Mindfulness

, Volume 5, Issue 5, pp 574–588 | Cite as

How Does Mindfulness Reduce Anxiety, Depression, and Stress? An Exploratory Examination of Change Processes in Wait-List Controlled Mindfulness Meditation Training

  • Nicholas T. Van Dam
  • Andréa L. Hobkirk
  • Sean C. Sheppard
  • Rebecca Aviles-Andrews
  • Mitch Earleywine
ORIGINAL PAPER

Abstract

The evidence base supporting mindfulness meditation training (MMT) as a potential intervention for anxiety, depression, and stress has grown dramatically in the last few decades. As MMT has grown in popularity, considerable variation has arisen in the way that mindfulness is conceptualized and in the trainings and interventions that have been included under this umbrella term. Increasing popularity has also raised concerns about how MMTs seem to have their effects. While previous studies have examined a wide variety of potential mechanisms, few studies have simultaneously examined these processes, potentially limiting conclusions about how MMTs might best be characterized as having their effects. The present study aimed to compare aspects of mindfulness, self-compassion, and emotion regulation, ascertaining which was most predictive of changes in anxiety, depression, and stress among 58 participants, randomly assigned on a 2:1 basis to MMT training or wait-list in a pre-/post-assessment design. The results indicated that the facets of overidentification and self-judgment (components of self-compassion) were most robustly predictive of changes in outcome variables, though mindfulness and emotion regulation also contributed. The findings suggest that mindfulness, as a process, may be more complicated than some have given credit and that attention and emotional balance may be particularly important aspects related to its effects.

Keywords

Mindfulness Meditation Anxiety Depression Stress Self-compassion 

References

  1. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. doi:10.1016/j.cpr.2009.11.004.PubMedCrossRefGoogle Scholar
  2. American Psychiatric Association, A. (2000). Diagnostic and statistical manual of mental disorders : DSM-IV-TR. Washington: American Psychiatric Association.Google Scholar
  3. Analāyo, B. (2003). Satipaṭṭ hāna: The direct path to realization. Cambridge: Windhorse.Google Scholar
  4. Analāyo, B. (2013). Satipaṭṭ hāna in comparative perspective. Birmingham: Windhorse.Google Scholar
  5. Arch, J. J., Ayers, C. R., Baker, A., Almklov, E., Dean, D. J., & Craske, M. G. (2013). Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders. Behavioural Research and Therapy, 51, 185–196. doi:10.1016/j.brat.2013.01.003.CrossRefGoogle Scholar
  6. 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(1), 27–45. doi:10.1177/1073191105283504.PubMedCrossRefGoogle Scholar
  7. Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. doi:10.1177/1073191107313003.PubMedCrossRefGoogle Scholar
  8. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.Google Scholar
  9. Berking, M., Wupperman, P., Reichardt, A., Pejic, T., Dippel, A., & Znoj, H. (2008). Emotion-regulation skills as a treatment target in psychotherapy. Behaviour Research and Therapy, 46(11), 1230–1237. doi:10.1016/j.brat.2008.08.005.PubMedCrossRefGoogle Scholar
  10. Bodhi, B. (2011). What does mindfulness really mean? A canonical perspective. Contemporary Buddhism, 12(1), 19–39.CrossRefGoogle Scholar
  11. Boswell, J. F., Castonguay, L. G., & Wasserman, R. H. (2010). Effects of psychotherapy training and intervention use on session outcome. Journal of Consulting and Clinical Psychology, 78(5), 717–723. doi:10.1037/a0020088.PubMedCrossRefGoogle Scholar
  12. Bränsträm, R., Kvillemo, P., Brandberg, Y., & Moskowitz, J. T. (2010). Self-report mindfulness as a mediator of psychological well-being in a stress reduction intervention for cancer patients—A randomized study. Annals of Behavioral Medicine, 39(2), 151–161.CrossRefGoogle Scholar
  13. Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: Results from a randomized controlled trial. Behavior Therapy, 43(2), 365–380. doi:10.1016/j.beth.2011.08.006.PubMedCrossRefPubMedCentralGoogle Scholar
  14. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personlity and Social Psychology, 84(4), 822–848.CrossRefGoogle Scholar
  15. Carmody, J., Baer, R. A., Lykins, L. B. E., & Olendzki, N. (2009). An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program. Journal of Clinical Psychology, 65(6), 613–626. doi:10.1002/jclp.20579.PubMedCrossRefGoogle Scholar
  16. Chiesa, A., & Malinowski, P. (2011). Mindfulness-based approaches: Are they all the same? Journal of Clinical Psychology, 67(4), 404–424. doi:10.1002/jclp.20776.PubMedCrossRefGoogle Scholar
  17. Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40(08), 1239–1252. doi:10.1017/S0033291709991747.PubMedCrossRefGoogle Scholar
  18. Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research, 187(3), 441–453. doi:10.1016/j.psychres.2010.08.011.PubMedCrossRefGoogle Scholar
  19. Christopher, M. S., Charoensuk, S., Gilbert, B. D., Neary, T. J., & Pearce, K. L. (2009). Mindfulness in Thailand and the United States: A case of apples versus oranges? Journal of Clinical Psychology, 65(6), 590–612. doi:10.1002/jclp.20580.PubMedCrossRefGoogle Scholar
  20. Coffey, K., Hartman, M., & Fredrickson, B. (2010). Deconstructing mindfulness and constructing mental health: understanding mindfulness and its mechanisms of action. Mindfulness, 1(4), 235–253. doi:10.1007/s12671-010-0033-2.CrossRefGoogle Scholar
  21. Cohen, J. D., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Lawrence Erlbaum.Google Scholar
  22. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 386–396.CrossRefGoogle Scholar
  23. Cohen, S., & Williamson, G. M. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health. Newbury Park: Sage.Google Scholar
  24. Crane, R., Kuyken, W., Williams, J. M., Hastings, R., Cooper, L., & Fennell, M. V. (2012). Competence in teaching mindfulness-based courses: concepts, development and assessment. Mindfulness, 3(1), 76–84. doi:10.1007/s12671-011-0073-2.PubMedCrossRefPubMedCentralGoogle Scholar
  25. David, D., & Szentagotai, A. (2006). Cognitions in cognitive–behavioral psychotherapies; toward an integrative model. Clinical Psychology Review, 26(3), 284–298. doi:10.1016/j.cpr.2005.09.003.PubMedCrossRefGoogle Scholar
  26. Eaton, W. W., Muntaner, C., Smith, C., Tien, A., & Ybarra, M. (2004). Center for Epidemiologic Studies Depression Scale: review and revision (CESD and CESD-R). In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (3rd ed., Vol. 3, pp. 363–377). Mahwah: Lawrence Erlbaum.Google Scholar
  27. Efron, B., & Tibshirani, R. J. (1993). An introduction to the boostrap. New York: Chapman & Hall.CrossRefGoogle Scholar
  28. Ellis, A. (1958). Rational psychotherapy. The Journal of General Psychology, 59(1), 35–49. doi:10.1080/00221309.1958.9710170.PubMedCrossRefGoogle Scholar
  29. Farb, N. A. S., Segal, Z. V., & Anderson, A. K. (2012). Mindfulness meditation training alters cortical representations of interoceptive attention. Social Cognitive and Affective Neuroscience. doi:10.1093/scan/nss066.PubMedPubMedCentralGoogle Scholar
  30. Fliege, H., Rose, M., Arck, P., Walter, O. B., Kocalevent, R.-D., Weber, C., et al. (2005). The Perceived Stress Questionnaire (PSQ) reconsidered: Validation and reference values from different clinical and healthy adult samples. Psychosomatic Medicine, 67(1), 78–88. doi:10.1097/01.psy.0000151491.80178.78.PubMedCrossRefGoogle Scholar
  31. Gilbert, P. (2009). The compassionate mind: A new approach to life’s challenges. Oakland: New Harbinger.Google Scholar
  32. Gratz, K., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. doi:10.1023/b:joba.0000007455.08539.94.CrossRefGoogle Scholar
  33. Greeson, J. M., Webber, D. M., Smoski, M. J., Brantley, J. G., Ekblad, A. G., Suarez, E. C., et al. (2011). Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction. Journal of Behavioral Medicine, 34(6), 508–518.PubMedCrossRefPubMedCentralGoogle Scholar
  34. Gros, D. F., Antony, M. M., Simms, L. J., & McCabe, R. E. (2007). Psychometric properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): comparison to the State-Trait Anxiety Inventory (STAI). Psychological Assessment, 19(4), 369–381. doi:10.1037/1040-3590.19.4.369.PubMedCrossRefGoogle Scholar
  35. Gros, D. F., Simms, L. J., & Antony, M. M. (2010). Psychometric properties of the state-trait inventory for cognitive and somatic anxiety (STICSA) in friendship dyads. [validation studies]. Behavior Therapy, 41(3), 277–284. doi:10.1016/j.beth.2009.07.001.PubMedCrossRefGoogle Scholar
  36. Grossman, P. (2010). Mindfulness for psychologists: Paying kind attention to the perceptible. Mindfulness, 1(2), 87–97. doi:10.1007/s12671-010-0012-7.CrossRefGoogle Scholar
  37. 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. doi:10.1016/S0022-3999(03)00573-7.PubMedCrossRefGoogle Scholar
  38. Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper, U. (2007). Mindfulness training as an intervention for fibromyalgia: Evidence of postintervention and 3-year follow-up benefits in well-being. Psychotherapy and Psychosomatics, 76(4), 226–233. doi:10.1159/000101501.PubMedCrossRefGoogle Scholar
  39. Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408–420.CrossRefGoogle Scholar
  40. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2003). Acceptance and commitment therapy: An experiental approach to behavior change. New York: Guilford.Google Scholar
  41. Heeren, A., Van Broeck, N., & Philippot, P. (2009). The effects of mindfulness on executive processes and autobiographical memory specificity. Behaviour Research and Therapy, 47(5), 403–409. doi:10.1016/j.brat.2009.01.017.PubMedCrossRefGoogle Scholar
  42. Höfling, V., Moosbrugger, H., Schermelleh-Engel, K., & Heidenreich, T. (2011). Mindfulness or mindlessness? A modified version of the Mindful Attention and Awareness Scale (MAAS). European Journal of Psychological Assessment, 27(1), 59–64. doi:10.1027/1015-5759/a000045.CrossRefGoogle Scholar
  43. Hofmann, S. G., & Asmundson, G. J. (2008). Acceptance and mindfulness-based therapy: New wave or old hat? Clinical Psychology Review, 28(1), 1–16. doi:10.1016/j.cpr.2007.09.003.PubMedCrossRefGoogle Scholar
  44. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183. doi:10.1037/a0018555.PubMedCrossRefPubMedCentralGoogle Scholar
  45. Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559. doi:10.1177/1745691611419671.CrossRefGoogle Scholar
  46. 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. doi:10.1207/s15324796abm3301_2.PubMedCrossRefGoogle Scholar
  47. Jazaieri, H., Goldin, P. R., Werner, K., Ziv, M., & Gross, J. J. (2012). A randomized trial of MBSR versus aerobic exercise for social anxiety disorder. Journal of Clinical Psychology. doi:10.1002/jclp.21863.PubMedPubMedCentralGoogle Scholar
  48. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Random House.Google Scholar
  49. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. doi:10.1093/clipsy.bpg016.Google Scholar
  50. Kabat-Zinn, J. (2005). Coming to our senses: Healing ourselves and the world through mindfulness. New York: Hyperion Books.Google Scholar
  51. Kabat-Zinn, J. (2011). Some reflections on the origins of MBSR, skillful means, and the trouble with maps. Contemporary Buddhism, 12(1), 281–306.CrossRefGoogle Scholar
  52. Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The ‘trier social stress test’—A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28(1–2), 76–81.PubMedCrossRefGoogle Scholar
  53. Kuyken, W., Watkins, E., Holden, E., White, K., Taylor, R. S., Byford, S., et al. (2010). How does mindfulness-based cognitive therapy work? Behaviour Research and Therapy, 48(11), 1105–1112. doi:10.1016/j.brat.2010.08.003.PubMedCrossRefGoogle Scholar
  54. Levenson, R. W., Ekman, P., & Ricard, M. (2012). Meditation and the startle response: A case study. Emotion. doi:10.1037/a0027472.Google Scholar
  55. Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Berto, E., Luzi, C., et al. (1993). Development of the Perceived Stress Questionnaire: A new tool for psychosomatic research. Journal of Psychosomatic Research, 37(1), 19–32.PubMedCrossRefGoogle Scholar
  56. Linehan, M. M. (1993). Cognitive–behavioral treatment of borderline personality disorder. New York: Guilford.Google Scholar
  57. Lord, F. M. (1963). Elementary models for measuring change. In C. W. Harris (Ed.), Problems in measuring change (pp. 21–38). Madison: University of Wisconsin Press.Google Scholar
  58. Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Science, 12(4), 163–169. doi:10.1016/j.tics.2008.01.005.CrossRefGoogle Scholar
  59. MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York: Lawrence Erlbaum Associates.Google Scholar
  60. Manicavasgar, V., Parker, G., & Perich, T. (2011). Mindfulness-based cognitive therapy vs cognitive behaviour therapy as a treatment for non-melancholic depression. Journal of Affective Disorders, 130(1–2), 138–144. doi:10.1016/j.jad.2010.09.027.PubMedCrossRefGoogle Scholar
  61. Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analysing data: A model comparison perspective (2nd ed.). Mahwah: Lawrence Erlbaum Associates.Google Scholar
  62. McCown, D., Reibel, D. K., & Micozzi, M. S. (2011). Teaching mindfulness: A practical guide for clinicians and educators. New York: Springer.Google Scholar
  63. Meichenbaum, D. (1977). Cognitive behaviour modification. Scandinavian Journal of Behaviour Therapy, 6(4), 185–192. doi:10.1080/16506073.1977.9626708.CrossRefGoogle Scholar
  64. Nanamoli, B., & Bodhi, B. (1995). The middle length discourses of the Buddha: A translation of the Majjhima Nikaya. Boston: Wisdom Publications.Google Scholar
  65. Nawrot, P., Jordan, S., Eastwood, J., Rotstein, J., Hugenholtz, A., & Feeley, M. (2003). Effects of caffeine on human health. Food Additives and Contaminants, 20(1), 1–30.PubMedCrossRefGoogle Scholar
  66. Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. doi:10.1080/15298860309027.CrossRefGoogle Scholar
  67. Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the Mindful Self-Compassion program. Journal of Clinical Psychology, 69, 28–44. doi:10.1002/jclp.21923.PubMedCrossRefGoogle Scholar
  68. Neff, K. D., Kirkpatrick, K. L., & Rude, S. S. (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality, 41(1), 139–154. doi:10.1016/j.jrp.2006.03.004.CrossRefGoogle Scholar
  69. Norcross, J. C., & Wampold, B. E. (2011). What works for whom: Tailoring psychotherapy to the person. Journal of Clinical Psychology, 67(2), 127–132. doi:10.1002/jclp.20764.PubMedCrossRefGoogle Scholar
  70. Nyklicek, I., & Kuijpers, K. F. (2008). Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: is increased mindfulness indeed the mechanism? Annals of Behavioral Medicine, 35(3), 331–340. doi:10.1007/s12160-008-9030-2.PubMedCrossRefPubMedCentralGoogle Scholar
  71. Paul, G. L. (1967). Strategy of outcome research in psychotherapy. Journal of Consulting Psychology, 31(2), 109–118.PubMedCrossRefGoogle Scholar
  72. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.PubMedCrossRefGoogle Scholar
  73. Pruessner, J. C., Hellhammer, D. H., & Kirschbaum, C. (1999). Burnout, perceived stress, and cortisol responses to awakening. Psychosomatic Medicine, 61(2), 197–204.PubMedCrossRefGoogle Scholar
  74. Radloff, L. S. (1977). The CES-D Scale. Applied Psychological Measurement, 1(3), 385–401. doi:10.1177/014662167700100306.CrossRefGoogle Scholar
  75. Ree, M. J., French, D., MacLeod, C., & Locke, V. (2008). Distinguishing cognitive and somatic dimensions of state and trait anxiety: Development and validation of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). Behavioural and Cognitive Psychotherapy, 36(03), 313–332. doi:10.1017/S1352465808004232.CrossRefGoogle Scholar
  76. Roemer, L., Lee, J. K., Salters-Pedneault, K., Erisman, S. M., Orsillo, S. M., & Mennin, D. S. (2009). Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary Evidence for independent and overlapping contributions. Behavior Therapy, 40(2), 142–154. doi:10.1016/j.beth.2008.04.001.PubMedCrossRefPubMedCentralGoogle Scholar
  77. Schmidt, S., Grossman, P., Schwarzer, B., Jena, S., Naumann, J., & Walach, H. (2011). Treating fibromyalgia with mindfulness-based stress reduction: Results from a 3-armed randomized controlled trial. Pain, 152(2), 361–369. doi:10.1016/j.pain.2010.10.043.PubMedCrossRefGoogle Scholar
  78. Sears, S., & Kraus, S. (2009). I think therefore I om: Cognitive distortions and coping style as mediators for the effects of mindfulness meditation on anxiety, positive and negative affect, and hope. Journal of Clinical Psychology, 65(6), 561–573. doi:10.1002/jclp.20543.PubMedCrossRefGoogle Scholar
  79. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.Google Scholar
  80. Shahar, B., Britton, W. B., Sbarra, D. A., Figueredo, A. J., & Bootzin, R. R. (2010). Mechanisms of change in mindfulness-based cognitive therapy for depression: Preliminary evidence from a randomized controlled trial. International Journal of Cognitive Therapy, 3(4), 402–418. doi:10.1521/ijct.2010.3.4.402.CrossRefGoogle Scholar
  81. Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: Results from a randomized trial. International Journal of Stress Management, 12(2), 164–176. doi:10.1037/1072-5245.12.2.164.CrossRefGoogle Scholar
  82. Slagter, H. A., Lutz, A., Greischar, L. L., Francis, A. D., Nieuwenhuis, S., Davis, J. M., et al. (2007). Mental training affects distribution of limited brain resources. PLoS Biology, 5(6), e138.PubMedCrossRefPubMedCentralGoogle Scholar
  83. Tucker, L. R., Damarin, F., & Messick, S. (1966). A base-free measure of change. Psychometrika, 31(4), 457–473.PubMedCrossRefGoogle Scholar
  84. van Aalderen, J. R., Donders, A. R. T., Giommi, F., Spinhoven, P., Barendregt, H. P., & Speckens, A. E. M. (2012). The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: a randomized controlled trial. Psychological Medicine, 42(05), 989–1001. doi:10.1017/S0033291711002054.PubMedCrossRefGoogle Scholar
  85. Van Dam, N. T., & Earleywine, M. (2011). Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186(1), 128–132. doi:10.1016/j.psychres.2010.08.018.PubMedCrossRefGoogle Scholar
  86. Van Dam, N. T., Earleywine, M., & Borders, A. (2010). Measuring mindfulness? An item response theory analysis of the Mindful Attention Awareness Scale. Personality and Individual Differences, 49(7), 805–810. doi:10.1016/j.paid.2010.07.020.CrossRefGoogle Scholar
  87. Van Dam, N. T., Earleywine, M., & Danoff-Burg, S. (2009). Differential item function across meditators and non-meditators on the Five Facet Mindfulness Questionnaire. Personality and Individual Differences, 47(5), 516–521. doi:10.1016/j.paid.2009.05.005.CrossRefGoogle Scholar
  88. Van Dam, N. T., Gros, D. F., Earleywine, M., & Antony, M. M. (2013). Establishing a trait anxiety threshold that signals likelihood of anxiety disorders. Anxiety, Stress, Coping, 26(1), 70–86. doi:10.1080/10615806.2011.631525.PubMedCrossRefGoogle Scholar
  89. Van Dam, N. T., Hobkirk, A. L., Danoff-Burg, S., & Earleywine, M. (2012). Mind your words: Positive and negative items create method effects on the Five Facet Mindfulness Questionnaire. Assessment, 19(2), 198–204. doi:10.1177/1073191112438743.PubMedCrossRefGoogle Scholar
  90. Van Dam, N. T., Sheppard, S. C., Forsyth, J. P., & Earleywine, M. (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders, 25(1), 123–130. doi:10.1016/j.janxdis.2010.08.011.PubMedCrossRefGoogle Scholar
  91. Vollestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4), 281–288. doi:10.1016/j.brat.2011.01.007.PubMedCrossRefGoogle Scholar
  92. Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, S. H. (2013). Mindfulness-based relapse prevention for substance craving. Addictive Behaviors, 38, 1563–1571.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Nicholas T. Van Dam
    • 1
  • Andréa L. Hobkirk
    • 1
  • Sean C. Sheppard
    • 2
  • Rebecca Aviles-Andrews
    • 1
  • Mitch Earleywine
    • 1
  1. 1.Department of PsychologyUniversity at Albany, SUNYAlbanyUSA
  2. 2.National Center for Veterans StudiesUniversity of UtahSalt Lake CityUSA

Personalised recommendations