Positive Reappraisal Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral Process

Abstract

The stress-reductive effect of mindfulness practice is well-established, yet less is known about the cognitive mechanisms underlying this salutary outcome. We conducted a prospective observational study of 339 participants (mean age 45.7 ± 13.4) undergoing an 8-week mindfulness-based stress and pain management course and found support for our hypotheses that a) pre-post intervention increases in dispositional mindfulness are reciprocally linked with increases in positive reappraisal coping and b) the stress-reductive effects of increases in dispositional mindfulness are mediated by increases in positive reappraisal independent of changes in catastrophizing. Positive reappraisal and mindfulness appear to serially and mutually enhance one another, creating the dynamics of an upward spiral. Through mindfulness practice, individuals may engender a broadened state of awareness that facilitates empowering interpretations of stressful life events, leading to substantially reduced distress. Study findings have implications for cognitive therapy that couples mindfulness practices with restructuring techniques oriented toward benefit finding and positive reappraisal.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

References

  1. Baer, R. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.

    Article  Google Scholar 

  2. Baer, R.A., Smith, G.T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.

    Google Scholar 

  3. Barnard, J., & Rubin, D. B. (1999). Small-sample degrees of freedom with multiple imputation. Biometrika, 86(4), 948–955.

    Article  Google Scholar 

  4. Barron, R. M., & Kenney, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical consideration. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  Google Scholar 

  5. Benson, H., Beary, J. F., & Carol, M. P. (1974). The relaxation response. Psychiatry, 37(1), 37–46.

    PubMed  Google Scholar 

  6. Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246. B.

    PubMed  Article  Google Scholar 

  7. Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64(1), 71–83.

    PubMed  Google Scholar 

  8. Bower, J., Low, C., Moskowitz, J., Sepah, S., & Epel, E. (2008). Benefit finding and physical health: Positive psychological changes and enhanced allostasis. Social and Personality Psychology Compass, 2(1), 223–244.

    Article  Google Scholar 

  9. Brosschot, J. F., Pieper, S., & Thayer, J. F. (2005). Expanding stress theory: Prolonged activation and perseverative cognition. Psychoneuroendocrinology, 30(10), 1043–1049.

    PubMed  Article  Google Scholar 

  10. Burns, A. B., Brown, J. S., Sachs-Ericsson, N., Plant, E. A., Curtis, J. T., Fredrickson, B. L., et al. (2008). Upward spirals of positive emotion and coping: Replication, extension, and initial exploration of neurochemical substrates. Personality and Individual Differences, 44, 360–370.

    Article  Google Scholar 

  11. Carrico, A. W., Ironson, G., Antoni, M. H., Lechner, S. C., Duran, R. E., Kumar, M., et al. (2006). A path model of the effects of spirituality on depressive symptoms and 24-h urinary-free cortisol in HIV-positive persons. Journal of Psychosomatic Research, 61(1), 51–58.

    PubMed  Article  Google Scholar 

  12. Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clinical Psychology Review, 29(6), 560–572.

    PubMed  Article  Google Scholar 

  13. Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine, 15(5), 593–600.

    Article  Google Scholar 

  14. Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40(8), 1239–1252.

    PubMed  Article  Google Scholar 

  15. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.

    Google Scholar 

  16. Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M., Boyers, A. E., Alferi, S. M., et al. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosomatic Medicine, 62(3), 304–308.

    PubMed  Google Scholar 

  17. Ditto, B., Eclache, M., & Goldman, N. (2006). Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. Annals of Behavioral Medicine, 32(3), 227–234.

    PubMed  Article  Google Scholar 

  18. Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(430–457).

    Google Scholar 

  19. Farb, N.A., Anderson, A.K., Mayberg, H., Bean, J., McKeon, D., Segal, Z.V. (2010). Minding one's emotions: mindfulness training alters the neural expression of sadness. Emotion, 10, 25–33.

    Google Scholar 

  20. Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science & Medicine, 45(8), 1207–1221.

    Article  Google Scholar 

  21. Fredrickson, B. L. (2004). The broaden-and-build theory of positive emotions. Philosophical Transactions of the Royal Society of London B Biol Sci, 359(1449), 1367–1378.

    Article  Google Scholar 

  22. Fredrickson, B. L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13(2), 172–175.

    PubMed  Article  Google Scholar 

  23. Fredrickson, B. L., & Losada, M. F. (2005). Positive affect and the complex dynamics of human flourishing. The American Psychologist, 60(7), 678–686.

    PubMed  Article  Google Scholar 

  24. Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. R. (2003). What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84(2), 365–376.

    PubMed  Article  Google Scholar 

  25. Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5), 1045–1062.

    PubMed  Article  Google Scholar 

  26. Garland, E. L. (2007). The meaning of mindfulness: A second-order cybernetics of stress, metacognition, and coping. Complementary Health Practice Review, 12(1), 15–30.

    Article  Google Scholar 

  27. Garland, E. L., Gaylord, S., & Park, J. (2009). The role of mindfulness in positive reappraisal. Explore (NY), 5(1), 37–44.

    Article  Google Scholar 

  28. Garland, E. L., Fredrickson, B. L., Kring, A. M., Johnson, D. P., Meyer, P. S., & Penn, D. L. (2010). Upward spirals of positive emotions counter downward spirals of negativity: Insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clinical Psychology Review, 30, 849–864.

    Article  Google Scholar 

  29. Garnefski, N., & Kraaij,V. (2007). The Cognitive Emotion Regulation Questionnaire: Psychometric features and prospective relationships with depression and anxiety in adults. European journal of Psychological Assessment, 23, 141–149.

    Google Scholar 

  30. Garnefski, N., Kraaij, V. ∓ Spinhoven, Ph. (2001). Negative life events, cognitive emotion regulation and depression. Personality and Individual Differences, 30, 1311–1327

  31. Greeson, J.M. (2008). Mindfulness Research Update: 2008. Complementary health practice review 2009;14:10–8.

  32. Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106(1), 95–103.

    PubMed  Article  Google Scholar 

  33. Gross, J. J., & Thompson, R. A. (Eds.). (2007). Emotion regulation: Conceptual foundations. New York: Guilford Press.

    Google Scholar 

  34. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43.

    PubMed  Article  Google Scholar 

  35. Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74(5), 797–816.

    PubMed  Article  Google Scholar 

  36. Holahan, C. J., Moos, R. H., Holahan, C. K., Brennan, P. L.,   Schutte, K. K. (2005). Stress generation, avoidance coping, and depressive symptoms: A 10-year model. Journal of Consulting and Clinical Psychology, 73, 658–666.

    Google Scholar 

  37. Holzel, B. K., Ott, U., Hempel, H., Hackl, A., Wolf, K., Stark, R., et al. (2007). Differential engagement of anterior cingulate and adjacent medial frontal cortex in adept meditators and non-meditators. Neuroscience Letters, 421(1), 16–21.

    PubMed  Article  Google Scholar 

  38. Hu, L. T., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3, 424–453.

    Article  Google Scholar 

  39. Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33(1), 11–21.

    PubMed  Article  Google Scholar 

  40. Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical consideratoins and preliminary results. General Hospital Psychiatry, 4, 33–47.

    PubMed  Article  Google Scholar 

  41. Kalisch, R. (2009). The functional neuroanatomy of reappraisal: Time matters. Neuroscience and Biobehavioral Reviews, 33(8), 1215–1226.

    PubMed  Article  Google Scholar 

  42. Kok, B. E., & Fredrickson, B. L. (2011). Upward spirals of the heart: Autonomic flexibility; as indexed by Vagal tone; reciprocally and prospectively predicts positive emotions and social connectedness. Biological Psychology.

  43. LeDoux, J. (2002). Synaptic self. New York: Viking Press.

  44. Lindsley, D. H., Brass, D. J., & Thomas, J. B. (1995). Efficacy-performance spirals: A multilevel perspective. Academy of Management Review, 20, 645–678.

    Article  Google Scholar 

  45. Little, R. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(4), 1198–1202.

    Article  Google Scholar 

  46. Little, R. J., & Rubin, D. B. (2002). Statistical analysis with missing data (2nd ed.). Hoboken: Wiley.

    Google Scholar 

  47. Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Sciences, 12(4), 163–169.

    PubMed  Article  Google Scholar 

  48. McGregor, B. A., Antoni, M. H., Boyers, A., Alferi, S. M., Blomberg, B. B., & Carver, C. S. (2004). Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer. Journal of Psychosomatic Research, 56(1), 1–8.

    PubMed  Article  Google Scholar 

  49. Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109(3), 504–511.

    PubMed  Article  Google Scholar 

  50. Pessoa, L. (2008). On the relationship between emotion and cognition. Nature Reviews. Neuroscience, 9(2), 148–158.

    PubMed  Article  Google Scholar 

  51. Salanova, M., & Llorens, S. (2011). “Yes, I Can, I Feel Good, and I Just Do It!” On gain cycles and spirals of efficacy beliefs, affect, and engagement. Applied Psychology: An International Review.

  52. Salanova, M., Schaufeli, W. B., Xanthopoulou, D., & Bakker, A. B. (eds). (2011). The gain spiral of resources and work engagement: Sustaining a postivie worklifeericksoner.

  53. Sheldon, K. M., & Houser-Marko, L. (2001). Self-concordance, goal attainment, and the pursuit of happiness: Can there be an upward spiral? Journal of Personality and Social Psychology, 80(1), 152–165.

    PubMed  Article  Google Scholar 

  54. Sheppes, G., & Meiran, N. (2007). Better late than never? On the dynamics of online regulation of sadness using distraction and cognitive reappraisal. Personality and Social Psychology Bulletin, 33(11), 1518–1532.

    PubMed  Article  Google Scholar 

  55. Spreitzer, G., Sutcliffe, K., Dutton, J., Sonenshein, S., & Grant, A. M. (2005). A socially embedded model of thriving at work. Organization Science, 16(5), 537–549.

    Article  Google Scholar 

  56. Taylor, S.E., & Stanton, A. (2007). Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology, 3, 129–153.

    Google Scholar 

  57. Trungpa, C. (1985). Shambhala: The sacred path of the warrior. Boston: Shambhala Publications.

    Google Scholar 

  58. Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86(2), 320–333.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

Eric L. Garland was supported by Grant Number T32AT003378 from the National Center for Complementary and Alternative Medicine and a Francisco J. Varela Research Grant from the Mind and Life Institute, Boulder, CO.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Eric L. Garland.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Garland, E.L., Gaylord, S.A. & Fredrickson, B.L. Positive Reappraisal Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral Process. Mindfulness 2, 59–67 (2011). https://doi.org/10.1007/s12671-011-0043-8

Download citation

Keywords

  • Mindfulness
  • Reappraisal
  • Stress
  • Catastrophizing
  • Positive emotion
  • Upward spiral