Change in Decentering Mediates Improvement in Anxiety in Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder
Open accessAbstract
We sought to examine psychological mechanisms of treatment outcomes of a mindfulness meditation intervention for generalized anxiety disorder (GAD). We examined mindfulness and decentering as two potential therapeutic mechanisms of action of GAD symptom reduction in patients randomized to receive either mindfulness-based stress reduction (MBSR) or an attention control class (N = 38). Multiple mediation analyses were conducted using a non-parametric cross product of the coefficients approach that employs bootstrapping. Analyses revealed that change in decentering and change in mindfulness significantly mediated the effect of MBSR on anxiety. When both mediators were included in the model, the multiple mediation analysis revealed a significant indirect effect through increases in decentering, but not mindfulness. Furthermore, the direct effect of MBSR on decrease in anxiety was not significant, suggesting that decentering fully mediated the relationship. Results also suggested that MBSR reduces worry through an increase in mindfulness, specifically by increases in awareness and nonreactivity. Improvements in GAD symptoms resulting from MBSR are in part explained by increased levels of decentering. © 2014, Springer Science+Business Media New York.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
9 of 31 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured
- Premisecitation
The previously published RCT found MBSR efficacious in reducing self-reported anxiety symptoms.
“Results from our previously published RCT revealed that MBSR was efficacious in reducing self-reported anxiety symptoms (Hoge et al., 2013).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Hoge et al., 2013 source
- Findingown data
BAI change effect size in this subsample was similar to the parent RCT.
“Effect sizes for change in BAI and PSWQ were similar to those found in the parent RCT (BAI: d = 0.71 vs. d = 0.74 in parent; PSWQ: d = 0.79 vs. 0.63 in parent) for MBSR.”
Quote in the paperNot a substantial claim - Findingown data
With both mediators in the model, the indirect effect through mindfulness was no longer significant.
“When both mediators were examined simultaneously, results from our multiple mediator mediation analysis revealed that the indirect effect through increases in decentering remained significant; however, the indirect effect through change in mindfulness was no longer significant suggesting that decentering may be a unique independent mediator of the effect of MBSR (see Table 2 and Figure 1).”
Quote in the paperSubstantial claim - Findingown data
PSWQ change effect size in this subsample was similar to the parent RCT.
“Effect sizes for change in BAI and PSWQ were similar to those found in the parent RCT (BAI: d = 0.71 vs. d = 0.74 in parent; PSWQ: d = 0.79 vs. 0.63 in parent) for MBSR.”
Quote in the paperNot a substantial claim - Findingown data
Change in GAD symptom severity was strongly inversely associated with change in decentering.
“Preliminary correlation analyses found that change in GAD symptom severity was strongly and inversely associated with change in mindfulness (r = −0.54, p<0.001) and change in decentering (r = −0.53, p<0.001).”
Quote in the paperSubstantial claim
- Findingown data
Non-reactivity to inner experience significantly mediated MBSR's effect on PSWQ reductions.
“only non-reactivity to inner experience (B = .96, SE = .66; BCa 95% CI = .066; 2.92) and acting with awareness were significant mediators (B = .76, SE = .59; BCa 95% CI = .01; 2.59), while observing (B = .41, SE = .60; BCa 95% CI = −.54; 1.97), describing (B = .38, SE = .53; BCa 95% CI = −.32; 1.92), and non-judging of inner experience (B = .03., SE = .28; BCa 95% CI = −.33; .83) were not.”
Quote in the paperSubstantial claim - Findingown data
There was a significant indirect effect of MBSR on PSWQ reductions through change in mindfulness.
“Separated bootstrapping analyses of the individual mediators indicated that there was a significant indirect effect of MBSR on reductions in PSWQ score through change in mindfulness (See Table 2).”
Quote in the paperSubstantial claim - Findingown data
There was a significant indirect effect of MBSR on BAI reductions through change in decentering.
“Separated bootstrapping analyses of the individual mediators indicated that there was a significant indirect effect of MBSR on reductions in BAI score through change in decentering and change in mindfulness (See Table 2).”
Quote in the paperSubstantial claim - Findingown data
Between-group difference on BAI change was significant.
“Between group differences on BAI change (t= −1.83, p=0.038) were significant, however, this was not the case for change in PSWQ (t=−0.64, p=0.26).”
Quote in the paperSubstantial claim - Findingown data
There was only a small relative greater treatment effect of MBSR compared to SME.
“Second, there was only a small relative greater treatment effect of our active arm, MBSR, compared to the attention control treatment, SME.”
Quote in the paperNot a substantial claim - Findingown data
Non-judging of inner experience did not significantly mediate MBSR's effect on PSWQ reductions.
“only non-reactivity to inner experience (B = .96, SE = .66; BCa 95% CI = .066; 2.92) and acting with awareness were significant mediators (B = .76, SE = .59; BCa 95% CI = .01; 2.59), while observing (B = .41, SE = .60; BCa 95% CI = −.54; 1.97), describing (B = .38, SE = .53; BCa 95% CI = −.32; 1.92), and non-judging of inner experience (B = .03., SE = .28; BCa 95% CI = −.33; .83) were not.”
Quote in the paperNot a substantial claim - Findingown data
Change in GAD symptom severity was strongly inversely associated with change in mindfulness.
“Preliminary correlation analyses found that change in GAD symptom severity was strongly and inversely associated with change in mindfulness (r = −0.54, p<0.001) and change in decentering (r = −0.53, p<0.001).”
Quote in the paperSubstantial claim - Findingown data
Acting with awareness significantly mediated MBSR's effect on PSWQ reductions.
“only non-reactivity to inner experience (B = .96, SE = .66; BCa 95% CI = .066; 2.92) and acting with awareness were significant mediators (B = .76, SE = .59; BCa 95% CI = .01; 2.59), while observing (B = .41, SE = .60; BCa 95% CI = −.54; 1.97), describing (B = .38, SE = .53; BCa 95% CI = −.32; 1.92), and non-judging of inner experience (B = .03., SE = .28; BCa 95% CI = −.33; .83) were not.”
Quote in the paperSubstantial claim - Findingown data
Observing did not significantly mediate MBSR's effect on PSWQ reductions.
“only non-reactivity to inner experience (B = .96, SE = .66; BCa 95% CI = .066; 2.92) and acting with awareness were significant mediators (B = .76, SE = .59; BCa 95% CI = .01; 2.59), while observing (B = .41, SE = .60; BCa 95% CI = −.54; 1.97), describing (B = .38, SE = .53; BCa 95% CI = −.32; 1.92), and non-judging of inner experience (B = .03., SE = .28; BCa 95% CI = −.33; .83) were not.”
Quote in the paperNot a substantial claim - Findingown data
Describing did not significantly mediate MBSR's effect on PSWQ reductions.
“only non-reactivity to inner experience (B = .96, SE = .66; BCa 95% CI = .066; 2.92) and acting with awareness were significant mediators (B = .76, SE = .59; BCa 95% CI = .01; 2.59), while observing (B = .41, SE = .60; BCa 95% CI = −.54; 1.97), describing (B = .38, SE = .53; BCa 95% CI = −.32; 1.92), and non-judging of inner experience (B = .03., SE = .28; BCa 95% CI = −.33; .83) were not.”
Quote in the paperNot a substantial claim - Findingown data
The MBSR group showed significantly greater change in decentering than SME.
“Individuals in the MBSR group exhibited a significantly greater change in decentering levels (t(36) = 4.13, p<0.001) and greater change in mindfulness levels (t(36)= 1.81, p=0.079) than individuals in the SME group (see Table 1).”
Quote in the paperSubstantial claim - Findingown data
With both mediators in the model, the indirect effect through decentering remained significant.
“When both mediators were examined simultaneously, results from our multiple mediator mediation analysis revealed that the indirect effect through increases in decentering remained significant; however, the indirect effect through change in mindfulness was no longer significant suggesting that decentering may be a unique independent mediator of the effect of MBSR (see Table 2 and Figure 1).”
Quote in the paperSubstantial claim - Findingown data
Between-group difference on PSWQ change was not significant.
“Between group differences on BAI change (t= −1.83, p=0.038) were significant, however, this was not the case for change in PSWQ (t=−0.64, p=0.26).”
Quote in the paperNot a substantial claim - Interpretationreasoning
MBSR was proposed for GAD because it focuses on the present moment rather than the past-oriented ruminations and future-oriented worries typical of GAD.
“MBSR was proposed as a treatment for GAD because of the intervention’s focus on the present moment, rather than the past-oriented ruminations and future-oriented worries that tend to be the attentional focus of individuals with GAD.”
Quote in the paperSubstantial claim - Premisecitation
Individuals with GAD have lower mindfulness than healthy controls.
“Furthermore, individuals with GAD have lower levels of mindfulness compared to healthy controls (Roemer et al., 2009).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Roemer et al., 2009 source
- Interpretationreasoning
Increasing mindfulness may help reduce GAD anxiety symptoms.
“Thus, increasing mindfulness may help decrease GAD anxiety symptoms.”
Quote in the paperSubstantial claim - Interpretationreasoning
Decentering and mindfulness differentially influence GAD symptoms.
“Finally, decentering and mindfulness appear to differentially influence symptoms of GAD. Specifically, decentering appears to be a process by which MBSR reduces anxiety, especially physiological anxiety (which is the primary construct measured by BAI), while mindfulness (awareness and nonreactivity) appears to be a key process by which MBSR reduces worry.”
Quote in the paperSubstantial claim - Interpretationown data
Mindfulness and decentering are distinct constructs.
“First, these results provide evidence that mindfulness and decentering are indeed distinct constructs.”
Quote in the paperSubstantial claim - Interpretationown data
Mindfulness (awareness and nonreactivity) appears to be a key process by which MBSR reduces worry.
“Finally, decentering and mindfulness appear to differentially influence symptoms of GAD. Specifically, decentering appears to be a process by which MBSR reduces anxiety, especially physiological anxiety (which is the primary construct measured by BAI), while mindfulness (awareness and nonreactivity) appears to be a key process by which MBSR reduces worry.”
Quote in the paperSubstantial claim - Interpretationown data
MBSR reduces worry (PSWQ) through increases in mindfulness, specifically awareness and nonreactivity.
“In particular, results from our study suggest that MBSR promotes reductions in anxiety (i.e., BAI score) through increases in decentering, but reduces worry (i.e., PSWQ score) through increases in mindfulness, specifically via increases in awareness and nonreactivity.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The pre-post assessment design precludes establishing that change in decentering and mindfulness preceded change in anxiety.
“A third limitation is that the nature of the assessments (pre- and post-treatment only) precludes us from establishing that change in decentering and mindfulness preceded change in anxiety.”
Quote in the paperSubstantial claim - Interpretationown data
Decentering appears to be a process by which MBSR reduces anxiety, especially physiological anxiety as measured by BAI.
“Finally, decentering and mindfulness appear to differentially influence symptoms of GAD. Specifically, decentering appears to be a process by which MBSR reduces anxiety, especially physiological anxiety (which is the primary construct measured by BAI), while mindfulness (awareness and nonreactivity) appears to be a key process by which MBSR reduces worry.”
Quote in the paperSubstantial claim - Interpretationreasoning
The small relative treatment effect was largely due to non-specific effects of treatment in the attention control.
“We believe that this was largely due to non-specific effects of treatment in the attention control (expectation bias, attention, group support).”
Quote in the paperSubstantial claim - Interpretationcitation
Decentering in response to anxiety may make one less prone to detrimental consequences of focusing on anxiety symptoms, which can exacerbate negative affect.
“Decentering in response to anxiety may make one less prone to the detrimental consequences that can result from focusing attention on anxiety symptoms, which has been known to exacerbate negative affect (Mor & Winquist, 2002).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Mor & Winquist, 2002 source
- Interpretationown data
Decentering may be a unique independent mediator of MBSR's effect.
“When both mediators were examined simultaneously, results from our multiple mediator mediation analysis revealed that the indirect effect through increases in decentering remained significant; however, the indirect effect through change in mindfulness was no longer significant suggesting that decentering may be a unique independent mediator of the effect of MBSR (see Table 2 and Figure 1).”
Quote in the paperSubstantial claim - Study design and conductown data
There were no significant baseline differences between MBSR and SME on any variables.
“Although the baseline BAI scores were higher in the MBSR group compared to SME (d=0.49), there were no significant differences between individuals randomized to MBSR compared to those assigned to SME on any of the variables at baseline.”
Quote in the paperNot a substantial claim - Interpretationown data
MBSR reduces anxiety (BAI) through increases in decentering.
“In particular, results from our study suggest that MBSR promotes reductions in anxiety (i.e., BAI score) through increases in decentering, but reduces worry (i.e., PSWQ score) through increases in mindfulness, specifically via increases in awareness and nonreactivity.”
Quote in the paperSubstantial claim - Interpretationreasoning
Decentering may be a crucial process by which psychotherapies target and alleviate distressing physical sensations.
“Taken together, these findings suggest that decentering may be a crucial process by which psychotherapies target and alleviate distressing physical sensations.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 30
- May combine two claims. 14
- The quote only partly states this claim. 1
Probably not a substantial claim: may not pass S2 (checkable).
PremisecitationDecentering is a metacognitive ability to see mental events as merely psychological events.
“Decentering is a metacognitive capacity of individuals to observe items that arise in the mind (e.g., thoughts, feelings, memories, etc.) as mere psychological events (Fresco, Moore, et al., 2007; Fresco, Segal, Buis, & Kennedy, 2007; Teasdale et al., 2002).”
Quote in the paperNot a substantial claim2 of 3 sources checkedClassified as probably not a substantial claim.
PremisecitationDecentering includes recognizing thoughts, feelings, and urges as temporary internal events, not permanent parts of the self or accurate reflections of reality.
“This ability also involves recognizing that one’s thoughts, feelings, and urges are transient internal events rather than inherent, permanent aspects of the self or accurate representations of reality (Fresco, Moore, et al., 2007; Segal, Williams, & Teasdale, 2002).”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Fresco, Moore, et al., 2007 source
The paper’s introduction (p. 1) defines decentering as observing thoughts and feelings as temporary events in the mind rather than necessarily true reflections of the self. It also says thoughts and feelings do not necessarily reflect objective reality (p. 1). These passages support the central paraphrase, but our copy does not extend that definition to urges. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites Segal, Williams, & Teasdale, 2002
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn a randomized wait-list controlled trial of MBSR for adults with general psychological distress, mindfulness partially mediated improvements in quality of life and stress reductions.
“More compelling are results from a randomized, wait-list controlled study of MBSR for adults with general psychological distress in which mindfulness partially mediated improvements in quality of life and reductions in stress (Baer et al., 2012; Nyklicek & Kuijpers, 2008).”
Quote in the paperNot a substantial claim1 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPatients with major depressive disorder show lower decentering than healthy controls.
“as compared to healthy control participants, patients with major depressive disorder evidence lower levels of decentering (Fresco, Moore, et al., 2007)”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Fresco, Moore, et al., 2007 source
The Study 3 discussion (p. 10) reports lower decentering in participants with remitted MDD than in healthy controls. The claim omits the remission qualifier, so the paper does not establish the comparison for patients with current MDD generally. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAcross diverse patient groups, mindfulness-based interventions have shown benefit for stress and anxiety.
“Results from both controlled and uncontrolled studies have demonstrated the efficacy of mindfulness-based interventions for stress and anxiety in a variety of patient populations (e.g., Hofmann, Sawyer, Witt, & Oh, 2010).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Hofmann, Sawyer, Witt, & Oh, 2010 source
The Results (page unavailable) report reduced anxiety symptoms across several patient groups and significant effects in controlled studies. But the Methods specify anxiety and mood outcomes, not stress outcomes, and the Discussion cautions that most controlled effect estimates were unreliable and that randomized trials are still needed to establish efficacy. The claim therefore overstates the evidence for stress and for established efficacy across study designs. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHigher mindfulness has been linked to lower depressed mood, stress, medical symptoms, and anxiety symptoms.
“For instance, increases in mindfulness have been found to be associated with increases in well-being (Splevins, Smith, & Simpson, 2009) and decreases in depressed mood, stress, medical symptoms, and anxiety symptoms (Dobkin & Zhao, 2011; Goldin, Ziv, Jazaieri, & Gross, 2012).”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites Dobkin & Zhao, 2011 source
- cites Goldin, Ziv, Jazaieri, & Gross, 2012 source
The Introduction (page unavailable) reports that MBSR is associated with reductions in anxiety, stress, and depression symptoms. Results > Clinical responses (page unavailable) shows mindfulness scores rising and social-anxiety scores falling after MBSR. The paper does not establish a direct association between increases in mindfulness and those symptom decreases, and our copy does not report a decrease in medical symptoms. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationSimple mediation analyses accompanied the multiple mediation analysis to bypass suppression effects.
“As has been recommended (see MacKinnon, Krull, & Lockwood, 2000; Preacher & Hayes, 2008), the multiple mediation analysis was accompanied by simple mediation analyses to bypass the issues that suppression effects can obscure possible indirect effects of individual mediators.”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites MacKinnon, Krull, & Lockwood, 2000 source
- cites Preacher & Hayes, 2008 source
The Recommendations section says correlated mediators can obscure whether an individual variable mediates an effect. But the paper recommends testing specific indirect effects within a multiple-mediator model, not accompanying that model with separate simple mediation analyses; the Strategies section warns that separate simple models can produce biased estimates. (LLM, conf=0.87)
Experimental — accuracy not yet measured
May combine two claims.
Findingown dataUsing FFMQ subscales instead of the total score did not change the pattern; decentering was the sole significant mediator.
“Conducting a similar analysis using the FFMQ subscales instead of the FFMQ total score did not change the pattern of result (i.e., change in decentering was the sole significant mediator).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThere was a significant indirect effect of MBSR on BAI reductions through change in mindfulness.
“Separated bootstrapping analyses of the individual mediators indicated that there was a significant indirect effect of MBSR on reductions in BAI score through change in decentering and change in mindfulness (See Table 2).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataChange in mindfulness and change in decentering were positively correlated.
“Change in mindfulness and in decentering were also correlated (r=0.56, p<0.001).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.
Findingown dataThe MBSR group showed greater change in mindfulness than SME.
“Individuals in the MBSR group exhibited a significantly greater change in decentering levels (t(36) = 4.13, p<0.001) and greater change in mindfulness levels (t(36)= 1.81, p=0.079) than individuals in the SME group (see Table 1).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPatients with major depressive disorder show gains in decentering after CBT but not after antidepressant medication.
“demonstrate gains in decentering following treatment with cognitive behavioral therapy (CBT) but not antidepressant medication (ADM) (Fresco, Segal, et al., 2007).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Fresco, Segal, et al., 2007
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe present subsample did not differ from the full RCT sample on demographic variables.
“There were no differences between this subsample and the full RCT sample in demographic variables (all p’s >0.29, all Chi2 < 0.59, and t-values < 1.3, which are comparable to Cohen’s d <0.24).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAmong patients with anxiety disorders, increases in dispositional mindfulness accounted for reductions in anxiety and stress after a mindfulness-based intervention.
“Additionally, although they were not able to test for true mediation, researchers found that increases in dispositional mindfulness accounted for reductions in anxiety and stress following a mindfulness-based intervention among patients with anxiety disorders (Vollestad, Sivertsen, & Nielsen, 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Vollestad, Sivertsen, & Nielsen, 2011 source
Classified as probably not a substantial claim.
PremisecitationGains in decentering during acute CBT or prophylactic MBCT predict a more durable treatment response.
“Further, gains in decentering during acute treatment with CBT (Fresco, Segal, et al., 2007) or prophylactic treatment with mindfulness-based cognitive therapy (MBCT) (Bieling et al., 2012) are predictive of a more durable treatment response.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Fresco, Segal, et al., 2007
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Bieling et al., 2012 source
Classified as probably not a substantial claim. May combine two claims.
InterpretationcitationBecause worry in GAD is ruminative and thoughts are hard to separate from, increases in decentering could also contribute to symptom improvement.
“Given the ruminative nature of worry in GAD and the difficulty in separating from those thoughts (Marino, Lunt, & Negy, 2008), increases in decentering could also play a role in symptom improvement.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Marino, Lunt, & Negy, 2008 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationChanges in mindfulness came before changes in mental health outcomes, suggesting that distress reductions might result from earlier mindfulness increases.
“A second study found that changes in mindfulness preceded changes in mental health outcomes, raising the possibility that reductions in distress occurred as a result of earlier increases in mindfulness (Baer, Carmody, & Hunsinger, 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Baer, Carmody, & Hunsinger, 2012 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHigher mindfulness has been linked to greater well-being.
“For instance, increases in mindfulness have been found to be associated with increases in well-being (Splevins, Smith, & Simpson, 2009) and decreases in depressed mood, stress, medical symptoms, and anxiety symptoms (Dobkin & Zhao, 2011; Goldin, Ziv, Jazaieri, & Gross, 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Splevins, Smith, & Simpson, 2009 source
Probably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenWhile mindfulness improvements are thought to mediate symptom improvements, other mechanisms such as decentering may also mediate symptom reduction.
“Although improvements in mindfulness are thought to mediate symptom improvements, other mechanisms of action such as decentering may mediate symptom reduction.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationPromoting distance from the self in time and space has been reported to yield psychological benefits.
“Studies report psychological benefits from promoting distance from the self in time (e.g., viewing inner experiences as temporary; Watkins, Teasdale, & Williams, 2000) and distance from the self in space (e.g., viewing inner experiences as physical objects that are separate from oneself; Kalisch et al., 2005).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationMindfulness and decentering are theoretically similar, but mindfulness involves enhanced awareness with nonjudgment, while decentering is adopting a psychologically distanced stance.
“Some have noted that decentering and mindfulness are theoretically similar constructs (Carmody, Baer, E, & Olendzki, 2009); however, mindfulness involves bringing enhanced awareness coupled with an attitude of nonjudgment, whereas decentering more specifically refers to the ability to adopt a psychologically distanced stance.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Carmody, Baer, E, & Olendzki, 2009 source
Classified as probably not a substantial claim.
Study design and conductreasoningSME was designed as an active control for MBSR to control for non-specific treatment effects.
“The SME was designed as an active control intervention for MBSR to control for the non-specific effects of treatment, such as group support, attention from the instructor, and participants’ expectations.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataFFMQ internal consistency was good at baseline and follow-up.
“Internal consistency was good at baseline (Cronbach’s alpha = 0.86) and follow-up (Cronbach’s alpha = 0.92).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningThe BAI emphasizes physiological arousal rather than core GAD symptoms, so it may not capture precisely the distress associated with GAD.
“In addition, our anxiety symptom outcome measure, the BAI, has an emphasis on physiological arousal symptoms rather than a focus on the core symptoms of GAD. Therefore, it is possible that the BAI did not capture precisely the distress associated with GAD.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataMBSR reduces GAD symptoms through different mechanisms, namely mindfulness and decentering.
“Second, MBSR promotes reductions in GAD symptoms through different mechansims, namely mindfulness and decentering, suggesting that both skills are crucial components of successful GAD treatment.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationThese findings extend prior findings that decentering predicts improvements or lack of relapse in psychological symptoms after MBSR and MBCT.
“Concerning the role of decentering in mediating outcomes in MBSR, these findings extend previous findings suggesting that decentering predicts improvements (or lack of relapse) in psychological symptoms after MBSR and MBCT (Bieling et al., 2012; Carmody et al., 2009).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Study design and conductreasoningUse of an attention control yields a smaller between-group difference, but a strength is that treatment differences can be more confidently attributed to mindfulness meditation rather than non-specific effects.
“However, while the use of an attention control yields a smaller difference between groups, a strength of this design is that we can feel more confident that treatment differences are actually due to mindfulness meditation, rather than non-specific effects of treatment.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningBoth mindfulness and decentering are crucial components of successful GAD treatment.
“Second, MBSR promotes reductions in GAD symptoms through different mechansims, namely mindfulness and decentering, suggesting that both skills are crucial components of successful GAD treatment.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationBootstrapping is a nonparametric resampling method that avoids normality assumptions and is more powerful, especially with small samples.
“Bootstrapping is a nonparametric resampling method that bypasses assumptions of normality common to traditional tests of mediation and is thus more powerful, particularly with smaller samples (Preacher & Hayes, 2004, 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Preacher & Hayes, 2004, 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataBaseline BAI scores were higher in the MBSR group than in SME.
“Although the baseline BAI scores were higher in the MBSR group compared to SME (d=0.49), there were no significant differences between individuals randomized to MBSR compared to those assigned to SME on any of the variables at baseline.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenFindings are limited by small sample size.
“First, findings are limited by small sample size, so they should be interpreted with caution.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataChanges in both decentering and mindfulness may mediate MBSR's effect on GAD symptoms.
“In this sample of patients with GAD who were trained in MBSR or received an attention control, we found evidence that changes in both decentering and mindfulness may mediate the effect of MBSR on symptoms of GAD.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataDecentering subscale internal consistency was good.
“Internal consistency for the decentering subscale was good (Cronbach’s alpha = 0.83).”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationBy not reacting to worries, individuals may be less likely to try to control or suppress worry, which can paradoxically increase distress.
“For example, by not reacting to the worries, individuals may be less likely to attempt to control or suppress the worry, which can paradoxically increase distress (Abramowitz, Tolin, & Street, 2001).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Abramowitz, Tolin, & Street, 2001 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationnone givenFindings from a GAD sample are not necessarily generalizable to other conditions.
“Lastly, we studied a sample with GAD and therefore our findings are not necessarily generalizable to other conditions.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA recent study found nonreactivity, nonjudging, and acting with awareness significantly and negatively associated with worry.
“These findings are in concert with results of a recent study which found that nonreactivity, nonjudging, and acting with awareness, were significantly and negatively associated with worry (Fisak & von Lehe, 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Fisak & von Lehe, 2012 source
The paper relies on this without support.
The mediation hypothesis that decentering and mindfulness jointly mediate outcomes in mindfulness-based treatment has not been tested before.
“Although these studies provide preliminary evidence that decentering might at least partially mediate treatment outcomes, to our knowledge, this mediation hypothesis has not yet been tested nor have decentering and mindfulness been jointly examined as mediators of outcome in a study utilizing mindfulness-based treatment.”
The paper relies on this without support.
The psychological mechanisms of mindfulness-based interventions and MBSR specifically are not fully understood.
“In sum, mindfulness-based interventions are effective in decreasing symptoms in a range of disorders including anxiety disorders, but the psychological mechanisms of mindfulness-based interventions and MBSR specifically are not fully understood.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some prior studies have found that metacognitive abilities mediate outcomes in other cognitive behavioral therapies for generalized anxiety disorder.
“A few studies thus far have demonstrated a mediating role for these metacognitive abilities in other cognitive behavioral therapies (CBTs) for GAD.”
From Changes in Decentering and Reappraisal Temporally Precede Symptom Reduction During Emotion Regulation Therapy for Generalized Anxiety Disorder With and Without Co-Occurring Depression. (2019) · cites this paper as Hoge et al., 2015
The Discussion reports that decentering and mindfulness mediated symptom improvements in this paper’s MBSR study of patients with GAD. It also describes improvements with other cognitive-behavioral treatments for GAD, but does not report that metacognitive abilities mediated outcomes in those treatments. The Introduction discusses earlier CBT findings in depression, not GAD. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn Hoge and colleagues' study, changes in mindfulness and decentering mediated the effect of mindfulness-based stress reduction on anxiety symptoms but not worry; when both mediators were included, only decentering remained significant.
“Analyses revealed that changes in both mindfulness and decentering significantly mediated the effect of MBSR on anxiety symptoms but not worry. When both mediators were included in the model, only increases in decentering remained statistically significant.”
From Changes in Decentering and Reappraisal Temporally Precede Symptom Reduction During Emotion Regulation Therapy for Generalized Anxiety Disorder With and Without Co-Occurring Depression. (2019) · cites this paper as Hoge et al., 2015
The Results (Mediation Analyses, Anxiety Symptoms; page unavailable) support the claim that mindfulness and decentering each mediated anxiety reduction when tested separately, but only decentering remained significant when tested together. The Results (Mediation Analyses, Worry; page unavailable) contradict the phrase “but not worry”: change in mindfulness significantly mediated reductions in worry. (LLM, conf=0.92)
Experimental — accuracy not yet measuredIn line with previous research, the current study provided supporting evidence for the effectiveness of this mindfulness component compared to a sham intervention.
“In short, in line with previous research (Bernstein et al., 2015; Hoge et al., 2015; Lebois et al., 2015), the current study provided supporting evidence for the effectiveness of this mindfulness component compared to a sham intervention.”
From Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations (2024) · cites this paper as Hoge et al., 2015
The Results report greater improvement in anxiety for MBSR than for SME, supporting the cited comparison at a broad level. But the Methods describe SME as an active attention-control intervention, not a sham, and MBSR included several practices rather than testing an isolated mindfulness component. (LLM, conf=0.85)
Experimental — accuracy not yet measuredA randomized controlled trial reported that increased non-reactivity to inner experience mediated the effect of mindfulness ecological momentary intervention versus treatment-as-usual on pre-follow-up worry, but did not test treatment as a moderator.
“An RCT that reported how increased non-reactivity to inner experience mediated the effect of mindfulness ecological momentary intervention (MEMI) versus treatment-as-usual on pre-follow-up worry also did not test treatment as a moderator [38].”
From Treatment condition as a moderator and change in trait mindfulness as a mediator of a brief mindfulness ecological momentary intervention for generalized anxiety disorder (2024) · cites this paper as [38]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredDecentering may help individuals disengage from perseverative worry habit loops that are perpetuated through reinforcement learning.
“Decentering may help individuals disengage from perseverative worry habit loops that are perpetuated through reinforcement learning [46-48,74].”
From Clinical Efficacy and Psychological Mechanisms of an App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Controlled Trial (2021) · cites this paper as [74]
The Introduction (page not provided) describes decentering as disengagement from internal experiences and suggests it could help people with GAD separate from ruminative worry thoughts. The Discussion (page not provided), however, reports that mindfulness mediated reductions in worry, while decentering mediated reductions in anxiety. Our copy does not describe worry as a habit loop perpetuated by reinforcement learning. (LLM, conf=0.86)
Experimental — accuracy not yet measured
The negative association between trait mindfulness and anxiety severity is partially mediated by decentering-related abilities.
“This is reflected by evidence that the negative association between trait mindfulness and anxiety severity is partially mediated by decentering-related abilities69,87.”
From Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report (2021) · cites this paper as [87]
The Results (Mediation Analyses; page not available) find that changes in decentering mediated reductions in anxiety among patients with GAD receiving MBSR. They do not test whether decentering mediates a negative association between trait mindfulness and anxiety severity; the predictor in this analysis was treatment, not trait mindfulness. The abstract also describes decentering as fully, rather than partially, mediating the treatment effect. (LLM, conf=0.86)
Experimental — accuracy not yet measuredTreatment-related increases in decentering mediated the impact of mindfulness training on anxiety severity in adults with GAD; rate of decentering increase was associated with decreases in worry and stress; session-by-session increases predicted decreases in social anxiety in CBT.
“Treatment-related increases in decentering mediated the impact of mindfulness training on anxiety severity in adults seeking treatment for generalized anxiety disorder (GAD) (37.6 ± 11.6 years)87.”
From Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report (2021) · cites this paper as [87]
Split into 3 atoms — 0 confirmed, 3 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredImprovements in decentering consistently predict acute and enduring treatment effects for patients suffering from MDD, GAD and GAD (with and without MDD) as well as the prevention of MDD relapse following prophylactic treatment with mindfulness based cognitive therapy.
“Improvements in decentering consistently predict acute and enduring treatment effects for patients suffering from MDD (Fresco et al., 2007b), GAD (Hoge et al., 2015) and GAD (with and without MDD; Mennin et al., 2015, under review; Renna et al., under review) as well as the prevention of MDD relapse following prophylactic treatment with mindfulness based cognitive therapy (Bieling et al., 2012).”
From Distinct functional connectivities predict clinical response with emotion regulation therapy (2017) · cites this paper as Hoge et al., 2015
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn mindfulness-based stress reduction for generalized anxiety disorder, decentering acted as a mediator of outcome.
“another showed that decentering mediated outcome in mindfulness-based stress reduction for generalized anxiety disorder (Hoge et al., 2015).”
From Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder (2018) · cites this paper as Hoge et al., 2015
Hoge and colleagues' analyses did not address the timeline of change because mediators and outcomes were measured only before and after treatment.
“These analyses do not speak to the timeline of change, as mediators and outcomes were only evaluated pre- and posttreatment.”
From Changes in Decentering and Reappraisal Temporally Precede Symptom Reduction During Emotion Regulation Therapy for Generalized Anxiety Disorder With and Without Co-Occurring Depression. (2019) · cites this paper as Hoge et al., 2015
Mindfulness and decentering were mediators in mindfulness-based intervention treatment of generalized anxiety disorder.
“mindfulness (i.e., awareness and non-reactivity) and decentering (the capacity to observe thoughts from a distance) were mediators in MBI treatment of GAD [60].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [60]
Mindfulness changes have been found to mediate MBSR and MBCT across clinical samples and in patients with generalized anxiety disorder.
“Changes in mindfulness have been found to be a mediator of MBSR and MBCT across clinical samples (Gu et al., 2015), and specifically in patients with generalized anxiety disorder (Hoge et al., 2015).”
From Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial. (2016) · cites this paper as Hoge et al., 2015
Mindfulness has been found to effectively lower anxiety and distress.
“One practice that has been found to effectively lower anxiety and distress is mindfulness (Bernstein et al., 2015; Hofmann et al., 2010; Hoge et al., 2015; Lebois et al., 2015).”
From Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations (2024) · cites this paper as Hoge et al., 2015
Improvements in worry following MBSR are mediated by improvements in Awareness.
“improvements in worry following MBSR are mediated by improvements in Awareness (Hoge et al., 2015).”
From Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression (2019) · cites this paper as Hoge et al., 2015
In that sample, improvements in Nonreacting mediated reductions in worry after MBSR.
“Finally, in a treatment-seeking sample of individuals with GAD, Hoge et al. (2015) found that improvements in Awareness and Nonreacting specifically mediated reductions in worry following MBSR.”
From Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression (2019) · cites this paper as Hoge et al., 2015
In a treatment-seeking GAD sample, improvements in Awareness mediated reductions in worry after MBSR.
“Finally, in a treatment-seeking sample of individuals with GAD, Hoge et al. (2015) found that improvements in Awareness and Nonreacting specifically mediated reductions in worry following MBSR.”
From Facets of Mindfulness in Adults with Generalized Anxiety Disorder and Impact of Co-occurring Depression (2019) · cites this paper as Hoge et al., 2015
Anxiety sensitivity can uniquely predict poor sleep quality in clinical samples.
“anxiety sensitivity can uniquely predict poor sleep quality in clinical samples [31,32]”
From A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms (2019) · cites this paper as [31]
Anxiety sensitivity is associated with poor sleep quality in clinical samples, including individuals with panic disorders and HIV-infected individuals, after controlling for negative affect and relevant medical covariates.
“The role of anxiety sensitivity and intolerance of uncertainty in sleep disorders has not been studied extensively, but there is evidence that anxiety sensitivity is associated with poor sleep quality in clinical samples, including individuals with panic disorders [31] and HIV-infected individuals, after controlling for negative affect and relevant medical covariates [32].”
From A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms (2019) · cites this paper as [31]
Anxiety sensitivity had a central role.
“In keeping with previous research, anxiety sensitivity had a central role [31,32,33].”
From A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms (2019) · cites this paper as [31]
Decentering contributes to the salutary benefits of meditation training, MBIs, and mindfulness-enriched CBTs.
“Decentering contributes to the salutary benefits of meditation training [48], MBIs [33, 54, 57, 58] and mindfulness enriched CBTs [59–63].”
From All together now: utilizing common functional change principles to unify cognitive behavioral and mindfulness-based therapies (2019) · cites this paper as [33]
MBIs have comparatively weaker acute treatment effects for GAD and MDD.
“and comparatively weaker acute treatment effects for GAD and MDD [31–34].”
From All together now: utilizing common functional change principles to unify cognitive behavioral and mindfulness-based therapies (2019) · cites this paper as [33]
This study builds on previous research that indicates that mindfulness-based interventions delivered in-person can decrease anxiety in individuals with moderate to severe anxiety and decrease physician burnout.
“This study builds on previous research that indicates that mindfulness-based interventions delivered in-person can decrease anxiety in individuals with moderate to severe anxiety (eg, generalized anxiety disorder) and decrease physician burnout [20,28,45,46].”
From Physician Anxiety and Burnout: Symptom Correlates and a Prospective Pilot Study of App-Delivered Mindfulness Training (2020) · cites this paper as [46]
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentt(36) = 4.13reported p < .001 · recomputed p < .001
“t(36) = 4.13, p < .001”
- Consistentt(36) = 1.81reported p = .079 · recomputed p = .079
“t(36)= 1.81, p = .079”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
Cites
Preacher, K. J., & Hayes, A. F. (2008) · Behavior Research Methods · doi:10.3758/brm.40.3.879 · Cited by 34,117 · cited 4× · see citing works
“As has been recommended (see MacKinnon et al. 2000; Preacher and Hayes 2008), the multiple mediation analysis was accompanied by simple mediation analyses to bypass the issues that suppression effects can obscure possible indirect effects of individual mediators.”
MethodInfluentialSPSS and SAS procedures for estimating indirect effects in simple mediation models
Preacher, K. J., & Hayes, A. F. (2004) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03206553 · Cited by 17,383 · cited 2× · see citing works
“Bootstrapping is a nonparametric resampling method that bypasses assumptions of normality common to traditional tests of mediation and is thus more powerful, particularly with smaller samples (Preacher and Hayes 2004, 2008).”
MethodAn inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407 · cited 1× · see citing works
“The 21-item self-report Beck Anxiety Inventory (BAI; Beck et al. 1988) was used to assess anxiety at baseline and week 8 (endpoint).”
MethodBeyond Baron and Kenny: Statistical Mediation Analysis in the New Millennium
Hayes, A. F. (2009) · Communication Monographs · doi:10.1080/03637750903310360 · Cited by 9,757 · see citing works
Using Self-Report Assessment Methods to Explore Facets of Mindfulness
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006) · Assessment · doi:10.1177/1073191105283504 · Cited by 7,511 · cited 1× · see citing works
“Mindfulness The 39-item Five Facet Mindfulness Questionnaire (FFMQ; Baer et al. 2006) was used to assess change in mindfulness.”
Method(2008) · Medical Entomology and Zoology · Cited by 7,477 · see citing works
Mindfulness: A proposed operational definition.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., et al. (2004) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bph077 · Cited by 7,234 · see citing works
(1999) · Cited by 5,934 · see citing works
Kabat-Zinn, J. (1982) · General Hospital Psychiatry · doi:10.1016/0163-8343(82)90026-3 · Cited by 4,255 · cited 1× · see citing works
“…several years and some of their core components have been integrated into a variety of behavioral interventions, including acceptance and commitment therapy (ACT; Hayes et al. 1999), dialectical behavior therapy (Linehan 1993), and mindfulness-based stress reduction (MBSR; Kabat-Zinn 1982, 1990).”
BackgroundEquivalence of the Mediation, Confounding and Suppression Effect
MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000) · Prevention Science · doi:10.1023/a:1026595011371 · Cited by 4,188 · cited 1× · see citing works
“As has been recommended (see MacKinnon et al. 2000; Preacher and Hayes 2008), the multiple mediation analysis was accompanied by simple mediation analyses to bypass the issues that suppression effects can obscure possible indirect effects of individual mediators.”
MethodThe effect of mindfulness based therapy on anxiety and depression: A meta analytic review
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018555 · Cited by 3,846 · cited 1× · see citing works
“Results from both controlled and uncontrolled studies have demonstrated the efficacy of mindfulnessbased interventions for stress and anxiety in a variety of patient populations (e.g., Hofmann et al. 2010).”
BackgroundClinical Psychology: Science and Practice
(2021) · Clinical Psychology Science and Practice · doi:10.1111/(issn)1468-2850 · Cited by 3,683 · see citing works
(2001) · Cited by 3,666 · see citing works
Rudd (2006) · doi:10.1002/(issn)1097-4679 · Cited by 2,635 · see citing works
(1993) · Medical Entomology and Zoology · Cited by 2,491 · see citing works
Metacognitive awareness and prevention of relapse in depression: Empirical evidence.
Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.2.275 · Cited by 1,221 · cited 2× · see citing works
“Decentering is a metacognitive capacity of individuals to observe items that arise in the mind (e.g., thoughts, feelings, memories, etc.) as mere psychological events (Fresco et al. 2007a, b; Teasdale et al. 2002).”
BackgroundMetacognitive awareness and prevention of relapse in depression: Empirical evidence
Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.2.275 · Cited by 1,221 · see citing works
Self-focused attention and negative affect: A meta-analysis.
Mor, N., & Winquist, J. (2002) · Psychological Bulletin · doi:10.1037/0033-2909.128.4.638 · Cited by 1,069 · cited 1× · see citing works
“Decentering in response to anxiety may make one less prone to the detrimental consequences that can result from focusing attention on anxiety symptoms, which has been known to exacerbate negative affect (Mor and Winquist 2002).”
BackgroundFresco, D. M., Moore, M. T., van Dulmen, M. H. M., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007) · Behavior Therapy · doi:10.1016/j.beth.2006.08.003 · Cited by 810 · cited 9× · see citing works
“One example is Emotion regulation therapy (ERT; Fresco et al. 2013; Mennin et al. Under Review), which integrates CBT with emotion-focused interventions, and develops regulatory capacities including attending, allowing, decentering, and reframing.”
BackgroundMethodInfluentialSelf-citationParadoxical effects of thought suppression: a meta-analysis of controlled studies
Abramowitz, J. S., Tolin, D. F., & Street, G. P. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(00)00057-x · Cited by 564 · cited 1× · see citing works
“For example, by not reacting to the worries, individuals may be less likely to attempt to control or suppress the worry, which can paradoxically increase distress (Abramowitz et al. 2001).”
BackgroundWeekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program
Baer, R. A., Carmody, J., & Hunsinger, M. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21865 · Cited by 546 · cited 2× · see citing works
“A second study found that changes in mindfulness preceded changes in mental health outcomes, raising the possibility that reductions in distress occurred as a result of earlier increases in mindfulness (Baer et al. 2012).”
BackgroundResultNyklíček, I., & Kuijpers, K. F. (2008) · Annals of Behavioral Medicine · doi:10.1007/s12160-008-9030-2 · Cited by 532 · cited 1× · see citing works
“More compelling are results from a randomized, wait-list controlled study of MBSR for adults with general psychological distress in which mindfulness partially mediated improvements in quality of life and reductions in stress (Baer et al. 2012; Nyklicek and Kuijpers 2008).”
BackgroundAn empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program.
Carmody, J., Baer, R. A., L. B. Lykins, E., & Olendzki, N. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20579 · Cited by 526 · cited 2× · see citing works
“Concerning the role of decentering in mediating outcomes in MBSR, these findings extend previous findings suggesting that decentering predicts improvements (or lack of relapse) in psychological symptoms after MBSR and MBCT (Bieling et al. 2012; Carmody et al. 2009).”
BackgroundResultHoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., Worthington, J. J., Pollack, M. H., & Simon, N. M. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12m08083 · Cited by 511 · cited 6× · see citing works
“Results from our previously published RCT revealed that MBSR was efficacious in reducing self-reported anxiety symptoms (Hoge et al. 2013).”
BackgroundMethodResultInfluentialSelf-citationRoemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0012720 · Cited by 502 · cited 1× · see citing works
“…therapy (ABBT), which encourages use of mindfulness exercises, teaching distancing from thoughts, and engagement in important, values-consistent activities; this treatment has demonstrated efficacy in treating GAD and in increasing decentering (Hayes-Skelton et al. 2012; Roemer et al. 2008, 2013).”
MethodBrannan, A. M., Heflinger, C. A., & Bickman, L. (1997) · Journal of Emotional and Behavioral Disorders · doi:10.1177/106342669700500404 · Cited by 452 · cited 1× · see citing works
“A mean imputation method with 15 % or less missing items for each instrument was employed (Brannan et al. 1997) (nine subjects had missing questionnaire items).”
MethodRoemer, L., Lee, J. K., Salters-Pedneault, K., Erisman, S. M., Orsillo, S. M., & Mennin, D. S. (2009) · Behavior Therapy · doi:10.1016/j.beth.2008.04.001 · Cited by 392 · cited 1× · see citing works
“Furthermore, individuals with GAD have lower levels of mindfulness compared to healthy controls (Roemer et al. 2009).”
BackgroundVøllestad, J., Sivertsen, B., & Nielsen, G. H. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.01.007 · Cited by 361 · see citing works
Anxiety Reduction through Detachment: Subjective, Physiological, and Neural Effects
Kalisch, R., Wiech, K., Critchley, H. D., Seymour, B., O'Doherty, J. P., Oakley, D. A., Allen, P., & Dolan, R. J. (2005) · Journal of Cognitive Neuroscience · doi:10.1162/0898929054021184 · Cited by 303 · cited 1× · see citing works
“Studies report psychological benefits from promoting distance from the self in time (e.g., viewing inner experiences as temporary; Watkins et al. 2000) and distance from the self in space (e.g., viewing inner experiences as physical objects that are separate from oneself; Kalisch et al. 2005).”
BackgroundRelationship of posttreatment decentering and cognitive reactivity to relapse in major depression
Fresco, D. M., Segal, Z. V., Buis, T., & Kennedy, S. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.3.447 · Cited by 256 · cited 9× · see citing works
“One example is Emotion regulation therapy (ERT; Fresco et al. 2013; Mennin et al. Under Review), which integrates CBT with emotion-focused interventions, and develops regulatory capacities including attending, allowing, decentering, and reframing.”
BackgroundMethodInfluentialSelf-citationBieling, P. J., Hawley, L. L., Bloch, R. T., Corcoran, K. M., Levitan, R. D., Young, L. T., MacQueen, G. M., & Segal, Z. V. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0027483 · Cited by 241 · cited 2× · see citing works
“Further, gains in decentering during acute treatment with CBT (Fresco et al. 2007b) or prophylactic treatment with mindfulness-based cognitive therapy (MBCT) (Bieling et al. 2012) are predictive of a more durable treatment response.”
BackgroundResultDecentring and distraction reduce overgeneral autobiographical memory in depression
WATKINS, E., TEASDALE, J. D., & WILLIAMS, R. M. (2000) · Psychological Medicine · doi:10.1017/s0033291799002263 · Cited by 231 · cited 1× · see citing works
“Studies report psychological benefits from promoting distance from the self in time (e.g., viewing inner experiences as temporary; Watkins et al. 2000) and distance from the self in space (e.g., viewing inner experiences as physical objects that are separate from oneself; Kalisch et al. 2005).”
BackgroundStöber, J., & Bittencourt, J. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00031-x · Cited by 162 · cited 2× · see citing works
“The 15-item self-report Penn State Worry Questionnaire- Past Week (PSWQ-PW; Stober and Bittencourt 1998) was used to assess worry at baseline and endpoint.”
MethodMennin, D. S., Fresco, D. M., Ritter, M., & Heimberg, R. G. (2015) · Depression and Anxiety · doi:10.1002/da.22377 · Cited by 149 · see citing works
Self-citationGoldin, P., Ziv, M., Jazaieri, H., & Gross, J. J. (2012) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2012.00295 · Cited by 128 · cited 1× · see citing works
“…ehoge@partners.org D. M. Fresco Department of Psychology, Kent State University, Kent, OH 44242, USA found to be associated with increases in well-being (Splevins et al. 2009) and decreases in depressed mood, stress, medical symptoms, and anxiety symptoms (Dobkin and Zhao 2011; Goldin et al. 2012).”
BackgroundMindfulness-based cognitive therapy for depression: a new approach to preventing relapse
de Silva, P. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00146-8 · Cited by 122 · see citing works
Emotion regulation therapy for generalized anxiety disorder
Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2013.02.001 · Cited by 120 · cited 1× · see citing works
“One example is Emotion regulation therapy (ERT; Fresco et al. 2013; Mennin et al. Under Review), which integrates CBT with emotion-focused interventions, and develops regulatory capacities including attending, allowing, decentering, and reframing.”
BackgroundSelf-citationDo improvements in emotional distress correlate with becoming more mindful? A study of older adults.
Splevins, K., Smith, A., & Simpson, J. (2009) · Aging & Mental Health · doi:10.1080/13607860802459807 · Cited by 98 · cited 2× · see citing works
“(Splevins et al. 2009) and decreases in depressed mood, stress, medical symptoms, and anxiety symptoms (Dobkin and Zhao 2011; Goldin et al.”
BackgroundIncreased mindfulness – The active component of the mindfulness-based stress reduction program?
Dobkin, P. L., & Zhao, Q. (2011) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2010.03.002 · Cited by 94 · cited 1× · see citing works
“…ehoge@partners.org D. M. Fresco Department of Psychology, Kent State University, Kent, OH 44242, USA found to be associated with increases in well-being (Splevins et al. 2009) and decreases in depressed mood, stress, medical symptoms, and anxiety symptoms (Dobkin and Zhao 2011; Goldin et al. 2012).”
BackgroundMcCracken, L. M., Gutiérrez-Martínez, O., & Smyth, C. (2013) · Health Psychology · doi:10.1037/a0028093 · Cited by 87 · cited 1× · see citing works
“Although they were not examining individuals with anxiety conditions per se, a recent study found that decentering was beneficial among individuals with chronic pain (McCracken et al. 2013).”
BackgroundThe relation between the five facets of mindfulness and worry in a non-clinical sample
Fisak, B., & von Lehe, A. C. (2012) · Mindfulness · doi:10.1007/s12671-011-0075-0 · Cited by 67 · see citing works
Mindfulness and acceptance-based behavioral therapies for anxiety disorders.
Roemer, L., Williston, S. K., Eustis, E. H., & Orsillo, S. M. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0410-3 · Cited by 46 · cited 1× · see citing works
“…therapy (ABBT), which encourages use of mindfulness exercises, teaching distancing from thoughts, and engagement in important, values-consistent activities; this treatment has demonstrated efficacy in treating GAD and in increasing decentering (Hayes-Skelton et al. 2012; Roemer et al. 2008, 2013).”
MethodThought–action fusion: A comprehensive analysis using structural equation modeling
Marino, T. L., Lunt, R. A., & Negy, C. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2008.03.005 · Cited by 29 · cited 1× · see citing works
“Given the ruminative nature of worry in GAD and the difficulty in separating from those thoughts (Marino et al. 2008), increases in decentering could also play a role in symptom improvement.”
Backgroundindicated, N. A. (1992) · Contemporary Psychology: A Journal of Reviews · doi:10.1037/032287 · Cited by 19 · see citing works
Flagged first, then by citations
2 of the 46 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- First, M. B., Spitzer, R. L. G. M., & Williams, J. B. W. (2002). Structured clinical interview for DSM-IV-TR Axis I disorders-patient edition (SCID-I/P, 11/2002 revision). New York, NY: Biometrics Research Department, New York State Psychiatric Institute.
Cited by
Sorted by citations
Creswell, J. D. (2017) · Annual Review of Psychology · doi:10.1146/annurev-psych-042716-051139 · Cited by 1,702 · see citing works
“…studies showed that self-reported increases in decentering mediated MBSR treatment effects on anxiety reduction in generalized anxiety disorder patients (Hoge et al. 2014) and MBCT-related decreases in depressive symptoms among individuals at risk for depression relapse (Bieling et al. 2012).”
Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT
Lindsay, E. K., & Creswell, J. D. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.10.011 · Cited by 919 · see citing works
“…use, and posttraumatic stress disorder) (Adams et al., 2012; Boden et al., 2012; Compare et al., 2012; Fernandez, Wood, Stein, & Rossi, 2010; Hoge et al., 2015; Kalill, Treanor, & Roemer, 2014; Lavender, Gratz, & Tull, 2011; Ostafin & Marlatt, 2008; Owens, Walter, Chard, & Davis, 2012;…”
Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice
Dahl, C. J., Lutz, A., & Davidson, R. J. (2015) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2015.07.001 · Cited by 809 · see citing works
“Clinical studies have shown that a diminished ability to step back and observe one's internal processes of thinking and feeling plays an important role in a variety of psychiatric conditions, including depression [39] and anxiety [40].”
BackgroundDecentering and Related Constructs: A Critical Review and Metacognitive Processes Model
Bernstein, A., Hadash, Y., Lichtash, Y., Tanay, G., Shepherd, K., & Fresco, D. M. (2015) · Perspectives on Psychological Science · doi:10.1177/1745691615594577 · Cited by 539 · see citing works
Self-citationMindfulness Meditation and Psychopathology
Wielgosz, J., Goldberg, S. B., Kral, T. R. A., Dunne, J. D., & Davidson, R. J. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-021815-093423 · Cited by 435 · see citing works
“Dereification of anxiety-related cognitions may contribute to both of these processes, with self-reported dereification having been shown to mediate the effects of MBSR on symptoms of generalized anxiety (Hoge et al. 2015).”
BackgroundAlsubaie, M., Abbott, R., Dunn, B., Dickens, C., Keil, T. F., Henley, W., & Kuyken, W. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.04.008 · Cited by 383 · see citing works
“(2002, 2013) and Kabat-Zinn (1990, 2013), whilst one study (Hoge et al., 2015) adapted MBSR to people with generalised anxiety disorders.”
BackgroundResultInfluentialEconomides, M., Martman, J., Bell, M. J., & Sanderson, B. (2018) · Mindfulness · doi:10.1007/s12671-018-0905-4 · Cited by 250 · see citing works
“By observing thoughts and feelings as mental events, rather than as reality or truths about the self, one can retrain negative thought patterns and reduce reactivity, thus fostering a greater sense of calm and well-being (Feldman et al. 2010; Hoge et al. 2014).”
Beyond linear mediation: Toward a dynamic network approach to study treatment processes
Hofmann, S. G., Curtiss, J. E., & Hayes, S. C. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101824 · Cited by 232 · see citing works
“Similarly, a common interest in healthy variation in sense of self and perspective taking might draw together psychodynamically grounded mediators such as mentalization (Rossouw & Fonagy, 2012) with cognitive behavioral mediators such as decentering (Hoge et al., 2014).”
BackgroundAyahuasca: pharmacology, neuroscience and therapeutic potential
Domínguez-Clavé, E., Soler, J., Elices, M., Pascual, J. C., Álvarez, E., de la Fuente Revenga, M., Friedlander, P., Feilding, A., & Riba, J. (2016) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2016.03.002 · Cited by 226 · see citing works
“…et al., 2007b; Gecht, 2014; Hargus et al., 2010; Teasdale et al., 2002), but also in generalized anxiety disorder (Hayes-Skelton et al., 2015; Hoge et al., 2015), social anxiety (Hayes-Skelton and Graham, 2013), eating disorders, substance use disorders (Shapiro et al., 2006; Soler et al.,…”
BackgroundGroup CBT versus MBSR for social anxiety disorder: A randomized controlled trial.
Goldin, P. R., Morrison, A., Jazaieri, H., Brozovich, F., Heimberg, R., & Gross, J. J. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000092 · Cited by 202 · see citing works
“Changes in mindfulness have been found to be a mediator of MBSR and MBCT across clinical samples (Gu et al., 2015), and specifically in patients with generalized anxiety disorder (Hoge et al., 2015).”
Brief mindfulness meditation training reduces mind wandering: the critical role of acceptance
Rahl, H. A., Lindsay, E. K., Pacilio, L. E., Brown, K. W., & Creswell, J. D. (2017) · Emotion · doi:10.1037/emo0000250 · Cited by 169 · see citing works
“Acceptance may also lead to the use of other emotion-regulatory strategies, including decentering (Bernstein et al., 2015; Bieling et al., 2012; Hoge et al., 2015).”
BackgroundDorjee, D. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01788 · Cited by 123 · see citing works
Gupta, R. S., Kujawa, A., & Vago, D. R. (2019) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2019.08.006 · Cited by 122 · see citing works
Mennin, D. S., Fresco, D. M., O'Toole, M. S., & Heimberg, R. G. (2018) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000289 · Cited by 119 · see citing works
“However, mindfulness-based interventions have also demonstrated mediation by metacognitive variables (i.e., decentering; Hoge et al., 2015; Bieling et al., 2012) and comparative trials with two active treatment arms have shown nonspecific effects on both attentional/ mindfulness and metacognitive variables across both…”
BackgroundSelf-citationder Gucht, K. V., Dejonckheere, E., Erbaş, Y., Takano, K., Vandemoortele, M., Maex, E., Raes, F., & Kuppens, P. (2018) · Emotion · doi:10.1037/emo0000406 · Cited by 102 · see citing works
Apolinário-Hagen, J., Drüge, M., & Fritsche, L. (2020) · Advances in Experimental Medicine and Biology · doi:10.1007/978-981-32-9705-0_17 · Cited by 100 · see citing works
Pérez-Aranda, A., García-Campayo, J., Gude, F., Luciano, J. V., Feliu-Soler, A., González-Quintela, A., López-del-Hoyo, Y., & Montero-Marin, J. (2021) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2021.100229 · Cited by 92 · see citing works
Shoham, A., Goldstein, P., Oren, R., Spivak, D., & Bernstein, A. (2017) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000154 · Cited by 87 · see citing works
“…2012) and improved psychological functioning (Carmody, Baer, Lykins, & Olendzki, 2009; Forman et al., 2012), as well as reduced levels of distress (Hoge et al., 2015; Kross & Adyuk, 2009; Kross, Ayduk, & Mischel, 2005) and anxiety, depression, and dysfunctional attitudes (Bieling et al., 2012;…”
BackgroundBennett, M. P., Knight, R., Patel, S., So, T., Dunning, D., Barnhofer, T., Smith, P., Kuyken, W., Ford, T., & Dalgleish, T. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01397-5 · Cited by 81 · see citing works
Kiraga, M. K., Mason, N. L., Uthaug, M. V., van Oorsouw, K. I. M., Toennes, S. W., Ramaekers, J. G., & Kuypers, K. P. C. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.721537 · Cited by 85 · see citing works
Britton, W. B., Desbordes, G., Acabchuk, R. L., Peters, S., Lindahl, J. R., Canby, N. K., Vago, D. R., Dumais, T., Lipsky, J., Kimmel, H. J., et al. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.730972 · Cited by 81 · see citing works
“, 2013), increases in decentering mediated decreases in anxiety but not worry in MBSR compared to stress management education (Hoge et al., 2015).”
ResultSelf-centeredness and selflessness: happiness correlates and mediating psychological processes
Dambrun, M. (2017) · PeerJ · doi:10.7717/peerj.3306 · Cited by 79 · see citing works
“, experiential fusion Dahl, Lutz & Davidson, 2015) would be involved in self-centeredness, selflessness would be more intertwined to a decentering attention (Fresco et al., 2007; Hoge et al., 2015; Hadash et al., 2016) and to mindfulness characteristics, such as attention to the present moment, acting with awareness,…”
BackgroundBogosian, A., Hughes, A., Norton, S., Silber, E., & Moss‐Morris, R. (2016) · British Journal of Health Psychology · doi:10.1111/bjhp.12201 · Cited by 75 · see citing works
A common factors perspective on mindfulness-based interventions
Goldberg, S. B. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00090-8 · Cited by 75 · see citing works
O’Toole, M. S., Renna, M. E., Mennin, D. S., & Fresco, D. M. (2019) · Behavior Therapy · doi:10.1016/j.beth.2018.12.005 · Cited by 66 · see citing works
Self-citationA balanced view of mindfulness at work
Choi, E., Gruman, J. A., & Leonard, C. (2021) · Organizational Psychology Review · doi:10.1177/20413866211036930 · Cited by 73 · see citing works
“For example, it has been shown that changes in decentering mediate the relation between mindfulness-based stress reduction interventions and outcomes (e.g., reduced anxiety; Hoge et al., 2015).”
BackgroundBaer, R., Gu, J., Cavanagh, K., & Strauss, C. (2019) · Psychological Assessment · doi:10.1037/pas0000744 · Cited by 66 · see citing works
“In adults with generalized anxiety disorder, Hoge et al. (2015) reported higher mindfulness scores in MBSR than in a stress management education group.”
BackgroundBai, C.-F., Cui, N.-X., Xu, X., Mi, G.-L., Sun, J.-W., Shao, D., Li, J., Jiang, Y.-Z., Yang, Q.-Q., Zhang, X., et al. (2019) · Human Reproduction · doi:10.1093/humrep/dez066 · Cited by 65 · see citing works
“…encouraging studies indicate that mindfulness interventions reduce depressive and anxiety symptoms (Boettcher et al., 2014; Strauss et al., 2014; Hoge et al., 2015; Eisendrath et al., 2016), chronic pain (Garland et al., 2014; Morone et al., 2016), substance abuse (Brewer et al., 2011;…”
BackgroundLauriola, M., Carleton, R. N., Tempesta, D., Calanna, P., Socci, V., Mosca, O., Salfi, F., De Gennaro, L., & Ferrara, M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16183253 · Cited by 63 · see citing works
“The role of anxiety sensitivity and intolerance of uncertainty in sleep disorders has not been studied extensively, but there is evidence that anxiety sensitivity is associated with poor sleep quality in clinical samples, including individuals with panic disorders [31] and HIV-infected individuals, after controlling f…”
BackgroundEvaluation of a mobile mindfulness app distributed through on-line stores: A 4-week study
Chittaro, L., & Vianello, A. (2015) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2015.09.004 · Cited by 65 · see citing works
“…particularly important in the literature because it can be helpful in reducing negative emotional states, such as anxiety, worry and ruminative thinking, by helping individuals realize that their thoughts are impermanent events in the mind, see e.g. (Hoge et al., 2015; Querstret and Cropley, 2013).”
BackgroundDambrun, M., Berniard, A., Didelot, T., Chaulet, M., Droit‐Volet, S., Corman, M., Juneau, C., & Martinon, L. M. (2019) · Mindfulness · doi:10.1007/s12671-019-01104-y · Cited by 66 · see citing works
Adair, K. C., Fredrickson, B. L., Castro‐Schilo, L., Kim, S., & Sidberry, S. (2017) · Mindfulness · doi:10.1007/s12671-017-0811-1 · Cited by 68 · see citing works
Biobehavioral Mechanisms of Mindfulness as a Treatment for Chronic Stress: An RDoC Perspective
Garland, E. L., Hanley, A. W., Baker, A. K., & Howard, M. O. (2017) · Chronic Stress · doi:10.1177/2470547017711912 · Cited by 62 · see citing works
Roy, A., Druker, S., Hoge, E. A., & Brewer, J. A. (2020) · JMIR mHealth and uHealth · doi:10.2196/15608 · Cited by 55 · see citing works
“This study builds on previous research that indicates that mindfulness-based interventions delivered in-person can decrease anxiety in individuals with moderate to severe anxiety (eg, generalized anxiety disorder) and decrease physician burnout [20,28,45,46].”
ResultSelf-citationScoping Review of Mindfulness Research: a Topic Modelling Approach
Kee, Y. H., Li, C., Kong, L. C., Tang, C. J., & Chuang, K.-L. (2019) · Mindfulness · doi:10.1007/s12671-019-01136-4 · Cited by 58 · see citing works
Mindful moments: A review of brief, low‐intensity mindfulness meditation and induced mindful states
Heppner, W. L., & Shirk, S. D. (2018) · Social and Personality Psychology Compass · doi:10.1111/spc3.12424 · Cited by 58 · see citing works
Ghahari, S., Mohammadi-Hasel, K., Malakouti, S., & Roshanpajouh, M. (2020) · East Asian Archives of Psychiatry · doi:10.12809/eaap1885 · Cited by 55 · see citing works
“Evans et al,15 2008 USA 11 49 (18-80) 66 DSM-IV for GAD Beck Anxiety Index”
BackgroundStructure and validity of measures of decentering and defusion
Naragon-Gainey, K., & DeMarree, K. G. (2017) · Psychological Assessment · doi:10.1037/pas0000405 · Cited by 56 · see citing works
“…they are implicated as mediators of decreased symptoms and increased quality of life in different forms of psychotherapy for a variety of disorders (e.g., Arch, Wolitzky-Taylor, Eifert, & Craske, 2012; Bieling et al., 2012; Hayes-Skelton, Calloway, Roemer, & Orsillo, 2015; Hoge et al., 2015).”
BackgroundInfluentialLin, Q., Li, T., Shakeel, P. M., & Samuel, R. D. J. (2021) · Journal of Ambient Intelligence and Humanized Computing · doi:10.1007/s12652-020-02650-3 · Cited by 54 · see citing works
RetractedGawrysiak, M. J., Grassetti, S. N., Greeson, J. M., Shorey, R. C., Pohlig, R., & Baime, M. J. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22521 · Cited by 52 · see citing works
“Emerging research also implicates decentering as a mechanism of change in MBIs for depression (Bieling et al., 2012) and anxiety (Hoge et al., 2015).”
How Does Paying Attention Improve Sexual Functioning in Women? A Review of Mechanisms
Arora, N., & Brotto, L. A. (2017) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2017.01.005 · Cited by 52 · see citing works
Levit‐Binnun, N., Arbel, K., & Dorjee, D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.727857 · Cited by 51 · see citing works
Distinct functional connectivities predict clinical response with emotion regulation therapy
Fresco, D. M., Roy, A. K., Adelsberg, S., Seeley, S., García-Lesy, E., Liston, C., & Mennin, D. S. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00086 · Cited by 43 · see citing works
“…targets of treatment for GAD with and without co-occurring MDD. Keywords: generalized anxiety disorder, major depressive disorder, worry, somatic anxiety, decentering, resting state functional connectivity Frontiers in Human Neuroscience | www.frontiersin.org 1 March 2017 | Volume 11 | Article 86”
BackgroundSelf-citationKarl, J. A., Johnson, F. N., Bucci, L., & Fischer, R. D. (2021) · Journal of the Royal Society of New Zealand · doi:10.1080/03036758.2021.1915804 · Cited by 57 · see citing works
Beerse, M. E., Van Lith, T., Pickett, S. M., & Stanwood, G. D. (2020) · Experimental Biology and Medicine · doi:10.1177/1535370219883634 · Cited by 45 · see citing works
Roy, A., Hoge, E. A., Abrante, P., Druker, S., Liu, T., & Brewer, J. A. (2021) · Journal of Medical Internet Research · doi:10.2196/26987 · Cited by 41 · see citing works
Self-citationHunkin, H., King, D. L., & Zajac, I. T. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23189 · Cited by 40 · see citing works
Increased Attention Regulation from Emotion Regulation Therapy for Generalized Anxiety Disorder
Renna, M. E., Seeley, S. H., Heimberg, R. G., Etkin, A., Fresco, D. M., & Mennin, D. S. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-017-9872-7 · Cited by 36 · see citing works
“2005) and appear efficacious in the treatment of mood and anxiety disorders, including GAD (Hofmann et al. 2010; Hoge et al. 2014).”
BackgroundSelf-citationMindfulness Reduces Reactivity to Food Cues: Underlying Mechanisms and Applications in Daily Life
Keesman, M., Aarts, H., Häfner, M., & Papies, E. K. (2017) · Current Addiction Reports · doi:10.1007/s40429-017-0134-2 · Cited by 36 · see citing works
Fresco, D. M., & Mennin, D. S. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2018.10.014 · Cited by 36 · see citing works
“Decentering contributes to the salutary benefits of meditation training [48], MBIs [33, 54, 57, 58] and mindfulness enriched CBTs [59–63].”
BackgroundSelf-citationJoss, D., & Teicher, M. H. (2021) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-021-00240-4 · Cited by 35 · see citing works
A neurobehavioral account for decentering as the salve for the distressed mind
King, A. P., & Fresco, D. M. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.02.009 · Cited by 36 · see citing works
Self-citationGilpin, H. R., Stahl, D. R., & McCracken, L. M. (2018) · European Journal of Pain · doi:10.1002/ejp.1310 · Cited by 36 · see citing works
Decentering Attenuates the Associations of Negative Affect and Positive Affect With Psychopathology
Naragon-Gainey, K., & DeMarree, K. G. (2017) · Clinical Psychological Science · doi:10.1177/2167702617719758 · Cited by 34 · see citing works
Compared to self-immersion, mindful attention reduces salivation and automatic food bias
Baquedano, C., Vergara, R. C., López, V., Fabar, C., Cosmelli, D. J., & Antoine Lutz, A. (2017) · Scientific Reports · doi:10.1038/s41598-017-13662-z · Cited by 33 · see citing works
Domhardt, M., Nowak, H., Engler, S., Baumel, A., Grund, S., Mayer, A., Terhorst, Y., & Baumeister, H. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102084 · Cited by 32 · see citing works
Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder
Hayes-Skelton, S. A., & Lee, C. S. (2018) · Behavior Therapy · doi:10.1016/j.beth.2018.01.005 · Cited by 28 · see citing works
Contemplative neuroscience, self-awareness, and education
Berkovich‐Ohana, A., Jennings, P. A., & Lavy, S. (2019) · Progress in brain research · doi:10.1016/bs.pbr.2018.10.015 · Cited by 29 · see citing works
Vanzhula, I. A., & Levinson, C. A. (2020) · Mindfulness · doi:10.1007/s12671-020-01343-4 · Cited by 30 · see citing works
Cognitive Reappraisal Facilitates Decentering: A Longitudinal Cross-Lagged Analysis Study
Kobayashi, R., Shigematsu, J., Miyatani, M., & Nakao, T. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00103 · Cited by 28 · see citing works
“Similar results have been reported in other studies (e.g., Carmody et al., 2009; Hoge et al., 2015).”
BackgroundResultNewman, M. G., Basterfield, C., Erickson, T. M., Caulley, E., Przeworski, A., & Llera, S. J. (2022) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2022.2125800 · Cited by 27 · see citing works
“awareness and non-reactivity) and decentering (the capacity to observe thoughts from a distance) were mediators in MBI treatment of GAD [60].”
Promoting Emotional Well-Being in Older Breast Cancer Patients: Results From an eHealth Intervention
Villani, D., Cognetta, C., Repetto, C., Serino, S., Toniolo, D., Scanzi, F., & Riva, G. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02279 · Cited by 27 · see citing works
Development of a self-distancing task and initial validation of responses
Shepherd, K. A., Coifman, K. G., Matt, L. M., & Fresco, D. M. (2016) · Psychological Assessment · doi:10.1037/pas0000297 · Cited by 27 · see citing works
“A uthor M anuscript A uthor M anuscript A uthor M anuscript A uthor M anuscript Discussion Numerous researchers have called for the development of valid, objective measures of mindfulness and decentering, which may be used to evaluate the benefits of many common interventions (e.g., MBCT, MBSR, ERT, DBT, ACT) (e.g., B…”
InfluentialSelf-citationCognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD)
Newman, M. G., Zainal, N. H., & Hoyer, J. (2020) · Generalized Anxiety Disorder and Worrying · doi:10.1002/9781119189909.ch10 · Cited by 25 · see citing works
Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program
Davis, K. M., Wojcik, C. M., Baillie, A. J., Foley, E., Goddard, T., Lau, M. A., & Haigh, E. A. P. (2024) · Mindfulness · doi:10.1007/s12671-024-02359-w · Cited by 25 · see citing works
“There has also been some evidence that decentering mediates the positive effects of MBSR on anxiety symptoms in those with generalized anxiety disorder (Hoge et al., 2015).”
InfluentialWilliams, M., Honan, C., Skromanis, S., Sanderson, B., & Matthews, A. J. (2024) · Current Psychology · doi:10.1007/s12144-023-04695-x · Cited by 25 · see citing works
Decentering From Emotions in Daily Life: Dynamic Associations With Affect, Symptoms, and Well-Being
Naragon‐Gainey, K., DeMarree, K. G., Kyron, M. J., McMahon, T. P., Park, J., & Biehler, K. M. (2023) · Clinical Psychological Science · doi:10.1177/21677026221147262 · Cited by 24 · see citing works
The decentering component of mindfulness reduces reactions to mental imagery.
Keesman, M., Aarts, H., Häfner, M., & Papies, E. K. (2020) · Motivation Science · doi:10.1037/mot0000137 · Cited by 23 · see citing works
Kraemer, K. M., Luberto, C. M., Hall, D. L., Ngo, L. H., & Yeh, G. Y. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103746 · Cited by 21 · see citing works
Mindfulness in Borderline Personality Disorder: Decentering Mediates the Effectiveness
Schmidt, C., Soler, J., Carmona, C., Elices, M., Domínguez‐Clavé, E., Vega, D., & Pascual, J. C. (2021) · Psicothema · doi:10.7334/psicothema2020.437 · Cited by 22 · see citing works
Dolbier, C. L., Haley, E. N., Conder, L., & Guiler, W. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.06.001 · Cited by 20 · see citing works
Effects of a Mindfulness Intervention Among Arab Teachers Are Mediated by Decentering: A Pilot Study
Berkovich‐Ohana, A., Lavy, S., & Shanbour—Srour, K. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.542986 · Cited by 19 · see citing works
Veringa‐Skiba, I. K., Ziemer, K. L., de Bruin, E. I., de Bruin, E. J., & Bögels, S. M. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04380-0 · Cited by 22 · see citing works
“Other research on mindful awareness also found that a greater mindful awareness acted as a mechanism of change for MBSR in non-pregnant populations with anxiety disorders in reducing worries [28], anxiety, and avoidance symptoms [29].”
BackgroundJu, R., Chiu, W., Zang, Y., Hofmann, S. G., & Liu, X. (2022) · BMC Psychology · doi:10.1186/s40359-022-00831-7 · Cited by 20 · see citing works
“Some studies provided support for MBSR as a way to relieve psychological distress in the general population [4], such as negative emotions [5], anxiety [6] and recurrent depression [7, 8].”
BackgroundToward Greater Clarity in Defining and Understanding Nonattachment
Tremblay, L., Gordon, W. V., & Elander, J. (2024) · Mindfulness · doi:10.1007/s12671-024-02378-7 · Cited by 19 · see citing works
Hoge, E. A., Reese, H. E., Oliva, I. A., Gabriel, C. D., Guidos, B. M., Bui, É., Simon, N. M., & Dutton, M. A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00082 · Cited by 18 · see citing works
Self-citationTakahashi, T., Kikai, T., Sugiyama, F., Kawashima, I., Kuroda, A., Usui, K., Maeda, W., Uchida, T., Guan, S., Oguchi, M., et al. (2020) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-19-00015 · Cited by 15 · see citing works
“Studies demonstrated that decentering increased by MBCT, preventing relapse of depression (Bieling et al., 2012), and by MBSR, improving generalized anxiety disorder (Hoge et al., 2015).”
Backgroundvan Vugt, M. K., Moye, A., Pollock, J., Johnson, B., Bonn‐Miller, M. O., Gyatso, K., Thakchoe, J., Phuntsok, L., Norbu, N., Lobsang, T., et al. (2019) · Progress in brain research · doi:10.1016/bs.pbr.2018.10.018 · Cited by 16 · see citing works
“Reasoned understanding of the decentered perspective can take substantial time to develop, in contrast to the fleeting experience of decentering that arises even during practice of beginning mindfulness meditators (Hoge et al., 2015).”
BackgroundSelf-citationAn integrative framework for the mechanisms underlying mindfulness-induced cognitive change
Cásedas, L., Schooler, J. W., Vadillo, M. A., & Lupiáñez, J. (2024) · Nature Reviews Psychology · doi:10.1038/s44159-024-00374-1 · Cited by 19 · see citing works
Jiga, K., Kaunhoven, R. J., & Dorjee, D. (2018) · Mindfulness · doi:10.1007/s12671-018-0977-1 · Cited by 15 · see citing works
The Effectiveness of Mindfulness-Based-Stress-Reduction for Military Cadets on Perceived Stress
Chen, Y.-H., Chiu, F.-C., Lin, Y.-N., & Chang, Y.-L. (2021) · Psychological Reports · doi:10.1177/00332941211010237 · Cited by 16 · see citing works
Exploring experiences of children in applying a school-based mindfulness programme to their lives
Hutchinson, J. K., Huws, J. C., & Dorjee, D. (2018) · Journal of Child and Family Studies · doi:10.1007/s10826-018-1221-2 · Cited by 16 · see citing works
Effect of a Brief Meditation Intervention on Gambling Cravings and Rates of Delay Discounting
Shead, N. W., Champod, A. S., & MacDonald, A. (2019) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-019-00133-x · Cited by 15 · see citing works
“conceptualization of mindfulness that was also used by other researchers to target various psychological symptoms (Hendrickson and Rasmussen 2013; Hoge et al. 2014; Huijbers et al. 2012; Michalak et al. 2011).”
BackgroundMethodReimagining Education: The International Science and Evidence Based Education (ISEE) Assessment
Duraiappah, A. K., van Atteveldt, N., Buil, J. M., Singh, K., & Wu, R. (2022) · doi:10.56383/jofk3902 · Cited by 15 · see citing works
Duncan, N. S., Zimmer-Gembeck, M. J., Gardner, A. A., & Modecki, K. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110932 · Cited by 14 · see citing works
Hayes-Skelton, S. A., & Lee, C. S. (2020) · Behavior Modification · doi:10.1177/0145445519850744 · Cited by 13 · see citing works
The effects of a mindfulness-based program on higher education students
Serrão, C., Rodrigues, A. R., & Ferreira, T. B. (2022) · Frontiers in Education · doi:10.3389/feduc.2022.985204 · Cited by 14 · see citing works
“In addition, although MIBs are effective in decreasing symptoms in a variety of disorders, the psychological mechanisms are not entirely understood, particularly amongst individuals with generalized anxiety symptoms (e.g., Hoge et al., 2015).”
BackgroundOliveira, P. D., Juneau, C., Stinus, C., Corman, M., Micheli, N., Pellerin, N., Shankland, R., & Dambrun, M. (2024) · Psychological Reports · doi:10.1177/00332941241246469 · Cited by 15 · see citing works
“…that the reduction in anxiety or depressive-related thoughts resulting from mindfulness training can be attributed to an increase in the decentered perspective (Bieling et al., 2012; Farb et al., 2018; Hargus et al., 2010; Hoge et al., 2015; O ’ Toole et al., 2019; Teasdale et al., 2002).”
Mindfulness as a Promoter of Adaptive Development in Adolescence
Amada, N. M., & Shane, J. (2018) · Adolescent Research Review · doi:10.1007/s40894-018-0096-1 · Cited by 14 · see citing works
Yun, J., Choi, Y., Kwon, Y., Lee, H. Y., Choi, S., & Jang, J. H. (2017) · Scientific Reports · doi:10.1038/s41598-017-18189-x · Cited by 14 · see citing works
The associations and effects of mindfulness on anger and aggression: A meta-analytic review
O’Dean, S., Summerell, E., Harmon‐Jones, E., Creswell, J. D., & Denson, T. F. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102584 · Cited by 20 · see citing works
Guo, L. (2024) · Mindfulness · doi:10.1007/s12671-024-02395-6 · Cited by 19 · see citing works
Wu, J., Hamilton, J. L., Fresco, D. M., Alloy, L. B., & Stange, J. P. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.104017 · Cited by 14 · see citing works
Self-citationRosencrans, P. L., Bui, E., Rogers, A. H., Simon, N. M., & Baker, A. W. (2017) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2017.10.4.283 · Cited by 12 · see citing works
Self-citationSeah, T. H. S., Matt, L. M., & Coifman, K. G. (2020) · Clinical Psychological Science · doi:10.1177/2167702620953636 · Cited by 12 · see citing works
Does Using a Mindfulness App Reduce Anxiety and Worry? A Randomized-Controlled Trial
Abbott, D., Lack, C. W., & Anderson, P. L. (2023) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-20-00058 · Cited by 14 · see citing works
TANGAEON: Tangible Interaction to Support People in a Mindfulness Practice
Vianello, A., Chittaro, L., & Matassa, A. (2018) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2018.1509540 · Cited by 12 · see citing works
“…experience with meditation, consistently with the research literature on meditation, see e.g. Moore and Malinowski, (2009), Soler et al. (2014), and Thompson and Waltz (2007). negative emotional states such as anxiety, worry, and ruminative thinking (Hoge et al., 2015; Querstret & Cropley, 2013).”
BackgroundBaer, R., Caldera, C. A., & Nagy, L. M. (2020) · The Wiley Encyclopedia of Personality and Individual Differences · doi:10.1007/978-3-319-24612-3_820 · Cited by 2 · see citing works
Baker, A. W., Frumkin, M. R., Hoeppner, S. S., LeBlanc, N. J., Bui, E., Hofmann, S. G., & Simon, N. M. (2019) · Mindfulness · doi:10.1007/s12671-018-1059-0 · Cited by 9 · see citing works
Self-citationMindfulness-Based Stress Reduction for the Treatment of Anxiety Disorders
Wharton, E., & Kanas, N. (2019) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2019.1599289 · Cited by 9 · see citing works
“The mediator analysis in the Hoge et al. (2015) study suggested that both mindfulness and decentering significantly mediated the effect of MBSR on self-reported symptoms, but there were differences in the symptoms that were affected.”
BackgroundMethod
- Authors
- Hoge, E. A., Bui, E., Goetter, E., Robinaugh, D. J., Ojserkis, R. A., Fresco, D. M., & Simon, N. M.
- Affiliations
- Massachusetts General Hospital (US)
- Kent State University (US)
- Corresponding author
- Hoge, Elizabeth A.
- Venue
- Cognitive Therapy and Research
- Published
- 2014-10-14
- Volume
- 39
- Issue
- 2
- Pages
- 228-235
- ISSN
- 0147-5916 (ISSN-L)
- 1573-2819
- PMC
- PMC5354303
- OpenAlex
- W1988619037
- Cited by
- 188
- References
- 46
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 19 · 2023: 14 · 2022: 20 · 2021: 19 · 2020: 19 · 2019: 20 · 2018: 17 · 2017: 28 · 2016: 10 · 2015: 3 · 2014: 1
- FWCI
- 16.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Cognitive Therapy and Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Highland Street Foundation
- National Institutes of Health
- National Center for Complementary and Alternative Medicine
- National Center for Complementary and Integrative Health (K23AT004432)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- decentering, mindfulness, mindfulness-based stress reduction, generalized anxiety disorder, anxiety reduction, therapeutic mechanisms, worry, non-reactivity, awareness, mediation analysis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
