Self-report Mindfulness as a Mediator of Psychological Well-being in a Stress Reduction Intervention for Cancer Patients—A Randomized Study

BackgroundThere is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning.PurposeThe aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects on these outcomes.MethodsSeventy women and one man with a previous cancer diagnosis (mean age 51.8 years, standard deviation = 9.86) were randomized into an intervention group or a wait-list control group. The intervention consisted of an 8-week mindfulness training course.ResultsCompared to participants in the control group, participants in the mindfulness training group had significantly decreased perceived stress and posttraumatic avoidance symptoms and increased positive states of mind. Those who participated in the intervention reported a significant increase in scores on the five-facet mindfulness questionnaire (FFMQ) when compared to controls. The increase in FFMQ score mediated the effects of the intervention on perceived stress, posttraumatic avoidance symptoms, and positive states of mind.ConclusionsThis study indicates that the improvements in psychological well-being resulting from mindfulness stress reduction training can potentially be explained by increased levels of mindfulness as measured with the FFMQ. The importance of these findings for future research in the field of mindfulness is discussed.

[1]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[2]  S. Bauer-Wu,et al.  Mindfulness Meditation for Oncology Patients: A Discussion and Critical Review , 2006, Integrative cancer therapies.

[3]  R. Ryan,et al.  Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects , 2007 .

[4]  R. Durazo-Arvizu,et al.  Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer , 2008, Brain, Behavior, and Immunity.

[5]  Marsha M. Linehan,et al.  Skills Training Manual for Treating Borderline Personality Disorder , 1993 .

[6]  B. Fredrickson The broaden-and-build theory of positive emotions. , 2004, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[7]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[8]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[9]  R. Bootzin,et al.  The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study. , 2003, Journal of psychosomatic research.

[10]  Gregory T. Smith,et al.  Using Self-Report Assessment Methods to Explore Facets of Mindfulness , 2006, Assessment.

[11]  W. Friesen,et al.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Positive Emotions in Early Life and Longevity : Findings from the Nun Study , 2004 .

[12]  T. Kamarck,et al.  A global measure of perceived stress. , 1983, Journal of health and social behavior.

[13]  L. Carlson,et al.  Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients , 2004, Psychoneuroendocrinology.

[14]  J. Astin,et al.  Mechanisms of mindfulness. , 2006, Journal of clinical psychology.

[15]  J. Kabat-Zinn,et al.  Full catastrophe living : using the wisdom of your body and mind to face stress, pain, and illness , 1990 .

[16]  P. Grossman,et al.  Mindfulness-based stress reduction and health benefits: A meta-analysis , 2004, Journal of Psychosomatic Research.

[17]  J. Moskowitz,et al.  Positive Affect Predicts Lower Risk of AIDS Mortality , 2003, Psychosomatic medicine.

[18]  L. Carlson,et al.  Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients , 2005, International journal of behavioral medicine.

[19]  L. Carlson,et al.  The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up , 2001, Supportive Care in Cancer.

[20]  Matthew J. Goodman,et al.  Randomized controlled trial of mindfulness‐based stress reduction (MBSR) for survivors of breast cancer , 2009, Psycho-oncology.

[21]  S A Black,et al.  Emotional Well‐Being Predicts Subsequent Functional Independence and Survival , 2000, Journal of the American Geriatrics Society.

[22]  N. Adler,et al.  Additional Validation of a Scale to Assess Positive States of Mind , 1998, Psychosomatic medicine.

[23]  Scott R. Bishop,et al.  What Do We Really Know About Mindfulness-Based Stress Reduction? , 2002, Psychosomatic medicine.

[24]  J. Richardson,et al.  Mindfulness-Based Stress Reduction as supportive therapy in cancer care: systematic review. , 2005, Journal of advanced nursing.

[25]  Meredith Y. Smith,et al.  Post‐traumatic stress disorder in cancer: a review , 1999, Psycho-oncology.

[26]  Hiroaki Kumano,et al.  Mindfulness‐based stress reduction and cancer: a meta‐analysis , 2009, Psycho-oncology.

[27]  Z. Segal,et al.  Mindfulness: A Proposed Operational Definition , 2004 .

[28]  P. Grossman On measuring mindfulness in psychosomatic and psychological research. , 2008, Journal of psychosomatic research.

[29]  G. Ostir,et al.  The Association Between Emotional Well-Being and the Incidence of Stroke in Older Adults , 2001, Psychosomatic medicine.

[30]  J. Moskowitz,et al.  Positive affect uniquely predicts lower risk of mortality in people with diabetes. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[31]  N. Adler,et al.  A scale for measuring the occurrence of positive states of mind: a preliminary report. , 1988, Psychosomatic medicine.

[32]  L. Carlson,et al.  A Randomized, Wait-List Controlled Clinical Trial: The Effect of a Mindfulness Meditation-Based Stress Reduction Program on Mood and Symptoms of Stress in Cancer Outpatients , 2000, Psychosomatic medicine.

[33]  S. Folkman The case for positive emotions in the stress process , 2008, Anxiety, stress, and coping.

[34]  M. Kenny Mindfulness-based cognitive therapy for depression , 2008 .

[35]  L. Carlson,et al.  Mindfulness‐Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients , 2003, Psychosomatic medicine.

[36]  Gregory T. Smith,et al.  Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples , 2008, Assessment.

[37]  Karlijn F. Kuijpers,et al.  Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism? , 2008, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[38]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[39]  Steven C. Hayes,et al.  Get out of your mind & into your life : the new acceptance & commitment therapy , 2005 .

[40]  S. Shapiro,et al.  Cultivating mindfulness: effects on well-being. , 2008, Journal of clinical psychology.

[41]  Jun Shao,et al.  Last observation carry‐forward and last observation analysis , 2003, Statistics in medicine.