Stress appraisal and emotion regulation mediate the association between mindfulness and affect in cancer patients: Differential mechanisms for positive and negative affect
Open accessAbstract
Objective: Cancer patients are at an increased risk for affective problems, including feelings of anxiety and depression. Mindfulness has been linked to an array of benefits for affective functioning in various populations including cancer patients, but the mechanisms underlying this relationship are still poorly understood. Based on emotion‐regulation and stress‐coping models, this study examined the potential mediating role of stress appraisal and coping strategies in the associations between mindfulness and cancer patients' positive and negative affect. Methods: For this cross‐sectional study, 245 cancer patients completed self‐report questionnaires measuring mindfulness (FFMQ), positive and negative affect (PANAS), stress appraisal (SPSI‐R:S), coping through positive reappraisal and positive refocusing (CERQ), rumination (RRQ), and distraction (COPE). Serial mediation analyses were conducted using the regression‐based bootstrapping method. Results: Higher levels of mindfulness were associated with higher levels of positive affect; this relationship was mediated via stress appraisal and positive reappraisal. We also found an indirect effect from mindfulness directly via positive reappraisal to positive affect. In addition, higher levels of mindfulness were negatively associated with negative affect; this relationship was mediated via stress appraisal and rumination, with also an indirect effect from mindfulness directly via stress appraisal to negative affect. Conclusions: Results suggest that stress appraisal and distinct coping strategies mediate the relationship between mindfulness and affect. Mindfulness may provide benefits for cancer patients' affect by allowing adaptive stress appraisal and ways of coping through more positive and less negative thinking.
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Cross-sectional results show rumination mediates the relationship between mindfulness and negative affect.
“cross-sectional results showing rumination mediates the relationship between mindfulness and negative affect. 54”
From Mindfulness and Psychosocial Symptoms in People with Cancer: Testing Rumination and Experiential Avoidance as Mediators, and Sex as a Moderator. (2025) · cites this paper as [54]
The Model 2 discussion reports a cross-sectional association between mindfulness and negative affect mediated through stress appraisal followed by rumination. The results passage reports a significant indirect effect along that serial path, but no significant indirect effect through rumination alone. The claim omits the necessary stress-appraisal step. (LLM, conf=0.87)
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- Authors
- Tungtong, P., Ranchor, A. V., & Schroevers, M. J.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Tungtong, Puttichai
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2023-08-16
- Volume
- 32
- Issue
- 10
- Pages
- 1548-1556
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W4385897715
- Cited by
- 11
- References
- 40
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 1
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psycho-Oncology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- mindfulness, cancer patients, stress appraisal, emotion regulation, positive affect, negative affect, positive reappraisal, rumination, distraction, coping strategies, anxiety, depression
- MeSH terms
- Rumination, Cognitive, Emotional Regulation, Adaptation, Psychological, Adult, Affect, Aged, Anxiety, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Neoplasms, Surveys and Questionnaires, Stress, Psychological, Mindfulness
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