experience of the particular leisure episode. Meditation retreats generally were perceived as providing more opportunities for mastery but fewer opportunities for control and relaxation compared to vacations in general. Vacations with and without meditation did not differ in any variable except for the practice of meditation.

The intercorrelation of variables is presented in Table 2. It should be noted that relaxation and control showed a fairly high correlation, indicating that a greater sense of control during the stay was associated with a greater experience of relaxation. As expected, the number of years of meditation practice was positively associated with acting with awareness. Furthermore, acting with awareness was negatively related to fatigue and positively with emotional well-being. Fatigue and emotional well-being showed a high negative correlation.

Table 2. Intercorrelations of variables.

1 2 3 5 6 7 8 9 10 11 12 13 14
1 Age (years)
2 Sex (females) .06
3 Partner (yes) .21 .15
5 Paid work (yes) -.28 -.00 -.19
6 Language (English) .17 .02 .03 -.09
7 Years med experience .41 .11 .27 -.21 .08
8 Every-day practice (h/w) .21 -.01 .14 -.08 .03 .09
9 Duration of the stay (days) -.07 .07 .04 -.01 .04 .21 -.08
10 Relaxation (T2) -.09 -.02 .15 -.01 -.19 -.05 .03 -.04
11 Mastery (T2) -.02 -.03 .06 -.19 .30 -.03 .21 .01 .09
12 Control (T2) .04 .01 .23 -.01 -.31 .08 .08 .04 .60 -.05
13 Acting with awareness (T1) .23 .20 .11 -.06 -.14 .32 .25 .00 .07 -.09 .12
14 Fatigue (T1) -.26 -.10 -.05 .24 -.19 -.21 -.26 .00 -.04 -.10 -.11 -.50
15 Emotional well-being (T1) .27 .07 -.03 -.22 .19 .20 .22 .01 -.01 .09 -.04 .39 -.75

Note: T1: 10 days before the stay, T2: 10 days after the stay; Coefficients r≥.18 are significant (p < .05).

Changes over time

To determine the change over time of the total study group, paired t-tests were calculated. Overall, the three leisure episodes taken together led to an increase in acting with awareness (t>5.5, p < .001) and emotional well-being (t>2.9, p < .004) and a decrease in fatigue (t>5.1, p < .001) both ten days (T2) and ten weeks (T3) after the episodes. Estimated means corrected for the four control variables are displayed in Fig 1.

Fig 1. Estimated means of outcome variables.

Fig 1

Note: Means corrected for the corresponding variable at T1, partner, age, language, paid work.

Differential effects of the three leisure episodes (hypotheses 1–3)

The results of the Generalized Linear Model (GLM) are presented in Tables 35. All analyses predicting acting with awareness, fatigue and well-being were significant for all models. To test hypotheses 1 (differences between leisure episodes in acting with awarness), hypothesis 2 (differences between leisure episodes in fatigue) and hypothesis 3 (differences between leisure episodes in emotional well-being), the type of leisure episode was entered into the analyses together with the corresponding outcome variable at T1 and the four control variables (Model 1). At T2 and T3, acting with awareness did not differ between vacation-with-meditation and meditation retreats (Table 3). Thus, hypothesis 1a was not confirmed. However, both at T2 and T3, acting with awareness was higher after vacations with meditation than after vacation-without-meditation, resembling a medium effect (d = .50), thus supporting hypothesis 1b. Pairwise comparisons revealed that acting with awareness was also higher following meditation retreats than following vacation-without-meditation both at T2 (p = .03, d = .51) and T3 (p < .001, d = .92). At T2, the leisure episodes did not differ in fatigue or emotional well-being (Tables 4 and 5). However, at T3, fatigue was lower (d = .62) and emotional well-being was higher (d = .70) after vacation-with-meditation than after vacation-without-meditation, whereas meditation retreats and vacation-with-meditation did not differ in fatigue or emotional well-being. Therefore, hypotheses 2a and 3a were not supported for T2 or T3 nor were hypotheses 2b and 3b supported for T2, but hypotheses 2b and 3b were supported for T3. In addition, pairwise comparisons revealed that fatigue was lower (d = .80) and emotional well-being higher (d = .81) after meditation retreats than after vacation-without-meditation at time point T3 (p < .001). To summarize, we found no differences between the leisure episodes at T2 in fatigue or emotional well-being, but higher levels of acting with awareness following leisure episodes including meditation. At T3, both vacation-with-meditation and meditation retreats outperformed vacation-without-meditation in all three variables to a medium to large degree, while meditation retreats and vacation-with-meditation showed similar effects.

Table 3. Results (GLM) predicting acting with awareness after vacation/retreat.

Acting with awareness at T2 Acting with awareness at T3
Model 1 3 1 3
Acting with awareness (T1) .55** .55** .50** .48**
Meditation retreats .04 .98 1.72 3,09**
Vacation-with-meditation ref ref ref ref
Vacation-without-meditation -2.18* -1.93* -1.90* -1.87*
Partner (no<yes) -.67 -1.18 -.30 -.32
Age (ys) -.01 .84 .05 .07*
Language (German<English) .16 .39 -.30 -.06
Paid work (no<yes) -.88 -.47 -.25 -.11
Control (T2) .29** .07
Mastery (T2) .18 -.09
Relaxation (T2) .11 .23*
Chi Square (leisure episode) 5.8 6,7** 15.3** 19.0**
Chi Square (total model) 65.4** 85.5** 73.6** 82.0**

Note: T1: 10 days bevor the stay, T2: 10 days after the stay, T3: 10 weeks after the stay; regression coefficients B are displayed;

**: p < .01,

*: p < .05

Table 5. Results (GLM) predicting emotional well-being after vacation/retreat.

Well-being at T2 Well-being at T3
Model 1 2 3 1 2 3
Emotional well-being (T1) .42** .45** .43** .54** .56** .55**
Meditation retreats -.02 -.03 .23 .47 .48 .76
Vacation-with-meditation ref ref ref ref ref ref
Vacation-without-meditation -1.96 -.91 -.77 -2.98** -2.35* -2.28*
Partner (no<yes) .24 .59 .23 1.16 1.36 1.17
Age (ys) .00 .00 .02 .02 .02 .03
Language (German<English) 1.34 1.21 1.01 -.47 -.56 -.62
Paid work (no<yes) -.38 -.85 -1.12 -1.89* -2.17* -2.28*
Residual acting with awareness (T2) .47** .38** .2** .23*
Control (T2) -.10 -.02
Mastery (T2) .16 .07
Relaxation (T2) .34** .15
Chi Square (leisure episode) 4.3 1.1 1.0 12.3** 8.3* 6.8*
Chi Square (total model) 33.5** 61.1** 77.4** 49.7** 58.9** 61.8**

Note: T1: 10 days bevor the stay, T2: 10 days after the stay, T3: 10 weeks after the stay; regression coefficients B are displayed;

**: p < .01,

*:p < .05

Table 4. Results (GLM) predicting fatigue after vacation/retreat.

Fatigue at T2 Fatigue at T3
Model 1 2 3 1 2 3
Fatigue (T1) .52** .52** .52** .60** .60** .59**
Meditation retreats .27 .30 -.24 -.80 -.79 -1.18
Vacation-with-meditation ref ref ref ref ref ref
Vacation-without-meditation 1.39 .03 -.02 2.74* 2.11 2.05
Partner (no<yes) .61 .20 .26 -.23 -.42 -.17
Age (ys) -.01 -.01 -.03 -.04 -.04 -.06
Language (German<English) -.78 -.70 -.66 .84 .88 .92
Paid work (no<yes) .81 1.35 1.46 1.59 1.84 2.01*
Residual acting with awareness (T2) -.62** -.58** -.29** -.22**
Control (T2) .07 .02
Mastery (T2) .00 -.10
Relaxation (T2) -.24* -.22
Chi Square (leisure episode) 1.7 0.2 .06 11.5** 7.8* 6.7*
Chi Square (total model) 65.2** 114.5** 12.7** 85.5** 94.9** 101.0**

Note: T1: 10 days bevor the stay, T2: 10 days after the stay, T3: 10 weeks after the stay; regression coefficients B are displayed;

**: p < .01,

*: p < .05

Moderating effects of acting with awareness (hypothesis 4)

To investigate the effect of the leisure period related change in acting with awareness, residual acting with awareness at T2 (corrected for acting with awareness at T1) was additionally entered into the model (Model 2). Residual acting with awareness was a significant predictor both of fatigue and emotional well-being at T2 and T3 (Tables 4 and 5). The inclusion of acting with awareness into the model reduced the overall impact of the leisure episodes on fatigue at T2 and T3 as can be seen in the reduction of leisure episode Wald Chi-Square (Table 4). Similarly, the inclusion of acting with awareness reduced the impact of the leisure episodes on emotional well-being at both time points (Table 5). Taken together, these findings indicate that the change in acting with awareness partially mediated the effect of the leisure episodes on fatigue and well-being and thus supports hypothesis 4.

Moderating effects of leisure experiences (hypothesis 5)

To investigate the effects of leisure experiences, the variables control, mastery and relaxation were additionally entered into the model (Model 3, Tables 35). We expected the experience of the leisure episode regarding control, mastery and relaxation to moderate the effect of the leisure episodes on the outcome variables. This hypothesis was partly confirmed for the experience of relaxation, which predicted fatigue and well-being at T2. Thus, hypothesis 5 was confirmed for relaxation at T2.

Effects of experience with meditation

To test possible effects of the years of meditation experience on the stay related changes in acting with awareness, fatigue, and emotional well-being, we conducted six additional GLM analyses for these three outcome variables at T2 and T3, with the same variables as in Model 1, plus the number of years of meditation practice as additional independent variable. For none of the analyses the effect of years of meditation practice was significant, with effects varying between a relatively high prediction for acting with awareness at T3 (B = -.05, p = .156) and a relatively low prediction for emotional well-being at T3 (B = -.0001, p = .983). This indicates that the number of years of meditation practice did not affect the overall change during the leisure episodes.

Discussion

The present study sought to investigate whether meditation practiced in the context of a leisure episode would promote (i.e., prolong) known beneficial effects on well-being. In this effort, the effect of two different types of leisure episodes, namely meditation retreats and vacations, on mindfulness, fatigue, and emotional well-being was studied in a sample of individuals with meditation experience. To be able to account for the effect of meditation, vacations during which individuals practice meditation at their own discretion (vacation-with-meditation) were distinguished from vacations during which meditation was not practiced (vacation-without-meditation). In addition, some mechanisms bringing about well-being improvement were investigated by determining the mediating effects of the change in mindfulness, as well as the mediating effect of the experience of the leisure episodes (i.e., relaxation, mastery and control). We assumed that meditation practice would increase mindfulness and in consequence foster the effect of the leisure episode on well-being. Thus, we expected meditation retreats to outperform vacations with meditation, and vacations with meditation to outperform vacations without meditation regarding both the increase in mindfulness, as well as the improvement in well-being. In addition, we expected leisure episodes experienced as relaxing, providing opportunities for mastery, and allowing control, to lead to a greater improvement in well-being.

The outcomes of the leisure episodes were assessed 10 days (T2) and 10 weeks (T3) after the end of the stays. Ten days after the leisure episodes, there were no differences between the three types of leisure episodes (i.e. meditation retreats, vacation-with-meditation and the vacation-without-meditation) regarding well-being variables, but meditation retreats and vacations with meditation lead to a greater increase in mindfulness than vacations without meditation. At first glance, this lack of differences in well-being is surprising and not in line with our hypotheses. However, it is in line with the well-established short-term effects of vacation on well-being which was also found in the present study [1, 57], potentially masking the effects of meditation practice and the corresponding increase in mindfulness. These findings are also in line with research showing that individual differences in well-being markedly decline during vacation and in the first one or two weeks after vacation. For example, a vacation reduces rumination and affective well-being in obsessive versus non-obsessive workers [58]. In other words, just being away from work and/or everyday life and enjoying leisure makes most of us happy on a short term basis, independent of our personal characteristics. This may also apply to individual differences in mindfulness brought about by the practice of meditation during the leisure episodes. However, our results and the former reasoning are at variance with one study showing that trait mindfulness did affect the short-term improvement of exhaustion and vigor during a leisure weekend in a positive fashion [59]. Future studies will have to resolve this inconsistency.

Interestingly, ten weeks after the leisure episodes, acting with awareness and emotional well-being were higher and fatigue was lower following meditation retreats and vacation-with-meditation compared to vacation-without-meditation. This is in line with previous research both on the effects of mindfulness training [22, 27], as well as on the effects of meditation retreats [38, 39] showing that meditation practice and/or retreats not only improve mindfulness but also well-being in a durable fashion. The superior long-term outcome of meditation retreats and vacation-with-meditation (compared to vacations-without-meditations) on fatigue and emotional well-being are partly due to the greater increase in acting with awareness found for the leisure episodes during which meditation was practiced. As described above, 10 days after the leisure episode, it is likely that transient factors associated with the respite from work and everyday life brought about the increases in well-being, thereby masking the effect of mindfulness. At 10 weeks after the episode, when individuals had resumed work and/or their every-day chores, the more enduring practice-related improvements in acting with awareness most likely accounted for the sustained improvement of fatigue and emotional well-being found in those leisure episodes including meditation, considering the rapid post-vacation decline of well-being observed otherwise [3, 15]. Thus, meditation practice has the potential to make the effects of vacations more lasting.

As suggested above, leisure episode related changes in acting with awareness were at least partly responsible for related changes in fatigue and emotional well-being in the present study. Increases in acting with awareness were associated with a decrease in fatigue and an increase in emotional well-being both 10 days and 10 weeks after the leisure episodes. In addition, the fact that changes in acting with awareness explained some of the differences between the three leisure episodes regarding well-being and the fact that the leisure episodes differed in their effect on acting with awareness imply that acting with awareness partly moderates the effect of the leisure episodes on well-being. In other words, the increase in acting with awareness partly explained the effect of the leisure episodes on fatigue and emotional well-being. This result is in line with several studies finding practice related increases in mindfulness to be associated with increases in well-being both during meditation programs [23, 26, 60] as well as during retreats [38] and implies that one factor explaining the increased and prolonged effect of the leisure episodes in the present study is indeed an increase in mindfulness. It should be noted that other psychological processes associated with meditation practice not included in this study might also play a role in improving well-being, such as self-compassion [61, 62], neuroticism, and perceived control [31]. We suggest that future research on vacation, meditation retreats, and regular meditation practice should consider a broader range of potential mediators.

Contrary to our expectation, meditation retreats with several hours of meditation per day were not superior to vacations during which individuals practiced meditation for a few hours per week, neither regarding mindfulness nor in regard to well-being. This is at variance with the assumption that more hours of meditation practice should bring about greater improvements of both mindfulness and well-being [21, 23]. However, there are some reasons why this may not be the case. Firstly, the meditation retreats differed in relevant aspects of leisure experience from the vacations in this study. Vacations were experienced as more relaxing and more under the individual’s control than the meditation retreats. As both of these recovery experiences are associated with a greater decline in fatigue and/or a greater increase in vigor [43], the more beneficial experience of vacations may have compensated for less frequent meditation practice during vacation. Secondly, a meta-analysis on the impact of group-based mindfulness training on self-reported mindfulness did not find a dose-response relationship between the number of sessions and the increase in mindfulness [27]. Thus, the extent of meditation practice during a leisure episode may have less effect on mindfulness and well-being than whether one practices meditation during this leisure episode at all. This suggests that a limited amount of meditation practice during a vacation can sustain the positive vacation effects on well-being. However, other studies found that long-term retreat outcomes dependent on the extent of daily practice [28].

Despite this lack of differences between meditation retreats and vacations during which individuals practiced meditation, meditation retreats are a setting where individuals can learn the practice of meditation in the first place. It might also be the case that long-term meditators have acquired skills over their years of meditation practice that continued into post-meditation where they do not formally meditate, such as on vacation. Indeed, in the present study, the retreat participants had somewhat (though non-significantly) fewer years of meditation practice than the vacationers.

Next to the improvement of acting with awareness, the experience of the leisure episodes impacted fatigue and emotional well-being. Experiencing leisure episodes as relaxing was related to a greater decrease in fatigue and a greater increase in emotional well-being 10 days after returning from the vacation and/or retreat. This is in line with previous research finding the experience of relaxation during a vacation and/or a weekend to be related to greater post-vacation health and well-being [41], to less perceived effort while conducting work after vacation [12], and to more positive affective states following the weekend [63]. However, these effects were not found 10 weeks after vacation. Also, the other facets of leisure experience assessed in the present study, namely mastery, and control, were not related to the change of fatigue or emotional well-being after vacation.

Meditation practice, despite its overall beneficial effect on well-being, can also be associated with adverse events, such as anxiety, depression, or cognitive anomalies. The overall prevalence of these adverse events is 8.3% and thus, similar to that found for psychotherapy [64]. These unpleasant meditation-related experiences are more common in non-religious participants, participants with higher levels of repetitive negative thinking, and in those engaging in deconstructive types of meditation such as insight meditation [65].

Four potential limitations of the present study need to be addressed. Firstly, the participants were individuals with an average of 10 years of meditation practice and members or affiliates of a Buddhist organization. Apart from being more accustomed and more inclined to the practice of meditation than the general population, it is also likely that they exhibit higher levels of mindfulness [27]. Higher levels of trait mindfulness, as well as meditation practice per se, are associated with higher levels of well-being, as mindfulness has been shown to reduce emotional reactivity and psychological distress [22]. In addition, individuals with higher levels of trait mindfulness may benefit more from formal meditation practice [66] as well as leisure episodes [59]. Perhaps the long-term training in meditation creates healthy patterns of disengagement from stressful external stimuli (such as work) which compound rumination so that moderate practice of meditation would reinvigorate the acting with awareness. Thus, it is possible that the individuals in the present study responded better both to the leisure episodes, as well as to the practice of meditation, potentially leading to greater improvements in acting with awareness, fatigue, and emotional well-being than in individuals not practicing meditation. However, an association of years of meditation practice with outcomes was not found in the present study. Thus, we conclude that the present study results can cautiously be generalized to the general population, although the general population may not be as inclined to practice meditation during leisure episodes to the same extent as the individuals of our study.

Secondly, we did not assess the extent to which the leisure episodes affected regular meditation practice in the aftermath of the stays. It cannot be ruled out that the lasting effect of retreats on mindfulness and well-being was due to an increase in everyday mindfulness practice as has been reported elsewhere [28]. However, as the average home-based meditation practice was fairly intense and did not differ between the groups before the leisure episodes, we do not believe that a substantial change in practice duration occurred after the retreat, though this cannot be ruled out. Future studies would have to assess the impact of meditation retreats on the extent of home-based meditation practice.

Thirdly, the study design was naturalistic observational. Individuals were not randomized to the various leisure episodes but had chosen these episodes on their own accord. This implies that the sample was selective and that the group comparisons we made should be regarded with caution, despite our efforts to control for group differences statistically.

Fourthly, we used a relatively short scale (i.e., 5 items) to assess emotional well-being. Even though this scale has good psychometric qualities demonstrating high levels of reliability, validity as well as sensitivity [67], future research could replicate our findings with more comprehensive scales and broaden the well-being construct to include eudaimonic well-being, thriving and meaning [68, 69].

Conclusions

To conclude, we found that meditation retreats, as well as vacations during which vacationers practiced meditation at their own discretion, were associated with greater medium-term increases in mindfulness and emotional well-being than an “ordinary” vacation during which meditation was not practiced. Differences between meditation retreats with several hours of meditation per day and vacations with a few hours of meditation practice per week were negligible. In particular, 10 weeks after the leisure episodes including meditation, acting with awareness, and emotional well-being were higher and fatigue was lower than after “ordinary vacations” without meditation. From a theoretical point of view, this supports previous findings on the beneficial effects of mindfulness training on psychological well-being. From a practical point of view, the findings suggest that the inclusion of meditation during vacation could help to alleviate vacations’ greatest pitfall, namely the rapid decline of its positive effects, thus making the benefits of vacation on fatigue and well-being more lasting.

Despite our effort to determine some mechanisms explaining the improvement of well-being, such as acting with awareness, future research should include a variety of theory-driven measures to extend our knowledge on the psychological mechanisms promoting well-being durably, including the assessment of the extent and type of post-retreat mediation practice [28], self-report measures such as acceptance, self-compassion, and empathy [19] as well as behavioral and physiological measures of attention [19, 28].

Supporting information

S1 File. Recruitment emails.

(PDF)

S2 File. SPSS data file containing all relevant data.

(SAV)

Data Availability

The data file (SPSS 25) is provided in the supporting information.

Funding Statement

The author(s) received no specific funding for this work.

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Decision Letter 0

Stefan Hoefer

24 Sep 2020

PONE-D-20-21236

Is a meditation retreat the better vacation? Effect of retreats and vacations on fatigue, emotional well-being, and mindfulness

PLOS ONE

Dear Dr. Blasche,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Nov 07 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

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We look forward to receiving your revised manuscript.

Kind regards,

Stefan Hoefer

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for considering me to review this manuscript (“Is a meditation retreat the better vacation? Effect of retreats and vacations on fatigue, emotional wellbeing, and mindfulness”). As detailed in the manuscript, there is a growth of Buddhist Psychology in different parts of the world. Some of the Buddhist teachings have increasingly been employed to help individuals and organizations to cope with stress and distress. Along such the development, ashram, or, in modern parlance, retreats have cropped up to provide cloistered environments for the ‘seekers’ to get the breadth and depth of Buddhist therapy or ‘trio of life’. Previous studies have explored the functioning (psychological and emotional) of seekers during the entrance and upon ‘discharge’ or completion of the retreat. The questions arise on the durability or persistence of what has been gained from the retreat. This is an enticing empirical question which this manuscript has attempted to address. To fulfil the research objective, the authors did what it seems like an intervention study. The study has accrued three types of participants: (1) ‘MeR’ group (MEDITATION RETREATS), (2) ‘VwM’ group (VACATIONS WITH MEDITATION) and (3) ‘VoM’ group (VACATIONS WITHOUT MEDITATION). The outcome measures included Acting with awareness/ mindfulness that was tapped by the Kentucky Inventory of Mindfulness Skills, Fatigue solicited by Fatigue Assessment Scale) and wellbeing tapped by W HO-5 Well-Being Index. Since this study aimed to tease the durability of what was gained during the retreat, participants underwent three assessment occasions, one at Baseline (T1), 10 days (T2), and 10 weeks (T3). The authors observed the typological changes among the accrued sample (n=120) in terms of operationalized outcome measures- mindfulness, fatigue, and wellbeing. This study has the potential to shed light on the relative long-term benefit of Buddhist philosophy and technique. However, the authors were not diligent on the study design and approach to science. For the authors’ consideration, I will now focus on the ‘bigger pictures’ and if the authors would be able to rebut or circumvent the below-mentioned constraints, then the manuscript will deserve a full-fledged review for which I would be happy to contribute.

MAJOR ISSUES

1.STRUCTURE

The structure of the manuscript could be improved. For example, instead of using myriad subheadings. The authors could focus on the following: Introduction/Background, Method, Result, Discussion, Conclusion, and reference. The aims of the study should be clearly stated at the end of the introduction.

2. SAMPLE

The study failed to show the homogeneity of the sample. Some participants have had the “average of 10 years of meditation practice”. This represents an important confounder. The authors did not inform the reader how the sample size was calculated so that generalization of this study could be considered.

2. CONTEXT

To me, this study has all the veneers of the intervention study. According to the best practice, all intervention studies should be registered. The authors stated (approved by the” institutional review 184 board of Miami University, Oxford, OH, USA 45056 with the project reference number: 01554e:). Something is missing here. Please check.

3.CONCEPTUALIZATION

Since some of the participants were regular in meditation, conceptualize this study is not equipped to examine ‘durability’ or ‘recovery’. To match the authors’ aims, a different methodology will be required. This study, as alluded above, has features of the intervention study. Since the authors did not assign into three interventions, the study could be conceived as a ‘naturalistic observation’ or ‘preliminary study’.

4.LANGUAGE AND ABBREVIATION

As a non-native speaker, I could not escape noticing many problems in syntax and grammar as well as usage of bombastic words (“meditation training during vacation could alleviate the greatest pitfall of vacations”). Too many abbreviations have been thrown in the text. Their judicial use will be paramount to avoid confusing the reader.

Reviewer #2: This manuscript aims to address timely research questions on the effects of intensive meditation practice, answers to which are usually limited by an absence of meaningful control groups. A clear merit is the novelty and elegance of the authors’ methodological approach. This study has, in principle, the potential to offer an important contribution to the ongoing debate on the efficacy of intensive meditation practice. However, there are some important conceptual points that need to be addressed before this manuscript could be considered for publication. Please regard the suggestions below as an attempt to improve the positive impact of this study on this nascent research field. Please find the Comments to the Author attached. Thank you.

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Reviewer #1: Yes: Samir Al-Adawi

Reviewer #2: No

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Attachment

Submitted filename: Letter to authors_Plos One.docx

PLoS One. 2021 Feb 8;16(2):e0246038. doi: 10.1371/journal.pone.0246038.r002

Author response to Decision Letter 0


17 Nov 2020

Responses to reviewers

Reviewer #1

This study has the potential to shed light on the relative long-term benefit of Buddhist philosophy and technique. However, the authors were not diligent on the study design and approach to science. For the authors’ consideration, I will now focus on the ‘bigger pictures’ and if the authors would be able to rebut or circumvent the below-mentioned constraints, then the manuscript will deserve a full-fledged review for which I would be happy to contribute.

1. Structure: The structure of the manuscript could be improved. For example, instead of using myriad subheadings. The authors could focus on the following: Introduction/Background, Method, Result, Discussion, Conclusion, and reference. The aims of the study should be clearly stated at the end of the introduction.

Response:

Thank you for carefully reading our manuscript. As suggested, we have deleted the subheadings from the introduction. We left the subheadings in the methods and results section for easier readability. We use the other main headings as suggested, i.e., Introduction, Method, Result, Discussion, Conclusion, and References. We now state the aims of the study in the second to last paragraph of the introduction, which also improves the structure in our view.

2. Sample: The study failed to show the homogeneity of the sample. Some participants have had the “average of 10 years of meditation practice”. This represents an important confounder. The authors did not inform the reader how the sample size was calculated so that generalization of this study could be considered.

Response:

We have tested various differences between the three groups (e.g., background variables, baseline values of variables) and display results of the tests in Table 1. There were a few significant differences between the groups (i.e., partner, language, meditation practice per week during stay, relaxation, mastery, control). We have added all these potential confounders as control variables in the subsequent analyses.

This study indeed concerns a naturalistic observation study and thanks to the reviewer for suggesting this clarification. Participants were not randomly assigned to experimental groups but freely chose whether they went on a vacation, whether they meditated on vacation or whether they chose to go on a meditation retreat. As the sample was recruited via a Buddhist organization, most participants identify themselves as Buddhist and have affinity and experience with meditation practices.

We discuss this as a limitation of our study in the discussion section (last paragraph). We have also added a clear description of the study design, using the term “naturalistic observation” in the introduction, method section and in the abstract.

3. Context: To me, this study has all the veneers of the intervention study. According to the best practice, all intervention studies should be registered. The authors stated (approved by the” institutional review 184 board of Miami University, Oxford, OH, USA 45056 with the project reference number: 01554e. Something is missing here. Please check.

Response:

As stated above and suggested by the reviewer, this study is not an intervention study in which participants were randomized into experimental groups. Therefore, the study was not registered, but ethical review was requested and granted. We are clearer about our design in the method section now and refer to this study as a “naturalistic observation” (introduction, next to last paragraph; method section, design, first paragraph). We also checked the reference number of the report of the institutional review board which is correct.

4. Conceptualization: Since some of the participants were regular in meditation, conceptualize this study is not equipped to examine ‘durability’ or ‘recovery’. To match the authors’ aims, a different methodology will be required. This study, as alluded above, has features of the intervention study. Since the authors did not assign into three interventions, the study could be conceived as a ‘naturalistic observation’ or ‘preliminary study’.

Response:

Please see our comments above regarding the study design we use. Most of the participants in our study are indeed experienced meditators and regularly practiced meditation for an average of 5 hours per week (see table 1). The aim of the present study was to test effects of meditation during a leisure episode (vacation, retreat), assuming that meditation will show a lasting improvement on well-being connected to improvements in mindfulness. However, we thank the reviewer for pointing out a potential limitation of the study: the effects may be due to changes in the extent of home-based meditation practice. We added this point as a potential limitation in the limitation section of our study (discussion, last paragraph).

We have also changed the wording in the abstract and write now: “The aim of the present study was to investigate whether vacation effects would be more lasting if individuals practiced meditation during the leisure episode. Meditation is known to improve well-being in a durable fashion among others by enhancing the mental faculty of mindfulness. In this aim, leisure vacations during which individuals practiced meditation to some extent were compared with holidays not including any formal meditation practice as well as with meditation retreats (characterized by intense meditation practice) utilizing a naturalistic observational design.”

5. Language and abbreviation: As a non-native speaker, I could not escape noticing many problems in syntax and grammar as well as usage of bombastic words (“meditation training during vacation could alleviate the greatest pitfall of vacations”). Too many abbreviations have been thrown in the text. Their judicial use will be paramount to avoid confusing the reader.

Response:

Thank you for pointing out these weaknesses in our writing style. We have deleted the abbreviations from the text and tables and use the exact and complete terms now. This indeed improves readability. We have also removed the first paragraph in the introduction, including the “bombastic” wording. We carefully reread the manuscript and made sure that syntax and grammar are correct. Several minor changes were made to the text in this process. Also, one of our co-authors is a native speaker.

Reviewer #2

This manuscript aims to address timely research questions on the effects of intensive meditation practice, answers to which are usually limited by an absence of meaningful control groups. A clear merit is the novelty and elegance of the authors’ methodological approach. This study has, in principle, the potential to offer an important contribution to the ongoing debate on the efficacy of intensive meditation practice. However, there are some important conceptual points that need to be addressed before this manuscript could be considered for publication. Please regard the suggestions below as an attempt to improve the positive impact of this study on this nascent research field.

Major point:

Overall, the description and discussion of meditation practice is too general and broad. A more careful presentation of the complexities and nuances of contemplative research is needed, including a discussion of theoretical frameworks of meditation practices through which the type of meditation practiced on these retreats can be conceptualised. Specific suggestions are offered below.

Response:

Thank you for the positive feedback on our manuscript, careful reading and suggesting many helpful references to the literature that we had missed. We have done our best to incorporate references to these papers and improve our theoretical and conceptual framework.

1. Introduction: The terms “mindfulness meditation” and “meditation” are often used interchangeably. In the introduction, please offer a more nuanced definition of meditation as a family of diverse practices that include but are not limited to mindfulness meditation. Please refer to landmark papers including:

• Dahl CJ, Lutz A, Davidson RJ. Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice. Trends in cognitive sciences. 2015 Sep 1;19(9):515-23.

• Lutz A, Slagter HA, Dunne JD, Davidson RJ. Attention regulation and monitoring in meditation. Trends in cognitive sciences. 2008 Apr 1;12(4):163-9.

• Van Dam NT, Van Vugt MK, Vago DR, Schmalzl L, Saron CD, Olendzki A, Meissner T, Lazar SW, Kerr CE, Gorchov J, Fox KC. Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on psychological science. 2018 Jan;13(1):36-61.

Response:

Thank you for pointing out this weakness in our definition. In general, the manuscript has been edited to use a more nuanced definition of meditation, with reference to published conceptual framework/ taxonomy offered from key papers as suggested by reviewer. Specifically, we have adapted the definition/description as suggested and also included reference to the three papers mentioned above. We write now: (introduction, 3rd paragraph): “Meditation can be understood as a family of diverse practices that include, but are not limited to, mindfulness meditation. Found within Buddhism and other contemplative traditions, such meditation practices seek to cultivate and regulate specific psychological processes lastly aimed at increasing well-being. Recently, these practices have been grouped into three families, the attentional, the constructive and the deconstructive family {Dahl, 2015 #5328}. These families not only include different practices but also affect well-being through different avenues. The attentional family for example, encompassing mindfulness meditation and mindfulness based stress reduction, improves well-being by a process known as “meta-awareness” or “cognitive distancing”, i.e. “stepping back and observing one’s internal processes of thinking and feeling” {Dahl, 2015 #5328}. This includes overcoming experiential fusion, that is being absorbed in the contents of consciousness, which reduces our ability to monitor and/or regulate psychological processes. To be able to promote these processes, two cognitive faculties have to be developed: focused attention, i.e. “sustaining selective attention moment by moment on a chosen object” and open monitoring, i.e. “nonreactively monitoring the content of experience” {Lutz, 2008 #5329}”.

2. It is unclear why the manuscript starts off with a general statement about books published on “mindfulness”. Please consider deleting the first sentence of the introduction.

Response:

We have deleted the first sentence of the introduction as suggested. Due to a more thorough revision of the introduction, we deleted the entire first paragraph. We used the saved space to instead provide a more detailed definition and description of meditation practices (see our response above).

3. It is not clear why an elaborate presentation of research on mindfulness-based interventions is needed in the context of the present manuscript. On several levels, intensive meditation retreats differ markedly from standard mindfulness-based programmes. Please consider embedding the narrative of this manuscript within previous research on meditation retreats.

Response:

We agree with the reviewer that a shifting of the narrative towards retreats mirrors the aims of the present study more closely and thus would improve the manuscript. Therefore, we expanded our discussion on meditation retreats, adding two new paragraphs (introduction, paragraph 5 & 7) and explicitly acknowledge the differences between retreats and standard mindfulness-based programmes in our description of meditation retreats (introduction, 5th paragraph). We kept a short summary of effects of standardized mindfulness programs (introduction, 4th paragraph) to illustrate the effects of mindfulness meditation, a form of meditation both used during retreats as well as by some of the study participants during vacation, constituting one of our study groups.

4. Please add a discussion of the systematic reviews and theoretical papers listed below. Please also use them to elaborate on the limitations and future directions of research on meditation retreats.

• McClintock AS, Rodriguez MA, Zerubavel N. The effects of mindfulness retreats on the psychological health of non-clinical adults: A meta-analysis. Mindfulness. 2019 Aug 15;10(8):1443-54.

• Khoury B, Knäuper B, Schlosser M, Carrière K, Chiesa A. Effectiveness of traditional meditation retreats: A systematic review and meta-analysis. Journal of Psychosomatic Research. 2017 Jan 1;92:16-25.

• King BG, Conklin QA, Zanesco AP, Saron CD. Residential meditation retreats: their role in contemplative practice and significance for psychological research. Current opinion in psychology. 2019 Aug 1;28:238-44.

Response:

We thank the reviewer for suggesting these relevant publications. In the revised version of the manuscript, we summarize the results of the meta-analyses (introduction, 7th paragraph) and included insights of King et al. (2019) in our description of retreats (introduction, 5th paragraph). In addition, we have included these references in our discussion of limitations as well as in the section on recommendation for future research (conclusions).

5. “Propelled by research and relatively distanced from its spiritual roots, mindfulness radiated through medicine into society at large.” Please consider reframing this. It seems that the retreats included in this study took place within an explicitly Buddhist framework.

Response:

We have removed the entire paragraph, including the problematic sentence (see also response to point 2). The retreats included in this study did indeed take place within a Buddhist framework as also stated in the methods section. Thank you for pointing this out.

6. Page 5, line 113: “While a meditation retreat aims at developing non-judgmental present moment awareness through meditation practice, …”. This is too broad and general. What types of meditation were primarily practiced during these particular retreats (see comment 4 below)? Please describe why you have chosen retreats that have focused primarily on “mindful-awareness”. Also, the term “mindful-awareness” is not commonly used in meditation research. Please clarify and specify the terminology in accordance with published conceptual frameworks (e.g. Dahl et al. 2015).

Response:

We have removed this brief description and included a more precise description of the primary meditation practiced during the retreats elsewhere (introduction, 6th paragraph) referring to the suggested conceptual frameworks. In the chosen retreats, the primary form of meditation taught was Shamata meditation based on the Buddhist background of the organization.

7. Methods: Page 7, line 213: “The formal sitting practice of meditation taught at these retreats is mindful-awareness, where the practitioner learns to focus their attention on an object of meditation, often the breath, to cultivate awareness of one’s inner world: thoughts, emotions, sensations, perceptions.” Please elaborate on the type of practice that was used, its perceived goals, and the cognitive mechanism it primarily cultivates. Please try to embed this type of practice within a theoretical taxonomy of meditation practices (e.g. Dahl et al. 2015) to differentiate it from other practices.

• Reference: Dahl CJ, Lutz A, Davidson RJ. Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice. Trends in cognitive sciences. 2015 Sep 1;19(9):515-23.

Response:

We thank the reviewer for demanding clarity in regard to the meditation practices used during the retreats. In the revised version of the paper, we describe the types of meditation practiced during the retreats and embed the practices with the proposed theoretical framework. We also included the discussion of the meditation practices, their theoretical underpinning and their cognitive mechanisms in the introduction (paragraph 4 & 5). In the method section, we state the major forms of meditation practice engaged in during retreats in accordance with the proposed theoretical framework to clarify the practices used.

8. Could you please include (either in methods section or as supplementary material) the information that was given to participants during recruitment, including the wording of the aims of the study. Could there have been a likelihood that participants believed that the study might aim to demonstrate that meditation retreats (or vacation with meditation) are superior to vacations? If so, please discuss this as a limitation.

Response:

Behavioral interventions require participants to be aware on the purpose of the study in order to adhere to the behavioral guidelines. So, motivation and honest information on the purpose of the study is not only ethically required, but also necessary in order to ensure that the study can be effective. As suggested, we have added the text of the recruitment e-mails to the supplementary materials. After reviewing the invitation letters again, we do not believe that we induced the belief that retreats were superior to vacations in any way. Thus, we did not add this point to the limitation section.

9. Please specify the types of meditation practices that participants in the vacation-with-meditation group engaged in. If those differed from the types of meditation practiced on retreat, then please highlight and discuss this when interpreting the results.

Response:

Unfortunately, we did not assess the type of meditation practices that participants in the vacation-with-meditation group engaged in. However, it is likely that this individual meditation closely resembled the practices engaged in during the retreats, i.e. Shamata and Tonglen, as all individuals were members of the same Buddhist organization. We added this information to the method section, description of retreat- and vacation stays.

10. Results: If available, could you please add to Table 1 the number (%) of participants in each group who have previously been on retreat.

Response:

Regretfully, this information is not available and can thus not be added to the table.

11. Discussion: To nuance the discussion, please briefly mention potential downsides of meditation retreats that are unlikely to be encountered on vacation without intensive meditation practice. For instance, a recent meta-analysis highlights potential meditation-related challenges (Farias et al., 2020) and a large study of regular meditators indicated that individuals with retreat experience were more likely to report unpleasant meditation-related experiences (Schlosser et al., 2019).

• Farias M, Maraldi E, Wallenkampf KC, Lucchetti G. Adverse events in meditation practices and meditation‐based therapies: a systematic review. Acta Psychiatrica Scandinavica. 2020 Aug 7.

• Schlosser M, Sparby T, Vörös S, Jones R, Marchant NL. Unpleasant meditation-related experiences in regular meditators: Prevalence, predictors, and conceptual considerations. PloS one. 2019 May 9;14(5):e0216643.

Response:

Thank you for pointing out these issues. We have gladly included reference to these papers and the potential downsides of retreats. We have added a paragraph discussing these potential adverse effects of meditation (Discussion, 8th paragraph).

12. Tables: Please add full names of MeR, VvM, VoM, AWA etc. to the footnote of each table.

Response:

In line with point 5 of reviewer 1, we deleted all abbreviations related to variables from the manuscript. In addition, we included the full names of remaining abbreviations in the footnote of the tables. Thank you for pointing this out. This measure has indeed improved readability.

We would like to thank the reviewers for their feedback and hope that they also feel that our paper improved a lot thanks to their constructive comments.

Attachment

Submitted filename: Responses to reviewers.docx

Decision Letter 1

Stefan Hoefer

11 Dec 2020

PONE-D-20-21236R1

Is a meditation retreat the better vacation? Effect of retreats and vacations on fatigue, emotional well-being, and mindfulness

PLOS ONE

Dear Dr. Blasche,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

I kindly ask you to address reviewers 2 comments carefully. As reviewer 2 states, after consideration of these remaining minor issues, acceptance of the manuscript can be recommended. 

Please submit your revised manuscript by Jan 25 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Stefan Hoefer

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for considering me to review this manuscript, “Is a meditation retreat the better vacation? Effect of retreats and vacations on fatigue, emotional well-being, and mindfulness”. I have read with interest in the revised manuscript. I have paid particular attention to two reviewers’ comments, my counterpart, and myself. I have raised issues pertinent to the methodological approach while my counterpart has commented on the conceptualization issue of the study. The authors appeared to have responded or rebutted the protracted comments from two reviewers. Otherwise, the authors have highlighted some of the un-addressable points as the limitations of the study. In my opinion, the scientific merit of the manuscript has significantly improved. On this ground, I have no hesitation to recommend this manuscript for publication.

Reviewer #2: I thank and commend the authors for diligently addressing my conceptual concerns. I believe that the impact of the paper and its resilience to critics has been substantially improved. Importantly, the authors have added a more nuanced discussion of the nascency and heterogeneity still characterising meditation research. After addressing the minor comments below, I would recommend this manuscript for publication.

Line 113

“Thus, within a retreat, meditation practice invites a practitioner to be more open and non-judgmental to one’s experience, without labeling them as pleasing or unpleasing, through repetitive familiarization with one’s cognitive processes as well as the content of one’s consciousness. As such, meditation is geared at “seeing things as they are “.

Could you please delete or substantially reframe this section? Indeed, some meditative traditions and schools purport that particular meditative practices (e.g. Goenka vipassana retreats, certain forms of mindfulness training) help us to see “things as they are”. Other frameworks, however, criticise this approach because it rests on a set of unquestioned assumptions (e.g. “there really is a real reality a meditator can see”) and prevents a deeper inquiry into the dependent arising and empty nature of all phenomena (e.g. see Burbea, 2014). Further, some meditative practices (e.g. samadhi practice, forms of samatha practice) actually encourage meditators to cultivate profound states of well-being (e.g. jhanas) by actively inclining the mind towards pleasant sensations and abiding in them, thereby actively re-habituating the mind to not get drawn into the difficult and unpleasant perceptions. Some meditative practices are very passive and receptive in their approach; others are very proactive; different practices will be helpful for different people at different times. Again, all this speaks to the rich diversity of meditative practices and implies that using the term meditation in a broad and generalised manner (“meditation is geared at …”) is likely to add more confusion than clarity to this nascent research field. When re-reading your manuscript to make final edits, please also consider other sections in your manuscript where the (very understandable) tendency to generalise might be apparent.

References:

Burbea, R. (2014). Seeing that frees: Meditations on emptiness and dependent

arising. Hermes Amāra Publications.

Line 147

“ones meditation practice”

Please correct: “ones” to “one’s”

Line 168

“… by various psychological mechanisms associated with an increase in mindfulness.”

Please change “associated with” to “including”. Otherwise, it can sound as if mindfulness is the primary cognitive mechanism by which all meditative practices exert their effects.

Discussion

Could you please add 1-2 sentences briefly noting that other psychological processes not assessed in this study might also play an important role in improving well-being and reducing suffering in the context of a regular meditation practice. These potential mediators include self-compassion (e.g., Baer et al., 2012, n = 77 meditators; Schlosser et al., 2020, n = 1281 meditators), neuroticism, and perceived control (Jacobs et al., 2011; already cited in your manuscript). You could recommend that future research on the effects of vacation, meditation retreats, and regular meditation practice consider a broader range of potential mediators.

References:

Baer, R.A., Lykins, E. L. B.,& Peters, J. R. (2012). Mindfulness and self-compassion as predictors of psychological wellbeing in long-term meditators and matched non-meditators. The Journal of Positive Psychology, 7(3), 230–238. https://doi.org/10.1080/17439760.2012.674548

Jacobs, T. L., Epel, E. S., Lin, J., Blackburn, E. H., Wolkowitz, O. M., Bridwell, D. A., ... & King, B. G. (2011). Intensive meditation training, immune cell telomerase activity, and psychological mediators. Psychoneuroendocrinology, 36(5), 664-681.

Schlosser, M., Jones, R., Demnitz-King, H., & Marchant, N. L. (2020). Meditation experience is associated with lower levels of repetitive negative thinking: the key role of self-compassion. Current Psychology. https://doi.org/10.1007/s12144-020-00839-5

Discussion

Could you please add one sentence that your results might be more a reflection of the short 5-item well-being measure you utilised rather than the latent well-being construct it was intended to capture. You could recommend that future research explores whether your findings can be replicated with longer and more comprehensive well-being measures.

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Reviewer #1: Yes: Samir Al-Adawi

Reviewer #2: No

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PLoS One. 2021 Feb 8;16(2):e0246038. doi: 10.1371/journal.pone.0246038.r004

Author response to Decision Letter 1


12 Jan 2021

Responses to reviewers

We would like to thank the reviewer and the editor for the renewed review of our manuscript and for the positive assessment. Below, we address the remaining issues raised by Reviewer 2 point by point.

We are looking forward to receiving your feedback on these changes.

Reviewer #2

Points:

1. Line 113: “Thus, within a retreat, meditation practice invites a practitioner to be more open and non-judgmental to one’s experience, without labeling them as pleasing or unpleasing, through repetitive familiarization with one’s cognitive processes as well as the content of one’s consciousness. As such, meditation is geared at “seeing things as they are “.

We deleted this section as suggested. We understand that this statement may have been unsatisfactory in various ways and did not reflect the diversity of meditation practices sufficiently.

2. Line 147: corrected

3. Line 168: “… by various psychological mechanisms associated with an increase in mindfulness.” We changed “associated with” to “including” as suggested.

4. Discussion, end of 4th paragraph: We thank the reviewer for this suggestion and added the following paragraph: “It should be noted that other psychological processes associated with meditation practice not included in this study might also play a role in improving well-being, such as self-compassion [60,61], neuroticism, and perceived control [31]. We suggest that future research on vacation, meditation retreats, and regular meditation practice should consider a broader range of potential mediators.” We have also included the suggested literature (Baer, 2012; Schlosser, 2020).

5. Following the advice to add one sentence regarding the relatively short well-being measures we used, we added the following paragraph in the discussion: “Fourthly, we used a relatively short scale (i.e., 5 items) to assess emotional well-being. Even though this scale has good psychometric qualities demonstrating high levels of reliability, validity as well as sensitivity [66], future research could replicate our findings with more comprehensive scales and broaden the well-being construct to include eudaimonic well-being, thriving and meaning [67,68].” In addition, the results for emotional well-being and fatigue are comparable in our study, thus supporting the validity of the WHO-5 measure.

Attachment

Submitted filename: Responses to reviewers revision 2.docx

Decision Letter 2

Stefan Hoefer

13 Jan 2021

Is a meditation retreat the better vacation? Effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness

PONE-D-20-21236R2

Dear Dr. Blasche,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Stefan Hoefer

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Acceptance letter

Stefan Hoefer

21 Jan 2021

PONE-D-20-21236R2

Is a meditation retreat the better vacation? Effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness

Dear Dr. Blasche:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

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Kind regards,

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on behalf of

Dr. Stefan Hoefer

Academic Editor

PLOS ONE

Associated Data

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    Supplementary Materials

    S1 File. Recruitment emails.

    (PDF)

    S2 File. SPSS data file containing all relevant data.

    (SAV)

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    Submitted filename: Letter to authors_Plos One.docx

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    Submitted filename: Responses to reviewers.docx

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    Submitted filename: Responses to reviewers revision 2.docx

    Data Availability Statement

    The data file (SPSS 25) is provided in the supporting information.


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